Objective To investigate the correlation of P-selectin ( SELP) gene S290N polymorphisms and P-selectin glycoprotein ligand-1 (PSGL-1) gene M62I polymorphisms with ischemic cerebral infarction. Methods One hundred and forty-eight ischemic cerebral infarction patients were in cerebral infarction group, and these patients were divided into large artery atherosclerosis cerebral infarction ( LAA) subgroup, cardioembolism ( CE) subgroup and small artery occlusion cerebral infarction ( SAO ) subgroup. Eighty-eight healthy controls were in normal control group. Polymorphisms of SELP gene S290N and PSGL-1 gene M62I of all subjects were detected by gene sequencing. Results Compared with normal control group, there was no significant difference of frequency of S290N genotype and allele in cerebral infarction group and its subgroup (all P>0. 05). Compared with normal control group, there was significant differences of frequency of M62I genotype and allele in cerebral infarction group (all P<0. 01). Compared with normal control group, there was no significant difference of M62I genotype in LAA subtypes group (χ2=5. 889, P=0. 053). Compared with normal control group, there was significant difference of M62I allele frequency in LAA subgroup (χ2 =6. 156, P=0. 021). Compared with normal control group, there was no significant difference of M62I genotype and allele frequency in CE subgroup (χ2 =1. 693, P=0. 429;χ2 =1. 372, P=0. 238). Compared with normal control group, there were significant differences of M62I genotype and allele frequency in SAO subgroup (χ2 =12. 572, P=0. 002; χ2 =8. 736, P=0. 004). S290N gene had no correlation with the risk of ischemic cerebral infarction (all P>0. 05). However, dominant and over-dominant models of M62I were associated with the&nbsp;risk of ischemic cerebral infarction ( OR =2. 662, 95%CI: 1. 531 -4. 630, P=0. 000; OR =0. 392, 95%CI:0. 219-0. 701, P=0. 001), while recessive and additive models of M62I were not (OR=1. 428, 95%CI:0. 528-3. 862, P= 0. 630; OR = 2. 121, 95% CI: 0. 766 - 5. 872, P= 0. 156). Conclusion PSGL-1 gene M62I polymorphism is correlated with ischemic cerebral infarction.

目的 检测急性脑梗死患者各类血小板-白细胞聚集体(PLA)水平,探讨其临床应用价值.方法 选取58例急性脑梗死患者,其中大动脉粥样硬化性脑梗死(LAA)19例、小动脉闭塞性脑梗死(SAO)39例,以体检健康者20名作为正常对照组.采用流式细胞术检测总PLA、血小板-单核细胞聚集体(PMA)、血小板-粒细胞聚集体(PNA)、血小板-淋巴细胞聚集体(PLyA)和血小板(PLT)CD62P阳性率.采用免疫荧光干式定量法检测高敏C反应蛋白(hs-CRP),以hs-CRP<1.0 mg/L、1.0~3.0 mg/L、>3.0 mg/L将急性脑梗死患者分为低风险组、中度风险组和高风险组.由临床医师依据美国国立卫生研究院卒中量表(NIHSS)对患者进行评分,以NIHSS<5分为轻度梗死,NIHSS≥5分为中重度梗死.采用受试者工作特征(ROC)曲线评价各类PLA及CD62P诊断急性脑梗死的价值.结果 LAA组、SAO组PMA及LAA组PNA明显高于正常对照组(P<0.05),LAA组PMA与SAO组比较差异无统计学意义(P>0.05).3组间PLA和PLyA差异均无统计学意义(P>0.05).SAO组PLT活化后CD62P高于正常对照者(P<0.05).SAO患者PMA与CD62P阳性率呈正相关(r=0.692,P<0.01).ROC曲线分析显示,PMA、PNA、CD62P、PLA和PLyA诊断急性脑梗死的ROC曲线下面积分别为0.769(P<0.01)、0.652(P<0.05)、0.686(P<0.05)、0.641(P>0.05)和0.517(P>0.05).各类PLA与hs-CRP、NIHSS评分之间均无相关性(P>0.05).结论 不同类型PLA在急性脑梗死中的变化不同.PMA与PNA水平在急性脑梗死中升高更显著,对急性脑梗死有一定的诊断意义,但可能不能用于鉴别LAA与SAO以及提示病情严重程度和预后.

