Humans ; Interleukin-33 ; Interleukins ; Liver Cirrhosis

Objective To investigate the clinical and epidemiologieal feat ures of epidemic cerebrospinal meningitis in recent 3 years,aiming to develop the strategies for controlling this disease.Methods A retrospective analysis was conducted in 65 hospitalized patients with epidemic cerehrospinal meningitis from 2003 to 2006.Chi-square test was used for statistical analysis.Results The majority of these 65 patients were juvenile and adult,accounting for 44.6%(29 cases)and 35.4%(23 cases),respectively,while the infant patients account for the smallest percentage,only 6.2%(4 cases).Most cases occurred in spring(from February to April).The clinical features of most patients belonged to common type(72.3%),followed by fulminant type(27.7%).Five cases(7.7%)died,all of whom were fulminant cases.Totally 33 strains of Neisseria meningitidis were isolated,with positive culture rate of 50.8%(33/65 cases).The positive rate of blood culture was 44.6%(29/65 cases)and that of cerebrospinal fluid cuhure was 31.4%(16/51 cases).Isolates of Neisseria meningitidis were still highly sensitive to penicillin,ceftriaxone and cefotaxime.However,the resistance rates of strains to compound sulfamethoxazole,gentamycin and ciprofloxacin were all above 80%.Resuhs of serological typing revealed thai 82.8%(53/64 cases)cases belonged to group C.There were more severe cases and higher death rate in patients infected by group C meningococcus.Conclusions Serogroup C of the meningococcus have become the preponderant strains in Anhui Province.Most of the patients infected hy group C are J uveniles and adults.Penicillin and the third generation cephalosporins are still highly aclive againsl Neisseria meningitidis.

Objective To investigate the inhibitory effect of aqueous extract of Taxus chinensis.vat (AETC) combining Cisplatin (DDP) on vitro cultured human lung carcinoma A549 cells,and the effects on resistance genes.Methods The A549 cells were divided into different concentrations of DDP groups,different concentrations of AETC groups,and blank group,and drug effect of 48 h with the method of cell counting kit-8 (CCK-8) and the effect on cell survival were detected.Based on the above results,then A549 cells were divided into DDP combining different concentrations of AETC groups,DDP group,blank control group,and drug effect of 48 h with the method of CCK-8 and the effect on cells survival were detected.The gene expressions of adenosine triphosphate (ATP)-binding cassette subfamily B member 1 trans-porter (ABCB1),ABCG2,and ABCC1 were examined by polymerase chain reaction (RT-PCR).Results Cisplatin 12 μg/ml (DDP),DDP + ATEC 400 μg/ml,DDP + ATEC 800 μg/ml,DDP + ATEC 1 200 μg/ml,DDP + ATEC 1 600 μg/ml,A549 cell inhibition rate of each group was 44.36％,69.61％,74.73％,80.10％,and 74.73％,respectively;Different concentrations of AETC combining DDP could decrease the resistance related gene ABCC1,ABCB1 expressions,and correlated to the dose.AETC combining DDP showed no effects on ABCG2 gene expression.Conclusions AETC combining DDP could inhibit the growth of A549 cells,and decrease the resistance-related gene ABCC1,ABCB1 expressions.

