Objective To determine the nucleic acid content of hepatitis B virus with different clinical types of hepatits B before、after liver transplantation patients and explore the approach for detection of hepatitis B.Methods The HBV DNA content in before the liver transplantation, 7 day, 30 day, 90 day after the liver transplantation was detected with fluorescent quantitative PCR and HBV M with ELISA in 275 liver transplantation patients.Results HBsAg、HBcAb was positive of 275 patients;HBV DNA was positive in all HBsAg(+)/HBeAg(+)/HBcAb(+) specimens;79( 73.8 % )out of the 107 HBsAg(+)/HBeAb(+)/HBcAb(+) specimens; 48( 67.6 % )out of the 71 HBsAg(+)/HBcAb(+) specimens in before the liver transplantation.HBV DNA was negative in out of the 275 HBsAg(-) in 7 day after the liver transplantation; 48( 69.6 % ) out of the 69 HBsAg(+) in 30 day after the liver transplantation;104( 75.9 % ) out of the 137 HBsAg(+) in 90 day after the liver transplantation.Conclusions The recurrent hepatitis B were higher in the different clinical types of hepatitis B after liver transplantation,Detection of HBV DNA with fluorescent quantitative PCR can accurately reflect the state of HBV infection and HBV replication and HBV DNA was complementarity with HBV M,it can be used to guide clinical diagnosis with recurrent hepatitis B.

Objective To observe the curative effect of paracetamol and indomethacin suppository in cancer- ous febrile. Methods 108 patients of lung cancer with fever were divided into.two groups,the treatment group of 54 cases and the control group of 54 cases, administered with paracetamol and indomethacin suppository respectively. Results After the two groups took medicine, the difference in defervesceing was significant, with statistics signifi- cance( P < 0.05). Conclusion Indomethacin suppository shows better function of defervesceing than paracetamol.

Objective To detect the Bag-1 and VEGF expressions in HCC tissues,cancerous liver tissues and normal liver tissues,and to explore their relationship with prognosis.Methods Immunohistochemical staining (SP method) was used to detect Bag-1 and VEGF in 60 cases of hepatocellular carcinoma specimens,next to the 30 cases of hepatocellular carcinoma in liver tissue,and 14 cases of normal liver tissue specimens,and their clinicopathological features were analyzed.Results Bag-l,VEGF expression rates were highest in HCC tissues [80.0 ％ (48/60),73.3 ％ (44/60)] and with adjacent tissues [46.7 ％ (14/30),43.3 ％ (13/30)],normal liver tissue [28.6 ％ (4/14),21.4 ％ (3/14)] expression rates had differences (P ＜ 0.05).Bag-1,VEGF expression had relationship with liver cancer staging,lymph node metastasis,tumor thrombosis formation,the correlation between the presence or absence of capsule formation (P ＜ 0.05),while had no relationship with the patient gender,age,tumor grade,tumor size,and alpha-fetoprotein (AFP) and other factors correlation (P ＞ 0.05).Bag-1 and VEGF expression in HCC specimens positive 40 cases,while negative eight cases,both in HCC tissues expression was positively correlated (P ＜ 0.05).Bag-1,VEGF positive expression in patients 1-year,2-year survival rates were less than negative patients,the survival time of patients with positive group was significantly lower than the negative patients (P ＜ 0.05).Conclusion Bag-1 and VEGF expressions are closely related with biological characteristics of liver cancer,and which is closely related to the prognosis of patients with hepatocellular.

