Objective To investigate the effects of bisphosphonate on the proliferator-activated receptor γ(PRARγ)expression of glucocorticoid-induced osteoporosis. Methods ① Twenty-two cases of systemic lupus erythematosus(SLE)patients with glucocorticoids(＞0.5 mg·kg-1 ·d-1)were divided into 2 groups: 9 cases in the treatment group in which patients received alendronate 70 mg qw., 13 cases in the control group without anti-osteoporosis treatment. All of the patients had bone marrow puncture after 24 weeks, bone tissues were embedded, sliced, and the value of average optical density of PPARγwas tested with immunohistochemistry. ② Human bone mesenchymal stem cells were cultured in the same conditions and stimulated to adipocytes. During the adipogenic process, the cells were divided into four groups, three of which were experimental groups treated with 10-5 mol/L(high-dose group), 10-7 mol/L(medium-dose group)and 10-9 mol/L(low-dose group)bisphosphonate respectively, while the other was the control group without bisphosphonate in the medium. The adipocytes were identified by oil Red O stain seven days later. The adipocyte rate was measured by light absorption at 515 nm. The expression of PPARγ was measured by quantitative PCR. Comparisons between groups were tested by One-Way ANOVA analysis and t test. Results The average optical density of PPAR-gamma immunohistochemistry in the treatment group was less than the control group(P＜0.05). Seven days later, the absorbance between adipogenic induction group and low-dose group was not significant(P=0.167). but the adipogenic absorbance between the high-dose group, middle dose group and the control groups(P values were 0, 0.041). There was significant difference in the quantitative PCR results between the high-dose group, middle dose group and the expression of PPARγ adipogenic induction group(P value was 0, 0.01), but there was no significant differences between the low-dose group and adipogenic induction group(P＞0.05). Conclusion Effective concentrations of bisphosphonate can inhibit the expression of PPARγ which in turn lead to the suppression of hMSCs to the adipocytes. The glucocorticoid-induced osteoporosis is also depressed.

[Objective] To summarize the experience of Professor ZHANG Qin, a famous Chinese doctor in Zhejiang Province, in the treatment of dysmenorrhea by clinical syndrome differentiation. [Methods] Through the examples of teacher ZHANG's clinical treatment of primary dysmenorrhea and secondary dysmenorrhea in three cases, combined with the usual clinical experience of Professor ZHANG Qin to follow, analyze and summarize teacher ZHANG's clinical experience of the treatment of dysmenorrhea. [Results] Three cases show that, whether it is the primary dysmenorrhea or secondary dysmenorrhea, ZHANG believes that the total incidence of cold stagnation of Qi, blood circulation is not smooth, the main reason for the lack of collateral. A sense of cold dampness to menstrual wading, passengers in the cytoplasm, with warm and cold, blood, Tiaochong;with blood stasis, expelling, warming channels to dispel cold, removing blood stasis and relieving pain; also, liver blood deficiency and blood stasis of uterus, cure properly via removing film, streteving liver and removing stasis to relieve pain. Along with symptoms, with mild blood for treatment, in order to reconcile Qi and blood, Chongren unblocked. [Conclusion] Professor ZHANG Qin's experience in the treatment of dysmenorrhea by clinical syndrome differentiation has distinctive features and positive effects, so it is worth in-depth study and application.

Objective To observe the effect of ionizing radiation on the expressions of TLR4 and adaptor protein MyD88 in mouse peritoneal macrophages in the Toll-mediated signal transduction pathways.Methods 160 male Kunming white mice were randomly divided into 16 groups(ten each group):sham-irradiation and five groups after 4,8,16,24 and 48 h X-ray irradiation for time-course experiments;sham-irradiation and nine groups after 0.05,0.075,0.100,0.200,0.500,1.000,2.000,4.000,6.000 Gy irradiation for dose-effect experiments.Flow cytometry was used to detect the expressions of TLR4 and MyD88 after whole body irradiation (WBI) with X-rays.Results Both of TLR4 and Myd88 expressed more than shamirradiation after 0.075 and 2.000 Gy WBI for 4 h,and the expressions of them reached the peak at 16 h or 4 h after WBI(P

Abstract:Objective To study the pathogen of root surface caries in the elderly. Methods Plaque samples from the experimental group and the control group were collected. After culturing in selective and non-selective media, the different bacteria were isolated. The counts and the positive rates of total bacteria, porphyromonas group, pervotella group, streptococcus mutants group, actinomyces group and lactobacillus group were compared.Results The counts of total bacteria, streptococcus mutants, actinomyces and lactobacillus of the experimental group were higher than those of the control group. The positive rates of actinomyces and lactobacillus of the experimental group were significantly higher than those of the control group. Conclusion Actinomyces and lactobacillus are the main related pathogens of root surface caries in the elderly.

