Objective To investigate the hysteromyoma treated with the gonadotropin releasing hormone agonist(GnRH-a)and the impact on immunologic function.Methods 130 cases selected from the patients with hysteromyoma enrolled from January 2016 to December 2016 in hospital have been randomly divided into two groups.The control group has been treated with mifepristone while the study group GnRH-a.Results The sizes of uterus and myoma of both groups have no significant difference before treatment.After treatment, both of them are significantly improved, and those of the study group is significantly smaller than that of the control group(P<0.05).The levels of serum sex hormone and immunologic function of both groups have no significant difference before treatment.They are both improved after treatment, and the study group is significantly better than the control group(P<0.05).Conclusion Applying GnRH-a therapy to the patients with uterine myoma benefits for improving the therapeutic effect, which can improve the serum sex hormone levels and immunologic function.

Objective To investigate the relationship between serum uric acid level and the severity of pregnancy induced hypertension (PIH) in pregnant women with hypertension.MethodsFrom January 2016 to July 2016 in our hospital for treatment of 100 cases of patients with pregnancy induced hypertension, as PIH group, divided into severe hypertension group (33 cases), moderate PIH group (33 cases) and mild PIH group (34 cases), then select 100 cases of normal pregnant women normal pregnancy group.The serum uric acid levels were measured and the results were analyzed.ResultsThe average serum uric acid levels in PIH group (359.75+89.23) mol/L was significantly higher than the control group (188.24+54.54) mol/L in PIH group, the average level of serum uric acid in severe, moderate and mild degree is decreasing, respectively (449.32+81.11), (352.89+76.41), (288.76+59.58) mol/L, a statistically significant difference between the groups (P<0.05).ConclusionThe detection of serum uric acid level in pregnant women can effectively determine the degree of pregnancy induced hypertension in pregnant.

Fluoride can cause phrenology and non-phrenology damage,but the mechanisms were unclear.It is reported that fluoride can decrease protein synthesis and induce cell apoptosis,leading to extensive systemic damage.Many studies have found that the mechanism is closely associated with endoplasmic reticulum stress.Protein kinase receptor-like ER kinase/Eukaryotic translation initiation factor 2α (PERK/eIF2α) signaling pathway is the first activation pathway when endoplasmic reticulum stress occurs which may play an important role in the pathogenesis of fluorosis.This present paper is focused on the role of PERK/elF2α signaling pathway-related factors in the systemic and organism damages resulted from fluorosis,which may provide new ideas in mechanism and prevention of fluorosis.

Objective To investigate the effect of fimH gene on type 1 fimbriae adhesion of uropathogenic Escherichia coli (UPEC) and the gene variations between type 1 fimbriae adhesion positive and negative bacteria.Methods A total of 171 UPEC strains (not catheter associated) were collected from the Second Hospital of Tianjin Medical University,Tianjin First Center Hospital,and Tianjin Children's Hospital during January 2012 and January 2013.fimH gene was detected by PCR technique,and type 1 fimbriae adhesion was detected by yeast agglutination test.RT-PCR was used to exterminate gene transcript factor impacting on adhesion.Chi-square and Yates' chi-squared tests were performed to comparefimH gene sequences between the adhesion positive and negative bacteria.Results Among 171 UPEC strains,142 (83％) werefimH gene positive,and type 1 fimbriae was expressed in 98 strains (57％).All adhesion positive strains carriedfimH gene.Among 44 strains with positivefimH gene and negative adhesion RT-PCR revealed thatfimH gene did not transcript in 8 strains (18％).The sequencing results showed that gene mutation on the 51 st amino acid site was more prevalent in the adhesion positive group compared with the negative group (x2 =6.64,P =0.010).In adhesion,mutations on the 190th and 219th amino acid sites were observed in 6 strains and 7 strains of negative group,respectively; while not observed in the adhesion positive group (x2 =4.69 and 5.87,P ＜ 0.05).Negative adhesion in other 23 strains was not attributed to single nucleotide polymorphism.Conclusion Adhesion function of type 1 fimbriae mignt be affected by mutation and deletion offimH gene.Three key site mutations may also affect the adhesion function of type 1 fimbriae.Besides fimH gene,there may be other genes that can affect the adhesion function of type 1 fimbriae.

