Objective To study the relationship between EBV infection of classic Hodgkin's lyphoma and expression of p16 protein.Methods EBER-1 and p16 protein expression in 80 cases of CHL were studied with EBER-1 oligonucleotide probe and immunohistochemistry respectively.Results 80 cases of CHL were enrolled in this study,including male 52 cases,28 cases of female,male to female ratio of 1.86 ∶ 1.The positive rate of EBER-1 in female was 39.29％ and in male was 63.46％,which have statistically significant difference (x2 =4.298,P =0.038).The positive rate of EBER-1 in children and the older was significantly higher than that in adult (x2 =20.13,P =0.000).EBER-1 positive expression located in the R-S nuclei which positive expression rate was 55.00％,including mixed cell type (MC) 71.79％,lymphocyte depletion type (LD) 42.85％.lymphocyte predominance (LP) 47.06％ and nodular sclerosis type (NS) 29.41％.MG type was significantly higher than NS ( x2 =8.787,P =0.003 ) ; p16 was noted in thc nucleus and cytoplasm.The total positive expression rate was 45％,and subtype positive rates were 47.05％ (LP),48.71％ ( MC),35.29％ (NS) and 42.85％ (LD).There was a negative correlation between p16 protein and EBER-1 ( r =-0.242,P ＜ 0.05 ).Conclusions CHL may be related to EBV latent infection and it can be considered as potential markers to identify HRS cells in diagnosis.

Objecive To investigate the prevalence of NDM-type carbapenemases in the carbapenem-resistant Escherichia coli strains collected from Ruijin Hospital, Shanghai Jiaotong University School of Medicine. The epidemiological characteristics of NDM-type carbapenemase-producing isolates were analyzed.Methods Eighteen strains were collected from November 2013 to January 2015 in the clinical microbiology laboratory of Ruijin Hospital. All of them were resistant to imipenem or meropenem (inhibition zone diameter≤19 mm). The blaNDM gene was detected by PCR. The amplified products were subjected to sequencing analysis. Conjugation experiment was carried out to verify the transferability of plasmids. Multilocus sequence typing (MLST) and pulsed field gel electrophoresis (PFGE) were performed to analyze the molecular epidemiology.Results The blaNDM gene was identified in 6 strains, 4 of which had blaNDM-1-type and 2 had blaNDM-5-type carbapenemase gene. Three strains were positive in the conjugation experiment. MLST analysis showed that 6 NDM carbapenemase-producing isolates belonged to ifve sequence types, corresponding to five PFGE-DNA patterns (A-E). Two of these isolates shared the identical sequence type (ST5018) and nearly the same PFGE-DNA patterns (A1, A2).Conclusions NDM-type carbapenemase-producing E. coli is identified in this study. Most blaNDM-positive cases were sporadic. Plasmid might play an important role in the spread of blaNDM inE. coli. The blaNDM-5 type carbapenemase gene was first identified in Shanghai, to which more attention should be paid.

Objective To study the expression levels of microRNA (miR)-16 and miR-146a in rat lungs of decompres-sion sickness (DCS) caused by fast buoyancy ascent escape or diving .Methods At 0.5 h after fast buoyancy ascent es-cape or diving, the pathological changes in rat lungs and expression levels of miR-16,and miR-146a were detected by re-verse transcription-quantitive polymerase chain reaction and compared with normal control group .Results The pathological characteristics of lungs in two DCS groups were tissue damage .At 0.5 h after DCS caused by fast buoyancy ascent escape , the lung tissue expression levels of miR-16 and miR-146a did not significantly change compared with normal control and diving DCS groups ,but the rat lung tissue expression level of miR-146 a in diving DCS group was obviously increased , com-pared with normal control group .Conclusion miR-146a may play a role in post-transcriptional regulation in the process of diving DCS .

