Objective:To probe the possibility of using STR polymorphism on chromosome 21 to diagnose Down's syndrome.At the same time,some parents of Down's syndrome were analysed using the same motbed.To develop a rapid anti accurate method for Down's syndrome diagnosis and review its pattern.Methods:The small tandem repeats(STR)of D21S11 and D21S1414 on chromosome 21 were analysized by polymerase chain reaction(PCR).100 Down's syndrome samples(blood)and 20 parents' samples(blood)were analyzed with.denaturing polyacrylamide gel(8%)and Silver Nitrate staining.Results:(1) The normal person and two kinds of status in the genotype of a STR gene:①Two bands of same size on the gel electrophoresis were displayed to the heterozygote of two different alleles.②A band on gel electrophoresis was shown to the homozygote of two same allele But the width and thickness of the band were about two times of a single one.(2)There were three kinds of characteristic changes of the number and/or the bands thickness of allele for the Down's Syndrome:①Three different alleles,with three bands of same thickness on gel electrophoresis.②Only two of the three alleles are the same,two bands on gel electrophoresis,and one of the two bands was two times thicker than the other.③Three alleles were the same, only one band on gel electrophoresis.The width and thickness of the band are about three times than single band of normal.(3) The analysis about parents of 20 cases Down's syndrome shows that the two bands were usually derived from mother,and another derived from father in bands of the Down's syndrome on gel electrophoresis.Conclusions:(1)As genetic marker with STR sites (D21S11 and D21S1414)of chromosome 21,Down's syndrome can be diagnosed by PCR,denaturing polyacrylamide gel and Silver nitrate staining analysis.(2)Genetic analysis of the parents of Down's syndrome show that onset of Down's syndrome does not have relationship with the karyotype of the parents.Besides,the extra chromosome 21 is derived from mother usually.

Objective The changing patterns of pathogenic isolates and antibiotic susceptibility in Chongqing's neonates between 2010 and 2015 were investigated for the purpose to provide evidence for rational use of antibiotics and control of nosocomial infections.Methods The distribution of pathogenic bacteria and antibiotic susceptibility were analyzed.Identification and antibiotic susceptibility testing were carried out using BD Phoenix 100 automated system and the conventional Kirby-Bauer method.The results were interpreted in accordance with the breakpoints of the Clinical and Laboratory Standards Institute.Results A total of 10 569 pathogenic bacterial strains were isolated during the period,most of which were gram-negative bacteria (80.8 ％,8 540/10 569),primarily Klebsiella pneumoniae (29.3 ％),followed by Escherichia coli (16.7 ％),Acinetobacter baumanmii (9.9 ％),Enterobacter cloacae (8.6 ％) and Pseudornonas aeruginosa (3.3 ％).Gram-positive strains accounted for 14.1％ (1 490/10 569),mainly Staphylococcus aureus (7.8％),Staphylococcus epidermidis (2.2 ％),and Staphylococcus haemolyticus (1.8 ％).Imipenem and meropenem showed high activity against Enterobacteriaceae (＜ 10％ resistant),followed by P.aeruginosa (＞ 10 ％ resistant),and A.baumannii (＞20％ resistant).The prevalence of carbapenem-resistant strains was 8,4 ％ in K.pneumoniae and 2.9 ％ in E.coli isolates,No gram-positive isolates were resistant to vancomycin,teicoplanin or linezolid.Conclusions K.pneumoniae was the most frequently isolated pathogen in the neonates treated in Children's Hospital of Chongqing Medical University.The prevalence of A.baumannii isolates is increasing.Carbapenem-resistant Enterobacteriaceae strains are emerging.

