ObjectiveTo explore the role of psychological capital in psychological stress and mental maladjustment in recruits.Methods405 recruits were sampled and investigated using the psychological stress selfevaluation test( PSET),the psychological capital questionnaires(PCQ),and military mental maladjustment scale (MMMS).ResultsPsychological stress had significant positive correlation with each factor of mental maladjustment ( r =0.164 ～ 0.438,P ＜ 0.01 ),and psychological capital had significant negative correlation with each factor of mental maladjustment ( r=-0.312 ～ -0.463,P＜ 0.001 ).The hierarchical regression analysis indicated that psychological capital,confidence,hoping,resiliency and optimism had the positive prediction of all the four factors of mental maladjustment,the variance contribution rates were 27.2％,20.1％,25.8％ and 15.9％,respectively; the main effect of psychological capital(β1 =-0.406,P＜0.01 ;β2 =-0.351,P＜0.01 ) and psychological stress(β1 =0.304,P ＜ 0.01 ;β2 =0.267,P ＜ 0.01 ) on recruits'behavioral problem and interpersonal relationship maladjustment was significant,the interaction effect of psychological capital and psychological stress on recruits' behavioral problem (β =- 0.098,P ＜ 0.05 ) and interpersonal relationship maladjustment (β =- 0.087,P ＜ 0.05 ) was significant.ConclusionPsychological capital is a moderator in interaction between mental maladjustment and psychological stress.The PCQ score may predict the variation of recruits'mental status.

Objective To investigate whether B-cell activating factor (BAFF) involved in the patho-genesis of lupus nephritis (LN) by regulating phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling. Methods Twenty-eight lupus nephritis patients and 20 controls were included in this study. The clinical data were collected. BAFF levels in plasma were measured by ELISA, and the relationship between systemic lupus erythematosus disease activity index (SLEDAI) and BAFF were analyzed. The mRNA and protein levels of BAFF, phosphorylated-PI3K (p-PI3K), phosphorylated-Akt (p-Akt), phosphorylated-mTOR (p-mTOR) and Bcl-2 in kidney tissues were measured using real-time polymerase chain reaction (RT-PCR) and Western blotting. Data were analyzed using Mann-Whitney U test and Spearman correlation analysis. Results ①Plasma BAFF levels were significantly higher in LN patients [(580 ±45) ng/L] compared with controls [(208 ±30) ng/L](Z=-5.856, P<0.01), and significant positive correlation was found between plasma BAFF levels with SLEDAI (r=0.723, P<0.01). ② Plasma BAFF level in LN patients was positively correlated with 24 h UP and anti-dsDNA titers (r=0.381, 0.461, P<0.05). The protein level of BAFF in kidney tissues was positively correlated with 24 h UP and anti-dsDNA titer (r=0.469, 0.489, P<0.05).③The mRNA levels of BAFF, p-PI3K, p-Akt, p-mTOR and Bcl-2 in kidney tissues were increased in patients compared to controls[5.8±1.8 vs 2.1±0.7, Z=-4.915, P<0.01;6.7±0.9 vs 1.71±0.53, Z=-5.857, P<0.01;5.6±0.9 vs 1.8 ±0.5, Z=-5.751, P<0.01; 5.6 ±1.4 vs 1.6 ±0.4, Z=-5.291, P<0.01; 2.11 ±0.36 vs 1.33 ±0.22, Z=-4.844, P<0.01].④The protein levels of BAFF, p-PI3K, p-Akt, p-mTOR and Bcl-2 in kidney tissues were increased in patients compared to controls [0.72±0.19 vs 0.31±0.05, Z=-4.747, P<0.01;0.73±0.11 vs 0.33±0.09, Z=-5.834, P<0.01;0.77±0.06 vs 0.22±0.07, Z=-5.855, P<0.01;1.18±0.27 vs 0.47±0.13, Z=-5.416, P<0.01;2.08±0.37 vs 1.32±0.18, Z=-4.998, P<0.01]. Conclusion The findings of this study indicate that BAFF may participate in the pathogenesis of LN by regulating PI3K/Akt/mTOR signaling.

