To identify the species of Mycobacterium clinical isolates by molecular biology techniques,six clinical isolates which were preliminarily recognized as Mycobacterium tuberculosis by the TCH and PNB culture methods were selected in this study.PCR was applied to amplify the oxyR-ahpC interval resistant-zone(intergenic region) and the length of PCR product in four strains was the same as that of H37Rv,while the length in the other two strains was different from that of H37Rv but same as Mycobacterium intracellulare 95002.With sequencing and on-line homology comparison with H37Rv,U18263 and U71061,the DNA sequence of oxyR-ahpC intergenic region displayed a 99% homology with Mycobacterium intracellulare U71061 and an 84% homology with Mycobacterium tuberculosis H37Rv.In addition,the results of hsp65 PCR-restriction fragment length polymorphism analysis and multi-locus PCR amplification in the two strains were identical with those of Mycobacterium intracellulare 95002.These two clinical isolates which were preliminarily recognized as Mycobacterium tuberculosis by PNB and TCH culture methods were finally identified as Mycobacterium intracellulare.Results predicted that the application associated with various techniques of molecular biology would provide a faster,easier and more correct way for the species identification of Mycobacterium.

Objective To evaluate prospectively the preoperative use of 16-multidetector computed tomography (MDCT) with cholangiography and angiography in determining the resectability of hilar cholangiocarcinoma.Methods From January 2002 to January 2009,75 consecutive patients with hilar cholangiocarcinoma underwent preoperative MDCT with cholangiography and angiography.3D images of the portal vein,hepatic artery,and bile ducts were created and viewed simultaneously.The accuracy of MDCT with cholangiography and angiography was determined by comparison with intraoperative and pathologic findings.Results All patients tolerated the CT imaging well.The sensitivity,specificity,and accuracy rates were 92.9%,100%,and 96%for portal invasion and 83.3%,100 %,and 93.3%for hepatic arterialinvasion.The accuracy rate of longitudinal tumor extension,using the Bismuth-Corlette classification system,was 96 %.The sensitivity,specificity,and accuracy of prediction of resectability were 95.7%,82.1%,and 90.7%,respectively.Conclusion Preoperative MDCT with cholangiography and angiography gave a good assessment of the degree of biliary and vascular involvement of hilar cholangiocarcinoma.It also accurately predicted resectability in patients with hilar cholangiocarcinoma.

Objective To assess the value of MSCT and postprocessing techniques in displaying abnormal blood vessels of pulmonary sequestration. Methods Ten patients with pulmonary sequestration proved with operation and pathology underwent both plain and enhanced chest CT scan. The reconstructed images of maximum intensity projection, multiplanar reconstruction and volume rendering were analyzed retrospectively. Results Of 10 patients, intra-lobe type sequestration was seen in 9 patients and extra-lobar type in 1 patient. The lesions located in the left lower lobe in 8 patients and in the right lower lobe in 2 patients. Angiography postprocessing technique displayed abnormal supplying vessels in 9 patients (7 from descending aorta and 2 from abdominal aorta) and displayed the origin, courser, branches and distribution of lesions clearly. Vessels in 9 patients drained into inferior pulmonary veins except in one drained into azygos vein. Conclusion MSCT angiography with postprocessing reconstruction techniques can display abnormalities of pulmonary sequestration clearly and has great value in the diagnosis of pulmonary sequestration, so as might be the first choice in diagnosing pulmonary sequestration.