Objective To investigate the susceptibility and resistance profile of clinical isolates.Methods Clinical isolates were collected from Children's Hospital of Chongqing Medical University from January 1 to December 31,2015.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were analyzed according to CLSI 2015 breakpoints.Results A total of 13 109 clinical isolates were collected from January to December 2015,of which gram negative organisms and gram positive cocci accounted for 65.3 ％ (8 560/13 109) and 34.7 ％ (4 549/13 109),respectively.Methicillin resistant strains in S.aureus (MRSA) and coagulase negative Staphylococcus (MRCNS) accounted for 29.6 ％ and 67.1％,respectively.Most (93.1％) MRSA strains were still susceptible to trimethoprim-sulfamethoxazole,while 80.2 ％ of MRCNS strains were susceptible to rifampin.No staphylococcal strains were found resistant to vancomycin,teicoplanin or linezolid.The resistance rates of E.faecalis strains to most antibiotics tested (except tetracycline) were much lower than those of E.faecium.Some strains of both species were resistant to vancomycin.No E.faecalis or E.faecium strains were found resistant to vancomycin.The prevalence of ESBLs-producing strains was 55.7 ％ in E.coli and 43.5 ％ in Klebsiella (K.pneumoniae and K.oxytoca) and 11.6 ％ in Proteus mirabilis isolates.ESBLs-producing Enterobacteriaceae strains were more resistant than non-ESBLs-producing strains in terms of antibiotic resistance rates.Enterobacteriaceae strains were still highly susceptible to carbapenems.Overall,less than 16.0 ％ of these strains were resistant to carbapenems.About 10.5 ％ and 9.4 ％ of the A.baumannii strains were resistant to imipenem and meropenem,respectively.Compared to the data of year 2014,the prevalence of extensively-drug resistant P.aeruginosa and K.pneumoniae strains increased.Conclusions The antibiotic resistance of clinical bacterial isolates is growing.The emerging and increasing prevalence of multi-drug or pan-drug resistant strains poses a serious threat to clinical practice and implies the importance of strengthening infection control.

Objective To observe the pulmonary X-ray changes of malignant malaria.Methods The chest routine X-ray examination in 86 cases with malaria in company with respiratory tract symptoms such as fever was performed,the pulmonary changes were obsenved.Results Of 86 cases, 58 cases were abnormal on chest filmes,including lung framework marked in 33 cases,miliary,small or large patchy shadow in 24 cases and multiple round opaque mass lesion in one case.Conclusion The pulmonary X-ray changes of malignant malaria are varied,the common characteristic is that most of them are situated at middle and lower portion of the lungs.This may attribute to blood dynamic abnormality resulting from malaria protozoan and the pathological changes of involved tissues.

OBJECTIVE To investigate the distribution and the drug resistance of pathogens in infective cases and to provide a foundation for reasonable application of antibacterials.METHODS The information of all bacterial cultures and susceptibility tests from the inpatients in the year of 2006 was analyzed.RESULTS A total of 336 strains of pathogens were isolated,and the pathogens causing lower respiratory tract infection rated the top(60.7%).The resistance rate of Acinetobacter baumannii was the highest in Gram-negative bacilli.It was 33.3% to imipenem,and more than 66.6% towards the other antibacterials.All Gram-positive cocci were sensitive to vancomycin.The resistance rate of Enterococcus and Staphylococcus aureus was more than 75% to the most antibacterials.CONCLUSIONS Inspecting pathogens and strengthening susceptibility tests are very important in reducing drug abuse,decreasing the resistance rate and raising the cure rate in hospital.

Objective To investigate the eating problems of outpatient infants,preschool age children(1 to 7 years old) enrolled in the Department of Child Health Care,Nanjing Maternal and Child Health Hospital Affiliated to Nanjing Medical University,and to analyze its correlation with children's physical development,so as to establish strategies for preventing abnormal eating habit in children.Methods A toll of 2458 children met the criteria,and caregivers (mothers) completed the Children's Eating Behavior Questionnaires (CEBQ) in Department of Child Health Care,Nanjing Maternal and Child Health Hospital Affiliated to Nanjing Medical University were selected and the children's sociodemographic data and the morbidity of children eating problems were investigated.The correlation between children's body mass index(BMI) with children's eating problems was determined by using Chi-square test and multiple regression analysis.Results About 66.2％ (1627/2458 cases) had normal weight,and 10.8％ (257/2458 cases) and 8.5 ％ (210/2458 cases) were overweight (BMI ＞ P85-P95) or obese (BMI ≥ P95),respectively.The prevalence of eating behavior problems was detected during 25-36 months.For 1-to-7-year-old children,the highest detection rate of eating problems was inattention and eating at non-permanent locations,occupying 64.7％ (1590/2458 cases)and 50.5％ (1241/2458 cases),respectively;the prevalence rate of preferring to junk food was the lowest,accounting for 19.3％ (474/2458 cases).The children's eating problems had a high association with the children's BMI.Among them,children with eating problems,such as difficultly in accepting the varying food stuff[at the age of 12 month,odds ratio(OR)=11.50,95％ confidence interval(CI):1.84-72.16] and eating at non-permanent locations(at 25-36month,OR=1.77,95 ％ CI:1.11-2.83),were prone to be wasting away;children with eating problems,such as preferring to junk food (at 12 month,OR=5.08,95 ％ CI:1.43-18.00;13-18 month,OR=2.17,95 ％ CI:1.06-4.44),rarely eating vegetables or fruit (19-24 month,OR=4.06,95％CI:1.46-11.31) and inattention (12 month,OR=3.85,95 ％ CI:1.52-9.79),were associated with overweight or obesity (all P＜0.01).Conclusions There was a high prevalence of eating problems in children between 12-84 month(1-7 years old) in Nanjing.Improper children's eating behaviors can increase the risks of wasting away or children's overweight/obesity.