Targeting mitochondrial respiration has emerged as an attractive therapeutic strategy in blood cancer due to their unique metabolic dependencies. In this study, we show that pyrvinium, a FDA-approved anthelmintic drug, selectively targets lymphoma T-cells though inhibition of mitochondrial functions and JAK2/STAT5. Pyrvinium induces apoptosis of malignant T-cell line Jurkat and primary T-cells from lymphoma patients while sparing T-cells from healthy donors. Increased level of active caspase-3 and decreased levels of Bcl-2 and Mcl-1 were also observed in Jurkat and lymphoma T-cells but not normal T-cells treated with pyrvinium. In addition, pyrvinium impairs mitochondrial functions by inhibit mitochondrial respiration, suppressing mitochondrial respiratory complex I activity, increasing ROS and decreasing ATP levels. However, the effects of pyrvinium were abolished in mitochondrial respiration-deficient Jurkat ρ(0) cells, confirming that pyrvinium acts on lymphoma T-cells via targeting mitochondrial respiration. We further show that lymphoma T-cells derived from patients depend more on mitochondrial respiration than normal T-cells, and this explains the selective toxicity of pyrvinium in lymphoma versus normal T-cells. Finally, we demonstrate that pyrvinium also suppresses JAK2/STAT5 signaling pathway in Jurkat cells. Our study suggests that pyrvinium is a useful addition to T-cell lymphoma treatment, and emphasizes the potential therapeutic value of the differences in the mitochondrial characteristics between malignant and normal T-cells in blood cancer.

BACKGROUND:Platelet-leukocyte aggregations (PLA) play key roles in acute ischemic stroke (AIS) process and they are formed by the combination of P-selectin (SELP) expressed on the surface of the platelet membranes with P-selectin glycoprotein ligand-1(PSGL-1) expressed on the surface of the leukocytes. There are genetic polymorphisms in SELP and PSGL-1. We tested the differences in all kinds of PLA among subtypes of AIS and the association of SELP S290N and PSGL-1 M62I polymorphism with AIS to assess the correlations of PLA with SELP S290N and PSGL-1 M62I genetic polymorphisms. METHODS:One hundred and forty-eight patients with acute ischemic stroke, including thirty patients with large artery atherosclerosis stroke (LAA), twenty-four patients with cardioembolism (CE) and ninety-four patients with small artery occlusion stroke (SAO), and eighty-eight control subjects were evaluated. The lab parameters and levels of PLA were measured within 3h after the ischemic event in the case subjects and within empty stomach in the control subjects. In all subjects, SELP S290N and PSGL-1 M62I polymorphisms were also measured. RESULTS:Platelet-monocyte aggregates (PMA), platelet-lymphocyte aggregates (PLyA) and platelet-neutrophil aggregates (PNA) in LAA group, CE group and SAO group were all higher than that in control group (P=0.000 for all comparisons). Compared with LAA group, PMA and PLyA in CE group were significantly higher (P=0.018 and P=0.003, respectively). Compared with SAO group, PMA and PLyA in CE group were also significantly higher (P=0.041 and P=0.019, respectively). Compared with control group, there were significantly differences of I allele frequencies of PSGL-1 M62I in LAA group and SAO group (OR=2.249, 95%CI: 1.175-4.304, P=0.021 and OR=2.055, 95%CI: 1.269-3.328, P=0.004, respectively). In SAO group, there were significantly differences of PNA among MM, MI and II genotype of PSGL-1 M62I (P=0.008). CONCLUSIONS:PLA increased in AIS patients rapidly within 3h. The I allele of PSGL-1 M62I was associated with risk of developing AIS, especially LAA and SAO. SAO patients with the II genotype of PSGL-1 M62I have the higher level of PNA.