Objective To evaluate therapeutic effect of endoscopy on duodenal papilla tumor. Methods Clinical data of patients who underwent the endoscopic duodenal papilla tumor resection in Zhongshan Hospital were retrospectively studied from April 2007 to May 2014. Results A total of 21 patients underwent 28 procedures. Postoperative biliary stent were retained in 6 cases (6/28) , with no perforation or postoperative pancreatitis. Delayed bleeding occurred in 7 cases (7/28) and controlled by endoscopic hemostasis, and no death occurred. Mean follow-up was 31. 5 months. There were 6 recurrent cases, and mean recurrence time was 14. 1 months. All these recurrent cases are treated by endoscopy treatments or surgery. Conclusion Endoscopic treatment of duodenal papilla tumor is safe, effective and minimally invasive, but the occurrence of delayed bleeding is worth concern.

Acute myocardial ischemia (AMI) was induced by occlusion of the left anterior descending (LAD) coronary artery in rats.AMI rats and normal rats were administered with protocatechuic aldehyde(Pal) at a single dose of 20 mg/kg through peritoneal injection.Concentrations of Pal,protocatechuic acid (PAC) and vanillic acid (VAC) in plasma were determined by HPLC to evaluate the effect of AMI on pharmacokinetics of Pal in rats.Pal was quickly metabolized to PAC,which was then methylated into VAC.Compared to the normal group,AUC_(0-∞) of PAC significantly increased from 14.01 ±3.11 to 22.31 ±4.96 μg·h/mL in AMI group (P ＜ 0.01),and AUC_(0-∞) of VAC markedly elevated from 19.64 ±4.36 to 38.76±5.75 μg·h/mL (P＜0.01).Both MRT of PAC and VAC increased (0.43 ± 0.08 h vs 0.27 ± 0.04 h,0.61 ± 0.11 h vs 0.38 ± 0.05 h,P ＜ 0.01).Metabolic ratio M/P of PAC increased from 1.43 ±0.31 to 1.77 ±0.22 (P ＜0.05).Results indicated that AMI status had great influence on pharmacokinetic behavior of Pal.Meanwhile,the level of methylation was greatly increased.

Objective To investigate the safety and efficacy of nephron-sparing surgery (NSS)for selective T2 stage renal tumor.Methods The surgical database of 26 patients treated with NSS for clinical T2 stage renal cell carcinomas between March 2010 and May 2013 were collected and analyzed retrospectively.There were 17 males and 9 females,with a mean age of 52 years (39-74 years),mean tumor size of 10.3 cm(7.2-16.5 cm),and mean R.E.N.A.L score of 7.5 (6-10).Patients'demographics,clinical characteristics,oncologic outcomes,renal function were reviewed.Results The renal masses were removed successfully and the surgical margins were negative.There were 21 (80.8％) cases of clear cell carcinoma,4 (15.4％) papillary carcinoma and 1 (3.8％) chromophobe carcinoma.The mean ischemia time was (28.3 ± 12.5) minutes (7 patients were clamp-free).Three patients needed transfusion,one experienced urine fistula and cured by conservative treatment,and one patient's renal function got progressive worsening and required long-term hemodialysis.The average serum creatinine was 121 μ mol/L before and 136 μmol/L after surgery (P =0.06).After a period of 22-47 months' follow-up,no patient had local recurrence or metastasis.Conclusions NSS can be safely performed and provide effective oncologic outcomes for selective patients with clinical T2 stage renal cell carcinomas.R.E.N.A.L nephrometry is an important factor and should be used to evaluate the feasibility of NSS.

OBJECTIVETo observe depot medroxyprogesterone acetate (DMPA) and testosterone undecanoate (TU) injected at 8-week intervals for the suppression of spermatogenesis in healthy Chinese men.

METHODSAfter screening, 30 healthy volunteers were enrolled and randomly assigned to 3 dosage-groups (n = 10/group): 1000 mg TU (Group A), 1000 mg TU plus 150 mg DMPA (Group B), 1000 mg TU plus 300 mg DMPA (Group C). All dosages were given as intramuscular injections at 8-week intervals. The study consisted of an 8-week control (baseline) period, a 24-week treatment period and a 24-week recovery period.

