Objective To determine the clinical features of Klebsiella pneumoniae pneumonia and antimicrobial resistance of Klebsiella pneumoniae, providing the basis for rational use of antibiotics. Methods Eighty-six strains of Klebsiella pneumoniae were isolated from the sputum specimen which collected from the inpatients in our hospital from Dec 2008 to Dec 2010,which were identified with Bio Merieum Vitek 2. A total of 86 children were enrolled in the study, which were divided into hospital infection/colonization group (n = 68) and community infection group (n = 18). Clinical information were recorded. Extended spectum β-lactamase (ESBLs) and antibiotic susceptibility of Klebsiella pneumoniae were determined. Results Klebsiella pneumoniae pneumonia in children mainly occured in infants, especially in infants with basic diseases.Clinical manifestations of Klebsiella pneumoniae pneumonia had no much difference from common pneumonia. The detection rate of ESBLs was high(76. 7%). ESBLs were found in 64 strains of the hospital infection/colonization group (94. 1% ,64/68) ,while in 2 strains of the community infection group (11. 1% ,2/18).There was a significant difference between the two groups (P ＜0. 01). The drug resistance of hospital infection/colonization group was significantly higher than that of community infection group. The strains of hospital infection/colonization group were sensitive with cefotan, piperacillin/tazobactam, carberpenem, amikacin and ciprofioxacin only, while were highly resistant to penicillins, cephalosporins and monoamine antibiotics.The average hospital stay of the hospital infection/colonization group was (15.0 ± 7. 1) d, while the other was (8. 2 ± 3. 8) d. There was a very significant difference between the two groups in average length of stay (P＜0.01). Conclusion Klebsieila pneumoniae pneumonia in children mainly occurs in infants with basic diseases. The symptoms are untypical. Klebsiella pneurmoniae multi-drug resistance is a serious problem,which must be paid attention to. We should make a difference between the two groups when antibiotics were prescribed.

The nuclear transcription factor nuclear factor erythroid 2-related factor 2 (NRF2) plays a crucial role in maintaining cellular redox homeostasis. The aberrant NRF2 signaling confers enhanced antioxidant capacity, which is linked to tumor progression and therapeutic resistance. The current study investigates the biological effects and molecular mechanism of tribbles homolog 3 (TRIB3), a stress-induced protein, in regulating cell survival and apoptosis in lung cancer. This study first performed the RNA sequencing data analysis with 576 lung adenocarcinoma patients from the cancer genome atlas (TCGA) database. The NRF2- antioxidant response element (ARE) signature was enriched in patients with high TRIB3 expression. Dual-luciferase reporter assay and real-time quantitative polymerase chain reaction (PCR) were used to confirm the effect of TRIB3 on the kelch-like ECH-associated protein-1 (KEAP1)-NRF2 pathway. Abrogation of TRIB3 impaired NRF2 transcriptional activity and reduced the expression of its target genes. Moreover, TRIB3 enhanced NRF2 stability via blocking KEAP1-NRF2 interaction. TRIB3-depletion promoted reactive oxygen species (ROS) production, restrained cell proliferation, and enhanced carboplatin-induced apoptosis. In addition, NRF2 overexpression recovered the tumor inhibition effect of TRIB3-depletion. Consistently, TRIB3 failed to modulate apoptosis in NRF2 depletion cells. In summary, this study shows that TRIB3 inhibits the KEAP1-NRF2 interaction and upregulates the transcriptional activity of NRF2, thereby promoting lung cancer cell proliferation and reducing the sensitivity to chemotherapy. Targeting the TRIB3-NRF2 signal axis may become a new strategy for ROS homeostasis and lung cancer treatment.

Objective Toexploretheclinicalefficacyandtoxicityofintensitymodulatedradiationtherapy(IMRT)combined with high intensity focused ultrasound(HIFU) for inoperatable recurrent hepatic carcinoma after operation and TACE .Methods Total 60 patients with inoperatable recurrent hepatic carcinoma after operation and TACE were randomly divided into two group ,30 patients in observation group received IMRT and HIFU ,while 30 patients in control group received only IMRT .For both groups , the same radiotherapy technic was given with IMRT in 6 MV X‐ray ,the total dose was 54 -70 Gy/6 -7 weeks .In observation group ,HIFU was carried out concurrently with IMRT (5 days/week ,6-7 weeks) .Results The difference of the short‐term effi‐cacy between the observation group and the control group was statistically significant (P<0 .05) ,there was no significant difference in acute radioactive toxicity between the two groups (P>0 .05) .The one and two year overall survival rate 89 .9% ,78 .9% in obser‐vation group ,while 72 .8% ,36 .2% in control group ,the differnces were statistically significant (P<0 .05);the one and two year progression‐free survival rate were 85 .9% and 50 .9% in observation group ,while 64 .3% and 28 .1% in control group ,the differ‐ences between two groups were statistically significant (P<0 .05) .The medium survival time was 36 months in observation group , and 24 months in control group;the medium progression‐free survival was 27 months in observation group ,and 17 months in control group .Conclusion For recurrent unresectable or reject surgery after TACE in patients with primary hepatic carcinoma ,the efficacy of IMRT combined with HIFU treatment is effective ,the toxicity can be tolerated ,and has certain application value .

