Objective To establish the rapid pathogen identification method for HIV and Mycobac-terium tuberculosis (Mtb)co-infection and the assay for the drug susceptibility. Methods Geneprobe and 16S rDNA sequencing were used to differentiate mycobacterium species and modified microscopic observation drug susceptibility (MODS) was used for the drug susceptibility test. The above assays were compared with acid-fast smear, L-J culture and proportional drug susceptibility tests. Results (1) Thirty-four mycobacte-rial isolates were obtained from 112 samples collected from 68 HIV patients. Among these isolates, the strain species were determined by Geneprobe and 16S rDNA sequencing as the followings: 21 Mtb complex, 10 NTM including 5 M.avium complex, 2 M.gordonae, 2 M.kansasii, 1 M.colombiense, and 3 co-infection. (2) The sensitivity of Mtb to rifampicin, ethambutol, isoniazid and streptomycin were 100%, 100%, 76.2%, 90.5% respectively, while the sensitivity of NTM to rifampicin, ethambutol, isoniazid and strepto-mycin were 40%, 60%, 0%, 30% respectively. There is no significant statistic difference between the two methods, MODS and the reference standard, for the drug susceptibility test. (3) Six to eight weeks are nee-ded for the identification of the species of mycobacteria and the drug susceptibility test by using traditional method. In this study, 5-14 d, 6-15 d and 10-14 d are needed for Geneprobe, 16S rDNA sequencing, and MODS respectively. The time for the testing has been dramatically shortened. Conclusion The identifica-tion of mycobacterial species and the drug susceptibility test using clinical samples could be completed within 15 days by using combined Geneprobe, 16S rDNA sequencing and modified MODS. This combined method can be used for the pathogen identification and drug resistant test in HIV patients who are co-infected by my-cobacteria.

Objective To explore the significance of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) for the death risk evaluation in elderly patients with chronic disease in five years.Methods A total of 765 elderly patients with chronic disease[136 patients with coronary heart disease (CHD),76 patients with hypertension disease (HD),86 patients with chronic obstructive pulmonary disease (COPD),75 patients with Type 2 diabetic mellitus (T2DM),76 patients with cerebral infarction (CI),73 patients with coronary heart disease combined with hypertension,71 patients with coronary heart disease combined with chronic obstructive pulmonary disease,61 patients with coronary heart disease combined with diabetic,51 patients with coronary heart disease combined with cerebral infarction,and 60 patients with three comorbidity] were classified into the survival group (312 cases) and the death group (453 cases) according to disease prognosis.The serum NT-proBNP levels of 88 healthy controls and 765 elderly patients with chronic disease were determined by bi-directional lateral flow immunoassay.The death events were followed up and observed for an average of 5 years.The results were analyzed statistically.Results The serum NT-proBNP levels in the death group with various diseases were significantly higher than the survival group (P ＜0.01),the patient's age and the proportion of male in the death group and the survival group had no significant difference (P ＞ 0.05).The serum NT-proBNP levels,the patient's age and the Proportion of male in the death group with various elderly chronic diseases had no statistical significance (P ＞ 0.05).The serum NT-proBNP levels in the death group with various elderly chronic diseases had no statistical significance (P ＞ 0.05),and were significantly higher than the survival group (P ＜ 0.01).The patient's age and the proportion of male in the death group and the survival group had no significant difference (P ＞ 0.05).The serum NT-proBNP levels in the death group in the different periods had statistical significance (P ＜ 0.01),and were significantly higher than the survival group and healthy control group (P ＜ 0.01).The more shorter of the survival time was,the higher the serum NT-proBNP 1eve was.The serum NT-proBNP levels were negatively correlated with the survival time of the patients (r =-0.378,P =0.000).The receiver operator characteristic (ROC) curve indicated that the optimal cut-off values of serum NT-proBNP levels for the death risk evaluation in elder patients with chronic disease were 1 499.50 ng/L.Kaplan-Meier survival curve showed that the survival rates of serum NT-proBNP levels had significant difference (P ＜0.01).The higher the serum NT-proBNP level was,the more shorter of the Survival rates were.Conclusions The levels of serum NT-proBNP have an important prognostic value in the death risk evaluation in elderly patients with various chronic disease.It is an independent risk factor for the death occurred in eiderly patients with chronic disease.The levels of serum NT-proBNP are closely correlated with the survival rates and survival time of elderly patients,It can be used as a monitoring indicator of the elderly patients with chronic disease in risk stratification.

