OBJECTIVE:To investigate medical staff’s awareness and knowledge level on the rational use and management of antibacterials in our hospital.METHODS:A questionnaire survey was conducted on the spot among medical staff in our hospital,and the results of survey were recorded in Excel electronic form and subjected to data analysis and processing.RESU-LTS & CONCLUSION:The medical staff had a good mastering about the general knowledge about antibacterials(such as definitions,classifications and so on).However,their answers to the questions such as reasonable antibacterial drug use,bacterial resistance,safety and expertise were relatively concentrated(tended to tick the same answer).Therefore,it is advisable to develop different forms of training through different ways among hospital medical staff to enhance their knowledge level on antibacterials and strengthen their awareness of correct and rational use of antibacterials meanwhile setting related measures and management norms.

Objective To observe the expression of tumor necrosis factor-α induced protein 8 like-2 (TIPE2) in CD4 + CD25 + regulatory T cells ( CD4 + CD25 + Tregs) and analyze its potential effect on immunosuppressive activity of CD4 + CD25 + Tregs. Methods CD4 + CD25 + Tregs were purified from spleen of the BALB/c mice by using magnetic cell sorting system.The expressions of TIPE2 mRNA and protein in CD4 + CD25 + Tregs were detected by using RT-PCR and Western blot.CD4 + CD25 +Tregs were further infected with the recombinant lentiviruses that carried small interference RNA(siRNA)to knock down the TIPE2 expression.Based on the expressions of cell surface molecules including cytotoxic T-lymphocyte-associated antigen (CTLA)-4 and forkhead/winged helix transcription factor p3 (Foxp3) detected by flow cytometry and the levels of cytokines including interleukin (IL)-10 and transforming growth factor (TGF)-3 examined by ELISA in CD4 + CD25 + Tregs,the functional role of TIPE2 in controlling suppressive activity of CD4 + CD25 + Tregs was analyzed.In the meantime,the proliferation activities of T effector cells were assayed by MTT test. Results A 147 bp TTPE2 gene band and a clear TIPE2 band with a molecular mass of approximately 21 000 in CD4 + CD25 + Tregs were detected by using Westem blot.Cell surface molecule as well as cytokine expressions were significantly down-regulated when the CD4 + CD25 + Treg stimulated and activated by anti-CD3/CD28 was cultured for 24 hours after the siRNA silenced CD4 + CD25 + Treg cells ( P ＜ 0.01 ).Meanwhile,the suppression role of CD4 +CD25 + Tregs on the proliferation activity of T effector cells was weakened obviously ( P ＜ 0.05 ). Conclusions As an important immunoregulatory molecule,TIPE2 not only expresses in the CD4 + CD25 +Tregs,but also affects the immunosuppressive function of CD4 + CD25 + Tregs.

Adult ; Cerebrospinal Fluid Rhinorrhea ; Female ; Humans ; Sphenoid Sinus ; pathology

Objective To study the impact of postoperative aerobic exercise on the cardiac function of breast cancer patients during anthracyclines-based chemotherapy. Methods Sixty cases of female breast cancer pa-tients, from June 2014 to December 2015 for anthracyclines-based chemotherapy, were randomly divided into ex-perimental group (n = 30) and control group (n = 30). Four cycles of conventional anthracyclines-based chemotherapy were conducted in control group, while three times of aerobic exercise per week were added in exper-imental group until the end of treatment course apart from conventional treatment. The peak oxygen consumption (VO2max) and maximum heart rate (HRmax) were measured before and after chemotherapy in both groups, ac-companied by ECG monitoring and blood collecting to measure the changes in their N-terminal pro-brain natriuretic peptide (NT-proBNP), serum creatinine (SCr) and kinase isoenzyme (CK-MB). Results No significant differ-ences in various indicators before chemotherapy were reported between two groups (P>0.05). After chemotherapy, VO2 max/kg [(21.9 ± 3.6) vs. (14.5 ± 2.8) mL/(min·kg)], VO2 max [(1 523 ± 186) vs. (911 ± 185) mL/min] and HRmax[(115 ± 15) vs. (129 ± 16) beats/min] in experimental group were significantly improved when com-pared with those in control group; significant differences in hematological levels and ECG changes were also ob-served between two groups. Conclusion Aerobic exercise during chemotherapy can mitigate the cardiotoxicity of anthracyclines to patients, which provides a new idea and therapy to reduce the incidence of clinical cardiovascular events induced by anthracyclines-based chemotherapy.