AIM: The aim of this study was to observe the cardiac performance in 2-week or 4-week levothyroxine(T4)-induced cardiac hypertrophy and to elucidate the possible underlying mechanism of cardiac hypertrophy transition to heart failure in T4 treatment rats.METHODS: The blood pressure and pulse rate were measured by tail-cuff technique.The cardiac output and the preload-cardiac output were measured in working heart mode.The shortening of unloading contraction in cardiomyocytes was observed by an edge-detector system.RESULTS: Resting heart rate in T4 treatment rats increased significantly and the width of cardiomyocytes widened in T4 rats,but the length of cardiomyocytes had no difference compared with control values.The cardiac output in 2-week T4 group was higher than that in control group.The cardiac output increased when the preload increased from 5 mmHg to 15 mmHg.The unloading shortening amplitude at 1 Hz and 2 Hz increased in 2-week T4 group.No difference between 2-week T4 group and control group at 4 Hz was observed.When the stimulating frequency increased from 1 Hz to 4 Hz,the shortening amplitude also increased in control cardiomyocytes,but decreased in 2-week or 4-week T4 group.The shortening amplitude increased further in 4-week T4 group as compared with that in control.The time to peak shortening and time from peak shortening to 75% relaxation reduced at each frequency in 2-week and 4-week T4 group.The shortening and relaxation rates in 2-week or 4-week T4 group were higher than those in control group at 1 Hz and 2 Hz.The shortening and relaxation rate kept higher at 4 Hz in 2-week T4 group,but showed no difference with control at 4 Hz in 4-week T4 group.CONCLUSION: These above results suggest that shortening amplitude-frequency relationship of cardiomyocytes in 4-week T4 rats is earlier to be altered than cardiac performance in working heart.

Objective To analyze the major adverse reactions of anti-hyperlipidemia drugs and their influencing factors.Methods The adverse reactions of anti-hyperlipidemia drugs in 579 patients were retrieved from the National Population and Health Scientific Data Platform.An adverse reaction-matched dictionary was established by normalizing the names of anti-hyperlipidemia drugs according to the drug name + dosage form and describing the adverse reactions according to the WHO adverse reaction terminology.The data set dimensions were analyzed by data mining.Results The adverse reaction rate of intravenous drip was 75.4% and manifested as chest distress,itching and dyspnea.The rate of adverse reaction involving organ systems was 61.1% and manifested as systemic injury,fever,discomfort and anorexia.Logistic regression analysis showed that the drug giving route was a factor influencing the severity of adverse reaction.Conclusion The adverse reactions of anti-hyperlipidemia drugs involve systemic,skin and its appendix injury.Drug giving route is the major factor influencing the severity of adverse reaction.

Objective To study the T cells lineage polymorphism of TCR BV CDR3 in the peripheral blood of ankylosing spondylitis (AS) patients,in order to provide experimental basis for the immunological patho-genesis study of AS.Methods Twenty-six subfamilies of CDR3 T cells of TCR BV in the PBMC of AS patients were amplified by RT-PCR method,then TCR BV CDR3 lineages polymorphism were analyzed by immunization scanning spectrum.Results TCR BV CDR3 scanning spectrum of 20 active AS patients showed abnormal distribution peak,including monoclonal,oligoclonal/oligoclonal trend,skewing peak and irregular abnormal peak.Among them,some subfamilies of 18 patients showed oligoclonal/oligoclonal trend expansion,BV16 and BV18 two subfamilies of one case showed monoclonal expansion.Most spectral type of PBMC TCR BV CDR3 in five normal controls showed Gauss distribution.Conclusion TCR BV CDR3 lineage have significant characteristic polymorphism and spectrum drift characteristics in the peripheral blood of AS patients,which further indicate that T cells has plaied an important role in the immunological pathogenesis of AS.Monoclonal/oligoclonal expansion of T cells may be autoreactive T cells in nature and they may be involved in the pathogenesis of AS.

