Objective To explore tuberous scierosis(TS)clinical characteristic.Method To review analyzes 13 cases TS patient's clinical material.Result Among 13 TS cases,age from 6 month ~10 years old.5 cases(38.46%)of them have the family history,11 cases(84.62%)of them presents the epileptic paroxysm,11 cases(84.62%)of them have hypophrenia,Simultaneously 2 cases(15.38%)of them have the face adenoma sebaceum,hypophrenia and epilepsy.All of the have the skin harm,calcification tubercle of under the brain ependyma.Electroencephalogram abnormal rate of is 88.89%.Conclusion The clinical manifestation of TS is very different from case to case,Main character is the skin harm and the nervous system harm,CT is the very reliable radiological diagnosis method for TS

Objective To investigate the effects of aerobic exercise during chemotherapy on cancer-related fatigue in breast cancer patients, and related mechanism thereof. Methods Sixty breast cancer patients who underwent radical surgery were randomly assigned to exercise group and control group, 30 patients for each group. Patients in exercise group received regular nursing care plus aerobic exercise during chemotherapy, while patients in control group only received regular nursing care. The revised Piper fatigue scale (RPFS) was used to assess the fatigue degree. Values of hemoglobin concentration(Hb), maximal oxygen uptake (VO2max) and RPFS scores were detected before chemotherapy, at the end of chemotherapy and 4 weeks after chemotherapy, respectively. Results There was no significant difference in Hb concentration before chemotherapy, at the end of chemotherapy and 4 weeks after chemotherapy between two groups (P>0.05). The level of Hb was significantly lower at the end of chemotherapy and 4 weeks after chemotherapy than that before chemotherapy in two groups (P<0.05). There were no significant differences in VO2max and RPFS score before chemotherapy between two groups (P>0.05). At the end of chemotherapy and 4 weeks after chemotherapy, there were no significant differences in VO2max and RPFS scores than those before chemotherapy in exercise group (P>0.05). In control group, value of VO2max was significantly lower at the end of chemotherapy and 4 weeks after chemotherapy than that before chemotherapy (P<0.05), RPFS score was significantly higher than that before chemotherapy (P<0.05). Conclusion Aerobic exercise during chemotherapy can be effectively against cancer-related fatigue, which may be related to the inhibitory effect of aerobic exercise on debasement of VO 2max.

Objective To investigate the effects of dexmedetomidine (DEX) on the mRNA expression of triggering receptor expressed on myeloid cells 1 (TREM-1) in peripheral blood mononuclear cells of rats with acute obstructive suppurative cholangitis (AOSC).Methods Sixty healthy male Wistar rat models of AOSC induced by complete common bile duct ligation and injection of E.coli into the bile duct through an intubation tube were replicated successfully.After modeling,the peripheral blood was collected and mononuclear cells were isolated and cultured.According to random number table method,the mononeuclear cells were divided into model group (no drug added in culture of mononuclear cells) and low,medium and high dose DEX groups (final concentrations 0.4,0.8,1.2 μg/L DEX were in low,medium and high DEX mononuclear cell cultures,respectively).After the mononuclear cells were cultured for 24 hours,the levels of tumor necrosis factor-α (TNF-α),interleukins (IL-1 and IL-6) in the supernatant of the cultured mononuclear cells were detected by enzyme linked immunosorbent assay (ELISA).The level of C-reactive protein (CRP) was detected by immunity transmission turbidimetry.The expression of TREM-1 mRNA in the mononuclear cells was detected by reverse trantscription-polymerase chain reaction (RT-PCR).Results Compared with the model group,the levels of TNF-α,IL-1,IL-6,CRP were decreased,the TREM-1 mRNA expressions were down-regulated in the different DEX dose groups,and the degrees of descent in medium and high dose groups were more significant than those in low dose group [TNF-oα (ng/L):95.5±8.6,88.9±5.3 vs.131.1 ± 14.2;IL-1 (ng/L):53.5±8.3,48.3 ± 6.7 vs.73.7 ± 12.8;IL-6 (ng/L):266.9±26.2,252.1 ± 17.7 vs.349.9±40.4;CRP (ng/L):4.3 ± 1.1,3.9 ±0.7 vs.5.6 ± 1.7;TREM-1 mRNA (A value):0.43 ± 0.18,0.39 ± 0.16 vs.0.65 ±0.25,all P ＜ 0.05].Conclusion DEX can down-regulate the expression of TREM-1 mRNA and inhibit the formation and secretion of inflammatory factors TNF-α,IL-1,IL-6 and CRP in peripheral blood mononuclear cells of rats with ASOC.

