OBJECTIVE To understand the clinical distribution and drug resistance of Enterococcus to provide evidence for the rational use of antibiotics. METHODS The Enterococcus isolated form clinic from Jan 2006 to Dec 2007 and the sensitivity to 13 kinds of antibiotics were tested by K-B method. RESULTS All of 122 strains of Enterococcus were isolated which included 76 strains of E.faecalis(62.3%),29 strains of E.faecium(23.8%) and 17 strains of other enterococcus(13.9%).Most enterococcus were detected from vaginal secretion,urine,drainage fluid,cervical secretion and throat swab.Drug sensitivity test showed that the sensitivity to vancomycin and teicoplanin was high while the resistance to rifampicin,erythromycin,tetracycline and ciprofloxacin was the highest,and the total resistance rate of E.faecium was higher than E.faecalis. CONCLUSIONS The detection rate and resistance rate of Enterococcus present a rising trend,which should be paid for more attention by clinic.Bateria cultivation is necessary for suspected enterococcus infection and the drugs selected according to sensitivity result to improve the curative effect.

Objective To evaluate the clinical value of 18F-FDG PET-CT in monitoring response to therapy in patients with follicular lymphoma (FL) staging Ⅲ-Ⅳ.Methods The clinical data of 20 patients with FL were analyzed retrospectively.All patients underwent PET-CT at three times:baseline,after 3-4 cycles of chemotherapy,and end of treatment.Kaplan-Meier method was used to analyze the survival of patients.Results 14 patients achieved CR at the interim PET-CT,all patients achieved CR at post therapy PET-CT:all patients were alive with no evidence of disease in the follow-up.2 patiens achieved PR at the interim PET-CT,and 1 patient achieved CR,and 1 patient was PD,at post therapy PET-CT,all patients were relapsed in the follow-up.4 patients achieved PD,and all patients were changed the chemotherapy plan.At post therapy PET-CT,2 patients achieved CR,1 patient achieved PR,and 1 patient was PD,1 patient was no evidence of disease,2 patients were relapsed,and another was died in the follow-up.The negative predictive values (NPV) of the interim and the post therapy PET-CT were 100 ％ (14/14),88.2 ％ (15/17) respectively.The interim PET-CT was no significantly correlated with PFS (P =0.135),while the post therapy PET-CT was significantly correlated with PFS (P =0.0006).Conclusion 18F-FDG PET-CT is useful to monitor response to chemotherapy in patients with FL staging Ⅲ-Ⅳ,and set personalized treatment plan.

Objective To investigate the clinical efficacy and safety of radiofrequency ablation (RFA)combined with low frequency ultrasound radiation with microbubble for the treatment of malignant liver neoplasms.Methods The clinical data of 25 patients with malignant liver neoplasms who received RFA combined with low frequency ultrasound radiation with microbubble at the Kunming General Hospital from January 2010 to June 2011 were retrospectively analyzed.RFA was firstly performed with ultrasonic guidance,and then low frequency ultrasound radiation with microbubble was performed according to the results of ultrasound contrast examination 1 week after RFA.Ultrasound contrast examination was performed and the hepatic function and serum alpha fetoprotein (AFP) were assayed before operation,3 and 6 months after operation,respectively.All data were analyzed using the t test or chi-square test.Results The gross tumor volumes of 16 patients reduced by 30％ at 3 months after operation when compared with that before operation.The gross tumor volumes of 17 patients reduced by 50％ at 6 months after operation when compared with that before operation.The gross tumor volume of 7 patients reduced,but tissues surrounding tumors showed the signal of bloodstream.The gross tumor volume of 1 patient did not reduce.The levels of aspartate aminotransferase (AST),total bilirubin (TBil) and alpha fetoprotein (AFP) at 3 months after operation were significantly lower than those before operation (t =23.51,13.79,257.07,P ＜0.05).The levels of alanine aminotransferase (ALT),AST,TBil and AFP at 6 months after operation were significantly lower than those before operation (t =5.67,27.19,21.02,333.46,P ＜ 0.05).No local recurrence was detected during a follow-up of 6 months.The scores of quality of life (QOL) were very good in 21 (84.0％) patients,good in 2 (8.0％) patients,fair in 1 (4.0％) patient and poor in 1 (4.0％) patient.The scores of Karnofsky (KPS)were improved in 19 (76.0％) patients,stable in 5 (20.0％) patients and aggravated in 1 (4.0％) patient.There were significant differences in QOL and KPS between pre-and postoperation (x2=41.600,18.960,P ＜0.05).Conclusion RFA combined with low frequency ultrasound radiation with microbubble is effective in reducing the tumor size and protect the hepatic function for patients with malignant liver neoplasms.

