Objective:To systematically review the relevant researches on aspiration screening tools for stroke patients. Methods:Literatures aboute stroke aspiration screening tools till December, 2018 were recalled from PubMed, Cochrane Library, Web of Science, EMbase, CNKI, Wanfang Database and China Biomedical Literature Database. Two researchers independently screened the literatures and extracted the basic information, such as the content, screening format, scoring standard and measurement characteristics. Results:A total of 25 studies were included, involving ten aspiration screening tools. The content, screening format, scoring standard and measurement characteristics of the aspiration screening tools were analysed. There was no evidence to support the tools. Conclusion:Tools would be selected according to the patient's condition, age and swallowing related characteristics.

The chemical consituents from the stems and leaves of Psychotria serpens were separated and purified by column chromatographies with silica gel, ODS, Sephadex LH-20 and PR-HPLC. The structures of the isolated compounds were identified on the basis of physicochemical properties and spectroscopic analyses, as well as comparisons with the data reported in literature. 18 compounds were isolated from the 90% ethanol extract of the stems and leaves of P. serpens, which were identified as chrysin(1), acacetin(2), genkwanin(3), chrysoeriol(4), rhamnocitrin(5), isorhamnetin(6), tricin(7), jaceosidin(8), dillenetin(9), kumatakenin(10), ayanin(11), isosakuranetin(12), eriodictyol(13), homoeriodictyol(14), taxifolin(15), pomonic acid(16), fupenzic acid(17) and euscaphic acid(18). All compounds were isolated from the genus Psychotria for the first time.
Drugs, Chinese Herbal ; Plant Leaves ; Plant Stems ; Psychotria

Objective To analyze and validate the key molecular targets correlated with the overall survival of patients with HER2-positive breast cancer.Methods First,the survival time and transcriptome data of patients with HER2-positive breast cancer in stage Ⅰ / Ⅱ and Ⅲ/Ⅳ were downloaded from the TCGA database.The significantly differential genes between overall survival ＜2 years and ＞8.5 years in stage Ⅰ / Ⅱ were picked out by edgeR package,and the pathways were enriched by KEGG.Similarly,the differential genes between overall survival ＜2 years and ＞7 years in stage Ⅲ/Ⅳ were analyzed.Furthermore,KEGG pathway analysis was performed using the differential genes overlapped by stage Ⅰ /Ⅱ and Ⅲ/Ⅳ.Second,the relationships between the expression levels of key node genes and other genes in enriched pathway and the overall survival of patients with HER2-positive breast cancer were validated by KMplot database.Last,the correlation between the activity of pathway enriched in KEGG and the resistance to anti-HER2 treatment was validated in HER2-positive breast cancer cell line BT474.Results In patients with stage Ⅰ / Ⅱ HER2-positive breast cancer whose overall survival was ＜2 years,PI3K/AKT was the 9th signaling pathway enriched by up-regulated differential genes.In patients with stage Ⅲ/Ⅳ whose overall survival was ＜2 years,PI3K/AKT was the 2nd signaling pathway enriched by up-regulated differential genes.Furthermore,PI3K/AKT was the first signal pathway enriched by the overlapping upregulated genes of patients in stage Ⅰ / Ⅱ and Ⅲ / Ⅳ whose overall survival was ＜2 years.Patients with high expression of PI3K and AKT (key node genes) or CFAP221 and COL4A6 (other genes) of PI3K/AKT pathway had shorter overall survival than those with low expression.PI3K inhibitors could enhance the growth inhibitory effect of HER2 small molecule inhibitor on HER2-positive breast cancer cell line BT474.Conclusions The overexpression of PI3K/AKT pathway is associated with the shorter overall survival in HER2-positive breast cancer patients,and associated with anti-HER2 resistance in HER2-positive breast cancer cell line.

