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A perforated leakage occurred in a gas field sewage storage tank in service. In order to analyze the cause of the perforation and to clarify the critical wall thicknesses of the common perforated points of the sewage storage tank, the micro hardness tester, universal testing machine, metallurgical microscope, scanning electron microscope (SEM), energy spectrometer (EDS) and X - ray diffraction (XRD) were used to analyze the physical and chemical properties of the storage tank, perforation characteristics, the morphology and composition of corrosion products. Results showed that the physical and chemical properties of the material met the requirements; the corrosion products were loose, mainly containing Fe2O3 and having a small amount of FeS. The corrosion pit developed from the inner wall of the storage tank to the outer wall, and the depth of the corrosion pit was about 2.6 mm. Therefore, the perforation mechanism and process of the storage tank could be destribed as follow: the water and corrosive medium penetrated between the layer and the inner wall of the storage tank, leading to an oxygen corrosion (the main corrosion) and a SRB corrosion (the auxiliary corrosion), and as a result, local corrosion pits formed on the inner wall of the storage tank. When the depth of the corrosion pit reached 65% of the initial wall thickness of the storage tank, the stress level at the bottom of the pit exceeded the internal pressure resistance of the storage tank, resulting in a perforation leakage of the storage tank.

[Objectives] In order to maintain the stability of the position of a ship, a mooring system is required to reduce the translational motion of floating structures.[Methods] Taking a pipe-laying vessel in the South China Sea as an example, it is possible to minimize the translational displacement of the anchor chain in the mooring state by optimizing the arrangement of the anchor line to ensure the safe operation of the ship. First, we can obtain several different layouts through orthogonal testing after selecting the azimuth and distance of the anchor chain as the test factors. We then calculate the different movements and force in time domain value at different wave direction angles for each layout using Moses. With the calculation results as samples, the BP neural network method achieves time domain simulation in Moses. After choosing the azimuth and distance of the anchor chain as the optimization variables, and with each wave-weighted translational displacement probability as the optimization objective, we find that the generalization capability of the BP neural network method can replace the time domain calculation of Moses.[Results] Using a genetic algorithm optimization solution, movement is significantly reduced at different wave direction angles.[Conclusions] This conclusion can provide a reference for the mooring arrangements of floating structures.

Objective To explore the correlation between the number of people suffering from heat stroke and the main climatic factors in Hainan province. Methods The complete cases of heat stroke were collected from the hospitals located in eight regions (Haikou, Sanya, Danzhou, Wenchang, Wanning, Qiongzhong, Baisha, Dongfang, etc.) in Hainan Province from 2010 to 2019. In the same period, we collected the average temperature and relative humidity recorded by meteorological monitoring points (Haikou, Sanya, Danzhou, Qionghai, Lingshui, Dongfang, Qiongzhong) in Hainan Province from 2010 to 2019 from the National Greenhouse Data System website. A total of 177 patients with heat stroke who met the data collection requirements and the average temperature and relative humidity in Hainan Province were retrospectively analyzed. Results The number of patients with heat stroke in Hainan Province from 2010 to 2019 showed an obvious upward trend compared with previous years, and the number of patients was concentrated in May to July, with the largest number in June. From 2010 to 2019 in Hainan province, there was a significant positive correlation between the number of residents suffering from heat stroke and their monthly mean temperature (r=0.797, P<0.05) and annual mean temperature (r=0.801, P<0.05); there was a significant negative correlation between the number of residents suffering from heat stroke and their monthly mean relative humidity (r=-0.650, P<0.05); there was no significant correlation between the number of residents suffering from heat stroke and their annual mean relative humidity (r=-0.172, P>0.05). Conclusion In recent years, the trend of heat stroke in Hainan Province has been fluctuating and rising, and it has obvious characteristics of "almost all year round; the higher the monthly average temperature is, the lower the monthly average relative humidity is, and the more the number of patients is", we should pay attention to it and do the corresponding protection. As heat stroke usually involves multiple systems of the whole body, its mortality is high and its harm is great, therefore, strengthening meteorological monitoring, strengthening the publicity of heat stroke prevention and control, and guiding residents in Hainan Province to carry out heat acclimatization can prevent or reduce the occurrence of heat stroke. [ABSTRACT FROM AUTHOR]

