Objective:To construct eukaryotic expression plasmid ecording a novel surface protein Fba of GAS, and to explore its impact on host immune responses.Methods:Fba gene was amplified by PCR using strain SSI-9 (GAS M1 serotype isolates) as the template, then cloned into pcDNA3.1 for constructing eukaryotic expression plasmid pcDNA3.1/fba and sequenced. Female CD1 mice were randomly individed into 6 groups, and immunized respectively with Fba protein, M protein, pcDNA3.1/fba + Fba protein, pcDNA3.1/fba, pcDNA3.1 and PBS as control. Blood was obtained from the mice and specific antibody of IgG was detected by ELISA. Spleen cells were assessed with lymphocyte proliferation assays.CD4+T cell and CD8+T cell were detected by flow cytometry (FCM). Assay results were analyzed with SPSS10.0.Results:The IgG against Fba protein kept hightest levels in group immunized with Fba protein. The levels of lymphocyte proliferation, CD4+, CD8+T cell were significantly high in the group pcDNA3.1/fba. Conclusion:(1) Just as M protein, the antibody to Fba protein could be efficiently induced by immunization with Fba protein, which showed that Fba protein was hopefully to be a candidate protein for vaccine against GAS.(2) Eukaryotic expression plasmid pcDNA3.1/fba was successfully constructed and this recombinant plasmid could efficiently induce antibody and CD4+ T cell for againsting GAS.

Objective To explore the effects of virtual reality (VR) combined with motor imagery therapy on the upper limb function of hemiplegic stroke survivors.Methods Thirty-nine hemiplegic stroke patients were divided randomly into a treatment group (n =20) and a control group (n =19).Both groups were treated with motor imagery therapy,but the treatment group also received VR training lasting 20 min/day,6 days/week for 8 weeks.All of the patients were assessed with the Fugl-Meyer (FMA) upper limb assessment,the modified Barthel index (MBI) and electromyography at the beginning and after eight weeks of treatment.Results Before the intervention there was no significant difference between the groups in any of the assessments.After eight weeks of treatment,all the assessment results in the treatment group were significantly better than those in the control group.Conclusion Virtual reality combined with motor imagery therapy can distinctly improve the upper limb motor function of hemiplegic stroke survivors and their ability in the activities of daily living.

Objective To explore the symptoms of anxiety,family structure,and the distribution features of family about in-patients.And to find out the influence of the family structure on in-patients' symptoms of anxiety.The results would provide evidentiary support and suggestions for in-patients to improve quality of life and for prevention and intervention of anxiety.Methods Family table was used to register the family structure which was classified as the nuclear family,stem/expended family and other classification.The anxiety of in-patients was measured by self-rating anxiety scale.Results A total of 512 cases of in-patients completed the survey,there were 483 valid questionnaires.The rate of effective questionnaire was 94.34％.In family structure of in-patients,core family accounted for 48.65％,stem/expended family was 36.85％.The sex of family structure showed significant difference,the female proportion of the nuclear family was significantly higher than male.Among all in-patients,78.05％ did not have anxiety,low-level,medium-level,and severe anxiety showed no significant differences.The effects of anxiety on family structure had significant differences.The anxiety level of stem family was relatively higher.Conclusions Economic development and the population flow due to industrialization and globalization changed family structure of our country,especially in coastal de-velopment cities with fast economic development,fast-paced and stressful work,and it may affect the influ-ence of Chinese traditional family structure on anxiety of the in-patients.

Objective:To analyze and compare the clinicopathological characteristics in low weight proteinuria(LWP) and nephrotic proteinuria(NP) multiple myeloma(MM) patients with renal involvement.Methods:From October 1991 to October 2005,46 patients with MM were diagnosed in the Research Institute of Nephrology of Jinling Hospital(Nanjing,China).Renal biopsies were done in 41 of them.The patients were devided into two groups,LWP and NP groups.Their clinical and pathological features were investigated and compared. Results:The epidemiological features and type of MM in LWP and NP groups were similar.The patients in LWP group had higher incidence of D-S Ⅲ stage and heavier anaemia compared to NP group.Compared to patients in NP group,patients in LWP group had higher incidence of renal insufficiency and lower urine osmotic pressure.Part of patients checked urine N-acetyl-?-glucosaminidase,RBP and there were no difference between two groups.Cast nephropathy was the most frequent pathologic type in LWP group,while light chain deposition disease and glomerular amyloidosis were the most common pathologic type in NP group.Conclusion:According to this study,we get the conclusion that proteinuria analysis may be a significant test to evaluate the clinicopathological characteristics of MM patients with renal involvement.

