Objective To investigate the molecular types and related clinical features of methicillin-resistant Staphylococcus aureus (MRSA) in Jingzhou area, Hubei Province.Methods A total of 80 MRSA strains confirmed by mecA gene were isolated from inpatients in Jingzhou Central Hospital of Hubei province during January and December 2014. Vitek 2 Compact was used for antibiotic susceptibility test . Staphylococcus protein A (SPA) types and Staphylococcal cassette chromosome mec (SCCmec) genotypes were detected by multiplex polymerase chain reaction ( PCR ) and gene sequencing . Panton-valentine leucocidin ( pvl) gene of the strains was detected by PCR .Chi-square test and Wilcoxon test were used for data analysis .Results There were 16 spa types in 80 MRSA isolates , in which t030 and t437 were the most prevalent ones accounting for 50.0% ( 40 strains ) and 28.8% ( 23 strains ) of the total strains, respectively.There were 77 strains of SCCmec type Ⅰ-Ⅴ, in which SCCmecⅢ and SCCmecⅣ were the most prevalent ones accounting for 45.0% (36 strains) and 35.0% (28 strains), respectively.t030 was the main spa type in isolates of SCCmecⅢ(33/36, 91.7%), while t437 was the main spa type in isolates of SCCmecⅣ(20/28, 71.4%).Patients infected with t030/SCCmecⅢMRSAs were with higher ages than those infected with t437/SCCmecⅣMRSAs (T=446.500 and 607.500, P<0.01).Patients infected with t030/SCCmecⅢ MRSAs were mainly from surgical wards and intensive care unit ( ICU ) , while those infected with t437/SCCmecⅣ MRSAs were mainly from pediatrics wards , and there were significant differences in ward distribution between two groups (χ2 =33.724 and 29.768, P <0.01).Seventy percent and above strains of t030/SCCmec type Ⅲ were resistant to rifampin, erythromycin, clindamycin, tetracycline, levofloxacin, moxifloxacin, ciprofloxacin and gentamicin .Strains of t437/SCCmec type Ⅳwere resistant to erythromycin , clindamycin and tetracycline , but were sensitive to most non-β-lactam antimicrobial drugs (with resistance rates <20%).Virulence gene pvl was found in 11 strains (13.8%), in which 7 were strains of t437-SCCmec typeⅣ.Conclusions MRSAs in Jinzhou are of various genotypes , in which t030-SCCmecⅢand t437-SCCmecⅣare the most prevalent ones .Strains of t030-SCCmec typeⅢare usually multiple-drug resistant , mainly seen in elderly patients in surgical wards and ICU .Strains of t437-SCCmecⅣare sensitive to most non-β-lactam antimicrobial drugs , and its infection is mainly seen in children and young people .