OBJECTIVE To survey the distribution of class Ⅰ integron in extended-spectrum beta-lactamases(ESBLs)-producing Escherichia coli and Klebsiella pneumoniae and its contribution in horizontal transfer of ESBLs genes.METHODS The presence of class Ⅰ integron among 230 ESBLs-producers and 197 non-ESBLs-producers of E.coli and K.pneumoniae were detected by PCR.The correlation and co-transfer between integron and genes coding for SHV,CTX and TEM were studied. RESULTS One hundred and thirty-seven(59.6%) isolates were positive for intⅠ gene among ESBLs-producers,contrasted to 48(24.4%) in non-ESBLs-producers(P

OBJECTIVE To determine the drug resistance phenotype and genotype of plasmid-mediated AmpC ?-lactamase in Klebsiella pneumoniae isolated from Harbin.METHODS Isolates of K.pneumoniae with an inhibition ring to cefoxitin of ≤18 mm diameter were used.Antimicrobial susceptibilities were determined by disc diffusion method.AmpC genes were detected by PCR with six pairs of primers.RESULTS Sixty-three isolates had an inhibition ring to cefoxitin of ≤18 mm diameter and 26(11.3%)were detected to be AmpC-producing in a total of 231 clinical isolates of K.pneumoniae.Seventy-six percent,70.2%,53.8%,50.5%,57.7%,38.5% and 7.7% of AmpC-producers were resistant to cefoxitin,cefotaxime,ceftazidime,amoxicillin/clavulanic cid,ciprofloxacin,amikacin and imipenem,respectively.ACT,DHA and CIT types of AmpC beta-lactamase were detected in 13,8 and 5 isolates,respectively.No ACC,MOX and FOX were detected.CONCLUSIONS The AmpC ?-lactamase in Harbin is mainly in the types of ACT,DHA and CIT.AmpC-producing K.pneumoniae shows decreased susceptibilities to cefoxitin and third generation cephalosporins.

Objective To evaluate the quality of domestic hepatitis C diagnostic reagents objectively,and to build up the quality control systems for assessment of hepatitis Cdiagnostic reagents.Methods4080 serum samples from blood donors were collected and detected with EIA kits.146anti-HCV positive and negative samples were selected and tested repeatedly by two different imported ( Murex and Ortho) and domestic anti-HCV EIA kits(InTec,ZHONGSHAN BIO-TECH,WANTAI and KHB),then confirmed by CHIRON RIBA HCV 3.0 and PCR qualitative reagents.The samples were tested by nucleic acid quantitative assay and the RNA positive samples were detected by genotyping reagents.ResultsThe quality control systems of diagnostic reagents of anti-HCV and HCV RNA were constructed.Each quality control system was consisted of 50 samples,including 20 anti-HCV/HCV RNA positive,20 anti-HCV/HCV RNA negative and 10 diluted specimens for sensitivity evaluation.The positive samples with dominant HCV genotypes in China contained strong,moderate and weak positive samples.The negative samples involved those S/CO value ( signal-to-cutoff ratios ) close to threshold.Conclusion The quality control systems established in this study are suitable for assessment of the new and improved domestic hepatitis C diagnostic reagents.

Objective To investigate the association between nutrition and peripheral artery disease (PAD) in continuous ambulatory peritoneal dialysis (CAPD) patients.Methods One hundred and two stable CAPD patients from a single center were enrolled in this cross-sectional study.Automatic ankle-brachial index (ABI) measuring system was applied to examine ABI.Patients were divided into PAD group (ABI ＜ 0.9) and non-PAD group (ABI≥0.9).Clinical data were collected.Biochemical parameters were detected.Nutritional status was evaluated by serum albumin,handgrip strength (HGS) and subjective global assessment (SGA).Logistic regression analysis was performed to estimate the association of PAD with each nutritional marker as well as other potential risk factors.Results The incidence of PAD was 23.53％ (24/102).ABI was significantly lower in patients with malnutrition as compared to those without malnutrition [(0.72 ± 0.21) vs (1.04 ± 0.14),P＜0.01].Compared with non-PAD patients,serum albumin (P ＜ 0.01),HGS (P ＜ 0.01),diastolic blood pressure (P ＜ 0.05),serum creatine (P ＜ 0.05)、blood urine nitrogen (P ＜ 0.01) were significantly decreased,but age (P ＜ 0.01),the incidence of malnutrition [SGA,P ＜ 0.01],diabetic status (P ＜ 0.01),cardiovascular disease history (P ＜ 0.01) were significantly increased in PAD patients.Logistic regression analysis showed that serum albumin (OR=0.762,95％ CI:0.611-0.948,P=0.015),HGS (OR=0.988,95％ CI:0.979-0.997,P=0.013) were independent protective factors for PAD,malnutrition [(SGA),OR=21.101,95％ CI:5.008-88.901,P＜0.01] was independent risk factor for PAD in CAPD patients.Conclusions The PAD incidence of CAPD patients in our center is 23.53％.Nutrition is independent factor associated with PAD in CAPD patients.

