OBJECTIVE To explore the value of microbiological rapid on-site evaluation(M-ROSE)technique in treatment of the patients with severe community-acquired pneumonia(SCAP).METHODS A total of 124 patients with SCAP who were treated in the department of respiratory and critical care medicine of The Fourth Medical Center of Chinese PLA General Hospital from Sep.2023 to Dec.2024 were enrolled in the study and were random-ly divided into the M-ROSE group and the control group in a 1∶1 ratio based on the status of M-ROSE for bron-choalveolar lavage fluid(BALF).The M-ROSE test and conventional etiological test[metagenomic next genera-tion sequencing(mNGS),smear,culture]were performed for the M-ROSE group,and the conventional etiologi-cal test was only carried out for the control group.The baseline data,symptoms and signs,C-reactive protein lev-el,treatment status and outcomes were observed and compared between the two groups of patients.RESULTS A-mong the 62 patients for whom the BALF specimens were detected with M-ROSE,45(72.58％)patients showed the consistent test result for fungi with mNGS,47(75.81％)patients showed the same test result for cocci with mNGS,and 30(48.39％)patients showed the same test result for bacilli with mNGS.The duration of the M-ROSE test was 1.50(1.50,2.00)h,shorter than that of the smear,culture and mNGS(P＜0.05).The body temperature returning to the normal and the property,volume of sputum were improved more early in days in the M-ROSE group than in the control group after the anti-infection treatment(P＜0.05);the level of inflammatory factor CRP declined more quickly in the M-ROSE group than in the control group(P＜0.05);the effective rates of treatment of the M-ROSE group were higher than those of the control group after the hospitalization for 3,5 and 7 days(P＜0.05).CONCLUSION The M-ROSE test for BALF may facilitate the rapid etiological diagnosis for the patients with SCAP in early stage,provide guidance for the anti-infection treatment strategies,and accelerate the improvement of symptoms and inflammatory factors;it has certain clinical application value.

OBJECTIVE To explore the value of microbiological rapid on-site evaluation(M-ROSE)technique in treatment of the patients with severe community-acquired pneumonia(SCAP).METHODS A total of 124 patients with SCAP who were treated in the department of respiratory and critical care medicine of The Fourth Medical Center of Chinese PLA General Hospital from Sep.2023 to Dec.2024 were enrolled in the study and were random-ly divided into the M-ROSE group and the control group in a 1∶1 ratio based on the status of M-ROSE for bron-choalveolar lavage fluid(BALF).The M-ROSE test and conventional etiological test[metagenomic next genera-tion sequencing(mNGS),smear,culture]were performed for the M-ROSE group,and the conventional etiologi-cal test was only carried out for the control group.The baseline data,symptoms and signs,C-reactive protein lev-el,treatment status and outcomes were observed and compared between the two groups of patients.RESULTS A-mong the 62 patients for whom the BALF specimens were detected with M-ROSE,45(72.58％)patients showed the consistent test result for fungi with mNGS,47(75.81％)patients showed the same test result for cocci with mNGS,and 30(48.39％)patients showed the same test result for bacilli with mNGS.The duration of the M-ROSE test was 1.50(1.50,2.00)h,shorter than that of the smear,culture and mNGS(P＜0.05).The body temperature returning to the normal and the property,volume of sputum were improved more early in days in the M-ROSE group than in the control group after the anti-infection treatment(P＜0.05);the level of inflammatory factor CRP declined more quickly in the M-ROSE group than in the control group(P＜0.05);the effective rates of treatment of the M-ROSE group were higher than those of the control group after the hospitalization for 3,5 and 7 days(P＜0.05).CONCLUSION The M-ROSE test for BALF may facilitate the rapid etiological diagnosis for the patients with SCAP in early stage,provide guidance for the anti-infection treatment strategies,and accelerate the improvement of symptoms and inflammatory factors;it has certain clinical application value.

After nearly 70 years development,bariatric and metabolic surgery has become one of the most innovation and technical challenges sub-specialty in general surgery.Jejunoileal bypass, Roux-en-Y gastric bypass,vertical banded gastroplasty,biliopancreatic diversion and duodenal switch, adjustable gastric banding and sleeve gastrectomy have ever dominated during the development of bariatric and metabolic surgery. In addition, new procedures such as minigastric bypass,are also being developed. Improvement in minimally invasive surgery, cognition of gastrointestinal and metabolic physiological mechanisms, and multidisciplinary treatment promote the development of bariatric and metabolic surgery.

