Objective To investigate the thyroid structure changes using a high-frequency sonography and thyroid dysfunction in end-stage renal failure(ESRF) patients.Methods From Jan.2012 to Apr.2012,50 ESRF patients and 55 consecutive outpatients(nonthyroid diseases visitors)as normal controls were included in the study.The size of thyroid gland was measured with ultrasonography and the volume was calculated.The internal echo changes and status of nodules were observed.Measurement such as thyroid hormones,parathyroid hormones and renal function were performed all patients.Results The serum level of T3,FT3 in ESRF patients were significantly lower than those of the control patients(1.05 ±0.23 mg/ml vs 1.14 ±0.25 pg/ml,P =0.038;3.1 ± 0.41 pg/ml vs 3.31 ±0.57 pg/ml,P =0.029),while the serum level of TSH was significandy higher in ESRF group than in the control group (3.29 ± 1.77 mIU/L vs 2.37 ± 0.67 mIU/L,P =0.001).Ultrasonography showed that 32％ (16/50) of ESRF patients and 3.6％ (2/55) of the controls had thyroid goiter (P ＜ 0.001).Compared to ESRF patients without nodules,the average age was significantly higher in patients with nodules (52.94 ± 14.21 vs 42.32 ± 11.37,P =0.006).Conclusion ESRF patients tend to have a higher incidence of alteration of thyroid function and nodular goiter which can be effectively assessed by ultrasonography.

AIM:Bioactive constituents were expected to be obtained from the roots of Angelica morri Hayata. METHOD:They were extracted with 95% alcohol and isolated by using column chromatography and recrystallization methods. The structures were elucidated by means of physico-chemical data and UV,IR,1HNMR, 13CNMR,and EIMS. The inhibitory effect on the constriction of rat aortic rings was induced by K+ or Ca2+. RESULT:3′S-(-)-hamaudol,3′S-(-)-Ο-acetylhamaudol,3′R-(+)-hamaudol,and (±)-hamaudol were isolated from the pieces of Radix Angelica Morri. The inhibitory rate of 3′S-(-)-Ο-acetylhamaudol and (±)-hamaudol on the above pharmacologic model appears the relation of quantity response. CONCLUSION:All the above compounds were found in this species for the first time,and(±)-hamaudol is a new. One of effect mechanisms of 3′S-(-)-Ο-acetylhamaudol and (±)-hamaudol diluted aorta could contribute to be inhibiting Ca2+ influx of vascular smooth muscle.

AIM:To obtain new typical compounds with dual mechanism,antagonizing Ca2+and inhibiting acetylcholinesterase,on Alzheimer's disease.METHODS:Resorcinol was chosen as primitive substrate,and AD-mix-β as asymmetrically dihydroxylated reagent;all products were screened against acetylcholinesterase in vitro.RESULTS:cis-3′R,4′R-disubstituted angular dihydropyranocoumarins were synthesized enantioselectively,however,its inhibitory activity on acetylcholinesterase is distinctively lower than that of cis-3′R,4′R-disubstituted linear dihydropyranocoumarins.

Objective To explore the function of the regional medical image network consultation system in propelling the quality control of regional medical image.Methods Based on the regional medical image network con-sultation system,the unified standard of quality control was implemented to reach the integrated management of the imaging quality control in region.The imaging specialists checked the quality of image and report in real time.In addi-tion,the specialists and inspectors monthly examined the quality of image and report.Subsequently,the unqualified causes were analyzed and the improvement measures were used.Finally,the quality of image and report were continu-ously improved.Results After the homogeneity management was applied for one year,the rates of remaking photos and returning the report were significantly decreased from 10% to 2%,and 12% to 4% respectively.Additionally,the rates of good image and report were significantly increased from 83% to 98%,and 89% to 100% respectively.The objective of good rate ≥90% was excellently achieved.Conclusion Based on the regional medical image network consultation system,the management in quality control of the networking hospitals has been uniform,and the technique of examination and the report format have been consistent.The standardability and accuracy of image examination have been realized.

