Objective To screen the factors that can affect α-toxin expression of CA-MRSA except for quorum-sensing system and to investigate the regulative mechanism of the interesting genes. Methods S. aureus CA-MRSA transposon mutagenesis library was constructed by using mariner based transposon mutagenesis system. The clones with significantly changed level of hemolysis were selected, the location of erm insertion in a gene was confirmed by arbitrary primed (inverse) PCR and nucleotide sequence. Genetic complementation, mice bacteremia and skin abscess models and real time RT-PCR were used to study the function of the interesting gene. Results Twenty-five mutants with down-expression of α-toxin were selected by screening about 104 isolates of transposon mutagenesis library. The hemolytic diameter of CA-MRSA wild type was about 212 mm, no clear hemolysis was found in AraC-, The hemolytic diameter of AraC-pT181 araC was about 197 mm. Real time RT-PCR results showed that compared to the expression of the virulence factors in CA-MRSA wild type( PSMα 257. 30 ±37. 33 ;agr 115. 60 ±0. 81 and α-toxin 3.23 ±0. 21), in AraC-, α-toxin, PSMα and agr were significantly down regulated(α-toxin 1.09 ±0.01 :t = 10. 18, P <0.01 ;PSMα 34.85 ±2. 15:t=5.95,P<0.05;agr35. 19 ±1. 72:t =42. 33, P<0. 01). The result of mice bacteremia model showed that the virulence of wild type and AraC- ( (x) ± s ) were significantly different (x2 = 21. 34, P < 0.01). The expression of PSMα, agr and α-toxin in AraC-pT181araC ( PSMa 180.10 ± 15.29;agr 101. 50 ±8. 96;α-toxin 2.59 ±0.26) had no significant difference compared to the expression of the virulent factors in CA-MRSA wild type (PSMα: t =1.914, P>0.05;agr:t= 1.563, P>0.05;α-toxm: t = 1. 923, P > 0. 05 ). There were no significant difference of the expression of ClpP in AraC-(0. 21 ±0.01) and in AraC-pT181araC(0.17 ±0.03)compared to the expression of ClpP in CA-MRSA wild type (0. 20 ± 0.01) (t=0.555, P>0.05 and t=0. 851, P>0.05). The result of mice skin abscess model showed that the dermonecrosis area caused by CA-MRSA was (136. 5 ±21.45) mm2, the dermonecrosis area caused by AraC- was (55. 69 ± 13. 81) mm2, the different was significant (t = 3.169, P < 0. 05). Conclusion In CA-MRSA, AraC-type transcriptional regulator controlled the pathogenesis of CA-MRSA by regulating the expression of the most important virulence factors such as hla, PSMα and agr.

In this study, researchers adopted the network analysis method to study Buyang Huanwu decoction at three levels, namely chemical ingredients, targets and diseases, and discovered the potential effect of Buyang Huanwu decoction in cancer treatment. Besides, they analyzed the "target-target" network of Buyang Huanwu decoction based on diseases, calculated four network indexes, namely node centrality, closeness centrality, betweenness centrality and eigenvector centrality for a comprehensive evaluation on the importance and significance of each target in the network. Afterwards, key targets of Buyang Huanwu decoction were excavated to obtain two important targets--COX-2 and PPAR-gamma, which may be important targets involved in the qi deficiency and blood stasis diseases. Meanwhile, the two targets were the basis to build the core network of "chemical component-target-disease" of Buyang Huanwu decoction, which provided reference for further studies on the effect of Buyang Huanwu decoction in treating qi deficiency and blood stasis diseases. According to the study, the network analysis method was helpful to excavate potential targets Buyang Huanwu decoction in treating qi deficiency and blood stasis diseases, and could provide methodological reference for revealing the mechanism of Buyang Huanwu decoction at multiple levels, with a guiding significance for interpreting mechanisms of traditional Chinese medicinal formulae and developing new drugs.
Drugs, Chinese Herbal ; pharmacology ; Hematologic Diseases ; drug therapy ; Medicine, Chinese Traditional ; Qi ; Yang Deficiency ; drug therapy ; Yin Deficiency ; drug therapy

