Objective To determine the sensitivity and specificity of ramification amplification method for detecting Shiga toxin and to determine the feasibility in detecting E. coli 0157: H7 and other shiga toxin-producing E. coli isolated from food and clinical specimens. Methods The sensitivity and specificity of RAM were compared with those of PCR by detecting synthetic Shiga toxin DNA target and isolates from food and clinical specimens. Results The lowest number of targets detected by RAM assay was 10 molecules. Several clinical isolates of E. coli 0157 :H7, Shigella dysenteriae and nonpathogenic E. coli were further tested. The results showed that E. coli 0157: H7 and Shigella dysenteriae were positive for shiga toxin gene,while nonpathogenic E. coli were negative. The results of RAM and PCR by detecting isolates were same. Conclusion RAM assay could be an alternative to PCR to detect STEC in food product and clinical specimens because of its high sensitivity and specificity , simplicity and isothermal amplification.

General practitioner system is an important part of national health service system.Improving general medical education is an inevitable tendency of modern medical education.General medical science starts late in China.Development of Chinese general practitioner training system and general medical education are relatively insufficient and lack of relevant experiences.This paper introduced family doctor training process of Washington university school of medicine and revealed characteristics of systematization,standardization and pervasive of it to inspire our country to learn from the following aspects:(1) paying fully attention to the important role of general medical science in the national health service system； (2) systematically planning three-step training of general medical education ； (3) implementing general medical education teaching content and teaching staff development.

Objective To assess the effect of xiaojin wan plus nimesulide on patients with subacute granu-lomatoas thyroiditis(SAT). Methods 70 SAT cases were divided into nimesulide group(nimesulide 0.1 g,2/d) and combined group(nimesulide 0.1 g,2/d and xiaojin wan 1.2 g,2/d). When the patients' conditions were re-lieved after 3-4 weeks treatment,half doses of the medicines were given in two groups for 8 weeks. The efficacy,safe-ty and relapse rate after withdrawing medicines for 12 weeks were observed. Results The effective rates were 82.90% (29/35) in nimosulide group and 85.7% (30/35)in combined group, but both groups' effective rate was 50.0% (3/6) in patients with high temperature (higher than 39 ℃). The time for fever relieved in two groups were similar (P>0.05), but the thyroid pain smoothing time, normalized rates of blood sedimentation after 1 week therapy, enlarged thyroid or thyroid nodule after 3 week therapy, relapsed rate were significantly more efficacious in combined group than in nimesulide group (P<0.05). There was no severe side effects in the two groups. Conclu-sious There is a synergic effect of xiaojin wan plus nimesulide on patients with SAT, that is an effective and safe therapeutic regimen for SAT patients without high temperature.

Objective To investigate the value of CT perfusion imaging in quantitative monitoring on microcirculation hemodynamics,differences between tumor and normal tissues,differences between mass center and edge,and on tumour microvascular responses to anti-angiogenesis therapy. Methods Fifteen male New Zealand white rabbits were established to VX2 tumor-bearing model. The animals were divided into 2 groups,anti-angiogenesis therapy (n=11,TNP-470,20 to 30 mg/kg),and control (n=4). DEC-CT scanning (80 kV,120 mA,20 cm VOF) was performed at 1 week after tumor implantation,1 week after anti-angiogenesis therapy,and 2 week after anti-angiogenesis therapy. Perfusion parameters,including blood flow (BF),blood volume (BV),mean transit time (MTT),and permeability surface (PS) were calculated for tumor mass,tumor edge,tumor center and normal tissue. Results Significant differences of the average values were observed in BF,PS and MTT between tumor and normal tissue [149.32?30.99 vs 32.18?4.10 ml/(100 g?min),28.24?5.15 vs 11.88?0.71 ml/(100 g?min),2.79?0.66 vs 6.57?0.90 s,P

