Objective To investigate the clinic and microbial characteristic of fever along with agranulocy-tosis in patients with malignant hematopathy. Methods Retrospective study was carried out on patients with malig-nant hematopathy who developed agranulocytosis during hospitalization. Results A total of 512 febrile events occurred. Duration of agranulocytosis,severe agranulocytosis,poor physical condition,previous exposure to broad-spectium antibiotics and central venous catheterization were correlated with higher incidence of febrile event. There are 328 cases(64.06%)with definite infected sites and 184 cases(35.94%)with fever of unknown origin(FUO). Gram-negative bacterium was most common(64.35%),followed by Gram-positive bacterium(23.61%)and fungus (12.04%). 57 cases resistant bacteria were detected. Mortality incidence resulting from pulmonary infection was higher than that from FUO(P < 0.005). No significance was found between pulmonary infection and blood stream infection(P>0.25)or between blood stream infection and FUO(P>0.1). Conclusions Many factors were corre-lated with incidence of fever along with agranulocytosis in patients with malignant hematopathy. Gram-negative bacte-rium was most common pathogenic microorganism,followed by Gram-positive bacterium,all of which manifested high drug resistance rate. Understanding the epidemiological trend will be beneficial for clinic treatment.

Objective To investigate the tumor-inhibitory effect of cytokine-induced killer cells(CIK)co-cul-tured with dendritic cells (DC)pulsed by breast cancer stem cell antigen on the same tumor-bearing mice. Methods Breast cancer stem cells were isolated from the cell line of MCF-7/ADR and extract lyses antigen of the stem cell was saved. DC and CIK derived from peripheral blood mononuclear cells of healthy individuals were co-cultured and pulsed or un-pulsed by the above antigen lyses. This DC+CIK were injected to breast tumorbearing mice (BCSC-AP-DC+CIK group), and were used to compared with the common breast cancer cell antigen (rather than breast cancer stem cell antigen) pulsed DC+CIK group(AP-DC+CIK group), DC+CIK group, CIK CIK group and normal saline group(NS group). The tumor-inhibitory effect were evaluated and compared among all 5 groups through the tumor size, TdT-mediated dUTP nick end labeling test (TUNEL), examining expression level of bcl-2 and bax by immunohistochemistry. Results The tumor size in each group before and after therapy and the tumor size after therapy between each group was of significant difference(P＜0.05). The maximum size is NS group(3.625±0.093)cm3 and BCSC-AP-DC+CIK group is minimum,which is (1.234±0.131)cm3. BC-SC-AP-DC+CIK group is of highest expression of bax and apoptotic index value, lowest bcl-2 expression in all 5 groups. Conclusion The CIK co-cultured with DC pulsed breast cancer stem cell antigen was more effective to induce apoptosis of breast cancer cells than those of CIK cells co-cultured with DC pulsed breast cancer cell antigen,CIK cells co-cultured with DC and CIK cells.

Objective To investigate the therapy and influencing factors for prognosis of ventilator-associated pneumonia(VAP) caused by multidrug-resistant organisms(MDROs).Methods 169 patients with VAP who were admitted to a hospital between January 2012 and December 2013 were included in analysis, 125 were in MDRO infection group and 44 in non-MDRO infection group.MDRO infection group was subdivided into MDR-A group(n=78, resistant to selected antimicrobial agents) and MDR-B group (n=47, sensitive to at least one kind of selected antimicrobial agent).Antimicrobial choice and prognosis between each group were analyzed and compared.Results 242 strains of pathogenic bacteria were isolated from airway secretion of VAP patients, 173(71.49％) were MDROs.The major pathogens causing VAP were Klebsiella spp.(n=66), Pseudomonas aeruginosa(n=64), Acinetobacter spp.(n=60), Staphylococcus aureus(n=27), and Escherichia coli (n=17), the percentages of MDROs of above pathogens were 68.18％, 50.00％, 91.67％, 88.89％, and 76.47％ respectively.The prognosis of MDRO infection group was poorer than that of non-MDRO infection group, MDR-A group had the worst prognosis(P<0.001).Persistent fever, leukocytosis, and progress of pulmonary inflammation in VAP patients suggested poor prognosis(all P<0.001);antimicrobial use in patients with effective therapy was higher than those in a worsened condition before onset, at the beginning of onset, and after culture of specimens(all P<0.001), while coma, early-onset VAP and multiple bacterial infection had no prognostic significance in patients with VAP(all P>0.05).Conclusion There is high incidence of MDRO infection in patients with VAP, effective antimicrobial therapy can improve the prognosis.

