Objective To explore the value of Sysmex UF-1000i urinary sediment analyzer in diagnosis of urinary tract infection (UTI) and clarify the influence caused by different specimen on UF-1000i diagnosing UTI.Methods Totally 466 specimens examined bacterial culture and routine urinalysis were collected from patients suspected of UTI during July and August,2015 (samples of group A).148 specimens during late March and early April were gathered to implement a urine culture and then the rest of urine were detected byUF -1000i urinary sediment analyzer instantly(samples of group B).Bacteria and leukocyte counts were gathered and then receiver operating characteristic (ROC) carve was drawn regarding thegold standard as bacterial culture by SPSS18.0.Next,the threshold values of bacteria and leukocyte counts for diagnosis of UTI were found out.Meanwhile,itssensitivity,specificity,positive/negative predictive value,false positive/false negative value,and diagnostic accuracy were calculated.Results The cut off values to samples of group A were101.7 bacteria/μl and 18.8WBC/μl respectively and to samples of group B were 98.7 bacteria/μl and 11.1WBC/μl respectively.The area of Bacteria and leukocyte counts under ROC carve was 0.604 and 0.661 to samples of group A and 0.941 and 0.848 to samples Of group B.To samples of group B,combined Bacteria and leukocyte counts for UTI,the optimum sensitivity was 82.4％,specificity was 92.1％,positive predictive value was 77.8％,negative predictive value was 93.8％,false positive rate was 7.9％,false negative rate was 17.6％,and accuracy was 89.9％.Bacterial culture was reduced by 70.9％.Conclusion UF-1000i urine sediment analyzers have the value of early screening value and help to diagnose UTI.Urine that was sterilely collected and examined within two hours can make the value of UF-1000i maximized.

Objective To investigate the effects of normal caloric high-protein diet on metabolic parameters and gastrointestinal hormones in patients with obesity or type 2 diabetes mellitus (T2DM).Methods Totally 30 obese subjects (OB group) and 40 obese patients with type 2 diabetes mellitus (T2DM group) received normal caloric high-protein diet for 24 weeks.Then body weight,fat mass,and metabolic parameters were assessed.The serum ghrelin and glucagon-like peptide-1 (GLP-1) levels were also measured at 0 and 2 h after an oral 100 g of steamed bread meal test.Results After 24 weeks,body weight [(78.23 ± 7.51) kg vs (80.83±8.13) kg,P=0.016; (80.45±7.48) kg vs (83.26±9.35) kg,P=0.011],body mass index [(31.03 ±2.72) kg/m2 vs (32.01 ±2.95) kg/m2,P=0.033; (32.63 ±2.81) kg/m2 vs (33.86±3.03) kg/m2,P =0.043],waist circumference [(93.65 ± 6.23) cm vs (97.30 ± 7.81) cm,P =0.041 ;(97.02±7.43) cm vs (101.87 ±9.87) cm,P =0.034],fat mass [(30.42 ±6.18) kg vs (32.47 ±5.91) kg,P=0.022; (34.23 ±7.03) kg vs (36.64 ±6.83) kg,P =0.032],fasting serum insulin [(10.81±3.69) mmol/Lvs (13.58±4.86) mmol/L,P=0.012; (9.58±3.51) mmol/Lvs (10.82±4.28) mmol/L,P =0.015],HOMA-insulin resistance index [(2.42 ± 0.83) vs (3.16 ± 1.21),P =0.019; (3.15±0.74) vs (4.13±0.67),P=0.024] and triglycerides [(1.24±0.32) mmol/Lvs (1.49±0.52) mmol/L,P=0.046; (1.86±1.05) mmol/L vs (2.46±1.85) mmol/L,P=0.034] were significantly decreased in OB and T2DM groups,respectively,compared with 0 week.Fasting blood glucose (FBG)and glycosylated hemoglobin were also significantly declined in T2DM group [FBG:(6.73 ± 1.25) mmol/Lv s (8.63 ±2.81)) mmol/L,P=0.010; HbA1c (6.44 ±0.47) vs (7.38 ±0.33),P=0.031].The serum ghrelin and GLP-1 both increased at 0h and 2 h after meal test in OB and T2DM groups [fasting serum ghrelin:(4.98 ±0.89) μg/L vs (3.95 ±0.98) μg/L,P=0.021; (4.23 ± 1.67) μg/L vs (3.15 ± 1.01) μgL,P=0.025; 2 h postprandial serum ghrelin:(2.98 ±0.96) μg/L vs (2.56 ±0.83) μg/L,P =0.046; (2.83 ± 1.03) μg/L vs (1.95 ±0.92) μg/L,P =0.033; fasting serum GLP-1:(6.06 ±0.63) μg/L vs (5.13±0.59) μg/L,P=0.041; (5.23±0.71) μg/Lv s (4.49±0.53) μg/L,P=0.039; 2 h postprandialserum GLP-1:(10.01±1.01) μg/L vs (7.68±0.94) μg/L,P=0.007; (8.87±0.94) μg/Lvs (6.59 ± 0.87) μg/L,P =0.013].Conclusions Normal caloric high-protein diet can reduce body weight and serum glucose.Those effects may be due to the increase in secretion of GLP-1.

