Group B Streptococcus ( GBS) is a conditional pathogenic bacteria related to late-term abortion, premature delivery, premature rupture of membranes, perinatal infection, neonatal sepsis and other diseases.Prevention and treatment guidelines by the US Centers for Disease Control and Prevention ( CDC) suggest that all the pregnant women at 35-37 gestational weeks should screen for GBS .The detection methods for GBS include microbiology , immunology, molecular biology, etc.The appropriate method should be chosen depending on circumstances .Penicillin is recommended for the preventive treatment of GBS , and the treatment for the insensitive should base on the antibiotic susceptibility results .No vaccine against GBS is currently available for clinical use .

Objective To analyze the levels of IL-35, IL-10 and TGF-β in women with or without pregnancy and to investigate the correlation between IL-35 and recurrent spontaneous abortion.MethodsLevels of IL-35, IL-10 and TGF-β in serum were analyzed by enzyme-linked immunosorbent assay (ELISA) in 120 gravidas with normal pregnancy, 40 gravidas with a history of recurrent spontaneous abortion, 40 healthy postpartum women and 40 healthy non-pregnant women of childbearing age.Single factor logistic regression analysis was used for correlation analysis.Results The level of serum IL-35 in normal pregnancies was significantly higher than that in non-pregnant women [333.6 (59.32, 1 391) pg/ml vs 123.9 (8.763, 471.7) pg/ml, P<0.001].The level of TGF-β increased significantly in the first trimester as compared with that in non-pregnant women [473.4 (398.0, 580.5) pg/ml vs 379.7 (311.0, 441.3) pg/ml, P<0.01].No significant difference in the level of serum IL-10 was observed between gravidas and non-gravidas [8.602 (5.854, 12.89) pg/ml vs 9.339 (5.691, 12.07) pg/ml, P>0.05].The level of serum IL-35 in gravidas with recurrent spontaneous abortion was significantly lower than that in healthy gravidas in their first trimester [220.4 (4.951, 702.0) pg/ml vs 386.5 (64.37, 1 355) pg/ml, P<0.05].Serum IL-35 was negatively correlated with the occurrence of recurrent spontaneous abortion (regression coefficient=-0.003, OR=0.997).Conclusion The level of serum IL-35 increases in healthy gravidas, but decreases in gravidas with recurrent spontaneous abortion.IL-35, rather than IL-10 or TGF-β, is recognized as an active player in maternal-fetal immune tolerance.

Acinetobacter baumannii, a glucose-nonfermentative gram-negative coccobacillus, is an important pathogen isolated in nosocomial infections, and the clinical detection rate has been increasing in recent years. Acinetobacter baumannii attracts widespread attention due to strong viability, broad resistance spectrum and high rate of drug resistance. The resistance mechanisms include the production of β-lactamases, alterations in penicillin-binding proteins, decreased outer membrane permeability and overexpression of active efflux pumps. The mechanisms of Acinetobacter baumannii resistance to β-lactarn antibiotics, especially those of the outer membrane porin and active efflux system are reviewed in this paper.

Objective To investigate the molecular epidemiology of 114C. albicans strains isolated from the vaginal discharge of female patients treated in three obstetrics and gynecology hospitals in Shanghai by analyzing the relationship between the main genotypes and resistance proifle, and the relationship between genetic diversity and cluster ofC. albicans.Methods A total of 114 strains ofC. albicans were collected from the Obstetrics & Gynecology Hospital of Fudan University, Shanghai First Maternity and Infant Hospital Corporation and the International Peace Maternity & Child Health Hospital of China welfare institute. Phylogenetic analysis of strains were carried out by eBURST.C. albicans strains were also analyzed by multilocus sequence typing (MLST). The susceptibility of theC. albicans strains was tested by ATB FUNGUS 3.Results A total of 47 diploid strain types (DSTs) were identiifed from the 114 strains, 30 of which were known types. DST 79 and DST 435 were the main types. Of the 114C. albicans strains, 96.5% were susceptible to lfucytosine, 100% to amphotericin B, 85.1% to lfuconazole, 55.2% to itraconazole and 84.3% to voriconazole.Conclusions The pathogenicC. albicans strains isolated from different obstetrics and gynecology hospitals in Shanghai were originated from multiple clones, the main type of which was DST 79 and DST 435 with certain degree of antifungal resistance. MLST typing suggests that genetic diversity is present in theC. albicans strains isolated in Shanghai area. The clustering analysis ofC. albicans strains is consistent with its genotypes.

Objective To explore the value of MSCT enhanced scanner in diagnosis and differential diagnosis of spleen tumor. Methods The MSCT enhanced feautures of 23 cases of spleen tumor proved by imaging examination,follow-up and pathologically were anlayzed retrospectively,the features of MSCT enhanced scanner in spleen tumor were analyzed.Results All cases included 12 benign tumor (5 cysts,6 hemangiomas,1 lymphangioma).1 1 malignant tumor(2 primary lymphomas,3 secondary lymphomas,6 metastatic tumors).Conclusion MSCT enhanced scanning for the qualitative diagnosis of spleen tumors with high value.

