Congenital microtia with aural atresia or stenosis accompany with first branchial cleft anomaly: report of 5 cases / 中华耳鼻咽喉头颈外科杂志

Objective@#To summarize the experience of the diagnosis, treatment and effects of the cases with coexistence of first branchial cleft anomaly(FBCA) and microtia with congenital aural atresia or stenosis(external auditory canal stenosis, EACS).@*Method@#This was a retrospective study. The clinical data of 5 patients with microtia and EACS in Beijing Tongren Hospital of Capital Medical University from October 2015 to March 2018 were collected, including 3 males and 2 females, aged from 5 to 28 years. The clinical characteristics, imaging findings, treatment methods and effects of 5 patients were analyzed.@*Result@#The 5 cases were all coexistence of EACS and FBCA, three of who associated with cholesteatoma of external auditory canal. CT showed external auditory canal stenosis with soft tissue shadow, sometimes gas or bone septum found inside, filling in the external auditory canal, combined with canal bone destruction irregularly. All patients underwent surgical resection of FBCA, 3 patients accompanied by cholesteatoma resection and canalplasty. The postoperative follow-up ranged from 10 to 39 months, and no recurrence of infection was observed.@*Conclusions@#EACS and FBCA both result from maldevelopment of the first branchial cleft. These two malformations, FBCA and EACS with or without cholesteatoma, can occur simultaneously, in which situation CT shows external auditory canal stenosis with soft tissue shadow inside. These patients underwent surgical resection of FBCA combined with cholesteatoma resection with good result.

The implantation of Bonebridge in bilateral congenital malformation of external and middle ear / 中华耳鼻咽喉头颈外科杂志

Objective@#To evaluate the auditory efficacy of Bonebridge implantation in patients with bilateral congenital malformation of external and middle ear.@*Methods@#Eleven cases (6 males and 5 females) had unilateral Bonebridge implantation. The age ranged from 8 to 26 and the average age was 16.9. Seven to ten days after operation, the first fitting was undergone. In acoustic sound field, the average auditory thresholds were respectively measured for unaided ears and Bonebridge implanted ears by pure tone auditory (PTA, 0.25, 0.5, 1, 2 and 4 kHz). For the group over 12-year-old, MSTM was applied to evaluate speech discrimination score (SDS). For the other cases, MLNT was used as the test material. The auditory efficacy post Bonebridge implantation would be analyzed and evaluated by comparing the differences between unaided ears and Bonebridge implanted ears.@*Results@#The bone conduction audibility threshold after Bonebridge implantation was as well as the preoperative. The auditory threshold with Bonebridge aided was improved to 25-35 dB HL, when compared to that of the unaided ears in the sound field. The SDS in the group over 12-year-old was improved about 50%; the efficacy was slightly limited for the other two cases (both less than 12 years old). Statistical analysis showed that there were significant differences between unaided ears and Bonebridge implanted ears in the sound field and SDS(P<0.05).@*Conclusions@#The auditory efficacy of Bonebridge is significant and noticeable in patients with bilateral congenital malformation of external and middle ear. Bonebridge provides a new and effective way for patient with congenital malformation of external and middle ear to reconstruct hearing.

The prevalence of intradialytic hypotension under different diagnostic criteria and its association with mortality / 中华肾脏病杂志

Objective Intradialytic hypotension (IDH) is one of the common complications during hemodialysis,however its diagnostic criteria are highly controversial at present.In order to fully understand the prevalence of IDH in our center and figure out which diagnostic criteria is better for Chinese maintenance hemodialysis (MHD) patients,we choose several IDH definitions by reviewing published literatures and analyze their association with mortality.Methods The patients were recruited from Blood Purification Center of Ruijin Hospital undergoing hemodialysis during July 2012.Pre-,intra-and post-dialysis blood pressure were recorded.Patients' clinical characteristics,laboratory results and cardiac ultrasound results were collected.Based on several IDH definitions,we investigated the prevalence rate of IDH and its frequency among MHD patients.SPSS 23.0 was used to analyze data and conduct survival analysis.Results Totally 219 MHD patients underwent 16084 hemodialysis in 6 months.The prevalence rate,overall and individual frequency of IDH fluctuated between 45.21％-100.00％,4.64％-37.60％ and 0.00％-33.00％ respectively.For every IDH criteria,the patients were recruited into the group IDH(+) if they ever met the corresponding definition,otherwise the group IDH(-).Survival analysis found that IDH (the criteria of an absolute systolic blood pressure (SBP) ＜ 90 mmHg or with a decrease of SBP≥ 20 mmHg) could decrease the risk of patients' cardiovascular mortality but was not relevant to all-cause mortality.Further analysis showed these patients had better cardiac functions mainly reflecting in lower Pro-BNP (2880 ng/L vs 6909 ng/L),lower prevalence rate of left ventricular hypertrophy (52％ vs 83％) and higher left ventricular ejection fraction (65.0％ vs 62.5％) than IDH(-) patients.No correlation was found between other IDH criteria and mortality.Conclusions The prevalence rate,overall and individual IDH frequency of IDH are of high variability when diagnosed by different IDH criteria.All IDH episodes defined by our selected definitions are of no association with all-cause mortality.An absolute SBP ＜ 90 mmHg or with a decrease of SBP≥20 mmHg can decrease the risk of cardiovascular mortality due to their better cardiac function.Large scale researches should be conducted to find optimal IDH definition and explore the association of IDH and mortality.