Objective To assess the diagnostic value of anti-mutated citrullinated vimentin antibodies (anti-MCV) for rheumatoid arthritis (RA), and compare it with anti-cyclic citrullinated peptide antibodies (anti-CCP), rheumatoid factors (RF). Methods Commercially available enzyme-linked immunosorbent assay (ELISA) kit was used to detect anti-MCV antibodies in a group of 177 RA patients, 46 patients with other rheumatic diseases, and 48 healthy blood donors. At the same time, anti-CCP, RF were detected. T test and χ2 test were selected. Results The average concentration of anti-MCV was (523±376) U/ml in RA, (96± 55) U/ml in patients with other rheumatic diseases, (34±18) U/ml in healthy controls. Different threshold levels (20, 40, 60, 80, 100, 120, 140 U/ml) for positive results were calculated bythe areas under the ROC curve (the areas were 0.521, 0.706, 0.769, 0.791, 0.816, 0.826, 0.822), then the best diagnosis efficacy for RA was determined as more than 120 U/ml. At this level, the sensitivity and the specificity for anti-MCV were 80.1% and 80.9% for RA diagnosis. The positive and negative predictive value were 92% and 67.8%. Comparing with anti-CCP, anti-MCV showed comparable specificity but higher sensitivity. And it's also better than RF apparently. If all 3 antibodies were detected at the same time, or anti-MCV combine with one of them, the sensitivity would increase to 95.7%. In addition, Anti-MCV showed positive in 32 of 67(55.2%) patients with RA whose anti-CCP was negative, meanwhile 31 of 59 (52.5%) patients with RA whose RF was negative. Conclusion RF and anti-CCP are complementary in diagnosing RA. The combination detection of RF and anti-CCP could significantly improve the specificity for the diagnosis of RA.

Objective To elucidate the prevalence and clinical characteristics of human metapneumovirus(hMPV)in hospital- ized children with respiratory infection.Methods A total of 452 hospitalized children with lower respiratory tract infection were observed from Aug 2004 to Jan 2005.Respiratory tract aspirates were collected from all patients within 48 hours after admis sion.The specimens were routinely tested for respiratory syncytial virus,influenza virus A and B,parainfluenza virus 1 to 3 and adenovirus by direct fluorescent assay(DFA).The 245 specimens negative by DFA were tested for hMPV by RT-PCR. PCR products of hMPV M gene from some patients were randomly selected for sequencing analysis.Results hMPV was identi- fied in 59(24.1%)of the 245 specimens tested,hMPV infection alone accounted for 13.1% of the infections in the 452 chil- dren under study,The prevalence of hMPV was higher than other respiratory viruses in winter.The mean age of hMPV-infec- ted children(n=59)was 27.7 months.There was no significant difference between age groups in terms of the prevalence of hMPV(P＞0.05).There were no statistically significant difference in demographics and clinical symptoms between hMPV in- fection and other common respiratory virus infection.Genotyping for the hMPV M gene from 23 Shanghai patients showed two distinct hMPV genotypes.Sequence analysis of these hMPV M genes showed 82.8%-100% homology to the registered se- quence in GenBank.There was no significant difference in clinical characteristics between the 2 genotypes.Conclusions hMPV plays an important pathogenic role in lower respiratory tract infection of children,hMPV prevailed in the winter of 2004.Clini- cally,hMPV infection can not be discriminated from the infection of other respiratory viruses.Clinical manifestation is similar between the two hMPV genotypes.