Objective To investigate the association of polymorphism of P-selectin( SELP) gene S290 N and P-selectin glycoprotein ligand-1( PSGL-1) gene M62I with platelet leukocyte aggregation in ischemic cerebral infarction.Methods A total of 58 ischemic cerebral infarction patients including 19 large artery atherosclerosis cerebral infarction( LAA) patients and 39 small artery occlusion cerebral infarction( SAO) patients and 20 healthy controls were enrolled into the study. The levels of platelet leukocyte aggregation( PLA),platelet monocyte aggregations( PMA),platelet lymphocyte aggregations( PLy A) and platelet neutrophilic aggregations( PNA) were detected by flow cytometric analysis and the polymorphisms of SELP gene S290 N and PSGL-1 gene M62I were detected by gene sequencing. Results The percentages of PMA were significant differences between the cases group and the controls group,the LAA group and the controls group,the SAO group and the controls group( P = 0. 000,P = 0. 018,P = 0. 000,respectively). The percentages of PNA were significant differences between the cases group and the controls group,the LAA group and the controls group( P = 0. 045,P =0. 002,respectively). The percentages of PNA were significant differences between SS and SN genotypes of SELP gene S290 N in the LAA group( P = 0. 008) and the percentages of PLA were significant differences among MM,MI and II genotypes of PSGL-1 gene M62I in the LAA group( P = 0. 046). Conclusion PMA and PNA are correlated with ischemic cerebral infarction. The genotypes of SN in SELP S290 N and MM in PSGL-1 M62I can increase the risk of large artery atherosclerosis cerebral infarction.

Objective:To explore the value of combined detection of serum human epididymis protein 4 (HE4) and CA125 in the diagnosis of early ovarian carcinoma .Method:HE4 and CA125 were determined by Roche electri‐cal chemiluminescence immunoassay in 32 ovarian cancer patients ,79 pelvic benign tumors patients and 30 health controls .Results:The serum levels of HE4 and CA125 in ovarian cancer group were statistically significantly higher than those in benign pelvic masses group and healthy women (P< 0 .01) .The area under ROC curve of HE4 and CA125 to distinguish between malignant versus benign ovarian masses were 0 .935 and 0 .896 ,there was no statisti‐cally significant difference(P>0 .05) .The specificity of HE4 ,CA125 ,combined HE4 and CA125 were 84 .38% , 87 .50% and 81 .25% ,respectively .The sensitivity of HE4 and combined HE4 and CA125 were 96 .20% and 98 . 73% ,compared with single detection of CA125 ,there was a statistically significant rise(P< 0 .05) .Conclusion:HE4 is a useful marker for ovarian carcinoma with higher specificity ,combined detection of HE4 and CA125 can in‐crease the accuracy .

Objective To investigate the molecular types and related clinical features of methicillin-resistant Staphylococcus aureus (MRSA) in Jingzhou area, Hubei Province.Methods A total of 80 MRSA strains confirmed by mecA gene were isolated from inpatients in Jingzhou Central Hospital of Hubei province during January and December 2014. Vitek 2 Compact was used for antibiotic susceptibility test . Staphylococcus protein A (SPA) types and Staphylococcal cassette chromosome mec (SCCmec) genotypes were detected by multiplex polymerase chain reaction ( PCR ) and gene sequencing . Panton-valentine leucocidin ( pvl) gene of the strains was detected by PCR .Chi-square test and Wilcoxon test were used for data analysis .Results There were 16 spa types in 80 MRSA isolates , in which t030 and t437 were the most prevalent ones accounting for 50.0% ( 40 strains ) and 28.8% ( 23 strains ) of the total strains, respectively.There were 77 strains of SCCmec type Ⅰ-Ⅴ, in which SCCmecⅢ and SCCmecⅣ were the most prevalent ones accounting for 45.0% (36 strains) and 35.0% (28 strains), respectively.t030 was the main spa type in isolates of SCCmecⅢ(33/36, 91.7%), while t437 was the main spa type in isolates of SCCmecⅣ(20/28, 71.4%).Patients infected with t030/SCCmecⅢMRSAs were with higher ages than those infected with t437/SCCmecⅣMRSAs (T=446.500 and 607.500, P<0.01).Patients infected with t030/SCCmecⅢ MRSAs were mainly from surgical wards and intensive care unit ( ICU ) , while those infected with t437/SCCmecⅣ MRSAs were mainly from pediatrics wards , and there were significant differences in ward distribution between two groups (χ2 =33.724 and 29.768, P <0.01).Seventy percent and above strains of t030/SCCmec type Ⅲ were resistant to rifampin, erythromycin, clindamycin, tetracycline, levofloxacin, moxifloxacin, ciprofloxacin and gentamicin .Strains of t437/SCCmec type Ⅳwere resistant to erythromycin , clindamycin and tetracycline , but were sensitive to most non-β-lactam antimicrobial drugs (with resistance rates <20%).Virulence gene pvl was found in 11 strains (13.8%), in which 7 were strains of t437-SCCmec typeⅣ.Conclusions MRSAs in Jinzhou are of various genotypes , in which t030-SCCmecⅢand t437-SCCmecⅣare the most prevalent ones .Strains of t030-SCCmec typeⅢare usually multiple-drug resistant , mainly seen in elderly patients in surgical wards and ICU .Strains of t437-SCCmecⅣare sensitive to most non-β-lactam antimicrobial drugs , and its infection is mainly seen in children and young people .