Objective To investigate the diagnostic value of combined copeptin, cardiac troponin I (cTnI) and high sen?sitive cardiac troponin T (hs-TnT) in determination of acute myocardial infarction (AMI). Methods A total of 152 patients with AMI were selected as AMI group and 143 healthy examinees during the same period were selected as control group. (1) The levels of copeptin, cTnI and hs-TnT were detected at 0, 4, 6 and 12 h in two groups. (2) The combined detection of cop/cTnI and cop/hs-TnT were studied. The positive rates of these items were evaluated at different time points of AMI. ( 3) The diagnostic sensitivity, specificity and accuracy of different cardiac biomarkers for AMI were compared. Results (1) There were significant differences in copeptin at 0, 4, 6 and 12 h between two groups (P<0.05). There were no significant differ?ences in cTnI and hs-TnT between two groups. (2) cop/cTnI and cop/hs-TnT combined detection showed better positive rates than those of copeptin, cTnI or hs-TnT detection alone. (3) In addition, the combined detection of cop/cTnI and cop/cTnI improved significantly the diagnostic sensitivity of AMI. Compared to cop/cTnI combination, cop/hs-TnT combination detec?tion showed better diagnostic sensitivity, specificity and accuracy for AMI. Conclusion The combined detection of cop/cTnI and cop/hs-TnT are very helpful for early diagnosis of AMI, which shows a very good diagnostic value in clinical application.

Objective To investigate the adhesion levels in uropathogenic Escherichia coli with various degree of drug resistance.Methods One hundred strains of Escherichia coli isolated from urine specimen were collected from patients admitted to 4 Grade A tertiary hospitals in Tianjin during March 2012 to October 2015.Escherichia coli were divided into drug sensitive group and drug resistant group by drug sensitivity tests with 50 strains in each group.The expressions of fimH,fimA,fimB genes of type I fimbriae and papA,papB,papC,papGII genes of P fimbriae were detected by polymerase chain reaction(PCR)and real-time fluorescence quantitative RCR (RT-PCR),respectively.Adhesion ability of type I fimbriae and P fimbriae were tested by yeast cell adhesion test and erythrocyte agglutination test.Chi square test and t(Z) test were used to analyze the data.Results The positive rate of papGII in drug resistant group (42.0%) was significantly higher than that in the drug sensitive group (16.0%)(χ2 =8.208,P <0.05),while there were no significant differences in the positive rates of fimH,fimA,fimB,papA,papB and papC genes between two groups(all P >0.05).The expression levels of fimH,fimB and papC genes in the sensitive group were higher than those in the resistant group(Z =3.427,t =5.182 and 8.120,all P <0.05).The adhesion ability of strains carrying type I fimbriae in sensitive group was stronger than that of resistant group (χ2 =5.769,P <0.05).Conclusions The decline in adhesion ability of type I fimbriae in drug resistant E.coli strains is possibly associated with the adaptive cost of bacteria,the transcription and deficiency of other genes encoded by fim and pap gene cluster will also affect the adhesion function of type I pili and type P pili.