Distribution and drug resistance analysis of bile-isolated pathogens In Xiamen area / 国际检验医学杂志

Objective To analyze the distribution and drug resistance of bile-isolated pathogens in Xiamen area ,providing evi-dence for clinical use of antibiotics .Methods Bile cultures and antibiotic susceptibility tests were performed on strains isolated from the First Affiliated Hospital of Xiamen University .WHONET 5 .6 was used for data analysis .Results In 35 out of 217 samples ,2 kinds of pathogens were isolated .Among these ,Enterococcus and Enterobacteriaceae coinfection was most common .There were 252 strains isolated totally ,with 83 gram-positive strains(32 .9% ) ,165 gram-negative strains (65 .5% ) and 4 fungi strains (1 .6% ) . Escherichia coli ,Enterococcus faecalis and Klebsiella pneumoniae were three of the most common pathogens isolated .Pseudomonas aeruginosa and Acinetobacter baumannii were two of the most common nonfermenters isolated .The resistance rates of Enterobacte-riaceae to aminoglycosides ,fourth generation cephalosporins ,carbapenems or piperacillin/tazobactam were lower than 40 .0% .The resistance rate of Escherichia coli to quinolones was higher than 50 .0% .Enterococcus faecalis or enterococcus faecium were less re-sistant to vancomycin ,linezolid and tigecycline .The resistance rates of enterococcus to high concentration of streptomycin or genta-micin were lower than 30 .0% .Conclusion The top three common pathogens isolated from bile are Escherichia coli ,Enterococcus faecalis and Klebsiella pneumonia in Xiamen area .Infections by Enterococcus together with Enterobacteriaceae account for large numbers of coinfection cases .The resistance rates to cephalosporin or quinolones of pathogens causing biliary tract infections have increased dramatically .

Analysis on distribution and drug resistance of pathogenic bacteria causing postoperative infections in gastrointestinal surgical inpatients / 国际检验医学杂志

Objective To explore the distribution and drug resistance of pathogenic bacteria causing postoperative infections in gastrointestinal surgical inpatients during 2011-2015 in order provide the basis for clinical rational use of antibacterial drugs .Meth‐ods The bacterial species identification and drug susceptibility test were performed by adopting the BacT/ALERT3D automatic culture system and VITEK‐2 system .The analysis was performed by using the WHONET5 .6 statistical software .Results Among 1 140 specimens ,753 strains of pathogenic bacteria were detected .The specimens sources were mainly blood ,sputum ,abdominal drainage fluid ,pus and urine (77 .7% ) .In pathogenic bacteria ,537 strains (71 .3% ) were Gram‐negative bacteria(G-) ,198 strains (26 .3% ) were Gram positive bacteria(G+ ) and 18 strains (2 .4% ) were fungi .The top five detected pathogenic bacteria were E . coli (32 .3% ) ,klebsiella pneumoniae (11 .4% ) ,pseudomonas aeruginosa (10 .0% ) ,staphylococcus aureus (8 .1% ) and acinetobact‐er baumannii (5 .8% ) .E .coli ,klebsiella pneumoniae and pseudomonas aeruginosa had higher resistance to second and third genera‐tion cephalosporin antibacterials ,but had lower resistance to piperacillin/tazobactam and imipenen ,acinetobacter baumannii had higher resistance to multiple antimicrobial agents (> 50% ) ,no vancomycin‐resistant positive staphylococcus strain was found;Gram‐positive staphylococcus aureus had higher resistance to quinolones (>40% ) and traditional antibiotics of penicillin and eryth‐romycin(>50% );enterococcus faecalis and enterococcus faecium were highly sensitive to vancomycin and linezolid .Conclusion Strengthening the bacterial drug resistance surveillance and reducing the generation and spread of drug‐resistant bacteria is of great significance to improve the effect of gastrointestinal surgical infection treatment .

