Objective To investigate the genetic diversity of variable number tandem repeats (VNTR) of Mycobacterium tuberculosis (M,ib) isolates and their impact factors on transmission.Methods A total of 1 310 patients with smear-positive pulmonary tuberculosis registered during 2013 from 30 counties of drug-resistance monitoring sites in Guangxi were enrolled.The VNTR genotyping technique was used to identify and analyze M.tb genotypes.Count data was analyzed by Chi-square test using descriptive statistical method,unconditioned Logistic regression was used to analyze the characteristics of gene clusters.Results A total of 1 310 strains of M.tb were classified into 964 genotypes,of which 779 strains were classified into a single gene cluster,531 strains were classified into 185 clusters.Each cluster contained 2 to 40 strains (mean 6.6).Patients aged between 41 and 60 years old had a highest gene cluster proportion (45.5％).Seven hundred and forty-six strains were Beijing genotype,while 564 were nonBeijing genotype,among which 7.4％ was original Beijing genotype.The estimated recent infection (cluster rate) was 26.41％.The cluster rate was higher in sensitive strains (24.40％) than in drugresistant strains (9.55 ％,x2 =23.621,P =0.000) and multi-drug resistant (MDR) strains (8.97 ％,x2=-9.675,P=0.002),and that was higher in Beijing genotype (28.69％) than Non-Beijing genotype (23.40％,x2 =4.610,P=0.032).The clusters proportion in sensitive strain (37.43％) was higher than drug-resistant strains (14.09％) and MDR strains (15.38％),and that was higher in Beijing genotype (40.88％) than Non-Beijing genotype (37.77％).Conclusions M.tb genetic polymorphisms display highly diversity in Guangxi region.Sensitive strains and Beijing genotype strains are the main epidemic strains.

Objective To explore the effect of treatment of children's stress hyperglycemia with glucose-insulin-potassium.Methods Thirty children with stress hyperglycemia were randomly divided into two groups,15 cases in each group.Patients in the treated group were admi-nistered with glucose-insulin-potassium,whereas those in the control group,glucose were transfused at the speed

Objective To explore the preventive effect and mechanism of pioglitazone on nonalcoholic fatty liver disease in rats.Methods Thirty six male Sprague-Dawley ( SD) rats were randomly divided into normal control group , high-fat diet group , and pioglitazone intervention group , with 12 rats in each group .Normal control group fed with standard diet for eight weeks , and the rest two groups fed with high fat diet .Pioglitazone intervention group fed with pioglitazone in the four to eight weeks , the rest two groups in the same period fed with distilled water .Fasting serum alanine aminotransferase , aspartate aminotransferase , total cholesterol , triglyc-erides, fasting glucose , and fasting blood insulin levels were determined .The fasting insulin resistance index was calculated .Routine histological features of hepatic section were observed by hematoxylin eosin (HE) staining.The shape change of Kupffer cells in the liv-er was detected .The levels of tumor necrosis factor ( TNF)-αand nitric oxide ( NO) secreted by Kupffer cells were measured .Results The fasting insulin resistance index , triglycerides , and total cholesterol in rats of high-fat diet group were significantly higher than in normal control group ( P <0.05 ) .Histopathological examination showed hepatocellular macrove sicular steatosis , lobular inflammatory cell infiltration, and inflammatory cell infiltration .Hepatic Kupffer cell morphology change , its produced TNF, NO and liver tissue pa-thology changes were positively correlated ( P <0.05 ) .The fasting insulin resistance index , triglycerides , total cholesterol was signifi-cantly lower in rats of pioglitazone intervention group than the high-fat diet group ( P <0.05 ) .The liver tissue structure was obviously improved pioglitazone intervention group rats , morphology and function of liver Kupffer cells were normal .Conclusions Pioglitazone can prevent the nonalcoholic fatty liver disease induced by high fat diet .The mechanism may be related to improve insulin resistance , reduce blood fat , and regulate function of Kupffer cells .

Nicotinamide phosphoribosyltransferase (NAMPT) is the rate-limiting enzyme in the salvage pathway for the biosynthesis of nicotinamide adenine dinucleotide (NAD+) from nicotinamide. NAMPT is also a cytokine that inhibits the apoptosis of neutrophils under various inlfammatory stimuli, regulates various diseases and closely associates with the progression and prognosis of cancers. However, it is still not clear whether the cytokine-like function of NAMPT is interrelated with the biosynthesis enzyme activity of NAD+. This article aims to provide novel insights for inflammation and cancers treatment by reviewing the function of NAMPT in inflammation, carcinogenesis, cancer progression and its inhibitors, APO866/FK866.