Objeetive:To study the expression and clinical significance of NF-κ Bp65 protein and selective autophagy adaptor protein SQSTM1/p62 1(p62) in gastric carcinoma and its clinical significance.Methods:NF-κ Bp65 protein and p62 protein were determined in 72 cases of gastric carcinoma by immunohistochemistry PV-9000,and the relationship between them in the occurrence and development of gastric cancer was analyzed.Results:The positive expression of in gastric cancer tissues of NF-κ Bp65 (65.3％) was significantly higher than that of paracancerous gastric tissues (27.8％,P＜0.05);the positive expression rate of p62 (66.7％)was significantly higher than that in paracancerous gastric tissues (30.6％,P＜0.05);The expression of NF-κ Bp65,p62 was significantly correlated with the cancerous tissue differentiation degree,infiltrative depth,and lymph node metastasis (P＜0.05);NF-κ Bp65,p65 expression in the gastric cancer was positively correlated (P＜0.05).Conclusions:p62 and NF-κ Bp65 may be involved in apoptosis and cell proliferation of gastric carcinoma,and play anessential role in carcinogenesis.Detection of the two indexes would be used to assess and predict the prognosis of gastric cancer patients.

Objective To investigate the distribution and antimicrobial resistance of clinical isolates from surgery wards in Peking Union Medical College Hospital ( PUMCH ) .Methods A total of 3084 non-duplicate clinical isolates were collected from PUMCH surgery wards during the period from January 1, 2012 to December 31, 2013.Disc diffusion test (Kirby-Bauer method) and automated systems were employed to detect the antimicrobial resistance of these isolates .The data were analyzed by WHONET 5.6 software according to Clinical and Laboratory Standards Institute 2013 breakpoints.Results Of the 3084 clinical isolates, the 10 most common bacteria isolated were:A.baumannii (14.1%), E.coli (12.4%), P.aeruginosa (12.4%), K.pneumonia (11.8%), S.aureus (8.9%), E.faecalis (5.4%), coagulase-negative staphylococcus (5.3%), E.cloacae (3.7%), S.maltophilia (3.6%) and E.faecium ( 3.2%) , in which gram-negative bacteria accounted for 71.6% ( 2208 isolates ) and gram-positive accounted for 28.4%(876 isolates).In S.aureus and coagulase-negative staphylococcus, methicil-lin-resistant strains ( MRSA and MRCNS ) accounted for 42.7%(117/274) and 77.3%(119/154) , respectively . The resistance rates of methicillin-resistance strains to β-lactams and other antimicrobial agents were much higher than those of methicillin-susceptive strains including methicillin-susceptible Staphylococcus aureus ( MSSA ) and methicillin-susceptible coagulase-negative Staphylococcus (MSCNS).In addition, 80.3% of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole , while 95.0%of MRCNS strains were susceptible to rifampin .No staphylococcal strains were found resistant to vancomycin , teicoplanin, or linezolid.The drug resistance rates of E.faecalis strains to most antimicrobials tested were much lower than those of E.faecium, except for the resistance rate to chloramphenicol , which was only 4.3%in E.faecium.One strain of E.faecalis and 5 strains of E.faecium were found resistant to vancomycin .No linezolid-resistant strains were found in enterococcal isolates .Extended spectrum β-lactamases ( ESBLs )-producing strains accounted for 56.7% ( 217/383 ) , 23.8% ( 97/408 ) , and 22.8%(13/57) in E.coli, Klebsiella species (K.pneumoniae and K.oxytoca), and P.mirabilis, respectively. The drug resistance rates of ESBLs-producing strains were higher than the corresponding non-ESBLs-producing strains.Enterobacteriaceae strains were still highly susceptible to carbapenems , the overall resistance rates being 1.6%-3.3%.A few pan-resistant strains of K.pneumoniae ( 0.8%, 3/363 ) were identified .The resistance rates of P.aeruginosa to imipenem and meropenem were 19.5%and 15.0%, respectively , while the resistance rate to amikacin was the lowest ( 8.6%) .The resistance rates of A.baumannii to imipenem and meropenem were 74.1%and 74.0%, respectively , compared with the lowest resistance rates to cefoperazone-sulbactam (51.5%) and minocycline (28.9%) .The prevalence of pan-resistant strains in A.baumannii and P.aeruginosa were 44.3%(193/436) and 0.8%(3/381), respectively.Conclusion Regular surveillance of bacterial resistance could pro-vide practical guidance of rational selection of antimicrobial agents for clinicians .

