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

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 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.

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.

Objective To evaluate the significance of color Doppler ultrasound examination of renal blood flow combined with the detection of bone morphogenetic protein-7(BMP-7)in early diagnosis of type 2 diabetic nephropathy.Methods Blood BMP-7 level was tested in 90 patients with type 2 diabetic nephropathy and 30 controls,and parameters of renal blood flow were measured by color Doppler ultrasound examination.Blood BMP-7 level as well as resistant index(RI)of segmental renal artery(SRA)and interlobar renal artery(IRA),were compared between these two groups.Results Compared with controls,blood BMP-7 level gradually decreased with the aggravation of diabetic kidney damage(P＜0.01).The peak systolic velocity(Vmax)and the end diastolic velocity(Vmin)of SRA and TRA were slowed gradually,while RI increased(P＜0.01).Blood BMP-7 level was negatively correlated with IRA's and SRA's RI of IRA and SRA(r =-0.603,P＜0.01;r =-0.652,P＜0.01).Conclusions Color Doppler ultrasound examination of renal blood flow combined with detection of BMP-7 might play an important role in early diagnosis of type 2 diabetic nephropathy.

Background and purpose:Loss or altered expression of Ras association domain family 1A gene (RASSF1A) through DNA methylation has been associated with the pathogenesis of a variety of cancers, which suggests the tumor suppressor function of this gene. This study aimed to explore the effect of DNA methyltransferase inhibitor 5-Aza-2’deoxycytidine (5-Aza-dc) on demethylation and expression of RASSF1A in cervical cancer cell lines. Methods:HPV positive cervical cancer cell lines HeLa and Caski, HPV negative cell lines HT-3 and C-33A were treated with two different concentration of 5-Aza-dc (5 μmol/L, 10 μmol/L). MSP (methylation-specific PCR) and Bisulfite genomic sequencing PCR (BGS) combined with TA clone were used to investigate methylation status of RASSF1A gene promoter and exon 1 before and after treatment of 5-Aza-dc. RASSF1A gene mRNA expression was detected by RT-PCR. Results:Two HPV positive cell lines showed hypomethylated RASSF1A promoters and expressed RASSF1A mRNA, and after treatment with 5-Aza-dc, the mRNA expression of RASSF1A did not change significantly (FHeLa=3.003, P=0.125; FCaski=0.045, P=0.956). Two HPV negative cervical cancer cell lines showed hypermethylation status of RASSF1A promoter and silenced RASSF1A. After treatment with 5-Aza-dc, demethylation occurred in the promoter region of RASSF1A gene, which subsequently induced re-expression of this gene in HT-3 and C-33A. The F test (FHT-3=18.002, P=0.03;FC-33A=17.179, P=0.03) and LSD-t test (P<0.05) demonstrated that significant difference in the expression of RASSF1A was found upon two different concentrations drug treatment.Conclusion:The methylation status of promoter and exon 1 of RASSFIA gene in HPV positive and HPV negative cervical cancer cell lines are different. The promoter hypermethylation is correlated with RASSF1A gene expression in HPV negative cervical cancer cell line HT-3 and C-33A, and plays a key role in RASSF1A silencing. 5-Aza-dc may effectively reverse the methylation status of RASSFIA gene promoter in cervical cancer HT-3 and C-33A cells and reactivate gene expression silenced by aberrant hypermethylation in a dose-dependent manner within certain extent.

Objective To discuss the role of assistance of intraoperative uitrasonography in ret-roperitoneal laparoscopic nephron-sparing surgery for renal tumors. Methods The intraoperative laparoscopic ultrasonography was applied in retroperitoneal nephron-sparing surgery for 20 patients, of whom 11 were men and 9 were women. The average age was 53(range 33 to 73) years. There were 12 patients with renal cell carcinoma and the mean tumor size was 2.9(range 1.4 to 4.6)cm in diame-ter. All of them were staged as T1 N0 M0. Seven patients had angiomyolipoma and the mean tumor size was 4.5(range 1.8 to 8.0)cm in diameter and 1 patient had a 3.1 cm oncocytoma in diameter. The ul-trasonography was used to locate the tumor, observe the bloodstream and detect whether there were small satellite tumors. The surgical time, time of renal artery occlusion and operative effect were ob-served. Results Laparoscopic surgery was successful in all cases without conversion to open surger-y. Mean operative time was 115 (range 85 to 270) min, mean time of renal artery occlusion was 28 (range 22 to 50) min. During the mean followup of 16(range 4 to 30) months, no patients with renal cell carcinoma had local or port site recurrence or metastatic disease. Conclusion In retroperitoneal laparoscopic nephron-sparing surgery, the intraoperative uhrasonography is helpful to locate the tumor in the surgery, to estimate whether the renal artery is occluded completely and to excise the tumor pre-cisely.