Objective:To investigate the implementation method of statistical inference for binomial dis-tribution in Excel.Methods:With the application of Excel functions,such as BINOMDIST,FINV,NORMS-INV and otherwise,the probability that the the positive times was m ,no more than m and just m,the quan-tile of normal distribution and F distribution during n times of independent tests can be obtained under the condition that the positive probability was p in each times.Deploy p,n,m and other original data and the final conclusion of statistical analysis on the same interface,conceal the other intermediate computing data,final conclusion of statistical analysis can be presented immediately along with the original data.Results:When im-plementing the statistical inference for binomial distribution data,the statistical analysis can be obtained only through logging in relevant p,n and m instead of imputing any statistical formal and command if the Excel worksheet has been created.Conclusion:it is possible to conduct statistical inference for common binomial dis-tribution data visually and quickly with the application of Excel.

Objective To study the prevalence rate of Acinetobacter baumannii infection in the patients with malignant tumor and the drug resistance to provide reference for clinical prevention and treatment .Methods 691 ca‐ses of malignant tumor were selected .Sputum ,pharynx swabs ,puncture fluid and urine were collected as specimens for detecting Acinetobacter baumannii ,and the drug resistance analysis was performed by using the disk diffusion method .Results 1 355 samples were taken from different parts in 691 patients ,52 strains of Acinetobacter bauman‐nii were isolated with the detection rate of 3 .84% and the infection rate of 7 .53% .The prevalence rates of males and females were 7 .80% and 7 .21% respectively ,the difference was not statistically significant(P > 0 .05) .The preva‐lence rate in malignant tumor patients aged ≥ 60 years old was 9 .09% ,which in the patients aged < 60 years old was 4 .13% ,the difference was statistically significant (P < 0 .05) .The prevalence rates of Acinetobacter baumannii in lung cancer and colorectal cancer were 10 .06% and 9 .12% respectively ,which were significantly higher than those in other parts of tumor .The detection rate of Acinetobacter baumannii was 5 .93% in sputum specimens ,which was sig‐nificantly higher than that in the other specimens ,the difference was statistically significant(P< 0 .05) .The resistant rate in 52 strains of Acinetobacter baumannii to cefazolin reached 100 .00% ,which to cefuroxime ,ceftriaxone and gentamicin were higher and were 88 .46% ,82 .69% and 78 .85% respectively ;the resistant rate to polymyxine was lowest ,only 1 .92% ,in addition ,the resistant rates to meropenem and imipenem were lower ,which were 11 .54% and 17 .31% respectively .Conclusion The prevalence rates of Acinetobacter baumannii exists in different ages and differ‐ent primary tumors .The the clinical work ,the invasive operations in the patients should be reduced .The antibacterial drugs should be normally used ,and the sensitive antibacterial drugs should be selected according to the drug suscepti‐bility test for controlling the generation of drug‐resistant strains .

