Objective To investigate the distribution and antibiotic resistance of the enteric pathogens in Shanxi province to guide the choice of antibacterials.Methods 798 cases of fecal samples from patients with diarrhea were treated in the outpatient and inpatient.The suspected pathogen was separated then PCR,biochemical test,serum agglutination tests were used for identification of suspected pathogen,and bacterial pathogens constitution and patho-genic characteristics were analyzed.Antimicrobial susceptibility testing was conducted by diskdiffusion method for the suspected pathogen with 6 antimicrobial agents.Results 81 strains isolated from 798 specimens were positive with 10.15% for pathogen detection.Diarrheagenic Escherichia coli was the first frequently pathogen,accounting for 46.91%,followed by Shigella,Salmonella and Aeromonas.Drug sensitivity monitoring showed that the most of the 81 strains had lower level of resistance to cefoitin,cefotaxime and ciorofloxacin,and higher level of resistance to tetra-cycline and nalidixic aid.Conclusion Diarrheagenic Escherichia coli,Shigella,Salmonella and Aeromonas are the major bacterial diarrheal pathogens in the hospital.Surveillance of antimicrobial resistance in these bacteria should be strengthened to provide reliable evidence for clinical anti infection treatment.

Objective To analyze the PCR and molecular characters of the first serogroup W135 meningo-coccal death case in Shanxi province on April,2013.Methods Epidemiological survey of suspected epidemic cere-brospinal meningitis case was conducted,blood serum and petechia tissue fluid samples were identified by PCR for crgA gene and siaD gene of W 135.Multilocus sequence typing(MLST)was performed for determining the sequence types(STs).Results The patient in the case died of serogroup W135 Neisseria meningitides,which belonged to ST-11.Conclusion This is the first case died of serogroup W135 Neisseria meningitidis in Shanxi province,which prompts that the surveillance of meningococcal pathogeny should be strengthened.

Objective To investigate the expression of EGFR, Her-2 and TOPO Ⅱ in esophageal canceration course, analyze the correlation between the expression and clinical pathological parameters and the correlation of the three genes. Methods EGFR, Her-2 and TOPO Ⅱ were detected by Tissue microarray technology and Envision immunohistochemistry method in 107 cases of esophageal carcinoma, including normal esophageal epithelium, esophageal intraepithelial neoplasia and esophageal squamous cell carcinoma. Results The positive expression rates of EGFR and TOPO Ⅱ display an improving trend from normal esophageal epithelium, intraepithelial neoplasia to carcinoma (P =0.031) in the above four groups. The positive expression rates of EGFR were 8.41 %, 7.94 %, 27.27 %, 50.47 %, and TOPO Ⅱ were 3.74 %, 4.76 %, 20.45 %, 43.93 %. Furthermore, the expression showed gradually incresing with histological grades advance (P =0.009). There was no correlation between EGFR or TOPO Ⅱ and gender, age, lymph node or distant metastasis (P >0.05). There was a positive correlation between EGFR and TOPO Ⅱ (r 1=0.410, P <0.05). There were no significance of Her-2 protein expression among the three groups(P >0.05), no correlation was obtained between Her-2 and gender, age, the depth of invasion or lymph node metastasis (P >0.05), no relationship between Her-2 and EGFR or TOPO Ⅱ either. Conclusion EGFR and TOPO Ⅱ are closely related to the occurrence and development of esophageal squamous cell carcinoma, their expressions all make a qualitative change in the esophageal high-grade intraepithelial neoplasia. The role of Her-2 in the development of esophageal squamous cell carcinoma is still not definite in Shanxi province.

Objective To identify the prevalence of different amyloid types in renal biopsies.Methods The renal biopsies of 205 patients diagnosed as renal amyloidosis from January 1990 to December 2011 were reassessed.Immunohistochemistry was performed with a penal of antibodies directed against λ-light chain,κ-light chain,amyloid A,fibrinogen,transthyretin,apolipoprotein A1,and lysozyme.Immune electron microscopy and gene analysis were performed when the results of immunohistochemistry were indeterminate.Results Among 205 patients,190 cases (92.7％) were classified as immunoglobulin light chain amyloidosis (AL),1 (0.5％) case as amyloid A amyloidosis and 1 (0.5％) case as fibrinogen A α-chain amyloidosis.The amyloid types of remaining 13 (6.3％) cases were undetermined.In the AL patients,the distribution of λ and κ was 6.6∶1.Conclusion AL is the most common form of renal amyloidosis in China,with a predominant light chain type of λ.