Objective To investigate the antimicrobial resistance of bacteria isolated from clinical samples in Peking Union Medical College Hospital in 2013 .Methods A total of 7236 nonduplicate clinical isolates were collected from January 1 to December 31 , 2013 .Disk diffusion test ( Kirby-Bauer method ) and automated sys-tems were employed to test the antimicrobial resistance of these isolates .The data were analyzed using WHONET 5.6 software and judged according to the Clinical and Laboratory Standards Institute guideline 2013 .Results Of the 7236 nonduplicate clinical isolates , Gram-negative and Gram-positive bacteria accounted for 71.1%(5147) and 28.9%(2089), respectively.Methicillin-resistant Staphalococcus aureus (MRSA) accounted for 34.9%(244/700) and methicillin-resistant coagulase-negative Staphylococcus (MRCNS) accounted for 67.2% (123/183 ) of Staphalococcus aureus isolates .No staphylococcus strains resistant to vancomycin , teicoplanin , or linezol-id were detected .A few strains of Enterococcus faecium were found resistant to vancomycin and teicoplanin .No linezolid-resistant enterococcus strains were found .Extended spectrum β-lactamases ( ESBLs )-producing strains accounted for 49.5%(698/1410), 25.4% (235/925) and 22.6% (30/133) in Escherichia coli, Klebsiella species ( K.pneumoniae and K.oxytoca) and Proteus mirabilis, respectively .The Enterobacteriaceae strains were still highly sensitive to carbapenems , with only 1.5%-2.3%resistant to carbapenems .The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 19.4% and 15.6%, respectively .The resistance rates of Acinetobacter baumannii to these two antimicrobials were 70.9% and 72.0%, respectively .The preva-lence of pan-resistant strains in Acinetobacter baumannii was 42.9% ( 306/714 ) .Conclusions Antimicrobial resistance is still a serious problem , especially pan-resistant Acinetobacter baumannii strains.It is mandatory to take effective measures controlling nosocomial infection and ensuring rational antimicrobial use .

OBJECTIVETo explore the association between mortality rate of hepatic carcinoma and the distance from Suihe River in Lingbi county, Suzhou, Anhui province.

METHODSUsing the disease mapping and spatial statistical analysis techniques,we described the spatial distributions of the mortality rate of hepatic carcinoma from 2005 to 2010 in Lingbi county. Taking the distance between villages and polluted rivers as proxy variable of environmental exposure, mortality rate of hepatic carcinoma in each village as dependant variable, and using the Glimmix model and Bayesian spatial model (BYM) to undertake the univariate and multivariate analysis, we investigatived the association between mortality rate of hepatic carcinoma and the water pollution of Suihe River in Lingbi county.

RESULTSObvious clustering of high mortality rate of hepatic carcinoma along the polluted river was observed in Lingbi county. Results of Glimmix model showed that whether spatial autocorrelation was considered or not, closer to the polluted river has higher mortality rate of hepatic carcinoma. Results of univariate analysis of the BYM model showed that, compared with the villages far from the polluted river more than 12 km (the mortality rate of hepatic carcinoma was 33.12/100 000(1068/3 224 562) ), the RR values of the hepatic carcinoma mortality was 1.38(95%CI:1.06-1.82) for the villages apart from the polluted river within 6 km (the mortality rate of hepatic carcinoma was 42.48/100 000(777/1 829 064)), and 1.13 (95%CI:0.92-1.39) for villages apart from the river between 6 and 12 km (the mortality rate of hepatic carcinoma was 35.65/100 000(651/1 825 848)). In the BYM model multivariate analysis, adding the volume of fertilizer and pesticides used per cultivated area, GDP per capita to do multivariate analysis were, the relation between mortality rate of hepatic carcinoma and distance from polluted rivers remains unchanged.

CONCLUSIONThe mortality rate of hepatic carcinoma was associated with the exposure to the polluted river in Lingbi county. The polluted river may increase the hepatic carcinoma mortality of nearby residents.

