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 investigate the drug-resistant status of Acinetobacter baumannii in clinical strains isolated from our hospital,and get to know the distribution of integrons carried by Acinetobacter baumannii,analyze the correlation between integron and drug-resistant of Acinetobacter baumannii..Methods Collected 85 Acinetobacter baumannii isolated in our lab,the drug-sensitivity tests were completed by the method of KB,the integrase genes were amplified by polymerase chain reaction(PCR),and identified the type of integron..Analyzed the correlation between the drug-resistant and integron in Acinetobacter baumannii..The open reading frame of integron were amplified by PCR,the polymorphism of integron was identified,and sequenced the PCR products.Results Except for Imipenem and Cefoperazone/ sulbactam(drug resistant rate less than 10%),the drug resistant rate of other 15 antibacterial was no more than 30% among the 85 Acinetobacter baumannii isolated in our lab..66.1 %(57/85) stains carried the integrons I,we didn't find out the integron Ⅱ and Ⅲ.The drug-resistant rates of Acinetobacter baumannii with integron were higher than that of Acinetobacter baumannii without integron.The length of amplified products in variable region of open reading frame of integron varied from 03 to 25kb,.The sequencing results confirmed the integron included multidrug resistant gene code.Conclusion In our hospital,the drug-resistant rate of Acinetobacter baumannii was high,and the majority were multidrug resistant strains.The drug-resistant rate of Acinetobacter baumannii was enhanced with integron,The multidrug resistant of Acinetobacter baumannii was associated with integrons.

Objective:To investigate the expression of IGF-IR and PKC and their clinical significance in laryngeal squamous cell carcinoma(LSCC).Method:The expression of IGF-IR and PKC protein were detected by immunohistochemistry and Western blot in 60 cases of LSCC, 25 cases of adjacent non-tumorous laryngeal epithelium and 10 cases of normal laryngeal epithelium.Result:The positive rate of IGF-IR and PKC expression in LSCC were significantly higher than that in normal laryngeal epithelium and adjacent non-tumorous laryngeal epithelium(P<0.05). IGF-IR positive expression were increased more in cases with stage Ⅲ-Ⅳ, cervical lymph node metastasis and well differentiation than that in cases with stageⅠ-Ⅱ, non-lymph node metastasis and poor/mediate differentiation, respectively(P<0.05).The positive rate of PKC in LSCC were correlated with clinical stage and cervical lymph node metastasis.There was a correlation between the expression of IGF-IR and PKC in LSCC.Conclusion:The overexpression of IGF-IR and PKC in the laryngeal carcinoma may play an important role in the carcinogenesis and development of LSCC. It is suggested that detecting the expression of IGF-IR and PKC can be used for early diagnosis and treatment of LSCC.

Objective To investigate the effects of p38 mitogen-activated protein kinase (MAPK) short hair RNA (shRNA) delivered by lentiviral vectors (pGLV) on cardiac function after myocardial infarction (MI) in aldosterone overload rats and to explore the mechanism.Methods Aldosterone overload rat myocardial infarction model was obtained by ligating the left anterior descending coronary artery.The pGLV-shRNA was constructed,sequenced and injected into rats via tail vein.Rats were divided into 3 groups:pGLV-shRNA group (n=6),pGLV-shRNA-NC group (n=6,contained a nonsense shRNA) and the sham-operation group (n=6).Cardiac function was measured by cardiac ultrasound.Apoptosis was assessed by transferase (TdT)-mediated biotin-16-dUTP nick-end labelling (TUNEL).The p38 MAPK mRNA expression was analyzed by RT-PCR.The protein expressions of p38 MAPK and caspase-3 were detected by Western blot.Results Compared with the sham-operation group,cardiac systolic function was reduced and myocardial apoptosis index was significantly increased [(31.26 ± 4.45) ％ vs.(15.20 ± 2.18) ％,P ＜ 0.01] in pGLV-shRNA-NC group.The mRNA and protien expressions of p38MAPK and caspase 3 protein expression were significantly increased in pGLV-shRNA-NC group (all P＜0.01).Compared with pGLV-shRNA-NC group,cardiac function was improved,myocardial cell apoptosis index was reduced [(22.35±3.59)％ vs.(31.26±4.45)％,P＜0.05],and the mRNA and protien expressions of p38MAPK and caspase 3 protein expression were decreased in pGLV-shRNA group (all P＜0.05).Conclusions Cardiac dysfunction is associated with p38MAPK-mediated myocardial apoptosis in aldosterone overload MI rats.pGLV-shRNA may inhibit cardiomyocyte apoptosis and improve postMI cardiac function.