Objective To explore the clinical characteristics and the treatments on traumatic diaphragmatic rupture and diaphragmatic hernia.Method A retrospective study was carried out in 49 cases of traumatic diaphragmatic rupture and diaphragmatic hernia.Results There were 32 cases with left diaphragmatic hernia,13 cases with right diaphragmatic hernia and 4 cases with bilateral diaphragmatic hernia.One case with closed combined thoraco-abdominal wound and shock,died of multiple organ failure after the surgery,3 cases were diagnosed more than 24 h after injury,the others closed injury patients were diagnosed within 24 h and cured.In patients with open diaphragmatic rupture and diaphragmatic hernia,16 cases underwent laparotomy surgery,5 cases of misdiagnosis experienced re-thoracotomy,7 cases thoracotomy,2 cases changed the thoraco-abdominal surgery.Three cases underwent thoraco-abdominal surgery.Twenty-five cases were cured; 1 patient with suppurative costal chondritis,duration up to 13months.Conclusion Traumatic diaphragmatic rupture and diaphragmatic hernia is easily missed and misdiagnosed,the establish of rational examination preoperatively can reduce complications,misdiagnosis and mortality.

BACKGROUND:Severe acute respiratory syndrome (SARS),an acute infection with a mutant coronavirus,is characterized by acute pulmonary inflammatory injury accompanied by possible multiple organ injuries. Besides somatic symptoms,affective disorder constitutes an obvious neuropsychiatric symptom in SARS patients.OBJECTIVE:To analyze the clinical features of SARS with neuropsychiatric involvement.DESIGN:A retrospective case analysis.SETTING:Department of Neurology,Department of Respiratory Diseases and Department of Radiology of Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS:Totally 325 SARS patients treated in the Second Affiliated Hospital of Sun Yat-sen University and the 8th People's Hospital of Guangzhou from February 2003 to May 2003 were involved,including 173cases who developed neuropsychiatric symptoms.METHODS:The clinical data of 325 of SARS including 173 cases with neuropsychiatric symptoms were retrospectively analyzed.MAIN OUTCOME MEASURES:Clinical neuropsychiatric symptoms,ophthalmoscopic examination,and pathological findings in autopsy.RESULTS: ①The incidence of neuropsychiatric involvement was about 53.2% in SARS patients. The manifestations consisted mostly of headache (67.1%),dizziness(28.9%),conscious-ness disturbance(10.4%),mental disorder(4.6%), local orientational disorder(0.6%),seizures(1.2%),and affective disorders (30.6%);anxiety occurred in 20.2%,depression in 6.4%,suicidal tendency in 1.2%,and phobia in 7.5% of the patients with neuropsychiatric involvement. ②Among the 325 patients,56 were in critical condition of whom 47 had accompanying neuropsychiatric impairment,with significantly greater incidence than that in mild cases (P＜0.01). ③Ophthalmoscopic examination performed in 4 patients showed blurred margin of the optic disc with retinal venous congestion. ④Autopsy in 2 cases identified edema of the perivascular tissue and vascular wall of the small veins with mononuclear cell and lymphocyte infiltration,neuron degeneration and demyelination in focal brain tissues.CONCLUSION:The manifestations of neuropsychiatric involement can vary in association with the severity of SARS,and the typical pathological changes include edema,neuronal demyelination etc.in the brain.

