Autoimmune Diseases ; diagnosis ; immunology ; pathology ; therapy ; Child ; China ; Gastroenterology ; Hepatitis B ; diagnosis ; pathology ; therapy ; Humans ; Infant

Drug Resistance, Microbial ; Immunity ; Infection

Research of the impacts of probation administration on teaching quality for students'clinical probation study is to control the whole process of probation teaching,which is through the strengthening of administration on three parts,including pre-clinical probation,clinical probation and post-clinical probation,so that administration elements of teaching for probation forms close links,including formulation of teaching plan goals,organization and implementation of the probation process,means and methods of probation,and evaluation of effects and quality of probation results and quality of student evaluation of teaching management trainee factors into a closed ring. Considering highly the administration process,refining the administration flow-sheet,identifying administration objectives,and systematic evaluation of the quality of teaching trainees to achieve continuous improvement of the quality of probation teaching reflect the concept of "student-centered" teaching management concepts,and provides a new approach to enhancing the quality of clinical probation teaching for adapting to the new model of medical education and management development needs.

Objective To explore the value of vascular enhancement technology (VET) in the evaluation of therapeutic efficacy of stenting for Budd-Chiari syndrome (BCS).Methods Two-dimensional ultrasound,color Doppler and VET were performed on 39 BCS patients with 41 stents,the static and dynamic images of stents and vessels with stents were stored.VET and two-dimensional ultrasound imaging quality of intravascular stent were compared.Patients with stent stenosis found by ultrasound were examined by digital subtraction angiography(DSA).The ranges of stent thrombosis were measured by DSA and VET and the difference was compared.Results VET image quality scores of endovascular stent were higher than those of the two-dimensional ultrasound,the difference was statistically significant.The ranges of stent thrombosis measured by VET were similar to DSA.Conclusions VET can improve the clarity of intravascular stents.VET and color Doppler can enhance the clinical value of ultrasound in the evaluation of therapeutic efficacy of stenting for BCS.

Objective To investigate the change in expressions of lipoxin A4 (LXA4) and lipoxin A4 receptor (ALX) in rats with fat embolism syndrome(FES).Metbods Sixty healthy male SD rats were assigned to control group and FES group which was subgrouped at l,6,12 and 24 h according to the random number table,with 12 rats each.Allogeneic perinephric fat (0.706 ml/kg) was injected to rat caudal veins in FES group.Instead isotonic saline in an equal volume was given to rats in control group.Lung samples were harvested from each group to detect pathological morphology,concentration of total protein and LXA4 in bronchoalveolar lavage fluid (BALF),lung weight to dry ratio (W/D),and activity of myeloperoxidase (MPO) and ALX mRNA.Additional 40 SD rats were divided into control group,FES 24-hour group,BML-1 11 + FES 24-hour group,and Boc-2 + FES 24-hour group according to the random number table,with 10 rats each.Pathology of lung tissue was observed using microscopy and expression of lung MPO mRNA was detected.Results Lung tissues in FES group were seriously injured compared with control group.Total protein concentration in BALF was (71.12 ± 11.05) μg/ml in FES 12-hour group,significantly increased compared to (29.82 ± 0.64) μg/ml in control group (P ＜ 0.05).LXA4 concentration in BALF was (2.72 ± 0.24) ng/ml in FES 24-hour group,significantly higher than (0.69 ±0.05)ng/ml in control group (P ＜ 0.05).Lung W/D value was 9.13 ±0.83 and 9.60 ±0.86 respectively in FES 6-hour and 12-hour groups,higher than 3.09 ±0.10 in control group (P ＜0.05).Activity of MPO in lung tissue was (0.74± 0.07)U/g and (0.53 ±0.08)U/g respectively in FES 6-hour and 12-hour groups,significantly higher than (0.19 ± 0.03) U/g in control group (P ＜ 0.05).Expression of ALX mRNA was 3.99 ± 1.09 in FES 24-hour group,significantly higher than 1.00 ±0.21 in control group (P ＜0.05).Expression of MPO mRNA was lower in BML-111 + FES 24-hour group (0.69-0.08) and was higher in Boc-2 + FES 24-hour group (2.05-0.14),when compared to 1.52 ±-0.07 in FES 24-hour group (P＜0.05).Conclusion LXA4 mainly involves in the resolution of inflammation in FES rats,which may be achieved at least in part by binding to ALX.

As an important neurotransmitter, adenosine displays its functions by acting on the adenosine receptors. Recent studies have shown that the distribution, expression and balance among subtypes of adenosine receptors are closely related with cognitive activities, and changes of adenosine receptors play key roles in neurodegenerative disorders including Alzheimer's disease. It has been pointed out that prolonged activation of adenosine receptors by high level adenosine may lead to the disturbance of balance among adenosine receptor subtypes. This imbalance mainly performed as increased expression of A2a receptor and decreased expression of A1 receptor, and enhancement of the excitatory signals mediated by A2a receptor and weakened inhibitory signals mediated by A1 receptor. Changes of these two subtypes of adenosine receptors may lead to a lot of disorders of neurological activities which developed into dysfunction of cognition to the end. These findings imply that the potential of maintaining the balance among adenosine receptors on the treatment of AD would facilitate both the revealing of the mechanism and the cure of AD.

