OBJECTIVE To investigate pulmonary fungal infection spectrum and its resistance in older COPD patients with mechanical ventilation.METHODS Retrospective study were performed in 67 cases of COPD patients with mechanical ventilation treatment who were admitted to our ICU from Jan 2004 to Doc 2007.Bronchoalveolar lavage fluid was cultured,differentiation and antifungal susceptilibity testing were taken.RESULTS Seventy-eight fungi strains were cultured in 78 cases,among them,41 strains were Candida albicans(52.56%),14 of C.tropicalis,9 of C.krusei,5 of C.parapsilosis,7 of yeast-like fungi and 2 of Aspergillus.CONCLUSIONS There were increasing fungal infection rate in older COPD patients with mechanical ventilation and C.albicans is still the most frequent type.The resistance to triazole antifungal drug is also increasing.

BACKGROUND:The effect of placenta-derived growth factor(PLGF)on promoting vascular regeneration remains uncertain.In studies of models with PLGF deletion,PLGF has been considered to play critical role in inducing angiogenesis.OBJECTIVE:To summarize the research advances in effect of PLGF and its receptor in vascular regeneration and ischemic cerebral disease.METHODS:A computer-based online search of Pubmed and CNKl was performed for relevant articles published between 1990 and 2009 with key words of"PLGF"in Chinese and"PLGF angiogensis"Articles related with biological characteristics of PLGF and its roles in vascular regeneration and articles related with angiogenesis and PLGF expression after cerebral ischemia were selected.Repetitive articles were excludedRESULTS AND CONCLUSION:The role of PLGF and its receptor in vascular regeneration,mechanism of PLGF and its receptor to promote angiogenesis,vascular endothelial growth factor A,and the expression of PLGF and its receptor in brain after cerebral ischemia were introduced.PLGF can promote pathological angiogenesis,arteriogenesis,branch formation and hemopoietic progenitor cell mobilization.PLGF and its receptor play an important role in the angiogenesis of ischemic cerebral disease and display a good clinical prospect in the treatment of ischemic cerebral disease However,the specific role and mechanism require further study.

Objective To preliminary study clinical efficacy and toxicity of endostatin (ES) combined radiotherapy and chemotherapy in advanced non-small cell lung cancer (NSCLC),and evaluate its effectiveness and safety.Methods We retrospectively reviewed 64 patients with Ⅲ B-Ⅳ stage NSCLC of Harbin Medical University Cancer Hospital from February 2009 to February 2012.The patients were divided into two groups:chemoradiotherapy group,39 patients and ES add chemoradiotherapy group,25 patients.The short-term effect,the total efficiency,median survival time,progression-free survival time and disease-free survival time were compared.Results The total effective rate of chemoradiotherapy group was 76.9％,while the total effective rate of ES add chemotherapy group was 84.0％ (x2 =0.47,P =0.492).Chemoradiotherapy group,compared to ES add chemotherapy group,the median survival time,median progression-free survival time,median disease-free survival time were 11.52 months vs 16.51 months (x2 =3.74,P =0.042),7.32 months vs 10.37 months (x2 =5.32,P =0.025) and 5.21 months vs 7.57 months (x2 =4.56,P =0.035) respectively.The mainly adverse drug reactions were hematologic toxicity and gastrointestinal reactions,but there were no significant differences between the two groups; radiotherapy side effects mainly showed the grade 1 to 2 radiationinduced lung injury and radiation esophagitis (chemotherapy group had one case of grade 3 radiation-induced lung injury),but also had no significant differences between the two groups.Conclusion ES combined chemoradiotherapy can achieve a better short-term clinical efficacy without increasing adverse effects of radiotherapy or chemotherapy in advanced non-small cell lung cancer.

Objective To observe the clinical efficacy of esomeprazole combined with trimebutine maleate in the treatment of reflux esophagitis patients without helicobacter pylori infection.Methods 78 patients with reflux esophagitis were randomly divided into two groups,46 patients in study group and 32 patients in control group.30 minutes before the breakfast,all the patients took Nexium 20mg,twice a day.The study group was given trimebutine maleate 200mg,thrice a day additionally.The treatment course was 4 weeks.The effect and the result of gastroendoscopy were observed.Results The average time of clinical symptoms disappeared in study group was (10.51 ± 2.43) days,which was significantly shorter than (12.31 ± 3.17) days of the control group (t-2.84,P ＜ 0.01).The total effective rate of the study group was 97.83％,which was significantly higher than 81.25％ of the control group (x2 =4.48,P ＜ 0.05).Conclusion Esomeprazole combined with trimebutine maleate in the treatment of reflux esophagitis without helicobacter pylori infection can promote gastric emptying,prevent reflux,control esophageal inflammation and promote ulcer healing effectively.

AIM: To investigate the effect of intravitreal injection of anti-vascular endothelial growth factor (VEGF) drug Bevacizumab on connective tissue growth factor(CTGF) and pigment epithelium derived factor (PEDF) in proliferative membranes in patients with proliferative diabetic retinopathy (PDR).METHODS: From January 2015 to December 2016, 117 patients (126 eyes) with PDR were analyzed using the case-control study.The selected cases were randomly divided into two groups, respectively, Group A of 60 cases (63 eyes) and Group B of 57 cases (63 eyes).The Group A was treated with vitrectomy alone, while the Group B received intravitreal injection of 0.05mL/1.25mg bevacizumab before vitrectomy.The peeled epiretinal membranes in patients were stained and then the histopathological changes were observed for primitive cells and angiogenesis, the expression of CTGF and PEDF were tested.RESULTS: The expression of CTGF and PEDF in the proliferative membrane of the two groups were expressed in the cytoplasm.The Group A showed positive expression in 38 cases, the positive rate was 60.3%.Compared with Group A, the positive expression rate of CTGF in Group B (92.1%) was significantly higher (P<0.05).The positive expression rates of PEDF in the two groups were 90.5% and 95.2% respectively, and there was no significant difference between the two groups (P>0.05).CONCLUSION: In patients with PDR after intravitreal injection of bevacizumab, the retinal neovascularization is significantly reduced, which is conducive to vitrectomy.The positive expression rate of CTGF significantly increased in patients with PDR after intravitreal injection of bevacizumab, but there was no significant change in the expression of PEDF in the anterior membrane.

