Objective To observe the clinical features of AIDS coinfected with cryptococcus meningitis. Methods The clinical data of 19 AIDS patients coinfected with cryptococcus meningitis were retrospectively analyzed.Results Among 19 patients, the main clinical manifestation including headache (100.0%), nausea/vomiting (94.7%), fever (78.9%) and neck stiffness (84.2%).Seven cases revealed increased CSF protein, 10 cases showed depressed CSF glucose levels and 11 patients revealed elevated CSF pressures.The mean CD4+cell count was (58.9 ±27.8)/mm3.Imaging examination showed the neurological complications were hydrocephalus, cerebral infarction, cerebral atrophy and cerebral hernia.The usage rate of amphotericin B, amphotericin B liposome, fluconazole and fluorine cytosine was 31.6%, 21.1%, 47.4% and 47.4%, respectively.Only 2 cases received antiretroviral therapy.The misdiagnosis rate was 31.6%, and mortality rate was 21.1%.Conclusions AIDS coinfected with cryptococcus meningitis onsets hidden, with the clinical manifestation is atypical, and the misdiagnosis rate is higher.Early diagnosis and early usage of appropriate antifungal therapy/antiretroviral therapy can help to prevent the development of it.

OBJECTIVE To investigate the drug-resistance status of clinically isolated Staphylococcus aureus(SAU) and provide scientific evidence for clinically reasonable use of antibiotics.METHODS Retrospective review was adopted to analyze the specimen source and the clinical distribution of 311 SAU strains.BioMerieux VITEK 32 was used to identify SAU.Antibiotic susceptibility testing was performed by K-B method.RESULTS Isolating rate of meticillin-resistant S.aureus(MRSA) was 48.9%.SAU were resistant to the diverse antibiotics in different degree except for 100% sensitivity to glycopeptide antibiotics.The drug-resistance to antibiotcs in MRSA were all higher than those in meticillin-sensitive S.aureus(MSSA).CONCLUSIONS Monitoring and controlling of antibiotics resistance are effective measures of prevention from nosocomial infections.

Objective To study the effects of long-term use of simvastatin on mechanical ventilation induced lung injury.Methods Forty SPF adult male Sprague-Dawley (SD) rats weighing 300-350 g were randomly divided into four groups (n =10,each):normal saline (NS) control group (group A),mechanical ventilation group (group B),simvastatin control group (group C),and simvastatin + mechanical ventilation group (group D).The rats in groups C and D were treated with simvastatin dissolved in 1 mL NS by gavage with a dose of 10 mg/kg,and the rats in groups A and B were treated with the same volume of NS by gavage for 28 days.Half an hour after the last garage,the rats in groups B and D underwent tracheostomy and intubation for 4 hours,and then received a tidal volume of 30 mL/kg with the respiratory frequency of 40 times/min,inspiratory:expiratory ratio of 1:3,and the rats in groups A and C received tracheostomy and intubation,spontaneous breathing for 4 hours.Four hours later rats were sacrificed by abdominal aorta bloodletting,and the lung tissue was harvested for hematoxylin and eosin (HE) staining to observe pathological changes under light microscope.The activity of malondialdehyde (MDA),superoxide dismutase (SOD),and myeloperoxidase (MPO) was determined.The lung wet/dry weight ratio (W/D) and white blood cell (WBC) count in bronchoalveolar lavage fluid (BALF) were determined.The levels of interleukins-6 (IL-6) and tumor necrosis factor-α (TNF-α) in BALF were determined by enzyme linked immunosorbent assay (ELISA).Results Under light microscope,the structure of lung tissue was integrity in groups A and C without obvious edema and inflammatory cells aggregation;the pathological changes in lung tissue in group B was obvious;and the alveolar structure was clear in group D,pulmonary edema and inflammatory cells aggregation were significantly reduced as compared with those of group B.Compared with group A,SOD activity in group B was significantly decreased (U/g:17.97±2.27 vs.28.51 ±4.58,P ＜ 0.01),while MDA,MPO,lung W/D ratio and WBC,IL-6,TNF-α in BALF were significantly increased [MDA (μmol/g):5.40 ± 0.71 vs.3.56 ± 0.55,MPO (U/g):1.26±0.29 vs.0.68±0.12,lung W/D ratio:6.60±0.99 vs.4.84±0.26,WBC (× 109/L):6.59±0.82 vs.2.35±1.31,IL-6 (ng/L):207.11± 18.67 vs.123.17±20.15,TNF-o (ng/L):421.38±36.27 vs.207.15±44.39,all P ＜ 0.01].Compared with group B,SOD activity in group D was significantly increased (U/g:22.05±2.45 vs.17.97±2.27,P ＜ 0.05),MDA,MPO,lung W/D ratio,and WBC,IL-6,TNF-α in BALF were significantly decreased [MDA (μmol/g):3.77±0.55 vs.5.40±0.71,MPO (U/g):0.96±0.14 vs.1.26±0.29,lung W/D ratio:5.16±0.42 vs.6.60±0.99,WBC (× 109/L):3.18± 1.24 vs.6.59±0.82,IL-6 (ng/L):147.90±21.70 vs.207.11 ± 18.67,TNF-α (ng/L):237.16±50.83vs.421.38 ± 36.27,all P ＜ 0.01].There were no significant difference in all parameters between group C and group A.Conclusion The long-term simvastatin treatment could significantly reduce lung injury induced by mechanical ventilation in rats,and its mechanism was related with simvastatin reduced oxidation-antioxidant imbalance and the inflammatory cytokines activity changes.

