Alloys ; toxicity ; Cobalt ; toxicity ; Humans ; Lung Diseases ; chemically induced ; Tungsten ; toxicity

OBJECTIVE To investigate the distribution and antibiotic resistance of nonfermenting gram-negative bacilli isolated from lower respiratory tract infection patients from 2003 to 2007 for rational antimicrobial therapy in practice.METHODS The data of distribution and antibiotic resistance of nonfermenting gram-negative bacilli isolated from sputum samples of lower respiratory tract infection in our hospital from 2003 to 2007 were retrospectively analysed.RESULTS The most predominant nonfermenting gram-negative bacilli isolates were Pseudomonas aeruginosa,Acinetobacter baumannii,Acinetobacter lwoffii and Stenotrophomonas maltophilia.From 2003 to 2007,the resistance rates of these isolates to 15 antibiotics increased,especially P.aeruginosa to ceftazidime.The resistance changed from 30.2% in 2003 to 55.4% in 2005,54.8% in 2006,and reduced to 41.5% in 2007.The resistance to gentamicin,imipenem,netilmicin,ticarcillin and tobramycin varied in the similar way.The resistance of A.baumannii to imipenem increased from 21.1% to 59.7% within the five years.The resistance rate of A.lwoffi was still relatively low.S.maltophilis isolates were highly multi-resistant to antimicrobial agents tested with a rate ranging from 61.9%-100.0% except ceftazidime,ticarcillin and trimethoprim-sulfamethoxazole.CONCLUSIONS P.aeruginosa,A.baumanii and S.maltophilia are the main nonfermentive pathogens of lower respiratory tract infections and not susceptive to many antibiotics.The tendency of susceptibility and distribution changes of those bacteria should be considered in practice for proper antimicrobial therapy.

Recent studies have shown that changes in the form and color of sublingual collaterals were related to diabetes. And the changes of sublingual collaterals have certain clinical value in judging the condition, stage, treatment and prognosis of diabetes. This article summarized the research progress of sublingual collaterals from two aspects: the relationship between sublingual collaterals and diabetes mellitus and laboratory indexes, and the modern science and technology.

OBJECTIVETo carry out genetic testing for a family affected with pulmonary hypertension (PH) as the initial sign of hereditary hemorrhagic telangiectasia (HHT).

METHODSHigh throughput sequencing was performed to detect potential mutation in the coding regions of endoglin (ENG), activin receptor-like kinase 1 (ACVRL1) and mothers against decapentaplegic homolog 4 (SMAD4) genes.

RESULTSA pathogenic heterozygous c.814C>T (p.Gln272Ter) mutation of the ACVRL1 gene was identified in the proband. Her mother and two sons have carried the same mutation.

CONCLUSIONThe c.814C>T (p.Gln272Ter) mutation of the ACVRL1 gene probably underlies the disease in this family. Genetic testing should be recommended to HHT patient, in particular those with pulmonary hypertension.

Activin Receptors, Type II ; genetics ; Child ; Endoglin ; genetics ; Female ; Genetic Testing ; High-Throughput Nucleotide Sequencing ; Humans ; Hypertension, Pulmonary ; etiology ; genetics ; Male ; Middle Aged ; Mutation ; Telangiectasia, Hereditary Hemorrhagic ; complications

Objective: To investigate the etiology, clinical features, treatment and outcome of nephrotic syndrome associated with chronic mercury poisoning. Methods: From June 2013 to April 2018, Beijing Chaoyang Hospital, Capital Medical University received 33 patients with chronic mercury-neutral nephrotic syndrome. The clinical manifestations, laboratory tests, treatment methods, and outcomes were analyzed. Results: Among the 33 patients, 27 patients had mercury exposure due to daily-life contact and the other 6 patients were caused by iatrogenic mercury. The symptom was characterized by typical nephrotic syndrome such as lower extremity edema and proteinuria at first onset. The treatment was based on mercury-removing treatment, 19 cases were treated with mercury removal alone, 16 cases were completely relieved; 10 cases were treated with mercury removal and glucocorticoids, all of which were completely relieved; 4 cases were treated with mercury removal, glucocorticoids and immunosuppressive agents, all complete remission; clinical complete remission rate is about 90.9% (30 cases in total) . Urinary mercury levels decreased the fastest between the first and second courses of mercury treatment, but the total amount of urine protein increased. As the amount of urinary mercury excreted increased, the total amount of urine protein decreased gradually (Z=2.86, P<0.01) . Conclusion The clinical features of chronic mercury-induced nephrotic syndrome are non-specific, easy to be misdiagnosed and missed. The treatment is mainly treated with mercury removal treatment. The prognosis is good. In severe cases, glucocorticoid therapy can be supplemented.

