OBJECTIVE:To investigate the pathogen distribution and drug resistance situation in bronchoalveolar lavage fluid (BALF) from patients with refractory pulmonary infection,and provide reference for clinical rational drug use. METHODS:The sputum and BALF specimen of 136 inpatients with refractory pulmonary infection from the First People’s Hospital of Zhenjiang City from Jan. 2012 to Dec. 2015 were cultured and identified,pathogen detection was compared,and results of drug sensitivity test for pathogen in BALF specimen was analyzed. RESULTS:The positive rates of sputum and BALF specimen of 136 inpatients were 22.06%and 47.79%,with statistical significance(P<0.01);a total of 32 and 72 strains were isolated,they mainly were Ste-notrophomonas maltophilia,Pseudomonas aeruginosa,Acinetobacter baumannii and Staphylococcus aureus. S. maltophilia in BALF was sensitive to minocycline and levofloxacin;resistance rate of P. aeruginosa to common antibiotics was lower than 50%;A. baumannii was sensitive to imipenem,ampicillin sodium and sulbactam sodium,amikacin and minocycline;S. aureus was sen-sitive to linezolid,chloramphenicol and vancomycin. CONCLUSIONS:The positive rate of BALF specimen is higher than spu-tum,the pathogens are mainly Gram-negative bacteria. Clinic should rationally select antibiotics based on the drug sensitivity test and clinical symptoms.

This paper presents the common psychological problems and the efficacy of psychological warfare in modern ages, suggesting that enough emphasis should be paid to the psychological injury caused by the war itself and by psychological warfare. The related researches in our country were also reviewed.

Objective To observe the expression of anti-cardiac myosin antibody(AMA) and the collagen volume fraction(CVF) in serum in mice with chronic viral myocarditis(CVMC),and to explore the preventive and protective function of oxymatrine on myocardium.Methods BALB/c mice(n=60) were infected with coxsackievirus B3(CVB3) of increased dose biweekly to establish CVMC model.Mice in normal control group(n=8) received equal-volume 9 g?L-1 saline without CVB3 at the same time.The surviving mice in CVMC model group were randomly divided into CVMC control group(n=8) and oxymatrine therapy group(n=8) at the 42th day.From then on,mice in oxymatrine therapy group were treated with oxymatrine at the dose of 100 mg?kg-1?d-1 by gastric perfusion once a day for 28 days,and meanwhile mice in CVMC control group and the normal control group received equal-volume 9 g?L-1 saline by gastric perfusion every day.Then all mice were sacrificed at the end of the experiment.The ratio between heart weight to body weight(HW/BW) was calculated.Myocardium slides were stained with collagen specific Picric acid-Sirius red staining,and the CVF was calculated with image analysis software.The serum level of AMA(optical density value,A value) was detected by enzyme-linked immunosorbent assay(ELISA).Results HW/BW(0.007 9?0.000 3),CVF [(15.30?1.08)%] and the A value of AMA(0.286?0.053) in mice of CVMC control group were increased significantly compared with those in normal control group HW/BW(0.005 5?0.000 2),CVF[(6.84?1.11)%],the A value of AMA(0.160?0.050)(Pa

[ ABSTRACT] AIM:To observe the effect of endogenous nitric oxide synthase ( NOS) inhibitor asymmetric dimeth-ylarginine ( ADMA ) and its signaling pathways on NO levels and skeletal muscle contractility in 4-week running rats. METHODS:The 4 weeks running rat model was established.The twitch tension, tetanic tension and the fatigue test of sole-us muscle induced by electrical stimulation ex vivo were detected.The ATP content, mitochondrial DNA levels and the mR-NA expression of peroxisome proliferator-activated receptor γcoactivator-1α(PGC-1α), nuclear respiratory factor (NRF) were measured to reflect the mitochondrial function and biosynthesis in the skeletal muscle.Serum ADMA concentration was detected by high performance liquid chromatography.The endogenous ADMA enzymes PRMT1 and 2 subtypes of ADMA me-tabolism enzyme DDAH, 3 subtypes of NOS protein expression in the skeletal muscle were determined by Western blot.NOS activity and nitric oxide ( NO) content were analyzed by colorimetric method.RESULTS: Compared with normal control group, the twitch tension, tetanic tension and the anti-fatigue capability of soleus muscle in running group were significantly enhanced, ATP content, mitochondrial DNA content and the mRNA expression of PGC-1αand NRF were significantly in-creased (P<0.01).In addition, the protein expression of constitute type NOS (cNOS) and NOS activity were significantly increased (P<0.01), but the increase in NO content was relatively smaller in soleus muscle in exercise group (P<0.05). Moreover, serum ADMA concentration in running group was increased, while the DDAH2 expression in skeletal muscle was decreased.CONCLUSION:Short-term endurance exercise enhances the twitch tension, tetanic tension and fatigue resist-
ance of soleus muscle.The mechanism may be that increased cNOS expression feedbacks to increase ADMA concentration, thus maintaining the increase in NO synthesis at a relatively low level, and resulting in promoting skeletal muscle mitochon-dria biosynthesis and mitochondrial function.

