A confirmed case of blood flow infection caused by Vibrio vulnificus at Fenyang Hospital in Shanxi Province is reported to provide a reference for the diagnosis and treatment of Vibrio vulnificus infection. The patient is a male sanitation worker who accidentally scratched his right forearm while working and was admitted to the hospital due to swelling and pain in his right forearm accompanied by fever. The patient had recently resided in the local area, and had no history of working outside, or recent exposure to seawater or raw seafood. On the morning of the second day of admission, all four blood culture bottles tested positive. The positive blood culture bottle broth was directly smeared and transferred to a blood plate or a hemophilic chocolate plate. Under the microscope, it was Gram-negative bacilli, and the bacteria body was curved and rod-shaped. In the afternoon (about 7 hours of cultivation), the bacteria membrane was identified as Vibrio vulnificus by matrix-assisted laser desorption ionization-time of flight mass spectrometer (MALDI-TOF MS). Sepsis caused by Vibrio vulnificus has a high mortality rate, and it can also cause necrotizing fasciitis. With the cooperation of multiple disciplines, the patient improved and was discharged. Through this case, Vibrio vulnificus infection should be included in the differential diagnosis for patients with fever, redness, swelling, and pain in the limbs (with a history of trauma). The patient's prognosis can be improved with the timely finding of the pathogenic bacteria through blood culture and other techniques, early surgical intervention and establishment of an MDT (multidisciplinary joint) team.

Objective To investigate the safety and efficacy of transvaginal hydrolaparoscopic pelvic adhesiolysis (THLPA) treatment in the infertile women.Methods From May 2007 to Sep.2008,30 infertile patients underwent THLPA.The dye-test,hysteroscopy,and dye-test using catheterization of tubal ostium by hysteroscopy were performed at the same time.Pelvic adhesions were scored according to the revised American Fertility Society classification of endometriosis (1985).The adhesions were graded as mild (score 1-9),moderate (10-19),and severe (≥20).Twenty-four cases were in mild adhesions,5 moderate adhesions,and 1 severe adhesion.The duration of the operation and discharge,pelvic adhesions score,tubal patency,complications,and pregnancy rate were investigated.Results (1) THPLA:the majority of pelvic adhesions in all patients were successfully performed adhesiolysis.Only a little filmy adhesions of proximal peritube of 7 tubes and proper ligament of 5 ovaries and cohesive adhesions of 4 ovaries did not underwent surgical lysis.(2) Tubal patency:35 tubes were of proximal occlusion by dye-test,of which 21 (60%,21/35) were unobstructed and 4 (11%,4/35) were partly unobstructed after the dye-test using catheterization of the tubal ostium by hysteroscopy.(3) The duration of operation:the overall operative time were (32±6) minutes in mild adhesion,(52± 6) minutes in moderate adhesion,and 83 minutes in severe adhesion.Of which the time of THLPA were (11±5) minutes in mild adhesion,(35±7)minutes in moderate adhesion,and 62 minutes in severe adhesion,respectively.(4)The duration of discharge:the postoperative discharge time was 120-175 minutes.No complications occurred.(5)The rate of pregnancy:in the (15.8±4.3) months' follow-up,the rate of pregnancy was 45% (13/29),which one patient lost follow-up.Conclusions THLPA is safe,efficacious and not being hospitalized management.When compared with laparoscopy,it is simpler,more economic,and less minimally invasive approach.The appropriate indication of THLPA is to treat filmy,especially mild pelvic adhesions.It could partly avoid transabdominal operative laparoscopy for the infertile women.

