Objective To investigate the molecular epidemiology of 114C. albicans strains isolated from the vaginal discharge of female patients treated in three obstetrics and gynecology hospitals in Shanghai by analyzing the relationship between the main genotypes and resistance proifle, and the relationship between genetic diversity and cluster ofC. albicans.Methods A total of 114 strains ofC. albicans were collected from the Obstetrics & Gynecology Hospital of Fudan University, Shanghai First Maternity and Infant Hospital Corporation and the International Peace Maternity & Child Health Hospital of China welfare institute. Phylogenetic analysis of strains were carried out by eBURST.C. albicans strains were also analyzed by multilocus sequence typing (MLST). The susceptibility of theC. albicans strains was tested by ATB FUNGUS 3.Results A total of 47 diploid strain types (DSTs) were identiifed from the 114 strains, 30 of which were known types. DST 79 and DST 435 were the main types. Of the 114C. albicans strains, 96.5% were susceptible to lfucytosine, 100% to amphotericin B, 85.1% to lfuconazole, 55.2% to itraconazole and 84.3% to voriconazole.Conclusions The pathogenicC. albicans strains isolated from different obstetrics and gynecology hospitals in Shanghai were originated from multiple clones, the main type of which was DST 79 and DST 435 with certain degree of antifungal resistance. MLST typing suggests that genetic diversity is present in theC. albicans strains isolated in Shanghai area. The clustering analysis ofC. albicans strains is consistent with its genotypes.

Objective To evaluate the value of transvaginal ultrasonography in diagnosis of ovarian pregnancy. Methods Ultrasound features of 21 cases of ovarian pregnancy were retrospectively studied in comparison with those of surgery and pathology. Results All the cases were diagnosed extrauterine pregnancy and suggested 3 cases with the lesion localizing inside the ovary,3 cases superficial to the ovary, 1 case unclear localization and 2 cases misdiagnosed as tubal ectopic pregnancy, the correct localization was made in 66.7 % of 9 unruptured cases by endovaginal sonography. Twelve ruptured cases were unclear localization by endovaginal sonography. The sonographical appearance of ovarian pregnancies showed normal or little bigger uterus, empty uterine cavity, a gestational sac or inhomogenous strong echoes interior or superior to the ovary, or complex mass in the adnexal area with abundant free fluid in the pelvic. Conclusions Transvaginal sonography is of diagnostic value in ovarian unruptured pregnancy.

Objective To discuss the influencing factors of lead poisoning in children and adolescents in certain region of Yunnan and to provide evidence for effective prevention measures.Methods Venous blood samples of 1379 children and adolescents were collected and lead levels in the blood were tested by atomic absorption spectrometer.Children and adolescents with lead level higher than 100 μg/L were diagnosed with lead poisoning.Results The lead level ranged from 1 μg/L to 450 μg/L,with the average level of 82.87 ± 66.97 μg/L,and 341 children and adolescents were diagnosed with lead poisoning,with the poisoning rate of 24.7％.The differences of lead poisoning rates by gender,age,and place of residence were significant (P＜0.05).Gender,age,and distance between place of residence and mining area were the main influencing factors of the lead poisoning rate.Conclusion The blood lead poisoning rate of children and adolescent are high in this region.Boys,children in preschool age and children living closer to the mining area are susceptible to blood lead poisoning.

Aim:To characterize the immune response to YCP, a polysaccharide (PS) isolated from marine filamentous fungus Phoma herbarum YS4108. Methods:YCP was coupled to bovine serum albumin (BSA) to construct three neoglycoproteins which are different in their degrees of substitution (DSs; ≈ 3, ≈ 6, or ≈ 10 mol of BSA carrier/mol of YCP hapten, respectively), and their immunogenicities were evaluated in mice following subcutaneous immunization,respectively. IgG subclasses against the PS and the carrier protein were measured in addition to the total IgG and IgM antibodies for YCP induced by the neoglycoproteins. Results: While unconjugated PS was weakly immunogenic, theneoglycoprotein induced vigorous primary IgM and booster IgG responses to PS and the carrier protein. Interestingly,the IgG subclass distribution was different between PS and the carrier protein; for PS, the IgG response was predominant of IgG2a subclass with approximately low levels of IgG2b and IgG1, while the response to the carrier protein was mainly of the IgG1 subclass with relatively low levels of IgG2a and IgG2b, and the lowest of IgG3. Conclusion:YCP has the potential to elicit preferentially IgG2a as the dominant isotype antibody in mice.

