Effect of Bushen Huoxuetang on Expression of Bax/Bcl-2 and Cleaved Caspase-3 in Nude Mice with Bone Metastasis of Breast Cancer / 中国实验方剂学杂志

ObjectiveTo study the effect of Bushen Huoxuetang on the apoptosis and the expression of B-cell lymphoma （Bcl-2）-associated X protein （Bax）/ Bcl-2 and cleaved cysteine-containing aspartate proteolytic enzyme-3 （cleaved Caspase-3） in the nude mouse model of bone metastasis of breast cancer， and explore the mechanism of Bushen Huoxuetang in inhibiting bone destruction. MethodThirty BALB/c female nude mice were randomly assigned into blank group （n=6） and model group （n=24）. The suspension of 4T1 breast cancer cells was injected into the tibia of mouse right lower limb to establish model of bone metastasis of breast cancer. The successfully modeled nude mice were randomly assigned into model group， Bushen Huoxuetang group， zoledronic acid group， and combined drug group， with 6 mice in each group. Bushen Huoxuetang was administrated at a dose of 36.67 g·kg-1， once a day， and zoledronic acid was administrated by subcutaneous injection at a dose of 100 μg·kg-1， twice a week. The combined drug group was administrated with the same doses of Bushen Huoxuetang group by gavage and zoledronic acid by subcutaneous injection. The mice in the blank group and the model group were administrated with the same volume of distilled water by gavage for 14 days. On the next day at the end of drug administration， the mice were sacrificed by cervical dislocation. The general situation and weight changes of the mice were examined. The right lower limb was collected， and X-ray scanning and hematoxylin-eosin （HE） staining methods were used for observation of pathological changes in the bone. The terminal deoxynucleotidyl transferase dUTP nick-end labeling （TUNEL） was employed to detect the apoptosis of bone tissue in nude mice， and Western blot to determine the expression of Bax/Bcl-2 and cleaved Caspase-3 in the bone tissue. ResultCompared with the blank group， the modeling reduced the body weight （P<0.01） and increased the right lower limb weight of the nude mice （P<0.01）. Compared with the model group， Bushen Huoxuetang， zoledronic acid， and their combination increased the body weight （P<0.01） and decreased the right lower limb weight （P<0.01）. Compared with the blank group， the other groups showed obvious tumor cell atypia， deep nuclear staining， and clear bone metastasis， and the model group showed obvious osteolytic damage in right lower limb and loss of proximal tibia and knee joint. Compared with the model group， Bushen Huoxuetang， zoledronic acid， and their combination reduced the osteolytic lesions in the right lower limb and recovered part of the bone structure， demonstrating an inhibitory effect on bone destruction. The TUNEL assay showed that the model group had lower apoptosis rate of bone metastatic tumor cells than the blank group， Bushen Huoxuetang group， zoledronic acid group， and combined drug group （P<0.01）. Compared with the blank group， the modeling down-regulated the expression of Bax and cleaved Caspase-3 （P<0.01） and up-regulated the expression of Bcl-2 （P<0.01）. Compared with the model group， Bushen Huoxuetang， zoledronic acid， and their combination up-regulated the expression of Bax （P<0.01） and cleaved Caspase-3 （P<0.05， P<0.01） and down-regulated the expression of Bcl-2 （P<0.05， P<0.01）. ConclusionBushen Huoxuetang may inhibit bone destruction in the nude mouse model of bone metastasis of breast cancer by up-regulating the expression of Bax， down-regulating the expression of Bcl-2， activating cleaved Caspase-3， and further inducing apoptosis.

Therapeutic Observation of Shipiyin Combined with Diosmin in Treatment of Lymphedema with Spleen Yang Deficiency Syndrome After Modified Radical Mastectomy / 中国实验方剂学杂志

