Persister cells are dormant or slowly grown variations in microbial populations .They are highly tolerant to antibiot-ics but the tolerance are not inherited as the genetic resistance , when persisters are inoculated to fresh medium , most bacteria are still susceptive to antibiotic , while only a small fractiont become persisters again .Persisters are believed to be closely related to clinic bio-film forming and the recurrence and recalcitrance of chronic infections .Different persisters have been found in Escherichia coli , Pseud-omonas aeruginosa , Staphyococcus aureus , Mycobacterium tuberculosis , Candida albicans and so on , and a few mechanisms about per-sisters formation have been studied .This article reviews the current progresses of research methods and achievements on persisters from different levels .

AIM: To investigate the changes of intraocular pressure (IOP) and associated factors of IOP elevation after 4mg intravitreal injection of triamcinolone acetonide (IVTA) in treatment of macular edema.METHODS: The study is prospective, consecutive, and non-comparative interventional case series including 93 eyes with macular edema associated with retinal vein occlusion (n=54 eyes) or diabetic retinopathy (n=39 eyes), which received 4mg IVTA injection. The change in IOP was followed for all cases at pre-operation and 14 days, 1, 2, 3, 4, 5, and 6 months post-operation. Associated factors of IOP elevation were examined regarding baseline IOP, causal disease, age and gender.RESULTS: IOP increased significantly (P＜0.001) at 14 days 16.02± 2.45mmHg after injection and peaked at 18.80± 6.20 at 2 months post-injection (P＜0.001) from 14.85 ± 2.55 mmHg preoperatively. An IOP rise to the value higher than 21mmHg was observed in 2 (2.2%) eyes 14 days after injection and which was observed in 14 (15.1%), 18(19.5%),9(9.6%), 4(4.3%), 0, and 0 eyes respectively at 1, 2, 3, 4, 5,and 6 months after injection. One eye (0.01%) showed pressure elevation of over 5mmHg than baseline 14 days after injection and IOP peaked to 22 mmHg (23.7%) at 2 months after injection. Five (5.3%) eyes had an increase of 10mmHg at 1 month and IOP peaked to 12mmHg (12.9%) at 2 months after injection. The rise in IOP was statistically associated with younger age (correlation coefficient -0.18- -0.29, P ＜0.05), high baseline IOP (correlation coefficient 0.52-0.79, all P ＜0.001),and the presence of diabetes mellitus (correlation coefficient 023, P＜0.001) but independent of gender (correlation coefficient -0.002-0.04, all P ＞0.05). In all eyes, IOP could be lowered to the normal range with topical medication, without development of glaucomatous optic nerve head changes.CONCLUSION: Elevated IOP after 4mg IVTA injection is common and patients should be monitored beyond 6 months post-injection. In all the cases, IOP can be normalized by topical medication. Patients with high baseline IOP, diabetic retinopathy, and younger age should be carefully monitored for an elevated IOP.

Objective To investigate the effect of dietary fiber on carbohydrate metabolism of healthy volunteers after the intake of corn starch meal. Methods Totally 12 healthy volunteers aged (25. 8 ± 5. 3) years were enrolled in this study, and they were equally randomly divided into two groups (group A and group B). This was an open, randomized, cross-over, and two-period study, and each period lasted for one day. In period 1, the subjects in group A received fiber-free corn starch and group B received high-fiber corn starch (containing 16 g dietary fiber). In period 2, the two groups are crossed. There was a one-week wash-out time between the two study days. On the study day, breath samples of fasting and 0. 5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0,7. 0, 8. 0 hours post meal were collected to measure13 CO2. Results The delta over baseline at 0. 5, 1.5, 2. 0,2. 5, 3. 0, 4. 0 hour after test meal in fiber free group and in high fiber group were 0. 79, 2. 03, 2. 57, 2. 86,3. 02, 3. 18 and 0. 16, 1. 33, 1.77, 2. 10, 2. 34, 2.42, respectively (the P value was 0. 014, 0. 014, 0. 011,0.018, 0. 036, and 0.020, respectively). Peak concentration of delta over baseline of fiber free group and high fiber group was 3.18 and 2. 56 respectively, there was no significant difference between two groups (P > 0. 05) ,peak time of the group at 4. 0 hour and 3. 5 hour respectively, showed significant difference (P = 0. 032). The cumulative percentage dose recovered 0. 5-6. 0 hours after test meal in fiber-free group and in high-fiber group were 0.41, 1.46, 3.15, 5.50, 8.28, 11.30, 14.42, 17. 62, 23. 65, 28. 78 and 0. 09, 0. 55, 1.61, 3.22,5.23,7.53, 10.09, 12.68, 17.60, 22.27 respectively (the P value was 0.014, 0.018, 0.018, 0.014, 0.013,0.014, 0.018, 0.020, 0.025, and 0.044, respectively). However, there was no significant difference 6.0 hours after meal (P > 0. 05 ). Conclusion The dietary fiber used in this study can delay the absorption of carbohydrate 6. 0 hours within intake without influencing its total absorption amount.

