Objective To evaluate cerebrospinal fluid adenosine deaminase(CSF-ADA)activity in the diagnosis of tuberculous meningitis(TMB), and to observe its dynamic changes. Methods A total of 160 patients were included and were divided into two groups: 76 cases of TBM and 84 cases of non-TBM.Among the cases of non-TBM, there were 36 cases of bacterial meningitis, 30 cases of viral meningitis and 18 cases of cryptocoocal meningitis. All the patients were measured with their CSF-ADA activity by Enzymecoupled assay(Trinder method)and 47 patients of TBM were measured again after 2 weeks' and 6 weeks'antitubercular therapy. Results were expressed as(-x)± s. Mann-Whitney U test and paired-samples t test were used. Results CSF-ADA activity in TBM group was(12.9 ±6.4)U/L, while that in the non-TBM group was(6.0 ± 4.1)U/L, the difference was of statistical significance(U = 7.860, P ＜ 0.05). With the cutoff value of 9 U/L, the sensitivity and specificity to differentiate TBM from non-TBM was 84.21% and 83. 33%, respectively. CSF-ADA activity decreased in TBM patients after antitubercular treatment.Conclusions CSF-ADA activity can be an effective laboratory marker for early differential diagnosis of TMB with the cut-off value of 9 U/L. Dynamic changes of CSF-ADA activity may be a indicator for the effect of antitubercular treatment.

Objective To understand the drug resistance and antibiotic resistance mechanism ofβ-lactam antibiotics of invasive Streptococcus pneumoniae isolated from Shanghai Children′s Hospital, provides the reference for the rational use of antimicrobial agents.Methods This study is based on the research of the mechanism of drug resistance.62 isolates of invasive Streptococcus pneumoniae were collected from Shanghai Children′s Hospital from January 2005 to December 2011.Minimum inhibitory concentrations ( MIC) of strains to 9 antimicrobial agents were determined by E-test method.The penicillin binding protein coding genes pbp2x, pbp2b, and pbp1a of Streptococcus pneumoniae were amplified by PCR.Then, the correlation between the gene mutation andβ-lactam antibiotics resistant level were analyzed.The murM gene of Streptococcus pneumoniae was amplified by PCR and the correlation of mutation and β-lactam antibiotics resistant level was analyzed.Results Out of 62 strains of invasive Streptococcus pneumoniae from children, the detection rate of penicillin resistant Streptococcus pneumoniae was 43.6% (27/62).Between penicillin intermediate Streptococcus pneumoniae ( PISP ) ( 100%, 25/25 ) and penicillin sensitive Streptococcus pneumoniae (PSSP) (3/10), the difference of gene mutation rate near the pbp2b conserved sequence was statistically significant (χ2 =21.875, P<0.01).The same situation occurred between penicillin resistant Streptococcus pneumoniae (PRSP)(100%, 27/27)and PSSP (3/10) (χ2 =23.310, P<0.01).Also the difference of gene mutation rate of PISP (84%, 21/25) vs PSSP (0) and PSSP (0) vs PRSP (85.2%, 23/27) near or in the pbp2x conserved sequence were statistically significant (χ2 =21.000, P <0.01;χ2 =22.513,P<0.01).The difference of gene mutation rate near the pbp1a conserved sequence and Insertion sequence, which were statistically significant, occurred between PISP and PSSP (χ2 =13.22,P<0.01), between PRSP and PSSP (χ2 =37.000,P<0.01), between PISP and PRSP (χ2 =10.211,P=0.001). MurM gene mutation rate was statistically significant different between the 2 group penicillin MIC≥8 mg/L or ceftriaxone MIC≥2 mg/L group (95.8%, 23/24) and penicillin MIC<8 mg/L or ceftriaxone MIC<2 mg/L group (0) (χ2 =56.2,P =0.002 6).Conclusions The resistance phenomenon of invasive Streptococcus pneumoniae in Shanghai Children′s Hospital is serious.The gene mutations of pbps and murM play a role in amide in the beta of antibiotic resistance, and there is a certain correlation with the antibiotic resistance level.

