Non-responding pneumonia describes the situation, in which an inadequate clinical response is present de-spite antibiotic treatment. The incidence of treatment failure in community acquired pneumonia (CAP) can range up to 31%. At present, the diagnosis and treatment of this kind of disease remain a great challenge to CAP. For this reason, several stud-ies have attempted to establish risk factors and new strategies for the treatment of non-responding pneumonia. This article re-views the progress of the pathogeny and treatment of non-responding CAP.

Myeloid-derived suppressor cells (MDSC) are a heterogeneous population of cells of myeloid origin that comprises myeloid progenitor cells and immature macrophages, which expand in tumorbearing mice and patients' bone marrow, spleen and peripheral blood and recruit to the tumor site. MDSC express high levels of arginase 1 (ARG1), inducible-nitric oxide syntheses (iNOS), reactive oxygen species (ROS) and peroxynitrite. They could suppress T-cell functions by cell contact or not, and induce regulatory T cells (Treg), all of the above are its weapons to defend individuals' immune system. Anti-tumor strategies targeted at MDSC develop rapidly now. In this review, we briefly introduce the strategies that targeted at MDSC and their mechanisms.

Arteries ; surgery ; Arteriosclerosis Obliterans ; surgery ; Bioprosthesis ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; instrumentation ; Humans ; Lower Extremity ; blood supply ; surgery

Objective To observe the effects of sodium arsenite (NaAsO2) on the expression of transcription factor nrf2 (Nrf2) and heme oxygenase 1 (HO-1) in Chang liver cells, and to explore the possible mechanism by using buthionine sulfoximine ( BSO), a GSH synthesis inhibitor. Methods Chang liver cells were treated with NaAsO2 at the doses of 5, 10 and 20 ?mol/L, alone, for 24 h, or pretreated with BSO (3 mmol/L, 12 h). Western blot assays were used to detect the protein expression of Nrf2 and HO-1. Results The protein expression of Nrf2 and HO-1 significantly increased in 5, 10 and 20 ?mol/L of NaAsO2 alone groups, and Nrf2 and HO-1 protein expression was up-regulated even higher by BSO pretreatment (P

As a technique which can assess both the micro-vascularization and macro-vascularization of the tumor,contrast-enhanced ultrasound have been developed rapidly,and its researches in thyroid nodules check and differentiation has became more and more widely.Different infusion modes in the diagnostic of thyroid nodules are really meaningful.The development of CEUS and identification of thyroid nodules will be reviewed in this article.

[Objective]To discuss the significance of tissue repairing and functional reconstruction in treatment of extremity malignant tumors by allogeneic bone graft and replanting devitalized bone after malignant bone tumor resection. [Method]A retrospective study of 56 patients with malignant bone tumor was conducted, including 35 male patients and 21 female patients. The age was between 9 and 60, with an average of 18.Tumor in 9 cases was in the proximal hunerus, 30 in the distal femur, and 17 in the proximal cnemis.Thirty-two cases were osteogenic sarcoma,17 cases were chondroma sarcomatosum,3 cases were maligant giant cell tumor of bone and 4 cases were metastatic.Soft tissue was repaired and extremity function was reconstructed by adopting allogeneic bone graft and replanting devitalized bone. Extremity functions, bone healing conditions, and complication were estimated according to Mankin metheds.[Result]Among these 56 patients,results in 20(35.7%) were excellent,11(19.6%) were good,8(14.3%) were fair,17 (30%) were poor. The satisfactory rate was 70%.Thirty-eight patients survived for two years without tumor.Thirty patients survived for 5 years with the survival rate of 55%. Except local relapsed, the major complications were infection (4 cases), fracture (3 cases),collapse of articular facet (1 cases), and arthrocleisis (5 cases),with the infection rate of 7%.No internal fixation was broken.[Conclusion]For extremity malignant tumor, effective tissue repairing and functional reconstruction not only offer a limb-sparing effect, but also keep the limb in good function. This is an effective method for bone malignant tumor.