Objective To evaluate the effect of long-term use of simvastatin on aquaporin 5 (AQP5) expression in a rat model of ventilator-induced lung injury.Methods Thirty-two adult male Sprague-Dawley rats, weighing 250-280 g, were randomly divided into 4 groups (n=8 each) using a random number table: control group (group C), simvastatin group (group Sim), mechanical ventilation group (group MV) and simvastatin + mechanical ventilation group (group SMV).In C and Sim groups, normal saline 1 ml/d and simvastatin 10 mg · kg-1 · d-1 were injected, respectively, through a gastric tube into stomach for 4 weeks, and then the rats were tracheostomized, and mechanically ventilated, and the animals kept spontaneous breathing for 4 h.In MV and SMV groups, normal saline 1 ml/d and simvastatin 10 mg · kg-1 · d-1were injected, respectively, through a gastric tube into stomach for 4 weeks, and then the rats were tracheostomized, and mechanically ventilated (tidal volume 50 ml/kg) for 4 h.The rats were then sacrificed, and lungs were removed for determination of wet to dry lung weight ratio (W/D ratio), activities of myeloperoxidase (MPO) and superoxide dismutase (SOD), malondialdehyde (MDA) content,and expression of AQP5 protein and mRNA in lung tissues, and for microscopic examination of pathological changes.Results Compared with group C, the W/D ratio, MPO activity, and MDA content were significantly increased, the SOD activity was decreased, and the expression of AQP5 protein and mRNA was down-regulated in group MV (P＜0.01).Compared with group MV, the W/D ratio, MPO activity, and MDA content were significantly decreased, the SOD activity was increased, and the expression of AQP5 protein and mRNA was up-regulated in group SMV (P＜0.01).The pathological changes of lungs were significantly mitigated in group SMV as compared with group MV.Conclusion Long-term use of simvastatin alleviates ventilator-induced lung injury, and the mechanism is related to down-regulated expression of AQP5 in rats.