Aim To obtain the encoding gene sequences of TEM-type ?-lactamases produced by 4-strain Klebsiella pneumoniae in Zhejian g Province, identify their genotypes and study some properties of these TEM-typ e ?-lactamases.Methods The encoding genes of TEM-type ?-la ctamases produced by 4 isolates were amplified by PCR. The purified PCR products were ligated with pGEM-T easy vectors, expressed in E. coli DH 5?, and sequenced by Sanger's dideoxy chain termin ation composition method. Compared with anino acid sequences in the GenBank,TEM -types of the ?-lactamases was determined. The genes of TEM ?-lactamases were ligated with pET-28 c vector to express recombinant proteins in E. coli DH 5?. Plasmids were extracted from the p ronucleus expression strains and PCR was performed to determine whether the pron ucleus expression was successful or not. Their phenotypes were determined by ESB Ls phenotype affirmative test. The isoelectric points (pIs) of the recombinant p roteins were determined by isoelectric focus. Conjugation test was performed to determine whether their genes existed in plasmid or chromosome. Results The encoding genes of ?-lactamases were determined as TEM by PCR. It s PCR product had 1 009 nucleotides. The pI of the novel TEM ?-lactamase was 5.4. The enzyme was determined as non-ESBLs by ESBLs phenotype affirmative tes t.Transconjugants were successfully selected from the paternal producers in conj ugation tests. The TEM-type ?-lactamase produced by 4 strains was determined as TEM-105(AF516720) by GenBank. Conclusion The ?-lactamase produced by 4-strain K. pneumoniae from 4 patients in Zhejiang Province was TEM-105. It was the first report of TEM-105 type ?-lactamase produced by 4-st ain K. pneumoniae from China in the world.

OBJECTIVE To investigate the distribution and the resistance rate of Shigella in Anhui Province to guide the choice of antibacterials. METHODS Ninety one strains of Shigella were cultured in Sep 2005.The groups were identified by biochemical and serologic tests.Susceptibility of 91 strains of Shigella in Anhui to various antibiotics was tested using standardized custom dilution MIC panels according to CLSI(2005) guidelines. RESULTS There were 57 strains of Shigella flexneri,31 strains of S.sonnei and 2 strains ofS.boydii among 91 strains of Shigella.The resistance rates of Shigella to cefoperazone/sulbactam and piperacillin/tazobactam were remarkably lower than to other third generation cephalosporins.The susceptible rates to carbopenems were 100%.The resistance rates to ciprofloxacin lactate and pazufloxacin mesilate were 27.47% and 32.97%,respectively. CONCLUSIONS There is a certain resistance rate of the Shigella to fluoroquinolones and the third generation cephalosporins.More attention should be paid to the surveillance and control of such resistance.

Objective To investigate the profile and antibiotic resistance of bacteria in patients with ascites infection in intensive care unit (ICU) patients in order to provide a reference for rational clinical use of antibiotics. Methods A retrospective analysis was conducted. The bacteria isolated from ascetic fluid patients admitted from January 1st, 2004 to October 31st, 2015 to ICU of the First Affiliated Hospital of Anhui Medical University were identified, and their susceptibility to antibiotics was analyzed. Patients, who were admitted from January 1st, 2004 to December 31st, 2009 were assigned to group A, and patients admitted afterwards were assigned to group B. Results A total of 637 specimens of ascetic fluid were examined, with 185 positive culture (29.0%) during the 12 years, and 203 strains of bacteria were found. Among them 126 strains (62.1%) of gram-negative bacteria (G-), 54 (26.6%) of gram-positive bacteria (G+) and 23 (11.3%) strains of fungi were found. Compared the result of group B with that of group A, the proportion of G- bacteria was increased [71.2% (99/139) vs. 44.2% (27/64)], and that of G+ decreased [17.3% (24/139) vs. 46.9% (30/64)] in group B. The difference was statistically significant (χ2 = 20.34, P = 0.001). The main pathogenic bacteria were G-, and Enterobacteriaceae was the most common pathogenic bacteria in intra-abdominal infection of ICU patients. The isolation rate of Escherichia coli and Klebsiella pneumoniae(35.7%, 10.3%) ranked in the first and third in G- bacteria, respectively. The resistant rate of Escherichia coli against penicillin and third generation cephalosporin were > 95.0% and > 73.3%, and it showed a sensitive rate of 70% to β-lactam/inhibitor, amikacin and minocycline, and a higher sensitivity to carbapenems and tigecycline (11.1%, 0). Forty-eight strains of non-fermentation bacteria were found with a rate of 23.7%. The positive rates of Acinetobacter baumannii in groups A and B were 7.8% (5/64) and 23.7% (33/139), respectively, and they ranked first among non-fermentation bacteria. Twenty strains (62.5%) multidrug-resistant Acinetobacter baumannii were found. Acinetobacter baumannii showed a resistance rate of 84.6% to cefoperazone/sulbactam, 35.3% to minocycline, and 53.3% to tigecycline. Candida albicans was the most commonly isolated fungus in intra-abdominal infections (87.5%). No strains resistant to common antifungal drugs were isolated. Conclusions G- bacteria was the main pathogen in intra-abdominal infection in patients with ascites. Non-fermenters showed an increasing trend of producing infection, and the proportion of multidrug-resistant Acinetobacter baumannii infection increased year by year, and more attention should be taken by attending doctors.

