Objective To explore the feasibility of detecting the mutations of rpoB gene in rifampin-resistant Mycobacterium tuberculosis strains by gene chip. Methods The DNA chip was designed according to the sequence of Mycobacterium tuberculosis rpoB gene. The DNA fragments which contained hot mutation sites of rpoB gene were labelled with cy3 fluorescence, amplified by PCR technique and hybridized with gene chip. The DNA sequencing was used as the control. Results Eighteen of the Mycobacterium tuberculosis strains were detected for the mutations of rpoB gene by gene chip. Among them, one sensitive strain was identical with the type strain, and all of 17 strains with rifampin-resistant, rpoB mutations were detected. Of the 17 strains with rpoB mutations, 14 were detected as single point mutation, one was detected as double sites point mutations with the sites of 511 and 516, and two were detected as single point mutation with the sites of 518 and 526, respectively. Because the probe of 517 rifampin-resistant did not be dotted on the gene chip, only sites of 518 and 526 mutations were detected, which were consistent with the results of DNA sequencing. Conclusion Using the gene chip could detect mass rpoB gene mutation of rifampin-resistant with higher specialty and sensitivity, which could be used for clinical detection of rifampin-resistant strains and clinical medicine.

To study the therapeutic action of tuberculosis Ag85A DNA vaccines. Methods:BALB/c mice were infected by in-traperitoneal injection with M. tuberculosis H37Rv for 8 weeks, and then treated with the saline (A), plasmid vector (B), M. bovis BCG (C), M. vaccae (D), and Ag85A DNA vaccine (E). Ag85A-specific antibodies were determined by ELISA. The lungs, livers and spleens were taken and observed their pathological changes, weighted and performed mycobacterial cultures 2 or 5 monthes after treatment. Spleen cells were tested for proliferative responses.Results:Ag85A-specific antibodies increased in the mice of group E. At 2 months after immunothera-pies, the stimulation rates of spleen cells had no significant difference among each group. The numbers of viable bacteria in the lungs and spleens of therapeutic group were lower than those in the control group. The group C and B could be observed slight .lesion of lung. At 5 months after immunotherapies, the stimulation rates of spleen cells all increased significantly in the immunotherapeutic groups. The numbers of viable bacteria in the lung and spleen had no significant difference among each group. No lesions of lung could be observed in group E and D. Conclusion:The tuberculosis DNA vaccines seem to have some immunotherapeutic actions.

Objective To determine the normal position of the fetal conus medullaris and assess its clinical significance.Methods A total of 550 singleton pregnant women who were examined by fetal ultrasonography in the Department of Ultrasound at the Second Hospital of Fujian Medical University from June 1, 2013 to September 31, 2014 were included.Inclusion criteria were pregnancies with regular menstruation cycle and known last menstrual period, gestational age (GA) confirmed by ultrasonographic examinations, and neonate abnormality excluded by pediatrician after born.Routine obstetric ultrasound examinations were performed to measure the biparietal diameter (BPD), femur length (FL), head circumference (HC) and abdominal circumference (AC).The conus distance (CD) was determined by measuring the distance between the distal end of the conus medullaris and the caudal end of the last vertebra.The average value was calculated for each group according to GA.Fifty normal fetuses were randomly selected for quality control.For inter-observer reliability assessment, the same data were collected and analyzed by two different operators.For intra-observer reliability assessment, the data were collected and analyzed twice by the same operator with an interval of half an hour.Linear regression correlation analysis was performed to analyze the relationship between CD and GA, BPD, FL, HC and AC.Intraclass correlation coefficient (ICC) and Bland-Altman analysis were used to analyze the repeatability of the analysis.Results In 518 (94.2％) of 550 fetuses, the CD was successfully measured.Positively correlations between the conus distance and the gestational age was observed.The CD was (10.0± 3.3) mm at ＞ 14-≤ 15 weeks (n=17), (27.7±3.8) mm at ＞ 20-≤ 21 weeks of gestation (n=18), (41.5±2.4) mm at ＞ 26-≤ 27 weeks (n=8), (54.7±3.0) mm at ＞ 32-≤ 33 weeks (n=17), and (71.9±2.7) mm at ＞ 41-≤ 42 weeks (n=6).Linear regression correlations between CD (mm) and FL, AC, HC, BPD and GA were:CD=1.04× FL (mm)-8.71, CD=0.23 × AC (mm)-10.11, CD=0.28× HC (mm)-18.10, CD=0.90× BPD (mm)-17.65, CD=2.34× GA (weeks)-20.94 (r=0.990, 0.985, 0.978, 0.974 and 0.973, respectively, all P ＜ 0.01).The measurement of the conus distance exhibited good reproducibility between different operators (ICC=0.984, 95％CI: 0.972-0.991) and for the same operator (ICC=0.992, 95％CI: 0.985-0.995) with the 95％ limits of agreement of-1.8 to 3.5 mm and-4.3 to 2.1 mm.Bland-Altman analysis showed that most of the measured values were within 95％ confidence interval suggesting good consistency.Conclusions The distance, between the end of the conus medullaris and the end of the last vertebral body under ultrasound scan, is positively correlated with FL and other ultrasonographic indicators, which implies that it could be used as a new index for position of fetal conus medullaris.

