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Objective:To investigate the clinical value of peripheral blood T lymphocytes in the diagnosis and prognosis of patients with hepatocellular carcinoma (HCC) recurrence after liver transplantation.Methods:The clinical and laboratory data of 50 HCC patients, who received liver transplantation and were followed up in the Liver transplantation Center of Beijing Youan Hospital from January 2014 to December 2016, were retrospectively analyzed. The differences on clinical laboratory indicators and five-year survival were compared between HCC recurrence group ( n=29) and non-recurrence group ( n=21). Spearman correlate analysis was used to analyze the correlation between clinical laboratory indicators and HCC recurrence after liver transplantation. Receiver operator characteristic (ROC) curve was used to analyze the diagnostic value of CD4+T lymphocytes in HCC recurrence after liver transplantation. Kaplan-Meier survival curve was used to compare the survival time of patients with different CD4+T lymphocytes levels post liver transplantation. Results:Compared to non-recurrence group, the level of alanine aminotransferase, aspartate aminotransferase, γ-glutamyltransferase, albumin, lymphocytes, alpha-fetoprotein, protein induced by vitamin K deficiency or antagonist-Ⅱ, CD3+, CD4+and CD8+T lymphocytes were significantly different (all P<0.05). The median recurrence time after liver transplantation was 13.0 (6.0, 24.0) months, and the mortality rate was 100%. The 5-year mortality rate was 0 in the non-recurrence group. During 5-year follow-up, the median survival time of patients in the HCC recurrence group was 18.0 (9.0, 36.0) months, which was significantly lower than that of non-recurrence group [60.0 (60.0, 60.0) months, ( P<0.05)]. Compared with non-recurrence group, the CD3+, CD4+, and CD8+T lymphocytes were significantly lower in the recurrence group (all P<0.05). Spearman correlate analysis showed that HCC recurrence after liver transplantation was negatively correlated with the CD3+, CD8+and CD4+T lymphocytes ( r=-0.43, -0.38, -0.44, all P<0.05). ROC analysis showed that CD4+T lymphocytes at cutoff of≤265.50 cells/μl was valuable for the diagnosis of HCC recurrence after liver transplantation (specificity 100%, sensitivity 48.30%). Survival curve analysis showed that the survival time was significantly lower in the CD4≤265.50 cells/μl group [15.0 (10.0, 36.8) months] than that in the CD4>265.50 cells/μl group [53.0 (19.5, 60.0) months] ( P<0.05). Conclusion:There is a significant negative correlation between CD4+T lymphocytes and HCC recurrence after liver transplantation. CD4+T lymphocytes at cutoff value of≤265.50 cells/μl is valuable for the clinical diagnosis and prognosis evaluation of HCC recurrence after liver transplantation.
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Objective:To investigate the correlation between serum lipoprotein (a) [LP(a)] and the severity of white matter hyperintensities (WMHs) in the middle-aged and elderly people in the community.Methods:Consecutive middle-aged and elderly residents residing in the community underwent physical examinations in the Affiliated Jiangning Hospital of Nanjing Medical University from June 2016 to August 2021 were retrospectively collected. Fasting venous blood was collected on the next day of admission to detect the level of Lp(a). During hospitalization, cranial MRI examination was performed and the severity of WMHs was graded using the Fazekas visual scoring method. Ordinal multivariate logistic regression analysis was used to determine independent related factors for the severity of WMHs.Results:A total of 1 752 patients were included in the analysis. There were 969 males (55.31%) and 783 females (44.69%). Their age was 66.18±10.32 years old. There were 1 167 patients (66.61%) in the mild WMHs group, 407 (23.23%) in the moderate WMHs group, and 178 (10.16%) in the severe WMHs group. Ordinal multivariable logistic regression analysis showed that after adjusting for confounding factors, a higher serum Lp(a) level was independently related to the severity of WMHs (with the first quartile as a reference, the third quartile: odds ratio 1.441, 95% confidence interval 1.050-1.976, P=0.023; the fourth quartile: odds ratio 1.717, 95% confidence interval 1.252-2.354, P=0.001). Conclusion:Serum Lp(a) is independently correlated with the severity of WMHs.
