Objective To study the distribution and its clinical significance of hepatitis B virus genotypes and subtypes in HBV-infected patients in Hefei. Methods 192 serum samples from HBV-infected patients were collected to extract HBV DNA. HBV the genotypes and subtypes of HBV were detected by PCR. Results Among 192 HBV-infected patients, 82 had genotype B, 99 had genotype C, and 11 had B/C. In genotype B, 57 were subtype Ba, 8 were subtype Bj, and the remaining 17 were neither Ba nor Bj. In genotype C, 8 were subtype C1, 56 were subtype C2, and the other 35 were neither C1 nor C2. In genotype B/C, 6 were Ba/C2, 2 Bj/C2, 2 Ba/neither C1 nor C2, and one neither Ba nor Bj/C2. Tthe distribution of HBV genotypes and subtypes exhibited significant differences in the various clinical types; and it showed that genotype C was predominant among patients with liver cirrhosis and hepatocellular carcinoma , while genotype B was predominant in asymptomatic carriers. In addition, there were no differences in HBV genotype distribution among patient wih different gender; but the genotype distribution differed significantly between patients positive with HBeAg and those negative with HBeAg. Conclusions Subtypes Ba and C2 are predominant in HBV-infected patients in Hefei. Genotype C may be associated with the development of liver cirrhosis and hepatocellular carcinoma.

Objective To investigate the relevance of liver function and neurobehavior of offspring of SD rats ex-posed to sodium valproate in the second trimester. Methods 30 SD rats at 12. 5 d of pregnance were randomly di-vided into three groups: low-dose group (300 mg/kg VPA was injected into abdominal cavity), high-dose group (600 mg/kg VPA);control group (normal saline). The offspring of low-dose groupe were grouped as VPA-low-dose;the offspring of high-dose groupe were grouped as VPA-high-dose; and the offspring of control group were grouped as control group. Then, we tested the liver and neurological function of each group of offspring, respective-ly, and analyzed their relevance. Results The levels of serum total protein and albumin of the high-dose group were considerably lower than these of the low-dose group which were significantly lower than these of control group ( P<0. 01 for both total protein and albumin);the levels of ALT, AST and blood ammonia of the high dose group were drastically higher than these of the low dose group, which were dramatically higher than these of control group ( P<0. 01 ) . The duration and of stereotyped movement disorder in experimental group was markedly longer than this of the control group, while this of the high-dose group was notably longer than this of the low-dose group ( P<0. 01 );the frequency of the stereotyped movement disorder of experimental group was significantly more than this of the control group, while this of high-dose group was obviously more than this of the control group (P<0. 01). In the Morris water maze, the escape latency of the high-dose group was remarkably longer than this of low-dose group, which was observably longer than this of control group (P<0. 01);the swimming distance of the high-dose group was tremendously shorter than this of low-dose group, which was considerably shorter than this of control group ( P<0. 05 , P<0. 01 ) . Correlation analysis of liver function and neural behavior showed that the neurobe-havioral abnormalities were negatively correlated with level of total protein and albumin, and were positively related with the level of blood ammonia, ALT and AST ( P<0. 01 ) . Conclusion The VPA exposure in the second tri-mester leads to the decrement of serum albumin and total protein and to the increment of AIL, AST and blood am-monia;and it also causes the neurobehavioral abnormalities of offspring. The reduction of synthesis of liver albumin and the rise of ALT, AST and blood ammonia can influence the neurobehavioral abnormalities. And there were both of the factors which result in the neurobehavioral abnormalities of offspring exposured to VPA in the second trimes-ter.

The peripheral renous blood which were taken from healthy volunteers and platelet was isolated. Platelet samples were randomly divided into six groups. The effects of different concentration of taurine( Tau) on benzo py-rene( BAP) induced platelet aggregation in vitro activation function were investigated by detecting the maximum platelet aggregation rate, the positive expression rates of platelet membrane surface CD62P and PAC-1. The results showed that platelet maximum aggregation rate had significant differences between each concentration of BAP-Tau groups and solvent control group in adenosine diphosphate(ADP) and collagen induced (P<0. 01). The positive expression rates of platelet membrane surface CD62 P and PAC-1 in BAP-Tau high concentration group had signifi-cant differences compared with solvent control group ( P<0. 01 ) . Different concentration of Tau could antagonize platelet function damage induced by BAP with a concentration gradient change.

