Objective The distribution and drug resistance of Klebsiella pneumonia isolated from clinical department were ana‐lyzed in this article .It will provide evidence for the clinical rational medication and the control of nosocomial infections .Methods In this hospital ,892 strains of Klebsiella pneumonia isolated from January 2011 to December 2013 were performed a statistical analy‐sis .Results Among all the samples ,the extended spectrumβ‐lactamases(ESBLs) positive Klebsiella pneumoniae accounted for 40 . 92% .The highest detection rate in the all the clinical department is the ICU with a value of 46 .46% .The highest detection rate in the sample is the sputum with a value of 43 .51% .In addition ,the ESBLs positive strains had a trend of multiple drug resistance . The Klebsiella pneumonia was the most sensitive bacteria to imipenem ,meropenem ,piperacillin/tazobactam and cefoperazone/sul‐bactam ,no matter whether they produced ESBLs or not .Conclusion The resistant rate of ESBLs positive strains is higher than that of ESBLs negative strains .It was recommended to the rational use of antibiotics based on the duration of disease and the products with or without ESBLs .Furthermore ,it will be of great importance to reduce the incidence of multiple drug resistance ,and to con‐trol the hospital infection effectively .

Fructus Ligustri Lucidi ( FLL) is a traditional Chinese medicine commonly used in clinic. This paper reviews the phar-macological action of FLL and its compounds, especially demon-strates the regulation and mechanism in calcium homeostasis and bone metabolism.

Objective To explore the clinical efficacy of polyp of vocal cord. Methods The clinical data of 187 cases were retrospectively analyzed. Results According to the 187 cases, 164/187 cases were cured, 21 cases had obvious improvement, 2 cases have no effect, general effective rate is 98.9%. Conclusion Suspension laryngoscope were visual field widen and visual, every kind of surgical instruments binding equipments improve operation accuracy and reduce complication to acquire better clinical therapeutic effects.

Objective To study the prognostic value of immunophenotypes in the patients with diffuse large B-cell lymphoma (DLBCL) and its prognostic significance of immunohistochemical markers for rituximab.Methods The data of 186 initial DLBCL patients were retrospectively analyzed.According to the international prognostic index,all patients were divided into relatively high-risk group and relatively low-risk groups,and the patients in both groups were divided into chemotherapy (CHOP) group and immune chemotherapy (R-CHOP) group,respectively,hnmunohistochemical method and Hans typing method were applied to immune classification in all of groups.The prognostic significances of the immunological subtypes in different prognosis group were compared by Log-rank test.Results The 5-year OS rate of the GCB subtype patients in the CHOP group was significantly higher than that of the non-GCB subtype (58.82 ％ vs 32.00 ％,X2 =8.482,P=0.004),while that was no significant difference between GCB and non-GCB subtypes patients in the R-CHOP group (72.97 ％ vs 61.54 ％,X2 =2.694,P =0.101).Further analysis results showed that non-GCB subtype patients treated with R-CHOP had significantly higher 5-year OS rate than those treated with CHOP (61.54 ％ vs 32.00 ％,X2 =7.385,P=0.007).In the 107 cases of low risk group,there was no significant difference in 5-year OS rate between GCB and non-GCB subtype patients in the CHOP group or in the R-CHOP group (all P ＞ 0.05),and there was no significant difference in 5-year OS rates between the CHOP and R-CHOP groups in the GCB group or in the non-GCB group (all P ＞ 0.05).In the 79 cases of high risk group,the 5-year OS rate in the GCB subtype group was significantly higher than that in the non-GCB subtype in the CHOP group (40.00 ％ vs 22.72 ％,X2 =3.978,P =0.045),while there was no significant difference in 5-year OS rates between GCB and non-GCB subtype patients in the R-CHOP group (62.50 ％ vs 42.31％,X2 =2.072,P =0.150).Conclusions By immunohistochemistry,DLBCL can be divided into two immunophenotype subgroups,which have guiding significance for early prognosis and therapeutic strategies,but which are no longer or weak in prognostic significance in the era of post-rituximab.R-CHOP improve significantly survival of non-GCB subgroup patients.However,its function needs to be further explored in the GCB subgroup.