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Objective:To explore the effect of modified multifunctional dressing bag with glauber's salt for relieving swelling and pain in early patients with limb fracture.Methods:A total of 111 patients with limb fracture in Tongde Hospital of Zhejiang Province were divided into two groups according to the admission time. The control group consisted of 53 patients with limbs fracture using common mirabilite bag with glauber′s salt and ice bag for external application admitted from January to August 2018, and the observation group consisted of 58 patients with limbs fracture using modified multifunctional dressing bag with glauber′s salt admitted from September 2018 to January 2020. The degree of pain, the time of appearance of dermatoglyphia, the cases of severe swelling, waiting time for operation, compliance and comfort of the patients were observed within 72 hours after injury.Results:The degree of pain, the time of appearance of dermatoglyphia, the waiting time, the cases of severe swelling for surgery in the observation group were (1.8±0.7) points, (4.5±1.2) days, (5.7±1.2) days,1 case, respectively, which were all lower than those in the control group (2.2±0.8) points, (6.0±1.5) days, (6.5±1.4) days, 19 cases, the differences between the two groups were statistically significant ( t values were -2.6,-5.6,-3.3, χ2 value was 21.8, all P<0.05). The total compliance rate in the observation group was 82.76% (48/58), higher than that in the control group 56.60% (30/53), the differences were statistically significant ( χ2 value was 9.34, P<0.05). The comfort of the observation group was 82.76% (48/58), significantly higher than that of the control group 3.77% (2/53), the difference was statistically significant ( χ2 value was 69.8, P<0.05). Conclusions:The modified multifunctional dressing bag with glauber′s salt can reduce the swelling of limbs, reduce the appearance of skin blisters, stop bleeding and pain, and shorten the waiting time for operation, at the same time, it improves the compliance and comfort of the patients.
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Objective:To investigate the correlation between white matter hypertensities (WMHs) and the overall burden of cerebral small vessel disease (CSVD) and clinical outcome of patients with acute ischemic stroke.Methods:From November 2018 to June 2019, patients with acute ischemic stroke hospitalized in the Department of Neurology, the Affiliated Jiangning Hospital of Nanjing Medical University were enrolled prospectively. Their demographic and clinical data were collected. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the baseline severity of stroke. The total burden of CSVD was evaluated according to the head MRI findings. The severity of WMHs was assessed based on Fazekas scale. The modified Rankin Scale (mRS) was used to evaluate the outcomes at 90 d after onset. The mRS score 0-1 was defined as good outcome, and ≥2 was defined as poor outcome. Multivariate logistic regression analysis was used to determine independent risk factors for poor outcomes. Results:A total of 153 consecutive patients with acute ischemic stroke were enrolled, of which 126 (82.35%) had a good outcome and 27 (17.65%) had a poor outcome. There were significant differences in age, baseline NIHSS score, lipoprotein-associated phospholipase A 2, total Fazekas score, periventricular WMHs score, and deep WMHs score between the two groups, while there was no significant difference in the total burden of CSVD. Multivariate logistic regression analysis revealed that the baseline NIHSS score (odds ratio 1.245, 95% confidence interval 1.023-1.515; P=0.028) and the total Fazekas score (odds ratio 1.635, 95% confidence interval 1.049-2.549; P=0.030) were the independent risk factors for poor outcomes at 90 d after the onset in patients acute ischemic stroke. Conclusions:The overall burden of CSVD is not associated with the short-term outcomes in patients with acute ischemic stroke. WMHs and baseline NIHSS score are the independent risk factors for poor short-term outcomes in patients with acute ischemic stroke.
