Objective To investigate the existence and variance of quinolone-resistance genes in a group of pan-drug resistant of Acinetobacter baumannii ( A.baumannii ).Methods Twenty strains of pandrug resistant A.baumannii were isolated from patients registered in Affiliated Hospital of Nantong University from January 2011 to April 2011.Drug target genes to quinolone (gyrA,parC) and quinolone-resistance genes mediated by mobile genetic elements [ qnrA,qnrB,qnrS,aac(6')-Ⅰ b-cr,qepA] were analyzed by PCR and verified by DNA sequencing.Results In all 20 strains of A.baumannii,the sense mutation was found in the quinolone resistance-determining region of the gyrA gene in the form of TCA to TTA at codon 83 (Ser-83-Leu).Moreover,in the quinolone resistance-determining region of the parC gene sense mutation was found in the form of TCG to TTG at codon 80 (Ser-80-Leu) and 3 synonymous mutations were CCC to CCT at codon 40,GTA to GT]T at codon 41 and CGT to CGC at codon 44.And parC gene was a new mutation.However,mutations were not found in quinolone-resistance genes mediated by mobile genetic elements [ qnrA,qnrB,qnrS,aac( 6 ' )-Ⅰ b-cr,qepA ].Conclusion Quinolone-resistance-determining region play a key role in resistance to quinolones in this group of A.baumannii.To our knowledge,this is first report about the emergence of the new mutation of parC gene in China.

OBJECTIVETo evaluate the bond strength and durability of a self-adhesive resin cement with a zirconia ceramic pretreated by a zirconia primer.

METHODSZirconia ceramic (Vita Inceram YZ) plates with a thickness of 2.5 mm were fired, polished, and then cleaned. Half of the polished ceramic plates were sandblasted with 50 μm alumina particles at 0.3 MPa for 20 s. The surface compound weight ratios were measured via X-ray fluorescence microscopy. The polished and sandblasted ceramic plates were directly bonded with self-adhesive resin cement (Biscem) or were pretreated by a zirconia primer (Z Primer Plus) before bonding with Biscem. The specimens of each test group were divided into two subgroups (n=10) and subjected to the shear test after 0 and 10,000 thermal cycles. The data were analyzed via three-way ANOVA.

RESULTSAfter air abrasion, 8.27% weight ratio of alumina attached to the zirconia surface. Compared with air abrasion, primer treatment more significantly improved the primary resin bond strength of the zirconia ceramic. The primary resin bond strength of the zirconia ceramic with no primer treatment was not affected by thermocycling (P>0.05). However, the primary resin bond strength of the zirconia ceramic with primer treatment was significantly decreased by thermocycling (P<0.05).

CONCLUSIONPrimer treatment can improve the primary resin bond strengths of zirconia ceramics. However, the bond interface of the primer is not stable and rapidly degraded during thermocycling.

Adhesives ; Aluminum Oxide ; Ceramics ; Dental Bonding ; Dental Porcelain ; Dental Stress Analysis ; Materials Testing ; Resin Cements ; Surface Properties ; Zirconium