Objective To investigate the prevalence of plasmid-mediated quinolone resistance (PMQR) genes among clinical isolates of Klebsiella pneumoniae (K.pneumoniae) in pediatrics.MethodsA total of 131 non-duplicate clinical isolates of K.pneumoniae were collected in the Affiliated Children′s Hospital of Capital Institute of Pediatrics from 2010 to 2012.PMQR genes [qnrA, qnrB, qnrS, aac(6′)-Ⅰb-cr and qepA], mutations in the quinolone resistance-determining region (QRDR) and extended spectrum β-lactamases (ESBLs) genes in those strains were analyzed by PCR.Minimum inhibitory concentrations (MIC) of different antibiotics against those K.pneumoniae strains were determined by broth microdilution method and E-test according to the guidelines issued by the Clinical and Laboratory Standards Institute (CLSI).Transferability of the PMQR genes was examined by conjugation test with the sodiumazide-resistant Escherichia coli J53.Results Among the 131 isolates, 9.92% were resistant to quinolone and 30.5% were positive for PMQR genes, including 6.87% harboring qnrB gene, 22.9% harboring qnrS gene and 4.58% harboring aac(6′)-Ⅰb-cr gene.Neither qnrA-positive nor qepA-positive strain was detected.Among these PMQR genes-positive isolates, 90% were ESBLs-producing strains and two presented mutations in gyrA and parC genes.Conjugation test showed that these PMQR genes could be transferred horizontally and the ciprofloxacin resistance increased 2 to 32 folds in transconjugants.Conclusion This study indicates that the PMQR gene-carrying rate is high in K.pneumoniae strains isolated in paediatrics in China.Most of the PMQR gene-positive strains are also ESBLs-producing strains.The PMQR genes could be transferred horizontally in bacteria.

Objective To study the application of P1 adhesin protein epitopes in diagnosis of Mycoplasma pneumoniae(Mp) infected patient. Methods The major epitope(P1-534) of P1 adhesin protein were predicted by ProPred and ANTIGENIC according to its primary structure. The high value fragment was cloned into a constructed recombinant vector. The gene was induced to express fusion protein in E. coli host strain BL21(DE3) and the fusion protein was identified by Western blot. BALB/c mice were immunized with purified protein to test its immunogenicity. Then the purified protein was used as antigen to test the serum of Mp infected patient by ELISA, and compared with the Mp whole cell antigen. Results The P1-534 protein was successfully expressed and purified. ELISA data showed that P1-534 protein could elicit high levels of IgG in immunized mice, the sensitivity and specificity of P1-534 were determined to be 85.00% and 97.67%, while the Mp whole cell antigen were 72.50% and 74.42%. Conclusion The results conformed that the recombinant epitope has certain immunogenicity,and its sensitivity and specificity are better than Mp whole cell antigen. P1-534 protein can be used as an antigen for immunodiagnosis of Mp infection.

Objective To compare the capabilities of culture method, polymerase chain reaction ( PCR) and serological test in identifying Mycoplasma pneumoniae infection in children with confirmed com-munity acquired pneumonia. Methods Bronchoalveolar lavage fluid and serum samples were collected from hospitalized children with community acquired pneumonia in Capital Institute of Pediatrics from March to May in 2016. Three methods, traditional culture method, PCR and serological test, were respectively used to de-tect Mycoplasma pneumoniae infection in those children. Statistical analysis was performed by using SPSS18. 0 software and chi-square test. Results Seventy-nine children with community acquired pneumonia were enrolled in this study. Eight (10. 13%) patients were diagnosed with Mycoplasma pneumoniae infec-tions by the traditional culture method with an average positive culture period of 21 days. Twenty-three (29. 11%) patients showed positive results by using PCR analysis, including the 8 patients identified by the culture method. Forty-one (51. 90%) patients were found to be positive for Mycoplasma pneumoniae infec-tions by the serological test. However, four negative samples identified by the serological test were confirmed to be positive by PCR analysis, including two positive samples confirmed by the culture method. Statistical analysis showed that the differences in positive rates detected by using the three methods were statistically significant. Conclusion It is recommended that both serological test and PCR analysis should be used in combination with clinical symptoms for a comprehensive assessment of Mycoplasma pneumonia infection in children.

