Chlamydia trachomatis (Ct) is the causative agent of bacterial sexually transmitted diseases (STDs) worldwide.The incidence of Ct infection has exceeded that of Neisseria gonorrhoeae,and becomes the highest in STDs in many countries.Ct infection can lead to urethritis,epididymitis,prostatitis and infertility in males,and cervicitis,endometritis,pelvic inflammatory disease,infertility in females,and neonatal conjunctivitis.Additionally,urogenital Ct infection is always ignored due to its concealed symptoms,leading to a long clinical course,recurrence or repeated infections.Furthermore,Ct infection can increase the risk of human immunodeficiency virus and human papilloma virus infections.Therefore,how to prevent and control the transmission of Ct has become one of the global public health issues.Currently,a growing body of researches have focused on the molecular epidemiological characteristics of Ct,which are aiming to identify the mutant strains,elaborate transmission dynamics,investigate the distribution of Ct serotypes in different populations,so as to provide molecular epidemiological evidence for the prevention and control of Ct infection.This review summarizes the epidemic status and research methods for molecular epidemiological characteristics of Ct,as well as application of Ct serotyping in clinical practice,providing references for the prevention,control and research of Ct infection.

Objective: To investigate the effect and mechanism of G protein coupled receptor 119 (GPR119) in regulating lipid metabolism. Methods: (1) Macrophage THP-1 was induced by oxidized low density lipoprotein (oxLDL) to the formation of lipid foam cells, protein expression of GPR119, hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) were detected by Western blotting. (2) Constructing GPR119 over-expressed and low-expressed plasmids, the plasmids were transfected into THP-1 cells which induced by oxLDL. The lipid content in macrophages was observed by oil red O staining. Cholesterol efflux was detected by liquid scintillation counter. The mRNA and protein expressions of HIF-1α, VEGF were detected by reverse transcription PCR and Western blotting. (3) Constructing GPR119, HIF-1α, and VEGF over-expressed plasmids, then co-transfection of GPR119 and HIF-1α/VEGF plasmids. The lipid content in macrophages was observed by oil red O staining. Cholesterol efflux was detected by liquid scintillation counter. Results: Compared with the control group, the lipid droplets were densely distributed in macrophages, with a large number and volume. The protein expression of GPR119 was significantly decreased and HIF-1α, VEGF were significantly increased in macrophages induced by oxLDL (P<0.05). After over-expression of GPR119, the lipid droplets were sparsely distributed and the number was significantly reduced in macrophages, the lipid droplets were mostly located in the area around the cells. The cholesterol efflux was significantly increased (P<0.01). The mRNA and protein expressions of HIF-1α and VEGF were significantly decreased (P<0.01). On the contrary, in the GPR119 inhibition group, the lipid droplets were densely distributed in macrophages, with a large number and volume. The lipid droplets even covered the nuclei. The cholesterol efflux was significantly reduced (P<0.05). The mRNA and protein expression of HIF-1α, VEGF were significantly increased (P<0.05). After GPR119 were co-expressed with HIF-1α and VEGF, the number of lipid droplets was increased, lipid droplets were dense and bulky in oxLDL-induce macrophages. The cholesterol efflux was inhibited. Conclusion GPR119 can regulate lipid metabolism and possibly by down-regulating the expression of HIF-1α and VEGF.

