BackgroundProliferative vitreo-retinal disease (PVD)is one group of ocular complications marked by the enhanced proliferation of various cells included retinal pigment epithelial (RPE) cells.Insulin-like growth factor-1 (IGF-1)and vascular endothelial growth factor(VEGF) are implicated in the aberrant cell proliferation and pathological neovascularization that characterizes PVD,but the signaling mechanism is unclear now. Objective This study was to explore the effect of IGF-1 on VEGF in cultured human RPE cells under the small hairpin loop RNA (shRNA) keeping hypoxia-inducible factor-1 α ( HIF-1 α) silencing. Methods Human retinas were isolated from 4 healthy male donors,and the RPE cells were harvested and cultured.The ceils were identified using anti-human keratin antibody.The third to fifth generation of human RPE cells were used in the experiment.One target site of HIF-1α mRNA was chosen by certain design principle,and shRNA was designed and synthesized by the target site and transferred into the cells in vitro,and then the cells were cultivated with 50 μg/L IGF-1 for 24 hours.The mRNA and protein expressions of HIF-1α and VEGF were detected by RT-PCR and Western blot respectively. Results Cultured human RPE cells showed the flat irregularly multangular shape,and 97％cells appeared the positive response for keratin.HIF-1α mRNA expression in human RPE cells was significantly lower in 50 μg/L IGF-1 group than the 0 pg/L IGF-1 group ( 1.49±0.18 vs 1.46±0.17 ) ( t =0.335,P =0.743 ),however,the expressing levels of HIF-1α protein( 1049.86±172.54 vs 0.00±0.00) and VEGF mRNA(0.95±0.15 vs 0.35±0.07) and VEGF protein (391.98±56.77 vs 214.36±37.15)were raised in the 50 μg/L IGF-I group compared with 0 μg/L IGF-1 group (t=16.098,9.935,6.928,P＜0.05).After the HIF-1α-specific shRNA was transferred into cultured RPE cells,the expressions of both HIF-1α mRNA and its protein significantly decreased in RPE cells under 50 μg/L IGF-1 concentration condition( F=68.679,89.904,P=0.000),moreover,the expression of VEGF mRNA and its protein were significantly lowed(F=21.770,6.205,P＜0.05). ConclusionsIGF-1 promotes the accumulation of HIF-1α protein and induce the expression of VEGF in human RPE cells,which probably play a pivotal role in the development of PVD.

Based on the formation and developing course of the system of diagnosis and treatment of Traditional Chinese Medicine(TCM),to explain three modes of diagnosis and treatment,including differential diagnosis of diseases therapy,determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs,illness-syndrome coalescent.The latter one consist of the mode of illness-syndrome coalescent of TCM,which is based on diagnosing disease in TCM,to carry out determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs and that based on diagnosing disease in modern medicine,to carry out determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs of TCM.Meanwhile,to approach the advantages and flaws among different modes of diagnosis and treatment,accordingly we could offer theory evidences for elevating the level of curing disease of TCM.

Adolescent ; Child ; Electromyography ; Female ; Humans ; Male ; Stomach ; physiology

Objective To evaluate the level of specific anti human leukocyte antigen IgG antibodies and its effect on renal transplantation Methods Specific anti HLA IgG antibodies of 685 serum samples were measured by the micro enzyme linked immunosorbent assay with Lambda Antigen Tray and Lambda Antigen Tray Mixed Results There were 12% positive recipients of anti HLA IgG antibodies among 685 renal transplantation patients The rates of allografts rejection after transplantation were 50% and obviously higher in the sensitized recipients than in non sensitized ones ( P

Objective To investigate the clinical teaching situation by using developmental inspection of School of Medicine,Shanghai Jiaotong University(SJTU-SM),and to put forward some suggestions. Methods By checking questionnaires and informal discussions,the relevant information was collected and analyzed by using SPSS statistics sofware. Results The clinical teaching quality of SJTU-SM was basically satisfied.The satisfaction from internship of grade 2004 was better than that of grade 2003.However,some problems in clinical teaching must be improved.Conclusion The investigation showed that the clinical teaching quality of SJTU-SM is being improving.However,in order to achieve the international accreditation standards,the quality guarantee system of clinical teaching need to be further perfected.

