Objective To obtain a simple method to treat segmental vitiligo. Methods The grafting was carried out as following: the epidermal cellular suspension was obtained from leg skin by razor blade after trypsinization. The suspension of epidermal cells were injected into depigmented lesion blisters which were produced by freezing with nitrogen. Results All of the patients which received treatment had successful repigmentation. Conclusion This technique is an effective and simple method for treating patients with segmental vitiligo.

OBJECTIVE To enhance the positive rate of the blood culture in order to make pathogenic diagnosis actually and quickly and conducting usage of antimicrobial agents in clinic.To value the clinical applied circumstance of BacT/Alert 3D automated blood culture system.METHODS The 3728 blood cultures were detected by BacT/Alert 3D automated blood culture system,and bacterial susceptibility test was conducted on all isolates using Kirby-Bauer methods with CLSI standards.To statistically analyze the examined time,the positive rate and variety and drug resistance for all kinds of pathogens.RESULTS The blood culture positive rate was 6.0% in the 3728 blood cultures with 222 strains of bacteria.The false positive rate was 0.2% and the false negative rate was 0.4%.The positive rate of blood culture was 0.89% in 12 hours,2.01% in 18 hours,and 3.51% in 24 hours.Among all the 222 isolates,29.7% were Enterobacteriaceae,the drug resistant rates to amikacin,ceftazidime,ciprofloxacin,and imipenem were 13.6%,36.3%,42.4%,and 3.0%,respectively;20.3% were Staphylococcus,the drug resistant rates to erythromycin,levofloxacin,cefoxitin,and vancomycin were 75.6%,33.3%,68.9%,and 0,respectively;11.7% were Enterococcus,the drug resistant rates to errythromycin,levofloxacin,fosfomycin,and vancomycin were 96.2%,80.8%,23.1%,and 0,respectively;11.3% were non-fermented bacilli,the drug resistant rates to amikacin,ceftazidime,ciprofloxacin,and imipenem were 32.0%,52.0%,32.0%,and 32.0%,respectively;12.6% were fungi.CONCLUSIONS The pathogens in the blood specimens are more wider in distribution and more higher in drug resistance rates than before.BacT/Alert 3D automated blood culture system can be an important tool for the blood culture,it can provide the diagnostic help quickly for the clinic and increase the positive rates in blood culture.It can not only shorten the check-up time,but also be more quick and more exact.

OBJECTIVE To understand the distribution or change and drug resistance of the bacteria flora in nosocomial infection,in order to provide laboratory evidence for controlling nosocomial infection and to indicate clinical antimicrobial agents usage.METHODS All isolates were identified by routine procedure and VITEK microbe automatic system and API identified system.Drug susceptibility test was used K-B paper disk diffusion method in accordance with the CLSI/NCCLS standards.RESULTS There were 11 464 strains of bacteria which were obtained from 2002 to 2006.Sputum,secretion and middle urine were the major specimens.The major bacteria floras were Pseudomonas aeruginosa,Escherichia coli,Acinetobacter,Enterococcus,Staphylococcus and Candida albicans,whose isolating rates were 57.02% in 2002,64.46% in 2003,57.83% in 2004,57.49% in 2005,and 60.73% in 2006.E.coli and Klebsiella pneumoniae produced ESBLs rates were from 39.87% to 61.98% that drug resistance rates to cefoperazone/sulbactam and imipenem were 14.06% and 0.64%.The drug resistance rates of nonferment Gram-negtive bacteria to cefoperazone/sulbactam were below 33.22%,Gram-positive cocci to vancomycin was below 0.34%.CONCLUSIONS Now,the important bacteria flora is nonferment Gram-negative bacteria in nosocomial infection.The P.aeruginosa,E.coli,Acinetobacter baumannii,Enterococcus faecalis,C.albicans,and meticillin-resistant staphylococcus(MRS) were prevalent important bacteria in nosocomial infection.The situation of producing ESBLs in Enterobacteriaceae is very severe.Glycopeptides are the best choice to MRS.To zymogenic bacteria and the nonferment Gram-negtive bacteria that cause severe infection,combining-drug treatment can be chosen according to drug susceptibility test results.

Objective:To explore the understanding among medical rehabilitation staff about pain in children with cerebral palsy.Methods:A questionnaire was developed by referring to the literature on children′s rehabilitation and pain. It was used to survey 856 rehabilitation personnel including 110 doctors, 313 therapists and 433 nurses from 12 hospitals in 10 provinces using an online platform at www.wjx.cn.Results:The overall rate of correct responses was (67.89±13.35) %. Doctors and therapists scored about 70% correct and nurses about 65%. There were significant differences in pain knowledge related with educational background, age, work experience and position. Gender, professional title and parent status were not significant predictors. About 93% of those surveyed thought it was necessary to provide pain-related training, and 95% were willing to receive such training.Conclusions:There is a lack of knowledge about pain in children with cerebral palsy among rehabilitation medical staff. It is urgent to provide more related training and guidance to those in clinical practice.