Bayes Theorem ; China ; epidemiology ; Environmental Exposure ; Female ; Humans ; Liver Neoplasms ; epidemiology ; mortality ; Male ; Rivers ; Spatial Analysis ; Water Pollution

Adult ; Female ; Humans ; Hypercalcemia ; diagnosis ; surgery ; Hyperparathyroidism ; diagnosis ; surgery ; Male ; Middle Aged ; Parathyroid Neoplasms ; diagnosis ; surgery

Objective To understand the current situation related to genotypic resistance in patients receiving the first-line antiretroviral treatment,but with with virologic failure,in Henan province and to compare the patterns of drug resistance in patients from different areas.Methods 276 patients with virologic failure on first-line antiretroviral treatment were selected in three different areas of Henan,in 2010.CD4 +T cells,virus load and genotypic resistance were measured and tested.Prevalence and mutations related to drug-resistant were analyzed.Results The overall prevalence of drug-resistance was 68.48％ in 257 patients,with non-nucleoside reverse transcriptase inhibitor (NNRTIs) as 67.70％.Rate of nucleoside reverse transcriptase inhibitor (NRTIs) was 54.09％,and protease inhibitors (PIs) was 1.18％.The prevalence rates of drug-resistance in A,B and C groups were 82.35％,97.47％ and 52.80％,respectively,and withs significant differences (x2=50.624,P=0.000).The Prevalence rates related to resistance of NNRTIs and NRTIs were also significantly different ( x2＝48.771,P=0.000 and x2=33.912,P=0.000).26.46％ of the samples had M184V/I mutation which was the highest NRTIs mutation among the 257 patients.The prevalence rates on resistance of A and B were 47.06％ and 49.37％,higher than that of C( 13.04％,x2=39.905,P=0.000)followed by TAMs,TAMs-1 and TAMs-2 which were 8.56％ and 4.28％.C had the lower prevalence of TAMs-1 thanA and B (x2=13.499,P=0.001).40.47％ of the samples harbored ≥1 TAM,with T215Y/F having the most,as 33.85％.31.13％ of 257 patients appeared most NNRTIs mutation K103N in this study,with the prevalence rates also significant different (x2=14.213,P=0.001 ) in the three areas.Two PIs mutations were detected in 257 patients:M461/L,(1.17％) and V82F (0.39％).However,none was detected in area A.Conclusion Different patterns of drug resistance were found in different areas of Henan province and should be treated differently.The work related to AIDS second-line antiretroviral therapy in Henan should be more opportune,rigorous and standardized.

OBJECTIVETo evaluate the efficacy of compound Dixiong Decoction (地芎汤, a Chinese herbal decoction) on early prevention of radiation pneumonitis.

METHODSForty-six patients with non-small cell lung cancer who were planning to receive radiotherapy were randomly assigned to the treatment group treated with the compound Dixiong Decoction and the control group treated with a commonly used herbal decoction which has the effects of supplementing qi and nourishing yin, clearing heat and detoxifying at the time of radiotherapy. Primary measure was the incidence of radiation pneumonitis after radiotherapy. Secondary outcomes included Watters clinical radiographic physiologic (CRP) dyspnea score, the Radiation Therapy Oncology Group (RTOG) grading score, Karnofsky Performance Status (KPS) score, and the application of corticosteroids.

RESULTSThe incidence of radiation pneumonitis in the treatment group was 10.0%, while that in the control group was 26.3% (P=0.0032). The Watters CRP dyspnea score and RTOG grading score in the treatment group were significantly =lower than those in the control group (P<0.05). The KPS score in the treatment group was significantly higher than that in the control group (P<0.01). The dosage of corticosteroids was smaller with a shorter duration of therapy in the treatment group than that in the control group.

CONCLUSIONThe early application of the Chinese herbal decoction compound Dixiong Decoction can decrease the incidence of radiation pneumonitis, reduce the injury of the lung, and improve the life quality of the patients.

Adrenal Cortex Hormones ; administration & dosage ; Carcinoma, Non-Small-Cell Lung ; radiotherapy ; therapy ; Humans ; Incidence ; Lung Neoplasms ; radiotherapy ; therapy ; Pneumonia ; etiology ; therapy ; Prospective Studies ; Radiotherapy ; adverse effects