OBJECTIVE To investigate the incidence of integrons in Pseudomonas aeruginosa strains isolated from blood samples in Peking University People′s Hospital and to analyze the correlation between integrons and drug resistance of P.aeruginosa.METHODS Forty-two strains of clinically isolated P.aeruginosa were collected.The antibiotics susceptibility was tested by K-B methods.Integrase gene of integron was amplified by PCR using degenerate primers.The integrons were classified by restriction fragment length polymorphism(RFLP) analysis of positive PCR products with Hinf Ⅰ restriction enzyme.RESULTS The drug-resistance rates of 42 strains of P.aeruginosa against 20 kinds of antibiotics ranged from 9.5% to 100%.Twenty-three strains were resistant to 12 kinds of antibiotics.Nineteen of the 42 isolates(45.2%) contained integrons,all of which were revealed as class Ⅰ of integrons by RFLP analysis.Neither class Ⅱ nor class Ⅲ of integron was detected.The positive percentage of integrons was increased by years.CONCLUSIONS Class Ⅰ integrons are widespread in isolates from blood samples in our hospital.The presence of integrons is closely associated with multi-drug resistance of P.aeruginosa.

Adolescent ; Humans ; Male ; Pigmentation Disorders ; pathology ; Skin ; pathology

BACKGROUND:In treatment of lumbar diseases, lumbar fusion therapy fails in 20%of cases and may lead to a series of complications such as pain, intervertebral space col apse, and delayed kyphosis deformity.
OBJECTIVE:To observe the effect of nucleus pulposus on interbody fusion after removing the anterior column disc of rabbit lumbar vertebra.
METHODS:A total of 36 healthy Japanese white rabbits were randomly and equal y divided into three groups, with 12 rabbits in each group. (1) Group of anterior longitudinal ligament+bone grafting:The L3 intercalated disc were wel exposed and anterior longitudinal ligament was stripped, obtaining a space to L3 intercalated disc, then the iliac bone was implanted. (2) Group of excising anterior 1/3 disc+bone grafting:After the anterior 1/3 disc tissue was excised, the iliac bone was implanted and sutured as Group of anterior longitudinal ligament+bone grafting. (3) Group of excising anterior 1/3 disc+fixation:After the anterior 1/3 disc tissue was excised, the iliac bone was implanted and the anterior column fixation was performed.
RESULTS AND CONCLUSION:Biomechanical testing showed that, at 12 weeks, the verticality tensile force in the group of anterior longitudinal ligament+bone grafting was obviously higher than other two groups, and have better fusion rate and could bear stronger force. Lateral position lumbar radiography showed that, the bone graft was absorbed and no new bone grew into the intervertebral space in the group of excising anterior 1/3 disc+bone grafting at 12 weeks;the formation of osseous bridge was found in the group of excising anterior 1/3 disc+fixation;complete bony fusion was found in the group of anterior longitudinal ligament+bone grafting. Histological examinations showed that, at 12 weeks, no bone tissue formed in the group of excising anterior 1/3 disc+bone grafting;a smal amount of bone trabecula and osteocytes were observed in the group of excising anterior 1/3 disc+fixation;a great quantity of newborn bone trabecula and osteocytes, remodeling lamel ar bone and canalis haversi structure were observed in the group of anterior longitudinal ligament+bone grafting. The stability of anterior column has notable effect on interbody fusion, after the anterior column disc is destroyed, the free nucleus pulposus may affect spinal fusion, so restoring the stability of the anterior column may promote interbody fusion, but stil cannot get solid spinal fusion.