Objective To investigate the epidemiology and antibiotic resistance of communityassociated and hospital-associated meticillin-resistant Staphylococcus aureus (CA-MRSA and HA-MRSA) in Jingzhou.Methods A total of 159 MRSA isolates were successively collected from patients in Jingzhou Central Hospital during January 2012 and December 2013.The minimum inhibitory concentrations of 16 antimicrobial agents against 159 MRSA isolates were detected.SCCmec types of the strains were detected by multiplex PCR,and the homology of the strains was analyzed using pulsed field gel electrophoresis (PFGE) and cluster analysis of antibiogram.WHONET 5.6 and SPSS 19.0 were used for data analysis.Results Among 159 MRSA strains,131 were hospital-associated,and 28 were community-associated,which accounted for 82.4％ and 17.6％,respectively.There were significant differences in the age of patients,ward distribution,specimen type,length of stay,length of anti-infection treatment,type of infection and underlying diseases between patients with CA-MRSA or HA-MRSA infections (x2 =19.103,31.372,59.756,71.703,54.153,59.756 and 54.232,all P ＜ 0.01).No vancomycin,linezolid,tigecyeline and nitrofurantoin resistant strains were found,but all strains were resistant to penicillin,cefoxitin and oxacillin.HA-MRSA had higher resistance rates to moxifloxacin,levofloxacin,rifampicin,ciprofloxacin and gentamicin than CA-MRSA (x2 =30.179,27.352,28.523,28.523 and 25.987,all P ＜ 0.01),but its resistance rates to erythromycin and clindamycin were lower (x2 =13.106 and 11.743,both P ＜ 0.01).Among 159 MRSA strains,12 (7.5％) were of SCCmec type Ⅱ,113 (71.1％) were of SCCmec type Ⅲ,26 (16.4％) were of SCCmec type Ⅳ,and 8 were of undifferentiated type.The predominant SCCmec types were type Ⅳ for CA-MRSA (26/28,92.9％) and type Ⅲ for HA-MRSA (113/131,86.3％),respectively.Six PFGE patters were found in 49 HA-MRSA isolates from ICU,and the predominant patters were A1 (24,49.0％),A2 (9,18.4％) and B (9,18.4％).Cluster analysis of antibiogram showed that three groups of HA-MRSA were of high correlations,and they were of PFGE patter A1,A2 and B,respectively.Conclusions HA-MRSA is the predominant MRSA in Jingzhou area,and it is different from CA-MRSA in the age of patients,ward distribution,type of infection and antibiotic resistance.Most HA-MRSA strains are of type SCCmec Ⅲ,and may cause epidemic outbreak in ICU.

Alzheimer′s disease(AD)is a neurodegenerative disorder resulted from complicate interactions between genes and environment. There is no effective therapy so far. The genome-wide association study(GWAS)provides the opportunity to discover the risk genes of sporadic AD,which is informative for revealing the pathogenesis of AD and guiding new drug development. In this re?view,we summarize the current findings of genetic studies of AD,the risk genes and their biological relevance with AD,and new drug development strategy supported by genetic studies.

BACKGROUND: Jinguishenqi pills (JP) can ameliorate the symptoms of kidney deficiency, but the molecular mechanism of the effect is unclear.OBJECTIVE: To observe the differentially expressed genes of panic-induced kidney deficiency model mice treated with JP using suppression subtractive hybridization (SSH).DESIGN: Randomized control animal experiment.SETTING: Institute of Traditional Chinese Medicine Genetics, Chengdu University of Traditional Chinese Medicine; Sichuan Key Laboratory of Molecular Biology and Biotechnology, College of Life Science, Sichuan University.MATERIALS: This experiment was carried out at the Experimental Animal Center of Chengdu University of Traditional Chinese Medicine. Totally 30 BALB/c male adult mice were used in the experiment, and they were randomly divided into model group, JP-treated group and control group,with 10 in each.METHODS: Mice models of kidney deficiency were created in the mice of model group and JP-treated group with the methods of "terrifying mouse with cat" and "suspending mouse over water". Mice of the JP-treated group were intragastrically administrated of JP (produced in Tongrentang Pharmacy Co., Beijing, Z11020147, composed of Guizhi, Fuzi, Shudi, Shanyao,Shanzhuyu, Zexie, Fuling, Danpi, etc) 20-fold as human taken according to the bodyweight once per day. Modeling and administration were conducted in 14 days. Mice of normal control group were fed normally without any extra stimulation. Twenty-four hours after the last administration, 100 μL blood was collected respectively from mice of each group. Switch Mechanism at 5' end of RNA Template (SMART) technique was used in reverse transcription and amplification to obtain the whole length of total cDNA of mice in each group; Forward and reverse SSHs were used to acquire 6 groups of differential expression cDNA segments which were under 3 states(at kidney deficiency, after treatment and at normal physiological status).MAIN OUTCOME MEASURES: Effect of JP on gene expression of kidney deficiency mice RESULTS: ① Differentially expressed cDNA segments were found in each group; The differentially expressed cDNA profile of model mice had restored to that of the normal physiological state by JP treatment. cDNA of the same kind was used as the tester and driver of SSH, and almost all the homologous fragments were subtracted completely, which showed that the subtraction efficiency was very high. ② 6 cDNA libraries were acquired. CONCLUSION: Panic-induced kidney deficiency is related to differential expression of some genes. The gene expression of the kindey deficiency model mice could be affected by JP treatment,making it trend to normal physiological status.

