OBJECTIVEThis study aimed to detect the difference in the expression levels of autolysin atIS gene of Streptococcus gordonii (S. gordonii) at different growth stages and pH values, as well as to analyze the factors regulating atlS gene expression in S. gordonii.

METHODSS. gordonii wild strains (ATCC 35105) were collected at different growth stages (early exponential phase, mid-exponential phase, late exponential stage, and platform stage) and pH values (pH 7 and pH 5.5), and total RNA was extracted by using a conventional method. Fluorescence quantitative polymerase chain reaction (FQ-PCR) was used to measure the relative mRNA expression of atlS gene, with bacterial 16S rRNA as internal reference, for a comparison of the mRNA levels of atlS gene expression in S.gordonii at different growth stages and pH values.

RESULTSFQ-PCR results showed that atlS gene expression increased with gradually increasing growth stage under neutral conditions and was higher than that under acidic conditions (P < 0.05).

CONCLUSIONThe atlS gene expression in S. gordonii is influenced by growth stage and pH value factors.

Objective To incestigate the fetures of cranial CT and MRI in the patients with hypertensive encephalopathy. Methods The CT and MRI findings of ten cases of hypertensive encephalopathy with the charge of CT,MRI appearance of FLAIR (fluid attenvated inversion-recovery), DWI(difussion weighted imaging),ADC(apparent diffusion coefficient) were analyzed retrospectively. Results Of ten patients,3 cases had abnormal finding in the cranial CT;10 cases had abnormal finding in the cranial MRI,the lesions were demonstrated as slightly hypointensity on T1WI and slightly hyperintensity on T2WI and remarkably hyperintensity on FLAIR,and iso or slightly hyperintensity on DWI,and remarkably hyperintensity on ADC.The lilateral parietal occipital lobes and cerebellar hemisphere and Brain Stem were the more common sites. Conclusions The only characteristric finding of hypertensive encephalopathy in MRI and CT imaging studies is vasogenic edema,especially in the subcortical white matter of the parietal and occipital lobes bilaterally,and cereballar hemisphere et al;especially FLAIR,DWI and ADC of MRI can be helpful for diagnosis and diffenential diagnosis,prognosis and curative effect of hypertensive encephalopathy.

Updated guidelines on the management of non-Hodgkin lymphoma (2015.V2) have been issued by the National Comprehensive Cancer Network (NCCN) in March 3, 2015.The Castleman disease (CD) is included for the first time.References from relevant publications, the standards for diagnosis and treatment of CD are described in detail and it also provides professional healthcare with clear guidance on the management of patients with CD.

Objective To analyze the risk factors that affect severe infection following flexible ureteroscope Holmium laser lithotripsy for upper urinary tract calculus,and to construct the regression model and nomogram for predicting the probability of postoperative SIRS.Methods We retrospectively analyzed the clinical data from 457 cases (male 302 and female 155) of upper urinary calculi treated by flexible ureteroscopy from January 2014 to May 2016,with mean age of 49.9 (ranged 20-76) years.The mean maximum size of stones was (16.5 ± 3.0) mm (ranged 12-22rmm).There were 51 cases (11.2％) with a recent infectious febrile history related to stones.The patients were divided into two groups as patients developing SIRS or not.Univariate and multivariate statistical analyses were performed to determine factors affecting the development of postoperative SIRS,and then a nomogram was built based on regression coefficients.Results The incidence of SIRS after flexible ureteroscopic lithtripsy was 5.9％ (27/457).Multivariable logistic regression analysis identified febrile history related to urinary stones (OR =1.5569,P =0.009),without preoperative placement of ureteral stent (OR =1.4004,P =0.004),small-caliber (F 13-14) ureteral access sheath (OR =1.1120,P =0.016),endoscopic signs of infection (OR =2.0176,P =0.000) and infectious stones (OR =1.0981,P =0.013) as independent risk factors for postoperative SIRS.The concordance index was 0.845 in the nomogram model sample and 0.79 in the validation sample.Conclusions Febrile history related to urinary stones,without preoperative placement of ureteral stent,small-caliber ureteral access sheath,endoscopic signs of infection and infectious stones would be independent risk factors to predict SIRS after flexible ureteroscope holmium laser lithtripsy.A nomogram based on perioperative clinical factors could be used to predict the risk of SIRS.

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.

Digital hospital construction is foundational project for the modern management,which challenges the management mode and idea in hospital.With regard to the status on the construction of digital hospital of infectious disease in 302 hospital of the People's Liberation Army,The article reviews the experience and prospect of digital hospital of infectious disease.

ObjectiveTo diagnose and classify 249 patients with myelodysplastic syndrome (MDS) according to the WHO standards.MethodsAccording to the WHO standards,cell morphology,cytogenetics,immune phenotype and bone marrow pathologic biopsy in 249 cases of MDS were analyzed.ResultsGreat shape and oval cell of mature erythrocyte could be observed in all MDS patients peripheral blood. The incidence of immature erythrocyte,immature granulocyte,pelger-like abnormal nucleus and neutrophils cells without granular increased with subtypes progressing.These abnormal characteristics and proportion tended to more apparent with MDS subtypes progressing.With the dynamic follow-up,we found the rate of MDS transition to AL increased with subtypes progressing(P＜0.05 ).The immune phenotype analysis of 148 patients was undertook and found that the trend to express myeloid specific antigen (CD33) increased gradually with subtypes progressing The chromosome inspection in 138 patients was undertook and found that 53 patients (38.7 ％ with abnormal karyotype,mainly in 20q- and +8;16 cases with complex abnormal karyotype (28 ％), two patients in 5q-. 180 patients were underwent bone marrow biopsy at the same time and found that 19 patients with abnormal morphology;42 patients with bone marrow fibrosis.ConclusionsCombining with multiple index to detect the MDS contributes to the classification and diagnosis more accuratcly and long-term follow-up helps to judgment the prognosis.

