Objective To investigate the clinical value of the bedside color Doppler in the assessment infants with periventricular-intraventricular hemorrhages (PIVH).Methods Sixty-eight cases of PIVH newborns and 156 healthy newborns were involved in the study,dynamic monitoring were undergone within a week after birth.The middle cerebral artery(MCA) hemodynamic parameters of velocity systolic (Vs),velocity diastolic(Vd) and resistance index (RI) were recorded,and the differences of the parameters were compared between different grades as well as those of the normal newborns at 1 d,4 d and 7 d after born.Results Total 68 PIVH infants were diagnosed by bedside color Doppler accurately.Prevalences of premature and low birth weight infants were higher than term infants and normal birth weight children,respectively (P ＜0.05).Vs and Vd of 4 groups of children with PIVH showed an increasing trend in a week after born.The differences of Vs between grade Ⅰ and normal newborns in 4 d and 7 d were not statistically significant (P＞ 0.05),the differences of the other three groups compared with normal newborn group in1 d,4 d and 7 d were statistically significant (P ＜0.05).Vd of grade Ⅱ newborns within 7 d were greater than those of other 4 groups (P ＜0.05),grade Ⅲ and grade Ⅳ within 7 d were less than healthy newborns (P ＜0.05).The difference of RI between all groups were not statistically significant (P ＞ 0.05).Conclusions The diagnostic accuracy rate of PIVH by bedside Doppler is high and the dynamic monitoring of neonatal hemodynamics could provide an important basis for assessing the occurrence and development of PIVH.

Objective To discuss the imaging features of the localized fibrous tumor of pleura(LFTP).Methods 10 cases of LFTPproved patholgically were underwent CT scanning,while MRI scanning was performed in 3 cases.The imaging findings of LFTP wereanalysed.Results 9 cases were benign tumors and 1 case was malignant tumor.The main CT manifestations were single soft tissue massadhering to the pleural surface,clearly boundary,homogeneous or unhomogeneous density,obvious homogeneous or non-uniformityenhancement."Pleura mass hat"was characteristic appearance located the pleura mass.The mass formed acute angle or obtuse angle with the adjacent pleura,which was related to mass size and shape.MRI manifestations were hypointense or isointense on T_1WI and T_2WI,non-uniformity signal.1 case of giant LFTP showed scattered in disorder and clutter signal on T_2WI.Inside tumor peduncle of the giant LFTP was connected with the pericardium.Conclusion CT is a main imaging diagnostic technique for LFTP,while MRI is commonly superior to CT in localizing the mass and showing inner characteristics for the bigger pleural masses.The appearance of pleuraL tumor peduncle is an important sign in diagnosis of LFTP.

AIM: To establish quality standard for Yinxie Tablets(Fructus Gardeniae, Radix Astragali, Radix Angelicae Sinensis, etc.). METHODS: Fructus Gardeniae, Radix Astragali and Radix Angelicae Sinensis were identified by TLC, and the content of geniposide was determined by HPLC. RESULTS: Fructus Gardeniae, Radix Astragali and Radix Angelicae Sinensis could be identified by TLC. The calibration curve of geniposide was linear (r=0.999 5). The precision was perfect (RSD=0.98%). The average recovery was 101.81% with RSD of ~0.54% . CONCLUSION: This method is simple, quick and specific, suitable for the quality control.

Objective:To search for differences in early immune reconstitution after allogenic or autolo-gous hematopoietic stem cell transplantation (HSCT).Methods:The peripheral blood (PB)from 31 adult patients undergoing allogenic HSCT (allo-HSCT,1 5 patients)or autologous HSCT (auto-HSCT, 1 6 patients)for the treatment of hematological malignancies and from 20 related healthy controls (HC) from December 201 1 to August 201 4 was used to analyze the kinetic recovery of lymphocyte subsets by means of flow cytometry during 1 2 months after HSCT.The T cell receptor rearrangement excision circle (TREC)levels among CD3 + T cells were measured in the patients and HC to evaluate the thymic-dependent T cell reconstitution.Results:The allo-and auto-HSCT recipients did not differ significantly in CD4 + T cells,CD8 na?ve T cells,effecter memory T cells (TEM),CD4 central memory T cells (TCM),mid-activated T cells and dendritic cells (DC)during the follow-up (P >0.05).But they both differed significantly from HC (P <0.05).CD8 + T cells and NK cells reconstructed rapidly.There was no significant difference in the numbers of B cells between the allo-and auto-HSCT groups from M1 to M3 (P >0.05).B cells in both the groups were lower than those in HC (P <0.05).The recovery of B cells in auto-HSCT group was faster than in allo-HSCT group at M6 and M1 2 (P <0.05).The frequen-cies of CD4 na?ve T cells and later activated T cells in allo-HSCT group were significantly higher than in auto-HSCT group at M6 and M1 2 (P <0.05).The frequencies of CD8 TCM in auto-HSCT group were significantly higher than in allo-HSCT group at M6 and M1 2 (P <0.05).The TREC levels were signifi-cantly lower than in both the groups compared with the age-matched HC during the follow-up (P <0.05).No significant difference was observed between allo-HSCT and auto-HSCT groups (P >0.05). Conclusion:The differences of the nature and the speed of lymphocyte reconstitution observed between the two patents groups were minor.This leads us to conclude that in allografted patients,immune recons-titution and subpopulations of peripheral blood lymphocytes are probably not related to the allogenicity of the graft,but due to the impaired thymus functions and slow differentiation of T lymphocytes in thymus.

