Non-cultural laboratory diagnostic methods include fungal antigen detection, anti-fungal antibody detection and molecular methods. Fungal antigen detection aim at ( 1, 3 )-β-D-glucan, galactomannan, cryptococcal capsular polysaccharide antigen and candida mannan antigen.Different antigen is used to diagnose different fungal infection.Antifungal antibody include antibody against Histoplasma capsulatum, Coccidioides immitis/Paracoccidiodes and Blastomyces dermatitidis.Molecular methods include non-amplification nucleic acid detection, nucleic acid amplification test, direct sequencing and matrix-assisted laser desorption/ionization time of flight mass spectrometry ( MALDI-TOF MS ) technology.Even though molecular methods are limited because of no standardization, the future of its usage is promising.

Antimicrobial susceptibility testing is an important tool for guiding rational use of antimicrobial agents in clinical settings.Proper use of antimicrobial susceptibility testing results requires clinicians and clinical microbiologists to have the knowledge of antimicrobial susceptibility testing and breakpoints,and have the ability to use pharmacokinetic and pharmacodynamic (PK/PD) principles to optimize antimicrobial therapy regimen.(Chin J Lab Med,2013,36:289-291)

Objective To explore the effects and molecular mechanisms of arsenic trioxide(As 2O 3) in inducing apoptosis of colonic cancer cell line SW480. Methods The morphologic changes and apoptotic rate of SW480 cells induced by As 2O 3 were observed with fluorescent microscopy and flow cytometry. The bcl-2 and Fas expressions induced by As 2O 3 in SW480 cells were examined by immunohistochemical method. Results 24 hours after exposed to As 2O 3, SW480 cells exhibited typical morphologic changes of apoptosis, the apoptotic rate of which was 2.1%～10.6%. A typical subdiploid peak before G 1 phase was observed by flow cytometry, and As 2O 3 mainly acted in G 2/M phase. As 2O 3 decreased bcl-2 expression and increased Fas expression in SW480 cells. Conclusion As 2O 3 could induce apoptosis of SW480 cells. The molecular mechanism of As 2O 3-induced apoptosis of SW480 cells might be down-regulating the bcl-2 expression and up-regulating the Fas expression.

Objective The aim of this study was to evaluate the in vitro activity of Ciprofloxacin(CIP)or Amikacin(AK)combined with four clinically-used antipseudomonas ?-lactams against multidrug-resistant Pseudomonas aeruginosa strains.Methods Determining the MICs of six antibiotics to 35 clinically isolated Pseudomonas aeruginosa strains which have different resistance patterns by 2-fold broth dilution method;determining the in vitro activity of Ciprofloxacin or Amikacin combined with Ceftazidime(CAZ),Imipenem(IMP),Meropenem(MEM)and Piperacillin/Tazobactam(TZP)by broth checkerboard method.Results The combinations of Ciprofloxacin or Amikacin with four ?-lactams have mainly synergistic or additive effect,the synergistic rate of AK-group(AK+CAZ:71.43%;AK+IMP:42.86%;AK+MEM:54.29%;AK+TZP:85.71%)was higher than that of CIP-group(CIP+CAZ:20%;CIP+IMP:25.71%;CIP+MEM:14.29%;CIP+TZP:31.43%).The combination of CIP+TZP has the highest synergistic rate in CIP-group;the combination of AK+TZP has the highest synergistic rate in AK-group.None of the combinations had an antagonistic effect.Conclusion the combination of ciprofloxacin or amikacin with ?-lactams have good in vitro activity to multidrug-resistant Pseudomonas aeruginosa strains.

