OBJECTIVE To investigate the pathogens of HAP and their drug resistance in our hospital,the impact of duration of hospitalization on etiology,and the risk factors for the resistant pathogens.METHODS The respiratory tract secretion was collected from HAP patients to culture and analyze the susceptibility of antimicrobials,compare the etiology of early-onset and late-onset HAP including prior antibiotics exposure and severity of HAP to drug resistant bacteria.RESULTS During the period of study,there were 1.04% of patients suffering from HAP.Early-onset HAP was commonly caused by G+ cocci while the main agents of late-onset HAP were G-bacilli.Most of the HAP pathogens were resistant to the antimicrobials commonly used in clinic with the prior antimicrobials exposure and the severe HAP increased the resistant bacteria rate(P

regulatory T cell(Treg)is a subset of immunosuppressive Th cell lines with ability to sup-press anti-tumor immunity. Tregs are recruited into local tumor microenvironment by tumor-released chemokine CCL22. Tregs induce Th2-type immune responses which contribute the host ignorance and tolerance to tumor cells via releasing of immunosuppressive cytokines and immunosuppressive receptors. Accumulating evidences indicate that inhibiting Treg can break immune tolerance,and subsequently inhibit the growth and progress of cancer. These discoveries and exploration of Treg provide us a new therapeutic target and strategy with promising clinic application.

Oxidative stress phys a very important role in the cerebral ischemia-reperfusion injury.The role of NADPH oxidases (NOX) in oxidative stress after ischemic stroke has been paid more attention and may become a new therapeutic target.This article sums up the major research progress between NOX and cerebral ischemia-reperfusion injury,discusses the characteristics of various isozymes and their relationship with stroke,further investigates the pathogenesis of stroke from the perspective of NOX,and provides a new idea for the prevention and treatment of ischemic stroke.

Objective To analyze the prevalence of brucellosis with the initial symptom of fever in non-pasture area and to investigate the method of early diagnosis.Method Clinical features including symptoms,blood routine tests,blood cultures,rose-bengal plate agglutination tests,treatment and follow-up were analyzed in 18 patients with brucellosis admitted to the Department of Infectious Diseases,Tianjin First Centre Hospital from January 2010 to June 2013.Results Middle-aged men with history of smoking and drinking accounted for the majority of patients with initial symptom of fever.Twelve were not complicated with any underlying diseases.Twelve had no contact history.Four had history of farm animal contact,one had history of consuming raw meat products,and one had history of dog raising.All of them had fever,15 of which had hyperpyrexia and 13 had irregular fever.White cells in blood routine test were normal in 12 cases,decreased in 6 cases.And the proportion of rhabditiform nucleus neutrophil increased.Six showed neutrophil left shift.Blood platelet decreased in 3 cases.Thirteen cases showed increased alanine aminotransferase and aspartate aminotransferase.C-reactive protein was elevated in 14 cases.Twelve cases had positive culture of Brucella melitensis in blood or bone marrow culture.Eighteen cases had positive results of rose-bengal plate agglutination test.The proportions of neutrophil and lymphocyte were normal.The treatment included moxifloxacin,levofloxacin,isepamicin,etimicin,amikacin,rifampicin,minocycline.The regimens were usually two or three drugs in combination.The duration of follow-up ranged from 4 to 11 months with good prognosis.Conclusions Patients from nonpasture area with initial symptom of fever could be brucellosis.Clinician should be alert to the disease and inquiry contact history in detail.Brucella serology test should be performed.Early diagnose and prompt treatment could avoid serious complications.

Objective To investigate the clinical characteristics, pathological and biochemical featur es of paraneoplastic syndromes (PNS) of hepatocellular carcinoma (HCC). Methods The clinical data of 624 HCC patients (the ratio of male to female 5.3∶1) ident ified by pathology were retrospectively reviewed. Results Among the patients with HCC, 32.2% (201/624) had PNS, the ratio of male to femal e was 4.6∶1. PNS mainly manifested as six clinical abnormalities: hyperchol esterol emia (15.9%), hypoglycemia(8.2%), thrombocytosis(7.7%), leucocytosis(4.8%), eryt hrocytosis(3.4%), hypercalcemia (1.0%). The carcinoma of PNS originated in multi si tes, they mainly located at the right lobe of liver, whilst 47.5% of patients wi th PNS were involved in two lobes. The level of ?-glutamyltranspeptidase in PN S was statistically higher than that free of PNS controls (261.2?224.0 vs. 165 .8?152.2, P

Objective To evaluate the X-ray signs of the ascending venography of the lower limbs.Methods The imaging findings of ascending venogaphy in 80 sides lower limb were reviewed retrospectively.Results According to the imaging findings,all patients were divided into normal groups and abnormal groups;unusual groups including simple venous valvular inadequacy 4 sides,traffic venous valvulor inadequacy 6 sides,primary deep venous valvular inadequacy 32 sides and secondary 5 sides,thrombosis 3 sides,congenital dysplasia 2 sides,phlebangioma 5 sides.Conclusion The ascending venoraphy of the lower limbs is a simple and effective method,it is valuable in diagnosis of venous disease.