Objective We investigated urinary incontinence (UI) among patients of the Gynecological Department of Renmin Hospital of Wuhan University,to observe characteristics of women with UI in our province,and to analyze preliminary factors affecting their treatment.Methods We evaluated 15 300 patients treated for UI from August 2009 to April 2011,using site information and questionnaires.We also compared them to 66 825 other gynecology outpatients at our hospital over the same period.Results We found that the incidence of UI tended to increase with age,and was associated with body mass index,parturition,and surgery history.But 54.63％ (8358/15 300) of them refused surgical treatment.Of these 8358 patients,29.78％ (2489/8358) because of economic factors,25.83％ (2159/8358) because of mental stress,and 24.30％ (2031/8358) because of lack of faith in the efficacy of surgical treatment,20.09％ (1679/8358) did so because of knowing little of the disease.Conclusions UI is inconvenient to patients,and seriously affects their physical and mental health. Many patients refuse surgical treatment.Medical staff should attempt to educate patients better with regard to treatment,and to offer them help to improve the quality of their lives.

BACKGROUND:LL37, the only antimicrobial peptide of the cathelicidin family identified from the human, not only promotes the proliferation of endothelial cel s, but also plays an important role in angiogenesis and re-epithelialization.
OBJECTIVE:To construct a recombinant adenovirus overexpressing human antimicrobial peptide LL37 gene, and to detect the expression and secretion of LL37 after transfected into the canine vaginal epithelial cells.
METHODS:The cDNA encoding LL37 was amplified by PCR. Recombinant adenovirus expression plasmid encoding LL37 and green fluorescent protein (EGFP) was constructed, and identified using restriction endonuclease technology and DNA sequencing method. Adenovirus particles were generated by cotransfecting the 293-packaging cel line. The adenovirus were col ected, amplified and concentrated, and viral titers were determined by end-point dilution assay by applying serial dilutions of the purified viruses to 293 cel s. Primary cultured canine vaginal epithelial cel s were transfected by the recombinant adenovirus. The transfection efficacy was observed by fluorescence microscope, and the cultured supernatant was col ected to determine the expression of LL37 by ELISA method at 1, 2, 3, 5 and 7 days after transfection.
RESULTS AND CONCLUSION:The adenovirus vector GV314-LL37 with the titer of 3×109 pfu/mL was successful y constructed and identified by DNA sequencing methods. Canine vaginal epithelial cel s were successful y isolated and cultured and grew stably. After transfection, vaginal epithelial cel s could express the EGFP and LL37 efficiently in a time-dependent manner detected by fluorescence microscope and ELISA method. The transfection efficacy of EGFP reached to 89%at 72 hours. The level of LL37 in the cel culture supernatant in the transfection group was significantly higher than that in the control group, the highest expression of LL37 was found at 3 days that lasting for 7 days. In conclusion, the recombinant adenovirus overexpressing human antimicrobial peptide LL37 gene is successful y constructed, which can express and secrete LL37 after transfected into canine vaginal epithelial cel s, providing a foundation for constructing the tissue-engineered vagina possessing anti-infection and neovascularization.

Objective To investigate thecurative effect of Hanchuan Zupa granule combined with ventolin atomizing inhalation in the treatment of infantile bronchial asthma and the influence of serum myeloperoxidase(MPO),neutrophil(PMN),monocyte chemotactic protein-4(MCP-4).Methods 92 cases of infantile bronchial asthma from June 2015 to June 2016 in yiwu materal and child health care family planning senice center,according to the draw method was divided into the control group(n=46)and experimental group(n=46),the control group was treated with salbutamol inhalation,and the experimental group was based on control group treated with Hanchuan Zupa granule,the curative effect,MPO,PMN,MCP-4,inflammatory factor,the T lymphocyte subgroup,arterial blood gas index,clinical symptoms disappeared time and safety of two groups were observed.Results After treatmented,the total effective rate of experimental group was 93.48％higher than that of control group 76.08％,the difference was statistically significant(P<0.05).The MPO,PMN,MCP-4 of experimental group was lower than the control group,the difference was statistically significant(P<0.05).The inflammatory factor,T lymphocyte subgroup,arterial blood gas index in the experimental group were more significantly improved than those in the control group,the difference was statistically significant(P<0.05).The clinical symptoms disappear time of experimental group was better than that of control group,the difference was statistically significant(P<0.05).There was no significant difference in safety between the two groups.Conclusion Hanchuan Zupa granule combined withventolin atomizing inhalation of children with bronchial asthma in the exact effect,and down-regulated the expression of MPO,PMN,MCP-4,promote the recovery of children.

