Antibiotic resistance and molecular epidemiology characteristics of methicillin-resistant Staphylococcus aureus in Shenzhen area / 中国人兽共患病学报

The aim of this study is to investigate antibiotic resistance and molecular epidemiology characteristics of methicillin-resistant Staphylococcus aureus (MRSA) in Shenzhen area.We collected 428 Staphylococcus aureus isolates from eight hospitals in Shenzhen in 2012.According to the results of minimum inhibitory concentration (MIC) to cefoxitin,26.2％ of Staphylococcus aureus isolates (112/428) were identified as MRSA.The MIC of 10 antimicrobial agents was determined by agar dilution method.Panton-Valentine leucocidin(PVL) was detected by polymerase chain reaction(PCR).Positive strains of PVL were detected by multilocus sequence typing(MLST).Among the 112 strains,the resistance rates to trimethoprim-sulfamethoxazole,moxifloxacin,ciprofloxacin,gentamicin,erythromycin,clindamycin and tetracycline were 4.46％,12.50％,16.96％,19.64％,46.42％,25.00％ and 26.79％ respectively.No isolates resistant to vancomycin,linezolid and teicoplanin were found.Among the 112 strains,there were 13 (11.61％) strains carried PVL gene.There were no significant differences in the resistance rates of PVL positive strains and negative strains to 10 kinds of antimicrobial agents.Among the 13 strains carried PVL gene,7 kinds of old sequences and 1 kind of new sequence type were found by MLST.ST338 and ST25 were the most common type.All the data indicate that surveillance of MRSA in Shenzhen has a distinct genetic background from other regions.

Analysis of Cut-off Value in Screening of Thalassemia by Capillary Hemoglobin Electrophoresis for Pregnant Women from Shenzhen Region of China / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the cut-off value in screening of thalassemia in pregnant women from Shenzhen region by capillary hemoglobin electrophoresis.</p><p><b>METHODS</b>The data of capillary hemoglobin electrophoresis and genetic diagnosis of thalassemia from 2122 examined prenatal women were retrospectively analyzed. Capillary hemoglobin electrophoresis and α-, β- genetic diagnosis of thalassemia were carried out for every woman. Hemoglobin electrophoresis was performed using Capillarys 2 full-automated electrophoresis instrument. Gap polymerase chain reaction and reverse dot blot were used for genetic diagnosis of thalassemia genotyping test. The cut-off value in screening of thalassemia was determined by receiver operating characteristic curve and next to analyze the value of HbA2 and HbF in screening of thalassemia using the decided cut-off value.</p><p><b>RESULTS</b>The areas under the curve (AUC(Roc)) of HbA2 for diagnosis of α-, β- thalassemia were 0.75 and 0.981 respectively, and the AUC(Roc) of HbF for diagnosis of β-thalassemia was 0.787. When HbA2 ≤ 2.55 was taken as the cut-off value of HbA2 for diagnosis of α-thalassemia, the sensitivity, specificity, positive likelihood ratio (LR(+)) and negative likelihood ratio (LR(-)) were 89.5%, 54.8%, 1.98, 0.19 respectively. When HbA2 ≥3.9 was taken as the cut off value of HbA2 for diagnosis of β-thalassemia, the sensitivity, specificity, LR(+) and LR(-) were 96.1%, 99.8% 480.5, 0.04 respectively. When HbF ≥0.75 was taken as the cut off value of HbF for diagnosis of β-thalassemia, the sensitivity, specificity, LR(+) and LR(-) were 83.6%, 61.8% respectively.</p><p><b>CONCLUSION</b>The cut-off value in screening of thalassemia by capillarys 2 full automated electrophoresis instrument is different from that of the traditional method of hemoglobin electrophoresis, such as cellulose acetate membrane electrophoresis and agarose gel electrophoresis. Each laboratory should establish their own respective cut off value.</p>

Quality characteristics of human spermatozoa with hyaluronic acid receptors / 中华男科学杂志