ObjectiveTo investigate the clinical effect of Shipiyin combined with diosmin in the treatment of lymphedema with spleen Yang deficiency syndrome（SYDS）after modified radical mastectomy and the specific effect on the function of the affected limb. MethodEighty-two patients with lymphedema with SYDS after modified radical mastectomy from outpatient and inpatient department of breast department and oncology department of the First Affiliated Hospital of Hunan University of Chinese Medicine were randomly divided into an observation group（41 cases） and a control group（41 cases）. The control group was given diosmin tablets（0.9 g per time， two times per day）on the basis of conventional treatment，and the observation group was given Shipiyin（one dose per day）on the basis of the control group. The course of treatment was 14 days. The clinical symptoms were observed and the limb circumference，traditional Chinese medicine（TCM） syndrome score，functional assessment of cancer therapy-breast cancer（FACT-B） score，disability of arm， shoulder and hand questionnaire（DASH） score，and joint range of motion were measured to analyze the TCM syndrome therapeutic effect and clinical efficacy. ResultAfter 14 days of treatment， the total effective rate of the observation group was 85.37% （35/41） and that of the control group was 63.41% （26/41） in the TCM symptoms， showing a statistically significant difference （Z=-2.212， P<0.05）. In terms of the clinical efficacy， the total effective rate in the observation group was 82.93% （34/41） and that in the control group was 75.61% （31/41）， indicating a statistically significant difference （Z=-2.061， P<0.05）. Compared with the situations before treatment， the scores of clinical symptoms such as the swelling of the upper limb， pain， sense of heaviness， stuffiness， fatigue， fullness， tightness， and skin keratosis and pruritus in the two groups were significantly lowered （P<0.01） after treatment. Compared with the control group， the observation group could better improve the swelling and fullness（P<0.01），as well as the feeling of pain，heaviness，stuffiness，fatigue，tightness，skin keratosis and pruritus （P<0.05）of the upper limbs of patients. The affected limb circumference， TCM syndrome score， and DASH score decreased significantly， while the FACT-B score and upper limb joint range of motion increased significantly in the two groups after treatment （P<0.01）. Compared with the control group， the observation group showed significantly reduced limb circumference at 10 cm proximal to the elbow striae， lowered TCM syndrome score， elevated FACT-B score（P<0.05）， decreased DASH score and improved range of motion of the upper limb joint （P<0.01） after treatment. ConclusionShipiyin combined with diosmin has better clinical efficacy in the treatment of lymphedema with SYDS after modified radical mastectomy than diosmin alone，which can better improve the clinical symptoms，signs，quality of life and limb functional activity of patients. This provides a new clinical program for the treatment of lymphedema after breast cancer surgery with integrated Chinese and western medicine.

Differential diagnosis for breast ductal carcinoma in situ and plasma cell mastitis by magnetic resonance imaging / 中南大学学报(医学版)

To investigate the magnetic resonance imaging (MRI) features for ductal carcinoma in situ (DCIS) and plasma cell mastitis (PCM) , and to improve diagnostic accuracy for DCIS and PCM. 
 Methods: The MRI morphology confirmed by surgical pathology and dynamic enhancement for 35 patients with DCIS and 45 patients with PCM were retrospectively analyzed, which included T1 pre-scan high signal, enhanced distribution characteristics, internal strengthening mode, whether centrifugation or centripetal diffusion, dynamic enhancement curve morphology, diffusion-weighted imaging (DWI) signal characteristics, and apparent diffusion coefficient (ADC) values. 
 Results: The segmental distribution, clustered ring, T1 pre-catheters diffusion and the dynamic delayed concentric diffusion were more common in DCIS than those in PCM (P<0.05). Regional distribution, internal heterogeneity enhancement, and enhanced delay period eccentric diffusion were more common in PCM than those in DCIS (P<0.05). In the PCM group, nipple repertoire, DWI center high signal, adjacent skin thickening, and sinus formation were significantly higher than those in the DCIS group (P<0.05).
 Conclusion: Both DCIS and PCM show a non-mass like enhancement on MRI. Images in DCIS mostly show duct-like, branch-like and segment-like distribution. The internal enhancement mode is centripetal diffusion. Images in PCM mostly show regional distribution, and the inside displays heterogeneity enhancement with the adjacent skin thickening and nipple subsided.

Application of continuity nursing model in caring patients receiving percutaneous transhepatic biliary drainage / 介入放射学杂志

Objective To investigate the clinical value of continuity nursing model in caring patients with malignant obstructive jaundice treated with percutaneous transhepatic biliary drainage (PTBD).Methods A total of 120 patients with malignant obstructive jaundice treated by PTCD were enrolled in this study.The patients were divided into the control group (n=60) and the observation group (n=60).Routine discharge guidance and health education was conducted for the patients of control group,while for the patients of observation group,in addition to conventional discharge education,the continuity nursing was executed by the responsible nurse.Continuity nursing was meant to continue the service,to guide the observation of the wound and dressing change,the observation of the quantity and quality of drainage solution,to teach the knowledge of the management of PTCD catheter as well as its complications,to guide patient's diet and rest,and to establish the continuity nursing records.Results The patients of both groups were followed up for 3 months.The patients' awareness rate of the knowledge related to PTCD tube in the observation group was significantly higher than that in the control group.The wound infection rate,the rate of PTCD tube prolapse or blockage,and the tube-related re-hospitalization rate in the observation group were strikingly lower than those in the control group (P＜0.05).Conclusion The continuity nursing model can significantly improve patients' awareness rate about the knowledge related to PTCD tube,reduce the incidences of biliary tract infection,PTCD tube prolapse or blockage,wound infection,and tube-related re-hospitalization,therefore,the quality of life can be surely improved.