Objective To evaluate the relationship between spectinomycin resistance in Neisseria gonorrhoeae and mutations in the rpsE gene.Methods Genomic DNA was extracted from 4 clinical isolates of Neisseria gonorrhoeae with different levels of spectinomycin resistance.Then,PCR was performed to amplify the entire rpsE gene and the spectinomycin resistance-determining region (SRDR) in the 16S rRNA gene followed by direct sequencing.Two spectinomycin-sensitive Neisseria gonorrhoeae strains were transformed with the genomic DNA containing the mutant rpsE gene.Subsequently,the susceptibility of the transformants to spectinomycin was determined,and PCR was performed to amplify the rpsE and 16S rRNA genes in the transformants followed by sequencing.Results All the 4 spectinomycin-resistant Neisseria gonorrhoeae strains harbored an A70C transversion in the rpsE gene,but no abnormality in the SRDR of the 16S rRNA gene.No mutations were detected in the spectinomycin-sensitive Neisseria gonorrhoeae strains.The A70C transversion in the rpsE gene was also detected in the two Neisseria gonorrhoeae transformants with spectinomycin resistance.Conclusion The A70C point mutation within the rpsE gene is associated with spectinomycin resistance in Neisseria gonorrhoeae.

Objective To evaluate the efficacy of intermittent pneumatic compression or sequential compression device in prevention of deep venous thrombosis in long-term bedridden patients.Methods We searched Pubmed (1996～),The Cochrane Library (1997～),CLNAHL (1980～),CNKI (1994～),EM-BASE,Science Direct,Oxford Journals,Wanfang Data(1998 ～),and randomized controlled trials (RCTs) in which IPC or SCD was used as an intervention to prevent DVT,and all the trials were published in English or Chinese.The methodological quality of the included studies was assessed according to the standard of Cochrane systematic review.RevMan 5.0 software was used for Meta-analysis.Results Seven RCTs were included.The results of Meta-analysis showed that the incidence of DVT in the IPC or SCD group was lower than that in the control group.Conclusions IPC or SCD shows an effective tendency in DVT prevention,but because of the low quality and the small sample of the included studies,this conclusion needs to be verified by protocols of more samples and higher quality.

Objective To analysis the DNA sequence of HEV ORF3 cDNA and express in HepG2 cell .Methods Recombinant vector carrying HEV ORF3 cDNA was constructed and identified by DNA sequencing .Expression of recombinant vector in HepG2 cell was determined by immunofluorescence technique .Results The recombinant vector was constructed and expressed in HepG2 cell successfully .Conclusion The research laid experimental foundation for exploring the biological function of ORF3 protein in the pathogenesis of viral hepatitis E .

OBJECTIVE:To study the pharmacokinetics of triptolide in Tripterygium glycosides tablet in normal rats and adju-vant arthritis model rats in vivo,and provide reference for clinical rational drug use. METHODS:12 SD rats were randomly divid-ed into normal group and model group,6 in each group. Model group was subcutaneously injected complete Freund's adjuvant 0.1 mL to induce adjuvant arthritis model,normal group was subcutaneously injected the same volume of saline. After 14 d model-ing,2 groups were given Tripterygium glycosides tablet suspension 96 mg/kg intragastrically,the blood sample of eyes 0.4 mL were respectively taken before and 10,30,45,60,90,120,150,180,240,300,420 min after administration. The plasma con-centration of triptolide was determined by HPLC,the pharmacokinetic parameters were calculated by DAS 2.0 software,and the parameters were compared. RESULTS:The pharmacokinetic parameters of triptolide in normal group were cmax of(1.139±0.114)μg/mL,tmax of(2.167±0.606)h,t1/2α of(5.500±3.610)h,AUC0-7 h of(5.052±0.371)μg·h/mL,MRT0-7 h of(3.224±0.119)h, and CL of(11.616±2.986)mL/h;and those in model group were cmax of(0.916±0.103)μg/mL,tmax of(3.083±0.801)h,t1/2αof(5.593±1.795)h,AUC0-7 h of(4.707±0.347)μg·h/mL,MRT0-7 h of(3.429±0.139)h,and CL of(11.246±2.638) mL/h. Compared with normal group,cmax in model group was significantly decreased,tmax and MRT0-7 h were significantly prolonged(P<0.05). CONCLUSIONS:Adjuvant arthritis can affect the pharmacokinetics of triptolide in rats in vivo,and promote its absorption and removal.

