ObjectiveTo facilitate the establishment of fully automatic clinical diagnostic nucleic acid assay,a study was carried out for developing a fast and convenient method of extracting highly purified viral nucleic acid from human blood with magnetic beads.Method Five KHB (Shanghai Kehua Biological Engineering Company Limited) internal strong positive HBV serum samples were used in the process,for the method development,screening and selecting the magnetic beads based on magnetism,suspension power and extraction effects of HBV DNA,the optimization of the selected key components of extraction reagents were performed,which including the quantity of magnetic beads( 1 - 1.75 μl/ml),the buffer pH of lysis (4 -9),washing conditions with or without alcohol,elution for proliferation with or without magnetic beads,and etc.The evaluation for the extraction method was carried out including linearity,precision,sensitivity,specificity,anti-interference and resistance to contamination.The magnetic beads method was compared with domestic mature boiling method in a quantitative test with 100 HBV serum samples,the magnetic beads method was also compared with the interntional Gold standard Roche COBAS Tagman test method ( Roche method) in a quantitative test with 50 HBV serum samples and the results were statistically compared for their linear regression.ResultsOptimization experiment result showed superparamagnetic beads A was the best among the candidates ( C,B,D) in terms of their physical properties and extraction effects of DNA.The optimum condition of the assay were as follow:magnetic beads best used at 1.25 μl/ml,buffer pH 7 - 8 of lysis,ethanol was eliminated from washing buffer,proliferation can be carried out with magnetic beads.The parallel comparison experiments with five KHB internal strong positive HBV serum sample and gradient diluted serum sample between beads method and boiling method were carried out.The results showed that the linear range of beads method was 4 × 101 -4 × 108 IU/ml and that of boiling method was 4 × 102 -4 × 108 IU/ml.The sensitivity for beads method was 30 IU/ml and that of boiling method was 100 IU/ml.The precision CV of beads method was 6.0％ and boiling method was 11.9％.The false positive rate was 0 for beads method vs 3.1％ for boiling method.The anti-interference ability experiment showed that when sample contained sodium heparin concentration exceed 62.5 U/ml, there was significant drop of HBV DNA detection with boiling method and no HBV DNA was detected when sodium heparin concentration in the sample reached 1000 U/ml.However,sample sodium heparin concentration had no effect on HBV DNA detection with beads method.The comparison study between beads method and boiling method was carried out by use of 100 clinical HBV positive serum samples.The result showed that the sensitivity for beads method was 86％ vs boiling method 74％.The correlation between the two method was R2 =0.948,P ＜ 0.05.The comparison study between beads method and Roche method was carried use of 50 clinical HBV DNA positive serum samples and the result showed that sensitivity for beads method was 95％ (49/50) vs Roche method was 100％ (50/50).The correlation was R2 =0.963,P ＜ 0.05.ConclusionsThe established method for automatic nucleic acid extraction with magnetic bead displayed characteristic of high yield nucleic acid extraction,broader testing range,accurate quantification and convenient in operation.This can be one choice for nucleic acid extraction and applicable for clinical automatic diagnostic system.( Chin J Lab Med,2012,35:843 -850 )

OBJECTIVE To evaluate the distribution of pathogens causing infection and current status of antimicrobial resistance in order to offer experimental data for clinical administration.METHODS The resistance tests were performed using K-B method.WHONET5.2 and EXCEL were used to analyze bacteria distribution and resistance.RESULTS From 119 cases of patients were earned the routine bacteria culture results,the tested rate was 96.75%,the positive specimens were 379 and the postitive rate was 83.85%.The strains of Pseudomonas aeruginosa were the most frequent organisms isolated then were the strains of Streptococcus pyogenes,coagulase-negative Staphylococcus,Nesseria spp,and Stenotrophomonas maltophilia.CONCLUSIONS It is important to strengthen antibiotics administration,bacteria isolation and resistance surveillance.

