Objective To determine the incidence of long bone lesions and clinical characteristic in early newborn with asymptomatic congenital syphilis. Methods The syphilis antibody in 26 infants with asymptomatic congenital syphilis who were diagnosed and treated in our hospital from April 2001 to May 2004 were detected,and the clinical feature and X-ray features were analyzed.Results Twenty-six infants and their mothers all had the antibody positive of syphilis.Treponemal antibody titer were 4 times higher than their mothers in the infants blood serum.Their general conditions showed normal and had no symptoms when they were hospita-(lized).Then,there were 24 cases (92%) with positive physical signs and /or abnormal findings on the liver function tests and blood routine and long-bone radiographs.Long-bone radiographs were abnormal for approximately 38%(10 of 26)of asymptomatic newborns with congenital syphilis.Metaphysitis was shown and looked like sandwich biscuit in X-ray photograph.Conclusions Asymptomatic congenital syphilis has no symptoms in the early stage.Bone X-ray photograph should be included in the assessment of newborns with a positive serology.Further support is needed in the diagnosis and treatment of early newborns with asymptomatic congenital syphilis.

Adolescent ; Humans ; Male ; Pigmentation Disorders ; pathology ; Skin ; pathology

Objective To explore the clinical characteristics,diagnosis and therapeutic strategies of acute appendicitis in pregnancy.Methods The clinical data of 45 cases with acute appendicitis in pregnancy,which had been diagnosed by surgeries in our hospital since Jan 2010 to Jun 2016,were retrospectively analysed.Results All patients had exhibited abdominal pain.Among them,15 patients(33.3％)had exhibited shifting pain in right lower quadrant,and 44 patients(97.8％)had abdominal tenderness.4 cases with appendiceal gangrene and 1 case with necrosis of the great omentum had been found during the surgeries.There were 5 patients had occurred complications after the surgeries,including 2 cases with poor wound healing,1 case with septic shock,1 case with inflammatory ileus and 1 case with incompletely adhesive ileus.Threatened abortion and threatened premature delivery were found in 11 patients(during 22+3 to 36+2 weeks gestation)after the surgeries.Finally,1 patient occurred abortion(25+3 weeks gestation)and 3 patients occurred premature delivery(during 28+4 to 30+4 weeks gestation).Conclusion Abdominal pain as the main clinical manifestations of the pregnancy with acute appendicitis,prone to severe complications.

The mainly antigenic sites for the adenovirus neutraliation are present on Loop1 and Loop2 of hexon.Majority research were focus in the human adenovirus.Little was known on infectious canine hepatitis virus (ICHV), which was also called canine adenovirus typeⅠ.Here,ICHV (the isolated strain) DNA was isolated and purified from the cultured MDCK cells.The Loop1 and Loop2 fragments were amplified by polymerase chain reaction(PCR) method,and then was connected by ligase T4.The target fragment was then connected with vector pET28a.The nucleotide sequence ecoding Loop1 and Loop2 was determined.The nucleotide sequence identity of Loop1 region between the isolated strain and CLL, RI261 and Toronto A26/61 strains is 100%, 100% and 83.8%, and the nucleotide sequence identity of Loop2 region between the isolated strain and CLL, RI261 and Toronto A26/61 strains is 88.1% , 88.1% and 99.3%, and amino acid identity is 93.6%, 93.6% and 98.6%.The recombinant Loop protein was expressed in E.coli and was approximately 36kDa in size,and then was purified. Then BALB/c mice were injected subcutaneously in the back and armpit with the recombinant Loop protein.The anti-ICHV antibody titers of immunized serum was tested by indirect ELISA and the titers were up to 1:320.Western blot demonstrated that immunized sera could specifically combine with ICHV. The research laid a foundation for creating new genetic engineering products of infectious canine hepatitis virus.