As a carrier for MRI contrast agent,active targeting liposome demonstrates distinct advantages in tumor diagnosis and treatment due to its characteristics of biocompatibility,non-toxicity and targeting ability.Tumor targeting imaging with liposome labeled with molecular recognition system,or liposome sensitive to pH value or temperature is a popular research topic.The application of various types of active targeting liposome for tumor magnetic resonance imaging is reviewed in this review.

Objective To explore the effect of hemorrhage on cell apoptosis in the hippocampal CA1 region of rats under controlled hypotension (CH).Methods A total of 36 Sprague Dawley rats were randomly divided into 2 groups: Group C (with no CH) and Group H (with CH).According to different ratios of blood loss to total blood volume, Group C and Group H were redivided into 6 subgroups (6 in each group):C_1,H_1(10%);C_2,H_2(20%);C_3,H_3 (30%). Induced by so-dium nitroprusside and esmolol, the mean aterial pressure in Group H was decreased to 50～55 mmHg and kept for 10 minutes, and then blood loss was started, keeping the pump speed. Without CH, the same style of hemorrhage was performed in Group C. The aterial pressure was increased 60 minutes later after the hemorrhage.Expression of bcl-2 and caspase-3 protein was detected by immunohistochemical method, and apoptosis cells were detected by TUNEL staining. Results The average optical density of bcl-2 and caspase-3 was higher in Group H_3 than that in Group C_3(P＜0.05). There were more apoptosis cells examined by TUNEL in Group H_3 than in Group C_3(P＜0.05).Conclusion Thirty percent blood loss under controlled hypotension can induce cell apoptosis in hippocampal CA1 region in rats.

Objective To compare the differences of epidemiology, clinical characteristics, laboratory results and prognosis between patients with severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) infection and those with hemorrhagic fever with renal syndrome (HFRS).Methods Medical records of 16 hospitalized cases with SFTSV infection and 28 hospitalized HFRS cases from January 2012 to June 2016 were reviewed in affiliated Yijishan Hospital of Wannan Medical College.In details, the comparative analysis of patients between the two groups were conducted in sex, age, occupation, onset season, contact history, underlying diseases, fever duration, oliguria, bleeding (including petechiae, ecchymoses, gum bleeding, bloody stool and hematuria), secondary infection, consciousness disturbance, dialysis treatment, length of hospital stay, laboratory results and prognosis.Continuous variables of normal, non-normal distribution data were compared using two-sample t test and rank sum test, respectively.Categorical variables were showed in rate and compared using chi-square test.Results The differences between the two groups in age (t=2.585), occupation (χ2=4.914), onset season (χ2=4.325) and contact history (χ2=9.617) were all statistically significant (all P<0.05).In SFTSV infection group, the mean fever duration was (8.81±3.17) d.There were 2 cases of oliguria, 10 cases of bleeding, 7 cases of secondary infection, 5 cases of consciousness disturbance.No patient received dialysis.The average length of hospital stay was (13.44±7.91) d.In HFRS group, the mean fever duration was (5.96±2.20) d.In addition, there were 24 cases of oliguria, 25 cases of bleeding, 9 cases of secondary infection, 3 cases of consciousness disorder.Twelve cases received dialysis treatment in this group.The average length of hospital stay was (18.04±15.75) d.Furthermore, there were significant differences between the two groups in fever duration (t=3.511), oliguria (χ2=22.578), bleeding (χ2=4.490) and dialysis (χ2=7.392) (all P<0.05).The significant differences were also found in white blood cell count, blood urea nitrogen, serum creatinine, albumin, amylase, lipase, creatine kinase, serum sodium, chloride, calcium, carbon dioxide combining power and blood glucose between the SFTSV infection group and HFRS group (all P<0.05).However, there was no significant difference in prognosis between the two groups (Z=1.574, P=0.115).Conclusions There are differences in epidemiological history, clinical manifestations and laboratory findings between the SFTSV infection group and HFRS group, which may help differential diagnosis and treatment of these two diseases.

Aim To study the inhibitory effect of ginkgolide B (BN52021) on the PAF induced changes of chemotaxis of murine peritoneal macrophages and the related polymerization of F-actin.Methods Chemotaxis assays were performed using a modified 48-well Boyden chamber. Actin polymerization of murine peritoneal macrophages was analyzed by flow cytometry using a specific fluorescent stain. Results Peritoneal macrophages significantly migrated toward platelet-activating factor(PAF) through a micropore filter; however, in the presence of PAF receptor antagonist BN52021 (0. 01the actin polymerization of murine peritoneal macrophages induced by PAF in the presence of Ca2+ , but not in Ca2+ -free medium. Conclusion The results suggested that preventing polymerization of F-actin may be a pathway by BN52021 to inhibit the chemotaxis of macrophages, and this effect seems to be Ca2+dependent. The data further indicated that inhibition of PAF induced macrophage chemotaxis is an important mechanism underlying the anti-inflammatory action of BN52021.