Objective To investigate the genotype of carbapenem-resistant Acinetobacter baumannii(CRAB) acquired from intensive care units (ICUs) environment in Shanghai hospitals and to evaluate the gene homology of CRAB isolated from patients and environment in ICUs in Shanghai hospital.Methods Sixty-one CRAB isolated from ICUs environment in Shanghai hospitals and 14 strains isolated from ICUs patients in S hospital were typed by REP-PCR based DiversiLab system.Results There were 7 types of the CRAB isolated from ICUs environment in Shanghai hospitals.Type G1 was the dominant type,accounting for 75.4％ of all CRAB,mainly in 13 hospitals in Shanghai.The percentage of the 7 types CRAB strains were 75.4％,13.1％,3.3％,1.6％,1.6％,3.3％ and 1.6％,respectively.Except for 1 strain of type G6 isolated in D hospital,type G1 CRAB was identified in every hospital which was isolated CRAB.There were 25 strains isolated from patients and environment in S hospital ICUs,which were divided into 4 types.Type G1 was the dominant type mainly distributed in SICU and CICU,including 9 from patients and 8 from environment.The distribution diagram of environmental and patients' strains indicated that the patients in adjacent bed isolated G1 CRAB in SICU and a patient in CICU and its surrounding environment both isolated G1 CRAB.Conclusion Type G1 is the dominant type in ICUs environment in Shanghai hospitals.There are inter-hospital transmission of CRAB in ICUs environment and highly homology of CRAB isolated from patients and environment in ICUs in Shanghai hospitals.Active surveillance of infection and colonization by CRAB,together with implementation of enhanced control strategies should be taken to eradicate CRAB in ICU environment.

Objective To introduce the clinical experience and investigate venous drainage of distal- ly-based dorsal digital neurocutaneous flap for finger-pulp reconstruction.Methods From Mar.2004 to Oct.2005,18 patients with traumatic finger-pulp defect (＞2cm) were treated by distally based dorsal ho- modigital neurocutaneous flaps.The flap measured 2 cm?2cm～3cm?4cm with the neuro-veno-adipal ped- icle 1cm wide and 2～3cm long.The pivot points were proximal to the PIP joints.The dorsal digital nerve was neurorrhaphied with the proper digital nerve of the recipient site.The dorsal digital vein was ligated at 1cm distal to the pivot point to prevent venous ingress.No venous anastomosis was performed.Results All the flaps survived but had some degrees of venous congestion and swelling,and 8 flaps developed tension blisters. In 13 flaps with follow-up more than 6 months,protective sensation was restored.Conclusion Dorsal digit- al neurocutaneous flap is simple and effective for finger-pulp reconstruction.Ligating the big superficial vein at the distal base to interrupt venous ingress,and allowing the proximal vein open and venous egress,can reduce flap congestion and swelling.

Objective To investigate the effects of high spermatic vessel dissection on testicular morphological alteration of SD rats in prepuberty,puberty and sexual maturity phases.Methods Thirty-day-old SD rats were divided into 2 groups underwent sham operation and left high spermatic vessel dissection as a simulation of Palomo′s maneuver.Detailed morphological investigations were made at 3 different postoperative intervals among the 3rd day,30th day and 56th day.Results High spermatic vessel dissection in prepubertal rats induced acute testicular ischemia in the operated testes on the 3rd day.Most of the operated testes on the 30th day showed testicular atrophy.And all the operated testes showed testicular atrophy and sperm disappearance in epididymis on the 56th day.Conclusion High dissection of spermatic vessel in prepubertal rats induced testicular ischemia in prepuberty and testicular growth failure in puberty,testicular atrophy completely and sperm production losing in sexual maturity phase.

OBJECTIVETo determine the risk factors in the development of central nervous system (CNS) congenital malformations.

METHODSA hospital-based 1:2 matched case-control study was conducted. Each case was matched with two normal controls on sex and residential area, date of birth, within half a year. By means of simple and multivariable conditional logistic regression, 48 factors were analyzed.

RESULTSMaternal exposure to pesticide or having cold with fever, family history of positive congenital malformations, preference eating pickled vegetables, negative life events, large consumption of meat, eggs, beans and milk during pregnancy and paternal exposure to poisonous chemicals were significantly associated with CNS congenital malformations, with odds ratios 16.471, 12.621, 10.246, 7.274, 3.730, 0.229, 5.616, respectively.

CONCLUSIONSMaternal exposure to pesticides, cold with fever, positive congenital malformations family history, preference of eating pickled vegetables, negative life events during pregnancy, and paternal exposure to poisonous chemicals were the key risk factors contributing to CNS congenital malformations, while maternal exposure to big consumption of meat, eggs, beans and milk during pregnancy was protective factors that reducing CNS congenital malformations.

Adult ; Case-Control Studies ; China ; epidemiology ; Environmental Exposure ; Female ; Humans ; Male ; Maternal Exposure ; Nervous System Malformations ; epidemiology ; etiology ; Neural Tube Defects ; epidemiology ; etiology ; Paternal Exposure ; Pregnancy ; Risk Factors

OBJECTIVETo identify the self-preparation monoclonal antibody which target to clenbuterol, and set up the standard curve to clenbuterol (CL) detection.

