A 68-year-old patient with non-small cell lung squamous carcinoma who received 6 cycles of sintilimab combination chemotherapy and sintilimab 200 mg,ivd,monotherapy developed severe diarrhea,abdominal pain,blood in the stool and other discomforts,and ultrasound and colonoscopy demonstrated extensive congestion and inflammation in the intestinal tract,and the pathologic biopsy was comprehensively considered to be an acute immune enteritis.Immunotherapy was suspended,adequate glucocorticoids and symptomatic treatment were given,and the patient's diarrhea and blood in stool improved after 2 days,and the symptoms were relieved and returned to normal after 6 days.The association between the patient's immune enteritis and sintilimab was assessed as probably relerant.This article reviews the literature on the case of immune-associated enteritis caused by sintilimab,describes how to use experimental methods and enteroscopy to detect the pathological changes in the clinic;and combines them with the clinical manifestations of diarrhea and blood in the stools to make the diagnosis and differentiation;and then refers to the guideline grading for timely management;and discusses the case to improve the clinicians'ability to recognize and deal with the relevant scenarios.

【Objective】 To evaluate the efficacy and safety of different doses and frequencies of oral Sildenafil in the treatment of erectile dysfunction (ED). 【Methods】 The randomized,open clinical trial included 120 ED patients who met the inclusion and exclusion criteria. The patients were randomly divided into the following groups:on-schedule (25 mg/day),on-demand (50 mg,taken irregularly half an hour before each sexual life),new regular group (25 mg/day,50 mg more before each sexual life),regular group (100 mg/time,twice/week). All treatments lasted for 8 weeks. The follow-up indexes included the five-item International Index of Erectile Function (IIEF-5),Erection Hardness Scale (EHS) and Sexual Encounter Profile (SEP2/3). The adverse reactions were recorded. 【Results】 The IIEF-5 scores of the four groups were significantly higher than those after baseline treatment (P<0.001),but there was no significant difference among the four groups (P>0.05). In terms of effective rate,at the 16th week,there were significant differences between the on-demand group (10.7%) and new regular group (62.1%),and between the on-demand group (10.7%) and regular group (50.0%) (P<0.001). In terms of EHS, the percentage of grade 4 patients in regular group was significant higher than that in the on-demand group at the 8th week and 16th week (all P<0.05). In terms of positive rate of SEP-3,there was a significant difference between the on-demand group and regular group (P=0.042) at the 16th week. In the course of treatment,there were transient adverse reactions such as headache,blurred vision,stuffy nose and back pain,which did not affect the treatment. 【Conclusion】 All of the four treatment methods of oral sildenafil showed good efficacy. Both regular group and new regular group maintained good clinical efficacy during the follow-up,which is better than that of the on-demand group. The new regular scheme can be used as a new,safe and effective treatment option.

The goal of the study was to investigate the protective effect and mechanism of Artemisia argyi ethanol extract on chemotherapeutic vancomycin (VAN)-induced acute kidney injury (AKI).The acute kidney injury model of male ICR mice was induced by intraperitoneal injection (ip) of VAN.Thirty mice were divided into the blank group, model group, high dose group, middle dose group and low dose group, which were given medicine by gastric perfusion (ig).Serum levels of cystain C (Cys C), blood urea nitrogen (BUN) and serum creatinine (Scr) were measured, which could reflect renal function of mice.Serum oxidative stress and inflammation indices were also determined, including muscular dystrophy association (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), tumor necrosis factor-alpha (TNF-α), Interleukin-1β (IL-1β), and high-sensitive c-reactive protein (hs-CRP).In addition, hematoxylin-eosin staining (HE) was employed for measuring the damage of renal tissues and the content of apoptosis b-cell lymphoma-2 (Bcl-2), Bcl-2 assaciated X protein (Bax) and caspase-3 were measured too.All results showed that Artemisia argyi extract exhibits protective effect on chemotherapeutic VAN-induced AKI, whose mechanism could be related to the oxidative stress, inflammatory reaction and apoptosis.