One-step solution approach to prepare FA0.95Cs0.05PbI(3-x)Clx perovskite solar cells was demonstrated. The influence of CsI additive on the morphology, optical absorption and photovoltaic performances was investigated. The results show that compared with FAPbI(3-x)Clx films, grain sizes of FA0.95Cs0.05PbI(3-x)Clx perovskite with CsI additive were larger and compact stacking. FA0.95Cs0.05PbI(3-x)Clx perovskite film showed stronger UV-Vis absorption in the range of 300 to 810 nm. The FA0.95Cs0.05PbI(3-x)Clx solar cells exhibited open circuit voltage of 0.88 V with power conversion efficiency of 5.84%. [ABSTRACT FROM AUTHOR]

Objective: To investigate the value of serum free light chain (sFLC) and serum calcium ion in the diagnosis and prognosis of multiple myeloma (MM)., Methods: Forty patients with MM treated in Henan Provincial People's Hospital from January 2018 to January 2022 were selected as the observation group, and 40 healthy volunteers were selected as the control group. The differences of sFLC-κ、sFLC-λ、sFLC-κ/λ, serum calcium ions, etc between the two groups were compared. Meanwhile, the differences of sFLC-κ、sFLC-λ、sFLC-κ/λ, serum calcium ions, etc in different international staging systems (ISS), chemotherapy efficacy and prognosis patients were analyzed., Results: The levels of sFLC-κ［(98.39±21.19) vs (12.01±4.45) mg/L］, sFLC-λ［(210.20±45.54) vs (14.10±5.11) mg/L］ and proportions of hypocalcemia （65% vs 0） in the observation group were significantly higher than those in the control group ( P < 0.05), while sFLC-κ/ λ ratio［（0.44±0.10） vs (0.87±0.12)］ and serum calcium ions ［（1.98±0.46） vs （2.42±0.40）mmol/L］ were significantly lower than those in the control group ( P < 0.05). The sFLC-κ, sFLC-λ, the proportion of hypocalcemia and the course of hypocalcemia in ISS stage III patients in the observation group were significantly higher than those in stage I and II patients ( P < 0.05), while sFLC-κ/λ ratio, and serum calcium ions were significantly lower than those in stage I and II patients ( P < 0.05). The levels of sFLC-κ ［（107.76±21.22） vs （94.67±20.11）mg/L］, sFLC- λ［（245.54±41.12） vs （205.54±50.22）mg/L］ of patients with hypocalcemia in the observation group was significantly higher than those without hypocalcemia ( P < 0.05), while the sFLC-κ/λ ratio was significantly lower than those without hypocalcemia ［（0.42±0.04） vs （0.47±0.06）； P < 0.05］. The levels of sFLC-κ ［(107.29±20.14） vs （ 91.11±18.92）mg/L］, sFLC-λ［（247.98±42.26） vs （179.29±39.32）mg/L］ in patients with ineffective chemotherapy were significantly higher than those in patients with effective chemotherapy ( P < 0.05), while the sFLC-κ/λ ratio was significantly lower than those in patients with effective chemotherapy ［(0.43±0.10) vs (0.50±0.09)； P < 0.05）］. The area under the ROC curve for sFLC-κ, sFLC-λ, sFLC-κ/λ predicting ineffective chemotherapy was 0.803, 0.793 and 0.699 respectively, P < 0.05. There was no significant difference in sFLC-κ, sFLC-λ, sFLC-κ/λ ratio, serum calcium ion, hypocalcemia ratio and hypocalcemia course between survival and death patients ( P >0.05)., Conclusion: sFLC and serum calcium are related to ISS stage of MM patients. sFLC level has a certain value to predict the curative effect of chemotherapy in MM patients. However, the prognostic values of sFLC and serum calcium are not yet confirmed for MM patients.

