Objective To summarize the clinical features of infectious mononucleosis(IM)in aduIt patients.Methods Thirty cases of adult patients with IM were analyzed retrospectively being inDatient in Huashan Hospital from 2002 to 2007.Results Of these 30 patients with IM,male was slightly more than female with average age of 31.8 years old.Liver function of 77 percent patients were abnormal,while 70%splenomegaly,33%skin rash,20%EB virus-IgM positive and 10%hepatomegaly.Two cases were diagnosed with chronic active EB virus infection(CAEBV).Treatment strategies of IM were antiviral and symptomatically therapy.Conclusions IM diagnosis is difficult due to the variety of clinical features.CAEBV is rare in adult patients.The clinical prognosis of IM is good if treated properly.

Multidrug resistance (MDR) is one of the primary causes of failure in chemotherapy of leukemia. It is very difficult in clinical therapy. In comparison with reverse RNA, RNAi technique is inexpensive, high effective, high specific, simple and fast. It is a new way for the study of multidrug resistance of leukemia. RNAi may be a new research tool of molecular diagnosis and molecular therapy on leukemia in the future.

OBJECTIVE To investigate the oropharyngeal bacterial carriage in hospitalized elderly patients without acute infections and the antimicrobial resistance,and the risk factors for the bacterial carriage.METHODS An oropharyngeal swab was taken from each patient after they rinsed their mouths with sterile saline.Bacteria were cultured and identified with routine methods and the antimicrobial susceptibility testing was carried out with disk diffusion method.RESULTS The oropharyngeal bacterial carriage rate was 55.2% in elderly patients.Sixty two pathogens were isolated including 56(90.3%) strains of Gram-negative bacilli,5(8.1%) Gram-positive cocci and 1 Candida albicans.All of 34 strains of Haemophilus spp were susceptible to antimicrobials tested such as ampicillin and cefaclor,a few strains were resistant to gentamicin and ciprofloxacin.Of 10 strains of Klebsiella pneumoniae,4 strains were extended-spectrum ?-lactamases positive and resistant to cefotaxime.Logistic analysis indicated that denture-wearing was the risk factor for the oropharyngeal bacterial carriage in elderly.CONCLUSIONS Oropharyngeal bacterial carriage rate is high in hospitalized elderly patients.The major colonized bacteria are Gram-negative bacilli.Denture-wearing is the risk factor for the oropharyngeal bacterial carriage in elderly.

Objective To evaluate the effects of acupuncture combined with relaxation training on the pain,anxiety and sleep quality in advanced cancer patients.Methods Seventy-one advanced cancer patients with different severity of pain were included in this study and divided into an experimental group and a control group.Besides treatment of analgesic,patients in experimental group were additionally given treatment of acupuncture and relaxation training,while those in control group were only given analgesic.All subjects were evaluated with questionnaires of Pain Inventory,Self-rating Anxiety Scale(SAS),Pittsburgh Sleep Quality Index(PSQI)and Functional Assessment of Cancer Therapy(FACT-G)before and after treatment.Results Total rate of pain relief in the experimental group was 90.63%,which was significantly lower than that in the control group(84.62%)(P＜0.05),showing that acupuncture combined with relaxation training was more effective for pain relief than analgesic therapy in cancer patients.The scores of sleep indexes and anxiety of PSQI and SAS in experimental group were significantly better than those in control group(P＜0.01).There was no significant difference in the scores of quality of life(QOL)between the two groups.Conclusion Acupuncture combined with relaxation training was more effective for relief of pain and anxiety,and for improvement of sleep quality than analgesic therapy in cancer patients.But short-term intervention had no effect on QOL in advanced cancer patients.

