Objective To evaluate the safety and efficacy of fiberoptic bronchoscopy in the diagno-sis of 41 neonates with weaning failure.Methods A retrospective study on the results of fiberoptic broncho-scopy was performed in 41 neonates with weaning failure.Results A total of 41 neonates of throat abnor-malities were examined by fiberoptic bronchoscopy,including 38 cases with laryngomalacia,8 cases with seri-ous hyperemia and swelling of the vocal cords,2 cases with scar stenosis of subglottic,and one case in each of congenital laryngeal web,glottic insufficiency and congenital epiglottis cyst;trachea-bronchial abnormali-ties,including 31 cases with tracheomalacia,2 cases with tracheal stenosis,4 cases with partial bronchial ste-nosis,1 cases with bridging bronchus and 1 cases with tracheoesophageal fistula.Thirty-eight neonates under-went fiberoptic bronchoscopy to obtain bronchoalveolar lavage fluid and culture,bacterial culture positive in 15 cases(39.4%),of which 5 cases of Klebsiella pneumoniae,3 cases in each of Pseudomonas aeruginosa and Acinetobacter baumannii,2 cases of Staphylococcus aureus,1 case in each of Escherichia coli and Strep-tococcus mitis;fungal culture positive for 6 cases(15.7%),of which 3 cases of Aspergillus fumigatus,1 case in each of Candida glabrata,Candida albicans and Candida parapsilosis.The most common complications of fiberoptic bronchoscopy were hypoxia and heart rate transient decline(26 cases,63.4%),3 cases fever af-ter operation.Conclusion Fiberoptic bronchoscopy can not only find congenital tracheal deformity and tra-cheal mucosa lesions,but also complete the etiology from deep discharge.Fiberbronchoscopy is safe and relia-ble given adequate preparation and if it is performed by skilled personnel.

Objective To assess the value of fiberobronchoscopy in the diagnosis of endobronchial tuberculosis. Methods A total of 67 children suspected of endobronchial tuberculosis in our ward from March 2010 to December 2012 had been tested by chest CT and ifberobronchoscopy, mycobacteria culture, liquid-based interlayer vessel technique and FQ-PCR from bronchoalveolar lavage fluid and biopsy. Results 50 patients were clinically diagnosed as endobronchial tuberculosis. The positive rate of FQ-PCR (60%) and liquid-based interlayer vessel technique (42%) are higher than that of mycobacteria culture (20%), which showed no signiifcant difference with biopsy. The positive rate of the combined detection (FQ-PCR and liquid-based interlayer vessel technique) is significantly higher than that of mycobacteria culture and biopsy. Conclusions Fiberobronchoscopy is effective for the diagnosis of endobronchial tuberculosis.

Objective To explore the effect of exposure of the recurrent laryngcal nerve(RLN) in prevention of RLN injury during thyorid surgery.Methods The clinical data of 810 cases of thyroid operation in which the RLN was exposed in 252 cases(group A) and was unexposed in 558 cases(group B) were analyzed.Results Although the extent of thyroid resection was greater in group A than in group B,the rate of RLN injury in group A(1.19 %) was significantly lower than that of group B(3.05 %,P

Aim To discuss the pathway of resveratrol for anti-acute myeloblastic leukemia.Methods Human acute myeloblastic leukemia cell Kasumi-1 was applied in this study.After different doses of Res treatment for different time, methyl thiazolyl tetrazolium(MTT)colorimetry was used to detect the cell proliferation.Furthermore, apoptosis and cell cycle were detected by flow cytometry.Western blot and reverse transcription polymerase chain reaction(RT-PCR)were used to detect the expression levels of Bcl-2 and Bax for mRNA and protein.The activity of signal transducers and activators of transcription 3(STAT3)was detected by immunoblotting and Luciferase reporter gene assay.On the other hand, leukemia-bearing mice models were made to investigate the live situation, survival time and the activation of STAT3 by Western blot and immunohistochemical method.Results Resveratrol could suppress the proliferation of Kasumi-1, and induce cell cycle arrest and apoptosis.At the same time, the ratios of Bcl-2/Bax and phosphor-signal transducers and activators of transcription 3(p-STAT3)were decreased significantly.In vivo, resveratrol could prolong the life span of Kasumi-1-bearing mice and attenuate the activity of STAT3 in a dose-dependent manner.Conclusions Resveratrol is a natural occurring chemotherapeutic agent present in Chinese Herbals.The regulatory effect on signaling pathways involved in STAT3 by resveratrol may be associated with its anti-leukemia effect.