Objective To summarize the timing, procedure and early and late outcomes of Surgical treatment of traumatic tricuspid insufficiency. Methods From May 1984 through September 2004, eight patients with traumatic tricuspid insufficiency were treated surgically. All were male, and the ages ranged from 7 to 67 years (median 38 years). Seven patients were blunt chest trauma (including traffic accidents in three). The median duration between trauma and operation was 19 months (range 1 month to 20 years). At operation, the heart functions of patients were in class II to IV (NYHA). Diagnoses were conformed by echocardiogram. The anterior leaflet was prolapsed because of the rupture of chord or anterior papillary muscle in all the patients, combined with chordal rupture of septal leaflet in one. In all the patients, right ventricular was enlarged in various degrees, as well as tricuspid annulus. In three patients, the tricuspid valve was repaired. Five cases received valve replacement, after repair failed. Results All the patients were recovered well without complication after operation. Only one of the three patients after tricuspid valve repair was detected mild tricuspid regurgitation by echocardiogram. The mean postoperative hospital stay was (16.6?6.5) days (7 to 24 days). The median follow-up period was 39 months (range 7 to 129 months). The heart functions were improved to class I (NYHA) in all patients. Conclusion The outcome of surgical treatment of traumatic tricuspid valve insufficiency is good. Surgical intervention should be done as early as possible once diagnosis was made to increase the feasibility of tricuspid valve repair. Tricuspid valve repair is the procedure of choice, while tricuspid valve replacement is also acceptable according to the long-term result of this report.

Objective To evaluate the capabilities of disc diffusion and Vitek2-compact GN13 methods for testing antimicrobial susceptibility of screening ESBLs ( extended-spectrumβ-lactamase) in En-terobacteriaceae clinical isolates.Methods A total of 93 Enterobacteriaceae strains were isolated from pa-tients with intra-abdominal infections in 21 hospitals during 2011 to 2012.The in vitro minimum inhibition concentration ( MIC ) values of ampicillin-sulbactam, piperacillin-tazobactam, ertapenem, ceftazidime, ceftriaxone, cefepime, imipenem, amikacin, ciprofloxacin and levofloxacin were determined by disc diffu-sion, Vitek2-compact GN13 and broth microdilution methods, respectively.Categorical agreement ( CA ) rates of disc diffusion and Vitek2-compact GN13 methods were determined by using broth microdilution meth-od as the reference method.The genes encoding ESBLs were screened in Escherichia coli (E.coli), Kleb-siella pneumoniae (K.pneumonia), Klebsiella oxytoca (K.oxytoca) and Proteus mirabilis (P.mirabilis) strains by using PCR analysis and gene sequencing.Disc diffusion and Vitek2-compact GN13 methods were used for the phenotypic confirmatory test of ESBLs and the sensitivity, specificity, positive predictive value and negative predictive value of the two tests were evaluated.Results The CA values of disc diffusion and Vitek2-compact GN13 methods for the 10 antibiotics were all >90% as compared with broth microdilution method.The major error (ME) rate for ertapenem was 3.2%and the very major error (VME) rates for am- picillin-sulbactam, ceftazidime and cefepime tests were all 2.2% by using Vitek2-compact GN13 method. The sensitivity, specificity, positive predictive value and negative predictive value of disc diffusion and Vitek2-compact GN13 methods in the phenotypic confirmatory test of ESBLs were 96.7%(29/30), 100%(20/20), 100%(30/30) and 95%(19/20), respectively.Conclusion Both disc diffusion and Vitek2-compact GN13 methods could be used for testing the antimicrobial susceptibility and the detection of ESBLs in Enterobacteriaceae clinical isolates with the advantage of accuarcy.Attention should be paid to the posibil-lity of oaurance of ME and VME when testing ertapenem, ampicillin-sulbactam, ceftazidime and cefepime by using Vitek2-compact GN13 method.

Objective To evaluate the therapeutic strategy and effects of surgical treatment for patients with closed trauma of heart valves. Method A total of 32 patients, 28 male and 4 female, aged from 21 to 48 years old with closed trauma of heart valves treated with surgical intervention from June 1987 to November 2008 were retrospectively studied. The duration from trauma to surgical treatment ranged from 18 days to 4 years. Results There was no peri-operative mortality within 30 days. Clinical follow-up for one month to 22 years showed cerebral hemorrhage in only one patient 27 months later and sudden death in one patient probably due to choke of the valve.Conclusions The mortality of patients with closed trauma of heart valves may be decreased by timely and correct diagnosis and treatment, and the outcomes may be improved.