Objective To investigate the influence of overweight and obese on serum expressions of adipocytokines and prognosis of patients with acute leukemia. Methods Five hundred and seventy patients diagnosed as acute leukemia in the People's Hospital of Liaoning Province and Shengjing Hospital of China Medical University from July 2008 to July 2015 were collected. According to the body mass index (BMI), the patients were subdivided into two groups as obese/overweight group (BMI≥24 kg/m2) and control group (BMI<24 kg/m2). The avidinbiotincomplex-enzyme-linked immunosorbent assay (ELLSA) was used to detect the adiponectin, leptin, and resistin levels in the two groups. The t test was used to compare the difference of serum adiponectin, leptin and resistin expression between the two groups; Kaplan-Meier method was used to compare the difference of survival between the two groups. Results In patients with acute lymphoblastic leukemia (ALL)and acute myeloid leukemia (AML), the adiponectin levels in obese/overweight group were lower than those in the control group [adult ALL:(3.8±2.1) pg/ml vs. (6.4±2.9) pg/ml, child ALL:(4.2±2.7) pg/ml vs. (7.4±3.1) pg/ml, AML:(4.1±2.3) pg/ml vs. (6.9±3.1) pg/ml;t values were-2.291,-2.462,-2.244;P values were 0.023, 0.015, 0.026, respectively]. The leptin levels were high in the child ALL obese/overweight group than those in the control group (34±17 vs. 21±17) (t= 2.092, P= 0.038). The resistin levels of all the acuteleukemia patients did not have statistical difference between the obese/overweight group and control group(all P>0.05). In AML and adult ALL patients, the survival analysis showed that the 5-year overall survival rate in obese/overweight group were lower than that in the control group (38.0％vs. 46.6％,χ2= 1.449, P= 0.001;41.4％vs. 48.4％,χ2= 4.166, P= 0.041). Conclusion For the acute leukemia, the adiponectin levels are low in obese or overweight patients, and the 5-year survival rate of obese or overweight AML and adult ALL patients is lower than that of normal weight patients.

Objective To explore the prevalence and clinical and echocardiography features of the basal septal hypertrophy(BSH).Methods Clinical and echocardiography data of 1 056 elderly population in an urban community of Beijing were analyzed.BSH was defined as the thickness of basal interventricular septum ≥1.4 cm and basal septal/mid septal ≥1.3.Data were compared between BSH and non-BSH,and the risk factors of BSH were evaluated.Results The prevalence of BSH in this population was 7.39%(95%CI:5.8%-9.0%).BSH was not associated with current cardiovascular diseases (P >0.05).Its correlates in logistic analysis included male,diabetes mellitus,small end diastolic left ventricular dimension and abnormal left ventricular diastolic function (P <0.05),with OR 0.49(0.29,0.83),1.99(1.18,3.37),2.24 (1.35,3.72),0.39(0.26,0.59),and 1.96(1.01,3.81),respectively.Conclusions BSH is common in elderly community population and not associated with cardiovascular diseases.Its risk factors included male, obesity,diabetes mellitus,small end diastolic left ventricular dimension and abnormal left ventricular diastolic function.

OBJECTIVETo elucidate the epidemic condition and molecular subtyping of ciprofloxacin and cefotaxime co-resistant Salmonella Indiana (S. Indiana) isolated from retail chicken carcasses in six provinces of China.

METHODSA total of 2 647 Salmonella strains isolated from retail chicken carcasses collected from six provinces of China were subjected to antimicrobial susceptibility testing. All Salmonella isolates co-resistant to ciprofloxacin and cefotaxime were further characterized by serotyping, extended-spectrum beta-lactamases (ESBLs) producing strains screening and pulsed field gel electrophoresis (PFGE) typing.

RESULTSAmong 2 629 Salmonella isolates tested, 227 (8.52%) isolates were co-resistant to ciprofloxacin and ceftazidime/cefotaxime (Beijing: 11.67% (99/874), Jilin: 8.20% (60/726), Guangdong: 1.39% (7/502), Jiangsu: 15.61% (42/260), Shaanxi: 8.56% (16/186), Inner Mongolia: 0 (0/81)), and 224 of them were identified as S. Indiana. 213 (95.10%) isolates of S. Indiana were ESBLs producing strains. All ciprofloxacin and cefotaxime co-resistant S. Indiana isolates developed a multi-drug resistant profile and 17.86% (40/224) of them were resistant to all antibiotics tested except carbapenems, and 50.89% (114/224) of them resistant to 9 antibiotics, additionally, 25.45% (57/224) of them showed multi-drug resistance to 8 antibiotics. All ciprofloxacin and cefotaxime co-resistant S. Indiana isolates were divided into 32 PFGE clusters and 150 PFGE patterns. Strains of S. Indiana from same or different sampling site and time seemed to either share the same PFGE patterns or be differential to each other in different regions.