Objective To investigate the relationship between body mass index (BMI),total body fat (TBF),body fat distribution,and dyslipidemia in the elderly.Methods A total of 395 healthy elderly people who had annual examination at Peking Union Medical College Hospital were consecutively enrolled from October 2013 to March 2014.Body weight (BW),TBF,abdominal fat (AF),visceral fat (VF),visceral fat area (VFA) and waist-to-hip ratio (WHR) were measured with multi-frequency bioelectric impedance analysis.Serum triglyceride (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured at the same time.The relationship between BMI,TBF,body fat distribution,and dyslipidemia were analyzed.Results The incidences of obesity (17.8％ vs.9.6％,P=0.036),overweight (49.6％ vs.30.4％,P=0.000) and dyslipidemia (67.0％ vs.44.8％,P =0.000) in male were significantly higher than those in female;while female showed a significantly higher percentage of TBF (60.0％ vs.41.1％,P =0.001).TC was positively correlated with TBF (P =0.020),AF (P =0.018),VF (P =0.015) and VFA (P =0.017);TG was positively correlated with BMI (P =0.000),TBF (P=0.000),WHR (P=0.000),AF (P=0.000),VF (P=0.000) and VFA (P=0.000);LDL-C was positively correlated with BMI (P =0.049),TBF (P =0.005),AF (P =0.004),VF (P =0.003) and VFA (P =0.004);while HDL-C was negatively correlated with BMI (P =0.000),TBF (P=0.020),WHR (P=0.000),AF (P=0.021),VF (P=0.024) and VFA (P=0.022).Receiver operating characteristic curve analysis showed that the predictive curves of BMI,TBF,WHR,AF,VF and VFA were above the reference line.TBF (P =0.000),WHR (P =0.000),AF (P =0.000),VF (P =0.000),VFA (P =0.000),TG (P =0.000) and LDL-C (female:P =0.021) in obesity/overweight group were significantly higher than those in normal weight group.Conclusion Obesity/overweight,high TBF and large WHR may increase the risk of dyslipidemia in the elderly.

To improve the clinical skills of medical students and to train qualified and profes-sional ophthalmologist,the school of optometry and ophthalmology in Wenzhou Medical College car-ried out reforms and innovations in clinical practice and training. In order to strengthen and train clin-ical thinking and clinical skills,and to cultivate the humanistic qualities of medical students,the di-verse-training mode were applied in clinical practice and training. In this paper explored the design goal, objective and actual effect of diverse-training mode for clinical practice and training.

Objective To study MRI features of pituitary stalk interruption syndrome(PSIS).Methods 10 cases in 42 with growth retardation patients diagnosed as PSIS by MRI,all of them were male,age ranged from 5 to 18 with average 13.6 years.Results The anterior-pituitary superior border was depressed,anterior-pituitary volume decreased(average height 2.1 mm,average width 7.8 mm),ectopic posterior-pituitary lobe located at infundibulum stem and pituitary stalk was absent in all cases.The blood hormorne test showed the growth hormone deficiency and multiple growth hormone deficienty.Conclusion PSIS often see in men,MRI findings of PSIS are characteristic.

Objective To investigate the expression of human epididymal protein 4 (HE4) in chronic kidney disease (CKD) and its clinical value.Methods From April 2014 to December 2015,Serum samples of 92 non-cancer patients diagnosed as CKD and 84 healthy controls were collected in Nantong University Hospital.HE4,BUN,Scr,Cys C and β2MG were detected.The difference of HE4 expression in different stages of CKD and the correlation of HE4 with Urea,Scr,Cys C and β2MG were analysized,respectively.ROC curve was used to evaluate the auxiliary diagnostic value of HE4,BUN,Scr,Cys C and β2MG.Results The serum HE4 expression in patients with impaired renal function was 388.2 (130.1～1 659.5)mIu/ L,(F=16.237,P=0.001).Which was significantly higher than that in the control group [38.1 (32.77 ～ 48.17)mIu/L].The serum HE4 expression was increased by the stage of renal damage and the difference was existed among different groups (P＜0.05).HE4 expression was positive related with Cys C and β2MG.The AUC of HE4,BUN,Scr,Cys C and β2MG were 0.878,0.785,0.816,0.874 and 0.819,respectively.Conlusion It needs to consider the exsits of impaired renal function when the HE4 was detected.The HE4 might be a novel early diagnostic indication for CKD.