OBJECTIVE To understand the distribution of common pathogens and their drug resistance trend and to provide the basis of the correct selection of antibiotics for clinic.METHODS Retrospective analysis was taken for blood culture specimens during 2 years in our hospital.And statistical analysis was done.All of 4028 cases of blood culture specimens were detected on automatic BacT/Alert3D rapid blood culture system,strains isolated were taken to VITEK-2 automatic microbiological analysis/sensitivity system for identification and drug susceptibility testing.Drug susceptibility results were analyzed using WHONET 5.3 software.RESULTS Totally 435 pathogen were isolated from 4028 cases of blood culture sample and the positive rate was 10.8%.195 Gram-negative bacteria strains accounted for 44.8%,mainly Escherichia coli,Klebsiella pneumoniae,Burkholderia cepacia,Acinetobacter baumannii,and Pseudomonas aeruginosa.Gram-positive bacteria accounted for 49.9%;mainly Staphylococcus epidermidis,S.haemolyticus and S.aureus dominated.Fungi were 23 strains(5.3%),mainly Candida albicans.Among them,extended-spectrum ?-lactamases(ESBLs) produced by E.coli and K.pneumoniae strains were 43.9% and 48.8%,respectively.Meticillin-resistant S.aureus and coagulase-negative staphylococci were 35.3% and 72.9%,respectively.But vancomycin-resistant S.aureus was not found.CONCLUSIONS The bacteria identification detected in blood culture class is quite complicated,and the drug resistance is high.Laboratories should increase the detection rate of bacterial culture and provide drug monitoring results for the clinics on time based on CLSI norms.Clinicians should use the antibiotics reasonably based on the drug susceptibility results in order to reduce nosocomial infections and the emergency of multiple drug-resistant strains.

Objective We evaluated the molecular epidemiology ofStenotrophomonas maltophilia strains in adult patients in Renji Hospital to Shanghai Jiao Tong University School of Medicine for better control ofS.maltophilia infections.Methods Nonduplicate clinical isolates of S.maltophilia were collected from Renji Hospital from January 2014 to September 2014.We examined the clonality among the S.maltophilia isolates by multilocus sequence typing (MLST) and pulsed field gel electrophoresis (PFGE).Antimicrobial resistance pattern was investigated by Kirby-Bauer method and prevalence of toxin genes (Stmpr1,Stmpr2,stmr-1,Smlt3773locus) by PCR.We also studied the biofilm formation of S.maltophilia by semiquantitative biofilm formation test.Results A total of 78 nonduplicate S.maltophilia isolates were analyzed,of which 26 were isolated from surgical intensive care unit,and 53 strains were from male patients.All patients infected by S.maltophilia had received antibiotic therapy before the strains were isolated.At least three kinds of antibiotics were used in 62.8％ of the patients.MLST analysis indicated that 49 isolates were assigned novel STs(STnewl-STnew38),with new combinations of allelic profiles.The largest cluster of isolates was ST23 (6 strains).PFGE showed that there was weak genetic linkage between S.maltophilia strains.The 78 isolates were divided into 58 groups.About 2.6％ (2/78) and 10.3％ (8/78) of these strains were resistant to levofloxacin and trimethoprim-sulfamethoxazole,respectively.All the strains were susceptible to minocycline.The prevalence of virulence genes Stmprl,Stmpr2,snf-1 and Smlt3773 locus was 79.5％ (62/78),93.6％ (73/78),94.9％ (74/78) and 48.7％ (38/78),respectively.Biofilm formation test indicated that the mean ability of biofilm formation was 0.51±0.44 in terms of D492.There was no significant difference between males and females.Conclusions All patients with Stenotrophomonas maltophilia infection had a history of antibiotic use and male patients were susceptible population.Stenotrophomonas maltophilia isolates showed high prevalence of virulence genes.No clonal dissemination was found in the same department of hospital.

