Objective:To analyses distribution and resistant profile of acquired infections of acinetobacter baumanii.Methods:Distribution and the resistant patterns of acquired infections of acinetobacter baumanii in our hospital were analysed by a retrospective analysis from the year 2003~2005.All of the isolates were tested by Kirby-Bauer susceptibility,and the antibiotic resistance was judged according to NCCLS standard.Results:The isolation rate of Acinetobacter baumannii was the higher in vena pipe,sputum,secretion and bile,the isolation rate was 11.5%~37.5%respectively.Primary acquired infections were Acinetobacter baumannii in department of breathe,burn,neurosurgery,heart internal medicine,transplantation,chest surgery and intensive care units.The bacterial resis-tancet rate to common antimicrobial agents increased year by year.There sistance rate s of Acinetobacter baumannii to antibiotics such as Cefop-erazone,Ampicillin,Ceftriaxone,Cefuroxime,Amoxicillin/Clavulanic Acid were over 50 % every year respectively.Levofloxacin,Meraopenem,Imipenem,Cefopera-zone/Sulbactam,Ampicillin/Sulbactam and Piperacillin/Tazobactam all had antisepsis activity to Acinetobacter baumannii relatively.Conclusion:The infection rate and the antibiotics rate of hospital acquired infections of Acinetobacter baumannii was yearly increase,resistance to anti-microbial agents have the characteristics of high prevalence.Its necessary to strengthen the clinic monitoring and select reasonable antibiotic in order to improve curative effect and delay bacteria of resistance to antimicrobial agents.

Objective To investigate the distribution and drug resistance of pathogens of ventilator-associated pneumonia(VAP) in general intensive care unit(ICU).Methods Statistical methods were used to analyze retrospectively the data of pathogens and drug resistance of VAP in general ICU from 2004 to 2006.Results Totally 347 pathogens were isolated from deep-part secretion of lower respiratory tracts of 302 VAP in general ICU.The main pathogens included Pseudomonas aeruginosa(32.3%),Acinetobacter baumanii(31.1%),Staphylococcus aurous(16.7%),Klebsiella(7.5%) and Coagulase-negative Staphylococci(6.1%).Gram-negative bacillus showed a high resistance to piperacillin and Cefotaxime but high susceptibility to carbapenems and the enzyme inhibitor antibiotics.Gram-positive coccobacteria showed a high resistance to Penicillin,Clindamycin and Erythromycin but high susceptibility to Vancomycin and Quinolone.Conclusion Gram-negative bacillus was the main pathogen of VAP in general ICU,multidrug resistance was serious.The rate of methicillin-resistant staphylococcus aurous(MRSA) and methicillin-resistant coagulase-negative staphylococci(MRCNS) was high,with serious drug resistance.According to the data of the bacteria pathogen and antibiotics susceptibity,we can select antibiotics reasonably to control the infection and delay the emergency of new drug-resistant bacteria.

Objective To investigate the levels of platelet-derived growth factor-BB (PDGF-BB) and its role in the pathogenesis of the patients with hepatic diseases.Methods The levels of serum PDGF-BB in 30 chronic patients (hepatitis B,26; hepatitis C,4),24 patients with post-hepatitis cirrhosis,30 patients with primary hepatocellular carcinoma,and 20 normal controls were measured by ELISA.The levels of PDGF-B mRNA in peripheral blood mononuclear cells were measured by reverse transcription polymerase chain reaction (RT-PCR).Results The serum levels of PDGF-BB and the levels of PDGF-B mRNA in peripheral blood mononuclear cells were significantly higher in the patients with hepatic diseases (F=1774.40,1037.42,P

The clinical laboratory department practice in hospital is very important in the teaching process of medical laboratory science and medical laboratory technology science .It is the transition link of guiding the students to go to the clinical job .This paper analyzes the problems and challenges in the process of clinical teaching and management of the trainees majored in medical laboratory science and medical laboratory technology science .Then summarizes the countermeasures to effectively cultivate these trainees , including setting up a teaching group , doing the overall quality control for the process of practice teaching using ISO15189 quality control methods for reference , establishing the evaluation mechanism for both trainees and tutors , founding virtual laboratory to improve the teaching effect of morphology , strengthening the consciousness of quality control , expanding the professional vision of interns and strengthening the cultivation of the scientific research ability of interns .