Variation of weight for age Z scores in preterm infants with extrauterine growth restriction / 中华实用儿科临床杂志

Objective To understand variation of weight for age Z scores in premature infants with extrauterine growth restriction(EUGR).Methods Retrospective analysis was adopted with the data of very -low -gestational age (VLGA)preterm infants who met with the following criteria:admitted to Neonatal Medical Center of Huai′an Maternity and Child Healthcare Hospital from January 201 1 to December 201 3,gestational age <32 weeks,more than 4 weeks of hospital stay and survived when discharged.All VLGA premature infants were divided into non -EUGR group and EUGR group according to whether the standard weight on hospital discharge was below the 1 0th percentile of body weight at corrected age.The weight for age Z scores of preterm infants were calculated at each time point.The differences and trends between 2 groups were compared.The receiver operating characteristic (ROC)curve in diagnosing EUGR by weight for age Z scores was drawn.Results A total of 1 77 VLGA premature infants were enrolled,and among them there were was 1 04 cases of EUGR and the incidence amounted to 58.8%.The weight for age Z scores curve of EUGR group was under that of all preterm infants,and the curve of non -EUGR group was above that of all preterm infants. The weight for age Z scores of all preterm infants and EUGR group showed overall downward trend along with prolonged hospitalization.However,the weight for age Z scores of non -EUGR group did not change significantly at each week point except for the first week.The weight for age Z scores of EUGR group was lower than that of non -EUGR group at birth (-0.84 ±0.39 vs -0.31 ±0.41 ),the first week after birth (-1 .1 9 ±0.36 vs -0.74 ±0.40),the second week after birth (-1 .1 7 ±0.36 vs -0.68 ±0.40),the third week after birth (-1 .23 ±0.34 vs -0.64 ±0.39),the fourth week after birth (-1 .35 ±0.41 vs -0.65 ±0.42),the fifth week after birth (-1 .45 ±0.41 vs -0.56 ± 0.38),the sixth week (-1 .54 ±0.49 vs -0.70 ±0.36)and on discharge time (-1 .72 ±0.38 vs -0.67 ±0.42). The difference at each week point was statistically significant (all P =0.000).The weight for age Z scores on discharge were negatively correlated with start time of enteral feeding in preterm infants (r =-0.271 ,P <0.05),time of paren-teral nutrition up to 41 8 kJ/(kg·d)(r =-0.388,P <0.05),time of full enteral feeding (r =-0.332,P <0.05),a-mino cumulative dose (r =-0.298,P <0.05)and fat milk cumulative dose (r =-2.221 ,P <0.05).Area under the curve at each week point of the weight for age Z scores predicting the EUGR gradually increased along with prolonged hospitalization.There was a statistical significance in the weight for age Z scores value at each week point on the diagno-sis of EUGR(P =0.000).There was a high sensitivity and specificity at each week point.Conclusions Dynamic mo-nitoring weight of age Z scores of the premature infants can show the nutrition and growth trend,and may be a risk warning of the preterm infants suffering from EUGR.

Predictive value of Downes score on respiratory failure in term neonates / 中华围产医学杂志