Objective To investigate the role of cell cycle regulatory protein CDK4,p18,p19 in the genesis and development of esophageal squamous cell carcinoma (SCC).Methods Tissue microarray and immunohistochemical method (Envision) were used to detect the protein expression of CDK4,p18,p19 in 120 cases of esophageal tissues.The results were statistically analyzed.Results The positive rate of CDK4 protein expression in normal esophageal epithelium was low [28.3 % (34/120)],it increased in esophageal intraepithelial neoplasia [32.5 % (39/120)],and it was high in esophageal SCC [84.2 % (101/120)],which increased with the degree of SCC differentiation decreasing gradually.There was significant differences between the SCC and normal esophageal epithelium or esophageal intraepithelial neoplasia (x2= 76.004,P ＜0.05; x 2= 65.897,P ＜ 0.05).The expression of CDK4 in group with lymphatic metastasis [93.88 % (46/49)]was higher than without it [71.43 % (55/71)] (x2= 5.860,P ＜ 0.05).The positive rates of p18,p19 protein expression in normal esophageal epithelium were high [34.2 % (41/120),29.2 % (35/120)],it decreased in esophageal intraepithelial neoplasia [19.2 % (23/120),15.0 % (1 8/120)] (x 2= 134.481,P ＜ 0.05; x 2 = 141.376,P ＜ 0.05),but it were high in esophageal SCC [63.3 % (76/120) and 61.7 % (74/120)] which decreased with the degree of SCC differentiation gradually increased.There were significant differences between the normal esophageal epithelium and esophageal intraepithelial neoplasia,esophegeal intraepithelial neoplasia and SCC,normal esophageal epithelium and SCC (p 18:x 2 = 6.903,48.296,20.429,P ＜ 0.05; p1 9:x2 = 6.998,55.276,25.565,P＜ 0.05).CDK4 protein expression was correlated with both p18 and p19 (r =0.696,0.630,P ＜0.05),and there was significant positive correlation between the protein expression of p18 and p19 (r =0.833,P ＜0.05).Conclusion Cell cycle regulatory gene CDK4,p18,p19 get involved in the genesis and development of esophageal squamous cell carcinoma.Their protein expressions are closely related to canceration of esophageal epithelium.

Objective To improve the knowledge of primary gout in children. Methods Clinical data of a 12-year-old girl with primary gout was collected. Analysis of UMOD gene, REN gene and HNF-1βgene was performed using PCR and di-rect sequencing. Results The girl was admitted for 1-month history of left hallux pain accompanied with elevations of serum uric acid concentration and serum creatinine concentration. Several examinations showed serum uric acid/creatinine ratio was greater than 2.5. The fractional excretion of uric acid was 3.4%-6.6%. The X-ray showed that the proximal phalanxes of halluces were erosion. The diagnosis of renal biopsy was ischemic renal injury and chronic tubulointerstitial nephropathy. Blood uric acid concentrations of parents were normal, and the family history of gout was negative. Two single nucleotide polymorphisms (c.264C>T heterozygous and c.866-71 G>A heterozygous) in UMOD gene, 1 single nucleotide polymorphism (c.373+44C>G heterozygous) in REN gene, and 2 single nucleotide polymorphisms (c.100-50-49ins TCTG heterozygous and c.781-22T>C homozygous) in HNF-1βgene were detected. No pathological mutation was detected in these 3 genes. Conclusions This child is highly suspected to have primary gout caused by familial juvenile hyperuricemic nephropathy.

With the rapid development of imaging and percutaneous coronary intervention, the application of contrast media has become more and more widespread, and contrast-associated AKI has become one of the most common causes of acute kidney injury. Contrast-associated AKI seriously threatens patients' health and brings greater economic burden to patients, so it is particularly important to prevent the contrast-associated AKI. Nicorandil is a common vasodilator drug in clinical practice, widely used in the treatment of angina pectoris, with the effects of anti-oxidative stress, anti-apoptosis, anti-inflammatory and vasodilation, and is considered to be effective in preventing contrast - associated AKI. However, there is still a lack of further research on the efficacy of nicorandil in preventing contrast-associated AKI.

