Objective To elucidate the molecular basis for induced resistance of N. gonorrhoeae to ceftriaxone in vitro. Methods The reference strain ATCC49226 and clinical isolate ZSSY00205 of N. gon-orrhoeae were exposed to subinhibitory concentration of ceftriaxone for the induction of resistance. Then,suppression subtractive hybridization was performed with the pre-induction parent strains as drivers and post-induction mutant strains as testers to create a subtractive cDNA library. Following that, a total of 192 clones were randomly selected from the library, and arrayed by spotting onto nylon membranes. Finally, dif-ferentially expressed genes were screened by hybridization with labeled-RsaI restriction fragments from the sensitive and resistant N.gonorrhoeae strains respectively, and analyzed by sequencing and homology research using Blast program. Results A subtractive library for these resistant N.gonorrhoeae strains was generated by SSH technique. Microarray analysis and homology research confirmed 5 genes related to ceftriaxone resistance, i.e. mtrR, mtrC, gyrB, rpsJ and PJD1. Conclusions The induced resistance of N. gonorrhoeae to ceftriaxone may be associated with mtrR, mtrC, gyrB, rpsJ and PJD1 genes which probably mediate the resistance by enhancing the activity of efflux pump system.

Objective To explore the expression and significance of vascular endothelial growth factor (VEGF) and transforming growth factor β1 (TGF-β1) in hepatic fibrosis.Methods Fifty-six cases of patients with hepatic fibrosis were selected as observation group and 50 healthy persons as control group.Immunohistochemistry were performed to detect VEGF and TGF-β1 in two groups.Results Serum VEGF and TGF-β1 in observation group were significantly higher than those in control group(VEGF:(110.87 ±32.64) μg/L vs (15.98 ±6.75) μg/L,t =20.166,P ＜0.001;TGF-β1:(15.08 ±4.27) ng/L vs (7.17 ±2.86) ng/L,t =11.066,P ＜ 0.001) ;There were significant differences on VEGF and TGF-β1 level among S1,S2,S3 and S4 subgroups(VEGF:(84.25 ±16.86) μg/L vs (101.87 ±36.70) μg/L vs (118.04 ±40.75)μg/L vs (134.65 ± 45.73) μg/L,F =15.689,P =0.015 ; TGF-β1:(10.87 ± 2.64) ng/L vs (13.06 ± 2.74)ng/L vs (17.87 ± 3.28) ng/L vs (22.76 ± 4.75) ng/L,F =12.438,P =0.026).VEGF had positive correlation with TGF-β1 (r =0.532,P =0.013).Conclusion VEGF and TGF-β1 level have close relationship with the occurrence and development of hepatic fibrosis.Combined detection of VEGF and TGF-β1 can be serum index for diagnosis and evaluation disease condition.

Objective To evaluate the application effect of mind map in admission guidance of patients receiving gamma knife treatment.Methods 153 cases of hospitalized patients admitted in our hospital were selected for this study,which had been divided according to the random number table method,the observation group(77 cases) was guided with the hospital mind map method,and the control group (76 cases) was given traditional oral hospital instruction,respectively.The database was established for the double entry,calibration and data cleaning,which were obtained from the result of gamma knife treatment of intracranial tumor disease related knowledge questionnaire,hospital satisfaction questionnaire and also patient adherence questionnaire assessment.Results The comparison of knowledge assessment questionnaire outcome,the admission guide satisfaction questionnaire assessment,the patients compliance questionnaire assessment outcome showed that the observation group was significantly different from the control group.Conclusions Application of mind map in admission guidance for hospitalized patients was a more efficient method than the traditional oral admission instruction,the method is simple,practical and effective,which is worthy of clinical practice.

