Objective:To study the value of detection of rpsl gene mutation in streptomy cin(SM)-resistance in clinical isolates of mycobacterium tuberculosis by PCR -SSCP,and to expect to set up a r apid detective method of rpsl gene mutation in mycobacterium tuberculosis,Method Eighty seven specimens isolated from patients were detected by PCR-SSCP silver staining,and using strain H 37Rv as a control,Results In 87 mycobacterium tuberculosis clinical isolates,the r psl DNA fragments from 16 drug-susceptible isolates had no mutation in rpsL gene ,48 of 62 sputum specimens showed rpsl gene mutation by PCR-SSCP,positive rate w as 77.4%.Conclusions The rpsL gene mutation is an important molecular mechanism of M.tuberc ulosis resistance to SM.PCR-SSCP might become a rapid detecting method of SM-r esistance of M.tuberculosis.

Objective:To study the value of detection of rpsl gene mutation in streptomycin(SM)-resistance in clinical isolates of mycobacterium tuberculosis by PCR-SSCP,and to expect to set up a rapid detective method of rpsl gene mutation in mycobacterium tuberculosis,Method Eighty seven specimens isolated from patients were detected by PCR-SSCP silver staining,and using strain H 37 Rv as a control,Results In 87 mycobacterium tuberculosis clinical isolates,the rpsl DNA fragments from 16 drug-susceptible isolates had no mutation in rpsL gene,48 of 62 sputum specimens showed rpsl gene mutation by PCR-SSCP,positive rate was 77 4%.Conclusions The rpsL gene mutation is an important molecular mechanism of M.tuberculosis resistance to SM.PCR-SSCP might become a rapid detecting method of SM-resistance of M.tuberculosis.

Objective To analyze the effect of clinical temporomandibular joint (TMJ) functional training for prevention of trismus in nasopharyngeal carcinoma (NPC) patients treated with radiotherapy.Methods According to the performance of patients clinical TMJ functional training, 43 NPC patients treated with three-dimensional conformal radiation therapy (3DCRT) and 82 NPC patients treated with general twodimensional radiation therapy were assigned respectively to the study group and the contrast group. The clinical TMJ functional training on patients of the study group was performed regularly and intensively under good guidance and supervision from the beginning of radiotherapy. The clinical TMJ functional training on patients of the contrast group was performed without such strict supervison after the first guidance. The size of the distance was measured between the incisors of the patients of the study group and the contrast group before radiotherapy and the final follow-up within two years after radiotherapy. Results The reduction of the distance between the incisors were [(0.64±0.59) cm] in the study group of 3DCRT in contrast to the [(0.81±0.64) cm] in the contrast group (P ＞0.05). The incidence of trismus was 8.1% in the study group of 3DCRT in contrast to the 21.1% in the contrast group (P ＞0.05); The reduction of the distance between the incisors were [(0.72±0.65) cm] in the study group of general two-dimensional radiotherapy in contrast to the [(1.64±0.73) cm] in the contrast group (P ＜0.01). The incidence of trismus was 19.0% in the study group of general two-dimensional radiotherapy in contrast to the 47.5% in the contrast group (P ＜0.01). Conclusion TMJ Functional training method is the good method that can lower the severity and the incidence of trismus in NPC patients treated with radiotherapy. It is more evident and more important for patients with general twodimensional radiotherapy.

Objective To investigate the potential of inflammatory markers for short-term prognosis of acute cerebral infarction.Methods A total of 272 consecutive patients with acute cerebral infarction were divided into a high hs-CRP group (hs-CRP level ＞3 mg/L) and a low hs-CRP group (hs-CRP level ≤3 mg/L),and their general information and medical history were collected.The Trial of Org 10172 in Acute Stroke Treatment (TOAST) stroke subtype classification was conducted and scores of the National Institutes of Health Stroke Scale (NIHSS),the Barthel index (BI) and the modified Rankin scale (mRS) were collected after admission.White blood cell count,blood glucose,blood homocysteine (Hcy) and C-reactive protein were measured within 24 hours following admission.Multivariate Logistic regression analysis was performed to identify independent risk factors for short-term prognosis of acute cerebral infarction.Results Between the high hs-CRP group and the low hs-CRP group,there were significant differences in the incidences of atrial fibrillation history,cardiogenic embolism of TOAST,blood homocysteine,blood glucose,white blood cell count,NIHSS,BI and mRS score 1,7,14 days after admission (P＜0.05 for all).The hs-CRP level (OR=0.876,P＜0.001,95％ CI:0.817-0.917),white blood cell count (OR=1.137,P=0.029,95％ CI:1.013-1.275),lipid metabolism disorders (OR=2.863,P＜0.001,95％ CI:1.561-5.250),and BI score (OR=1.038,P=0.047,95％ CI:1.001-1.077) 1 day after stroke were independent risk factors for short-term prognosis of acute cerebral infarction.Conclusions Increased levels of the inflammatory marker hs-CRP and elevated white blood cell count may be independent risk factors for short-term prognosis of acute cerebral infarction.

