Persister cells are dormant or slowly grown variations in microbial populations .They are highly tolerant to antibiot-ics but the tolerance are not inherited as the genetic resistance , when persisters are inoculated to fresh medium , most bacteria are still susceptive to antibiotic , while only a small fractiont become persisters again .Persisters are believed to be closely related to clinic bio-film forming and the recurrence and recalcitrance of chronic infections .Different persisters have been found in Escherichia coli , Pseud-omonas aeruginosa , Staphyococcus aureus , Mycobacterium tuberculosis , Candida albicans and so on , and a few mechanisms about per-sisters formation have been studied .This article reviews the current progresses of research methods and achievements on persisters from different levels .

Objective:To investigate the expression of apolipoprotein A-Ⅰ( ApoA-Ⅰ) in eight histo-logical types of renal neoplasms and to explore a new biomarker for differential diagnosis .Methods:The immunochemistry was used to detect the expression of ApoA-Ⅰ in 23 cases of renal tumors , including clear cell carcinoma , papillary cell carcinoma , chromophobe cell carcinoma , oncocytoma , multilocular cystic carcinoma , renal pelvis invasive urothelial carcinoma , metanephric adenoma and collecting ducts carcinoma.Five cases of cancer-adjacent normal tissues were obtained from another five renal tumor pa-tients and were chosen as control group .Results: In the 23 cases of renal tumors , ApoA-Ⅰ was ex-pressed in 21 cases(positive rate was 91.3%).There were only two in five cases of normal tissues which expressed this protein ( positive rate was 40 .0%) .A significant differentiation was observed between the two groups(Z=-2.829,P=0.003).In renal clear cell carcinoma(RCC), ApoA-Ⅰ expression level was correlated with the grade and stage of tumor tissues .ApoA-Ⅰ was stained much more stronger in RCCⅡ-Ⅲ than in RCCⅠ( Z=-2.070,P=0.038).In various histological types of renal cancer , ApoA-Ⅰwas all expressed to some degrees .Conclusion:ApoA-Ⅰcan be chosen as a tumor biomarker to differentiate various histological types of renal neoplasms .

0.05), but hospitalization duration was shorter in the invasive group than in the conservative group (10.3?5.6 days vs 14.6?10.7 days, P

Objective:To optimize the extraction process of Hegan Lidan granules. Methods:In order to choose the optimal tech-nological parameters, the content of baicalin was determined by HPLC. An orthogonal method was utilized with solvent volume, extrac-tion time and extraction times as the impacting factors and the content of baicalin and extraction rate as the indices. Results:The opti-mal parameters were as follows:using 8-fold water as the solvent, the raw material was extracted three times with 2 h for each. Con-clusion:The process is steady and feasible, and can be used in the extraction of Hegan Lidan granules.

Objective: To establish the quality standard for Shangtongning capsules. Methods: Microscopic identification was used for the qualitative identification of Bombyx batryticatus, Scorpio, Eupolyphaga steleophada, Pheretima, Notoginseng radix et rhizo-ma and Gastrodiae rhizoma. A TLC method was used for the qualitative identification of Chuanxiong Rhizoma, Angelicae Sinensis Ra-dix, Notoginseng Radix ET Rhizoma, Dipsaci Radix and Glycyrrhizae Radix ET Rhizoma. HPLC was used to determine the content of liquiriti. The determination was performed on an Agilent TC C18 (250 mm × 4. 6 mm,5μm) column with the mobile phase consisting of acetonitrile-water(15:85)at the flow rate of 1. 0 ml·min-1. The detection wavelength was set at 276 nm. Results: The features of the microscopic identification were significantly visible. The TLC spots were clear and well-separated without any negative interference. The linear range of liquiriti was 0. 341-1. 193 μg (r=0. 999 9)with the average recovery of 98. 97%(RSD=0. 77%, n=6). Con-clusion:The method is simple, accurate and reproducible, which is effective in controlling the quality of Shangtongning capsules and provides the basis for improving the quality standard for Shangtongning capsules.