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Objective@#To analyze the serological characteristics of anti-mitochondrial antibody M2 subtype (AMA-M2) in patients with drug-induced liver injury (DILI) and primary biliary cholangitis (PBC), in order to provide reference for clinical differential diagnosis.@*Methods@#Laboratory data of 2802 DILI cases who visited the hospital between January 2011 and December 2017 were retrospectively collected. AMA-M2 positive patients were analyzed with respect to laboratorical findings, and serum data of 120 patients with primary biliary cholangitis (PBC) at the same period was taken as a control. A chi-square test was used for group comparisons. One-way ANOVA and rank sum tests was used for ALT, AST, ALP, GGT and three groups of immunoglobulin M.@*Results@#Among 2802 DILI patients, AMA-M2 positive rate was 5.1% (144/2 802), 77.1% (111/144) was DILI alone, 22.2% (32/144) was DILI with PBC, and 0.7% (1/144) was DILI with Sjogren's syndrome. An AMA-M2 level in DILI alone group was mostly mild and moderate than the PBC group and the DILI combined with the PBC group. There was significant difference between the two groups (P < 0.05).There was no significant difference in AMA-M2 levels between DILI group combined with PBC group and PBC group (P > 0.05). ALT and AST levels of DILI alone group and DILI combined with PBC were (585.92 ± 653.04) U/L, (501.45 ± 512.67) U/L and (373.47 ± 502.60) U/L, (335.97 ± 513.96) U/L, respectively, which were significantly higher than PBC group [(106.33 + 134.08) U/L, (112.59 + 152.20) U/L]. There were statistically significant differences between the two groups (P < 0.05).The ALP level of DILI alone group was (152.58 + 81.46) U/L, which was lower than PBC group (237.86 + 215.09). The difference was statistically significant (P < 0.05). The level of immunoglobulin M in the DILI alone group was (1.76 ± 1.16) g/L, which was lower than PBC group (4.74 ± 5.74) g/L and the DILI combined with the PBC group (3.31 ± 1.68) g/L. There was significant difference between the two groups. During follow-up, 2.7% of patients with DILI had cirrhosis, 42.3% had lower AMA-M2 titer, 14.4% had lower AMA-M2 titer, 13.5% had higher AMA-M2 titer and five cases developed PBC.@*Conclusion@#AMA-M2 is not only positive in patients with PBC, but also low-to-medium or even high-level AMA-M2 may be detected in DILI patients. For AMA-M2-positive DILI patients, it is necessary to identify whether they are associated with PBC. Secondly, the levels of ALT, AST and ALP should be analyzed, and the patients should be on regular follow up for early and timely detection of drug-induced PBC.
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Objective To investigate the therapeutic effect and mechanism of non-mitogenic acid fibroblast growth factor 1( NMFGF1) on diabetic cardiomyopathy ( DCM) by using PEG-modified nano-liposomes combined with ultrasound-targeted microbubble destruction technique ( UTMD ) . Methods The NMFGF1 loaded PEG-modified nano-liposomes were prepared by a water-in-water emulsion method and their quality inspections were also investigated. Type 1 diabetes animal model was induced by intraperitoneal injection of streptozotocin ( 70 mg/kg) in male SD rats. The diabetic rats were raised twelve weeks after the diabetes model was established and DCM rats were selected by ultrasonic heart function examination. After two weeks of intervention, all rats were kept for another two weeks and then underwent transthoracic echocardiography examination. The rats were sacrificed and myocardial tissue was obtained to quantify myocardial collagen fraction ( CVF ) and cardiac myocyte apoptotic index by Sirius red staining and TUNEL staining. Results NMFGF1-loaded PEG-nano-liposomes showed a good morphology and 90.3％± 1.4％ NMFGF1 encapsulation efficiency. Compared with DCM group, NMFGF1group, and NMFGF1-PEG-nano-liposomes group, NMFGF1-loaded PEG-nano-liposome plus UTMD group showed increased left ventricular end diastolic diameter (LVIDd) [(7.36±0.42) vs (5.75±0.24), (6.64±0.27), (6.72±0.24)mm, all P<0.05]and leftventricularfractionshortening(LVFS) [(50±3) vs (33±2), (44±5), (43±3)mm, all P<0.05], and decreased left ventricular posterior wall thickness (LVPW) [(1.65±0.07) vs (1.89±0.08), (1.73±0.11), (1.73 ±0.07) mm, all P<0.05], with decreased CVF and apoptotic index(all P<0.05). Conclusion PEG-nano-liposomes combining with UTMD technique has a greater translational potential in the delivery of NMFGF1 for the treatment of DCM by attenuating oxidative stress-induced injury and may provide a promising strategy for treating diabetes cardiomyopathy.
