Objective To identify strains of Acinetobacter(A.)calcoaceticus-A.baumannii complex accurately,and investigate the species distribution of Acinetobacter calcoaceticus-A.baurnannii(ACB)complex isolated in Daping Hospital.Analysis the anti-biotics resistance of ACB complex.Methods A total of 95 clinica1 isolates of ACB complex were collected from Daping Hospital from February to April 2014,identify by sequence analysis of 1 6S rRNA gene spacer region.Use VITEK-2compact automatic iden-tification of bacteria by susceptibility meter to detect the precise identification of all ACB complex group of drug sensitivity.Results Among all the 95 strains of ACB complex identification results were A.baumanni (81,85.26%),A.pittii(10,10.53%),A.noso-comialis (4,4.21%).A.baumannii to third generation cephalosporins,aminoglycosides and carbapenem antibiotic resistance in seri-ous condition,the sensitive rate was only about 20.00%.But A.pittii and A.nosocomialis had a high sensitivity rate to commonly used antibiotics.Conclusion VITEK-2 Compact automatic identification of bacteria susceptibility meter has limitations in identifica-tion of Acinetobacter,with analysis of 1 6S rRNA gene sequencing,the ACB complex could be accurately identified.There is signifi-cant difference in the composite group-resistant characteristics of each species,clinical infection is also various.

OBJECTIVESTo evaluate the clinical characteristics, in-hospital and three-year outcome in ST-elevation myocardial Infraction (STEMI) patients receiving conservative treatment (CT), thrombolytic treatment (TT) and primary percutaneous coronary intervention (PCI) in Beijing.

METHODSThis 12-month prospective, multicenter registry study was conducted in 19 hospitals with 808 patients with STEMI in Beijing between Jan. 2006 and Dec. 2006, 518 (64%) received PCI, 106 (16.1%) received TT and 184 (22.8%) received CT therapy. Patients were followed up for 3 years.

RESULTSAt baseline, the age of patients in CT group [(64.5 ± 13.5) years] was significantly higher than those in TT group p(57.9 ± 11.0) years] and in PCI group [ (60.4 ± 12.3) years, all P<0.01]; and the median time from symptom onset to hospital in CT group (207 min) was significantly longer than those in TT group (130 min) and PCI group (130 min, all P<0.01). Emergency Medical Service (EMS) use was significantly higher in PCI group (184/518, 35.5%) than in CT group (46/184, 27.3%) and TT group (29/107, 25.0%, all P<0.05). Health insurance holder was the highest in PCI group (P<0.01). PCI was performed less frequently than thrombolytic therapy [66.6% (345/518) vs. 80.2% (85/106)m P=0.02] during off-hours and more frequently performed in tertiary hospitals than in secondary hospitals[66.8%(437/651) vs. 52.6% (81/154, P<0.01)]. The in-hospital mortality and the cardiovascular mortality at 3 year after hospital discharge was significantly higher in CT group [9.2% (17/185) and 9.4% (15/159)] than in PCI group [3.5% (18/518), 4.5% (20/446)] and TT group [6.6% (7/106), 2.3% (2/86), all P<0.01]. Patients in PCI group had the highest adherence level of aspirin, β-blocker, angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers or statins at 3-years follow-up (all P<0.05). Multivariable Cox proportional hazards regression analysis showed that only PCI was associated with lower risk of cardiovascular death (HR-0.40, 95% CI:0.21-0.73, P<0.01).

CONCLUSIONSSocial and clinical setting may affect the physician's decision to provide reperfusion therapy in Beijing for STEMI patients. Better adherence of secondary preventive drugs and lower cardiovascular death are observed in STEMI patients receiving PCI during the 3-year follow-up

Aged ; China ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Percutaneous Coronary Intervention ; Prognosis

