Objective:To screen the potential characteristic gene spectrums and signal pathways of osteoarthritis based on gene chips.Methods:We analyzed 2 microarrays of human joint synovial tissue (GSE82107 and GSE55235) derived from the Gene Expression Omnibus (GEO) database and included for this study 20 osteoarthritis (OA) samples and 17 healthy control samples. The differentially expressed genes (DEGs) between OA and HC were screened by GEO2R tool. Analyses of Gene Ontology function and Kyoto Encyclopedia of Genes and Genomes pathway enrichment were performed using the Database for Annotation, Visualization and Integrated Discovery to identify the pathways and functional annotations of DEGs (https://david.ncifcrf.gov/). Protein-protein interaction of these DEGs was analyzed based on the Search Tool for the Retrieval of Interacting Genes database and visualized by Cytoscape software (http://www.string-db.org/).Results:191 up-regulated DEGs and 49 down-regulated DEGs were screened out from the 2 microarray databases. Enrichment of DEGs was mainly found in regulation of such biological functions as "inflammation" , "bone cell differentiation" and "positive apoptotic cell regulation" , HTLV-I infection, silk crack on the original amp-activated protein kinase (MAPK) signaling pathway, swine flu, tumor necrosis factor (TNF) signaling pathway, the nf-kappa B signaling pathway, PI3 kinase/Akt pathway, toll-like receptor pathway, legionella, salmonella and other 14 signaling pathways. In 2 modes of MNC and Degree, the top 10 core genes were screened, of which interleukin-6 (IL6), JUN, chemokine 8 (CXCL8), early reaction growth factor (EGR1) and cyclin (CCND1) were identified as valuable biomarkers of OA.Conclusions:Based on GEO chips, 10 characteristic gene profiles such as IL6, JUN, CXCL8, EGR1, CCND and 14 signal pathways such as tumor necrosis factor (TNF) signal pathway, NF-κB signal pathway, PI3 kinase/Akt pathway and Toll-like receptor pathway were screened, which may provide new clues for understanding of the pathogenesis of osteoarthritis.

Meningoencephalitis caused by the human herpes virus 6 is common in acquired immune deficiency syndrome patients or in patients after organ transplantation, rarely in immunocompetent adults. The clinical manifestations include headache, drowsinesss, coma, epileptic attack, psychiatric symptom and focal neurological signs. Antiviral therapy is effective, however the prognosis should be poor if the treatment is not timely. The clinical data of one case of meningoencephalitis caused by the human herpes virus 6 in Tianjin Haihe Hospital in October 2019 were analyzed. Meningoencephalitis caused by the human herpes virus 6 can be recurrent. The clinical manifestations are nonspecific and the diagnosis is difficult. The next generation sequencing of cerebrospinal fluid is a powerful method to identify pathogens.

Objective To seauch the ideal management for gross hematuria in autosomal dominant polycystic kidney disease (ADPKD).Methods ADPKD patients who were ever hospitalized and followed up in our department since 1993 were enrolled in the study.Demographic and clinical data were colloected,such as gender,age of gross hematuria,level of renal function,causative factors,management strategies,duration of gross hematuria,blood platelet count,activated partial thromboplastin time,prothrombin time,international normalized ratio,size of kidney cyst and so on.ADPKD patients were divided into different groups according to causative factors or management.The clinical data were compared among groups.Results A total of 905 ADPKD patients were screened,among whom 279 patients ever had gross hematuria (male/female:150/129),One hundred and forty-six patients had integrated therapeutic process records,while only 101patients could provide relevant laboratory examination results.In these 101 patients,gross hematuria was found in any stage of chronic kidney disease (CKD); the average eGFR was (56.4±44.1) mml·min-1 ·(1.73 m2)-1; the duration of gross hematuria was (8.8±8.0) d; no significant difference between male and female in duration of gross hematuria existed [(8.2±7.3) d vs (9.5±8.8) d,P=0.426]; coagulation parameters were all normal.The platelet count was also normal in 91 patients.Duration of gross hematuria among groups divided according to different causative factors was significantly different (P＜0.05).The patients in bed rest group had significantly shorter duration of gross hematuria compared with other groups (P＜0.05).The platelet count,prothromhin time and international normalized ratio were all at similar level in different groups.Conclusions The causative factors in ADPKD patients with gross hematuria should be confirmed as the first step of management strategies.Bed rest is the key point in management.Antifibrinolytic agent is a proper choice in the cases receiving bemostatic drugs.It is unnecessary to use antibiotic agent for prevention.