Reform in personnel matters and the distribution system began to be implemented from October 2001 in line with the guiding principle of putting quality at the core of medical practice, taking doctors as the axis, putting emphasis on profits, and using distribution by merit as a lever. A series of reform measures was adopted: the employment of the entire staff on the basis of a contract system and transformation of identity management into post management; division of medical service units based on medical groups, with the attending doctors being in charge; and intra hospital distribution by the principle of more pay for more and better work. As a result, a management operating mechanism that specifies clear cut job responsibilities and combines responsibilities, powers and interests has been set up, bringing about good results.

Objective To study the relationship between the genetic polymorphisms of carboxylesterase 1 gene (CESI) and the susceptibility to antituberculosis drug-induced hepatotoxicity (ATBDIH).Methods Genetic polymorphisms of CES1 in 473 tuberculosis patients with or without hepatotoxicity (200∶ 273) after antituberculosis chemotherapy were analyzed by PCR-MassArray.Results In4 tags of CES1 single nucleotide polymorphism (SNP),the frequency of the rs1968753 allele had statistical difference between the hepatotoxicity group and the no-hepatotoxicity group ( P =0.0236 ).The characteristics of anti-hepatotoxicity had been shown relationship with rs8192950 ( P =0.044,OR =0.649,95％ CI =0.426-0.989,AC/AA ) and rs1968753 ( P =0.048,OR =0.556,95％ CI =0.311-0.995,GG/AA).The diplotypes with ‘ CGC' haplotype exhibited significant protection against hepatotoxicity at one copy (P=0.048,OR=0.654,95％CI=0.430-0.996).Conclusions The genetic polymorphisms of CESI might have significant association with ATBDIH.SNP rs8192950 AC genotype and rs1968753 GG genotype might be the candidates for risk prediction of ATBDIH.

To observe the cerebral activating effects of needling at Waiguan (SJ5) versus SJ5 plus Yanglingquan (GB34) points in young healthy volunteers based on the hypothesis of "needling effect of combined acupuncture points relates to the brain activation".

Objective To study the correlation between genetic polymorphisms of interleukin (IL)-1A/1B and susceptibility to tuberculosis (TB).Methods Genetic polymorphisms of IL-1A and IL1 B in 1032 TB patients and 1008 non-TB patients were analyzed using PCR-MassARRAY method.The correlation between genetic polymorphisms of IL-1A/1B and susceptibility to TB was statistically analyzed.Results Two tag SNPs of IL-1A and three tag SNPs of IL-1B were screened for the study.There were differences in the allele frequencies of rs2853550 and rs3783526 between TB group and non-TB group (P=0.047and P =0.034,respectively).IL-1 B SNP1 rs2853550 (P =0.025,OR =1.302,95 ％ CI =1.034-1.640,TC vs.CC) was found to be highly associated with TB,while the other SNPs showed no significant correlations with TB.Furthermore,IL-1B SNP1 rs2853550 [P=0.019,OR=1.308,95％ CI=1.045-1.638 for (TC+TT) vs.CC] in the dominant model conferred significant risk for TB,but IL-1A SNP2 rs3783526 [P=0.000,OR=0.764,95％ CI =0.591-0.988 for GG vs.(AA+GA)] in the recessive model showed protective effects against TB.The haplotype ‘TG’ in the IL-1B block showed a higher risk for TB compared with the common ‘ CA’ haplotype (P=0.032,OR=1.265,95％ CI=1.020-1.567).The diplotypes containing ‘ GA’ haplotype in IL-1A block and ‘ TG’ haplotype in IL-1B block were major risk factors for TB (for onecopy,adjusted P=0.014,OR=1.403 and 95％ CI=1.072-1.836; adjusted P=0.013,OR=1.339 and 95％ CI=1.063-1.688,respectively),but the diplotype with ‘CG’ in IL-1B block played a protective effect against TB (for two-copy,P=0.006,OR=0.664 and95％ CI=0.494-0.891).Conclusion The genetic polymorphisms of IL-1B rs2853550 might be closely associated with TB,but the GG genotype of IL1 A SNP rs3783526 might have the characteristic of anti-TB.

