Objective To investigate the carbapenem-resistant mechanism of one strain of Klebsiella pneumoniae( KPN) and one strain of Pseudomonas aeruginosa( PAE) .Methods The identity of the isolates was confirmed by using MALDI-TOF mass spectrometry, 16S rDNA and special gene amplification .The minimum inhibitory concentrations (MICs) of the antimicrobial agents were determined by VITEK 2 Compact System .CarbaNP Antimicrobial susceptibility testing , plasmid extraction, electroporation experiment , PCR amplification, and cloning and sequencing were carried out to analyze the en-coding gene of β-lactamases.Results The types of β-lactamases of the KPN were blaKPC-2 and blaSHV, confirmed by se-quencing of the PCR products , and that of the PAE were blaKPC-2 .Only blaKPC-2 was displayed in both transformants .All of the results of CarbaNP were type A .Conclusion Both strains of KPN and PAE resisting to carbapenem produce a plasmid-mediated carbapenemase blaKPC-2 , which belongs to Bush group 2f, class A β-lactamase.The extended-spectrum β-lacta-mases gene encoding blaSHV of the KPN might be located in the chromosome or not in the plasmid carrying with blaKPC-2 .

ObjectiveTo evaluate the clinical effect and reliability of basiliximab as immune inducer combined with classic triad resisting immune rejection scheme in preventing immune rejection after heart transplant.MethodsWe continuously collected the clinical information of 214 patients undergoing heart transplantation from June 2004 to January 2011.Basiliximab was used at 1st h before heart transplant and 4 days after the operation by 20 mg each time.Triad resisting immune rejection scheme included methylprednisone,cyclosporine A and mycophenolate mofetil.The endocardial biopsy was done to diagnose rejection postoperatively,and the severity of acute rejection was graded according to the standardized criteria of the International Society for Heart and Lung Transplantation (ISHLT).The recipients were followed up for 1year after the surgery,the data of the endocardial biopsy and rejection were collected,and the postoperative complications and deaths were observed.Results The first time of recipients to accept the endocardial biopsy was 20.1±7.3 days postoperatively,including 63 (29.4％) cases of Grade Ⅰ A,8 (3.7％) cases of grade Ⅰ B,and 12 (5.6％) cases of grade Ⅱ.One year after operation,143 recipients accepted the endocardial biopsy,including 29 (20.3％) cases of grade Ⅰ A,1(0.7％) case of grade Ⅰ B,12 (7.7％) cases of grade Ⅱ.During hospitalization,5 recipients died,including 3 cases due to transplant heart failure,1case due to multiple organ failure and 1due to sudden death.One year after discharge,there were 2 deaths,including one case of serious rejection and 1case of multiple organ failure One month after operation,infection occurred in 7 cases (3.3％),and acute renal insufficiency in 11cases (5.1％).ConclusionCombined use of Basiliximab with triad resisting immune rejection scheme was a kind of safe and effective therapy to prevent early acute rejection after heart transplantation.

·AIM: To detect the effect of CTGF on the apoptosis in the diabetic retina with small interfering RNAs (siRNA) targeting with CTGF. ·METHODS: A total of 60 rats were divided into six groups including control group, diabetic 4,8,12,16 weeks group, and interference group. Diabetic rats were induced by STZ intra-peritoneal. At 4, 8, 12, 16 weeks after diabetic setting up, retinas were obtained from control, diabetic rats and diabetic animals treated by intravitreal injection of CTGFsiRNA to suppress the expression of CTGF mRNA. Retinal cells apoptosis was detected by Tunnel staining and mRNA expression of CTGF was analyzed by RT-PCR.·RESULTS: The levels of CTGF and the apoptosis in the retinas of diabetic rats were significantly higher than those in the controls. Apoptosis occurred at 4 weeks after a diabetic model setting up, became serious with the diabetes developing, while CTGF elevated at 8 weeks. The cell apoptosis counts increased to 25.8cells/mm2 at 24 weeks of diabetes. SiRNA-mediated inhibition of CTGF mRNA resulted in a significant decrease in apoptosis. Significant correlations were found between CTGF and apoptosis in the retina.·CONCLUSION: These results suggest that CTGF might be involved in retinal cells apoptosis which is a characteristic of early diabetic retina. siRNA targeting CTGF seems to have the advantage of ameliorating retinal cells lost.

