Group B Streptococcus ( GBS) is a conditional pathogenic bacteria related to late-term abortion, premature delivery, premature rupture of membranes, perinatal infection, neonatal sepsis and other diseases.Prevention and treatment guidelines by the US Centers for Disease Control and Prevention ( CDC) suggest that all the pregnant women at 35-37 gestational weeks should screen for GBS .The detection methods for GBS include microbiology , immunology, molecular biology, etc.The appropriate method should be chosen depending on circumstances .Penicillin is recommended for the preventive treatment of GBS , and the treatment for the insensitive should base on the antibiotic susceptibility results .No vaccine against GBS is currently available for clinical use .

Acinetobacter baumannii, a glucose-nonfermentative gram-negative coccobacillus, is an important pathogen isolated in nosocomial infections, and the clinical detection rate has been increasing in recent years. Acinetobacter baumannii attracts widespread attention due to strong viability, broad resistance spectrum and high rate of drug resistance. The resistance mechanisms include the production of β-lactamases, alterations in penicillin-binding proteins, decreased outer membrane permeability and overexpression of active efflux pumps. The mechanisms of Acinetobacter baumannii resistance to β-lactarn antibiotics, especially those of the outer membrane porin and active efflux system are reviewed in this paper.

Objective To analyze the levels of IL-35, IL-10 and TGF-β in women with or without pregnancy and to investigate the correlation between IL-35 and recurrent spontaneous abortion.MethodsLevels of IL-35, IL-10 and TGF-β in serum were analyzed by enzyme-linked immunosorbent assay (ELISA) in 120 gravidas with normal pregnancy, 40 gravidas with a history of recurrent spontaneous abortion, 40 healthy postpartum women and 40 healthy non-pregnant women of childbearing age.Single factor logistic regression analysis was used for correlation analysis.Results The level of serum IL-35 in normal pregnancies was significantly higher than that in non-pregnant women [333.6 (59.32, 1 391) pg/ml vs 123.9 (8.763, 471.7) pg/ml, P<0.001].The level of TGF-β increased significantly in the first trimester as compared with that in non-pregnant women [473.4 (398.0, 580.5) pg/ml vs 379.7 (311.0, 441.3) pg/ml, P<0.01].No significant difference in the level of serum IL-10 was observed between gravidas and non-gravidas [8.602 (5.854, 12.89) pg/ml vs 9.339 (5.691, 12.07) pg/ml, P>0.05].The level of serum IL-35 in gravidas with recurrent spontaneous abortion was significantly lower than that in healthy gravidas in their first trimester [220.4 (4.951, 702.0) pg/ml vs 386.5 (64.37, 1 355) pg/ml, P<0.05].Serum IL-35 was negatively correlated with the occurrence of recurrent spontaneous abortion (regression coefficient=-0.003, OR=0.997).Conclusion The level of serum IL-35 increases in healthy gravidas, but decreases in gravidas with recurrent spontaneous abortion.IL-35, rather than IL-10 or TGF-β, is recognized as an active player in maternal-fetal immune tolerance.

Objective To investigate the molecular epidemiology of 114C. albicans strains isolated from the vaginal discharge of female patients treated in three obstetrics and gynecology hospitals in Shanghai by analyzing the relationship between the main genotypes and resistance proifle, and the relationship between genetic diversity and cluster ofC. albicans.Methods A total of 114 strains ofC. albicans were collected from the Obstetrics & Gynecology Hospital of Fudan University, Shanghai First Maternity and Infant Hospital Corporation and the International Peace Maternity & Child Health Hospital of China welfare institute. Phylogenetic analysis of strains were carried out by eBURST.C. albicans strains were also analyzed by multilocus sequence typing (MLST). The susceptibility of theC. albicans strains was tested by ATB FUNGUS 3.Results A total of 47 diploid strain types (DSTs) were identiifed from the 114 strains, 30 of which were known types. DST 79 and DST 435 were the main types. Of the 114C. albicans strains, 96.5% were susceptible to lfucytosine, 100% to amphotericin B, 85.1% to lfuconazole, 55.2% to itraconazole and 84.3% to voriconazole.Conclusions The pathogenicC. albicans strains isolated from different obstetrics and gynecology hospitals in Shanghai were originated from multiple clones, the main type of which was DST 79 and DST 435 with certain degree of antifungal resistance. MLST typing suggests that genetic diversity is present in theC. albicans strains isolated in Shanghai area. The clustering analysis ofC. albicans strains is consistent with its genotypes.

Objective To explore the value of MSCT enhanced scanner in diagnosis and differential diagnosis of spleen tumor. Methods The MSCT enhanced feautures of 23 cases of spleen tumor proved by imaging examination,follow-up and pathologically were anlayzed retrospectively,the features of MSCT enhanced scanner in spleen tumor were analyzed.Results All cases included 12 benign tumor (5 cysts,6 hemangiomas,1 lymphangioma).1 1 malignant tumor(2 primary lymphomas,3 secondary lymphomas,6 metastatic tumors).Conclusion MSCT enhanced scanning for the qualitative diagnosis of spleen tumors with high value.

Objective To summarize the experience of nursing patients undergoing NovaSure endometrial ablation. Methods Two hundred and eleven patients with abnormal uterine bleeding claiming no need of giving birth,who were hospitalized in our hospital during August 2011 to April 2013,were managed with NovaSure endometrial ablation and nursing care was performed.Follow-ups were conducted for investigating the curative effects.Results All the patients lived through the operations,their life signs were stable.As for the adverse effects,124 of them had mild abdominal pains,7 medium-level or severe hypogastralgia,1 dizziness and nausea,10 uterial hematocele,and 1 cystitis.All of them got recovered after treatment.One-month follow-up after hospitalization showed a success rate of 98.0%.Conclusions NovaSure is a new approach to abnormal uterine bleeding.It is advantageous for its simplicity,shortness in operation duration,less trauma to patients and good effects.Meanwhile,preoperative mental care and cooperative care during operation may facilitate their recoveries.