Sepsis associated encephalopathy is an independently risk factor for nosocomial coma in patients with supratentorial intracerebral hemorrhage：a retrospective cohort study of 261 patients / 中华危重病急救医学

Objective To investigate whether the presence of sepsis associated encephalopathy (SAE) would predict nosocomial coma (NC) and poor outcome in patients with supratentorial intracerebral hemorrhage (SICH). Methods A retrospective cohort study was conducted. The adult acute SICH patients with or without coma admitted to intensive care unit (ICU) of Shuyang People' Hospital Affiliated to Xuzhou Medical University from December 2012 to December 2015 were enrolled. Brain computed tomography (CT) scans were analyzed and the patients were divided into pre-hospital coma (PC) and NC groups. The clinical data and the incidence of SAE of patients in two groups were compared, and the 30-day prognosis was followed up. Univariate and Cox regression analyses were performed to analyze whether SAE would predict NC and poor outcome in patients with SICH. Results A total of 330 patients with acute SICH and coma were enrolled, excluding 60 cases of infratentorial cerebral hemorrhage, 3 cases of primary intraventricular hemorrhage, and 6 cases of unknown volume hematoma. Finally, 261 patients were included, with 111 patients of NC events, and 150 patients of PC events. 69 (62.2%) SAE in SICH with NC and 33 (22.2%) SAE in SICH with PC was diagnosed, and the incidence of SAE between two groups was statistically significant (P < 0.01). Compared with PC group, SICH patients in the NC group had lower incidence of hypertension (81.1% vs. 96.0%), longer time from onset to NC [days: 2.3 (23.9) vs. 0 (0.5)] and length of ICU stay [days: 5.0 (34.0) vs. 3.0 (12.0)], higher initial Glasgow coma score (GCS, 10.2±1.5 vs. 6.6±1.6) and sequential organ failure assessment (SOFA) score [4.0 (6.0) vs. 3.0 (3.0)], lower initial National Institutes of Health Stroke Scale (NIHSS) score (19.4±6.6 vs. 30.2±6.8), as well as more frequent sepsis (78.4% vs. 38.0%), vegetative state (24.3% vs. 14.0%), acute respiratory failure (24.3% vs. 10.0%), pneumonia (37.8% vs. 24.0%), septic shock (8.1% vs. 0), acute liver failure (5.4% vs. 0), hypernatremia (8.1% vs. 0), CT indicating that more frequent vasogenic edema (64.9% vs. 16.0%) and white matter lesion (13.5% vs. 2.0%), and less mannitol usage (94.6% vs. 100.0%), and less brain midline shift (32.4% vs. 68.0%) and hematoma enlargement (8.1% vs. 30.0%), less hematoma volume (mL: 28.0±18.8 vs. 38.3±24.4) in CT, and higher 30-day mortality (54.1% vs. 26.0%) with statistical differences (all P < 0.05). It was shown by Cox regression analyses that SAE [hazard ratio (HR) = 3.5, 95% confidence interval (95%CI) = 1.346-6.765, P = 0.000] and SOFA score (HR = 1.8, 95%CI = 1.073-1.756, P = 0.008) were independent risk factors of death of SICH patients with NC, and hematoma enlargement was independent risk factor of death of SICH patients with PC (HR = 3.0, 95%CI = 1.313-5.814, P = 0.000). Conclusion SAE is the independent factor of inducing NC event and poor prognosis in SICH patients.