Objective To study the correlation between preoperative dye exclusion test and liver function in patients with primary hepatic carcinoma.Methods This was a cross sectional survey.A total of 192 cases of primary liver cancer patients were recruited from May 2014 to March 2015 at the Second Military Medical University Affiliated Eastern Hepatobiliary Surgery Hospital.Hereinto, 160 cases were male and 32 females, the male to female ratio was 5: 1.The age of the patients ranged from 26 to 72 years old, and the average age was 50.5 years old.ICG 15 minutes retention rate of ICG clearance test was determined by PDD method in 192 cases of primary liver cancer patients.ICGR15 value was stratified into three stages: ICGR15 ＜ 10％ , ICGR1510％-20％ , and ICGR15 ＞ 20％.The ICGR15 stage of patients with different ChildPugh grades was analyzed.The biological liver function indexes of patients were simultaneous detected including TBIL, TBA, TP, ALB, PA, ALT, AST, PT-INR, HA, LN, Ⅲ, Ⅳ, APRI, PLT etc.The correlations of ICGR15 and biological indexes of liver function were analyzed using Spearman nonparametric correlation analysis.Results (1) ICGR15 was positively correlated with Child-Pugh grade (r =0.477, P ＜ 0.01) in the 192 cases of HCC.The hierarchical analysis showed that there were significant differences between ICGR15 and different Child-Pugh grades (P ＜ O.05).(2) Child-Pugh classification and ICGR15 comparison further showed that, ICGR15 increased with Child-Pugh grade.While ICG plasma clearance rate (ICGK) and effective hepatic blood flow (EHBF) reduced (P ＜ 0.05).(3) The correlation analysis between ICGR15 and biological indexes of liver function showed that: ICGR15 was positively correlated with TBIL,TBA, ALT, AST, AFU, GGT, PT-INR, HA, LN, Ⅲ, Ⅳ and APRI index [(AST/ULN) × 100/ PLT (× 109/L)] (r =0.422, 0.389, 0.219, 0.301, 0.219, 0.244, 0.325, 0.652,0.403, 0.523, 0.519, 0.434, P ＜ 0.05);and was negatively correlated with TP, ALB, PA, SOD, WBC, PLT (r =-0.290,-0.532, 0.546, 0.531, 0.256, 0.327, P＜ 0.05).Conclusions ICGR15 as a indicator for liver reserved and dynamic function can comprehensively reflect the liver reserve function is associated with the existing Child-Pugh grades and liver function biochemical indexes.Therefore, ICGR15 could be served as a sensitive index reflecting the preoperative liver reserve function.