Objective To evaluate the feasibility of using comprehensive geriatric assessment (CGA) in estimating if standard dose treatment is fit for the elderly patients with diffuse large B cell lymphoma.Methods.Comprehensive geriatric assessments including three assessments of activity of daily living,instrumental activity of daily living and comorbidity scoring according to Cumulative Illness Rating Score for Geriatrics were adopted to assess if standard dose treatment is fit for the elderly patients in our prospective study.Thirty seven patients with diffuse large B cell lymphoma,aged ＞70 years were enrolled in the study,and grouped into fit,unfit and frail groups according to comprehensive geriatric assessment scoring and their age.The treatment protocolswere not determined by comprehensive geriatric assessment scores,but by clinical judgments made by clinicians based on their clinical experience and disease features.The clinically effective response and overall survival (OS) were analyzed in the three groups.Results According to CGA scores,patients were grouped into fit [21 cases (56.8％)],unfit [7 (18.9％)] and frail [9 (24.3％)].37 cases received 213 courses of treatment at average 5.76 courses per case.The overall response (complete / partial remission) rates were [85.7％(18/21) vs.28.6％ (2/7) vs.44.4％ (4/9),x2=9.69,P=0.008] and median survival times were (44 months vs.10 months vs.9 months;x2 =7.03,P=0.03) among fit,unfit and frail groups with statistically significant differences.Total effective rate (achieving all clinical targets) in fit group of 21 cases were 100 ％ (12/12)with receiving standard dose therapy,and 66.7％ of(6/9)with low dose therapy(P=0.06).Overall response rate(total/partial remission) [85.7％(18/21) vs.28.6％(2/7) vs.44.4％(4/9),x2=9.69,P=0.008] and median survival (44 months vs.10 months vs.9 months;x2 =7.03,P=0.03) amongfit,unfit and frail groups.In fit group,the two-year overall survival was higher in patients receiving standard dose treatment than receivingpalliativetreatment,with statistical significance [83.3 ％ (10/12) vs.33.3 ％ (3/9),P =0.032],without significant hematologic toxicity observed between the subgroups.Conclusions Comprehensive geriatric assessment can identify if elderly patients diffuse large B cell lymphoma can acquire a satisfactory curative effect from a standard dose treatment ofimmunochemotherapy.

Melanoblasts, the precursors to melanocytes, originate in the neural crest. Some melanoblasts can travel to the hair follicle and further differentiate into pigment melanin-producing melanocytes. Hair follicles contain a pool of undifferentiated melanocyte stem cells (MSCs), which are sources of differentiated melanocytes, and functional melanocytes exhist in the hair bulb. The volume, life, and activity of melanocytes in a hair follicle is closely related with the growth cycle of follicle. Appearance of gray hair gray results from incomplete MSCs maintenance.
Aging ; physiology ; Cell Differentiation ; Hair Follicle ; cytology ; physiology ; Humans ; Melanocytes ; physiology ; Stem Cells ; physiology

Objective: To validate comprehensive geriatric assessment (CGA) system in Chinese elderly diffuse large B cell lymphoma (DLBCL) patients. Methods: Patients ≥ 65 years of age who had been diagnosed with de novo DLBCL were screened for eligibility (n=99). CGA was performed during staging procedures through application of the following instruments: age, comorbidity score according to the Cumulative Illness Rating Score for Geriatrics(CIRS-G), activities of daily living (ADL), and instrumental activities of daily living (IADL). Results: All patients were classified as "ft" , "unfit" , and "frail" . Forty-nine (49.5%), 14 (14.1%), and 34 (36.4%) patients were categorized into the fit, unfit, and frail groups, respectively. The overall response rate was 91.8%, 64.3%, and 69.5% in fit, unfit, and frail group, respectively (χ²=9.311, P=0.007). Eleven (22.4%), 7 (50.0%), and 16(44.4%) patients showed disease relapse/progression in fit, unfit, and frail group, respectively (χ²=6.309, P=0.040). The 2-year probability of overall survival was 90.6%, 43.0%, and 58.5% in fit, unfit, and frail group, respectively (χ²=14.774, P=0.001). The 2-year probability of progression-free survival was 72.9%, 32.5%, and 37.3% in fit, unfit, and frail group, respectively (χ²=11.038, P=0.004). Conclusion The CGA index can predict the clinical outcomes of elderly DLBCL patients in China.