Objective: To explore the clinical and prognostic features of lipoprotein glomerulopathy (LPG) in renal allografts. Methods: Retrospective analysis was performed for two case of LPG in renal allografts. The onset time was 6 and 9 years after living transplantation respectively. Initial symptoms included proteinuria and hypoproteinemia. Color Doppler ultrasound showed an enlarged graft size and greater parenchymal echogenicity. One patient had hyperlipemia and elevated apolipoprotein E (ApoE). Methylprednisolone pulse was offered with an early control of hyperlipidaemia and proteinuria by fenofibrate and angiotensin-converting enzyme inhibitors (ACEIs). Yet it had no effect on graft function. The definite diagnosis was made by graft biopsy. Pathological examination indicated non-homogeneous lipid deposition in glomerular capillary, glomerular sclerosis, mesangial hypercellularity and tubular atrophy. Results: During a follow-up period of 8 and 10 years post-transplantation, two cases eventually lost their grafts within 2 and 1 year after biopsy respectively. With long-term dietary control and drug therapy, regular dialysis continued and both awaited a second transplantation. Conclusions LPG is generally steroid-resistant and refractory in renal allografts. And routine biopsy is recommended for patients with a high risk of occurrence. Early controls of hyperlipemia and hypoproteinemia and other risk factors should be also properly managed.

Objective: To investigate the clinical efficacy and safety profile of hyaluronic acid dermal filler(Restylane®) in treating nasolabial folds in Chinese population. Methods: 103 subjects in this study were recruited from five Chinese clinical trial centers between July 2014 and December 2015. Subjects were treated with hyaluronic acid dermal filler in correcting nasolabial folds and an optional re-treatment was performed after 12 months according to the subjects′wishes. The improved of nasolabial folds was evaluated by the change of severity (wrinkle severity rating scale, WSRS) and aesthetic improvement (global aesthetic improvement scale, GAIS). Satisfaction of subjects on treatment was evaluated using subject satisfaction questionnaires (SSQ). Safety indicators such as pain, skin and soft tissue presentation at the injection site were continuously evaluated throughout the whole treatment process. Results: Significant improvement in scores of WSRS and GAIS of all subjects was observed after treatment. Nine months after treatment, the scores of WSRS in 80 subjects (77.7%) and GAIS in 96 subjects (93.2%) were still improved. The 68 subjects (95.8%) received re-treatment after 12 months gained further improvement in nasolabial folds. Most adverse events were mild or moderate (transient/reversible local manifestations) and all resolved before study end, no severe adverse event related to products observed. Conclusions Hyaluronic acid dermal filler is effective and safe in treatment of nasolabial folds in Chinese population and the effect can last up to 12 months.

Objective: Hepatitis B surface antigen (HBsAg) loss is seldom achieved with nucleos(t)ide analog (NA) therapy in chronic hepatitis B patients but may be enhanced by switching to finite pegylated-interferon (Peg-IFN) alfa-2a. We assessed HBsAg loss with 48- and 96-week Peg-IFN alfa-2a in chronic hepatitis B patients with partial response to a previous NA. Methods: Hepatitis B e antigen (HBeAg)-positive patients who achieved HBeAg loss and hepatitis B virus DNA < 200 IU/mL with previous adefovir, lamivudine or entecavir treatment were randomized 1:1 to receive Peg-IFN alfa-2a for 48 (n = 153) or 96 weeks (n = 150). The primary endpoint of this study was HBsAg loss at end of treatment. The ClinicalTrials.gov identifier is NCT01464281. Results: At the end of 48 and 96 weeks' treatment, 14.4% (22/153) and 20.7% (31/150) of patients, respectively, who switched from NA to Peg-IFN alfa-2a cleared HBsAg. Rates were similar irrespective of prior NA or baseline HBeAg seroconversion. Among those who cleared HBsAg by the end of 48 and 96 weeks' treatment, 77.8% (14/18) and 71.4% (20/28), respectively, sustained HBsAg loss for a further 48 weeks. Baseline HBsAg < 1 500 IU/mL and week 24 HBsAg < 200 IU/mL were associated with the highest rates of HBsAg loss at the end of both 48- and 96-week treatment (51.4% and 58.7%, respectively). Importantly, extending treatment from 48 to 96 weeks enabled 48.3% (14/29) more patients to achieve HBsAg loss. Conclusion Patients on long-term NA who are unlikely to meet therapeutic goals can achieve high rates of HBsAg loss by switching to Peg-IFN alfa-2a. HBsAg loss rates may be improved for some patients by extending treatment from 48 to 96 weeks, although the differences in our study cohort were not statistically significant. Baseline and on-treatment HBsAg may predict HBsAg loss with Peg-IFN alfa-2a.

