Objective:To analyze the genetic evolution and molecular characteristics of H5N8 avian influenza viruses (AIVs) isolated from the poultry in a live poultry market (LPM) in Urumqi, Xinjiang.Methods:Oropharyngeal and cloacal swabs of poultry were collected from a LPM in Urumqi in 2016. AIVs were isolated by inoculating swab samples into chicken embryos. Hemagglutination test and RT-PCR were used to identify the AIVs. The genes of isolated AIVs were amplified with the universal primers of AIV and whole-genome sequencing was also performed. Pairwise sequence alignment and analysis of phylogenetic and molecular characteristics were performed using BLAST, Clustal W, MEGA-X and DNAStar software.Results:Five H5N8 AIVs were isolated from poultry. These strains shared a nucleotide identity of 99.70%-100.00%, which indicated that they were from the same source, and were named XJ-H5N8/2016. Phylogenetic analysis based on hemagglutinin( HA), NS and PB2 genes showed that these isolates were clustered together with H5N8 AIVs isolated from the migratory swans in Hubei, Shanxi and Sanmenxia, and the ducks in India during 2016 to 2017. Moreover, they were also clustered together with H5N6 AIVs isolated from minks in China and the first case of human infection in Fujian. The phylogenetic tree of neuraminidase( NA) gene indicated the five isolates clustered together with H5N8 AIVs isolated from ducks in India in 2016, and the phylogenetic trees of PB1, MP, PA and NP genes showed that they were clustered together with H5N8 AIVs isolated from wild birds and poultry in Egypt, Cameroon, Uganda, Congo and other African countries in 2017. The HA cleavage sites of XJ-H5N8/2016 contained five consecutive basic amino acids, indicating high pathogenicity. Multiple mutations in the genes of XJ-H5N8/2016 could enhance its virulence and pathogenicity to mammals. Conclusions:The five strains of H5N8 AIVs isolated from the LPM were highly pathogenic and closely related to the H5N8 AIVs isolated from migratory birds and poultry in Hubei, Shanxi, Sanmenxia area, Africa and India during 2016 to 2017. Meanwhile, some of the viral genes were also closely related to the H5N6 AIVs isolated from the minks and human in China. Multiple mutations could increase the virulence and pathogenicity of AIVs to mammals, which could pose a potential threat to public health.

Objective:To analyze phylogenetic structure and molecular characteristics of H5N6 avian influenza virus (AIVs) isolated from live poultry market (LPM).Methods:Oropharyngeal and cloacal swabs from poultry, and environmental samples were collected from LPM in Urumqi in December 2018, AIVs were isolated and identified by inoculation of chicken embryo, hemagglutination test and RT-PCR, the viral whole genome was amplified with the universal primers of influenza A virus, and then sequenced, pairwise sequence alignments, phylogenetic and molecular characteristics analysis were performed by BLAST, Clustal W, MEGA-X and DNAStar software.Results:Six strains of H5N6 AIVs were isolated from poultry samples, the identity between the viral genes was high (99.4%-100.0%), so the isolates were the same source. BLAST analysis revealed that the viral NP sequence had the highest identity (99.7%) with H5N6 AIVs isolated from poultry in Suzhou, while the sequence of the remaining 7 viral genes had the highest identity (99.0%-100.0%) with H5N6 AIVs isolated from environment in Guangdong during 2017 to 2018. Phylogenetic analysis showed that the viral HA belonged to Clade 2.3.4.4C, and the viral HA, NA, PB1, PA, NP, and MP were all clustered together with H5N6 AIVs isolated from mink in Eastern China in 2018, while the PB2 and NS were clustered together with H5N6 AIVs isolated from environment in Guangdong from 2017 to 2018. The HA cleavage site contained multiple basic amino acid residues, which was highly pathogenic AIVs (HPAIVs). S137A and T160A mutations of HA could increase binding to human-type receptor SAα2, 6-Gal. Additionally, the viral multiple mutations, including 59-69 deletion in NA, the L89V, G309D, R477G, I495V, I504V, D391E, and A661E in PB2, as well as the P42S, D92E, and 80-84 deletion in NS1, could enhance the viral virulence and pathogenicity to mammals. Conclusions:The 6 strains of H5N6 HPAIVs isolated from LPM have relatively close genetic relationship with H5N6 AIVs isolated from mink in Eastern China and environment in Guangdong during 2017 to 2018, the viral multiple mutations could increase its pathogenicity to mammals, which could pose a potential risk to public health.

