Objective To investigate the main genotypes and the epidemic characteristics of TEM-type and SHV-type extended-spectrum beta-lactamases (ESBLs) of the gram-negative bacilli in Guangzhou.Methods The phenotype of ESBLs from 3 500 clinical isolates were primary screened and confirmed by the NCCLS confirmatory test according to guidelines of NCCLS(2001). PCR were performed on 3 500 clinical isolates using primers specific for blaTEM and blaSHV, respectively, the PCR product were purified and sequenced by ABI prism 377 DNA sequencer.Results Total of 3 500 un-replicated and consecutive Gram-negative bacilli were isolated from 13 hospitals in Guangzhou in the past two years, and the prevalence of ESBLs-producing clinical Gram-negative isolates was 31.0%(1 084/3 500). The positive rates of PCR results for blaTEM, blaSHV, and both of them in all the clinical Gram-negative isolates were 24.0%(840/3 500),10.8%(378/3 500),and 3.7%(128/3 500), respectively. All PCR products for blaTEM were further identified as TEM-1-type non-ESBLs gene, including TEM-1,TEM-1B,TEM-1D,and TEM-1F,by DNA sequencing analyses. However, almost all of the blaSHV gene were further identified as SHV-type ESBLs gene(the prevalence of SHV-1 is 7.2% only).The prevalence of SHV-12/5a accounted for highest(50.0%,152/304) in Guangzhou. Our test also showed that 53%(340/641) of blaTEM-producers [JP2] were Escherichia coli, and 57.9%(176/304) of blaSHV-producers were Klebsiella pneumoniae.Conclusions [JP]We could conclude from above results that SHV-type ESBLs, especial SHV-12/5a, was the prevalent genotype of ESBLs of clinical gram-negative bacilli in Guangzhou. TEM-type ESBLs did not exist in our city. In addition, SHV-12/5a-producing strains probably were main epidemic strains in Guangzhou. As for detection of ESBLs with regular phenotype methods, there was possibility of false negative and false positive.

AIM: To explore the effects of adipose-derived stem cell (ADSC) transplantation on the expression of IL-10 amd TNF-α after cerebral ischaemia in Middle cerebral artery occlusion (MCAO) rats. METHODS: 72 male adult Sprague-Dawley rats were randomly divided into 4 groups: sham group, MCAO group, Vehicle group and ADSC group (n=18). Rat's cerebral ischemia model was established by MCAO with Longa' s method. ADSC were labeled by DAPI before transplantation. One day after MCAO, 30 μL of cell suspension containing 1×10~6 ADSCs were injected into the lateral ventricle of ADSC group and the same dose of PBS was given to the Vehicle group. At day 4, day 7 and day 14 after MCAO, the rats were decapitated to detect the expression of IL-10 and TNF-α in ischaemic rat' s brain by ELISA, immunohistochemistry and RT-PCR. RESULTS: Compared with sham group, the expression of IL-10 and TNF-α significantly up-regulated at 4 d, 7 d of MCAO group(P<0.05). There was no statistical difference of IL-10 and TNF-α expression between MCAO and vehicle group ant any time point(P>0.05). Compared with Vehicle group, the expression of IL-10 significantly up-regulated while TNF-α expression significantly decreased of ADSC-treated group at any timepoint post MCAO(P<0.05). CONCLUSION: The transplantation of ADSC could up-regulate the expression of IL-10 and down-regulate the expression of TNF-α in MCAO rat' s brain, which might contribute to its protective role upon cerebral ischaemia.

Objective To study the balance function of normal persons and to explore the differences in gender and age groups.Methods Forty parameters of 445 normal persons(16-70 years old, 205 of male, 240 of female ) were detected by static posturography while they were in seat, double foot standing with opening and closing eyes, and single foot standing with opening eyes. The results of male and female, standing with opening eyes and closing eyes, left foot standing and right foot standing were compared.Results Everyone's center of gravity was distributed in A zone while they were in seat. At standing with opening eyes and closing eyes, the center of gravity in A zone were in 429 subjects( 96.4%) and 436 subjects( 98.0%). Most parameters showed significant difference between the women and the men, opening eyes and closing eyes, left foot standing and right foot standing, different age groups. The stability in closing eyes was better than that in opening eyes, right foot standing was better than left foot standing. Most values of 20—39 years old group were the best, 70—79 years old group were the worst.Conclusion Static posturography can evaluate human balance function objectively and quantitatively. The stability is related to age and gender. To judge the balance function, the subject's age and sex must be taken into account.

