Objective To analyze the clinical characteristics of pulmonary nocardiosis misdiagnosed as pulmonary tuberculosis and the causes of misdiagnosis, aiming to improve the diagnosis and treatment of the disease. Methods　Clinical data were collected from 18 cases of pulmonary nocardiosis misdiagnosed as pulmonary tuberculosis admitted to Beijing Chest Hospital (1 case), Hebei Chest Hospital (15 cases), the 5th Hospital of Shijiazhuang (1 case), and the 1st Hospital of Xinji (1 case) from October 2018 to June 2024, and the clinical manifestations, laboratory tests, imaging, treatment process, disease outcomes, and the causes of misdiagnosis were retrospectively analyzed. Results Among the 18 patients, there were 10 males and 8 females, with a median age of (59±14) years. All of the cases had the common clinical manifestations of cough and sputum. Seventeen cases had underlying disease, including 1 case with AIDS, 1 case with diabetes, 2 cases with obsolete pulmonary tuberculosis, 2 cases with chronic obstructive pulmonary disease, and 14 cases with bronchiectasis. Sputum or bronchoalveolar lavage fluid samples from 18 patients were cultured positive on Columbia blood plates, Roche medium, or MGIT 960, identifying 11 cases of Nocardia farcinica, 1 case of Nocardia otitidiscaviarum, and 6 cases of Nocardia cyriacigeorgica. All of the 18 patients received treatment with trimethoprim-sulfamethoxazole, 14 in 18 receiving combination therapy, resulting in 8 cures, 8 improvements, and 2 deaths. The reasons for misdiagnosis included: When an infectious disease in patients with long-term expectoration could not be controlled initially, the diagnosis of pulmonary tuberculosis would often be made clinically, and the patients would be given anti-tuberculosis therapy; insufficient understanding of the knowledge of Nocardia by laboratory physicians and doctors; the laboratory physicians neglected the importance of the judgment of Nocardia morphology by Gram staining; the bacterial culture period was usually 48 hours, while Nocardia grew slowly, resulting in missed detections; MGIT 960 culture and Roche culture had long cultivation period, which could increase the positive rate of Nocardia, but fewer units were carrying out such cultivation; insufficient understanding of the morphology differences between cultured Nocardia and Nocardia in the original specimen resulted in misjudgment. Conclusions Pulmonary nocardiosis is easily misdiagnosed as pulmonary tuberculosis. For patients, who have long-term expectoration, with hypoimmunity, or diseases that damage the lung structure such as bronchiectasis, if the response of conventional treatment is poor, Nocardia infection should be considered; Medical staff should enhance their understanding of Nocardia and pay more attention to the microscopic examination of Gram staining, weak acid-fast staining, and culture of sputum; Timely treatment following the diagnosis of nocardiosis can significantly improve the prognosis.

Bacterial multi-drug resistance (MDR) is a global challenge in the fields of medicine and health, agriculture and fishery, ecology and environment. The cross-region spread of antibiotic resistance genes (ARGs) among different species is one of the main cause of bacterial MDR. However, there is no effective strategies for addressing the intensifying bacterial MDR. The CRISPR-Cas system, consisting of clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR associated proteins, can targetedly degrade exogenous nucleic acids, thus exhibiting high application potential in preventing and controlling bacterial MDR caused by ARGs. This review briefly introduced the working mechanism of CRISPR-Cas systems, followed by discussing recent advances in reducing ARGs by CRISPR-Cas systems delivered through mediators (e.g. plasmids, bacteriophages and nanoparticle). Moreover, the trends of this research field were envisioned, providing a new perspective on preventing and controlling MDR.
Anti-Bacterial Agents ; Bacteriophages/genetics* ; CRISPR-Cas Systems ; Drug Resistance, Bacterial/genetics* ; Plasmids/genetics*