Objective To determine the influencing factors on informed consent associated with decline or delay of primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods This study was conducted in Peking University People′s Hospital from 1 August, 2014 to 31 March, 2016, with 229 consecutive cases of acute STEMI enrolled in the study.Data were collected by reviewing medical records and STEMI treatment time records.180 patients with ischemic symptoms ≤12 hours were included in the final analysis.Patients were divided into the consent group and the refusal group according to the final decision.For patients who received primary PCI, they were further categorized into two groups based on the 30min cut-off time.Results Among the 180 STEMI patients reviewed, 139 patients agreed to primary PCI and the remaining 41 patients refused primary PCI.Multivariate logistic analysis showed that symptom relief (OR 5.532, 95% CI 1.165-26.278, P=0.031) and history of chronic kidney disease (OR 4.786, 95% CI 1.346-17.011, P=0.016) were predictors of dissent of primary PCI.Self-rated symptoms severity (OR 0.094, 95% CI 0.034-0.260, P<0.001)was predictor of consent to primary PCI.106 patients had complete time point records of informed consent in the consent group (n=139).Among these patients, the median informed consent delay was 24 min.64 patients made a decision within 30 minutes, and the other 42 patients had their decision made beyond 30 minutes.Symptom-to-door time ≥4 hours (OR 4.563,95% CI 1.682-12.385, P=0.003) was independent predictor of informed consent delay.Conclusions Patients with resolved symptoms, self-rated mild symptoms or renal insufficiency were more inclined to refuse primary PCI.For patients who eventually received primary PCI, symptom-to-door time ≥4 hours was the independent predictor of informed consent delay.

Objective To study the therapeutic effects of Bizhi pills in mycobacterium tuberculosis infection.Methods KunMing mice were infected by intratail-vein injection with mycobacterium tuberculosis H37Rv, then treated with saline(A)or Rifampin(B) or Bizhi pills(C).The lungs,hvers and spleens were taken to observe their pathological changes,weighted and performed mycobacterial culture after 4 months of treatment.Results After 4 months of treatment, indexes of the lung in group C were markedly lower than that in group A (P＜0.05),but higher than that in group B,although the differences were not significant.The lesion of lung in group C were similar as that in group B,and were lessen than that in group A.No obvious lesion of lung was observed in 8 mice of group B and C,but the differences were not significant.Swell of spleen was observed in 9 mice in group A,2 mice in group B and5 mice in group C,the differences were significant(P＜0.01).The numbers of bacteria in the lung and spleen of the female mice of C group were remarkably less than that in group A, and decreased 4 times and 10 times respectively compared with group A(P＜0.01),the numbers of bacteria in the lung and spleen of the male mice of C group were less than that in group A, and decreased 3 times and 2 times respectively.However,the numbers of bacteria in the lung and spleen of the male mice of B group was decreased 14 times and 7 times respectively(P＜0.01).Conclusions The therapeutic efficacy of Bizhi pills in mice with mycobacterium tuberculosis infection is significant, but it is not as good as Rifampin.The therapeutic efficacy of Bizhi pills in female mice of mycobacterium tuberculosis infection is better than that in male mice.

Objective To investigate the application of integrated medical care model in transurethral 2μm laser enucleation of the prostate patients .Methods Integrated medical care model was applied from June 2013 in transurethral 2 μm laser enucleation of the prostate patients .Health care work ability , incidence of complications , satisfaction of the health care work were compared before and after the implementation of integrated medical care model .Results Before the implementation of integrated care clinic capacity , the scores of health communication skills, teamwork skills, ability to work nursing, nurse-patient relationship were (16.5 ± 2.2),(13.2 ±3.6),(10.5 ±2.1),(16.5 ±3.6),(15.4 ±2.8), respectively; after implementation of integration the scores were (17.0 ±2.1),(17.8 ±4.2),(16.9 ±3.7), (17.0 ±3.4), (18.4 ±3.3), and medical care communication skills , teamwork, nurse-patient relationship scores were higher than that before the application of health care integration , the differences were statistically significant (t=6.592 9,3.718 9,6.727 5, 3.100 0, respectively;P<0.05).The total incidence of complications of observation group was lower than the control group, the difference was statistically significant (8.1% vs 24.2%,χ2 =5.961 5,P<0.05).Health care job satisfaction score of observation group was (87.1 ±6.8), significantly higher than the control group (t=10.48,P<0.05).Conclusions Application of integrated medical care model in transurethral 2μm laser enucleation of the prostate patients can help improve coordination and work capacity , reduce patient morbidity and improve patient satisfaction with health care work , which is worthy of clinical application .