Expression of microRNA-206 in peripheral blood mononuclear cells in asthmatic children / 临床儿科杂志

s: Objective To explore the role of microRNA-206 in peripheral blood mononuclear cells (PBMC) in the pathogenesis and development of childhood asthma. Methods Twenty-seven asthmatic children and 25 healthy controls were enrolled in the study. Peripheral blood mononuclear cells were isolated in both healthy subjects and asthmatic children in acute attack and remission stages. Total RNAs were extracted from PBMC stimulated by PMA and ionomycin, and then the RNA was reversely transcribed into cDNA. The expressions of microRNA-206 and Kruppel-like factor 4 (KLF4) and IL-17 mRNA were detected by real-time quantitative PCR (qRT-PCR) method. Results There was signiifcant difference of microRNA-206 levels among asthmatic children in attack stage and in remission stage and normal controls (F=46.58~72.81, P=0.000). Through pair-wise comparison, the microRNA-206 levels of asthmatic children in attack stage were signiifcantly lower than those in remission stage and normal control groups (P0.05). Furthermore, a negative correlation was found between the expression of miR-206 and KLF4 (r=–0.66, P<0.01) and between the expression of miR-206 and IL-17 mRNA (r=–0.81, P<0.01) in asthmatic children in attack stage. A positive correlation was also found between KLF4 and IL-17 mRNA in asthmatic children in attack stage (r=0.70, P<0.01). Conclusions The expression of miR-206 is decreased in asthmatic children, and miR-206 might be involved in the pathogenesis and development of asthma.

The level of miR-206 in per ipheral blood mononuclear cells and their signicance in systemic lupus erythematosus patients / 中华风湿病学杂志

Objective To explore the role of miR-206 in peripheral blood mononuclear cells (PBMCs) of systemic lupus erythematosus (SLE) patients.Methods Human PBMCs were isolated by standard densitygradient centrifugation over Ficoll-Hypaque solution in SLE and healthy controls.Total RNAs were extracted from PBMCs which were stimulated by PMA and ionomycin,thenthe RNA was transcribed reversely into cDNA.The expression of miR-206 and Kruppel-like factor 4 (KLF4) and the orphan nuclear receptor RORγt mRNA was detected by real-time quantitative polymerase chain reaction (qRT-PCR) method.T test and Spearman's correlation test were used for statistical analysis.Results The expression of miR-206 in the PBMCs of SLE patients was significantly decreased compared with that of healthy controls (0.066±0.021 vs 0.143±0.059,t=3.136,P＜0.01).The levels of KLF4 and RORγt mRNAin the PBMCs of SLE patients were increased significantly than those of healthy controls (0.637 ±0.186 vs 0.104 ± 0.028,t=6.673,P＜0.01),(0.575±0.263 vs 0.065±0.014,t=7.386,P＜0.01).Furthermore,there was a negative correlation between the expression of miR-206 and KLF4 or RORγt mRNA in SLE patients (r=-0.627,P＜ 0.01),(r=-0.853,P＜0.01).Conclusion These results indicate that the augmented expression of KLF4 mRNA may be caused by the attenuated expression of miR-206,and the high level of KLF4 mRNA evokes the proportion of Thl7 cells in SLE patients.

Construction of a mutant strain of Streptococcus mutans with clpC-deletion to study the role of clpC ;gene in genetic competence / 中华微生物学和免疫学杂志

Objective To construct a mutant strain of Streptococcus mutans ( S.mutans ) with clpC-deletion and to investigate the role of clpC gene in genetic competence.Methods The fragment of clpC gene and the kanamycin resistant cassette flanked by two loxP sites were amplified by PCR.The purified fragment of clpC gene was cloned into pMD-19T simple vector to construct pCKX1.The pCKX1 vector was digested with ClaⅠ/EcoRⅠ, then blunted and introduced into lox71-KMR-lox66 to obtain pCKX2 vector via homologous recombination.The pCKX2 vector was linearized with SalⅠ and transformed into S.mutans UA159 strain.The positive strains constructed via homologous recombination were screened with kanamycin and transformed with the thermosensitive plasmid pCrePA.The KMR cassette was excised after incubating at 30℃ for 48 hours.Then the pCrePA plasmid was removed after overnight incubating at 37℃for the prepara-tion of clpC-deletion mutant.Total RNA were extracted from the S.mutans UA159 strain and the clpC-dele-tion mutant strain respectively, and then reverse transcribed into first strand cDNA.The target gene frag-ments were amplified by RT-PCR and analyzed by the agarose gel electrophoresis and sequencing.After be-ing verified by PCR and sequencing, the S.mutans UA159 strain and the clpC-deletion mutant strain were re-spectively transformed with E.coli-S.mutans shuttle vector pDL276 to observe the competence development induced by the competence-stimulating peptide (CSP).Results The PCR and sequencing results showed that the pCKX2 vector and the mutant strain with clpC-deletion were constructed successfully via homologous recombination.No clpC gene was detected in the clpC-deletion mutant as indicated by RT-PCR analysis.The formation of competent clpC-deletion mutant was delayed and the competence state was prolonged as com-pared with its parent strains.Conclusion The clpC gene negatively regulated the formation of competent S.mutans.