Objective To investigate the role of TLR9 in the glomerulonephritis through observing the changes of Toll-like receptor 9 in the glomerulo nephritis kidney tissue with or without CpG-ODN stimulation .Methods Wistar male rats were randomly divided into normal group(N),nephritis model group(M),CpG-ODN group(CpG) and GpC-ODN group(GpC).The urine samples were collected at 2,4,6 and 8 weeks after treatment,respectively.Blood samples were collected at the end of the last urine sample was collected,and the kidney tissue was collected,then the rats were killed.24 h urine protein was measured by Coomassie light blue technique.Serum album and renal function were determined by serological method.The pathologic changes of kidney were observed by light microscope and NF-?B p65 expression was detected using immunohistochemystry,RT-PCR was performed to detect the expressions of TLR9,INF-? and IL-6 mRNA.Results The expression of TLR9 was lighter in group M,and significantly increased after CpG-ODN stimulation compared with group M.Furthermore,24 h urine protein excretion was markedly increased,serum album was markedly decreased.The histopathologic changes of kidney were more severe.The mesangial cells(MCs) proliferated diffusifully in midrange and wide range,some of the glomeruli formatted cellularity crescent,micrangium loop was limitted,mononuclear macrophile cells were seen in the mesangial region.Conclusion Inflammatory factors mediated by TLR9 can deteriorate the biochemical and histopathologic changes.The immunologic reaction mediated by TLR9 is one of the mechanisms for the glomerulonephtitis' progression.

Objective To investigate the effect of heart rate variability (HRV) biofeedback training on patients with three types of insom-nia disorder. Methods From June, 2016 to March, 2017, 17 patients in simple insomnia group, 19 patients in insomnia with anxiety group, and 19 patients in insomnia with depression group were included. All the patients received HRV biofeedback training and same medication (zolpidem tartrate, 10 mg every night). They were assessed with Pittsburgh Sleep Quality Index (PSQI), Symptom Checklist 90 (SCL-90), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD), and HRV parameters were tracked before and after training. Re-sults After training, the scores of PSQI, SCL-90, HAMA , HAMD and the ratio of low frequency (LF) and high frequency (HF) (LF/HF) de-creased in all groups (t>1.446, P<0.05). There was significant difference in PSQI among three groups (F=3.537, P=0.038). The D-values of the PSQI score and LF/HF before and after training were more in the insomnia with anxiety group and the insomnia with depression group than in the simple insomnia group (P<0.05), however, no significant difference was observed between the insomnia with anxiety group and the insomnia with depression group (P>0.05). Conclusion HRV biofeedback training could improve the symptoms of patients with three types of insomnia disorder, especially for those with anxiety or depression.

Objective To investigate the reason for hidden hemorrhage of hip fracture in elder.Methods All of 94 elder patients,who were diagnosed with intertrochanteric fracture or femoral neck fracture and received treatment in our department from October,2013 to September,2015,were included in this study.The time between injuries to admission was less than 4 hours of the two groups of patients.And the patients whose hemoglobin was less than 100 g/L were removed when admission,in order to avoid the interference of primary anemia.All information,including height,weight,and the value of hemoglobin (Hb) and hematocrit (Hct),were collected.Blood tests were performed immediately after admission,at daily morning preoperatively,and at the morning of the day of surgery.Preoperative blood loss (hidden hemorrhage) was recorded.With respect to blood loss of hidden hemorrhage,statistical analysis was performed at different times (immediate time after admission,and day 1,2,and 3 postoperatively)in the group of intertrochanteric fracture or in the group of femoral neck fracture,and subsequently performed between the two groups.Results The blood loss in the group of intertrochanteric fracture was 196.3 ml,310.1 ml and 418.3 ml in the 1st day,the 2nd day and the third day after admission.There was a significant difference among different time with respect to blood loss.The blood loss was 39.8 ml,65.7 ml and 82.9 ml in the 1st day,the 2nd day and the third day after admission in the group of femoral neck fracture.There was also a significant difference among different time with respect to blood loss.In experimental group,mean blood loss was 418.3 ml and mean Hb decreased by 23.7 g/L at day 3 postoperatively.In control group,mean blood loss was 82.9 ml and mean Hb decreased by 6.7 g/L at day 3 postoperatively.A significant difference was observed between the two groups.The blood loss in patients with intertrochanteric fracture was higher than that in patients with femoral neck fracture.Conclusion The blood loss was gradually increased in elder patients with intertrochanteric fracture over time.There was a significant difference in different time with respect to blood loss.Moreover,a significant difference was found in blood loss of hidden hemorrhage between intertrochanteric fracture and femoral neck fracture.