Objective To determine risk factors of environment and lifestyles involved in acute hematology departments of 29 secondary-care and tertiary-care hospitals in Shanghai. There were 206 hospitalized patients with de novo AML during June 2003 to April 2007 meeting the diagnostic criteria for AML by the World Health Organization, excluding those with definite history of radiotherapy or chemotherapy, and 412 age- and gender-matched controls with non-hematological other diseases from the same hospitals. All the participants were interviewed face-to-face using a standard structured questionnaire,including personal medical history, family medical history, history of medications, traditional Chinese herb medicines, exposure to occupational hazards, lifestyle factors, etc. in the past five years prior to onset of the disease. Conditional univariate and multivariate logistic regression analyses were performed to identify risk factors for AML. Results Logistic regression analysis showed that taking traditional Chinese herb medicine might be a protective factor for AML, with an odds ratio (OR) of 0. 39 and its 95% confidence interval (CI) of 0. 16-0. 98. Potential risk factors for AML included history of diabetes and taking hypoglycemic agents ( OR: 1.39, 95% CI: 0.67 -2. 87), occupational exposure to metal ( OR: 1.73, 95% CI: 0. 77 -3. 91 ), glue, paint and other coating materials, etc. ( OR: 1.72, 95% CI: 0. 93 - 3.2), raising animals (OR: 1.33, 95% CI: 0. 79 -2. 24). No association of living within a distance of 100 meters from high voltage power transmission lines, home renovation and decoration in the past year, hair dyeing, smoking,alcohol drinking with AML in adults was found. Conclusions Factors mentioned above such as occupational exposure to metal, glue, paint and other coating materials potentially increase risk for AML in adults,however taking traditional Chinese herb medicine is possibly a protective factor for it.

OBJECTIVE: To develop RP-HPLC method for the rapid determination of resveratrol in serum and tissue homogenates (in some organs) of mice.METHODS:HPLC determination was performed using Kromasil C18 column,the mobile phase consisted of methanol - water (48∶ 52) with a flow rate of 1ml/min,the column was under room temperature with its pressure at 12kPa,the detection wavelength was 303nm and the sample size was 20?l. RESULTS: The linear range for resveratrol was 0.25～25?g/ml, with minimal detectable drug concentration at 0.1?g/ml (S/N=3). The average absolute rec_overy of the samples was above 88% and the methodological recovery rates of which ranged from 96% to 100%,RSD were below 10%. CONCLUSIONS: The established determination method is economical, reliable, simple and rapid, and suitable for the blood concentration determination of resveratrol and the study of its distribution in animal body.

Objective To test the expression of MIF in peripheral blood mononuclear cells (PBMCs)from patients with Cry-tococcal Meningitis and further discuss its clinical significance.Methods Peripheral blood from 42 patients with Crytococcal Meningitis diagnosed in Changhai Hospital,Shanghai and 42 healthy individuals examined at the same time was collected from August,2012 to November,2015.PBMCs were separated by density gradient centrifugation method,mRNA relative expression of MIF in PBMCs was measured by PCR,the level of MIF,IL-17,IL-1β,TNF-α,IFN-γand IL-4 in plasma was tested by Enzyme-linked immunosorbent assay (ELISA).The comparison for expression level of cytokines between the two groups was by two-independent samples t test.Pearson correlation coefficient was used to measure the relation between MIF and other cytokines.Results The protein levels of MIF in experimental and controlled groups were 34.17±7.88 ng/ml vs 10.89±2.76 ng/ml(t=18.07,P<0.0001),while relative expression of RNA was 2.87±0.94 vs 1.95±0.89(t=4.606,P<0.0001),and there was statistical significance (P<0.005).Pearson correlation analysis showed that MIF was positively related with IL-1β,IL-17 (r=0.467,0.401,P<0.01),with statisticaldifference.Conclusion MIF may involve in the im-mune regulation for Crytococcal Meningitis by affecting the secretion and function of cytokines as IL-1β,IL-17,and it was potential target and monitored biomarker for this disease.

Background and purpose: Abnormal expression of arginase 2 (ARG2) in a variety of human malignant tumors was detected. Previous studies found that ARG2 significantly increased in hepatocellular carcinoma (HCC) and was related to histological grading of HCC. This study aimed to analyze the association of ARG2 expression with cell proliferation, apoptosis and prognosis in HCC. Methods: The expression levels of ARG2 mRNA in 14 samples of HCC, paracancerous liver tissues and 14 samples of normal liver were detected by reverse transcriptionpolymerase chain reaction (RT-PCR). Tissue sections from 158 HCC patients were examined immunohistochemically for protein expression of ARG2, proliferation-related proteins (Ki-67 and cyclin D1) and apoptosis-related proteins (activated caspase-3, caspase-8 and caspase-9). Immunofluorescence double labeling method was used to detect the coexpression of ARG2 and activated caspase-3, and the colocalization between ARG2 and apoptotic cells. Patients were followed up by telephone. Results: TThe expression of ARG2 mRNA was significantly increased in HCC compared with the paracancerous liver tissues and normal liver tissues (F=27.10, P＜0.01). The expression of ARG2 was positively correlated with the expression of Ki-67 and cyclin D1, respectively (r=0.247 8, P＜0.01; r=0.372 7, P＜0.01). The expression of ARG2 was positively correlated with the expression of activated caspase-3 and caspase-8, respectively (r=0.191 0, P＜0.05; r=0.180 5, P＜0.05), but not with the caspase-9 (r=0.108 9, P＞0.05). Immunofluorescence double labeling showed that ARG2 was coexpressed with the activated caspase-3 and colocalized with apoptotic cells. Kaplan-Meier survival curves showed that the median survival time was 32 months in ARG2(-) group, 18 months in ARG2(+) group and 15 months in ARG2(++) group. The log-rank test results showed that there were significant differences in median survival time between the groups, and the median survival time in ARG2(-) group was longer than that in ARG2(+) and ARG2(++) groups (χ2=12.278, P＜0.01). Conclusion: ARG2 may be involved in regulating the proliferation and apoptosis of HCC cancer cells. Detecting the expression of ARG2 in HCC tissues may indicate prognosis.