AIM The effects of GW501516, a peroxisome proliferator-activated receptor β (PPARβ) agonist, in long term diet induced obesity (DIO, high fat and maltose diet for 4 months) mice were evaluated, and the efficacy of GW501516 against insulin resistance and the involved mechanism was investigated. METHODSMice were divided into 3 groups: normal control, DIO model and DIO model+GW501516. GW501516 (10 mg·kg-1·d-1) was administered by ig once a day for 14 d. During the treatment, body weight and food intake were monitored every other day. The oral glucose tolerance test, and the serum biochemical parameters including the serum triglyceride, total cholesterol and high density lipoprotein cholesterol (HDL-C) levels were measured according to the specifications. To confirm the GW501516-mediated PPARβ activation, the mRNA levels of downstream genes related to glucose, lipid metabolism and energy expenditure was measured. RESULTS GW501516 treatment effectively improved the glucose intolerance, increased the area under the glucose curves[DIO model, (32.4±4.6) mmol·h·L-1 compared with DIO model+GW501516, (23.4±2.5) mmol·h·L-1, n=7-8, P<0.05], normalized the fasted blood glucose, and increased serum HDL-C level, besides, histological analysis revealed the decreased hepatic lipid accumulation and hypertrophy of hepatocyte in DIO mice. Moreover, RT-PCR results indicated that carnitine palmitoyltransferase 1b, uncoupling protein 2, uncoupling protein 3 and glucose transport protein 4 were all upregulated. CONCLUSIONGW501516 significantly ameliorates glucose intolerance, decreases fasted blood glucose and hepatic steatosis, which might be related to ① the enhancement of fatty acid oxidation and energy uncoupling in muscle, and ②the improvement of insulin-stimulated glucose transportation in skeletal muscle in the long term DIO mice.

Objective To study genotypes,antibiotic resistance and epidemiology of extendedspectrum β-lactamases (ESBL)-producing Shigella isolated in Tianjin,and to discuss the relationship between ESBL-producing Shigella and drug-resistance plasmid.Methods A total of 136 Shigella spp.were isolated from stool specimens of patients with diarrhea who presented mainly with bloody purulent stool from Tianjin Children's Hospital,Tianjin Medical University No.2 Hospital and Tianjin No.1 Central Hospital between May 2009 and September 2010.Suspicious ESBL-producing isolates were screened by K-B disc diffusion method. The conjugation experiment was performed in the confirmed ESBL-producing strains and antibiotic resistance was compared between clinical strains and transconjugants to confirm the plasmid-mediated resistance. The genotypes of these isolates were detected by polymerase chain reaction (PCR) using universal primers for TEM,SHV,CTX-M-1 group,CTX-M-2 group,CTX-M-9 group,respectively.Intergenic consensus PCR (ERIC-PCR) was employed to understand the molecular homology of the ESBL-producing isolates. The data were analyzed by x2 test.ResultsESBL were identified in 14.7％ (20/136) of Shigella isolates,but no AmpC enzyme were detected.Among all the Shigella isolates,16 strains were genotype CTX-M-14,4 were genotype CTX-M-15.The strains with CTX-M ESBL were resistant to multiple antibiotics,while 100％ sensitive to imipenem.The transconjugant test of 18 ESBL-producing isolates were positive,and these conjugations were only resistant to β-lactamases. Conclusions CTX-M type is the common genotype of ESBL-producing Shigella isolates in Tianjin. ESBL-producing is the main cause of multiple resistance to β-lactams.The transmission of CTX-M producing strains is mainly mediated by plasmids.

Objective The expression of agr and sigB regulation system in Staphylococcus aureus with different infection types were assessed by analyzing the characteristics of m /z value generated by MALDI-TOF-MS.Methods A total of 50 isolates with specific genotypes were collected from Tianjin First Center Hospital during Jun 2013 to Feb 2014 for retrospective study .The pattern profiles of these isolates were obtained by MALDI-TOF-MS with RUO model, and the m/z value was also analysed to evaluate the expression the agr and sigB regulation system .The phylogenetic tree based on mass spectrum peak feature was constructed using SARAMIS software .Results A total of 50 strains of Staphylococcus aureus were divided into two groups: acute infection and chronic persistent and recurrent infection .The expression of delta toxin in acute infection and in chronic infection was 99.2 ±4.1 and 60.5 ±10.1 ( t =16.83, P<0.05), respectively.The regulation of stress proteins of sigB system was enhanced in chronic persistent and recurrent infections , and the expression intensities of SAS 030, SAS049 and SA0772 were 27.1 ±14.7, 54.8 ±21.5 and 51.6 ±19.2, respectively; while in acute infections , those were 4.9 ±1.9, 12.4 ±2.8 and 15.7 ±6.9, respectively.The t values between the two groups were -6.88 (P<0.05),-8.98 (P<0.05) and -1.87 (P<0.05), respecitively.The expression of phenol-soluble modulins (PSMs) was inconsistent , and the relative strength of PSMα3 was 100%in the colony variants small strains .Conclusions Different types of the Staphylococcus aureus infections could be evaluated through the assessment of the agr and sigB regulation system .The m/z value obtained by MALDI-TOF mass spectrometry is a marker for the expression of agr and sigB regulation system .The application of this technology needs further development .