Objective: To provide prenatal diagnosis, pedigree analysis and genetic counseling for a pregnant woman who had given birth to a child featuring global developmental delay., Methods: A pregnant woman who underwent prenatal diagnosis at the Affiliated Hospital of Southwest Medical University in August 2021 was selected as the study subject. Peripheral blood samples were collected from the woman, her husband and child, in addition with amniotic fluid sample during mid-pregnancy. Genetic variants were detected by G-banded karyotyping analysis and copy number variation sequencing (CNV-seq). Pathogenicity of the variant was predicted based on the guidelines from the American College of Medical Genetics and Genomics (ACMG). Candidate variant was traced in the pedigree to assess the recurrence risk., Results: The karyotypes of the pregnant woman, her fetus, and affected child were 46,XX,ins(18)(p11.2q21q22), 46,X?,rec(18)dup(18)(q21q22)ins(18)(p11.2q21q22)mat and 46,XY,rec(18)del(18)(q21q22)ins(18)(p11.2q21q22)mat, respectively. Her husband was found to have a normal karyotype. CNV-seq has revealed a 19.73 Mb duplication at 18q21.2-q22.3 in the fetus and a 19.77 Mb deletion at 18q21.2-q22.3 in her child. The duplication and deletion fragments were identical to the insertional fragment in the pregnant woman. Based on the ACMG guidelines, the duplication and deletion fragments were both predicted to be pathogenic., Conclusion: The intrachromosomal insertion of 18q21.2-q22.3 carried by the pregnant woman had probably given rise to the 18q21.2-q22.3 duplication and deletion in the two offspring. Above finding has provided a basis for genetic counseling for this pedigree.

Objective: To investigate the influence and mechanism of atorvastatin on glycolysis of adriamycin resistant acute promyelocytic leukemia (APL) cell line HL-60/ADM., Methods: HL-60/ADM cells in logarithmic growth phase were treated with different concentrations of atorvastatin, then the cell proliferation activity was measured by CCK-8 assay, the apoptosis was detected by flow cytometry, the glycolytic activity was checked by glucose consumption test, and the protein expressions of PTEN, p-mTOR, PKM2, HK2, P-gp and MRP1 were detected by Western blot. After transfection of PTEN-siRNA into HL-60/ADM cells, the effects of low expression of PTEN on atorvastatin regulating the behaviors of apoptosis and glycolytic metabolism in HL-60/ADM cells were further detected., Results: CCK-8 results showed that atorvastatin could inhibit the proliferation of HL-60/ADM cells in a concentration-dependent and time-dependent manner ( r =0.872, r =0.936), and the proliferation activity was inhibited most significantly when treated with 10 μmol/L atorvastatin for 24 h, which was decreased to (32.3±2.18)%. Flow cytometry results showed that atorvastatin induced the apoptosis of HL-60/ADM cells in a concentration-dependent manner ( r =0.796), and the apoptosis was induced most notably when treated with 10 μmol/L atorvastatin for 24 h, which reached to (48.78±2.95)%. The results of glucose consumption test showed that atorvastatin significantly inhibited the glycolytic activity of HL-60/ADM cells in a concentration-dependent and time-dependent manner ( r =0.915, r =0.748), and this inhibition was most strikingly when treated with 10 μmol/L atorvastatin for 24 h, reducing the relative glucose consumption to (46.53±1.71)%. Western blot indicated that the expressions of p-mTOR, PKM2, HK2, P-gp and MRP1 protein were decreased in a concentration-dependent manner ( r =0.737, r =0.695, r =0.829, r =0.781, r =0.632), while the expression of PTEN protein was increased in a concentration-dependent manner ( r =0.531), when treated with different concentrations of atorvastatin for 24 h. After PTEN-siRNA transfected into HL-60/ADM cells, it showed that low expression of PTEN had weakened the promoting effect of atorvastatin on apoptosis and inhibitory effect on glycolysis and multidrug resistance., Conclusion: Atorvastatin can inhibit the proliferation, glycolysis, and induce apoptosis of HL-60/ADM cells. It may be related to the mechanism of increasing the expression of PTEN, inhibiting mTOR activation, and decreasing the expressions of PKM2 and HK2, thus reverse drug resistance.