Objective:To investigate the diagnostic value of mitochondrial associated protein fumarylacetoacetate domain containing protein 1 (FAHD1) and growth differentiation factor-15 (GDF-15) in sepsis.Methods:Based on the database of the whole process of sepsis early warning, diagnosis and treatment management, which was established on the study of sepsis early warning and standardized diagnosis and treatment system, adult patients with suspected infection admitted to the department of critical care medicine of Zhejiang Hospital, Second Affiliated Hospital of Zhejiang University, the First Affiliated Hospital of Sun Yat-Sen University, West China Hospital of Sichuan University, Ningbo First Hospital from May 2014 to October 2015 were enrolled. The basic vital signs, and the main blood routine results, liver and kidney function, blood gas, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and sequential organ failure assessment (SOFA) score at the time of diagnosis of patients with or without sepsis were analyzed. The preserved serum samples were taken, the levels of procalcitonin (PCT), C-reactive protein (CRP) were detected by electrochemiluminescence method, immunoturbidimetry respectively, and FAHD1 and GDF-15 were detected by enzyme linked immunosorbent assay (ELISA). Univariate and multivariate Logistic regression were used to analyze the risk factors for sepsis diagnose. The indexes' diagnostic efficacy in sepsis were analyzed by receiver operating characteristics curve (ROC curve).Results:A total of 132 patients were enrolled, including 76 cases of sepsis and 56 cases of non-sepsis. Compared with the non-sepsis group, the heart rate in the sepsis group was increased (bpm: 116.4±17.8 vs. 97.4±19.1), while the mean arterial pressure (MAP), platelet count (PLT), arterial partial pressure of oxygen (PaO 2) were significantly decreased [MAP (mmHg, 1 mmHg = 0.133 kPa): 65.8±9.7 vs. 74.7±10.3, PLT (×10 9/L): 120 (69, 204) vs. 163 (117, 239), PaO 2 (mmHg): 83.0 (66.6, 108.0) vs. 108.0 (84.4, 130.0), all P < 0.05], direct bilirubin (DBil), serum creatinine (SCr), lactic acid (Lac), APACHEⅡ score and SOFA score were significantly increased [DBil (μmol/L): 13.00 (5.55, 55.31) vs. 6.20 (2.20, 21.90), SCr (μmol/L): 118.00 (70.00, 191.73) vs. 77.20 (59.65, 110.86), Lac (mmol/L): 2.90 (1.50, 4.10) vs. 1.90 (1.20, 2.80), APACHEⅡ score: 20.0 (16.0, 25.0) vs. 16.0 (10.0, 21.0), SOFA score: 12.0 (8.0, 16.0) vs. 8.0 (5.0, 13.0), all P < 0.05]. In addition, the serum levels of FAHD1, GDF-15, PCT and CRP in sepsis group were significantly higher than those in non-sepsis group [FAHD1 (μg/L): 3.96 (2.25, 5.92) vs. 2.47 (1.03, 3.54), GDF-15 (μg/L): 8.46 (4.37, 19.68) vs. 4.32 (1.74, 10.39), PCT (μg/L): 3.79 (1.37, 11.32) vs. 0.42 (0.12, 2.14), CRP (mg/L): 154.43 (61.33, 283.20) vs. 65.95 (28.15, 144.69), all P < 0.01]. Multivariate Logistic regression showed that serum FAHD1 [odds ratio ( OR) = 1.135, 95% confidence interval (95% CI) was 1.045-1.234], GDF-15 ( OR = 1.090, 95% CI was 1.029-1.155) and CRP ( OR = 1.007, 95% CI was 1.002-1.011) were risk factors for sepsis (all P < 0.05). ROC curve analysis of sepsis showed that the areas under ROC curve (AUC) of serum mitochondrial associated proteins FAHD1 and GDF-15 were 0.727 (95% CI was 0.641-0.802) and 0.677 (95% CI was 0.588-0.757), respectively; and the AUC of classical infection indexes PCT and CRP were 0.767 (95% CI was 0.683-0.837) and 0.680 (95% CI was 0.59-0.760), respectively. There was no significant difference between the AUC of mitochondrial associated proteins and classical infection indexes. The combination of FAHD1, GDF-15, PCT and CRP had the largest AUC, which was 0.809 (95% CI was 0.730-0.874), and the sensitivity was 75.00%, and the specificity was 80.00%. Conclusion:Mitochondrial associated protein FAHD1 and GDF-15 are associated with sepsis, and the diagnostic efficiency is improved when combined with PCT and CRP, which might provide experimental basis for screening diagnostic markers of sepsis.