Objective To investigate the incidence, clinical patterns, and species distribution of pathogenic fungi of onychomyeosis in patients with chronic viral hepatitis (CVH), and to analyze the relationship between onychomycosis and CVH. Methods From November 2005 to October 2006, direct microscopy and fungal culture were performed on nail samples from CVH patients with clinically suspected onychomycosis in the two largest institutions for communicable disease control in Guangzhou city. The incidence, clinical patterns, and species distribution of pathogenic fungi of onychomycosis were assessed based on the findings in mycologic examinations. Results The study randomly recruited 995 patients with CVH, and onychomycosis was diagnosed in 116 patients. The incidence of onychomycosis was 11.66% in total, 6.20%, 8.59%, 14.09%, 19.67% in patients with mild, moderate, severe and extremely severe CVH respectively, 7.09%, 17.29%, 19.13% and 27.27% in patients with a clinical course of CVH of 0.5-9 years, 10-19 years, 20-29 years, ≥30 years respectively. The most common clinical pattern was distal and lateral subungual onychomycosis (DLSO, 69.83%), followed by total dystrophic onychomycosis (TDO, 14.66%). Among the pathogenic fungi, dermatophytes amounted to 71.43%, yeasts 21.43%, moulds 7.14%, and Trichophyton rubrum was the most frequently isolated fungus (42.86%). Conclusions The incidence of onychomycosis in patients with CVH is correlated with the severity and course of CVH. Among these patients, the most common clinical pattern is DLSO with the most frequent fungal species being dermatophytes and predominant fungal isolate being Trichophyton rubrum.

Objective To compare cognitive function and alexithymia between the schizophrenic patients treated with chlorpromazine and those treated with clozapine. Methods The patients with schizophrenia in stable condition that received maintenance treatment either with chlorpromazine or clozapine and normal control subjects were recruited (n=24 per group). Neuropsychological tests, including Digit Vigilance Test, Controlled Oral Word Association Test, Trail Making Test-A&B (TMT-A&B), Animal Naming Test, Stroop Color-Word Test, Block Design and Spatial Span Test were used to assess the participant’s cognitive function. The twenty-item Toronto Alexithymia Scale (TAS-20) were used to evaluate the participant’s alexithymia. Results The significant differences were found between the patients and the controls in all items of cognitive function and all factor scores of TAS-20 (P<0.05). There were no significant differences in all items of cognitive function and all factor scores of TAS-20 between chlorpromazine group and clozapine group (P>0.05). Multivari? ate linear regression analysis showed that in the clozapine group, attention function associated with the total score of TAS (β=-0.20, P<0.05), executive function associated with TAS factor 1 (β=-0.26, P=0.03), spatial function associated with TAS factor 2 (β=-0.24, P<0.01). In the chlorpromazine group, attention function associated with TAS factor 2 (β=-1.24, P<0.01), executive function associated with TAS factor 2 (β=-0.33, P=0.02). Conclusions Patients with schizophrenia in maintenance period have widely cognitive impairment and alexithymia, both of which are related to each other.

AIM:To investigate whether Notch1 changes stemness and chemotherapeutic sensitivity in human glioma U251 cells.METHODS: The lentiviral vectors, which expressed Notch1-shRNA or Notch1 intracellular domain ( NICD) , were transfected into U251 cells .Western blot and immunofluorescence staining were applied to monitor the va-lidity of the cells, down-regulation of Notch1 expression or over-expression of NICD.The proportion of CD133 +cells was analyzed by flow cytometry.The expression of nestin and GFAP was identified by immunofluorescence staining.The forma-tion rate of tumor cell spheres and the implanted tumor growth in SCID mice were observed.MTT assay was performed to e-valuate the chemotherapeutic sensitivity to VM-26 and BCNU of the cells with different treatments.RESULTS:Stemness was significantly enhanced in the cells over-expressing NICD.For example, the proportion of CD133 +cells was increased, the expression of nestin was up-regulated, the expression of GFAP was down-regulated, and the formation rate of tumor cell spheres and implanted tumor growth were increased.The chemotherapeutic sensitivity to VM-26 and BCNU of the cells was decreased.In the cells with Notch1 gene down-regulation by RNAi, the stemness was inhibited and chemotherapeutic sensi-tivity was increased.CONCLUSION:Notch1, which leads to the change of stemness and chemotherapeutic sensitivity in human glioma U251 cells, is likely to be a potential molecular target for treatment of glioma.