CONCLUSIONThe results indicated that chicken carcasses collected from parts of China were heavily contaminated by ciprofloxacin and cefotaxime co-resistant S. Indiana and could serve as an important reservoir of ciprofloxacin and cefotaxime co-resistant Salmonella. Molecular subtyping results indicated that cross contamination or common pollution source might be in these strains.

Animals ; Anti-Bacterial Agents ; pharmacology ; Cefotaxime ; pharmacology ; Chickens ; microbiology ; China ; Ciprofloxacin ; pharmacology ; Drug Resistance, Multiple, Bacterial ; Electrophoresis, Gel, Pulsed-Field ; Food Contamination ; Food Microbiology ; Meat ; microbiology ; Salmonella ; classification ; isolation & purification ; Serotyping ; beta-Lactamases

Objective To elucidate the epidemic condition and molecular subtyping of ciprofloxacin and cefotaxime co-resistant Salmonella Indiana(S. Indiana)isolated from retail chicken carcasses in six provinces of China. Methods A total of 2 647 Salmonella strains isolated from retail chicken carcasses collected from six provinces of China were subjected to antimicrobial susceptibility testing. All Salmonella isolates co-resistant to ciprofloxacin and cefotaxime were further characterized by serotyping, extended-spectrum beta-lactamases (ESBLs) producing strains screening and pulsed field gel electrophoresis (PFGE) typing. Results Among 2 629 Salmonella isolates tested, 227 (8.52%) isolates were co-resistant to ciprofloxacin and ceftazidime/cefotaxime (Beijing:11.67%(99/874),Jilin:8.20%(60/726), Guangdong: 1.39%(7/502),Jiangsu: 15.61%(42/260),Shaanxi: 8.56%(16/186),Inner Mongolia: 0(0/81)), and 224 of them were identified as S. Indiana. 213(95.10%)isolates of S. Indiana were ESBLs producing strains. All ciprofloxacin and cefotaxime co-resistant S. Indiana isolates developed a multi-drug resistant profile and 17.86%(40/224)of them were resistant to all antibiotics tested except carbapenems, and 50.89%(114/224)of them resistant to 9 antibiotics, additionally, 25.45%(57/224)of them showed multi-drug resistance to 8 antibiotics. All ciprofloxacin and cefotaxime co-resistant S. Indiana isolates were divided into 32 PFGE clusters and 150 PFGE patterns. Strains of S. Indiana from same or different sampling site and time seemed to either share the same PFGE patterns or be differential to each other in different regions. Conclusion The results indicated that chicken carcasses collected from parts of China were heavily contaminated by ciprofloxacin and cefotaxime co-resistant S. Indiana and could serve as an important reservoir of ciprofloxacin and cefotaxime co-resistant Salmonella. Molecular subtyping results indicated that cross contamination or common pollution source might be in these strains.

Objective To elucidate the epidemic condition and molecular subtyping of ciprofloxacin and cefotaxime co-resistant Salmonella Indiana(S. Indiana)isolated from retail chicken carcasses in six provinces of China. Methods A total of 2 647 Salmonella strains isolated from retail chicken carcasses collected from six provinces of China were subjected to antimicrobial susceptibility testing. All Salmonella isolates co-resistant to ciprofloxacin and cefotaxime were further characterized by serotyping, extended-spectrum beta-lactamases (ESBLs) producing strains screening and pulsed field gel electrophoresis (PFGE) typing. Results Among 2 629 Salmonella isolates tested, 227 (8.52%) isolates were co-resistant to ciprofloxacin and ceftazidime/cefotaxime (Beijing:11.67%(99/874),Jilin:8.20%(60/726), Guangdong: 1.39%(7/502),Jiangsu: 15.61%(42/260),Shaanxi: 8.56%(16/186),Inner Mongolia: 0(0/81)), and 224 of them were identified as S. Indiana. 213(95.10%)isolates of S. Indiana were ESBLs producing strains. All ciprofloxacin and cefotaxime co-resistant S. Indiana isolates developed a multi-drug resistant profile and 17.86%(40/224)of them were resistant to all antibiotics tested except carbapenems, and 50.89%(114/224)of them resistant to 9 antibiotics, additionally, 25.45%(57/224)of them showed multi-drug resistance to 8 antibiotics. All ciprofloxacin and cefotaxime co-resistant S. Indiana isolates were divided into 32 PFGE clusters and 150 PFGE patterns. Strains of S. Indiana from same or different sampling site and time seemed to either share the same PFGE patterns or be differential to each other in different regions. Conclusion The results indicated that chicken carcasses collected from parts of China were heavily contaminated by ciprofloxacin and cefotaxime co-resistant S. Indiana and could serve as an important reservoir of ciprofloxacin and cefotaxime co-resistant Salmonella. Molecular subtyping results indicated that cross contamination or common pollution source might be in these strains.