AIM: To study the effect of intravitreal injection of anti-vascular endothelial growth factor (VEGF) on best corrected visual acuity (BCVA) and multifocal-electroretinogram (mfERG) before and after treatment for choroidal neovascular disease.METHODS: A total of 264 patients (332 eyes) with macular neovascularization (MCNV) and idiopathic choroidal neovascular disease (ICNV) who underwent pathologic myopia from January 2015 to January 2017 were enrolled in this study.Intraocular pressure and BCVA, fundus using 90D front mirror and slit lamp detection, and the fundus photograph, OCT, ICGA and FFA angiography, mfERG detection were taken.One month after the drug, 1mo after the final treatment, we recorded BCVA, intraocular pressure and mfERG and so on.RESULTS: Ranibizumab was injected into the 254 eyes, and 78 eyes were injected with conbercept.There were 37 eyes injected once, 147 eyes were injected twice, 72 eyes were injected 3 times, 57 eyes were injected 4 times, 19 eyes 5 times.There were no significant differences on intraocular pressure between the two groups (P>0.05).The BCVA before treatment was significantly different compared with those 1mo after treatment and 1mo after the final treatment (P>0.05).The amplitude of Ring1, Ring2 and Ring4 increased after treatment, the difference was statistically significant.(P<0.05).The amplitude of Ring3 and Ring5 increased at 1mo after final treatment(P<0.05).CONCLUSION:Intravitreal injection of anti-VEGF drugs has a significant effect on BCVA and mf ERG in patients with choroidal neovascular disease and is safe.

Objective To investigate the protective effects of quercetin on primary cultured SD neonate rats cardiomyocyte injury induced by daunorubicin.Methods Cultured cardiomyocytes were divided into blank groups,DNR groups,DNR+QUE groups,QUE groups.After preincubation of cardiomyocytes for 24 hours,cytoprotection effect was assessed by cell morphous,and cell apoptotic rates determined by flow cytometry,extracellular lactate dehydrogenase(LDH),superoxide dismutase(SOD) and malondialdehyde(MDA).Results Compared with DNR groups,the shedded cardiomyocytes and the cell debris of DNR+QUE groups decreased;the cardiomyocyte apoptosis rates decreased;the content of LDH and MDA decreased(P

OBJECTIVE To investigate the pathogenic causes of community acquired pneumonia(CAP) in the elderly and to guide experience antibiotic therapy.METHODS An etiological study was performed on 204 elder patients with CAP in the Cadres Medical Department of Beijing Shijitan Hospital from May 2005 to Apr 2008.The count scores were by CURB-65 scoring system.RESULTS Pathogens were identified in 204 patients: there were Mycoplasma pneumoniae(42,20.6%),Streptococcus pneumoniae(30,14.7%),Haemophilus influenzae(24,11.8%),Chlamydia pneumoniae(17,8.3%),Klebsiella pneumoniae(14,6.9%),Escherichia coli(7,3.4%),Pseudomonas aeruginosa(5,2.5%),Staphylococcus aureus(4,2.0%),Legionella pneumophila(2,1.0%),and Acinetobacter baumannii(1,0.5%).The score,by CURB-65 scoring system,of mixed infected patients was higher than single infections.CONCLUSIONS Atypical pathogens have important role in elderly CAP,the most common pathogenare Gram-negative bacilli,S.aureusand fungi.Mixed infection couldn′t be ignored.

Objective To analyze the clinical characteristics of patients with cholesterol crystal embolism (CCE) after percutaneous coronary intervention. Methods Six patients with atherosclerosis presenting with simultaneous occurrence of acute renal failure and peripheral ischemic changes were diagnosed as cholesterol crystal embolism and their clinical data were analyzed. Results The patients, 5 men and 1 woman, had an average age of 72 years. Most of them had risk factors of atherosclerosis such as hypertension, diabetes and smoking. The levels of serum creatinine increased progressively after coronary angiography. All patients had concomitant skin lesions, including blue toes. Cutaneous biopsy of 1 patient found cholesterol emboli in arterioles. All patients received statins, and 2 received dialysis. Three patients died, and 3 patients remained chronic renal failure. Conclusion Since the morbidity of CCE is growing and the disease is iatrogenic in origin, special attention should be paid to this disease.

Aim To research the effects of HSP70 in-hibitor ( PFTμ) on the expressions of iNOS induced by IFN-γ in RAW 264. 7 cells. Methods The NO con-centration was measured by Griess Kit. The expression of interest protein was measured by Western blot and iNOS mRNA was measured by RT-PCR. Mouse cardi-ac ischemia-reperfusion ( I/R ) model was established to set up the inflammatory response. These were divid-ed into control and treated groups. The infarct size was monitored on myocardial I/R mice. Results We found that PFTμsignificantly blocked the production of NO and the expression of iNOS protein and mRNA in RAW 264. 7 cells. The mechanism may be part of the inhibition of nuclear IRF-1 protein expression. We also found that PFTμ reduced the infarct size in myocardial I/R mice ( P <0. 05 ) . Conclusion These results suggest that PFTμ down-regulates the IFN-γ-induced iNOS transcription through decreasing translocated IRF-1 protein.