Adult ; Angiofibroma ; Humans ; Male ; Nose Diseases ; Turbinates ; pathology

Objective:To observe the clinical effect of tuina plus Baixiao moxibustion in the treatment of temporomandibular joint dysfunction syndrome (TJDS). Methods: A total of 70 TJDS patients who met the inclusion criteria were randomized into an observation group and a control group by flipping a coin, with 35 cases in each group. Patients in the observation group were treated with tuina plus Baixiao moxibustion, while patients in the control group received oral intake of diclofenac potassium (75 mg/pill), 1 pill after every dinner. Both tuina and Baixiao moxibustion were done once a day during treatment. The therapeutic evaluation was evaluated after 10 treatments in both groups. The maximum mouth opening distance and visual analog scale (VAS) were observed before and after treatment, and the therapeutic efficacy was also compared. Results: After treatment, the maximum mouth opening distance and VAS improved in both groups (all P＜0.05); both items in the observation group were superior to those in the control group (both P＜00.05). The total effective rate was 91.4% in the observation group, versus 74.3% in the control group, and the between-group comparison of the total effective rate showed statistical significance (P＜0.05). Conclusion: Tuina plus Baixiao moxibustion can effectively improve TJDS patient’s temporomandibular joint function and alleviate pain, with better efficacy than oral intake of diclofenac potassium.

AIMTo investigate the effects of resveratrol (Res) on the proliferation of VSMCs induced by Ang I and the expression of calmodulin (CaM) and calcineurin (CaN) in the proliferation of VSMCs treated by Ang 1 and to discuss the mechanism.

METHODSRabbit arterial VSMCs were cultured in vitro and VSMCs were identified with the method of immunocytochemistry. A cell proliferating model of VSMCs induced by AngII was established. VSMCs were cultured for 4-8 passages. The experiments were randomly divided into control group, AngII group (0.1 micromol/L) and AngII + Res groups with different concentrations(20, 40, 80, 160) micromol/L. VSMCs proliferation was determined with MTT colorimetric method. CaM was detected with Coomassie brilliant blue method and CaN was determined by enzyme reaction phosphorus measurement.

RESULTSRabbit VSMCs were cultured successfully and could be passaged. After immunocytochemistry staining, all the cells cytoplasm were stained and positive. Cell proliferation, CaM and CaN activities were increased significantly in VSMCs proliferation induced by AngII (P <0.05, P < 0.01). The index of AngII + Res groups were obviously reduced compared with AngII group ( P < 0.01).

CONCLUSIONThe VSMCs proliferation induced by AngII can be inhibited by Res significantly, and the inhibiting mechanism of Res may be related to inhibiting CaM and CaN activities then restraining the proliferation of VSMCs in a dose dependent manner.

Angiotensin II ; pharmacology ; Animals ; Calcineurin ; metabolism ; Calmodulin ; metabolism ; Cell Proliferation ; drug effects ; Cells, Cultured ; Female ; Muscle, Smooth, Vascular ; cytology ; metabolism ; Rabbits ; Random Allocation ; Stilbenes ; pharmacology

OBJECTIVE To explore the correlation between hands pollution and nosocomial infection,and to raise measures to keep hand hygiene.METHODS To evaluate the condition of hand pollution and hand washing,the relationship between hands pollution and nosocomial infection,and measures to improve hand hygiene.RESULTS Most nosocomial infections were transmitted by the hands pollution,bacteria of which were thought to be the main microbial population of nosocomial infection.Handwashing was considered to be the most important intervention to prevent nosocomial infections.However,the present studies indicated that there was not enough handwashing practice among the medical personnel,lacking the consciousness of the importance of hand cleaning,misunderstanding the standard hand cleaning steps,like the length of washing time and the choose of hand disinfectant,and inadequately providing the hospital condition for cleaning work,all these played an important role in declining the efficiency of hand disinfection in hospital.Medical workers could achieve their goal through the improving of the above aspects of work.CONCLUSIONS Hands pollution is closely related to nosocomial infection.Handwashing can reduce nosocomial infections.