Objective To study the effects of fat grafting on partial jaw deformity.Methods A total of 19 cases of partial jaw deformity.were used fat grafting in past 2.5 years,from January 2012 to June 2015.All analyses were to find suitable fat grafting method for partial jaw deformiw.Fat graft was obtained by low pressure suction and low speed centrifugation.Results A lot of 15 patients in this group had been followed up for 6 months to 2 years.9 patients was satisfied with once fat grafting and 6 with twice.Conclusions Fat grafting provides a useful alternative to partial jaw deformity with normal occlusion.But it also remains to be seen what the forward effects of fat grafting on partial jaw deformity are.

This paper presents a new, simple and fast algorithm of automated P wave detection in multi-lead ECG Signals. Range of QRS-T complex is detected firstly. Then QRS-T complex is eliminated. Final y, P wave’s onset and offset are detected by using the average of low-pass difference method and tangent method. Tangent method is always used to locate the offset of T Wave but it wil firstly be used to locate the P wave onset and offset in this paper. The proposed algorithm is tested by the annotated CSE database. Result shows that algorithm test result has a good consistency with BIS CSE annotation. Compared with the mean and standard deviation of P wave onset and offset, our algorithm and CSE annotation is-2.01 ms, 3.94 ms and 4.96 ms, 5.86 ms.

Objective To investigate the effect of microRNA-21 (miR-21) antisense oligonucleoti-de on collagen synthesis in the rat hepatic satellite cells ( HSCs) .Methods Rat hepatic stellate cells were isolated and cultured; the miR-21 antisense oligonucleotide was transfected into HSCs with lipofectamine 2000;after incubation 48 h, the HSCs were collected.The expression of miR-21 was detected with reverse transcription polymerase chain reaction ( RT-PCR) , andα-smooth muscle actin (α-SMA) protein in HSCs with Western blot.The cell proliferation was assayed with methyl thiazolyl tetrazolium ( MTT) method.Re-sults Compared to scrambled control group, the expression of miR-21 was reduced by 76%( P <0.01), the proliferation activity of HSCs was reduced by(26 ±3)%( P <0.01), the expressions of type I and III collagen proteins were reduced by(61 ±7)%and (48 ±6)%( P <0.01).Conclusions The miR-21 an-tisense oligonucleotide could reduce significantly the expression of miR-21, and inhibit HSC proliferation and extracellular matrix production.

ObjectiveTo explore the value of the diagnosis of breast cancer by acoustic elastography, conventional ultrasonography (including gray-scale ultrasonography, color Doppler flow imaging and Doppler spectrum) and mammography.MethodsOne hundred and four patients with breast disease conifrmed by surgical pathology were studied retrospectively in Zibo Maternal and Children Health Hospital. All the patients were examined by acoustic elastography, conventional ultrasonography and mammography before surgery.ResultsPathological results of 104 cases were: sixty-five malignanies and 39 benignities. The most common signs in the diagnosis of breast cancer by conventional ultrasonography were spicule sign (76.9%, 50/65), taller-than-wide sign (73.8%, 48/65), vascular resistance index>0.7 (70.8%, 46/65), calciifcation (53.8%, 35/65). And breast masses without these signs were regarded as benign lesions. The diagnostic criteria of breast cancer by acoustic elastography was 5-point method. We regarded the lesions got more than 3 points as malignancy. The most common signs in the diagnosis of breast cancer by mammography were dense shadow (73.8%, 48/65), spicule sign (70.8%, 46/65), calcification (69.2%, 45/65). And breast masses without these signs were regarded as benign lesions. The diagnostic accuracy of acoustic elastography, conventional ultrasonography, mammography, conventional ultrasound plus acoustic elastography, conventional ultrasound plus mammography and acoustic elastography plus mammography for breast tumor were 88.4% (92/104), 86.5% (90/104), 83.7% (87/104), 93.3% (97/104), 90.4% (94/104) and 89.4% (93/104), respectively. ConclusionsThe combination of any two imaging modalities can improve the diagnostic accuracy of breast cancer. And conventional ultrasound combined with acoustic elastography could be an effective method in the diagnosis of breast cancer.