[Abstract] Objective To evaluate the effect of Mycobacterium tuberculosis Direct Assay (MTD) for rapid detecting Mycobacterium tuberculosis rRNA and Multi-locus PCR for M.bovis BCG strain typing in patients with suspected extra-pulmonary tuberculosis.Methods From June 2010 to December 2011,47 children and 75 adult patients with suspected extra-pulmonary tuberculosis in Shanghai public health clinical center were recruited.Also 48 non-tuberculosis patients were taken as a negative control.Clinical specimens from these patients were collected.Acid fast stain,solid culture,liquid culture,and MTD were used to detect all clinical specimens simultaneously.Screen tuberculosis strains of the culture isolates by MPT64 antigen assay and use Multi-locus PCR for the BCG strain genotyping of the isolates without MPT64 antigen.SPSS16.0 was used to analyse the results.Results The sensitivity for acid fast stain,solid culture,liquid culture and MTD test was 10.7％ (13/122),11.5％ (14/122),16.4％ (20/122) and 37.7％ (46/122),respectively.And the specificity of MTD was 100.0％.Six clinical isolates from children were identified as BCG by Multi-locus PCR typing,the same with chemical tests.Conclusions The MTD assay and the MGIT960 liquid culture are effective and reliable method for diagnosing extra-pulmonary tuberculosis.And Multi-locus PCR can be assisted for the early diagnosis of extra-pulmonary tuberculosis patients with suspected BCG infection.

Objective To establish a HPLC method for determination of the content of catechin in Songling- Xuemaikang capsules. Methods The analysis was performed on Alltima C18 column (250 mm × 4.6 mm, 5 μm) with mobile phase consisting of methanol (A) -l% Acetic Acid (B) for gradient elution. The flow rate was 1 ml/min and the column temperature was 25 ℃. Results The results showed that catechin was well separated with the good linearity in 0.00756-0.05040 μg/μl. The average recovery of catechin was 100.147%. Conclusions The method could be applied to determine catechin in Songling-Xuemaikang capsules, which would make sure the quality control of capsules.

Eighteen patients with early cancer and precancerous lesions of esophagogastric junction underwent multiband mucosectomy (MBM) in Yangzhou First People's Hospital from January 2013 to February 2014.The clinicopathological data of patients were analyzed retrospectively and the short-term efficacy and safety of MBM were evaluated.Operations were successful in all 18 cases.The mean operative time was 35.8 min.Intraoperative bleeding occurred in 3 cases and successfully managed by endoscopic hemostasis.Small perforation occurred in 1 patient and was closed by metal clips.Pathological examination showed mucosal cancer in 5 cases,high-grade intraepithelial neoplasia in 8 cases and low-grade intraepithelial neoplasia in 5 cases.No relapse of cancer was found during follow-up.Results indicate that MBM is an effective and safe method in treatment of early cancer and precancerous lesions in the esophagogastric junction.

Objective To investigate the echocardiographic features and clinical significance of prenatal diagnosis of total anomalous pulmonary venous connection (TAPVC). Methods Fetal echocardiographic images of 13 fetuses with TAPVC conifrmed by pathology or postnatal echocardiography were reviewed. Echocardiographic features and clinical signiifcance of prenatal diagnosis of TAPVC were summarized. Results Twelve fetuses with TAPVC were diagnosed prenatally by fetal echocardiography, including seven cases of supracardiac type, three cases of infracardiac type and two cases of intracardiac type. The common echocardiographic characteristics of 12 fetuses with TAPVC included slightly size discrepancy of left heart and right heart, large foramen ovale with increased shunting at the atrial level, increased distance between left atrium (LA) and descending aorta, absent insertions of pulmonary veins in the LA, presence of pulmonary venous conlfuence on the top of LA and dilatation of vessels where pulmonary venous conlfuence drained. One case was missed prenatally and intracardiac type TAPVC was diagnosed by postnatal echocardiography. Among the 13 cases, three were isolated and the other ten were all in association with other abnormalities. Conclusions There are fetal echocardiographic characteristics of TAPVC. Fetal echocardiography plays an important role in prenatal diagnosis of TAPVC.

Tumor microenvironment is composed of mesenchymal cells and extracellular matrix components, which plays an important role in the growth, invasion and metastasis of tumor cells. Characteristic changes of stroma are usually accompanied with the malignant transformation of epithelial cells even ahead. The key component in the process-activated fibroblasts, also known as myofibroblasts, or cancer-associated fibroblasts (CAF), is the most abundant cells in tumor stroma. They promote the malignant transformation of epithelial cells through cell-cell communication via various soluble factors. This article reviews cancer-associated fibroblasts and their role in tumor development.
Cell Communication ; Cell Transformation, Neoplastic ; pathology ; Disease Progression ; Epithelial Cells ; pathology ; Fibroblasts ; pathology ; Humans ; Myoblasts ; pathology ; Neoplasms ; pathology ; physiopathology