Background and purpose:Cyclooxygenase-2 (COX-2) participates in angiogenesis and lymph node metastasis of lung cancer. COX-2 inhibitors could inhibit invasion and metastasis of lung cancer. This study aimed to investigate the inhibition of invasion and metastasis by COX-2 inhibitor imrecoxib in xenograft tumor of lung adenocar-cinoma A549 cell in nude mice and to explore its possible mechanisms, in addition, to observe the efficacy of imrecoxib combined with lobaplatin.Methods:Thirty male BALB/c nude mice were injected subcutaneously with A549 cells into the right axillary region to establish xenograft models. Twenty-nine successfully modeled mice were randomly divided into four groups: control group (n=7), imrecoxib group (n=8), lobaplatin group (n=7), imrecoxib combined with lobaplatin group (n=7). The control group was treated with the same amount of sterile distilled water and injected with the same amount of 0.9% sodium chloride solution via caudal vein. The treatment group was treated with imrecoxib tablets 40 mg/kg per day through gavage and injected with lobaplatin 7.5 mg/kg per week via caudal vein respectively. The diet, physical activity and other normal conditions of nude mice were observed everyday. After 6 weeks, 29 mice were sacrificed and transplanted tumor tissues were cut off. The expression of PTEN, cortactin protein and mRNA were detected by immunohistochemistry and real-time PCR. The data were analyzed with one-way anova and non-parametric test.Results:In the last week, the diet and physical activity of all nude mice were less than before, and they became thinner, which were more obvious among the mice in lobaplatin group and imrecoxib combined with lobaplatin group. Compared with the control group, the expression of PTEN protein and mRNA were significantly increased in imrecoxib group and imrecoxib combined with lobaplatin group (P<0.001, respectively). Compared with the control group, the expression of cortactin protein and mRNA were significantly decreased in imrecoxib group and imrecoxib combined with lobaplatin group (P<0.001, respectively). PTEN and cortactin protein, PTEN and cortactin mRNA had significantly negative correlation (r=-0.660, -0.983,P<0.001, respectively). Conclusion:Imrecoxib can inhibit non-small cell lung cancer invasion and metastasis which may be involved in upregu-lating PTEN protein and reducing cortactin protein. Imrecoxib could enhance the effect of lobaplatin chemotherapy.

Cancer is a leading cause of death worldwide. Although a variety of cancer therapies, such as surgical resection and local ablation, chemoembolization, radiotherapy, and systemic chemotherapy, have developed rapidly in recent years, the curative effect and 5 year-survival rate of cancer remain to be unsatisfactory. In recent years, with the deepening basic research of hydrogen, its role on the treatment of various diseases including cancer has attracted an increased attention. Hydrogen can promote the apoptosis of colon cancer cells, and which combined with 5-fluorouracil has a synergistic effect and can reduce the renal toxicity induced by cisplatin, without affecting its anti-tumor effect. Hydrogen can alleviate the side effects of radiotherapy, significantly improve the quality of life for patients with liver cancer, and does not affect the effect of radiotherapy. Hydrogen application provides a new therapeutic approach to the treatment of cancer. The specific mechanism of hydrogen in cancer treatment needs further study. This article reviewes the research progress of the role of hydrogen on the treatment of cancer, including antioxidant, anti-inflammatory, adjuvant chemoradiotherapy, and the regulation of signaling pathways.

Objectives To estimate the prevalence of the cardiovascular health (CVH) status in south Jiangsu adults. Methods A cross-sectional study was conducted, a total of 11 996 participants that took health examination in hospitals from March 2013 to August 2013 and live in south Jiangsu were selected. Results Totally 136 participants (1.1%) met all 7 ideal CVH metrics;while 27.6%participants met 5 to 7 ideal CVH metrics, women had higher proportion (47.2%) than men (16.9%). The percentage of participants who met 5 to 7 ideal CVH metrics, whether male or female, decreased with increasing age. Ideal total cholesterol (TC) was the most prevalent (72.0%), whereas ideal salt intake was the least (19.9%). The mean (± SD) number of ideal CVH metrics for urban participants was (3.61 ± 1.46), higher than the rural participants (3.45±1.49). Old age, male and residence in rural area were risk factors for ideal CVH metrics≥5. Conclusions The prevalence of ideal CVH was extremely low in South Jiangsu adults, and there were differences in the distribution of ideal CVH metrics across gender and age. To improve CVH, specific promotion and interventions at the population and individual levels should be developed and implemented actively.

