Forty two resident general practitioners (GPs) attending obstetrics and gynecology course in Beijing Hospital were divided into trial group and control group with 21 in each group. The 2-hour study content uterine fibroids was taught by the same teacher. For control group the traditional classroom teaching mode was used, while for the trial group the WeChat-based flipped classroom model was used. The teaching effectiveness was evaluated by means of paper examination, critical examination and questionnaire survey. The average scores and the clinical reasoning scores of trial were significantly higher than those of control group [(90.5±3.4) vs. (82.5±4.2) points and (94.5±1.5) vs. (84.5±2.0) points; t=4.28, P<0.05 and t=5.01, P<0.05, respectively]. Compared with the control group, the trial group presented more learning interest, higher learning efficiency and self-learning ability; and also the ability of expression and communication was improved, the ability of teamwork and the ability of analyzing and solving problems was enhanced more markedly in trial group (all P<0.05). The result indicates that WeChat-based flipped classroom teaching model can improve the learning efficiency in general practice residency training.

Based on their inherent relationship,some independent and verifying experiments of medical immunology were intergrated into a series of comprehensive and open experiments,which was embodied in the preparations of antiserum.so as to set up a new experiment teaching system emphasizing the training of student comprehensive capability.Achievements in training students'scientific research capacity,innovative motivation and practical working ability have been obtained and the results could provide valuable experience for innovation and reform of medical immunology experiment teaching model and method.

Objective This study examined the value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1)in serum and exhaled ventilator condensate (EVC)in early diagnosis and prognosis of ventilator-associated pneumonia (VAP). Methods A total of 37 adult patients undergoing mechanical ventilation were evaluated after treatment,including 24 patients with infection,13 without infection.Of the 24 patients with infection,10 patients were assigned to ineffective subgroup and 14 to effective subgroup.Levels of sTREM-1 in serum and EVC were measured on days 1,3,5,and 7 for all patients.sTREM-1 in serum and EVC were determined in patients by double antibody sandwich enzyme-linked immunosorbant assay (DAS-ELISA).The early diagnostic and prognostic value was assessed by receiver operating characteristic (ROC)curve analysis.Re-sults On Day 1,the sTREM-1 levels in serum and EVC did not show significant difference between the three groups (P>0.05).On Day 3 and Day 5,the level of sTREM-1 in the infection group was higher than that in the non-infection group (P <0.01).On Day 7,the sTREM-1 levels of serum and EVC in ineffective subgroup were higher than those in the effective subgroup and non-infection group (P <0.01). There were no difference between the non-infection group and effective subgroup (P >0.05).For ROC analysis,area under the curve (AUC)of serum sTREM-1 was 0.897,and AUC of EVC sTREM-1 was 0.909 on Day 3.When the cut-off value of EVC sTREM-1 was set at 4.70 ng/mL on Day 3,the sensitivity was 85.8%,specificity was 92.3%.Conclusions The results suggest that the levels of sTREM-1 in serum and EVC are conducive to the early diagnosis of VAP.The levels of sTREM-1 in serum and EVC on Day 7 are helpful for estimating the prognosis.EVC sample is easier to collect than serum.

Objective:To study the in vitro effect of adipose stromal stem cells(ASC) on phenotype and secretion of cytokines of allogenetic T lymphocytes,and to elucidate the possible roles of ASC for immunomodulation.Methods:ASC was isolated and cultured.The supernatant of ASC and ASC itself were co-cultured with allogenetic T lymphocytes.MTT assays were used to detect the proliferative rates of T cells.Annexin-Ⅴ/PI staining was used to detect apoptotic rates,and flow cytometry to detect the proportion of CD4+CD25+ cells.ELISA was used to detect the secretion of IL-10 and TGF-?1.Reverse transcription-polymerase chain reaction(RT-PCR) was used to detect the expressing level of Foxp3 gene.Results:The supernatant of ASC had no deep impact on the proliferation and apoptosis of T lymphocytes.ASC had the direct inhibitory effect on growth of T lymphocytes,while the stem cells did not affect apoptosis.Both the supernatant of ASC and ASC itself increased the proportion of CD4+CD25+ cells in T lymphocytes,and increasd the level of IL-10 and TGF-?1.They could also up-regulate expressing level of Foxp3 in T cells.Conclusion:ASC can affect the function of T lymphocytes via cell-to-cell contact and secretion of cytokines.By these ways ASC exhibits negative immunomodulation and plays an important role in inducing immune tolerance.