Objective To investigate the correlation of serum levels of retinol binding protein 4 (RBP4) and andomen?tin-1 with ischemic stroke and carotid artery stenosis. Methods Healthy adult (n=50) were selected as the control group while ischemic stroke patients with different degrees of carotid artery stenosis (n=143) were enrolled as the disease group. According to the ultrasonic Doppler performance, these ischemic stroke patients were divided into three groups:mild steno?sis group (carotid artery stenosis was normal or less than 50%, n=67), moderate stenosis group (carotid artery stenosis was 50%to 70%, n=45), severe stenosis group (carotid artery stenosis was 70%to total occlusion, n=31). BMI index, hyperten?sion, total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) and fasting blood glucose (FPG) were detected by Automatic biochemical analyzer and serum levels of RBP4 and omentin-1 were measured by ELISA. Results Hypertensive population in carotid artery stenosis group was larger than that in control group (P<0.05). Serum TC, TG, LDL, FPG and RBP4 levels were significantly higher while omentin-1 level decreased remarkably in disease group than those in the control group (P<0.05). Logistic regression analysis showed that TC and RBP4 were the risk factors of ischemic stroke with carotid artery stenosis, while omentin-1 was a protective factor. Conclusion RBP4 is a risk factor for ischemic stroke with carotid artery stenosis and omentin-1 is a protective factor.

Objective To study the effect of urodynamic factors on the urinary retention of the patients with cervical cancer received radical hysterectomy. Methods Seventy-two patients with cervical cancer Ininternational Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ bl to Ⅱ a hospitalized in Fujian Provincial Maternity and Child Health Hospital between June 2006 and August 2009, who were not found any abnormal representation of urodynamics before the operation, were divided into the group with urinary retention and the group without urinary retention based on whether urinary retention after the operation. All patients were detected by urodynamic examination following radical hysterectomy. Data obtained from urodynamic examination were analysed by logistic regression to evaluate the influence of urodynamic factors on the urinary retention postoperation. Results Twenty-one patients out of all were found with urinary retention after the operation , the incidence rate of urinary retention was 29%. The first sensation after operation in both groups were increased significantly than those before operation[ ( 171 ±61 )ml vs.(126 ±28)ml, (134±39)ml vs. (119 ± 17)ml,all P＜0.05], while the maximum volume[ (337 ±66) and (300 ±66)ml, respectively], the compliance[ (31 ±25) and (29 ± 18) ml/cm H2O (1 cm H2O =0. 098 kPa), respectively], the maximum flow rate[ (10 ±4) and (12 ±5) ml/s, respectively] and the pressure at the maximum flow rate [ (27 ±9) and (32 ±8) cm H2O, respectively] were decreased obviously after radical hysterectomy in both the group with urinary retention and the group without urinary retention ( all P ＜0.05), compared with the corresponding value before the operation. The urodynamic changes in urinary retention group was much more severe than those in group without urinary retention ( P ＜ 0. 05 ). The single factor analysis results showed that bladder destusor dysfunction ( OR = 8. 20, 95% CI: 2.62 - 25. 66, P ＜0. 01 ) and lack of sensation ( OR = 6. 90, 95% CI: 1.95 - 24. 43, P ＜ 0. 01 ) were relevant to the urinary retention post-operation. While there were not relationship was found between low compliance bladder( OR =1.99, 95% CI:0. 70 - 5.63, P = 0. 195 ), detrusor overactivity ( OR = 2. 51, 95% CI: 0. 73 - 8.67, P =0. 144), bladder outlet obstruction ( OR = 3.77, 95% CI: 0. 76 - 18. 57, P = 0. 104 ) or dyssynergia of urethral external sphincter( OR =2. 67, 95% CI:0. 49- 14. 45, P =0. 255 ) and urinary retention following the operation. There were an antagonistic effects ( OR = 7.60, 95% CI: 1.43 - 40. 39, P = 0. 017 ) of detrusor overactivity and bladder destrusor dysfunction on urinary retention. The multiple factors analysis results revealed that bladder destusor dysfunction( OR = 7.01, P ＜ 0. 01 ) and lack of sensation( OR = 5.45, P =0. 018)were the independent risk factors influening on the urinary retention post-operation. Conclusions There are obvious urodynamic change in cervical cancer patients following radical hysterectomy. Bladder destrusor dysfunction and lack of sensation are the independent urodynamic risk factors influencing on urinary retention following radical hysterectomy, while detrusor over activity may be a protective effect on bladder destrusor dysfunction post-operation in some degree. Urodynamic test is important for analysis and treatment of urinary retention following radical hysterectomy.