Aim To prepare and characterize a monoclonal antibody against recombinant glutathione S-transferase(GST) for purifying GST fusion protein. Methods The GST-follistatin fusion protein was expressed by using a pGEX4T-1 expression vector in Escherichia coli BL21 and purified by glutathione-resin affinity column chromatography. Then female Balb/c mice were immunized with the GST-FS, The immunized splenocytes were fused with NS-1 hybridoma cells. Dreparation of the mAb was used by conventional hybridoma techniqal. The mAb purified by protein A, was culpled with Sepharose4B to purify further GST fusion protein by affinity chromatography. Results The SDS-PAGE showed that the GST fusion protein could be purified effctively by specific mAb affinity chromatography as same as by glutathione-resin affinity chromatography. Conclusion mAb affinity chromatography will be a ecnomical and useful method and it can be used for secondary purification of GST fusion protein following glutathione-resin affinity chromatography.

Objective To explore the circadian rhythm of interleukin (IL)-6 in collagen induced arthritis (CIA) rats and investigate the effectiveness and safety of methotrexate (MTX) administered according to IL-6 rhythm.Methods Serum IL-6 concentrations of CIA and normal rats at different time points were measured by enzyme-linked immunosorbent assay (ELISA).CIA rats were randomly divided into the experimental group A,experimental group B and control group.MTX (1/7 mg·kg-1 ·d-1) was administered once a day when the IL-6 level began to increase or decrease in the experimental group,while MTX (1 mg/kg) administered once a week in the control group.Arthritis scores and leukocyte counts were observed.The production of IL-6 and C reactive protein (CRP) levels in the serum were measured.Moreover,histological changes in the ankle joint were examined.One-way analysis of variance (ANOVA),two independent sample t test were used to evaluate the experimental data.Results The plasma IL-6 levels in CIA rats were different at different time points,which began to increase at 18:00 and decrease at 6:00.Arthritis score in the experimental group A (4.8±0.7)was lower than that in the control group (5.8±1.0,t=2.256,P=0.0406) and experimental group B (5.5±0.5,t=2.393,P=0.0313).The levels of TNF-α [(185±21) ng/L],IL-6 [(99±6) ng/L],IL-1β[(20.1±1.6) ng/L] and CRP[(1251±282) μg/L] in the experimental group A were significantly lower than those in control group [TNF-α:(207±10) ng/L,t=2.726,P=0.016 4;IL-6:(100±6) ng/L,t=2.669,P=0.0183;IL-1β:(22.0±1.3) ng/L,t=2.814,P=0.0138;CRP:(1 417±278) μg/L,t=2.369,P=0.0327].The level of IL-6 in the experimental group A[(93±6) ng/L] was lower than that in the experimental group B [(99±6) ng/L,t=2.323,P=0.0358].Compared with the control group [(9650±1062)/μl],the counts of leukocyte in the experimental group A [(4595±603)/μl,t=3.841,P=0.0064] and experimental group B [(3833±585)/μl,t=4.442,P=0.003] were significantly lower.Compared with the control group (9.1 ±2.0),histopathology scores in the experimental group A (6.6±1.3,t=2.606,P=0.015) and experimental group B (7.4±1.3,t=3.857,P=0.0007) were significantly lower.Conclusion The plasma IL-6 levels in CIA rats have shown evident circadian rhythm.There-fore,once a day administration is better than once a week.The therapeutic effect of RA may be improved by administering MTX at the time points according to the circadian rhythm of IL-6.

OBJECTIVE To explore the NG rapid and accurate detection method,epidemiological characteristics and the control of nosocomical infection.METHODS From 1989 to 2008,46 898 patients were under taken the NG smear test,culture and NG immune latex test.RESULTS In the 46 898 cases,764 cases were found out G-diplococci both inside and outside cells or cell.The positive rate was 1.63%.In 764 positive samples,721 cases were not found out other bacteria(94.37%),NG positive smears had their own features.CONCLUSIONS When no bacteria growth and a large number of swollen neutrophils,particular attention should be paid.NG smears particularly for small media-size community and rural hospitals,without NG culture,PCR and NG antigen/antibody test can be choosed first.