Objective To investigate the effects of dexmedetomidine on the end-tidal concentration of sevoflurane during recovery from breast cancer surgery under general anaesthesia. Methods A total of 120 patients undergoing unilateral breast cancer radical operation were randomly divided into four groups:group C (infusion of saline, n=30), group D0.5 [infusion of dexmedetomidine 0.5μg/(kg·h) during operation, n=30], group D0.6 [dexmedetomidine 0.6μg/(kg·h), n=30] and group D0.7 [dexmedetomidine 0.7 μg/(kg · h), n=30]. The end-tidal concentrations of sevoflurane during surgery and postoperation were observed. The end-tidal concentration of sevoflurane on palinesthesia was recorded. The time from stopping administration of anesthetic drug to palinesthesia and the operation time were recorded. The palinesthesia of patients from general anaesthesia and the degree of emergence agitation of the patient were measured using Riker ’s sedation-agitation scale. The operation time, anesthesia time, intraoperative remifentanil dosage, intraoperative auditory evoked potential index (AAI), sevoflurane inhalation concentration and the corresponding time were recorded. Results There were no significant differences in clinical data, remifentanil dosage, operation time and AAI between four groups. The anesthesia time was longer in group D0.7 than that in the other three groups (P<0.05). Compared to group C, the end-tidal concentration of sevoflurane during surgery, postoperation and palinesthesia were lower and the time of palinesthesia was delayed in groups D0.5, D0.6 and D0.7 (P<0.05). And the time of palinesthesia was delayed in group D0.7 than that of group D0.5 and group D0.6. Compared with group C, the ratio of Riker’s sedation-agitation scale>7 was lower in groups D0.5, D0.6 and D0.7 (P<0.05). The ratio of Riker’s sedation-agitation scale>4 was significantly higher in group D0.6 and group D0.7 than that in group C and group D0.5, but the ratio of score>6 was lower (P<0.05). The ratio of score>3 was higher in group D0.7 than that of other three groups (P<0.05). Intraoperative cardiac tachycardia was found in group D0.6 and group D0.7 (4 cases, 13%and 8cases, 7%). Conclusion Sevoflurane inhalation anesthesia and intravenous infusion of dexmedetomidine 0.6μg/(kg·h) can effectively reduce intraoperative sevoflurane dosage, the end-tidal concentration of sevoflurane during recovery, and the occurrence of agitation in patients undergoing general anesthesia.

