Objective To investigate the drug resistance of fungi and bacteria detected by using blood culture from 2010 to 2013. Methods BacT/Alert 3D blood culture system was used,Then VITEK microbiological analyzer was used to identify the bacteria and perform drug sensitivity test,the results were analyzed using WHONET5.4 software.Results There were 108 positive speci-mens among 1 176 samples,the detection rate was 9.18%.Among 123 isolates,60 strains were gram positive(48.78%),47 strains were gram negative(38.21%),16 strains was fungus(13.01%).The major five kinds of pathogenic bacteria were coagulase nega-tive staphylococcus(CNS,44 strains),Escherichia coli (18 strains),Klebsiella pneumoniae (15 strains),candida albicans (10 strains)and Staphylococcus aureus(7 strains).The detection rate of methicillin resistant coagulase negative staphylococci(MRCNS) and Staphylococcus aureus(MRSA)were 72.73%(32/44)in CNS strains and 57.14% (4/7)in Staphylococcus aureus strains,the antibiotic resistance rates of MRSA and MRCNS were significantly higher than that of MSSA and MSCNS,none of Staphylococcus aureus strain was resistant to vancomycin and linezolid.The sensitive rate of Candida albicans to fluconazole,ketoconazole and mi-conazole was high.50% of Escherichia coli strains and 40% percent of Klebsiella pneumoniae strains produced extended spectrum beta-lactamases(ESBLs).The sensitive rate of Enterobacteriaceae to imipenem and meropenem were both 100.00%.The sensitive rate of Pseudomonas aeruginosa to cefoperazone/shubatan,piperacillin/tazobactam were both high.Conclusion CNS is the major kind of bacteria in blood culture.The antibiotic resistance of bacteria is increasing and it is necessary to pay attention to blood cul-ture results in order to guide the clinical use of drugs.

Objective To investigate the clinicopathological and prognosis features of enteropathy-associated T-cell lymphoma (EATL).Methods 21 cases of EATL,6 cases of peripheral T-cell lymphoma (PTCL) and 11 cases of natural-killer/T-cell lymphoma (NKTCL) were collected from January 2008 to May 2015.The immunophenotype of the tumor cell was tested by EnVision and as well as EBV-EBER for EB virus.Some patients were performed with follow-up data.Results 21 EATL patients included 14 males,7 females and the middle age was 55 years old (40-79 years old).15 patients affected the small bowel,4 cases affected colon,2 cases affected more than one site.18 cases were mono-morpholohic EATL while 3 cases were classical EATL.The expression rates of neoplastic cells for CD3ε,CD4,CD8,CD56,Granzyme B,TIA-1 were 95.24 ％ (20/21),20.00 ％ (3/15),73.68 ％ (14/19),85.71％ (18/21),64.71％ (11/17),88.89 ％ (16/18) respectively.The expression of EBER in EATL patients (0,0/21) was obviously lower than that in NKTCL patients (100 ％,11/11).17 EATL patients had follow-up data,and the middle survival time was 15 months.No different prognosis was found in the three kinds of T-NHL (P =0.697).Conclusions EATL usually occurs in elder male and jejunum.The diagnosis of EATL needs a lot of information,including clinical history,endoscopy,histomorphology,immunophenotype and EBV-EBER result.EATL has low mobidity and high malignancy,it still lacks impactful therapeutic regimen.

Objective To investigate the clinical application of ultrasound-guided percutaneous puncture aspiration and sclerotherapy of liver hydatid cysts.Methods Thirty-eight patients of hepatic hydatid cysts underwent ultrasound-guided percutaneous puncture aspiration and sclerotherapy;then 20%-25%septic hypertonic saline or 95%absolute alcohol were injected into the cysts (the volume was about 25%-50%of the aspirated fluid) ;and the fluid was reaspirated after 5-15 min.At last,5-10 ml sclerosing agent was injected again.Oral albendazole 30-50 mg/kg was administrated to all patients before and after the above procedures.Ultrasonic follow-up was performed at 3-month interval in the first year and once a year afterwards.Results The successful rate of once puncture was 100%.Aher 6 months,cysts volume reduced 50% in 16 patients,reduced 30% in 22 patients.One year later,34 patients were cured,3 were effectively treated and 1 was improved.All hydatid cysts volume gradually decreased and calcification occurred.The total cure rate was 100%. Conclusion Ultrasound-guided percutaneous puncture aspiration and sclerotherapy is a safe,effective and reliable treatment of liver hydatid cysts.

