Objective To evaluate the clinical efficacy and safety of flexible fiberoptic bronchoscopy (FFB) and bronchoalveolar lavage (BAL) in treatment of neonatal atelectasis.Methods Eligible patients, who were diagnosed as neonatal pulmonary atelectasis and admitted consecutively to the neonatal intensive care unit of the Children's Hospital of Hebei Province from January 2013 to January 2015, were included in the study.They were randomly assigned to FFB group (n=30) and control group (n=28).Newborns in the FFB group received BAL under FFB, while those controls received tracheal irrigation after intubation.The duration of lung recruitment, oxygen exposure and antibiotic administration, hospital stay, culture results of respiratory secretions, prognosis and total expenses during hospitalization were compared between the two groups.Complications of FFB were also recorded.Chi-square test and t-test were performed for statistical analysis.Results (1) In the FFB group, atelectasis occurred in the upper fight lobe (n=26), upper lobes of both sides (n=1), lower right lobe (n=2) and lower left lobe (n=1), while in the control group, atelectasis occurred in the upper right lobe (n=26), lower left lobe (n=1) and middle right lobe (n=2) (x2=0.094, P ＞ 0.05).(2) The positive rate of bacteria culture results showed no difference between bronchoalveolar lavage fluid in FFB group and tracheal secretions in the controls [43％(13/30) vs 32％(9/28), x2=0.770, P ＞ 0.05].(3) The duration of lung recruitment, antibiotic administration and hospital stay of the FFB group were all shorter than those of the control group [(4.7±3.4) vs (7.4±6.6) d, (14.0±4.5) vs (20.3±10.9) d, (15.1±4.7) vs (21.8±12.3) d, t=-5.718, 8.604 and 7.733, all P ＜ 0.05].(4) Among babies in the FFB group, nine experienced fever and returned to normal after physical cooling;three showed more shadow in chest X-ray with aggravated dyspnea during a short period, and relieved 12 hours later;two had minimal hemorrhage from tracheal mucous membrane;one showed crying hoarse.Serious complications, such as pneumothorax, massive bleeding or cardiac arrest, did not occurred.No death or refuse of treatment was reported.Conclusion FFB and BAL is much more effective than tracheal irrigation after intubation in treatment of neonatal atelectasis without any severe complications.

Objective To investigate the early diagnostic and the prognostic value of amplitude integrated e-lectroencephalography(aEEG)in neonates with hypoxic - ischemic encephalopathy( HIE). Methods The medical data subjects were admitted to the Department of Neonatology,Children's Hospital of Hebei Province from January 2012 to December 2013. Ninety term infants with HIE were divided into 3 groups(mild,moderate and severe),and they were investigated respectively by aEEG monitoring within 12 hours after birth,and all of the infants accepted cranial magnetic resonance imaging(MRI)on 3 to 7 days after birth. The outcomes by MRI were divided into 3 groups(mildly abnor-mal,moderately abnormal and severely abnormal). The findings of aEEG monitoring were divided into 3 groups(nor-mal,mildly abnormal and severely abnormal),the correlation between the findings of aEEG and the severity of HIE was analyzed. The correlation between the results of aEEG and severity of MRI were analyzed. Behavior evaluation of infants with HIE were applied by Neonatal Behavioral Neurological Assessment(NBNA)score on 7 d,14 d,28 d after birth and prognostic evaluation of children with HIE was conducted based on Children's Development Center of China infants intelligence development test at 12 months of age. Results (1)Among 90 term infants with HIE,44 cases(48. 9% ) had mild HIE,29 cases(32. 2% )moderate and 17 cases(18. 9% )severe HIE;49 cases(54. 4% )had mildly ab-normal MRI,23 cases(25. 6% )moderately abnormal MRI and 18 cases(20. 0% )severely abnormal MRI;43 cases (47. 8% )had normal aEEG,25 cases(27. 8% )mildly abnormal and 22 cases(24. 4% )severely abnormal aEEG. (2)The findings of aEEG classification were correlated with the severity of HIE(r = 0. 970 7,P ﹤ 0. 001). The findings of aEEG classification were correlated with the severity of MRI(r = 0. 933 5,P ﹤ 0. 001).(3)NBNA score with severe-ly abnormal aEEG was obviously lower than that with the mildly abnormal aEEG. NBNA score on 7 d after birth:(14. 1 ± 4. 2)scores vs(32. 2 ± 2. 3)scores,on 14 d after birth:(17. 8 ± 5. 6)scores vs(33. 4 ± 2. 1)scores,on 28 d after birth:(18. 9 ± 8. 4)scores vs(34. 6 ± 2. 6)scores,and the difference was statistically significant(all P ﹤0. 05).(4)The infants with HIE were followed at 12 months of age. The development quotient mental development in-dex(MDI)and psychomotor development index(PDI)with severely abnormal aEEG were obviously lower than that with the mildly abnormal aEEG[MDI(65. 1 ± 4. 1)scores vs(89. 1 ± 6. 7)scores,PDI(67. 5 ± 10. 1)scores vs(90. 7 ± 8. 3)scores],the difference was statistically significant(all P ﹤ 0. 05). Conclusion It is indicated that aEEG can early evaluate the severity of HIE and help predict its neurological outcome.