Objective To investigate the effect of prebiotics supplement on intestinal epithelial tight junctions and barrier function of the rats with acute pancreatitis (AP). Methods The AP model in Wistar rat was established by intraperitoneal injection of L-arginine. The rats were randomly divided into 3 groups: control group, AP group, GOS group. GOS was given 4g·kg-1·d-1at 7d before ANP induced. Twelve hours after modeling, the AP rats in each group were sacrificed. 2 ml of blood sample was taken from heart for the analysis of plasma diamine oxidase (DAO) activity. Jejunum was taken for histological examination. The transmembrane binding proteins (occludin) were measured with immunohistochemistry. Results The plasma DAO level in AP group was (7.29±0.68) U/L, and significantly higher than (2.01±0.34) U/L of control group (P＜0.01). The DAO level in GOS group was (3.44±0.59) U/L, and significantly lower than that of AP group. The occludin protein level in AP group was 95.1±9.2, and significantly lower than 44.7±8.2 of control group and 59.7±7.8 of GOS group (P＜0.01). The occludin protein level in COS group was significantly higher than that of control group (P＜0.05). Conclusions The prebiotics may increase the expression of occludin protein, enhance the intestinal epithelial tight junction, maintain the intestinal permeability, and protect the intestinal barrier function.

Objective To evaluate the prognostic value of fluorodeoxyglucose (FDG) standardized uptake value (SUV) of positron emission tomography (PET) before radiotherapy in non-small cell lung cancer (NSCLC) treated with three-dimensional conformal radiation therapy (3DCRT). Methods Seventy-three patients with stage Ⅲ NSCLC underwent PET to calculate SUV within 2 weeks before 3DCRT. The a-nalysis was carried out after the irradiation of 60 -66 Gy. The possible prognostic factors were assessed by Cox proportional hazards model. Results The mean SUV for squamous cell carcinoma, adenocarcinoma and others were 16.94, 14.40 and 6.33, respectively (F = 0. 51, P = 0. 604). The mean SUV for tumor volume less than and more than 50 cm~3 was 13.81 and 20.18 (F = 7.54, P = 0. 008). In the univariate analysis, a cutoff SUV of 17 and chemotherapy were correlated with the prognosis. In the multivariate analysis, SUV was the only independent prognostic factor (relative risk = 2.61). Conclusions SUV is a prognostic factor in patients with NSCLC treated by 3DCRT, which deserves further studies.

Objective To analyse long-term follow-up outcome of cryoballoon ablation (CBA) for atrial ifbrillation (AF) in a single center and to investigate the clinical relative factors which affecting the effect. Methods The inpatient, operating and outpatient data of patients, who were treated by CBA for AF in our center from January 2009 to April 2013, were retrospectively analyzed. Left atrium diameter (LAD) was measured by transthoracic echocardiography. Failure-treatment of CBA was defined by episode of AF, atrial lfutter, atrial tachycardia lasted for 30 seconds after 3 months. Results A total of 199 patients were enrolled. The rates of phrenic nerve paralysis, pericardial effusion, transient ischemic attack were 1.5%(n=3), 0.5%(n=1), 0.5%(n=1),respectively. All complications were resolved spontaneously.152 patients had completed follow-up data after ifrst-time CBA during a long-term follow-up of mean 23±14 months, 65 patients (42.8%) treated success. 75 patients with failure-treated were (86.2%) experienced the atrial arrhythmia recurrence in ifrst 12 month. The characteristics of failure-treated patients included with older age[(62±7) years vs. (52±10) years, P=0.0379]and larger LAD[(48±6)mm vs. (43±6) mm, P<0.0001]. The Logistic analysis showed that LAD[OR=0.896(0.842,0.953), P=0.005]and age[OR=1.037 (1.000,1.076), P=0.0488]could individually predict the treat-failure after ifrst CBA, and only LAD[OR=0.876 (0.822,0.935), P < 0.0001]could individually predict the total CBA. Conclusions CBA procedure for AF is safe and effective, and the result of long-term follow-up is preferable. Most atrial arrhythmia are recurred during ifrst 12 month after CBA. LAD can individually predict the failure in treatment of CBA.