Objective: To compare the effects of tension band combined with patellar cerclage and memory alloy patellar concentrator fixation in the treatment of comminuted fracture of the lower pole of patella., Methods: From July 2015 to July 2019, 60 patients with distal patellar fracture were treated and were divided into two groups according to different operation methods. In group A, 30 patients were fixed with memory alloy patellar concentrator (NiTi PC), 17 males and 13 females, aged 20 to 71 (39.4±9.9) years, including 19 cases of falling injury, 9 cases of traffic injury and 2 cases of sports injury. The time from injury to operation was 10 to 75 (33.1±7.8) hours; 30 cases in group B were fixed with tension band andcerclage, 15 males and 15 females, aged 21 to 76 (38.6±10.2) years, including 17 cases of falling injury, 12 cases of traffic injury and 1 case of smashing injury. The time from injury to operation was 10 to 91 (34.5±9.1) hours. The curative effects of two groups were observed and compared., Results: All 60 patients were followed up for 9 to 30 months. There was no significant difference in intraoperative bleeding, operation time, follow-up time and fracture healing time between the two groups. Six months after operation, according to the Bostman function score of knee joint:30 cases in group A, the total score was 28.6±4.7, of which 26 cases were excellent and 4 cases were good. The total score of 30 cases in group B was 25.5±4.4, of which 20 cases were excellent, 8 cases were good and 2 cases were poor. There were significant differences in Bostman total score and curative effect evaluation between two groups ( P <0.05). The score of group A was significantly better than that of group B. In group B, 1 case had Kirschner wire withdrawal, 2 cases had joint stiffness and 3 cases had internal fixation irritation., Conclusion: Memory alloy patellar concentrator is strong and reliable in the treatment of inferior patellar fracture. It can take early rehabilitation exercise after operation, with good recovery of joint function and range of motion and less complications.

Objective: To evaluate the capacity and efficiency of human umbilical cord mesenchymal stem cells (HUCMSCs) to differentiate into neuron- like cells after induction with B27- supplemented serum- free medium., Methods: HUCMSCs at passage 4 were cultured for 14 days with serum-containing medium (SCM) (group A), SCM supplemented with 20 ng/mL nerve growth factor (NGF) and 10 ng/mL basic fibroblast growth factor (bFGF) (group B), serum-free medium (SFM) (group C), or SFM supplemented with 20 ng/mL NGF and 10 ng/mL bFGF. The culture medium were changed every 3 days and the growth of the neurospheres was observed using an inverted microscope. The cell markers were analyzed with flow cytometry and the expressions of nestin, neuron- specific enolase (NSE), neurofilament heavy polypeptide (NEFH), and glial fibrillary acidic protein (GFAP) were quantified by quantitative real-time PCR (qRT-PCR) and Western blotting., Results: Before induction, HUCMSCs expressed abundant mesenchymal stem cell surface markers including CD29 (99.5%), CD44 (49.6%) and CD105 (77.7%). Neuron-like cells were observed in the cultures on days 7, 10, and 14, and the cell differentiation was the best in group D, followed by groups C, B and A. In all the 4 groups, the cellular expressions of nestin and GFAP gradually lowered while those of NEFH and NSE increased progressively. The expressions of GFAP, NEFH, nestin and NSE were significantly different between group A and the other 3 groups ( P < 0.001 or 0.05)., Conclusions: B27-supplemented SFM effectively induces the differentiation of HUCMSCs into neuron- like cells, and the supplementation with cytokines (NGF and bFGF) strongly promotes the cell differentiation.

In order to explore the advantage of intercropping on phosphorus (P) efficient utilization and the reduction of soil P loss, a field experiment in a maize-soybean intercropping system, which included three P application (P 2 O 5 ) rates (CP: 168 kg·hm -2 ; RP 1 : 135 kg·hm -2 ; RP 2 : 101 kg·hm -2 ) and three P application depths (D 1 : applied in 5 cm depth; D 2 : applied in 15 cm depth; D 3 : 1/2 of P fertilizer applied in 5 cm depth and another 1/2 in 15 cm depth) was carried out to analyze the effects of P application rates and depth on crop aboveground biomass, grain yield, crop P uptake, soil total and available P contents, and soil P adsorption-desorption characteristics. Compared with control treatment, the aboveground biomass, grain yield, crop P uptake, soil total P, and available P content were increased significantly by P application, regardless of P rate and application depth. Under the same application depth, RP 1 had similar grain yield but higher crop P uptake compared with CP, and thus higher P apparent utilization efficiency. Under the same P application rate, the application depth of D 2 had the highest crop aboveground biomass, grain yield, P uptake, soil total P, and available P. According to the characteristic of soil P adsorption-desorption, the treatment with the rate of RP 1 and the depth of D 2 had the strongest soil P retention capacity, which had advantage in alleviating P loss. These results suggested that reducing application rate but increasing application depth of P fertilizer could improve P use efficiency and reduce soil P loss without sacrifice in crop production in maize-soybean relay intercropping system.

