Objective To investigate the roles of fiberoptic bronchoscopy in diagnosis and treatment for infants with refractory and persistent wheezing. Methods From Jun. 2012 to Dec. 2013, 52 hospitalized children with age between four 4 months and 1 year old were recruited for ifberoptic bronchoscopy, who had been wheezing for at least four weeks and treated ineffectively with conventional anti-inlfammatory agents:budesonide and compound ipratropium bromide solution. Then, the pathogenesis of refractory and persistent wheezing was summarized based on clinical features, detection of CT imaging of three-dimensional airway reconstruction and cardiac CT, results of bronchoscopy inspection, and bronchoalveolar lavage lfuid culture. Results Among the 52 cases, 40 were with ground glass-like changes (76.92%) in pulmonary spiral CT testing, 4 with mosaic perfusion syndrome (7.69%), 8 with segmental pulmonary consolidation (15.38%), 8 with obstructive pulmonary emphysema (15.38%), and 1 with left primary bronchial foreign body. In addition, through bronchofibroscopy, there were 52 cases with imlfammation (100%),3 with tracheal stenosis (5.77%), 3 with left and/or right main bronchus stenosis of the external pressure, 18 with bronchomalacia(34.62%), 2 cases with foreign body (3.84%), one in trachea (1.92%), the other in left main bronchus (1.92%), 10 with bronchial mucus plug (19.23%), and 8 (15.38%) with congenital airway malformations (including 3 at tracheal bronchus, 1 at left upper lobe bronchial stenosis and 1 at bronchial Bridge). The culture of bronchoalveolar lavage lfuid were conducted for all patients. The positive rate of bronchoalveolar lavage lfuid was 9.62%(5/52 cases), including 2 cases with tip Escherichia coli, 2 with Haemophilus inlfuenzae, and 1 with Acinetobacter baumannii. Conclusions First, infection is the primary cause of refractory and persistent wheezing, which is persistent in airway resulted from multi-drug resistant bacteriua. Second, refractory and persistent wheezing is often caused by multi-factors including infection, congenital airway malformations, the endogenous and exogenous foreign body, cardiovascular malformation, etc. These factors often lead to dififcult wheezing control. The last, the diagnosis rate of the refractory and persistent wheezing can be improved by combination of ifberoptic bronchoscopy and lung spiral CT.

Objective To reach digitization of medical imaging equipment,the medical equipments were improved that have not yet equipped with digital image processing workstation system. Methods Under the premise of ensuring the stability,convenience and better cost-effective of medical image processing workstation system,the appropriate medical imaging workstation system software and hardware were selected and configured. Results Through transformation,configuration and integration,the new function of original equipment has been achieved for the desired results. Conclusion The use of the system about one year proves well economic effect and good society benefit.