RESULTSConsistent azoospermia or severe oligozoospermia was achieved and maintained in all the volunteers during the treatment period, except 2 in the mere TU group who experienced a "rebound" in sperm concentrations. An 8-week regimen of TU plus DMPA at both tested combination dosages effectively suppressed spermatogenesis to azoospermia. All volunteers tolerated the injections; no serious adverse effects were reported.

CONCLUSIONThe lower combined dosage is recommended for further testing in an expanded clinical trial or contraceptive efficacy study.

Adult ; Androgens ; pharmacology ; China ; Gonadotropin-Releasing Hormone ; biosynthesis ; Humans ; Hypothalamo-Hypophyseal System ; metabolism ; Male ; Medroxyprogesterone Acetate ; pharmacology ; Prospective Studies ; Sperm Count ; Spermatogenesis ; drug effects ; Testosterone ; analogs & derivatives ; pharmacology

Objective To investigate the distribution and transmission characteristics of vancomycin -resistant Enterococcus faecium (VREF) carrying both vanA and vanM in the intensive care unit.Methods VREF strains were isolated from patients in the intensive care unit of Jinshan Hospital , Fudan University in Shanghai from 2013 to 2017.Antimicrobial susceptibilities of the VREF strains to nine antibiotics , including vancomycin, teicoplanin, linezolid and chloromycetin , were tested by broth microdilution method.Multiple polymerase chain reaction (PCR) was used for van genotyping and pulsed field gel electrophoresis (PFGE) was used for homology analysis.Results Thirty-five strains were mainly isolated from urine (16 strains), blood (11 strains), feces ( five strains ), bile ( two strains ) and pleural effusion ( one strain ).All the strains (100.00%) were resistant to vancomycin , ampicillin and levofloxacin , but only 40.00% were resistant to teicoplanin.All the strains were sensitive to linezolid.The results of van genotyping showed that 33 (94.3%) strains belonged to vanA and vanM dual genotype VREF, and the other two were vanA type VREF.PFGE results showed that 35 strains could be divided into 14 PFGE patterns, and seven out of 10 strains isolated in 2014 were identical and the other three belonged to three different PFGE patterns.Conclusions A dual genotype VREF carrying both vanA and vanM has been emerging and spreading in the intensive care unit of Jinshan Hospital , Fudan University in Shanghai.

Objective To investigate the value of endoscopic ultrasonography(EUS)in the diagnosis and treatment of undetermined etiology of common bile duct (CBD) dilatation. Methods Patients, who were referred for dilated CBD but unable to identify the cause by imaging, underwent EUS for the diagnosis of etiology in Endoscopy Center of Zhongshan Hospital Affiliated to Fudan University from December 2015 to December 2016. The therapy was on the basis of diagnosis of EUS. Final diagnoses were determined by surgical pathology or follow-up for at least 3 months. Results A total of 76 patients were included in the study. The sensitivity, specificity and accuracy of EUS for patients with choledocholithiasis,patients with ampullary tumor, and patients with inflammatory stenosis were 100.0%(7/7), 100.0%(69/69), 100.0%(76/76), and 88.0%(22/25), 92.2%(47/51), 90.8%(69/76),and 90.9%(40/44), 93.8%(29/32), 90.8%(69/76), respectively. Accuracy of EUS for etiological diagnosis of CBD dilatation was 90.8%(69/76). The sensitivity,specificity and accuracy of EUS combined with tumor markers for patients with malignant CBD dilatation were 96.0%(24/25), 96.1%(49/51),and 96.1%(73/76), respectively. Conclusion EUS is an effective method for the etiological diagnosis of CBD dilatation and has guiding significance for the treatment. EUS combined with tumor markers may benefit differential diagnosis of benign and malignant CBD dilatation.