OBJECTIVE To investigate the value of fibrobronchoscopy and bronchoalveolar lavage in etiologic diagnosis of pneumonia in immunocompromised patients.METHODS The clinical document and results of fibrobronchoscopy and bronchoalveolar lavage in 36 immunocompromised patients with pneumonia were retrospectively analyzed,whose conditions were mainly after organ transplantation and hematologic neoplasia.RESULTS Through fibrobronchoscopy and(or) bronchoalveolar lavage,22 cases(61.1%) were etiologically diagnosed.In 19 cases taking cytomegalovirus(CMV) quantitative PCR test of both peripheral blood and BALF,the positive rate of blood and BALF was 14.3% and 42.9%,respectively(P

Objective: To investigate the protective factors and risk factors of nosocomial infection of severe acute respiratory syndrome (SARS) among health care workers (HCWs) , and thus provide the scientific basis for prevention and control of nosocomial infection. Methods: With the case-control study,a standardized questionnaire was used for data collection in three general hospitals where nosocomial infection had occurred. Univariate analysis was done at first. All concerned factors about SARS infection were scanned by using Chi-square test and Fisher' s exact test one by one, and determined as to whether they were risk factors or protective factors according to odd ratio (OR) score. Then, multivariate unconditional logistic regression analysis was used to re-analyze the picked-out factors for finding out which factors played independent roles. Results: Twenty-two factors (nineteen protective factors and three risk factors), among the total fifty-six factors, were significantly associated with SARS infection. Multivariate unconditional logistic regression revealed that factors such as double exposure suits ( OR = 0.053 ), education ( OR =0.072), gloves ( OR =0.102), hands sterilized by iodine ( OR =0.231 ), room air ventilation (OR = 0.32), were significantly protective; conversely, tracheal intubation ( OR = 30.793 ) was a significant risk factor. Conclusion: Strict defense and antisepsis measures were pivotal in preventing SARS infection among high-risk medical personnel. Education about associated knowledge and effective air ventilation were also important factors.

Objective To investigate the micro -channel percutaneous nephrolithotomy under ultrasound guidance in clinical studies of renal calculi in non -dilated collecting system.Methods Clinical data of 126 patients with renal calculi in non -dilated collecting system treated by ultrasound -guided percutaneous nephrolithotomy microchannel were retrospectively analyzed.Ureteroscopy up to the renal pelvis or ureter segment,zebra guide wire was placed along the guide wire indwelling ureteral catheter end connected to the blood transfusion needle while external saline suspension 100cm.Ultrasound -guided puncture target cup,established 16 -18F channel percutaneous nephro-lithotomy,ureteroscopy downlink percutaneous nephrolithotomy lithotripsy.The clinical data of operation time,stone clearance rate,blood loss,complications were analyzed.Results 124 patients with successful puncture,puncture fail-ure in two patients,conversion to open surgery.118 cases of successful implementation of a single -channel stone, nine cases of postoperative residual stones was found,again two stone surgery in 6 cases,3 cases refused surgery again;six cases were due to stones larger load,operation time exceeded 2h,to 2 stage of stone surgery in 4 cases, 2 cases changed to standard channel.Operation time was 30 -150min,average 78min.A stone clearance rate was 87.3%,summarize stone clearance rate was 95.2%(118 /124).Postoperative hemoglobin level decreased to (16.0 ± 7.6)g/L,7 patients with postoperative bleeding more blood transfusion 400 -800mL,none embolization.4 cases of postoperative fever,septic shock in 1 case,1 case of pneumothorax.Conclusion The micro -channel percutaneous nephrolithotomy under ultrasound guidance in the treatment of renal calculi in non -dilated collecting system is safe and feasible,it is the preferred method of treating renal calculi in non -dilated collecting system.