Objective To establish the prediction model for ischemic stroke recurrence. Methods Consecutive patients with ischemic stroke from January 1st, 2008 to December 31st, 2009 were followed up until June 30th, 2010. The rate of recurrence were described with Kaplan-Meier curve, and the factors associated with recurrence were analyzed with monovariant and multivariate Cox's proportional hazard regression. Results There were 79 cases relapsed during the follow-up. The independent risk factors associated with recurrence were age(X),history of hypertension (X2), family stroke history (X3), total cholesterol (X4), disease progression (X5), total scores of Essen stroke risk score (X6). The personal prognosis index (PI) for predicting recurrence was as: PI=0.025X1+0.681X2+0.973X3+0.395X4+0.636X5+0.283X6. As the receiver operating characteristic (ROC) curve showed, when the cut-off point of PI was 2.289, the sensitivity of the model was 0.731 and specificity was 0.795. Conclusion The model for predicting recurrence of ischemic stroke was established.

Objective To investigate the association between the HLA-DRB1 gene polymorphisms and susceptibility of pulmonary tuberculosis (TB) in patients with type 2 diabetes mellitus in North China. Methods A 1∶1 matched case-control study was adopted. Polymerase chain reaction-sequence-specific primers techniques (PCR-SSP) and restriction fragment length polymorphism (RFLP) was used to type polymorphisms (DR15, DR16, DR1, DR11). Information on environmental-related risk factors and pathological changes of tuberculosis was collected using a pre-tested standard questionnaire. Variance analysis, Chi-square, univariate and multivariate conditional Logistic analysis were conducted with SPSS 12.0 for Window. Results A sample of 124 pairs of cases and controls was studied. Univariate analysis demonstrated that DR15 mutant increased the risk of susceptibility of pulmonary tuberculosis (OR＝2.461, 95%CI: 1.363~4.444, P=0.002),and it would further increased if DR16 mutant occurred together (OR=4.904, 95%CI: 1.554~15.476). In multivariate analysis, DR15 mutant also associated with susceptibility of pulmonary tuberculosis (OR=2.996, 95%CI: 1.51~5.945). Conclusion Polymorphism of DR15 genotype might be a susceptible genotype of TB patients with type 2 diabetes mellitus in North China.

OBJECTIVETo investigate the changes in the structure and function of the carotid artery and their relationship with subclinical inflammation in patients with H-type hypertension.

METHODSSixty patients with H-type hypertension and 49 with non-H-type hypertension were enrolled in this study, with 20 healthy volunteers as the control group. All the subjects underwent color Doppler ultrasound examination of the carotid artery, and their blood levels of hyper-sensitive C-reactive protein (hs-CRP), fibrinogen (FIB), and tumor necrosis factor-α (TNF-α) were measured to investigate the correlation between the structural and functional changes of the carotid artery and the inflammatory factors.

RESULTSNo significant difference was found in the blood pressure level between the H-type and non-H-type hypertension groups (136.0∓10.1 vs 131.9∓7.0 mmHg for systolic blood pressure, P>0.05; 80.9∓8.9 vs 73.2∓7.9 mmHg for diastolic pressure, P>0.05). The intima-media thickness, distensibility of the common carotid artery, carotid artery stiffness, and blood homocysteine level all showed significant differences between patients with H-type and non-H-type hypertension (1.52∓0.08 vs 1.09∓0.06 mm, 0.23∓0.14 mmHg(-1)×100 vs 0.46∓0.14 mmHg(-1)×100, and 15.37∓5.89 vs 8.19∓4.53 µmol/L, respectively, P<0.05). The H-type hypertensive patients showed significantly higher hs-CRP, FIB, and TNF-α levels than the non-H-type hypertensive patients, and these inflammatory factors were positively correlated with the structural and functional changes of the carotid artery.