Objective The aim of this report was to study the early and mid-term outcome in hospital and follow-up mortality, predictors for late pulmonary stenosis (PAS) and insufficiency of neo-aortic valve (neo-AVI) in patients with transposition of great arteries (TGA) and Taussig-Bing malformation undergoing arterial switch operation ( ASO ). Methods Between January 2004 and December 2007, 169 patients (129 male, 40 female; mean age of [(11.71 ± 26.3 ) months] with TGA or Taussig-Bing malformation underwent ASO. The patients were divided into Group Ⅰ (n = 56 ): TGA with intact ventricular septum and Group Ⅱ ( n = 113 ): TGA with ventricular septal defect (VSD). All patients were followed up in out-patient department by ultrasonic cardiogram. The mean follow-up periods was (27.66 ± 14.6 ) months. Multiple logistic regression analysis was performed to find out the risk factors. Results The overall hospital mortality was 11.24% (19/169)and there was no significant difference between the two Groups. With the improving of perioperative management, the hospital mortality decreased from 16.67% in 2004 to 3.92% in 2007. The overall actuarial survival at 1-, 3- and 5-year follow-up was 94.00%,91.33%, and 91.33%, respectively. The multivariate analysis revealed that age above 6 months was a strong predictor for poor postoperative survival. Predictors for neo-AVI were: combined with VSD, age > 6 months and postoperative neo-AVI Z-score > 1. Predictors for moderate to severe PAS were age ＜ 1 months and pulmonary artery plasty with an unstretchable patch. Conclusion ASO remains the optimal choice for treating various forms of TGA with an acceptable early and mid-term outcome regarding overall survival rate. Patients with TGA should be treated as early as possible. Age >6 months is a predictor for poor postoperative survival and neo-AVI. Mismatch between the neo-aortic root and distal aorta may induce neo-AVI. Unstretchable patch in pulmonary artery plasty may induce PAS.

Background and purpose:Antracycline combined with paclitaxel is more widely applied in breast cancer as neoadjuvant chemotherapy.There are differences in applications of different paclita~els.In this research,the efficacy and toxicity of neoadjuvant chemotherapy with ET,ED regimen were compared for the patients with stageⅢbreast cancer.Methods:64 cases of stageⅢbreast cancer patients were divided in two groups.Before surgery,one group had received ET(EPI ivgtt 60 mg/m~2 d_1?21,PTX ivgtt 175 mg/m~2 d_2?21),the other group had received ED(EPI ivgtt 60 mg/m~2 d_2?21,DOC ivgtt 75 mg/m~2 d_2?21)neoadjuvant chemotherapy for three weeks. Curative effect and side effects were evaluated after 2-4 cycles.Results:Total effective rate was 87.5%.Effective rate in ED group was 92.9%,and effective rate in ET group was 83.5%.There was no significant difference(P=0.253).In pCR cases,8 cases in ED group achieved pathologically complete response compared to 3 cases in ET group(P=0.033). The number of patients in ED group(24 cases)hadⅣ-Ⅴgrade pathology evaluation after chemotherapy,it was higher than that in ET patients(21 cases).There was a significant difference(P=0.017).In both groups side effects including hair loss,nausea and vomiting,liver dysfunction were similar.Incidence rate of peripheral neurotoxicity in ET group was higher than that in ED group(P=0.002).Incidence rates of leukopenia,skin rash and phlebitis in ED group were higher than that in ET group.There was a significant difference between two groups in the leukopenia(P=0.034). Conclusions:For the patients with stageⅢbreast cancer patients,both two regimens could achieve better curative effect.ET and ED regimen have similar effect.But in ED regimen,the number ofpCR cases was obviously higher than in ET group.In both groups side effects were similar.There were significant differences in terms of leukopenia and peripheral neurotoxicity,but the side effects could be tolerated.

Objective To assess the effects of absorbable biomedical membrane-embedded intrauterine device ( IUD) in prevention of recurrence after hysteroscopic adhesiolysis for severe intrauterine adhesions ( IUA ) .Methods A prospective study was carried out among 125 patients who underwent hysteroscopic adhesiolysis for severe IUA from February 2013 to January 2015.Foley catheter was placed immediately after surgery and removed 7 days later.Then patients were randomly divided into three groups:group A (40 cases) received round IUD insertion after catheter removal;froup B (41 cases) received IUD placement and intrauterine injection of sodium hyaluronate; group C ( 44 cases ) received absorbable biomedical membrane-embedded IUD insertion.All patients received two artificial cycles ( oral estradiol valerate, 9 mg/d) the first day after surgery.Hysteroscopy was carried out two months later to assess the repair of endometrium.Patients who were cured or whose condition was greatly improved received three-dimensional transvaginal ultrasound examination in the first natural cycle.Thickness of endometrium, uterine volume and blood flow index were compared.Results Cure rate and effective rate in group C were significantly higher than that in groups B and A [43%(19/44) vs.22%(9/41) and 20%(8/40), χ2 =6.89,P=0.03, 86%(37/44) vs.56%(26/41) and 65%(23/40), χ2 =9.78, P =0.01].The improvement rate of menstruation was higher in group C compared with groups B and A [84%(37/44) vs. 63%(26/41)and 58%(23/40),χ2 =7.73, P=0.02].Average endometrium thickness, uterine volume and blood flow index were also significantly improved in Group C[(8.4 ±1.1) vs.(7.2 ±1.5) and (7.6 ± 1.1) mm, F=5.42,P=0.01,(4.3 ±0.3) vs.(3.9 ±0.4) and (4.0 ±0.6) cm3 ,F=7.12,P=0.00, 28.0 ±4.0 vs.24.6 ±4.7 and 23.4 ±4.0,F =5.40,P =0.01] .No significantly differences were observed between group B and group A in terms of the above indices.Conclusion Insertion of absorbable biomedical membrane embedded-IUD has a good therapeutic effect and can better prevent adhesion recurrence in patients with severe intrauterine adhesion after adhesiolysis.