Objective To observe the correlation of hepatocyte growth factor (HGF) and Hepato- cyte growth factor receptor (c-Met ) in serum and gastric mucosa tissues of chronic erosive gastritis pa- tients. Methods Totally 70 patients with chronic erosive gastritis were selected and assigned to turbidity toxin intrinsic syndrome group and Gan-wei disharmony syndrome group, HGF expression level of ser- um,and HGF,c-Met expression level of gastric mucosa tissues were measured;the correlation of HGF and c-Met in gastric mucosa tissues, and the correlation of HGF in serum and gastric mucosa tissues were analyzed. Results The expression level of HGF and c-Met in turbidity toxin intrinsic syndrome group was higher than that in Gan-wei disharmony syndrome group (P <0. 05) ; the expression level of HGF in gastric mucosa tissues was positively correlated with c-Met(r =0. 831 , P <0. 05) ; the expression level of HGF in serum was positively correlated with that of gastric mucosa tissues(r =0. 656, P <0. 05). Conclusions There was correlation between turbidity toxin intrinsic syndrome of Chronic Erosive Gastri- tis patients and the expression level of HGF and c-Met.

The main objective of this research is to observe protective effects of three phenylallyl compounds(cinnamyl alcohol,cinnamaldehyde and cinnamic acid)from Guizhi decoction against ox-LDL-induced oxidative stress injury on human brain microvascular endothelial cells(HBMEC).In this study,the toxicity and optimal protective concentration of three phenylallyl compounds from Guizhi decoction were determined by MTT assay.The HBMEC were divided into control group(DMSO),model group(ox-LDL),tert-butylhydroquinone (t-BHQ) group,cinnamyl alcohol group, cinnamaldehyde group and cinnamic acid group.The model group were treated with ox-LDL (50 mg•L⁻¹)for 24 h,other groups were separately treated with t-BHQ, cinnamyl alcohol, cinnamaldehyde and cinnamic acid of 20 μmol•L⁻¹, and exposed to ox-LDL (50 mg•L⁻¹) for 24 h at the same time.The survival rate of HBMEC was detected by MTT assay,reactive oxygen species(ROS) production of injured cells were detected using laser scanning confocal microscope (LSCM),the content of SOD, MDA, eNOS and NO in HBMEC was determined by ELISA, and the expressions of Nrf2 mRNA were detected by quantitative Real-time PCR(qRT-PCR).The results shows that oxidative stress injury of HBMEC could be induced by ox-LDL, the three phenylallyl compounds from Guizhi decoction did not affect morphology and viability of normal HBMEC.Compared with model group, the three phenylallyl compounds from Guizhi decoction could improve the above oxidative stress status and up-regulate Nrf2 mRNA expressions in injured HBMEC(P<0.05, P<0.01) .These findings suggested that the three phenylallyl compounds from Guizhi decoction have certain protective effects against ox-LDL-induced oxidative stress injury on HBMEC(cinnamaldehyde> t-BHQ> cinnamic acid>cinnamyl alcohol),the protective mechanism maybe related to regulation of antioxidant enzymes gene expression in HBMEC by Nrf2., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

Objective: To investigate the effect of human umbilical cord mesenchymal stem cells (hUC-MSC) on VP16-induced apoptosis of Nalm-6 cells., Methods: hUC-MSC were isolated and identified using morphological observation and flow cytometry, then Nalm-6 cells were treated with hUC-MSC with or without VP16. Apoptosis and cell cycle were assayed by FACS. The mRNA levels of apoptosis-related genes BCL-2, BAX and caspase-3 were detected by quantitative RT-PCR, and the protein levels of BCL-2, BAX and caspase-3 were examined by Western blot., Results: FACS showed that hUC-MSC inhibited the proliferation and decreased apoptosis of Nalm-6 cells resulted from VP16. The quantitative RT-PCR showed that hUC-MSC increased the mRNA expression level of BCL-2 and decreased the expression level of BAX and caspase-3 (P < 0.05). Western blot showed that the protein expression level of BCL-2 increased, and expression level of BAX and caspase-3 decreased in Nalm-6 cells after co-culture with hUC-MSC (P < 0.05)., Conclusion: hUC-MSC may protect Nalm-6 cells from apoptosis induced by VP16 through regulation of BCL-2, BAX and caspase-3.