METHODSThe affinity constants and activity of the monoclonal antibody which target to CL were determined by ELISA. ELISA was also used to confirm whether the monoclonal antibody had any across-reaction with BSA and CL analogues. The rat ascites which contains the monoclonal antibody target to CL was purified by (NH4)2SO4 salt-out method and further by affinity column. At last, the CL detection standard curve which based on indirect competition ELISA was established.

RESULTSThe ELISA experiment showed that the antibody titer was 10(6) and the monoclonal antibody affinity constants was 2.90 x 10(10) L/mol. The result of the indirect competition ELISA confirmed that the monoclonal antibody had no cross-reaction with BSA and a few kind of CL analogue. CL detection standard curve based on indirect competition ELISA was established, which R2 was 0.9812, and the lowest detectable limit was 1.0 ng/ml.

CONCLUSIONThe standard curve based on indirectly competitioning ELISA was established. The self-preparation monoclonal antibody which target to CL has high affinity and high specific to CL, which had established the foundation to the advanced development of the CL immune test paper and CL ELISA kit.

Animals ; Antibodies, Monoclonal ; chemistry ; isolation & purification ; Antibody Affinity ; Clenbuterol ; immunology ; Cross Reactions ; Enzyme-Linked Immunosorbent Assay ; Limit of Detection ; Rats

BACKGROUNDEarly stage (FIGO stage I-II) endometrioid endometrial adenocarcinoma (EEA) is very common in clinical practice. However, patients with the early stage EEA show various clinical behaviors due to biological heterogeneity. Hence, we aimed to discover distinct classes of tumors based on gene expression profiling, and analyze whether the molecular classification correlated with the histopathological stages or other clinical parameters.

METHODSHierarchical clustering was performed for class discovery in 28 early stage EEA samples using a special cDNA microarray chip containing 492 genes designed for endometrial cancer. Correlations between clinicopathologic parameters and our classification were analyzed. And the significance analysis of microarrays (SAM) array was used to identify the signature genes according to the tumor grade and myometrial invasion.

RESULTSThree tumor subtypes (subtypes I, II and III) were identified by hierarchical clustering, each subtype had different clinicopathological factors, such as tumor grade, myometrial invasion status, and FIGO stage. Moreover, SAM analysis showed 34 up-regulated genes in high grade tumors, and 38 up-regulated genes and 1 down-regulated in deep myometrial invasive tumors. The overlap genes between these two high-risk factors were markedly up-regulated in subtype I, but down-regulated in subtype III.

CONCLUSIONWe have identified novel molecular subtypes in early stage EEA. Differential gene signatures characterize each tumor subtype, which could be used for recognizing the tumor risk and providing a basis for further treatment stratification.

Adenocarcinoma ; genetics ; pathology ; Endometrial Neoplasms ; genetics ; pathology ; Female ; Gene Expression Profiling ; Humans ; Neoplasm Staging ; Oligonucleotide Array Sequence Analysis

OBJECTIVETo investigate the correlation between visceral adipose tissue-derived serine protease inhibitor (vaspin) concentration and insulin sensitivity in the visceral adipose tissue of young obese Sprague-Dawley (SD) rats.

METHODSTwenty-four SD rats which had been weaned 3 weeks before were randomly divided into two groups (n=12 each) to receive a high-fat and normal diet. The weight and abdominal circumference (AC) of each rat were measured, the fasting plasma glucose (FPG) and fasting insulin (FINS) in blood from the angular vein were measured after 12 hours of fasting and blood glucose (BG) and insulin (INS) levels in blood from the angular vein were measured at 60 and 120 minutes after intraperitoneal injection of 50% glucose (2 g/kg). The rats were sacrificed, and their liver and visceral adipose tissue were weighed. The vaspin concentration of the visceral adipose tissue in each rat was measured using ELISA. Correlation analysis was performed on the vaspin concentration and other indices.

RESULTSCompared with the normal diet group, the high-fat diet group showed significantly higher weight, AC, weight of visceral adipose tissue, FPG, FINS, 120 minute INS level, vaspin concentration, homeostasis model assessment for insulin resistance (HOMA-IR) and homeostasis model assessment of β cell function (HOMA-β) (P<0.05) Insulin sensitivity index (ISI) was significantly lower (P<0.01). Vaspin concentration was positively correlated with visceral adipose tissue and liver weight, AC, 120 minute INS level, FPG, FINS, HOMA-IR and HOMA-β (P<0.05), and negatively correlated with ISI (P<0.05).

CONCLUSIONSHigh expression of vaspin is associated with insulin resistance in young obese SD rats. Vaspin is presumably an adipocytokine that can increase insulin sensitivity, promote insulin secretion by islet β-cells and improve glucose tolerance, and it may be involved in insulin resistance and the disturbance of carbohydrate metabolism.

Animals ; Female ; Glucose Tolerance Test ; Insulin ; blood ; Insulin Resistance ; Intra-Abdominal Fat ; chemistry ; Male ; Obesity ; metabolism ; Rats ; Rats, Sprague-Dawley ; Serpins ; analysis ; physiology

OBJECTIVENoninvasive method for estimating the pulmonary vascular resistance (PVR) was used in patients waiting for two staged Fontan procedure to observe the relationship between estimated PVR and surgical results.