Objective　To study the causes and management of the reoperation after cholangiointestiostomy(CIS). Methods　A retrospective analysis was made on the clinical data of 28 cases of reoperation after CIS from June 1995 to June 1999. Results　Among the 28 cases, 26 cases(92%) had CIS anastomotic stenosis. Of the 26 cases, 9 cases accompanied with left hepatobiliary duct stenosis, 3 cases with right hepatobiliary duct stenosis, 5 cases with left and right hepatobiliary ducts stenosis. 9 cases with biliary reflux comfirmed by barium meal radiography, all of the 9 cases were subjected to a choleduodenostomy. Of the 28 patients, 3 underwent reanastomose after excision the primary anstomosis, 8 operated with hilar bile duct reform and left lateral hepatolobectomy, 2 with left hepatic duct jejunostomy and hilar bile duct jejunostomy. 15 cases with intrahepatic bile duct jejunal Roux-en-Y anastomosis, after resolved the intrahepatic bile duct stenosis. Conclusions　The basic cause of reoperation after CIS is anastomotic stenosis, the other causes are as follows: the selected operation is unsuitable, the intrahepatic bile duct stenosis is not resolved, and the stonedoes not clean out completly. When reoperation is performed on these cases, the following principles must be abided by: romoving all the stones, resolving the stenosis, making a clear drainage; and performing hepatic lobectomy, anastomotic sustaining and drainage, and cholefibroscopic management must be done if needed.

BACKGROUND:Previous studies have found that miR-21 expression is increased during osteogenic differentiation of bone marrow mesenchymal stem cells, but the action and molecular mechanism of miR-21 are stil unclear. OBJECTIVE:To verify the target gene of miR-21, Spry1, and to explore the role of Spry1 in osteogenic differentiation of human bone marrow mesenchymal stem cells. METHODS:Luciferase report was used to verify Spry1 gene targeted by miR-21, and western blot assay was used to detect the expression of Spry1 in the osteogenesis of human bone marrow mesenchymal stem cells. Spry1 expression vector was established and transfected into human bone marrow mesenchymal stem cells. Osteogenesis ability of human bone marrow mesenchymal stem cells was analyzed after Spry1 high expression by alkaline phosphatase, alizarin red staining, RT-PCR and western blot. RESULTS AND CONCLUSION:Luciferase report suggested that Spry1 was a target gene of miR-21. The expression level of Spry1 was decreased in the osteogenesis of human bone marrow mesenchymal stem cells. Increasing expression of Spry1 could inhibit osteogenic differentiation of human bone marrow mesenchymal stem cells. These results indicate that Spry1 as a target gene of miR-21 negatively regulates osteogenic differentiation of human bone marrow mesenchymal stem cells, and plays an important role in bone formation process.

Objective To investigate the clinical effect of McDonald cervical cerclage and the affecting factors. Methods Between January 2002 to December 2013 in Peking University First Hospital we performed McDonald cervical cerclage for 116 single pregnant women. They were defined as the successful group who deliveried the live babies after 28 weeks after the cerclage and the failure group who deliveried in the second trimester. According to the surgical indications they were divided into preventive cerclage group and therapeutic cerclage group. Then we analyzed the curative effect and the affecting factors in the groups. Results (1) In the 116 cases, 12 cases (10.3%) failed, and 104 cases (89.7%) succeeded. In the successful group, 37 cases (35.6%,37/104) deliveried pretermly and 67 cases (64.4%) deliveried termly. And there were 56 cases of vaginal delivery (53.8%), and 48 cases (46.2%) of cesarean section. (2) Among the 116 cases, 48 cases (41.4%) were included in prophylactic cerclage group, the gestational age was (16.3± 2.2) weeks, 68 (58.6%) cases were included in therapeutic group, the gestational age was (24.0±2.2) weeks. The operation time was (22±9) minutes in preventive group and (24±13) minutes in therapeutic group,there was no statistical difference between the two groups (P>0.05). Live-birth rate between preventive cerclage group and therapeutic cerclage group was no statistically significant difference (P>0.05). The term birth rate (72.9%, 35/48) in preventive group was higher than that in therapeutic group (47.1%, 32/68), the difference was statistically significant (P<0.01). Neonatal hospitalization rate was lower in preventive group (14.6%, 7/48) than therapeutic group (36.8%, 25/68) , the difference was statistically significant (P< 0.01). (3) In the failure group placental pathology was examed in 7 cases. The placental tissue showed a large number of neutrophils infiltrating in 6 cases (6/7). In the successful group, 27 pregnant women deliveried between 28 to 33+6 weeks (26.0%,27/104), 10 pregnant women deliveried between 34 to 36+6 weeks 10 cases (9.6%, 10/104), 67 cases deliveried after 37 weeks (64.4%, 67/104). A lot of factors including maternal age, the previous cervix operation history, perioperative application of progesterone, operation time and preoperative invasive procedure were compared between the successful group and the failure group. Only maternal age and preoperative invasive proedcure were statistically significant (P<0.05) and the others had no statistical significance (P>0.05). (4) There were 68 cases in the therapeutic group, 7 cases failed, and 61 cases succeeded;the preoperative cervical os in failure group [ (21 ± 20) mm] was wider than that in successful group [(14±5) mm], the difference was statistically significant (P<0.05);and preoperative vaginal ultrasound measurement of cervical canal length were (18 ± 8) mm versus (19 ± 10) mm, there was no statistically significant difference (P>0.05). Conclusions The McDonald cervical cerclage for cervical incompetence is a simple, safe and high successful rate of intervention measures. The term labor rate of prophylactic cervical cerclage was higher than that of the therapeutic cerclage. Older maternal age and preoperative invasive procedure may be the risk factors for cerclage. The infection may play an important factor leading to the failure of McDonald cervical cerclage.