Objective:To analyze the effectiveness of antiviral therapy on adolescents and adults with infectious mononucleosis (IM).Methods:The clinical data of patients aged≥16 years old with IM who were hospitalized in Peking University First Hospital from January 1, 2005 to December 31, 2018 were analyzed retrospectively, and the patients were divided into antiviral treatment group and non-antiviral treatment group. The duration of hospitalization day, fever duration, ratio of lymphocytes and duration for normalization of Epstein-Barr virus (EBV) markers were compared between the two groups through single factor and propensity score matching analysis. Statistical analysis was conducted by independent sample t test, Mann-Whitney U test, chi-square test or Fisher exact probability method. Results:A total of 274 cases were enrolled and 176 cases (64.23%) were divided into antiviral treatment group and 98 cases (35.77%) into non-antiviral treatment group. The proportion of male (56.25%(99/176) vs 56.12%(55/98)), age (21.0(18.0, 26.0) years old vs 21.0(18.0, 27.0) years old), the ratio of fever (98.30%(173/176) vs 93.88%(92/98)), sore throat (90.34%(159/176) vs 88.78%(87/98)), lymphocyte ratio (0.648(0.568, 0.707) vs 0.663(0.581, 0.711)), atypical lymphocyte ratio (0.150(0.100, 0.235) vs 0.135(0.060, 0.250)) and serum EBV DNA level (2.71(2.70, 3.47) lg copies/mL vs 2.70(2.70, 3.28) lg copies/mL) were comparable between two groups at admission, and the differences were all not statistically significant(all P>0.05). The durations of hospitalization and fever in antiviral treatment group were 14.0(10.0, 18.0) d and (14.91±7.24) d, respectively, which were both significantly longer than those in non-antiviral treatment group (11.0(7.0, 15.0) d and (9.95±5.67) d, respectively). The differences were both statistically significant ( Z=-3.294 and t=-5.035, respectively, both P<0.01). Twenty-six patients each in the antiviral treatment group and non-antiviral treatment group were included in the propensity score matching assessment. The fever days of the two groups were 15.0(10.0, 18.0) d and 7.5(5.0, 12.5) d, respectively, and the hospitalization days were (15.4±5.5) d and (12.0±5.7) d, respectively. The differences were both statistically significant ( Z=-3.781 and t=-2.187, respectively, both P<0.05). However, there were no significant differences in the time required for the ratio of lymphocytes returning to normal, the time required for the ratio of atypical lymphocytes decreasing to <0.100, and the time required for serum EBV DNA becoming negative(all P>0.05). Conclusion:The antiviral treatment could not improve the prognosis of adolescent and adult IM patients.

Abstract: Objective　To investigate the antimicrobial activity of omadacycline (OMC) against clinical Streptococcus agalactiae (GBS) isolates, as well as its relationship with biofilm formation, resistance genes and virulence genes. Methods　A total of 136 strains of Streptococcus agalactiae isolated from Shenzhen Nanshan People's Hospital between 2015 to 2020. The minimum inhibitory concentration (MIC) of OMC against Streptococcus agalactiae was determined by broth microdilution. Crystal violet staining was used to detect the biofilm formation ability of GBS. Resistance genes (tetM, tetO, tetK, ermB, OptrA) and virulence genes (cpsⅢ, bca, fbsA, cpsA, scpB) were investigated by polymerase chain reaction (PCR). Results　Among the 136 clinical isolates of GBS, 20 strains (14.7%) were resistant to OMC, 64 (47.1%) were intermediate, and 52 (38.2%) were sensitive. Fifty-seven strains (41.9%) were biofilm-positive, 20 of which (35.1%) were sensitive to OMC. Seventy-nine strains (58.1%) were biofilm-negative, 32 of which (40.5%) were susceptible to OMC. There was a statistically significant difference in the sensitivity rates between the two groups of strains (χ2=63.062, P<0.001), but there was no significant difference in the sensitivity of OMC among the biofilm-positive strains (Fisher's exact test, P=0.824). The resistance rates of tetM, tetO, ermB and OptrA positive strains were higher than those of negative strains, while tetK was opposite. The presence of tetM (Z=0.815, P=0.415), tetO (Z=0.151, P=0.88), tetK (Z=0.567, P=0.571), ermB (Z=1.198, P=0.231) resistance genes in Streptococcus agalactiae had no significant impact on the sensitivity of OMC. However, the presence of the OptrA resistance gene showed a statistically significant effect on the sensitivity of OMC (Z=2.913, P=0.004). The virulence factors cpsⅢ, bca, fbsA, cpsA and scpB were all detected at a rate higher than 50%. The presence of the virulence genes cpsⅢ (Z=0.222, P=0.824), bca (Z=0.141, P=0.888), fbsA (Z=0.813, P=0.416), and cpsA (Z=1.615, P=0.106) in Streptococcus agalactiae had no significant impact on the sensitivity of OMC. However, there was a significant inter-group difference in the scpB virulence gene (Z=2.844, P=0.004), but the rank mean values and resistance rates of scpB-positive strains were lower than those of the negative strains. Conclusions　The formation of biofilm in Streptococcus agalactiae reduces its sensitivity to OMC, but there was no significant difference in the sensitivity to OMC among the biofilm-positive strains. The presence of resistance genes tetM, tetO, tetK, ermB, and virulence genes cpsⅢ, bca, fbsA, cpsA, scpB in Streptococcus agalactiae is not associated with OMC resistance, but the presence of the resistance gene OptrA is correlated with OMC resistance..