Objectives To explore the optimal startup time of patient controlled intravenous analgesia (PCIA) in aged patients after thoracotomy for pulmonary lobectomy.Methods The 67 aged patients after thoracotomy for pulmonary lobectomy from January to December 2008 were randomized divided into two groups:PCIA was startup immediately after waking (instantly group) or after removal tracheal intubation (delayed group).The analgesia efficacy,cardiopulmonary function and side effect were evaluated at the awake time,12,24 and 48 hours after surgery respectively.Result Both of VAS scores at 12 hours after surgery and oxygenation index at 48 hours after surgery had significant difference (P<0.05) between the two groups.The analgesia efficacy was better in the instantly group.There was no significant difference on the duration of mechanical ventilation and side-effect rates between the two groups.No patient suffered from respiratory depression.Conclusion The early use of PCIA in aged patients after thoracotomy for pulmonary lobectomy can gain better pain control and oxygenation effect.

Objective To explore the serum lipids levels in healthy pregnant women,and to establish the reference intervals of serum lipids in middle and late pregnancy.Methods Triglyceride (TG),total cholesterol (TCH),high density lipoprotein (HDL),low density lipoprotein (LDL),apo-lipoprotein-A (APO-A) and apo-lipoprotein-B (APO-B) were measured in 3 200 pregnant women and 3 200 healthy women of childbearing age(the control group) from January 2014 to Febuary 2015 in Obstetrics and Gynecology Hospital of Fudan University.In the healthy pregnant women,serum lipids were measured at 14-20,24-28 and 37-40 gestational weeks,respectively.All the parameters were detected by Hitachi 7180 automatic biochemical analyzer.The test results were calculated and determined by the C28-A3 standard of the National Clinical and Laboratory Standards Institute.And the normal reference intervals of serum lipids in middle and late pregnancy were defined as 2.5％-97.5％.Results (1) The levels of TG,TCH,HDL,LDL,APO-A and APO-B in the control group were 0.8,4.2,1.0,2.7 mmol/L and 1.1,0.8 g/L,respectively.The levels of TG,TCH,HDL,LDL,APO-A and APO-B in middle and late pregnancy were significantly higher than those in the control group (P＜0.05).(2) The serum lipids levels at 14-20,24-28 and 37-40 gestational weeks in healthy pregnant women were compared with the control group as following.The TG levels were 1.9,3.8 and 4.4 folds of the control group;the TCH levels were 1.1,1.5 and 1.5 folds of the control group;the HDL levels were 1.2,1.6 and 1.5 folds of the control group;the LDL levels were 1.1,1.4 and 1.4 folds of the control group;the APO-A levels were 1.3,1.4 and 1.5 folds of the control group;and the APO-B levels were 1.1,1.5 and 1.5 fold of the control group respectively.The TG level was the most increased,and it increased gradually with gestational age (P＜0.01).(3) The median of LDL to HDL cholesterol ratio in the healthy pregnancy group at 14-20,24-28 and 37-40 gestational weeks were 2.7,2.5,2.6,respectively,which were significantly lower than that of the control group (2.8;P＜0.05).(4) Reference intervals of serum lipids at 14-20,24-28 and 37-40 gestational weeks in healthy pregnant women were as following.The TG levels were 0.7-3.9,1.7-6.3 and 1.6-8.1 mmol/L,respectively;the TCH were 3.3-6.9,4.3-8.3,4.3-8.7 mmol/L,respectively;the HDL were 0.8-1.8,1.0-2.1 and 1.0-2.1 mmol/L,respectively;the LDL were 2.1-4.5,2.7-5.1 and 2.6-5.2 mmol/L,respectively;the APO-A were 1.1-1.8,1.2-1.9 and 1.1-2.4 g/L,respectively;and the APO-B were 0.6-1.4,0.9-1.8 and 0.8-2.1 g/L,respectively.The LDL/HDL ratios were 2.3-3.1,2.2-2.9 and 2.1-3.0,respectively.Conclusions Serum lipids increased physiologically with gestational age in middle and late pregnancy.The establishment of reference intervals for serum lipids in pregnancy will help to distinguish abnormal serum lipid levels in middle and late pregnancy.

Objective To study imaging features of primary chondrosarcomas and the correlation with pathologic basis.Methods The imaging materials of primary chondrosarcoma in 21 cases were retrospectively analyzed and correlated with pathological results. Results In 21 cases,the pathologic classifications were as following:15 cases of conventional intramedullary,1 case mesenchymal,2 cases myxoid,1 case dedifferentiated and 2 cases with no subtypes.For 6 cases of conventional intramedullary in gradeⅠand 8 cases in gradeⅡ,bone destruction in varying degrees accompanied with soft tissue mass(n=1 1),regional thickening cortical bone (n=2),“ring-arc”like matrix mineralization(n=6),amorphous (n=3)were showed on X-ray study.CT were performed,in 6 cases in gradeⅠ,6 cases in gradeⅡ and 1 case in grade Ⅲ in which there were intraosseous calcification (n=12),regional thickening cortical bone (n=2)and periosteal new bone formation (n=1).Lesions appeared expansive or osteolytic bone destruction accompanied with soft tissue mass on CT and MRI srudy MRI were performed in 5 cases in gradeⅠ and lesions were heterogeneous high signal intensity on T2 WI with spot like and “ring-arc”like low signal intensity.Conclusion Pathologic classifications and grading of primary chondrosarcoma may be presumed with imaging features.Pathologic characteristic manifestions on MR are superior to that on CT and X-ray.