Objective To establish a simple and rapid method for extraction and determination promethazine and its metabolite in urine.Methods The urine was added to celite column and the elutions was effected with dichloromethane.The eluat was evaporated on a water bath at 50℃.The dry residue was redissolved with 3.0ml H2SO4 solution of 0.05mol/L,and then zinc dust was added,in order to make it reaction on the water bath of 100℃ for 3min.The promethazine and its metabolite concentration were determined with the second derivative UV spectrum.Resvlts The extraction rate was 90% for both promethazine and its metabolite.The linear range of determination was 0.5～5.0?g/ml.Conclusion The method for determinating promethazine and its metabolite in urine is simple,convenience,and with high extraction rate.

s:Objective To explore effect of the Tangshen Tongluo (TSTL) recipe on ET and ANP in patients with early diabetic nephropathy (DN). Methods 45 Cases of early DN patients were randomly divided into the TSTL recipe group (25 cases) and Lotensin group (20 cases). After the treatment of TSTL recipe and Lotensin, TCM symptom, the level of FBG, HbA1c, ET, ANP, TC, TG, HDL-C, LDL-C and urine micro albumen excretion rate (UAER) were detected. Results After the treatment of TSTL recipe and Lotensin, TCM symptom, the level of FBG, ET, ANP, TC, TG, LDL-C and UAER were found markedly lower in the TSTL recipe than that in the Lotensin group (P

Objective To observe the therapeutic effect of the Zishen Huoxue Jiedu (ZSHXJD) method on patients with chronic renal failure (CRF). Methods 252 cases of CRF were treated by ZSHXJD method. TCM symptom, the serum level of Cr, BUN, ET, ANP, IL-8, ?2-mg, HGB and level of urine protein were detected. Results After the treatment, TCM symptom, the level of Cr, BUN, ET, ANP, IL-8, ?2-mg and urine protein were found markedly lower than that before the treatment (P

Objective To investigate the effection of Shenfu Injection (Ginseng-radix aconitum Injection)to the blood coagulation system and its prognosis in the patient of multiple trauma complicated with shock.Methods We prospectively studied 90 patients of multiple trauma complicated with shock,who came from the emergency center of the Second Affiliated Hospital of Medicine' s college of Zhe-Jiang University and emergency department of Lishui People' s Hospital from February 2007 to December 2011,and excluded those suffered with the dysfunction of coagulation system and uncontrolled ongoing bleeding before trauma.And then these eligible patients were randomly divided into two groups:treatment group ( 45 cases ) and control group (45 cases),the control group were received the routine treatment,the treatment group were received Shenfu Injection in early stage based on the routine treatment.The two groups were measured the platelet count (PLT),prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),fibrinogen (FIB) before treatment and 3,7 days after treatment.Results The differences of the PLT,PT,APTT,TT,FIB between the treatment group and control group at 3,7 d after the treatment was statistically significant (P ＜ 0.05 ). Conclusions Shenfu Injection has positive regulation to the coagulation system in the patient of multiple trauma complicated with shock.

Objective To examine the role of c-Jun NH2-terminal kinase(JNK) 1 in cytolytic T lymphocyte (CTL) responses against virus infection.Methods Wild-type (WT) and JNK1-knockout (JNK1-/-) mice were infected with ectromelia virus(ECTV) through hind footpads.Survival and virus titers in the target organs (liver and spleen) were analyzed.Effector T cells in the spleen and popliteal lymph nodes were determined on day 3 and 7 post-infection.Proliferation and INF-γ production of CTL were also detected.Results JNK1 deficiency caused an increased susceptibility to ECTV infection in mice,indicated by higher case fatality and viral burden in target organs.The decrease in CTL response correlated with a defect in CTL proliferation and INF-γproduction.Conclusion The data suggest that JNK1 is involved in expansion of activated CTL during ECTV infection,and plays an important antiviral role in regulating the proliferation and effector function of CTL.