Objective Toexplore the expressions of interleukin-16 (IL-16), interferon-γ (IFN-γ), CXC chemokine receptor 3 (CXCR3), and CRP and their clinical significance in acute exacerbation chronic obstructive pulmonary disease by observing the changes in these factors in patients with AECOPD. Methods 103 patients with AECOPD and 20 healthy controls were collected. According to the 2013 GOLD guideline, all the patients with AECOPD were divided into4 groups(group A of 21 patients, B of 30, C of 27, andD of 25). Results As compared withthe control group, plasma concentrations of IL-16, IFN-γ, CXCR3. and CRP were significantly increased in the patients with AECOPD (P < 0.01), and as the severity of the disease was elevating, these expression levels were significantly increased.While the expression levels of IL-16, IFN-γ, CXCR3, and CRP levels were significantly reduced after treatment, but they were still higherthan those in the control group (P < 0.05). The expression levels of serum IL-16, IFN-γ, CXCR3, and CRP were significantly correlated in patients with AECOPD. Conclusions Expressions of IL-16, IFN-γ and CXCR3 are significantly increased in AECOPD, which is correlated with disease severity and decreased after treatment, suggesting that these three factors may be associated with the occurrence and development of COPD.

Objective:To investigate the changes and clinical significance of prothrombin time (PT) during chemotherapy for non-Hodgkin lymphoma (NHL) in high-altitude area and low-altitude area, and understand the relationship between NHL and PT.Methods:From August 2018 to September 2019, data of 68 cases of NHL patients in the Fifth People′s Hospital of Qinghai Province in the high-altitude area (average altitude: 2 261 m) and the Tianjin Fourth Central Hospital in the low-altitude area (average altitude: 1.3 m) were collected and compared with those of 20 subjects from health examination. The patients were divided into groups according to the NHL classification, stage and grade (international prognostic index, IPI score), the PT at initial diagnosis was compared. The PT changes before and after chemotherapy (6 cycles) were compared between high-altitude area and low-altitude area.Results:The PT in healthy subjects and PT at initial diagnosis in NHL patients in low-altitude area were lower than those in high-altitude area: (12.3 ± 1.3) s vs. (13.4 ± 1.9) s, (12.2 ± 0.8) s vs. (13.7 ± 1.1) s, and there was statistical difference ( P<0.05). There was no significant difference between NHL patients and healthy patients in the same area ( P>0.05). In NHL patients in high-altitude area and low-altitude area, PT of different NHL classification, stage and grade were statistically significant ( t = 4.611, 8.202, 6.893, 5.345, 3.121, 5.397, 2.838 and 3.720, P<0.05). In the same altitude area, NHL classification, stage and grade of NHL patients had no significant effect on PT, and there were no statistically significant difference ( P> 0.05); in NHL patients, there were statistically significant differences in PT before and after chemotherapy between high-altitude area and low-altitude area: (13.7 ± 1.1) s vs. (12.2 ± 0.8) s, (13.4 ± 1.4) s vs. (12.0 ± 1.3) s, and there were statistical differences ( P<0.05), and no significant changes in PT before and after chemotherapy in the same altitude area ( t = 1.377 and -1.222, P>0.05). Conclusions:PT of NHL patients in low-altitude area is lower than that in high-altitude area, and there is no significant correlation with NHL classification, stage, grade and chemotherapy in NHL patients.