Background and purpose:Early evaluating the therapeutic efficacy of transcatheter arterial chemoembolization (TACE) in patients with hepatic cancer is still a diffcult clinical problem. The purpose of this study was to evaluate the ability of the apparent diffusion coeffcient (ADC) to help predict early disease progression after TACE.Methods:Institutional review board approval was obtained, and all patients signed informed consent. Magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) (b=50, 500, 1 000 mm2/s) were performed before and 1 month after initiating TACE for 23 patients with hepatic cancer (14 were male, 9 were female; mean age: 53.3 years;range: 21-85 years). Contrast-enhanced MRI was performed 3 months after initiating TACE. Patients were classiifed as either progressing or non-progressing according to RECIST 1.1. The preoperative ADC values of tumor and the ADC values of tumor 1 month after TACE were analyzed by pairedt-test in both progressing and non-progressing group. Unpairedt-test was used to compare ADC parameters between progressing and non-progressing group. In all the 23 hepatic cancer patients, receiver operating characteristic (ROC) curve analysis was performed to determine a threshold ADC ratio (ADC%) to differentiate progressing from non-progressing patients.Results:Thirteen progressing and 9 non-progressing patients were evaluated. Increase in ADCs of tumor was observed in non-progressing patients at 1 month after TACE compared with preoperative ADCs. There was a signiifcant difference between the 2 groups (P=0.01). In progressing group, preoperative ADCs of tumor were similar to those at 1 month after TACE (P=0.221). There was no significant difference in preoperative ADCs of tumor and ADC% between the progressing and non-progressing groups. In patients with hepatic cancer, 1 month ADC ratio in non-progressing patients were signiifcantly higher than those of progressing patients (P=0.029). Using ROC to evaluate the ability of ADC% could predict early disease pro-gression after TACE. Using -6.455% as the threshold, the area under the ROC curve was 0.867 (95%CI: 0.643-1.000). The sensitivity was 100%, and the speciifcity was 66.7%.Conclusion:One month after TACE, the increases in ADCs of tumor were observed only in the non-progressing group; and the ADC ratio seems to be a promising tool for helping predict the early disease progression after TACE in patients with hepatic cancer.

Objective To observe the roh of cytoimmunologic factors,careinoembryonic antigen (CEA),serum ferritin(SF)and prognostic factors in patients with Iung adenous cancer.Methods Eightyone patients with lung adenous cancer were analyzed retrospectively.The clinical features as well as the alternation of T-lymphocyte subsets and its relationship with CEA.SF,disease stage and metastasis of lymph node were studied.Results(1)The percentage of CD4+ T cell decreased and that of CD8+T cell increased,the ratio of CD4+/CD8+ went down accompanied by the increase of disease stage.CEA and SF increased as the dmease stage increased.(2)Thedecrease of percentage of CD4+ T cell and the ratio of CD4+/CD8+ was obvious in patients with metastasis of lymph nodes[LN(+)](p＜0.01).The increase of percentage of CD8+Tcell and CEA,SF level was obvious in LN(+)(P＜0.01 or＜0.05).(3)The decrease of percentage of CD4+T cell and the ratio of CD4+/CD4+ was obvious in CEA (+)(P＜0.01).The increase of percentage of CD8+ T cell and SF level was obvious in CEA (+)(P＜0.01).(4)The decrease of percentage of CD4+ T cell and the ratio of CD4+/CD8+ was obvious in SF(+)(P＜0.01).The increase of percentage of CD3+ CD8+ T cell and the CEA level was obvious in SF (+)(P＜0.05 or＜0.01).Conclusion Disorder of cytoimmunologic situation exists in patients with lung adenous cancer,and it is closely correlatod with the CEA,SF level disease stage and metastasis of lymph node.

OBJECTIVETo explore Chinese medical syndrome typing features of epigastric pain and its association with gastroscopic manifestations.

METHODSUsing associated rules data mining method, an analysis study was performed in 234 patients with epigastric pain by combining holistic Chinese medical syndrome typing and results of gastroscopic examinations.