Objective To investigate the clinical risk factors of delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH).Methods From January 2015 to April 2016,106 consecutive patients with aSAH treated with endovascular embolization at the Department of Neurosurgery,Nanjing General Hospital of Nanjing Military Command were enrolled retrospectively.The patients were divided into either a DCI group (n =34) or a non-DCI group (n =72) according to whether the occurrence of DCI.The general information of patients were collected,including sex,age,Hunt-Hess grade,modified Fisher grade,world federation of neurosurgical societies (WFNS) grade,acute cerebral edema,early (bleeding 1-3 d) hypoalbuminemia,and hypohemoglobinemia.Univariate and multivariate Logistic regression analyses were used to analyze the risk factors for occurrence of DCI.Results The incidence of DCI was 32.1％ (34/106).The Hunt-Hess grade ≥ Ⅲ,modified Fisher grade ≥ Ⅲ,WFNS grade ≥ Ⅳ,acute cerebral edema,the incidences of hypoalbuminemia and hypohemoglobinemia in the DCI group were higher than those in the non-DCI group.There were significant differences between the 2 groups (all P ＜ 0.05).There were no significant differences in the ratios of sex,age ≥ 55 years,hypertension,diabetes and hyponatremia between the 2 groups (all P ＞ 0.05).In univariate analysis,the Hunt-Hess grade ≥ Ⅲ grade,modified Fisher grade ≥ Ⅲ,WFNS grade ≥ Ⅳ on admission,and hypoalbuminemia were used as the independent variables for multivariate analysis,the results showed that WFNS grade ≥ Ⅳ (OR,8.02;95 ％ CI 2.41-26.70),modified Fisher grades ≥ Ⅲ (OR,4.44;95％ CI 1.38-14.32),and hypoalbuminemia at day 1-3 (OR,5.42;95％ CI 1.40-20.76) were the independent risk factors for occurring DCI in patients with aSAH (all P ＜ 0.05),and the Hunt-Hess grade ≥ Ⅲ was not the risk factor for occurring DCI in patients with aSAH (OR,1.86;95％ CI 0.39-8.88,P ＞ 0.05).Conclusion The patients with hypoalbuminemia,WFNS grade≥Ⅳ on adrnission,and modified Fisher grade ≥ Ⅲ may were the independent risk factors DCI after aSAH,and the clinical diagnosis and treatment should attach great importance to.

Objective To explore the curative effect and adverse reaction of applying stereotactic radiotherapy to primary lesion inside chest cavity of patients with oligometastasis non-small cell lung cancer and rendering radical radiotherapy to all metastases. Methods 43 patients with≤5 metastases of non-small cell lung cancer received initial treatment during 2009-2015 in our department were analyzed;the stereotactic radiotherapy was adopted to implement radical radiotherapy on primary lesion and all metastases. The average and neutral position BED10 respectively were 101416 Gy and 102700 Gy,the number of neutral position chemotherapy period was 4. Kaplan-Meier method, survival analysis, Cox model, multi factor Prognosis analysis were used. Results By the end of January 10,2017 in 36 months' neutral position follow-up visit, the total effective rate of lesion treatment of 86%;the survival rates after 1,2 and 3 years respectively were 74%, 70% and 51%. Neutral survival time was 48 months, and the progression-free time of neutral position was 15 months. Multi-factor analysis indicated that,ECOG<2 and ECOG≥2(P=0000),BED10<100 Gy and BED10≥100 Gy ( P=0006) generated obvious influence on survival prognosis. About 90% of the patients only got 1-2 degree of adverse reaction without emerging treatment related death. Conclusions On the premise of systematic therapy of oligometastasis non-small cell lung cancer, combined with radical radiotherapy of primary lesion and metastasis can obviously improve patients ' overall survival and progression-free survival,the adverse reaction is durable.

Objective To investigate the effectiveness and safety of endovascular embolization for the treatment of middle cerebral artery aneurysms. Methods From March 2007 to May 2015,the clinical data of 170 patients with 173 middle cerebral artery aneurysms treated with endovascular embolization at the Department of Neurosurgery,Nanjing Jinling Hospital were analyzed retrospectively,including 120 (69.4%)ruptured aneurysms and 53 (30. 6%)unruptured aneurysms. The incidence of complications and prognosis were compared between the 2 groups. Results (1)A total of 170 patients who could perform endovascular embolization after preoperative evaluation successfully completed the interventional procedure. None of the patients died. (2)18 patients (10. 6%)had intraoperative and postoperative complications,including 4 (7. 5%,4/53)in the unruptured aneurysm group and 14 (11. 7%,14/120)in the ruptured aneurysm group. There was no significant difference in the incidence of complications between the two groups. (3)101 patients were followed up for 3-48 months. No new nervous system symptoms and reruptured aneurysm were observed. One patient had recurrence in the unruptured aneurysm group and 4 had recurrence in the ruptured aneurysm group. Conclusion Endovascular treatment of middle cerebral artery aneurysms is a safe,effective,and feasible technique.