Objective: To evaluate the reliability and validity of a questionnaire for job satisfaction with influenza vaccine recommendation of community diabetes management doctors. Methods: Through the literature review,expert interviews and pilot survey,a questionnaire for job satisfaction with influenza vaccine recommendation of community diabetes management doctors was initially formed. Cronbach's α coefficient was used to evaluate the reliability of the questionnaire; correlation analysis,exploratory factor analysis（EFA）and confirmatory factor analysis（CFA）were used to evaluate the validity of the questionnaire. Results : The questionnaire had 23 items, which were categorized into four dimensions: working environment,job itself,general satisfaction and occupational load. The Cronbach's α coefficient of working environment,job itself,general satisfaction, occupational load and the total questionnaire was 0.924,0.884,0.937,0.891 and 0.936,respectively. EFA showed that the characteristic roots of four dimensions were all more than one,and the cumulative variance proportion was 73.82%. The Pearson correlation coefficient between each item and the total questionnaire ranged from 0.339 to 0.818, and the correlation coefficient between each dimension and the total questionnaire ranged from 0.429 to 0.872（all P<0.05）. CFA showed that the variances of parameter estimation errors were all positive,and the standard errors ranged from 0.035 to 0.099,which were statistically significant（P<0.05）;the standardized parameters between each item and dimension ranged from 0.596 to 0.939; χ2/df was 4.627（P<0.05）, the comparative fit index was 0.827,the root mean square error of approximation was 0.076,which indicated the model fit. Conclusion The questionnaire has good reliability and validity,so it can be used to evaluate the satisfaction with influenza vaccine recommendation of community diabetes management doctors.

Although the efficacy of nucleos(t)ide analogue (NA) has been confirmed for treatment of chronic hepatitis B,long-term therapy has been recommended due to the high frequency of off-therapy viral DNA rebound and disease relapse.In this review,the RNA virion-like particles of hepatitis B virus (HBV) are integrated into the life cycle of HBV replication,and the potential significance of serum HBV RNA is systematically described.The production of HBV RNA virion-like particles should not be blocked by NA;in this regard,serum HBV RNA is found to be a suitable surrogate marker for the activity of intrahepatic covalently closed circular DNA (cccDNA),particularly among patients receiving NA therapy.Therefore,the concept of virological response is redefined as persistent loss of serum HBV DNA and HBV RNA.In contrast to hepatitis B surface antigen (HBsAg) that can originate from either the cccDNA or the integrated HBV DNA fragment,serum HBV RNA,with pregenomic RNA origination,can only be transcribed from cccDNA.Therefore,the loss of serum HBV RNA would likely be a promising predicator for safe drug discontinuation.The clinical status of consistent loss of serum HBV RNA accompanied with low serum HBsAg levels might be implicated as a "para-functional cure," a status nearly close to the functional cure of chronic hepatitis B,to distinguish the "functional cure" characterized as serum HBsAg loss with or without anti-HBs seroconversion.

Objective: To investigate the effect of macrophage-capping protein (CapG) on migration and proliferation of human gastric cancer cell line.Methods: Real-time PCR method was used to detect the expression of CapG gene in four gastric cancer cell lines, and AGS cells with low expression and transfection were selected as the research objects.Specific primers were designed for CapG and recombinant plasmids synthesized.A lentivirus packaging system which could express CapG was constructed, and a cell line stably expressing CapG was established by infecting human gastric cancer cell line AGS cells.The effect of overexpression of CapG gene on the growth and proliferation of AGS cells was analyzed by CCK8 assay.Cells cratch and Transwell assay were used to analyze the effect of overexpression of CapG gene on AGS cell migration.Results: After the overexpression of CapG, the growth rate of AGS cells was slightly lower than that of the control group, but there was no significant difference between the two groups (t=2.424, P=0.073).Scratch test showed that the average narrowing distance of the scratches in the CapG experimental group was significantly reduced compared with the control group, the average narrowing distance of the CapG experimental group and the control group was 336.99 μm and 45.54 μm, the difference was statistically significant (t=14.97, P=0.004).The average number of cell penetra-ting membrane in the CapG experimental group and the eGFP control group was 176 and 70, the number of the cells in the CapG experimental group was significantly higher than that of the control group (t=40.00, P<0.001).Conclusion: The overexpression of CapG gene has no significant effect on the growth and proliferation of AGS cells of gastric cancer cell line.Overexpression of CapG gene can promote the migration of AGS cells of gastric cancer cell lines.