Objective To evaluate the clinical value of ultrasonography in the diagnosis of hermaphroditism.Methods Ultrasonographic appearances of 45 cases with hermaphroditism were reviewed retrospectively,and the results were compared with clinical data.Results All cases were confirmed pathologically.5 cases showed true hermaphroditism (11.1％),14 cases showed male pseudohermaphroditism (31.1 ％),24 cases showed female pseudohermaphroditism (53.3 ％),2 cases showed gonadal dysgenesis(4.4％).Compared with pathological results in the ultrasound examination,4 cases showed true hermaphroditism,the coincidence rate was 80％.11 cases showed male pseudohermaphroditism,the coincidence rate was 78.6％.20 cases showed female pseudohermaphroditism,the coincidence rate was 83.3％.1 cases showed gonadal dysgenesis,the coincidence rate was 50.0％.Conclusions Ultrasonography can not only evaluate internal reproductive organs in the patients,but also estimate the site,size,morphology and structure,which provides important imaging evidence for the clinical diagnosis and treatment.

Objective To analyze the clinical features of the patients with meningitis caused by the Campylobacterfetus.Methods The clinical data of one case of meningitis caused by the Campylobacter fetus in Tianjin Haihe Hospital in September 2016 were analyzed and the literature was reviewed.In the PubMed database with “ Campylobacter fetus,meningitis” as keyword,we retrieved 51 English literature,from 1962 to 2016,excluding infant infection and non infection meningitis.Results Finally 17 articles,20 patients,were retrieved.With these patients,a total of 21 patients were analyzed.There were 19 male cases,two female cases,average age being 47 years (23-84 years).The clinical manifestations were fever,headache,some patients with altered consciousness,increased white blood cells and protein in cerebrospinal fluid,normal or decreased glucose.Antibiotic treatment was effective,and the prognosis was good.No specific clinical fetures were found.Alcoholism,diabetes and immunodeficiency were independent risk factors of the disease.Positive cerebrospinal fluid and blood cultures can help to diagnose the disease.Conclusions Campylobacter fetus caused meningitis in clinic is extremely rare,and its clinical manifestations are nonspecific.Antibiotic therapy is effective,and the prognosis is good.

Objective To investigate and assess the current situations on information management of rehabilitation service in Shanghai. Methods The information management in 6 districts in Shanghai were assessed in field, the fulfilling of the first- and second-degree index and the standard-reaching rate of the third-degree index were calculated separately according to the first-degree index- information management of the Evaluation Index System of Rehabilitation Service for All Disabled in Shanghai. Results The average fulfilling degree of the first-degree index was 73.1%. There were only 2 districts reached the standard of Registration of Rehabilitation. The average fulfilling degrees of the Development and Dynamic Maintenance of Rehabilitation Service Information Database were 50.0% and 66.7%, respectively. The standard-reaching rate of the Disabled Children First-diagnose Report System, Effectual Providing Referral Rehabilitation Service Across-the-board, Suspicious Disabled Persons Report System in Community were 16.7%, 16.7% and 50%, respectively. Conclusion The development and supervision of rehabilitation service information should be reinforced and the referral rehabilitation service should be improved.