Objective To study in vitro anti-HIV activity of an extract of herb medicines,SanJiangDan,and the possible mechanism.Methods The main active ingredient of SanJiangDan was extracted by distillation.Three subtypes of HIV pseudovirus (B subtype,C subtype,CRF01_AE subtype) were used to evaluate the anti-HIV activity of SanJiangDan extract in vitro.The possible mechanism was evaluated through analyzing the effects of SanJiangDan extract on the expression of surface receptors and cytokines by T cells.The cytotoxicity of SanJiangDan extract was detected by using four different sources of cell lines including epithelial cells Caco-2 cells,TZM cells,Huh7 cells derived from liver cells and lymphocyte Jurkat-T cells.Results SanJiangDan extract effectively inhibited the infection of HIV pseudoviruses at concentrations of 1.6 mg/ml and 0.16 mg/ml.The inhibition rates were 30.9％,36.6％ and 65.0％ for B subtype,C subtype and CRF01_AE subtype respectively at the concentration of 0.16 mg/ml.As the concentration increased to 1.6 mg/ml,the inhibition rates increased to 96.4％ (B subtype),97.4％ (C subtype) and 99.5％ (CRF01_AE subtypes),but no toxicity to host cells was detected.Moreover,SanJiangDan extract inhibited the expression of HIV surface receptors including CD4,CXCR4 and CCR5 on TZM-bl cells,but enhanced IL-2 production.Conclusion SanJiangDan extract could inhibit HIV pseudovirus infection without causing cytotoxicity to host cells in vitro.The possible mechanism might be associated with the reduced expression of CD4,CXCR4 and CCR5 and enhanced secretion of IL-2 as well.

OBJECTIVE To analyze the high risk factors and etiology character of ventilator-associated pneumonia(VAP) and provide the guidance for preventing VAP. METHODS Eighty three cases given mechanic ventilation over 48 hours in ICU of our hospital from Jan to Oct 2005 were observed.Thirty seven cases met the diagnosis criteria of VAP,while 46 cases without VAP were taken as control. RESULTS Airway secretion was cultivated and Gram-negative germ was the majority(58.0%).The first three pathogens were Pseudomonas aeruginosa(32.0%),Acinetobacter,and Staphylococcus epidermidis,22.0% cases had mixed infection with fungi.Except antiacid treatment,the following factors,such as long time for mechanical ventilation,trachea incision,corticosteroids treatment and coma state had significant relationship with the occurrence of VAP. CONCLUSIONS The occurrence of VAP is related with multiple clinical factors.Clinicians should reduce high risk factors to lower the occurrence of VAP.

Objective To investigate the cytopathic effect of amino acid residues 86 to 175 of rotavirus nonstructural protein 4 (NSP486-175) on rat neurons and to analyze the underlying mechanism.MethodsPrimary cultured rat neurons were treated with NSP486-175 and the morphological changes induced in rat neurons were observed.Lactate dehydrogenase (LDH) activity in the culture supernatant of NSP486-175 treated-neurons was measured.Laser scanning confocal microscope was used to detect the concentration of intracellular Ca2+ labeled with Fluo-3 AM.Results Exogenous addition of NSP486-175 induced obvious cytopathic effect on rat neurons.The LDH activity in the culture supernatant of treated-neurons was stronger than that of the control group.The intensity and the distribution of fluorescence in neurons were altered after stimulation with NSP486-175.Conclusion NSP486-175 can induce the damage of rat neurons, which may be related to its role in increasing the concentration of intracellular Ca2+.This study may provide certain theoretical basis for understanding extra-intestinal spread and pathogenesis of rotavirus infection.

OBJECTIVE To find out the situation of bacteriological contamination of oxygen humidified fluid in the hyperbaric oxygen chamber in Nanfang Hospital and take appropriate measures accordingly to provide valuable reference for avoiding possibly resulting hospital infection.METHODS Before and after beginning periodically changing oxygen humidified fluid,the humidifying fluid in the oxygen humidifiers of three hyperbaric oxygen chambers in this hospital was sampled once a season.The samples were analyzed with bacteria counting and identification.RESULTS The average amount of bacteria in the samples before and after changing oxygen humidified fluid was(7.9 ? 104) CFU/ml and(2.8 ? 103) CFU/ml,respectively.Identified bacteria were conditioned pathogens,including Chryseobacterium,Acinetobacter baumannii,Escherichia coli,Pseudomonas aeruginosa,Candida albicans,etc.Among them the frequency of Chryseobacterium was the highest.The results had no correlation with the changing of seasons.CONCLUSIONS Hyperbaric oxygen chamber should be disinfected periodically,the humidified fluid should be changed every day,and the amount of bacteria in it should lower than 103 CFU/ml.