Caco-2 cell monolayer model is widely utilized in drug absorption study and 12-well transwellTM plates were commonly used to study the absorption of different kinds of natural products. To establish a stable method for the study of traditional Chinese medicine prescription, 6-well plates were chosen because of the larger well volumes than 12-well plates. To study the impacts of collagen kinds, coating density as well as coating time on the cell culture, the transepithelial electrical resistance of Caco-2 cell monolayers grown on different collagen coating transwells was determined, and the permeations of propranolol and atenolol as standard markers were detected with HPLC. The results showed that the kinds of collagen, the different coating densities and coating time of rat tail collagen had no significant influences on the Caco-2 cell monolayer integrality and absorption capacity. 6-well plates coated with 2 micro g Scm-2 rat tail collagen for 1 hour were enough reliable and suitable for the study of traditional Chinese medicine prescription in vitro.
Adsorption ; Animals ; Caco-2 Cells ; Cell Culture Techniques ; methods ; Collagen ; chemistry ; Drug Prescriptions ; Humans ; Medicine, Chinese Traditional ; Rats ; Time Factors

The improvement of diagnostics teaching system,including the establishment of curriculum system and evaluation system,is the base of promoting clinical- medicine teaching.Our study showed that the theoretical knowledge and clinical skill of medical students could be improved by constructing clinical diagnostics curriculum system and improving organization management and assessment system,which could pave the way for the transition from medical students to clinicians.

Objective To explore the effect of soluble tyrosine kinase 2 fusion protein (sTie-2-Fc) on peritoneal angiogenesis, solute transport and ultrafi]tration capacity in uremic rats undergoing peritoneal dialysis (PD). Methods Thirty-two male Wistar rats were randomly divided into sham-operation group, uremic group, uremic PD group, and sTie-2-Fc group (all n=8).Uremic PD group and sTie-2-Fc group received intraperitoneal infusion of 3 ml/100 g of peritoneal dialysis fluid (PDF) containing 4.25% glucose twice daily for 4 weeks. Rats in sTie-2-Fc group were infused with PDF supplemented with 1 μg sTie-2-Fc. Before the rats were sacrificed, a peritoneal equilibration test (PET) was performed to evaluate the peritoneal solute transport and ultrafiltration capacity, and omenta was obtained for anti-CD31 immunohistochemical staining to determine the vessel density. Results Compared to their counterparts in sham-operation group,rats in uremic group had higher 2 h-dialysate to plasma creatinine concentration ratio (D/Pcr, 0.78±0.05 vs 0.70±0.09, P=0.028), lower 2 h to initial dialysate glucose concentration ratio (D/D0, 0.69±0.05 vs 0.76±0.07, P=0.033), decreased peritoneal ultrafiltration [UF, (2.29±0.50) ml vs (4.58±1.64) ml, P=0.005], and increased omental vessel density [(5.8±3.0)/HP vs (1.6±0.5)/HP, P＜0.01]. When compared to uremic group, rats in uremic PD group showed higher D/Pcr (0.89±0.05 vs 0.78±0.05, P=0.001), lower D/D0 (0.47±0.09 vs 0.69±0.05, P＜0.01), decreased UF [(0.40±0.59) ml vs (2.29±0.50) mi, P=0.005] and more omental vessels [(16.7±1.2)/HP vs (5.8±3.0)/HP, P＜0.01]. Improved peritoneal UF [(1.56±0.48) ml vs (0.40±0.59) mi, P=0.014] and decreased omental vessels [(9.2± 1.2)/HP vs (16.7 ± 1.2)/HP, P＜0.01] were observed in rats treated with sTie-2-Fc compared with those in uremic PD group, however, the differences of D/Pcr (0.87±0.06 vs 0.89±0.05, P=0.122) and D/D0 (0.60±0.11 vs 0.47±0.09, P=0.06) between these two groups did not reach statistical significance. Conclusion sTie-2-Fc preserves peritoneal ultrafiltration capacity and ameliorates peritoneal angiogenesis caused by uremia and exposure to bioincompatibal PDF.