ObjectiveTo explore the effect of bladder curer in the treatment of patients with neurogenic bladder after spinal cord injury.Methods60 spinal cord injury patients with neurogenic bladder were randomly divided into intervention group (n=30) and control group (n=30). Comprehensive rehabilitation therapy was used in the two groups, but bladder curer was used only in intervention group. Residual urine in the bladder, incidence of urinary tract infection and course of achieving bladder balance were observed in the two groups.ResultsAfter 8 weeks, residual urine in the bladder decreased significantly in intervention group compared with control group, and the course of achieving bladder balance shortened significantly in intervention group compared with control group, but incidence of urinary tract infection had no difference between intervention group and control group. ConclusionBladder curer could decrease residual urine in the bladder early, and shorten the course of achieving bladder balance in the treatment of patients with neurogenic bladder after spinal cord injury.

Objective To determine the prevalent herpes simplex virus (HSV) strain in patients with genital herpes (GH),and to evaluate the sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of anti-herpes simplex virus type 2 (HSV2) IgG and IgM antibodies in the diagnosis of genital herpes (GH) before in vitro fertilization (IVF).Methods Totally,193 HSV2 clinical strains isolated in cell culture from the lesions of patients with GH in the Department of Dermatology,First Affiliated Hospital,Sun Yat-sen University between 2009 and 2011 were typed by using type-specific fluorescein isothiocyanate (FITC)-labelled anti-HSV monoclonal antibodies.Serum samples were obtained from 57 anti-HSV2 IgM/IgG antibody-positive females with suspected GH as well as their husbands (clinical observation group),68 HSV culture-positive patients diagnosed with GH (positive control group),and 120 children aged 8-12 years (negative control group).Enzyme-linked immunosorbent assay (ELISA) was performed to detect anti-HSV1/HSV2 IgG/IgM antibodies in these serum samples.Statistical analysis was carried out using chi-square test.Results There was a significant difference between the positive control group and negative control group in the positivity rate of anti-HSV1 IgG (89.71％ (61/68) vs.40.80％ (49/120),P ＜ 0.01) and anti-HSV2 IgG (91.18％ (62/68) vs.0,P ＜ 0.01),but not in that of anti-HSV1 IgM (20.59％ (14/68) vs.21.70％ (26/120),P ＞ 0.05) or anti-HSV2 lgM (13.24％ (9/68)vs.13.30％ (16/120),P ＞ 0.05).In the clinical observation group,the positivity rate of anti-HSV1 and anti-HSV2 IgM antibodies,anti-HSV1 and anti-HSV2 IgG antibodies was 80.70％ (46/57),91.23％ (52/57),84.21％ (48/57) and 14.04％ (8/57) respectively in the females,19.30％ (11/57),8.77％ (5/57),87.71％ (50/57),12.28％ (7/57)respectively in the males,with significant differences in the positivity rate of anti-HSV1 and-HSV2 IgM antibodies (both P ＜ 0.01),but not in that of anti-HSV 1 or-HSV2 IgG antibodies (both P ＞ 0.05).The sensitivity,specificity,PPV and NPV were 13.24％ (9/68),86.67％ (104/120),36.00％ (9/25) and 63.80％ (104/163) respectively for anti-HSV2 IgM antibody in the diagnosis of GH,91.18％ (62/68),100.00％ (120/120),100.00％ (62/62),and 95.24％ (120/126) respectively for anti-HSV2 IgG antibody.Conclusions HSV2 prevails in the patients with GH in this region,while HSV1 only amounts to 5.18％.The type-specific anti-HSV2 IgG antibody shows a higher specificity,sensitivity,PPV and NPV in the diagnosis of GH than anti-HSV2 IgM antibody,hence,the type-specific anti-HSV2 IgG antibody is superior to anti-HSV2 IgM antibody in diagnosing GH before assisted reproduction.