OBJECTIVE Through investigation of the changes in biological characteristics of an E scherichia coli bacteriophage with broad host range,to study the mechanism of phage-host specificity and the bactericidal efficacy on sewage water samples.METHODS In this study,one strain of E.coli bacteriophages with broad host range was screened from natural environment using the E.coli 285.Then,in order to analyze the difference of biologic effects before and after the host range changed,we made a comparison of biological properties between the phage with broad host range and the phage f2.RESULTS The ultrastructure under electron microscope showed that the two phages were round-shaped particles,but phage XY′s diameter between 20-90 nm,short-tailed and occasionally visible;the anti-serum K value of phages f2 and XY was 30.1 and 41.5,respectively;whereas,between phages XY and f2,there was a low correlativity(K value

Objective:To investigate the effects of cardiac exercise rehabilitation on heart failure with preserved ejection fraction.Methods:200 patients with clinically diagnosed heart failure with preserved ejection fraction who received treatment from May to December 2019 were included in this study. They were randomly assigned to receive either routine treatment (control group, n = 100) or routine treatment combined with cardiac exercise rehabilitation (observation group, n = 100). Before and after treatment, the distance walked during the 6-minute walk test was compared between the control and observation groups. Before and after treatment, plasma level of brain natriuretic peptide, left ventricular ejection fraction, left ventricular short-axis fractional shortening, left atrial diameter, left ventricular end diastolic diameter were compared between the two groups. Adverse events such as falls during treatment were recorded in each group. Before and after treatment, quality of life was evaluated using The Minnesota Living With Heart Failure Questionnaire in each group. All patients were followed up for 3 months. Three-month rehospitalization rate was calculated in each group. Results:After treatment, the distance walked during the 6-minute walk test in the observation group was significantly longer than that in the control group [(421.63 ± 86.75) m vs. (328.44 ± 74.93) m, t = 8.130, P < 0.001). After treatment, the distance walked during the 6-minute walk test in each group was significantly increased compared with before treatment ( tcontrol group = 6.584, P < 0.001; tobservation group = 15.337, P < 0.001). After treatment, plasma level of brain natriuretic peptide in the observation group was significantly lower than that in the control group [(227.68 ± 31.22) mg/L vs. (269.74 ± 36.81) mg/L, t = 8.714, P < 0.001]. After treatment, plasma level of brain natriuretic peptide in each group was significantly decreased compared with before treatment ( tcontrol group = 24.669, P < 0.001; tobservation group = 38.776, P < 0.001). After treatment, left ventricular end diastolic diameter and left atrial diameter in each group were significantly decreased compared with before treatment ( t = 4.031, 10.166, 3.715 and 12.569, all P < 0.05), while left ventricular ejection fraction and left ventricular short-axis fractional shortening in each group were significantly increased compared with before treatment ( t = 7.610, 11.906, 3.915 and 6.105, all P < 0.05). The amplitude of improvement in abovementioned indices in the observation group was significantly greater than that in the control group ( t = 7.255, 12.739, 4.703 and 2.442, all P < 0.05). During the treatment, no falls, adverse cardiovascular events, or death occurred in each group. After treatment, the Minnesota Living With Heart Failure Questionnaire scores in physical domain, emotional domain and other domains in the observation group were (23.96 ± 4.75) points, (9.47 ± 2.02) points, (26.31 ± 1.84) points, respectively, which were significantly lower than those in the control group [(28.63 ± 5.12) points, (12.35 ± 1.89) points and (32.76 ± 2.49) points, t = 6.867, 10.411 and 20.833, all P < 0.001]. After treatment, the Minnesota Living With Heart Failure Questionnaire scores in various domains in each group were significantly decreased compared with before treatment ( t = 6.648, 14.746, 28.782, 35.262, 9.665 and 27.962, all P < 0.05). Three-month rehospitalization rate in the observation group was significantly lower than that in the control group [10.0% (10/100) vs. 22.0% (22/100), χ2 = 5.357, P = 0.021]. Conclusion:Cardiac exercise rehabilitation for the treatment of heart failure with preserved ejection fraction can help improve the heart function, increase exercise endurance, improve prognosis, reduce rehospitalization rate, and improve quality of life.