METHODSThirty-three candidate patients for two staged Fontan procedures were randomly selected for this trial. Preoperative hemoglobin (HGB), hematocrit (HCT) and pulse oxygen saturation (SpO2) were measured. Estimated PVRs were then calculated by the regression equations. The cases were divided into three groups of low risk group with PVR less than 2.4 wood, high risk group with PVR between 2.4 to 3.2 wood, and extremely high risk group with PVR more than 3.2 wood. The incidences of postoperative low cardiac output and multi-organ failure were compared. Simultaneously, the cases without or with postoperative severe low cardiac output and multi-organ failure after operation were divided into two groups. The preoperative HGB, HCT and estimated PVR among the groups were analyzed.

RESULTSThe rates of postoperative severe low cardiac output and multi-organ failure were 10.0%, 32.4% and 63.6% for the patients of low, high and extremely high risk groups respectively. The difference was significant (P < 0.01). The preoperative HGB, HCT, SpO2 and PVR were all significantly different between the patients without or with postoperative severe low cardiac output and multi-organ failure. The PVR (HGB) were (2.53 +/- 0.56) wood and (3.24 +/- 0.58) wood respectively. The PVR (HCT) were (2.59 +/- 0.58) wood and (3.21 +/- 0.79) wood respectively. The PVR (SpO2) were (2.22 +/- 0.55) wood and (2.93 +/- 0.58) wood, respectively. The differences were all significant (t = 3.25, 2.52 and 3.33 respectively, P < 0.01 or 0.05).

CONCLUSIONSPreoperative estimated PVRs calculated by HGB, HCT and SpO2 were comparable with the postoperative results. Thus, the invasive preoperative estimation of pulmonary vascular resistance could be a method in estimating the surgical indication and predicting the surgical result for two stage Fontan procedure.

Adolescent ; Cardiovascular Abnormalities ; physiopathology ; surgery ; Child ; Child, Preschool ; Contraindications ; Female ; Fontan Procedure ; methods ; Humans ; Male ; Treatment Outcome ; Vascular Resistance

Objective To investigate the therapeutic effects of oleanolic acid-loaded polylactic-co-glycolic acid-D-α-tocopheryl polyethylene glycol 1000 succinate (PLGA-TPGS ) nanoparticles (OPTN ) combined with heparin sodium-loaded PLGA-TPGS nanoparticles (HPTN)on liver cancer,and explore whether OPTN combined with HPTN has a synergistic effect by comparing the results of single medication.Methods Coumarin 6 and eosin were used as fluorescent probes to examine the cellular uptake by human liver cancer HepG2 cell and murine ascitic hepatocarcinoma cell strain with high metastasis potential in the lymphatic system (HCa-F).The in vitro cytotoxic combination effect and apoptosis of HepG2 cells induced by OPTN combined with HPTN were also determined using WST-1 assay and Annexin V-FITC staining. The antitumor effect in vivo was determined by tumor growth inhibition rate and hematoxylin & eosin staining (H & E)method.Results Both OPTN with green fluorescence and HPTN with red fluorescence were found in HepG2 cells and HCa-F cells,suggesting that they had been internalized.The cell cytotoxicity test and Annexin V-FITC staining results showed that OPTN combined with HPTN had a synergistic effect.The therapeutic effect in vivo showed that OPTN combined with HPTN effectively inhibited tumor growth better than the drug alone.Conclusion OPTN combined with HPTN has a synergistic effect in more effectively inhibiting liver cancer better than single medication.

Objective: To analyze the clinical manifestation of suppurative meningitis of newborn, characteristics of cerebrospinal fluid (CSF) and the abnormal manifestation of brain MRI. Methods: The clinical documents of 87 newborn with suppurative meningitis were implemented by using retrospective research, and these patients were divided into refractory group (47 cases) and common group (40 cases) according to the ease or difficulty level. And the clinical appearance and radiography characteristics of brain MRI about suppurative meningitis for newborn were analyzed. Results: In the 87 cases, 38 cases (43.68%) were positive in the culture of blood or cerebrospinal fluid (CSF). The occurrence rate of convulsions of refractory group was significantly higher than that of common group (x2=-5.187, P<0.05). The differences of glucose concentration, protein concentration and white cell count between the two groups, respectively, were significant (x2=-4.471, x2=-4.433, x2=-5.739, P<0.05). The abnormal rate of brain MRI of refractory group was significantly higher than that of common group (x2=3.227, P<0.05). The hospital stay time of refractory group was significantly longer than that of common group (t=4.815, P<0.05). Conclusion: The newborn with suppurative meningitis more likely becomes refractory suppurative meningitis when the pathogenic bacteria culture of CSF or blood is positive, and the glucose concentration in CSF is reducing and newborn occurs convulsions. The brain MRI of refractory suppurative meningitis often occurs series of abnormal manifestation including of the white matter reducing in the periphery of ventricle, ventricle expansion or cerebral external gap and so on.