Objective To retrospectively analyze the role of 3-dimensioual conformal radiotherapy (3-DCRT) after percutaneous transhepatic portal vein stenting and transcatheter arterial chemoembolization (PTPVS-TACE) in the treatment of patients with hepatocellular carcinoma (HCC) complicated by main portal vein tumor throw.bus (MPVTT).Methods Between July 2002 and July 2007,45 patients with HCC complicated by MPVTT were treated by PTPVS-TACE.Among them,3-DCRT were undertaken for MPVTT in 16 patients (group A),the other 29 patients were not treated with 3-DCRT(group B).The clinical effects,complication,stent patency rates,cumulative survival rates were evaluated among groups.The Kaplan-Meier method and log-rank test were used for survival analysis.Results No patient died during stent placement or within the preceding first 24 hours.No severe procedure-related complications were observed.The 60--,180--,360--day cumulative stent patency rates were 100.0%,62.2% and 34.6% in group A,and 58.6%,21.7% and 10.8% in group B,respectively,showing significant difference between the two groups (X2 =9.672,P <0.01).The mean patency time was(475±137) and (200±61)days,respectively.The 60--,180--,and 360--day cumulative survival rates were 93.8%,81.3% and 32.5% for group A,86.2%,13.8% and 6.9% for group B,respectively.There were significant statistical differences between the two groups(X2=9.672,14.596,P < 0.01).Conclusion Treatment with PTPVS-TACE-3-DCRT is a more effective modality than PTPVS-TACE for HCC complicated by MPVTT.

Objective To investigate the distribution,epidemiologic features and antibiotic resistance of the enteric pathogens i-solated from children with diarrhea.Methods Enteric pathogens were isolated from children’s stool samples.The children with diarrhea were treated in the outpatient and inpatient of Shanghai Children’s Hospital between 2008 and 2013.Antimicrobial susceptibility testing was conducted by disk diffusion method for Salmonella and Shigella with 6 antimicrobial agents.Results A total of 545 enteric pathogens were collected.Salmonella was the dominant pathogen,accounting for 67.2%,followed by Shigella (20.7%),S.aureus (4.6%),C.jejuni (3.7%),Aeromonas (2.4%),and enteropathogenic E.coli (0.9%).The main serotypes of Salmonella were S.typhimurium and S.enteritidis.Approximately 56.3% of the patients were boys.A-bout 72.7% of the patients were infants under 2 years.The prevalence of diarrhea peaked in summer and autumn (72.9%). The susceptibility of these isolates was only tested with seven antibiotics.Shigella showed higher level of resistance to ampicil-lin and trimethoprim-sulfamethoxazole than Salmonella (P<0.05).Significantly higher percentage of S.flexneri isolates were resistant to sulbactam-ampicillin,ceftriaxone,ciprofloxacin,and chloramphenicol than S.sonnei (P<0.001).Further-more,the prevalence of multidrug resistant strains in Shigella (68.3%)was much higher than that in Salmonella (44.7%,P<0.001).Conclusions A variety of diarrhea-causing enteric pathogens are isolated from the children in Shanghai Children’s Hospital.The isolates are predominantly Salmonella and Shigella species.The epidemiological features of Salmonella and Shigella species are different in terms of gender,age,season and geographical distribution.The resistance to antibiotics is a serious problem and varies with different types of pathogens. Intensive and ongoing surveillance of enteric pathogens and their changing resistant pattern is required to control diar-rhea in children.

