Objective To investigate and dispose an outbreak of seasonal influenza in hospital,so as to provide reference for the prevention and control of influenza outbreak in hospital.Methods Eight cases of influenza-like in-fection occurred in the department of neurosurgery at a hospital between July 29 and August 7,2014,epidemiologi-cal investigation was conducted,throat swabs of infected persons were collected for laboratory detection.Results Of 8 infected persons,6 were health care workers (HCWs)in department of neurosurgery,1 was a family member of HCW,and 1 was a patient,the major symptoms of the infected persons were low-grade fever,sore throat,and ma-laise,there were 67 patients and HCWs in this department,the attack rate of influenza was 11.94%,there was no similar infection in other departments of the hospital during the same period.The throat swabs from 6 infected HCWs were positive in influenza virus nucleic acid detection.Office for healthcare-associated infection (HAI)man-agement participated the investigation,after active isolation and antiviral treatment,the outbreak was effectively controlled.Conclusion This HAI outbreak is a seasonal influenza H3 outbreak,ventilation and environmental dis-infection in wards should be strengthened when central air conditioning is running,anti-influenza vaccination among HCWs should be performed during the epidemic season of influenza,and surveillance should be strengthened to pre-vent influenza outbreak in hospital.

BACKGROUND:At present, few studies concerned pulmonary infection after treatment of senile fracture. For special parts of senile patients, there are no studies on complications of pulmonary infection in perioperative period after hip fracture. OBJECTIVE:To study risk factors for pulmonary infection in patients with senile hip fractures in perioperative period. METHODS:The data of 46 senile hip fracture patients with perioperative pulmonary infection were retrospectively analyzed. A matched case-control study was conducted in 46 senile hip fracture patients without pulmonary infection in the same hospital and the same period. The difference in perioperative various clinical indexes was compared between the two groups. Risk factors of pulmonary infection received Logistic regression analysis. RESULTS AND CONCLUSION:Multivariate analysis screened out 14 possible perioperative pulmonary infection factors:chronic obstructive pulmonary disease, smoking, diabetes mel itus, heart disease, mechanical ventilation, intraoperative bleeding amount, erythrocyte infusion, operation time, preoperative low body mass index (body mass index<18.5 kg/m2 ), serum albumin<35 g/L, electrolyte disturbance, time of entering intensive care unit and length of stay. Logistic regression analysis displayed that chronic obstructive pulmonary disease (OR=23.317;95%CI:2.702-60.312;P=0.000), entering intensive care unit (OR=7.890;95%CI:2.624-76.012;P=0.008), mechanical ventilation (OR=35.210;95%CI:8.464-131.203;P=0.017) and operation time (OR=12.122;95%CI:5.154-99.098;P=0.012) were independent risk factors for perioperative pulmonary infection in patients with senile hip fracture. These data indicated that one should be alert to the possible occurrence of pulmonary infection in senile hip fracture patients with the presence of chronic obstructive pulmonary disease, entering intensive care unit and mechanical ventilation.

(3S)-Linalool synthase (LIS) is a key enzyme involved in the monoterpene biosynthetic pathway. Based on our previous transcriptome study, the expression level of LIS gene was exceedingly related to glycyrrhizic acid (GA) biosynthesis. Therefore, we used hairy root culturing to further investigate the effect of LIS on the GA biosynthesis. A LIS gene (GenBank accession number: MZ169552) was cloned from Glycyrrhiza uralensis. The plant binary overexpression vector pCA-LIS was constructed by gene fusion. G. uralensis hairy roots overexpressing LIS were induced by the Agrobacterium rhizogenes ATCC15834. The expression levels of LIS were analyzed by real-time quantitative PCR (RT-qPCR) and the contents of GA in hairy root lines were determined by UPLC. It was found that in the hairy root lines overexpressing LIS, the expression levels of LIS were significantly higher than that in the wild type, while the contents of GA were remarkably lower than those in the wild type and negative control. These findings indicate that the expression level of LIS is negatively correlated with the accumulation of GA. In this study, LIS was cloned from G. uralensis for the first time and the negative regulatory effect of LIS on GA biosynthesis was confirmed by reverse genetics. This work provides support for further improvement of the molecular regulatory network of GA biosynthesis in G. uralensis.