Objective To investigate the impact of enhanced recovery after surgery (ERAS) program on postoperative recovery in patients undergoing laparoscopic colorectal resection. Methods Eighty-four patients undergoing laparoscopic colorectal resection from March 201 5 to June 201 6 (55 males,29 females,aged 36-78 years,ASA physical status Ⅰ or Ⅱ),were randomly divid-ed into two groups (n = 38 each).Patients in group E were received epidural block combined with general anesthesia,and a series of perfect ERAS strategies,such as strengthen preoperative educa-tion, maintaining perioperative normothermia, perioperative goal-directed fluid therapy, intraoperative and postoperative analgesia.While the patients in group C received routine anesthetic management.The volume of fluid,the nasopharyngeal temperature,the time of recovery of bouel sound,first anal exhaust,eating fluid food,ambulation and remove of the catheter were recorded in two groups.Furthermore,time of PACU after surgery,the total days of hospitalization and total hos-pital costs were recorded.Results The volume of fluid [(1 328 ± 64)ml vs.(2 463 ± 135 )ml]in group E were significantly lower than group C (P <0.05),the nasopharyngeal temperature [(36.2± 0.2)℃ vs.(35.1±0.5)℃]was significantly higher in group E (P <0.05).Compared with group C,the time of recovery of bowel sound [(33.4 ± 12.5 )h vs.(42.8 ± 14.3 )h],first anal exhaust [(43.6±13.9)h vs.(60.7±1 5.4)h],eating fluid food [(26.8±4.1)h vs.(67.4±13.5)h],first ambulation [(7.4±1.6)h vs.(26.5±3.8)h]and remove of the catheter [(29.2±6.1)h vs.(5 1.8 ±7.6) h ], time of PACU [(26.4 ± 8.5 ) min vs.(37.2 ± 1 1.6 ) min ], the total days of hospitalization [(7.5±0.9)d vs.(9.7±1.2)d]were significantly shorter (P <0.05),and hospital costs [(2.1±0.6)ten thousand yuan vs.(2.6±0.8)ten thousand yuan]were significantly decreased (P <0.05).The incidence of adverse reactions such as nausea and vomiting (2.4% vs.21.4%),pru-ritus (7.1% vs.23.8%),agitation (4.8% vs.26.2%)and chills (0% vs.1 9.0%)were significantly lower in group E (P <0.05).Conclusion ERAS program applied to patients undergoing laparoscopic colorectal resection can reduce the intraoperative sufentanil consumption,avoid the occurrence of postoperative hypothermia, accelerate recovery of gastrointestinal function, which can obviously reduce the hospitalization costs and shorten the hospitalization time.

OBJECTIVE To isolate bacteria from three second-class hospitals in Zhenjiang Jiangsu Provine,to detect their drug(-resistance) to antibacterial(agents) and analyzed the results in order to find out pathogen distribution and drug(-resistance) trend of the common causative organism.METHODS We isolated 1661 strains of bacteria from clinical samples between 2002 and 2004,and analyze their drug-resistance.RESULTS The number of Gram-positive(bacteria) was 634,accounting for 38.2%,from them there were 312 strains of coagulase-negative Staphylococcus epidermidis,and 148(coagulase)-positive S.aureus.Drug-fast of two above staphylococci was similar.The(resistance) rate to penicillin and to oxacillin surpassed 85%,that to erythromycins exceeded 75%,to quinolones and cephalosporins surpassed 30% and 35%,respectively.The resistance rate to(vancomycin) was zero.Gram-(negative) bacteria were 1 027 strains,accounted for 61.8%.(According) to quantity order,the first was Enterobacter(249 strains);then were Klebsiella(226 strains);Escherichia(167 strains);Pseudomonas aeruginosa(136 strains);and Proteus(62 strains).The resistant rate to semisyhthesized penicillins among the first five Gram-(negative) bacteria species,was the most,especially the Proteus.CONCLUSIONS Clinical doctors,the(laboratorians) and detecting infection department in hospital should markedly pay attention to drug-resistant(bacterium) detection,pathogen mutation and drug-resistance trend,in(order) to reasonably use antibacterial(agents).

Objective To study the prognosis in the patients with distant metastasis after nasopharyngeal carcinoma radical radiotherapy and to analyze its influencing factors .Methods One hundred and fifty patients with distant metastasis after nasopha-ryngeal carcinoma radical radiotherapy were followed up .Their clinical data were collected to conduct the prognosis analysis and in-fluencing factors analysis .Results The median survival time in the follow up cases was 13 .50 months ,the one-year survival rate was 49 .8% ,two-year survival rate was 31 .0% and three-year survival rate was 19 .3% .The Cox model single factors analysis re-sults showed that the N stage in initial diagnosis ,whether conducting chemotherapy in initial diagnosis ,time interval from radiother-apy finish to distant metastasis occurrence ,metastasis site ,chemotherapy after distant metastasis ,chemotherapy cycles and palliative radiotherapy were the prognosis related influencing factors (P<0 .05) ,in which the N stage ,metastatic site ,chemotherapy after dis-tant metastasis ,time interval from radiotherapy finish to distant metastasis occurrence and palliative radiotherapy were the inde-pendent influencing factors of prognosis(P<0 .05) .Conclusion The independent factors of prognosis in the patients with distant metastasis after nasopharyngeal carcinoma radical radiotherapy are the N stage at initial diagnosis ,metastatic site ,whether having chemotherapy after distant metastasis ,time interval from radiotherapy finish to distant metastasis occurrence and whether conduc-ting the palliative radiotherapy .