Objective To establish a rapid detection approach by visual interpretation directly for OprD2 resistance gene of Pseudomonas aeruginosa based on the Loop-mediated isothermal amplification (LAMP),and provide a quick and effective method for clinical monitoring of Pseudomonas aeruginosa strains.Methods Totally 47 strains of Pseudomonas aeruginosa collected from December 2011 to June 2012 in Southwest Hospital of microorganisms were prospectively studied.Four LAMP primers (two inner,two outer) were designed according to the six zones of the OprD2 gene of Pseudomonas aeruginosa.A positive reaction is indicated by the color change after adding an intercalating dye (hydroxy naphthol blue) to the reaction solution.This method was used to detect and analyze the distribution of OprD2 resistance gene in 47 strains of Pseudomonas aeruginosa and its coirelation with antibiotic resistance.Results The LAMP assays showed 100％ specificity for the OprD2 gene,and the sensitivity (with the lowest detection limits of 17.414 μg/L) was 10-fold higher than that of conventional PCR assays.The OprD2 gene was negative in 23 strains by both conventional PCR and LAMP.In OprD2 negative strains,the resistance rate of cefotaxime,levofloxacin,aztreonam,piperacillin,imipenem and meropenem was 100％ (23/23),57％ (13/23),48％ (11/23),48％ (11/23),48％ (11/23) and 43％ (10/23).Compared with the OprD2 positive strains,statistical analysis showed that the resistance rate of imipenem,levofloxacin and meropenem in OprD2 negative strains increased significantly (chisquare value is 9.155,4.846,4.037,P value was 0.002,0.028,0.045,and so there was significant difference).Conclusions The established LAMP approach in this study enables rapid,sensitive and specific detection of OprD2 gene in Pseudomonas aeruginosa by visual interpretation.Deficiency of OprD2 gene confers Pseudomonas aeruginosa a basal level of resistance to carbapenems especially to imipenem.The identification of OprD2 gene distribution in Pseudomonas aeruginosa is helpful to the selection of antimicrobial agents in the infection treatment.

Objective To discuss the outcomes of the clinically insignificant residual fragments after minimally invasive percutaneous nephrolithotomy. Methods 75 patients (11％) with CIRF among 655 who underwent initial MPCNL from January 2008 to December 2010 were diagnosed by CT scan.Clinical data of 68 patients (39 male and 29 female) were analyzed retrospectively.Previous open surgery hadbeen performed in 13 and ESWL in 20 cases.The median residual fragment size was 1.8 mm.The anatomical distribution of CIRF was 9 at upper pole,14 at middle,34 at lower,9 at renal ureteropelvic junction and 2 at upper and lower pole.Stone analysis showed 40 cases of calcium oxalate calculi,15 of calcium oxalate calculi mixed with carbonate calculi,2 calcium oxalate calculi mixed with uric acid,3 calcium oxalate calculi mixed with struuvite stone,3 struuvite stone,2 uric acid stone and 3 carbonate apatite mixed with struvite stone.Mean follow up was 23 months (12-36).Follow-up consisted of physical examination,serum routine,urine routine and CT imaging. Results 14(21％) patients (3 upper pole,1 middle pole,4 lower pole and 6 ureteropelvic junction) had symptomatic episodes,including 9 hematuria,2 renal colic pain,5 lower urinary tract symptoms,12 with size of CIRF ＞ 4 rmm.8 patients required surgical procedures.5 patients (1 middle,2 upper pole and 2 renal pelvis) underwent ESWL.3 patients with ureteral CIRF were performed ureteroscopic lithotripsy.The CIRF were clear after surgeries.4 paticnts with CIRF ＞ 4 mm did not have symptoms.These patients were recommended to conservational treatments.2 patients with ureteral CIRF had renal colic pains.The stones were excluded after spasmolytic analgesic treatments.27％ (3/11)CIRF located in upper pole had symptom,compared with 4％ (1/14) in middle pole,11％ (4/36) in lower pole and 67％ (6/9) in ureteropelvic junction. Conclusions CIRF can be located variously in the kidney and ureter.Most CIRF are calcium oxalate calculi and locate in the lower pole.Patients with the history of previous open surgery or SWL are more likely to get CIRF.Medium-term follow-up of CIRF revealed that CIRF located in the renal ureteropelvis junction are more likely to have clinical symptoms.

Objective To compare 1HMRS and DTI findings of Alzheimer disease (AD) patients and normal elderly controls. Methods Fifteen mild AD patients, 20 moderate to severe AD patients and 20 aging controlled normal subjects (CN) were recruited. MRS imaging and DTI were performed on a 1.5 T MRI scanner. A ROI was positioned in the posterior part of the cingulate. MRS data were processed and the metabolite ratios were estimated, including the ratios of NAA/Cr, Cho/Cr, mI/Cr. Comparing with the axial MRS location, we chose the same level to posit the ROIs on both sides of the posterior cingulated fibers on fractional anisotropy map (FA) and mean diffusivity map (MD). Mean spectroscopy data and DTI values for each groups were analysed with Mann-Whitney U non parametric test. Correlations between MRS and DTI values for AD groups were estimated using partial correlations test controlling for the age related bias. Results Compared to normal aging groups, mild AD group showed a significantly lower FA value in the left side of posterior cingulum bundle (0. 549±0. 056 vs 0. 517±0. 058,Z =2. 014,P <0. 05). Whereas, moderate to severe group versus mild AD group revealed significantly elevated MI) value and a decrease in FA value in the right side of posterior cingulate ( FA 0. 517 ± 0. 059 vs 0. 432 ± 0. 073, Z = 3. 216, P < 0. 01 ; MD (0.726±0.041) × 10-3 mm2/s vs (0.761±0.057) × 10-3 mm2/s,Z = 1.970,P <0.05) . Obvious increasing mI/Cr ratio was found in mild AD group ( 0. 61 ± 0. 07 vs 0. 68 ± 0. 12, Z = 2. 911, P < 0. 01 ). NAA/Cr ratio showed gradually decrease in AD groups. Partial correlations analysis revealed a positive correlation between ml/Cr ratio and left posterior cingulated FA value in mild AD group ( r = 0. 586, P < 0. 05) and negative correlation between NAA/Cr and MD value in the right side of posterior cingulated region ( r = - 0. 505, P < 0. 05 ). Conclusions These findings suggested that there were different regional and temporal pattern in different course of AD disease, resulting from axonal loss or gliosis. Combining MRS with DTI alternations could be a better potential indicator and could better explain the pathological changes in AD progression.