Objective To determine the immune responses induced by recombinant Salmonella ty-phimurium expressing the secreting antigen ESAT-6 of Mycobacterium tuberculosis. Methods ESAT-6 cod-ing gene was cloned and identified by PCR and sequencing. Prokaryotic expression plasmid pYA33-esat car-rying the ESAT-6 coding sequence was constructed firstly and electro-transformed into an attenuated strain X4550 of Salmonella typhimurium, the recombinant bacteria was named as X4550(33-esat). C57BL/6 mice were immunized intranasally (I. N) with 108 CFU recombinant bacteria at day 0 and 18. Cells from spleen, lung, mesenteric lymph node (MLN) and Peyer's patch (PP) were collected from mice after second immu-nization, and the specific IFN-γ-secreting cells and IL-4-secreting cells were detected by ELISPOT assay u-sing ESAT-6 peptide as stimulus. Furthermore, CTL effects were in vivo evaluated by CFSE assay. Results The results showed that cellular immune responses specific for ESAT-6 could be detected by ELISPOT assay. In lung and PP cells, immune responses against ESAT-6 were biased toward Th1 type, the frequency of IFN-γ-secreting cells was much higher than that of IL-4-secreting cells. In splenocytes and MLN cells, the anti-gen specific immune responses acted as Thl and Th2 balance, the frequency of IFN-γ-secreting cells was close to that of IL-4-secreting cells. CFSE assay indicated that recombinant bacteria could induce the high level of CTL effects specific for ESAT-6 peptide. Conclusion These results suggested that recombinant Sal-monella typhimurium X4550(33-esat) not only can induce cellular immune responses, but also can elicit specific CTL responses after I. N immunization. It also provided the useful information for the control of infec-tious disease of tuberculosis.

Objective To evaluate masseter thickness and its complications of radiofrequency ablation and botulinum toxin type A in the treatment of masseter hypertrophy.Methods Totally 36 patients of benign masseter hypertrophy were randomly divided into radiofrequency ablation therapy group (18 patients) and the injection of botulinum toxin type A treatment group (18 patients).The thickness of the masseter and complications were analyzed before treatment,6 months and 12 months after treatment.Results The average thickness of masseter muscle in botulinum toxin type A and radiofrequency ablation groups was significantly reduced 6 or 12 months after treatment,and the difference was statistically significant (P＜0.05).However,the thickness of masseter muscle in radiofrequency ablation group after 12 months reduced greater than that in botulinum toxin type A group (P＜0.05).Complications of botulinum toxin type A group were swallow difficulty (one patient),unnatural facial expressions (4 patients) and pain at injection site (10 patients) and that in radiofrequency ablation treatment group were that 18 patients had swelling of the skin 1 to 2 weeks after treatment.All patients had recovery 2 weeks after treatment.There was no facial nerve,parotid duct injury,or oral dysfunction.Conclusions The lasting effect of radiofrequency ablation treatment for benign masseter hypertrophy is longer than that of botulinum toxin type A.

Objective To investigate the effects of postoperative adjuvant chemotherapy (CT) and chemoradiotherapy (CRT) or radiotherapy(RT) for Ⅰ b-Ⅱ a cervical cancer with risk factors.Methods From March 1995 to June 2010,there were 137 patients underwent radical hysterectomy and systematic pelvic lymphadenectomy for stage Ⅰ b-Ⅱ a cervical cancer admitted at Peking University First Hospital.These patients had risk factors,intermediate risk factors including bulky tumor (＞4 cm),lymph vascular space invasion,deep stromal invasion; high risk factors including positive surgical margin,parametrial invasion,lymph node involvement.Of the all patients,79 cases of them were treated with CT,58 of them were treated with RT or CRT.The 5-year survival and prognosis factors were analyzed retrospectively,the prognosis was compared between two adjuvant therapy groups.Results The univariate analysis shown that types of pathology,different grade of risk factors,stroma invasion and lymph node involvement were prognostic factors of 5-year overall survival Patients with squamous cell carcinoma,intermediate risk factors,no parametrial invasion,and no lymph node involvement had better prognosis (P ＜ 0.05).Whether patients with high-risk factors or intermediate-risk factors,the 5-year overall survival and 3-year disease-free survival had no difference between CT and RCT or RT groups respectively.Cox regression multivariate analysis of survival indicated that clinical stages,types of histology,different grade of risk factors were independent prognostic indicator.Patients with early stage,squamous cell carcinoma,intermediate risk factors had better prognosis.Univariate and multivariate analysis indicated that different postoperative adjuvant therapies had no effects on the prognosis.The 5-year overall survival was 88.6％ in patients treated with CT,and 89.7％ in patients treated with RT or CRT (P =0.455).Conclusion There are equivalent therapeutic results between CT and RT or CRT for patients with risk factors after radical surgery,CT may be as one choice of postoperative adjuvant therapy for stage Ⅰ b-Ⅱ a cervical carcinoma with risk factors.

OBJECTIVETo explore the clinical application of mandibular-driven simultaneous maxillo-mandihular distraction to correct hemifacial microsomia with rapid prototyping technology.

METHODSThe patient' s skull resin model was manufactured with rapid prototyping technology. The osteotomy was designed on skull resin model. According to the preoperative design, the patients underwent Le Fort I osteotomy and mandibular ramus osteotomy. The internal mandible distractor was embedded onto the osteotomy position. The occlusal titanium pin was implanted. Distraction were carried out by mandibular-driven simultaneous maxillo-mandihular distraction 5 days after operation.

RESULTSThe distraction in five patients was complete as designed. No infection and dysosteogenesis happened. The longest distance of distraction was 28 mm, and the shortest distance was 16 mm. The facial asymmetry deformity was significantly improved at the end of distraction. The ocelusal plane of patients obviously improved.