Objective To investigate the immunological properties of Rv1009 domain. Methods BALB/c mice were immunized with Rv1009 domain three times at 2-week interval. ELISA was used to detect the antiRv1009 domain antibody titer in the sera of immunized mice sera. The spleen lymphocytes of the immunized mice were separated and the stimulation index (SI) was measured by MTT colorimetry. Levels of secreted IFN-γ, IL-10 and IL-12 upon specific antigen stimulation were detected by ELISA. The BALB/c mice immunized with Rv1009 domain were intravenously infected with MTB H37Rv. Four weeks after the final injection, the number of CFU in spleens was determined. Results The titer of the specific antibody in sera of the immunized BALB/c mice was 1:12 800. The SI of Rv1009 domain immunized group (2. 40±0. 18) was significantly higher than that of saline immunized group (0.90±0.21). The IFN-γ,IL-10 and IL-12 levels in culture supematant of spleen lymphecytes from the fusion proteins immunized mice was (1 432±30) ng/L, (503±11) ng/L and (311±11) ng/L respectively, significant different from that of saline immunized group[(256±20) ng/L, (76±6) ng/L and(56±8) ng/L,P<0.01]. Four weeks after the final injection,compared with normal saline immunized mice (6.64±0.13), dramatic reduction in MTB replication was observed in the spleen (4.86±0.14) from BALB/c mice immunized with fusion proteins following a subsequent MTB H37Rv challenge, but the protection efficacy of mice immunized with Rv1009 domain was not as good as that of BCG vaccination group (3.81±0.16). Conclusion Rv1009 domain can be used as a candidate for the new TB vaccine.

Objective To investigate the molecular epidemiological characteristics and homology of Staphylococcus aureus (S. aureus)isolated from patients in intensive care units (ICUs)of a hospital,so as to provide laboratory basis for the effective control of healthcare-associated infection(HAI). Methods 62 S. aureus strains isolated from various specimens from ICU patients with infection in March-August 2013 were collected,7 housekeeping genes were amplified with polymerase chain reaction (PCR),the amplified products were sequenced,ST typing of strains was performed by multilocus sequence typing (MLST ), phylogenetic analysis of ST typing was conducted. Results 62S. aureus strains were amplified specific product of 7 housekeeping genes;there were 10 ST genotypes, in which 2 ST genotypes(STn1and STn2)were first discovered,1 ST genotype(ST675)was first discovered domes-tically. ST239 was the main ST type of S. aureus from ICU patients in this hospital,accounting for 74.20% ,which distributed in 6 ICUs,ST5 distributed in 3 ICUs. 62 strains formed 7 main branches in the phylogenetic tree,55 (88.71% )MRSA strains were detected. Conclusion S. aureus isolated from hospital ICUs has some homology, and the small number of types showed the trend of concentrated distribution.

Objective To understand the clindamycin resistance gene and molecular epidemic of Staphylococcus aureus in the pa‐tients with bloodstream infection in our hospital during 2014 .Methods The clinical isolates of Staphylococcus aureus in clinical bloodstream infection were collected during 2014 .The phenotype of erythromycin to clindamycin induced resistance was assessed by D test .The erm gene was detected by PCR .The different erm types of the molecular epidemiology of Staphylococcus aureus were studied by spa and MLST typing .Results In 33 strains of Staphylococcus aureus ,the isolation rate of MRSA strains were 78 .79% ,moreover all of MRSA strains carried ermA gene .In 7 strains of methicillin sensitive Staphylococcus aureus(MSSA) ,4 strains respectively carried ermB or ermC gene .The results of MLST and spa results showed that the main type of MRSA in our hospital was ST239‐t030 .But MSSA had more types ,such as ST59‐t437 ,ST398‐t3625 and so on .Conclusion MRSA has higher i‐solation rate in our hospital ,which is dominated by ST239‐t030 type .For the detection of gene erm ,ermA (86 .67% ) is the main type .The strains are obviously resistant to antibacterial drugs .The laboratory should strengthen the detection of clindamycin in‐duced resistance for guiding the clinical rational use of antibacterial drugs .

Objective To express recombinant HBHAΔC and HBHAΔN protein,and compare the HBHA series protein activity with each other.It will be provide a experimental basis for the research on clinical diagnostic of HBHA.Methods The HBHAΔC and HBHAΔN gene fragments were cloned and expressed by transforming E.coli BL-21.Test the protein heparin binding ability by CL-6B column.And then added protein to the BCG 7H9 culture medium,to observe the induced BCG aggregation.Results nHB-HA,rHBHA and HBHAΔN protein have heparin binding ability.Meanwhile nHBHA,rHBHA and HBHA Δ C protein have in-duced BCG aggregation effect.Conclusion The HBHAΔC and HBHAΔN protein were successfully obtained.It was proved that the HBHA C-terminal could be combined with heparin and the N-terminal involved could induce the aggregation of BCG.This results provide a basis for further study on molecular mechanism of TB infection and clinical application.