Adolescent ; Adult ; Cytarabine ; administration & dosage ; blood ; pharmacology ; Drug Interactions ; Female ; Humans ; Instillation, Drug ; Leukemia ; blood ; drug therapy ; Male ; Methotrexate ; administration & dosage ; blood ; pharmacology ; Middle Aged ; Young Adult

Objective To investigate the clinical significance of acute insulin resistance during surgical sepsis. Methods Forty surgical patients with sepsis in experimental group and twenty patients with similar APACHEⅡ but without sepsis in experimental control group were enrolled in our study. In the experimental group, the patients were categorized to sepsis group and septic shock and MODS(SM)group according to clinical manifestations, and were also grouped according to different causes of sepsis, i.e.severe acute pancreatitis(SAP)group, intestinal fistula group and other diseases group. Determinations of fasting blood glucose, fasting plasma insulin, clinical nutritional parameters, plasma TNF-α, APACHEⅡ, sepsis-related organ failure assessment(SOFA)and severe scores were simultaneously performed at designated time points. Insulin resistance index was calculated using homeostasis model assessment(HOMA)to assess insulin sensitivity of surgical patients with sepsis. Results (1)A significant elevation of lgHOMA-IR levels was found in 84% of tests in sepsis. Peak lgHOMA-IR values increased in all patients.(2)LgHOMA-IR was significantly higher in patients with sepsis than those without sepsis from the first 24 hours(1.22±0.23 vs 0.73±0.21, P＜0.01)to the 7th day(0.46±0.32 vs 0.30±0.13, P＜0.01).(3)There was no significant difference in lgHOMA-IR among SAP, intestinal fistula and other groups at different times(P＞0.05).(4)There was significant difference in lgHOMA-IR between sepsis group and SM group during the whole septic episode(P＜0.01).During the septic episode, there were significant correlation between lgHOMA-IR and APACHEⅡ(r=0.591, P＜0.01), lgHOMA-IR and SOFA(r=0.496, P＜0.01), lgHOMA-IR and SS(r=0.553, P＜0.01), and lgHOMA-IR and TNF-α(r=0.658, P＜0.01).(5)lgHOMA-IR was independently directly correlated with LDL, prealbumin, cholesterol and triglyceride. R2 of the equation was 0.188. Conclusion There usually is insulin resistance in surgical sepsis, regardless the primary diseases. Insulin resistance may simply be a marker reflecting an underlying physiological derangement, implying indicates higher mortality. Among several clinical nutrition parameters, LDL, prealbumin, cholesterol, and triglyceride showed closer relationship with insulin resistance in patients with sepsis.

Objective: To understand the HIV infection status and related factors in men who have sex with men (MSM) in Tianjin during 2016-2018. Methods: According to the sentinel surveillance protocol, continuous cross-sectional studies were conducted to collect the information about the awareness of AIDS, related behaviors, HIV infection, syphilis prevalence and HCV infection in the MSM in Tianjin with the annual sample seize of 400 between April and June during 2016-2018. Results: From 2016 to 2018, a total of 1 200 MSM were surveyed. The condom use rate in anal sex was 45.4% (544/1 198) in the past 6 months. The HIV test rate in MSM recruited through network declined with year (trend χ²=42.742, P<0.001). The overall HIV infection rate was 3.3% (40/1 200). The HIV-1 infection rate was 2.6% (95%CI: 1.7%-3.5%). The overall prevalence rate of syphilis was 6.7% (80/1 200). The overall HCV infection rate was 0.8% (9/1 200). Results from multivariate logistic regression analysis showed that the risk factors associated with HIV infection in the MSM included divorced or widowed (compared with unmarried, aOR=7.137, 95%CI: 1.621-31.419) and syphilis positive group (compared with syphilis negative group, aOR=3.684, 95%CI: 1.520-8.932). The protective factors for HIV infection in the MSM included consistent use of condom in the past 6 months (compared with occasional use of condom, aOR=0.343, 95%CI: 0.126-0.932) and HIV test (compared with receiving no HIV test, aOR=0.314, 95%CI: 0.123-0.801). Conclusions The HIV infection rate in the MSM in Tianjin was high from 2016 to 2018. Syphilis prevalence status in MSM should not be neglected. The rate of consistent condom use in anal sex was low in the MSM. It is necessary to take effective measures to promote condom use and strengthen HIV test in MSM.