Objective To study the relationship between Escherichia coli (E.coli.) phylogenetic groups and the antimicrobial resistance in elderly patients with urinary tract infections.Methods 133 Escherichia coli were collected from elderly patients with urinary tract infections in 3 general hospitals in Tianjin.Kirby Bauer method was used to test susceptibility of E.coli.to four antibiotics.Escherichia coli DNA was extracted by boiling method.Phylogenetic groups (A,B1,B2 and D) of the E.coli was isolated by the two-step triplex-PCR.Results In all the strains,levofloxacin resistance rate was the highest (54.1％,72 strains),piperacillin/tazobactam resistance rate was the lowest (15.0％,20 strains) (Z=51.57,P＜0.01).The detection rates of Escherichia coli phylogenetic group A,B1,B2 and D were 24.8％ (33 strains),15.0％ (20 strains),18.0％ (24 strains),42.1％(56 strains) (Z=31.2,P＜0.01).Levofloxacin-sensitive strains were more common in Escherichia coli phylogenetic group B2 strains,and there was a significant difference in the strain number between the resistant and sensitive strains [29.5％ (18/61) vs.8.3％ (6/72),x2 =10.01,P＜0.01].Levofloxacin-resistant strains were more common in Escherichia coli phylogenetic group D strains,and there was a significant difference in the strain number between the resistant and sensitive strains [31.1％ (19/61) and 51.4 ％ (37/72),x2 =5.55,P＜0.05].There was no significant relationship between the Escherichia coli phylogenetic groups and the other three antibiotic resistance (all P＞0.05).Conclusions The detection rates of group D are the highest in the Escherichia coli phylogenetic groups,and it has a relationship with levofloxacin resistant.The antimicrobial resistance can be estimated by phylogenetic analysis in elderly patients with E.coli urinary tract infections.

Objective To examine the detection rate of 30 known virulence factors (VFs) of extraintestinal pathogenic Escherichia coli(ExPEC), and to investigates the epidemiology of ExPEC in elderly nosocomial infection. Methods A to?tal of 140 ExPEC clinical isolates from elderly nosocomial patients in hospitals in Tianjin were investigated. Multiplex PCR was performed to detect the 30 virulence factors among the E.coli strains and the detection rate of virulence factors for Ex?PEC were compared between isolates from different sites of infection.Fifty E. coli strains were shown to carry fimH gene that was amplified and sequenced. These sequences were used besides3 references strains (CFT037、UTI89 and K-12 ) to detect SNPs of fimH gene using DNAMAN Version 6.0.3.93 these 53 fimH sequences were used for genotyping and building dendrogram by MEGA4 software. Results In ExPEC, the following virulence factor genes, fimH, traT, fyuA, iutA and kpsMT II, had a higher detection rate than those of the rest . The following virulence factor genes, kpsMT II, K5, papC, pa?pEF ,papG allele II (Internal), papA, cnf1 (CNF), sfa/focDE and rfc had a a higher detectionrate from non-urine origin sam?ples than those from urine origin samples. fimH SNPs analysis of the 50 clinical isolated samples and 3 references samples showed 60 SNPs at 57 polymorphic sites. The fimH SNPs analysis classified the 53 strains into 25 genotype. The genetic fin?gerprintings of 11 isolates were exactly the same. Conclusion Many kinds of virulence factors can be found in ExPEC of el?derly nosocomial infection. The ExPEC strain isolated from non-urine origin had a stronger pathogenicity than those from urine-origin specimens. fimH SNPs analysis is suitable for molecular epidemiological investigation of ExPEC in hospital.

Objective To study drug resistance of carbapenem-resistant Klebsiella pneumonia ( CRKP) in neonates hospitalized in the neonatal unit , and to identify the risk factors for CRKP colonization in neonates .Methods Totally 108 neonates with Klebsiella pneumonia colonization admitted in Department of Neonates , the Second Hospital of Tianjin Medical University during January 2012 and June 2014 were enrolled in the study , including 23 cases with CRKP colonization ( case group ) and 85 cases with carbapenem-sensitive Klebsiella pneumonia (CSKP) colonization (control group).Chi-square test and fisher exact test were used to compare the differences in resistance to 21 antibiotics between CRKP and CSKP . Univariate analysis and Logistic regression analysis were performed to identify the risk factors for CRKP colonization in neonates .Results All of the CRKP strains were resistant to penicillins , cephalosporins and SMZco, and 95.7% and 87.0% of the CRKP strains were resistant to meropenem and imipenem , respectively.All of the CRKP strains were susceptible to amikacin , gentamicin, ciprofloxacin and tetracycline, but were highly resistant to the rest 16 antibiotics compared with CSKP strains (all P<0.05). Univariate analysis showed that 14 factors were associated with CRKP colonization: exposure to cefoxitin (χ2 =20.053, P<0.01), sputum suction (χ2 =15.817, P<0.01), gastrointestinal decompression (χ2 =10.731, P<0.01), nasogastric feeding (χ2 =15.146, P<0.01), invasive procedure (χ2 =22.572, P<0.01), birth weight (χ2 =6.026, P<0.05), frequency of sampling for CRKP/CSKP (χ2 =18.577, P<0.01), hypertension of pregnancy (χ2 =8.698, P<0.01), premature birth (χ2 =4.904, P<0.05), prenatal hospitalization experience (χ2 =8.396, P<0.01), adequacy for gestational age (χ2 =7.295, P<0.05), gestational age (χ2 =7.294, P<0.05), rupture of membranes (χ2 =9.397, P<0.01), length of hospitalization (χ2 =14.649, P<0.01) and admission to the neonatal intensive care unit (NICU) (OR=11.050, P<0.01).Multivariate Logistic regression analysis showed that hypertension of pregnancy (OR=9.718, P<0.01), rupture of membranes ( <24 h) (OR=6.640, P<0.01) and admission to NICU ( OR=4.119, P<0.05) were independent risk factors for CRKP colonization .Conclusions CRKP strains are highly resistant to most antibiotics .Preventing hypertension of pregnancy and rupture of membranes , and monitoring bacterial resistance in NICU may help to reduce the occurrence of CRKP colonization and dissemination .