An accurate segmentation of vascular systems is fundamental for many medical applications. In this paper, we propose a 3D vessel enhancement and extraction method. It is based on the analysis of Hessian matrix and Gaussian mixture model-expectation-maximization (GMM-EM) algorithm. Firstly, tube-like vessels were detected and enhanced based on the Hessian matrix eigenvalues. And then, the vascular system was segmented, and then a rough system was obtained with GMM-EM. Hessian-based filters were found to be sensitive to noise and sometimes gave discontinued vessels. Hence, we utilized the closing operation to avoid discontinuity and a 3D-filter on the segmented vessels to reduce noise brought by the contrast agent. Finally, a searching method based on spatial connected area is presented to connect the vascular system in 3D. The experimental results illustrated the efficiency of the method for 3D liver vessel segmentation proposed in this paper.
Algorithms ; Hepatic Artery ; diagnostic imaging ; Hepatic Veins ; diagnostic imaging ; pathology ; Humans ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; Liver ; blood supply ; diagnostic imaging ; Portal Vein ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

OBJECTIVEDevelopment of new methods, ELISA and immunostrip test, for the diagnosis of nasopharyngeal carcinoma.

METHODSThe engineering purified antigens coat plate or absorb on nitrocellulose filter. The plate and diagnostic strips carrying antigens were used for detection of IgG antibody in the sera from nasopharyngeal carcinoma patients and outpatients patients.

RESULTS127 cases sera from nasopharyngeal carcinoma patients were parallel detected TK/IgG antibody by ELISA and immunostrips. The TK/IgG antibody are all positive in the 127 cases of nasopharyngeal carcinoma patients. 55 cases show positive by ELISA, 58 cases positive by immunostrips in 247cases sera from outpatient. The antibody positive rate to early antigen p54 lower then to TK. Conclusion ELISA and imuunostrips are sensitive and specific means for detection of the IgG antibody to TK of EBV and the diagnosis of nasopharyngeal carcinoma.

Antibodies, Viral ; blood ; Carcinoma ; diagnosis ; immunology ; virology ; Enzyme-Linked Immunosorbent Assay ; methods ; Epstein-Barr Virus Infections ; diagnosis ; immunology ; virology ; Herpesvirus 4, Human ; enzymology ; immunology ; Humans ; Immunoglobulin G ; blood ; Nasopharyngeal Neoplasms ; diagnosis ; immunology ; virology ; Reagent Strips ; Thymidine Kinase ; blood ; immunology ; Viral Proteins ; blood ; immunology

Objective To explore the residual undifferentiated mouse embryonic stem cells (ESCs) in embryoid bodies. Methods Mouse R1 and Oct-4-GFP transgenic ESCs were firstly cultured in suspension to form embryoid bodies (EBs). Twenty days later, EBs were digested into single cells and then re-plated in standard ESC culture condition. The morphology of residual undifferentiated cells in EBs was observed, and surface makers and in vitro redifferentiation potency of residual cells were examined by flow cytometry and immunofluoreseent staining. The residual cells were expanded and subcutaneously injected into nude mice, and the specimens were harvested from the injection site for histological analysis 6 weeks after injection. Results There were residual undifferentiated ESCs in EBs differentiated for 20 days, which displayed clonal morphology and expressed undifferentiated cell markers of ESCs, including SSEA1, CD31, CD9 and Oct-4. The cells could be differentiated to form EBs again, and could be re-expanded from secondary EBs. The residual cells were able to form teratoma at the injection site, and mature endoderm, mesoderm and ectoderm tissues could be found in teratoma tissues. Conclusion There are residual undifferentiated ESCs after differentiation of ESCs into EBs. The residual ESCs can differentiate again in vitro and in vivo, and can residue again in the in vitro differentiation.