Objective To investigate the causes,diagnosis and treatment of postoperative acute cholecystitis. Methods Clinical data of 9 cases with postoperaive acute cholecystitis were analyzed retrospectively. Results7 cases was confirmed by ultrasonography, 1 case was confirmed by CT, and 1 case died of gallbladder perforation, no operative mortality in emergency cholecystectomy. Conclusion The prevalent etiology is biliary stasis. Early diagnosis and treatment is the key point to decrease the death rate.

BACKGROUND: Present studies have verified that Baicalin has protective effects on various brain damage in the nervous system.OBJECTIVE: To study the possibility of intravenous transplantation of human umbilical blood mesenchymal stem cells (hUBMSCs) and Baicalin after hypoxic-ischemic brain damage (HIBD) in neonatal rats.DESIGN, TIME AND SETTING: The randomized controlled animal study was performed at the Laboratory of the Department of Neurology, First Affiliated Hospital, Nanchang University from February 2007 to January 2008.MATERIALS: Totally 10 umbilical blood samples from healthy full-term pregnant women were obtained from the Department of Obstetrics, First Affiliated Hospital, Nanchang University. A total of 85 clean Sprague Dawley neonatal rats aged 7 days were randomly assigned to a normal control group (n=15), a model group (n =20), a cell transplantation group (n =25), a cell transplantation + Baicalin group (n =25).METHODS: The umbilical blood mononuclear cells were isolated by the gelatin sedimentation + density gradient centrifugation method, and amplified in vitro. Cells at the fifth passage were used for transplantation. Cells were labeled by DAPI at 6-12 hours before use. Neonatal rats in the model, cell transplantation and cell transplantation + Baicalin groups were used to establish HIBD models. Rats in the blank control group were left intact. At 2, 3,4, 5 weeks following model induction, rats in the cell transplantation and cell transplantation + Baicalin groups were injected with DAPI-labeled hUBMSCs (5-10 μL/g) via caudal vein at the density of 1 ×10~9/L. From the first day of transplantation, rats in the cell transplantation + Baicalin group were injected with 120 mg/kg Baicalin via intraperitoneal injection, once a day, for three successive days.MAIN OUTCOME MEASURES: The following parameters were measured: brain tissue lesion, DAPI-positive cell number, location of hUBMSCs following transplantation.RESULTS: Lesion rate of brain tissue was significantly lower in the cell transplantation + Baicalin group compared with the model and cell transplantation groups at 4 weeks following transplantation (P < 0.05). Compared with the cell transplantation group,DAPI-positive cell number was significantly increased in the cell transplantation + Baicalin group at 1, 2, 4 weeks (P < 0.01). From the 3~(rd) week following model induction, abundant DAPI-labeled cells were found surrounding the lesion site, without obvious boundary integrated with the host brain. Few DAPI-positive hUBMSCs were found in non-ischemic region. At 4 and 5 weeks following model induction, DAPI-positive cells were significantly decreased in the lesion site.CONCLUSION: The third week following HIBD is an optimal time for cell transplantation. Baicalin can make a large number of hUBMSCs across the blood-brain barrier to distribute and scatter around the disease focus integrated with host brain tissue.

OBJECTIVE To investigate the resistant patterns of ESBLs-producing Escherichia coli and Klebsiella spp isolated from 3 hospitals in Xinjiang and to determine the genotypes of ESBLs. METHODS Using 2-fold agar dilution test to determine MICs of ten antibiotics.Using polymerase chain reaction and DNA sequencing to determine ESBLs genotype;using isoelectric focusing to determine the isoelectric points of ?-lactamases produced by strains in which no ESBLs genes were amplified by PCR. RESULTS Strains had low susceptibility to aztreonam,cefotaxime and ceftazidime.The susceptibility to cefepime,cefoperazone/sulbactam,cefmetazole,piperacillin/tazobactam,and meropenem were relatively high.Fifty five strains mainly carried blaCTX-M-1 subgroup gene and blaCTX-M-9subgroup gene,and blaSHV-12 gene were also detected. CONCLUSIONS blaCTX-M-1 Group gene and blaCTX-M-9 group gene are prevalent in three hospitals of Xinjiang,blaSHV-12 gene also plays a part role in leading to resistance of E.coli and Klebsiella spp to ?-lactams.