Objective To explore the effect of childhood abuse on suicidal ideation and the influencing factors among recruits.Methods Through stratified sampling,505 recruits in Nanjing were tested by childhood Trauma Questionnaire (CTQ),Simplified Coping Style Questionnaire (SCSQ),Social Support Rating Scale (SSRS),Self-rating Idea of Suicide Scale(SIOSS) and Beck Hopelessness Scale (BHS).Results 1.The scores of suicidal ideation and hopelessness in recruits who had childhood abuse were significantly higher than those in control group ((5.56±4.58) vs (2.11±2.79),(5.93±3.01)vs (3.10±2.27),P＜0.01).2.The score of positive coping in recruits who had childhood abuse was significantly lower than that in control group(18.98±6.16 vs 23.27±7.45; P＜0.05).The score of negative coping in recruits who had childhood abuse was significantly higher than that in control group(9.27±5.04 vs 23.27±7.45; P＜0.01).3.The scores of social support in recruits who had childhood abuse were significantly lower than that in control group ((69.38± 10.43),(20.16±3.97),(25.73±3.68),(22.82±5.52) vs(75.55±9.67),(23.25±2.50),(27.56±3.51),(24.67±5.33) ; P＜0.05).4.The score of total CTQ was positively correlated with suicidal ideation,hopelessness,negative coping(r=0.379,0.402,0.228; P＜0.01),but negatively correlated with active coping style,social support(r=-0.285,-0.302; P＜0.01).Conclusion The recruits who had childhood abuse are susceptible to suicidal ideation.The negative coping style and lacking of social support may be the main factors to the suicidal ideation.

Objective To inspect the source of an outbreak with Mycoplasma pneumoniae (Mp).Methods We carried out real-time PCR to analyze specimens collected from pediatric patients in Beijing during January 2010 to May 2012,diagnosed as pneumonia or a respiratory infection according to clinical symptoms.These positive samples were analyzed by the M-P typing system(M:multiple-locus variable-number tandem-repeat analysis,MLVA; P:P1-restriction fragment length polymorphism analysis,P1-RFLP).Results Sixty-nine specimens were tested positive to Mp by the real-time PCR in 446 specimens from pediatric patients.The infection rate was 11.69％,15.56％ and 20.00％ respectively in 2010,2011 and the first half of 2012.According to the M-P system,11 distinct genotypes were identified from 69 positive specimens,M43562P1 and M53562P1 were the two main genotypes that showed an increasing trend from 2010 to 2011,and M33562P1 and M63562P1 showed an increasing trend from 2011 to 2012 in China.Conclusion During this international Mp epidemic,the infection rate of Mp was also increase in Beijing in 2011,and M43562P1 and M53562P1 were the two main genotypes.Among them,M43562 were consistent with pop genotypes in Europe,and M53562 were consistent with pop genotype in Israel.The M-P system would be valuable to monitor the epidemic of Mp in different countries in the world.

Objective To evaluate the efficiency of using nested PCR in restriction fragment length polymorphism analysis (P1-RFLP) for genotyping Mycoplasma pneumonia (M.pneumonia) in clinical specimens.Methods Based on the gene sequence of RepMp4 and RepMp2/3 in P1 gene of reference strains M129 (type 1) and FH (type 2),two sets of inner primers were designed with a HaeⅢ restriction enzyme site (GGCC).The nested PCR was set up to detect the target DNA in clinical specimens.The amplification products were mixed and digested with Hae Ⅲ enzyme.The genotypes were analyzed by comparing with various restriction maps and the results were verified by sequencing analysis.The concentration of DNA extracted from standard and clinical strains were detected by ten-fold dilution to evaluate the sensitivity of nested PCR-P1-RFLP and P1-RFLP.M.pneumonia-positive specimens isolated from Beijing in 2012 were analyzed by the nested PCR-P1-RFLP and the results were compared with those by P1-RFLP analysis.Results The nested PCR-P1-RFLP could effectively genotype M.pneumonia in clinical specimens and the results were consistent with those by sequencing analysis.The sensitivity of new assay was 103 times higher than that of the original P1-RFLP.Of the 115 M.pneumoniae positive clinical specimens,97.4％ (112/115) were type 1 and the rest were type 2.Conclusion The nested PCR-P1-RFLP shows high efficiency for genotyping of M.pneumonia in clinical specimens.It might be useful for the surveillance of M.pneumoniae infection.