Purpose A RP-HPLC method was used to determine genioside and breviscapine in plasma and to study its pharmacokinetics in rat, respectively.Methods Rat plasma samples were collected after a single dose of Zhideng injection and pharmacokinetic parameters of genioside and breviscapine were estimated,respectively.Results A good linear relationship was obtained between 0.2-40.0 μg/mL for breviscapine, and 0.5-200.0 μg/mL for genioside.The recoveries from plasma were larger than 85%,and RSDs of inter-day asaay and intra-day assay were below 10%. The pharmacokinetic results showed that genioside and breviscapine were rapidly eliminated from plasma after iv administration of three doses of Zhideng injection.The mean half-life was 72.6 min and 21.6 min,respectively.Conclusion The established HPLC method was suitable for the pharmacokinetic study of genioside and breviscapine.

This study is purposed to investigate the effects of praeruptorin A (PA) and praeruptorin C (PC) on UGT1A1 in HepG2 cells through hCAR pathway. PA and PC were incubated with HepG2 cells for 24 h and 48 h, mRNA and protein expressions of UGT1A1 were determined by real-time PCR and Western blotting assays. Additionally, effects of PA and PC on UGT1A1 mRNA and protein expressions were also measured after transient transfection of a specific CAR siRNA for 72 h in HepG2 cells. UGT1A1 mRNA and protein expression levels were significantly increased by PA and PC after incubation for 48 h. Moreover, the mRNA and protein up-regulations of UGT1A1 were attenuated by transient transfection of a specific CAR siRNA, suggesting the induction was mediated by CAR. The results suggest that PA and PC can significantly up-regulate UGT1A1 expression partially via the CAR-mediated pathway.

Objective To investigate the clinical value of circulating miR-125b-5p in coronary atherosclerotic heart disease.Methods With case-control study,80 cases of coronary atherosclerotic heart disease were recruited in Affiliated Hospital of Nantong University from February 2014 to august 2015.According to coronary angiography result they were divided into two groups: there are coronary artery stenosis group(n=49)and control group(n=31).All patients were also divided into non-ST-segment elevation myocardial infarction and ST-segment elevation myocardial infarction group(n=35),unstable angina group group(n=25),stable angina group(n=20).The level of miR-125b-5p before coronary angiograph was detected.By independent sample t test and variance analysis,the levels of miR-125b-5p were compared between the groups of coronary artery stenosis and the group with no stenosis of the coronary artery,the coronary artery lesions in each group,and between the various types of coronary atherosclerotic heart disease respectively.Results MiR-125b-5p expression level of Coronary artery stenosis group(0.35±0.10)was lower than that in group coronary artery with no stenosis(0.95±0.12),the difference was statistically significant(t=24.179,P<0.000 1).With the increase in the number of diseased coronary arteries,miR-125b-5p expression level decreased gradually.There is also statistical significance(t=8.399,P<0.000 1; t=13.067,P<0.000 1)in miR-125b-5p expression among NSTEMI+STEMI,UA and SAP groups.miR-125b-5p expression level was negatively correlated with Gensini score(R2=0.822,P<0.05).The area under the ROC curve(AUC)of miR-125b-5p was 0.86(95％CI 0.67-0.90),and 0.66 was the optimal cut-off value with sensitivity of 81.22％and specificity of 78.62％.Conclusions With the increase of the number of stenosis,plasma miR-125b-5p expression level decreased gradually.The expression level of miR-125b-5p was negatively correlated with the Gensini score of coronary artery,which indicated that the expression level of miR-125b-5p may be a potential biomarker that can reflect the lesion degree of coronary artery.