Objective To investigate the effects and outcomes of four procedures for hysterectomy. Method Retrospectively, we analyzed the clinical characteristics of 756 cases who respectively received hysterectomy by total abdominohysterectomy (TAH,260 cases), modified abdominohysterectomy (MAH, 180 cases), transvaginal hysterectomy (TVH, 106 cases), or laparoscopic assisted vaginal hysterectomy (LAVH)(210 cases) and compared their effects and outcomes. Results The average operation time of TAH(98 ?23)minutes, MAH(67?18)minutes, TVH (63?19)minutes and LAVH(99?35)minutes. The average operation time of LAVH and TAH groups was significantly longer than that of TVH and MAH groups (P

Objective:To investigate the effect of compound 48/80(C48/80) activated mast cell on dendritic cell homing to draining lymph nodes(DLN) in order to explore the potential mechanism of C48/80 promoting adaptive immune response.Methods: C57BL/6 mice bone marrow derived dendritic cells(BM-DC) and MC/9 mast cell line were propagated in vitro.Chemotaxis of BM-DC supplemented with supernatant of C48/80 treated MC/9 to CCL21 was measured by transwell chemotaxis assay.C48/80 was injected into murine scapular site,local skin mast cell degranulation was detected by toluidine blue staining method.The number of CD11c+ DC in draining lymph nodes(DLN) was detected by Flow cytometry.Exogenous green microbeads labeled BM-DC homing to DLN was detected by fluromicroscope.The mice pretreated with or without C48/80 were vaccinated by ovalbumin pulsed DC(OVA-DC),DLN lymphocyte proliferation was detected by WST-8 reagent.Results: A large amount of typical BM-DC were harvested from media supplemented with murine recombinant IL-4 and GM-CSF.Product of activated MC/9 enhanced chemotaxis of BM-DC to CCL21(P<0.01).Intradermal injection of C48/80 induced local mast cell obvious degranulation and local inflammation.Mice pretreated with C48/80 demonstrated high number of total cells and DC cells in DLN.The number of fluorescent positive BM-DC in DLN also increased in C48/80 pretreated mice.Antigen specific lymphocyte proliferation enhanced in OVA-DC inoculated C48/80 pretreated mice.Conclusion: Mast cell activation induced by C48/80 can enhance DC homing to DLN and increase specific lymphocyte proliferation,which may be one of a mechanism of C48/80 in promoting adaptive immune response.

