Objective To evaluate the relationship between spectinomycin resistance in Neisseria gonorrhoeae and mutations in the rpsE gene.Methods Genomic DNA was extracted from 4 clinical isolates of Neisseria gonorrhoeae with different levels of spectinomycin resistance.Then,PCR was performed to amplify the entire rpsE gene and the spectinomycin resistance-determining region (SRDR) in the 16S rRNA gene followed by direct sequencing.Two spectinomycin-sensitive Neisseria gonorrhoeae strains were transformed with the genomic DNA containing the mutant rpsE gene.Subsequently,the susceptibility of the transformants to spectinomycin was determined,and PCR was performed to amplify the rpsE and 16S rRNA genes in the transformants followed by sequencing.Results All the 4 spectinomycin-resistant Neisseria gonorrhoeae strains harbored an A70C transversion in the rpsE gene,but no abnormality in the SRDR of the 16S rRNA gene.No mutations were detected in the spectinomycin-sensitive Neisseria gonorrhoeae strains.The A70C transversion in the rpsE gene was also detected in the two Neisseria gonorrhoeae transformants with spectinomycin resistance.Conclusion The A70C point mutation within the rpsE gene is associated with spectinomycin resistance in Neisseria gonorrhoeae.

Objective To investigate the prevalence of and risk factors for neurosyphilis in syphilitic patients with persistently positive nontreponemal serological tests after regular therapy.Methods Clinical data were collected from 248 syphilitic patients with persistently positive nontreponemal serological tests after regular therapy,and analyzed retrospectively.Univariate analysis,multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed to assess factors associated with neurosyphilis.Results Of the 248 patients,25 (10.1％) were diagnosed with neurosyphilis.As univariate analysis showed,the occurrence of neurosyphilis was associated with the degree of decline in serum toluidine red unheated serum test (TRUST) titers (x2 =20.663,P ＜ 0.05) and persistent positive serum TRUST titers (Z =-7.021,P ＜ 0.05),but not with gender,age,stage of syphilis,treatment protocols,initial serum TRUST titers,or the presence or obsence of neurological symptoms (P ＞ 0.05).Multivariate logistic regression analysis revealed that persistent positive serum TRUST titers were a risk factor for neurosyphilis (OR =4.685,95％ CI =2.552-8.601,P ＜ 0.05).ROC curve analysis showed that the best cut-off point of persistent positive serum TRUST titer was 1 ∶ 8 for predicting neurosyphilis,with the area under the curve (AUC) being 0.907.Conclusion Serum TRUST titers are somewhat valuable for predicting neurosyphilis in syphilitic patients after regular therapy.

Objective To study the association of U. urealyticum biovar and genotype with nongonococcal, nonchlamydial mucopurulent cervicitis. Methods The study population consisted of two groups: patient group (226 female patients with nongonococcal, nonchlamydial mucopurulent cervicitis) and control group (118 healthy women). The biovar and genotype of U. urealyticum were identified in specimens positive for U. urealyticum culture by using PCR-single-strand conformation polymorphism (PCR-SSCP) analysis. Results The most common genotype in both groups was mba 3/14 in biovar 1 with the detection rate being 30.98%(57/184) in patients with mucopurulent cervicitis and 43.42% (33/76) in the controls. A significant difference was observed in the prevalence of genotype 2B in biovar 2 between the patients and controls [16.30% (30/184) vs 6.58% (5/76), χ2 = 4.367, P= 0.037). The genotype 1, 3/14 and 6 in biovar 1 predominated in the controls with their total prevalence being 81.58%. Conclusion The genotype 2B in biovar 2 of U. urealyticum may be associated with nongonococcal, nonchlamydial mucopurulent cervicitis among female patients attending an STD clinic.

Objective To study the relationship between M. Genitalium and nongonococcal, non-chlamydial mucopurulent cervicitis. Methods A total of 226 patients with nongonococcal, nonchlamydial mu copurulent cervicitis and 118 healthy female volunteers were recruited in this study. Cervical samples were collected and M.genitalium was detected by PCR amplification of 16s rRNA and Pa genes. Information about socio-demographic characteristics, medical history, and sexual behaviors was gathered by questionnaire from both populations. Results The prevalence of M. Genitalium infection was 11.06% (25/226) in patients with mucpurulent cervicitis, 0,85% (1/118) in the healthy controls; the difference was significant between the two groups (x2 = 11.58, P < 0.001). Single variant analysis on the 226 patients showed that the preva-lence of M. Genitalium infection was 27.78%, 16.36%, 18.28% and 14.12% in patients with ectopic pregnancy history, cervical inflammation, pelvic organ tenderness, 10 or more polymorphonuclear leukocytes (PMNs)per oil immersion field in cervical discharge, respectively, significantly higher than that in patients without ectopic pregnancy history, cervical inflammation or pelvic organ tenderness, and those with less than 10 PMNs per oil immersion field in cervical discharge (9.62%, 6.03%, 6.02% and 1.79%, all P < 0.05). M.genitalium infection was also related to multiple sex partners and the presence of mucopurulent secretion in cervix (P < 0.001). Conclusion The prevalence of M.genitalium infection is higher in patients with non-gonococcal, nonchlamydial mucopurulent cervicitis attending STD clinic than that in normal population.