OBJECTIVE:To prepare aciclovir multivesicular liposomes of high encapsulation efficiency and good stability. METHODS: Aciclovir multivesicular liposomes were prepared by multiple emulsion method. The preparation technology was optimized by orthogonal experiment with entrapment efficiency as index and the amount of lubricant glyceryl trioleate (A),drug/lipid ratio (B),pH of buffer solution (C) and the amount of tween-80 (D) as factors. The concentration of the aciclovir was determined by the UV spectrophotometry and the entrapment efficiency of the aciclovir multivesicular liposomes was computed. The change of the entrapment efficiency of the optimized preparations within 7 days in different conditions was investigated and the leaking rate was computed. RESULTS: The optimal technology was as follows: A 0.50 g,B 5∶150,C 6.5 and D 0.40 g. The entrapment efficiency of the aciclovir multivesicular liposomes was 85.82% and the leaking rate was 5.84% within 7 days under common temperature. CONCLUSIONS: The preparation technology of the aciclovir multivesicular liposomes is simple and the preparation is of high entrapment efficiency and good stability under common temperature.

Objective To test whether the prophylactic small dose amitriptyline has any beneficial influence on the rate of poststroke depression (PSD) by clinical experiment. Methods All 123 patients with first stroke were divided into the intervention group and the control group according to the block randomization tables. The patients in the intervention group were treated with 12. 5 mg amitriptyline every night for more than 1 month and the control group was blank Before and at the end of the observation, the rate of PSD and activities of daily living (ADL), degree of neurological deficit (NIHSS) of all the subjects were assessed. Results At the end of the one-month treatment, the intervention group had lower rate of PSD (16. 4% ) than the control (51.6%);and they had lower score in NIHSS (2. 83 ± 1.74 vs 3. 64 ±1.93) and higher score in ADL (93.0 ± 16. 1 vs 87.0 ± 37. 1) than the control. Multivariate Logistic regression analysis showed: the change of ADL score was closely related to the rate of PSD (RR =3.01 ,P =0. 04); the change of NIHSS score was closely related to the rate of PSD ( RR = 2. 42, P = 0. 03 );prophylactic small dose amitriptyline was closely related to PSD ( RR = 3.11, P = 0. 01 ). Conclusions Prophylactic small dose amitriptyline can decrease the rat of PSD, reduce the neurologic impairment and improve the activity of daily living.

Objective To investigate the efficacy and feasibility of extra-peritoneal larparoscopic radical prostatectomy (eLRP) in the treatment of patients with high-risk prostate cancer (HRPC).Methods From February 2009 to December 2013,121 patients,who were diagnosed as HRPC according to the D'Amico definition,were received eLRP.The mean age was 70 years old (range 54 ～ 82 years old).The mean PSA level was 25.45 (range 2.40 ～ 111.31) μg/L and mean Gleason score was 8 (range 6 ～ 10).The classification of clinic stage in this study included 52 cases in cT1-cT2b,58 cases in cT2c,8 cases in cT3a,and 3 cases incT3b,respectively.The perioperative data were collected,including operative time,blood loss,intraoperative complications,urine leakage,lymph leakage,incontinent ability,erectile function and changing of PSA level.Results All the operations were successfully performed.The mean operative time was 165 minutes (range 105 ～341min),the average blood loss was 150 ml(range 50 ～ 1500ml).The intraoperative complications included hemorrhage in 4 cases and intra-operative obturator nerve injury in 3 cases.The mean duration of intestinal function recovery was 35h (range 24 ～72h) The mean interval of catheter indwelling was 9 days (range 7 ～14 days).The anastomotic leakage was found in 12 cases,including 1 day after surgery in 5 cases,2 days after surgery in 3 cases,3 days after surgery in 2 cases,4 day after surgery in 1 case and 5 day after surgery in 1 case.The anastomotic stricture in 3 cases within 2 to 4 months after operation,which the symptom improved after urethral dilation in 2 cases and urethrotomy in 1 case.Deep vein thrombosis was noticed in 1 case 5 days after the procedure.And lymphatic fistula was recorded in 1 case after the operation.Positive surgical margin,seminal vesicle invasion,and positive iliac vessel lymph node were found in 18,21,and 9 patients,respectively.The mean hospitalization duration was 10 days (range 5 ～ 22 d).Of the 107 patients followed-up,Ninety-six patients were continent in 1 year,except other 11 patients.Nerve sparing procedure was performed in 51 patients,and thirty-three of them were potent.The mean PSA level was 0.14 μg/L (range 0 ～8.75 μg/L) six weeks after the surgey.Fourty-eight patients had biochemical recurrence with 5 ～36 months followed-up,mean 18 months.Conclusions Extraperitoneal LRP is an efficacious approach for patients with high-risk prostate cancer.