Objective To investigate the type of plasmid map of Y. pestis in the R. opimas natural plague loci in Junggar Basin. Methods A total of 39 plasmid DNA of Y. pestis which were isolated from the natural plague loci of Junggar Basin, Tianshan Mountain, Kunlun Mountain, Qinghai-Tibet Plateau and In-ner Mongolia were extracted by the methods of Kado and Liu. The plasmid map was analyzed by the methods of agarose gel eleetrophoretogram. Results Two types of plasmid map were found in 26 Y. pestis which were isolated from Junggar Basin. Of them 23 were 6 × 106, 45 × 106 and 65 × 106 type of plasmid map, and 3 were 6 × 106, 45 × 106 and 72 × 106 type. Conclusion There are two types of plasmid map in the R. opi-mus natural plague loci in Junggar Basin. One type, which is the dominant type in this area, is 6 × 106, 45 × 106 and 65 × 106 type. This type is also similar to the dominant plasmid map type of the nature plague loci of Tianshan Mountain, Kunlun Mountain, Qinghai-Tibet Plateau and Inner Mongolia. The other type is 6 × 106, 45 × 106 and 72 × 106 type, and this type is new plasmid map type of Y. pestis in our country.

Objective To explore biomechanical properties and clinical results of a new type of dynamic Hoffmann external fixator(NDHEF)for tibial shaft fractures.Methods Fifteen specimens of adult tibia were randomly divided into three groups and osteotomized obliquely in the mid part of the tibia.These specimens were fixed with NDHEF,improved Hoffmann external fixator(IHEF)and maltifunctional external fixator(MEF)re- spectively.The axial compression,bending,torsion and stress shielding tests were performed on the specimens in each group for biomechanical comparison.From 1995 to 2004,40 cases of open tibiofihular fractures were treated with NDHEF and 88 cases with IHEF and their clinical results were analyzed and compared.Results The biomechanical tests showed that the compressive rigidity,bending rigidity and torsion rigidity of NDHEF were similar to those of IHEF(P＞0.05)but significantly stronger than those of MEF(P＜0.05).The stress shielding of NDHEF was obviously weaker than that of other external fixators(P＜0.05).All the 128 cases were followed up for 12 to 36 months(average,16.8 months).The mean substantial bone healing time for NDHEF treatment was 22.3 weeks and that for IHEF was 26.8 weeks.The difference was significant(P＜0.05).The rates of delayed union and malunion were all 7.5% for NDHEF,but 15.9% and 4.5% respectively for IHEF.The difference was insignificant (P＞0.05).Conclusions The biomechanical performance of NDHEF is superior to that of IHEF,for it can diminish the stress shielding and accelerate bone healing.It is a good external fixator for tibial fractures.

Objective To investigate the resistance of clinical isolated gram negative bacilli to tigecycline.Methods One hun-dred and fifteen Escherichia coli isolates,110 Klebsiella pneumoniae isolates and 99 Acinetobacter calcoaceticus-Acinetobact-er baumannii complex isolates were collected from Affiliated Second Hospital of Zhejiang University College of Medicine from the year 2012.The other 393 A.calcoaceticus-A .baumannii complex isolates were collected from 15 hospitals of nine cities in Zhejiang province during September to October 2012.Species identification and susceptibility test were confirmed by VITEK-2 compact system,while the 393 A.calcoaceticus-A .baumannii complex strains isolated from Zhejiang province were identified by MALDI-TOF MS.Moreover,159 A.baumannii isolates with tigecycline MIC value ≥8 μg/ml or 4 μg/ml and part of the MIC value ≤0.5 μg/ml,1 μg/ml and 2 μg/ml which were firstly determined by VITEK 2 GN AST-16 Suscepti-bility card were then determined by Etest.Results The 393 A.calcoaceticus-A .baumannii complex strains were identified as 317 of A.baumannii,32 of A.pittii and 44 of A.nosocomialis.When using the FDA breakpoints,the resistance rate of tige-cycline against 115 E.coli isolates,110 K.pneumoniae isolates and 99 A.calcoaceticus-A .baumannii complex isolates were 0.0%,7.3% and 6.1%,respectively.Interestingly,85.7% of the tigecycline-resistant gram negative bacilli were resistant to carbapenems.However,only 10.0% of the carbapenem-resistant gram negative bacilli were resistant to tigecycline.Conclu-sion Tigecycline had a good activity against clinical isolated multi-drug resistant or even pan-drug resistant gram negative bacilli.No matter which criteria for tigecycline was referred to,the resistance rate oftigecycline was slightly lower by Etest than by GN AST-16 Susceptibility card.