Objective To compare the efficacy of three endoscopic surgery in impacted upper ureteral calculi treatment.Methods 218 patients with impacted upper ureteral calculi were treated with minimally invasive percutaneous nephrolithotomy (MPCNL),transurethral ureteroscope lithotripsy(URL)and retroperitoneal laparoscopic urerolithotomy (RLU)respectively.The operation safety,efficacy and complication were compared in the three groups.Results In the MPCNL group,URL group,RLU group one success rate of lithotripsy were 100.00%,85.19%,100.00% respec-tively.The mean operative time were (76.35 ±16.20)min,(46.26 ±15.30)min,(89.20 ±19.60)min respectively. Decreased hemoglobin values were (22.24 ±8.63)g/L,(4.15 ±1.89)g/L,(10.68 ±4.55)g/L respectively.The stone -free rates of one month postoperation were 96.32%,79.59%,100.00%.Length of hospital stay were (8.56 ± 2.13)d,(6.58 ±1.76)d,(9.79 ±2.14)d,respectively,the differences were statistically significant(t/χ2 =36.916, 27.629,all P <0.05).Conclusion MPCNL and URL for impacted upper ureteral calculi is safety and has good efficacy and less complications,but the MPCNL is recommended the first choice,some cases can try URL.

Objective To investigate the expression of proline rich tyrosine kinase 2 (Pyk2) in non-muscle invasive bladder cancer,and analyze its correlation to clinicopathologic features and prognosis of non-muscle invasive bladder cancer.Methods 114 surgical specimens and 50 normal bladder mucosa specimens were collected from 114 non-muscle invasive bladder cancer patients who underwent TURBT at our hospital,from June 2013 to March 2018.Of the 114 patients,63 were male and 51 were female,aged 42-87 years,average age of (63.6 ± 13.8) years,73 cases of tumor ＜3 cm,41 cases of tumor ≥3 cm,83 cases were single and 31 cases were multiple tumor,53 cases were high grade and 61 cases were low grade,59 cases were Ta and 55 cases were T1 stage.Pyk2 protein expression was detected by immunohistochemistry and western blot.The correlation of the expression of Pyk2 with clinicopathologic features,including gender,age,tumor size,the number of tumors,histological grade and clinical stage were analyzed.Survival analysis was calculated by using the Kaplan-Meier method,and the difference in survival curve was analyzed by using the log-rank test.Association of Pyk2 expression with prognosis of non-muscle invasive bladder cancer analyzed by using the Cox proportional hazards regression model.Results Compared with normal bladder tissues,expression of Pyk2 protein was increased in bladder cancer tissue significantly(0.571 ±0.230 vs.0.253 ± 0.152,P ＜0.01).The expression of Pyk2 protein was closely related to clinical stage(P =0.027) and grade(P =0.010),rather than gender (P =0.275),age (P =0.419),tumor size (P =0.317),and tumor number(P =0.208).The recurrence rate in the Pyk2 positive group and negative group were 46.1％ (35/76)and 28.9％ (11/38)respectively.The progression rate in the Pyk2 positive group and negative group were 35.5％ (27/76) and 10.5 ％ (4/38) respectively.Survival analysis suggested expression of Pyk2 in non-muscle invasive bladder cancer had a significant relation to recurrence-free survival rate(P ＜0.001) and progression-free survival rate(P =0.003).In the multivariable Cox analysis,we found that Pyk2 protein was an independent predictor of recurrence-free survival rate(HR 0.245,95％ CI 0.078-0.768,P =0.016) and progression-free survival rate (HR 0.095,95％ CI 0.012-0.764,P =0.027).Conclusions The expression of Pyk2 in non-muscle invasive bladder cancer was significantly increased.The expression of Pyk2 has a significant relation to recurrence and progression of non-muscle invasive bladder cancer.High Pyk2 expression is an independent prognostic factor in non-muscle invasive bladder cancer.