Objective To investigate the molecular epidemiological characteristics of Staphylococcus aureus associated with bloodstream infection in hospital. Methods 47 Staphylococcus aureus strains isolated from bloodstream in PLA General Hospital were collected from January 2006 to December 2008. Susceptibility of the strains to 11 antimicrobial agents was detected and DNA homology of them was analyzed with Rep-based DiversiLab~(TM) Microbial Typing System. Panton-Valentine leukocidin (PVL)gene was determined by PCR. For methicillin-resistant Staphylococcus aureus (MRSA) strains,the genotypes of SCCmec were determined and ST239 clone was screened with multiplex PCR. Multilocus sequence typing (MLST) was used to determine the STs of the selected isolates. Results In the 47 Staphylococcus aureus isolated from blood,methicillin-resistant strains accounted for 51.1%,all belonged to SCCmec Ⅲ type,with only 2 pvl gene positive strains identified. 12 different patterns (A-L) were found among 47 strains with Rep-PCR. All MRSA strains clustered in the A and B subtypes. Conclusion Most MRSA strains isolated from blood in PLA General Hospital belonged to ST239-MRSA-SCCmec Ⅲ clone. DiversiLab~(TM) Microbial Typing System could provide a rapid and effective method to investigate the molecular epidemiological characteristics of Staphylococcus aureus in the hospital settings.

Objective To evaluate the effectiveness of suberselective uterine arterial embolization for uterine fibroids.Methods Uterine arterial embolization with golyvimylalcohol(PVA) particles or Iodized oil and Gelfoam or Pingyangmycin lipiodol and Gelfoam was performed in 182 patients with uterine fibroids.Results Bilateral and unilateral superselective uterine arterial embolization were performed in 173 cases and 9 cases respectively. 6～28 months (mean 11 months) after the procedure, complete disappearance of tumor(16 cases), an average shinkage of 67% in tumor volume(152 cases) and a mean 42% reduction of uterine volume were obtained in 168 followed-up cases. The clinical symptoms were relieved significantly.The main side effets were hypogastic pain(135/182).Conclusion Superselection uterine arterial embolization is an effective and microinvasive method in treating uterine fibroids.

Objective To study Edg4 and Edg7 expression in placenta of women with hypertensive disorder complicating pregnancy,and to investigate the relation between the expression of lysophosphatidic acid(LPA)and hypertensive disorder complicating pregnancy.Methods Immunohistochemical SP method was used to measure the expressions of Edg4 and Edg7 in placenta of women with normal pregnancy,20 women with gestational hypertension,20 with mild preeclampsia,and with severe preeclampsia.Results (1)Location:immunohistoehemical staining for Edg4 and Edg7 protein were located at the membrane and endoehylema of cytotrophoblast as well as decidua cells.(2)The positive expression of Edg4 protein and Edg7 protein on membrane and endochylema of cytotrophoblast was 25% and 20%(normal women),60% and 40%(gestational hypertension),80% and 65%(mild preeclampsia),and 83.3% and 86.7%(severe preeclampsia).The expression of Edg4 and Edg7 protein in mild preeclampsia and severe preeclampsia was significantly correlated with the degree of differentiation(P0.05). (3)The positive expression of Edg4 protein and Edg7 protein on membrane and endochylema of decidua was 20% and 25%(normal pregnancy),55% and 50%(gestational hypertension),70% and 55%(mild preeclampsia),and 83.3% and 73.3%(severe preeclampsia)respectively.The expression of Edg4 and Edg7 protein in mild preeclampsia and severe preeclampsia showed a significant correlation with the degree of differentiation(P0.05).Conclusions The high expression of Edg4 and Edg7 protein in the placentas of patients with hypertensive disorder complicating pregnancy indicates that LPA combines with Edg4 and Edg7,inducing the occurrence of hypertensive disorder complicating pregnancy.