Objective To investigate the karyotype of Candida albicans DNA by pulsed field gel electrophoresis (PFGE), and evaluate the significance of the karyotype used as a method for molecular epidemiology controlling. Methods 14 isolates of C. albicans from various clinical samples were evaluated for molecular relatedness by PFGE. Isolates were identified by MircroScanWalkAway 96 RY-ID. Results The karyotype analysis revealed a total of 9 different genotypes among 14 isolates of C. albicans from 11 patients. Among the isolates, 4 were isolated from difference parts of a patient and had same karyotype, implying that they were from the same isolate and differed to different sub-clones. In another 10 isolates from different patients, 3 had same karyotype, and the karyotypes of the remainder 7 isolates were different. Conclusion PFGE may well reveal the autoploidy and polymorphism of the isolates of C. albicans with different origin, thus may be used as an effective method for molecular epidemiological study.

Objective To evaluate ECG-aided tip localization of peripherally inserted central catheter(PICC),and to explore the predictive value of in vitro measurement length to optimal length.Methods Convenience sampling method was used to recruit 743 patients from 18 tertiary hospitals in 11 provinces.Patients received ECG-aided tip localization during PICC placement.After PICC was inserted,orthophoria chest radiograph (OCR) was conducted to check whether the tip position of PICC was appropriate.Results Totally 624 valid questionnaires were collected.OCR showed that all tips of PICCs were located in the optimal position.The optimal length was positively correlated with in vitro measurement length (r=0.920,P＜0.01).Linear regression showed regression equation was Y(the optimal length inserted through left basilic vein)=4.290+0.897X(in vitro measurement length)(R2=0.834,F=942.459,P＜0.001),and Y(the optimal length inserted through right basilic vein)=3.097+0.922X(in vitro measurement length)(R2=0.855,F=2055,P＜0.001).Conclusion Change of P-wave can be used to guide PICC placement and predict tip location.ECG-aided tip localization of PICC is accurate,and can be used as an alternative way.Besides,regression equation can be used to predict the optimal length of PICC.

Objective To explore the function of placental trophoblast cell apoptosis on the pathogenetic mechanism of pregnancy induced hypertension (PIH). Methods Apoptosis of trophoblast cells in 20 cases of PIH(PIH group) and in 10 cases of normal pregnancy (control group) were directly observed using the terminal-deoxynucleotidyl transferase mediated d-UTP nick end labeling (TUNEL) method. Apoptosis gene expression patterns were screened with gene chip provided by Poxing Company, Shanghai. Standards for differently expressed genes were: (1) An absolute value of the natural logarithm of cy5(PIH group)/cy3(control group) greater than 0.69 with a difference of signal of cy5 2 times over that of cy3. (2) The signal value either cy3 or cy5 must be greater than 800. Results (1) TUNEL test showed that the number of trophoblast cells apoptosis per ten thousand ?m 2 was 1.584 in the PIH group and 0.032 in the control group with significant difference between the two groups (P

Objective To study the relationship between serum hepatitis B virus covalently closed circle DNA (HBV cccDNA) as well as liver function and liver tissue pathological changes in children with chronic hepatitis B.Methods One hundred and twenty-four HBV-DNA positive children with hepatitis B were enrolled.Among 124 patients,65 cases were HBV carriers,59 cases were chronic hepatitis (mild in 31 cases,moderate in 18 cases and severe in 10 cases).HBV cccDNA in serum and liver function were detected,46 of which underwent liver biopsy and liver tissue inflammation and fibrosis grading classification was made.Results In moderate and severe cases,positive rates of serum HBV cccDNA (77.8％,100％) were higher than those of the HBV carriers and mild cases (32.3％,54.8％) (x2 =25.429,P ＜ 0.01),indicating more severe illness in children,detection rate of serum HBV cccDNA was higher.ALT,AST,and TBIL were higher in serum HBV cccDNA positive group than those of negative group[(95.6 ± 18.2) U/L vs (52.5 ± 17.7) U/L,(88.8 ±20.3) U/L vs (48.4 ±21.4) U/L,(68.4 ±24.6) μmol/L vs (28.3 ± 23.9) μmol/L](t =15.572,10.750,17.067,P ＜ 0.01).Serum HBV cccDNA and liver inflammatory activity and fibrosis showed no significant correlationship.Conclusion Serum HBV cccDNA is a sensitive indicator of viral replication,the more severe the disease situation,the peripheral HBV cccDNA detection rate is higher.But it is not entirely consistent with liver inflammation and fibrosis,so it can not completely reflect the degree of liver damage.