Objective To explore the clinical significance of Downes score in predicting respiratory failure (RF) in term neonates.Methods From June 1, 2011 to December 31, 2013, 243 hospitalized term neonates with dyspnea, who were born at 37 to 42 gestational age and admitted to the hospital within 24 h after birth, were selected from Neonatal Medical Center of Huai'an Maternity and Child Healthcare.Downes scores were evaluated based on five indicators including respiratory rate, skin color, three depressions sign, moaning and lung breath sounds at the time of admission.RF was diagnosed based on clinical menifestations and radial arterial blood gas analysis.Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of Downes score on RF.Results The average Downes score of the 243 cases was 6.57±0.86 and the RF rate was 69.6％ (169/243).The RF rate was 93.4％ (169/181) when Downes score ≥ 4.5, with the sensitivity, specificity, misdiagnostic rate and missed diagnositic rate of 100.0％, 83.8％, 16.2％ and 0.0％, respectively.While, the RF rate was 80.7％ (130/161) when Downes score ≥ 5.5, with the sensitivity, specificity, misdiagnostic rate and missed diagnositic rate of 76.9％, 58.1％, 41.9％ and 23.1％, respectively.When Downes score ≥ 6.5, the incidence of RF was 97.6％ (123/126), with the sensitivity, specificity, misdiagnositic rate and missed diagnositic rate of 72.8％, 95.9％, 4.1％ and 27.2％, respectively.The cutoff value was 6.5 according to the Youden Index, which with lower rate of misdiagnosis and missed diagnosis.When Downes score ≥ 7.5, the incidence of RF was 100.0％(22/22), with the sensitivity, specificity, misdiagnositic rate and missed diagnosis rate of 13.1％, 100.0％, 0.0％ and 87.0％, respectively.The area under the ROC curve was 0.906 (95％CI: 0.866-0.955).The higher the Downes score, the greater the possibility of RF (P=0.000).Conclusions Dynamic Downes scores in term neonates with dyspnea could predict the risk of RF.The higher the Downes score, the greater the possibility of RF.

The target adjustment of the end-tidal carbon dioxide partial pressure in preterm infants under mechanical ventilation / 中华实用儿科临床杂志

Objective To reduce the incidence of the hypocapnia,the cutoff value of the end-tidal carbon dioxide partial pressure[Pet(CO2)] for predicting the hypocapnia so as to understand the suitable adjustment target and target range of the Pet(CO2) in preterm infants under mechanical ventilation.Methods From Jan.2012 to Oct.2013,96 cases of the preterm infants with respiratory distress syndrome(RDS) who needed mechanical support were selected from the Huaian Maternity and Child Health Care Hospital.Pet(CO2) value of each time point(1 h,24 h,48 h and 72 h after mechanical ventilation) were recorded,while radial artery blood was collected for blood gas analysis.The level of pa (CO2) ＜ 35 mmHg(1 mmHg =0.133 kPa) diagnosed hypocapnia;while the level of Pa (CO2) ＞ 60 mmHg was for diagnosing hypercapnia.The diagnostic cutoff and the suitable adjustment target and adjustment target range of the Pet(CO2) were confirmed by receiver operating characteristic (ROC) curve.Results The data from 381 arterial blood gas analysis results were gained,of which 151 times belonged to hypocapnia,and the rate was 39.6％,the other 230 cases were normal,and no case was of hypercapnia.The area under the ROC curve was 0.895,and the area of the standard error was 0.016.There was a statistical significance in Pet(CO2) value for the diagnosis of hypocapnia(P =0.000).The lower the value of Pet (CO2),the greater the likelihood of hypocapnia,and 95 ％ confidence interval area was 0.864-0.926.The Pet (CO2) optimal diagnostic cutoff value determined in accordance with Youden index was 30.5 mmHg.When Pet (CO2) among 41.5 mmHg,sensitivity was 100％.Conclusions Diagnostic cutoff value for forecasting hypocapnia is 30.5 mmHg.The suitable adjustment target of mechanical ventilation parameter adjustment is 41.5 mmHg for the Pet(CO2).The target range of mechanical ventilation parameter adjustment is 30.6-41.5 mmHg for the Pet(CO2).

Detection of soluble triggering receptor expressed on myeloid cell-1 for diagnosis of early-onset neonatal sepsis / 中华临床感染病杂志