Objective: To investigate the clinical effect of anastomosis of superficial veins for improving the drainage of perforator propeller flaps., Methods: From Sept. 2011 to Dec. 2012, 11 cases with soft tissue defects and chronic ulcer wound at extremities were treated with adjacent perforator propeller flaps, which were pedicled by the peroneal artery(5 cases), or the lateral supramalleolar artery(3 cases), or the ulnar artery (2 cases), or the posterior interrosseous artery (1 case). The wound size ranged from from 3.0 cm x 2. 5 cm to 11. 0 cm x 4. 0 cm, and the falps size ranged from 6 cm x 3 cm to 21 em x 5 cm. One superficial vein in all the flaps was anastomosed with superficial vein in the recipient area. The blood supply of the flaps were recorded after operation 1 - 3 months after operation, the fluency of anastomosed vein was detected by color Doppler ultrasound. Flap swelling evaluations were performed in early 3 months and later 3 - 6 months, and the results were classified into 4 grading degrees. 6 months later, Questionnaire of the flap aesthetic satisfactory was performed for seven patients during follow-up period., Results: 9 flaps survived completely, two flaps had partial marginal skin necrosis in the distal end, which were both managed with surgical debridement, and both wounds healed in two months. 9 cases were followed up for more than 12 - 19 months. The early rsults of flap swelling evaluations were: I degree 0 case, II degree 8 cases, III degree 3 cases, IV degree 0 case, and the later results were: I degree 7 cases, II degree 4 cases, III degree 0 case, IV degree 0 case. The flaps had ideal appearance, good contour, and high aesthetic satisfactory (100%). The mean flap survival area rate of veins anastomosed was (98. 6 ± 9. 7) %., Conclusions: Perforator propeller flaps with anastomosis of superficial veins can improve the flap venous drainage, avoid transient venous venous congestion, so as to increase the flap survival. It is an effective way for improving the vein drainage.

In the book of Chinese Acupuncture and Moxibustion by CHENG Dan-an, direct moxibustion with moxa cone was regarded as a classic style of moxibustion because of its innate character of heat induced thermal stimulus and burn toxin. CHENG Dan-an made the quantity of moxibustion more controllable through the selection of moxa wool, the size and number of moxa cones, and the tightness of moxa cones, etc. CHENG Dan-an 's clinical experience is summarized through treating stubborn and infectious diseases with direct moxibustion with moxa cone. The results showed that only with understanding the characteristics of moxibustion and key pathological mechanism of suitable disease could direct moxibustion with moxa cone and the appropriate methods be performed correctly. CHENG Dan-an confirmed the clinical effect of treating stubborn and intectious diseases with direct contact moxibustion with moxa cone, and optimized the specific operation scheme of direct moxibustion with moxa cone. It tell us that we should deeply study on moxibustion, to make it wide spread in the hereafter, bring benefit to mankind.

Objective: to highlight the clinical manifestation, histologic characteristics, diagnostic and therapeutic method of tracheal lobular capillary hemangioma (LCH)., Methods: the clinical, auxiliary examinational and pathological data of two patients with tracheal LCH were presented, and relevant literatures were reviewed., Results: LCH is a polypoid form of capillary hemangioma which usually occurs on skin or muscosal surface of oral and nasal, rarely be seen in trachea. The most common presenting symptom of tracheal LCH is recurrent haemoptysis, CT scan can help to make diagnosis. Transbronchoscopic interventional therapy is the most effective treatment for tracheal LCH. Histologic examination can help to make the extreme diagnosis., Conclusions: tracheal LCH is a scarce benign lesion of tracheal. There isn't any typical clinical manifestation and auxiliary examination. Histologic examination can make a definite diagnosis, and bronchoscopes plays the most effective part in diagnosis and therapy.