ObjectiveThe possibility of the hyperplasi a of prostatic outer gland was studied with transrectal ultrasound (TRUS) guided biopsies. MethodsTwenty-seven prostatic outer glands in patients suspicious for prostatic cancer (PCA) were biopsied by TRUS guided, the total sites were 47. The same site was biopsied in sagittal and longitudinal section respectively. The hypoechoic lesion was biopsied 2 times if it was discovered in the outer gland. The histological results were diagnosed in double blind. Results Twenty prostatic inner glands looked symmetrical hyperplasia; 9 outer glands became thin because of the compression, there was no compressive sign in 18 patients; there was a hypoechoic lesion in outer gland of 3 patients. Benign prostatic hyperplasia was diagnosed in the specimens of 47 sites. ConclusionsThe hyperplasia of prostatic outer gland can occur like inner gland because it is glandular tissue.

Objective To evaluate the clinical value of repeat transrectal ultrasound (TRUS) guided biopsy in prostatic cancer (PCA). Methods Repeat TRUS guided biopsy was conducted on 54 patients of the previous benign TRUS guided biopsy at high risk of PCA. Postatic specific antigen ranged in 0.5- 90.0 ?g/L(mean 16.3 ?g/L). Twenty-nine patients were abnormal in digital rectal examination, 21 patients were abnormal in TRUS. Results Forty-seven patients had 2 consecutive times of the biopsy, 6 patients had 3 consecutive times, 1 patient had 4 consecutive times in 54 patients of repeat TRUS guided biopsy. The pathological finding was confirmed in 14 PCA ( 25.9%), and 31 benign prostatic hyperplasia, 5 prostatic intra-epithelial neoplasmia, 4 chronic prostatitis. Conclusions The detection of PCA will be increased by repeat TRUS guided biopsy at high risk of PCA after the previous benign TRUS guided biopsy.

Objective To study the characteristic of the hyperplasia hypoechoic nodules in outer gland of prostate with transrectal ultrasound (TRUS) guided biopsies. Methods 42 patients were suspected of prostatic cancer (PCa) for the existence of hypoechoic nodules in their outer glands of prostate. Each nodule was TRUS guided biopsied in sagittal and longitudinal section, respectively. The histological examinations were performed in double blind. Results Among the 42 patients, there were 22 cases of benign prostate hyperplasia (52.4%) and 20 cases of prostate cancer (47.6%). Conclusions The sonographic findings of the hypoechoic nodules in outer glands included not only PCa, but also benign hyperplasia nodules. Therefore, the definitive diagnosis must dependent on pathologic examinations.

Objective To detect the apoptosis and the intensity of proliferation in different types of renal pathology in children with lupus nephritis (LN), analyzed the relationship between apoptosis and proliferation in LN. Methods Twenty - seven children (aged 7-16 years old, 21 type IV and 6 type V ) with biopsy- proven LN and nine as controls were included in the study. Apoptosis was detected by in situ nick- end labeling techniques (TUNEL) in renal biopsy samples. Immunohistochemistry was employed to detect the proliferating cells identified by proliferating cell nuclear antigen (PCNA) and detect the expressions of proteins of apoptosis associated gene PDCD5 and Caspase - 3 in these patients. Results 1. Compared to type V LN, the patients with type IV LN had more apoptolic cells,more PCNA positive cells and higher ratios of PCNA/apoptosis (P/A) in glomeruli. 2. There were no difference in expression of PDCD5 in glomeruli in type IV LN compared with those in type V LN. Numbers of apoptotic cells were observed in glomeruli. The expression of Caspase- 3 in type IV LN increased in glomeruli compared with that in type V LN. Conclusions The up- regulation of mechanism of apoptosis in type IV LN was less than that of type V LN. Caspase- 3 participated in the apoptosis of glomeruli of LN, but PDCD5 did not play a role during apoptosis of glomeruli of LN or the effect of PDCD5 promoting apoptosis was depressed.