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Objective To investigate the advanced preventive effect of acid fibroblast growth factor (aFGF) on diabetic cardiomyopathy(DCM) by using heparin-modified nano-liposomes combined with ultrasoundtargeted microbubble destruction technique (UTMD).Methods aFGF-loaded nano-liposomes (aFGF-lips) were prepared by lyophilization technique.Type Ⅰ diabetes model was induced by intraperitoneal injection of streptozotocin (STZ,70 mg/kg) in male SD rats.Before and twelve weeks after intervention,all rats underwent the transthoracic echocardiography.The segmental mean peak systolic radial velocity (Vs),systolic circumferential strain (Sc),and systolic circumferential strain rate (SRc) were measured.The expression of aFGF in DCM rats was detected by western blot.The rats were sacrificed and myocardial tissue were stained with masson staining and Tunel staining to quantify myocardial collagen fraction(CVF) and cardiac myocyte apoptosis index(AI).Results aFGF-lips showed good morphology and aFGF encapsulation efficiency (89.4±1.2)％ with high stability.From the animal experiments,the echocardiographic indexes including Vs,Sc and SRc had significantly improvements over DM group (P＜0.05) and all other treatment group (P＜0.05).The Masson's trichrome staining demonstrated that CVF was significantly higher in DM group than in the control group and was significantly lower in the aFGF-loaded nano-liposome+UTMD group than other groups(all P＜0.05).The TUNEL results showed that AI was significantly higher in DM group than in the control group and was significantly lower in aFGF-loaded nano-liposome +UTMD group than other groups (all P＜0.05).Conclusion aFGF nano-liposome combining with UTMD technique can improve the functions and pathologies of the hearts in type 1 diabetes mellitus model,which might provide a novel technique for aFGF in DCM prevention.
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Objective To evaluate the application of Addenbrooke′s cognitive examination revised(ACE?R)scale to evaluate cognitive function in patients with chronic kidney disease(CKD). Methods We used ACE?R scale to evaluate the cognitive function on 205 cases of CKD patients received outpatient and inpatient treatment in renal Department of four hospitals in Nanjing. One?way ANOVA analysis ,receiver operating characteristic (ROC)curve and other statistical methods were adopted to compare differences. Results (1)There is significant difference of ACE?R scale scores among group NC?NCDs(89.18 ± 4.80),group Mild?NCDs(77.28 ± 5.80)and group Major?NCDs(55.90 ± 10.90)(F = 292.28,P < 0.01). There is significant difference between any two groups(all P<0.01).(2)(ACE?R)scale(AUC=0.944,P<0.01)showed significantly higher sensitivity than mini?mental state examination(MMSE)scale(AUC = 0.777,P < 0.01)on identifying Mild?NCDs patients with chronic kidney disease(P < 0.01);(3)The optimal cut?off value of total ACE?R score between group NC?NCDs and group Mild?NCDs was 83/84,(sensitivity 88.00%,specificity 85.90%,Youden index 0.739),the optimal cut?off value between group Mild?NCDs and group Major?NCDs was 83/84(sensitivity 89.70%,specificity 96.10%, Youden index 0.858). Conclusion ACE?R possesses a good ability in distinguishing different severity of cognitive impairment in patients with CKD. ACE?R can effectively identify early mild cognitive impairment ,which is suitable for clinical application as a tool to evaluating and studying of cognitive function in patients with CKD.