RESULTSPi-Wei deficiency cold syndrome (PWDCS) was associated with pale gastric mucosa, or superficial ulcers accompained with unobvious redness and swelling. Inversed Gan-qi invading Wei syndrome (IGIWS) was associated with bile regurgitation. Damp-heat stagnating in the middle jiao syndrome (DSMJS) was associated with obvious redness and swollen mucosa, or ulcers accompanied with yellow and white fur. Wei-yin exhaustion syndrome (WYES) was associated with coarse mucosa and exposed blood vessels, or rare mucus. Retention of blood stasis in Wei syndrome was associated with bulged swelling and erosion. Indigestion impairing Wei syndrome (IIWS) was associated with retention of water and food, or more mucus attached. The endoscopic manifestations of PWDCS and DSMJS occurred most frequently, while PWDCS and IGIWS ranked the first place in macroscopic Chinese medical syndrome typing.

CONCLUSIONSThe manifestations of endoscopic features were closely associated with Chinese medical syndrome typing. The syndrome typing features of epigastric pain could be objectively and further grasped by summarizing syndrome typing laws using modern devices such as gastroscopic examinations, thus improving the accuracy of clinical syndrome typing.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Gastric Mucosa ; pathology ; Gastroscopy ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Pain ; diagnosis ; pathology ; Yang Deficiency ; diagnosis ; pathology ; Yin Deficiency ; diagnosis ; pathology ; Young Adult

In order to study the analgesic effect of Shaoyao Gancao Decoction, this paper discussed material basis and mechanism from the perspective of macromolecules in traditional Chinese medicine. Inspired by the phenomenon of turbidity after boiling Chinese medicine, this experiment took Shaoyao Gancao Decoction as the research object to study the formation process of precipitation during boiling. The results showed that aggregates with a certain shape were formed in the solvent during the boiling process, and the precipitate was obtained by standing and centrifuging. Analysis found that the precipitation was mainly composed of small molecules such as paeoniflorin, albiflorin, liquiritin, glycyrrhizic acid, isoliquiritin and gallic acid, and macromolecules such as protein and polysaccharide. The composition of precipitate was consistent with that of Shaoyao Gancao Decoction, but the analgesic effect of Shaoyao Gancao Decoction after removing the precipitate was significantly reduced. Based on these results, we isolated small molecular compounds, polysaccharides and protein from Shaoyao Gancao Decoction and their contents are 60.4, 700.7 and 207.2 mg·g^-1 respectively. We get the ratio, polysaccharide: small molecule = 11.6∶1, protein: small molecule = 3.4∶1, the precipitate is prepared in the state of boiling. The characterization results showed that the particle size of the precipitate will change significantly after co-heating, and the content determination results showed that the content of the six small molecular compounds which was free in solvent was significantly reduced after the formation of the precipitate. The acetic acid writhing experiment proved that the precipitate has a good analgesic effect, and effectively reduced the levels of inflammatory factors prostaglandin E2 and nitric oxide, and increased the level of anti-inflammatory factor interleukin-10. These results proved that the precipitate in Shaoyao Gancao Decoction is an important material basis for analgesic effect, and macromolecules such as protein and polysaccharide are the main components of the precipitate. The study of macromolecules in the precipitate of Shaoyao Gancao Decoction not only provides new ideas and methods for elucidating the pharmacodynamic material basis of Shaoyao Gancao Decoction, but also provides a reference for analyzing the scientificity of traditional decoction.

