Objective To investigate the microbiological and epidemiological characteristics of bloodstream infections in Peking University Third Hospital Methods The clinical, microbiological and epidemiological data of bloodstream infections in Peking University Third Hospital from January lst,2005 to December 31st, 2007 were analyzed retrospectively. Differences in proportions were compared using X2 test. Results Six thousand four hundred and eighty-eight blood culture tests for 5 138 episode of bloodstream infections of 3 795 patients were performed. The positive rate was 9.9%. The average incidence rate of nosocomial infection was 40.8 cases per 10 000 hospital admissions. In the 593 pathogens, 483 (81.5%) were pathogens causing nosocomial. The ratio of Gram-positive microbs, Gram-negative ones and fungi (all were Candida spp.) were 38.5%, 54.7%, and 6.8%, respectively. The corresponding ratio of nosocomial pathogens were 42.0%, 49.9% and 8.1%, respectively. The most frequently isolated strain was Escherichia coli (25.3 %). The coagulase negative staphylococcus was the second one (18.8%). The corresponding ratio of Staphylococcus aureus, Klebsiella pneumoniae, Enterococcus spp. , Pseudornonas aeruginosa , Acinetobacter baumannii and anaerobs were 7.1%, 7.4%, 8.3%, 3.2%, 2.2% and 0.7%, respectively. Ten patients (1.7%) had experienced polymicrobial infection. In hospital setting, Streptococcus spp. And Escherichia coli infections were more frequently in non-intensive care unit (ICU) than ICU (X2= 9.240, P= 0.002; X2= 23.609, P,<0.01; respectively). But the infection rate of Candida spp. Was significantly higher in the ICU (X2= 5.498, P= 0.019). The time interval between hospital admission and onset of infection for the most frequently isolated pathogens ranged from 15.1 days (Escherichia coli) to 29.7 days (Acinetobacter baumannii). The degree of resistance to the common antimicrobal agents had no change in the three years. Conclusions The average incidence rate of nosocomial bloodstream infection is 40.8 cases per 10 000 hospital admissions. The main pathogens are the Gram-negative microbs.

Objective To study the mechanism of insulin resistance in obesity, impaired glucose tolerance (IGT) and type 2 diabetes. Methods Insulin sensitivity index (SI), glucose effectiveness (S G) and insulin secretory function of ? islet cells were assessed by the reduced sample number of Bergman's minimal model method with frequently sampled intravenous glucose tolerance test in patients with obesity, IGT and type 2 diabetes as well as in the controls. Body mass index (BMI) and waist hip ratio (WHR) were determined in four groups. Results SI and S G were significantly higher in the controls than those in the IGT and type 2 diabetes patients. The S G in obesity group was nearly the same as that in the controls, but its SI was significantly lower. The area under curve 1 (AUC 1) of insulin in the controls was smaller than that in obesity and IGT (P

Child ; Drug Resistance, Viral ; HIV ; drug effects ; genetics ; HIV Infections ; virology ; Humans

[Summary] A 61-year-old female patient was diagnosed as ACTH independent Cushing′ syndrome, right adrenal adenoma, right facial infection. The situation was well controlled with antibacterial agents, abscess incision drainage and ketoconazole therapy. The patient received partial adrenolectomy of her right adrenal gland 16 months later. This case indicated that anti-adrenal agents could be a reasonable choice when the Cushing′syndrome patients were acompanied with severe infection.

This study aims to analyse the value of CODEHOP RT-PCR in the detection of Flavivirus. According to the amino acid sequences of polyproteins of different flaviviruses published in GenBank, a pair of primers was designed using the CODEHOP method. One-step RT-PCR was used to detect Japanese encephalitis virus strain JEV1201, Dengue virus strain JKD001, and yellow fever virus vaccine YV6161. BLAST analysis and phylogenetic analysis were performed after the RT-PCR products of nucleocapsid genes were sequenced. The results showed that this method could amplify Flavivirus specifically, and the size and sequence of the target fragment accorded with the anticipated result. JEV1201 had the highest homology to Japanese encephalitis virus strain YL2009-4/YC2009-3, belonging to the branch of the phylogenetic tree of Japanese encephalitis virus strains. JKD001 had the highest homology to Dengue virus strain DENV-2/ID/1022DN/1975, belonging to the branch of the phylogenetic tree of Dengue virus strains. YV6161 had the highest homology to Yellow fever virus strain 17D, belonging to the branch of the phylogenetic tree of Yellow fever virus strains. In conclusion, the method of CODEHOP RT-PCR can be effectively used to detect, identify, and phylogenetically analyse Flavivirus.
DNA Primers ; genetics ; Flavivirus ; classification ; genetics ; isolation & purification ; Flavivirus Infections ; virology ; Humans ; Molecular Sequence Data ; Phylogeny ; Reverse Transcriptase Polymerase Chain Reaction ; methods ; Viral Nonstructural Proteins ; genetics

OBJECTIVETo investigate the correlation of the deleted azoospermia (DAZ) gene copy related to gr/gr and b2/b3 deletions in the AZFc region with male spermatogenic impairment.

METHODSThis study included 121 infertile men with different de- grees of spermatogenic impairment and 95 healthy donors from the sperm bank. Using PCR, PCR-RFLP, and Y chromosome specific sequence tagged sites (STS) , we analyzed the association of DAZ gene copy deletions related to gr/gr and b2/b3 deletions in the AZFc region with spermatogenic impairment.