BACKGROUND: Rejection is the main cause of the failure in small bowel transplant. Chemotatic factor RANTES and receptor mediated cellular immunity are very important in acute rejection.OBJECTIVE: To explore the immunosuppressive effect of early adopting chemokine receptor antagonist, Met-RANTES after small bowel transplant on acute allograft rejection and its coordinative effect with Tacrolimus (FK506).DESIGN: Randomized complete-block design, controlled animal experiment.SETTING: Department of General Surgery, the 451 Hospital of Chinese PLA; Laboratory of Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA; Electronic Microscope Center, School of Basic Medicine, Fourth Military Medical University of Chinese PLA.MATERIALS: This study was carried out in the Laboratory of Department of Gastrointestinal Surgery, Xijing Hospital,Fourth Military Medical University of Chinese PLA from September 2003 to March 2005. Totally 192 animals including 96 SD rats (donors) and 96 Wistar rats (recipients) were involved in this study. Heterotopic segmental small bowel transplantation was performed.METHODS: The transplant rats were divided into 4 groups averagely by the randomized complete block design: control group (allogeneic small bowel transplant untreated group), Met-RANTES group(200 μg/d, 0-7 days, i.p.), FK506 group [0.5 mg/(kg·d) ,0-7 days,i.p.], Met-RANTES + FK506 group [Met-RANTES, 200 μg/d,0-7 days,i.p.+ FK506 0.5 mg/(kg ·d),0-7 days, i.p.]. Rats in the latter 3 groups were intraperitoneally administrated after transplant within 7 days successively.Rats in the control group were not given any treatments before and after transplant. Postoperatively, gross status,survival time and immunocyte infiltration were observed. Pathological examination was conducted in 6 rats of each group on postoperative days 3, 5 and 7. Fluorescent staining and successive quantitative measurement were conducted to detect the expressions of intragraft RANTES, CD4+, CD8+ and CD25+ T lymphocyte. Survival duration of the rest 6 rats of each group was observed for 5 weeks.MAIN OUTCOME MEASURES: ① Survival time of rats in each group following transplant. ② Pathological changes of small bowel intragraft of rats in each group. ③ RANTES and T lymphocyte expressions of rats in each group.RESULTS: Following transplantation, 96 Wistar rats (recipient) were all involved in the final analysis. ①Compared with control group, the survival time of rats in Met-RANTES group, FK506 group, Met-RANTES + FK506 group was significantly longer (P ＜ 0.01). In addition, rats in Met-RANTES + FK506 group survived the longest. There were significant differences in survival rate as compared with Met-RANTES group and FK506 group (P ＜ 0.01). ②All rats in the control group died of acute rejection and infection. Histopathologic examination showed mild, moderate and severe rejection on the postoperative days 3,5 and 7, respectively. No obvious rejection was found in the rats in the Met-RANTES group, FK56 group and Met-RANTES+FK506 group on the postoperative days 3,5 and 7. ③Postoperatively, intragraft RANTES expression of rats was significantly higher in each time period in control group than in the other 3 groups (P ＜ 0.01), and its dynamic change was positively correlated with the process of acute rejection; The expression of intragraft RANTES, CD4+, CD8+ and CD25+ T lymphocytes of rats was significantly lower, respectively, in the Met-RANTES group and Met-RANTES+FK56 group than in the control group (P ＜ 0.01).CONCLUSION: Met-RANTES may obviously suppress acute allograft rejection in small bowel transplant, effectively protect the function of grafts, and significantly prolong the survival time of the recipients. In addition, Met-RANTES may enhance the immunosuppressive function of small dose of FK506[0.5 mg/(kg · d)].

