Objective:To investigate the characteristics of real-time three plane strain rate imaging of left atrial function in the patients with primary hypertension and coronary artery stenosis, and to evaluate its clinical application value.Methods:Total 82 patients with primary hypertension were selected and divided into primary hypertension group (EH group,n=42)and primary hypertension complicated with coronary artery stenosis group (EHCHD group,n=40).In addition,the physical examination people were selected as control group (n=42).All the subjects were examined by conventional echocardiography,and the left atrial function in real-time three plane strain rate imaging was analyzed.The parameters of conventional echocardiography and real-time three plane strain rate imaging were compared.Results:Compared with control group,the systolic left atrial mean peak strain rate (SRs),early diastolic left atrial mean peak strain rate (SRe)and SRe/SRa of the patients in EH group and EHCHD group were significantly decreased (P < 0.05);the atrial systolic mean peak strain rate (SRa)and Time-SRa in EH group and EHCHD group were significantly increased (P <0.05).Compared with EH group,SRs,SRe and SRe/SRa in EHCHD group were obviously decreased (P < 0.05 );SRa and Time-SRa were significantly increased (P <0.05).Conclusion:Real-time three plane strain rate imaging can easily and accurately analyze the left atrial function in the patients with essential hypertension and coronary artery stenosis,it is worth to popularize in clinical application.

Objective To study immunological property of chimeric BPVL1 / HPV16 E7 virus-like particles (VLPs) in mice. Methods HPV16 E7 gene was cut into three fragments, ligated to BPVL1 sequence, respectively, and then expressed as chimeric VLPs. The ability of the chimeric VLPs to stimulate in vivo cytotoxic response was analysed with lymphocytes taken from mice C57BL/6J lymph nodes. Results A strong CTL response against C-2 cells (HPV16 E7 aa47-59 transfected EL-4 cell) was induced in mice immunised with chimeric VLPs BPVL1 / HPV16 E7(b). Furthermore, no CTL response was detected against EL-4 cells in immunized mice. Conclusions Chimeric BPVL1/HPV16 E7 VLPs, serving as antigens, can activate mouse T lymphocytes and elicit a strong antigen-specific CTL response. Chimeric BPVL1/HPV16 E7 VLPs could be used as an efficient antigen delivery system, and might provide a novel strategy for HPV16 vaccine design.

Animals ; Disease Models, Animal ; Ischemic Preconditioning ; methods ; Lipid A ; administration & dosage ; analogs & derivatives ; MAP Kinase Signaling System ; Male ; Rats ; Rats, Wistar ; Reperfusion Injury ; metabolism

Objective To analyze risk factors and antimicrobial use for hospital-acquired pneumonia (HAP)due to multidrug-resistant organisms (MDROs)in an intensive care unit(ICU),so as to perform risk assessment and guide antimicrobial use.Methods From January 2012 to December 2013,HAP patients were conducted retrospective co-hort study,risk factors for MDRO-HAP and rationality of antimicrobial use were analyzed.Results A total of 110 cases of HAP occurred in ICU,63 cases (57.27%)were MDR-HAP.Logistic regression analysis revealed that re-cent hospital stay ≥5 days (OR=19.94),transference from other hospitals (OR =19.33),infection type of late-onset HAP (OR=7.98),and antimicrobial use in recent 90 days (OR =3.42)were independent risk factors for MDR-HAP.Initial empirical anti-infective treatment revealed that there were no significant difference in timing of antimicrobial administration within 24 hours after clinical diagnosis was confirmed,and rationality of antimicrobial selection between MDR-HAP group and non-MDR-HAP group (both P >0.05);The isolation rate of pathogens in MDR-HAP group was lower than non-MDR-HAP group (73.02% vs 91 .49% P <0.05 ).Targeted antimicrobial therapy revealed that there were no significant difference in selection,dosage,and frequency of antimicrobial use be-tween two groups(all P >0.05 );the rationality rate of therapy course in MDR-HAP group was higher than no-MDR-HAP group,but rationality rate of combination use of antimicrobial agents was slightly lower than the latter (both P < 0.05 ).Conclusion Patients in ICU should be conducted risk factor assessment,and according prevention and control measures should be formulated,so as to reduce the occurrence of MDR-HAP,health care workers should standardized the initial empirical anti-infective treatment.