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Objective To investigate the distribution of T follicular helper(Tfh)cell subsets in hepa-titis B patients at different immune stages and to clarify the relationships between the level of CXCL13 and the distribution of Tfh cell subsets. Methods Flow cytometry analysis was performed to detect the distribution of Tfh cells. Enzyme-linked immunosorbent assay(ELISA)was performed to measure the levels of CXCL13 in ser-um samples collected from hepatitis B patients. RT-PCR and Western blot assay were used to analyze the expres-sion of CXCL13 in HepG2 and HepG2. 2. 1. 5 cells. Results The percentages of Tfh1 cells were significantly up-regulated at the immune activation(IA)stage,while those of Tfh2 cells were significantly raised at the im-mune tolerance(IT)stage. The percentages of Tfh17 cells in patients at the stage of IT were similar to those in patients at the stage of IA,but were higher than those in responders with HBsAg seroconversion(RP)or healthy controls(HC). The expression of CXCL13 was positively correlated with the percentage of Tfh2 cells. More over,hepatitis B virus(HBV)enhanced the expression of CXCL13 at both transcriptional and translational lev-els. Conclusion HBV might up-regulate the percentage of Tfh2 cells through promoting the expression of CXCL13,which resulted in the induction of immune tolerance. Elucidating the functions of Tfh1,Tfh2 and Tfh17 cells and understanding the type conversion mechanism among the three subsets are important for further researches on HBV-induced immunosuppression.
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Objective To investigate the diagnostic value of serum FER, AFP and AFP-L3 alone or in combination for diagnosis of primary hepatic carcinoma( PHC).Methods This was a case-control study. Serum FER, AFP and AFP-L3 were determined in 212 patients with PHC ( StageⅠ45 cases, StageⅡ78 cases, StageⅢ81 cases, StageⅣ8 cases) , 127 patients with cirrhosis, 101 patients with chronic hepatitis and 98 controls in the Beijing Youan Hospital affiliated to Capital Medical University from January 2014 to December 2014.Levels of FER, AFP and AFP-L3 were measured by chemiluminescence, while serum samples were pre-treatment with affinity adsorption before AFP-L3 detection.FER, AFP and AFP-L3 levels were analyzed using the nonparametric Wilcoxon test among all groups.Diagnostic performance were analyzed among the groups with the three biomarkers independently and combined.Logistic regression, plotted ROC curve and calculated the area under ROC curve ( AUC) were applied to assess the diagnostic value of each index.Results Serum concentration of FER in PHC, cirrhosis, chronic hepatitis groups and healthy controls were 308.45 ( 148.98 -662.80 ) , 151.70 ( 51.44 -507.40 ) , 298.20 ( 157.30 -701.80 ) , 113.50( 54.98-221.38) μg/L, respectively.The concentration of AFP were 48.50(5.25 -748.40), 3.91(1.80-17.53), 4.76 (2.29-30.56), 2.57 (0.93-3.68) μg/L in each group.The serum levels of AFP-L3 in each group were 4.75(0.61-127.95), 0.61 (0.61-2.50), 0.61 (0.61-2.85), 0.61 (0.61-0.61) μg/L.The concentration of FER, AFP and AFP-L3 differs statistically in PHC, cirrhosis, chronic hepatitis group and healthy controls (χ2 =67.66,146.31,119.02,P<0.001).The content of serum FER, AFP and AFP-L3 increased gradually as the stage level aggravating ( StageⅠ-Ⅳ) , there was significant differences among groups (χ2 =21.63,22.68,21.98, P<0.001) .When using one serum marker, FER had the highest sensitivity (75.00%) , while AFP-L3 had the highest specificity (82.52%). While using two serum markers, FER/AFP had the highest sensitivity (89.15%) , FER+AFP-L3 and AFP+AFP-L3 had a higher specificity (86.20%).The combined detection of FER/AFP/AFP-L3 improved the sensitivity of the test to 89.15%, while FER+AFP+AFP-L3 had a specificity of 86.50%.The AUC of combination of FER, AFP and AFP-L3 was 0.803 ±0.019 (95% CI:0.765-0.841), which was higher than the AUC of either FER(0.748 ±0.022,95% CI:0.705-0.790, Z=4.67,P<0.001) and AFP-L3 (0.726 ±0.024,95% CI: 0.679 -0.772, Z=3.64,P<0.001).However, there was no significant difference in AUC between AFP alone ( 0.776 ±0.021, 95% CI: 0.735 -0.818 ) and the combined detection ( Z=1.34, P=0.18 ) .Conclusions FER was a potential marker for PHC diagnosis.The combination of FER, AFP and AFP-L3 has higher value of clinical applications than one of them independently.