Objective To determine the prevalence of penicillinase-producing Neisseria gonorrhoeae(PPNG) and the distribution of blaTEM-135 gene variants in PPNG at several gonococcal antimicrobial surveillance sites in China, to compare N. gonorrhoeae multi-antigen sequence typing(NG-MAST)types of PPNG and its blaTEM-135 gene variants, and to assess the difference and association in NG-MAST types of blaTEM-135 gene variants among different regions. Methods A total of 572 N. gonorrhoeae isolates were collected at 6 gonococcal antimicrobial surveillance sites from Jiangsu, Shanghai, Zhejiang, Tianjin, Guangdong and Guangxi in 2012. After isolation, purification, and identification, cefalotin paper discs were used for detection of PPNG. DNA was extracted by QIAxtractor DX kits after cultivation of the PPNG strains. Then, mismatch amplification mutation assay (MAMA) PCR was performed to identify blaTEM-135 variants, and NG-MAST analysis to determine N. gonorrhoeae genotypes. Results Among the 572 N. gonorrhoeae strains, 38.1%(218/572) were identified as PPNG, and of the PPNG strains, 52.3% (114/218) were blaTEM-135 variants. The detection rate of PPNG at these surveillance sites from high to low was as follows: 51.7% (45/87, Zhejiang), 45.6%(36/79, Shanghai), 38.0% (78/205, Guangdong), 37.5% (12/32, Guangxi), 31.2% (24/77, Jiangsu) and 25.0%(23/92, Tianjin), and that of blaTEM-135 variants was as follows: 68.9%(31/45, Zhejiang), 58.3%(14/24, Jiangsu), 50.0%(39/78, Guangdong), 47.2%(17/36, Shanghai), 39.1%(9/23, Tianjin)and 33.3%(4/12, Guangxi). NG-MAST analysis showed that the ST2318, ST1768, ST1866, ST1053 and ST8726 types predominated among these bla TEM-135 variants, and a strong correlation was found between blaTEM-135 variants and some NG-MAST types, such as ST1768, ST1053 and ST8726 types. The distribution of NG-MAST types was significantly different between the surveillance site in Tianjin (in the Northern part of China) and the other sites (in the Southern part of China), but highly similar among the surveillance sites in Jiangsu, Zhejiang and Shanghai regions. Conclusions There is a high prevalence of PPNG and its blaTEM-135 variants at several gonococcal antimicrobial surveillance sites in China, with significant differences in NG-MAST genotype distribution of PPNG and its blaTEM-135 variants among different regions.

Objective To investigate the preoperative and intraoperative assessed values of the color-coded digital subtraction angiography (DSA ) for intracranial arteriovenous malformation (AVM). Methods Fifteen patients with AVM performed preoperative routine whole brain DSA were analyzed retrospectively,and the iFlow software was used to perform color-coded DSA of image post-processing. A comprehensive analysis such as the range of lesions,vascular architecture and hemodynamics of AVM was conducted on the two-dimensional DSA images and color-coded DSA. Results Of the 15 patients with AVM,9 were small-sized (including 4 nidi showed diffuse type),3 were medium-sized,and 3 were large-sized;8 patients had single feeding artery,and 7 had multiple feeding arteries;11 had single draining vein,and 4 had multiple draining veins. When showing the size of AVM nidus,particularly diffuse type nidus, the color-coded DSA was clearer than the two-dimensional image. The color-coded DSA could visually display the traveling of the superficial and deep draining veins,at the same time,the primary and secondary draining veins could be identified according to the size of the area under the curve and the full width at half maximum,and intuitively reflected the complete cycle of cerebral blood flow. Conclusion The color-coded DSA can quickly and accurately depict the range of AVM,angioarchitecture features and intraoperative hemodynamic changes.