Objective To explore the mechanisms and effects of adoptive immunotherapy with ovarian cancer vaccine modified by GM-CSF gene which was used after immunologic reconstitution during lymphopenia induced by chemotherapy.Methods Lymphopenia was induced by chemotherapy with cyclophosphamide.The immune reconstituted model was built in rats.The tumor vaccine draining lymph nodes were harvested after the ovarian cancer cells NUTU-19 modified by GM-CSF gene were injected.The effector T cells (T_E) were got after being stimulated and amplified.Enzyme-linked immunosorbent assay was used to detect the level of interleukin (IL)-2 and IL-4 secreted by T_E.Intracellular cytokine staining was used to determine frequency of tumor-specific T_E.Fluorescence-activated cell sorting (FACS) was used to detect the special cytotoxicity ofT_E killing target cells.The survival period of rats bearing pre-established abdominal ovariam carcinoma after being adoptively transferred byT_E.was observed.Results Compared with those in control group,the significant higher levels IL-2[(65.7±4.0) pg/ml]and lower levels IL-4 [(277±49) pg/ml]were observed in chemotherapy-immune recunstitution-vaccine immunization group.The amount of CD_4~+ T cells secreting interferon-γ (13.0±2.1)% were also significantly increased.The rate of the special cytotoxicity of killing T cells (86.5±1.1) % was markedly improved.The survival period of rats (110±16) days was increased in chemotherapy-immune reconstitution-vaccine immunization group.Conclusions The combined immunotherapy of chemotherapy-immune reconstitution-tumor vaccine immunotherapy may increase the frequency and function of specific tumor T_E.The specific cytotoxicity is increased and the weak reaction of T_E to tumor is improved,which showed that this therapy can enhance immune reaction.

Objective To study the relationship of symptoms of female gonococcal infections to Chlamydia trachomatis infection, serum sex hormone levels, etc. Methods A total of 136 gonorrhea female patients without obvious symptoms were recruited in this study together with 45 gonorrhea patients with obvious symptoms as the controls. Serum progesterone (P) and estradiol (E2) levels were measured by radio immunoassay (RIA). Cervical swabs were obtained from the subjects and eluted into isotonic saline solution, the elution was divided into 2 portions and tested for the levels of TNF-α and IL-1β by ELISA and for the DNA of C. Trachomatis and N. Gonorrhea with PCR. Statistical analysis was carried out by SPSS for Windows (version 12.0). Results There was no statistical correlation between C. Trachomatis infection and asymptomatic status of female gonococcal infection (χ2 = 0.016, P > 0.05). However, the decrease in the level of TNF-α and IL-1β significantly correlated with the increase in serum progestogen (r = -0.8798, -0.8935, respectively, both P < 0.01). Conclusion The high serum level of progesterone may be associated with the asymptomatic status of gonococcal infection.

AIM:To describe our clinical experience in treating circumscribed choroidal haemangioma(CCH)in a tertiary referral centre over a fifteen year period prior to photodynamic therapy.METHODS:The departmental database and photographic records of a tertiary referral center were used to identify patients who were treated for CCH between 1992 and 2007.Their case records were reviewed.RESULTS:Visual acuity improved(＞2 Snellen lines)in eleven patients(69%)remained stable in one patient (6%)and deteriorated in four patients(25%).Six of the seven treated with brachytherapy and three of the four treated with transpupillary thermotherapy achieved better visual acuity after treatment.86% of patients treated within six months of onset of symptoms and 50% of patients treated after six months of onset of symptoms noted an improvement in visual acuity.Only one patient in our series had a final VA of 6/60 or worse.Mean follow-up was thirty-five months.CONCLUSION:Visual outcome is better when treatment is performed within 6 months of symptoms.The majority of patients achieved an improvement in visual acuity without any adverse effect following treatment.