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.

Surgical resection remains the cornerstone of therapy for early stage lung cancer. Five-year survival rates are reported as high as 92% for stage Ⅰ non-small cell lung cancer (NSCLC). However, many patients presenting with resectable early stage disease are unable to tolerate pulmonary resection, even sublobular resection, because of compromised cardiopulmonary functions or other comorbidities. Traditionally,patients deemed medically inoperable have been treated by external-beam radiation. But the results were poor with a mean survival of 20 months and a 5-years survival rate of 12%. In this scenario, we need to develop other non-surgical local therapies. One of these was image-guided percutaneous radiofrequency ablation(RFA).Many clinical trials show that RFA for lung tumors is a minimally invasive, feasible and safe technique with minor mortality and morbidity. Moreover, its efficacy seems to be promising, even in the long-term follow-up.Further experiences and comparison with other emerging minimally invasive local treatments are required to determine its rote in the treatment of medically inoperable early stage NSCLC.

Recently,the progress in employing transplanting stem cells to cure injured retina is very fast and has been continuously yielding exciting results.Various sources are used in the studies,including retina-derived cells such as M?ller cells and ciliary body cells,and non-retina-derived cells such as embryonic stem cells and brain-derived stem cells.This review briefly discusses the recent progress of these studies.

Using a UPLC-MS/MS (MRM) and cocktail probe substrates method, the metabolic fingerprint of the compatibility of Radix Aconite (RA) and Radix Paeoniae Alba (RPA) and its effect on CYP450 enzymes were investigated. These main CYP isoforms include CYP 1A2, CYP 2C, CYP 2E1, CYP 2D and CYP 3A. Compared with the inhibition effect of RA decoctions on CYP450 isoforms, their co-decoctions of RA and RPA with different proportions can decrease RA' inhibition on CYP3A, CYP2D, CYP2C and CYP1A2, but can not reduce RA' effect on CYP2E1. The metabolic fingerprints of RA decoction and co-decoctions with different proportions of RPA in CYP450 of rat liver were analyzed by UPLC-MS. Compared with the metabolic fingerprints of RA decoction, the intensity of diester-diterpenoid aconitum alkaloids decreased significantly, while the intensity of monoester-diterpenoid alkaloids significantly increased in the metabolic fingerprints of co-decoctions of RA and RPA. The results suggest that RA coadministration with RPA increased the degradation of toxic alkaloid and show the effect of toxicity reducing and efficacy enhancing.
Aconitum ; chemistry ; Alkaloids ; chemistry ; Animals ; Chromatography, High Pressure Liquid ; Cytochrome P-450 Enzyme Inhibitors ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Liver ; drug effects ; enzymology ; Metabolome ; Paeonia ; chemistry ; Rats ; Tandem Mass Spectrometry

Objective To study the synthesis and degradation of collagen at the transcription level during liver fibrosis in rabbits with schistosomiasis japonica. Methods New Zealand rabbits infected with Schistosoma japonicum cercariae were served as animal models of liver fibrosis. The liver specimens were collected through operations at 4, 6, 8, 10, 12, 16, 20, 24 and 28 weeks after infection. TypeⅠcollagen, type Ⅲ collagen, type Ⅳ collagen, MMP\|1 and MMP\|9 mRNA levels of liver tissue were detected by RT\|PCR plus dot blotting, and the size of egg granulomas and the degree of liver fibrosis were measured by histopathological examinations. Results TypeⅠcollagen, type Ⅲ collagen, type Ⅳ collagen, MMP\|1 and MMP\|9 mRNA levels increased simultaneously in the early stage after the infection, mostly reaching their peaks at 10 weeks after infection. Compared with normal controls, type Ⅰ collagen, type Ⅲ collagen, type Ⅳ collagen, MMP\|1 and MMP\|9 mRNA levels increased by 12\^0 , 11\^0 , 6\^6 , 10\^0 and 11\^0\|fold, respectively, coinciding with the changes of egg granulomas. Thereafter, both collagen and collagenase mRNA levels decreased. TypesⅠ, Ⅲ and Ⅳ collagen mRNA levels declined to 2\|fold to 3\|fold compared with normal controls ( P 0\^05) at 28 weeks. This study showed that the synthesis and degradation of collagen remained dynamic balance in the early stage of schistosomiasis, while in the later stage the metabolism of collagen synthesis was higher than that of collagen degradation. Conclusion It was confirmed at the transcription level that when the metabolism of collagen synthesis was higher than that of collagen degradation in rabbits with schistosomiasis japonica, liver fibrosis might be produced.