Objective To understand teicoplanin concentration in cerebrospinal fluid (CSF)during intravenous in-fusion in patients following neurosurgery operation,and evaluate whether drug concentration can be increased if blood-brain barrier was damaged, and effect of continuous pump of drug on drug concentration in CSF. Methods The post-neurosurgical surgery patients with surgical site/ventricular drainage were enrolled in the study, patients were divided into routine administration group(a dose of teicoplanin of 400 mg/12 h was administered for 30 min)and continuous administration group (a dose of 400 mg teicoplanin was administered for 30 min followed by a continuous infusion of 200 mg/6 h).CSF specimens were collected at respective time points of administration, teicoplanin concentration in specimens was measured.Results For routine administration group,drug concentration in CSF was (0.004 ± 0.0123 )mg/L immediately after teicoplanin was bumped,the peak concentration was (0.712 ± 1.028)mg/L after 1-hour bumping,then concentration decreased gradually,which were (0.254 ±0.222),(0.173 ± 0.152),and (0.355±0.207)mg/L at 12,18,and 24 hours of bumping respectively.For continuous administration group, drug concentration in CSF was(0.017±0.020))mg/L immediately after teicoplanin was bumped,the peak concentration reached (0.587±0.255)mg/L after 4-hour bumping,then concentration were (0.429±0.416),(0.325±0.254),(0.476 ±0.686),and (0.318 ±0.464)mg/L at 6,12,18,and 24 hours of bumping respectively,teicoplanin concentration was relatively stable 6 hours later,which were (0.318±0.464)mg/L-(0.476±0.686)mg/L.The area under the curve during 24 hours (AUC0-24 )in routine administration group and continuous administration group were 5.590 mg/L·h and 9.082 mg/L·h respectively.For two groups of patients,teicoplanin concentration only at the area near peak value a-chieved 50% minimum inhibitory concentration(MIC50 )for coagulase negative staphylococcus (CNS),but the time for a-chieving concentration higher than CNS MIC50 was far less than 50% of total administration time;teicoplanin concentration in CSF of both groups of patients didn’t achieve MIC50 for Staphylococcus aureus .Conclusion After continuous infusion of teicoplanin,drug concentration in CSF can be increased compared with routine administration group,but still can’t achieve the effective MIC;the increase of blood drug concentration is benefit to drug concentration in CSF,it is necessary to in-crease the dose appropriately to achieve clinical effectiveness.

Objective To understand the changing characteristics of drug concentration in the serum and cerebrospinal fluid(CSF) after intravenous (IV) drip of norvancomycin in patients after neurosurgery procedure.Methods Patients with surgical cavity/ventricular drainages after neurosurgery procedure in a hospital in 2014 were selected, and they were divided into 2 groups according to the administration modes (12 in each group), conventional administration group: 0.8 g norvancomycin IV drip for 60 minutes, repeated every 12 hours;continuous administration group, 0.8 g norvancomycin, IV drip for 60 minutes, followed by 0.4 g of IV drip for 11 hours, then 0.4 g for 12 hours, serum and CSF specimens were collected at different time points after administration, concentration of norvancomycin was determined.Results Serum norvancomycin concentration reached a peak of (55.52±26.04) and (59.22±41.88) mg/L in conventional administration group and continuous administration group respectively, 24-hour serum concentration were (8.21±6.04) and (9.11±5.09)mg/L respectively;CSF norvancomycin concentration reached a peak of (16.31±11.15) and (8.82±8.91)mg/L in conventional administration group and continuous administration group respectively, 24-hour CSF concentration were (6.12±2.34)and (5.71±4.72)mg/L respectively;CSF penetration rate of conventional administration group was calculated by ratio of area under curve (AUCCSF/AUCserum), at 0-12 and 12-24 h hour were 63.3% and 59.0% respectively;in continuous administration group were 25.4% and 47.4% respectively.According to 95% of the minimum inhibitory concentration (MIC90) 2 mg/L of target bacteria methicillin-resistant Staphylococcus aureus (MRSA), AUC0-24/MIC90 in conventional administration group and continuous administration group were 192 and 184 respectively.Conclusion For patients who receives early use of standard dose of norvancomycin after neurosurgery procedure, CSF drug concentration after convention and continuous administration of norvancomycin can both reach MIC90 against target bacteria.