Objective The purpose d this investigation was to evaluate the effect d influenza vaccination among medical staff. Methods We chose 134 medical staff who worked in out-patient department and the wards and received influenza vaccination as the inoculation group, 135 medical staff who did not receive influenza vaccination as the non-inoculation group. Investigation with questionnaires was carried out in the two groups 3 months after vaccination. Results The incidence rate of influenza-like disease in the observation group and the control group was 11.2% and 18.5% respectively. The protective rate was 39.46%. The average illness process of influenza-like disease in the observation group and the control group was 1.73 days and 2.96 days. The percent of patients with no medication, one kind of drug medication and two kinds of drag medication was 46.7%, 33.3% and 20.0% in the observation group and 32.0%, 8.0% and 60.0% in the control group. Conclusion Influenza vaccination exerted protective effect for medical staff and other people at high risk of emergency.

Objective To assess the treatment efficacy and safety of lanthanum carbonate (LC) in patients on maintenance hemodialysis. Methods MEDLINE (1996—2014), Embase (1974—2014.12), Pubmed (1996—2014.12), Cochrane library, Chinese Wanfang database (1996—2014.12) and CNKI (1979—2014.12) were searched. Lanthanum carbonate and hemodialysis were used as Chinese and English search terms respectively, and the articles met the inclusion and exclusion criteria were used as supplements. Quality assessment and data mining were conducted by two independent investigators who performed Meta-analysis using RevMan5.2. Results Nine trials with 2 674 participants were included in this study. The Meta-analysis showed that there were similar blood levels of calcium [WMD=-0.24,95%CI:(-0.61)-0.14, P=0.21], phosphorus [WMD=0.14,95%CI:(-0.02)-0.30,P=0.08] and phosphate control rates (RR=0.91,95%CI:0.70-1.17, P=0.44) between control group and lanthanum carbonate group. There were lower incidence rates of hypercalcemia (RR=0.17, 95%CI:0.06-0.47, P=0.000 7) and blood levels of calcium-phosphorus product [WMD=-2.17,95%CI:(-3.99)-(-0.35), P=0.02], and higher levels of parathyroid hormone (iPTH, WMD=105.69, 95%CI:70.38-141.00, P<0.000 01) and bone-specific alkaline phosphatase (BAP, WMD=6.47, 95%CI:0.43-12.50, P=0.04) in these two groups. There were no significant differences in incidence rates of gastrointestinal adverse events between two groups. Conclusion Lanthanum carbonate should be used as preferred choice of phosphate binders to control serum phosphorus in patients on maintenance hemodialysis.

OBJECTIVE CYP2D is one of the most abundant subfamily of CYPs in the brain, especially in the cerebellum. Brain CYP2D is responsible for the metabolism of endogenous neurotransmitters such as tyramine and serotonin. Our previous studies have shown brain CYP2D can be regulated by exogenous and endogenous substances with tissue- specificity. The purpose of this study is to examine the effects of cerebral CYP2D on the mice behavior and the regulatory mechanism of brain CYP2D by growth hormone. METHODS Mice received the stereotaxic injection with CYP2D inhibitor quinine in deep cerebellar nuclei of cerebellum. The animals were tested with rotarod apparatus, balance beam, water maze, elevated plus maze and open field. The changes in CYP2D22, PPARαand PPARγ in brain regions and liver were assayed in male growth hormone receptor knockout mice, SH-SY5Y cells and HepG2 cells. RESULTS The inhibition of cerebellum CYP2D significantly affected the spatial learning and exploring ability of mice. Compared with WT mice, CYP2D expression was lower in brain regions from GHR(-/- ) male mice; however, hepatic CYP2D level was similar. Pulsatile GH decreased PPARα mRNA level, and increased mRNA levels of CYP2D6 and PPARα in SH- SY5Y cells. In HepG2 cells, pulsatile GH resulted in decreases in PPARα and PPARγ mRNA levels, but not CYP2D6. PPARα inhibitor induced CYP2D6 mRNA and protein by 1.32-fold and 1.43-fold in SH-SY5Y cells. PPARγ inhibitor decreased CYP2D6 mRNA and protein by 74.76% and 40.93%. PPARα agonist decreased the level of CYP2D22 mRNA in liver and cerebellum, while PPARγ agonist rosiglitazone resulted in diametrically increases. The luciferase assay showed that PPARγ actived the CYP2D6 gene promoter while PPARα inhibited its function. Pulsatile GH declined the binding of PPARα with CYP2D6 promoter by 40%, promoted the binding of PPARγ with CYP2D6 promoter by approximate 60%. The levels of brain and liver PPARα expression in male GHR(-/- ) mice is obviously higher than those in WT mice. The level of PPARγ in male GHR(-/- ) mice was decreased in the frontal cortex and hippocampus, while remained stable in the cerebellum and striatum; meanwhile, PPARγ was increased in the liver. CONCLUSION Brain CYP2D may be involved in learning and memory functions of central system. Masculine GH secretion altered the PPARs expression and the binding of PPARs to CYP2D promoter, leading to the elevated brain CYP2D in a tissue- specific manner. Growth hormone may specifically alter the metabolic and synthetic of important endogenous substances in the central nervous system (such as serotonin) through the specific regulation of brain CYP2D expression.

