Totally, 125 elderly inpatients with aspiration pneumonia (AP) were enrolled from departments of respiratory medicine and neurology at Zhongnan Hospital, Wuhan during June 2005 to October 2009 for analysis. Results showed that listlessness was manifested in 70 cases (56%), primary neurological illness in 80 cases (64%), 57 of them (46%) complicated with respiratory failure and 26 died with case-fatality of 21%. Main pathogen for them was Gram-negative bacillus, accounting for 57% of the total. Two kinds or more of antibiotics had ever been administered in 98 cases (78%), with an average length of antibiotics use for 28 days, ranging from one day to 128 days. Nasal feeding was instituted for those with choking over their feeding and coughing, and their inspired feeding was aspirated from the trachea or bronchi and lavished with bronchoscopy, with 38 cases by tracheal intubation, 26 by tracheotomy and 42 with artificial ventilation. Their average duration of hospital stay spanned 28 days with an average cost of 25 000 RMB yuan per capita, significantly higher than that for those with common pneumonia. In conclusion, clinical features of these elderly patients with AP were not so typical, most of them manifest severe, with lots of medical cost and bad prognosis.

Objective To explore the impact of short-term meditation on ego-depletion in college students.Methods Sixty college students without any meditation and mental calculation experience were recruited voluntarily,and were allocated randomly and equally into three groups: the control group,the rest group,and the meditation group(n=20 in each group).Participants completed the positive affect and negative affect scale and the first handgrip test.A difficult mental calculation task was used to induce ego depletion.After that,the control group performed the second handgrip test immediately,and the rest group had a 5-min break,while the meditation group had a 5-min meditation practice following a meditation audio.Participants then reported the task difficulty and the impulse to write down intermediate answers during the mental calculation task.They also finished the positive and negative affect scale again.The task difficulty and impulse scores,the number of response items and correct items,the change of the handgrip time and the mood between pretest and posttest were compared among three groups.Results There were no differences in the task difficulty score,the impulse score,the number of response items and correct items among the three groups (all P>0.05).The handgrip time was shorter in posttest ((71.91±24.58) s) than in pretest ((91.39±37.63) s) in the control group (P<0.05).The handgrip time was also shorter in posttest ((81.75±25.77) s) than in pretest ((97.88±33.77) s) in the rest group (P<0.05).However,the difference between the handgrip time in posttest ((82.21±34.63) s) and in pretest ((83.11±42.45) s) was not significant in the meditation group (P>0.05).There were no differences in the change of positive and negative affect between pretest and posttest (all P>0.05).Conclusions hort-term meditation buffers ego depletion in college students,which cannot be attributed to affect.

Objective:To explore whether implicit priming of self-awareness can prevent self-control depletion.Methods:Totally 60 college students volunteers were recruited,and were allocated pseudo-randomly and equally into the control group,the non-self-awareness priming group,and the self-awareness priming group,20 volunteers in each group.The scrambled sentence task was applied in implicit priming,the mental calculation task was used to induce self-control depletion indexed by task difficulty,the impulse to write down the intermediate answers,the number of response items and correct items,the handgrip test was used to measure self-control performance,and the Positive Affect and Negative Affect Scale (PANAS) was used to measure affect.The self-control depletion,the handgrip time and the PANAS scores were compared among three groups.Results:There was no significant difference in task difficulty score,impulse score,the number of response items and correct items among the three groups (Ps ＞0.05).The group differences of the change of positive and negative affect before and after depletion were also not significant (Ps ＞0.05).After controlling the effect of the first handgrip time before depletion,the difference of the handgrip time after depletion between the control group and the non-self-awareness priming group was not significant (P ＞ 0.05).However,the handgrip time in the controI group and in the non-self-awareness group were both shorter than that in the self-awareness priming group [(69.2 ± 3.6) s,(71.1 ± 3.6) s vs.(81.9 ± 3.6) s,Ps ＜0.05].Conclusions:It suggests that implicit priming of self-awareness might hold promise in preventing self-control depletion.