Objective To investigate the efficacy of docetaxel combined with capecitabine in the treatment of patients with locally advanced breast cancer and its effect on immune function.Methods 160 patients with locally advanced breast cancer were randomly divided into observation group and control group.The control group was treated with capecitabine.The patients in the observation group were treated with docetaxel combined with capecitabine.The clinical effective rate, median time to progress, median survival time, one year survival rate and immunoglobulin protein expression levels were observed.Results The clinical effective rate and stable rate in the observation group were 88.75% and 95.00%, which were significantly higher than 68.75% and 87.50% in the control group, the differences were statistically significant (x2=5.89,4.17,all P<0.05).After treatment, the median time to progression, median survival time and one year survival rate of the observation group were significantly higher than those of the control group (t=3.43,5.09,6.23,all P<0.05).Compared with before treatment, after treatment, the IgG,IgM and IgA levels in the observation group significantly decreased(t=2.34,3.16,3.27,all P<0.05), while those of the control group were not significantly changed (t=0.79,0.22,0.27,all P>0.05).Conclusion Docetaxel combined with capecitabine in the treatment of patients with locally advanced breast cancer can improve the clinical efficacy and stability, prolong the survival time of patients.Compared with using single agent chemotherapy, combined use has no significant effect on human immune function, the effect is better than the use of capecitabine alone, which is worthy of promotion in clinical use.

Objective To observe the efficacy and safety of oxycontin treatment in cancer patients with mod-erate to severe chronic cancer pain.Methods This study was performed by study group and control groups.120 cases of patients with moderate to severe chronic pain were enrolled in study group and treated with oxycontin(10mg/time, once every 12 hours).50 cases of patients with moderate to severe chronic pain were randomly allocated to control group and treated with tramadol hydrochloride sustained-release tablets(100mg/time,once every 12 hours).Clinical efficacy and adverse reactions of patients in the study group and control group were evaluated after therapy for three weeks.Results There was 35 cases of complete remission,80 cases of partial remission,and 5 cases of mild remis-sion,and the overall response rate was 95 .8% in the study group.In addition,there was 4 cases of complete remis-sion,4 0 cases of partial remission,4 cases of mild remission and 2 cases of no effect,and the overall response rate was 88.0%,there was statistically significant difference(P=0.004).Meanwhile,the rates of adverse reactions in the study group and the control group were 16.7% and 14.0%,respectively,there was no statistically significant differ-ence(χ2 =0.188,P>0.05 ).Conclusion Oxycontin can effectively safely treat cancer patients with moderate to severe chronic pain.

Objective To analyze diagnostic classification and karyotype characteristics of patients with myelodysplastic syndrome(MDS)in Xinjiang Uygur Autonomous Region.Methods 149 patients with MDS were retrospective observed.The features of clinical,laboratory examination,morphologic and cytogenetics were analyzed from patients classified by the 2008 WHO classification.The rates of survival and leukemia conversion in different subgroups,the differences between uygur and han nationalities,and the rates of abnormal karyotypes in different subgroups were compared.Results Among 149 cases,there were 28 cases of RCUD(including 25 RA and 3 RN),8 cases of RARS,32 cases of RCMD,30 cases of RAEB-Ⅰ,44 cases of RAEB-1,5 cases of MDS-U and 2 cases of 5q-.There was no difference between uygur and han nationality of diagnostic classification(x2=3.627,P=0.822).The overall survival time and AML conversion rates were different among subtype groups.Karyotype abnormalities were found in 74 cases(49.7 ％),which showed no difference between uygur and han nationalities.The distribution of karyotype were normal karyotype(72 cases),complex karyotype(34 cases),+8(14 cases),-7(11 cases),+11(7 cases),20q-(5cases),-Y(2 cases),+21(2 cases)and 5q-(2 cases),which were no differences between uygur and ban nationality(X2=10.015,P=0.264).When comparing abnormal karyotype rates in different diagnostic classification subgroups excepting 5q-,RAEB-Ⅰ and RAEB-Ⅱ subtype were higher than that of RCUD subtype(X2=7.034,P=0.008;X2=6.395,P=0.016).Conclusions According to the 2008 WHO classification,the incidence of abnormal karyotype,survival time and AML conversion rates are different among subtype groups.There are no regional and ethnical differences in distribution of diagnostic classification and karyotype in patients with MDS in Xinjiang Uygur Autonomous Region.