ObjectiveTo investigate its dynamic characteristics and pathological mechanism on magnatic resonance diffusion weighted imaging (DWI) after chemoembolization in rabbit liver VX-2 tumor model.MethodsForty New Zealand rabbits were included in the study and forty-seven rabbit VX-2 tumor models were raised by implanting directly and intrahepatically after abdominal cavity was opened.Forty VX-2 tumor models from them were divided into four groups.DWI was performed periodically and respectively for each group after chemoembolization.All VX-2 tumor samples of each group were studied by pathology.The distinction of VX-2 tumors on DWI was assessed by their apparent diffusion coefficient (ADC) values.The statistical significance between different time groups,different area groups,or different b-value groups was calculated using SPSS 12.0 software.ResultsWhen b-value was 100 s/mm2,ADC values in the area of VX-2 tumor periphery,VX-2 tumor central,or normal liver parenchyma around tumor became gradually low in sixteen hours after chemoembolization,and were the lowest at sixteenth hour,and then they increased gradually from sixteenth hour to fourty-eighth hour after chemoembolization.The distinction of ADC between different time groups was significant,respectively ( F =7.325,P ＜ 0.01 ; F =2.496,P ＜ 0.05 ; F =6.856,P ＜0.01 ).Cellular edema in the area of VX-2 tumor periphery or normal liver parenchyma around tumor increased quickly in sixteen hours after chemoembolization; however,from sixteenth hour to forty-eighth hour,cellular edema in the area of normal liver parenchyma around tumor decreased gradually and that in the area of VX-2 tumor periphery decreased lightly at first and then increased continually.Cellular necrosis in the area of VX-2 tumor periphery after chemoembolization was more significant than that before chemoembolization.The areas of dead cells in VX-2 tumors manifested low signal and high ADC value while the areas of viable cells manifested high signal and low ADC value.ConclusionsDWI is able to detect and discriminate tumor necrotic areas from viable cellular areas before and after chemoembolization.ADC of normal liver parenchyma and VX-2 tumor are influenced by intracellular edema,tissue cellular death,and microcirculation disturbance after chemoembolization.

Objective To investigate dynamically characteristics of apparent diffusion coefficient (ADC) of MR diffusion-weighted imaging (DWI) in the rabbit VX-2 tumor model.Methods Forty New Zealand rabbits were included in the study and forty-seven rabbit VX-2 tumor models were raised by implanting directly and intrahepatically after abdominal cavity was opened.DWI was carried out periodically and respectively on seventh,fourteenth,and twenty-first day after implantation.Part samples of VX-2 tumors were studied by pathology.The distinction of VX-2 tumors on DWI was assessed by their ADC values.The statistical significance between different time groups,different area groups,or different b-value groups was calculated using SPSS12.0 software,respectively.Results ADC values of 47 VX-2 tumors in the area of tumor periphery,tumor center,and normal parenchyma around tumor were greater when b-value was 100 s/mm2 than those when b-value was 300 s/mm2 and the distinction of VX-2 tumor ADC in the area of tumor periphery,tumor center,and normal parenchyma around tumor between different b-value groups was significant,respectively( F =17.964,P ＜0.01 ; F =13.986,P ＜0.01 ; F =128.681,P ＜0.01 ).The ADC values in the area of normal liver parenchyma around tumor were greater than those in the area of VX-2 tumor periphery and tumor center when the b-value was 100 or 300 s/mm2.When b-value was the same( 100 or 300 s/mm2),the distinction of VX-2 tumor ADC between different areas was significant( F =176.586,P ＜0.01 ; F =55.089,P ＜0.01 ).The ADC of VX-2 tumor in the area of tumor periphery and tumor center became gradually low from seventh to fourteenth or twenty-first day after implantation and the distinction of ADC between different time groups but the area same (?) was significant( b =100 s/mm2,F =48.211,P ＜0.01 ;b =300 s/mm2,F =20.955,P ＜0.01 ).There were not obvious cellular necrosis in VX-2 tumors on seventh and fourteenth day after implantation but ADC of VX-2 tumor decreased unobviously because of cellular edemata in or around tumors.There were obvious cellular necrotic areas in VX-2 tumors on the twenty-first day after implantation.ADC of viable tumor cells in VX-2 tumors were lower on DWI than that in the area of normal liver parenchyma around tumor and ADC of dead tumor cells in VX-2 tumors were unequal,including high values,equal values,and low values but they were higher than that in the area of normal liver parenchyma around tumor after dead tumor cells had been liquified or had become cystic.Conclusions ADC is able to reflect objectively the diffusion of water molecules in the tumor and to reflect indirectly the degree of the growth and liquified necrosis of a tumor.ADC has an important and potential value in monitoring dynamical tumor growth and in evaluating malignant degree and therapeutic effect.