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This article was aimed to study the mechanism of interaction between human serum albumin (HSA) and zinc ions, in order to provide the information on the secondary structure modification of HSA and the thermodynamics parameters using circular dichroism (CD) and isothermal titration calorimetry (ITC). CD and ITC were applied in the study. The concentration of HSA were 0.025 mmol·L-1, 0.05 mmol·L-1, 0.1 mmol·L-1, and 0.2 mmol·L-1, respectively. The concentration of zinc ion was 5 mmol·L-1. The CD analysis revealed that the secondary structure modification of HSA differed depending on the concentration of HAS. And the content ofα-helix was inversely proportional to the concentration of HSA. When the concentration of HSA was 0.2 mmol·L-1, the content ofα-helix was special. A series of thermodynamics parameters including association constants (Kb), stoichiometry (N), entropy (ΔS) and enthalpy (ΔH) were investigated by ITC analysis. And two types of binding sites were observed when ZnSO4(mmol·L-1)?HSA (mmol·L-1)= 5?0.2. The secondary structure modification of HSA interacting with zinc ions depended on the concentration of HSA, a dramatic reduction ofα-helix was detected when the concentration of HSA attained 0.2 mmol·L-1. And the protein hydrophobicity reduction and peptide chains expansion were equally observed at this concentration. The ITC analysis also revealed endothermic and exothermic binding sites in the ZnSO4-HSA interaction when ZnSO4 (mmol·L-1)?HSA (mmol·L-1)= 5?0.2, indicating that the endothermic sites were specific but not preferential for zinc ions interactions. These results provided theoretical supports for the application of Zn2+ to open the endothermic sites of HSA.
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BACKGROUND:With the introduction of related policies on organ procurement and distribution, the organ procurement and standards of the organ procurement have a clear operational criteria, as wel as how to al ocate organs. But the work processes and organizational positioning on organ procurement organization are not enough elaborated and normal. OBJECTIVE:To analyze the experience of Guangzhou General Hospital of Guangzhou Military Command as the organ procurement organization units in quality management, timely review working progress and explore areas for improvement, which provide the corresponding countermeasures for enhancing quality management and establishing the efficient and professional organ procurement organization. METHODS:A computer-based online search in CNKI database and PubMed database was performed with the keywords of“organ donation, organ transplantation, Organ Procurement Organization, quality management”in English and Chinese by screening titles and abstracts. RESULTS AND CONCLUSION:According to relevant laws and regulations, Guangzhou General Hospital of Guangzhou Military Command formulates a standard evaluation standard and sets up the team, thus achieving the reunification of the responsibilities and powers. At the same time, they improve the relevant organ donation,acquisition, preservation, registration, and design different quality management plans according to these different aspects. In addition, In addition, the hospital hold regular coordinator training and make it standardization. Through a series of quality management measures, the hospital organ procurement organization has gradual y regularized and achieved some results. It is recommended to further strengthen scientific research, achieve the unification of efficiency and effectiveness of scientific research;improve the awareness of the hospital leaders, consummate the mechanism of organ procurement;focus on personnel training, improve the professional quality of the organization members;enhance information management, achieve multi-disciplinary col aboration;build quality evaluation system, achieve the whole process of quality management;emphasize on medical ethics, and promote the harmony between the hospital and the patient.