Objective To study whether post-operative radiotherapy is necessary for patients with early breast cancer after radical mastectomy. Methods In 1998, 270 early breast cancer patients with 0 -3 pathologically confirmed positive axillary lymph nodes after radical mastectomy were retrospectively ana-lyzed. There were 156 patients with negative lymph node and 114 with 1 -3 positive lymph nodes. The prog-nostic index (PI) was defined as the sum of scores of the tumor size, number of positive axillary lymph nodes, receptor status, surgical margin status, lymphatic thrombi status, pathological grading and age. The PI≥ 4 was considered as high-risk, and PI <4 as the low-risk. Numerical variables were compared using t test and categorical variables were compared using chi-square test. Kaplan-Meier method was used to calcu-late the survival rates, and the Log-rank test was used for the comparison of the survival curves between dif-ferent groups. Results Of the patients with lymph node negative and 1 - 3 positive, the survival rates were 75.0% and 63.2% (χ~2 = 4.40 ,P =0.036), respectively. The corresponding disease-free survival rate, lo-cal recurrence rate, distant metastasis rate were 71.2% and 9.6% (χ~2 = 3.90, P = 0.048), 7.7% and 16.7%(χ~2 =5.22,P=0.022),12.8% and 21.1%(χ~2=3.27,P=0.070), respectively. The mean dis-ease-free survival time of the two groups was 97.03 ± 2.53 months and 87.01 ± 3.80 months, respectively. In the high-risk group, the 10-year survival rates of patients with and without radiotherapy were 72% and 56% (χ~2 = 4.07, P = 0.044), the local recurrence rates were 5% and 24% (χ~2= 11.16, P = 0. 001), and the distant metastasis rates were 16% and 26% (χ~2= 2.18 ,P = 0. 140). In the low-risk group, the survival rate of patients with and without radiotherapy were 81% and 71% (χ~2 = 1.57 ,P = 0.210), the local recur-rence rates were both 11% (χ~2=0.01 ,P=0.975), and the distant metastasis rates were both 13% (χ~2 = 0.00,P = 1. 000). Conclusions Early breast cancer patients with 1 -3 positive axiilary lymph nodes should receive post-operative radiotherapy after radical mastectomy. The prognostic index may decrease the chance of unnecessary radiation by distinguishing the patients under low risk of recurrence from those under high risk.

Objective To explore the application value of pulse induced contour cardiac output (PiCCO) monitoring in diagnosis and treatment of patients with neurogenic pulmonary edema (NPE).Methods With review of literature, the data of 4 patients of severe neurological disease complicated by NPE admitted into Department of Critical Care Medicine of Huangshan People's Hospital Affiliated to Wannan Medical College from 2011 to 2013 were retrospectively analyzed and discussed in their PiCCO hemodynamic characteristics and processes of treatment.Results The PiCCO of 4 patients with NPE showed that the extravascular lung water index (EVLWI) was increased significantly (EVLWI was 12 - 42 mL/kg on admission and 10 - 22 mL/kg after hospitalization for 24 hours), all revealing a high permeability pulmonary edema type. The capacity balance of the first 24 hours in the 4 cases was all of positive balance (+1 130, +1 200, +1 750, +1 120 mL respectively). In the treatment, the supplementary colloid was strengthened, the vasoactive drugs such as, dopamine, dobutamine, milrinone, etc were applied to improve the circulatory oxygenation, then the EVLWI was declined; finally the disease situation in 3 cases was improved and one died.Conclusions The clinical diagnosis and treatment of NPE is complex, and many contradictions appear in the therapeutic course. PiCCO monitoring is valuable in early diagnosis, identification of pulmonary edema type, guidance in fluid supplement and vascular active drug application, and assessment of disease severity and prognosis.