RESULTSThere were 15 cases of gr/gr deletion (12. 40% ) and 6 cases of b2/b3 deletion (4.96%) in the infertility group as compared with 13 cases of gr/gr deletion (13.68%) and 1 case of b2/b3 deletion (1.05%) in the control. Analysis of the DAZ-specific single nucleotide variant (SNV) loci revealed 11 gr/gr-DAZI/DAZ2 deletions (9.09%), 4 gr/gr-DAZ3/DAZ4 deletions (3.31%), and 6 b2/b3-DAZ1/DAZ2 deletions (4.96%) in the infertile men in comparison with 3 gr/ gr-DAZ1/DAZ2 deletions (3.16%), 10 gr/gr-DAZ3/DAZ4 deletions (10.53%), and 1 b2/b3- DAZ3/DAZ4 deletion (1.05%) in the control.

CONCLUSIONPartial deletions of gr/gr and b2/b3 exist in both healthy men and male patients with different degrees of spermatogenic impairment and cannot be considered as a risk factor for spermatogenesis impairment. However, deletions of different DAZ duplicons in gr/gr and b2/b3 deletions have different effects on spermatogenesis. DAZ1/DAZ2 instead of DAZ3/DAZ4 deletions might be associated with spermatogenesis impairment.

Prostate cancer (PCa) is one of the most common malignant tumors as well as a frequent cause of cancer-related mortality in men worldwide. The test of serum markers has dramatically improved the early diagnosis of PCa, but its underlying molecular mechanisms are not yet completely identified. Long noncoding RNA (IncRNA) is emerging as a new player in the PCa paradigm demonstrating its potential roles in both oncogenic and tumor suppressive pathways. LncRNA is frequently aberrantly expressed in the majority of PCa cases. This review highlights recent findings of the aberrant expression of lncRNA in PCa and discusses its novel roles in the diagnosis, prediction, prognosis, metastasis, and potential clinical treatment of PCa.
Humans ; Male ; Prognosis ; Prostatic Neoplasms ; metabolism ; RNA, Long Noncoding ; metabolism

Objective To assess the diagnosis and treatment of enterovesical fistula.Methods The clinical data of 12 cases (10 men and 2 women;mean age,57 years) of enterovesical fistula were retro- spectively analyzed.Of the 12 cases,7 (58%) had colovesical fistula,3 (25%) had ileovesical fistula,and 2 (17%) had rectovesical fistula.The etiology of fistula was intestinal malignancy in 7 cases,Crohn disease in 3 ,and bladder cancer in 1,and intestinal diverticulitis in 1.The clinical features included fecaluria in 10 cases,recurrent urinary tract infection (UTI) in 6,abdominal pain in 4,and pneumaturia in 3.Five patients (5/9) had a definite diagnosis by CT;3 (3/6),by cystoseopy;2 (2/5),by cystography;and 1 (1/5),by barium enema.Among the 10 patients undergoing surgical intervention,resection of the involved bowl with one-stage anastomosis and partial cystectomy was performed in 4;resection of the bowl with one-stage anasto- mosis and repair of the fistula or single bladder drainage in each of 2;one-stage transverse colostomy and two- stage radical colectomy with partial cystectomy in 1;palliative proximal colostomy in 3;and conservative ther- apy in 2.Results One patient died of septic shock 10 d after admission.Nine patients were followed for 3 months to 16 years (mean,6.5 years).One patient had intestinal fistula recurrence and was cured with re- operation;1 patient with conservative therapy and 1 with palliative surgery died of tumor metastasis;and 1 died of cerebrovascular accident 2 years later without fistula recurrence previously.Five patients undergoing surgery had a better survival with no complication.Conclusions The major cause of enterovesical fistula is intestinal malignancy.Fecaluria and recurrent UTI are the most common symptoms.CT and cystoscopy are the preferred adjunctive examinations.Surgical intervention is the major therapeutic choice.

Objective To investigate the clinical and genetic characteristics in a patient with 17β-hydroxy-steroid dehydrogenase (17β-HSD) 3 deficiency, regarding its pathophysiology and pathogenesis. Methods Clinical features and laboratory data were analyzed in a pedigree of 17β-HSD3 deficiency. Blood samples from the patient and his parents were collected. HSD17B3 gene was screened for mutations by PCR and subclone sequencing. Results The patient presented with pubertal virilization and gynecomastia. The physical examination showed female external genitalia and testes in inguinal canals. The chromosome karyotype was 46, XY. Serum FSH, LH, dehydroepiandrosterone sulfate, androstenedione and 17-OH-progesterone levels were raised, whereas plasma testosterone was lowered. Sequencing analysis revealed 4 nucleotide deletion (172-175del) of HSD17B3 gene. Conclusion Virilization and gynecomastia in puberty suggest the probability of 17β-HSD deficiency. It may be verified clinically by hCG-stimulating test and confirmed by gene diagnosis.

Objective To investigate the clinical and genetic characteristics in a male patient with 21hydroxylase deficiency combined with adrenal and testicular tumors.Methods Clinical features and laboratory data were collected from the patient.Testicular biopsy was performed.The CYP21 gene was sequenced for mutations.Results The patient presented left adrenal and testicular enlargements.The laboratory examinations showed that plasma ACTH,androstenedione,testosterone,progesterone,and 17-hydroxyprogesterone were markedly elevated.CT scan revealed that the right adrenal gland being resected and the left adrenal with nodular enlargement.Furthermore,testicular biopsy showed a prominent peritubular fibrosis with increased number of peritubular fibroblasts,tubular hyalinisation,and calcification.Sequencing analysis showed a A>G homozygous mutation at intron 2.Conclusion Patients with untreated 21-hydroxylage deficiency may.have adrenal adenomas and(or)testicular adrenal rest tumor simultaneously.