Objective To evaluate the effect of plan-do-check-act (PDCA)cycle method in improving disinfection efficacy of object surface in intensive care unit (ICU).Methods On the basis of management of healthcare-associat-ed infection (HAI)and prevention of multidrug-resistant organisms,disinfection efficacy of object surface in an ICU was intervened,data about surface object specimens taken before,during,and after intervention,HAI in patients, as well as detection of MDROs were collected.Results The total qualified rate of specimens taken before,during, and after intervention was 58.24%,76.74%,and 88.71 %,respectively,there was an increased tendency,the difference was significant (χ2 =17.41 ,P =0.009);the incidence of HAI was 3.72%,2.42%,and 1 .78%,respec-tively,there was a decreased tendency(χ2 =6.03,P =0.039),case infection rate was 4.36%,2.75%,and 2.37%respectively,there was a decreased tendency (χ2 = 7.24,P = 0.046 );detection rate of MDROs was 34.03%, 27.45%,and 14.05%,respectively,there was a decreased tendency (χ2 =33.84,P =0.007),the percentage of pa-tients who were detected MDROs and HAI caused by MDROs showed a decreased tendency(χ2 =6.14,6.02,both P<0.05).Conclusion The implementation of PDCA cycle can effectively improve disinfectant efficacy of ICU object surface,and reduce the incidence of MDRO HAI.

Objective To investigate the prevalence of plasmid-mediated quinolone resistance ( PMQR ) determinants [ qnr,aac ( 6' ) -Ib-cr and qepA ]and mutations in quinolone resistance-determining regions (QRDRs) of gyrA and parC and their association with fluoroquinolone susceptibility in clinical isolates of Serratia marcescens in Anhui.Methods The minimum inhibition concentration ( MIC ) of 104 strains of S.rnarcescens collected from various clinical specimens from 34 hospitals during 2005 to 2010 were determined by agar dilution method.The qnr,aac (6')-Ib,qepA,gyrA and parC genes were screened by polymerase chain reaction (PCR) in 31 strains resistant to ciprofloxacin,and positive results were subsequently confirmed by sequencing.The conjugation experiments were performed for qnr and aac(6')-Ib-cr positive strains.The MIC of S.marcescens isolates,recipient strains and conjugants were tested by agar dilution method for quinolones and other antimicrobial agents.Results Six strains of the 31 S.marcescens isolates harboured qnr and/or aac(6')-Ib-cr genes.Among those 6 strains,2 strains harboured a qnrB6 gene,1 harboured a qnrS2 gene,and 4 harboured aac( 6' ) -Ib-cr,whereas no qnrA-,qnrC- or qnrD-positive isolate was detected.None of the 31 isolates carried the qepA gene.Mutations in the QRDR of gyrA and parC genes were detected in 9 and 7 isolates,respectively.The conjugation experiments were successfully carried out in 5 isolates of 6 PMQR determinants-postive strains.The MIC of conjugants for quinolones were increased evidently compared to recipient strains.Conclusions Chromosome and plasmid-mediated resistance determinants play an important role in quinolone resistance in clinical isolates of S.marcescens.And more important is that the PMQR determinants can be horizontal transmitted.It is necessary to continuously survey and watch for the spread of PMQR in S.marcescens in public health control program.