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Objective To evaluate the accuracy and reliability of Diana automated blood grouping analyzer in blood grouping and cross matching.Methods 2 300 patients′ABO and RhD blood groups were examined by conventional tube test and the fully auto-mated blood grouping analyzer and 900 patients′samples were tested using Diana automated blood grouping for blood cross matc-hing,and it was compared with polymatching method.Results The analyzer′s accuracy rate of blood grouping by two methods were 99.87% and 100.00%.The incompatibility occurred in 30 specimens in automatic blood type instrument,in 3 specimens in manual polymatching method.Conclusion The results of Diana automated blood grouping analyzer used for blood grouping and cross matc-hing blood testing are reliable.Its experimental operation is normalized and standardized with an advantage of low incidence of human er-ror.Moreover,the experimental results can be permanently preserved,which provides a convenience to search for medical proof.
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ObjectiveTo study the postoperative complications and nursing intervention of high myopia combining posterior scleral staphyloma macular rhegmatogenous retinal detachment. MethodsFrom January 2010 to December 2011,120 cases of patients with high myopia combining posterior scleral staphyloma macular rhegrnatogenous retinal detachment were selected as research objects.All patients were given vitrectomy combined with silicone oil filling operation,then we observed the postoperative complications. ResultsIn 120 patients,14 cases of patients occurred high intraocular pressure ( 11.67％ ),6 cases of patients were found bleeding(5.0％),68 cases of patients had great pain,all the postoperative complications alleviated after nursing intervention,the comparing difference had statistical significance between before and after nursing intervention. 31 cases of patients occurred cataract (25.83％),and 2 cases in intraocular infection (1.67％),the postoperative complications were properly handled. ConclusionsHigh intraocular pressure,internal bleeding of eyes,cataracts,postoperative pain,and intraocular infection are the postoperative complications of high myopia combining posterior scleral staphyloma macular rhegrnatogenous retinal detachment,targeted nursing intervention can effectively treat complications.
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Objective For decreasing the mistreatment and the excess treatment of Chlamydia trachomatis pneumonia,this article analyze Chlamydia trachomatis pneumonia clinic features in the infant.Methods Making review analysis to the clinic data of 64 infant age of 0 to 3 months old suffering from Chlamydia trachomatis pneumonia.Results The infection history of these babies is not identify in their perinatal period.The average age when they were ill is 32.77?19.03d;It happened more frequently in spring and winter.The patient's condition is gently with cough as their feature,following fever,gasping,fine crackles,or none of those.It does not prolong the course of disease by following the air tube virtue infection.The increase of the Blood white cell is 43.8% and that of the neutrophile is less than 20%.The level of Few CRP increase.The abnormal of the baenosome X-ray is on both sides.It can relieve symptom and physical sign,and shorten the time in hospital for using the macrolide medicine,and it surpass the cephalosporin.Conclusions The Chlamydia trachomatis infection does not result in the damage of the organ,even if jeopardizing the life.It is helpful to recognize the clinical course correctly for the analysis of the complicated clinical condition exactly.
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OBJECTIVE To investigate the antibiotic resistance pattern of MRSA,homology and carriage of Panton-valentine leukocidin(PVL) in 50 meticillin-resistant Staphylococcus aureus isolates to guide the clinical treatment.Results of homology provide the proof for molecular epidemiology.METHODS According to CLSI′s guideline,antimicrobial susceptibility tests were performed with disk diffusion method.PVL gene and mecA gene were detected by PCR.The homology was analyzed by repetitive estra-genic palindromic elements(Rep)-PCR method.RESULTS MecA gene was detected in all 50 MRSA isolates.All isolates MRSA were resistant to oxacillin and cefoxitin.But they were all sensitive to vancomycin and teicoplanin.The rates of sensitivity to clindamycin,ciprofloxacin,piperacillin and sulbactam,SMZ-TMP,gentamicin,cefazolin and erythromycin were 7.5%,1.9%,24.5%,92.5%,20.8%,1.9% and 3.8%,respectively.The resistance rates of MRSA were higher than that of MSSA.Twenty PVL genes were detected from 50 MRSA isolates.CONCLUSIONS The resistance rates of MRSA are higher than MSSA.There is no isolate resistant to vancomycin and teicoplanin.40.0% MRSA carry PVL gene and part isolates have high homology.