ObjectiveTo detect the value of ultrasound-guided steroids injection for the treatment of plantar fasciitis.MethodsThirty-eight physical therapy ineffective plantar fasciitis patients were enrolled in this study, and randomly divided into ultrasound-guided and palpation-guided groups. Pain intensity was measured using a visual analog scale (VAS) and plantar fasciitis were evaluated by high frequency ultrasound including assessment of the thickness before injection and at 4 weeks, 12 weeks post injection.ResultsThirty-eight patients who received either ultrasound guided or palpation-guided injection had significantly lower visual analog scale scores and lower plantar fascia thickness (bothP<0.01) at 4 weeks, 12 weeks post injection. The differences in plantar fascia thickness, VAS score between the two groups before, and at the 4 weeks follow-up were not statistically significant [2.52±0.77vs 2.68±0.82,P>0.05; (4.56±0.25) mmvs (4.72±0.38) mm, P>0.05]. However, the ultrasound guided group had lower mean visual analog scale score (1.47±0.77vs 2.37±0.68,P<0.01) and lower mean plantar fascia thickness [(4.02±0.24) mmvs (4.53±0.35) mm,P<0.01] than the palpation-guided group at 12 weeks post injection. The calcification of the plantar fascia at 12 weeks post injection in ultrasound guided group was completely disappeared or significantly decreased.ConclusionUltrasound-guided injection for treating plantar fasciitis is more accurate and effective than palpation-guided injection, and is of great clinical value for both patients and doctors.

ObjectiveTo evaluate the effectiveness of ultrasound-guided (US-guided) subacromial bursa injection of betamethasone combined with hyaluronate for treatment of subacromial bursitis.MethodsA total of 72 patients who were diagnosed as subacromial bursitis by ultrasound and then decided to performed US-guided subacromial bursa injection were randomly divided into two groups. The study group was treated with compound betamethasone suspension followed by sodium hyaluronate, and the control group was treated only with compound betamethasone suspension. Visual analogue score (VAS) and the shoulder active abduction range of motion (AAROM) score were observed before treatment, 1 week and 4 weeks post-treatment during 1 month's followed-up.ResultsThere were signifi cantly decreased in VAS score and increased in AAROM score at 1 week and 4 weeks post treatment for both groups (bothP<0.05). There was no difference of both VAS score and AAROM score between the two groups at 1 week post treatment (bothP>0.05). But at 4 weeks post treatment, the VAS score of the study group was signifi cantly lower than that of the control group (2.08±1.95vs 3.14±2.0,P<0.05), while the AAROM score of the study group was signifi cantly higher than that of the control group (7.12±2.10vs 6.11±1.93,P<0.05). ConclusionsUltrasound-guided subacromial bursa injection of betamethasone combined with hyaluronate is effective in treating subacromial bursitis. It produces better pain and active abduction functional improvement than betamethasone at a short-term follow-up.