Objective To probe into the present professional identity among physicians and to explore the influencing factors on identity.Methods A custom-made professional identity scale was used to study 277physicians in two public hospitals in Wuhan and Wenzhou.Results The scale consists of professional reward and recognition,professional capacity and professional significance.The total score of physicians' professional identity and that of the three dimensions were 1.89 and 1.26,2.42,2.02 respectively.Regression analysis showed that the predictors of the total score were:age,reward and penalty system,salary system,the work-family conflict (P＜0.05),and the predictors could account for 22.8％ of the variation.Those for professional reward and recognition were:Education,age,reward and penalty system,patient-doctor relationship,and income satisfaction,and the perdicators could account for 13.6％ of the variation.Those of professional significance were:age,reward and penalty system,and work-family conflict,and the predicators could account for 17.9％ of the variation.Conclusion Professional identity of physicians was found at a high level in general,yet their professional reward and recognition were found with a lower score.It is recommended to build a better hospital system for salary and reward/penalty management,improve doctor-patient relationship and minimize work-family conflict,for the purpose of raising their professional identity.

Objective serous endotoxin(ET) were measured to determine the relationship between serous endotoxin and differ‐ent type of intestinal obstruction in children .Methods 25 inguinal hernia patients and 43 intestinal obstruction patients were classi‐fied into control group(n=25) ,incomplete intestinal obstruction (n=20) and complete intestinal obstruction group without necrosis of intestine (n=23) according to degree of obstruction .Serous endotoxin were measured in different time (the day of admission ,one day after admission or ,preoperation and one day postoperation ) ,and t test is used to determine the difference between them . Results ET in different group was(6 .53 ± 14 .96) ,(4 .40 ± 1 .15) ,(4 .20 ± 1 .20) ,(4 .09 ± 1 .31) ,(3 .70 ± 1 .46)EU/mL ,respec‐tively .There were no difference between each group .Conclusion ET examination suggests there is no difference between different type of intestinal obstruction in children and endotoxemia is not found in intestinal obstruction according to the results .

Objective To investigate the prevalence and transmission mechanisms of plasmid-mediated blaoxa-23 resistance genes in Acinetobacter baumannii.Methods One hundred and one Acinetobacter baumannii were collected from Obstetrics and Gynecology Hospital of Fudan University and Renji Hospital Shanghai Jiaotong University School of Medicine.Antibiotic susceptibility of carbapenems were determined by standard agar dilution method.Molecular typing of Carbapenem-resistant Acinetobacter baumannii (CRAB) was performed by MLST.blaoxa-23、blaoxa-24、blaoxa-51、blaoxa-58、blaIMP-1、blaVIM-1/2 and blaAmp-C were analyzed by PCR.The analysis of blaoxa-23 transposons for carbapenems resistant A.baumannii isolates was also performed by PCR.Plasmid was analyzed by gel electrophoresis.Conjugation experiments were performed to determine the transferability of blaoxa-23.Results The antibiotic susceptibility tests showed the resistant rates to carbapenems were extremely high , and the ones of imipenem and meropenem were 64.4%and 69.3%.Fifty-six (53%) isolates were carbapenems-resistant A.baumannii.Main clone ST208 includes 28 isolates(50%) in CRAB.A total of the CRAB isolates harbored blaoxa-23 and blaoxa-51 (100%), 44 for blaIMP-1(78.6%) and 54 for blaAmp-C(96.4%), while blaoxa-24, blaoxa-58 and blaVIM-1/2 was undetected.Two previously identified transposons ( Tn2006 and Tn2008 ) was found in the isolates.Plasmid gel electrophoresis results showed that the isolates carried 2-4 plasmids and blaoxa-23 were transferable by plasmids.Conclusions There is high carbapenems resistance of A.baumannii infections.ST208 was the most prevalent molecular type.The mainly drug-resistant genes of A.baumannii are blaoxa-23.Based on the findings, blaoxa-23 is plasmid mediated, suggesting that it may transfer by plasmids carrying Tn 2008 transposon, thus induced isolates resistant to carbapenemase.