Objective To evaluate the clinical value of whole-brain diffusion tensor imaging(DTI) in diagnosing patients with social anxiety disorder(SAD) using an automated method based on support vector machine(SVM) classification.Methods Whole brain DTI data were collected from 19 patients with SAD and 19 age-,gender-and education-matched healthy control(HC) subjects.Fractional anisotropy(FA) of whole brain was obtained by input all tensor images into Diffusion Toolkit software.Based upon the characteristics of brain FA,the pattern recognition of brain image data(PROBID) toolbox on the grounds of SVM algorithm was employed to classify the subjects,evaluate the diagnostic value of whole-brain FA data based SVM in diagnosing SAD patients and verify the robustness of the diagnostic results using permutation test with the threshold at P≤0.001.The weight vector score of each voxel was calculated according to the ratio between this voxel and whole brain in FA differences of the two groups.The white matter regions identified by setting the threshold to the top 30％ of the weight vector scores with at least 10 contiguous voxels were demonstrated by MRIcro software.Results Diagnostic accuracy of whole-brain FA based SVM in diagnosing SAD was 92.11％ (35/38) in which the specificity was 94.44％ (17/18),the sensitivity was 90.00％(18/20),the positive likelihood ratio was 17.01,the negative likelihood ratio was 0.11 and the diagnostic index was 184.22％.Permutation test suggested that the diagnostic results were significantly reliable.White matter regions showing major contributions favoring SAD over HC were located in the genu and splenium of the corpus callosum,the left uncinate fasciculus,the left inferior longitudinal fasciculus,the left inferior fronto-occipital fasciculus,bilateral frontal gyri and the left occipital lobe.Whereas,white matter in bilateral anterior cingula,the left middle cerebellar peduncle and the left inferior parietal lobule showed more contributions to diagnose HC than to diagnose SAD.Conclusions As whole brain FA data based on SVM showing a high accuracy in diagnosing SAD,brain DTI characteristics have the potential to be the specific indicators in the diagnosis of SAD.SVM might be used as a tool to verify the reliability of white matter abnormalities and provide regions of interest in DTI study of neurological and psychiatric diseases.

Objective To observe the expressions of OPN, COX-2 and CyclinD1 in breast infiltrating carcinoma and evaluate their relationships with clinic pathological features. Methods Expression of the above three indexes were detected from 70 breast cancinoma patients by immunohistochemistry. The relationships among them and clinicopathological features were analyzed. Results The positive expression rates of OPN were 78.8% in cases (≤45 years old) and 73.0% in cases (> 45 years old); the positive expression rates were 79.3%(tumor diameter ≤ 3 cm) and 73.2% (tumor diameter > 3 cm); the positive expression rates were 77.8%, 73.8% and 78.9% in cases ofⅠgrade, Ⅱgrade and Ⅲ respectively, the positive rates had no statistical significances(P > 0.05). The expression rates of OPN in cases of breast infiltrating carcinoma without and with axillary node metastasis were 62.5% and 93.3%, in cases at stage Ⅰ~Ⅱ and Ⅲ ~Ⅳ were, 68.0% and 95.0% respectively, the positive rates had statistical significances(P < 0.05). The expression of OPN was negatively correlated with ER and PR while positively correlated with CerbB2, COX-2 and CyclinD1. Conclusions OPN plays an important role in the invasion and metastasis of breast carcinoma coordinated with COX-2 and CyclinD1.