Objective:To compare two methods for the determination of compound cod-liver oil emulsion. Methods:The content of ciprofloxacin in compound cod-liver oil emulsion was determined by HPLC and UV, respectively. The determination by HPLC was performed on a Thermo C18 column (150 mm ×4.6 mm, 5 μm). The mobile phase was 0.025 mol·L-1phosphate-acetonitrile (87∶13)andpHwasadjustedto3.0±0.1withtriethylamine. Thedetectionwavelengthwas277nmandtheflowratewas1.5ml·min-1. The detection wavelength of UV was 277 nm. Results:The average recovery of HPLC and UV was 100. 44% and 100. 84% with RSD of 1. 01% and 1. 09% (n=9), respectively. The detection results of the two methods were compared by paired sample t-test, and no statistically significant difference was found (P>0. 05). Conclusion:The two methods are specific and accurate, and can be used for the determination of ciprofloxacin hydrochloride in compound cod-liver oil emulsion.

To carry out the teaching of hospital management in-depth and improve teaching quality, the group of teaching hospital management in 2010, through questionnaires, discussion and other forms, found out and analyzed the teaching situation, including the nature of this course, start time and hours, teacher team, teaching content, teaching methods, evaluation form, and so on. The result was that most students thought it not necessary to open so many courses. Then the article put forward some suggestions and countermeasures to further improve the management course.

Objective To study the molecular epidemiology of C.albicans isolates in infectious disease patients and to explore biofilm phenotypic characterization responsible for biofilm formation in clinical strains.Methods A total of 104 hospital-acquired C.alibcans clinical isolates collected from sterile sites and mucosal lesions of 92 infectious disease patients ( viral hepatitis, tuberculosis and AIDS) in Shanghai Public Health Clinical Center were analyzed.MLST analysis was performed to identify their phylogenetic status.The capability of biofilm formation was measured by [2,3-bis-(2-methoxy-4-nitro-5-sulphenyl)-2H-tetrazolium-5-carboxanilide] XTT assay.The results were compared using Kruskal-Wallis test.Results MLST analysis identified 63 DSTs with a decentralized phylogeny among 104 C.albicans isolates, of which 41 DSTs (65.1%) had not been reported in the online MLST database.The Single Locus Sequence Query from the C.albicans database identified new alleles.MEGA6 analysis of the MLST data assigned the 104 isolates within 14 of the 18 known clades; among them the clade 1 contained the greatest proportion of isolates (26.9%).Of the 43 novel DSTs isolates, 37 ( 86.0%) clustered within 11 of the 18 known clades.16 high biofilm formers were found from a total of 104 clinical isolates.The biofilm formation capabilities differed in strains isolated from different anatomical sites (H =18.23,P=0.0326).Biofilm formation by blood-originated isolates was lower than that of catheter-originated isolates ( Z=-72.20,P<0.001).Genotypes also affected the biofilm formation capability of the C.albicans isolates (H=10.01,P=0.0185).Conclusions A high level of diversity within C.albicans isolates.Microevlution clearly influences C.albicans genetic alterations upon environmental selection.The site of isolation and genotype associates with the biofilm formation capability.

Objective To investigate the level of CD73 expression in CD4+ regulatory T(Treg) cells in patients with systemic lupus erythematosus ( SLE ) and explore its role in the pathogenesis of SLE.Methods We selected 29 untreated/active SLE patients and 22 healthy controls. Frequencies of CD4+ CD25+CD73+ T cells and levels of FOXP3 protein expressed in CD4+ CD73+ CD4+ CDhi25, CD4+ CDhi25, CD4+ CD25+ T cells were analyzed by flow cytometry. Meanwhile, the levels of SLE disease activity index ( SLEDAI), C reactive protein (CRP), ESR,immunoglobulin and complement were measured. Results The percent of CD4+ CD25+ CD73+ T cells was decreased in new-onset SLE compared with healthy controls[(1.25±1.32) % vs (2.35±1.09) %, P ＜0. 01], and it had no correlation with the levels of SLEDAI, CRP, ESR, et al and anti-C1qand anti-nucleosome antibodies ( P ＞ 0.05 for each). Both in groups of new-onset SLE and healthy controls, CD73 level expressed in CD4+ CDhi25CDhi25T cells[(29.05 ± 12. 53)%, (43.35 ± 10. 09)%]was higher than that expressed in CD4+ CD25+ T cells[( 17.48 ± 6. 92 ) %, ( 29. 98 ± 10. 39 ) %, P ＜ 0.01]. In both SLE patients and healthy controls, levels of FOXP3 protein expressed in CD4+ CD73+ T cells[(65. 36 ± 14. 40)%,(63.80±14.05)%]and CD+4 CDhi25CD4+ CDhi25 T cells[(67. 30 ± 13.04)%, (56. 30 ±9. 21 )%]were higher than those in CD4+ CD25+T cells[(45.70 ± 12. 74)%, (43.98 ±5. 17)% ,P ＜0. 001], while it had no significant difference between the CD4+ CDhi25CD4+ CDhi25 and CD4+ CD73+ T cells(P＞0.05). Conclusion These results demonstrate that CD73 may be a new surface marker of regulatory T cells, and the abnormal expression of CD73 in Treg cells may participate in the pathogenesis of SLE.

