With the rapid development of clinical laboratory technology and clinical improvement,the discordance between department of microbiology and clinical departments got more and more.Based on the analysis of interface issues existed between them,we discussed and explored how to do a wonderful job to communicate with each other.(Chin J Lab Med,2013,36:375-376)

Klebsiella Pneumoniae is an important pathogen for various infections clinically,in which hypervirulent Klebsiella pneumoniae (hvKP) mainly causes pyogenic liver abscess.By now,there are no standardized method to identify hvKP strains.hvKP strains are usually with hypermucoviscous phenotype,and the prevailing serotypes and clonal types are K1,K2 and CC23,CC65,respectively.Genes rmpA,magA,alls and kfu contribute to the pathogenicity of hvKP.This paper reviews the identification,clonal types and serotypes,hypermucoviscous phenotype and some other virulent genes of hvKP.

Neuronal apoptosis is one of the important forms of neuronal death in ischemic stroke.N-methyl-D-aspartate (NMDA) receptor-mediated excitatory amino acid toxicity plays an important role in neuronal apoptosis. It is the initiator and executor of apoptosis in neuronal cells. NR2B is the major regulatory subunit of this receptor, its transmembrane segment M2 is a reflexed membrane loop region facing cytoplast toward intramembrane, forming the inner wall of ion channel, which determines the permeability of the NMDA receptor ion channel to calcium. Glutamate mediates cell injury mainly through calcium overload, therefore, NR2B subunit plays a vital role in the neuronal apoptosis in ischemic stroke.

Objective To investigate whether acupuncture can prevent postoperative nauseaand vomiting (PONV)in patients received breast surgery. Methods Two hundred and forty patients were randomly divided into the acupuncture group and the control group. Patients in the acupuncture group were treated at bilateral Hegu (L4) and Neiguan (P6) after surgery. Patients in the control group received no any interventions. The occurrence of postoperative nausea and vomiting, the number of complete remission and the remedial treatment were record ed. Results The incidences of nausea and vomiting in the acupuncture group were lower than those in the control group from 2 h to 6 h post-operation, with less need of remedy treatment (P < 0.05, respectively). Conclusion Acupuncture in preventing nausea and vomiting after breast surgery owns a certain value in the early postoperative (6 h) stage, with effectively reducing the occurrence of postoperative nausea and vomiting.

The occurrence of 20 to 25 percent of ovarian cancer is associated with genetic factors.Hereditary ovarian cancer includes genetic ovarian cancer and familial ovarian cancer.The genetic characteristics of tumors and the development of gene testing technology make it possible to detect tumor-related mutational genes by testing the gene of the proband and thus identify the other family members at risk and intervene early so as to realize early prevention and detection of the cancer.The paper reviews the genetic basis and pathogenesis of hereditary ovarian cancer as well as methods of detecting mutational genes, management of the proband, problems at present, and disease prevention for high-risk individuals.It stresses that we should pay attention to hereditary ovarian cancer in clinical work, identify the proband, and make comprehensive evaluation of risks of the patients` relatives so as to provide individualized guidance and carry out the concept of precision medicine.

Objective Exploring different strengthening immune strategy on long-term immune memory effects for tuberculosis vaccine lays the theoretical foundation.Methods The fusion protein AMM,adjuvant DDA and BCG-PSN mixed built AMM subunit vaccine.Choose only 50 C57BL/6 mice (SPF),according to the table of random number method was divided into 5 groups and each group 10 only,the experiment 1 group injected mice to phosphate buffer solution (PBS) as control; Experiment 2 mice only injected BCG vaccine (BCG) from early; Experiment 3 mice BCG initial free,in 10 weeks with AMM subunit vaccine strengthen immunity; The four mice from early after BCG,respectively on 8 weeks,10 weeks with AMM subunit vaccine strengthen immune mice one time.Experimental 5 groups of mice after BCG initial free,respectively on 6 weeks,8 weeks,10 weeks with AMM subunit vaccine strengthen immune mice a.28 weeks to remove spleen lymphocytes in mice,add 2.5μg/ml Ag85B stimulus 72 h after collecting spleen cell culture supernatant,with ELISA test Ag85B specificity splenic lymphocyte caused IFN ppar-gamma level.Results Spleen cells by antigen Ag85B stimulation,BCG initial free,AMM subunit vaccine strengthen immune once,twice,three times group and PBS compared all had difference (P ＜0.01 orP ＜0.05) ;BCG initial free-AMM subunit vaccine strengthen immune once,twice,three times group and BCG compared all had difference (P ＜0.01 or P ＜0.05) ; BCG initial free-AMM subunit vaccine strengthen immune once and twice or three times group compared with difference (P ＜0.01 orP ＜0.05) ; Initial free-AMM subunit vaccine strengthen immune two group and three times than group difference was statistically significant (P ＞0.05).Conclusion Mice strong immune strengthened the number is not the more the better,the appropriate number of strengthen the immune to induce the most lasting immunity memory,subunit vaccine strengthen immunization strategy may affect the immune memory is one of the important factors.

