[ ABSTRACT] AIM:To evaluate the clinical application of single nucleotide polymorphism array ( SNP array) in prenatal diagnosis for screening the abnormality of women with Down’ s syndrome ( DS) .METHODS:The amniotic fluid samples ( n=312) collected by amniocentesis for the DS screening abnormality women were tested by karyotyping and SNP array analysis, respectively.The findings of karyotyping and SNP array analysis were compared.RESULTS:Two cases of trisomy 21 were identified by karyotyping and SNP array analysis, but SNP array analysis failed to identify 6 cases of chro-mosome balanced structural rearrangement.SNP detected 176 cases copy number variants ( CNVs) in 303 cases normal karyotype were detected by SNP, including 106 benign CNVs, 61 variants of unknown significance (VOUS), 9 de novo CNVs, and none of them was pathogenic.The distribution difference of CNVs in DS screening positive group and DS screening positive plus advanced maternal age group was not statistically significant ( P>0.05) .Furthermore, we reported 14 kinds of CNVs for the first time in population.CONCLUSION:SNP array can further assure chromosome microdupli-cation/microdeletion.In normal karyotype fetus of prenatal diagnosis, SNP can detect some clinical significant CNVs.

Objective To study the ultrastructure of the renal papillary Randall's plaque in calclum oxalate stone formers. Methods The 14 biopsy samples of the Randall's plaque in 12 patients with calcium oxalate stone undergoing PCNL for stone removal were obtained using endoscopic biopsy technique,followed by staining with hematoxylin-eosin or fixing with osmium tetroxide,and then the ultrastructure of the Randall's plaque was observed under light microscope and transmission electron microscope. Results In all 12 patients,72 renal papillae were examined.All kidReys were found to have papillary plaque and 7 of the patients had attached stones.Sixty-three papillae(87.5%)contained plaque.Calcium deposition was seen in the 12 renal papilla tissue by light microscopy.Transmission electron microscopy images of the 2 Randall's plaque samples showed several cluster of sharp and large crystals lied closer to the surface of Randall's plaque.The typical crystals were acicular with light profile. Conclusions Randall's plaque is an interstitial medullary and papillary deposit of calcium oxalate.The appearance of the deposition of calcium oxalate crystals lies upon Randall's plaque,which might be an explanation for the mechanism of calcium oxalate stone formation.

OBJECTIVETo observe the clinical efficacy and safety on moderate and severe persistent allergic rhinitis treated with acupuncture.

METHODSSixty-six patients of moderate and severe persistent allergic rhinitis were randomized into an acupuncture group (34 cases) and a western medication group (32 cases). In the acupuncture, group, acupuncture was applied to Dazhui (GV 14), Feishu (BL 13), Pishu (BL 20), Ganshu (BL 18) and Shenshu (BL 23) in the prone, retained for 20 min; then in the supine, at Baihui (GV 20), Yintang (GV 29), yingxiang (LI20) Taichong (LR 3) and Hegu (LI 4), retained for 20 min. Acupuncture was given once every two days, three times a week, continuously for 8 weeks. In the western medication group, cetirizine hydrochloride was taken orally, 10 mg each time, once every day, continuously for 8 weeks. Separately, before treatment, after the treatment of 1 and 2 months and in 1 month after treatment, the total nasal symptom score (TNSS), the scores in the emotion rating scale for Ganzangxiang of TCM (ERSG) and the rhinoconjunctivitis quality of life questionnaire (RQLQ) were observed in the patients of the two groups. The clinical efficacy was compared between the two groups.