The analysis of the genotyping of plasmid-mediated AmpC β-lactamases produced by clinical strains of Escherichia coli and Klebsiella pneumoniae / 国际检验医学杂志

Objective To investigate the genotype and epidemiology of plasmid‐mediated AmpC β‐lactamases produced by the clinical strains of Escherichia coli and Klebsiella pneumoniae .Methods A total of 176 clinical nonrepetitive cefoxitin non‐sensitivity isolates of Escherichia coli and Klebsiella pneumoniae was collected from July 2011 to August 2012 .Polymerase chain reaction (PCR) for AmpC enzyme gene amplification and DNA sequencing were carried out for genotype of AmpC beta‐lactamases .Results The results of PCR showed that the positive rate of ampC of the 176 strains of Escherichia coli and Klebsiella pneumoniae AmpC was 18 .2% ,mainly DHA type ,counting for 59 .4% ,CIT counting for 37 .5% ,EBC counting for 3 .1% .The positive rate of ampC of Escherichia coli was 11 .4% ,mainly CIT type ,counting for 77 .8% ,the positive rates of DHA type and EBC type both were 11 .1% .The positive rate of ampC of Klebsiella pneumoniae were 23 .7% ,mainly DHA type ,counting for 78 .3% ,CIT type count‐ing for 21 .7% .The results of DNA sequencing showed that there were 18 strains DHA‐1 type and 1 strain ampC gene type of Morganella morganii in DHA type strains ,the concordance rate was 97 .0% ,10 CIT type strains was CMY‐2 type ,1 strain was CMY‐42 ,one strain was CMY‐4 type ,EBC type was ampC gene type of Enterobacter cloacae ,the concordance rate was 99 .0% .A total of 32 strains of gene sequencing were registered as KJ127248 - KJ127279 in GenBank .Conclusion The main genotypes of plasmid‐mediated ampC enzyme produced by Escherichia coli and Klebsiella pneumoniae were CMY‐2 and DHA‐1 respectively .

Changes of microRNA-206 in peripheral blood mononuclear cells from children with respiratory syncytial virus bronchiolitis / 中华实用儿科临床杂志

Objective To explore the role of microRNA-206 (miR-206) in peripheral blood mononuclear cells (PBMCs) in infantile bronchiolitis caused by respiratory syncytial virus (RSV).Methods Thirty-five cases of infantile bronchiolitis and 25 cases of healthy controls were enrolled into the current study.PBMCs were isolated from the peripheral blood of both healthy subjects and those with infantile bronchiolitis in the acute and the convalescent stages.Total RNAs were extracted from PBMCs which were stimulated by phorbol-12-myristate-13-acetate (PMA) and Ionomycin, and then the RNA was transcribed reversely into cDNA.The expressions of miR-206 and Kruppel-like transcription factor 4 (KLF4) were detected by real-time quantitative polymerase chain reaction (qRT-PCR) method.Plasma interleukin-17 (IL-17) was determined by enzyme linked immunosorbent assay (ELISA).Results There was a significant difference in miR-206 levels of children with RSV bronchiolitis in the acute stage(0.055 ±0.018) and the convalescent stage(0.187 ±0.069) as well as the healthy controls(0.204 ± 0.075).Through pairwise comparison, the miR-206 levels in the children in the acute stage were significantly lower than those in the convalescent stage and healthy control group (P ＜ 0.01), but no statistical significance was found between the convalescent stage group and healthy control group(P ＞ 0.05).The levels of KLF4 mRNA of children in the acute stage,convalescent stage as well as the healthy subjects were 0.588 ± 0.161,0.086±0.024,0.075 ±0.019, respectively,which was significantly difference (P ＜ 0.01).The levels of IL-17 were (58.26 ±25.88) ng/L, (9.87 ± 3.01) ng/L, (7.65 ± 2.16) ng/L, respectively (P ＜ 0.01).Compared to the convalescent and the normal control group,both the KLF4 mRNA and IL-17 levels were markedly higher in the acute stage (P ＜ 0.01), but there were no significant differences between children with RSV bronchiolitis in convalescent stage and in the healthy controls (P ＞ 0.05).Furthermore, the result of this study showed a negative correlation between the expression of miR-206 and KLF4(r =-0.624 ,P ＜0.01)and IL-17 (r =-0.609 ,P ＜0.01) in children in the acute stage and a positive correlation between KLF4 mRNA and IL-17 in children in the acute stage (r =0.662, P ＜ 0.01).Conclusion The levels of miR-206 may play a role in the onset of RSV associated post-bronchiolitis (PB) and the low expression of miR-206 in children infected with RSV may increase the susceptibility to PB.

