OBJECTIVE To investigate the pathogenic causes of community acquired pneumonia(CAP) in the elderly and to guide experience antibiotic therapy.METHODS An etiological study was performed on 204 elder patients with CAP in the Cadres Medical Department of Beijing Shijitan Hospital from May 2005 to Apr 2008.The count scores were by CURB-65 scoring system.RESULTS Pathogens were identified in 204 patients: there were Mycoplasma pneumoniae(42,20.6%),Streptococcus pneumoniae(30,14.7%),Haemophilus influenzae(24,11.8%),Chlamydia pneumoniae(17,8.3%),Klebsiella pneumoniae(14,6.9%),Escherichia coli(7,3.4%),Pseudomonas aeruginosa(5,2.5%),Staphylococcus aureus(4,2.0%),Legionella pneumophila(2,1.0%),and Acinetobacter baumannii(1,0.5%).The score,by CURB-65 scoring system,of mixed infected patients was higher than single infections.CONCLUSIONS Atypical pathogens have important role in elderly CAP,the most common pathogenare Gram-negative bacilli,S.aureusand fungi.Mixed infection couldn′t be ignored.

Objective To observe the changes of morphology and biochemical parameters in rats with D-galactose-induced skin ageing. Methods Twenty-six female and male rats were randomly divided into 2 groups. D-galactose group rats were injected subcutaneously with 120 mg?kg-1?d-1 of D-galactose everyday, whereas the control group with normal saline. The rats were sacrificed on days 100. The ageing-related biochemical parameters were detected in the blood and skin, and the cutaneous histopathology was observed. Epidermal thickness and area of elastic fibers were determined quantitatively with imaging analysis system. Results Epidermal thickness and content of elastic fibers were significantly lower in D-galactose group than those in the control group. The loose arrangement of collagen and elastic fibers was evident in D-galactose group. These features of the rats in D-galactose group were similar to those in the ageing skin of human beings. Compared with the control group, the levels of hydroxyproline decreased and malondialdehyde (MDA) increased in the skin of the D-galactose group. The activity of glutathione peroxidase (GSH-PX) and catalase (CAT) in the whole blood and that of superoxide dismutase (SOD) in erythrocytes were remarkably reduced in the D-galactose group as compared to the control group. Conclusions The rat models with skin ageing are established by subcutaneous injection of 120 mg?kg-1?d-1 of D-galactose once daily for 100 days. The changes of morphologic and biochemical parameters in these models are analogous to those in human skin ageing.

Objective To study the effects of Leptin on the expression of CD86 and HLA-DR in human monocytes.Methods The expression of CD86 and HLA-DR in THP-1 Cells and human primary monocytes were detected by flow cytometry.Results Expression of CD86 and HLA-DR in THP-1 cells was significantly increased after treatment with high-dose Leptin ( CD86Untreated group:8.78 ± 1.66,CD86leptin10:50.76 ± 4.29,CD86leptin100:95.20 ± 4.90; HLAUntreated group:20.75 ± 2.12,HLAleptin10:102.14 ± 5.75,HLAleptin100:104.32 ± 4.75;).The similar results were observed in human primary monocytes ( CD86Untreated group:17.91 ± 1.78,CD86leptin100:48.80 ± 3.60; HLAUntreated group:34.10 ± 2.76,HLAleptin100:88.86 ± 3.53).Conclusions By up-regulating CD86 and HLA-DR expression,Leptin might enhance the ability to present antigen in THP - 1 cells and human monocytes.

Objective:To detect the influence of Ipas, and construct better Shigella vaccines.Methods: Guniea pigs were immunized with Ipa + and Ipa - bivalent Shigella vaccines strains by eyes mucosal immunization, and challenged with willed strains. The specific antibodies in tears were measured by BA ELISA assays after immunization and challenge. Results: The levels of specific local specific antibodies of immunized groups increased significantly compared to the control group and Ipa + group compared to Ipa - group after immunization.Conclusion: The expression of invasive plasmid antigens(Ipa) can enhance the levels of specific local antibodies. The two Shigella vaccines have good immunogenicity.

Objective To investigate the effect of different concentrations of arsenic trioxide (As2O3,ATO) on neurokinin A (NKA) in renal tissue of BXSB mice and explore its clinical value.Methods Fifty BXSB mice (twelve weeks old and weighted 23～26 g) were randomly divided into control group,systemic lupus erythematosus (SLE) group,and therapeutic group of three different concentrations of ATO.All biochemical indicators were analyzed before and after treatment.The pathology of renal tissue was examined by immunohistochemistry.The concentration of NKA in renal tissues was detected by ELISA and the concentration of NKA mRNA was detected by RT-PCR.Results The concentration of NKA in SLE group in renal tissue (299±26) pg/g was significantly higher than that of normal control group (122±7) pg/g (P＜0.05).The concentration of NKA in the SLE group in renal tissue was significantly higher than that of three different concentrations of ATO in low-dose group (151±14) pg/g,moderate--dose group (147±9) pg/g and in highdose group (155±14) pg/g (P＜0.05).No difference was found between three different dosages of ATO treatment groups and normal control groups (P＞0.05).There were no significant differences among three different dosages of ATO treatment group (P＞0.05).The side effects in low-dose group were significantly lower than those of moderate and high-dosage groups (P＜0.05).Conclustion NKA concentration expressed in the renal tissues in the SLE group is higher than that in the control group.Decreasing the concentrations of NKA mRNA in renal tissues may be one of the important mechanisms of ATO in treating SLE.Low-dosage ATO is safe and effective to treat SLE and has therapeutic potentials.