Objective To summarize the clinical experience of combined liver and kidney transplantation (CLKT). Methods CLKT was performed on 22 patients. The orthotopic liver transplantation (LT) was preceded with the classic fashion in 10 patients and piggyback fashion in 12 patients. The renal allograft was implanted to the iliac fossa routinely. After operation, the patients received an induction therapy with anti-CD25 monoclonal antibody or antithymocyte globulin ( ATG) and a maintenance therapy with tacrolimus (Tac), mycophenolate mofetil and prednisone. Results The CLKT was successfully performed on all 22 patients, and the graft function was restored well postoperation. During the perioperative period, an acute rejection episode of liver occurred in one patient and acute renal allograft rejection episode in 2 patients. The Tac toxicity occurred in one patient. The hemorrhage of digestive tract occurred in one recipient and the hemorrhage of peritoneal cavity in one patient. The pleural effusion occurred in 6 recipients. The pneumonia occurred in 2 cases and the peritoneal infection in one patient During a follow-up period of 6 months to 7 years 11 months, three patients died because of cytomegalovirus pneumonia in 2 patients and acute myocardial infarction in, one patient, The 1-, 3-, 5-year survival rate of recipients was 86,4 %, 81.3 %, 72.7 % respectively. Conclusion The CLKT is an effective method for treatment of patients with end-stage liver djsease and chronic renal failure.

Objective To investigate a possible association of donor-recipient compatibility for ABO blood group alleles with acute rejection (AR) in renal transplantation. Methods A study comprising 87 pairs of donor and recipient was performed. The ABO genotype A1, A2, O1, O2, and B alleles of renal transplanted recipients and their respective donors were assessed by PCR amplification with sequence-specific primers (PCR-SSP). Accordingly, recipients were divided into donor-recipient ABO genotype matched and mismatched groups. Results The PCR-SSP based types of all cases showed total concordance with their serologically assigned ABO groups. Fifty pairs (57. 5%) were matched for ABO genotype among the 87 pairs of donor and recipient while 37 (42. 5%) were mismatched, including 1 allele mismatch in 31 pairs (83.8%), 2 alleles mismatches in 6 pairs (16. 2%).The incidence of AR was 12.0% (6 cases) and 29. 7% (11 cases) for ABO genotype matched and mismatched transplant patients, respectively ( P ＜ 0.05). After high dose methylprednisolone (MP)treatment, all cases exepienced reversion of AR except a A2O1 recipient receiving kidney from a A1O1enced 4 AR episodes within 3-10 months, and the period of AR was gradually shortened. After high dose MP was administered empirically, even though short-term improvement of renal function was observed, the serum creatinine continued to increase progressively with decreased efficacy of high dose MP. One year after operation the serum creatinine rose to 441 μmol/L. Conclusions Simultaneous definition of the ABO genotype and HLA is highly feasible. The A2 patient is suitable for receiving kidneys from blood group O donors. DNA mismatch for ABO genotype of renal transplant recipients and their respective donors is an independent risk factor for AR. Genotyping of ABO blood group is conducive to prevent AR.

Fifty-six patients diagnosed as early stage lung cancer by spiral CT scan,underwent CTguided percutaneous transthoracic biopsy with a successful rate of 100%.Forty nice cases were confirmed pathologically including adenocarcinoma in 30 cases,squamous carcinoma in 14,alveolar cell carcinoma in 2 and small cell lung cancer in 3.Three cases were diagnosed as chronic inflammatory lesion,2 cases as tuberculosis and the diagnosis was not confirmed in 2 cases.The results suggest that CT-guided percutaneous transthoracic biopsy is an effective diagnostic measure for patients with stage Ⅰ-Ⅱ lung cancer.

