Help T cell 1/Help T cell 2 and some cytokines disequilibrium can give a suitable explanation for hypersensitivity and hypogammaglobulinemia in primary nephritic syndrome(PNS) patients. The disturbance of regulatory T cell(Treg cell) and Th17 cell can lead to correlated cytokines derangement, which explained the pathogenesis of PNS from another aspect. Refractory nephrotic syndrome can be effectively treated by rituximab followed the percentage of regulatory T cell increasing, which indicated that Treg may play an important role in pathogenesis of PNS.

Objective To explore the establishment of peptide mapping database of Candida albicans ,laying the foundation for rapid diagnosis of Candida albicans infection .Methods 96 Candida albicans were collected clinically ,and its DNA was extracted . Polymerase chain reaction(PCR) was used to amplify the ITS1-5 .8S-ITS2 gene fragments and restriction endonucleases were a-dopted to identify them .Surface enhanced laser desorption ionization-time of flight-mass spectrometry(SELDI-TOF-MS) instrument was applied to detect the Candida albicans peptide mapping ,and Ciphergen ProteinChip software was used to collect data automati-cally .The established peptide mapping database was verified by confirmed Candida .Results According to restriction fragment length polymorphism analysis ,96 strains were confirmed as Candida albicans .15 peptide peaks were captured by SELDI-TOF-MS chips .Five peptide peaks of them with stable expression were screened out ,and the similarity analysis software was used to estab-lish peptide mapping database of Candida albicans .More than 95% of similarity was found between peptide mapping of Candida albicans and established database ,while less than 50% was found between peptide mapping of other Candida species and database . Conclusion The establishment of peptide mapping database of Candida albicans provides a theoretical basis for the rapid diagnosis of Candida albicans infection .

The construction of harmonious doctor-patient relationship is an important project in social medicine .The influen-cing factors about doctor-patient relationship are analyzed from three aspects which are responsibility ethics , bottom-line ethics and clin-ic ethics.Based on the discussion , certain countermeasures are proposed to reconstruct harmonious doctor -patient relationship .

Objective To observe the therapeutic efficacy of auricular point sticking in preventing pain after perianal abscess surgery.Method Sixty patients going to receive radical perianal abscess surgery admitted by the First Affiliated Hospitalof Guangzhou University of Chinese Medicine between December of 2015 and February of 2016 were enrolled and randomized into an ordinary group and an auricular point sticking group. Pain was scored at different time points after the surgery and the use of analgesics was also recorded.Result There were significant inter-group differences in comparing the pain intensity from 6 h after the surgery till 7:30 on the next day of the surgery (P<0.05);the between-group differences in comparing the Visual Analogue Scale (VAS) scores from the 2nd day till the 7th day despite of the dressing change time were unstable(P>0.05,P<0.05); the differences in pain intensity at the dressing change were statistical significant (P<0.05).Conclusion Auricular point sticking can effectively treat mild-moderate pain in the early stage after perianal abscess surgery at non-dressing-change time, and it can also produce a satisfactory effect in preventing moderate-severe pain at dressing change after perianal abscess surgery.

Refractive surgery for myopia is a common operation and has been performed on millions of patients .Improved technology has increased the satisfaction of patients and physicians .Surgery must follow the basic requirements of medical ethics , to ensure the safety and best interests of the patients .The choice of procedure depends on individual patient indications and ocular exami -nations .Before the surgery , the opthalmologists must ensure that the patient understands the potential risk of the operation and has re -alistic expectations for the visual acuity postoperatively .

Objective To investigate SCCmec types in clinical isolates of methicillin-resistant Staphylococcus epidermidis (MRSE) carrying psm-mec.Methods We collected 165 strains of Staphylococcus epidermidis identified by automated microbiological identification system and screened MRSE by PCR amplification of esp and mecA gene.Strains with psm-mec were identified by amplification of psm-mec,fudoh and p221 DNA fragment;mec,ccr and SCCmec typing was conducted by multiplex PCR assay.Results Among 138 strains of MRSE,29 strains were identified as MRSE with psm-mec,and the carrying rate was 17.58%.Results of mec and ccr typing by multiple PCR showed that MRSE with psm-mec carried Class A mec,but the ccr type had obvious diversity.Results of SCCmec typing showed that all strains with psm-mec belonged to type Ⅱ and/or Ⅲ SCCmec.Conclusion Clinical isolates of MRSE with psm-mec carry homologous type Ⅱ and/or Ⅲ SCCmec harboring Class A mec.

Objective To evaluate the diagnostic value of procalcitonin(PCT),C-reactive protein(CRP),prealbumin(PA)and white blood cell (WBC)count measurements in patients with severe pneumonia.Methods The serum samples of 34 patients with severe pneumonia,68 non-severe pneumonia patients and 40 healthy volunteers were collected.Serum concentrations of PCT,CRP, PA and WBC count of all samples were determined.Results The levels of PCT,CRP,PA and WBC in patients with severe pneu-monia were (24.07±34.77)ng/mL,(98.75 ±69.63)mg/L,(105.65 ±68.88)mg/L,(12.64±7.62)×109/L,which were signifi-cantly higher than those in non-severe pneumonia patients and healthy group(P <0.05).According to ROC analysis,the sensitivity, specificity and Youden index of PCT were 64.7%,77.9%,0.426.Conclusion The level of serum PCT could be used as good bio-marker for severe pneumonia.Detection of PCT,CRP and WBC together plays an important role in the diagnosis of severe pneumo-nia.