Objective:To establish a method of multi-PCR to amplify the complete DNA sequence (CDS) of TCR ? and ? chain of the antigen-specific T lymphocytes in local pathologic specimen of active pulmonary tuberculosis patients, and to analyze ?/? T cell receptor gene rearrangement and CDR3 repertoire.Methods:The lymphocytes in bronchoalveolar lavage (BAL) of active pulmonary tuberculosis patients were separated. Following total RNA extraction, cDNA synthesis, Multi-PCR, recombinant clones construction, and sequencing, the CDS of TCR ? and ? chains from these lymphocytes were analyzed by using software of DNAstar and internet TCR resources.Results:24 of ? chain CDS and 13 of ? chain CDS from 3 samples of BAL were obtained. As for TCR ? chain, AV1S2 (54%), AV12S3 (41%), and AV12S2(5%) appeared frequently. BV2(38%), BV29S1(46%), BV14(3%), and BV4S2(3%) in TCR ? chain appeared more often. There were CDR3 diversities between samples and even in the same sample by amino acid sequence analysis, but there were a few identical or similar amino acid sequences. There was the same amino acid sequence of SVGTGTLHQETQY in CDR3 region of ? chain of BAL sample No.1 and No.2; The sequence of AVRDWAGNMLT appeared in two ? chains of BAL sample No.2 and No.3; Moreover, the sequence of AV…DNN…RLM appeared in ? chains of BAL sample No.2 and No.3.Conclusion:A method of Multi-PCR is used to amplify TCR ? and ? chain CDS of tuberculosis patients. There are characteristic T cell clones to proliferate,with TCR ? and ? chain repertiore skewing in local infective focus. The sequences of CDR3 in different TCR clones are mostly different but there are a few identical or similar sequences in the same patient or even between different patients. The identical amino acid sequences of CDR3 are possibly specific for recognizing MTB polypeptide.

OBJECTIVETo investigate the incidence and risk factors for hypertension among taxi drivers working different shifts.

METHODSUsing the cluster sampling method, 415 day-shift and 304 night-shift taxi drivers in Jinan, China were selected and investigated. The influencing factors for hypertension were analyzed.

RESULTSThe incidence of hypertension in all taxi drivers was 33.2%. The incidence of hypertension in night-shift drivers was significantly higher than that in day-shift drivers (37.8% vs 29.9%, P<0.05). According to multivariate analysis, the incidence of hypertension in day-shift drivers was closely related to body mass index (BMI), working years, working hours, sleep duration, rest days, diet quality, water intake, and smoking, while the incidence of hypertension in night-shift drivers was closely related to BMI, working years, working hours, part-time job, sleep duration, rest days, and drinking.

CONCLUSIONBMI, working years, and working hours are the common risk factors for hypertension in day-shift and night-shift drivers. Sleep duration and rest days are the common protective factors. The risk factors for hypertension in taxi drivers vary with different shifts.

Automobile Driving ; Body Mass Index ; China ; epidemiology ; Humans ; Hypertension ; epidemiology ; Incidence ; Occupational Health ; Rest ; Risk Factors ; Time Factors ; Work Schedule Tolerance

OBJECTIVETo evaluate the efficacy and safety of high dose dexamethasone combined with recombinant human thrombopoietin (rhTPO) in adults with severe newly diagnosed immune thrombocytopenia (ITP).

METHODSForty-eight adult patients with severe ITP were randomized into two groups, experimental group and control group. The patients in experimental group were given high-dose dexamethasone combined with rhTPO treatment, the patients in control group were given single high-dose dexamethasone treatment. Platelet count, platelet increase, as well as the overall response rate were strictly observed in the process. At the same time, the patient's drug tolerance and any adverse drug reactions were observed.

RESULTSThe platelet counts and platelet increase of the patients in experimental group were significantly higher than that in control group (P<0.05) at day 3, 7, 14, 30. There was no significant difference in overall response rates between the two groups (34.8% vs 36.0%, 56.5% vs 48.0%, P>0.05) at day 3, 7. The overall response rates of experimental group at day 14, 30 were significantly higher than that of control group (91.3% vs 68.0%, 82.6% vs 52.0%, P<0.05). The muscle aches occurred in one patient in experimental group which was self-recovery without special treatment.

CONCLUSIONrhTPO combined with high-dose dexamethasone could rapidly increase the platelet count, reduce the risk of bleeding, and prolonge the effect with a low incidence of tolerable adverse events compared to single high-dose dexamethasone. rhTPO combined with high-dose dexamethasone could be a new therapeutic choice for severe primary ITP.

Adult ; Blood Platelets ; Dexamethasone ; administration & dosage ; therapeutic use ; Humans ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; drug therapy ; Recombinant Proteins ; administration & dosage ; therapeutic use ; Thrombopoietin ; administration & dosage ; therapeutic use ; Treatment Outcome