Objective:To compare the effects of volume-controlled ventilation (VCV),pressure-controlled ventilation (PCV) and pressure controlled ventilation-volume guarantee (PCV-VG) on respiratory mechanics and respiratory function index in patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Methods:Seventy-five patients who underwent EBUS-TBNA under general anesthesia during February to December in 2019 in Lishui City People's Hospital,China were included in this study.They were randomly assigned to undergo VCV (Group V),PCV (Group P) or PCV-VG (Group G),with 25 patients in each group during EBUS-TBNA.After exclusion because of different reasons,25,24 and 24 patients from the Groups V,P and G respectively were included in the final analysis.Peak airway pressure (P peak),pulmonary dynamic compliance (C dyn),the partial pressure of carbon dioxide in arterial blood (PaCO 2),and oxygenation index (OI) at baseline (T 0),at the time of EBUS-TBNA for 30 (T 1) and 60 min (T 2) and immediately after EBUS-TBNA (T 3). Results:At T 2 and T 3,P peak in the Group P was (22.5 ±5.2) cmH 2O and (16.2 ± 2.8) cmH 2O respectively,which was significantly lower than that in the Group V [(25.8 ± 3.5) cmH 2O,(18.2 ± 3.2) cmH 2O, q = 3.672,3.454, P = 0.031,0.045).At T 1,T 2 and T 3,C dyn in the Group P was (26.4 ± 5.0) mL/cmH 2O,(24.1 ± 4.5) mL/cmH 2O and (32.5 ± 4.2) mL/cmH 2O,respectively,which was significantly higher than that in the Group V [(23.0 ± 2.7) mL/cmH 2O,(19.9 ± 2.1) mL/cmH 2O,(28.5 ± 3.7) mL/cmH 2O, q = 3.732,4.795,4.118, P = 0.027,0.004,0.013).At T 2 and T 3,P peak in the Group G was (21.7 ± 4.3) cmH 2O,(15.6 ± 2.6) cmH 2O,respectively,which was significantly lower than that in the Group V [(25.8 ± 3.5) cmH 2O,(18.2 ± 3.2) cmH 2O, q = 4.493,4.332, P = 0.006,0.009]. At T 1,T 2,and T 3,C ydn in the Group G was (26.6 ± 5.6) mL/cmH 2O,(24.3 ± 5.6) mL/cmH 2O,(33.2 ± 6.3) mL/cmH 2O,which was higher than that in the Group V [(23.0 ± 2.7) mL/cmH 2O,(19.9 ± 2.1) mL/cmH 2O,(28.5 ± 3.7) mL/cmH 2O, q = 3.852,4.936,4.791, P = 0.022,0.002,0.003]. At T 2 and T 3,PaCO 2 in the Group G was (41.1 ± 3.8) mmHg,(38.4 ± 3.4) mmHg,respectively,which was significantly lower than that in the group V [(45.7 ± 3.4) mmHg,(41.0 ± 3.0) mmHg, q = 5.969,3.682, P = 0.000,0.030].At T 2,OI in the group G was significantly higher than that in the group V [(358.0 ± 32.8) mmHg vs.(326.6 ± 29.7) mmHg, q = 4.782, P = 0.030].There were no significant differences in indexes between groups P and G (all P>0.05). Conclusion:During EBUS-TBNA for>60 min,PCV combined with VG can not only reduce airway pressure and improve lung compliance,but also prevent respiratory acidosis and improve oxygenation.

Objective To investigate the amino acid patterns in penicillin-binding protein 2(PBP2)in Neisseria gonorrhoeae isolates with reduced susceptibility to ceftriaxonc.and the relationship between the amino acid patterns and reduced ceftriaxone susceptibility.Methods DNA was extracted from 13 clinical isolates of N.gonorrhoeae.including 11 strains with decreased susceptibility to ceftriaxone and 2 sensitive isolates.The full-length penA gene encoding the penicillin-binding protein 2 was amplified and sequenced.BLASTn and BLASTx programs were used to assess the insertion and substitution patterns of nucleotides in penA gene and of amino acids in PBP2,respectively.Results BLASTn analysis revealed insertion or substitution of 18-38 nucleotides in the penA gene of gonococcal isolates with reduced ceftriaxone susceptibility.As shown by BLASTX analysis.there were five patterns of amino acid substitution or insertion in PBP2 of the 11 isolates with reduced ceftriaxone susceptibility.However.mosaic structure of PBP2 was not found in any of these isolates.Conclusion Mosaic PBP2 seems not to be the major factor contributing to the decrease in susceptibility of N.gonorrhoeae to ceftriaxone.