Analysis of distribution and drug resistance of pathogens in premature infants with ventilator-associated pneumonia / 国际检验医学杂志

Objective To investigate the distribution and characteristics of drug resistance of pathogens in premature infants with ventilator‐associated pneumonia(VAP) ,and explore the therapeutic measures for premature infants with VAP ,so as to provide references for clinically reasonable administration of antibacterial agents .Methods A total of 54 cases of premature infants diag‐nosed with VAP in the First Affiliated Hospital of Xiamen University from January 2013 to June 2014 were enrolled in this study . Specimens of respiratory tract secretion were collected ,and species identification of pathogens and drug sensitivity test were per‐formed by VITEK 2 Compact system .Results A total of 69 strains were isolated .Gram negative bacteria was accounted for 94 .20% ,and gram positive bacteria was accounted for 5 .80% .Four of the most common pathogenic bacteria were Klebsiella pneu‐monia (29 strains ,42 .03% ) ,Enterobacter aerogenes (12 strains ,17 .39% ) ,Pseudomonas aeruginosa (10 strains ,14 .49% ) and Stenotrophomonas maltophilia(7 strains ,10 .14% ) .The results of antibiotics‐sensitivity tests showed that these strains were multi‐drug resistant to most commonly used antibiotics ,but sensitive to only a few antibiotics .Conclusion Gram‐negative bacteria are the major pathogens for premature infants with VAP in this hospital .Mixed infection and multidrug resistance are common .Therefore , the rational use of antibiotics according to drug sensitivity tests′results is critical in treating VAP .

Analysis on composition of blood culture pathogenic bacteria and drug resistance in a tertiary general hospital of Xiamen during recent three years / 国际检验医学杂志

Objective To analyze the distribution and antimicrobial resistance situation of pathogens isolated from blood culture to provide the scientific basis for the accuratel use of antibacterial drugs and preventing and controlling nosocomial acquired blood‐stream infection .Methods The US BACTEK‐FK automatic blood culture instrument and the French VITEK 2 COMPACT auto‐matic bacteria identification/susceptibility system were used to conduct the culture ,identification of blood culture isolated bacterial strains and drug susceptibility test .The results of drug susceptibility test were judged by adopting the 2011 criteria of the Clinical Laboratory and Standards Institute(CLSI) .Results The main isolated bacteria from blood culture for the recent three years were E coli ,staphylococcus aureus and klebsiella pneumonia bacteria ,coagulase negative staphylococcus(CNS) ,etc .The proportions of hos‐pital‐acquired bloodstream infections during these period were 42 .2% ,46 .9% and 54 .1% respectively .The detection rate of methi‐cillin‐resistant staphylococcus aureus (MRSA) was 18 .8% ,which of multiple drug resistant acinetobacter baumannii (MDRAB) was 42 .9% ,which of producing extended spectrum beta lactamase (ESBLs) in E .coli and klebsiella pneumoniae were 71 .8% and 69 .8% respectively .Conclusion The bloodstream infections pathogens in this hospital are mainly Enterobacteriaceae bacteria ,the proportion of hospital‐acquired bloodstream infections increases year by year ;the detection rate of multi‐drug resistant Acinetobact‐er baumanni (MDRAB) is higher ,clinic should pay more attention to the change of blood culture pathogens and their drug resist‐ance trend ,meanwhile nosocomial bloodstream infection should be prevented and controlled .

Idiopathic retroperitoneal fibrosis misdiagnosed as renal cancer: a case report and literature review / 南方医科大学学报

A 51-year-old male patient was presented to our hospital for inspection of right renal space-occupying lesions. CT revealed soft tissue density in the right renal pelvis and renal pelvis ureter transitional crumb, for which a clinical diagnosis of right renal cancer was made. After laparoscopic radical resection of the right kidney, pathological examination supported the diagnosis of idiopathic retroperitoneal fibrosis. With an unclear pathogenesis, idiopathic retroperitoneal fibrosis presents with atypical clinical manifestations but shows specific features in imaging examination. Its treatment is individualized according to the specific condition for which conservative medical or surgical treatment can be considered. Retroperitoneal fibrosis has a low incidence and a high misdiagnosis rate, and imaging examinations remain currently the primary modality for diagnosis with specific findings.