CONCLUSIONSRapid prototyping technology is helpful to design precisely osteotomy before operation. Mandibular-driven simultaneous maxillo-mandibular distraction can correct hemifacial microsomia. It is worth to clinical application.

Face ; abnormalities ; surgery ; Facial Asymmetry ; congenital ; surgery ; Goldenhar Syndrome ; surgery ; Humans ; Hyperplasia ; surgery ; Mandible ; surgery ; Maxilla ; surgery ; Osteogenesis, Distraction ; methods ; Osteotomy ; methods ; Osteotomy, Le Fort

Aims To investigate the protective effects of noninvasive limb ischemic preconditioning (LIPC) on myocardial ischemia-reperfusion (I /R)injury,and to explore the mechanism.Methods Healthy male Wistar rats were divided randomly into I /R,I /R +LIPC,I /R +5-Hydroxydecanoate (5-HD)and I /R +LIPC +5-HD groups.The I /R +LIPC and I /R +LIPC-5-HD groups of rats were subjected to three cy-cles of LIPC induction per day with 5 min of reperfu-sion after occlusion for 5 min at the left hind limb for 3 days.All rats were subjected to myocardial I /R injury on the fourth day.The I /R +5-HD and I /R +LIPC-5-HD groups of rats were given the inhibitor of ATP-sen-sitive potassium channel 5-HD before and during myo-cardial I /R injury. Results Compared with I /R group,LIPC reduced myocardial infarct size (P <0.05),lowered cardiocyte apoptosis index and Fas, FasL positive cell number (P <0.01 ),increased the reduced nitric oxide (NO)/endothelin (ET)-1 ratio (P <0.05)in serum in I /R +LIPC group.5-HD a-bolished the protective effects induced by LIPC in I /R+LIPC-5-HD group.Compared with normal myocardi-al tissue,expression of mir-30a-3p was increased in I /R group (P <0.01 )and was decreased in LIPC group (P <0.01 ).Conclusion LIPC alleviates myocardial I /R injury and improves endothelial function. The mechanism may be related with the opening of ATP-sensitive potassium channel,regulating the balance be-tween NO and ET-1 and decreasing the expression of myocardial mir-30a-3p.

Objective To investigate the mechanism of quinolone resistance in Psendomonas aeruginosa.Methods The minimum inhibitory concentrations (MICs)of ciprofloxacin and levofloxacin with and without carbonylcyainde-m-chlorophenylhydrazone(CCCP)were determined by agar dilution method.Polymerase chain reaction(PCR)and DNA sequencing were used to study the mutations in quinolone resistance-determining region of gyrA and parC genes.The strains were genotyped by enterbacterial repetitive intergenie consensus-PCR(ERIC-PCR).Results Sixteen quinolones-resistant Pseudomonas aeruginosa strains were obtained.The MICs of ciprofloxacin and levofloxacin were not reduced significantly by adding CCCP.Thr-83→Ile of gyrA and Ser-87→Leu of parC were found simultaneously in 16 strains of resistant Pseudomonas aeruginosa.Analysis of ERIC-PCR products indicated that 16 quinolone-resistant strains had an identical band pattern which was different from that seen in the sensitive strains.Conclusion Mutations in gyrA and parC may be the main mechanism of quinolone resistance in clinical isolates of Pseudomonas aeruginosa.

OBJECTIVETo compare effects of catgut embedding at "Zusanli" (ST 36) and "Shenshu" (BL 23) on Morphine analgesic tolerance and locomotor sensitization induced by chronic Morphine administration and the mechanism.

METHODSThe rats were randomly divided into a model group, a non-acupoint group, a Shenshu group and a Zusanli group. The rats, except those in the model group, were pretreated with acupoint catgut-embedding 10 days before the first Morphine injection. The Morphine-tolerance model was established and the pain threshold was detected by hot-plate test every day. Locomotor activities were recorded after the first Morphine injection and Morphine-challenging 1 week after withdrawal of Morphine. The positive neurons of nitric oxide synthetase (NOS) were showed by NADPH-d histochemical method.

RESULTSCompared with the non-acupoint group, catgut embedding at "Zusanli" (ST 36) could attenuate the Morphine analgesic tolerance and the increase of locomotor activities in rats. Meanwhile, the expression of NOS positive neurons in nucleus accumbens septi and dorsal striatum decreased in the Zusanli group. There were no significant differences between the Shenshu group and the non-acupoint group in the analgesic threshold and locomotor sensitization, but the expression of NOS positive neurons in the striatum region significantly decreased.

CONCLUSIONCatgut embedding at "Zusanli" (ST 36) can attenuate Morphine analgesic tolerance and reverse formation of locomotion sensitization induced by chronic Morphine administration, which are possibly related with inhibition of the expression of NOS positive neurons in nucleus accumbens septi and dorsal striatum.

Acupuncture Analgesia ; Acupuncture Points ; Analgesics, Opioid ; pharmacology ; Animals ; Catgut ; Drug Tolerance ; Male ; Medicine, Chinese Traditional ; Morphine ; pharmacology ; Motor Activity ; Rats ; Rats, Sprague-Dawley