Objective To investigate the inhibitory mechanism of emodin on lipopolysaccharide(LPS)-induced nitric oxide(NO)generation in rat peritoneal macrophages.Methods NO production and iNOS expression were measured through nitrite assay and Western blotting assay,respectively.NF-kB activity and nuclei P65 expression were estimated by dual-luciferase and Western blotting assay,respectively.Intracellular free Ca2+([Ca2+]i)was detected using the ratiometric fluorescent calcium indicator dye,Fura-2,and a microspectrofluorometer.PLC-γphosporylation was analyzed by Western blotting assay.Results First,emodin was found playing active roles in suppressing LPS-induced NF-kB activation in rat peritoneal macrophages.Second,emodin down-regulated transient[Ca2*]i and could increase in NF-kB upstream signal.Finally,emodin suppressed phosphorylation of PLC-γ by LPS stimulation in the upstream of[Ca2+]i.Conclusion Suppression of PLC-γ phosphorylation is involved in emodin inhibiting NO generation by LPS stimulation in rat peritoneal macrophages.

Objective To evaluate the value of transperineal targeted biopsy with real-time fusion images of transrectal ultrasound (TRUS)and multiparametric magnetic resonance imaging (mpMRI)for the diagnosis of prostate cancer (PCa).Methods Clinical and imaging data of 62 consecutive patients suspected of PCa at the mpMRI scan and PSA>4.0 μg/L were retrospectively analyzed.Targeted biopsies (TB)were carried out for each cancer-suspicious lesion,and followed a systematic 12-core biopsy (SB) protocol.Pathological findings of TB and SB were analyzed.Results The age of the patients was (68.38± 6.57)years (range 5 1 -79 years).The preoperative PSA value was (10.21 ±5.57)μg/L (range 4.5 -30.1μg/L).Preoperative prostate volume was (34.05±9.86)ml (range 19-64 ml).The PCa patients detected by SB and/or TB were 34 (54.8%).Cancer-detected rates of SB and TB cores were 7.53% and 26.2%, respectively (P <0.001).The positive core length of SB and TB cores were (3.71 ±2.77)mm (range 1 -14 mm)and (5.00±3.04)mm (range 2-1 7 mm),respectively (P =0.016).The positive core percent of SB and TB cores were (28.77 ± 20.13 )% (range 7 - 100%)and (35.76 ± 1 8.73 )% (range 1 1 % - 100%), respectively (P =0.048).Moreover,clinically cores detected by the SB and TB for final diagnosis of PCa were 19 cores (2.6%)and 48 cores (1 8.5%),respectively (P < 0.001 ).Conclusions Transperineal TB using real-time TRUS and mpMRI fusion imaging can improve sampling quality and elevate clinically detection rate of PCa when application combined with SB.

OBJECTIVETo detect the enterotoxin genes of Staphylococcus aureus (SA) isolated from clinical specimens and analyze the correlation between enterotoxin genes and drug resistance of SA.

METHODSThe mecA gene and enterotoxin genes A-F of clinical SA isolates were identified by polymerase chain reaction (PCR), and the genes were sequenced to investigate the correlation of these genes to drug resistance.