Objective To summarize the experience of nursing patients undergoing NovaSure endometrial ablation. Methods Two hundred and eleven patients with abnormal uterine bleeding claiming no need of giving birth,who were hospitalized in our hospital during August 2011 to April 2013,were managed with NovaSure endometrial ablation and nursing care was performed.Follow-ups were conducted for investigating the curative effects.Results All the patients lived through the operations,their life signs were stable.As for the adverse effects,124 of them had mild abdominal pains,7 medium-level or severe hypogastralgia,1 dizziness and nausea,10 uterial hematocele,and 1 cystitis.All of them got recovered after treatment.One-month follow-up after hospitalization showed a success rate of 98.0%.Conclusions NovaSure is a new approach to abnormal uterine bleeding.It is advantageous for its simplicity,shortness in operation duration,less trauma to patients and good effects.Meanwhile,preoperative mental care and cooperative care during operation may facilitate their recoveries.

Objective To investigate the resistance rates of the Candida albicans strains isolated from patients with vulvovaginal candidiasis to 5 antifungal agents and examine the mechanism of azole resistance in these strains.Methods A total of 1 646 C.albicans strains were collected in Obstetrics and Gynecology Hospital of Fudan University from January to December 2015.The resistance rates of these isolates to five antifungal agents were analyzed.Azole-resistant (n=30),dose dependent sensitive (S-DD) (n=13),and susceptible isolates (n=10) were randomly selected from the microbiology laboratories of three obstetrics and gynecology hospitals in Shanghai.The expression levels of drug efflux pump related gene CDR1,CDR2,MDR1 and drug target enzyme gene ERG11 were analyzed by real-time fluorescence quantitative polymerase chain reaction (PCR).At the same time,the ERG11 and ERG3 genes were amplified by PCR and sequenced,and analyzed for resistance-related mutations.Results Of the 1 646 C.albicans strains,5.2％,3.2％,2.5％ and 2.1％ were resistant to itraconazole,voriconazole,fluconazole and 5-fluorocytosine,respectively.All isolates were sensitive to amphotericin B.The expression of ERG11 gene was significantly higher in S-DD group and azole-resistant group than in azole-sensitive group (P＜0.05).The expression of CDR1,CDR2 and MDR1 did not show significant difference among the three groups.There were 13 missense mutations in the ERG11 gene,of which T123I,P98S and Y286D amino acid substitutions were newly discovered.Both T123I and Y132H were identified in 26 resistant isolates,of which 16 gene mutation was detected in two pan-azole-resistant isolates.Conclusions The C.albicans strains isolated from vulvovaginal candidiasis showed higher resistance rates to azole antifumgal agents than that to 5-fluorocytosine and amphotericin B.Mutation and over-expression ofERG11 gene may be one of the prevalent molecular mechanisms underlying azole resistance in C.albicans.were pan-azole-resistant.In addition,the ERG3 heterozygous

Objectives To explore the optimal startup time of patient controlled intravenous analgesia (PCIA) in aged patients after thoracotomy for pulmonary lobectomy.Methods The 67 aged patients after thoracotomy for pulmonary lobectomy from January to December 2008 were randomized divided into two groups:PCIA was startup immediately after waking (instantly group) or after removal tracheal intubation (delayed group).The analgesia efficacy,cardiopulmonary function and side effect were evaluated at the awake time,12,24 and 48 hours after surgery respectively.Result Both of VAS scores at 12 hours after surgery and oxygenation index at 48 hours after surgery had significant difference (P<0.05) between the two groups.The analgesia efficacy was better in the instantly group.There was no significant difference on the duration of mechanical ventilation and side-effect rates between the two groups.No patient suffered from respiratory depression.Conclusion The early use of PCIA in aged patients after thoracotomy for pulmonary lobectomy can gain better pain control and oxygenation effect.

Objective To describe and analyze the clinical characters of patients with FRG from 7 Chinese families.Then analyze and identify their mutations in SGLT2 gene,and explore the association of genotype and phenotype.Methods Quantitative test for 24-hour urine glucose and other laboratory tests were carried out among 7 probands (14 patients in all) and their family members from 7 pedigrees (totaling 23 subjects).All coding regions,including intron-exon boundaries,were analyzed using PCR followed by direct sequence analysis.Results Five novel mutations in SLC5A2 gene were identified in this investigation,including four missense mutations (A Serine to Glycine at position 335 (c.1003A＞G,p.S335G),a Glutamine to Arginine at position 448 (c.1343A ＞ G,p.Q448R),an alanine to proline at position 474 (p.A474P,c.1420G ＞ C) and a glycine to aspartic acid at position 580 (c.1739G ＞ A,p.G580D) and a deletion in intron 7 (c.886(-10_-31)del).By the minigene studies using the pSPL3 plasmids,we confirmed the deletion c.886(-10_-31)del as a splicing mutation.In this study,the mutation c.886(-10_-31)del accounted for about 43％ of the total alleles (12/28).These patients with compound heterozygous or homozygous mutations manifested middle degree or severe glycosuria (Quantitative test for 24-hour urine glucose:10.56-50.68 g/1.73 m2),however those with heterozygous variants presented with mild to moderate glycosuria (Quantitative test for 24-hour urine glucose ≤ 2.45 g/1.73 m2).This fits co-dominant inheritance pattern.Conclusions Five novel mutations which may be related to FRG are found in this study,and c.886(-10-31) del may be a high frequency mutation in Chinese patients.