Abstract: Objective　To investigate the molecular characteristics and drug resistance of Staphylococcus aureus (SA) isolated from wounds of paatients with orthopedic trauma, and analyze the molecular subtyping, virulence genes and drug resistance of SA in wounds of patients, so as to provide reference for the prevention and treatment of wound SA infection in patients. Methods　From January 2020 to June 2022, a total of 128 SA isolates were collected from wound specimens of orthopedic trauma patients at Wuxi 9th People's Hospital Affiliated to Soochow University. Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible Staphylococcus aureus (MSSA) were differentiated using PCR. Multilocus Sequence Typing (MLST), staphylococcal protein A (spa), staphylococcal chromatoidal cassette mec (SCCmec), and accessory gene regulator (agr) typing were performed to determine the molecular typing and presence of virulence genes and drug resistance profiles. Results　Among the 128 SA isolates, 76 (59.38%) were MRSA and 52 (40.62%) were MSSA. MRSA typing showed that, MLST was dominated by ST59 (46 strains, 60.53%), spa was dominated by t437 (52.63%), SCCmec was dominated by Ⅰ (42.11%) and Ⅳ (39.47%). MSSA typing showed that, MLST was dominated by ST188 (30.77%), spa was dominated by t189 (61.54%), agr was dominated by Ⅰ (53.85%). In MLST typing, ST59 of MRSA was higher than that of MSSA, and ST188 and ST6 of MRSA were lower than those of MSSA (χ2=36.207, 20.227, 9.984, P<0.05). In spa typing, the t437 of MRSA was higher than that of MSSA, and the t189 of MRSA was lower than that of MSSA (χ2=18.276, 32.781, P<0.05). The virulence genes showed that, the detection rates of hlb and seb in MRSA were higher than those in MSSA (χ2=47.838, 10.261, P<0.05), and the detection rates of cna and ebpS in MRSA were lower than those in MSSA (χ2=26.176, 8.305, P<0.05). Drug susceptibility test showed that, and the drug resistance rates of MRSA and MSSA to vancomycin (VAN) and linezolid (LNZ) were 0. The drug resistance rates of MRSA to oxacillin (OXA), ERY and CLI were 86.84%, 68.42% and 76.32%, which were higher than corresponding 7.69%, 42.31% and 46.15% of MSSA (χ2=78.055, 8.623, 12.200, P<0.05). The analysis of multi-drug resistant strains (MDR) showed that 76 MRSA strains were MDR strains, and 12 of 52 MSSA strains (23.08%) were MDR strains. Conclusions　The molecular characteristics of SA isolated from orthopedic trauma patients' wounds were predominantly associated with MRSA strains of ST59-t437-SCCmec Ⅰ/Ⅳ-MRSA and ST188/ST6-t189-agr Ⅰ. These strains showed higher resistance to oxacillin, erythromycin, clindamycin, and higher susceptibility to vancomycin and linezolid. Such characteristics were closely related to the carriage of virulence genes. Clinicians should pay attention to the presence of MDR MSSA and develop appropriate antimicrobial strategies based on SA's molecular characteristics and antimicrobial resistance.

Objective To observe the clinical characteristics of ophthalmic and cerebral artery occlusion after facial cosmetic injection.Methods A retrospective case study. Twenty patients (20 eyes) with ophthalmic and cerebral artery occlusion in Department of Ophtalmology, The Fourth Hospital of Xi'an from February 2014 to December 2016 were enrolled in this study. There were 2 males (2 eyes) and 18 females (18 eyes). They aged from 21 to 41 years, with the mean age of 29.8±1.4 years. The disease courses was ranged from 3.5 hours to 21 days, with the mean of 40 hours. Facial cosmetic injections of all patients were performed at out-of-hospital beauty institutions. The visual impairment was associated with eyelid pain 1 to 10 minutes after injection.There were 12 right eyes and 8 left eyes.The injection materials, 18 patients were hyaluronic acid and 2 patients were autologous fat, respectively. At the injection site, 13 patients were sacral, 4 patients were nasal, and 3 patients were frontal. The concentration and dose of the injected filler were not known. All patients underwent vision, slit lamp microscope, fundus color photography, visual field, FFA, OCT, and brain CT, magnetic resonance angiography (MRA) examination.Results The visual acuity was ranged from no light perception to 1.0. Among the 20 eyes, 3 eyes (15％) were obstructed by simple ophthalmic artery; 5 eyes (25％) were obstructed by ophthalmic artery combined with cerebral artery; 7 eyes (35％) were obstructed by simple retinal artery occlusion (RAO) alone, which including central RAO (CRAO, 4 eyes), hemi-lateral artery obstruction (1 eye) and branch RAO (2 eyes); 1 eye (5％) was CRAO with ciliary artery branch obstruction; 1 eye (5％) was branch artery occlusion with ischemic optic neuropathy; 2 eyes (10％) were CRAO with nasal dorsal artery occlusion; 1 eye (5％) was CRAO, posterior ciliary artery obstruction and right middle cerebral artery occlusion. Among 20 patients, 4 patients (20％) had eye movement disorder and eyelid skin bun; 2 patients (10％) had facial pain and nasal skin ischemic necrosis. MRA revealed 6 patients (30％) of new intracranial ischemic lesions. Among them, 5 patients of hyaluronic acid injection showed asymptomatic small blood vessel embolization; 1 patient of autologous fat injection showed ophthalmary artery occlusion, cerebral artery occlusion, ipsilateral eye blindness, eye movement disorder and contralateral limb hemiplegia.Conclusion Facial cosmetic injection can cause severe iatrogenic complications such as RAO, ciliary artery occlusion, ischemic optic neuropathy, ophthalmic artery occlusion, and cerebral artery occlusion.

