Objective: To study the correlation between the level of T-bet expression and liver damage in peripheral plasma cells of patients with autoimmune hepatitis (AIH) in order to provide reference for the study of pathogenesis and development of diseases. Methods: The peripheral venous blood and clinical examination data of 29 cases with AIH and 6 healthy volunteers were collected. The percentage of subpopulations of peripheral blood B cells and the proportion of T-bet⁺ cells in each subgroup were detected by flow cytometry. Plasma cells (CD19⁺CD10^-CD27^hiCD38^hi), primary B cells (CD19⁺CD10^-CD27^-IgD⁺), transitional B cells (CD19⁺CD10⁺), and memory B cells (CD19⁺CD10^-CD27⁺IgD^-) were the included subsets of B cells. Serum immunoglobulin G (IgG) and alanine aminotransferase (ALT) levels, the proportion of B cells in peripheral blood subsets and IgG level, the proportion of T-bet⁺ cells in each subset and the proportion of T-bet⁺ plasma cells in each subset in B cells, the proportion of T-bet⁺ plasma cells and the level of serum ALT were analyzed for correlation analysis. Statistical analysis was performed using two independent sample t-tests and linear regression. Results: The serum IgG level of AIH patients with abnormal ALT (19.47 ± 1.039)g/L was significantly higher than that of normal ALT patients (15.5 ± 1.069)g/L, and the difference was statistically significant (t = 2.65, P < 0.05). The percentage of peripheral plasma cells in B cells of AIH patients (2.80 ± 0.14) % was higher than that of healthy volunteers (0.73 ± 0.09) %, and the difference was statistically significant (P < 0.01). The percentage of T-bet⁺ cells in peripheral plasma cells of AIH patients (23.54 ± 1.61) % was higher than that of healthy volunteers (6.59±0.59) % , and the difference was statistically significant (P < 0.01). The correlation analysis showed that the proportion of T-bet⁺ cells in peripheral plasma cells of AIH patients was positively correlated with the proportion of plasma cells to B cells (r = 0.224 7, P < 0.01), and the percentage of peripheral plasma cells to B cells was positively correlated with the level of serum IgG (r = 0.299 1, P < 0.01). Serum IgG level was correlated with the level of ALT, reflecting an indicator of liver damage (t = 2.65, P < 0.05). Conclusion The increase of T-bet expression in the peripheral plasma cells of AIH patients is associated with liver damage, which is a new mechanism of AIH pathogenesis and disease progression.

Objective: Laboratory-based characterization and traceability were performed on an outbreak of necrotising enterocolitis (NEC) happened in a maternal and child health care hospital in China. Methods: Thirty-seven samples were collected from 3 NEC cases, that the clinical manifestations was bloody stools. Clostridium spp. isolation and identification were carried out on stool, breast milk, milk-based infant powder and environmental swab samples collected during NEC outbreak from October to November in 2016. Meanwhile, twenty-four swabs samples from ward environmental, staffs' hand as well as articles for neonates daily use were also collected and tested for Clostridium spp. after disinfection following outbreak. Pulsed-field gel electrophoresis (PFGE) analysis was performed on all Clostridium strains obtained. Results: 46% (17/37) samples were positive for a presumptive Clostridium spp. during the outbreak of NEC. One type of Clostridium spp. isolates was cultured from 10 samples including the hands of medical staffs, some medical equipments in the ward and milk-based infant powder ingested by the case, it was identified as C.butyricum. Another type of Clostridium spp. isolates was cultured from 2 samples including breast milk and inner wall of breast milk fresh-keeping bag, it was identified as C.sporogens. Both of these two types isolates were cultured from 5 samples including inner wall of breast milk box, inner wall of refrigerator, the handle of case's incubator and the case's stool. PFGE analysis showed that all 15 strains of C. butyricum and 7 strains of C.sporogens isolated from the samples mentioned above produced indistinguishable pulsotypes respectively. No NEC cases were found after disinfection following the outbreak and all samples collected after outbreak were negative for Clostridium spp. Conclusion The outbreak of NEC was highly related to C. butyricum contamination within the hospital.