AIM: To investigate the changes of intraocular pressure (IOP) and associated factors of IOP elevation after 4mg intravitreal injection of triamcinolone acetonide (IVTA) in treatment of macular edema.METHODS: The study is prospective, consecutive, and non-comparative interventional case series including 93 eyes with macular edema associated with retinal vein occlusion (n=54 eyes) or diabetic retinopathy (n=39 eyes), which received 4mg IVTA injection. The change in IOP was followed for all cases at pre-operation and 14 days, 1, 2, 3, 4, 5, and 6 months post-operation. Associated factors of IOP elevation were examined regarding baseline IOP, causal disease, age and gender.RESULTS: IOP increased significantly (P＜0.001) at 14 days 16.02± 2.45mmHg after injection and peaked at 18.80± 6.20 at 2 months post-injection (P＜0.001) from 14.85 ± 2.55 mmHg preoperatively. An IOP rise to the value higher than 21mmHg was observed in 2 (2.2%) eyes 14 days after injection and which was observed in 14 (15.1%), 18(19.5%),9(9.6%), 4(4.3%), 0, and 0 eyes respectively at 1, 2, 3, 4, 5,and 6 months after injection. One eye (0.01%) showed pressure elevation of over 5mmHg than baseline 14 days after injection and IOP peaked to 22 mmHg (23.7%) at 2 months after injection. Five (5.3%) eyes had an increase of 10mmHg at 1 month and IOP peaked to 12mmHg (12.9%) at 2 months after injection. The rise in IOP was statistically associated with younger age (correlation coefficient -0.18- -0.29, P ＜0.05), high baseline IOP (correlation coefficient 0.52-0.79, all P ＜0.001),and the presence of diabetes mellitus (correlation coefficient 023, P＜0.001) but independent of gender (correlation coefficient -0.002-0.04, all P ＞0.05). In all eyes, IOP could be lowered to the normal range with topical medication, without development of glaucomatous optic nerve head changes.CONCLUSION: Elevated IOP after 4mg IVTA injection is common and patients should be monitored beyond 6 months post-injection. In all the cases, IOP can be normalized by topical medication. Patients with high baseline IOP, diabetic retinopathy, and younger age should be carefully monitored for an elevated IOP.

Objective To investigate the correlation between two single nucleotide polymorphisms of the leukotriene A4 hydrolase (LTA4H) gene (rs2660845 and rs2540493) and risk of ischemic stroke in population of southern Zhejiang Province.Methods A total of 300 ischemic stroke patients and 300 healthy controls,recruited from the Department of Neurology,Third Affiliated Hospital of Wenzhou Medical University between September 2010 and June 2013,were enrolled in this study.Two single nucleotide polymorphisms of the LTA4H gene (rs2660845 and rs2540493) were analyzed by polymerase chain reaction and matrix-assisted laser desorption/ionization time of flight,respectively.Sixty-seven patients and thirty controls were randomly selected (complete randomization) and detected the serum leukotriene B4 (LTB4)concentration by ELISA method.Results There was no evidence of association between the two variants of LTA4H gene and the risk of ischemic stroke or its TOAST (Trial of Org 10 172 in acute stroke treatment)subtypes (P ＞ 0.05).Analysis of LTB4 levels revealed that there was no statistically significant difference in serum LTB4 concentration between patients (n =67) and controls (n =30; 0.991 ± 0.305 vs 1.035 ± 0.498 ; P =0.692),and no statistically significant difference in LTB4 concentration was found among the three genotypes of rs2660845 as well (AG genotype vs AA genotype vs GG genotype:0.938 ± 0.269 vs 1.038 ± 0.268 vs 1.043 ± 0.383 ; P =0.401).Conclusion The present study suggests that there is no association between the two polymorphisms in the LTA4H gene and risk of ischemic stroke in population of southern Zhejiang Province.