Objective: To monitor and evaluate the nutritional improvement of primary and middle school students in rural Tibet from 2015 to 2017, and to provide a reference for local nutritional policy. Methods: From 2015 to 2017, 10% of the primary and middle schools in 45 counties implementing the rural nutrition improvement plan in Tibet were selected to carry out nutrition monitoring assessment. The monitoring indicators included growth retardation, emaciation, overweight and obesity, and the percentage comparison was analyzed by chi-square test. Results: A total of 56 674 aged 6-16 students were monitored from 2015 to 2017, and the wasting rate was 11.62%, 9.08% and 8.39%, respectively.Growth retardation rate was 10.27%, 11.87% and 8.99%.The overweight rate was 5.17%, 6.78% and 7.04%.Obesity rate 2.49%, 2.70%, 5.65%. The wasting rate and growth delay rate of rural students in Tibet decreased year by year, while overweight rate and obesity rate increased year by year. The difference between wasting and growth delay prevalence in three years was statistically significant (χ2=122.40, 81.96, P<0.01).The difference between overweight and obesity prevalence within three years also had statistical significance (χ2=665.88,320.74, P<0.01).The emaciation rate of boys and girls monitored from 2015 to 2017 was 11.85% and 7.60, respectively. Growth retardation was 10.71% and 7.70%.The overweight rate was 6.59% and 6.00%.The obesity rate was 3.41%, 3.50%, the wasting rate difference between male and female in three years has statistical significance (χ2=290.25, P<0.01);The growth delay rate difference was statistically significant (χ2=153.63, P<0.01);The difference of overweight rate was statistically significant (χ2=8.33, P<0.01);There was no statistically significant difference in the obesity prevalence(χ2=0.34, P>0.05), since the emaciation rate, growth delay rate and overweight rate of male students were higher than that of female students. From 2015 to 2017, there were statistically significant differences in weight loss, growth delay, overweight and obesity prevalence among students aged 6-16 years old(P<0.05). With the growth of age, the weight loss rate and growth delay rate increased year by year, while the overweight rate and obesity rate decreased with the growth of age. Conclusion The malnutrition (wasting and growth retardation) of Tibetan rural primary and secondary school students has been improved obviously through the nutrition improvement plan, but the excess nutrition is also increasing.

Dried herb of Delphinium brunonianum Royle (Ranunculaceae) has long been used under the herbal name "Xiaguobei" (Delphinii Brunoniani Herba) in traditional Tibetan medicine and prescribed for the treatment of influenza, itchy skin rash and snake bites. In order to find a useful and convenient method for the identification of microscopic features, the technique of fluorescence microscopy was applied to authenticate "Xiaguobei" of Tibet. The transverse sections of stem and leaf, as well as the powder of "Xiaguobei" were observed to seek for typical microscopic features by normal light and fluorescence microscopy. A style-like, single-cell glandular hair containing yellow secretions on the leaf, young stem and sepal of "Xiaguobei" was found. Under the fluorescence microscope, the xylem and pericycle fiber group emitted significant fluorescence. This work indicated that fluorescence microscopy could be an useful additional method for the authentication work. Without the traditional dyeing methods, the main microscopic features could be easily found by fluorescence microscopy. The results provided reliable references for the authentication of "Xiaguobei".