Objective To investigate the role of OMA1 in acute kidney injury (AKI) induced by lipopolysaccharide (LPS).Methods OMA1 wild-type and knocked out mice (8 week old) were injected with 10 mg/kg body weight of LPS.The model was confirmed by testing mouse serum creatinine and blood urea nitrogen.The apoptosis in mouse kidney cortex was examined by TUNEL staining and cleaved caspase 3.In vitro,in humam kidney proximal tubular cells (HK2) were knocked down OMA1 by transfecting OMA1 shRNA,with the scramble shRNA being used as negative control of transfection.HK2 cells were cultured with 5 μg/ml of LPS for 24 hours to induce apoptosis.DAPI staining of cells and caspase-3 activity were applied to test apoptosis.The images of mitochondria in cells were obtained by transfection of mito-green plasmid and OMA1 shRNA.Western blotting was used to exam the OMA1 and Cytochrome C expressions.Resudts Compared with OMA1 KO mice,LPS induced more severe AKI of WT mice with higher Scr [(97.2±26.5) μmol/L vs (53.0±17.7) μmol/L,P ＜ 0.05] and BUN [(43.3± 13.7) mmol/L vs (29.7±7.7) mmol/L,P ＜ 0.05].Moreover,there were more apoptosis cells in kidney cortex in WT mice than in OMA1 KO mice [(75.4± 26.1)/ram2 vs (38.3± 14.4)/mm2,P＜ 0.05].About 46％ of OMA1 expressions in HK2 cells were inhibited by OMA1 shRNA transfection (P ＜ 0.05).Further,OMA1 shRNA cells with LPS stimulation had decreased mitochondria fragmentation [(29.8±10.9)％ vs (43.2±6.8)％,P ＜ 0.05],Cytochrome C release [(37.0±12.3)％ vs (76.0±26.2)％,P ＜ 0.05],and cell apoptosis [(13.2±3.9)％ vs (25.0±7.1)％,P ＜ 0.05] as compared with control cells.Conclusion Knockdown of OMA1 alleviated septic AKI through inhibition of cell apoptosis,mitochondria fragmentation,and Cytochrome C release.

Objective To investigate the relationship between noninvasive brachial artery blood pressure (B) and radial artery blood pressure (R) of the right arm.Methods Two hundred and ninetyfive patients with 149 males and age of (47 ± 16) years were studied.The height of patients was 163 ± 8 cm,and weight of patients was (61.2 ± 7.8) kg.The patients with peripheral vascular disease,wounds of arm skin or subcutaneous tissue infection were all excluded.Their B (with adult cuffs) and R (with infant cuffs) of the right arm were measured and analyzed after the patients under general anesthesia and stable hemodynamics.The relationships between B and R were analyzed by linear regression,the differences between B and R of each interval were compared using one-way ANOVA and then followed by SNK procedure.Results Right brachial artery blood pressure was significantly lower than radial artery blood pressure.The differences between the two varied from 13 to 18 mmHg in systolic BP (SBP),diastolic BP (DBP) and mean blood pressure (MAP).And linear regression was most applicable to describe their correlation [r=0.841 (SBP),0.808 (DBP),0.833 (MAP),all P＜0.01].Conclusions Radial artery blood pressure measured with infant cuffs can well reflect the variation of brachial artery blood pressure.

Objective To investigate the clinical features of non-steroidal anti-inflammatory drugs (NSAIDs) caused gastrointestinal bleeding in the elderly.Methods We performed a retrospective analysis ofNSAIDs caused gastrointestinal bleeding with 308 cases admitted to Department of Gastroenterology,The Second Hospital of Tianjin Medical University.Patients were divided into elderly group(≥65 years,n =208) and young group (＜ 60 years,n =100) to make a comparative analysis of two group differences in clinical characteristics.Results The NSAIDs in the elderly taking were mainly Aspirin (55.8 ％ (116/208)),which was significantly more frequent than that of young group (37.0％ (37/100),x2 =9.517,P ＜ 0.05).There was no significant difference on the blood routine and coagulation between the two groups (P ＞ 0.05).The recent bleeding rate of the elderly group (21.2％ (44/208)) was lower than the young group (63.0％ (63/100))(x2 =52.161,P ＜0.05).The two groups had no significant difference on the history of uleer and Hp infection (P ＞ 0.05).Conclusion The clinical characteristics of NSAIDs caused gastrointestinal bleeding on the elderly were different with young or middle-aged.This infers that elderly patients need individualized treatment.