Objective To investigate the clinical distribution and change in antimicrobial resistance of Acinetobact-er baumannii (A.baumannii)from a hospital between 2011 and 2013,so as to provide guidance for clinical treat-ment.Methods Sources and antimicrobial susceptibility testing results of A.baumannii from a hospital were ana-lyzed statistically.Results A total of 14 705 bacterial isolates were isolated in 2011 —2013,13.59%(n=1 999)of which were A.baumannii isolates,the percentage of A.baumannii in isolated pathogens in 3 years was 12.74%, 13.05%,and 14.85% respectively,which showed a rising trend (χ2 =9.458,P =0.002).The main specimen was sputum (n = 1 541 ,77.09%),bacteria were mainly isolated from patients in respiratory disease department (21 .71 %),surgical intensive care unit (16.26%),and emergency intensive care unit (8.26%).Antimicrobial re-sistance rates of A.baumannii increased year by year(all P <0.05);multidrug-resistant and extensively drug-resist-ant A.baumannii also increased year by year (all P <0.001).Conclusion Isolation rate and antimicrobial resistance rate of A.baumannii strains increase year by year,multidrug-resistant and extensively drug-resistant A.baumannii strains are obvious,which should be paid more attention in clinical department.

Objective To explore the association between polymorphisms of adiponectin gene and the risk of ischemic stroke in Han population from the Northern parts of China.Methods TaqMan probe of RT-PCR was applied to detect the genotype frequency of single nucleotide polymorphism(SNPs)(rs266729 and rs2241766)of adiponectin gene in 357 ischemic stroke cases who developed the episode at first time and with 345 healthy controls.Logistic regression analysis was used to evaluate the relationship of each genotype of SNPs and ischemic stroke.Results Mutation of rs2241766(T＞G)increased the risk of ischemic stroke among all the samples(0R=1.55,P=0.01)and it was still the risk factor of ischemic stroke when analyzed by multi-factors logistic regression after each factor was adjusted(OR=1.55,P=0.00).The polymorphism of rs266729 was not related to the risk of ischemic stroke among all the samples(OR=1.13,P=0.57).However,the genotype GG of rs266729 increased the risk of ischemic stroke among female population(OR=3.25,P=0.04).Conclusion The variance of rs2241766 in adiponectin gene was related to the risk of ischemic stroke in Han population from the Northern parts of China and the genotype GG of rs266729 could possibly increase the risk of ischemic stroke in women of Han population from the Northern parts of the country.

Migraine is a complex and heterogeneous disorder. Although several genetic models has been proposed including autosomal-dominant/autosomal recessive, sex-linked, sex-limited, mitochondrial, and multi-gene, none of these models can well-explain the transmission of the disease. We hypothesied that migraine is a sex-conditioned inherited disorder (autosomal dominant in females and autosomal recessive in males). This hypothesis is supported by the evidence such as the locations of genes associated with familial hemiplegic migraine, possibly "typical" migraine as well (dominantly on chromosome 19p, 1q, and 2q), male:female ratio of prevalence (1:2-1:4), the mostly youth-onset, the provocation by the contraceptives, the induction by menstruation, and the self-limitation after menopause. Female sex-hormones appear to be the key contributor to a higher prevalence of migraine in female. Socio-environmental factors may also play an important role.
Age of Onset ; China ; epidemiology ; Female ; Genes, Dominant ; genetics ; Genetic Predisposition to Disease ; epidemiology ; genetics ; Gonadal Steroid Hormones ; metabolism ; Humans ; Inheritance Patterns ; genetics ; Male ; Menstrual Cycle ; genetics ; Migraine Disorders ; epidemiology ; genetics ; Sex Factors

OBJECTIVETo compare the clinical effectiveness of blind intubation through the Cookgas intubating laryngeal airway(CILA) or Fastrach intubating laryngeal mask airway(FT-LMA) for anticipated difficult tracheal intubation.