RESULTS(1) For TNSS, the results after 1 and 2 months treatment and in 1 month after treatment were all, reduced as compare with that before treatment separately in the two groups (P < 0.05, P < 0.01) The result after 2 months treatment was lower than that after 1 month treatment in the acupuncture group (P < 0.05). In 1 month after treatment, the result in the acupuncture group was lower than that in the western medication group (P < 0.05). (2) For ERSG, the score after 2 months treatment was lower than that before treatment in the two groups (both P < 0.05). The score after 2 months treatment in the acupuncture group was lower than that in the western medication group (P < 0.05). (3) For RQLQ, the score after 1 month treatment was lower than that before treatment and the score after 2 months treatment was lower than that after 1 month treatment in the two groups (all P < 0.05). The score after 1 and 2 months treatment and in 1 month after treatment in the acupuncture group was lower than that in the western medication group separately (all P < 0.05). (4) The total effective rate was 91.2% (31/34) in the acupuncture group and was 90.6% (29/32) in the western medication group, without significant difference between the two groups (P > 0.05).

CONCLUSIONAcupuncture is the safe and effective intervention on moderate and severe persistent allergic rhinitis. Compared with the western medicine group, the efficacy in the acupuncture group presents much more advantageous at its durability.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Rhinitis, Allergic ; diagnosis ; therapy ; Young Adult

Objective To study the pathogenic bacteria distribution and drug resistance characteristics in HIV/AIDS patients with lower respiratory tract infection in Yunnan province, so as to guide the clinical medication. Methods We collected 278 cases of hospitalized patients with sputum,alveolar lavage specimen smear, culture, positive specimens from HIV/AIDS patients with lower respiratory infection in The Third People’s Hospital of Kunming from January 2008 to December 2012. Then we retrospectively analyzed the collected data. Results From 278 cases of sputum and alveolar lavage fluid specimens,we isolated a total of 127 strains of bacteria (45.7%), 53 strains of fungus (19.1%),50 strains of white candida,3 strains of aspergillus,49 strains of mycobacterium, 44 strains of mycobacterium tuberculosis,and the rest of atypical mycobacteria. Gram negative bacilli accounted for 64.6%,followed by pneumonia klebsiella bacteria, pseudomonas aeruginosa,e. coli,acinetobacter,sewer,e. coli, gram-positive bacteria accounted for 15.4%. Fungi accounted for 19.1%, and candida albicans was the common fungus. Mycobacterium tuberculosis accounted for 17.6%. Gram-negative bacilli were sensitive to imipenem, ptilinum ketone/sulbactam and amikacin,gram-positive bacilli were sensitive to vancomycin, nitrofurantoin and imipenem. Conclusions The major pathogenic bacteria are gram-negative bacilli in HIV/AIDS patients with lower respiratory tract infection in Yunnan province,but fungal infection ratio is increasing year by year, and conditional pathogenic bacteria are the major pathogen,which have antimicrobial resistance with different degree,TB infection rate is high and multi-drug resistant TB appears. Antimicrobial agents should be rationally used to delay the appearance of pathogen resistance.

· AIM: To compare the measurement of anterior chamber depth (ACD) and axial length (AL) by IOLMaster and contact ultrasonic (US) axial scan (A-scan).· METHODS: Measurements of ACD and AL were prospectively obtained in 137 eyes of 121 subjects with the IOLMaster compared with measurements with the US.· RESULTS: There was an excellent correlation between IOLMaster and US measurements for the ACD (r=0.823;P＜0.001) and AL (r=0.996;P＜0.001). The mean values of the parameters measured by IOLMaster and US were,respectively, as follows: ACD, 2.94±0.49mm, 2.58±0.51mm;AL, 24.37±3.04mm, 23.81±2.83mm. The mean differences of ACD and AL values between IOLMaster and US measurements were 0.36 ±0.30mm, 0.56 ±0.34 mm respectively, and they proved to be statistically significant (P＜0.001), With the 95%limits of agreement (LoA) from -0.08mm to +0.38mm for ACD and from -0.09mm to +0.69mm for AL.· CONCLUSION: As noncontact biometry, IOLMaster provides accurate values. A high degree of agreement between US and IOLMaster was noted. It not only has the advantage of performing noncontact examinations, but also produces various additional data simultaneously and may thus obviate the need for multiple examinations. Further studies are needed to assess the interchangeability of measurements in clinical practice.

