Aged ; Female ; Humans ; Immunophenotyping ; Leukemia, Large Granular Lymphocytic ; classification ; immunology

Objective To examine the impact of chronic diseases and blood biomarkers on daily living activities of hospitalized nonagenarians.Methods We used data from 161 nonagenarians who had been admitted to the Department of Internal Medicine from January to December 2014.Patients were divided into three groups:the mild dependence group,the moderate dependence group and the severe dependence group,based on the Barthel Index.Data were collected from patients' medical records.Differences in chronic disease characteristics and biomarkers between the three groups were compared and multiple regression and correlation analysis was also carried out.Results Compared with the mild independence group,patients in the severe dependence group were older(92.6 ± 2.6 vs.91.2 ±1.7 years,P＜ 0.05)and had lower levels of sodium(138.0 ± 5.0 vs.140.9 ± 3.7 mmol/L),albumin(35.4 ± 4.2 vs.39.2 ± 4.3 g/L),prealbumin,total cholesterol,low density lipoprotein cholesterol,and total iron binding (34.8 ± 7.9 vs.43.2 ± 7.4 mmol/L) respectively,P＜ 0.01 or 0.05),and higher levels of high-sensitivity C-reactive protein [22.0 (31.6) vs.2.6 (6.6) g/L,P＜ 0.01].Multivariate linear regression showed that albumin (β=0.23,P =0.011),sodium (β=0.21,P=0.003),total iron biding capacity(β=0.26,P=0.003),and age (β=-0.15,P =0.036) were significantly associated with daily living activities.Conclusions Higher proportions of hospitalized nonagenarians suffer multiple diseases.Activities of daily living are significantly associated with albumin,total iron biding capacity,and sodium.While the number of diseases has no influence on activities of daily living,good nutritional status and electrolyte balance are very important to nonagenarians.

Objective To learn the plague's host animals and parasitic flea composition, and to investigate the natural foci of plague in Xiji county in order to provide basic information for plague prevention and control. Methods The Citellus alaschanicus density, nocturnal rodents, the body flea, the burrow track flea, the nest flea were investigated in 8 townships (town) of Xiji county from June 11 2007 to July 25 2007. Specimens of small mammalian, fleas were collected for bacteriological and serological testing. Results The average density of the main host Citellus alaschanicus was 0.85 per hectare. The nocturnal mouse capture rate was 0.80%(24/2987).The survey found 16 species of small mammals that belonging to 3 orders, 9 families and 16 species with Citellus alaschanicus the dominant species. The Citellus alaschanicus had 2.84 fleas per body. Four families and 16 species of fleas were identified in the areas. The Citellus alaschanicus and Citellophilus Tesquorum Mongolicus were the dominant species. Plague bacteriology and serology tests were negative. Conclusions The study shows that the area is suitable for the formation of natural foci of Citellus alaschanicus plague. Surveillance is an important measure for prevention and control of the plague.

Objective To observe the dynamic serological test results of 28 patients with acute brucellosis,and to investigate the relationship between serological test results and diagnosis,curative effect and prognosis of brucellosis.Methods Twenty eight patients(infected with sheep brucellosis) with acute brucellosis in the Department of Brucellosis in Heilongjiang Provincial Land Reclamation Headquarters General Hospital were selected as research subjects,and their serological changes were tested by means of tube agglutination test (SAT)and clinical outcomes were compared before and after each stage of treatment.In addition,symptoms of fever,weakness,sweating,joint pain,swollen lymph nodes and biochemical parameters [alanine aminotransferase (ALT),lactate dehydrogenase (LDH)] were also tested 3,6 and 9 weeks after the treatment.Results Antibody titer reached the peak at the third week,1 ∶ 400(++),which accounted for 39.29％ (11/28); 2857％(8/28) of the patients became negative at the sixth week; 50.00％ (14/28) became negative at the ninth week.Before the treatment,20(71.43％) patients had the symptom of fever,8 (28.57％) patients had the symptom of hyperhidrosis,28 (100.00％) patients had the symptom of joint pain,7(25.00％) patients had the symptom of lymph node enlargement,28 (100.00％) patients' ALT was elevated,and 26(92.86％) patients' LDH was elevated.After three weeks of treatment,except the three patients (10.71％) who occasionally had fever,the rest of the patient's temperature was returned to normal.Also the numbers of patients with the symptoms of fatigue,sweating and joint pain were significantly reduced,and specifically,the conesponding number was 13(46.43％),2(7.14％),and 21 (75.00％)patients,respectively.ALT and LDH returned to normal(only one patient's ALT was out of the range).At the sixth week,all the patients' symptoms of fever and hyperhidrosis disappeared.The number of patients with the symptoms of joint pain and lymph node enlargement reduced to 12(42.86％) and 3(10.71％),respectively.The results of biochemical tests(ALT and LDT) returned to normal.At the ninth week,most patients' clinical symptoms disappeared.A few patients still had the symptoms of weakness[2(7.14％)] and joint piin[6(21.43％)].Conclusions After effective treatment,antibody titer of patients decreases rapidly,at the same time,the clinical symptoms improve quickly.There is a parallel relationship between the change of antibody titer and clinical symptoms.It is demonstrated that the appearing time of brucellosis specific antibodies,the ampfitude and speed of change of antibody titers can be used in diagnosis,therapeutic evaluation and prognosis of the disease.

