Objective To investigate the prevalence and molecular characteristic of heterogeneous‐ vancomycin intermediate Staphylococcus aureus(hVISA) among methicillin‐resistant Staphylococcus aureus (MRSA)strains isolated from sterile body fluid specimens from 2009 to 2013 in Huangzhou District People′s Hospital in Huanggang City .Methods The minimum inhibitory con‐centrations (MIC) of antibiotics was determined by agar dilution method .The hVISA strains were detected by population analysis profile/area under the curve method (PAP/AUC) .The staphylococcal cassette chromosome mec (SCCmec) ,multilocus‐sequence typing (MLST) ,accessory gene regulator (agr) and Staphylococcus aureus protein A(spa) typing of hVISA strains were detected using PCR method .Results 32 hVISA strains were detected among 285 MRSA strains ,the prevalence rate of hVISA was 11 .2% , and the detection rates of hVISA from 2009 to 2013 were 0 .0% ,6 .4% ,9 .0% ,14 .3% and 18 .8% ,respectively ,showed an increas‐ing trend .The main hVISA epidemic clone was ST239‐SCCmecIII‐ t030‐agrI type(28strains ,accounting for 87 .5% ) .Conclusion The detection rate of hVISA showed an increasing trend in the past 5 years ,should be paid attention to strictly control the utiliza‐tion of glycopeptide drugs .

Objective The paper applies Combination Evaluation Methods to the comprehensive evaluation of 31 cities' New RCMs condition in Fujian Province in 2007.Methods Four single Comprehensive Evaluation methods were employed to evaluate the results which were then combined by Combination Evaluation Methods.Results The results of Combination Evaluation Methods were more stable and accurate than those of single Comprehensive Evaluation methods.Conclusions The results of Combination Evaluation Methods are more stable and reliable.

Objective To investigate the distribution and the number of splenic lymphocytes in the patients with severe acute respiratory syndrome(SRAS).Methods Immunohistochemical method with four specific antibodies(CD3,CD4,CD8,CD20) was used to detect the distribution of lymphocyte special antigens in the spleens of six cases who died of SARS and six normal cases as the controls.The numbers of lymphocytes were analyzed with image analysis system.Results In the spleen of SARS patients,splenic corpuscle and periarterial lymphatic sheath (white pulp) were damaged severely. In the number of periarterial lymphatic sheath decreased 93.39% and in the number of splenic capsule decreased about 80% even disappeared at all. Red pulp hemorrhage necrosis was widely spread. In red pulp the number of CD3~(+)T cells decreased 71.76%,even disappeared at all,in the number of CD4~(+) and CD8~(+)T cells markedly decreased 86% and 84% respectively.The number of CD20~+ B cell decreased more than 80%. Conclusion T cells and B cells in spleens of SARS patients decreased widely spread and markedly in number,indicating that the immune system had been damaged severely,and the destroyment of the immunosystem may be the primary lesion of SARS.

Objective To analyse the number of dendritic cells and macrophages and the size of macrophages in the spleen of SARS patients so as to provide evident for the study of pathology and pathogenesis of SARS. Methods Immunohistochemical method with four specific antibodies(S-100,CD68,HLA-DR,CD83) were used to detect the dendritic cells and macrophages in the spleens of six dead patients of SARS and six accidental deaths as the controls,The number or the size of these positive cells was analysed with image analysis system. Results In the spleens of SARS patients,the number of S-100~+ dendritic cells in the white pulp was reduced by 80.4% on average,and even disappeard.The number of CD68~+ macrophages in the red pulp was reduced by 39.48% in SARS spleens,and the average size of individual macrophages was increased by 2.21 times.HLA-DR~+ antigen presenting cells(APC) reduced remarkably in the SARS spleen white pulp.CD83~+ mature dendritic cells did not exist in either SARS spleens or the control spleens.Conclusion The function of antigen presentation had been damaged severely,which supports that SARS should be categorized as a viral immune deficiency disease.SARS virus doesn't induce the maturation of DC.The increase in the size of macrophages indicated that they were in an activated state and may play a role in the pathogenesis of SARS.

Objective To investigate the molecular characteristics and virulence genes of 488 Staphylococcus aureus ( S.aureus) strains isolated from the People′s Hospital of Huangzhou District in Hubei Province during 2009 to 2013.Methods The minimum inhibitory concentrations (MICs) of Oxacillin and Cefoxitin to S.aureus were determined by agar dilution method .PCR analysis was used for the detection of staphylococcal cassette chromosome mec ( SCCmec ) and multilocus-sequence typing ( MLST ) .Multiplex PCR analysis was performed to detect the 31 common virulence genes .Results A total of 227 methicillin-resistant S.aureus ( MRSA) strains were identified from 488 S.aureus strains with a prevalence rate of 46.5%.The SCCmec Ⅲtype was the prevalent genotype accounting for 81.5% of the 227 MRSA strains, followed by Ⅳtype which accounted for 10.1%.The predominant clonal complex ( CC) of MRSA strains was CC8 accounting for 81.1%, followed by CC59 (4.8%) and CC5 (3.1%).CC1 was the predominant clonal complex of methicillin-sensitive S.aureus (MSSA) strains, accounting for 34.1% of the 261 MSSA strains, followed by CC398 (21.8%), CC121 (14.9%) and CC59 (13.0%).The number of MSSA iso-lates carrying no less than 15 test virulence genes was 109 ( 48 .2%) , which was significantly higher than that of MRSA isolates (28.2%) (P=0.002).A close relationship between the enterotoxins genes (sed, sej and ser) and the CCs of CC8 and CC5 was identified.Exfoliatin genes (eta and etb) and lukED gene were detected only in strains that belonged to CC 1.Strains that belonged to CC 1 and CC59 clones showed higher rates of pvl gene as compared with those belonging to other CCs (P<0.05).Conclusion The prevalence rate of MRSA strains was 46.5%in Huangzhou District, Hubei Province, which was consistent with the na-tional average rate .The predominant genotype of MRSA strains was ST 239-MRSA-SCCmecIII , accounting for 79.3%.Effective measures should be taken by Health sectors to control the spread of MRSA strains .The MSSA isolates carried more virulence genes than MRSA strains .The spectrums of virulence genes were var-ied in strains belong to different CCs clones , indicating the close relationship between virulence genes and genetic backgrounds .