OBJECTIVE:To explore the effects of Cangfu daotan decoction on expression of organic anion transporting poly-peptide(oatp4a1)and level of sex hormone in the endometrium and ovary tissues of rats with obesity-type polycystic ovarian syn-drome(PCOS). METHODS:Obesity-type PCOS rat models were established. 50 rats were randomized into a normal control(iso-metric normal saline)group,a model(isometric normal saline)group,a metformin(0.043 g/kg)group and Cangfu daotan decoc-tion high-dose and low-dose [5.68 and 1.42 g(medicinal materials)/kg] groups. The rats were given drugs ig once a day for 14 con-secutive days. The expression of oatp4a1 protein in the endometrium and ovaries of the rats was determined by ECL and Western blot. The levels of luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T)and estradiol(E2)in rat’s se-rum were detected by ELISA. RESULTS:Compared to the normal control group,those in the model group had weaker expression of oatp4a1 protein in the endometrium and ovaries,higher levels of serum LH,LH/FSH and T,lower levels of serum FSH and E2. There were statistical significances(P<0.01). Compared to the model group,those in metformin group,Cangfu daotan decoction high-dose and low-dose group had higher expression of oatp4a1 protein in the endometrium and ovaries,lower levels of LH/FSH and T,higher levels of serum E2;those in metformin group and Cangfu daotan decoction high-dose group had lower levels of serum LH,higher levels of serum FSH. There were statistical significances(P<0.01 or P<0.05). CONCLUSIONS:Cangfu daotan decoc-tion can increase the expression of oatp4a1 in the endometrium and ovaries of obesity-type PCOS model rat,alleviate phlegmy dampness and regulate the level of sex hormone.

Objective: To study the attenuating effect of angiotensin I type 1 receptor antagonist losartan and an-giotensin converting enzyme inhibitor captopril on aortic atherosclerosis in rabbits. Methods: Thirty-one male New Zealand rabbits were randomly divided into 5 groups:control group,high cholesterol diet group,losartan group, captopril group and combined drug administration groupdosartan+captopril). The animals were killed after 16 weeks and the serum total cholesterol ,triglyceride, high and low density cholesterol .atherosclertic ratio,endothelin,NO,plaque area percentage,aortic cholesterol content and vascular smooth muscle cell (VSMC) apoptosis were determined. Results:The plaque area percentage,aortic cholesterol contents and endothelin levels of 3 drug treatment groups were significantly lower than that of high cholesterol group,NO contents and VSMC apoptosis were significantly higher. Conclusion:Losartan and captopril can attenuate aortic atherosclerosis induced by high cholesterol diet .combined administration of the 2 drugs at low doses are more effective. The mechanism may be related to the protection of endothelial function and the effect on apoptosis of VSMC.

Objective : To learn the situation of vaccine management in Zhejiang Province by SWOT analysis,so as to provide basis for normalization and standardization of vaccine management. Methods: Through supervision and investigation,the data of vaccine management related human resources and information construction of the CDCs in Zhejiang Province were collected. The comprehensive evaluation of vaccine management in Zhejiang Province was carried out by SWOT analysis,and the SWOT matrix was established for suggestions. Results: The advantages of vaccine management in Zhejiang Province lay in the standardized management of purchase and supply,the construction of vaccine management information system and the guarantee of cold chain system;the disadvantages lay in the insufficient allocation of human resources,new problems of cold chain management,the lack of standardized vaccine management mode and the incomplete coverage of vaccine and vaccination information system;the opportunities lay in the legalization of vaccine management,“Healthy Zhejiang”initiative and the “one run at most”reform in healthcare services;the threats lay in the shortage of vaccine,the gap between the expectation of the public on vaccine management and the current situation,and the reduced capacity of vaccine deployment in the provincial CDC. We should constantly improve the construction of vaccine management system,strengthen the standardized administration,regularly carry out risk assessment on vaccine management,accelerate the full coverage of vaccine and vaccination management information system,and explore the standard operation procedure of vaccine management in Zhejiang Province. Conclusions Although some achievements have been made in vaccine management in Zhejiang Province,there is still a gap from the goals of high-efficiency,high-level,normalization and standardization. The standardization and full coverage of the information system of vaccine management should be strengthen in the next stage.