Objective To investigate the influence of different processing techniques on monocyte-platelet aggregation(MPA) by flow cytometry in order to provide the reference for the determination of MPA.Methods Sodium citrate anticoagulation whole blood samples were collected randomly.CD14-phycoerythrin( PE) and CD61-fluorescein isothiocyanate (FITC) were used to label monocytes and platelets.CD62P-PE was used to label activated platelets.The percentages of CD14-PE/CD61-FITC-double-positive MPA in monocytes and CD62P-positive platelets were determined by flow cytometry.Different processing techniques were performed as follows.Whole blood samples were prepared immediately after collection or delayed for different times.After preparation, samples were analyzed immediately or delayed for different times.Antibody immunolabeling was performed before fixation of whole blood samples, immediately after fixation or at different delayed times after fixation.Before immunolabeling, whole blood samples were centrifugated or not.Different antibodies, anti-CD14-PE with anti-CD61-FITC, anti-CD14-PE with anti-CD41-ECD and anti-CD45-ECD with anti-CD61-FITC, were used to label MPA.The results of MPA from different processing techniques were compared.Results Compared with immediate preparation after blood collection, the percentages of MPA and CD62P-positive platelets increased with the delayed time at room temperature ( 18-25℃) and low temperature ( 2-8℃) ( P<0.05), and there was a positive correlation(room temperature: r=0.82, P<0.05; low temperature: r=0.83, P<0.05).Compared with immediate determination after preparation, the percentages of MPA of samples stored at low temperature for 24h after preparation did not alter significantly(P >0.05).Compared with immunolabeling samples before fixation with 1% paraformaldehyde, no significant change was observed in MPA percentages from immediate immunolabeling after fixation or immunolabeling samples stored at low temperature for 24 h after fixation(P>0.05).&nbsp;Centrifugation of whole blood samples before immunolabeling resulted in significant increase of the percentages of MPA and CD62P-positive platelets(P<0.05).MPA percentages resulted from different antibodies had no significant variance (P >0.05).Conclusions Whole blood samples should be handled as soon as possible.Fixation with 1%paraformaldehyde at low temperature could store samples for 24h before handling.Centrifugation should be avoided before immunolabeling.After preparation and fixation, samples could be stored at low temperature for 24h before analysis.Different antibody combinations, including anti-CD14-PE/anti-CD61-FITC, anti-CD14-PE/anti-CD41-ECD and anti-CD45-ECD/anti-CD61-FITC, are all suitable for immunolabeling MPA.

目的 建立可靠的糖皮质激素(GC)实验诊断系统平台. 方法 采用超高效液相色谱串联质谱法检测人工合成GC药物(泼尼松、甲基泼尼松和地塞米松)血药浓度,流式细胞分析法检测糖皮质激素受体(GR)-α蛋白,逆转录实时荧光基因扩增定量分析法检测GR-α mRNA,并进行了方法学分析. 结果 质谱法检测PNS、DPNS、DX血药浓度分别在l～15 ng/mL、1～100 ng/mL、20 ～ 400 ng/mL范围内线性关系良好.标本置26℃6h、置-20℃30 d、加甘油三酯13.21 mmol/L、加总胆红素162.8 μmol/L,比较各组血药浓度未发现统计学差异.PNS、DPNS、DX血药浓度日内CV分别小于10.81％、7.98％、5.47％,`间CV分别小于10.72％、6.29％、12.36％.回收率试验显示PNS、DPNS、DX在20 ng/mL、20 ng/mL、400 ng/mL浓度的平均回收率分别是99.91％、102.49％、109.89％.流式细胞术分析GR-α蛋白,标本立即处理检测与放置6h、24 h后处理检测结果比较无统计学差异,标本处理后5h检测结果无显著性变化,3种抗体反应条件(室温孵育30 min、37℃孵育30 min、4℃孵育6h)检测结果无统计学差异,百分率及荧光强度CV值分别为3.4％与9.8％.逆转录实时荧光基因扩增定量分析法检测GR-α mRNA检测灵敏度达到101 copies/μL,批内和批间Ct值变异系数均小于2.0％. 结论 初步证实本体系设计科学、方法先进、系统可靠.

