Objective To investigate the molecular mechanism of Helicobacter pylori (H.pylori) resistance to clarithromycin. Methods The E test was used to determine clarithromycin resistant strains of H.pylori , and PCR Restriction Fragment Length Polymorphism (RFLP) analysis for 23S rRNA domain V gene mutations. Results Of nine clarithromycin resistant stains of H.pylori , including six primary and three acquired resistant strains, eight were found to have an A to G mutation in 23S rRNA domain V at position 2144. Conclusions The results indicated that the majority (88.8%) of clarithromycin resistant isolates of H.pylori in Shanghai have an A2144G mutation in 23S rRNA domain V.

Objective To investigate whether a novel mucosal adjuvant (DNA containing six base pair motifs consisting of an unmethylated CpG dinucleotide flanked by two 5′ purines and two 3′ pyrimidines, CpG Oligodeoxynucleotide, CpG ODN),which has not been shown to have significant toxicity,could be an ideal mucosal adjuvant for the development of a H. pylori vaccine in mice model. Methods C57BL/6 mice were orally or intranasally immunized with H. pylori whole cell sonicate(WCS) / cholera toxin (CT) or WCS /CpG ODN, and the corresponding control groups were set. Mice were dosed once a week for four weeks. One week after the last immunization, all animals were challenged by live H. pylori (5?10 8) three times in a five day duration. Two and 8 weeks after the last challenge, all animals were sacrificed to examine infection of H. pylori. Sera, saliva, gastric juice were collected to measure the concentrations of IgG, IgG1, IgG2a and IgA by ELISA. Results The protecting rates against H. pylori infection were 75%(9/12), 70% (7/10) and 0 (0/10) in the group of WCS/CT orally, WCS/CpG ODN intranasally and WCS/CpG ODN orally, respectively. Significantly higher levels of serum IgG2a antibody was found in the group immunized with WCS plus CpG ODN than those found in the sham immunized controls ( P

Objectives:To evaluate lung injury mechanism in SD rat with nitrogen dioxide(NO2) exposure. 　Methods:In the test-control study, pulmonary malondialdehyde(MDA),glutathione(GSH) and total-antioxidant content(T-AOC) were determined in 10 SD rats with long-term NO2 exposure,10 SD rats with short-term NO2 exposure and 10 SD rats with fresh air as control. 　Results: Pulmonary MDA content was increased and T-AOC was decreased significantly in SD rat exposed to NO2. Pulmonary GSH was decreased significantly in long-term NO2 exposure group as compared with short-term NO2 exposure group and control group. 　Conclusions: Imbalance between oxidant and antioxidant was an important mechanism in the pathogenesis of oxidizing lung injury in SD rat with NO2 exposure.

OBJECTIVE: To provide references for the improvement of drug recall system in China.METHODS: The problems existing in the drug recall system in China were analyzed through a comparison of the drug recall system between China and Australia.RESULTS & CONCLUSIONS: China should draw useful experiences from Australia to improve its drug recall system by perfecting the legal system and tracking measures,determining stratified drugs and the responsibilities of government etc.

Objectives: To analyze the strategies of the diagnosis and treatment in patients with the pulmonary infection after renal transplantation. Methods: A retrospective analysis was made on 28 cases of pulmonary infections among 285 patients undergoing renal transplantation. Results: The morbidity of pulmonary infection was 9.82%(28/285). The majority pathogens of pulmonary infection in this study were pseudomonas, staphylococcus epidermidis, canadida and cytomegalovirus. Chest X ray was important in the diagnosis, but there was no specificity to determine the pathogens. The mortality in 28 pulmonary infection patients was 32.1%(9/28). Most of the patients suffered from pulmonary infection within 4 months after the operation, and the postoperative period from 2 months to 4 months was a high risk time window for death caused by pulmonary infections. Conclusions: The morbidity and mortality of pulmonary infections, especially severe pneumonia, in patients with renal transplantation, are higher than healthy people. Treatment following clinical epidemiology and strategy of microbiology play a very important role to reduce the mortality in those patients.

Objective To investigate changes of coagulation function in patients with high altitude polycythemia (HAPC) .Meth‐ods Activated partial thromboplastin time (APTT) ,prothrombin time (PT) ,thrombin time (TT) and fibrinogen (Fbg) were de‐tected and compared between 69 patients with HAPC and 60 healthy subjects (controls) .Results Fbg ,APTT and TT levels in pa‐tients with HAPC were higher than controls (P<0 .05) ,while the difference of PT was not significant (P>0 .05) .Dynamic obser‐vation indicated that comprehensive therapy could these recover coagulation function .Conclusion Hemorrhage and coagulation process in patients with HAPC could be very complicated ,including physiological adaptation and the process of physiology evolving into pathology .

Objective: To explore and compare the clinical and pathologic features of breast cancer between the young women (< 40 years old) and the elder women (≥ 40 years old), and to evaluate the overall survival. Methods: There were 1393patients with breast cancer hospitalized in Department of Surgical Oncology, Sir Run Run Shaw Hospital, Medical College, Zhejiang University between August 1996 and April 2011. After exclusion of 15patients whose information of age was missed, 1378patients (194young and 1184elder patients) were included in this retrospective study. breast cancer patients who received treatment in Sir Run Run Shaw Hospital were retrospectively analyzed. The clinicopathological features and the survival were compared between the young and the elder patients. All patients were followed-up, and 218 were lost. The prognostic factors for all patients and young patients were analyzed, respectively. Results: The molecular subtypes, T stage, N stage and the rate of breast-conserving radical surgery were significantly different between the young and the elder patients (P < 0.05), but the positive rates of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2) and the stages of M and TNM were not significantly different (P > 0.05). The proportion of Luminal B was higher in the young patients than that in the elder patients. The median survial time was not significantly different between the young and the elder patients (58.2 vs 45.8 months, P > 0.05). The univariate analysis revealed that PR-negative and lymph node and distant metastases were associated with lower five-year survival rate in young patients (P < 0.05). The multivariate analysis revealed that lymph node and distant metastases were independent prognostic factors in young patients (P < 0.05). Conclusion: Young patients with breast cancer have more poor prognostic factors than the elders, such as later stages of tumor size and lymph node, more proportion of type Luminal B, and higher rate of breast-conserving radical surgery, but the overall survival between the young and the elder patients had no significant difference.