Objective To evaluate the diagnostic value of immunohistochemistry (IHC) for the identification and localization of Treponema pallidum (TP).Methods Rabbit anti-human TP polyclonal antibody labeled IHC was used to detect 20 paraffin-embedded biopsy samples from lesions of 14 patients with syphilis or suspected syphilis in Sir Run Run Shaw Hospital of Zhejiang University from January 2004 to May 2012.Results TP was detected in 80％ of all the 20 samples by IHC assay,including 83.3％ (5/6) in patients with primary syphilis,100.0％ (10/10) in patients with secondary syphilis,and 25.0％ (1/4) in patients with tertiary syphilis,with a positive diagnostic accuracy of 100.0％.TP was mainly present in lower part of epidermis or perivascular,characterized by an endotheliotropic and epitheliotropic patterns or in the tissue of granulomatous inflammation.Besides,the density of TP was associated with types of lesions.There were more TP in the lesions of syphilis chancre,syphilis proctitis and condyloma latum,and fewer TP in the lesions of squamous erythema,greyish-black plaque,ulcer of chest wall from tertiary syphilis,and least in syphilitic lymphadenitis.There were no correlations between the quantity of TP and the rapid plasma regain (RPR) test titer (P＞0.05).Conclusions IHC for TP is of both high sensitivity and specificity for the diagnosis of syphilis,suggesting that TP-IHC is helpful for the diagnosis of syphilis,especially for the diagnosis of early suspected syphilis with negative serological results,systemic damage of syphilis,or syphilis in untypical locations and unusual lesions.It can serve as an alternative method for the diagnosis of syphilis.

Objective To construct,express,purify and identify the gene encodi ng major outer membrane protein of Neisseria gonorrhoeae (Porin I, or PI). Metho ds The gene encoding for PI of N.gonorrhoeae was amplified by PCR and cloned int o expression plasmid pGEX-4T-2 to form pGEX-4T-2/PI recombinants. A high lev el expression of GST-PI fusion protein was obtained in GST gene fusion system (GST:glutathione S transferase). The analysis indicated that the expressed pr otein was present predominantly in the insoluble form. Therefore, the induced pr otein was purified by SDS-PAGE, and bands corresponding to polypeptides of GST-PI fusion protein were excised and subjected to electroelution. A dot immunoch romatographic assay was employed to demonstrate whether the purified protein was gonococcal PI specific. Results The pGEX-4T-2/PI expression recombinants were constructed,expressed,purified and identified successfully. SDS-PAGE analysis and dot immunochromatographic assay suggested that the recombinant GST-PI fusio n protein was a 60 000 molecular weight protein andidentical in size to native PI and reacted with anti-PI monoclonal antibody. Conclusion Our results may lead to a potentiality for further study of diagnosti c kits and vaccine for Neisseria gonorrhoeae.

Objective To predict the disease progression risks of healthy rhesus ( normal) and rhesus infected with simian immunodeficiency virus ( SIV) in the stages of long-term nonprogressor ( LTNP) , normal progressor ( NP) , rapid progressor ( RP) by discriminant analysis. Methods Five-year observation was carried out in SIV infected rhesus model without any intervention. The SIV infected rhesus model at the stages of LTNP, NP, RP were selected, 10 in each group, and T lymphocyte subsets and serum parameters for spleen-deficiency syndrome and kidney-deficiency syndrome in SIV infected rhesus were compared with 5 healthy monkey having the same survival time. The influence factors of different types of disease progression were screened from T cell subsets and Chinese medical syndrome indexes, and then the discriminant equation was established to predict the risks. Results White blood cell ( WBC) count and lymphocyte ( LYM) ratio were enrolled into the discriminant equation before infection, and T4 level and Log10RNA of set point were enrolled into the discriminant equation in the platform period. The test results for the uniform rate of the established discriminant function showed that the total coincidence rate of theoretic distinguish to the actual data was 57.1% , 91.2%respectively before infection and in the platform period. Conclusion The pre-infection WBC count and LYM ratio can be used as a reference for the evaluation of different types of disease progresson, and Log10RNA and T4 level at platform phase can be used as the predicting factors of different types of disease progression risk prediction.