ObjectiveTo evaluate the characteristics of patients on long-term peritoneal dialysis (PD). MethodsPatients who started PD since 1994 and received PD for at least one year were included in this study. According to dialysis duration, patients were divided into two groups. Group A (long-term) was defined as patients survived on PD for more than 5 years. Group B (short-term) was defined as patients who died or switched to bemodialysis within less than 5 years. Demography, biochemical indexes, dialysis prescription and adequacy were compared between two groups. ResultsThere were 68 patients in group A and 98 patients in group B. Mean followed-up period of group A and B was (84.80±19.42) months and (27.25±12.31) months, respectively. Younger, fewer episodes of diabetic comorbidity (group A 3/68 vs group B 18/98, P ＜0.05) and coronary heart disease (group A 6/68 vs group B 22/98, P＜0.05) were found in group A. Compared to group B, the level of serum albumin at the beginning of PD was much higher in group A [(35.56±4.74) g/L vs (33.69±5.45) g/L, P＜0.01). The levels of blood sugar, TC, TG, hemoglobin, calcium, phosphate and iPTH were not significantly different between two groups. Estimated GFR, renal Kt/V and renal Ccr at the beginning of dialysis were much higher in group A, however there was no significant difference in urinary volume between two groups. Both estimated GFR and urinary volume decreased more slowly in group A compared to group B. Peritonitis mobidity was lower in group A (1/81.22 months vs 1/29.03 months, P＜0.01). Conclusions In comparison to short-term survivors, long-term PD patients are characterized by being younger, less diabetic and coronary heart disease, fewer episodes of peritonitis, higher level of serum albumin, higher estimated GFR and less loss of residual renal function.

Objective To investigate effectiveness of anthropometric parameters and body composition analysis for the screening and prediction of metabolic syndrome and explore the best indicator for predicting metabolic syndrome in the elderly. Method A cross-sectional study of 763 (406 men and 357 women) elderly people who participated in the annual health check-up was conducted. Clinical data of all participants were obtained including anthropometric parameters, body composition, lipid profiles, fasting blood glucose, and high sensitivity C-reactive protein. Receiver operating characteristic (ROC) curve was used to determine the optimal cutoff points for waist circumference, waist-to-hip ratio, waist-to-height ratio, percent body fat and fat mass index in relation to the area under the curve (AUC), sensitivity and specificity in the screening and prediction of metabolic syndrome. Result In total subjects, compared with non-metabolic syndrome group,the ROC curve analysis showed that parameters including waist circumference, waist-to-height ratio, waist-to-hip ratio, percent body fat and fat mass index had a significant potential for predicting metabolic syndrome (P<0.001). It was determined that waist circumference of 87.5 cm and 77.5 cm, waist-to-hip ratio of 0.89 and 0.87, waist-to-height ratio of 0.51 and 0.52, percent body fat of 24.1%and 31.7%and fat mass index of 5.00 kg/m2 and 7.80 kg/m2 were the optimal cutoff points for screening and predicting the presence of metabolic syndrome among men and women with a sensitivity of 81.3%,78.8%,87.5%, 51.3%and 83.8%(in men) and 85.1%,79.8%,71.3%, 70.2%and 80.9%(in women) and a specificity of 57.7%,62.6%,50.0%, 75.5%and 51.8%(in men) and 38.0%,53.2%,55.1%, 50.6%and 52.5% (in women),respectively. The area under the ROC curve (AUC) was 0.728, 0.755, 0.716, 0.671 and 0.725 in men and 0.652, 0.707, 0.658, 0.619 and 0.675 in women,respectively. Waist-to-hip ratio showed the highest AUC in all the parameters in men and women. Conclusion Anthropometric parameters and body composition analysis play important roles in the screening and prediction of metabolic syndrome, and waist-to-hip ratio seems to be the best parameter in the screening and prediction of metabolic syndrome in the elderly.

Objective:To observe the expression of Ki-67,P53 and LAT1 in tissues of esophageal squamous cell carcinoma and precancerous lesions and to investigate its clinical significance.Methods: Immunohistochemical method was used to detect the expressions of Ki-67,P53 and LAT1 in tissues from 20 cases of normal esophageal mucosa,68 cases of precancerous lesions including 21 cases of mild atypical hyperplasia,22 cases of atypical hyperplasia,25 cases of severe atypical hyperplasia and cancer tissues from 34 esophageal cancer patients.The relationship between the expression of the three in esophageal carcinoma was analysed.Results: Re-spectively,the positive expression rate of Ki-67 in normal esophageal mucosa, mild atypical hyperplasia, moderate dysplasia, severe dysplasia and carcinoma was 0%( 0/20 ) , 23.8%( 5/21 ) , 40.9%( 9/22 ) , 76.0%( 19/25 ) , 82.4%( 28/34 ) and the positive expression rate of P53 was 0%(0/20),14.3%(3/21),31.8%(7/22),48.0%(12/25),67.6%(23/34) and the positive expression rate of LAT1 was 0%( 0/20 ) , 19.0%( 4/21 ) , 36.4%( 8/22 ) , 52.0%( 13/25 ) , 76.5%( 26/34 ).The rank correlation analysis showed that the positive expression of Ki-67,P53 and LAT1 were significantly correlated with histological grade(r=0.626,0.427, 0.586,P<0.01) and the expression of Ki-67,P53 was positively correlated with LAT1 in esophageal carcinoma tissues(r=0.428, 0.596,P<0.01).Conclusion:Abnormal expression of Ki-67,P53,LAT1 protein was significant related to carcinogenesis of esophageal cancer and the combined detection of the three has important clinical significance.