Objective To compare the results of stroke risk assessment system in patients with non-valvular atrial fibrillation u-sing CHADS2 and CHA2 DS2-VASc .Methods A total of 420 patients with non-valvular atrial fibrillation were evaluated using CHADS2 and CHA2DS2-VASc ,they were divided into three groups according scores :low risk group(scores 0) ,intermediate risk group(scores 1) ,high risk group(scores≥2) .Compare the average scores and the proportions of three groups of two stroke risk as-sessment system .Results The average score of CHA2DS2-VASc was significantly higher than that′s of CHADS2 (2 .41 ± 1 .93 vs . 1 .39 ± 1 .39 ,P<0 .05) .According to scores of CHADS2 ,the proportions of low risk groups were 34 .5% (145/420) ,intermediate risk group were 28 .8% (121/420) ,high risk group were 36 .7% (154/420) .According to scores of CHA2DS2-VASc ,the propor-tions of low risk group were 16 .2% (68/420) ,intermediate risk group were 23 .3% (98/420) ,high risk group were 60 .5% (254/420) .CHA2 DS2-VASc compared with CHADS2 ,the proportion of low-risk group significantly lower than the latter ,the proportion of high-risk groups significantly higher than the latter(P<0 .05) .Conclusion The scores of CHA2DS2-VASc is significantly high-er than that′s of CHADS2 in patients with non-valvular atrial fibrillation ,there are more patients needs anticoagulation using stroke risk assessment system CHA2 DS2-VASc .

To evaluate the clinical efficacy and safety of Qinghouyan lozenge in the treatment of acute pharyngitis due to Lung-heat and Yin-deficiency, and compare with Qinghouyan oral Liquid. Totally 144 subjects were enrolled and randomly divided into two groups (72 in the test group and 72 in the control group). The participants in the test group were given Qinghouyan lozenge for 5 days, and those in the control group were given Qinghouyan oral Liquid for 5 days. The effectiveness evaluation indexes were pharyngalgia/odynophagia disappearance rate, overall efficacy of TCM syndromes, TCM syndrome scores, and single syndrome and sign disappearance rate. During the test, the safety was evaluated by vital sign, lab examination indexes and adverse events. The results for the full analysis set showed that the couth disappearance rate, the incidence rate of TCM syndromes, and the throat/uvula congestion disappearance rate of the test group were higher than that of the control group (P < 0.05), with significant differences in the changes in syndrome scores between the two groups (P < 0.05). Altogether 3 adverse events were observed in the test group while 6 adverse events in the control group, without significant differences in the adverse event rate between the two groups (P < 0.05), serious abnormal laboratory examinations and vital signs. In conclusion, Qinghouyan lozenge has better efficacy in treatment of acute pharyngitis due to Lung-heat and Yin-deficiency than Qinghouyan oral liquid, with good safety.
Acute Disease ; Double-Blind Method ; Humans ; Medicine, Chinese Traditional ; Pharyngitis ; drug therapy

Objective To evaluate the effect of point-of-care hemoglobin/hematocrit (POC HGB/HCT) devices and intraoperative blood salvage on the amount of perioperative allogeneic blood transfusion and blood conservation in clinical practice.Methods A total of 46 378 medical records of 22 selected hospitals were reviewed. The volume of allogeneic red blood cell and plasma, number of patients transfused, number of intraoperative autologous blood salvage, total volume of autologous blood transfusion, and amount of surgery in the year of 2011 and 2013 were tracked. Paired t-test was used in intra-group comparison, while t-test of two isolated samples carried out in inter-group comparison. P<0.05 was defined as statistically significant difference.Results In the hospitals where POC HGB/HCT device was used (n=9), the average allogeneic blood transfusion volume per 100 surgical cases in 2013 was significantly lower than that in 2011 (39.86±20.20 vs. 30.49±17.50 Units, t=3.522, P=0.008). In the hospitals without POC HGB/HCT meter, the index was not significantly different between 2013 and 2011. The average allogeneic blood transfusion volume was significantly reduced in 2013 than in 2011 in the hospitals where intraoperative autologous blood salvage ratio [autologous transfusion volume/(autologous transfusion volume+allogeneic transfusion volume)] was increased (n=12, t=2.290, P=0.042). No significant difference of the above index was found in the hospitals whose autologous transfusion ratio did not grow.Conclusion Intraoperative usage of POC HGB/HCT devices and increasing autologous transfusion ratio could reduce perioperative allogeneic blood transfusion.