Objective To investigate the prevalence rate of hypertension among 30 to 70 years old Tibetan citizens in Lhasa municipality. Methods A total of 371 Tibetan men and women aged between 30 to 70 years old were included in this cross-sectional epidemiological study with simple random sampling from October to November 2006. All participants were requested to fill in a Standard questionnaire, blood pressure was measured, body mass index and waist and hip circumference ratio were calculated. Results The overall prevalence rate of hypertension was 40. 2%(36. 6% in men vs. 40. 9% in women, P=0.921). Prevalence rate of hypertension increased with age(r = 0. 995, P ＜ 0. 001). The age-standardized prevalence of hypertension was 37.6%(38. 0% in men and 37. 5% in women). Awareness rate of hypertension was 70. 9%, treatment rate of hypertension was 38. 1%, and control rate of hypertension was 2.4%. Conclusions There was a high prevalence rate and poor control rate of hypertension among 30 to 70 years old citizens of Lhasa. Intensive medical care aimed to better control of blood pressure should be applied to this population.

OBJECTIVETo study the chemical constituents of Incarvillea younghusbandii.

METHODThe chemical constituents were isolated by various column chromatographic methods and structurally identified by NMR and MS evidence.

RESULTFifteen compounds were obtained and identified as isobergapten (1), sphondin (2), imperatorin (3), xanthotoxin (4), phellopterin (5), heraclenol (6), rivulobirin A (7), methyl oleanolate (8), methyl caffeate (9), grevillic acid (10), boschniakinic acid (11), tert-O-beta-D-glucopyranosyl-(R)-heraclenol (12), 5-methoxy-8-O-beta-D-glucopyranosyloxypsoralen (13), 1'-O-beta-D-glucopyranosyl-3-hydroxynodakenetin (14) and phenylethyl-O-beta-D-glucopyranosyl-(1-->2)-beta-D-glucopyranoside (15).

CONCLUSIONAll of these compounds were isolated from this plant for the first time and most of them are furocoumarins.

Benzopyrans ; chemistry ; Bignoniaceae ; chemistry ; Caffeic Acids ; chemistry ; Coumarins ; chemistry ; Furans ; chemistry ; Furocoumarins ; chemistry ; Magnetic Resonance Spectroscopy ; Methoxsalen ; analogs & derivatives ; chemistry ; Molecular Structure

Objective To assess the endemic trend of Kaschin-Beck disease in Tibet and to provide scientific basis for prevention and etiology study of the disease. Methods A questionnaire designed by us was administered to 905 participants who were from Lhundrop county, Medro Gongkar county of Lhasa municipality and Sangri county of Lhoka region in July to November, 2007. The Kashin-Beck disease diagnostic criteria(GB 16003-1995) was used for clinical diagnosis, and children 5 to 14 years old were taken right wrist X-ray film for diagnosis.Results One hundred and forty-four genealogies were recruited in this study. The interview and clinical examination were done to 905 persons, 208 persons were detected with Kaschin-Beck disease, and the detectable rate was 22.98%(208/905). The numbers of patients with degrees Ⅰ , Ⅱ and Ⅲ of Kaschin-Beck disease were 148, 43 and 17, respectively, with proportion of 71.15%(148/208), 20.67%(43/208) and 8.17%(17/208) out of all patients, respectively. The detectable rates of Kaschin-Beck disease were 29.73% (102/343) and 18.86%(106/562), respectively in Lhasa and Lhoka district, and the difference between this two districts was statistically significant(x2= 15.257, P＜ 0.01) . A total of 368 males and 537 females were recruited in this study, the detectable rates of male and female with Kaschin-Beck disease were 19.29% (71/368) and 25.51% (137/537), respectively,and the difference between male and female was statistically significant (x2 = 5.372, P ＜ 0.01) . In this study most patient were between 31 to 70 years old, the patients with degrees Ⅱ or Ⅲ of Kaschin-Beck disease were mostly above 40 years old. There were only 5 patients who were less and equal 20 years old in chinical diagnosis. The Xray positive detectable rate of children between 5 to 14 years old was 6.85% (10/146). Conclusions The condition of Kashin-Beck disease area is relatively stable in these two regions in recent years, and shows a downward trend. However, there are still positive child cases diagnosed by X-ray, which should arouse the attention of the relevant departments to further strengthen the implementation of control measures.

OBJECTIVETo provide a reference for the standardization of Tibetan medicine.

