Objective To explore the diagnostic value of gram-stained sputum smears in elderly patients with ventilator-associated lower respiratory infection (VALRI).Methods 368 elderly patients undergoing mechanical ventilation over 48 hours in ICU were retrospectiely analyzed from Jun 2009 to Jun 2011.42 patients fulfilled the inclusion criteria (with good-quality sputa and presence of the same microorganism in sputum and blood cultures).58 gram-stained smears and sputum cultures were obtained and analyzed.Results The diagnostic sensitivity and specificity of Gram-positive bacteria and Gram-negative bacteria by gram-stained smears were 82.35％ and 78.05％,80.49％ and 82.35％,respectively.The positive and negative predictive value of Gram-positive bacteria and Gramnegative bacteria were 63.64％ and 91.43％,91.67％ and 60.87％,respectively.The coincidence rates in diagnosing Gram-positive bacteria and Gram-negative bacteria were 81.03％ and 79.31％,respectively.Conclusions Gram-stained sputum smear is reliable in diagnosing ventilator-associated lower respiratory infection in elderly patients,and has a certain clinical significance in guiding to the selection of antibiotics.

Altitude ; Altitude Sickness ; prevention & control ; Health Services Administration ; Humans

Adult ; Air Pollution, Indoor ; adverse effects ; Benzene ; adverse effects ; Control Groups ; Female ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Occupational Exposure ; adverse effects ; Paint

OBJECTIVETo compare the efficacy between eccentric fixation and internal fixation for treatment of intertrochanteric fractures of femur,to provide a theoretical basis for the selection of the treatment method of the intertrochanteric fractures of femur.

METHODSFrom February 2007 to January 2010,82 patients with femoral intertrochanteric fracture were treated by internal fixation including 39 cases of eccentric fixation involving 23 males and 6 females, aged from 41 to 81 years old with an average of (62.68±10.69), using the DHS or proximal femoral locking plate; 43 cases of intramedullary fixation involving 15 males, 28 females,aged from 43 to 78 years old with an average of (62.60±8.37),using PFN or PFNA fixed. The surgical incision length, operative time, blood loss and postoperative Harris score between two groups were compared.

RESULTSThe wound of two groups were primary healing without operative complications. All cases received follow-up for an average time of 18.3 months (12 to 28 months). The incision length, operative time and blood loss had a statistically significant difference between two groups (P<0.05). Harris scores of hip joint function at 1 month after operation had statistically significant difference between two groups (P<0.05), and Harris scores at 12 months after operation had no statistical significance difference between two groups. The rate of excellent and good was 89.7% in eccentric fixation group and 90.7% in intramedullary fixation group,the difference was not statistically significant (t=0.0613, P>0.05). In eccentric fixation group, there was 1 case of fracture nonunion with DHS loose and ensuing hip varus deformity. In intramedullary nail fixation group, there was no anti-rotation out,distal intramedullary nail of femoral refracture occurred in 1 case.

CONCLUSIONTwo treatment methods for the treatment of femoral fractures had a good therapeutic effect,but the intramedullary fixation had shorter operative time and less blood loss than the eccentric fixation,it prior to apply to osteoporosis and unstable femoral intertrochanteric fractures.

Adult ; Aged ; Aged, 80 and over ; Female ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Operative Time

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) as common seed cells have been widely used in tissue-engineered cartilage repair.OBJECTIVE: To use human amniotic membrane as a cell scaffold to carry rabbit BMSCs in order to repair articular cartilage defects in the femoral intercondylar fossa of rabbits.METHODS: Rabbit BMSCs were inoculated onto the human acellular amniotic membrane (HAAM) and co-cultured for 2 weeks. Articular defect models were made in the femoral intercondylar fossa of rabbits. The defects of the right knees served as blank control. BMSCs/HAAM composite was transplanted into the defect of the left knee joint as composite group, and HAAM was implanted into the defect of the left knee joint as HAAM group. These rabbits were killed at 8 and 12 weeks after implantation and the newly cartilage samples were evaluated grossly and histologically and then graded.RESULTS AND CONCLUSION: Gross observation showed the defects were filled with cartilaginous tissues in the composite group, and there were no cartilage tissues in the HAAM group, while only fibrous tissues were seen in the blank control group. Histologically, the defect region was full of chondrocytes in the composite group,immunohistochemistry staining indicated that collagen II was rich in the tissue, and furthermore, the cartilage matrix was stained deeply by toluidine blue. In the the HAAM group, there were few chondrocytes, toluidine blue staining was weakly positive, and immunohistochemistry staining was negative, indicating there was no cartilage matrix. In the blank control group, the defects were filled of fibroblasts and toluidine blue staining was weakly positive. To conclude, the BMSCs/HAAM is a good scaffold for BMSCs chondrogenic differentiation to effectively repair articular cartilage defects.