METHODSEighty-six patients with anticipated difficult tracheal intubation who were undergoing elective plastic surgery under general anesthesia were randomly allocated into CILA group(n=43) and FT-LMA group(n=43) . After general anesthesia being induced and CILA or FT-LMA being inserted, the patients were treated with blind intubation through CILA or FT-LMA. In each case, the number and the time of intubating laryngeal airway(ILA) insertion and blind intubation attempts and ILA removal were recorded. The view of glottis under fiberoptic bronchoscope(FOB) via CILA or FT-LMA was recorded. In addition, noninvasive blood pressure and heart rate were recorded before and after intravenous anesthetic induction, at ILA insertion, at intubation, at ILA removal and every minute thereafter for 5 minutes.

RESULTSCILA or FT-LMA was inserted successfully in all 86 patients. The rate of the first successful insertion was not significantly different between two groups(P>0.05) . In CILA group, the first intubation attempt succeeded in 35 patients;5 and 2 cases were intubated blindly at the second and the third attempt, one patient failed who was intubated successfully by FOB via CILA. In FT-LMA group, 32 patients were intubated successfully at the first attempt, 4 at the second attempt, 3 at the third attempt, and 4 cases failed, three of them were intubated smoothly with FOB through FT-LMA, one failed patient was intubated by FOB. The time of FT-LMA insertion(34.2∓13.9) s was significantly longer when compared with CILA(22.4∓18.9) s (P<0.05) . However, the time of blind intubation through CILA and FT-LMA [(46.0∓26.7) s vs.(51.8∓41.1) s]and the time of ILA removal[(39.3∓11.9) s vs.(35.3∓10.4) s] were not significantly different between groups(P>0.05) . Hemodynamic changes during blind intubation in the two groups showed no significant differences(P>0.05) .

CONCLUSIONSBlind intubation via CILA or FT-LMA is safe and effective for anticipated difficult tracheal intubation. Nevertheless, CILA is easier to be inserted, with relatively higher success rate of blind intubation.

Adolescent ; Adult ; Anesthesia, General ; Bronchoscopy ; Humans ; Intubation, Intratracheal ; instrumentation ; Laryngeal Masks ; Middle Aged ; Young Adult

OBJECTIVETo study the epidemiological and clinical characteristics and risk factors of cirrhosis-related hepatocellular carcinomas (HCC) in patients with hepatitis C virus (HCV) infection.

METHODSEighty-nine compensated and decompensated HCV cirrhosis patients were analyzed and followed-up. The main clinical and laboratory variables were analyzed as incidence factors of HCC with univariate analysis and multivariate analysis regression models.

RESULTSThe patients were followed-up for 86 months. Thirty-five of the 89 patients had HCC during the 86 months follow-up. Their five and ten-year cumulative incidences were 16.9% and 40.4% respectively. Of the 35 HCC patients, 4 had a family history of hepatitis C, 12 had a familial history of HCC, and 7 had a history of alcohol ingestion. Five and ten-year cumulative incidences of HCC in patients with hepatic steatosis were 24.6% and 51.0% respectively. Five-year and ten-year cumulative incidences of HCC in patients with non-hepatic steatosis were 8.7% and 26.2% respectively, and the difference in the cumulative incidences between them was significant (P < 0.05). Hepatic steatosis severity was associated with the severity of the cirrhosis. ALT and TBil levels were higher in the HCC group than in the non-HCC group, ALB was lower in the HCC group than in the non-HCC group, and the differences between them were significant (P < 0.05). Child-Pugh score and the severity of the hepatic steatosis during follow-up were independently correlated with HCC.

CONCLUSIONHCC is the most important and frequent outcome of chronic hepatitis C cirrhosis. Child-Pugh score and the severity of the hepatic steatosis are related to the risk factors. History of alcohol ingestion and family history of hepatitis C are also related to liver cancer.