Objective To explore the gene expression of interleukin-13 receptor (IL-13R)?2 and its relationship to proliferation activity of human gliomas.Methods The gene expression of IL-13R?in 50 hu- man gliomas,2 malignant human glioma cell lines and 6 normal brain tissues were studied by RT-PCR.Ki-67 labeling index (Ki267 LI) of all sample were detecteded by immunohistochemical staining.Results Only one normal brain tissues expressed very low IL-13R?2 mRNA,whereas 35 (70%) of 50 human brain tumors expressed 1L-13R?2 mRNA.The positive rate and expression level of IL-13R?2 mRNA were increased with the ascending of WHO tumor grade.(former:rs=0.87;letter:rs=0.69,P＜0.01).The difference of posi- tive rate and expression level of IL-13R 2?mRNA between the low grade and high grade tumors was statistical- ly significant,the proliferation activity of gliomas evaluated by Ki-67LI (Ki-67 Labeling Index,Ki-67LI) was positively correlated with IL-13R?2 gene expression and the tumor grade.Conclusion In human cerebral gliomas,IL-13R?2 genes may play an role in the malignant progression.The expression level of malignancy in molecular level and selecting the target of gene therapy.

OBJECTIVEIn order to understand the status of benzodiazepine (BZD) use in middleschool students from Wuhan city.

METHODSIn the Wuhan city zone, twenty-eight middle-schools were chosen randomly to the even numbers, with students from grade 8 to 12 had been studied. Altogether, 258 classes were investigated with 12 345 questionnaires were filled in by the subjects anonymously. SPSS 10.0 was used for data analysis.

RESULTSRate of BZD use in Wuhan middle school students was 4.0% with the rate of dependence as 4.1per thousand. There were differences in gender and grade: male students tend to be higher than females (P< 0.01), and senior higher than junior's (P < 0.01). More commonly used drugs would include Diazepam (59%) and Surazepam (29.7%). Among students who used drugs, 43.3% used for 1-7 day and 8.2% of them used 6 tablets or more. 57.6% used 1 tablet once a day (46.2%) before bed time (40.8%). The major reason for using drug was insomnia (43%), followed by pressure from school. The reasons for BZD abuse were: relief of anxiety (14.1%), curiosity (13.3%), peer pressure (10.8%), and fun seeking (9.85%), etc. The source of drugs was from their families (29%). By Multinomial logistic regression, the risk factors of abuse BZD were: ignorance of drug prescription, sex, regular alcohol intake, knowing that BZD use can bring amusement regular, smoking cigarettes, relationship with parents, mother's way of providing education, schooling of fathers, relationship between parents.

CONCLUSIONDifference was seen in the use of BZD between gender and age of the students. Multiple factors showed that: personal, family and social factors were related to the use of BZD.

Adolescent ; Benzodiazepines ; administration & dosage ; classification ; supply & distribution ; therapeutic use ; Child ; China ; epidemiology ; Cities ; statistics & numerical data ; Demography ; Drug Administration Schedule ; Drug Dosage Calculations ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Schools ; statistics & numerical data ; Substance-Related Disorders ; epidemiology ; Time Factors ; Young Adult

Objective To examine the distribution of bacterial species and antimicrobial susceptibility profile of pathogens in febrile neutropenic patients.Methods A total of 355 bacterial strains were isolated from febrile neutropenic patients in Shanghai General Hospital from January 2005 to December 2012. Antimicrobial susceptibility testing was done by Kirby-Bauer method. The susceptibility testing results were analyzed according to CLSI 2014 breakpoints.Results Gram-negative bacteria accounted for 70.4% of the 355 isolates, while gram-positive organisms accounted for 29.6%. The most common bacterial species werePseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, Stenotrophomonas maltophiliaand Staphylococcus haemolyticus. Non-fermentative bacteria accounted for 53.2% of all the gram-negative bacterial isolates. All theEnterococcus and
Staphylococcus isolates were susceptible to linezolid, vancomycin and teicoplanin. All theStaphylococcus strains were resistant to methicillin.P. aeruginosa isolates were relatively more susceptible to cefoperazone-sulbactam, piperacillin-tazobactam and cefepime (>70%) than imipenem (40.8%) and meropenem (59.2%). All theK. pneumoniae isolates were susceptible to imipenem and meropenem and more than 70% of the isolates were susceptible to cefoperazone-sulbactam, amikacin. More than 80% of theA. baumannii isolates were susceptible to carbapenems, cefoperazone-sulbactam, amikacin, ciprolfoxacin and aminoglycosides. All the E. coli isolates were susceptible to carbapenems and more than 70% were susceptible to cefoperazone-sulbactam and ceftazidime. More than 90% of theS. maltophilia strains were sensitive to levolfoxacin, minocycline, cefoperazone-sulbactam and trimethoprim-sulfamethoxazole.Conclusions Our data suggest that gram-negative bacteria, especiallyEnterobacteriaceae and non-fermentative bacteria, are still the primary pathogens in febrile neutropenic patients. Antimicrobial resistant strains are prevalent. Such data of bacterial species and antimicrobial susceptibility proifle of pathogens in febrile neutropenic patients are useful for empirical antimicrobial therapy of such infections.