Objective: The purpose of this study was to analyze the chest CT findings of immunocompetent patients with primary pulmonary cryptococcosis and to evaluate the utility of CT-guided percutaneous biopsy in the diagnosis., Methods: Chest CT scans of 12 immunocompetent patients with biopsy-proven primary pulmonary cryptococcosis were analyzed for the number of lesions, morphologic characteristics, distribution of parenchymal abnormalities, and the presence of lymphadenopathy and pleural effusion. Lung specimens were obtained by CT guided percutaneous biopsy (n = 9) and/or surgical resection (n = 7). A pulmonary pathologist reviewed the specimens., Results: The main manifestations were classified into two patterns. Localized multiple mixed lesions (nodules and/or masses and/or consolidation) were found in 67% (8/12) of the cases, and single nodules were found in 33% (4/12). Associated findings included air bronchograms (n = 9), cavity (n = 2), and CT halo sign (n = 4). Lung specimens were obtained by CT guided percutaneous biopsy in 9 cases, of which 7 (78%) were confirmed by pathology. Seven cases recovered after treatment with fluconazole, but cryptococcal meningitis occurred in 1 case 5 month after single excision., Conclusions: Chest CT findings of primary pulmonary cryptococcosis in immunocompetent patients have a predominant pattern of localized multiple mixed lesions. CT guided percutaneous biopsy is helpful in confirming the diagnosis. Fluconazole is effective in the treatment of pulmonary cryptococcosis in these patients.

Objective: To evaluate the efficacy and safety of large-volume whole lung lavage in the treatment of severe pulmonary alveolar proteinosis (PAP)., Methods: Five severe PAP patients underwent large-volume whole lung lavage under general anaesthesia using a double lumen endotracheal tube. Suction was used for returning fluid. The volume of lavage and return volume and the return rate were calculated. The efficacy was evaluated according to the improvement of symptoms, amelioration of chest radiograph or chest CT scan and the changes of pulmonary function and artery blood gas analysis., Results: After lavage, the symptoms, pulmonary function and artery blood gas were markedly improved, and the chest radiographs showed dissipation of lung consolidation. No severe complications were observed in the 5 cases., Conclusion: Large-volume whole lung lavage is an effective and safe therapeutic method in the treatment of PAP.

Objective: To study the epidemiology of Acinetobacter baumannii infection in patients with ventilator-associated pneumonia (VAP)., Methods: Prospective clinical study was carried out with 176 episodes of VAP with etiologic diagnosis being followed in two groups., Results: Twenty-six episodes were caused by Acinetobacter baumannii and one hundred-fifty episodes were caused by "other" organisms. Using logistic regression analysis, the risk of VAP due to Acinetobacter baumannii was found to be high in patients with head trauma [odds ratio (OR) = 4.20, 95% confidence interva (CI): 2.72 to 6.48], surgery (OR = 2.88, 95% CI: 1.78 to 4.66), acute respiratory dispnea syndrome (OR = 2.81, 95% CI: 1.19 to 6.64), and large-volume pulmonary aspiration (OR = 6.71, 95% CI: 3.91 to 11.50)., Conclusions: Acinetobacter baumannii pulmonary infection in incubated patients had an epidemiological pattern that different from "other" organisms. Patients with high risk identified in our study might mark the existence of cross-infection during airway manipulation.

Objective: To define the influence clinically related factors in the prognosis of ventilated pneumonia (VAP)., Methods: A prospective clinical study involving 120 patients with VAP was carried ont. Etiologic diagnosis was established under quantitative culture of endotracheal aspiration, a protected specimen brush and bronchoalveolar lavage. Prognostic using a statistical software package (SPSS) factors were examined for univariate and multivariate analyses., Results: Case fatality directly related to the infection was 14 percent. From univariate analysis, variables that significantly associated with attributable mortality were age older than 45 years, use of corticosteroids, presence of shock, in-hospital days of VAP over as follows 9, antecedent chronic obstructive pulmonary disease, and a prior antibiotic use. Through step-forward logistic regression analysis, only prior antibiotic use (P < 0.000 1, OR = 9.2) was defined as a significant factor influencing the risk of death from VAP. The same result was obtained when severity was included in the model. However, prior antibiotic use entirely dropped out as a significant risk factor when the etiologic agent was included in the regression equation., Conclusions: Distribution of microorganisms that responsible for VAP shown different in patients who had received prior antimicrobial therapy, and this factor caused higher mortality rate. We suggested a restrictive antibiotic use strategy among mechanically ventilated patients to reduce the risk of death from VAP.