Objective: To investigate the role of miR-19a/b in myocardial ischemia reperfusion injury (R/I) with its clinical significance. Methods: Our research included in 2 parts. Part 1: in H9c2 cells. miR-19a/b expression in H9c2 cells with 10 h hypoxia and 2 h re-oxygenation was detected by real-time PCR, miR-19a/b potential target gene was assessed by luciferase reporter activity assay. Part 2: in natural person. Control group,n=40 healthy subjects and AMI (acute myocardial infarction) group,n=40 relevant patients. Peripheral blood levels of miR-19a/b were detected as Part 1, cTnI were measured by chemiluminescence immune analysis and CK-MB were assessed by immune inhibition method. Results: Part 1: Compared with normal H9c2 cells, miR-19a/b expressions were increased 5.876 times and 2.761 times in H9c2 cells with 10 h hypoxia and 2 h re-oxygenation, bothP<0.01. With respectively transfected miR-19a/b mimic and inhibitor, miR-19a/b expression was up-regulated and down-regulated respectively. miR-19a/b and chromosome-10 deleted phosphatase, tensing homolog gene (PTEN) had the targeting effect. With up-regulated miR-19a/b expression, PTEN level was decreased and with down-regulated miR-19a/b expression, PTEN level was increased. Part 2: Compared with Control group, AMI group had elevated blood level of miR-19a/b,P<0.01. In AMI patients, miR-19a/b was increasing at 0-3 h of chest pain and reaching the peak at 6-12 h; CK-MB enzyme activity and cTnI content were elevating at 2-6 h of onset and reaching the peak at 24 h. Conclusion: miR-19a/b expression was up-regulated by myocardial ischemia reperfusion in H9c2 cells, PTEN was the potential target gene of miR-19a/b. Circulating miR-19a/b might be used as a new non-invasive biological marker for myocardial ischemia R/I diagnosis.

The application of test-driven methods in clinical immunology course can arouse students'interest,and give full play of their go-aheadism and creativity.Test-driven teaching methods surpasses the traditional teaching methods.

Objective To study the mechanism of chemotherapy resistance caused by interleukin-6 (IL-6) in ovarian cancer cells and its related signal pathways. Methods Ovarian cancer cell lines A2780(IL-6 receptor positive, while non-IL-6-expressing and cisplatin/paclitaxel-responsive) and SKOV3 cell lines( overexpressing of IL-6 receptor and IL-6 and cisplatin/paclitaxel-resistant) were suitable models for this study. The effect of exogenous (a short period of treatment with recombination IL-6) and endogenous IL-6(by transfecting with plasmid encoding for sense IL-6 ) in A2780 cells or deleting of endogenous IL-6expression in SKOV3 cells (by transfecting with plasmid encoding for antisense IL-6) on the sensitivity to cisplatin and paclitaxel was investigated. Meanwhile, the mechanism of chemotherapy resistance caused by IL-6 in ovarian cancer cells and its related signal pathways were also analyzed. Results We found that both exogenous and endogenous IL-6 induce cisplatin and paclitaxel resistance in non-IL-6-expressing A2780 cells (the resistance multiple to cisplatin and paclitaxel was: exogenous, 6. 25 and 7.31; endogenous, 7. 13 -8. 34 and 7. 61 - 10. 70), while deleting of endogenous IL-6 expression in IL-6-overexpressing SKOV3 cells promotes its sensitivity to anticancer drugs ( the resistance multiple to cisplatin and paclitaxel was 0. 15 and 0. 10, 0. 10 and 0. 08). IL-6 significantly up-regulated the expression levels of mRNA and protein of drug resistance-associated genes, MDR1 and GST-π, and apoptosis-inhibiting genes, bcl-2, bcl-xL and XIAP in a dose-dependent manner in A2780 cells. In accordance with this finding, the mRNA and protein levels of MDR1 and GST-π enhanced in sense IL-6-transfected A2780 cells, and reduced in antisense IL-6-transfected SKOV3 cells compared with the corresponding parental and control vector-transfected cells, which had no difference. It was found that PD98059 [ mitogen-activated protein kinase-extracellular signalregulated kinase (MEK) inhibitor ] and wortmannin [ phosphatidylinositol 3-kinase (PI3K) inhibitor ]significantly antagonized IL-6-induced phosphorylation of extracellular signal-regulated kinase ( ERK ) and protein kinase B (Akt), respectively, and both of them blocked IL-6-induced cisplatin and paclitaxel resistance and the inhibitory effects of PD98059 and wortmannin were dependent on its concentration.Conclusions These data suggest that IL-6-induced chemoresistance may be associated with increase of both drug resistance-associated genes ( MDR1 and GST-π) and apoptosis-inhibiting genes ( bcl-2, bcl-xL and XIAP), and activation of MEK/ERK and PL3K/Akt. Therefore, modulation of IL-6 expression or its related signaling pathway may be a promising strategy of treatment for drug-resistant ovarian cancer.