Objective: To explore serum levels of measles and rubella IgG antibodies among mothers and infants. Methods: According to the inclusion and exclusion criteria, we selected 319 puerperae and their infants in maternal hospitals of Songjiang district November 2016 to February 2017, venous blood were collected and serum measles and rubella IgG antibodies were measured using ELISA. To study the correlation between the level of measles and rubella antibodies in infants and mothers′ by using the Spearman′s correlation analysis. Results: The age at delivery was (29.71±4.25) years old; and the gestational age at delivery was (39.06±1.30) weeks. The positive rate and protection rate of measles antibody in puerperae were 82.5% (243/319) and 43.3% (135/319), the GMC [M (QR)] was 655.74 (251.21-1 299.02) mIU/ml. The positive rate of rubella antibody in puerperae was 61.1% (195/319), the GMC [M (QR)] was 31.34 (11.65-73.61) IU/ml. The positive rate and protection rate of measles antibody in infants were 84.1% (270/321) and 46.1% (148/321), the GMC [M (QR)] was 665.07 (279.63-1 544.07) mIU/ml. The positive rate of rubella antibody in infants was 69.5% (223/321), the GMC [M (QR)] was 40.30 (16.12-98.48) IU/ml. There was statistical difference in measles (Z=-14.64, P<0.001) and rubella (Z=-8.66, P<0.001) antibody levels between mothers and infants. There was positive correlation in measles (r=0.76, P<0.001) and rubella (r=0.86, P<0.001) antibody level between mothers and infants. Conclusion The maternal antibody of measles and rubella had a concentration effect. The level of measles and rubella antibodies in the infants was higher than that in the mothers′ and increased with the increase of the level of measles and rubella antibodies in the mothers.

Objective To study the relationship between detachment and puncture site and chest wall thickness after preoperative positioning of peripheral lung nodules by CT-guided Hookwire puncture.Methods From July 2017 to December 2021,190 patients in our hospital underwent thoracoscopic surgery for peripheral lung nodules.All patients underwent preoperative CT-guided HOOKWIRE puncture mapping,recording the puncture site,whether the needle had fallen off,chest wall thickness,and the interval between the end of the puncture and the start of the surgery,logistic regression analysis,and receiver operating characteristic(ROC)curve analysis to explore the risk factors affecting needle fall off.Results Clinical data were collected for 190 patients,including 119 males and 71 females,age 22 to 78(58.1±10.2)years.There were 31 cases of shedding,with a shedding rate of 16.3％.Among them,31 cases were detached in the medial aspect of the subscapular horn line,15 cases were detached,with detachment rate being 48.4％;67 cases were detached in the medial axillary line,10 cases were detached,with detachment rate being 14.9％;65 cases were detached in the medial axillary line of the midclavicular line,5 cases were detached,with detachment rate being 7.6％;27 cases were detached in the medial axillary line,1 case was detached,with detachment rate being 3.7％;the detachment rate was highest in the subscapular horn line,with statistical significance(P＜0.05)compared with other locations;the tissue thickness of the thoracic wall was(49.38±6.28)mm,but the tissue thickness of the thoracic wall was(36.36±7.77)mm,with statistical significance(P＜0.05).The interval between puncture and operation was 73 to 98 min,with an average one of(81.99±4.48)min.Conclusions The detachment of the positioning needle is related to the thickness of the chest wall,and the proportion of detachment is significantly higher in the chest back,especially in the subscapular angle,before surgical treatment of peripheral lung nodules.In cases of peripheral pulmonary nodules with surface projections medial to the inferior scapular horn line,other methods of localization should be preferably considered.