Objective To investigate the clinical efficacy of complete mesogaster excision in the radical gastrectomy for gastric cancer.Methods The clinical data of 100 patients with distal gastric cancer who were admitted to the First Affiliated Hospital of Harbin Medical University from January 2011 to December 2012 were retrospectively analyzed.All the patients underwent complete mesogaster excision in D2 radical gastrectomy for gastric cancer.The operation quality was evaluated according to operation time,volume of intraoperative blood loss,mean number of lymph nodes dissected,time to flatus,volume of drainage and duration of postoperative hospital stay.Patients were followed up by outpatient examination and telephone interview till May 2014.Results Complete mesogaster excision in the radical gastrectomy for gastric cancer was successfully carried out on all the 100 patients.The operation time,volume of intraoperative blood loss,mean number of lymph nodes dissected,time to flatus,volume of drainage and duration of postoperative hospital stay were (118 ± 34) minutes (range,90-160 minutes),(80±25)mL (range,45-135 mL),38± 10 (range,25-52),(3.0 ± 1.2)days (range,1.5-4.5 days),(62±15)mL (range,15-85 mL) and (7.0±1.5)days (range,4.0-11.5 days),respectively.According to the postoperative pathological results,there were 36 patients with high differentiated gastric carcinoma,38 with moderate and/or low differentiated gastric carcinoma,17 with low differentiated gastric carcinoma and 9 with signet ring cell carcinoma.After operation,3 patients had gastroplegia,2 with poor healing of abdominal incision,2 with duodenal stump fistula,1 with pancreatic fistula,and all of them were cured by conservative treatment.All the 100 patients were followed up for a mean time of 25.6 months (range,17.6-39.2 months).There was no tumor recurrence.Conclusions Complete mesogaster excision in the radical gastrectomy for gastric cancer is safe and feasible,with the advantage of minimal trauma,low morbidity and quick recovery during the follow up.

To study factors related to visual field damage in Possner- Schlossman Syndrome(PSS) .Methods 145 cases of PSS and 166 cases of promary open angle glaucoma(POAG)were followed up with tonometer and perimeter. Results①Prevalence of visual field damageamong PSS and POAG cases were 35.43% and 93.42% respectively;72.11% of the visual field damage in the PSS group was of early stage,while 78.92% of that in the POAG group was of middle or late stage.②Compared with PSS cases with no visual field damage,the damaged cases were older;their course of the disease was longer;the average IOP between crises was higher;more cases were involved binocularly;more cases demonstrated abnormal diurnal and nocturnal IOP varianle or no crossover phenomenon. ③Systematic examination was given to 26 PSS cases with visual field damage and among them, 11 cases were confirmed to be complicated with POAG. Conclusion①Although the incidence of visual field damage done by PSS is much smaller and the symptoms slighter than those done by POAG,the prognosis of PSS is by no means optimistic. ②Coses at more advanced age, with longer course, with higher IOP between crises, with binocular involvement or without IOP crossover phenomenon are at a higher risk of visual field damage. ③Serious damage can be done by PSS itself.

OBJECTIVE To investigate the drug-resistant rates of clinical Acinetobacter baumannii strains isolated from our hospital and to understand the integrons distribution carried by A.baumannii.To identify the type of the integrons and analyze the correlation between integron and drug resistance in A.baumannii clinical isolates. METHODS Collected clinical isolates and the drug-sensitivity tests were completed by the method of KB.Amplified integrase were tested by PCR and identified the integron category.Correlation between integron in A.baumannii and drug resistance was analyzed.The open reading frame(ORF) of integron were amplified and observed the polymorphism of integron,Part of amplified products were sequenced. RESULTS Apart from imipenem and cefoperazone /sulbactam,the drug-resistant rate of 85 A.baumannii clinical isolates to else 15 kinds of antibacterials surpassed 30.0%.67.1% A.baumannii clinical isolates carried the integrons,and confirmed all of them belonged to integron Ⅰ after identification,but integrons Ⅱ and Ⅲ were not found.The drug-resistant rates of A.baumannii with integron to 14 kinds of antibacterials were higher than those of A.baumannii without integron.The length of amplified products in variable region of ORF of integron varied from 0.15 to 2.5 kb.The sequencing results confirmed the integron carried multidrug-resistant gene code. CONCLUSIONS Drug-resistant rate of A.baumannii clinical isolates in our hospital is higher and the majority of them are multidrug-resistant strains.The drug-resistant rates of A.baumannii with integron to 14 kinds of antibacterial are higher.The multidrug-resistant A.baumannii is associated with integrons.