Objective:To analyze the modifiable risk factors for early-onset Alzheimer's disease (EOAD), and provide evidence for primary prevention of EOAD.Methods:Forty patients with EOAD, admitted to our hospital from January 2015 to April 2020, were selected as EOAD group, and 120 healthy controls accepted physical examination and matched with EOAD patients in age, gender and education level were selected. Demographic characteristics and clinical data of patients from the EOAD group and subjects from the control group were compared retrospectively, and multivariate Logistic regression was used to analyze the independent risk factors for onset of EOAD.Results:As compared with the control group, the EOAD group had significantly higher proportion of patients with hypertension, non-traumatic tooth loosening or loss, history of traumatic brain injury, hearing impairment, chronic stress and/or anxiety, and sleep disorder ( P<0.05). The results of multivariate Logistic regression analysis showed that hypertension ( OR=4.559, 95%CI=1.523-13.643, P=0.007), non-traumatic loss or loosing of tooth ( OR=5.345, 95%CI=1.989-14.346, P=0.001), hearing impairment ( OR=9.336, 95%CI=2.033-27.850, P=0.000), chronic stress and/or anxiety ( OR=7.375, 95%CI=2.612-20.822, P=0.000), and sleep disorder ( OR=4.875, 95%CI=1.520-15.625, P=0.002) were independent risk factors for onset of EOAD. Conclusion:Hypertension, non-traumatic loss or loosing of tooth, hearing impairment, chronic stress and/or anxiety, and sleep disorders are risk factors for onset of EOAD; the screening and intervention of these risk factors can be used as a primary prevention strategy for EOAD.

Objective To analyze the prevalence, annual trends, and co-morbidity trends of common chronic diseases among workers in a large automotive industry from 2019 to 2021, and to provide a scientific basis for the health management of workers in the automotive industry. Methods The health examination data of workers in a large automotive industry from 2019-2021 were analyzed. Trends in the prevalence of chronic diseases and co-morbidities were analyzed using Join Point software and trend χ² test. Results The prevalence of metabolic syndrome, hyperuricemia, and fatty liver in the 2019 – 2021 health checkups of workers in this enterprise increased at an average rate of 9.27%, 11.35%, and 3.99% per year, respectively. The prevalence of metabolic syndrome, hyperuricemia, and fatty liver in male workers showed an increasing trend at an average rate of 7.05%, 9.25%, and 2.91% per year, respectively. The prevalence of metabolic syndrome in female workers showed an increasing trend at an average rate of 20.76% per year. The prevalence of metabolic syndrome, hyperuricemia and fatty liver was on the rise in the age groups ≤ 29 years old and 40 – 49 years old. The proportion of metabolic syndrome and its co-morbidity with one or two common chronic diseases showed an increasing trend. Conclusion The prevalence and co-morbidity of common chronic diseases in this enterprise are generally on the rise. The enterprise should focus on health education and preventive care for chronic diseases among workers aged ≤ 29 and 40 – 49 years old and male workers and control the annual increasing trend of metabolic syndrome among female workers and workers in the age group ≤ 29 years.

BACKGROUND: Coronary artery disease (CAD) is the commonest cause of heart failure (HF), whereas pulmonary hypertension (PH) has not been established or reported in this patient population. Therefore, we assessed the prevalence, risk factors, and survival in CAD-associated HF (CAD-HF) complicated with PH. METHODS: Symptomatic CAD-HF patients were continuously enrolled in this prospective, multicenter registry study. Echocardiography, coronary arteriography, left and right heart catheterization (RHC), and other baseline clinical data were recorded. Patients were followed up and their survival was recorded. RESULTS: One hundred and eighty-two CAD-HF patients were enrolled, including 142 with HF with a preserved ejection fraction (heart failure with preserved ejection fraction [HFpEF]; left ventricular ejection fraction [LVEF] ≥50%) and 40 with a reduced ejection fraction (heart failure with reduced ejection fraction [HFrEF]; LVEF < 50%). PH was diagnosed with RHC in 77.5% of patients. Patients with PH showed worse hemodynamic parameters and higher mortality. HFrEF-PH patients had worse survival than HFpEF-PH patients. CAD-HF patients with an enlarged left ventricular end-diastolic diameter and reduced hemoglobin were at higher risk of PH. Nitrate treatment reduced the risk of PH. Elevated creatinine and mean pulmonary arterial pressure (mPAP), diastolic pressure gradient (DPG) ≥7 mmHg, and previous myocardial infarction (MI) entailed a higher risk of mortality in CAD-HF patients with PH. CONCLUSIONS: PH is common in CAD-HF and worsens the hemodynamics and survival in these patients. Left ventricle enlargement and anemia increase the risk of PH in CAD-HF. Patients may benefit from nitrate medications. Renal impairment, elevated mPAP, DPG ≥7 mmHg, and previous MI are strong predictors of mortality in CAD-HF-PH patients. TRIAL REGISTRATION ClinicalTrials.gov, NCT02164526.
Coronary Artery Disease/epidemiology* ; Creatinine ; Heart Failure/complications* ; Humans ; Hypertension, Pulmonary/complications* ; Nitrates ; Prevalence ; Prognosis ; Prospective Studies ; Registries ; Risk Factors ; Stroke Volume ; Ventricular Function, Left