Objective To analyze the clinical features of juvenile-onset clinically amyopathic dermatomyositis complicated by progressive interstitial pneumonia.Methods A retrospective analysis of a case of juvenile-onset clinically amyopathic dermatomyositis on clinical features,diagnosis and treatment was performed.Data of the other three reported cases were also reviewed.Results The patient was an adolescent girl presented with Gorrton's sign.The patient did not have fatigue and got normal result in creatine kinase and elctromyogram test.The HRCT exam showed interstitial pneumonia.The mean age of the four cases at the time of onset is 12.3 years old.Gottron's sign (3/4) and fever (2/4) are the most common symptoms of onset.Anti-nuclear antibody (ANA),anti-Jo-1 antibody are 100％ negative in the four patients.Two of the four patients who received anti-Ro-52 antibody test are both positive.Three of the four patients were asymptomatic when the CT scan showed interstitial pneumonia.The interstitial pneumonia was progressive and three of the four patients died of respiratory failure within six months.Treatment with glucocorticoid and immunosuppressant was successful in one case.Conclusions Juvenile CADM can be complicated by progressive interstitial pneumonia.Children suspected CADM should perform pulmonary imaging examinations to find interstitial pneumonia.Children diagnosed as CADM complicated by interstitial pneumonia should receive glucocorticoid and immunosuppressant treatment to prevent progression.

Objective:To establish the detection method for the interferon stimulated genes(ISGs), calculate the cut-off value and test it in clinical practice.Methods:Patients with type I interferonopathies who were admitted to Peking Union Medical College Hospital from November 2017 to September 2021 were chosen as the disease group, and healthy children were included as the control group. A total of 18 children were in the disease group, including 8 males and 10 females, with a median age of 8.5 years for the first test. From them 25 blood specimens were collected. A total of 28 healthy children, aged 1 to 18 years, with a median age of 10.5 years, including 15 males and 13 females, were included in the control group. Blood samples of 34 controls and 18 interferonopathies patients were collected, then total RNA extraction and cDNA synthesis were performed. Real-time quantitative polymerase chain reaction assays were run in duplicate to measure the expression of six ISGs: interferon induced protein with tetratricopeptide repeats 1 (IFIT1), interferon α inducible protein 27 (IFI27), interferon induced protein 44 like (IFI44L), interferon stimulated genes 15 (ISG15), sialic acid binding Ig like lectin 1 (SIGLEC1), and radical S-adenosyl methionine domain containing 2 (RSAD2). The relative abundances of each target transcript was normalized to the expression level of β-Actin and OAZ. The median fold change of the six ISGs was used to create an interferon score (IS) for each individual. Samples with abnormal expressions were removed and the cDNA mix of the remaining samples was used as a calibrator to calculate the IS. We define an abnormal IS as being greater than+2 standard deviations above the mean of controls. Differences in IS between groups were compared using t-test or Mann-Whitney U-test. Results:The mean IS of controls was 1.046, standard 0.755, and the cut-off value was 2.556. A total of 25 samples from 18 interferonopathies patients were tested. The mean value was 27.010 with a 15/18 abnormality rate. Compared with the control group, IS in patients was significantly higher, t=4.247( P=0.000 1). The accuracy, precision, sensitivity, and specificity were 91.30% (42/46), 7.47%(0.084/1.124), 15/18, and 96.43% (27/28), respectively. Conclusion:This study provides a new and reliable method for clinical screening and dynamic monitoring of type Ⅰ interferonopathies by detecting ISGs expression and creating an IS.

Objective:To provide reference for establishing the testing method for quality control of neutron beam in boron neutron capture therapy (BNCT) equipment in China by testing the radiation characteristic parameters and dosimetry characteristic parameters of epithermal neutron beam in hospital neutron irradiator (IHNI).Methods:By comparing the uncertainties in the result of various test items with the deviation values recommended by the European Joint Research Center (EC-JRC), the feasibility of the relevant of testing method was analyzed and evaluated.Results:The uncertainty in epithermal neutron fluence rate was 2.7%. The uncertainty in ratio of thermal to epithermal neutron fluence rate was 3.1%. The uncertainty in ratio of fast neutron air kerma to epithermal neutron fluence rate was 9.3%. The uncertainty in ratio of gamma air kerma to epithermal neutron fluence rate was 8.7%. The uncertainty in spatial distribution of neutron fluence rate was 2.7%. The uncertainty in thermal neutron fluence rate in phantom was 1.8%. The uncertainty in neutron and gamma-ray dose rate in phantom was 17.1% and 4.0%, respectively.Conclusions:The uncertainty in neutron dose rate measurement result in phantom is higher, and further research is needed to improve the accuracy of the testing method. The uncertainty in the measurement result of other test items is lower, and the accuracy of the test result is expected to meet the allowable deviation value recommended by the European Joint Research Center, and the test method is feasible.

