Objective To investigate the responsiveness of the Burke Lateropulsion Scale (BLS) evaluating Pusher syndrome recovery and the characteristics of BLS. Methods 48 patients diagnosed as Pusher syndrome after stroke were included. All the patients were assessed with BLS to measure the progress at admission, every 2 weeks and at discharge, respectively. The characteristics of BLS score at admission and discharge and the standardized response mean (SRM) were analyzed. Results 56.3% patients were rated as mild and 16.7% were rated as severe at admission; none were classified as severe, 43.8% were not enough to be diagnosed as Pusher syndrome and 47.9% were classified as mild on discharge. SRM was 1.27 during the whole hospitalization, and SRM was 1.41 and 2.18 at 4 and 6 weeks, respectively. Conclusion BLS is an appropriate tool for the evaluation of patients with Pusher syndrome and is responsive to monitor the progress and recovery during rehabilitation.

Objective To investigate the distribution and antimicrobial resistance of multidrug‐resistant organisms(MDROs) . Methods The distribution and antimicrobial resistance of MDROs ,isolated from 2010 to 2014 ,were retrospectively analyzed . MDROs were identified according to international consensus .The WHONET5 .6 software was used to analyze data .Results A to‐tal of 5 709 strains of MDROs were isolated in five years ,in which 2 441 strains were Staphylococcus(42 .76% ) ,2 091 strains were non‐fermentive bacterial(36 .63% ) ,737 strains were Enterococcus(12 .90% ) ,440 strains were Enterobacter(7 .71% ) .Of the 5 709 MDROs isolates ,55 .04% were isolated from respiratory tract specimens .The resistant rate of multidrug‐resistant E .coli and K . pneumoniae against cefoperazone/sulbactam ,imipenem and meropenem was less than 30% .The resistance of multidrug‐resistant A . baumanii was higher than 90% ,except to minocycline and cefoperazone/sulbactam ,20 .2% and 50 .6% respectively .The resistant rate of multidrug‐resistant P .aeruginosa was 71 .4% -97 .0% against other antimicrobial agents ,except to polymyxin B .The resist‐ance of multidrug‐resistant E .faecium against the antimicrobials was higher than 90% ,except 13 .8% to minocycline and less than 3% to linezolid ,teicoplanin and vancomycin .Meanwhile ,1 linezolid resistant strain was identified in 1 914 methicillin resistant S .au‐reus(MRSA) strains and all MRSA strains were susceptible to vancomycin and teicoplanin .Conclusion MDROs could be predomi‐nated by A .bauman and MRSA in this hospital .Monitoring and control measures to healthcare‐associated infections should be in‐tensified to prevent the spread of MDROs .

Objective To compare the sensitivity of four kinds of drug susceptibility test method in detecting sensitivity of tigecycline against Acinetobacter baumannii.Methods The susceptibility of 72 clinically isolated strains of carbapenemase-resistant Acinetobacter baumannii(CRAB) to tigecycline in vitro was detected with disk diffusion method,VITEK 2 Compact system,E-test and MIC test strip(MTS) test strip respectively,according to FDA standards,and the differences of four kinds of drug susceptibility test methods were compared.Results The susceptibility rates of 72 strains of CRAB to tigecycline by disk diffusion method,VITEK 2 Compact system,E-test and MIC test strip were 50.00%,69.44%,36.11% and 98.61% respectively,the intermediate rates were 48.61%,29.17%,26.39% and 1.39% respectively,the resistant rates were 1.39%,1.39%,37.50% and 0.00% respectively.Compared with MTS,the classification consistency rates of E-test,disk diffusion method and VITEK 2 Compact system were 36.11%,51.39% and 70.83% respectively.Conclusion There is difference among four kinds of method for conducting the drug susceptibility testing of tigecycline against CRAB,the consistency of disk diffusion method,VITEK 2 Compact system and E-test is lower.Detecting mediation or drug resistant strains of CRAB by disk diffusion method,VITEK 2 Compact system and E-test needs to be verified by MTS or Broth dilution method.

OBJECTIVE:To investigate the role of clinical pharmacists on drug therapy for acute exacerbations of chronic ob-structive pulmonary disease(AECOPD)patients with benign prostatic hyperplasia(BPH). METHODS:Clinical pharmacists partici-pated in drug therapy for a AECOPD patient with BPH. According to clinical guideline and relevant literatures,based on the history of disease,the characteristics of bronchodilators and the symptoms of acute urinary retention,it was suggested to stop taking Ip-ratropium bromide solution for inhalation but receive Finasteride capsules 5 mg,po,qd,to reduce prostate volume and improve ob-struction+Terazosin hydrochloride tablets 2 mg,po,qd,to relax urethral smooth muscle;the occurrence of ADR was monitored closely. Salmeterol xinafoate and fluticasone propionate powder for inhalation was suggested and medication guidance for patients af-ter discharge was given by clinical pharmacists. RESULTS:Physicians adopted some suggestions of clinical pharmacists. The pa-tient was stable and had no dysuria. The patient was allowed to leave the hospital with drugs. CONCLUSIONS:Rational use of bronchodilators is directly related to the remission of clinical symptoms and prognosis in AECOPD patients. In view of patient's dis-ease history,drug characteristics and clinical symptoms,clinical pharmacists point to possible risks of anticholinergics use,and as-sist physicians to formulate and adjust therapy plan so as to guarantee the safety and effectiveness of drug use.