Objective: To analyses the antimicrobial resistance and molecular characterization of 21 MRSA isolates cultured from retail foods from different provinces in China, and evaluate the molecular typing methods. Methods: Twenty-one MRSA isolates were obtained from national foodborne pathogen surveillance network in 2012 (Chinese salad, n=3; milk, n=1; cake, n=2; rice, n=1; cold noodle, n=1; spiced beef, n=1; dumpling, n=1; packed meal, n=1; salad, n=1; raw pork, n=9). The antimicrobial resistance of 21 strains to 12 antimicrobial agents was tested by broth dilution method. Polymerase chain reaction (PCR) and DNA sequencing were performed to obtain the genetic types of MLST (ST) and spa typing. The clonal complex (CC) was assigned by eBURST soft and the MLVA type (MT) and MLVA complex (MC) were identified via the database of the MLVA website (http://www.mlva.net). SmaI pulsed-field gel electrophoresis (SmaⅠ-PFGE) was also carried out to obtain the PFGE patterns of 21 strains. The genetic diversity and discriminatory power of typing were calculated by the Simpson's index of diversity (diversity index, DI) to find out the best genotyping method for MRSA. Results: All MRSA isolates showed multi-drug resistance(MDR), and were resistant to oxacillin, benzylpenicillin, clindamycin and erythromycin, and 71.4% (15/21), 47.6% (10/21), 42.9% (9/21) and 28.6% (6/21) of the MRSA isolates were resistant to tetracycline, ciprofloxacin, trimethoprim/sulfamethoxazole and gentamicin, respectively. Moreover, one strain was found to be resistant to all three antimicrobials of levofloxacin, moxifloxacin and rifampicin. Great diversity was found in these food-associated MRSA (6 STs, 7 spa types, and 9 MTs). PFGE patterns were more diverse than those of other three molecular typing methods (19 pulse types). The index of diversity (DI) of PFGE, MLVA, spa typing and MLST was 0.99, 0.80, 0.73, and 0.61, respectively. Among the MRSA isolates, CC9-ST9-t899-MT929-MC2236 (PFGE Cluster Ⅴ) was the most prevalent clone, which were all cultured from raw pork (9 isolates). Besides, two MRSA were identified as CC59-ST338-t437-MT621-MC621 (PFGE Cluster Ⅳ). Different clone had their own resistance spectrum profiles. Conclusion The food-borne MRSA isolates were all MDR in this study. Different clones had their own resistance spectrum profiles. MLVA represented a promising tool for molecular epidemiology tracing of MRSA in foodborne disease events.

Objective To compare predictive power for deep vein thrombosis among hip and knee joint replacement patients using Autar scale and Wells scale.Methods Convenience sampling method was used.Totally 331 patients from ten tertiary hospitals receiving hip and knee joint replacement were recruited.General information questionnaire,Autar scale and Wells scale were used to collect data.Telephone follow-up was performed at 2 weeks,1 month and 3 months after hospital discharge.The primary endpoint of follow-up was occurrence of DVT,and the secondary endpoint was no occurrence of DVT within 3 months after hospital discharge.Results The Cronbach's α coefficients of Autar scale ranged from 0.716 to 0.762 for scores 24h before operation,24h after operation and at the day of discharge,and those of Wells scale ranged from 0.580 to 0.603.The area under the ROC curve of Autar scale ranged from 0.726 to 0.798.The area under the ROC curve of Wells scale ranged from 0.568 to 0.628.Conclusion The predictive power of Autar scale was higher than that of Wells scale which enabled Autar scale to better predict deep vein thrombosis for patients receiving hip and knee joint replacement.

Objective To study the effect of fast tract surgery (FTS) used in patients undergoing total knee arthroplasty (TKA). Methods For the experimental group, 341 inpatients with TKA in the Joint Surgery Department of Shandong Provincial Hospital from June 2014 to June 2015 were treated with FTS nursing measures. For the control group, 355 inpatients with TKA of the same department from January 2013 to May 2014 were treated with conventional nursing measures. The effects of FTS nursing measures, the parameters of patients′ postoperative complications, average hospitalization days and the function recovery of knee joint were evaluated respectively. Results After implementing the FTS nursing measures , the incidence of deep venous thrombosis of lower limbs reduced from 8.45%(30/355) to 2.35%(8/341) (χ2=2.340, P<0.05). The average hospitalization days treated without/with FTS nursing measures were:unilateral knee (14.49±3.62) days (without FTS) vs. (11.95±4.53) days (with FTS), bilateral knees (15.80± 3.01) days (without FTS) vs. (13.19±4.08) days (with FTS)(t=3.166, P<0.05). Two weeks after surgery, the HSS scores in the experimental group was 65.72 ± 5.54, while the HSS scores in the control group was 52.43 ± 7.32 (t=2.452, P < 0.05). Three months after surgery, the HSS scores in the experimental group was 88.72 ± 7.10, while the HSS scores in the control group was 72.14 ± 8.73 (t=2.528, P < 0.05). Conclusions FTS nursing measures could significantly reduce the incidence of deep venous thrombosis of lower limbs, shorten the hospitalization days of inpatients, and promote the functional recovery of knees.