Objective To investigate the mutations of CLCNKB gene in a family with classic Bartter syndrome. Methods Genetic DNA was extracted from peripheral blood leucocytes of family members.The coding exons and intron exon junctions of CLCNKB gene were amplyfied by PCR and sequenced directly.Fifty unrelated healthy subjects were selected to exclude the possibility of polymorphism. Results A heterozygous(missense)mutation(482T>G,L161R)was detected in the exon 4 of patients.The hetemzygous mutation(L161R)was found in the mother,while no mutation was found in the father of this family.L161R had not been reported and was a novel mutation when referring to literatures and human genomic database home and abroad.Conclusion A new CLCNKB gene mutation(L161R)is identified for the first time.

ObjectiveTo investigate the action mechanism of CD20 lymphocyte infiltration in the renal allograft biopsy with chronic allograft nephropathy (CAN).MethodsCAN cases confirmed by renal biopsy within 2 years after renal transplantation served as study subjects. By using immunohistochemistry,the deposition of C4d and the CD20-positive lymphocytes infiltration in the renal grafts were examined.The clinical follow-up data were analyzed.ResultsForty-four cases of CAN were enrolled in the study, including 13 cases (29.5％ ) of CD20-positive lymphocytes infiltration,and 31cases (70.5％ )of CD20-negative lymphocytes infiltration. CD20-positive lymphocytes in biopsy showed nodular and scattered lymphocytes infiltration.There were 5 (26.3％)cases of CAN Ⅰ,4 cases (25.0％) of CAN Ⅱ,and 4 (44.4％) of CAN Ⅲ in CD20-positive group.There was no statistically significant difference between the only CAN group and CAN with AR group in CD20-positive rate.Immunohistochemical staining showed there were 12 cases (27.3％) with C4d linear deposition in peritubular capillary endothelial cells (PTC).C4d positive rate had no significant difference among the CAN classifications. There was no significant relationship between C4d deposition and CD20-positive lymphocytic infiltration.The average serum creatinine in CD20-negtive group and CD20-posigtive group was 140.8 ± 22.0 and 183.5 ± 25.5μmol/L before biopsy,and 165.6 ± 37.6 and 242.2 ± 59.1 μmol/L one year after biopsy.The average serum creatinine level in CD20-positive group was higher than in CD20-negtive group before and after biopsy.ConclusionProgressive chronic humoral immunity is high risk in the process of CAN. The CD20-positive lymphocyte infiltration has no relevance with CAN grade and C4d deposition in PTC,but is associated with circulating antibody PRA and allograft long-term outcome. Pathogenetic mechanism may not contribute to chronic humoral immune,but B cells presenting donor antigens,are recognized and activated by T cells as antigen-presenting cells.

Objective To compare the efficacy of total pelvic floor reconstruction with mesh patch and vaginal hysterectomy with anterior and posterior vaginal wall repair for presby-pelvic floor dysfunction patients.Methods We randomly chose 92 pelvic floor dysfunction inpatients of our hospital from September 2007 to February 2009 and divided them into 2 groups:total pelvic floor reconstruction group(n=70) underwent total pelvic floor reconstruction with mesh patch[12 patients of this group complicated with stress incontinence,4 patients received tension free vaginal tape-obturator(TVT-O) simultaneously];control group(n=22) received vaginal hysterectomy with anterior and posterior vaginal wall repair(3 patients of this group complicated with stress incontinence).A follow-up for 3 to 18 months after the surgery were taken in all the patients.Results In total pelvic floor reconstruction group,no recidivate case was found and the FOP scores and cure rate were 0 and 100% respectively.In control group,there were 7 recidivate cases,all of who were primary vagina anterior wall bulge patients.The cure rate of control group was 68%;For the patients complicated with stress incontinence,they were all cured by TVT-0 or by ascending the front patch in total pelvic floor reconstruction group,but 1 case was as before operation and 2 cases were even worse in control group.Conclusion Total pelvic floor reconstruction with vicarious materials had a definite efficacy for presby-pelvic floor dysfunction.