Staphylococcal chromosome mec genotyping and molecular epidemiology of hospi-tal-acquired methicillin-resistant Staphylococcus aureus / 中国感染与化疗杂志

Objective To investigate the staphylococcal chromosomal cassette mec (SCCmec)genotypes and molecular epidemi-ology of hospital-acquired MRSA.Methods A total of 26 non-duplicate MRSA isolates with the same resistant pattern were studied.SCCmec genotyping was analyzed by multiplex PCR.Repetitive element polymerase chain reaction (Rep-PCR)tech-nique was used to analyze the homology between these strains based on the DiversiLab system.Results The most common geno-type of these MRSA strains was SCCmec-III (84.6%).Two strains belonged to SCCmec-II and 1 SCCmec-IV.SCCmec-I strain was not identified.Based on the results of DiversiLab analysis,these MRSA strains were classified into 10 groups.The genetic similarity ranged from 40% to 100% among these SCCmec types.The two strains of SCCmec-II belonged to the same subtype.The similarity coefficient was higher than 90% for one strain of SCCmec-III subtype 1.The 4 strains of SCCmec-III subtype 3 were grouped into the same set with a similarity coefficient of > 95%.The MRSA strains of SCCmec-III subtype 2 was divided into 5 groups (similarity co-efficient > 90%).Conclusions SCCmec-III is the major genotype of MRSA isolates in our hospital.MRSA strains may spread in some wards.Clinicians and infection control department should pay close attention to this issue.

Level of MicroRNA-2 0 6 in Peripheral Blood Mononuclear Cells from Rheumatoid Arthritis and Their Significance / 现代检验医学杂志

Objective To explore the role of microRNA-206 (miR-206)in peripheral blood mononuclear cells (PBMC)from rheumatoid arthritis (RA)patients.Methods 27 patients with RA and 25 healthy controls were enrolled into the current study.Human peripheral blood mononuclear cells (PBMCs)were isolated by standard density-gradient centrifugation over Ficoll-Hypaque solution in rheumatoid arthritis and healthy control volunteers.Total RNAs were extracted from PBMCs which were stimulated by PMA and ionomycin,then the RNA was transcribed reversely into cDNA.The expression of mi-croRNA-206 and Kruppel-like factor 4 (KLF4)and the orphan nuclear receptor RORγt mRNA was detected by real-time quantitative PCR (qRT-PCR)method.Student’s unpaired t-test and spearman correlation were used for statistica1 analysis. Results The expression of miR-206 in the PBMCs of RA patients was significantly decreased compared with that of the healthy controls (0.056±0.019 vs 0.138±0.057,t=3.103,P<0.01),The levels of KLF4 and RORγt mRNAin the PB-MCs of RA patients were increased significantly verves those of the healthy controls(0.604±0.183 vs 0.098±0.027,t=6.651,P<0.01;0.583±0.271 vs 0.069±0.018,t=7.438,P<0.01),Furthermore,a negative correlated between the ex-pression of miR-206 and KLF4 or RORγt mRNA in RA patients (r=-0.639,P<0.01;r=-0.842,P<0.01).Conclusion These results indicated that the augmented expression of KLF4 mRNA may be caused by the attenuated expression of miR-206,and the high level of KLF4 mRNA evokes the proportion of Th17 cells in RA patients.

Detection and clinical significance of peripheral blood CD 4+T cell-derived leptin in patients with Hashimoto′s thyroiditis / 国际检验医学杂志

Objective To detect the level of CD4+ T cell-derived leptin(LP) in peripheral blood mononuclear cells(PBMC) from the patients with Hashimoto′s thyroiditis(HT) and to investigate its role in the occurrence and development of HT .Methods The peripheral blood samples in the patients with HT and the healthy controls were collected and separated for obtaining PBMC .The CD4+ T cells magnetic beads was adopted to separate CD4+ T cells for culturing in vitro .The LP level in supernatant was detected by ELISA .The relative expression amount of the orphan nuclear receptor RORγt was detected by real-time quantitative PCR (qRT-PCR) method .Results The LP level of CD4+ T cell culture liquid in the HT patients was markedly higher than that in the healthy control group ,difference was statistically significant (P<0 .05) .Furthermore ,the LP level in CD4+ T cell culture liquid was posi-tively related with the relative expression amount of RORγt in HT patients .Conclusion The CD4+ T cell-induced leptin level is in-creased in HT patients ,which is closely related with the occurrence and development of HT .