Objective To assess the effect of combined hypertension (HT) and aging on left atrial (LA) size and phasic function.Methods This evaluation was based on the data from a cross-sectional study including 738 subjects with high risk for cardiovascular disease from an urban community in Beijing.Subjects were divided into 3 groups according to age (41-59,60-69 and ≥70 years) and further into HT and non-HT sub-groups.LA volume index were calculated and LA global longitudinal strain in late diastole (Sa),early diastole (Se),and total strain (Stot =Sa + Se),and strain rate in late diastole (SRa),systole (SRs),and early diastole (SRe) were measured using off-line speckle-tracking echocardiography.Results LA volume index increased significantly in HT groups with aging,whereas no changes could be viewed in non-HT subjects among all age groups.LA conduit index (Se and SRe) decreased with aging in both HT and non-HT subjects with more sever in HT subjects than in non-HT subjects in all age groups.The LA conduit index in 41-59 year-HT,and in 60-69 year-HT subjects were comparable with that in 60-69 year-non-HT subjects [Se (11.0 ±4.4)％ vs (11.6 ±4.7)％,SRe (1.0 ±0.4) s-1 vs (1.0 ±-0.3) s-1],and in ≥70 year-non-HT subjects [Se(10.1 ±4.0)％ vs (9.5 ±5.4)％,SRe (0.9 ±0.3)s-1 vs (0.8 ± 0.4) s-1],respectively.LA reservoir (Stot and SRs) and contraction (Sa and SRa) index also decreased with aging in HT but not in non-HT subjects.Conclusions Aging along does not lead to LA enlargement in subjctes,but it does when combined HT.There is synergistic effect of HT and aging on LA volume and phasic function.

Objective:To investigate the correlation between anthropometric indices and arteriosclerosis detection indicators in the middle-aged and the elderly .Methods: A cross-sectional descriptive study was made of 1 626 individuals ( diabetics patients 23.37%, hypertensive subjects 39.48% and healthy individuals 37.15%), aged 45 to 90 years [mean age:(61.60 ±10.22) years)] in Shijingshan Dis-trict, Beijing.Their measurements:body mass index (BMI), waist circumference (WC), and waist to height ratio ( WHtR ) .Arterial stiffness was assessed according to brachial-ankle pulse wave velocity (baPWV), intima-media thickness (IMT), augmentation index (AI) and ankle-brachial index (ABI), which were measured by noninvasive detectors and equipment .The correlations between the various indi-cators were analyzed .Results:The percentages of the hypertensive and diabetic groups of central obesity ( male WC>85 cm, female WC >80 cm or WHtR>0.5 ) and of general obesity ( BMI>28 kg/m2 ) were significantly higher than those of the healthy group ( P<0 .01 ) .The difference between the two disease groups was not significant ( P>0 .05 ) .There was a moderate positive correlation between the measures of abdominal obesity (WHtR and WC) and the general obesity indicators (BMI) (r=0.710 and 0.716) .In the healthy group , WC and WHtR showed positive correlation with baPWV , IMT and ABI, and negative correlation with AI 75 .BMI showed positive correlation with IMT and negative correla-tion with AI75 , and no correlation with baPWV and ABI .There was negative correlation between BMI and baPWV in the diabetic group .In the hypertension group , we found negative correlation between BMI and baPWV, maximum IMT, AI75 , and also between WC and AI 75 .The simple regression straight line of baPWV versus the anthropometric parameters showed that the regression equations were y =0 .949 +1.379 x (baPWV vs.WHtR, R2 =0.046, P<0.001) and y=1.133+0.006x (baPWV vs.WC, R2 =0.027, P<0.001), respectively.baPWV and BMI did not have a linear relationship (P =0.62). Conclusion:WHtR and WC are superior to BMI indices in predicting arteriosclerosis .Anthropometric measurements for central obesity are good predictors of cardiovascular risk .