Objective To evaluate the inhibitory effect of imrecoxib combined with lobaplatin on tumor growth and lymph node metastasis of human lung adenocarcinoma xenografts in nude mice, and to explore its possible mechanisms. Methods Human lung cancer A549 cells were injected into Bal B/c nude mice subcutaneously. Twenty?eight healthy male nude mice were randomly divided into 4 groups:the control group, imrecoxib group, lobaplatin group and imrecoxib combined with lobaplatin group. Each group was treated with appropriate drugs and the tumor size was measured every five days. The expression of ezrin and E?cadherin protein was detected by immunohistochemistry and flow cytometry. Ezrin and E?cadherin mRNA were detected by real?time PCR. Results The tumor inhibition rates of imrecoxib group, lobaplatin group and combination group were 36.7%, 54.6% and 69.2%, respectively. The tumor volumes of imrecoxib group [(905.33±113.31) mm3] and combination group [(507.74±77.50) mm3] were significantly lower than that of the control group (1355.33±189.04) mm3(P<0.05), and the tumor weights were significantly reduced [(1.13±0.14) g, (0.63±0.10) g respectively] vs. (1.69±0.24) g (P<0.05). The expressions of ezrin protein and mRNA in the imrecoxib group and combined treatment group were significantly lower than that of the control group (136.53±35.52, 74.72±19.48 vs. 175.62±21.16 for protein expression level;0.54± 0.03, 0.36±0.03 vs. 1.02±0.02 for mRNA expression level, respectively, P<0.05 for both), while the expression of E?cadherin protein and mRNA in the imrecoxib group and combined treatment group was significantly higher than that of the control group ( 253. 78 ± 38. 87, 308. 94 ± 24. 67 vs. 213. 66 ± 30. 31 for protein expression level;2.19±0.02, 3.02±0.02 vs. 1.05±0.03 for mRNA expression level, respectively, P<0.05 for both) . There was a significant negative correlation between ezrin protein and E?cadherin protein (r=-0.737, P<0.01), as well as between ezrin mRNA and E?cadherin mRNA (r=-0.977, P<0.01). Conclusions Administration of imrecoxib combined with lobaphatin has inhibitory effects on the growth of non?small cell lung cancer xenografts and lymph node metastasis via down?regulated ezrin and upregulated E?cadherin. Imrecoxib and lobaplatin have a synergistic antitumor effect.

Objective To evaluate the inhibitory effect of imrecoxib combined with lobaplatin on tumor growth and lymph node metastasis of human lung adenocarcinoma xenografts in nude mice, and to explore its possible mechanisms. Methods Human lung cancer A549 cells were injected into Bal B/c nude mice subcutaneously. Twenty?eight healthy male nude mice were randomly divided into 4 groups:the control group, imrecoxib group, lobaplatin group and imrecoxib combined with lobaplatin group. Each group was treated with appropriate drugs and the tumor size was measured every five days. The expression of ezrin and E?cadherin protein was detected by immunohistochemistry and flow cytometry. Ezrin and E?cadherin mRNA were detected by real?time PCR. Results The tumor inhibition rates of imrecoxib group, lobaplatin group and combination group were 36.7%, 54.6% and 69.2%, respectively. The tumor volumes of imrecoxib group [(905.33±113.31) mm3] and combination group [(507.74±77.50) mm3] were significantly lower than that of the control group (1355.33±189.04) mm3(P<0.05), and the tumor weights were significantly reduced [(1.13±0.14) g, (0.63±0.10) g respectively] vs. (1.69±0.24) g (P<0.05). The expressions of ezrin protein and mRNA in the imrecoxib group and combined treatment group were significantly lower than that of the control group (136.53±35.52, 74.72±19.48 vs. 175.62±21.16 for protein expression level;0.54± 0.03, 0.36±0.03 vs. 1.02±0.02 for mRNA expression level, respectively, P<0.05 for both), while the expression of E?cadherin protein and mRNA in the imrecoxib group and combined treatment group was significantly higher than that of the control group ( 253. 78 ± 38. 87, 308. 94 ± 24. 67 vs. 213. 66 ± 30. 31 for protein expression level;2.19±0.02, 3.02±0.02 vs. 1.05±0.03 for mRNA expression level, respectively, P<0.05 for both) . There was a significant negative correlation between ezrin protein and E?cadherin protein (r=-0.737, P<0.01), as well as between ezrin mRNA and E?cadherin mRNA (r=-0.977, P<0.01). Conclusions Administration of imrecoxib combined with lobaphatin has inhibitory effects on the growth of non?small cell lung cancer xenografts and lymph node metastasis via down?regulated ezrin and upregulated E?cadherin. Imrecoxib and lobaplatin have a synergistic antitumor effect.