Objective To investigate the causes and treatment measures of an outbreak of Norwegian scabies oc-curred in a hospital.Methods In May 2013,an outbreak of Norwegian scabies among health care workers(HCWs) occurred because of the misdiagnosis of a patient with Norwegian scabies,epidemiological investigation was carried out by healthcare-associated infection(HAI)control department,medical intervention and disinfection and isolation measures were performed.Results A total of 27 HCWs and patients’relatives developed Norwegian scabies.After active medical treatment,patients’condition improved;all appliances used by patients were cleaned and disinfected after being wrapped and sealed with plastic bags for one week.Epidemic trend of infection was under control and no new case was found.Conclusion With highly contagious,Norwegian scabies can be spread in local area,it is neces-sary to improve HCWs’diagnostic ability to this disease and take effective measures to prevent the epidemic once HAI occur.

Background:Intestinal metaplasia(IM)and dysplasia in Barrett’s esophagus(BE)can be detected by endoscopic biopsy combined with pathological examination. Aims:To evaluate the efficacy of acetic acid stain-guided biopsies in detection of IM and dysplasia in BE under standard endoscopy. Methods:One hundred patients found to have columnar-lined esophagus by endoscopy from January 2012 to November 2014 at Shanghai Jing’an District Central Hospital were enrolled. Under standard endoscopy,acetic acid was sprayed and multi-point biopsies were performed in visible abnormal regions. This was followed by four-quadrant biopsies at every 1 to 2 cm of the remaining BE segments. Detection rates of columnar epithelium,IM and dysplasia were compared between acetic acid stain-guided biopsies and four-quadrant biopsies. Results:A total of 96 patients were diagnosed as BE. Detection rates of columnar epithelium by acetic acid stain-guided biopsies and four-quadrant biopsies were 96. 9%(93 / 96)and 90. 6% (87 / 96),respectively,no significant difference was found between the two methods(McNemar test,P = 0. 146),however,consistency of the two methods was poor(κ = 0. 340). A total of 32 patients were diagnosed as BE with IM. Detection rates of IM by acetic acid stain-guided biopsies and four-quadrant biopsies were 84. 4%(27 / 32)and 40. 6%(13 / 32),respectively,difference in detection rate between the two methods was significant(McNemar test,P = 0. 007),and consistency of the two methods was poor(κ =0. 266). Five cases of low-grade dysplasia were detected by acetic acid stain-guided biopsies only. Conclusions:Acetic acid stain-guided biopsies can detect BE with IM and dysplasia better than four-quadrant biopsies.

Objective To investigate the influential factors to the prognosis of senile patients with bladder cancer. Methods One hundred and forty-five senile patients with bladder cancer confirmed by pathology from 1998 to 2008 were clinically investigated and analyzed using measuring scales of Functional Living Index-Cancer (FLIC), Functional Assessment of Cancer Therapy-General (FACT-G) and Cancer Rehabilitation Evaluation System short form (CARES-SF). The factors influencing the prognosis were selected and quantified, and the relationship between the factors and prognosis was statistically analyzed. Results By retrospective analysis of clinical data, it was revealed that, suppose every 5 years from 65 were as an age grade, the age-gradient was positively correlated with the survival rates (r=0.687, P

Objective Examine and evaluate the influences and effects of Short-term Overseas Exchange Program (SOEP) on the medical students' global health capacity development.Methods This study collected data through interview and questionnaire of students participated in SOEP,and review of their exchange reports.The quantitative data was analyzed by using the SPSS 17.0 software.Results SOEP is a useful practice of global health capacity development of medicals students,the effects of which are shown in the following aspects:1.Learn and compare different medical education models; 2.Learn and compare different health care systems and models; 3.Cultivate students' global perspective; 4.Understand the different medical culture and medical humanistic philosophy; 5.Promote personal and career development.Conclusions SOEP has fundamental positive effects on the global health conception and capacities development of medical students.Therefore,SOEP should be promoted,and developed in a healthy,orderly and sustainable manner.