Objective This study was aimed to construct β-lactamase pen P-E166 C mutant and over-express it in E. coli,followed by purification and characterization. Method The plasmid of mutated β-lactamase pen P was successfully amplified by PCR-mediated mutagenesis,which was then confirmed by DNA sequencing. The confirmed plasmids were firstly transformed into competent BL21(DE3) cells and the positive colonies were selected by antibiotics kanamycin,which were then induced by the addition of IPTG.The bacterial cells were firstly liaised by sonication,followed by Ni2 +-affinity column purification,protease3 C digestion and gel filtration column purification to obtain target protein. The proteins were characterized by SDS-PAGE and ESI-mass spectrometry. Results We successively constructed pen P-E166 C mutant and purified this protein by Ni2 +-affinity column and gel filtration column. SDS-PAGE and ESI-mass spectrometry further identified the protein molecular weight was consistent with theoretical value. Conclusion The obtained pen P-E166 C protein with mutation at the active site will be used in later study,which will help us to understand the interaction between antibiotics and β-lactamase better.

目的 研究耐碳青霉烯鲍曼不动杆菌blaOXA-23基因的分布情况,并探讨blaOXA-23基因与鲍曼不动杆菌对碳青霉烯类抗生素产生耐药性的相关性.方法 按照全国临床检验规程,收集培养了178株亚胺培南耐药的鲍曼不动杆菌和4株敏感菌株,采用纸片扩散法(K-B法)检测鲍曼不动杆菌对16种临床常用抗菌药物的药敏试验,并利用聚合酶链式反应(PCR)对耐药基因blaOXA-23进行扩增,产物经DNA琼脂糖电泳后分离,并纯化测序.结果 PCR产物的DNA电泳显示扩增条带的大小与耐药blaOXA-23基因条带大小相吻合,测序结果与blaOXA-23基因序列比对,符合率为100％,携带blaOXA-23耐药基因的阳性菌株175株,阳性率为98.3％,且4株敏感(质控)菌株均未检出blaOXA-23耐药基因,且4株敏感(质控)菌株均未检出blaOXA-23耐药基因.结论 本地区鲍曼不动杆菌对临床常用抗菌药存在严重耐药现象,本地区鲍曼不动杆菌对碳青霉烯类抗菌药物的高度耐药性与blaOXA-23基因的表达有关.

目的：：探讨对假设检验资料进行样本量和检验效能估计的 Excel 快速实现的方法。方法：在 Excel 工作表中，利用Excel函数 ASIN、BINOMDIST、FINV、NORMSINV、NORMSDIST 等，将α、β、容许误差δ、标准差σ、总体率π等原始数据与最终估计的样本量和检验效能部署在同一界面，将其他中间计算数据隐藏，最终统计分析结论可随原始数据立即呈现。结果：建立“样本量和检验效能估计”的 Excel 工作表后，对常用的几种假设检验资料进行样本量和检验效能估计时仅仅录入相关的α、β、容许误差δ、标准差σ、总体率π等，不须再录入任何统计公式和命令，就能立即得到样本量和检验效能的估计值。结论：利用 Excel 能直观快速进行假设检验的样本量和检验效能的估计。

目的：根据CNAS-CL39的要求，探讨定性试验的性能验证方法。方法以 ELISA 法检测 HBsAg 为例，以厂家给定的性能指标为验证依据，根据空白检出限及样本检出限的验证方法对检出限进行验证，按照EP15-A2标准验证该方法的精密度，采用验证方法与公认方法比较的2×2列联表验证该方法的符合率，采用收集的 HBsAg阴性患者血清对cut off值进行验证。结果检出限、精密度（重复性和中间精密度）、符合率、诊断临界值的验证结果均符合要求。结论本研究按照 ISO15189和CNAS-CL39文件要求进行的免疫学定性试验性能验证方案是科学而适用的。