Objective: To analyze the effectiveness and response status of China Infectious Disease Automated Alert and Response System (CIDARS) in Hunan province from 2012 to 2016 for improving the system. Methods: To collect the early warning signals, the number of suspected events, the result of on-site investigation, the signal response time and the result of public health emergencies, and the χ² test, correlation analysis and non-parametric test were used to analyze the information on CIDARS in Hunan Province during the period from 2012 to 2016. Results: A total of 108 188 signals were generated by the CIDARS in Hunan Province; The warning involved 30 kinds of infectious diseases and 138 counties (districts), and each county (district) received 3.00 weekly warning messages on average; 100% early warning signal was responded, 2 h response rate was 92.43%; The median response time (P25-P75) was 0.28 (0.11-0.77) h in the single case warning, and the five-year timely response rate showed an upward trend year by year (trend χ²=58.89, P<0.05); the median response time (P25-P75) was 0.56 (0.28~1.06) h in the time series warning, and the five-year timely response rate showed no trend (trend χ²=2.43, P>0.05); the time series warning response was more timely than the single case warning, and the difference between the two timely response rates was statistically significant(χ²=5156.60, P<0.05). The studies showed that the sensitivity, specificity, and detection timeliness of the system were 84.80%, 69.53%, and 2.80 d, respectively; There was no significant difference in the infectious diseases detecting timeliness of CIDARS(H=8.75, P>0.05); the system had the best effect in rubella, and the positive likelihood ratio of rubella is 4.36. Conclusions CIDARS in Hunan province runs well overall with high sensitivity and timely response to the early warning signals, but the specificity of the early warning system needs to be improved. The quality of the epidemic report of infectious diseases needs to be further improved, and the early warning parameters and warning method should be adjusted according to the characteristics of different diseases and the differences among different regions.

OBJECTIVETo analyze causes of growing hepatitis E (HE) cases reported in Guizhou province, and probe into existing problems faced by medical institutions in diagnosis of clinical and laboratory-confirmed cases, for the purpose of improving the quality of HE surveillance system.

METHODSSix hospitals reporting greater HE cases from 2007 to 2011 were pinpointed, whose reported cases rose suddenly in 2011. Such cases were investigated by means of impatient medical record review, results of laboratory test and clinician interview.

RESULTS136 of the 354 reported HE cases investigated were found compliant with the diagnostic criteria of HE with an accordance rate of 38.42%. Difference of the HE diagnostic accordance rate among individual years, hospitals and reporting departments was statistically significant. Such rate of hospital reports was found to be the lowest in 2011, ranging from 0 to 18.18% respectively; HE cases reported by non-infectious departments accounted for 61.30% of total cases reported, with its accordance rate considerably below the infectious departments (8.29%). HE positive cases and HE positive rate in 2011 were significantly higher than that of preceding years.

CONCLUSIONSuch increase of reported HE cases in 2011 in the province was mostly attributable to more HE laboratory tests made by the hospitals, yet the accordance rates were lower than satisfactory. In this regard, the medical institutions in question were advised to enhance their competency training for HE diagnosis and case report quality.

China ; epidemiology ; Hepatitis E ; diagnosis ; epidemiology ; Hospitals ; Humans ; Laboratories ; Research Design