CONCLUSIONThe patients with H-type hypertension are more likely to have carotid artery structure and function impairments, which closely correlate with the subclinical inflammatory factors. These changes might be attributed to the synergism of subclinical inflammation and hyperhomocysteinemia, for which active intervention may prove beneficial.

Adult ; Aged ; Carotid Arteries ; pathology ; physiopathology ; Case-Control Studies ; Female ; Humans ; Hypertension ; classification ; pathology ; physiopathology ; Inflammation ; Male ; Middle Aged

Objective To investigate the effects of mannan-binding lectin(MBL) on TNF-α production induced by peptidoglycan (PGN) and its mechanism in human THP-1/CD14 monocytes.Methods The THP-1/CD14 cells were stimulated for 24 h with PGN at the indicated ratios after pretreated with human natural MBL at concentrations ranging from 1 to 20 mg/L for 2 h.The content of TNF-α and IL-6 in culture supernatants were detected by ELISA,and the levels of TNF-α and IL-6 mRNA expressions in these cells were determined by RT-PCR.FACS was used to investigate the interaction of MBL with THP-1/CD14 cells and the impact of MBL on PGN binding to THP-1/CD14 cells.Western blot was used to detect PGN-induced NF-κB translocation in THP-1/CD14 cells.Results ELISA showed that secretion of TNF-α and IL-6 from THP-1/CD14 cells could be induced by PGN ;The productions of TNF-α and IL-6 by THP-1/CD14 cells induced with PGN were profoundly inhibited by MBL at higher concentrations (10-20 mg/L) but not MBL at lower concentrations (1 mg/L).RT-PCR analysis also indicated that the mRNA expressions of TNF-α and IL-6 in THP-1/CD14 cells were decreased by MBL at higher concentration,compared to the corresponding THP-1/CD14 cells stimulated with PGN only.FACS showed that the binding of MBL to THP-1/CD14 cells was evident in a Ca2+-dependent manner.PGN could competitively inhibit the binding of MBL to THP-1/CD14 cells.MBL could competitively inhibit the binding of PGN to THP-1/CD14 cells by binding to THP-1/CD14 cells directly.Similarly,MBL at higher concentration (20 mg/L) decreased the NF-κB translocation in THP-1/CD14 cells.Conclusion MBL may inhibit TNF-α and IL-6 production induced by PGN in THP-1/CD14 cells through NF-κB signaling pathways,suggesting that MBL can play some roles in the regulation of PGN-induced inflammatory response.

Objective To evaluate the predictive value of eight scoring systems (Acute Physiology and Chronic Health Evaluation Ⅱ [APACHE Ⅱ] and APACHE Ⅲ,Improved Edinburgh-Scandinavian Scale [CSS],U.S.National Institutes of Health Stroke Scale [NIHSS],Activity of Daily Living [ADL] scale,Glasgow Coma Scale [GCS],Previous History of Disease Scale and Concomitant Disease Scale) in severity and outcomes of patients with acute ischemic stroke by using discriminant analysis,and to establish their mathematical models to predict the status of early death of stroke patients.Methods Three hundred and ninety-nine patients with acute ischemic stroke,admitted to our hospital from January 2008 to December 2012,were chosen in our study; these patients were tested with APACHE Ⅱ,APACHE Ⅲ,CSS,NIHSS,ADL,GCS,Previous History of Disease Scale and Concomitant Disease Scale within 24 h of admission.All of them were divided into two groups according to groups of survival (n=278) or death (n=121) one month after disease onset.Discriminant analysis was performed on all the data and the predictive values of these eight scales in the prognosis were analyzed.Results Patients from group of death had significantly higher scores of APACHE Ⅱ,APACHE Ⅲ,CSS,NIHSS and Concomitant Disease Scale,and statistically lower scores of ADL and GCS scores than those from group of survival (P＜0.05).Cluster analysis showed that CSS and NIHSS,and APACHE Ⅱ and APACHE Ⅲ,respectively,belong to clusters,which enjoyed higher predictive values than other scales.The areas under receiver operator characteristic (ROC) curves were 0.808,0.818,0.796 and 0.794 of APACHE Ⅱ,APACHE Ⅲ,CSS and NIHSS scores,respectively,enjoying good definition; Discriminant analysis was used to analyze the eight scoring systems and mathematical models were established to predict the outcomes of stroke patients,enjoying more than 80％ of coincidence rate.Conclusion APACHE Ⅱ,APACHE Ⅲ,CSS and NIHSS are superior to the other four score systems in evaluating severity of stroke patients,whose mathematical models,having more than 80％ of accuracy rate.