Objective To search for protein markers in urine from patients with diabetic nephropathy by proteomic method and discuss its clinical significance in laboratory diagnosis of diabetic nephropathy. Methods This study included 129 patients with diabetic nephropathy, 61 diabetes mellitus patients, and 102 healthy volunteers. The urinary protein profiles were obtained using surface-enhanced laser desorption-ionization time of flight mass spectrometry (SELDI-TOF-MS) and Au Chip (ProteinChip Gold Array). The differential peaks were screened by Biomaker Wizard software and the decision tree pattern was developed by Biomarker Patterns Software (BPS). The model was blindly tested to validate diagnostic efficiency. Some differentially expressed protein was preliminarily identified according to the molecular weight as compared with mass spectrometry data of standard proteins. Results Totally 40 distinguished protein peaks(t value: - 9.81-24.52, P < 0.05) were obtained after comparing the samples between diabetic nephropathy and the control groups. The peak with m/z 66 916 was automatically screened by BPS to develop decision tree pattern. The pattern was blindly tested and yielded a sensitivity of 98.7% (78/79) and a specificity of 98.2% (111/113). After we compared results from diabetic nephropathy with those from diabetes mellitus, twenty-four differential peaks were obtained in diabetic nephropathy (t value: -6.95-14.45,P < 0.05). The peaks with m/z 4 008, 11 619 and 66 916 were automatically screened by BPS to establish decision tree pattern. The model was blindly tested and yielded the sensitivity(129/129) and specificity(61/61) of 100%. After we compared our results with mass spectrometry data of standard proteins, the four differentially expressed proteins with m/z 11 619, 23 529, 66 916 and 79 378 were supposed to be β_2-microglobulin, α1-microglobulin, albumin and transfcrrin. Conclusion The preliminary results suggest that these SELDI-TOF and Au chip have the potential application value in identification of protein source and early diagnosis of diabetic nephropathy, and evaluation of renal injury.

Objective To investigate nutrition status and dyspnea in the patients with chronic obstructive pulmonary disease (COPD) between GOLD Ⅱ and GoLD Ⅲ, and test the evaluative validity of disease status by GOLD classification of COPD. Methods Thirty patients with clinically stable COPD were recruited, including 15 patients of GOLD Ⅱ of COPD and 15 patients of GOLD Ⅲ of COPD. Body mass index (BMI), triceps skin-fold thickness (TSF), serum albumin (Alb), and partial pressure of oxygen in arterial blood (PaO2) were measured in each patient. Dyspnea was assessed by the Borg Scale (BS). Exercise stress test was taken by incremental exercise test. Results BMI was significantly lower in the patients of GOLD Ⅲ than that in the patients of GOLD Ⅱ[(19±5 ) kg/m2 vs (23±3) kg/m2,p < 0.05]. TSF was significantly reduced in the patients of GOLD Ⅲ than that in the patients of GOLD Ⅱ[ (8±3) mm vs(13±5) mm, P < 0.01]. Alia in the patients of GOLD Ⅲ was significantly decreased than that in the patients of GOLD Ⅱ [(32±7) g/L vs (36±6) g/L, P <0.05]. The difference of PaO2 between the patients of GOLD Ⅲ and the patients of GOLD Ⅱ was significant [(72±9) nun Hg (1 mm Hg = 0.133 kPa ) vs (78±8) nun Hg, P < 0.01], and the significant difference of BS was found between the patients of GOLD Ⅲ and the patients of GOLD Ⅱ( 5.0±2.0) grades vs (3.0±1.0) grades, P <0.05 ]. In addition, 12 patients in the patients of GOLD Ⅱ took the exercise stress test and 8 patients were found anaerobic threshold (AT), 5 patients in the patients of GOLD Ⅲ took the exercise stress teat and no AT was found. Conclusions The parameters of BMI, TSF, Alb and PaO2 are significantly reduced in the patients of GOLD Ⅲ than those in the patients of GOLD Ⅱ. In the patients of GOLD Ⅲ, BS is higher than that in the patients of GOLD Ⅱ and AT is difficult to obtain, suggesting more severe in degree of impairment. GOLD classification of COPD reflects the disease stares and prognosis in the patients with COPD, as a valuable parameter in clinical practice.

Objective To establish protein fingerprints of common bacteria in clinics and to lay a foundation for rapid identification of bacteria.Methods Strains of Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus were detected by surface enhanced laser desorption and ionization time-of-flight mass spectrometry (SELDI-TOF MS).Stable expression protein peaks were screened and the data was input into the self-constructed Fingerwave software for identification of target bacteria by protein fingerprint comparison.Two hundred and fifty-six clinical isolates,including E.coli,K.pneumoniae,P.aeruginosa and S.aureus were detected and the data was compared with constructed database to evaluate its diagnostic value.Results The protein fingerprints including four common bacteia was used to identify the target bacteria with identification rate of 93.1％ (54/58) for E.coli,87.2％ (75/86) for K.pneumoniae,96.2％ (60/63) for P.aeruginosa and 96.2％ (51/53) for S.aureus,respectively.Conclusion Common bacteria can be rapidly identified by using the protein fingerprint comparison,which provides a powerful tool for bacterial identification.