Persister cells are dormant or slowly grown variations in microbial populations .They are highly tolerant to antibiot-ics but the tolerance are not inherited as the genetic resistance , when persisters are inoculated to fresh medium , most bacteria are still susceptive to antibiotic , while only a small fractiont become persisters again .Persisters are believed to be closely related to clinic bio-film forming and the recurrence and recalcitrance of chronic infections .Different persisters have been found in Escherichia coli , Pseud-omonas aeruginosa , Staphyococcus aureus , Mycobacterium tuberculosis , Candida albicans and so on , and a few mechanisms about per-sisters formation have been studied .This article reviews the current progresses of research methods and achievements on persisters from different levels .

0.05), but hospitalization duration was shorter in the invasive group than in the conservative group (10.3?5.6 days vs 14.6?10.7 days, P

Objective:To investigate the expression of apolipoprotein A-Ⅰ( ApoA-Ⅰ) in eight histo-logical types of renal neoplasms and to explore a new biomarker for differential diagnosis .Methods:The immunochemistry was used to detect the expression of ApoA-Ⅰ in 23 cases of renal tumors , including clear cell carcinoma , papillary cell carcinoma , chromophobe cell carcinoma , oncocytoma , multilocular cystic carcinoma , renal pelvis invasive urothelial carcinoma , metanephric adenoma and collecting ducts carcinoma.Five cases of cancer-adjacent normal tissues were obtained from another five renal tumor pa-tients and were chosen as control group .Results: In the 23 cases of renal tumors , ApoA-Ⅰ was ex-pressed in 21 cases(positive rate was 91.3%).There were only two in five cases of normal tissues which expressed this protein ( positive rate was 40 .0%) .A significant differentiation was observed between the two groups(Z=-2.829,P=0.003).In renal clear cell carcinoma(RCC), ApoA-Ⅰ expression level was correlated with the grade and stage of tumor tissues .ApoA-Ⅰ was stained much more stronger in RCCⅡ-Ⅲ than in RCCⅠ( Z=-2.070,P=0.038).In various histological types of renal cancer , ApoA-Ⅰwas all expressed to some degrees .Conclusion:ApoA-Ⅰcan be chosen as a tumor biomarker to differentiate various histological types of renal neoplasms .

BACKGROUND:Severe pain after total hip arthroplasty is an important factor for successful rehabilitation of postoperative joint function. Analgesic method after total hip arthroplasty is a hot issue. OBJECTIVE:To investigate the analgesic effect of different concentrations of ropivacaine after total hip arthroplasty. METHODS:69 patients undergoing total hip arthroplasty were recruited from Department of Anesthesiology, Suqian People’s Hospital, from January 2012 to June 2014. According to the ASA classification, their physical status was graded I to III. The involved patients were randomly divided into three groups:0.25%ropivacaine group, 0.3%ropivacaine group, 0.35%ropivacaine group. Each group had 23 cases. At 30 minutes after the surgery, different concentrations of ropivacaine, 20 mL, were injected to patients due to continuous fascia iliaca compartment block. The catheter was then connected to a patient-control ed analgesia pump programmed to deliver 10 mL with a lockout interval of 60 minutes, for postoperative analgesia (72 hours). At 12, 24, 48 and 72 hours of blockade, the visual analogous scale (VAS) scores at rest, passive and active activity were recorded. When VAS score at rest ≥ 4 points, parecoxib sodium 40 mg was injected intravenously. The consumption of ropivacaine within 72 hours after the blockade, application of parecoxib sodium, time of ambulation, and adverse reactions during blockade were recorded. The analgesic effect in the three groups was also observed. RESULTS AND CONCLUSION:Compared with 0.25%ropivacaine group, static VAS scores of 0.3%ropivacaine group and 0.35%ropivacaine group showed no significant difference (P>0.05), passive and active VAS scores were significantly decreased (P<0.05), and the consumption of ropivacaine within 72 hours after the blockade was significantly decreased. There was no significant difference in the rest, passive and active VAS scores between 0.3%ropivacaine group and 0.35%ropivacaine group (P>0.05). The ropivacaine consumption of 0.3%ropivacaine group and 0.35%ropivacaine group was not statistical y significant (P>0.05). The usage of parecoxib sodium in 0.3%ropivacaine group and 0.35%ropivacaine group was significantly lower than that in 0.25%ropivacaine group (P<0.05). Day of first walk was earlier in the 0.3%ropivacaine group and 0.35%ropivacaine group. The incidence of complications among the three groups showed no significant difference (P>0.05). Experimental findings indicate that, three different concentrations of ropivacaine has certain analgesic effects after total hip arthroplasty with fewer adverse reactions, and the concentration of 0.3%ropivacaine is the suitable concentration for postoperative analgesia of total hip arthroplasty, it can reduce the amount of parecoxib sodium and shorten the day of first walk.