ObjectiveTo detect the expression level of programmed cell death (PDCD) 5 and tumor necrosis factor(TNF)-α in serum and joint fluid from rheumatoid arthritis (RA) and osteoarthritis (OA)patients,and analyze the correlation between PDCD5 and TNF-α in order to study the role of PDCD5 in the pathogenesis of RA.MethodsFiftypatients(including 26 RA,24 OA) between December 2009 and August 2010 were selected to this study.ELISA was used to detect the concentration of PDCD5 and TNF-α in the serum and joint fluid.Two-independent sample t-test and Pearson's correlation analysis were used for statistics.ResultsIn both serum and joint fluid,the concentration of PDCD5 from RA patients [(37±33) vs (37±26) pg/ml ] was significantly higher than that of OA patients [ ( 13± 14) vs ( 11 ±7 ) pg/ml ] (P＜0.05).The concentration of TNF-α in the serum from RA and OA patients did not differ significantly(P=0.122),but its concentration in joint fluid of RA patients was significantly higher than that of OA patients (P=0.037).In the serum,there was significant correlation between PDCD5 and TNF-α (r=-0.55,P=0.004; r=-0.51,P=0.012)in both RA and OA patients.The correlation between PDCD5 and TNF-α in joint fluid of RA patients was statistically significant(r=-0.49,P=0.012),but no correlation could be found in joint fluid between PDCD5and TNF-α of OA patients(r=-0.353,P=0.09).ConclusionThis study suggests that PDCD5 and TNF-αare important apoptosis-regulatory factors in RA,and play important roles in the occurrence and development of RA.

Objective To investigate the prognostic value of regulatory B cells (Bregs) in patients with acute pancreatitis .Methods Flow cytometry analysis was performed to detected the percentages of CD19+IL-10+and CD19+CD24hiCD27hi Bregs in peripheral blood samples collected from patients with acute pancreatitis (36 cases with mild acute pancreatitis and 15 cases with severe acute pancreatitis ) as well as the surface costimulatory molecules including CD80 and CD86 on CD19+CD24hiCD27hi Bregs.Their correlations with lymphocytes and C-reactive protein ( CRP) were further analyzed .Results The numbers of lympho-cytes, CD19+lymphocytes, CD19+IL-10+and CD19+CD24hi CD27hi Bregs in peripheral blood samples col-lected from patients with severe and mild acute pancreatitis as well as the mean fluorescence intensities ( MFI) of CD80 and CD86 were significantly lower than those from healthy subjects .Compared with patients with mild acute pancreatitis , the numbers of lymphocytes and CD 19+lymphocytes , the absolute numbers of CD19+IL-10+and CD19+CD24hiCD27hi Bregs as well as the mean fluorescence intensities (MFI) of CD80 and CD86 in patients with severe acute pancreatitis were significantly decreased .The percentages of CD19+IL-10+and CD19+CD24hiCD27hi Bregs in patients with mild acute pancreatitis were significantly increased af-ter an initial drop , but in patients with severe acute pancreatitis those values were continuously decreased along with the disease progression .The percentage of CD19+IL-10+Bregs was positively correlated with the percentage of CD19+CD24hiCD27hi Bregs and the absolute number of CD19+lymphocytes, but was negatively correlated with CRP .Conclusion The abnormal number and function of CD 19+IL-10+and CD19+CD24 hi CD27hi Bregs might be one of the important reasons causing immune dysfunction in patients with acute pan -creatitis.

Objective To summarize the experiences and protocol of extracorporeal membrane oxygenation (ECMO) technique in donors with brain death and unexpected cardiac arrest.Method We described here the organ donation of one case of brain death complicated with hemodynamic instability and cardiac arrest,and the corresponding recovery of the receptor liver.A 50-year old female developed brain death due to brain aneurysmal hemorrhage.He was given two kinds of high-dose vasopressor,but hemodynarnic instability was not improved.After ECMO support,the hemodynamics turned to stable,but unexpected cardiac arrest happened.The total operating time of ECMO was 5 h,including 4 h after cardiac arrest.The liver was transplanted into a 65-year old female with hepatocellular carcinoma (diagnosed by Hangzhou Criteria) by classic orthotopic liver transplantation with end-to-end anastomosis.Result One liver and two kidneys were obtained successfully,and all the receptors recovered uneventfully.The post-operative ALT and AST levels reached the peak at 169 U/L and 365 U/L respectively,and returned to normal two weeks later.Conclusion ECMO can be used to support brain death complicated with hemodynamic instability and unexpected cardiac arrest.It can save precious time for organ donation,and preserve the function of liver and kidney as well.