Objective To observe the clinical features of brucellosis spondylitis and analyse the reasons for its misdiagnosis,and improve the level of diagnosis and differential diagnosis.Methods Forty-two clinically diagnosed patients with brucellosis spondylitis were studied retrospectively,and these patients were diagnosed and hospitalized in the General Hospital of Heilongjiang Land Reclamation Bureau.Their medical records were analyzed,which included the general information,medical history,clinical symptoms,results of magnetic resonance imaging(MRI) and serum tube agglutination test(SAT) and so on.Results Main clinical symptoms and signs were severe persistent neck,back and leg pain.They also had plate shape low back but without kyphosis.In addition,patients had to keep in one posture because their spinal activity was limited.Also,scoliosis or pelvic tilt and lameness may occur when standing,which were typical symptoms of nerve root compression.Thirteen cases were diagnosed as tuberculosis,accounting for 30.95％(13/42); 6 cases were diagnosed as lumbar disc herniation,accounting for 14.28％ (6/42); 2 cases were diagnosed as ankylosing spondylitis,accounting for 4.76％ (2/42).Therefore,the total rate of misdiagnosis was 50％ (21/42).Abnormal MRI signal intensity can be seen in the pathological vertebrae.Specifically,T1-weighted images (T1WI) showed low signal,T2-weighted images (T2WI) showed high signal,or mixed high and low signal intensity was observed.Vertebral showed wedge deformation without collapse and sequestrum; strip and sheet abnormal signal can also be found within the intervertebral disc.Normal structure disappeared and disc space became narrow.Accordingly,the plane dural sac was compressed to form visible abscess near the spine,but psoas abscess was not found.Patients with positive SAT result accounted for 92.85％ (39/42).Conclusion Reasons for misdiagnosis include lack of detailed medical records,atypical clinical symptoms and similar imaging changes and so on.

To study the clinical skills training methods and formulate a training objective for pediatric long-year-program students, to let the students, through three years of training program, reach the clinical ability as a chief resident, with better laboratory research skills, teaching awareness and responsibility, and also with good comprehensive quality and excellent English, and finally become clinical talents with great potential and innovation, this report summarized our study results of training two terms of long-year-program pediatric graduates, who fully meeted the training objectives in the department's practice.

AIMTo study modulation of protein kinase A (PKA) and protein kinase C (PKC) on the delayed rectifier potassium current (Ik)in guinea pig ventricular myocytes.

METHODSThe delayed rectifier potassium current was recorded by using whole cell arrangement of the patch-clamp procedure.

RESULTScAMP 150 micromol/L increased intracellularly Ik and Ik,tail(pA/pF) from 13.7 +/- 2.1 and 6.1 +/- 0.1 to 18.5 +/- 3.3 and 6.4 +/- 2.1 (P < 0.01, n=6). Ik and Ik,tail(pA/pF) were augmented by 8-CPT-cAMP 150 micromol/L extracellularly from 11.4 +/- 1.8 and 5.3 +/- 0.6 to 17.9 +/- 4.0 and 6.2 +/- 1.3. The half-maximal voltage of activation of Ik was shifted from + 23.3 mV to 18.7 mV by cAMP. Phorbol 12-myristate 13-acetate(PMA, 10.0 micromol/L) applied intracellularly caused an enhance effect on Ik, with increasing Ik and Ik,tail(pA/pF) from 12.9 +/- 1.8 and 5.0 +/- 1.7 to 23.7 +/- 2.8 and 7.5 +/- 1.1. With shifting position potential of depolarization, effect of PMA on Ik was gradually augmented. PMA resulted in shifting the slop of activation curve from +15.3 mV to +25.6 mV, with only a small effect on the half-maximal voltage of activation of Ik.