Objective To investigate the relationship between abdominal aortic calcification (AAC) and outcomes in maintenance hemodialysis (MHD) patients. Methods One hundred and seventy MHD patients in the dialysis center of the Second Hospital of Tianjin Medical University from June 2014 and October 2014 were enrolled prospectively. Abdominal aortic calcification (AAC) was measured using AAC score (AACS) by abdominal lateral plain radiography. According to the AACS, the patients were divided into mild AAC (AACS<5) group and severe AAC (AACS≥5) group for comparison, and Kaplan?Meier analysis was used to compare their survival rates. Multivariable COX regression models were used to determine the risk factors of all?cause mortality and cardiovascular disease mortality in MHD patients. Results Severe AAC (AACS≥5) was present in 28.2%(48/170) patients. The median follow?up duration was 25.6 (22.0, 26.0) months. During the follow?up, 6 patients (4.9%) in AACS<5 group and 14 patients (29.2%) in AACS≥5 group died. Kaplan?Meier analysis showed that patients in AACS≥5 group had higher all?cause mortality rate and cardiovascular disease mortality rate as compared with patients in AACS<5 group (χ2=9.746 ,P=0.002; χ2=9.697 ,P=0.002). Multivariate COX regression analysis demonstrated that high AACS (HR=4.373, 95%CI 1.562?7.246, P=0.005) and hypoproteinemia (HR=0.886, 95%CI 0.797?0.985, P=0.025) were independent risk factors for all?cause mortality, while hypoproteinemia (HR=0.829, 95%CI 0.718?0.956, P=0.010) and low 1,25(OH)D3 (HR=0.769, 95% CI 0.627 ? 0.944, P=0.012) were independent risk factors for cardiovascular disease mortality. Conclusions AAC is significantly associated with overall survival in MHD patients. To further evaluate the relationship between AAC and outcomes in MHD patients, multi?center and long term follow up studies of large sample size are necessary.

Objective To investigate the expression and function of integrin-iinked kinase (ILK) in the transdifferentiation process of primary tubular epithelial cell( TEC) and its effect on the accumulation of extracellular matrix (ECM) in the aging process. Methods Primary TEC was cultured from kidneys of male Wistar rats aged 3 and 24 months. Then the primary TEC was stimulated by TGF-? at the concentrations of 0, 5, 10 and 20-40/?g/L for 24 h. The TEC expressions of ?-SMA,ILK and F-actin were detected by immunocytochemistry or indirect immunofluorescence. FN or ILK protein expression levels were tested by Western-blot. DIG-labelled cRNA probe of rat ILK in situ hybridization was obtained by transcription in vitro, with which ILK expression level and the location of TEC were detected. Results ?-SMA expression levels were very low in young or aging rat TEC on the base situation, no significant difference was found between the two groups. However, ILK and F-actin levels in 24 months group were higher than in 3 months group. Along with increasing concentration of TGF-?, ?-SMA, ILK and F-actin levels were increased. The expression of ILK was associated with F-actin expression. FN and ILK expression levels were significantly lower in 3 monthsrats TEC than in 24 monthsrats, P

OBJECTIVEUsing molecular epidemiology method to characterize human immunodeficiency virus type 1 (HIV-1) subtype CRF01 _ AE strains being prevailed in Zhejiang province.