Acute Kidney Injury ; blood ; physiopathology ; therapy ; Blood Pressure ; Critical Illness ; therapy ; Electrolytes ; blood ; Female ; Hemofiltration ; methods ; Humans ; Infant ; Male ; Prognosis

ObjectiveTo investigate the action mechanism of CD20 lymphocyte infiltration in the renal allograft biopsy with chronic allograft nephropathy (CAN).MethodsCAN cases confirmed by renal biopsy within 2 years after renal transplantation served as study subjects. By using immunohistochemistry,the deposition of C4d and the CD20-positive lymphocytes infiltration in the renal grafts were examined.The clinical follow-up data were analyzed.ResultsForty-four cases of CAN were enrolled in the study, including 13 cases (29.5％ ) of CD20-positive lymphocytes infiltration,and 31cases (70.5％ )of CD20-negative lymphocytes infiltration. CD20-positive lymphocytes in biopsy showed nodular and scattered lymphocytes infiltration.There were 5 (26.3％)cases of CAN Ⅰ,4 cases (25.0％) of CAN Ⅱ,and 4 (44.4％) of CAN Ⅲ in CD20-positive group.There was no statistically significant difference between the only CAN group and CAN with AR group in CD20-positive rate.Immunohistochemical staining showed there were 12 cases (27.3％) with C4d linear deposition in peritubular capillary endothelial cells (PTC).C4d positive rate had no significant difference among the CAN classifications. There was no significant relationship between C4d deposition and CD20-positive lymphocytic infiltration.The average serum creatinine in CD20-negtive group and CD20-posigtive group was 140.8 ± 22.0 and 183.5 ± 25.5μmol/L before biopsy,and 165.6 ± 37.6 and 242.2 ± 59.1 μmol/L one year after biopsy.The average serum creatinine level in CD20-positive group was higher than in CD20-negtive group before and after biopsy.ConclusionProgressive chronic humoral immunity is high risk in the process of CAN. The CD20-positive lymphocyte infiltration has no relevance with CAN grade and C4d deposition in PTC,but is associated with circulating antibody PRA and allograft long-term outcome. Pathogenetic mechanism may not contribute to chronic humoral immune,but B cells presenting donor antigens,are recognized and activated by T cells as antigen-presenting cells.

Objective To conduct a Meta analysis based evaluation of dual-source computed tomography (DSCT) in the diagnosis of coronary artery disease (CAD). Methods Literatures publicated from January 2006 to July 2009, including in English or Chinese languages, were searched in Medline,China National Knowledge Infrastructure (CNKI), and Chinese Medical Assosiation Digital Periodicals (CMADP). A study was enrolled if it: ( 1 ) used DSCT angiography as the diagnostic test for the detection of significant coronary stenosis ( ≥50% diameter stenosis) in patients with suspected CAD; (2) used coronary angiography as the reference standard. The pooled sensitivity and specificity of the 95% confidence interval (95% CI) were acquired based on the bivariate random-effects modol. Hierarchical weighted symmetric summary receiver-operating curve (HSROC) was also estimated. The pooled likelihood ratios were calculated based on the pooled sensitivity and specificity. Combined with the pooled likelihood ratios, the clinical utility of the results was estimated according to Bayes'theory. Results Total of ten articles enrolled in this study, included 1271 patients. The mean rate of nonevaluable patients and segments were 5.6% (33/590) and 2. 3% (271/11 745 ), respectively. The pooled statistical results were as follows: the sensitivity and specificity were 99% (97%-99% ) and 86% (79%-90% ), respectively; the positive and negative likelihood ratio were 6. 84 and 0. 01, respectively. If a pre-test probability was below 84%, the likelihood of disease was less than 5% on a negative diagnosis of DSCT. If a pre-test probability was above 13%, the likelihood of disease was more than 50% on a positive diagnosis of DSCT. Conclusions DSCT angiography presents good diagnostic performance in the detection of CAD; however, it could not completely replace conventional coronary angiography.