BACKGROUND:Severe pain after total hip arthroplasty is an important factor for successful rehabilitation of postoperative joint function. Analgesic method after total hip arthroplasty is a hot issue. OBJECTIVE:To investigate the analgesic effect of different concentrations of ropivacaine after total hip arthroplasty. METHODS:69 patients undergoing total hip arthroplasty were recruited from Department of Anesthesiology, Suqian People’s Hospital, from January 2012 to June 2014. According to the ASA classification, their physical status was graded I to III. The involved patients were randomly divided into three groups:0.25%ropivacaine group, 0.3%ropivacaine group, 0.35%ropivacaine group. Each group had 23 cases. At 30 minutes after the surgery, different concentrations of ropivacaine, 20 mL, were injected to patients due to continuous fascia iliaca compartment block. The catheter was then connected to a patient-control ed analgesia pump programmed to deliver 10 mL with a lockout interval of 60 minutes, for postoperative analgesia (72 hours). At 12, 24, 48 and 72 hours of blockade, the visual analogous scale (VAS) scores at rest, passive and active activity were recorded. When VAS score at rest ≥ 4 points, parecoxib sodium 40 mg was injected intravenously. The consumption of ropivacaine within 72 hours after the blockade, application of parecoxib sodium, time of ambulation, and adverse reactions during blockade were recorded. The analgesic effect in the three groups was also observed. RESULTS AND CONCLUSION:Compared with 0.25%ropivacaine group, static VAS scores of 0.3%ropivacaine group and 0.35%ropivacaine group showed no significant difference (P>0.05), passive and active VAS scores were significantly decreased (P<0.05), and the consumption of ropivacaine within 72 hours after the blockade was significantly decreased. There was no significant difference in the rest, passive and active VAS scores between 0.3%ropivacaine group and 0.35%ropivacaine group (P>0.05). The ropivacaine consumption of 0.3%ropivacaine group and 0.35%ropivacaine group was not statistical y significant (P>0.05). The usage of parecoxib sodium in 0.3%ropivacaine group and 0.35%ropivacaine group was significantly lower than that in 0.25%ropivacaine group (P<0.05). Day of first walk was earlier in the 0.3%ropivacaine group and 0.35%ropivacaine group. The incidence of complications among the three groups showed no significant difference (P>0.05). Experimental findings indicate that, three different concentrations of ropivacaine has certain analgesic effects after total hip arthroplasty with fewer adverse reactions, and the concentration of 0.3%ropivacaine is the suitable concentration for postoperative analgesia of total hip arthroplasty, it can reduce the amount of parecoxib sodium and shorten the day of first walk.

AIM: To study the effect of tick anticoagulant peptide-staphylococcal superantigen like protein 5 (TAP-SSL5), an anti-inflammatory and anticoagulant fusion protein , on the binding of activated platelets to human lym-phocytes.METHODS:Human periphery lymphocytes were isolated by magnetic activated cell sorting (MACS).The toxic-ity of TAP-SSL5 on the viability of Jurkat cell was assessed by CCK-8 assay.Flow cytometry was applied to detect the ex-pression of CD162 (PSGL-1) on the Jurkat cells (human peripheral blood leukemia T lymphocyte cell line ) and the inhibi-tory effect of TAP-SSL5 on the binding of mouse anti-human CD162 monoclonal antibody (KPL-1) to Jurkat cells.Platelets were activated by ADP at concentration of 20μmol/L, the binding rates of activated platelets to Jurkat cells or human lym-phocytes were assayed by flow cytometry .RESULTS:The concentration of TAP-SSL5 below 30 mg/L didn’ t affect the vi-ability of Jurkat cells .TAP-SSL5 at 10 mg/L competitively inhibited KPL-1 binding to Jurkat cells .The binding rates of activated platelets to Jurkat cells or lymphocytes were (11.86 ±4.49)% and (8.32 ±1.00)%, respectively, which de-creased to (6.73 ±2.71)%and (5.51 ±0.70)%after the Jurkat cells and lymphocytes were pre-incubated with 10 mg/L TAP-SSL5 (P <0.05).CONCLUSION:TAP-SSL5 binds to PSGL-1 expressed on lymphocyte surface and directly in-hibits the binding of activated platelets to human lymphocytes , which may be one of the anti-inflammatory mechanisms of TAP-SSL5.

Objective:To compare two methods for the determination of compound cod-liver oil emulsion. Methods:The content of ciprofloxacin in compound cod-liver oil emulsion was determined by HPLC and UV, respectively. The determination by HPLC was performed on a Thermo C18 column (150 mm ×4.6 mm, 5 μm). The mobile phase was 0.025 mol·L-1phosphate-acetonitrile (87∶13)andpHwasadjustedto3.0±0.1withtriethylamine. Thedetectionwavelengthwas277nmandtheflowratewas1.5ml·min-1. The detection wavelength of UV was 277 nm. Results:The average recovery of HPLC and UV was 100. 44% and 100. 84% with RSD of 1. 01% and 1. 09% (n=9), respectively. The detection results of the two methods were compared by paired sample t-test, and no statistically significant difference was found (P>0. 05). Conclusion:The two methods are specific and accurate, and can be used for the determination of ciprofloxacin hydrochloride in compound cod-liver oil emulsion.