Objective:To explore the clinical charecteristics, imaging features, therapy and prognosis of stroke in children, and provide help for clinical treatment.Methods:The clinical data of 49 children with stroke were collectedand retrospectively analyzed in the Children′s Hospital of Soochow University from January 1, 2019 to December 31, 2019.Results:A mong the 49 children with stroke, 35 were male and 14 were female, aged 1-178 (65.69 ± 55.22) months; the specific etiologies were cerebrovascular malformation, craniocerebral trauma, tumor, vitamin K deficiencies, infectious diseases, rheumatic immune diseases, hemophilia and congenital heart disease. The first symptoms of stroke were disturbance of consciousness, hemiplegia, convulsions, vomiting and headache. The arterial ischemic stroke (18 cases) were mainly caused by craniocerebral trauma and cerebrovascular malformation. The hemorrhagic stroke (31 cases) were mainly caused by arteriovenous malformation, vitamin K deficiency and tumor. The surgical rate in the arterial stroke group was significantly lower than that in the hemorrhagic stroke group.Conclusions:Traumatic cerebral infarction and intracranial arteriovenous malformation are the main causes of arterial ischemic stroke and hemorrhagic stroke in children. Early diagnosis and treatment can significantly improve prognosis.

ObjectiveTo investigate the effects of Fangji Fulingtang on macrophage polarization and oxidative stress in the mouse model of myocardial fibrosis. MethodThe mouse model of myocardial fibrosis was established by subcutaneous injection of isoproterenol （ISO， 5 mg·kg^-1·d^-1）. Fifty C57BL/6J mice were randomly assigned into control （0.9% NaCl）， model （0.9% NaCl）， low- and high-dose （3.315 g·kg^-1·d^-1 and 13.26 g·kg^-1·d^-1， respectively） Fangji Fulingtang （FFD-L and FFD-H， respectively）， and metoprolol tartrate （Meto， 15 mg·kg^-1·d^-1） groups， with 10 mice each group. After 2 weeks of treatment， the heart appearance， cardiac weight index （CWI）， heart weight （HW）/tibia length （TL） ratio， and myocardial histopathological alterations were observed. Meanwhile， the serum levels of creatine kinase-MB （CK-MB）， transforming growth factor-β₁ （TGF-β₁）， tumor necrosis factor-α （TNF-α）， interleukin （IL）-1β， IL-6， IL-10， malondialdehyde （MDA）， superoxide dismutase （SOD）， and glutathione （GSH） were measured by enzyme-linked immunosorbent assay （ELISA）. The expression levels of CD86 and CD206 were observed by immunohistochemical staining. ResultCompared with the model group， the FFD-L， FFD-H， and Meto groups showed improved heart appearance， decreased CWI and HW/TL ratio （P<0.01）， lowered serum levels of CK-MB， TGF-β₁， TNF-α， IL-1β， and IL-6 （P<0.05， P<0.01）， and elevated IL-10 level （P<0.05）. Furthermore， the three groups showed reduced infiltration of inflammatory cells， myocardial injury， collagen deposition， and myocardial fibrosis， decreased CD86， SOD， and GSH （P<0.01）， and increased CD206 and MDA （P<0.01）. ConclusionFangji Fulingtang can mitigate ISO-induced myocardial fibrosis by regulating macrophage polarization and oxidative stress.