Objective To investigate the epidemiology and antibiotic resistance of communityassociated and hospital-associated meticillin-resistant Staphylococcus aureus (CA-MRSA and HA-MRSA) in Jingzhou.Methods A total of 159 MRSA isolates were successively collected from patients in Jingzhou Central Hospital during January 2012 and December 2013.The minimum inhibitory concentrations of 16 antimicrobial agents against 159 MRSA isolates were detected.SCCmec types of the strains were detected by multiplex PCR,and the homology of the strains was analyzed using pulsed field gel electrophoresis (PFGE) and cluster analysis of antibiogram.WHONET 5.6 and SPSS 19.0 were used for data analysis.Results Among 159 MRSA strains,131 were hospital-associated,and 28 were community-associated,which accounted for 82.4％ and 17.6％,respectively.There were significant differences in the age of patients,ward distribution,specimen type,length of stay,length of anti-infection treatment,type of infection and underlying diseases between patients with CA-MRSA or HA-MRSA infections (x2 =19.103,31.372,59.756,71.703,54.153,59.756 and 54.232,all P ＜ 0.01).No vancomycin,linezolid,tigecyeline and nitrofurantoin resistant strains were found,but all strains were resistant to penicillin,cefoxitin and oxacillin.HA-MRSA had higher resistance rates to moxifloxacin,levofloxacin,rifampicin,ciprofloxacin and gentamicin than CA-MRSA (x2 =30.179,27.352,28.523,28.523 and 25.987,all P ＜ 0.01),but its resistance rates to erythromycin and clindamycin were lower (x2 =13.106 and 11.743,both P ＜ 0.01).Among 159 MRSA strains,12 (7.5％) were of SCCmec type Ⅱ,113 (71.1％) were of SCCmec type Ⅲ,26 (16.4％) were of SCCmec type Ⅳ,and 8 were of undifferentiated type.The predominant SCCmec types were type Ⅳ for CA-MRSA (26/28,92.9％) and type Ⅲ for HA-MRSA (113/131,86.3％),respectively.Six PFGE patters were found in 49 HA-MRSA isolates from ICU,and the predominant patters were A1 (24,49.0％),A2 (9,18.4％) and B (9,18.4％).Cluster analysis of antibiogram showed that three groups of HA-MRSA were of high correlations,and they were of PFGE patter A1,A2 and B,respectively.Conclusions HA-MRSA is the predominant MRSA in Jingzhou area,and it is different from CA-MRSA in the age of patients,ward distribution,type of infection and antibiotic resistance.Most HA-MRSA strains are of type SCCmec Ⅲ,and may cause epidemic outbreak in ICU.

Objective To investigate the incidence of osteoporosis(OP) in rheumatoid arthritis(RA) patients by monitoring total N-terminal propeptide of type I procollagen (TPINP), β-collagen specific se-quences (β-CTx) and N-terminal-midfragment of osteocalcin (N-MID) in serum. Methods Bone mineral density (BMD) of 70 cases of RA inpatients and 60 cases of volunteers were measured by dual-energy X-ray absorptionmetry. The serum TPINP, β-CTx and N-MID were measured by electrochemiluminescence im-munoassay. The incidence of OP, bone turnover markers in RA patients and volunteers, bone turnover markers in the RA patients with or without OP were evaluated. Results The incidence of OP in RA patients group was significantly higher than that of control group, and difference had statistical significance(χ2=11.07, P<0.05). Compared with control group, the levels of TPINP and N-MID in RA patients were obviously decreased, but the level ofβ-CTx was dramatically increased and the differences all had statistical significance (Pall<0.05). There was no statistical significance in the differences for TPINP and N-MID between RA patients with OP and without OP(t=0.69, t=0.58, Pall>0.05), exceptβ-CTx(t=3.09, P<0.05). Conclusion The measurement of the serum TPINP,β-CTx and N-MID levels are helpful for evaluating the incidence of OP in RA patients.