<p><b>OBJECTIVE</b>To analyze the quality characteristics of human spermatozoa with hyaluronic acid (HA) receptors and search for a new indicator for the assessment of sperm quality.</p><p><b>METHODS</b>Using sperm-HA binding assay with HA-coated slides, we determined the binding rate of motile sperm with HA receptors and analyzed its correlation with routine semen parameters, sperm membrane function, sperm fertilizing function and diminished/arrested sperm maturation.</p><p><b>RESULTS</b>The motile sperm with HA binding sites in the acrosomal region showed significantly higher acrosomal integrity ([95.4 +/- 3.9]%) and mitochondrial membrane potential (MMP) ([97.8 +/- 2.1]%) than those in the initial semen ([68.8 +/- 6.2]% and [72.8 +/- 7.4]%) (P < 0.01). The sperm-HA binding scores were correlated mildly with many routine semen parameters (r = 0.195-0.268, P < 0.05), positively with the acrosome reaction level after ionophore challenge (r = 0.666, P < 0.01) and normal sperm morphology (r = 0.417, P < 0.01), and negatively with sperm nucleoprotein immaturation (r = -0.266, P < 0.01), DNA fragmentation (r = -0. 308, P < 0.01) and excessive residual cytoplasm (r = -0.218, P < 0.05).</p><p><b>CONCLUSION</b>Sperm with HA receptors in the acrosomal region exhibit significant advantages in plasma membrane structure, fertilizing potential and maturation. The sperm-HA binding assay, which is based on a relationship between sperm receptors for zona pellucida and HA, is likely to become a new independent indicator for assessing the multiple qualities of spermatozoa.</p>

Analysis of CYP21A2 gene mutation in one case of congenital adrenal hyperplasia / 中国当代儿科杂志

CYP21A2 gene mutations in a child with congenital adrenal hyperplasia (CAH), and the child's parents, were detected in the study. The clinical features, treatment monitoring and molecular genetic mechanism of CAH are reviewed. In the study, DNA was extracted from peripheral blood samples using the QIAGEN Blood DNA Mini Kit; a highly specific PCR primer for CYP21A2 gene was designed according to the sequence difference between CYP2lA2 gene and its pseudogene; the whole CYP2lA2 gene was amplified with PrimeSTAR DNA polymerase (Takara), and the amplification product was directly sequenced to detect and analyze CYP2lA2 gene mutation. The child was clinically diagnosed with CAH (21-hydroxylase deficiency, 21-OHD) at the age of 36 days, and the case was confirmed by genetic diagnosis at the age of 1.5 years. The proband had a homozygous mutation at c.293-13C in the second intron of CYP21 gene, while the parents had heterozygous mutations. Early diagnosis and standard treatment of CAH (21-OHD) should be performed to prevent salt-wasting crisis and reduce mortality; bone aging should be avoided to increase final adult height (FAH), and reproductive dysfunction due to oligospermia in adulthood should be avoided. These factors are helpful for improving prognosis and increasing FAH. Investigating the molecular genetic mechanism of CAH can improve recognition and optimize diagnosis of this disease. In addition, carrier diagnosis and genetic counseling for the proband family are of great significance.

The heterogeneity of aging brain: altered functional connectivity in default mode network in older adults during verbal fluency tests / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Successful aging (SA) and mild cognitive impairment (MCI) are heterogeneous groups of aging. To explore the heterogeneity, the functional connectivity was studied in these populations.</p><p><b>METHODS</b>The present study utilized functional connectivity magnetic resonance imaging (fcMRI) to investigate default mode network (DMN) in 8 healthy subjects of SA, 8 subjects of usual aging (UA), and 8 MCI patients during verbal fluency tests (VFTs). Functional connectivity (based seeds) of different groups was analyzed by using statistical test.</p><p><b>RESULTS</b>Compared with SA and UA groups, MCI subjects exhibited decreased functional connectivity in the DMN regions, including the inferior parietal lobule and left angular gyrus (t = 3.53, P < 0.001). Compared with UA and MCI groups, the SA elderly exhibited increased functional connectivity in the precuneus (t = 3.53, P < 0.001).</p><p><b>CONCLUSIONS</b>These findings suggested that abnormalities of functional connectivity in DMN might be related with semantic memory impairment in aging. Left angular gyrus and precuneus might be the potential imaging-based biomarker for distinguishing heterogeneous process of elderly.</p>

