Adolescent ; Child ; Child, Preschool ; Chronic Disease ; Colonoscopy ; methods ; Diarrhea ; diagnosis ; pathology ; Female ; Humans ; Infant ; Infant, Newborn ; Male

Objective To investigate the prevalence and molecular epidemiology of clinical isolates of plasmid-mediated 16S rRNA methylases-producing Klebsiella pneumoniae. Methods From January 2006 and September 2007, 337 non-replicate clinical isolates of Klebsiella pneumoniae were consecutively collected from inpatients in a teaching hospital in Wenzhou, China. All of the isolates were identified by the automated microbiology systems. MICs of amikacin, gentamicin and tobramycin were determined by agar dilution method. The isolates were investigated for the presence of ESBLs by the CLSI-recommended confirmatory tests. PCR was used to detect 16S rRNA methylase genes, ESBL genes and class Ⅰ integrase gene. The homology of these isolates was analyzed by pulse-field gel electrophoresis (PFGE). Results Sixty-four ( 19. 0% ), 28 ( 8. 3% ) and 55 ( 16. 3% ) of 337 isolates were resistant to gentamicin, amikacin and tobramycin, respectively. Twenty-one (6. 2% ) isolates carried 16S rRNA methylase genes (3 for armA, 13 for rmtB, 5 for both armA and rmtB) and high-level resistant to gentamicin, amikacin and tobramycin ( MICs ≥256 mg/L). Nineteen of 21 isolates with 16S rRNA methylase genes were ESBL producers, blaCTX-M-14-like, blaCTX-M-like and blaSHV-12-like were predominant genotypes of ESBLs. The plasmids of 13 isolates were transferred into the recipients E. co/iJ53. PCR and sequence analysis revealed that blaCTX-M-14-like,blaCTX-M-15-like and blaSHV-12-like were co-transferred with the armA or the rmtB to the recipients. All transconjugants harbored intll and blaTEN-1. Of the 21 isolates, 14 patterns were obtained by PFGE. Conclusion Both horizontal gene transfer and clonal spread were responsible for the dissemination of the rmtB or the armA gene in Klebsiella pneumoniae.

Antipsychotic Agents ; poisoning ; Clozapine ; blood ; poisoning ; Exchange Transfusion, Whole Blood ; methods ; Humans ; Infant, Newborn ; Male ; Treatment Outcome

Objective To assess the advantages of multi-source RF transmission(MT) for balanced fast field echo(BFFE) cardiac cine imaging.Methods Fifteen volunteers were scanned on a clinical 3.0 T MR system equipped with MT.Acquisition of B1 maps with and without MT were followed by axial and four chambers BFFE cine imaging for all subjects with different transmission modes[single source RF transmission (ST),MT and MT with allowable shortest TR(MTS)].The B1 field uniformity and contrast to noise ratio (CNR) were quantitatively analyzed.The B1 field uniformity was evaluated by the pixel values within the ROI and was compared with Student t test.CNR was defined as follows:(SIblood-SImyocardium)/ 0.5 ×(SDblood + SDmyocardium).CNR were tested with one-way ANOVA for three groups comparision and with LSD for inter-group comparison.Image qualities were blindly assessed by 2 readers with a 4-score scale.Global image quality scores were tested for statistical significance by using the nonparametric paired sample Friedman rank test for three groups and the Wilcoxon signed rank test for further inter-group comparison.The Kappa statistics was used to assess interreader agreement.Results B1 homogeneity was significantly improved for images with MT compared with ST under the condition of other parameters unchanged (t =21.632,P ＜0.01).In left ventricular,CNR of blood and myocardium was improved from 10.8 ±2.2 for ST to 14.4 ± 2.4 for MT and 14.1 ± 2.2 for MTS.In fight ventricular,it was improved from 7.7 ± 1.2 for ST to 12.2 ± 1.4 for MT and 12.0 ± 1.2 for MTS.The differences were statistically significant (F =11.617,61.472,P ＜0.01).The images of MT and MTS groups demonstrated greater CNR versus the ST images.There was no statistical difference between latter two groups.The image scores of Reader 1 and 2 were 4.60 ± 1.18 and 4.73 ± 1.10 for ST,6.53 ± 1.19 and 6.67 ± 1.29 for MT and 6.73 ± 1.03 and 6.73 ± 0.88 for MTS respectively.There were statistically differences among three groups (x2 =23.577,24.275,P ＜ 0.01).The image quality was improved on BFFE images using MT and MTS technology compared to ST technology,and there were also significant differences.The interreader agreement between two readers was good [K=0.643,0.722 and 0.814(P ＜0.05) for ST,MT,and MTS group respectively].Conclusions MT technology significantly improves B1 field uniformity,increases CNR and reduces artifact on BFFE cardiac cine images.The TR is decreased within the normal SAR ranges,and thus scanning speed is increased.