Objective To investigate the dynamic changes of vascular endothelium secreted factors after oral fatty meal test and the correlation of the factors with blood lipid in elderly diabetic patients. Methods Thirty-six elderly diabetic patients (diabetic group) and twenty heahhy elderly subjects(control group) were selected into the study and received oral fatty meal test for 6 hours. Diabetic group was divided into three subgroups, including fasting hypertriglyceridemia subgroup, postprandial hypertriglyceridemia subgroup and postprandial normotriglyceridemia subgroup. Serum nitric oxide (NO), endothelin-1 (ET-1), plasminogen activator inhibitor-1 (PAl-1) and tissue plasminogen activator (t-PA) were measured before and after oral fatty meal test. Results (1) The level of serum NO was significantly increased and ET-1 was significantly reduced in control group 2 hours after oral fatty meal test and were returned to basal state 6 hours after the test. But in diabetic group, postprandial serum NO level were decreased and ET-1 were increased gradually and reached to the peak 6 hours after oral fatty meal test. The ratio of NO/ET-1 was lower in diabetic group than that in control group (P< 0.01). There were important differences among fasting hypertriglyceridemia subgroup, postprandial hypertriglyceridemia subgroup and postprandial normotriglyeeridemia subgroup(P<0.05 or<0.01). (2) The level of PAl-1 was increased and t-PA was decreased slightly 4 hours after oral fatty meal test in control and diabetic groups. Compared with control group, PAI-1/ t-PA obviously increased in diabetic group. Meanwhile, PAI-1/t-PA in fasting hypertriglyeeridemia and postprandial hypertriglyceridemia subgroups were significantly higher than that in postprandial normotriglyceridemia subgroup(P<0. 05 or<0.01). (3) In the diabetic group, TG was negatively correlated with NO and t-PA(r=-0.360 P<0.05; r=-0.649, P<0.01) and positively correlated with ET-1 and PAI-1(r=0.421,P<0.01;r=0.520,P<0.01). Conclusions The elderly diabetic patients suffer from the imbalance of vascular endothelium secreted factors. The postprandial abnormal TG metabolism may aggravate the change and further damage the vascular endothelial function.

Objective To investigate the effect of rosuvastatin on the morphine tolerance in rats and the underlying mechanism.Methods Forty-eight male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 6 groups (n =8 each):control group (group C),morphine tolerance group (group MT),rosuvastatin control group (group RC),rosuvastatin 0.4 mg/kg group (group R1),rosuvastatin 2.0 mg/kg group (group R2)and rosuvastatin 10.0 mg/kg group (group R3).Morphine tolerance was induced by subcutaneous injection of morphine 10.0 mg/kg at 8:00 and 16:00 everyday for 5 consecutive days.The equal volume of normal saline was given in groups C and RC.Normal saline 10 ml/kg was injected through a gastric tube into stomach everyday at 30 min after subcutaneous injection of normal saline or morphine for 5 consecutive days in groups C and MT.Rosuvastatin 10,0.4,2.0 and 10.0 mg/kg were injected through a gastric tube into stomach everyday at 30 min after subcutaneous injection of normal saline or morphine for 5 consecutive days in groups RC,R1,R2 and R3,respectively.The paw withdrawal latency to nociceptive thermal stimulation was measured 1 day before (T1) and 1 day after morphine tolerance was induced (T2).The percentage of maximal possible effect (MPE) was calculated.The rats were sacrificed after the last measurement of pain threshold and the L5 segment of the spinal cord was removed for determination of the expression of extracellular signal-regulated kinase (ERK) and phosphorylated ERK (p-ERK)(by Western blot) and contents of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) (by ELISA).Results Compared with group C,MPE was significantly decreased at T2 and the expression of p-ERK and contents of IL-1β and TNF-α were increased in groups MT and R1 (P ＜ 0.05).Compared with group MT,MPE was significantly increased at T2 and the expression of p-ERK and contents of IL-1β and TNF-α were decreased in groups RC,R2 and R3 (P ＜ 0.05).There was no significant difference in the indicators mentioned above between groups R2 and R3,and in the expression of ERK between the six groups (P ＞ 0.05).Conclusion Rosuvastatin can attenuate the morphine tolerance in rats by inhibiting the phosphorylation of ERK and decreasing the level of IL-1β and TNF-α.