Objective To explore the clinical significance of detecting hand-foot-and-mouth disease (HFMD) children's cardiac enzymes and neuron-specific enolase (NSE).Methods One hundred and fiftytwo HFMD children were selected as observation group,and 56 cases of healthy children were selected as control group.Cardiac enzymes and NSE levels were compared between two groups.Results The levels of aspartic transaminase(AST),creatine kinase(CK),creatine kinase isozyme-MB(CK-MB),lactate dehydrogenase (LDH),alpha-hydroxybutyric dehydrogenase (α-HBDH),and NSE in observation group were (40.4 ± 14.8)U/L,(109.9 ± 87.5) U/L,(47.0 ± 29.4) U/L,(316.9 ± 119.2) U/L,(256.2 ± 96.1) U/L,(30.9 ± 18.2) μ g/L,and in control group were (24.5 ± 9.2) U/L,(77.4 ± 32.5) U/L,(15.4 ± 7.4) U/L,(134.0 ± 34.4) U/L,(131.1 ± 37.7)U/L,(9.8 ± 4.6) μ g/L.The differences between two groups were statistical significance(P ＜ 0.01).Conclusion The heart and nervous system lesions of HFMD children can be found through detecting cardiac enzymes and NSE early,which provide evidence for early diagnosis and treatment.

Objective To investigate the detection rate of abnormal cardiovascular and metabolic indicators in health check-up populations,and provide evidence for early screening and health interventions for cardiovascular and metabolic diseases.Methods A total of 5578 adults (male 3404 and female 2174) were recruited from a medical institution in Beijing in 2008 and 2010.Cardiovascular and metabolic indicators,including blood pressure,lipid profile and fasting plasma glucose,were tested at baseline and 2 years.Paired t test or paired rank sum test was used for data analysis.Results Detection rate of abnormal blood pressure in 2010 was lower than that in 2008; however,rates of abnormal total cholesterol,low-density lipoprotein cholesterol and fasting plasma glucose were higher in 2010 than in 2008 (t values were 5.378,13.885,3.210,10.401 and 4.355,respectively; all P ＜ 0.05).High-density lipoprotein cholesterol and triglyceride showed no statistically significant difference between 2008 and 2010 (t values were 1.204 and -0.012,respectively; both P ＞ 0.05).Conclusion We have been observing a dynamic change in abnormal cardiovascular and metabolic indicators,based on which effective interventions could be taken to reduce the risk of cardiovascular diseases.

BACKGROUND: Kyphoplasty-assisted bone cement augmentation can be used in lumbar pedicle screw fixation of osteoporotic patients.OBJECTIVE: To assess the fixation strengths of loosened sacral screws augmented with kyphoplasty-assisted and traditional bone cement techniques.METHODS: Fresh sacra were harvested from nine osteoporotic cadavers. After testing bilaterally placed unicortical and bicortical pedicle screws, two unicortical pedicle screws with the traditional and kyphoplasty-assisted cement augmentations were established on the same sacrum. Following 2000 cyclic compression loading to screw head on a MTS machine, their maximum pull-out forces were recorded and compared. RESULTS AND CONCLUSION: The bone mineral densities of nine specimens were ranged from 0.61 to 0.77 g/cm2 (0.71 g/cm2 in average). The mean maximum pull-out forces of unicortical and bicortical screws, and traditional and kyphoplasty-assisted cement screws were 203, 325, 437, and 565 N, respectively. The pull-out force was significantly higher in bicortical screw compared with unicortical (P < 0.05); however, these two fixations exhibited markedly lower pull-out strength compared with two cement augmentation techniques (P < 0.05). The pull-out strength was significantly higher in kyphoplasty-assisted cement augmentation group compared with traditional bone cement technique (P < 0.05). In addition, a significant positive correlation was exhibited between bone mineral density and pull-out force for the four fixations (P < 0.05). Results demonstrated that traditional and kyphoplasty-assisted cement augmentations can serve as the salvage technique for loosening sacral screw. However, kyphoplasty-assisted augmentation can provide higher stability.