BACKGROUND:Osteogenic differentiation is a complex process involving transcriptional and post-transcriptional regulation by multiple signaling pathways, and the specific mechanisms remain unclear. It is of great significance to study the role of critical miRNAs in the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in the treatment of osteoporosis and bone defects. OBJECTIVE: To explore the regulatory ability of miR-21/Sprouty1 function axis in the osteogenic differentiation of BMSCs in patients with postmenopausal osteoporosis. METHODS:BMSCs were isolated from healthy people (H-hBMSCs) and patients with postmenopausal osteoporosis (PMOP-hBMSCs), and their osteogenic ability was compared. Expression of miR-21 and Spry1 at gene and protein levels was detected by real-time RT-PCR and western blot assay, respectively. miR-21 expression was upregulated via transfection in PMOP-hBMSCs, and the osteogenic ability and Spry1 expression of the cells were detected, while real-time RT-PCR and western blot were used to detect the expression of osteogenic marker genes, Runx2 and Osterix. RESULTS AND CONCLUSION:Compared with H-hBMSCs, PMOP-hBMSCs osteogenic ability was weakened significantly, miR-21 expression decreased, and Spry1 expression increased, indicating an inhibition to the miR-21-Spry1 function axis. Through the transfection of miR-21 and down-regulation of Spry1, the expression levels of Runx2 and Osterix were increased, and PMOP-hBMSCs osteogenic ability was partially restored.

Objective To investigate the genetic diversity of five populations of cultivated Morinda officinalis in Guangdong Province using random amplified polymorphic DNA(RAPD).Methods Sixty-four individuals in five populations of cultivated M.officinalis were analyzed by RAPD markers to determine the genetic variations among the populations.The data of genetic diversity were analyzed with Popgen32 software.Results The levels of genetic variation and patterns of population structure in M.officinalis were investigated using RAPD markers.Of the 100 primers screened,15 primers produced highly reproducible RAPD bands,using these primers,224 discernible DNA fragments were generated with 112(50.00%) polymorphic fragments,indicating considerable genetic variation at the species level.In contrast,there were relatively high levels of polymorphism at the population level with the percentage of polymorphic bands ranging from 37.05% to 53.13%,and the mean percentage of polymorphic loic(P=45.86%).Genetic variation among populations was detected based on Nei's genetic diversity analysis(0.175 6),Shannon's diversity index(0.287 6) for every population with Shannon's index 0.103 3—0.236 2 and Nei's indexes 0.074 5—0.154 0.Conclusion There is a little genetic differentiation among populations of cultivated M.officinalis and result in different cultivated types,the genetic diversity with M.officinalis(POP2) is higher than that of other populations.It may be the main reason of the difference of cultivated M.officinalis quality.

Objective Establishing the scientific research competitiveness evaluation index system of Shanghai hospitals.Methods Delphi method and Analytic Hierarchy Process were applied.Results Thirty-four experts were invited to provide evaluation index and weighted scores.The positive coefficient from two rounds of expert's consultation were 88.24％ and 94％.The expert's opinion of authority coefficient of each indicator's was greater than 0.7.The degrees of coordinative consistency was high.Kendall concordance coefficient was increasing with the increasing of consulting times.After two rounds of Delphi expert consultation,2 level-one indictors,10 level-two indictors and 47 level-three indictors were confirmed.Conclusions After two rounds of Delphi expert consultation,using all objective indicators,an Index System for research competitiveness evaluation in the hospitals in Shanghai has been created and could be used with scientific,objectivity and feasibility.

ObjectiveTo explore the abilities of automatic processing,controlled processing,selective attention by Stroop color-word test in patients with ischemic cerebrovascular disease.Methods124 patients (aged 60-90 years) with ischemic cerebrovascular disease and 126 cases with age and civilization matched healthy people were examined by Stoop color-word test (SCWT).The SCWT indexes were compared between two groups.Results Reading time of card 1,timeconsuming and error of card 2,4 and Stroop interference effects (SIE) in SCWT had significantly decreased in the patients than in the healthy people (all P＜0.05).ConclusionsThe abilities of controlled processing and selective attention,but not automatic processing are damaged in patients with ischemic cerebrovascular disease.