In the course of patient care, it may occur that doctors and patients have unbalanced grasp of medical information, which directly affects the building of doctor-patient trust and patients'evaluation of medical effects. Instrumental methods for building and enhancing doctor-patient trust include mainly the use of relative networks or the presentation of favors while affective methods chiefly include mutual respect and the promotion of friendly relations via communication. The rebuilding of doctor-patient relationship of trust, however, can be approached from the following seven perspectives: ①establishing and perfecting the system of rendering information accessible to the public; ②raising the managers'awareness of trust; ③building an atmosphere of trust acceptable to the entire staff members; ④accepting the restraint of standards and morality; ⑤rendering information accessible to the public in a realistic way; ⑥taking the initiative in clearing up doubts and performing the obligation of notification; and ⑦perfecting the mechanisms of supervision and reward.

Objective To investigate the clinical significance of the joint detection of platelet parameters and coagulation function markers in hepatitis patients.Methods 310 patients with viral hepatitis were divided into 4 groups:acute hepatitis group,chronic hepatitis group,serious hepatitis group and hepatocirrhosis group.The control group was the 80 healthy examination eligible people.Each group were detected platelet parameters ( PLT), mean platelet volume( MPV),.platelet distribution width( PDW),platelet large cell ratio( P-LCR), prothrombin time( PT) ,activated partial thromboplasin time (APTT ) , thrombin time ( TT) and factorl ( Fbg).Results The levels of PLT,MPV and Fbg were obviously reduced in chronic hepatitis,serious condition chronic hepatitis patients and hepatocirrhosis had significant difference compared with those in the control group (all P < 0.01).Moreover, the levels of PDW,P-LCR,PT,APTT and TT were obviously increased in the four groups compared with the control group(all P <0.05 ).Conclusion The joint detection of platelet parameters and coagulation function markers could help to observe the degree of progression of virus hepatitis,and had important clinical significance for the treatment and prognosis.

Objective To explore renal clear cell carcinoma ( CCRCC) expression and significance of CD146 mR-NA in tumor tissue of patients with. Methods ELISA method for quantitative detection was used for CD146 protein and real-time PCR technique for the detection of CCRCC in 102 ( CCRCC) expression in tumor tissue of patients with CD146 mRNA, and 51 cases of renal patients with non tumor tissues as control. Results Found metastasis in patients with CCRCC, the CD146 protein concentration was statistically significant compared with the control group (F=52.1, P<0.01),the average expression of CD146 mRNA value (0.043 8±0.002 4) was significantly high-er than that of in situ CCRCC patients (0.038 2±0.001 1, P= 0.018) and control group (0.034 4±0.001 0, P=0.001 ) . Conclusion Pathological grading and lymph node up regulation of CD146 mRNA expression in renal cell carcinoma and metastasis, is expected to become a new index, evaluation of malignant degree of CCRCC me-tastasis and prognosis, and provide a reliable basis for the intervention of clinical treatment.

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS)is a powerful tool for routine identification of a variety of microorganisms,including bacteria,yeast and filamentous fungi.Fast,accurate, high-throughput and low-cost characteristics,and gradually used for filamentous fungal infection in the laboratory diagnosis. In the MALDI-TOF MS analysis of filamentous fungi,from sample preparation to obtaining accurate identification results, each step determines whether the medical technician can provide accurate results for the clinician.This review will provide a systematic overview of the applications and prospects of filamentous fungal analysis (including identification,typing,and an-tifungal susceptibility testing)from preparation of the test sample to the MALDI-TOF MS technique,as well as a review of some of its future developments.