Induced pluripotent stem cells ( iPSCs) have been first induced from mouse fibroblasts since 2006, and the research on iPSCs has made great progress in the following years .iPS cell lines were established from different so-matic cells through DNA , RNA, protein, and small molecule compounds and various methods of transduction , making the induction of iPSCs more secure and effective , and more attractive prospect of clinical application .In this review , different somatic cell reprogramming , different levels of reprogramming , different transduction pathways , and prospect of application are discussed .

Objective: To observe the clinical effects of Shu-acupuncture method in Nei Jing (Classic of Internal Medicine) in the treatment of shoulder and arm pain. Methods: A total of 90 patients with shoulder and arm pain were randomly divided into an observation group and a control group, 45 cases in each group. The treatment of Shu-acupuncture method in Nei Jing (Classic of Internal Medicine) was adopted in the observation group, routine acupuncture was used in the control group. The two groups were treated once every day, with 5 treatments as one course, and a 2-day rest between two courses. After 3 courses, pain was assessed by visual analog scale (VAS), and the clinical effects were compared between the two groups. Results: After the treatment, VAS scores were significantly changed in both groups (both P<0.01). The VAS score was lower in the observation group than that in the control group, with a statistical difference between the two groups (P<0.05). The total effective rate was 100% in the observation group, versus 91.1% in the control group, the difference was statistically significant (P<0.05). Conclusion: The therapeutic effect of Shu-acupuncture method in Nei Jing (Classic of Internal Medicine) is better than that of routine acupuncture in treating shoulder and arm pain.

Objective To explore differentiation in vitro of rat adipose-derived stem cells into photoreceptor cells and RPE cells.Methods The ADSCs were cultured by adhering to the flask surface and purified by continual passaging.Surface antigens including CD45、CD90、CD49d、CD106 were indentified by flow cytometry.ADSCs were induced to differentiate by EGF,activin A,taurine,retinoic acid(RA) and extracted liquid of retina respectively.Meanwhile,ADSCs were induced by EGF+taurine,EGF+RA,taurine + RA,EGF+taurine+RA respectively.Immunofluorescence was used for detecting the expression of rhodopsin,CK and S-100,and flow cytometry was used for quantification.Results For primary culture,the phenotypes of ADSCs were: CD45,CD90,CD49d and CD106,with a positive percentage of 1.6%,71.3%,7.8% and 3.5%,respectively.From passage 1 to 5,these phenotypes were: CD45(0.8%～9.3%),CD90(84.7%～94.8%),CD49d(16.8%～31.0%)and CD106(8.3%～22.2%).There was a higher CD49d percentage than CD106 in all the passages.The induction efficacy of ADSCs was 17.5%～46.0% for rhodopsin,19.7%～79.3% for CK and 27.3%～50.7% for S-100.Conclusion It is suggested that ADSC has potential to differentiate into photoceptors and RPE cells as evidenced by thepresence of the specific markers of photoceptors(rhodopsin) and RPE markers(CK and S-100).