Objective To analyze the changes of WBC classification,sugar and protein in cerebro-spinal fluid(CSF)and pathogenic bacteria of neonatal purulent meningitis.Methods Thirty-one neonates with bacterial meningitis in our department of neonatology from June 201 1 to June 2013 were enrolled,and the clinical features,pathogenic bacteria,laboratory examination of CSF were analyzed.Results Fever (90.3%),convulsions(67.7%)and changed consciousness(58.1 %)were common clinical symptoms.The incidences of other nervous system abnormal signs such as gastrointestinal dysfunction(25.8%),abnormal breathing(16.1 %),cervical resistance(16.1 %),bulging fontanel(9.7%)were lower.The Gram -negative bacteria was more than Gram -positive in both blood and CSF culture.The escherichia coli was the most common bacteria,with positive rate of 38.1 %(8 /21 )in blood culture and 55.5%(5 /9)in CSF culture.The germiculture positive rate in CSF was lower than in blood culture (29.0% vs.67.7%).Polymorphonuclear leukocyte(PMN)[(79.61 ±12.06)%]was the most predominant cell of the leukocyte classification in CSF within 1 week in all cases,PMN was still predominant in 1 to 2 weeks in 7 cases,while only 2 cases in 2 to 3 weeks still dominated by PMN,PMN was not the predominant cell 3 weeks later.Conclusion In the typi-cal neonatal purulent meningitis,PMN was the predominant cell in CSF within the first week,but the propor-tion of monocyte gradually increased and was dominant later.Escherichia coli was a common bacteria caused by this disease.

Objective:To construct eukaryotic expression plasmid ecording a novel surface protein Fba of GAS, and to explore its impact on host immune responses.Methods:Fba gene was amplified by PCR using strain SSI-9 (GAS M1 serotype isolates) as the template, then cloned into pcDNA3.1 for constructing eukaryotic expression plasmid pcDNA3.1/fba and sequenced. Female CD1 mice were randomly individed into 6 groups, and immunized respectively with Fba protein, M protein, pcDNA3.1/fba + Fba protein, pcDNA3.1/fba, pcDNA3.1 and PBS as control. Blood was obtained from the mice and specific antibody of IgG was detected by ELISA. Spleen cells were assessed with lymphocyte proliferation assays.CD4+T cell and CD8+T cell were detected by flow cytometry (FCM). Assay results were analyzed with SPSS10.0.Results:The IgG against Fba protein kept hightest levels in group immunized with Fba protein. The levels of lymphocyte proliferation, CD4+, CD8+T cell were significantly high in the group pcDNA3.1/fba. Conclusion:(1) Just as M protein, the antibody to Fba protein could be efficiently induced by immunization with Fba protein, which showed that Fba protein was hopefully to be a candidate protein for vaccine against GAS.(2) Eukaryotic expression plasmid pcDNA3.1/fba was successfully constructed and this recombinant plasmid could efficiently induce antibody and CD4+ T cell for againsting GAS.

Spore surface display is one of attractive microorganism surface display systems. With the advantage of resistance attribute and specific assembly pattern, the technology of spore surface display now is attracting more and more attention. According to the current reports and main achievements of spore surface display, the structure and assembly of spores, the principle for construction and some existing spore surface display systems were elaborated in this paper. Now with the unique property of spores, the technique is not only widely used in production of vaccines but also has great applied potential in the field of biocatalysis and cell-factory.
Bacillus subtilis ; genetics ; metabolism ; Biocatalysis ; Biotechnology ; methods ; Gene Expression Regulation, Bacterial ; Genetic Engineering ; methods ; Recombinant Proteins ; genetics ; metabolism ; Spores, Bacterial ; genetics ; metabolism ; Tetanus Toxoid ; genetics ; immunology

Objective To express the novel fibronectin-binding protein Fba of group A streptococcus(GAS)and analyze its immunogenicity,so that to evaluate the immune responses to GAS infection.Methods fba gene was amplified by polymerase chain reaction(PCR)and confirmed by sequencing.Then it was cloned into pGEX4T-2 vector and Fba protein was expressed in E.coli BL21.The protein expression was identified by enzyme-linked immunosorbent assay(ELISA)and Westernblot.The sera from mice infected with GAS and anti-streptolysin-O positive patients were detected using microtiter plates coated with purified Fba protein as antigen.Afterward Balb/C mice were immunized with this purified protein and the sera were collected after the third immunization for the detection of IgG titer.Results It was confirmed by ELISA and Western blot that the recombinant Fba protein had a specific affinity with anti-Fba sera of rabbit.The anti-serum IgG titer of mice imrnunized with Fba protein was up to 1:4800.Conclusions GAS infection or Fba protein immunization are able to induce high serum titer of anti-Fba which could react specifically with the recombinant Fba protein.It indicates that Fba protein has good immunogenicity and antigenicity.So Fba protein could be a GAS candidate vaccine and an important tool to detect anti-GAS titer in GAS infected patients.