[Objective]To study the clinical features and expressions of IL-17A,IFN-γ,and IL-10 in serum and intestinal mucosa of patients with post-infectious irritable bowel syndrome and non post-infectious irritable bowel syndrome.[Methods]44 diar?rhea-predominate IBS patients(21 with PI-IBS,23 with NPI-IBS)and 10 healthy controls were recruited in this study. Investigation questionnaires of GSRS,SAS,SDS were carried out to evaluate the gastrointestinal function,anxiety status and depression status of IBS patients. The expressions of IL-17A,IFN-γ,and IL-10 in intestinal mucosa and serum were measured by immunohistochemis?try(IHC)and enzyme-linked immunosorbent assay(ELISA).[Results]The SDS scores of NPI-IBS patients were higher than those of controls(P<0.05),and the SAS and SDS scores of PI-IBS patients were higher than those of controls(P<0.05). The GSRS, SAS and SDS scores of PI-IBS group were higher than those of NPI-IBS group(P<0.05). Compared with healthy controls,PI-IBS and NPI-IBS group showed significant rise of IL-17A,IFN-γlevels and decrease of IL-10 level in intestinal mucosa(P<0.05);In serum,the IL-17A levels were up-regulated and the IL-10 levels were decreased in PI-IBS group but not in NPI-IBS group when compared with controls(P<0.05). In intestinal mucosa and serum,IL-17A and IFN-γlevels in PI-IBS group were slightly higher than those in NPI-IBS group(P > 0.05).[Conclusion]PI-IBS and NPI-IBS patients existed various anxiety and depression. The levels of IL-17A and IFN-γ increased and level of IL-10 decreased in PI-IBS and NPI-IBS group. But the clinical symptoms and changes of cytokines of PI-IBS patients were more significant. There may exist other pathogenesis in PI-IBS but not in NPI-IBS.

Objective To compare the influence of whole sevoflurane inhaling and target-controlled infusion of propofol for the myocardial protective effect on patients with heart valve replacement surgery. Methods 30 adult patients who went through heart valve replacement surgery with cardiopulmonary by pass were selected, including ASA staging II-III and cardiac function classification (NYHA) II-III. All patients were randomly divided equally into sevoflurane group (Group S) and propofol group (Group P) . Patients were monitored before anesthetic induction. Group S got 1%sevoflurane (fresh gas flow 6 L/min) with concentration of the vaporizer increased from 1%to 3%with 1 minute interval during anesthetic induction. Group P got target-controlled infusion of propofol during anesthetic induction,the initial target plasma concentration was set at 0.8μg/mL,and the concentration increased 0.5 μg/mL every minute until intubation. All the patients got fentanyl 5 μg/kg and rocuronium 0.6 mg/kg, and intubation was conducted when BIS decreased lower than 60 and mean arterial pressure (MAP) <20%basic MAP. During anesthesia maintaince,patients got 0.5-2 MAC sevoflurane inhaling or target-controlled infusion of propofol 2-4μg/mL with discontinuous intravenous fentanyl and rocuronium, and maintained BIS 40-60, MAP<±20%basic MAP, central venous pressure 5-15 cm H2O. Outcome variables included demographic characteristics of patients. The following parameters were also recorded, including cardiac troponin I (cTnI), creatine kinase (CK), creatine kinase isoenzyme (CK-MB) and lactate (LAC) in before anesthetic induction (T0), aortic inbation (T1),30 minutes after aorta opening (T2), 6 hours after aorta opening (T3) and 24 hours after aorta opening (T4) . Results There was no statistical significance in demographic characteristics during peri-operation between the two groups ( > 0.05) . The pre-opertaive cTnI, CK, CK-MB and LAC were within the normal range, but increased siginicantly on T2, T3 and T4, and was more significant on T3 ( < 0.01) between two groups, and the intra-group comparison showed no difference on other time points. Conclusion When myocardial injury markers used as myocardial protection outcome variables, whole sevoflurane inhaling could not reduce the release of cTnI compared to propofol TIVA in heart valve replacement surgery.

Objective To establish a standardized and feasible family health assessment index system based on the family practice system in Shanghai urban communities.Methods On the basis of literature review and special topic discussion, a preliminary index system framework was developed and an expert consultation questionnaire was compiled.Twenty one experts of general practice, medical specialties, health administration and public health management were invited and two rounds of improved Delphi expert consultation were conducted.The results of statistical analysis were summarized and the evaluation index system was established.Results The evaluation index system included 5 first-level indicators, 17 second-level indicators and 63 third-level indicators.The weight coefficients of first-level indicators in basic information, family structure, family function, family resources and health status of the family members were 0.199 6, 0.197 5, 0.201 7, 0.185 0, 0.216 2, respectively.In the two rounds of consultation, the positive coefficient of experts was both 100%, the degree of expert authority was 0.867 and 0.880, and the coordination coefficient was 0.294 and 0.415, respectively (P<0.05).The operational coordination coefficients were 0.320 and 0.402 (P<0.05), respectively.Conclusion The family health assessment index system constructed by the Delphi expert consultation method can provide reference for family doctors to carry out family health assessment in urban communities.