Objective Toinvestigatetheapplicativevalueof3D-DSAandheadMRIorCTfusion technology for guiding the individualized treatment of intracranial arteriovenous malformation (AVM ). Methods Twenty-onepatientswithAVMdiagnosedwithDSAattheDepartmentofNeurosurgery,Nanjing General Hospital of Nanjing Military Command from January 2015 to May 2015 were analyzed retrospectively. All patients performed DSA,MRI,and CT scan respectively before procedure,and they also performed 3 D-DSA and MRI or CT fusion. Of the 21 patients,15 performed MRI and 3D-DSA fusion,6 performed CT and 3D-DSA fusion. According to the image fusion results of the patients,the individualized treatment regimens were further developed,including microsurgical resection,endovascular embolization,and stereotactic radiotherapy (alone or combined treatment). The patients were followed up and observed for 2 to 6 months after procedure.Results Fromthe3D-DSAwithheadMRIorCTfusionimagesofthepatientsbeforetheprocedure not only could observe the vascular architecture of AVM,the relationship between the niduses and the surrounding nerve structures,but also could precisely locate the positions of AVM with small aneurysms or tiny AVMs. According to the results of image fusion,17 patients with AVM were treated with microsurgical resection,2 were treated with interventional embolization and stereotactic radiotherapy,and 2 were treated with stereotactic radiotherapy only. Of the 17 patients with AVM underwent microsurgical resection, none experienced intracranial rebleeding during the follow-up period. The last Glasgow outcome scale (GOS)score was 5 in 13 cases,and 4 in 4 cases. One patient with AVM underwent combined stereotactic radiotherapy had intracranial rebleeding during the follow-up period,and their last GOS score was 4. The other remaining 3 patients did not have new neurological deficits or rebleeding during the follow-up period,and theirGOSscorewas5.Conclusions 3D-DSA,headMRI,andCTfusiontechnologyarenovel, the operative method is simple,and the fusion image is accurate. They can effectively develop the individualized treatment regimens for patients with AVM.

Objective To evaluate the effects of different dosage of aspirin and clopidogrel on the platelet inhibition rate by thromboelastography (TEG)before stent-assisted embolization of aneurysms. Methods The clinical data of 57 patients with unruptured aneurysms treated by stent-assisted coil embolization in General Hospital of Nanjing Military Command were analyzed retrospectively. The patients were divided into a low dose group (aspirin 100 mg + clopidogrel 75 mg,26 cases)and a high dose group (aspirin 300 mg +clopidogrel 75 mg,31 cases). All the patients were treated with aspirin and clopidogrel before surgery. The blood samples were collected on day 3 after oral administration with anti-platelet aggregation drugs. TEG was used to detect the arachidonic acid (AA )-induced inhibition rate of platelet aggregation and adenosine diphosphate (ADP)-induced inhibition rate of platelet aggregation. The platelet inhibition and drug resistance,as well as ischemic complications in the perioperative period between the two groups were compared. Results (1 )The platelet inhibition rates:there was no significant difference in the inhibition rates of platelet aggregation of AA and ADP between low dose group and high dose group at day 3 after oral antiplatelet drugs [AA inhibition rate:(76 ± 21)% vs. (80 ± 21)%;ADP inhibition rate:(72 ± 26)% vs. (73 ± 29 )%;all P >0. 05 ]. (2 )Drug resistance:in the low dose group,the patients of aspirin and clopidogrel resistant were 2 cases(7. 7%)and 1 case(3. 8%),and the patients in high dose group were 3 cases (9. 7%)and 4 cases(12. 9%). No statistical significant difference in the aspirin and clopidogrel resistant was detected in the two groups (all P>0. 05). (3)The ischemic complications in the perioperative period:there was 1 case (3. 8%)with ischemic complications in the low dose group,and 2 cases (6. 5%)in the high dose group. There was no significance difference in the incidence of ischemic complications between the two groups(P >0. 05). Conclusion For patients treated with stent-assisted embolization of aneurysms,no difference could be detected in the inhibitory effect of platelet aggregation between low and high dose groups of aspirin.