Objective To assess the long-term outcome of unilateral adrenaletomy in patients with adrenocorticotropic hormone independent macronodular adrenal hyperplasia (AIMAH).Methods The data from 82 cases of AIMAH were reviewed and summarized including clinical manifestations, endocrinological data, imaging findings and postoperative follow-up.Fouty-nine males and thirty-three females with a mean age of fifty years composed our series.Among the 82 cases, 41 demonstrated Cushing syndrome (CS), 74 presented with hypertension, 38 manifested diabetes mellitus, 35 complicated of osteoporosis and 11 of them with bone fracture, 39 complained of edema.Laboratory tests showed low ACTH plasma levels (＜ 2.2 pmol/L) in 62 of 79 cases.High level of 24-hour urinay free cortisol excretion(＞ 284.2nmol/L) was found in 67 of 79 cases.Elevated serum cortisol with loss of the circadian rhythm was presented in 55 of 60 cases.Failed to suppress cortisol secretion was observed in 61 of 63 conducted with low-dose dexamethasone suppression tests and in 47 of 53 implemented with high-dose dexamethasone suppression tests.Bilateral massively enlarged multinodular adrenal glands were found in all cases with CT or MR imaging.Unilateral adrenalectomy was performed in the larger side of adrenal gland in all 82 cases.All adrenalectomies were carried out including 47 in right sides and 35 in left sides, with 77 by retroperitoneoscopic approach and 5 by open retroperitoneal approach.Results Histopathological examination confirmed nodular hyperplasia of the adrenal cortex for all specimens.After a mean duration of 48.5 months, 80 of 82 patients were available for follow-up.Most clinical symptoms resolved within 6 months after operation.Cushingoid features disappeared in 58.5％ (24/41)of patients who initially presented with typical signs of Cushing Syndrome.Weight loss was seen in 56.3％ (45/80).Improvement of hypertension and diabetes was observed in 63.5％ (47/74) and 76.3％ (29/38) respectively.All the eyelids swelling and edema of the limbs subsided within 3 months.In long-term follow-up (more than 6 months), 82.9％ (63/76) had clinical and biochemical recurrence within a mean time of 14.6 months and 46.0％ (29/63) received contralateral adrenal surgery.Two patients died, one died from heart attack and another one died from pulmonary infection, 2 years and 7 years after unilateral adrenalectomy, respectively.Conclusions Unilateral adrenalectomy just has transient efficiency for AIMAH.Most patients will experience clinical and biochemical recurrence for a long period,and have to receive another operation for the contralateral hyperplastic adrenal gland.

Objective To explore the safety,technical feasibility,and catheter-related complications of ultrasound-guided implantation of totally implantable access port (TIAP) in the upper arm.Methods A total of 642 patients,who were admitted to authors' hospital during the period from February 2014 to December 2016 to receive ultrasound-guided implantation of TIAP in the upper arm,were enrolled in this study.The patients included 407 males (63.4％) and 235 females (36.6％),their age ranged from 11 to 89 years old,with a mean age of (58.29±4.33) years old.Under ultrasound guidance,by using Seldinger's technique TIAP was implanted in the upper arm.Results Implantation of TIAP in the upper arm was performed in all 642 patients.The initial success rate of implantation was 99.53％ (639/642),in 3 patients successful implantation was obtained in the second time of implantation as the initial puncturing failed.During the follow-up of 155,302 catheter days,complications occurred in a total of 58 patients (9.0％),including early complications in 9 patients and late complications in 49 patients.The complications included TIAP-related infection (n=28,4.4％),venous thrombosis (n=7,1.1％),sac bleeding (n=3,0.4％),port hub rotation (n=3,0.4％),cracked skin (n=l,0.2％),catheter obstruction (n=2,0.3％),catheter displacement (n=4,0.6％),movement restriction of catheter-side upper limb (n=7,1.1％),venous return obstruction of upper limb (n=2,0.3％) and median nerve injury (n=l,0.2％).No port-related death occurred.Conclusion The ultrasoundguided implantation of TIAP in the upper arm is technically-safe,clinically-effective and minimally-invasive,besides,it carries lower incidence of complications.Therefore,this method is worthy of clinical popularization and application.