Objective To investigate the expressions of hepatorna stem cell surface marker CD133 CD90 in tissues of hepatocellular carcinoma (HCC) and evaluate their related clinical significances. Method The expressions of CD133 CD90 were detected by immunohistochemical method in HCC tissues of 93 patients, and normal liver tissues of 10 cases. Results Among 93 cases with HCC, the positive expression of CD133 were found in 71 cases (76.3%), and CD90 positive expression in 64 cases (68.8%), and the percentage of positive cells were (6.4±3.3)% and (4.3±3.9)% respectively. No positive expression of CD133 and CD90 was found in normal liver tissues (P<0.01). CD133, CD90 expressions in the HCC tissues of TNM stage Ⅲ-Ⅳ [(8.1±3.7)%,(5.7±4.2)%] were higher than those of TNM stage Ⅰ - Ⅱ [(4.1±2.3)%,(2.3±1.9)%] (P<0.01). Spearman correlation analysis indicated that the expressions of CD133 and CD90 were up-regulated as the pathohistology grades increased (P<0.05). Positive correlation was observed between CD133 and CD90 expression (r=0.402, P<0.01). Conclusions CD133, CD90 positive cells exist in HCC tissues, their expressions positively relate to the TNM stage and the pathohistology grades for HCC patients.

Objective To study the methylation status of secreted frizzled-related protein (SFRP) 1 and SFRP2 genes in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) and the relationship between the methylation status of the two genes and the development of HCC.Methods Using methylation-specific polymerase chain reaction (MSP) to detect methylation status of SFRP1 and SFRP2 genes of 45 specimens of HCC tissue and adjacent non-tumorous liver tissue from HCC patients during operations,and 6 normal liver tissues from patients with cholecystolithiasis or hepatic hemangiomas. The data were analyzed by chi-square test and Fisher exact test. Results SFRP1 gene methylation was detected in 28 HCC tissues and 16 adjacent non-tumorous liver tissues,accounted for 62.2% and 35.6%,respectively;and SFRP2 gene methylation was detected in 23 HCC tissues and 13 adjacent non-tumorous liver tissues,accounted for 51.1% and 28.9%,respectively;while no methylation was detected in 6 samples of normal liver tissues. There was no significant difference between the methylation of SFRP1 and SFRP2 genes in HCC tissues and gender,age,HBV serum markers,types of adjacent non-tumorous liver tissues,metastasis and pathological stage (P＞0.05).The abnormal methylation status between SFRP1 and SFRP2 genes was linear correlated in HCC tissues (r=0.381,P=0.01).Conclusion Hypermethylation of SFRP1 and SFRP2 genes frequently occurs in HBV-related HCC,which may be an important molecular biomarker for prediction of hepatocarcinogenesis in the future.

Objective To investigate the significance of orthotopic liver transplantation in the management of primary hepatocellular carcinoma (PHC) ; To evaluate the survival and prognostic factors of liver transplantation for PHC.Method The clinical data from 194 consecutive PHC patients who underwent OLT were retrospectively analyzed.Result The 1-,3-and 5-year cumulative survival rate of the 194 patients was 92.78％,78.07％ and 76.80％ respectively.There were 37 cases of recurrence or metastasis of the tumor with the incidence rate being 19.1％ (37/194).The tumor TNM stage (P=0.026 667),tumor diameter (P =0.0045),tumor number (P =0.0318),vascular invasion (P =0.006 059),and AFP level before transplantation (P =0.003 426) were significantly related with tumor recurrence.Multivariate analysis revealed that tumor diameter (P =0.0081,OR =0.789,95％ CI:2.1233-6.124),vascular invasion (P＜0.001,OR =5.928,95 ％ CI:1.173-86.789),and AFP level before transplantation (P =0.019,OR =2.601,95％ CI:2.196-5.658) were independent risk factors for tumor recurrence.There was statistically significant difference in survival rate and tumor-free survival rate between Milan criteria group and beyond-UCSF criteria group (P＜0.01),and between UCSF criteria group and beyond-UCSF criteria group (P＜0.01).There was no significant difference in survival rate and tumor-free survival rate between Milan criteria group and UCSF criteria group (P ＞0.05).Conclusion Liver transplantation is an effective treatment for PHC.The tumor diameter ＞8 cm,vascular invasion and AFP level significantly affect the survival of PHC patients.