Objective:To investigate the ultrasonographic and clinical features of postmenopausal ovarian endometriosis(OEM).Methods:Clinical, transvaginal sonography(TVS)and pathological data of 26 postmenopausal OEM patients confirmed by surgery and histology in our hospital from June 2014 to June 2019 were included in this retrospective analysis.The ages of patients ranged from 47 to 65 years(median age: 57 years old), and the age at natural menopause was(48.8±3.3)years.The duration after menopause was 1-25 years(median duration: 8 years). Transvaginal sonography(TVS)results were compared with pathological data.Results:A total of 36 adnexal lesions were found by TVS.Postoperative pathological examination confirmed 39 lesions, of which 76.9%(30 cases)were OEM lesions and 23.1%(9 cases)were non-OEM lesions in the ovary.92.3% of the adnexal lesions(36 cases)were effectively screened by TVS, and 3 lesions less than 1 cm were missed in the ovary.Among 26 subjects, unilateral OEM lesions accounted for 84.6%(22 cases). Simple cysts were the most common concurrent condition(6 cases), followed by uterine leiomyoma(4 cases), ovarian cancer(2 cases)and serous cystadenoma(1 case). The sizes of 30 postmenopausal OEM lesions ranged from 0.8 cm to 6.6 cm, and 53.3%(16 cases)were anechoic, typical of OEM on TVS.TVS found that 40.0%(12 cases)showed no specific sonographic features, 16.7%(5 cases)showed a heterogeneous echo pattern, 13.3%(4 cases)showed a homogeneous hypoecho pattern, and 10.0%(3 cases)showed a hypoechoic mass with strong internal echo, following a shadow behind it.The rate of missed diagnoses of 30 postmenopausal OEM lesions by TVS was 30.0%(9 cases), of which 23.3%(7 cases)were misdiagnosed as solid masses in the adnexal area on TVS, and 6.7%(2 cases)were missed on TVS(OEM lesions less than 1.0 cm).Conclusions:Ultrasonographic heterogeneity exists in postmenopausal OEM patients.Unilateral and anechoic ultrasound is the most common type of ultrasound imaging.It is of great significance to pay attention to TVS examination and corresponding ultrasound imaging analysis in postmenopausal women for the early diagnosis of postmenopausal OEM.

During July to November in 2007, several outbreaks of Hemangiomas in Hy-line Brown laying hens were observed in China. The virus that infected these flocks was identified in cultured DF-1 cells by PCR and indirect fluorescent assay (IFA) with ALV-J specific monoclonal antibody JE-9. The gp85 gene of one strain named WS0705 of ALV-J was cloned and expressed. Phylogenetic analysis showed that gp85 amino sequences of WS0705 strain had the highest homology with that of the prototype HPRS-103. The gp85 gene from a constructed plasmid pMD18-T-WS0705gp85 was cloned into baculovirus transfer vector. rBac-WS0705gp85 was obtained by the Bac-to-Bac baculovirus expression system. The rBac-WS0705gp85 protein was analyzed by indirect immunofluor escence assay and Western blot. The results showed that positive green fluorescent was present in Sf9 cells infected with the recombinant virus and a 35 kD band was present in western blot. It is concluded that WS0705 gp85 gene was expressed in Sf9 cells infected with the recombinant virus and the SU protein of WS0705 can bind specifically to JE9 MAb of ALV-J. The expressed protein can be used to detect hemangiomas induced by ALV-J.
Amino Acid Sequence ; Animals ; Avian Leukosis Virus ; classification ; genetics ; Blotting, Western ; Cell Line ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Gene Expression ; Hemangioma ; virology ; Phylogeny ; Polymerase Chain Reaction ; Sequence Alignment ; Viral Envelope Proteins ; chemistry ; genetics ; isolation & purification ; metabolism