METHODSGag fragments of the HIV-1 strains were amplified by nested-polymerase chain reaction (nPCR) from the DNA extracted from whole blood of HIV-1 infected individuals in Zhejiang province. PCR products were sequenced and analyzed by phylogenetic method.

RESULTS81 HIV-1 subtype CRF01 _ AE sequences were identified from the 192 samples that sequenced successfully. As one of the dominant subtypes in Zhejiang, CRF01 _ AE was transmitted mainly by heterosexual or homosexual contact in local residents. In migrants living in Zhejiang, CRF01 _ AE were transmitted mainly by heterosexual contact or injecting drug use. There were three main clusters in the phylogenetic tree which bootstrap value was larger than 60. We named the clusters with group MIX (47 sequences), group SEX (7 sequences) and group MSM (12 sequences) based on the transmission. Pairwise DNA distances in the gag region within the three groups and between CM240 were different (P = 0.000). Data through the analyses of deduced amino acid sequences from the three groups showed that several signature amino acid sites were distinct from the same positions of the subtype reference strains.

CONCLUSIONThe CRF01 _ AE strain prevailing in Zhejiang province was from several sources, transmitted by more than three different transmission routes, and becoming the main subtypes circulating in homosexual population in this study. More attention needs to be paid to the epidemic characteristic of CRF01 _ AE.

Adolescent ; Adult ; Child ; Child, Preschool ; China ; epidemiology ; Female ; HIV Infections ; epidemiology ; virology ; HIV-1 ; classification ; genetics ; isolation & purification ; Humans ; Male ; Middle Aged ; Molecular Epidemiology ; methods ; Phylogeny ; Young Adult

OBJECTIVETo investigate the distribution and major influencing factors of annual systolic blood pressure variability from a large population cohort.

METHODSIn this prospective cohort study, data from Kailuan Group employees who attended all 4 physical examinations ( taken in June 2006 to October 2007, June 2008 to October 2009, June 2010 to October 2011, June 2012 to October 2013, respectively) were analyzed (32 959 males and 10 401 females, mean age: (48.2 ± 11.5) years old). Systolic blood pressure variability was defined as the standard deviation (SSD) and the coefficient of variation (SCV) of systolic blood pressure of 4 physical examinations. Multivariate linear regression analysis was used to determine the related influencing factors of SSD and SCV.

RESULTS(1) The mean of SSD and SCV for this cohort was 10.91 mmHg (1 mmHg = 0.133 kPa) and 8.34%, respectively. SSD and SCV increased in male and female with increasing age (both P < 0.001). (2) Multiple linear regression analysis showed that systolic blood pressure (β = 0.225, P < 0.001), age (β = 0.163, P < 0.001), fasting blood glucose (β = 0.038, P < 0.001), the use of anti-hypertensive drugs (β = 0.038, P < 0.001), sex (β = 0.038, P < 0.001), smoking (β = 0.025, P < 0.001), alcohol drinking (P = -0.022, P < 0.001), physical exercise (β = -0.018, P = 0.001), high-sensitivity c-reactive protein (β = 0.016, P = 0.001) body mass index (β = -0.011, P = 0.018) were related to SSD. Age (β = 0.139, P < 0.001), sex (β = 0.055, P < 0.001), systolic blood pressure (β = 0.047, P < 0.001), fasting blood glucose (P = 0.033, P < 0.001), drinking (β = -0.030, P < 0.001), body mass index (β = -0.026, P < 0.001), the use of anti- hypertensive drugs (β = 0.026, P < 0.001), smoking (β = 0.024, P < 0.001), physical exercise (β = -0.015, P = 0. 001), high-sensitivity c-reactive protein (β = 0. 014, P = 0. 001) were related to SCV.

CONCLUSIONSSSD and SCV increase with increasing age. Systolic blood pressure, age, fasting blood glucose, the use of anti-hypertensive drugs, sex, smoking, drinking, physical exercise, high-sensitivity c-reactive protein, body mass index are major influencing factors for SSD. Age, sex, systolic blood pressure, fasting blood glucose, alcohol drinking, body mass index, the use of anti-hypertensive drugs, smoking, physical exercise, high-sensitivity c-reactive protein are major influencing factors for SCV.

Alcohol Drinking ; Antihypertensive Agents ; Blood Pressure ; Body Mass Index ; C-Reactive Protein ; Cohort Studies ; Exercise ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Smoking