Objective To investigate the effect of gypenoside on lipopolysaccharide (LPS)-mediated inflammatory response. Methods The BV2 microglia cell line was cultured in vitro. The BV2 microglia cells were divided into four groups: normal control, LPS (10 ng/ml), GP + LPS (GP 20 μg/ml, LPS 10 ng/ml), and GP (20 μg/ml). After 24 h cultivation, ELISA was used to detect the levels of tumor necrosis factor α(TNF-α), interleukin (IL)-1β, and IL-6. Immunocytochemistry staining and Western blot were used to detect the expression levels of nuclear factor (NF-κB) and suppressor of cytokine signaling 1 (SOCS-1). Results Compared with the normal control group, the release of TNF-α, IL-1β and IL-6, as well as the expression level of NF-κB in the LPS group were increased significantly (all P < 0. 001). Compared with the LPS group, the release of TNF-α, IL-1β and IL-6, as well as the expression level of NFκB were decreased significantly, while the expression level of SOCS-1 was increased significantly (P < 0. 001). There were no significant differences in the release of TNF-α, IL-1β and IL-6, as well as the expression levels of NF-κB and SOCS-1 between the GP group and normal control group (all P > 0. 05 ). Conclusions GP can significantly inhibit the LPS-mediated microglial inflammatory response. SOCS-1 protein may be involved in GP inhibiting LPS-mediated microglial inflammatory response.

Objective To evaluate the effectiveness of standardized three-stage rehabilitation program on spasticity and motor function in the upper extremities after cerebral hemorrhage.Methods A total of 364 patients were included and randomly assigned to a control group (n =181) and a rehabilitation group (n =183).The standardized three-stage rehabilitation program,which included early-stage bedside rehabilitation,specialized treatment in rehabilitation ward during recovery and rehabilitation follow-up at regular intervals was applied in the rehabilitation group,but only rehabilitation guidance and follow-up after discharge were provided for the control group.The modified Ashworth scale (MAS) and Fugl-Meyer assessment (FMA) were performed at the time of recruitment,1 month (M1),3 months(M3) and 6 months(M6) later.Results There was no statistical difference between the groups at recruitment.The occurrence rate of spasticity was 22.7％ in the control and 23.5％ in the rehabilitation group.At M6 the occurrence rate of spasticity was about 59.7％ and 43.2％ in control group and rehabilitation group respectively,and the number of patients grade 1 + and grade 2 on the MAS was 50/181 in the control group,significantly more than in the rehabilitation group (25/183).At all time points,MAS grade 0 accounted for a large proportion of both groups.At M6,both MAS distributions and scores of the two groups were different statistically (P ＜ 0.01).FMA scores in both groups increased significantly (P ＜ 0.01) with time,with the score being (17.13 ± 16.46),(24.87±18.36),(30.68±19.41) at M1,M3 and M6 in the control group and (24.71 ±19.80),(39.83 ± 19.50),(48.87 ± 18.25) in the rehabilitation group,but the average scores of the latter were consistently significantly higher than the former (P ＜ 0.01).Conclusions Standardized three-stage rehabilitation can alleviate spasticity and improve motor function of the upper extremities in cerebral hemorrhage patients.

OBJECTIVE To elucidate the hospital-acquired infections of chronic kidney disease non-dialysis patients and associated factors.METHODS Clinical data of 996 non-dialysis patients between Jun 1,2003 and Jun 1,2006 were enrolled in this retrospective study of hospitalized cases,there were 112 cases of hospital-acquired infections.The infection site,pathogens,renal function,serum albumin and hemoglobin were analyzed.RESULTS During above period 124 hospital-acquired infection episodes occurred.The infection rate was 11.2%,It was significantly higher than rate of hospital-acquired infection of our hospital at the same time(P