Duloxetine versus placebo in the treatment of patients with generalized anxiety disorder in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Duloxetine is approved for the treatment of generalized anxiety disorder (GAD) in the United States and elsewhere. This study aimed to assess the efficacy, tolerability, and safety of duloxetine in Chinese patients with GAD.</p><p><b>METHODS</b>This 9-site study consisted of double-blind treatment for 15 weeks either with duloxetine 60 - 120 mg or with placebo. Patients with at least moderately severe GAD and a Sheehan Disability Scale (SDS) global functioning impairment total score ≥ 12 were included in this study. Patients who were randomly assigned to duloxetine received 60 mg for 7 weeks; at that point, for nonresponders the dose was increased to 120 mg for the remaining 8 weeks. The primary efficacy measure was mean change from baseline to endpoint on the Hospital Anxiety and Depression Scale-Anxiety subscale score (HADS-A). Secondary efficacy measures included the Hamilton Anxiety Rating Scale (HAMA), the SDS, and pain measures. Safety and tolerability were assessed.</p><p><b>RESULTS</b>Baseline characteristics did not differ significantly between treatment groups. Mean age of the subjects (n = 210) was 37.6 years, 50.5% were female, and 74.3% completed the 15 weeks treatment. Patients treated with duloxetine had significantly greater improvement compared to placebo on the HADS-A (mean change -6.6 vs. -4.9, respectively, P = 0.022). Improvement in anxiety was greater with duloxetine treatment at 7 weeks and continued through 15 weeks for both the HADS-A and the HAMA total score (0.01 ≤ P < 0.05). Compared with placebo, duloxetine was also associated with greater improvement on most secondary measures, but not on the SDS global functioning score. Nausea, dizziness, and somnolence occurred significantly more frequently as treatment-emergent adverse events with duloxetine treatment compared with placebo treatment.</p><p><b>CONCLUSIONS</b>Duloxetine 60 - 120 mg once daily is effective and well-tolerated for the treatment of patients with GAD in China.</p>

Association between painful physical symptoms and clinical outcomes in Chinese patients with major depressive disorder: a three-month observational study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Painful physical symptoms (PPS) may present as a component of major depressive disorder (MDD). Their effect in Chinese patients has not been investigated. This analysis reports the changes in disease severity, treatment patterns, quality of life and outcomes in a Chinese cohort according to the presence (PPS+) or absence (PPS-) of painful physical symptoms.</p><p><b>METHODS</b>A subgroup of Chinese patients from a large observational 3-month study of patients from Asian countries and regions of China were classified using the modified Somatic Symptom Inventory (SSI) as PPS+ (mean score >or= 2) or PPS- (mean score < 2). Depression severity was assessed with the Clinical Global Impression of Severity (CGI-S) scale and 17-item Hamilton depression rating scale (HAMD(17)). Pain severity was measured using a visual analogue scale (VAS), while the EuroQoL (EQ-5D) assessed patient well-being. Antidepressants were compared with regard to their efficacy.</p><p><b>RESULTS</b>Of the 299 Chinese patients enrolled in the study, 105 were classified as PPS+ (73/105, 70% women). At baseline, PPS+ patients reported greater pain severity (VAS, mean (SD): 49.56 (26.49) vs. 16.60 (20.99) for PPS-, P < 0.01), were more depressed (HAMD(17), mean (SD): 25.32 (5.47) vs. 23.33 (5.24) for PPS-, P = 0.002) and had poorer quality of life (EQ-5D Health State, mean (SD): 38.48 (22.38) vs. 49.57 (18.54) for PPS-, P < 0.001). PPS+ patients showed less overall improvement in depressive symptom severity (HAMD(17), change from baseline (95%CI): -17.38 (-18.65, -16.12) vs. -19.20 (-20.05, -18.35) for PPS-, P = 0.032; CGI-S, change from baseline (95%CI): -2.85 (-3.11, -2.58) vs. -3.20 (-3.38, -3.02) for PPS-, P = 0.044).</p><p><b>CONCLUSIONS</b>PPS were less frequent than expected compared with previous studies of Asian populations. PPS+ were associated with greater MDD severity and less improvement than PPS- when antidepressants were given.</p>