RESULTSThe detection rate of enterotoxin genes was 100% in 67 methicillin- resistant SA (MRSA), showing no significant difference from the rate in 57 methicillin-sensitive SA (MSSA) (83.5%, χ(2)=0.203, P>0.05). Of the 116 strains carrying enterotoxin genes (93.5%), the detection rates of SEA, SEB, SEC, SED and SEF were 90.5%, 6.9%, 61.3%, 5.2%, 25.9% and 93.5%, respectively, and none of the strains were positive for SEE gene. In these strains, 78 (67.2%) carried 2 or more enterotoxin genes, and the main genotypes were SEA and SEC (33.6%), SEA and SEF (7.8%), and SEA and SEC and SEF (13.8%). Compared with the strains carrying a single enterotoxin gene, those with multiple enterotoxin genes showed a higher drug resistance rate, among which 75% of the SA strains carrying SEA+SEC+SEF were resistant to SXT, significantly higher than the rates of SA carrying SEA (28.6%) and SEA+SEC (38.7%) (P<0.05). The SA strains carrying SEA+SEC+SEF and SEA+SEF showed significantly higher amikacin resistance rates than SA strain carrying SEA (75.0%, 77.0%, 21.5%, respectively, P<0.05).

CONCLUSIONClinical isolates of SA carrying multiple enterotoxin genes have a higher drug resistance rate than those with a single enterotoxin gene, suggesting the the important role of enterotoxin in multidrug resistance.

Drug Resistance, Multiple, Bacterial ; genetics ; Enterotoxins ; genetics ; Humans ; Staphylococcal Infections ; microbiology ; Staphylococcus aureus ; drug effects ; genetics ; isolation & purification

Seventy patients with advanced non-small-cell lung cancer (NSCLC) aged 65 or above were treated with epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) erlotinib or gefitinib from February 2006 to September 2010. The efficacy and toxicities of treatment were retrospectively analyzed.The overall response rate and disease control rate were 31.4％ and 84.3％,respectively. Themedian progression-free survival time and median survival time were 8.0 months and 13.5 months,respectively(P ＜ 0.05 ). One-year survival rate was 54.3％. Response rate ( CR + PR) ( 42.9％ ) anddisease control rate (94.3％ )in female patients were superior to males (20.0％ and 74.3％ ) (P ＜ 0.05 ).Non-smoking and PS score ＜ 2 were good predictors for survival.The side effects were generally mild and mainly were skin rash and diarrhea.

OBJECTIVE: To investigate the prevalence of throat disease in secondary school teachers of Urumqi. METHOD: Use Stage-Two random sampling at 11689 teachers from 109 secondary schools in Urumqi; Draw 3 217 from 11689 teachers in 109 secondary schools to accept voice self-assessment questionnaire survey and routine examination of throat, and the one who were confirmed abnormal in routine inspection would be underway stroboscopic laryngoscopy. RESULT: The total illness prevalence rate of throat disease in secondary school teachers of Urumqi is 28.23%; there is no statistic difference of illness prevalence rate between male and female teachers (P > 0.05). However, results showed statistical significance of illness prevalence rate in teachers of different racial-groups with different years of teaching experience (P < 0.05). Teachers who have 5 to 15 years of teaching experience suffer a high incidence of throat diseases. Among eight racial groups involved in investigation, Kazak teachers are in the highest illness prevalence rate. The results of assessment for voice disorder index between teachers with and without throat diseases showed statistical difference in total score TVH (P < 0.05), which is shown significant in the physical and emotional areas (P < 0.05), while there is no statistical difference in function. Diseases of pharyngeal portion are mainly chronic pharyngitis and hyperplastic tonsil in tongue root; Diseases of laryngeal portion are mainly chronic laryngitis and vocal nodule for female, while mainly chronic laryngitis and vocal polypus for male. CONCLUSION There is no significant difference in illness prevalence rate of throat disease for secondary school teachers in Urumqi between genders; the highest prevalence rate is in teachers who have 5 to 15 years teaching experience; among different racial groups, Kazak teachers are of the highest illness prevalence rate; the illness prevalence of throat diseases is related with voice disorder index.
Adult ; China ; epidemiology ; Faculty ; Female ; Humans ; Laryngeal Diseases ; epidemiology ; Male ; Middle Aged ; Occupational Diseases ; epidemiology ; Pharyngeal Diseases ; epidemiology ; Prevalence ; Surveys and Questionnaires ; Voice Disorders ; epidemiology ; Voice Quality ; Young Adult