METHODInvestigating the hospital preparations , Tibetan formulated products, and the literature recorded preparations in the Tibetan, Qinghai, Gansu, Sichuan and Yunnan Provinces. Moreover, the varieties, original bases and standard conditions of these preparations were analyzed. According to Chinese Pharmacopoeia, Tibetan medicine part of ministerial standard, Tibetan medicine standards and related monographs and literatures of Tibetan medicine.

RESULTAbout 502 various of herbs were used in 711 hospital preparations from 40 medical institutions, Tibetan formulated products from Tibetan pharmaceutical factories, and 439 literature recorded preparations. About 154 herbs were used in more than 10 preparations, while most of them were Tibetan endemic species. About 416 medicinal varieties have the original documented basis, including 287 botanicals, 78 animal medicines, 51 mineral medicines, involving a total of 94 families, 261 genus and 643 species of botanical origin (including species of the next grade), 35 families, 52 genera and 61 species of the animal origin (including species of the next grade). About 122 varieties of herbs were cross-used in the traditional Chinese medicine and Tibetan medicine, about 80% of Tibetan medicinal varieties are produced in the Tibetan Areas of Tibet Plateau. About 293 medicinal varieties were contained in the above standards. Most of the herb's standards only contains character, indentification, and examination, except for 8 varieties which were recorded in the Chinese Pharmacopoeia (2010) as Tibetan medicine.

CONCLUSIONThis study of quality standard of Tibetan medicine should have an emphasis on the general varieties, especially the study on the arrangement research and the efficacious material basis of the varieties and the original, as well as term standardization of the National Medicine.

Animals ; Drugs, Chinese Herbal ; standards ; Humans ; Medicine, Tibetan Traditional ; standards ; Plants, Medicinal ; chemistry

Objective:To investigate the clinicopathological and molecular genetic characteristics and prognosis of patients with diffuse large B-cell lymphoma (DLBCL).Methods:The clinicopathological data of 152 DLBCL patients receiving consultation and routine physical examination in Peking University Third Hospital and Peking University School of Basic Medicine from January 2008 to December 2015 were retrospectively analyzed. Immunohistochemistry was used to detect the expressions of CD10, bcl-6, MUM1, GCET1, FOXP1. EB virus encoded small RNA (EBV-EBER) was detected by using in situ hybridization. The aberrations of bcl-2, bcl-6 and c-myc genes were detected by using fluorescence in situ hybridization (FISH) to screen double-hit lymphoma (DHL). Kaplan-Meier method was used to make survival analysis.Results:Among 152 cases of DLBCL, the ratio of male to female was 1.49:1, the median age of onset was 59 years (7-90 years), and 79 cases (52.0%) were primary lymph nodes. The median overall survival (OS) time of all cases was 16 months (1-101 months). The 1-year, 3-year and 5-year OS rates were 70.2%, 44.7%, 30.3%, respectively. The OS of R-CHOP treatment group was better than that of CHOP treatment group and untreated group ( P = 0.001). Among all 137 patients receiving double-hit histochemistry score (DHS), there were 56 cases with 0 score, 57 cases with 1 score, 24 cases with 2 scores; and the difference in the OS of different DHS score groups ( P = 0.311). FISH detection showed that among 29 cases achieving results of c-myc gene detection, there were 2 cases of splitting gene and 3 cases of gene amplification; among 26 cases achieving results of bcl-2 gene detection, 2 cases had bcl-2 gene amplification; among 26 cases achieving results of bcl-6 gene detection, 2 cases had bcl-6 gene amplification and 3 cases had splitting gene. It was found that myc and bcl-2 genes were amplified simultaneously in 1 case, accompanied with bcl-6 gene splitting, which was called triple-hit lymphoma. In DHS 0-score group, 1 case of double gene abnormality was found, and 1 case of single gene abnormality was found in group 1-score; in group 2-score, 5 cases were single gene abnormality and 1 case was three gene abnormality, so the gene abnormality was inconsistent with the protein expression. Conclusions:The incidence of DHL in DLBCL patients in China is low. The major gene abnormalities are c-myc or bcl-2, bcl-6 single gene abnormalities.