BACKGROUND: In patients with obstructive sleep apnea(OSA),the degree of severity of OSA is mostly related to the sleep time spent in the supine position. According to the apnea-hypopnea index(AHI), positional and n onpositional OSA has been distinguished.OBJECTIVE: To compare the clinical characteristics of positional and nonpositional OSA and investigatethe relationship between sleep position and respiratory function of patients with OSA.DESIGN: A comparative clinica] observation based on the OSA patients.SETTING: Center of Sleep Disorders,Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA.PARTICIPANTS: From October 1998 to May 2002,225 patients were examined with overnight polysomnography in the Center of Sleep Disorders,Department of Respiratory Disease, Nanjing General Hospital of Nanjing Command. According to the inclusion criteria of ① AHI≥10 times/hour;② Sleep time in supine and lateral positions≥30 minutes; ③ Over 20years of age; 225 patients were selected from the total of 415 consecutive patients,including 63 with positional and 162 with nonpositional OSA.METHODS: All patients received overnight monitoring with HMS-5500polysomnography system(Respironics Inc USA) in the sleep laboratory. Queries for a detailed case history and physical examination were performed with the pulmonary functions evaluated with body p lethysmography. The clinical data and results of polysomnographic and pulmonary function tests were compared between the two groups of patients and a multiple stepwise regression analysis was employed to evaluate the determinant factors for sleep position dependence of the patients' condition.MAIN OUTCOME MEASURES: Main outcome: Comparisons of the clinical data,polysomnographic result and pulmonary function between the two groups. Secondary outcome: Correlation between classification of OSA and the clinical data.RESULTS: Totally 63 (28%) of the 225 OSA patients were identified as the positional type,who had significantly greater body mass index (BMI)then the nonpositional type patients [(43.46 ± 16.43) kg/m2 vs (23.90 ± 12.36) kg/m2,t =3. 977,P<0.01]. Except for sleeping time in lateral and supine positions, minimal SatO2 and basic SatO2 before the matching for BMI,all the other factors in polysomnograms of the two groups were significant different(P<0.05 or P<0.01). After BMI matching,all the measurements were identical to those recorded for the primary grouping with the exception of nocturnal limb movement frequency,which differed but insignificant between the two groups. The pulmonary function in the two groups was no significant difference(P>0.05) . Multiple stepwise regression analysis indicated that AHI and BMI were the two determinant factors for positional dependence of OSA with a predictive power of 26. 2%. Linear correlation analysis showed correlation of AHI and SatO2 with BMI in the whole group and nonpositional group(P<0.05 or P<0.01),but not in the positional group (P>0.05).CONCLUSION: About one-third of the OSA patients shows sleep position dependence,who may respond favorably to sleep position training. Sufficient patency can be retained in the upper airway of these patients to relieve respiratory obstruction during sleep and improve the respiratory function.

OBJECTIVETo observe application value of multispectral animal living imaging technology in rats model of osteoarthritis.

METHODSFifteen male SD rats weighed (180 +/- 20) g (3 months old) were received intra-articular injection of iodoacetic acid for establishing osteoarthritis. Articular cavity of left knee of rats were injected into 50 microl iodoacetic acid. The same volume of sterile saline was injected into right knee articular cavity as control. X-ray living imaging and bone mineral density were observed at 2 and 4 weeks after establishment of model. After 4 weeks,rats were sacrificed and their bilateral joints were collected and determined histologically based on Collins classification and Kellgren-Lawrence classification.

RESULTSOsteoarthritis model was successfully established, compared with control group, model group showed typical manifestation of osteoarthritis, including irregular cartilage surface,osteophyte formation,joint deformity and cartilage defect,and combined with significant decrease of bone density (P < 0.01), while the decrease was not obvious in proximal tibia (P < 0.05). After 2 weeks, knee joints in model group was classified as Collins grade 1 and Kellgren-Lawrence grade 2,then classified as Collins grade 4 and Kellgren-Lawrence grade 3 after 4 weeks,control group showed smooth articular surface,normal joint space and intact cartilage surface, knee joints was classified as Collins and Kellgren-Lawrence grade 0, and bone density of distal femur and proximal tibia were normal.

CONCLUSIONMultispectral animal living imaging technology could be used in dynamic observation of living imaging and detection of bone density in the animal model of osteoarthritis, and it is significant for evaluation of osteoarthritis model, and its realted tesearch.

Animals ; Bone Density ; Disease Models, Animal ; Humans ; Knee Joint ; diagnostic imaging ; Male ; Osteoarthritis ; diagnosis ; diagnostic imaging ; physiopathology ; Radiography ; Rats ; Rats, Sprague-Dawley

This article, introduces setting up of reflectance confocal microscope which is divided into four parts: optical system, scanning system, detecting system and software controlling system. This reflectance confocal microscope realizes in vivo epidermis tissue imaging in mouse skin as well as disease diagnosis related cell parameters measurement.
Animals ; Diagnostic Imaging ; instrumentation ; methods ; Microscopy, Confocal ; methods ; Rats ; Skin ; Software