Aged ; Carcinoma, Hepatocellular ; etiology ; Female ; Follow-Up Studies ; Hepatitis C, Chronic ; complications ; Humans ; Liver Cirrhosis ; complications ; Liver Neoplasms ; etiology ; Male ; Middle Aged ; Risk Factors

This study was aimed to investigate the therapeutic efficiency and complications after allo-hematopoietic stem cell transplantation (allo-HSCT) with reduced-intensity conditioning regimens in hematologic malignancies. 10 patients (6 CML patients, 2 AML patients, 1 ALL patient and 1 NHL patient) underwent related allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning regimens. The conditioning regimens consisted of "FLU + CY + TBI" basically and was appropriately improved in accordance with status of patients. Cyclosporin A (CsA) and mycophenolate mofetil (MMF) were used to prevent the graft-versus-host disease (GVHD). Detection of bone marrow cells, chromosomes, fused gene, ABO blood group and STR-PCR were used to observe engraftment, relapse, GVHD, transplantation- related complications (TRC) after transplantation and to evaluate patients quality of life. The results showed that the 10 patients successfully accepted the transplantation and their primary diseases were cured. In one patient, severe pulmonary infection happened, and in another one CMV infection occurred. Grade IV of acute GVHD occurred in one case and grade I of acute GVHD in 2 cases, the no chronic GVHD appeared. 5 patients relapsed after transplantation at various time points, the donor lymphocytes infusion (DLI) or drugs rescued these 5 patients. During median follow-up of 5 - 35 months, 2 out of which died, 8 survived, the overall survival rate was 80%, and the survivors live in a high-quality life. In conclusion, the hematopoietic stem cell transplantation with reduced intensity conditioning regimens was feasible with relatively low toxicity for recipients. GVHD and TRC were low, and life quality of patients after transplantation was high. DLI could cure the primary diseases even relapsed after transplantation.
Adult ; Cyclosporine ; administration & dosage ; Female ; Graft vs Host Disease ; prevention & control ; Hematologic Neoplasms ; therapy ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Lymphocyte Transfusion ; Male ; Middle Aged ; Mycophenolic Acid ; administration & dosage ; analogs & derivatives ; Transplantation Conditioning ; methods

OBJECTIVETo investigate the expression of EphA2 and EphrinA1 and its relationship with angiogenesis in renal cell carcinoma and its relevance to clinicopathologic features.

METHODSThe expression of the EphA2 and EphrinA1 was detected by immunohistochemistry (IHC) in the tissues samples from 68 renal cell carcinomas and 24 normal kidneys, and quantitatively analyzed. The microvessel density (MVD) was determined by CD34 immunostaining of microvascular endothelial cells. Statistical analysis was performed using the software SPSS (version 13.0).

RESULTSThe expression of EphA2, EphrinA1 and MND in the cancerous tissues were significantly higher (P<0.01) than that in the normal ones. Significantly increased expression of EphA2, EphrinA1 and MVD (P<0.01) was detected in cancer tissues with higher grade differentiation, more advanced stage and more lymph node metastasis, respectively (P<0.05 for each group). Expression of the EphA2 and EphrinA1 protein was shown to be positively associated with the MVD assessed by Spearman's correlation and factor analysis (r=0.555, r=0.485, P<0.01). The MVD was also significantly correlated with the diameter of the tumor (P<0.01).

CONCLUSIONEphA2 and EphrinA1 are highly expressed in renal cell carcinoma, and positively correlated with histological differentiation, clinical stage and angiogenesis in the cancer.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Renal Cell ; metabolism ; pathology ; Ephrin-A1 ; metabolism ; Female ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Microvessels ; pathology ; Middle Aged ; Neoplasm Staging ; Neovascularization, Pathologic ; metabolism ; pathology ; Receptor, EphA2 ; metabolism ; Tumor Burden ; Young Adult

OBJECTIVETo investigate the clinicopathological characteristics of large cell calcifying Sertoli cell tumor (LCCSCT) of the testis.

METHODSWe studied a case of LCCSCT by light microscopy, Western blotting and immunohistochemistry, reviewed relevant literature, and analyzed the clinical, morphological and immunohistochemical features, treatment and prognosis of the tumor.