The role of interleukin-17 (IL-17) in autoimmune hepatitis (AIH) was investigated. A mouse model of experimental autoimmune hepatitis was established, and the syngeneic S-100 antigen emulsified in complete Freud's adjuvant was injected intraperitoneally into adult male C57BL/6 mice. The IL-17 expression in serum and the livers of the mice models was detected by using ELISA and immunohistochemistry, respectively. IL-17 neutralizing antibody was used to study the biological effect of IL-17 in the experimental AIH. IL-17 neutralizing antibody in vivo administration alleviated the hepatic inflammation and ALT level in the AIH model. IL-17 in the peripheral blood mononuclear cells (PBMC) of AIH patients was measured by using real-time PCR method. The results showed that IL-17 level was significantly up-regulated in AIH patients and mice models. It was concluded that IL-17 contributed to the development of AIH and might be a potential therapeutic target of AIH.

Background Salivary transplantation or duct transposition can provide continuous physiological secretion of tear substitutes.This may be an ideal method in treatment of dry eye.But the relative anatomical literatures is few,and some of the conclusions in the literatures are still controversial,which limit its clinical application.Objective This study was to discuss the possibility and the advantage and disadvantage of applying three major salivary glands to treat xerophthalmia.Methods The relationship between the branches of the facial nerve out of the parotid gland and the salivary glands,the salivary glands size,origin of blood supply,out diameter of vessels and adjacent relation were observed in 34 sides pate specimens perfused with red latex under the operating microscope.To find the vessels in recipient site to anastomose,the vessels around fossa orbitalis and forehead were anatomized and observed.The parotid gland duct transfer operation,the submandibular gland free transplantation surgery and sublingual gland free transplantation surgery in the human anatomy specimens were simulated.Results The position of parotid duct was constant.The duct length was(4.20± 1.10) cm,duct diameter was (O.60±0.30) cm.The stensen's duct was likely to be prolonged by the cheek mucous membrane or venous andthe damage of buccal branch,zygomatic branch and temporal branches of facial nerve should be avoided during the operation of transplanting stensen' s duct.When submandibular gland was transplanted,facial vessel was taken as its pedicle,whose outside diameter was (2.70 ± 0.28) mm,and the length of the transplant vascular pedicle was (1.90 ± O.30) cm.Thc anastomosed vessel was superficial temporal vessel in recipient site.When sublingual gland was transplanted,sublingual(88.2％,30 sides) or submental vessel(11.8％,4 sides) was taken as its pedicle,whose outside diameter was(1.92±0.36) mm and (1.96±0.54) mm,and the length of the transplant vascular pedicle was(2.60± 1.10) cm and(3.50±0.40) cm,and the anastomosed vessel was the frontal branch of superficial temporal vessel in recipient site.Three sides of specimens lacked sublingual glands.Conclusions It is feasible that treating severe xerophthalmia by the operation of grafting the major salivary glands or transplanting stensen' s duct on the point of anatomical view.Parotid duct inversion and the submandibular gland transplantation have been applied to clinic.However,sublingual transplantation remains to be further confirmed by the animal experiments.

Objective To Compare postoperative complications between patients with varicose veins of the lower limbs treated with foam sclerotherapy or endovenous laser.Method From 2011 to 2015,simple varicosis of great saphenous vein patients (grade C3-6) in 2 542 cases,3 468 limbs were divided into 2 groups.Combined with high ligation of great saphenous vein plus stripping,foam sclerotherapy group (1 355 cases) underwent calf foam sclerotherapy (1％ polidocanol),endovenous laser group (1 187 cases) underwent endovenous laser therapy.All postoperative patients were treated with stretch socks for 3 months.Postoperative pain (calf),deep vein thrombosis,pulmonary embolism,superficial thrombophlebitis,saphenous nerve injury,ecchymoma,migraine,allergic dermatitis,pigmentation in 2 groups were compared.Result During the follow-up,28 cases in foam sclerotherapy group had saphenous nerve injury (2％),1 071 (79.1％) cases had subcutaneous ecchymosis,613 cases (51.6％) in endovenous laser group had saphenous nerve injury,979 cases (82.5％) had subcutaneous ecchymosis,8 cases (1.0％) had skin burns (x2 =824.660,4.786,9.161,P ＜ 0.05).Endovenous laser group (23.8％) was significantly better than that of foam sclerotherapy group (30.8％) in pigmentation (x2 =15.243,P ＜0.05).Conclusion Treatment of varicose veins of the lower leg with foam sclerotherapy has less postoperative complications compared with endovenous laser.