Because the biology characteristic of HIV is extremely different from that of other microorganisms, HIV vaccine research has being faced with unprecedented difficulties and challenges. In the last 20 years, HIV vaccine research has been carried out mainly with two strategies, i.e., neutralizing antibody based and cellular immunization based; however, substantive breakthroughs haven't been achieved until now. Inducing effective neutralizing antibody is always an important strategy in traditional vaccine research, but this strategy is much less efficient in HIV vaccine research because of high variation and much subtypes of HIV. In recent years, the discovery of broadly neutralizing monoclonal antibodies and elucidation of their corresponding antigen epitopes have brought new hopes for the development of neutralizing antibody based HIV vaccine. Reviewing these advancements will be helpful for reconsidering HIV vaccine development with a better strategy.

Objective To study the feasibility, safety, effectiveness of left atrial circumferential ablation of pulmonary veins for atrial fibrillation(Af) guided by EnsiteNavX mapping system. Methods Seventeen patients with paroxysmal or persistent Af were included. Real time 3-dimensional left artial (LA) and pulmonary veins (PVs) maps were constructed through EnsiteNavX mapping system. Pulmonary veins isolation was performed by encircle the left and right sides PVs at adistance of 1 to 2 cm away from the ostium of PVs. Results Seventeen patients were all reached the endpoint of abalation completely. The mean procedure time and fluoroscopy time were (226.1 ± 36.2) minutes and (41.3 ± 12.8) minutes. Mean radiofrequency energy delivery time was (61.9 ±15.4) minutes. Recur-rence of Af occurred in two patients, one was repeat ablation succnssfully. During 3 ～ 36 months followup, fourteen patients (82.3%) were free of Af without any antiarrhythmic drugs. Recurrence of Af occurred in three(11.7%) patients treated with amiodarone. No complications occurred during the procedure and the following up. Conclusion Left atrial circumferential isolation of pulmonary veins for Af guided by Ensite NavX mapping system was effective and salty.

Objective To evaluate the clinical efficacy and safety of high-dose Ambroxol in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Retrieved from PubMed, EMbase, Cochrane Library, CNKI, VIP and WanFang databases by computer, randomized controlled trials (RCTs) about high-dose of Ambroxol in treatment of AECOPD were included. According to the inclusive and exclusive criteria, literatures and data were independently screened and extracted by two researchers, and the quality of the studies were assessed, Meta-analysis was conducted by RevMan 5.2 software. Results A total of 7 RCTs were included, involving 534 patients. Meta-analysis showed that experiment group can obviously improve the overall effective rate [OR = 4.11, 95%CI (2.31, 2.31), P < 0.000 01), shorten hospital stays(OR = 3.60, 95% CI (4.66, 2.55), P < 0.00001), compared with the control group was statistically difference, and no obvious adverse reactions. Conclusion High-dose of Ambroxol could improve AECOPD overall effective rate, shorten hospital stays, improve pulmonary function and blood gas analysis, and no serious adverse reactions, be worth clinical promote using.

Objective To investigate the effects of different pacing sites of right ventricle on serum N terminal Pro brain natriuretic peptide (NT-ProBNP) and left ventricular systolic function.Methods A total of 76 patients with an implanted DDD pacemaker were randomly divided into right ventricular septal pacing group (RVSP group,n=40) and right ventricular apex pacing group (RVAP group,n=36) according to the ventricular leads position.Serum NT-proBNP level,left ventricular end diastolic dimension(LVEDD)and left ventricular ejection fraction(LVEF)were analyzed before and 6 months after operation in the two groups.Results There was no difference in serum NT-proBNP level between the two groups before operation,but the serum NT-proBNP level increased in both groups 6 months after operation,and it was higher in RVAP group than in RVSP group (P＜0.05).There were no significant differences in LVEDD and LVEF in RVSP group before and after implantation (P＞0.05).Compared with pre-implantation,LVEDD was increased and LVEF was decreased in RVAP group 6 months after implantation (both P＜0.05).Linear correlation analysis showed that serum NT-proBNP level was negatively correlated to LVEF (2γ=-0.76,P＜0.05).Conclusions Compared with RVAP,RVSP can keep the normal sequence of electrical activity and exert less adverse effects on left ventricular systolic function.Therefore,RVS is an ideal pacing location.

OBJECTIVE To study the expression situation of esp gene and the relativity between esp gene and resistance of Enterococcus faecalis derived-infection.METHODS The E.faecalis esp gene was amplified by PCR,then it was cloned and sequenced;the minimum inhibitory concentration(MIC) of five antimicrobicals against E.faecalis was determined by agar dilution method.RESULTS The positive rate of esp gene in 61 strains of E.faecalis was 42.6%;the positive rate of esp gene in the resistant strains against ampicillin,ciprofloxacin,high-level gentamicin,and erythromycin was 33.3%,54.8%,70.6%,and 51.0%,respectively,and the positive rate of esp gene in the susceptible strains against above 4 antibacterials was 43.6%,30.0%,7.4%,and 8.3%,respectively.CONCLUSIONS Incidence of esp gene does not correlate with the resistance of E.faecalis against ampicillin,but clearly correlate with the resistance of E.faecalis against ciprofloxacin,high-level gentamicin,and erythromycin;esp could become a marker of high-level gentamicin against E.faecalis derived-infection.