Objective The truncated fibronectin-binding proteins A (Fba protein) were cloned and expressed, then animals were immunized with Fba protein and subsequently challenged with group A streptococcus (GAS) to further investigate protective antibodies induced by each domain and determine the most immunogenic domain. Methods Fba proteins, which were divided into four overlaps based on the structural domains, were truncated and expressed. The fba truncated genes were amplified by polymerase chain reaction (PCR) with SSI-9 of GAS as template, and cloned into prokaryotic expression plasmid pGEX-2T and expressed in E. coli BL-21. The products were confirmed by Western blot and purified by affinity chromatography column. Female BALB/c mice were immunized with the four truncated proteins respectively, with phosphate buffered solution (PBS) as control. The serum IgG of mice was detected by enzyme-linked immunosorbent assay (ELISA). After the third immunization, mice were challenged with fatal dose of GAS (M+ Fba+ ) to evaluate the protective rates in each group. The data were compared by analysis of variance and Fisher's exact test.Results Prokaryotic expression plasmids of pGEX-2T/FbaAl, pGEX-2T/FbaA2, pGEX-2T/FbaA3 and pGEX-2T/FbaA4 were successfully constructed and the four truncated proteins were expressed and purified successfully. Serum levels of IgG in each experimental group gradually increased with immunization with Fba protein more times. After the third immunization, the IgG titer against FbaA2 1290.2, P<0. 01). After GAS challenge, four out of eight mice were protected in FbaA2 protein group, while two out of eight mice in FbaAl protein, FbaA3 protein and FbaA4 protein groups,respectively (P<0. 05). Conclusions Four truncated Fba proteins are constructed and expressed successfully. Truncated FbaA2 protein could be able to induce strongest protective immune response.

Objective To Discuss the impacts of different dosage of atorvastatirs on serum hsCRP,IL-10 and MCP-1 levels on post-intervention patients with coronary stenting. Methods 93 post-intervention patients with coronary stenting were selected and randomly divided into 3 groups.Each group took different dosage of oral atorvastatins after the operation for more than one week.The dosage for each group was 10 mg,20 mg and 40 mg,respectively.Each patient was phlebotomized for three times,which are 24 hours before the operation,24 hours after the operation and one week after the operation.Serum MCP-1,IL-10 and hs-CRP levels were measured by enzyme linked immunosorbent assay(ELISA)and immunoturbidimetry(ITM). Results Serum hs-CRP and MCP-1 levels of post-intervention patients were significantly higher than those of pre-intervention.This illustrated that the serum hsCRP and MCP-1 levels were closely related to PCI.Serum hs-CRP and MCP-1 levels decreased in those patients one week after operation which proves they are negatively correlated with the dosage of atorvastatins.There was no statistic evidence to prove the correlation between different dosage of atorvastatins and the level of serum IL-10.The ratio of MCP-1/IL-10 at 24h post-intervention patient was significantly higher than pre-intervention,which proves the ratio was negatively correlated with the dosage of atorvastatins. Conclusion Atorvastatins decreases serum MCP-1 and hs-CRP levels after PCI.Serum MCP-1 and hs-CRP levels were negatively correlated with the dosage of atorvastatins.

Objective:To observe cellular,humoral and mucosal immune responses induced by DNA-or protein-based of FimH of UPEC type 1.Methods:After mice were immunized respectively with recombinant plasmid pcDNA3.1/fimH or pcDNA3.1/fimC,and the combinant FimH and FimC protein,the anti-FimH protein IgG of sera and SIgA in bladders were detected by ELISA.The lymphocyte phenotypes of CD3,CD4 and CD8 were analyzed by FCM.Results:The titers of IgG in sera and SIgA in the bladders were all low in the group immunized by recombinant FimH plamid,but the percentage of CD4+T cells in spleen was high,which revealed that recombinant FimH plamid was able to trigger better cellular immune response.The titers of IgG were very high in the group immunized by FimH protein,which suggested that the FimH protein was able to trigger better humoral immune response,but SIgA in the bladders was not detectable.Conclusion:The DNA for FimH can induce humoral,mucosal and cellular immune response.FimH protein can only induce humoral immune response.FimC protein is able to enhance the immunogenicity of FimH protein.

Objective:To identify monoclonal antibody McAb2 recognizing epitope of Fba of GAS.Methods:The overlapped peptides were synthesized and their abilities to bind McAb2 were detected by dot-ELISA.The predominance amino acids specific for McAb2 were screened using phage 7 peptide library.Results:The result by dot-ELISA analysis demonstrated that the synthetized peptide,amino-acid residues 100-112~(th),could bind McAb2 with high affinity.The predominance amino acids specific for McAb2 were ITPDL,which was located in 100-110~(th)aa of Fba by panning with phage 7 peptide library.Conclusion:The domain and the predominance amino acids of Fba recognized by McAb2 is determined.The results would contribute to the research of the role of Fba on the pathogenic mechanism of GAS,the identification of function of McAb2,and the development of epitope-peptide vaccine.