Objective To investigate clinical features and prognostic factors in acquired immune deficiency syndrome (AIDS) patients with opportunistic infections.Methods Forty-two cases of AIDS patients with opportunistic infections were enrolled in this study.Clinical data and major factors affecting the prognosis were analyzed using Logistic regression.Results Bacterial infection was the first etiological factor(57.1%) of opportunistic infections in AIDS patients.Eighty-three point three percent of patients infected with more than two kind of etiological agents.Fifty-seven point one per- cent of cases were infected in multiple sites.CD4~+ T cells count was associated with the opportunistic infections.Conclusions The CD4~- T lymphocytes count is the key factor affecting the prognosis of AIDS patients with opportunistic infections.The average of CD4~+ T lymphocytes count is significant- ly related with the major opportunistic infections in AIDS paitents.

Objective To evaluate the sensitivity of sleep-deprivation electroencephalography(EEG) examination in diagnosis of partial seizures of children.Methods One hundred and six normal children (male 57,female 49, 3-12 years old)and 102 children suspected of epilepsy but with normal in standard EEG examination were selected at random(male 63,female 39,3-12 years old). Sleep-deprivation EEG was performed individually.Periods of sleep-deprivation were 18-20 hours for children below 7 years old and 24 hours for the older ones.Results The EEG showed slowing of background electric activity. In addition, 57 cases showed spindle/sharp-slow wave complex.The rate of EEG abnormality was 55.88%.The rates of EEG abnormality for partial seizures and generalized seizure were 76.32% and 43.8%,respectively(?~2=8.98 P

Objective To compare the sensitivity of sleep-deprivation electroencephalography(EEG)examination on children suffered with nonepileptic seizures in normal and suspected epileptic in children.Methods Thirty -eight children with nonepileptic seizures (male 13,female 25,age 4-12 years, mean 8.1 years) had induced a person to make a confession. One hundred and six normal children (male 57, female 49, age 3-12 years,mean 7.6 years) and 102 children(male 63,female 39,age 3-12 years,mean 7.3 years)suspected of epilepsy clinically but with normal standard EEG examination were selected at random as controls.Sleep-deprivation EEG was performed individually.Results The sleep deprivation EEG showed slow background electric activity in all 3 groups. In addition, the rates of EEG abnorma lity for nonepileptic seizures group were zero,no statistics were computed because F was a constant. Fifty-seven cases showed spindle/sharp-slow wave complex in suspected epileptic children.The rate of EEG abnormality was 55.9%.The rate of EEG abnormality for normal control group was 1.9 %.There were significant difference among 3 groups (?2=97.3 P

Objective To detect the expression of BRIT1 in cervical cancer tissues and cervical noncancer tissues ,and to analyze the differences between the two tissues .Methods The expression of BRIT1 mRNA and protein in cervical cancer tissues and the paired cervical noncancer tissues was evaluated by RT‐PCR and immmunohistochemistry .Its correlation with the clinicopathological parameters including age ,tumor types ,size ,tumor pathological grade and clinical stage was analyzed .Results RT‐PCR results showed that the BRIT1 mRNA level in cervical cancer tissues was significantly lower than that in the paired cervical noncancer tis‐sues ,the difference was statistically significant (P<0 .05) .The immmunohistochemistry results showed that the BRIT 1 protein ex‐pression level in 44 cases of 63 (69 .8% ) samples wa slower than that in the paired cervical noncancer tissues ,the difference was statistically significant(P<0 .05);In high pathological grades and high clinical stages ,the decrease of BRIT1 protein expression was more significant .Conclusion The difference of the BRIT1 expression between the cervical cancer tissues and cervical noncancer tis‐sues suggests that BRIT1 may play a certain role in the occurrence and development of cervical cancer .