Objective To research the immuno-protection of SJIR-2 DNA vaccine with nanometer microspheres a-gainst Schistosoma japonicum infection in mice. Methods To construct eukaryotic expression plasmid pEGFP-SJIR-2, identified by double digestion and sequenced delivery. The recombinant plasmid pEGFP-SJIR-2 was ex-tracted and was encapsulated into PLGA nanometer microspheres which were modified by CHS. 40 female BALB/c mice were randomly divided into 4 groups (n=10), each group of mice were injected with PBS, empty pEGFP plasmid, CHS-PLGA nanometer microspheres and CHS-PLGA-pEGFP-SJIR-2 nanometer microspheres 100 μg, re-spectively. Two weeks after the last immunization, each mouse was infected by cercaria of Schistosoma japonicum, sera of mice in each group were collected before each immunization and challenge infection. ELISA was used to de-tect the change of IgG in each group of micesera. 42 days later, all mice were sacrificed. The adult worms and eggs were collected and counted, and the worm and egg reduction rates were calculated as well. Results The recombi-nant plasmid pEGFP-SJIR-2 was successfully constucted, and there was significant difference in the numbers of worm and egg between CHS-PLGA-pEGFP-SJIR-2 group and PBS group ( P<0. 01 ) . The worm andegg reduction rates in CHS-PLGA-pEGFP-SJIR-2 group were 37. 36% and 46. 82% respectively. The IgG levels in mice sera of CHS-PLGA-pEGFP-SJIR-2 group were remarkably higher (P<0. 01) compared with PBS group. On the contrary, there was no significant difference between both pEGFP plasmid group and CHS-PLGA group in the numbers of worm and egg compared with PBS group. Conclusion SJIR-2 nanometer microspheres nucleic acid vaccine has some immuno-protection against Schistosoma japonicum infection in BALB/c mice,while it is worth further studying for it’ s potential value to be a candidate antigen molecule of Schistosoma japonicum vaccine.

Objective To study the expression of p35 and p25 in rat after focal cerebral contusion and to provide experimental data for estimating brain injury time. Methods Fifty adult male SD rats were randomly divided into 0 h, 6 h, 12 h, 24 h, 3 d, 5 d, 7 d, 10 d after focal cerebral contusion, control and sham-operated groups (5 rats each group). The focal cerebral contusion rat model was established. The expression of p35 and p25 protein of the damage peripheral zone in brain were detected by HEstain-ing, immunohistochemistry and western blotting at different injury time. Results Alarge number of p35 protein and a small amount of p25 protein were expressed in control group and sham-operated group. After focal cerebral contusion, p35 presented unimodal change with time and p25 presented bimodal changes with time. Conclusion Expression of p35 and p25 showed different regularity with good time correlation, which could help to estimate the brain injury time.

Objective To improve the diagnosis and treatment of infective endocarditis(IE)by exploring its causes,pathogenic microorganism and clinicsI characteristics.Methods The clinical data of 120 IE patients treated in Peking Union Medical College Hospital from October 1997 to September 2007 were analyzed retrospectively.Results Of the 120 consecutive cascs diagnosed as IE according to the Duke's new criteria,79 were male and 41 female with a average age of(43.2±16.7)years old.Twelve cases were prosthetic valve endocarditis(PVE)and 108 cases native valve endocarditis(NVE)and there were no previously known heart diseases in 29 of the cases.Seventy-nine of the 108(73.1%)NVE patients had basic cardiac abnormalifies before IE diagnosis,such as congenital cardiovascular disease(30 cases),idiopathic mitral valve prolapse(23 cases)and rheumatic heart disease(11 cases).Fever(100.0%),anemia(54.2%)and embolism(48.3%)were the most common clinical manifestations in the IE development.Of the 83 patients who had a positive blood culture result,Streptococcus vividaus(51.8%)was the most common isolated microorganism.Conclusions Congenital cardiovascular diseases and idiopathic mitral valve prolapse are the two most commonly heart diseases in IE.Blood culture and echocardiogram should always be done to exclude IE,especially presenting with fever of unknown reasons.