Background Qiang minority is minority groups of China with the special habits and customs and living condition. So whether the spectrum of disease and bacteria spectrum in conjunctiva are similar with Han nationality is worth paying attention. Objective Present survey was to obtain the data about bacterial species in conjunctival sac in Qiang minority population with the age 40 years old and more and the compare with matched Han nationality population. Methods This survey study was performed as the standardized training and protocol. A total of 212 eyes of 106 individuals from Qiang minority in Beichuan county and 640 eyes of 320 subjects from Han nationality in Mianyang city received questionnaire survey and ophthalmological examination. The secretion of the inferior palpebral conjunctival sac was embrocated and inoculated on blood plate for 48-72 hours. The bacteria was separated and identified. This study was approved by the Ethic Committee of Sichuan Provicial People' s Hospital. Orally informed consent was obtained before the medical procedure. Results All the examinee finished the survey and examination with a good compliance. No significant difference was found in the demography between these two groups of population. The multiple bacterial positive rate in conjunctival sac was 59. 4% in Qiang minority and that of Han people was 66. 3% with a considerably difference between them (χ2 = 2. 27,P = 0. 13). The multiple bacterial species were simultaneously detected in 26.2% in Qiang minority population and 11.88% Han people, showing evidently difference (χ2 = 106. 40, P = 0. 00 ) . The positive rate of corynbaccterium in conjunctival sac of Qiang minority was statistically lower than that of Han people (20. 7% versus 45. 0% ,χ2 =31. 75 ,P = 0. 00) ,but there was no statistical difference in the positive rate of staphylococcus epidemics between two groups (χ2 = 1. 89 ,P = 0. 17). Conclusion The bacteria positive rate in conjunctiva sac is resemble in the population over 40 years in both the Qiang minority and Han nationality. The simple bacterial species is found in majority people in two groups of subjects. The positive rate of multiple bacterial strains coexistence is more in the Qiang minority. The bacterial strains is different between Qiang minority and Han nationality.

Primary endocrine therapy (PET) is often included as a treatment option in elderly women with operable breast cancer. Elderly women tend to have pre-existing comorbidities and are often reluctant to undergo surgery. The benefit of surgery needs to be weighed against a relatively higher potential for operative morbidity and mortality, and a limited life expectancy. But while PET can provide relatively good locoregional control, it is not curative in nature and the possibility of local complications and metastasis remains. We retrospectively reviewed the outcome of PET in a series of 19 elderly women, older than 70 years of age, who had presented with operable non-metastatic breast cancer. Only about a third of these women were deemed medically unfit for surgery; the rest had declined surgery. Compliance was an issue, with almost half of these patients defaulting treatment and follow-up. Local control was achieved in most patients, but disease progression did occur in 5 patients. Three of these patients received additional treatment; which included surgery in 1 patient. PET should therefore not be considered an equivalent alternative to surgery in elderly women who were fi t to undergo surgery. However, having observed that only 1 of the 6 deaths in our study was related to breast cancer, PET does have a role in women whose life expectancy is more likely to be limited by coexisting morbidities than the breast cancer itself.
Aged ; Aged, 80 and over ; Antineoplastic Agents, Hormonal ; therapeutic use ; Breast Neoplasms ; drug therapy ; Drug Therapy ; utilization ; Female ; Humans ; Retrospective Studies ; Tamoxifen ; therapeutic use

Objective To analyze the outcomes of adjustable and set-pressure valves in the management of communicating hydrocephalus in children. Methods A retrospective study reviewing the medical records of 66 children with communicating hydrocephalus who received ventriculoperitoneal shunt at our center from January 2003 to December 2009 was performed. All the patients were divided into 2 groups: Codman Hakim adjustable valve group (n=27) and Medtronic set-pressure valve group (n=39). Rate of appearing complication and shunt survival time were analyzed between the 2 groups.Results The rate of shunt infection, proximal or distal obstruction, subdural hematoma and subdural hygroma showed no statistical significance between patients of the adjustable and set-pressure valve groups (P=1.000, P=0.727, P=0.455, P=0.691, respectively). The average shunt survival time of children in the adjustable valve group was 52.551 months (38.169-66.852, 95% CI) and that of children in the set-pressure valve group was 42.327 (31.636-53.019, 95%CI); no statistical significance on the average shunt survival time between these 2 groups was noted (x2=0.763, P=0.382).Conclusion The adjustable valve is not superior to set-pressure valve in the treatment of communicating hydrocephalus in children.