OBJECTIVETo evaluate the clinical value of the comprehensive therapy of acupuncture, Chinese herbal medicine and rehabilitation in the treatment of post-stroke flaccid limb dysfunction.

METHODSThe four-center, single-blind, randomized and controlled research method was adopted, 240 qualified subjects were randomized into a comprehensive therapy group, an acupuncture group, a rehabilitation group and a Chinese herbal medicine group, 60 cases in each one, at the ratio of 1 1. In the comprehensive therapy group, the comprehensive therapy of acupuncture, Chinese herbal medicine and rehabilitation was applied. The acupuncture therapy included the scale acupuncture at middle line of vertex, lateral line 1 of vertex, lateral line 2 of vertex, etc. with the single reinforcing and reducing technique by the speed of needle insertion and withdrawal, and the body acupuncture therapy at the acupoints on the antagonistic muscles with the reinforcing and reducing technique by the needle rotation. The Chinese herbal medicine therapy included No. 1 stroke formula for the cases of liver and kidney yin deficiency and the upward disturbance of wind yang, No. 2 stroke formula for qi deficiency and blood stagnation, and the stagnation in meridians and No. 3 stroke formula for the interaction of phlegm and stasis and blockage of meridians according to the pattern/syndrome differentiation. The rehabilitation therapy focused on the promotion technique by putting the healthy limb. The simple acupuncture, rehabilitation and Chinese herbal medicine therapies as the comprehensive therapy group were applied in the acupuncture group, rehabilitation group and Chinese herbal medicine group separately. The Chinese medicine symptom, the limb motor function, the daily life activity, fainting needle reaction, allergic reaction and the others were taken as indices to evaluate the efficacy and safety of the treatment.

RESULTS(1) The results of the four indices named the Chinese medicine symptom, the limb motor function, the limb balance function, the daily life activity were all improved significantly after treatment as compared with those before treatment in four groups (all P < 0.01). (2) Concerning to the improvement degrees, the improvements of the above four indices in the comprehensive therapy group were more significant than those in the other three groups (P < 0.01, P < 0.05). The improvement in Chinese medicine symptom in the acupuncture group and the Chinese herbal medicine group were more significant than that in the rehabilitation group (both P < 0.05). The improvement of the upper limb motor function in the acupuncture group was more significant than that in the rehabilitation group and the Chinese herbal medicine group separately (both P < 0.05).

CONCLUSIONThe comprehensive therapeutic program of acupuncture, Chinese herbal medicine and rehabilitation is safe and effective in the treatment of post-stroke flaccid limb dysfunction. It is more advantageous in efficacy as compared with any simple therapy.

Activities of Daily Living ; Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Muscle Hypotonia ; drug therapy ; etiology ; rehabilitation ; therapy ; Stroke ; complications

The tetrapeptide N-acetyl-seryl-aspartyl-lysyl-proline (AcSDKP), a physiological regulator of cell proliferation, has been principally reported as a potent inhibitor of the proliferation of haematopoietic stem cells and progenitors. The purpose of this study was to investigate whether the AcSDKP may directly affect the proliferative potential of human bone marrow mesenchymal stem cells (MSCs) in vitro. We added AcSDKP to the cultures of human bone marrow mononuclear cells and measured the number and average area of MSC colonies. MTT colorimetric assay and mitotic index determination were further used to examine the proliferative state of the third passage MSCs in subcultures with or without the addition of AcSDKP. In addition, we evaluated whether AcSDKP may kill MSCs by the trypan blue dye exclusion test. The results showed that the colony forming capacity, the number of viable cells and the mitotic index were reduced in human bone marrow MSCs cultured in 1x10(-12) mol/L to 1x10(-9) mol/L AcSDKP. Maximum inhibitory activity appeared in 1x10(-11) mol/L of AcSDKP. No difference in percent of living cells was observed between the MSC subcultures with and without the addition of AcSDKP. As a result, AcSDKP within a certain range of concentrations has negatively regulatory effects on the proliferation of human bone marrow MSCs in vitro.
Bone Marrow Cells ; cytology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Down-Regulation ; physiology ; Growth Inhibitors ; physiology ; Humans ; Mesenchymal Stromal Cells ; cytology ; Oligopeptides ; physiology