Objective To explore the effect of subinhibitory concentrations (sub-MICs) of four antibiotics on pan-ton-valentine leucocidin ( PVL ) expression by Staphylococcus aureus . Methods Eight strains of PVL-positive Staphylococcus aureus were isolated by PCR. The MICs of these antibiotics were determined by constant dilution. then, PVL expression of Staphylococcus aureus was measured at different MICs of these antibiotics by ELISA. Re-sults Clindamycin, linezolid and tigecycline all could reduce the expression of PVL at 1 / 8 MIC ~ 1 / 2 MIC. after 4 and 6 hours of culturing, the relative PVL mRNA expression was reduced about 17% ~ 82% , 8% ~ 85% and 11% ~ 78% by clindamycin, linezolid and tigecycline, respectively. The protein expression of PVL was reduced by 65% and 83% under 1 / 4 and 1 / 2 MIC of clindamycin, and reduced by 40% and 61% under 1 / 4 and 1 / 2 MIC of linezolid, and reduced by 61% only at 1 / 2 MIC of tigecycline. There had no effect of vancomycin on PVL expres-sion. Conclusion The effects of four antibiotics on PVL expression at sub-MICs were different. Clindamycin and linezolid could significantly reduced PVL expression. Tigecycline colud reduced PVL expression only at high sub-MICs. Vancomycin had no effect.

Objective To investigate the antimicrobial resistance of clinical isolated acinetobacter baumannii against the common antimicrobial agents in Huainan and to direct rational medication in clinical.Methods 160 acinetobacter baumannii strains were isolated from 3 hospitals in Huainan from Oct.2010 to Jun.2012.Bacteria identification and antimicrobial susceptibility testing were detected by VITEK32 of BioMérieux company.Cefoperazone sulbactam susceptibility was detected by Kirby-Bauer method.Results The drug resistant rate of acinetobacter baumannii against 10 antimicrobial agents was beyond 50.0％ and resistant rate of aztreonam was up to 90.1％.The drug resistant rate of only 4 antimicrobial agents was lower than 50.0％.In these 4 drugs,the lowest drug resistant rate was cefoperazone sulbactam (23.4％) and antimicrobial resistant rate of imipenem and meropenem was 26.0％ and 31.2％,respectively.Conclusion The antibiotic resistance and multiple resistance of acinetobacter baumannii in Huainan is serious.Cefoperazone sulbactam and imipenem are the first drugs for clinical therapy of acinetobacter baumannii infection.

Objective To understand the clinical characteristics of staphylococcal bloodstream infection in patients with secondary immunodeficiency,as well as the distribution and drug resistance of Staphylococcus aureus (SAU)and coagulase negative Staphylococcus (CNS).Methods A total of 101 patients with Staphylococcus isolated from blood sample were retrospectively reviewed in our hospital.The patients were classified into a group with secondary immunodeficiency and another group with normal immune function as control group.SPSS 18.0 statistical software was used to analyze the data,and compare the two groups of patients in terms of clinical characteristics,pathogens,antibiotic resistance,etc.Results All the 70 patients with staphylococcal bloodstream infection and secondary immunodeficiency had various degrees of fever except 2 cases (temperature < 36 ℃).Chills and shiver were reported in 30.0% of the patients,and migratory lesions in 15.5% of the patients.Lungs were the most common site of infection.About 11.4% of the patients complicated with septic shock.The case strains of SAU,of which 18 (43.9%)strains were MRSA,CNS 29 (41.4%)strains,of which 24 (82.8%)strains were MRCNS.In the control group,26 (83.9%)strains of SAU were identified,of which 11 (42.3%)strains were MRSA,and all the 5 (16.1%)strains of CNS were identified as MRCNS.The incidence of CNS infection in the patients with secondary immunodeficiency was significantly different from that in the control group (P =0.013).All the MRS strains were multidrug-resistant organism (MDRO)except one strain of Staphylococcus intermedius .The staphylococcal strains isolated from the patients with secondary immunodeficiency showed high rate of resistance to penicillin (100%), clindamycin (73.0%), erythromycin (90.0%)and gentamycin (61.0%).No strain was found resistant to tigecycline,linezolid or vancomycin.The resistance rate did not show significant difference between the patients with or without secondary immunodeficiency. Conclusions The clinical characteristics of staphylococcal bloodstream infection in the patients with secondary immunodeficiency are similar to the patients without secondary immunodeficiency,except higher incidence of septic shock and death,but the incidence of CNS infection is relatively higher,MDRO is more prevalent.Antimicrobial agents should be prescribed in clinical practice according to disease conditions and the result of antimicrobial susceptibility testing.