BACKGROUND:Acel ular dermal matrix has good biocompatibility and absorbability and exhibits superiority in the guided bone regeneration. OBJECTIVE:To compare the histological changes and osteogenic effects in bone defects after guided bone regeneration with acel ular dermal matrix and Bio-Gide membrane. METHODS:Mandibular second, third and fourth premolars and the first molars bilateral y were extracted from 12 beagle dogs. Three months later, four three-wal bone defect models in the mandible of each dog were made, and randomized into acel ular dermal matrix plus bone graft group (acel ular dermal matrix group), Bio-Gide plus bone graft group (Bio-Gide group), bone graft group, and blank control group (no treatment). In the former two groups, acel ular dermal matrix and Bio-Gide were used to cover the bone grafts, respectively. RESULTS AND CONCLUSION:After surgery, al the beagle dogs recovered wel . Al the groups except the control group showed dramatical improvement in histological changes and percentage of new bone area, and this improvement was more significant in the Bio-Gide and acel ular dermal matrix groups. Moreover, there was no significant difference between the Bio-Gide and acel ular dermal matrix groups. Therefore, the acel ular dermal matrix can be a candidate for bone repair instead of Bio-Gide membrane in the clinical practice.

Objective To explore the influence of coinfection with other pathogens on human metapneumovirus (hMPV) infection in children.Methods A total of 11 299 children admitted to the Department of Respiratory Disease,Children's Hospital of Soochow University between June 2010 and May 2015 were enrolled in this study.Sputum specimens were collected and multiple pathogenic joint detection was done,including peripheral blood,and blood routine,C reactive protein (CRP),hepatic function and cellular immunity.Patients' clinical data were collected.Results Among 11 299 hospitalized children,hMPV was positive found in 222 children (1.96％).One hundred and fourteen children (51.4％) had hMPV simple infection and 108 cases of them (48.6％) were coinfected with other pathogens.The hMPV coinfected with bacteria (63 cases,28.4％)was most common.The average age of multiple coinfected children was older than that of simple hMPV infection in children [(2.43 ± 2.47) years old vs.(1.27 ± 1.30) years old],and the difference was significant (Z =-2.360,P ＜ 0.05).Fever seemed to be more common in children coinfected with bacteria or multiple coinfection (63.5％ and 70.0％) compared with those with simple hMPV infection (43.0％),and the differences were significant (x2 =6.827,4.986,all P ＜ 0.05).There was no significant difference in other clinical features among 5 groups (all P ＞ 0.05).Multiple coinfection children had a higher percentage of neutrophils (0.50 ± 0.18) than that in simple hMPV infection children (0.37 ± 0.19),children coinfected with bacteria (0.39 ±0.19) or other virus (0.35 ±0.19),and the differences were significant (all P ＜0.05).CRP was elevated in 30.2％ (19/63 cases) of children coinfected with bacteria,which was significantly higher than that of simple hPMV infection children (16.7 ％,19/114 cases),and the difference was significant (x2 =4.381,P ＜ 0.05).CD3 + CD4 + was significantly lower in multiple coinfection children (0.31 ± 0.07),but there were no significant difference compared with other groups (all P ＞ 0.05).CD19 + CD23 + was significantly higher in children coinfected with other virus com pared with that of simple hMPV infection group,hMPV coinfected with bacteria,hMPV coinfected with Mycoplasma pneumonia and multiple coinfect group (0.37 ± 0.10 vs.0.30 ± 0.09,0.30 ± 0.08,0.29 ± 0.07,0.29 ± 0.09),and the differences were significant (all P ＜ 0.05).Conclusions It is suggested that hMPV seems easily coinfected with other pathogens,especially with bacteria.It should be on high alert that bacteria coinfection is accompanied with high percentage of neutrophils and high level of CRP.Coinfection does not significantly exacerbate the clinical symptoms of hMPV infection,but may exacerbate the cellular immune disorders to a certain extent.

Protracted bacterial bronchitis ( PBB) is a common cause of children with chronic wet cough. It is defined by the presence of persistent wet cough for longer than 4 weeks,often accompanied by wheezing,but lacks of specific symptoms or signs suggestive of other alternative diagnosis of chronic cough. Airway malacia frequently coexists with PBB,and haemophilus influenzae and streptococcus pneumoniae are the most commonly identified pathogens. Neutrophilic inflammation is present in bronchoalveolar lavage fluid,and usually resolves with appropriate antibiotic treatment for two weeks(amoxicillin/clavulanate). By far,PBB hasn′t been fully recognized by most pediatricians in China. In this commentary, diagnosis and treatment were reviewed.