Objective To study the detection and clinical signitlcanee of C reactivn protein(ClIP)and P-seleetin(P-sel)in patients with ulcerative colitis(UC).Methods The levels of peripheral blood ClIP and P-sel in patients with UC(n=53)and normal control group(n=35)were detected and the effects on disease severity were analyzed subsequently.Results The levels of blood CRP and P-sel in active phase group were significantly higher than those in catabasis group and normal controls group(P＜0.05);severe stage and medium stage were signiticandy higher than those in mild stage(P＜0.05,P＜0.01),severe stage was significantly higher than those in medium stage(P＜0.05);the blood level of CRP was positively related to P-sel in active phase group(r=0.638,P＜0.01).Conclusion CRP and P-sel were correlated with invasion and severity of UC.

Objective To observe the effects of salmeterol/fluticasone on the bone metabolism and bone density of the patients with moderate COPD and whether the effects is relate with inhaled corticosteroid course. Methods Sixty pa-tients with COPD were divided into 2 groups by random digit table. Patients in experimental group (n=30) were given conven-tional therapy with salmeterol/fluticasone one inhale(bid) for continuously 12 months while patients in control group (N=30) were given conventional therapy without any glucocorticoid.The bone mineral density (BMD) of the femoral triangle in all patients were measured by DXA before therapy, 3 months and 12 months after therapy. At the same time, biochemical indi-cators that are correlated with bone metabolism include bone gla protein (BGP) and alkaline phosphatase (ALP) were mea-sured by radioimmunoassay. Results The BMD, BGP and ALP of patients in experimental group and in control group be-fore therapy, 3 month and 12 month after therapy were compared. There is no significant difference (P>0.05) between these two groups before therapy and after 3 month but significant difference was shown after 9 months (P<0.05). Conclusion Short period inhaling salmeterol/fluticasone in patients with COPD is safe. But long-term inhaling salmeterol/fluticason may lead to decline of the bone density in patients with COPD.

ObjectiveTo compare the correlation and agreement of international normalized ratio (INR) measured by INRatio coagulometer and standard laboratory venous blood measurement in order to judge the clinical application value of measuring INR by INRatio coagulometer.MethodsOne hundred who received warfarin were chosen randomly.Venous blood and finger capillary blood were taken simultaneously for measurement of INR by laboratory coagulation analyzer SYSMEX CA-7000 and INRatio coagulometer respectively.The correlation and agreement of INR results tested by the two methods were analyzed.Results When INR ≤5,there was a good correlation between INRatio coagulometer and laboratory coagulation analyzer SYSMEX CA-7000 (r =0.898,P =0.000).The mean bias of the two methods was 0.36 and INR measured by INRatio coagulometer were higher than those tested by laboratory coagulation analyzer SYSMEX CA-7000.By Bland-Altman,it showed a good agreement for 91.2％ (62/68) of the difference INR located 95％ the limited of agreement when the mean INR 1.60 - 3.50,and a bad agreement for only 50.0％(1/2) of the difference INR located 95％ the limited of agreement when the mean INR ＞ 3.50.ConclusionsIn the therapeutic range,INR measured by INRatio coagulometer shows a good correlation and agreement with INR measured by the established laboratory method.INRatio coagulometer can be used to monitor INR in the patients received oral anticoagulant therapy.

Objective To investigate the symptom characteristis as well as the clinical assessment methods of dysphagia and oral motor function in children with cerebral palsy(CP).Methods A total of 116 children with CP,aged 18 months to 96 months(66 boys and 50 girls),treated in Qingdao Rehabilitation Center for Disabled Children from June 2009 to September 2010,were included in the study.Diagnosis and subtype of CP were determined by neuropaediatrician,the dysphagia disorders survey(DDS)as well as oral motor assessment were conducted by the speech therapists.Results Of the 116 cases,22.4％ of the cases were with mild dysphagia and 34.5％ with moderate to severe dysphagia,resulting in a prevalence of dysphagia of 56.9％.The main problems of these cases occurred during oral phase and pharyngeal phase,including inadequate feeding skills(involving sucking,biting,chewing or/and swallowing),coughing,vomiting and choking during feeding,cry/overextension of neck and head during feeding,drooling,hypertonic tongue and inadequate tongue lateralization.The severe dysphagia was encountered frequently in children with spastic quadriplegic,dyskinetic or mixed type CP children.Of the 116 cases,90 cases(77.59％)were with oral motor dysfunction(including all spastic quadriplegic,dyskinetic or mixed type children).The oral motor scores of CP children were significantly lower than those of the controls(P ＜ 0.01).Conclusions Oral phase dysphagia and oral motor disorder might be considered as the common clinical problems among the patients with CP,and could be assessed by using DDS combined with oral motor assessment,but for dysphagia during pharyngeal or esophagus phase,the videofluoroscopic modified barium swallow should be used for further evaluation.