ObjectiveAt present, there are few reports on the therapeutic effect of probiotic supplements in patients with dietary-controlled gestational diabetes mellitus (GDM). This study aims to evaluate the effect of probiotic supplements on insulin resistance in patients with dietary-controlled GDM.Methods122 pregnant women with dietary-controlled GDM who could control blood glucose less than 92 mg/dL through diet and exercise were selected from the Obstetrics Department in Bayannur Hospital from February to December 2018. The patients were randomly divided into two groups: Probiotics Group (probiotic supplements containing bifidobacterium and lactobacillus) and Placebo Group (placebo capsules). 61 patients in each group were treated continuously for 4 weeks. The main evaluation index was the mean difference of fasting blood glucose, fasting plasma insulin and insulin resistance index (HOMA-IR) between the two groups, and the secondary evaluation index was the change of maternal weight after intervention.ResultsThe increase of fasting blood glucose [(0.59±6.42)mg/dL], fasting plasma insulin [(1.14±1.95)mIU/mL] and HOMA-IR (0.27±0.45) in the Probiotics Group after intervention were significantly lower than those in the Placebo Group [(4.78±7.47 mg/dL), (3.86±1.82) mIU/mL, (0.86±0.59)], and the difference was statistically significant (P < 0.05). There was no significant difference in total weight gain, neonatal birth weight and neonatal hypoglycemia between the two groups (P>0.05).ConclusionDuring pregnancy, probiotic supplements for four weeks in patients with dietary-controlled GDM can reduce fasting blood glucose and increase insulin sensitivity. Therefore, probiotic supplements can be used as adjunctive therapy for blood glucose control in patients with dietary-controlled GDM.

Objective To investigate the expressions of thymidylate synthase (TS) and methylene tetrahydrofolate reductase (MTHFR) polymorphisms and the therapeutic efficacy of chemotherapy with pemetrexed and platinum in advanced lung adenocarcinoma patients. Methods Fifty-eight patients with advanced lung adenocarcinoma were enrolled in this study. The blood samples from 25 of them were examined for extraction of DNA. The associations of the gene polymorphisms with the chemotherapy efficacy and PFS were analyzed. Results Disease control rate was noted by 38％ and the median time of progression-free survival was 8.1 months among 58 patients.There were 16％, 32％, 52％, and TS genotypes as 2R/2R, 2R/3R and 3R/3R respectively; the difference in the control rate between those with TS gene of 3R/3R and those with TS gene of R/2R+2R/3 R was significant statistically (53.8％ vs. 91.7％, P = 0.046) , but the difference in PFS was statistically insignificant (9.3 vs. 10.4 months, P> 0.05). There were 40％, 52％, 8％, and MTHFR genotypes as CC, CT and TT respectively. The DCR in those with MTHFR CC and C/T + T/T was 70％ and 73.3％, respectively and PFS was 10 months and 9.7 months respectively, showing no significant difference (P> 0.05). Conclusion The TS gene polymorphism is associated with therapeutic effect of pemetrexed for advanced lung adenocarcinoma, but MTHFR is not.