Objective To investigate the effects of excessive aluminum on osteoclastic formation and function in C57BL/6 mice.Methods Six-week-old male C57BL/6 mice (n =20) were randomized by weight and divided into control group and treatment group.The mice were assigned to distilled water and 270 mg/L aluminum ion,respectively.After the 15-week treatment period,the mice were euthanized by ether asphyxiation.Concentration of serum aluminum ion was determined by inductively coupled plasma (ICP).TRAP+ cells in vivo were observed using histomorphometry and osteoclasts microstructure using electron microscope (TEM).Osteoclasts were induced by macrophage colony-stimulating factor (M-CSF) and receptor activator of nuclear factor κB ligand (RANKL) with bone marrow macrophages separated from femur and tibia.The expression of mRNA related with bone resorption was detected,including c-FBJ osteosarcoma oncogene (c-Fos),nuclear factor of activated T-cells cl (NFATc1),c-nonreceptor tyrosine kinase (c-Src),dentrocyte expressed seven transmembrane protein (DC-STAMP),d2 isoform of vacuolar (H1) ATPase v0 domain (ATP6v0d2) and matrix metalloproteinase 9 (MMP-9).Results The data showed that the treatment group [(12.04 ± 0.21)mg/L] had significantly increased serum aluminum ion compared with the control group [(11.00 ± 0.04)mg/L,F =10.286,P ＜ 0.05].TRAP+ cells examination confirmed osteoclasts in treatment group [(31.39 ± 9.80) number] were significantly higher than those in the control group [(5.46 ± 4.15) number,F =9.344,P ＜ 0.05].A large proportion of osteoclasts in treatment group lacked ruffled borders and showed vacuolation degeneration.The expression of mRNA in treatment group was lower than that of the control group.The expression of mRNA in control group and treatment group was NFATcl (3.25 ± 0.93 vs.0.29 ± 0.18,F =11.602,P ＜ 0.05),c-Fos (0.86 ± 0.16 vs.0.16 ± 0.02,F =9.405,P ＜ 0.05),c-Src (8.82 ± 1.51 vs.2.29 ± 0.36,F =9.128,P ＜ 0.05),DC-STAMP (3.70 ± 0.70 vs.1.36 ± 0.57,F =10.298,P ＜ 0.05),ATP6v0d2 (15.60 ± 4.81 vs.1.39 ± 0.95,F =8.828,P ＜ 0.05),and MMP-9 (18.64 ± 7.62 vs.2.10 ± 0.92,F =9.356,P ＜ 0.05),respectively.Conclusions Aluminum can increase the number of osteoclasts under epiphyseal plate,but inhibits osteoclasts differentiation.This phenomena may be related with decreased expression of c-Src,DC-STAMP,c-Fos,NFATcl,ATP6v0d2 and MMP-9 mRNA which regulate the function of osteoclasts.