Child ; Humans ; Proteomics ; methods

Adenocarcinoma ; drug therapy ; immunology ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; drug therapy ; immunology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Killer Cells, Natural ; immunology ; Lung Neoplasms ; drug therapy ; immunology ; Male ; Middle Aged ; Phytotherapy ; Quality of Life ; T-Lymphocyte Subsets ; immunology

Objective:To explore the clinical effect of lenalidomide combined with anti-B-cell maturation antigen chimeric antigen receptor T cell (anti-BCMA CAR-T) in the treatment of relapsed/refractory multiple myeloma (RRMM).Methods:The clinical data of a patient with RRMM who underwent lenalidomide combined with anti-BCMA CAR-T therapy in Henan Province Hospital of Traditional Chinese Medicine in January 2020 were analyzed. Clinical manifestations, diagnosis and treatment were also analyzed, and the related literature was reviewed.Results:The patient was a 51-year-old man who was diagnosed as IgD-λ multiple myeloma (MM) in October 2015. The patient achieved remission after 10 courses of chemotherapy regimens including immunomodulators and proteasome inhibitors, followed by autologous hematopoietic stem cell transplantation. MM relapsed after 14 months of transplantation. His disease continued to progress after multiple chemotherapy regimens and mouse or human-derived anti-BCMA CAR-T therapy. After a conditioning chemotherapy regimen of fludarabine and cyclophosphamide, the patient took lenalidomide on day 1 and was infused human-derived anti-BCMA CAR-T cells on the next day. Grade 3 cytokine releasing syndrome (CRS) appeared after infusion, and was resolved after symptomatic treatment. Very good partial response (VGPR) was achieved on day 14 after anti-BCMA CAR-T treatment. VGPR had been maintained for more than 3 months by press time.Conclusion:Lenalidomide combined with anti-BCMA CAR-T therapy is feasible and effective in the treatment of RRMM.

Objective To explore the effects of extract of Gingko biloba leaves (EGb) on learning, memory and hippoeampal heine oxygenase-1 (HO-1) expression in diabetic rats.Methods The behaviors of streptozotoein-induced diabetic rats were observed by Morris water maze for learning and memory after 6 months of diabetes.The HO-1 mRNA expression and protein expression in hippocampus of diabetic rats were detected by RT- PCR and immunohistochemistry respectively.Results The escape latency time in Morris water maze of diabetic rats was prolonged markedly.HO-1 mRNA and HO-1 protein expressions in hippocampus of diabetic rats were increased (1.635?0.326 vs 0.978?0.214,7.2?1.7 vs 1.9?0.5,respectively,both P＜0.01).The escape latency times in EGb (100,50 mg/kg) treated groups were shortened.HO-1 mRNA and HO-1 protein expressions in hippocampus were decreased at the same time as compared with diabetic group (100 mg/kg:0.954?0.144,2.0?0.8;50 mg/kg:0.988?0.154,2.5?0.6,all P＜0.01).Conclusion EGb can significantly inhibit HO-1 expression in hippocampus and improve learning and memory dysfunction in diabetic rats.

Objective To investigate whether leukotriene D4 (LTD4) regulates eotaxin-3 (Eot-3) expression in bronchial epithelial cells, and study effect of pranlukst on the regulation.Methods BEAS-2B cells and normal human bronchial epithelia cells were pre- treated with LTD4 for 1 hour,stimulated with interleukin-4, the cells were incubated for 24 hours. Eot-3 protein in supernatant were measured by enzyme linked immunosorbent assay(ELISA). The cells were pretreated with pranlukast in different concentration, then the above procedure was repeated. Results The untreated bronchial epithelial cell expressed Eot-3 protein on a very low level. After stimulating with IL-4 and incubating for 24 hours, Eot-3 production increased significantly. Pretreating the cells with LTD4 enhanced the inducing effect of IL-4. Pranlukast inverted the upregulation of LTD4. Conclusions Upregulating the expression of Eot-3 induced by IL-4 on bronchial epithelial cells may explain partially the mechanism of leukotrienes involving airway allergic inflammation of asthma. The invertion impact on upregulation of LTD4 by pranlukast may be one of mechanisms that leukotrienes receptor antagonist cure asthma.