Objective To explore the impact of broad antigen HLA-Bw4 on disease progression in HIV-1 infected subjects. Methods Three hundred and forty subjects chronically infected with HIV-1 and 69 HIV-1 negative subjects were recruited and HLA-B alleles were typed with sequence-based high resolution typing assay. HLA-Bw genotypes of these HIV-1 infected subjects were determined and their association with CD4+ T cell counts and viral loads were analyzed. Results Sixty-five HLA-B alleles were detected in HIV-1 positive subjects. Subjects with Bw4 (Bw4 homozygotes and Bw4Bw6 heterozygotes ) had higher CD4+ T cell counts ( P = 0. 004 ) and lower plasma viral load ( P = 0.003 ) than subjects without Bw4 ( Bw6 homozygotes). When compared with HIV-1 postive subjects with CD4+ T cell counts above 500 celis/μl, those with CD4+ T cell counts below 500 cells/μl were observed with decreased percentage of Bw4Bw6 heterozygote ( P =0.0002) and increased percentage of Bw6 homozygotes ( P < 0. 0001 ). There is no significant difference in CD4+ T cell counts between Bw4 homozygotes and Bw4Bw6 heterozygote, but lower viral loads were observed in Bw4Bw6 heterozygotes( P = 0. 037 ). Conclusion HLA-Bw4 can confer pretective effects on H1V-1 infected subjects by maintaining higher CD4+ T cell counts and lower viral load, the mechanism behind this effect need further exploration.

OBJECTIVE To explore study a method for rapid detection of bacterial infection in clinic to diagnose septicemia early.METHODS 16S rRNA gene of ten bacterial species was amplified with PCR,by using human genome DNA,HBV-DNA and Candida albicans as comparison.The sensitivity test was done by the method of gradual dilution of Escherichia coli.RESULTS The bacterial species were amplified and the products were 371 bp,but human genome DNA,HBV-DNA and C.albicans showed no amplification products.Sensitivity test showed that it could detect as low as 1.5?104/L of E.coli.CONCLUSIONS The method is rapid and highly specific and sensitive in detecting the existence of bacterial 16S rRNA gene.

OBJECTIVE To set up a quick method to detect pathogens in cerebrospinal fluid.METHODS The method of polymerase chain reaction(PCR),using a pair of universal primers targeted at the 16S rRNA gene,was adopted to amplify the DNA of bacterium.138 clinical specimens obtained from patients were examined by PCR method and bacterial culture method.RESULTS The positive rate was 39.86% of PCR and 17.39% of culture,the outcomes had statistical significance(P

Objective To evaluate and analyze relationship of plasma level of N-terminal probrain natriuretic peptides (NT-proBNP) and serum level of cystatin C (CysC) with cardiac and renal functions in patients with chronic heart failure (CHF) , and explore significance of CysC measurement in early diagnosis for renal damage in patients with CHF. Methods Totally, 162 patients with CHF and 150 normal healthy (controls) undergone routine physical check-up at, Taizhou People's Hospital, Jiangsu were enrolled in the study. Their plasma level of NT-proBNP and serum level of CysC, as well as serum levels of creatinine ( SCr) , urea nitrogen ( BUN) were measured and echocardiography was performed. Glomerular filtration rate (eGFR) was evaluated by modification of diet in renal disease (MDRD) study group formula. Results Compared with the control group, blood levels of NT-proBNP, CysC, SCr, BUN and left ventricular end diastolic diameter ( LVEDD) all elevated, both eGFR and left ventricular ejection fraction ( LVEF) decreased (P <0. 05 or P <0. 01 ) in CHF group, and CHF patients were prone to complicate with renal dysfunction (P<0. 01). Blood levels of NT-proBNP and CysC elevated significantly and LVEF lowered significantly in CHF patients with NYHA functional classes II , III and IV than those in control group. There was significant difference in blood levels of NT-proBNP and CysC between patients with varied NYHA functional classes (P<0. 05). Blood levels of NT-proBNP and CysC reversely correlated with LVEF (r = -0. 36, P < 0. 01 and r = - 0. 39, P < 0. 01) . Blood level of CysC correlated with that of NT-proBNP ( r = 0. 87 , P < 0. 01). Results of logistic regression analysis showed that elevated blood levels of NT-proBNP and CysC were risk factors for mortality during hospitalization in patients with CHF. Conclusions Patients with CHF were more likely to complicate with renal dysfunction than controls, with main manifestations of more severe damaged eGFR, more severe heart failure and more obviously renal damage. Blood levels of NT-proBNP and CysC can be used as indicators for evaluating exacerbation of chronic condition, and serumlevel of CysC can be used as marker for early diagnosing renal damage in patients with CHF.

Objective Using yeast two-hybrid system to screen the proteins which can interact with the human cytomegalovirus (HCMV) UL128 which have two difference transcription structure from human fetus brain cDNA library, and compare the difference with structure and function of interacting proteins. Methods Two fragments of UL128 were amplified by 3'RACE and 5'RACE technology, the length are 519 bp and 642 bp, respectively. The "bait plasmid" (named as pGBKT7-UL128-519 bp and pGBKT7-UL128-642 bp) was constructed successfully. Using pGBKT7-UL128-519 bp and pGBKT7-UL128-642 bp as a bait, a human fetus brain cDNA was screened and the proteins interacting with UL128-519 bp and UL128-642 bp encoded protein were searched, and the positive clones were sequenced and analyzed by bioinformatic methods. Results EFEMP2 interacting with HCMV UL128-519 bp were identified, THY-1 interacting with HCMV UL128-642 bp were identified. Conclusion EFEMP2 and THY-1 proteins interacting with HCMV UL128-519 bp and UL128-642 bp in human fetus brain cDNA library were successfully screened, but same proteins weren't found from the proteins interacting with UL128-519 bp and UL128-642 bp protein, UL128-519 bp and UL128-642 bp protein may be play an different effect in the process of infect by HCMV.