Objective To study the biological changes and the collagen synthesis of the primary cultured skin fibroblast treated with Cigarette Smoke Extract (CSE). Methods The morphological changes of fibroblasts after 24 hours' treatment with CSE were observed with invert microscope. The inhibitory effect at different concentrations of CSE on fibroblast activities was determined by the tetrazolium dye colorimetric test (MTT Test). The growth curves of fibroblasts treated with CSE were drawn with MTT method. Cell aging was observed with β-galactosidase, which was the biological marker of senescence. Flow cytometry (FCM) was used to estimate cell cycle phases after the fibroblasts were treated at different concentrations of CSE and different time. The mRNA expression of type Ⅰ procollagen was detected by RT-PCR. Results After the treatment, the fibroblasts displayed morphological changes and the growth of fibroblasts was apparently slowed down by CSE. The positive β-galactosidase staining was observed in the treated fibroblasts, which were affected by CSE for 5 passages. FCM analysis demonstrated that CSE decreased the cells in S phase and increased the cells in G1 and G2 phase. The result of RT-PCR showed that type Ⅰ procollagen was decreased after the treatment with CSE. Conclusion CSE can not only inhibit the growth and proliferation of the skin fibroblasts, but also decrease collagen synthesis of dermal fibroblast which is very important to the skin health.

Objective To analyze the clinical features, diagnosis, treatment and prognosis of neurosyphilis. Methods Clinical data on and laboratory findings in 18 cases with neurosyphilis collected in the Affiliated Provincial Hospital, Anhui Medical University from 2006 to 2008 were retrospectively studied.Results Among the 18 patients, 3 sufferred from asymptomatic neurosyphilis, 1 from meningeal syphilis, 7 from meningovascular syphilis, 5 from paralytic dementia, and 2 from intracranial space-occupation. Toluidine red unheated serum reagin test (TRUST) and Treponema pallidum particle agglutination test (TPPA) of sera were positive in all the patients; cerebrospinal fluid (CSF) TRUST was positive in 16 patients, and CSF TPPA in all patients. An increase was observed in CSF leukocyte count in 7 patients and in CSF protein in 13 patients.The findings on cerebral magnetic resonance imaging (MRI) mainly included demyelination, brain atrophy,cerebral infarction, etc. All the patients, except 2 with a TRUST titer of 1:4, experienced a 4-fold decrease in TRUST titer within a 3-month follow up. Clinical symptoms of neurosyphilis improved in all patients except 1 with paralytic dementia. Conclusions The diversity of clinical manifestations usually leads to the misdiagnosis of neurosyphilis, which should be diagnosed based on comprehensive analysis of clinical characteristics as well as laboratory and imaging findings. Early diagnosis and treatment are beneficial to its prognosis.

Objective:To compare the application value of ultrasound-guided lumbar plexus block (LPB) and continuous adductor canal nerve block (ACNB) in total hip arthroplasty (THA), and to explore the anesthesia scheme of THA.Methods:A prospective randomized controlled trial was used. Ninety patients who received THA admitted to in Lishui People′s Hospital from March 2019 to February 2022 were selected as the study subjects. According to the random number table method, 90 patients were divided into the test group and the control group, with 45 patients in each. The control group received LPB + general anesthesia, and the test group received ACNB + general anesthesia. By evaluating the hemodynamic parameters heart rate (HR) and mean arterial pressure (MAP) at the time of entry (T 1), osteotomy (T 2), prosthesis implantation (T 3) and immediately after surgery (T 4); the pain degree visual analogue score (VAS) at 6 h (S 1), 12 h (S 2), 24 h (S 3), 48 h (S 4) after awakening; the dosage of anesthetic drugs, the anesthetic effects of LPB and ACNB in THA were compared. Results:From T 2 to T 4, HR of patients in the two groups had a trend of increase: (85.24 ± 4.26) times/min vs. (86.13 ± 4.86) times/min, (83.82 ± 5.11) times/min vs. (85.16 ± 3.56) times/min and (81.64 ± 4.32) times/min vs. (82.24 ± 4.62) times/min, while MAP was in a downward trend: (86.54 ± 4.25) mmHg (1 mmHg = 0.133 kPa) vs. (85.35 ± 4.66) mmHg, (86.15 ± 3.92) mmHg vs. (84.86 ± 4.13) mmHg and (90.65 ± 5.25) mmHg vs. (92.12 ± 4.62) mmHg. The difference at different time points was statistically significant ( P<0.05). There was no statistically significant difference in HR, MAP and change trend between the two groups at different time ( P>0.05). The VAS score of the two groups increased from S 2 time point, and the difference between different time points was statistically significant ( P<0.05). The rising trend of VAS score in the test group was lower than that in the control group, and the VAS score at different time points was lower than that in the control group ( P<0.05). The dosage of sufentanil used in the test group was less than that in the control group: (114.37 ± 16.61) μg vs. (131.36 ± 18.31) μg, and the number of press of analgesia pump was less than that in the control group: 6.00 (5.00, 6.50) times vs. 8.00 (7.00, 9.00) times ( P<0.05). Conclusions:Ultrasound-guided LPB and ACNB could maintain hemodynamic stability in THA. Especially, ACNB could play an analgesic role within 48 h after THA and reduce the dosage of analgesic drugs.