Hesperidin (HDN) is a citrus bioflavonoid, which widely exists in many plants. Previous researches have proved that HDN has several functions such as anti-oxidant, anti-tumor, anti-inflammatory, immune regulation and so on. In the present study, we explored the protective effects of HDN on concanavalin A (Con A)-induced hepatic injury. Acute hepatic injury model was established successfully by intravenous administration of Con A (15 mg/kg) in male C57BL/6 mice, and HDN was pretreated for 10 days before Con A challenge. It was found that the hepatic injury was notably improved in HDN pretreated mice. Furthermore, hepatic oxidative stress and the production of proinflammatory cytokines including TNF-α and IFN-γ were decreased by HDN pretreatment. More importantly, compared with Con A-treated mice, the expression and releasing of HMGB1 and T-cell activation were markedly reduced in HDN pretreated mice. Thus, these results suggest that HDN protects mice from Con A-induced hepatic injury by suppressing hepatocyte oxidative stress, producing cytokines, expressing and releasing HMGB1 and activating T cells.

目的：研究抗角蛋白抗体（AKA）在类风湿关节炎（RA）的临床意义。方法收集171例RA患者和186例非RA患者，采用间接免疫荧光法检测患者血清标本中的AKA ，采用电化学发光法检测血清中的抗环胍氨酸肽（CCP）抗体，采用免疫比浊法检测血清中的类风湿因子（RF），采用酶联免疫吸附试验检测血清中炎性因子白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、白细胞介素-17（IL-17）、肿瘤坏死因子-α（TNF-α）。分析比较 AKA、抗CCP抗体、RF对于RA诊断的灵敏性和特异性，分析AKA与抗CCP抗体、RF及炎性因子之间的相关性。结果AKA、抗CCP抗体、RF对于 RA 诊断的灵敏性分别为56．73％、85．12％、75．61％，特异性分别为97．89％、96．48％、90．32％。AKA阳性组与 AKA 阴性组比较，抗 CCP抗体和 RF水平差异有统计学意义（P＜0．01）。AKA阳性组IL-1β、IL-6、IL-17、TNF-α水平与 AKA 阴性组比较偏高，但差异无统计学意义（P＞0．05）。结论AKA对于RA的诊断具有很高的特异性，AKA阳性可能预示更为严重的病情。

目的：探讨肾功能不全对应用氨基末端B型利钠肽前体（NT-ProBNP）诊断心力衰竭的影响。方法将240例心力衰竭患者作为心力衰竭组，按肾小球滤过率（GFR）将其分为肾功能正常组（GFR ：≥90 mL/min）和肾功能不全组（GFR ：＜90 mL/min）。根据GFR的降低程度将肾功能不全组再分为轻度组（GFR ：60～＜90 mL/min）、中度组（GFR ：30～＜60 mL/min）及重度组（GFR ：＜30 mL/min）。采集空腹静脉未抗凝血，分离血清。采用Roche Cobas E601型全自动电化学发光免疫分析仪检测血清NT-proBNP水平，Beckman Coulter LX20全自动生化分析仪检测血清肌酐、血糖和血脂水平；超声心动图仪检查测定心脏射血分数（EF）。结果肾功能不全组的血清NT-proBNP水平显著高于肾功能正常组（P＜0．01），组间年龄、身体质量指数（BMI）、EF、血糖、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇及三酰甘油水平的差异无统计学意义（P＞0．05）。轻度肾功能不全与肾功能正常组、中度肾功能不全组与重度肾功能不全组患者血清NT-proBNP水平的差异无统计学意义（P＞0．05），但轻度肾功能不全组和肾功能正常组患者血清NT-proBNP水平均显著低于中度和重度肾功能不全组（P＜0．01）；不同肾功能组患者EF值的差异无统计学意义（P＞0．05）。肾功能正常组和轻度肾功能不全组患者的EF值和LogNT-proBNP呈负相关（r值分别为-0．66、-0．54，P＜0．01）；中度和重度肾功能不全组的 EF值与 LogNT-proBNP无相关性（r值分别为-0．17、-0．36，P＞0．05）。结论应用血清NT-proBNP水平诊断心力衰竭必须考虑肾功能的影响，当患者肾功能处于中、重度损伤时，会严重影响NT-proBNP对心力衰竭诊断的准确性。