Because the medical treatment mode is being transformed into 'patients as orientation',our hospital introduces queuing system,transformsand redesigns programs of registration system,outpatient doctor workstation system,outpatient charge system and outpatient dosage system.By using liquid crystal display and automatic phonetic call,the outpatient procedure is optimized with a friendly service environment so as to improve the work efficiency and enhance the overall administration and service quality.

OBJECTIVE To investigate the distribution and antibiotic susceptibility of pathogens causing urinary infection,for the guide of rational use of antimicrobial agents in clinic. METHODS The bacteria isolated from the middle segment urine sample were identified by ATB system,and K-B method was used to study the antimicrobial resistance.The data were analyzed by WHONET 5.3. RESULTS Escherichia coli was one of the most common bacteria in the urinary tract infection(57.6%),and then were Enterococcus(14.4%).The results of antibiotic susceptibility test in vitro showed the susceptibility rate of Enterobacteriaceae and Acinetobacter baumannii to imipenem,was 100.0%,but the resistance rate of Pseudomonas aeruginosa was 13.6%.Gram-positive cocci were sensitive to glycopeptide antibiotics and linezolid. CONCLUSIONS Clinician should pay attention to the kinds of pathogenic bacteria causing urinary tract infection and their susceptibility to clinically common used antibiotics for reasonable use of drugs.

Objective To analyze the distribution and antimicrobial resistance of pathogenic bacteria in urinary tract infection (UTI)so as to provide evidence for appropriate selection of antimicrobial agents in clinical practice. Methods From January 2001 to December 2008 in Shanghai Ruijin Hospital,4683 strains of pathogenic bacteria isolated from urine samples were detected by ATB system;drug susceptibility test was performed with disk diffusion method and pathogenic bacteria distribution and drug resistance was analyzed with WHO NET 5.3 software. Results Among 4683 strains of pathogenic bacteria,most was gramnegative bacilli,accounting for about 77.8%,of which predominant strain was Escherichia coli (68.7%,3217/4683).The predominant strain of gram-positive bacteria was Enterococcus faecalis,accounting for 10.0%(468/4683).Escherichia coli showed hish resistance rotes to ampicillin,piperacillin and compound snlfamethoxazole(SMZ-TMP),which were 76.6%,61.7%and 57.4%respectively,while a low resistance to imipenem,cefoperazone-sulbactam,piperacillin-tazobactam,Enterococcus faecalis showed high resistance rates to erythromycin,gentamicin and levofloxacin,which were 65.8%,43.2%and 31.1%respectively,and were most susceptive to vancomycin and teicoplanin, both with resistance rates of 0. The susceptibility rate of Enterobacteriaceae to imipenem was 100%. From 2006 to 2008, the detection rate of extend-spectrum β-lactamases ESBLs -producing Escherichia coil in outpatient increased year by year, from 28.7% to 43.3% (P＜0.05), whereas no significant change was found in inpatients. The detection rate of (ESBLs)-producing Escherichia coil in inpatients was significantly higher than that in outpatients (P＜0.05).The detection rate of ESBLs-producing Escherichia coil was 23.6%. The antimicrobial resistance rate in elderly patients was significantly higher than that in overall antimicrobial resistance rote (P＜0.05). Conclusions The predominant bacteria of UTI are still gram-negative bacteria, main of which is Escherichia col. Bacteria are resistant to a variety of antibiotics. Approximate selection of antibiotics in clinical practice should be made on the basis of susceptibility test results.