Objective To update the knowledge of contact allergy to topical corticosteroids.Methods A total Of 1,822 patients,who Sufiered from inflammatory skin disorders but did not respond well to topical corticosteroids,were enrolled into this study.Patch test was performed on these subjects with corticosteroid allergens,following the standardized rocedures ecommended by the International Contact Dermatitis Research Group(ICDRG).Results Of all patients,78(4.28%)had positive patch test.Among the 78 patients,33 were males,45 females,and most were young or middle-aged.During 96-168 hours after the removal of patches,positive results Were observed in 42.31%(33/78)of the patients.Twenty eight patients had anaphy lactic reaction induced by hydrocortisone butyrate,25 by dexamethasone sodium phosphate,and 17 by triam cinolone acetonide.A correlation Between sensitizing glucocorticoids detected by patch testing and adminis trated drugs in clinic was found in 74 cases.ConclusionsContact allergy caused by topical corticosteroids is not rare,and more attention should be paid to this issue in the treatment of inflammatory skin disorders.

Objective To discuss the advantages of balloon combined with stent-assisted steel-coil embolization in treating intracranial wide-necked aneurysms located at artery bifurcation sites. Methods The clinical data of 20 patients with intracranial wide-necked aneurysms located at artery bifurcation sites (25 aneurysms in total), who were admitted to the First Affiliated Hospital of Kunming Medical University during the period from January 2014 to May 2014 to receive balloon combined with stent-assisted steel-coil embolization treatment, were retrospectively analyzed. Among the 20 patients, 16 had a history of subarachnoid hemorrhage and 4 had no history of subarachnoid hemorrhage. A total of 25 intracranial aneurysms located at artery bifurcation were detected; the locations included basilar terminal bifurcation (n=14), middle cerebral artery (MCA) bifurcation (n=8) and internal carotid artery (ICA) bifurcation (n=3). Three dimensional DSA was performed immediately and three months after the treatment , and the manifestations were evaluated according to Raymond classification. The clinical efficacy at three months after the treatment was assessed with the modified Rankin scale (mRS). Results Three dimensional DSA performed immediately after the balloon combined with stent-assisted steel-coil embolization treatment showed that among the 25 intracranial wide-necked aneurysms located at artery bifurcation 21 belonged to Raymond gradeⅠ, 2 belonged to Raymond grade Ⅱand 2 belonged to Raymond grade Ⅲ. Follow-up DSA performed three months after the treatment revealed that 20 aneurysms were Raymond grade Ⅰ, 3 aneurysms were Raymond gradeⅡand 2 aneurysms were Raymond grade Ⅲ. Three months after the treatment the mRS score was 0 point in 17 patients and one point in one patient, and the prognosis of these patients was good; the mRS score was 4-6 points in 2 patients, and the prognosis of the two patients was poor. Conclusion For the treatment of intracranial wide-necked aneurysms located at artery bifurcation sites, balloon combined with stent-assisted steel-coil embolization has obvious advantages.

Objective To analyze the clinical features of Weber-Christian disease (WCD) and to make a review of the literature for early diagnosis and treatment.Methods The clinical features of an atypical WCD patient who had been misdiagnosed as polymyositis were analyzed.Results WCD was characterized by subcutaneous nodules and systemic symptoms.Repeating physical examination and biopsy in time were important if the nodules were not obvious.Conclusion WCD is often misdiagnosed because of the complicated clinical manifestations.Carefully physical examination and timely biopsy are help for early diagnosis.

Objective: To observe the effect of telomerase-antisense DNA on apoptosis of hepatoma cells induced by arsenic trioxide, in an effort to look for a new anti-hepatic cancer agent with high efficiency, low cytotoxicity. Methods: We designed and synthesized a 20nt telomerase-antisense DNA targeting telomerase template and observed its influence on the telomerase activity of hepatoma cells. H-E staining, flow cytometry, and DNA agarose electrophoresis were used to study the preventive effect of telomerase-antisense DNA on hepatoma cells apoptosis induced by arsenic trioxide. Flow cytometry was used to detect the expression of Fas, Fas-L, and bcl-2. Results: Telomerase-antisense DNA (5 ?mol/L) effectively inhibited the telomerase activity of hepatoma cells after 24 hours (P

Objective To observe the effects of vitamin K3(VK3) on cell growth and apoptosis in the cell line SMMC-7721 of human liver cancer and the changes in expression of survivin gene.Methods The inhibitory effect of VK3 on SMMC-7721 cells was examined by CCK-8 (cell counting kit).Morphological evaluation of apoptosis was performed by Hoechst33342 staining.The amount of apoptotic cell was assayed by flowcytometry.The changes of survivin gene expression were detected by RT-PCR.Results The inhibitory rate of VK3 (at concentrations of 2,5,10,20,25 mmol/L for 48 h) on SMMC-7721 growth was 3.8%,50.1%,63.9%,78.5%,84.7% respectively.The cells in apoptosis were strongly stained by Hoechst33342 compared with the cells in control group.The apoptostic rate of cells was 33.28%,63.97%,77.69%,87.30% and 92.40%.Following exposure to VK3 at the concentration of 2,5,10,20 and 25 mmol/L for 48h,the survivin mRNA expression in SMMC-7721 was downregulated.Conclusion VK3 inhibits the proliferation of SMMC-7721 cells and induce apoptosis.The mechanism may related to survivn gene.