Clinical analysis of microsurgical carotid endarterectomy for carotid stenosis and occlusion / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical effects of carotid endarterectomy for carotid stenosis and occlusion.</p><p><b>METHODS</b>From August 2005 to November 2008 moderate and severe carotid stenosis or occlusion were found in 16 patients by Doppler ultrasonography (DUS), MRA, CTA, DSA. The stenosis degree ranged from 60% to 99% in 14 patients and complete occlusion in 2 patients. Twelve patients underwent standard carotid endarterectomy (sCEA) in whom 2 patients were placed carotid shunt and 1 patient underwent carotid patch angioplasty. Four patients underwent eversion carotid endarterectomy (eCEA). All operations were performed by microscope.</p><p><b>RESULTS</b>There was no stroke, transient ischemic attack and mortality perioperatively and during follow-up from 1 month to 3 years. The ICA flow detected by follow-up duplex scan and MRA was unobstructed. The primary cerebral ischemic symptoms were obviously improved or disappeared after operation. The postoperative complications included one case of upper gastrointestinal hemorrhage and one case of hoarseness and bucking, which disappeared after medical treatment.</p><p><b>CONCLUSIONS</b>CEA is an effective way for treating carotid stenosis. Different operative methods and techniques deal with different carotid lesions to achieve better effect. Microsurgical technique is useful for exposure of high ICA bifurcation and avoid effectively cranial nerve injury and other complications.</p>

Expression of cyclooxygenase-2 and vascular endothelial growth factor in human prostate cancer and its significance / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate expressions of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) in primary prostate cancer and its clinical significance.</p><p><b>METHODS</b>Expressions of COX-2 and VEGF were detected by immunohistochemical assay in tissues of 40 prostate cancer and 10 benign prostatic hyperplasia samples.</p><p><b>RESULTS</b>COX-2 and VEGF levels in prostate cancer were much higher than those in BPH. The degrees of cancer malignancy and invasion positively correlated with the expressions of COX-2 and VEGF. COX-2 level positively correlated with VEGF level.</p><p><b>CONCLUSION</b>The abnormal expression of COX-2 plays an important role in the development of primary prostate cancer. COX-2 and VEGF are good molecular markers of prostate cancer which are hopeful to be used for the assistant diagnosis and the prediction of prognosis of prostate cancer.</p>

Deactivation of medial prefrontal and posterior cingulate cortex in anxiety disorders / 中华放射学杂志

Objective We used blood oxygenation level dependent-functional MR imaging(BOLD- fMRI)to explore the characteristics of deactivation patterns in patients with anxiety disorders and the underlying neural mechanism of this disease.Methods Ten patients and ten healthy controls participated the experiments.All subjects performed the trait portion of the State-Trait anxiety Inventory(STAI-T)prior to the fMRI scans.The subjects underwent noninvasive functional magnetic resonance imaging while listening actively to emotionally neutral words alternating with no words(experiment 1)and threat related-words alternating with emotionally neutral words(experiment2).During fMRI scanning,subjects were instructed to closely listen to each stimuli word and to silently make a judgment of the word's valence.Data were analyzed with statistical parametric mapping(SPM 99).Individual and group analysis were conducted.Results Mean STAI-T score was significantly higher for patients group than that of controls(58?8 for patients group and 33?5 for controls,t=8.3,P