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OBJECTIVE To detect ?-lactamase of ampicillin-resistant Enterococcus in order to choose drugs for clinical treatment.METHODS According to CLSI's guideline,antimicrobial susceptibility tests were performed:to detect ?-lactamase with nitrocefin,to detect blaZ by PCR and to detect mutation of pbp4 by single-strand conformation polymorphism(SSCP).RESULTS The resistant rates of E.faecium and E.faecalis to ampicillin,penicillin,high level gentamicin,high level streptomycin,levofloxacin,erythromycin,tetracycline,and chloramphenicol were 100%,100%;86%,76%;46%,44%;84%,74%;100%,94%;54%,58%;and 42%,36%;to rifampicin 62%,58%;and to vancomycin both 0%,respectively.The positive rate of ?-lactamase in 50 E.faecalis strains with paper disk method and test tube method was 8% and 26%;and that of blaZ by PCR was 88%.But in 50 E.faecium strains the results were 0% and 2%,respectively.There was no significant mutation by SSCP and sequencing in E.faecalis.CONCLUSIONS The positive rate to ?-lactamase in E.faecalis is markedly higher than in E.faecium.The method of PCR is better than that of nitrocefin.The positive rate of test tube method is higher than paper disk method with nitrocefin.
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512 ?g/ml for vancomycin.Thirty seven VanA genes were detected in 37 VREFm.The drug resistance rates to erythromycin,ampicillin,levofloxacin,gentamicin,ciprofloxacin,nitrofurantoin(Euradantin) and chloramphenicol were 100.0%,100.0%,89.2%,86.5%,91.9%,59.5%,and 5.4%,respectively.The REP-PCR generated 3-14 bands between 100 and 2000bp.They were divided into six types.CONCLUSIONS There is 100.0% agreement between phenotypes and genotypes in VREFm.VREFm are multiresistant.REP-PCR method is simple,rapid,and with lower cost to detect the homology in enterococci.
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Objective To study LI gene sequence of HPV cp6108 from 5 cases of condyloma acuminata. Methods T-A cloning and direct sequencing of PCR product were used. Results The LI gene sequences of HPV cp6108 from 5 specimens were presented with the homology of 99% to reference sequence in GenBank. A total of 3 gene mutations were found, including a nonsense mutation of G70A, a missense mutation of D77N, and a missense mutation of Tl16P. Conclusions In comparison with the sequence in GenBank, at least 3 gene mutations of HPV CP6108, i.e. one nonsense mutation of G70A and missense mutations of D77N and Tl 16P, are found in the present study.
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Objective To screen primers used in polymerase chain reaction (PCR) for detecting Trichomonas vaginalis. Methods Three pairs of PCR primer reported in the literatures (TVA5-TVA6, TV1-TV2 and TVK3-TVK7) were screened. For each PCR, four components, including primers, Mg2+, dNTPs and Taq polymerase, were optimized using Taguchi methods to determine the optimal PCR conditions. With the optimal conditions, the sensitivities of three PCR were compared. Vaginal swabs were collected to detect Trichomonas vaginalis by culture and PCR, and the PCR with highest sensitivity was evaluated. Results All three PCR were of high specificity, and the PCR with primers of TVK3-TVK7 had the highest sensitivity. Of 25 clinical vaginal swabs, T. vaginalis was detected in 7 samples by the culture, however, it was detected in 8 samples by the PCR. All culture-positive samples were also positive by PCR. Conclusions The PCR with the primers of TVK3-TVK7 is highly sensitive and specific, which could be useful to detect T. vaginalis in vaginal swab samples.