Objective] To investigate the clinical features of amebic liver abscess, the causes of misdignosis and the effect of medical and surgical therapy on patient′s prognosis. [Methods] The clinical features of 36 patients with amebic liver abscess admitted from 1982 to 1997 in our hospital were retrospectively reviewed. [Results] The major clinical manifestations were: abdominal pain (86 1%), fever (86 1%),hepatomegaly with tenderness (83 3%) and right intercostal tenderness(58 3%). Leukocytosis was observed in 61 1%, and increased of ESR in 88 5% (23/28). Serologies against Entamoeba histolytica were noted in 92 6%. Ultrasonography showed single lesions in 75% and right\|lobe involvement in 75%. All patients were treated with metronidazole and 27 patients received treatment with needle aspiration or draining at the same time. After treatment, 10 patients were cured, 25 patients were improved significantly and effective rate was 97 2%. One patient died of hepatic failure. [Conclusion] Medical therapy alone was excellent for small abscesses, while percutaneous needle aspiration or draining was a successful approach in patients with large abscesses.

Objective To explore the methods and clinical application of percutaneous pediculoplasty in the treatment of vertebral pedicular osteolytic metastases.Methods Percutaneous pediculoplasty was performed in 18 patients with (23 Vertebral pedicles ) osteolytic metastases,3 cases localized in thoracic vertebral pedicles and 15 cases in lumbar vertebral pedicles,and two vertebral pedicles involved in 5 cases . Under Multislice helical CT guidance ,2.5～5ml of polymethylmethacrylate ( PMMA ) mixture (ratio of polymer,moner,ultrafluid iodinated oil was 20g:10ml:3ml) was injected into pathologic pedicles in step by step after successful puncture using 11-13G needles. All cases had been followed for 1～18 months.Results All cases were successful punctured. Pain relieved in all cases after percutaneous pediculoplasty.7 cases had cement leakage,among them,cement leaked into tumor tissue in 5 cases(2 cases with leakage into intervertebral foremen),nerve radicular pain occurred in one case,the pain disappeared 3 days later after intravenous mannitol and lower dose dexamethasone drips;the cement leaked into vertebral canal a little without clinical symptom in one case.Conclusion CT-guided percutaneous pediculoplasty is a minimally effective and safe method for osteolytic vertebral pedicular metastases in treatment of pain and enhancement of spinal stability.

Objective This study aims to evaluate the changes of Cdk5 expression at the time of 3 hours to 10 days after moderate brain injury by blunt force impact in a rat model,and to demonstrate its forensic significance.Methods To establish a rat model of blunt focal brain contusion,and to observe the changes of Cdk5 expression in brain tissue at different timepoints after brain injury by immunohistochemistry and Western blot.Results A low expression level of Cdk5 was observed in the brain tissue of both normal and sham control groups.The expression of Cdk5 increased after 3 and 6 hours,remarkably increased at 12 hours,and reached the maximal level at 24 hours after focal brain injury.The Cdk5 level gradually decreased 3 days,5 days,7 days,and 10 days and reached the normal level 7 and 10 days after the injury,with no statistical difference (P＞0.05) compared with the normal and sham control groups.Conclusion The expression of Cdk5 increased in the peripheral area of contusion tissue after blunt brain injury in rats,showing single peak change,and dropped to normal level with the time extension.The change of Cdk5 expression may provide a new reference index for the prediction of early brain contusion.