Objective To investigate the distribution of 22 beta-lactamase genes and enzyme activities in multi-drug resistant Acinetobacter baumannii (MDRAB). Methods Sixty-two MDRAB strains were isolated from the First Affiliated Hospital, College of Medicine, Zhejiang University. Twenty-two beta-lactamase genes were analyzed by PCR and verified by DNA sequencing. Enzyme activities of extended spectrum beta-lactamases (ESBLs) , cephalosporinase ( AmpC) and metallo-beta-lactamases ( MBL) were detected by the modified three-dimensional method using enzyme extraction. Results In 62 MDRABs, 51 (82.3% ) , 50 (80.6% ) and 36 (58.1% ) isolates were found to carry blaTEM, blaOXA-23 cluster, and blaADC, respectively. The rest 19 genes were not detected in this study. DNA sequencing and genomic comparison showed that 5 isolates carrying blaTEM had the same genotype as blaTEM-l , 6 isolates carrying blaOXA-23 cluster had the same genotype as blaOXA-23 carbapenemases (accession; CAB69042. 1) , and 2 isolates carrying blaADC had the same genotype as blaADC-like (accession: EU081908). Thirty-two isolates (51.6% ) produced ESBLs and AmpC, 19 isolates (30.6% ) produced ESBLs only, and 1 isolate (1.6%) produced AmpC only; and no isolate produced MBL. Conclusion MDRAB carrying blaOXA-23 carbapenemase and blaADC AmpC in this study are of high drug resistance.

Objective To investigate ADC type cephalosporinase genes in muhidrug-resistant strains of Acinetobater baumannii (MDR-ABA). Methods Sixty-two ABA strains were collected during November 2007 to February 2008 from the First Affiliated Hospital, College of Medicine, Zhejiang University. Kirby Bauer disk diffusion method was used to detect the susceptibilities of the strains to antimicrebial agents. PCR and DNA sequencing was performed to analyze the ADC type cephalosporinase gene. Results Sixty-two MDR-ABA strains showed high drag-resistance rate to most antimicrobial agents expect cefoperazone/sulbactam (69.4%), and 36 strains were ACD positive (58.1%). Conclusion MDR-ABA strains in this study are of high drug resistance, which is closely related to ADC type cephalosporinase.

OBJECTIVE To investigate in vitro activities of 12 antimicrobial agents including cefmetazole against extended-spectrum beta-lactamases-producing Escherichia coli(528 strains),Klebsiella pneumoniae(311 strains) and Proteus mirabilis(15 strains).METHODS They all collected from 15 teaching hospitals in China during 2005 and 2006 and included in the study.The levels of minimal inhibitory concentration(MIC) of 12 antimicrobial agents were determined by agar dilution method.WHONET 5.4 Software was used to analyze the data.RESULTS Against ESBLs-producing E.coli and ESBLs-producing K.pneumoniae,carbapenems were the most active antimicrobial agents(all 100.0% susceptible),followed by cephamycins(80.1-97.3%).Piperacillin/tazobactam(78.5-95.1%)showed a higher activity than cefoperazone/sulbactam(44.1-56.2%).The susceptible rate to ceftazidime against ESBLs-producing E.coli was remarkably higher than the other three cephalosporins,however the differences did not happen to ESBL-producing K.pneumoniae obviously.The susceptible rate to cefuroxime was below 1.6%.ESBLs-producing K.pneumoniae showed high sensitivity to carbapenems,cephamycins and ?-lactam/lactamase inhibitor combinations(all 100% susceptible),however the susceptible rates to cephalosporins were relatively lower.CONCLUSIONS Carbapenems and cephamycins remain the relatively high activity against ESBLs-producing Enterobacteriaceae.