Objective To observe the change characteristics of serum prealbumin and cholinesterase in the liver cirrhosis pa-tients ,and to discusses the determination of these two indicators in diagnosis ,treatment and prognosis of clinical significance in pa-tients with liver cirrhosis .Methods A total of 45 liver cirrhosis patients diagnosis in our hospital from July to December 2013 were recruited into study group ,at the same time 98 healthy people were recruited into control group .The Hitachi 7170 automatic bio-chemical analyzer was used to detected serum prealbumin and cholinesterase ,the former was detected by immunoturbidimetry meth-od ,the latter was detected by butyryl glucosinolates choline bottom method .The levels and abnormal rates of the two indicators be-fore and after treatment in the study group were compared with those of the control group .Results The serum prealbumin and cho-linesterase at different stage in the study group were significant lower than those of the control group(P<0 .05) .The abnormal rate of serum prealbumin after treatment was significant different with those among and before treatment in patients with cirrhosis (χ2 =10 .08 ,P<0 .05) ,but there were no significant difference on cholinesterase(P>0 .05) .Conclusion The serum prealbumin is a sensitive indicator of liver cell damage ,its change could reflect the condition of treatment and development status ,which has im-portant clinical significance on judging the prognosis of patients with liver cirrhosis .

The dynamic changes of the T cell subsets in the peripheral blood and the serum level of immunoglobin and complement C3 were observed in 32 breast cancer patients before and after surgery and after radiotherapy.20 patients with benign breast diseases and 20 normal women were observed likewise.It was found that the Ts cells and serum IgG and IgA were significantly increased and the TH/Ts ratio markedly decreased in the breast cancer group as compared with those of other 2 groups.In the first postoperative week,TH cells and TH/TS ratio were markedly decreased in all cases operated on.One month after operation,all the parameters returned nearly to the normal level in the group with benign breast diseases.In the group without radiotherapy,the proportion of OKT3+ cells in the 3rd postoperative month and OKT4+ cells in the 6th postoperative month exceeded the preoperative level while that of OKT8+ cells decreased.In the first week after radiotherapy,TH cells decreased,Ts cells increased and TH/Ts ratio decreased significantly.Meanwhile serum IgG was elevated.OKT3+ cells markedly increased in the 6th month after radiotherapy and OKT8+ cells decreased 1 year after that.The immunore-active state of breast cancer patients and the effects of therapeutic measures on them were discussed.

Objective To observe the morphologic changes of immature dendritic cells(imDCs) before and after the electransfection of human hepatic cancer cell RNA. Methods Monocytes were purified from human peripheral blood,and induced into imDCs.Then human hepatic cancer cell RNA was electransfected into monocyte-derived imDCs.ImDCs were identified by the immunocytochemical method with 7 specific antibodies before and after electransfection.These dendritic cells were observed by scanning electron microscopy. Results After electransfection of human hepatic cancer cell RNA there were few changes of molecule expressions in imDCs.ImDCs were in round,oval and irregular shapes before electransfection.Their sizes were not identical but all bigger than monocytes.There were many protrusions in different shapes which looked like dendrite,or/and bubble,veil cloud on the surface of these imDCs.Although there were some cell fusions and cell deaths after electransfection,most imDCs recovered from the damage.Electransfecting human hepatic cancer cell RNA into imDCs would make pores on cell membrane.Conclusions The pores on cell membrane make it possible that the exogenous material enters imDCs.This study can prove the possibility of electransfecting human hepatic cancer cell RNA into imDCs to make cancer vaccine,which provides a new way for tumor biologic therapy.

Objective To evaluate the diagnosis value of digestive tract clinical symptoms in multiple myeloma.Methods 21 patients with multiple myeloma with digestive tract symptoms as initial clinical manifestations were analyzed.Results In 21 patients,52% below 50 years(hepatomegaly and splenomegaly was 73%),abdominalgia and diarrhea,hematocytopenia,proteinuria were 57%,90% and 67%,respectively.Conclusion Digestive tract symptoms,especially hepatomegaly and splenomegaly,occur mostly in younger patients.Hematocytopenia and proteinuria are important clue in diagnosis of multiple myeloma.Digestive tract symptoms are the common clinical manifestations,but not chief clinical features in multiple myeloma.

Objective To explore the character of the myelodysplastic syndrome(MDS) with autoimmune disorders (AID).Methods The clinical data of 60 MDS patients were reviewed.Results 5 of 60 MDS patients had AID ,of which 3 had Graves' disease.The commonest MDS was refractory anemia with ringed sideroblasts (RAS).Conclusion MDS might occur with Graves' disease.Humoral immunological abnormality might play an important role in MDS patients with autoimmune disorders and FAB types might not be associated with this.