Objective To evaluate the etiological and clinical characteristics of fungemia in Peking Union Medical College Hospital.Methods Microbial and clinical information of patients with fungemia consulted in Peking Union Medical College Hospital during 2008 to 2010 were retrospectively analyzed.Results A total of 70 patients were diagnosed with fungemia,and 100％ of them had underlying diseases or potential risk factors.Of them,40 (57.1％) patients were monomicrobial fungemia,and the other 30 (42.9％) patients with positive blood cultures were caused by at least two different microbes during hospitalization.Among 122 strains of microbes isolated from blood cultures,72 were fungi and 50 were bacteria.Among the isolated fungi,61 (84.7％) were Candida species,31 (50.8％) were Candida albicans and 30 (49.2％) were non-albicans.According to the colonization or infected sites other than blood of the isolated fungi,35 cases (50.0％) were primary fungemia; 18(25.7％) were colonizing at lower respiratory tract simultaneously; 10 (14.3 ％) caused central-line related fungemia; 3 (4.3％) were secondary to intraabdominal fungal infection; and another 4 (5.7％) isolates had multiple colonization sites.During hospitalization,37 cases died with a crude mortality rate of 52.9％,and 22 (32.9％) died of fungemia itself.In single factor analysis,ICU hospitalization(x2 =15.136,P ＜ 0.001),operation history within 30 days (x2 =3.540,P =0.060) and invasive mechanical ventilation (x2 =4.450,P =0.035) were related to crude mortality.Bacteremia during hospitalization (x2 =5.657,P =0.017),circulatory underlying diseases (x2 =3.399,P =0.065) and ICU treatment (x2 =4.955,P =0.026) increased attributable mortality.In the multivariate analysis,ICU history increased mortality during hospitalization,however,the operation history within 30 days was independently irrelevant to crude mortality during hospitalization.ICU history and bacteremia during hospitalization were independently correlated to attribution mortality of the patients with fungemia.Conclusions Fungemia,usually accompanied with bacteremia,occurs often in the patients with underlying diseases.Patients with fungemia have poor prognosis and more than 50％ patients die.ICU history increases the risk both to crude and attributable mortality.The patients with fungemia who had polymicrobial bloodstream infection have a higher attribution mortality.Operation history within 30 days is independently negatively correlated to attributable mortality.

ObjectiveTo evaluatethe microbial spectrum and clinical characteristics of microbiological diagnosed bloodstream infections ( BSI ) with identified infective sources. Methods The hospitalized patients microbiologically diagnosed as BSI with identified infective sources were included in this study from January 2008 to December 2009.Data were collected retrospectively and analyzed by software SPSS 17.0.ResultsIn this 2-year study,301 strains of microbes were isolated from 249 patients.There were 205 ( 82.33％ ) patients with monomicrobial BSI,while the other 44 ( 17.67％ ) patients with polymicrobial BSI.The most common identified source of bloodstream infections was lower respiratory tract infection (125,41.5％ ),followed by intraabdominal infection (55,18.3％ ) and intravascular devices related infection (54,17.9％ ).The four most common isolated pathogens were Acinetobacter species (60,19.9％ ),Escherichia coli (50,16.6％ ),Pseudomonas species (35,11.6％ ) and Staphylococcus Aureus (34,11.3％ ).Eighty-eight (35.3％) patients died during hospitalization due to all causes,out of which 62(24.9％ ) patients died owing to BSI.The patients with BSI originated from lower respiratory tract had a higher crude in-hospital case-fatality ratio than those with BSI originated from other resources ( OR =2.186 ; 95％ CI 1.260-3.792; x2 =7.879,P =0.005). In the multivariate regression,age ≥ 65,invasive mechanical ventilation, reservation of central line and polymicrobial BSI during hospitalization were independent risk factors of death due to all causes. Conclusions Lower respiratory tract is the most common originated source of BSI with microbiological identified sources. Gram-negative bacillus taking advantage,the microbial spectrum of BSI with identified sources in our study is different from those reported before both in primary and secondary BSI.The patients with BSI originated from respiratory tract have a higher crude in-hospital case-fatality ratio.

Objective To evaluate the detection rate and the efficiency of the modified crushing-cercariae escaping method.Methods The detection rates of the modified crushing-cercariae escaping method and the crushing methods were compared by using a double-blind control experiment with the latter as a gold standard.meanwhile the number of the cercariae was quantified.The efficiency of the two methods aforementioned and the cereariae escaping method were compared in field.Results The detection rate of the modified crushing-cercariae escaping method was 100%.the average number of cercariae in each infected snail was (4 778±1 157);and the number in certain volume of water sample was positively correlated with the number of infected snails.The efficiency of the modified menthed Was 18.2 times and 17.3 times as high as those of the crushing method and cereariae escaping method,respectively.Conclusions The modified crushing-cercariae escaping method Can detect the infected snails quicky and Can quantify the number of infected snails and cercariae,and is suitable for the detection of infected snails in large number.