We report a case of fetal cerebellar vermis dysplasia diagnosed prenatally by ultrasonography. Ultrasonography of the 27-year-old woman at 20 +6 gestational weeks revealed partial separation of the cerebellar vermis (Dandy-Walker variants), unclosable upper and lower lips, and polydactyly, based on which a preliminary diagnosis of multiple fetal malformations was made. Karyotype and chromosomal microarray (CMA) analysis of the amniotic fluid showed no abnormality. After genetic counseling, amniocentesis was performed again for a whole-exome sequencing test. The results suggested that there are compound heterozygous variations of c.3435G>A(P.W1145X) and c.2941C>G(p. p981A) in the exon 19 and exon 17 of the CPLANE1 gene, which were both de novo mutations and inherited from the father and mother, respectively. The fetus was diagnosed as Joubert syndrome. Given the facial and limb deformities and a significant risk of neurological abnormalities of the fetus, the patient and her family decided to terminate the pregnancy.

OBJECTIVE To investigate the antimicrobial resistance of hospital-and community-acquired pathogens collected from 10 teaching hospitals located at different areas in China in 2006.METHODS According to the study protocol,the strains of Streptococcus pneumoniae,meticillin-susceptible Staphylococcus aureus(MSSA),Escherichia coli and Klebsiella pneumoniae were collected and sent to the central lab for reidentification and susceptibility testing.The minimal inhibitory concentrations(MICs) of antimicrobial agents against Str.pneumoniae were determined by Etest method and MICs of antimicrobial agents against S.aureus,E.coli and K.pneumoniae strains were determined by agar dilution method.WHONET5.4 software was used to analyze the data.RESULTS Among 353 Str.pneumoniae strains,74.2% were penicillin-susceptible(PSSP),9.6% were penicillin-intermediate(PISP) and 16.2% were penicillin-resistant(PRSP).Strains from different hospitals showed different sensitivity to penicillin.Among ?-lactam antibiotics,cefuroxime showed the lowest susceptibility rate of 0%(for PRSP) to 76.7%(for PSSP).The susceptibility rate to ceftriaxone and amoxicillin-clavulanic acid was 98.1% and 98.9% in PSSP group,61.8% and 64.7% in PISP group,and 15.8% and 10.5% in PRSP group.The ESBLs rate was 56.2% among 267 Escherichia strains and 42.7% among 206 K.pneumoniae strains.For ESBLs-producing strains,the susceptibility rates to cefotaxime and ceftriaxone were low and the rate to ceftazidime was relatively high among ?-lactam antibiotics.73.4% MSSA strains produced ?-lactamase.?-Lactam antibiotics tested showed high susceptibility against MSSA strains.The susceptibility rate was 98.9-100%.The susceptibility rate to ciprofloxacin and levofloxacin was 80.8% and 88.1%,separately.CONCLUSIONS Fluoroquinolones show high susceptibility against Str.pneumoniae.Ceftriaxone and amoxicillin-clavulanic acid have relatively high susceptibility among ?-lactams.For MSSA and non-ESBLs-producing E.coli and K.pneumoniae strains,?-lactams show high susceptibility.For ESBLs-producing E.coli and K.pneumoniae strains,the susceptibility rates to cefotaxime and ceftriaxone are low and that to ceftazidime,cefepime and cefoperazone-sulbactam are relatively high.

OBJECTIVETo investigate cellular immune function and its clinical significance in patients with multiple myeloma (MM).

METHODS45 MM patients were divided into three groups:newly diagnosed (n=18), stable stage (n=17) and relapsed/refractory (n=10). The frequencies of T cell subtypes, natural killer (NK) cells, dendritic cells (DC), helper T cells (including Th1 and Th2), regulatory T cells(Treg) and Th17 cells in peripheral blood were detected by flow cytometry. Serum concentrations of β2 microglobulin (β2-MG), lactate dehydrogenase (LDH) and hemoglobin (Hb) were also detected, respectively.

RESULTSCompared with controls and stable stage group, the ratios of CD4+/CD8+, DC1/DC2, and Th1/Th2, the numbers of Treg and NK cells were significantly lower in newly diagnosed group. However, the ratio of IL-17A/Treg was significantly higher in newly diagnosed group (P<0.05). Compared with stable stage group, the ratios of CD4+/CD8+, DC1/DC2 and Th1/Th2 were significantly lower, and the ratio of IL-17A/Treg was significantly higher in relapsed/refractory group (P<0.05). In higher ISS stages, the ratios of CD4+/CD8+ and Th1/Th2 were significantly lower and the ratio of IL-17A/Treg was significantly higher (P<0.05). There were negative correlations between the ratios of CD4+/CD8+, DC1/DC2, Th1/Th2 and the levels of β2-MG and LDH, respectively (P<0.05). The ratio of IL-17A/Treg was positively correlated with the levels of β2-MG and LDH (P<0.05). They were no correlated with the level of Hb (P>0.05).

CONCLUSIONThe abnormal ratios of CD4+/CD8+, DC1/DC2, Th1/Th2 and IL-17A/Treg were closely related with disease condition stages, treatment outcomes, progression and prognosis in MM patients.