Objective To explore the clinical,CT and MRI features of ovarian adenofibroma(OAF)and improve the diagnostic level. Methods Ninety-two cases of OAFs were analyzed retrospectively and summarized the features including clinical manifestations ,CT and MRI images. Results The probability of unilateral ,serous and benign OAFs were 91.3%,89.1%and 97.8%. OAFs associated with uterine or/and ovarian lesions was 40.2%. The clinical manifestations of OAF was not typical. These OAFs were divided into 2 groups according to whether or not accompanied with uterus or/ and ovarian lesions. The clinical manifestations and laboratory indexes were only found abnormal menstruation rate(P<0.05),but there were no significant difference between other indexes. The performance of CT plain scan and CT/MRI enhanced scan had not characteristic.The percentage of the"black sponge"on T2WI image and hyperintensity on DWI image of OAFs were 40.0% and 65.0%. Conclusion The"black sponge"on T2WI image and hyperintensity on DWI image may be helpful to diagnose OAF.

Objective To summarize the clinical and imaging characteristics of Rosai-Dorfman disease (RDD) in order to improve the diagnosis of the disease.Methods The clinical and imaging features of 10 patients with RDD proved by pathology were retrospectively analyzed and the related literatures were reviewed.Results Ten patients including 7 males and 3 females,aged 8 to 54 years old,with average of 32 years old.White blood cells (BCA) and erythrocyte sedimentation rate (ESR) in 8 cases were normal.Eight cases manifested as painless enlarged lymph node or mass,of which 4 cases were accompanied with multisystem involvement.Three lesions involved lymph nodes,5 lesions were located in extranodal sites,while 2 lesions involved both lymph node and extranodal sites.RDD occurred in lymph nodes (n=3) manifested as multiple enlarged lymph nodes on CT imaging,showing mild or moderate the enhancement,or a heterogeneous ring-enhancement.Of 5 extranodal RDD lesions,3 cases underwent MR exmination.2 lesions manifested as subcutaneous soft tissue mass on left shoulder and anterior abdominal wall,1 lesion manifested as intracranial mass accompany with localised cranial bone destruction.Lesions in all 3 cases had poor margins and showed scatted areas of high signal on diffusion weighted images.Lesions exhibited remarkable heterogeneous enhancement on Gd-DTPA enhanced MR imaging,dural/fascia tail sign and dilated blood vessels could be found around the lesions.Intrahepatic RDD lesion showed fast washing out phenomenon on CT enhanced imaging.In 2 cases involved both lymph node and extranodal sites,1 case manifested as swelling pharyngeal lymph chain and nasopharynx,enlargement of lymph nodes in bilateral submandibular and cervical region abdominal cavity on CT imaging,the enhancement is mild and moderate,accompany with osteolytic lesions in right proximal humerus on X-ray.For the other case,CT images manifested as bilateral neck lymphadenopathy,accompanied with soft tissue mass in nasal cavity,the lesion showed mild/moderate enhancement.Conclusions RDD mostly appears in young and middle-aged men,and is rarely preoperatively diagnosed.RDD mainly manifests as painless enlarged lymph node or mass.RDD has a broad spectrum of radiographic appearance,varied according to different location of lesion.Scatted higher signal areas on diffusion weighted images in the masses and significantly heterogeneity enhancement with dilated blood vessels around the lesion could be helpful in diagnosing of extranodal RDD.

Objective:To explore the effect of acceptance and commitment nursing therapy on the psychological resilience and post-traumatic growth of patients with hematopoietic stem cell transplantation.Methods:From January 2018 to December 2019, convenience sampling method was used to select 88 patients who underwent hematopoietic stem cell transplantation in Ningbo First Hospital as the research object. All patients were divided into control group and intervention group with the method of random number table, with 44 cases in each group. Control group was treated with conventional nursing care and medication, and intervention group received acceptance and commitment nursing therapy on this basis. We compared the scores of psychological resilience, post-traumatic growth and quality of life of patients between two groups before and after intervention.Results:Before intervention, there was no statistically significant difference in the total scores of psychological resilience, post-traumatic growth, quality of life and scores in each dimension between two groups ( P>0.05) . After intervention, the total scores of psychological resilience, post-traumatic growth and quality of life of intervention group were higher than those of control group, and the differences were statistically significant ( P<0.05) . Conclusions:Acceptance and commitment nursing therapy can improve the psychological resilience, post-traumatic growth and quality of life of patients with hematopoietic stem cell transplantation, which is worthy of clinical promotion.