OBJECTIVE To understand flora distribution and four antifungal drugs′in vitro antifungal activity of deep fungi in nosocomial infection in order to provide help to clinics.METHODS Fungi were cultured and isolated by routine procedure which identified by VITEK microbe automatic system.Drug susceptibility test used Rosco paper disk diffusion and broth dilution method with NCCLS M27-A.RESULTS Totally 156 strains with 9 species of deep fungi that main fungi were Candida albicans,and C.tropicalis with 57.69%,and 31.41%,respectively,were isolated from nosocomial infection.The major isolating rates of clinical infection specimens were from respiratory,cardiovascular surgery,and neurological departments with 26.28%,12.18%,and 9.62%,respectively.The main infection specimens were from respiratory tract and urinary tract with 71.15% and 16.67%,respectively.Drug resistance rates to fluconazole,amphotericin B,itraconazole,and ketoconazole with Rosco paper disk diffusion were 23.08%,2.56%,12.18%,and 17.36%,MIC90 were 64.0,2.0,8.0,and 16.0mg/L,respectively.CONCLUSIONS The main deep fungi are C.albicans and C.tropicalis.Antifungal activity of amphotericin B is the highest than others.The drug resistance rate to fluconazole is more and more higher.Clinics should use antifungal drug rationally in accordance with drug susceptibility test results.

OBJECTIVE:To investigate the characteristics and factors of ADR caused by Chinese patent medicine(CPM)and to provide reference for rational drug use and safety evaluation in the clinic. METHODS:158 cases of ADR caused by CPM collect-ed from our hospital during Jan.2009-Dec.2014 were analyzed. RESULTS:The occurrence of ADR caused by CPM was related to patient’s age,route of administration,category of drugs,irrational drug-use and so on. The incidence of ADR in patients over the age of 60 was the highest (31.01%),the largest number of ADR were caused by intravenous injection (79.11%),ADRs were most likely caused by blood-regulating preparation and dissipate blood stasis preparation (79.75%);ADR manifested as lesion of skin and its appendents(43.01%),followed by gastro-intestinal injury(16.06%)and whole-general injury(10.36%). The severe ADR was anaphylactoid reaction;after symptomatic treatment,the prognosis is good. CONCLUSIONS:According to syndrome differentiation and individual difference,CPM should be used rationally,and great importance should be attached to drug use moni-toring to reduce the incidence of ADR.

To obtain human antibodies against the Gn protein of Severe fever with thrombocytopenia syndrome virus (SFTSV) with phage display technology, this study aimed to screen anti-Gn protein antibodies from an anti-SFTSV Fab human phage display library. Antibody genes were identified by sequence analysis and the specificity of antibodies was confirmed by ELISA. The Fab antibody genes were cloned into the HL51-14 vector and expressed in a mammalian cell expression system. IgG antibodies were then purified by protein A affinity chromatography,and the results were further confirmed by ELISA,IFA,western blotting assays and micro-neutralization tests. The results showed that, after three rounds of panning, there were 390 human Fab antibodies against SFTSV particles, of which 364 were specific for nucleoprotein. Coated with the Gn protein, eight different Fab antibodies specific for Gn protein were obtained after the determination of the subtype and subclass of antibodies by gene sequencing; five of these antibodies were from the Lambda library and three were from the Kappa library. The eight IgG antibodies could specifically bind to Gn protein according to the ELISA, IFA and Western blotting assays. The micro-neutralization test showed that these eight antibodies had no neutralizing activity,but they could still provide a reference for research in human monoclonal antibodies against SFTSV.
Antibodies ; genetics ; immunology ; Bunyaviridae Infections ; genetics ; immunology ; virology ; Cell Line ; Cloning, Molecular ; Humans ; Immunoglobulin Fab Fragments ; genetics ; immunology ; Immunoglobulin G ; genetics ; immunology ; Neutralization Tests ; Phlebovirus ; genetics ; immunology ; Viral Proteins ; genetics ; immunology