BACKGROUNDEvidence shows that ezrin plays an important role in the development of some human malignancies. But the mechanism by which ezrin may affect tumor cell invasion and metastasis remains unclear.

METHODSIn this study, the expression of ezrin was verified in osteosarcoma (OS) cells and tissues by comparison with normal bone cells and tissues using Western blotting. OS-MG63 were transfected with pcDNA3.1-ezrin or pGenesil-1/shRNA-ezrin and the stably transfected cells were selected with G418 to yield the ezrin cell line. The OS-MG63 tumor cells were delivered by tail vein to female BALB/c to develop pulmonary metastasis model in vivo. Ezrin was identified as a direct target of miR-183 via a luciferase reporter carrying the 3'-untranslated region of ezrin. Migration assays and invasion assays were done with the transwells. Signaling pathway was studied by Western blotting and/or inhibitor.

RESULTSEctopic overexpression of ezrin in OS cell line MG63 promoted tumor cell invasion and migration. Consistent with this, knockdown of ezrin inhibited tumor cell invasion and migration. Similar results were obtained in the experimental metastasis model in vivo. We identified ezrin as a direct target of miR-183. What is more, ectopic expression of ezrin could induce the expression of N-cadherin and enhance the activity of extracellular signal-regulated kinase (ERK) signaling.

CONCLUSIONCollectively, these results suggest that ezrin as a direct target of miR-183 promotes the aggressiveness of OS via increased N-cadherin and activating ERK signaling.

Animals ; Bone Neoplasms ; metabolism ; pathology ; Cadherins ; genetics ; metabolism ; Cell Line, Tumor ; Cell Movement ; drug effects ; genetics ; Cytoskeletal Proteins ; genetics ; metabolism ; Female ; Humans ; In Vitro Techniques ; Mice ; Neoplasm Invasiveness ; genetics ; Osteosarcoma ; metabolism ; pathology

Objective: To explore the clinical and immunological features, gene mutations, treatment and prognosis in patients with activated phosphoinositide 3-kinase δ syndrome (APDS) caused by PIK3CD gene heterozygous germline mutation. Method: The data of clinical, immunological phenotype, treatment, and prognosis of 15 patients with APDS, who visited Children′s Hospital of Chongqing Medical University, Peking Union Medical College Hospital, and Shenzhen Children′s Hospital from June 2014 to November 2016, were collected and analyzed. Result: Of the 15 patients, 11 were males, remaining 4 patients were females. The median age of disease onset was 1 year, and median age at diagnosis was 4 years and 4 months. All patients had the de novo heterozygous germline mutation in PIK3CD (c. 3061G>A, p. E1021K). The common initial symptoms were respiratory infections, including pneumonia (12 cases) , bronchiectasis (5 cases). Other common clinical manifestations were recurrent and chronic diarrhea (11 cases), Epstein-Barr virus (EBV) and/or cytomegalovirus (CMV) viremia (10 cases), hepatosplenomegaly (13 cases), and lymphadenopathy (10 cases). The main immunological features were increased IgM (11 cases), decreased IgG (6 cases), decreased numbers of CD4⁺ T cell (7 cases) especially naïve CD4⁺ T cell (9 cases), reduced numbers of B cells (11 cases) particularly naïve B cells (9 cases), increased numbers of transitional B cells (5 cases) and CD8⁺ terminally differentiated effector memory T cells (5 cases). After 1-29 months follow up, 13 of the 15 cases remain survived, of whom 5 cases received regular intravenous immunoglobulin (IVIG) therapy, with reduced frequency of infections and improved severity of infections; of whom 3 cases received oral rapamycin therapy at the dosage of 1 mg/ (m²·d) and with a decrease in nonneoplastic lymphoproliferation. Conclusion E1021K is a hotspot for mutation in the PIK3CD gene in patients with APDS. Regular IVIG can improve their quality of life. Targetel treatment with rapamycin could mitigate hepatosplenomegaly.

A 15-year-old female was referred to the hospital with intermittent fever, where multiple systemic abnormalities were found, such as splenomegaly, secondary hypersplenism, retinitis pigmentosa, and ectodermal dysplasia. Medical history revealed that she had suffered recurrent respiratory infections, blurred vision at night, and dysplasia of teeth and nail beds since childhood. Then she was suspected to be experiencing ROSAH syndrome, a rare disease newly recognized in recent years, which was finally confirmed by gene sequencing results. During a course of treatment with tumor necrosis factor inhibitors, recurrent fever with elevated inflammatory markers reappeared, and the child developed headaches. To guide the comprehensive treatment and improve the patient's quality of life, the multidisciplinary team in Peking Union Medical College Hospital discussed together and directed the following treatment.