The relationship between apoptosis of granulosa cells and follicle development arrest in polycystic ovarian syndrome (PCOS) rats, and the contribution of tumor necrosis factor related apoptosis inducing ligand (TRAIL) in apoptosis of granulosa cells were explored. By using sodium prasterone sulfate rat PCOS model was induced. The apoptosis of granulosa cells in ovaries of rats was observed by TdT-mediated dUTP-biotin nick end-labeling (TUNEL), and the expression of TRAIL protein and mRNA in granulosa cells was detected by using immunohistochemical staining and reverse transcription polymerase chain reaction (RT-PCR) respectively. The apoptotic rate and the expression of protein TRAIL in granulosa cells were significantly higher in antral follicles from the PCOS rats than in those from the control rats (P<0.01, P<0.05). There was no significant difference in apoptotic rate and the expression of TRAIL protein in granulosa cells of preantral follicles between the PCOS rats and the control rats (P>0.05). No apoptosis and the expression of TRAIL protein in granulosa cells of primordial follicles were found in the two groups. The expression of TRAIL mRNA was significantly stronger in granulosa cells from the PCOS rats than in those from the control rats (P<0.01). It was suggested that the apoptotic rate in granulosa cells was significantly higher in antral follicle from the PCOS rats than in those from the control rats. TRAIL played a role in regulating the apoptosis of granulosa cells in PCOS rats.

AIM: To investigate the changes of intraocular pressure (IOP) and associated factors of IOP elevation after 4mg intravitreal injection of triamcinolone acetonide (IVTA) in treatment of macular edema.METHODS: The study is prospective, consecutive, and non-comparative interventional case series including 93 eyes with macular edema associated with retinal vein occlusion (n=54 eyes) or diabetic retinopathy (n=39 eyes), which received 4mg IVTA injection. The change in IOP was followed for all cases at pre-operation and 14 days, 1, 2, 3, 4, 5, and 6 months post-operation. Associated factors of IOP elevation were examined regarding baseline IOP, causal disease, age and gender.RESULTS: IOP increased significantly (P＜0.001) at 14 days 16.02± 2.45mmHg after injection and peaked at 18.80± 6.20 at 2 months post-injection (P＜0.001) from 14.85 ± 2.55 mmHg preoperatively. An IOP rise to the value higher than 21mmHg was observed in 2 (2.2%) eyes 14 days after injection and which was observed in 14 (15.1%), 18(19.5%),9(9.6%), 4(4.3%), 0, and 0 eyes respectively at 1, 2, 3, 4, 5,and 6 months after injection. One eye (0.01%) showed pressure elevation of over 5mmHg than baseline 14 days after injection and IOP peaked to 22 mmHg (23.7%) at 2 months after injection. Five (5.3%) eyes had an increase of 10mmHg at 1 month and IOP peaked to 12mmHg (12.9%) at 2 months after injection. The rise in IOP was statistically associated with younger age (correlation coefficient -0.18- -0.29, P ＜0.05), high baseline IOP (correlation coefficient 0.52-0.79, all P ＜0.001),and the presence of diabetes mellitus (correlation coefficient 023, P＜0.001) but independent of gender (correlation coefficient -0.002-0.04, all P ＞0.05). In all eyes, IOP could be lowered to the normal range with topical medication, without development of glaucomatous optic nerve head changes.CONCLUSION: Elevated IOP after 4mg IVTA injection is common and patients should be monitored beyond 6 months post-injection. In all the cases, IOP can be normalized by topical medication. Patients with high baseline IOP, diabetic retinopathy, and younger age should be carefully monitored for an elevated IOP.