Objective To discuss the signiifcance of serum albumin level in assessing severity, progress and prognosis of sepsis in children. Methods The clinical data of 212 patients diagnosed with sepsis admitted to PICU from February 2010 to July 2010 were retrospectively analyzed, and 52 patients had severe sepsis and 31 patients had septic shock. Meanwhile, 110 non-sepsis patients were selected as controls. The relationships of hypoalbuminemia with pediatric critical illness score (PCIS), pediatric risk of mortality III (PRISM III) and prognosis were evaluated, and the change of albumin level in patients with dif-ferent severity of sepsis was observed. Relative factors analysis of albumin level ≤25 g/L was performed. Results As the serum albumin level was decreased, the PCIS was signiifcantly decreased while the PRISM III was increased (P<0.01). The se-rum albumin level was signiifcantly different among children with septic shock, severe sepsis and sepsis and controls (F=13.938, P=0.000). The results of relative factors analysis showed that sepsis children with an albumin level≤25 g/L had more organ failures, higher mortality, longer hospital and PICU stay and more likelihood for ventilator support (P<0.01). Lower albumin levels were accompanied with lower rates of recovery and improvement but higher mortality (rs=-0.161, P=0.000). Conclusions Hypoalbuminemia can be used as indirect indicator for severity of infection. The albumin level≤25 g/L indicated the severity of illness and prognosis in children with sepsis.

OBJECTIVE: To investigate the clinical outcomes of artificial bone (hydroxyapatite) and bone cement implantation in treating young patients with avascular necrosis of the femoral head caused by different reasons. METHODS: A total of 18 patients (23 hips) with Ficat stage Ⅲ and Ⅱ avascular necrosis of the femoral head were treated with dead bone debridement, artificial bone and cement implantation in Department of Orthopedics, Third Affiliated Hospital of Guangxi Traditional Chinese Medical College from October 2003 to July 2008. The patients were followed up for 24.6 months (ranging 3 months to 5 years). The affected hip function was evaluated by modified Merled'Aubigne Scores and X-ray. RESULTS: Mean hip scores improved significantly from 11.65 to 15.09 after surgery. Postoperative radiographs demonstrated the improved collapse and restoration of femoral head sphericity. The femoral heads of most patients remained the appearance after surgery, and the necrosis range did not enlarge. The patients were satisfactory to the treatment results. CONCLUSION: Artificial bone and cement implantation could restore head sphericity and prevent further collapse. The method can be used as an alternative for treatment of avascular necrosis of femoral head at Ficat stage Ⅱ and Ⅲ, especially for young patients.

Objective To analyze the clinical factors for pathologic complete response ( pCR) after preoperative neoadjuvant chemoradiotherapy ( neo?CRT) for locally advanced rectal cancer. Methods From 2005 to 2012, 297 patients with locally advanced rectal cancer and complete clinical data were enrolled as subjects. Those patients were diagnosed with biopsy and treated with neo?CRT ( radiotherapy by 3?dimonsional conformal radiotherapy or volumetric?modulated arc therapy) followed by radical surgery. The logistic regression model was used for the multivariate analyses of the correlation of pCR with age, gender, distance between tumor and the anal verge, serum level of carcinoembryonic antigen ( CEA ) before treatment, hemoglobin level before treatment, cT staging, and cN staging. Results In all patients, 78 ( 26?7%) patients had pCR after treatment. The numbers of patients with pCR were 42( 34?4%) in patients with stage T1?T3 disease and 37(21?1%) in patients with stage T4 disease. In the patients with serum CEA levels no higher than 5?33 ng/ml, 55(36?4%) had pCR after treatment, while in the patients with serum CEA levels higher than 5?33 ng/ml, only 24( 16?4%) had pCR. The univariate analysis revealed that age, gender, distance between tumor and the anal verge, anemia before treatment, or cN staging were not related to pCR. The multivariate analysis showed that stage cT1?T3 and a serum CEA level no higher than 5?33 ng/ml before treatment were influencing factors for pCR after neo?CRT for locally advanced rectal cancer ( P=0?031,P=0?000) . Conclusions The clinical staging and the serum CEA level before treatment are influencing factors for pCR after neo?CRT for locally advanced rectal cancer. The serum CEA level before treatment can be considered as a predictor of pCR after neo?CRT for locally advanced rectal cancer.