CONCLUSIONIk was increased by both PKA and PKC, with different characteristics of regulation.

Animals ; Cyclic AMP-Dependent Protein Kinases ; pharmacology ; Delayed Rectifier Potassium Channels ; metabolism ; Female ; Guinea Pigs ; Heart Ventricles ; cytology ; drug effects ; Male ; Myocytes, Cardiac ; drug effects ; metabolism ; Patch-Clamp Techniques ; Potassium ; metabolism ; Protein Kinase C ; pharmacology

Objective To evaluate the relationship between the concentration of pentane in the exhaled air and degree of the lung injury in non-heart-beating (NHB) rabbits.Methods Twenty-four healthy male Japanese white rabbits weighing 2.4-3.0 kg were randomly divided into 4 groups ( n =6 each):A,B,C and D groups.The NHB model was established by exsanguination through the femoral artery.The exhaled gases were collected and lung tissues were removed at 0,30,60 and 120 min after cardiac arrest in A,B,C and D groups respectively.The concentration of pentane in the exhaled gases was detected immediately using the gas chromatography-mass spectrography.The wet to dry (W/D) lung weight ratio and content of malondialdehyde (MDA) in lung tissues were measured.The lung injury score (LIS) was recorded.The maximal volume ( Vmax ) of the lung was recorded when the airway pressure reached 30 cm H2O.Results Compared with groups A and B,the exhaled pentane concentration was significantly increased in group C,and the W/D ratio,content of MDA and LIS were significantly increased,while Vmax was significantly decreased in group D ( P ＜ 0.05).Compared with group C,W/D ratio and LIS were significantly increased in group D ( P ＜ 0.05 ).Conclusion The concentration of exhaled pentane can not reflect the degree of the lung injury in NHB rabbits.

Objective To discuss the influence factors on the quality of Potassium dehydroandrograpolide succinate for injection,and to optimize its production process.Methods The related substances were taken as the estimated standards and the orthogonal experimental method for determining the best production process was adopted.Results The water temperature and pH value had a significant effect on the related substances.The best production process was:dispensing water temperature at 40℃,pH at 6.4 and filling time being 2 h.Conclusion The optimized production process was quality control and reasonable,which can be used in industrial production.

Objective The surgery time for patients with infective endocarditis (IE) has been transformed.It has been supported that,for the patients with surgical indications,the surgery time should be as early as possible to improve the clinical outcome.The purpose of the research is to identify whether the patients with IE could get further benefit from early surgery.Methods Between June 1996 and July 2011,135 IE patients'data has been collected retrospectively,all of whom were verified through the modified Duke categories.The patients were devided into group A( the new therapeutic schedule group after 2008 ) and group B( the traditional therapeutic schedule group before 2008 ) by the year of 2008.The end points of observation were death associated with IE,cardiac failure,embolism,and re-infection.The comparison between the groups was by means of non-parameter rank and inspection test,variance analysis,t test,chi-square test,fisher exact test.The outcome comparison between the groups was via the Kaplan-Meier survival analysis.Results There were no significant differences in baseline data between the groups.No survival differences could be observed via the Kaplan-Meier analysis( Log Rank P =0.189).During the following-up visit,compared with the patients in group B,the mortality in group A is lower(9.4％ vs.23.0％,P=0.016),the incidence of heart failu re was less in group A (5.4％ vs.26.2％,P ＜0.001 ).No differences could be found in re-infection between the two groups(0 vs.4.9％,P =0.112 ). More patients in group A underwent surgery (67.6％ vs.32.8％,P ＜0.001 ).Conclusion The new therapeutic sehedule of IE coull reduce the mortality rate and promote the cardiae funetion.The incidence of re-infeetion didn't increase.