Objective To investigate the characteristics of lung function in the patients with asbestosis of different stages,and analyze the correlations between the puhnonary function values and imaging score of chest X-ray.Methods A cohort of newly diagnosed 249 asbestosis patients over a period of eight years in a single center were evaluated.Clinical data were colleeted from clinical charts.Radiographs were reviewed by the experts blinded to clinical data.The asbestosis patieuts were classified into Ⅰ to Ⅲ stages by chest X-ray according to the guideline.The correlations between the pulmonary function values and imaging score of chest Xray were aualyzed.Results The prevalence of stage Ⅰ to Ⅲ in this asbestosis cohort was 73.5％,19.3％ and 7.2％ respectively.With the stages iucreasing,the patients' forced vital capacity (FVC),total lung capacity (TLC),total carbon nonoxide diflitsion capacity (DLCO) predicted values were all reduced showing the restrictive ventilation impairment and/or gas exchange barrier.The obstruction of the small respiratory tracts was detected in the asbestosis of all the different stages.According to the small shadow density of each lung area,chest small shadow density score had a siguifieant negative correlation with FVC,TLC or DLCO predicted values respectively (all P＜O.01).Conclusion The patients with asbestosis of different stages had varying degrees of gas exchange impairment,small airway dysfunction with or without ventilation dysfunction.The decreasing of DLCO was earlier than lung volume change.Chest X-ray image score paralleled the decline of lung function values,reflecting the severity of the disease.

Objective To investigate the characteristics of lung function in the patients with asbestosis of different stages,and analyze the correlations between the puhnonary function values and imaging score of chest X-ray.Methods A cohort of newly diagnosed 249 asbestosis patients over a period of eight years in a single center were evaluated.Clinical data were colleeted from clinical charts.Radiographs were reviewed by the experts blinded to clinical data.The asbestosis patieuts were classified into Ⅰ to Ⅲ stages by chest X-ray according to the guideline.The correlations between the pulmonary function values and imaging score of chest Xray were aualyzed.Results The prevalence of stage Ⅰ to Ⅲ in this asbestosis cohort was 73.5％,19.3％ and 7.2％ respectively.With the stages iucreasing,the patients' forced vital capacity (FVC),total lung capacity (TLC),total carbon nonoxide diflitsion capacity (DLCO) predicted values were all reduced showing the restrictive ventilation impairment and/or gas exchange barrier.The obstruction of the small respiratory tracts was detected in the asbestosis of all the different stages.According to the small shadow density of each lung area,chest small shadow density score had a siguifieant negative correlation with FVC,TLC or DLCO predicted values respectively (all P＜O.01).Conclusion The patients with asbestosis of different stages had varying degrees of gas exchange impairment,small airway dysfunction with or without ventilation dysfunction.The decreasing of DLCO was earlier than lung volume change.Chest X-ray image score paralleled the decline of lung function values,reflecting the severity of the disease.

Objective:To analyze the correlation between peripheral blood eosinophil (EOS) level and clinical characteristics of patients with pneumoconiosis complicated with chronic obstructive pulmonary disease (COPD) .Methods:From January 2007 to November 2020, newly diagnosed patients with pneumoconiosis complicated with COPD in Beijing Chaoyang Hospital, were retrospectively analyzed. These patients were stratified into EOS<100 cells/μl group and EOS≥100 cells/μl group, taking 100 cells/μl as the cut-off value. Demographic characteristics, clinical symptoms, lung function and laboratory indexes were compared between the two groups.Results:The median EOS count of patients with pneumoconiosis complicated with COPD was 100 (40, 180) cells/μl. 50.2% (160/319) had blood eosinophil counts ≥100 cells/μl, and 11.0% (35/319) had blood eosinophil counts ≥300 cells/μl. In comparison with EOS<100 cells/μl group, EOS≥100 cells/μl group were older ( P=0.035), had higher body mass index ( P=0.008), and had lower forced respiratory volume in the first second ( P=0.017), had higher the ratio of residual volume to total lung volume ( P=0.010), and had lower diffusing capacity of the lung for carbon monoxide ( P=0.008). Arterial partial pressure of oxygen was significantly reduced in EOS≥100 cells/μl group ( P=0.039). The peripheral blood EOS count was negatively correlated with forced vital capacity, forced breathing volume in the first second, carbon monoxide diffusion, peak expiratory flow, and maximum mid expiratory flow as a percentage of expected values ( rs=-0.22, -0.18, -0.19, -0.19, -0.19, P=0.000, 0.001, 0.003, 0.008, 0.002), and positively correlated with the ratio of residual air volume to total lung volume ( rs=0.17, P=0.002) . Conclusion:There was a correlation between blood EOS count and pulmonary function parameters, can proide reference for the diagnosis and treatment of chnoric obstuctive pulmmory disease in clinical practice.