Objective To investigate the prevalence and main genotypes of carbapenemases in carbepenem‐resistant Enterobacteriaceae (CRE) .Methods A total of 114 strains of CRE were isolated in Shanghai Ruijin Hospital from May 2011 to June 2013 .The diameter of inhibition zone of imipemen or meropenem for these strains was not larger than 22 mm .PCR method was used to screen for the main carbapenemase genes (blaKPC ,blaIMP ,blaVIM ,blaOXA‐48 and blaNDM ) with previously described primers followed by nucleotide sequencing analysis . Conjugation experiments were performed to examine the transferability of plasmids .Pulsed‐field gel electrophoresis (PFGE) was used to show the relatedness of KPC‐2‐producing Enterobacteriaceae .Results Most of the 114 isolates were K lebsiella pneumoniae and Escherichia coli .Of the 114 isolates ,98 was positive for carbapenemases ,specifically ,78 blaKPC‐2‐positive ,15 blaIMP‐4‐positive ,2 blaIMP‐8‐positive ,1 positive for both blaKPC‐2 and blaIMP‐4 and 4 blaNDM‐1‐positive .None of the strains was positive for blaOXA‐48 or blaVIM .About 21 .4% (21/98) of the isolates were conjugated successfully .The 49 blaKPC‐2‐positive K .pneumoniae isolates were grouped into 12 types according to PFGE patterns .Majority (34/49) of these isolates belonged to the same type A .Conclusions BlaKPC‐2 was the primary epidemic genotype of Enterobacteriaceae in Ruijin Hospital ,followed by blaIMP‐4 .NDM‐1 carbapenemase was produced in 4 strains of CRE . Meanwhile , clonal spread of KPC‐2‐producing K . pneumoniae was observed in some departments of our hospital , such as surgical ICU , respiratory medicine and thoracic surgery . Appropriate measures should be taken timely and effectively to prevent the in‐hospital spread of resistant genes .

Objective To investigate the effects of TLR4 on the radiosensitivity of tumor cells.Methods The cell lines of RAW264.7,Lewis,MFC,Hepal-6,Bl6,and NIH3T3 were irradiated with 5 Gy X-rays or sham-irradiated.24 h after irradiation,the expression of TLR4 was detected by flow cytometry.According to the TKR4 level,cells were divided into three groups:without treatment,LPS stimulation and TAK242 block.CCK-8 kit and Annexin-V Apoptosis Kit were used to detect cell proliferation,apoptosis and cell cycle distribution of each group.Results After 24 h of 5 Gy ionizing radiation,TLR4 was significantly increased in Lewis cells (t =-8.68,P ＜0.01) but decreased in MFC cells (t =25.8,P ＜ 0.01) and had no significant changes in Hepal-6,B16 and RAW264.7 cells.In addition,the proliferation vitality (t =57.62,-6.23,P ＜ 0.01) and survival fraction (t =13.37,19.24,P ＜ 0.01) of the Lewis and MFC cells were reduced especially for the TLR4-blocked cells,and the apoptosis rates of both Lewis (t=-167.85,P＜0.01) and MFC cells (t=-26.45,P＜0.01) were elevated.The percentages of G0/G1 phase and S phase Lewis cells were significant increased (t =8.68,14.89,P ＜ 0.01) but its G2/M phase were reduced (t =-37.48,P ＜ 0.01).However,the percentages of G0/G1 phase and S phase MFC cells were obviously reduced (t =20.31,4.48,P ＜ 0.01) and G2/M phase increased (t =-13.06,P ＜ 0.01).For both cell lines of Lewis and MFC,the cycle distribution of TAK242 and LPS groups didn't change significantly.Conclusions High expression TLR4 in the Lewis cells is related to cell proliferation and apoptosis but not cell cycle distribution,and hence TLR4 could influence the radiosensitivity of tumor cells.

Objective To study the dose-and time-effect relationship between lipopolysaccharide(LPS) and CD14 expression in the cell line J774A.1 of mouse macrophages. Methods The cell line J774A.1 was stimulated with different doses of LPS,and the CD14 surface-positive cells from the cell line J774A.1 were detected by flow cytometry(FCM)45 min after stained with FITC-CD14 monoclonal antibody. The changes of CD14 surface expression in the cell line J774A.1 at different time(1,2,4,8 and 16 h)after stimulated with LPS were observed.After the best stimulant time was selected,the cell line J774A.1 was treated with different doses(1,10,50,100,500 and 1 000 ?g?L~(-1))of LPS and the changes of CD14 surface expression were observed.(Results In view) of time-effect,compared with control group(the positive rate was 12.50?3.71),LPS significantly enhanced the CD14 expression at 1,2 and 4 h after stimulation(the positive rates were 23.80?5.07,(23.04?)2.88 and 28.22?1.54,respectively) when the dose of LPS was 1 ?g?L~(-1)(P