ObjectiveTo investigate the effects of over expression of miR-34a on cellular proliferation and migration in bladder cancer cell line J82 by targeting Notchl.MethodsmiR-34a was predicted as a putative gene which can target Notchl through bioinformatics analysis,qRT-PCR and Western blot were performed to measure the expression levels of Notchl and miR-34a in invasive transitional cell carcinoma of bladder (TCCB) tissues and J82 cells transfected with miR-34a.Luciferase assay was employed to determine if miR-34a could target Notchl through binding to the 3'-untranslated region (3'UTR) of Notchl mRNA.J82 cells were transfected with pcDNA3.0-miR-34a or pcDNA3.0 control plasmid.MTS colorimetry was used to evaluate the effect of miR-34a on cell proliferation.The effect of miR-34a on cell migration was assessed by transwell migration assay.ResultsThe expression level of miR-34 in invasive TCCB tissues was lower than in adjacent bladder tissues (0.016(0.018) vs 0.042 (0.059),N =16; P =0.0006).On the contrary,the average levels of Notchl mRNA and protein were higher in tumors than in adjacent bladder tissues (2.765(2.156) vs 2.312(1.365),N =16; P =0.0025 and 0.857 ±0.197 vs 0.648 ±0.171 ;P ＜0.0001 ).After the transfection of miR-34a,the expressive level of miR-34a in J82 was highly induced ( (2.408 ±0.789) × 10-4 vs(0.153 ±0.029) × 10-4; P =0.0026).However,the expressive levels of Notchl mRNA and protein were obviously decreased (3.001 ± 0.106 vs 4.998 ± 1.053 ; P =0.0308 and 0.747 ± 0.050 vs 0.988 ± 0.102 ; P =0.0215 ).The results of luciferase assay showed that firefly activity was highly dimished (0.422 ± 0.028 vs 2.392 ± 0.148 ; P ＜ 0.0001 ).Cellular proliferation was inhibited after the transfection of miR-34a in J82 (P ＜ 0.0001 ).Moreover,number of migration cells of J82 was significantly reduced after the ectopic expression of miR-34a ( 179.3 ± 21.02 vs 269.7 ± 23.71 ; P =0.0078 ).ConclusionsmiR-34a inhibits the cellular proliferation and migration of bladder cancer cell line J82 via binding to the 3UTR of Notchl mRNA.

Objective: To investigate the antimicrobial resistance status and pulsed field gel electrophoresis (PFGE) patterns of Salmonella enteritidis (S.enteritidis) in Shanxi Province in order to provide references for the treatment of Salmonella infection and for tracing the source of outbreaks of foodborne diseases. Methods: Sixty-four S. enteritidis strains were collected by monitoring sites for foodborne diseases from April 2015 to March 2018. Biochemical identification system and serotyping analysis were used for bacterial identification. Drug susceptibility patterns were analyzed with micro-broth dilution method. PFGE was used for molecular typing. Results: The antimicrobial resistance rate of 64 S. enteritidis strains to nalidixic acid (95.31%) was the highest, followed by that to ampicillin (90.63%) and to ampicillin/sulbactam (81.25%). They had lower resistance rates to cefazolin, cefotaxime, tetracycline, ceftazidime, trimethoprim/sulfamethoxzole and ciprofloxacin (3.13%-23.44%) and were all sensitive to chloramphenicol, cefotaxime, azithromycin, imipenem and gentamicin. No statistically significant difference in drug resistance rates was found between the sporadic strains and the outbreak strains (P>0.05). All 64 S. enteritidis strains digested with XbaⅠwere divided into 33 molecular patterns by PFGE. The numbers of bacteria contained in each pattern ranged from 1 to 10 strains. The similarity among patterns was between 54.6% and 100%. Conclusion More attention should be paid to the drug resistance status of S. enteritidis in Shanxi Province. It is necessary to strengthen the standardized administration of antibiotics. The PFGE patterns of S. enteritidis reveal the presence of significant genetic polymorphism. PFGE is of great significance in analyzing the genetic relationship among S. enteritidis strains and in identifying and tracing the source of outbreaks of foodborne diseases.

Objective To investigate the autophagy level of Ana-1 cells after ingesting melanized Penicillium marneffei (PM),and to explore the feasibility of rapamycin in killing the bacteria by inducing macrophages autophagy.Methods Melanized PM was cultivated and isolated from the medium containing dopamine.The expression of microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ) in Ana-1 cells stimulated by conventional or melanized PM was detected by western blot.The expression levels of LC3 Ⅱ protein in Ana-1 cells treated with rapamycin and incubated with melanized PM was detected.Then,the localization of LC3 Ⅱ in Ana-1 cells which contained melanized PM was observed by immunofluorescence staining.Finally,the direct sterilization effect of rapamycin on melanized PM were detected,and the sterilization effect of Ana-1 cells treated with or without rapamycin on melanized PM was measured.Results No significant change was found in the LC3 Ⅱ level of Ana-1 cells after ingesting melanized PM (P＞0.05),while LC3 Ⅱ level in Ana-1 cells treated with rapamycin which contained melanized PM was significantly increased (P=0.009).The colocalization of LC3 Ⅱ with melanized PM in cytoplasm of Ana-1 cells was observed.For Ana-1 cells treated with rapamycin,3 h and 6 h after incubated with melanized PM,the survival rates of melanized PM both were significantly reduced (P=0.026,0.014).No significant sterilization effect of Ana-1 cells or rapamycin was observed under the same conditions.Conclusion Melanized PM can suppress the activation of macrophage autophagy,and rapamycin can improve sterilization effect of Ana-1 cells by inducing the activation of autophagy.