Objective To assess the clinical value of serum soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) for diagnosis of early-onset neonatal sepsis (EONS).Methods A total of 90 neonatal cases with risk factors or symptoms of bacterial infections were enrolled in the study.All infants were admitted to Huai' an Maternity and Child Healthcare Hospital within 24 h after birth during January and June 2014.The enrolled neonates were divided into sepsis group (n =33),general infection group (n =23) and non-infected group (n =34);and the sepsis group was further divided into culture-confirmed group (n =6) and clinical-diagnosed group (n =27).Twenty healthy neonates were also enrolled as the healthy control group.Blood samples were obtained from neonatal patients on d1,d3 and d7 after birth,and for healthy controls,the blood samples were only obtained at the first day.Serum levels of sTREM-1 and interleukin (IL)-6 were measured by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA).The receiver operating characteristic (ROC) curve was applied to evaluate the values of sTREM-1 and IL-6 in diagnosis of EONS.Results Compared with that in general infection group,non-infected group and healthy control group,the serum level of sTREM-1 was significantly higher in sepsis group (all P ＜ 0.05);serum levels of sTREM-1 in general infection group and non-infected group were also higher than that in healthy control group (all P ＜ 0.05);but no difference was observed between general infection group and non-infected group,between culture-confirmed group and clinical-diagnosed group (P ＞ 0.05).Serum level of sTREM-1 showed upward trend during d1-3 after the birth,and downward trend during d3-7.The areas under the ROC curve (AUC) were 0.810 and 0.811 (all P ＜ 0.05) for sTREM-1 levels on d1 and d3 in diagnosis of EONS,and the optimal cut-off values were 234.44 ng/L and 269.79 ng/L,respectively.If sTREM-1 and IL-6 on d1 were combined for diagnosis of EONS,the AUC,sensitivity and specificity were 0.858,92.00％ and 93.10％,respectively.Conclusion Serum level of sTREM-1 in early stage is valuable for diagnosis of EONS,and the combined use of serum sTREM-1 and IL-6 may improve the diagnostic value.

Application of lung recruitment maneuver in preterm infants with respiratory distress syndrome ventilated by proportional assist ventilation / 中华儿科杂志

<p><b>OBJECTIVE</b>To understand the effect of lung recruitment maneuver (LRM) with positive end-expiratory pressure (PEEP) on oxygenation and outcomes in preterm infants with respiratory distress syndrome (RDS) ventilated by proportional assist ventilation (PAV).</p><p><b>METHOD</b>From January 2012 to June 2013, thirty neonates with a diagnosis of RDS who required mechanical ventilation were divided randomly into LRM group (n=15, received an LRM and surport by PAV) and control group (n=15, only surport by PAV). There were no statistically significant differences in female (7 vs. 6); gestational age [(29.3±1.2) vs. (29.5±1.1) weeks]; body weight[(1,319±97) vs. (1,295±85) g]; Silverman Anderson(SA) score for babies at start of ventilation (7.3±1.2 vs. 6.9±1.4); initial FiO2 (0.54±0.12 vs. 0.50±0.10) between the two groups (all P>0.05). LRM entailed increments of 0.2 cmH2O (1 cmH2O=0.098 kPa) PEEP every 5 minutes, until fraction of inspired oxygen (FiO2)=0.25. Then PEEP was reduced and the lung volume was set on the deflation limb of the pressure/volume curve.When saturation of peripheral oxygen fell and FiO2 rose, we reincremented PEEP until SpO2 became stable. The related clinical indicators of the two group were observed.</p><p><b>RESULT</b>The doses of surfactant administered (1.1±0.3 vs. 1.5±0.5, P=0.027), Lowest FiO2 (0.29±0.05 vs. 0.39±0.06, P=0.000), time to lowest FiO2[ (103±18) vs. (368±138) min, P=0.000] and O2 dependency [(7.6±1.0) vs.( 8.8±1.3) days, P=0.021] in LRM group were lower than that in control group (all P<0.05). The maximum PEEP during the first 12 hours of life [(8.4±0.8) vs. (6.8±0.8) cmH2O, P=0.000] in LRM group were higher than that in control group (P<0.05). FiO2 levels progressively decreased (F=35.681, P=0.000) and a/AO2 Gradually increased (F=37.654, P=0.000). No adverse events and no significant differences in the outcomes were observed.</p><p><b>CONCLUSION</b>LRM can reduce the doses of pulmonary surfactant administered, time of the respiratory support and the oxygen therapy in preterm children with RDS.</p>

The high risk factors and clinical analysis of respiratory distress syndrome in neonates at different gestational age / 临床儿科杂志