BACKGROUND: The repair of articular cartilage defect is always a problem that is dedicatedly solved by doctors of orthopaedics. Autologous perichondrium, periosteum or allografting of cartilage have been used previously; however, the source of the donor is limited, the fixation is difficult as well as the occurrence of endochondrial ossification and delamination between the inferior cartilage and reparative cartilage, etc. Type Ⅱ collagen, the main component of cartilage matrix, has certain effects in the repair of articular cartilage defect.OBJECTIVE: To investigate the effects of type Ⅱ collagen sponge filling on the repair of articular cartilage defect.DESIGN: A randomized controlled trial.SETTING and MATERIALS: The study was conducted in the Guangzhou Institute of Traumatic Surgery. Materials were 24 adult male purebred New Zealand Rabbits(48 knees), ordinary grade, with a body mass of (2.29 ±0. 25) kg. Animals were fed with standard feeding in separate cage.INTERVENTIONS: A full-thickness defect in articular cartilage was made on the femoral trochlear surface by a drill of 5 mm in diameter and 3 mm in depth. Rabbits were allocated into filling group(type Ⅱ collagen sponge was grafted into left keen joint defect) and control group(right knee joint defect site was set as control) according to random number table.MAIN OUTCOME MEASURES: Gross morphological and histological observation of the defect repair in each dual week within 12 weeks after operation.RESULTS: During 10 - 12 weeks, in cuntrol group: The defect area was repaired by white and soft tissue that had no resistance to press. The repaired tissue was still lower than the surrounding articular surface with clear boundary. By histological observation, it was found that the defect was repaired by the mechanism similar to inflammatory reaction and the defect is ultimately filled by the hyperplasia of hyaline degenerative fibrous tissues. In filling group: the defect was repaired by semi-transparent, smooth, textured tissues with polish that had resistance to press as well as elasticity. The repaired tissue was almost similar to the shape of the surrounding cartilage,difficult to be distinguished. After histological observation, it was found that there was no inflammatory reaction, but active hyperplasia of inner bonetissue and cartilage tissues; a lot of osteoid tissues and trabeculation were found. Newlborn cartilage was fused with surrounding cartilage tissue and connected with surrounding tissues. Type Ⅱ collagen had significantly promoting effects in the repair of articular cartilage defect, and the repaired cartilage was close to normal cartilage. CONCLUSION: The self-made high purity type Ⅱ collagen sponge has favorable promoting effects in the repair of articular cartilage defect with good histocompatibility but without obvious toxic side effect.

The Ebola virus is highly infectious and can result in death in ≤ 90% of infected subjects. Detection of the Ebola virus and diagnosis of infection are extremely important for epidemic control. Presently, Chinese laboratories detect the nucleic acids of the Ebola virus by real-time reverse transcription-polymerase chain reaction (RT-PCR). However, such detection takes a relatively long time and necessitates skilled personnel and expensive equipment. Enzyme-linked immunosorbent assay (ELISA) of serum is simple, easy to operate, and can be used to ascertain if a patient is infected with the Ebola virus as well as the degree of infection. Hence, ELISA can be used in epidemiological investigations and is a strong complement to detection of nucleic acids. Cases of Ebola hemorrhagic fever have not been documented in China, so quality-control material for positive serology is needed. Construction and expression of human-mouse chimeric antibodies against the nucleoprotein of the Ebola virus was carried out. Genes encoding variable heavy (VH) and variable light (VL) chains were extracted and amplified from murine hybridoma cells. Genes encoding the VH and VL chains of monoclonal antibodies were amplified by RT-PCR. According to sequence analyses, a primer was designed to amplify functional sequences relative to VH and VL chain. The eukaryotic expression vector HL51-14 carrying some human antibody heavy chain- and light chain-constant regions was used. IgG antibodies were obtained by transient transfection of 293T cells. Subsequently, immunological detection and immunological identification were identified by ELISA, immunofluorescence assay, and western blotting. These results showed that we constructed and purified two human- mouse chimeric antibodies.
Animals ; Antibodies, Monoclonal ; genetics ; immunology ; Cloning, Molecular ; Ebolavirus ; genetics ; immunology ; Hemorrhagic Fever, Ebola ; immunology ; virology ; Humans ; Immunoglobulin Heavy Chains ; genetics ; immunology ; Mice ; Nucleoproteins ; genetics ; immunology ; Viral Proteins ; genetics ; immunology

Objective To explore the bone marrow pathology ,diagnosis and differential diagnosis of Waldenstrom macroglobulinemia(WM). Methods 19 WM patients was examined by bone marrow aspiration (BMA) and bone marrow biopsy (BMB) for morphology. Flow cytometry (FCM) and immunohistochemistry (IHC) for immunophenotyping. Results Plasmacytoid lymphocytes were identified in 11 BMA. All of 19 BMB were involved by lymphoma cells. 17 cases showed a predominance of small lymphocytes and 2 of plasmacytoid lymphocytes. Typically plasmacytoid lymphocytes were not seen in 4 cases. Patterns of bone marrow involvement were as follow: diffuse (12 cases), nodular (4 cases), interstitial (3 cases). Immunophenotypically, FCM showed all cases were CD_(19)~+, CD_(20)~+, CD_(22)~+, CD_5~- and CD_(10)~-. IHC revealed small lymphocytes and plasmacytoid lymphocytes were Pax5~+ CD_(20)~+ and plasma cells were CD_(38) CD_(138)~+ CD_(20)~- Pax5~-. Conclusion Small lymphocytes proliferation with plasmacytic differentiation is the typical bone marrow pathologic features of WM. IHC is benefit for identifying lymphocytes and plasma cells components. The Combination of morphology, FCM and IHC is contributive to the diagnosis and differentiation of WM.