Objectives To evaluate the efficacy of rituximab combined with chemotherapy in the treatment of diffuse large B-cell lymphoma (DLBCL) and the relationship of clinical prognosis with the International Prognostic Index (IPI) by the using rituximab in autologous peripheral stem cell transplantation (APBSCT) for the patients of DLBCL. Methods 21 patients with DLBCL, 11 patients of them were at IPI low risk, and 3 patients were IPI at low intermediate risk, 3 patients were at IPI high intermediate risk, 4patients IPI high risk. Rituximab combined with CHOP regimen (cyclophosphamide, adriamycin, vincfistine and prednisone) was given for 4～8 courses. 5 patients received APBSCT. The mobilizing regimen was rituximab combined with cyclophosphamide(CTX) and etoposide(VP16). The conditioning regimen were CBV(CTX combined with VP16 and carmustine). Results In 21 patients, the complete response rate was 61.9 %,with overall response rate 90.5 %. 2-year progression free survival was (69.74±10.43)%. 2-year overall survival was (84.44:1:8.35) %. The complete response rate was 92.9 % and overall response rate was 100 % in the patients IPI≤2. The overall response rate was 71.4 % in the patients with IPI≥3. The complete response rate was higher in the patients with IPI≤ 2 (P＜0.01). The amount of mononuclear cells (M NC) in harvest were 7.34 (4.6～8.53)×108/kg. The CD+34 cells in harvest were 8.82 (2.1～10.34)×1O6/kg. The mean time of neutrephil recovering to 0.5×109/L after APBSCT was +9 day. The mean time of platelet recovering to 20×109/L after APBSCT was +12 day. The major adverse reaction were infusion related response (14.3 %) and hematological toxieities. Conclusion The efficacy of rituximab combined with chemotherapy in the treatment of DLBCL is effective, The complete response rate was higher in the patients with IPI≤2 than in the patients with IPI≥3.Using rituximab in mobilizing regimen, all patients had harvested enough CD+34 cells. Rituximab given at +1day did not affect the hematopoiesis reconstruction.

Objective To explore the changes of plasma angiotensinⅡ (AngⅡ) and cardiac function,and the curative effect of children with acute viral myocarditis (VMC) treated with captopril(CAP).Methods Concentrations of plasma AngⅡ were measured with radio-immunity and cardiac function was detected by Doppler echocardiography for the VMC group (n=60) before and after treatment [the CAP group (n=30), the routine group (n=30) and the control group (n=30)].Results 1. The level of plasma AngⅡ significantly increased and the contractive and diastolic function obviously declined in children with acute VMC. There was a significant difference between VMC group and control group, with a significant correlation between the level of AngⅡand the contractive diastolic function.2. Compared with the level before treatment, the level of AngⅡ decreased and the contractive function obviously ameliorated in two groups; the diastolic function obviously ameliorated in the CAP group and did not ameliorate in the routine group after treatment. In CAP group the level of AngⅡ and the cardiac function significantly improved; there were statistical differences between the two groups after treatment.Conclusions 1.The increase of the plasma AngⅡ was an important factor for decrements of the contractive and diastolic function in acute viral myocarditis.2.It could decrease the concentration of plasma AngⅡ and ameliorate cardiac function in children with acute VMC treated with captopril,which was an effective therapy for acute VMC.

Stones in the seminal vesicles are extremely rare. We present a 62-year-old patient with a stone within a seminal vesicle cyst, who was cured by laparoscopic treatment. The operative time was 80 min, and the estimated blood loss was 90 mL. Scanning electron microscope examination of the stone showed a compact crystal image externally and sparse spherical crystal structure in kernel. Composition of the stone was calcium fluorophosphate on X-ray diffractometer. The follow-up time was 15 months with no recurrence of cyst or stone. To our knowledge, this case is the first to describe laparoscopic removal of a stone within a seminal vesicle cyst, and the first to describe calcium fluorophosphate as the composition of seminal vesicle stones.
Calculi ; surgery ; Cysts ; surgery ; Genital Diseases, Male ; surgery ; Humans ; Laparoscopy ; Male ; Microscopy, Electron, Scanning ; Middle Aged ; Seminal Vesicles