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 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 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 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 This study was performed to investigate the effect of high mobility group box-1 protein (HMGB 1) on immune function of human T lymphocytes in vitro and explore its potential role in cell-mediated immune dysfunction.Methods Fresh blood was obtained from healthy adult volunteers and peripheral blood mononuclear cells (PBMCs) were isolated,then rhHMGB 1 was added to PBMCs.Four-color flow cytometric (FCM) analysis was used for the measurement of intracellular cytokine including interleukin Results (1) Different stimulating time and dosage of rhHMGB 1 did not alter the number of IFN-a positive cells (Th 1).rhHMGB 1 stimulation provoked a dose-dependent and time-dependent increase in Th2 subset and decrease in ratio of Th 1 to Th2.(2) Compared with the untreated cells,when the cells were coincubated with rhHMGB 1 (10-100ng/ml) for 12 hrs,protein release of IL-2 and sIL-2R were significantly up-regulated.At 48 hrs,in contrast,protein production was relatively lower in cells after exposure to 100-1000 ng/ml rhHMGBI.Conclusions These findings demonstrated that HMGB1 has a dual influence on immune functions of human T lymphocytes.

Objective To study the potential role of tumor necrosis factor-α (TNF-α) induction in the development of mucosal barrier dysfunction in rats caused by acute intestinal ischemia-reperfusion injury, and to examine whether pretreatment with monoclonal antibody against TNF-α (TNF-α MoAb) would affect the release of D(-)-lactate after local gut ischemia followed by reperfusion. Methods Anesthetized Sprague-Dawley rats underwent superior mesenteric artery occlusion for 75 min followed by reperfusion for 6 hr. The rats were treated intravenously with either TNF-α MoAb (20 mg/kg) or albumin (20 mg/kg) 30 min prior to the onset of ischemia. Plasma D(-)-lactate levels were measured in both the portal and systemic blood by an enzymatic spectrophotometric assay. Intestinal TNF-αmRNA expression as well as protein levels were also measured at various intervals. In addition, a postmortem examination was performed together with a macropathological evaluation based on a four-grade scoring system.Results Intestinal ischemia resulted in a significant elevation in D(-)-lactate levels in the portal vein blood in both the control and treatment groups ( P ＜0.05). However, animals pretreated with TNF-α MoAb at 6 hr after reperfusion showed significant attenuation of an increase in both portal and systemic D(-)-lactate levels when compared with those only receiving albumin (P ＜ 0.05). In the control animals, a remarkable rise in intestinal TNF-α level was measured at 0.5 hr after clamp release ( P ＜ 0.01); however, prophylactic treatment with TNF-α MoAb completely annulled the increase of local TNF-α levels seen in the control animals. Similarly, after anti-TNF-α MoAb administration, intestinal TNF-α mRNA expression was markedly inhibited, which showed significant differences when compared with the control group at 0.5 hr, 2 hr and 6 hr after the release of occlusion ( P ＜ 0.05-0.01 ). In addition, the pathological examination showed marked intestinal lesions that formed during ischemia, which were much worse upon reperfusion,particularly at the 6 hr time point. These acute injuries were obviously attenuated in animals receiving TNF-α MoAb.Conclusions It appeared that acute intestinal ischemia was associated with failure of the mucosal barrier, resulting in increased plasma D(-)-lactate levels in both portal and systemic blood. These results suggest that TNF-α appears to be involved in the development of local damage associated with intestinal ischemic injury. Moreover, prophylactic treatment with TNF-α MoAb exerts preventive effects on ischemia/ reperfusion-induced circulating D (-)-lactate elevation and gut injury. ( J Geriatr Cardiol 2004;1(2):119-124. )

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.