Objective To investigate the application of radial endobronchial ultrasound (R-EBUS)-guided bronchoscopy in the diagnosis of peripheral pulmonary lesions (PPLs),assess its safety and diagnostic value,and explore the influencing factors.Methods Clinical data of 140 patients who underwent R-EBUS transbronchial biopsy (TBB) and brush biopsy in our department of respiratory endoscopy from January 2015 to March 2017 were collected and retrospectively analyzed in the study.Eighty-three cases were diagnosed as PPLs.The detection rate,ability to locate the peripheral lesions,and influencing factors of EBUS were analyzed.The incidence rate of complications was observed to assess its safety.Results Of the 83 PPLs patients,they were 55 males and 28 females,and at a mean age of 59.81 ± 11.85 years.The total success rate of EBUS-guided bronchoscopic diagnosis was 59.04％ (49/83),and the diagnostic rate was 50.94％ (27/53) for malignant lesions,and 73.33％ (22/30) for benign diseases.The rate of EBUS-TBB (56.92％,37/65) was significantly higher than that of brush biopsy (30.12％,25/83,Chi square =10.76,P =0.001).EBUS-guided diagnostic methods had an accuracy of 60.00％ (45/75),while the EBUS-guided bronchoscopy had a rate of 50.0％ (4/8),but no significant difference was seen between the 2 methods (Chi square =0.03,P =0.87).The sizes of the lesions ranged from 10.0 to 52.4 mm,and the diagnostic yield for PPLs ≤20 mm in diameter (36.84％,7/19) was lower than that for those ＞20 mm (65.62％,42/64,Chi square =5.02,P =0.003).There was no significant difference (Chi square =10.05,P =0.07)in the diagnostic yield for different sites,with that of right upper lobe of 46.15％ (12/26),right middle lobe 100.00％ (8/8),right lower lobe 53.85％ (7/13),left upper lobe 37.50％ (3/8),left lingula lobe 63.64％ (7/11),left lower lobe 70.59％ (12/17).But the detection rate was obviously lower in the upper lobe (22/45,48.89％) than the middle/lower lobe (27/38,71.05％,Chi square =5.02,P =0.003).Of all the 83 patients,74 ones (89.16％) were successfully identified using radial probe EBUS,but the lesions were not found in 9 patients.When the radial probe position was within the target lesion,the diagnostic yield was 81.58％ (31/38),notably higher than that when the probe was positioned adjacent to the lesion (50.00％,18/36,Chi square =8.24,P =0.004).Mild bleeding was observed when performing biopsy under bronchoscope,and no pneumothorax,or other serious complications were observed.Conclusion Radial EBUS is a safe and feasible nethod to accurately identify PPLs and improve its diagnostic rate.EBUS-guided bronchoscopy has higher positive detection rate for PPLs,and is cost saving.The relationship of the probe and the site of lesion is the main factor influencing the diagnostic rate.

Objective To analyze the association between β2-AK 27 locus genetic polymorphisms and asthma, and the protective effect in airway hyperreactivity. Methods The allel polymerase chain reaction were used to determine β2-AR 27 locus genetic polymorphisms in 149 patients with cough variant asthma who have the airway hyperreactivity. To observe these people for two years in order to know the proportion of changed to typical asthma. And compare with 90 people in healthy group. Results (1) The distribution frequency of β2-AR 27 locus genetic polymorphisms is major in heterozygote (57 % ) , and the Glu/Glu homozygote has the least ( 20% ) , (2) There was a significant decrease in the frequency of Glu/Glu genotype in asthmatics compared with healthy group(9% VS 20% ) ,OR = 0.4(P<0.05) ,95% CI (0.2 ～0. 9) ,but there was no significant difference in the allele frequency of asthmatics compared with healthy group,(3)The frequency of Glu/Glu genotype in severe asthma was lower than stable asthma group(P<0. 05). Conclusion These results suggesteded that β2-AR 27 locus genetic polymorphisms is correlated with asthma,and the Glu27 could have the protective effect to the airway.