Objective To investigate the appropriate method in diagnosing precursor lesions of pancreatic cancer and its treatment. Methods From Jan. 2006 to Dec. 2007, 92 cases were operated for pancreatic neoplasms. Among them 7 cases had pancreatic precursors. The mucinous cystic neoplasm was found in 1 case, intraductal papillary mucinous neoplasm(IPMN) in 2 cases, endocrine tumor in 1 case and pancreatic intraepithelial neoplasia (PanIN) in 3 cases. CA19-9 level was tested by immunoflucence assay. All of the 7 patients were examined by CT. Endoscopic ultrasound(EUS) and endoscopic retrograde cholangio-pancreatography examinations were performed on 1 and 2 patients respectively. Results There was neither specific symptom related to these precursors nor any evidence of mass as revealed by CT or ultrasound. But dilatation and stricture of pancreatic duct were found in PanIN patients, and cystic dilatation of pancreatic duct in pancreatic head was present more in IPMN patients. For cystic neoplasms in pancreatic body and tail, they were commonly solid and isolated. CA19-9 level was slightly elevated in some patients but with no diagnostic value. Surgical resection was done with excellent result. Conclusion For the suspected pancreatic precursors, aggressive diagnostic approach and surgical resection will be the best option and can further prevent cancer development.

Objective To investigate the expression and clinical significance of neutrophil S100A8/A9 in induced sputum in children with bronchial asthma. Methods A total of 108 cases of bronchial asthma patients in the FourthAffiliated Hospital of Nanchang University were involved in the study form October 2014 to October 2015. According to the severity of the disease, the patients were divided into mild group (n=40), moderate group (n=36) and severe group (n=32). Twenty health children were taken as control group at the same period. All the patients were treated with budesonide aerosol for three months, and the control group was received aerosol inhalation for normal saline (NS). The ratio of forced expiratory volume in one second and forced vital capacity (FEV1/FVC, FEV1%) were used to evaluate the pulmonary function in two groups. The asthma control questionnaire (AcQ-5) score was used to estimate the asthma control effects. The expression level of neutrophil S100A8/A9 mRNA in induced sputum was detected by real-time PCR. The correlation of S100A8/A9 mRNA, AcQ-5 score and FEV1%was analyzed. Results Before the treatment, the FEV1%decreased, while the AcQ-5 score and express level of S100A8/A9 mRNA significantly increased with the severity of disease (all P<0.01). Three months after treatment, asthma was completely controlled in 60 patients, partial controlled in 31 cases and uncontrolled in 17 cases. With the improvement of the therapeutic efficacy, the FEV1%significantly decreased, while the express level of S100A8/A9 mRNA significantly increased (all P < 0.01). The express level of S100A8/A9 mRNA in induced sputum neutrophils was negatively correlated with FEV1%(r=-0.327 and-0.406 respectively, P<0.05), which was positively correlated with ACQ-5 score (r=0.704 and 0.817, P<0.05). Conclusion The level of S100A8/A9 expression in induced sputum neutrophil is positively correlated with the severity of asthma, which can be used as clinical indicators of the severity and the efficacy of asthma.

BACKGROUND:Mimics software is a three-dimensional (3D) image processing and editing tool based on CT scan data. Mimics software can rebuild the data and images gotten in CT, MRI and ultrasound scans into 3D images and display on the computer screen so as to help clinicians understand the type of fracture and the relationship of the 3D structure of the surrounding tissue and to provide a great help in the development of orthopedics operation. OBJECTIVE:To explore the application effect of Mimics software 3D reconstruction on perioperative period of Pilon fracture. METHODS:This study selected 61 cases of Pilon fracture, who received the surgery in the Zhongshan City Xiaolan People’s Hospital from September 2008 to September 2013, as research objects. They were randomly divided into 3D group and control group in accordance with the time of admission. Al patients underwent anterioposterior and lateral X-ray film examination and multi-slice spiral CT scan. Patients in the control group received internal fixation according to above examination results. Patients of the 3D group, on the base of those of the control group, were subjected to internal fixation after three-dimensional entity reconstruction by using Mimics V 10.0 software. Operation time and functional curative effect in the postoperative folow-up were compared between the two groups. RESULTS AND CONCLUSION:The operation time was significantly less in the 3D group than in the control group (P < 0.05). The number of patients with excelent 6-month functional curative effect was more, and the number of patients with poor effect was less in the 3D group than in the control group. The 6-month functional curative effect was better in the 3D group than in the control group (P < 0.05). These results showed that the application of Mimics software 3D reconstruction to the perioperative period of Pilon fractures can give comprehensive assessment of the situation of fracture, optimize and improve the preoperative plan and reduce the risk of surgery, and promote the successful completion of internal fixation.