Objective To evaluate the preservation effect of normothermic mechanical perfusion with red blood cells from humanized genetically modified pig on severed human limbs.Methods Severed human limbs were perfused with red blood cells from humanized genetically modified pigs for 6 h.Perfusion solution was taken every hour to measure the oxygen partial pressure,Na+,K+,Ca2+,pH value,glucose,lactic acid and creatine kinase levels.Superficial flexor muscle was sampled to detect the changes of tumor necrosis factor(TNF)-α,interleukin(IL)-2 and IL-1 levels.At 0 and 6 h after perfusion,the superficial flexor muscles of the forearm were taken for pathological examination.Intercellular space and glycogen consumption of skeletal muscles were observed.An appropriate amount of forearm vessels was collected every 2 h to detect the apoptosis of vascular endothelial cells.X-ray angiography was performed before perfusion and 6 h after perfusion to observe the filling degree of finger-tip peripheral vessels.Results The oxygen partial pressure was observed in the normal range throughout the perfusion.Na+concentration peaked at 1 h,reaching 138.7 mmol/L,and then fluctuated within the normal range.K+level peaked at 2 h up to 6.08 mmol/L,then decreased and fluctuated within the normal range.Ca2+concentration reached the peak at 4 h,up to 1.03 mmol/L.Glucose level was gradually decreased at the beginning of perfusion,reaching the lowest value of 17.7 mmol/L at 2 h after perfusion,and then maintained a dynamic balance.The pH value was decreased to 7.28 at 6 h after perfusion.The lactic acid level was increased to 9.6 mmol/L at 1 h after perfusion,and then gradually decreased.The creatine kinase level was increased at the start of perfusion,reached the peak at 2 h up to 20 030 U/L,then decreased and remained stable at the end of perfusion.At the end of perfusion,the morphology of muscle fibers was normal,the gap among muscle fibers was expanded slightly,and the glycogen of skeletal muscles was not significantly accumulated.At 0 h perfusion,the number of apoptotic cells in vascular endothelial cells was large,which was declined at 6 h perfusion.Evident vascular filling was observed at 0 h,and the filling degree of some finger-tip vessels was decreased at 6 h.Conclusions Normothermic mechanical perfusion of severed human limbs with red blood cells from humanized genetically modified pigs may continuously and stably supply energy and oxygen,adjust the ion pH balance of perfusion solution,maintain normal cellular metabolism and exerts certain protective effect upon severed human limbs.

Objective: Human rhinovirus A21 (HRVA21) with mutations in antigenic gene has been reported causing severe human infections. This study aimed to investigate intensively the pathogenesis of HRVA21 by identifying the characteristics of neutralizing antibodies (NAbs) distribution. Methods: Virus stock was isolated from HRVA21-positive respiratory specimens. The tissue culture infective dose 50 (TCID₅₀) was applied. Sera from healthy volunteers in different age groups were used to analyze the NAbs by using the diluted serum and fixed viral TCID₅₀. Results: We obtained the HRVA21 virus stock and its whole genome sequences shared 100% similarity to the used clinical sample. In the 379 collected serum samples, the positive rates of NAbs were 21.7%, 14.1%, 28.2%, 25.4%, 27.9% and 20.7% in age groups of 0-5 y, 5-14 y, 15-25 y, 26-45 y, 46-60 y and > 60 y, respectively. In age groups of >5-14 y and 15-25 y, the positive rate of NAbs showed significantly different (χ²=4.68454, P=0.03044). Higher geometric mean titers were found in 15-25 y group compared to 5-14 y age groups (P=0.0313). Conclusions The low level of HRVA21 NAbs in different age groups indicated a low epidemic of HRV21 infection and high susceptability to infections by the virus.

In order to screen African swine fever virus (ASFV) diagnostic antigen with the best enzyme linked immunosorbent assay (ELISA) reactivity. By establishing the ELISA method, the diagnostic antigen of ASFV p30 protein expressed by baculovirus-insect cell expression system as reference, we explored the antigenic properties and diagnostic potential of ASFV p35 protein expressed by prokaryotic expression system as a diagnostic antigen. The results of Western blotting and immunofluorescence show that the molecular weight of the recombinant p35 protein and p30 protein obtained was 40 kDa and 30 kDa, respectively, and these two proteins had good immuno-reactivity with ASFV positive serum. Recombinant p30 and p35 proteins were used as diagnostic antigens to establish ELISA, and the sensitivity and repeatability of these methods were tested. The results show that although the detection sensitivity of the p30-ELISA established in this study was higher than that of the p35-ELISA, the sensitivity of p35-ELISA was 95.8%, and variations in intra- and inter-assay repeatability of the two methods were less than 10%. The coincidence rate between the p35-ELISA and the imported kit was 97.2%. Results show that p35-ELISA was sensitive and stable, and could detect specific antibodies against ASFV.
African Swine Fever/diagnosis* ; African Swine Fever Virus/genetics* ; Animals ; Antibodies, Viral ; Enzyme-Linked Immunosorbent Assay ; Recombinant Proteins/genetics* ; Swine

Humans ; Staphylococcus lugdunensis/genetics* ; Peptides, Cyclic ; Chromosomes ; Operon/genetics* ; Staphylococcal Infections/genetics* ; Bacterial Proteins/genetics* ; Anti-Bacterial Agents

Humans ; COVID-19 ; Quarantine ; Renal Dialysis ; SARS-CoV-2 ; Hospitals