Objective To observe the effects of rehabilitation intervention on the quality of life (QOL) of patients after coronary artery bypass grafting. Methods Fifty-eight hospital patients in need of coronary artery by-pass grafting (CABG) were randomly assigned to a cardiac rehabilitation group ( rehab ; n = 31 ) or a routine care group (control; n = 27 ). In the rehab group, patients received progressively increasing movement and appropriate psychological intervention. Changes in the medical outcome study short form (SF-36) scores and 6 min walk dis-tances (6MWDs)as well as the length of post-operative stays in hospital were observed in both groups. Results Compared with the control group, patients in the rehab group scored significantly higher on the SF-36. Their physical functioning, general health, vitality, role-emotion and mental health scores improved significantly, their final 6MWDs were longer, and they had significantly shorter average hospital stays after the operation. Conclusions Rehabilita-tion training can improve QOL for patients after coronary artery bypass grafting.

Objective To investigate the strategies of reducing the incidence of missed diagnosis of severe traumatic brain injuries combined with multiple trauma. Methods Data of 432 patients with severe traumatic brain injuries and multiple trauma (ISS≥20) from January 2000 to August 2007 were analyzed retrospectively. All patients were divided into missed diagnosis group (MD group, n =54) and non-missed diagnosis group (NMD group, n =378) for correlation analysis on ISS, GCS, anatomical locations of the missed diagnosis, the time of delayed diagnosis and the prognosis. Results ISS was (42.97±10.94) points in MD group, with statistical difference compared with NMD group (P < 0.05). The patients with GCS≤8 in MD group was more than those in NMD group (P < 0.05). Conclusions It is effective to prevent missed diagnosis and improve the survival of patients with severe traumatic brain injuries combined with multiple trauma by judging injury severity quickly and precisely based on the principle of "life first" and repeated and systemic physical examination.

Objective To observe the effects of rehabilitation on the quality of life and capacity of aerobic exercise in patients after coronary artery bypass graft. Methods 58 patients after coronary artery bypass graft were divided into rehabilitation group (n=31) and control group (n=27). Patients in the control group received routine drug treatment out of hospital, while the rehabilitation group was guided regularly for rehabilitation. All patients were surveyed with the MOS item short form health survey (SF-36) and 6 min walking test on the 15th and the 90th day after operation. Results Compared with the control group，the scores of all the items of SF-36 in rehabilitation group improved (P<0.01) except in body pain. The result of 6MWT was also higher in rehabilitation group than in controls(P<0.01). Conclusion Rehabilitation can improve capacity of aerobic exercise and the quality of life of patients after coronary artery bypass grafting.

OBJECTIVE To comprehend the mycoetiology of recurrent vulvovaginal candidiasis(RVVC),and to analyze the drug resistance of pathogens.METHODS Vaginal secretion samples extracted from the cases which were diagnosed RVVC were inoculated and identified by coloration medium.Susceptibility test was carried out by Rosco scrip diffusion method.RESULTS Totally 178 monilias were isolated from 159 RVVC samples.From them 122(68.5%) were Candida albicans,49(27.5%)C.glabrata.The susceptibility test result of C.albicans was as follows: to amphotericin B(100.0%),clotrimazole(100.0%),mycostatin(99.2%),ketoconazole(KCZ)(99.2%),and miconazole(36.9%).That of non-C.albicans was to mycostatin(100.0%),amphotericin B(98.2%),econazole(96.4%),fluconazole(60.7%),and terbinafine(0).CONCLUSIONS C.albicans and C.glabrata are the main pathogenic fungsi which induce RVVC,non-C.albicans infection is upgraded manifestly,so fungus culture and susceptibility test must be done.Mycostatin,KCZ,and clotrimazole are the first selection for treatment of RVVC.