Objective To assess the prevalence of hand hygiene compliance rates of health care workers (HCWs) at general hospitals in China in 2010-2012. Methods Literatures about hand hygiene compliance of HCWs from 2010 to 2012 were retrieved from China Biology Medicine disc (CBM),China National Knowledge Infrastructure (CNKI),Wan Fang database,VIP ,and PubMed database ,Comprehensive Meta Analysis V2 software and Stata 1 2 .0 software were adopted to conduct statistical analysis . Results Ninety literatures were selected with heterogeneity (Q= 48 118.32,P<0.01),random effect model was used. The overall hand hygiene compliance rate of HCWs was 47.83% (95% CI:43.27% -52.42% );When stratified by occupation group,the overall compliance rate of doctors,nur-ses,and unclassified HCWs was 40.36% (95% CI:35.42% -45.49% ),46.70% (95% CI:41.81% -51.65% ),and 40.72% (95% CI:27.75% -55.13% )respectively. According to subgroup analysis,there was no statistical difference in compliance rate between doctors and nurses(Q= 3.12,P>0.05);the compliance rate after patient contact was higher than before patient contact (54.33% [95% CI :44.76% -63.59% ]vs 20.21% [95% CI:14.12% -28.06% ])(Q= 32.59, P<0.01 );hand compliance rate from field observation was higher than from covert observation (70.91% [95% CI :70.71% - 71.10% ]vs 41.20% [95% CI:37.55% -44.94% ])(Q= 247.66,P<0.01).Conclusion The overall hand hygiene compliance rate of HCWs in 2010-2012 was low,in order to reduce the risk of healthcare-associated infec-tion,hand hygiene compliance of HCWs need to be increased .

Objective: To discuss the clinical features of basaloid squamous carcinoma(BSC)and the factors relating to its prognosis and to compare patient survival between poorly differentiated squamous cell carcinoma(PDSC)and BSC. Methods: Clinical and pathological data of BSC and PDSC cases seen in our hospital between January 2004 and December 2008 were reviewed. Results: There were no statistical differences in demographic and clinical features between PDSC and BSC patients,with the exception that a larger proportion of BSC patients were female(P=-0.001).Additionally,higher tobacco consumption was observed among BSC male patients (P=0.003).There were no significant differences in survival rate between BSC and PDSC groups(X2=0.03,P=0.5470).The median survival time of BSC and PDSC patients was 19 months and 30 months，respectively.The 4-year survival rate was 22.4%and 36.1%，respectively(u=0.740,P=0.230).No significant difference was found in survival rate between stage Ⅰ and stage Ⅱ patients(X~2=0.109，P=0.2974).The median survival time of stage Ⅰ and stage Ⅱ patients was 19 months and 46 months，respectively；and the 4-year survival rate of stage Ⅰ and stage Ⅱ patients was 47.3% and 45.2%，respectively(u=0.122，P=0.450).Using Cox proportional hazard model，we found that surgical types and clinical stages of BSC were correlated with its prognosis.Compared with that of patients who received lobectomy,the postoperative mortality hazard of patients who received pneumonectomy and segmentectomy was increased by 1.379 times(P=0.031)and 1.634 times(P=0.061)，respectively.A more advanced clinical stage was associated with an increase in the postoperative morta,ty hazard ratio(X~2=14.12,P=0.000).The postoperative mortality hazard of patients of stage Ⅲ and stage Ⅳ was 2.437 times higher than that of stage Ⅰ patients(P=0.018).There were no statistical differences in postoperative mortality risk between stage Ⅰ patients and stage Ⅱ patients(P=0.057). Conclusion: Compared with that of PDSC,the incidence of BSC is higher among females.However,there is no difference in the prognosis between BSC and PDSC.BSC can be treated with the same therapies as those for other types of non-small cell lung cancer(NSCLC).