The significance of peripheral blood CD4 + T cell-derived leptin in asthmatic children / 临床儿科杂志

Objectives To explore the role of CD4+T cell-derived leptin in peripheral blood mononuclear cells (PBMC) in asthmatic children. Methods Peripheral blood mononuclear cells were isolated from peripheral blood of both healthy subjects and asthmatic children in attack and remission stages. CD4+T cells were purified from PBMCs by mag-netic beads and were cultured in vitro. Supernatants were used to detect the levels of leptin by ELISA. The expression of the orphan nuclear receptor (ROR)γt was detected by real-time quantitative PCR (qRT-PCR) method. Results There was significant difference in CD4+T cell-derived leptin levels of asthmatic children in attack stage (68.46±13.08 pg/ml), remis-sion stage (36.73±6.13 pg/ml) and normal controls (32.82±5.79 pg/ml) (P0.05). The plasma leptin of children in attack stage and remission stage, as well as in normal subjects were 16.64 ± 3.53, 14.91 ± 3.24 and 13.72 ± 5.79 ng/ml respectively with no significant differences (P>0.05). The levels of RORγt mRNA were 0.341 ± 0.175, 0.089±0.028 and 0.068±0.018 in children with asthma during attack stage, remission stage and in normal children respec-tively (P0.05). Furthermore, the result of this study showed CD4+T cell-derived leptin positively correlated to RORγt in asthmatic children in attack stage (r=0.681, P<0.01). Conclusions CD4+T cell-derived leptin is elevated in asthmatic children in attack stage and its level is closely related to the pathological process of asthma.

Role of protein kinase C-δ in Dectin-1-Src-Syk-mediated killing of Candida albicans by macrophages / 中国免疫学杂志

Objective:To study the role of protein kinase C-δin the Dectin-1-Src-Syk-mediated killing of Candida albicans by macrophages and investigate the molecular mechanism of antifungal innate immunity .Methods:Cell surface receptors were accessed by Flow Cytometry.Mouse bone marrow derived macrophages were pre-incubated with different protein kinase inhibitors and then stimulated with C.albicans.The phosphorylation of related proteins was determined by Western blot.The ROS production,phagocytosis and killing of C.albicans by macrophages were measured.Results:Either Src or Syk inhibitor reduced C.albicans induced PKC-δphos-phorylation.PKC-δinhibitor Rottlerin reduced p40phox phosphorylation,ROS production and killing of C.albicans but had no effect on the phagocytosis of C.albicans by macrophages.Conclusion:PKC-δinhibitor Rottlerin reduced the killing of Candida albicans by mac-rophages through the inhibition of NADPH complex activation and ROS production ,suggesting that PKC-δplays an important role in an-tifungal innate immunity.

Distribution and drug resistance of clinically isolated Pseudomonas aeruginosa / 国际检验医学杂志

Objective To investigate the clinical distribution and the drug resistance characteristics of Pseudomonas aeruginosa . Methods The results of the bacterial culture and the antimicrobial susceptibility test in the hospital from July 2007 to October 2008 were performed the retrospective analysis.Results Totally 335 strains of Pseudomonas aeruginosa were isolated,accounting for 9.2% of isolated pathogenic bacteria.The main specimen source was sputum,accounting for 77.6%.The ICU ward was the high incidence area.The resistance rates of Pseudomonas aeruginosa to amikacin,piperacillin/tazobactam,tobramycin,levofloxacin, cefepime,gentamicin,ticarcillin and ciprofloxacin were less than 10%.The resistance rates of imipenem-insensitive Pseudomonas aeruginosa to aztreonam,ceftazidime,ciprofloxacin,levofloxacin,piperacillin/tazobzctam were significantly higher than those in imi-penem-sensitive Pseudomonas aeruginosa (P <0.05).Conclusion The multiple drug resistance phenomena of Pseudomonas aerugi-nosa generally exist,amikacin,piperacillin/tazobactam and tobramycin are recommended for the treatment of infections caused by Pseudomonas aeruginosa .