OBJECTIVE To investigate mechanisms of sulfamethoxazolel trimethoprim(SMZco) resistance in multi-drug-resistant strains of Shigella.METHODS The strains of multi-resistant Shigella were selected with K-B susceptibility method.The genes(sul1,dfrA1,dfrA5,dfrA12 and dfrA17) of SMZco resistance were detected by polymerase chain reaction(PCR).And using the DNA sequencing determined that bears the genotype.RESULTS In 20 Shigella strains the drug-resistance rate of Shigella to SMZco was 95.0%.Sul1,dfrA1,dfrA12 and dfrA17-positive rate was 15.0%,100.0%,5.0% and 0,DfrA1 positive gene sequencing showed highly homology with the sequence of GenBank.CONCLUSIONS There is a close relation of the SMZco resistance in Shigella to sul1 and dfrA1 existing.

OBJECTIVE To investigate mechanisms of chloramphenicol resistance in multi-drug-resistant strains of Shigella.METHODS The strains of multi-resistant Shigella were detected with K-B susceptibility method.The genes(catB,cmlA)of chloramphenicol resistance were detected by polymerase chain reaction(PCR)and the DNA sequencing.RESULTS In 20 strains,the drug-resistance rate of Shigella to chloramphenicol was 70.0%.Two strains carried cmlA but no catB detected was out.The cmlA gene product sequence showed it was cmlA1.CONCLUSIONS The multiple-drug resistante cmlA1 is detected out.This is the first report in China.

OBJECTIVE To study the constituent ratio of the pathogentic bacteria of the newborn omphlitis and their resistance.METHODS The bacteria were identified by ATB-Expression system and antibiotic susceptibility tests.RESULTS Of the specimens in 153 cases,there were 136 positive strains(88.9%).From high to low,Staphylococcus aureus occupied 26.5%,S.epidermidis occupied 16.2%,S.haemolyticus occupied 13.2%,Klebsiella pneumoniae occupied 13.2%,and Escherichia coli occupied 9.6%.Piperacillin/tazobactam,vancomycin,meropenem and imipenem had low drug resistance(2.0%) that doctors could choose the drugs according to pathogenic bacteria.MRSA occupied 13.9%,MRCNS occupied 73.2%.E.coli and K.penumoniae of ESBLs accounted for 21.4% and 44.4%.CONCLUSIONS The main pathogentic bacteria of the newborn omphlitis are S.aureus,S.epidermidis,S.haemolyticus,and K.pneumoniae.Doctors select the antibiotics according to the results of susceptibility test.It is necessary to advise how attend to the newborn in order to decrease the newborn omphlitis.

Objective To study the significance of rDNA transcription activity of peripheral blood T lymphocyte in patients with urinary tract tumors. Methods rDNA transcription activity of peripheral T lymphocyte was detected by a cell image analysis of Ag-NOR in 21 patients who were pathologically diagnosed with kidney cancer (including 6 cases of T_1N_0M_0,9 of T_2N_0M_0,4 of T_3N_0M_0 and 2 of T_4N_2M_1) and in 42 patients with bladder tumor (including 14 cases of TaN_0M_0,11 of T_1N_0M_0,1 of T_1N_0M_1,8 of T_2N_0M_0,4 of T_3N_0M_0 and 4 of T_4N_0M_0).Twenty-eight normal volunteers served as controls and 23 patients with uremia as positive controls.The peripheral blood was taken for detection of Ag-NORs in controls and in tumor patients before and after operation.The differences were compared among these groups. Results rDNA transcription activity of T cells was (8.55?1.11)%,(6.29?0.97)%,(5.44?0.68)% and (5.42? 0.68)% in controls and patients with uremia,renal and bladder tumors,respectively,showing a statistically significant difference among the normal uremia and tumor patients (P0.05).The parameters,such as TNM stages of renal and bladder tumor,the cell grades according to WHO criteria,tumor volume of the kidney,and invasion depth and recurrence frequencies of bladder tumors,had no significant correlation with rDNA transcription activity of T cells. Conclusions rDNA transcription activity of T cells may be used for monitoring the immune function in patients with kidney and bladder tumors,especially for primary screening of urinary tract tumors.