Objective To compare the high risk factors, complications, treatment and prognosis of respiratory distress syndrome (NRDS) in neonates at different gestational age (GA). Methods Between August 2012 and July 2013, 156 neonates with RDS were selected and distributed into 3 groups, 42 early preterm (GA<34weeks), 52 late preterm (GA 35 to 36 weeks), and 62 in term group (GA≥37 weeks). Retrospectively analysis was performed for high risk factors, complications, treatment and prognosis of the three groups. Results In 156 neonates with RDS, the male and female proportion was 2.25:1. All groups had more males, but the gender difference has no statistical signiifcance in three groups (P=0.923). The onset time of RDS and the hospitalization time both show an increasing trend of statistical signiifcance (P<0.05). Comparing the difference of high risk factors for RDS of the 3 groups, birth asphyxia, placental abnormalities, multiple pregnancy, premature rupture of membranes was most common in early preterm group, and followed by late preterm group, and C-section was most common in term group and unexplained preterm was more common in early preterm group than that in late preterm group (all P<0.05). Among the three groups, the ratio of pulmonary surfactant application was the lowest in the term group, the ratio of X-ray grade over II was high-est in early preterm group, oxygen and hospitalization time were the longest in early preterm group (P<0.05). The risks of com-plicated with pulmonary infection, intracranial hemorrhages and bronchopulmonary dysplasia were the highest in early preterm group and the risk of complicated pneumothorax was the highest in term group. Among three groups, the recovery rate was the lowest in the early preterm group (P<0.01). Conclusion The clinical characteristics, high risk factors, complications and treat-ment responses of RDS in neonates with different GA were different, so GA should be considered for diagnose and treatment. For the term infants, the elective caesarean section should be strictly controlled, in order to reduce the incidence of RDS.

Testing of initial contamination for three kinds of surgical implants producted in Beijing / 中国医疗器械杂志

The initial contamination of femoral head, femoral stem and femoral component producted by seven factories in Beijing is tested, all of the initial contamination values are 580 in total. Then these data is analyzed on statistics. The result indicates that the initial contamination values of three kinds of products according with normal distribution; The initial contamination values have not significant difference between femoral head and femoral component of the same factory; and the season has not significant effect on initial contamination in Beijing. According to the experimental data, the level of initial contamination is undulatory, so the factories should control the initial contamination and maintain the stability of initial contamination.

Screening the factors which affect α-toxin expression of CA-MRSA / 中华检验医学杂志

Objective To screen the factors that can affect α-toxin expression of CA-MRSA except for quorum-sensing system and to investigate the regulative mechanism of the interesting genes. Methods S. aureus CA-MRSA transposon mutagenesis library was constructed by using mariner based transposon mutagenesis system. The clones with significantly changed level of hemolysis were selected, the location of erm insertion in a gene was confirmed by arbitrary primed (inverse) PCR and nucleotide sequence. Genetic complementation, mice bacteremia and skin abscess models and real time RT-PCR were used to study the function of the interesting gene. Results Twenty-five mutants with down-expression of α-toxin were selected by screening about 104 isolates of transposon mutagenesis library. The hemolytic diameter of CA-MRSA wild type was about 212 mm, no clear hemolysis was found in AraC-, The hemolytic diameter of AraC-pT181 araC was about 197 mm. Real time RT-PCR results showed that compared to the expression of the virulence factors in CA-MRSA wild type( PSMα 257. 30 ±37. 33 ;agr 115. 60 ±0. 81 and α-toxin 3.23 ±0. 21), in AraC-, α-toxin, PSMα and agr were significantly down regulated(α-toxin 1.09 ±0.01 :t = 10. 18, P <0.01 ;PSMα 34.85 ±2. 15:t=5.95,P<0.05;agr35. 19 ±1. 72:t =42. 33, P<0. 01). The result of mice bacteremia model showed that the virulence of wild type and AraC- ( (x) ± s ) were significantly different (x2 = 21. 34, P < 0.01). The expression of PSMα, agr and α-toxin in AraC-pT181araC ( PSMa 180.10 ± 15.29;agr 101. 50 ±8. 96;α-toxin 2.59 ±0.26) had no significant difference compared to the expression of the virulent factors in CA-MRSA wild type (PSMα: t =1.914, P>0.05;agr:t= 1.563, P>0.05;α-toxm: t = 1. 923, P > 0. 05 ). There were no significant difference of the expression of ClpP in AraC-(0. 21 ±0.01) and in AraC-pT181araC(0.17 ±0.03)compared to the expression of ClpP in CA-MRSA wild type (0. 20 ± 0.01) (t=0.555, P>0.05 and t=0. 851, P>0.05). The result of mice skin abscess model showed that the dermonecrosis area caused by CA-MRSA was (136. 5 ±21.45) mm2, the dermonecrosis area caused by AraC- was (55. 69 ± 13. 81) mm2, the different was significant (t = 3.169, P < 0. 05). Conclusion In CA-MRSA, AraC-type transcriptional regulator controlled the pathogenesis of CA-MRSA by regulating the expression of the most important virulence factors such as hla, PSMα and agr.