Objective To study the influential factors of tacrolimus'dosage and concentration differences between individuals in morning periods after renal transplantation.Methods The clinical data consisted of 118 receptors in morning periods after renal transplantation,whose immune suppressions were tacrolimus,mycophenolate and hormone.At 3,7,14 and 30 d after operation,all the receptors'weight,dosage of tacrolimus,dosage of hormone,diarrhea,blood fat,liver function,renal function,albumn and erythrocrit were recorded respectively,and at the same time their concentrations of tacrolimus and genetic polymorphisms of CYP3A5,MDRl 3435,MDR1 2677 and MDRl 1236 weredetected.Multiple linear regressions were performed.Results The fitting degrees of stepwise regression equations were low.At 3,7,14 and 30 d after operation,the adjusted R2was 0.284,0.267,0.417 and 0.324,respectively.From the aspect of pharmacogenomics,the main factors rela-ted to the differences of tacrolimus'dosage and concentration included MDR1 2677,MDRl 1236 and MDR13435,which varied intensively.Age,albumn,renal function,blood fat and liver function were important factors too.Conclusions The main reasons of the differences of tacrolimus'dosage and concentration between individuals in morning periods after renal transplantation are medicines and changes of internal environment after operation.The genetic polymorphisms of MDR1,age,albumn,renal runetion.blood fat and liver function are important factors too.

Expressions of interleukin-6 (IL-6) and its receptor (gp80、gp130) in 8 patients with Graves' disease (GD) were compared with those in 8 euthyroid patients with nodular goiter or benign thyroid adenoma. The thyroid tissues of GD expressed significantly higher IL-6 mRNA, gp130 mRNA and IL-6 protein than those of the control group, suggesting that activated IL-6/gp130 signal pathway in the thyroid tissue may contribute to the pathogenesis of GD.

Objective To analyze the MP infection status in children with respiratory tract disease and the correlation with gen‐der ,age ,season and clinical conditions .Methods To investigate the clinical data retrospectively of 655 children with respiratory tract infection from January to December 2013 .Results The positive rate of MP antibody was 48 .09% with a higher incidence in girls than boys ,and those above 3 were more susceptible to it .Winter and spring were the peak seasons .The older group had a higher positive rate of MP antibody ,together with high morbidity of MPP and LP ,the differences were statistically significant (P<0 .05) ,while the younger group was inclined to get higher WBC count and percentage of increasing CRP and neutrophils ,the differ‐ences were statistically significant(P<0 .05) .Conclusion MP is a common pathogenic bacteria causes respiratory tract infection in children above 3 years ,especially in winter and spring .The antibody positive rate rise with age and the infected children are more likely to have pneumonia meanwhile the younger group has higher WBC count ,in which more cases get higher level of CRP and neutrophils .

Objective To explore the impact of induction therapy with anti-lymphocyte agents on long-term survival of kidney transplantation.Methods 271 recipients of first cadaveric kidney transplants were treated with tacrolimus,mycophenolate mofetil and prednisone.110 patients of them received induction therapy with anti-thymocyte globulin(ATG group),88 patients received Basiliximab(Bax group),and the remaining 73 patients did not receive induction therapy(control group).The data of AR,DGF,CMV infection,and 1- 3- 5-year patient/allograft survival rate in three groups were retrospectively during a follow-up period of 1 to 5 years postoperatively.Results Within 6 months after operation,the incidence of AR in control group,ATG group and Bax group was 17.8 %(13/73),9.1 %(10/110)and 10.2 %(9/88)respectively.The incidence of AR in ATG group and Bax group was significantly lower than in control group (P<0.05).There was no significant difference in incidence of DGF and CMV infection among three groups.The 1-,3- and 5-year allograft survival rate postoperation in ATG group and Bax group was 95.5 %,90.9 %,87.3 % and 93.2 %,87.5 %,83.8 % respectively,which was significantly higher than in control group(87.7 %,80.8 % and 75.3 %,P<0.05).Conclusion Induction therapy with anti-lymphocyte agents may reduce the early incidence of AR and prolong long-term allograft survival significantly.