Cerebral Hemorrhage ; epidemiology ; etiology ; prevention & control ; Cerebral Ventricles ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; epidemiology ; etiology ; prevention & control

Adult ; Cranial Nerve Neoplasms ; diagnosis ; Diagnostic Errors ; Facial Nerve ; pathology ; Hemangioma ; diagnosis ; Humans ; Male

Objective To evaluate mini-percutaneous nephrolithotomy in treating superior segmental ureteral calculi. Methods Two Hundred and thirty-six patients underwent mini-percutaneous nephrolithotomy with holmium laser for superior segmental ureteral calculi from May 2005 to May 2008, 133 male and 103 female. Their age ranged from 17 to 76 years old with a mean of 47. 2 years. Of the 236 patients,141 compli-cated with calculi in the left side and 88 cases in the right side,7 in the both sides. The calculi diameter ranged from 0. 7 cm to 2.2 cm and the mean diameter was 1.4 cm. One hundred and ninety-three patients had undergone ESWL from 1～6 times. Results Of the 236 patients,217 were rendered stone-free at 1 pro-cedure. Residual calculi were found in 12 cases after operation and drugs were used for treatment. The resid-ual calculi were removed after 1 month. Seven cases with residual calculi were treated by ESWL and the cal-culi were removed. The total stone clearance was 91.9%. The mean operation time was 31.3 min(rang from 19～52 min), and the mean hospital stay was 9.5 days(rang from 6 to 12 days). The main complications following operation included: durative hematuria in 25 cases relieved by haemostasis and diuresis treatment within 24 to 48 hours,pnstoperative fever in 141 cases within 24 hours of which 103 were relieved by antiin-flammatory and fluid replacement treatment within 24 to 48 hours. Thirty-eight cases were relieved by anti-inflammatory treatwent depending on urine culture results within 3 to 7 days. The postoperative pain in all patients was light. Conclusion Minimally invasive percutaneous nephrolithotomy with holmium laser under ultrasound guidance is simple,safe and effective in treating proximal ureteral calculi.

Child ; Child, Preschool ; Humans ; Sleep Apnea, Obstructive

Objective To induce mice bone marrow(BM) mono-nuclear cells into dendritic cells(DC) in vitro,and then produce function vaccine of anti-myeloma by bone marrow derived dendritic cells(BM-DC).Methods Mono-nuclear cells separated from mice bone marrow were cultured in tissue culture plastics which supplemented granulocyte-macrophage clonystimulating factor(GM-CSF),IL-4.During the 8 days,there were numerous of mature DCs outgrown,and then fused with SP 2/0 myeloma cells in logarithmic growth phase cultured with 8-azaguaine by polyethylene(PEG).The resulting purified DC/myeloma hybrids were generated by selecting with hypoxanthine-aminopterin-thymidine(HAT).The specific anti-tumor activity was examined in vitro.Results Mono-nuclear cells derived from BM cultured by supplement propriate cytokines milieu in tissue culture plastics,and then exposed to lipopolysaccharide(LPS).There were plenty of mature DCs appear as early as day 8,and exhibit dramatic veils of cytoplasm and extensive dendrites in their surfaces,high express CD11c(83.19%),major histocompatibility complex(MHC)-Ⅱ(95.25%),CD86(89.24%),their capacity to stimulate primary T cell responses in mixed leukocyte reaction(MLR) would be shown strongly.Hybrids could grow well through PEG fusion and HAT selection.These hybrids could stimulate naive T cells into cytotoxic T-lymphocyte(CTLs) directed against SP 2/0 myeloma,and exhibit strong specific killed ability.Conclusions BM-DCs is fused with tumor cells ensure the tumor associated antigens could be processed and presented effectively,and stimulate specific anti-tumor immunity so that prevent or cure this kind of tumor.So it's feasible in practice to produce anti-tumor vaccine by BM-DCs.