Objective To evaluate the effect of early exercise intervention on deep venous thrombosis (DVT) after joint replacement.Methods 100 patients with joint replacement were divided into observation group including 50 cases and control group including 50 cases by random number table method.Early exercise intervention was used in observation group and usual nursing was used in control group.The hemodynamic index (femoral vein blood flow peak velocity and average velocity) and DVT incidence were compared between the two groups.Results After the intervention for 3 days,the femoral vein blood flow peak velocity and average velocity of observation group respectively were (43.5±4.1) cm/s and (27.3±3.2) cm/s,those of control group respectively were(36.6±3.7) cm/s and (20.2±2.8) cm/s.The difference between the two groups was statistically significant (t=2.987,2.895,P ＜ 0.05).After the intervention for 7 days,the femoral vein blood flow peak velocity and average velocity of observation group respectively were (56.1±4.7) cm/s and (32.1±3.9) cm/s,those of control group respectively were (41.3±3.9) cm/s and (22.4±4.3) cm/s.The femoral vein blood flow peak velocity and average velocity of observation group significantly higher than control group(t=3.675,2.929,P ＜ 0.05).The DVT incidence of control group and observation group respectively were 40.0％(20/50) and 14.0％(7/50),showed significant differences between the two groups(x2=8.574,P=0.003).Conclusions Using the early exercise intervention on patients with joint replacement can effectively improve the lower limb venous blood flow velocity and prevent DVT.

ObjectiveTo study the epidemiological characteristics of diabetes mellitus and awareness rate in Zhejiang adults.MethodA total of 17 437 adults from 15 counties were randomly selected with stratified multi-stage cluster sampling method from July to November,2010.Each participant was required to complete a set of standardized questionnaire,physical examination,and blood specimen collection.ResultsThe overall standardized rate of diabetes mellitus was 5.94％ ( crude prevalence 8.80％ ).It was increased by 96.67％ during past 8 years,as compared with the prevalence 3.02％ in 2002.The standardized rate of diabetes mellitus of the urban and rural area were 7.52％ and 5.19％ ( crude prevalence 11.33％ and 7.09％ ),respectively.The standardized rate of diabetes mellitus in the urban was higher than rural ( u =6.58,P＜0.05 ).The standardized rate of diabetes mellitus of the male and the female were 5.74％ and 6.15％ ( crude prevalence 8.36％ and 9.13％ ),respectively,without significant difference ( u =1.39,P＞0.05 ).The awareness rate of diabetes mellitus was 59.19％ ( 56.66％ in male and 61.23 ％ in female,x2 =3.26,P＞0.05 ).The awareness rate of the urban was higher than the rural (63.47％ vs 54.69％,x2=12.20,P＜0.01 ).ConclusionThe prevalence of diabetes mellitus showed a rapidly rising trend in Zhejiang province.The effective intervention should be taken at its early stage.

OBJECTIVE: To investigate the available operation method of special type tracheobronchial foreign bodies removal. METHOD: Sixty one patients of special type tracheobronchial foreign bodies were extracted with some special instruments and methods depend on foreign body types. The features of operation on different kinds of foreign bodies were analyzed. RESULT: All patients were operated successfully by using foreign body hook (31 cases), pencil or writing screw brush extracted (11 cases), foreign body cage (13 cases), slender inverse claw esophagus foreign body clamp (3 cases) and so on. No complications and died cases were found. Only 5 patients were undertaken trachea incision before operation. CONCLUSION Suitable instruments and technique chose for every individual cases is the key to successful operation.
Adolescent ; Adult ; Aged ; Bronchi ; Bronchoscopy ; methods ; Child ; Child, Preschool ; Female ; Foreign Bodies ; surgery ; Humans ; Male ; Middle Aged ; Trachea ; Treatment Outcome ; Young Adult

Objective To investigate the association among oligospermatism,azoospermatism in male sterility patients and micro-deletion in AZF gene of Y chromosome and to establish a integrate clinical diagnostic method for screening micro-deletion in AZF gene in Chinese.Methods PCR method was used to detect micro-deletion in AZF gene in 62 oligospermatism and azoospermatism patients and 20 normal male controls.Results 13.64%(6/44) of oligospermatism patients and 22.22%(4/18) of azoospermatism patients presented micro-deletion.However,micro-deletion was not found in 20 normal male controls.Furthermore,micro-deletion occur mostly in AZFc region.Conclusion Micro-deletion of AZF gene from Y chromosome is one of the major risks for oligospermatism and azoospermatism.

Objective To observe the effect of drug pairs of extracts from Rhizoma Chuanxiong(RC)and Radix Paeoniae Rubra(RPR)in different proportions on promoting blood circulation and removing blood stasis in rats and to find the optimal proportion between the two extracts.Methods The Wistar rat models of blood stasis were established by injection of adrenalin.The changes of the platelet aggregation and adhesiveness and erythrocyte aggregation were observed.Results Blood vessel contraction increased,the platelet aggregation and erythrocyte aggregation increased,erythrocyte deformation occurred and the blood viscosity increased in the model rats.The drug pairs could reduce blood viscosity,ameliorate erythrocyte ability of deformation,reduce erythrocyte aggregation and inhibit platelet aggregation.The effects were obvious especially in the groups of RC and RPR in the proportions of 0.45 g to 0.45 g,0.21 g to 0.45 g.Conclusion The drug couples from RC and RPR in different proportions could improve the blood rheology,the effect being obvious in the groups of RC and RPR in the proportions of 0.45 g to 0.45 g,0.21 g to 0.45 g.