RESULTSThe patient was a 25 years old man. Pathohistologically, the tumor was characterized by a mass of polygonal tumor cells in a tubular and trabecular growth pattern, with abundant acidophilic cytoplasm, enlarged vesicular nuclei, and extensive calcified debris in stroma. The tumor cells were positive for inhibin, S-100, vimentin and alcian blue, but negative for PLAP, SMA, CK, AFP and periodic acid-Schiff (PAS) reaction.

CONCLUSIONLCCSCT is a rare testicular sex cord stromal tumor. Its diagnosis is based on immunohistochemical staining, and it is to be differentiated from other lesions of the testis, including seminoma, Leydig cell tumor, Sertoli cell node, and androgen insensitivity syndrome. For the treatment of LCCSCT, surgical resection often has a good prognosis.

Adult ; Humans ; Male ; Sertoli Cell Tumor ; pathology ; Sex Cord-Gonadal Stromal Tumors ; pathology ; Testicular Neoplasms ; pathology ; Testis ; pathology

OBJECTIVETo observe the safety and feasibility of tracheal intubation by target-controlled infusion of propofol and remifentanil without muscle relaxant in children.

METHODSTotally 100 4-10-year-old pediatric patients (ASA1) who had been scheduled for plastic surgery were equally divided into remifentanil group and control group through computer-generated randomized grouping. In all patients, five minutes after intravenous administration of atropine 0.01 mg/kg and midazolam 0.1 mg/kg, propofol was infused at the targeted effect-site concentration (Ce of 6 μg/ml. When the intended target Ce of propofol was reached, the remifentanil group began to be infused with remifentanil at a Ce of 5 ng/ml, and normal saline (0.1 ml/kg) was injected simultaneously. In the control group remifentanil was replaced by normal saline and rocuronium (0.8 mg/kg) was injected together with the normal saline. After the equilibration of plasma and the Ce of remifentanil were reached, tracheal intubation was attempted. The complications during the induction and tracheal intubation were recorded. The intubating conditions were assessed using a five-point scoring system based on ease of laryngoscopy, vocal cords position, coughing, jaw relaxation and limb movement.

RESULTSThe success rate of tracheal intubation was in 90% in remifentanil group and 98% in the control group (P=0.122).CONCLUSION Target-controlled infusion of propofol and remifentanil at Ce of 6 μg/ml and 5 ng/ml is feasible for the induction and tracheal intubation without muscle relaxant in children.

Child ; Child, Preschool ; Female ; Humans ; Infusions, Intravenous ; Intubation, Intratracheal ; Male ; Piperidines ; administration & dosage ; Propofol ; administration & dosage

OBJECTIVETo investigate the protective effects of selenium on rat hippocampal neurons against ischemia-reperfusion (IR) injury.

METHODSThirty-two rats were randomly divided into sham-operated group, IR group and selenium-treated group, and in the latter two groups, cerebral IR injury was induced by middle cerebral artery occlusion; Na2SeO3 treatment was administer in selenium-treated group. At 14 days after reperfusion, the brain tissues were harvested from the rats and hippocampal neuron injuries were observed by TUNEL and Methylene Blue staining. The levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and nerve growth factor (NGF) in the hippocampal tissues were measured by ELISA.

RESULTSCompared with IR group, the rats in selenium-treated group showed no significant increase in the expression of m-NGF (P>0.05), but pro-NGF expression was significantly increased (P<0.05) in the hippocampal tissue. Na2SeO3 treatment significantly inhibited the expressions of TNF-α and IL-1β and decreased the apoptosis of hippocampal neurons following cerebral IR injury (P<0.05).

CONCLUSIONSelenium produces antiapoptotic effect to protect the hippocampal neurons following cerebral IR injury possibly not by increasing the level of m-NGF but by decreasing the expressions of the inflammatory factors.

Animals ; Apoptosis ; Brain Ischemia ; metabolism ; pathology ; Hippocampus ; cytology ; metabolism ; pathology ; Interleukin-1beta ; metabolism ; Male ; Nerve Growth Factor ; metabolism ; Neurons ; drug effects ; metabolism ; pathology ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; pathology ; Sodium Selenite ; pharmacology ; Tumor Necrosis Factor-alpha ; metabolism