Objective To explore the value of interventional therapy in unruptured intracranial aneurysms combined with brain arteriovenous malformations (BAVM).Methods Data of 23 patients with unruptured aneurysms combined with BAVM were retrospectively analyzed.All patients were treated with interventional embolization,and the embolization methods were choosen according to the Redekop classification.The proximal or distal hemodynamic aneurysms were embolized with coils,and the intranidal aneurysms were embolized with Onyx.The outcome was assessed by the Glasgow outcome score (GOS) one week after treatment.DSA scan was used to observe whether there was recurrence during 3-6 months after embolization.Results Totally there were 36 aneurysms in 23 patients,including 8 intranidal aneurysms,16 proximal flow-related aneurysms,11 distal flow-related aneurysms and 1 unrelated aneurysm.Embolizations of 16 proximal hemodynamic aneurysms and l0 distal hemodynamic aneurysms were done with coils.And embolization of 8 intranidal aneurysms were done with Onyx.One distal hemodynamic aneurysm was not embolized due to the difficulty of embolization and the regular shap of aneurysm;and the patient died of cerebral hernia caused by intracranial hemorrhage on the sixth day after embolization.Because it was more suitable for surgical clipping,1 unrelated hemodynamic aneurysm was not embolized.In 23 cases,BAVM were completely embolized in 7 cases and incompletely embolized in 16 cases.A week after operation,the GOS score were 5 in 19 cases and 4 in 3 cases.The GOS score was not evaluated in the dead case.Except for 1 cases of death,the other 22 cases were followed up after embolization.No recurrence and intracranial hemorrhage occurred.Conclusion Interventional treatment of unruptured intracranial aneurysms combined with BAVM is safe and effective.Making treatment plan according to the hemodynamic characteristics of lesions and completely embolizing all lesions to prevent postoperative bleeding is helpful to improve the prognosis of patients.

Objective To investigate the spherical diopter and astigmatism change of humans at sitting and supine position.De- sign Prospective case series.Participants 96 eyes of 52 patients (spherical diopter from-2.50 D to-10.00 D,astigmatism diopter from -0.75 D to-4.50 D) were selected.Methods The subjects were examined with NIKON portable retinomax at sitting and supine posi- tion,respectively.Main Outcome Measures The spherical diopter,cylinder diopter and axis change were analyzed statistically.Re- sults Spherical diopter at supine position (-5.31?3.43 D) was a little higher than that at sitting position (-5.27?3.24 D) statistically(P= 0.25),and cylinder diopter at sitting position (-2.27?1.24 D) and at supine position (-2.35?1.19 D) was no statistically difference (P= 0.20).The axis of astigmatism changed from-16?to +18?.Axis change was within 2?in 52.1% eyes,6?-10?in 5.2%,over 10?in 3.1%. The change of axis rotation tended to counter-clockwise in the right eye and clockwise in the left eye.Conclusions Eye rotation at sit- ting and supine position may cause the astigmatism axis change.It may be one of the main factors affecting the results of LASIK.

AIM: To investigate whether transferrin rec ep tor (TfR) and Fc ?/? R are the major IgA 1 receptor on human mesangial cells (HMC). METHODS: Serum IgA 1 was isolated by jacalin affinity chromatog raphy and heated to aggregated form (aIgA 1). RT-PCR was performed to investiga te the expression of TfR mRNA and Fc?/?R mRNA. Binding capacity of aIgA 1 to human mesangial cell line (HMCL) was evaluated by radio-ligand binding assay. Bi nding specificity was determined by competitive inhibition assay and phosphoryla tion of extracellular signal-regulated kinase (ERK) was determined by Western bl ot. RESULTS: TfR cDNA and Fc?/?R cDNA products were amplified from HMC but not from HMCL. aIgA 1 was found to bind to HMCL in a dose-dependent, s aturable manner and the binding was inhibited by BSA. Scatchard analysis reveale d a Kd of (6.4?1.7)?10 -7 mol/L and the binding sites were (3.0?1.2) ?106/cells. Both aIgA 1 from patients with IgAN and healthy controls were ab le to induce the phosphorylation of ERK in a similar time-dependent manner, but the effect of aIgA 1 from patients with IgAN was much stronger (P