Objective To compare the difference in the microstructure of gray matter nucleus in basal ganglia of different movement subtypes of Parkinson's disease (PD) by diffusion kurtosis imaging (DKI) technique,and to analyze its clinical significance in the process of disease occurrence and development.Methods A total of 44 PD patients and 20 healthy controls (HC) admitted to the First Hospital of Shanxi Medical University from July 2017 to October 2018 were recruited into the study.The PD patients were classified into tremor dominant (TD) and non-tremor dominant (NTD) subtypes according to motor symptoms.All participants were scanned for DKI sequence.Fractional anisotropy (FA),mean kurtosis (MK),and mean diffusivity (MD) were obtained from bilateral red nucleus,substantia nigra,caudate nucleus,globus pallidus,putamen,and thalamus.The DKI of the deep brain nucleus in TD,NTD,HC groups was compared,and relationships between DKI and clinical measures were tested.Results Comparing the two substypes of PD with the HC group,the TD group had lower FA value (0.346±0.006 vs 0.389±0.009,U=-3.052,P=0.007),higher MK value (1.101±0.008 vs 0.981±0.006,U=-5.577,P=0.000) and higher MD value (1.005(0.919,1.082) vs 0.934 (0.899,0.970),U=2.493,P=0.038) in the substantia nigra ipsilateral to the more affected side than the HC group.The NTD group had higher MK value in the bilateral substantia nigra than the HC group (less affected side:1.090±0.022 vs 0.990±0.008,U=-4.102,P=0.000;more affected side:1.071±0.020 vs 0.981±0.006,U=-3.728,P=0.001).In the PD patients,the MK value in the substantia nigra ipsilateral to the more affected side showed a negative correlation with the Hoehn-Yahr (H-Y) grade,Unified Parkinson's Disease Rating Scale (UPDRS) Ⅲ scores,and non-tremor scores (r=-0.299,P=0.048;r=-0.366,P=0.015;r=-0.402,P=0.007).The FA values of the bilateral putamen of the TD group and the NTD group were lower than those of the HC group.The FA value in putamen contralateral to the more affected side was positively correlated with H-Y grade,UPDRS Ⅲ scores,and non-tremor scores (r=0.331,P=0.028;r=0.403,P=0.007;r=0.376,P=0.012).Compared with the HC group,the FA value of the bilateral globus pallidus was lower in the TD group.Comparing different subtypes of PD,only the FA and MK values of the bilateral thalamus were different.The tremor scores of PD patients were negatively correlated with the FA value of bilateral thalamus (less affected side:r=-0.371,P=0.013;more affected side:r=-0.402,P=0.007),and positively correlated with MK value (less affected side:r=0.547,P＜0.01;more affected side:r=0.532,P＜0.01).Conclusions The microstructure of the deep brain nucleus of PD is changed,while the TD and NTD patients have only differences in the microstructure changes of the thalamus.The changes in the microstructure of the thalamus are related to the severity of tremor in PD patients.

Objective: To investigate the therapeutic effect of dendritic cell-induced killer cells (DC-CIK) combined with 5-fluorouracil (5-FU) and loaded with CD133+ HT-29 cell lysate or RNA on mice bearing colon cancer HT-29 cell transplanted tumor, and to explore the underlying mechanism. Methods: Colon cancer xenograft model was established in BALB /c nude mice by using human colon cancer HT-29 cells at logarithmic growth phase; Antigen-free DC-CIK, 5-FU+DC-CIK, R+DC-CIK (loaded with total RNA of CD133+ cells), L+DC-CIK (loaded with CD133+ cell lysate), 5-FU and normal saline were respectively injected into transplanted mice, and the treatment efficacies on the growth of transplanted tumor in each group after three treatment cycles were observed, and the tumor growth curve was drawn. The nude mice were sacrificed by cervical dislocation and the tumor volume and body weight were measured. qPCR was used to detect the expression of AKT mRNA in transplanted tumor tissue, and WB was used to detect the expression of phosphorylated AKT protein. Results: After treatment, the body mass of nude mice in R+DC-CIK group, L+DC-CIK group and 5-FU+DC-CIK group increased steadily, while the body mass of nude mice in DC-CIK group and 5-FU group decreased gradually; the tumor growth speed of nude mice in R+DC-CIK group, 5-FU+DC-CIK group and L+DC-CIK group was significantly slower than that of the control group (P<0.05). Compared with 5-FU and DC-CIK alone, the combined treatment with loaded lysate/RNA had more sig nificant effect on mRNA and protein expressions of AKT(P<0.05). Conclusion: The effect of DC-CIKwithdifferentloadingoritscombinationwith5-FUisbetterthanthatofchemotherapy alone. One of the mechanisms is related to the down-regulation ofAKT level.