Objective To study the preliminary effects of percutaneously looped thread transection on the surgical treatment of carpal tunnel syndrome (CTS). Methods A total of 72 cases (103 sides) were treated from January 2012 to Decem?ber 2014 (27 males and 45 females, aged 22-94 years, with an average of 51.3 years). Among all the cases, 21 cases (30 sides) were treated with open decompression and 51 cases (73 sides) were treated with percutaneously looped thread transection. We did the incision in the ulnaris hypothenar pattern, revealed and cut off the transverse carpal ligament to decompress the carpal tunnel in the open surgery. Percutaneously looped thread transection was under the guidance of ultrasound, threading from the deep and shallow transverse carpal ligament, respectively, forming loops to cut off and decompressed the carpal tunnel. We observed the me?dian nerve aspect ratio (the ratio of length to width of the uncinatum median nerve on transverse section) and swelling ratio (the ra?tio of area of median nerve on transverse section of pisiform and distal radius) under ultrasound before, during and 3 months after operation. Telephone follow?up was conducted in postoperative 3 months according to the Boston Carpal Tunnel Questionnaire (BCTQ) to evaluate the symptoms of carpal tunnel syndrome and wrist joint function. Results There were 11 cases lost in the fol?low?up, and 61 cases were followed up for 3 to 27 months, with an average of 11.6 months. The preoperative BCTQ scores of open decompression group and looped thread transection group were 28.5±4.6 and 29.4±5.3, respectively. There was no statistically sig?nificant difference between two groups (t=1.34, P=0.528). The postoperative 3 months BCTQ scores were 16.3±5.7 and 15.7±4.9. There was no statistically significant difference between two groups (t=1.12, P=0.674). The median nerve aspect ratios measured under ultrasound of open decompression group before and 3 months after operation were 3.8 ± 0.7 and 2.6 ± 0.4, respectively. The swelling ratios were 2.3±0.4 and 1.2±0.3. The difference of preoperative and postoperative changes was statistically significant (P<0.05). The median nerve aspect ratios measured under ultrasound of looped thread transection group before and 3 months after op?eration were 3.9±0.6 and 2.7±0.5, respectively. The swelling ratios were 2.1±0.3 and 1.4±0.4. The difference of preoperative and postoperative changes was statistically significant (P<0.05). There were no infection, poor healing, blood vessel and nerve damage after operation in both two groups. Conclusion Percutaneously looped thread transaction under ultrasound for the surgical treat?ment of CTS has less trauma and rapid recovery. It can improve the symptoms of median nerve stimulation, restore the morphology and function of the median nerve and reach the same effects as the open decompression surgery.

One hundred and seventy-one cases of hyperlipidemia were treated by moxibustion on Shenque (CV 8) and bilateral Zusanli (ST 36). After moxibustion, the blood-lipid contents of the patients with hyperlipidemia of various types were all lower than those before moxibustion.There was a significant difference between them. It is indicated that moxibustion on Shenque (CV 8) and bilateral Zusanli (ST 36) had the functions of reinforcing the spleen and kidney,warning yang, removing the stasis and treating both the principal and the secondary aspects of a disease for hyperlipidemia, which embodied the advantage of the function of regulating organism of moxibustion. The treatment by regulating can mobilize the regulating function of self to get the benign and bi-directional regulating effect for the various indexes of lipid metabolism and reach the intention of lowering blood-lipid.

10.3969/j.issn.2095-4344.2013.25.017

OBJECTIVE To establish a method of loop-mediated isothermal amplification(LAMP) for detecting Staphylococcus aureus in positive blood culture bottles.METHODS Genomic DNA in 293 positive blood culture bottles was extracted by guanidine hydrochloride and benzenemethanol,then genes ssa and mecA were amplified by LAMP to identify S.aureus.Finally,the results of LAMP were compared with the results of traditional method.RESULTS Twenty-two strains of S.aureus were detected in 293 positive blood culture bottles by LAMP method.Compared with traditional method,the sensitivity and specificity of LAMP method were both 100%,respectively,the detection could be finished in an hour.CONCLUSIONS The LAMP-based assay is simple,rapid,sensitive and specific which can be used to detect S.aureus in positive blood culture bottles rapidly.

Objective To investigate the correlation between neural tube defects (NTDs) and DACT1 gene, and provide the basic data for disease diagnosis and genetic counseling. Methods Blood samples were obtained from 163 NTDs patients and 480 unrelated healthy individuals. Mutation detection of DACT1 gene and DNA direct sequencing was carried out by PCR amplification. Bioinformatics analysis of these mutated loci was performed. Results Six mutations were found in NTDs patients, including 4 missense mutations (p.R45W, p.D142G, p.N356K and p.V702G). But these mutations were not found in 480 healthy individuals. Three mutated amino acid residues (p.45R, p.142D and p.356N) were highly conservative in evolution, and the mutated carriers were female patients, and suffered from anencephaly. Conclusion DACT1 gene mutation may be a risk factor of NTDs in Han population of northern China.