Objective To investigate the effect of dietary fiber on carbohydrate metabolism of healthy volunteers after the intake of corn starch meal. Methods Totally 12 healthy volunteers aged (25. 8 ± 5. 3) years were enrolled in this study, and they were equally randomly divided into two groups (group A and group B). This was an open, randomized, cross-over, and two-period study, and each period lasted for one day. In period 1, the subjects in group A received fiber-free corn starch and group B received high-fiber corn starch (containing 16 g dietary fiber). In period 2, the two groups are crossed. There was a one-week wash-out time between the two study days. On the study day, breath samples of fasting and 0. 5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0,7. 0, 8. 0 hours post meal were collected to measure13 CO2. Results The delta over baseline at 0. 5, 1.5, 2. 0,2. 5, 3. 0, 4. 0 hour after test meal in fiber free group and in high fiber group were 0. 79, 2. 03, 2. 57, 2. 86,3. 02, 3. 18 and 0. 16, 1. 33, 1.77, 2. 10, 2. 34, 2.42, respectively (the P value was 0. 014, 0. 014, 0. 011,0.018, 0. 036, and 0.020, respectively). Peak concentration of delta over baseline of fiber free group and high fiber group was 3.18 and 2. 56 respectively, there was no significant difference between two groups (P > 0. 05) ,peak time of the group at 4. 0 hour and 3. 5 hour respectively, showed significant difference (P = 0. 032). The cumulative percentage dose recovered 0. 5-6. 0 hours after test meal in fiber-free group and in high-fiber group were 0.41, 1.46, 3.15, 5.50, 8.28, 11.30, 14.42, 17. 62, 23. 65, 28. 78 and 0. 09, 0. 55, 1.61, 3.22,5.23,7.53, 10.09, 12.68, 17.60, 22.27 respectively (the P value was 0.014, 0.018, 0.018, 0.014, 0.013,0.014, 0.018, 0.020, 0.025, and 0.044, respectively). However, there was no significant difference 6.0 hours after meal (P > 0. 05 ). Conclusion The dietary fiber used in this study can delay the absorption of carbohydrate 6. 0 hours within intake without influencing its total absorption amount.

To carry out the teaching of hospital management in-depth and improve teaching quality, the group of teaching hospital management in 2010, through questionnaires, discussion and other forms, found out and analyzed the teaching situation, including the nature of this course, start time and hours, teacher team, teaching content, teaching methods, evaluation form, and so on. The result was that most students thought it not necessary to open so many courses. Then the article put forward some suggestions and countermeasures to further improve the management course.

Objective:To establish the quality standard for two effective components in extractum glycyrrhizae capsules. Methods:Radix glycyrrhizae was identified by a TLC method. The contents of liquiritin and ammonium glycyrrhizinate in extractum glycyrrhizae capsules were determined by HPLC. An Inertsil C18 (150 mm × 4. 6 mm, 5μm) column was used. The mobile phase consisted of ace-tonitrile (A)-0. 2％ phosphoric acid (B) (0-8 min: 20％A-20％A;8-34 min: 20％A-50％A;34-35 min: 50％A-100％A;35-40 min:100％A-20％A) at a flow rate of 1. 0 ml·min-1 . The detection wavelength was at 237 nm under 25℃. Results: The spots in TLC were clear. Liquiritin showed a good linear relationship within the range of 0. 0020-0. 1000 mg·ml-1(r=0. 9995). The aver-age recovery was 100. 29％, and the RSD was 2. 94％(n=6). Ammonium glycyrrhizinate showed a good linear relationship within the range of 0. 0020-0. 1000 mg·ml-1(r=0. 9998). The average recovery was 101. 46％, and the RSD was 2. 33％(n=6). Conclu-sion:The method is simple,reliable and reproducible, which can be used for the quality control of the preparation.

Objective:To optimize the extraction process of Hegan Lidan granules. Methods:In order to choose the optimal tech-nological parameters, the content of baicalin was determined by HPLC. An orthogonal method was utilized with solvent volume, extrac-tion time and extraction times as the impacting factors and the content of baicalin and extraction rate as the indices. Results:The opti-mal parameters were as follows:using 8-fold water as the solvent, the raw material was extracted three times with 2 h for each. Con-clusion:The process is steady and feasible, and can be used in the extraction of Hegan Lidan granules.