Objective To observe and compare the value of B brain natriuretic peptide( BNP)and N-terminal pro-brain natriuretic peptide( NT-proBNP)in the diagnosis of heart failure after neonatal asphyxia, and to optimize early clinical diagnosis. Methods A retrospective analysis was conducted on 124 neonatal asphyxia cases from January 2013 to October 2015,who were divided into heart failure group(53 cases)and control group(71 cases)according to whether complicated with heart failure. Comparison was conducted on BNP,NT-proBNP,cardiac troponin T( cTnT),creatine kinase isoenzyme( CK-MB)through blood sam-pling from femoral vein puncture within 48 h. And Logistic regression analysis was introduced into explore effecting factors of heart failure,besides,correlations between BNP,NT-proBNP and left ventricular ejection fraction( LVEF)of asphyxia children were calculated,and receiver operating characteristic curve( ROC)was introduced into analyzing of BNP and NT-proBNP for diagnostic efficacy of heart failure after neonatal asphyxia. Results Heart failure group whose BNP[(835. 8 ± 154. 7)pg/ml vs. (235. 4 ± 38. 5)pg/ml], NT-proBNP(25 903. 8 pg/ml vs. 6 974. 5 pg/ml),cTnT[(0. 21 ± 0. 06)ng/ml vs. (0. 11 ± 0. 03)ng/ml], CK-MB[(61. 3 ± 11. 7)U/L vs. (40. 8 ± 9. 5)U/L]were significantly higher than those of control group ( P﹤0. 05). Logistic regression analysis indicated BNP and NT-proBNP were closely related with newborn heart failure(ORBNP =3. 013,P﹤0. 001;ORNT-proBNP =3. 808,P=0. 006). BNP and NT-proBNP were both significantly negatively correlated with LVEF(rBNP = -0. 650,P=0. 007;rNT-proBNP = -0. 721,P﹤0. 001). The ROC curve indicated the diagnostic efficacy of BNP and NT-proBNP for heart failure after neonatal as-phyxia were 0. 868,0. 911,with the highest diagnosis cut-off value were 268. 8 pg/ml,3 972. 3 pg/ml,respec-tively. Conclusion BNP and NT proBNP are specific indicators reflecting heart failure after neonatal as-phyxia,and NT-proBNP with higher auxiliary diagnostic efficacy comparatively.

Objective To investigate the clinical predictive value of rheumatoid factor (RF), anti-keratin antibodies (AKA), anti-cyclic citrullinated peptide (anti-CCP) antibody and anti-perinuclear factor (APF) in the transition from undifferentiated arthritis (UA) to rheumatoid arthritis (RA), and to analyze the clinical relevant factors. Methods 271 patients with UA who were followed up for a year were enrolled into the investigation. RF was measured by the rate scatting immunity method. APF and AKA were detected by immuniofluorescence method(IFA). Anti-CCP was measured by ELISA. Erythrocyte sedimentation rate (ESR) was analyzed by Wilcoxon method. The duration of morning stiffness, the numbers of swelling and tender joints, tender joints involved and DAS28 score were recorded and analyzed. Results 99% patients who had four-antibody-positive finally convetted from UA to RA. The conversation rate for those who had two or more than two antibody-positive was 83.0% and 65.9% respectively. The sensitivity and specificity of RF and anti-CCP antibody-positive in those who converted from UA to RA was 77.8% and 80.5% respectively. The percentage of polyarticular swelling in antibody-negative, one-antibody-positive, two-antibody-positive, three-antibody- positive and four-antibody-positive was 48%, 57%, 59%, 70% and 70% respectively. Meanwhile, the percentage of multi-small-joint involvement was 71%, 71%, 72%, 76% and 83% respectively. The proportion of elbow involvement in antibody-negative patients was 72%, which was the highest among all joint area involvement. The conversion differences of the group with more than 3 swelling joints or more than 3 small joints involvement ranked the first and second in frequency. Conclusion The combined detection of these autoantibodies could increase the specificity of early diagnosis of RA. The more positive antibodies present, the more likely the concersion form UA to RA. The sensitivity and specificity of RF and anti-CCP-positive is high, so the latter is expected to become one of the diagnostic criteria. The polyarticular swelling and multi-small-joint involvement are valuable in predicting the transformation from UA to RA.

OBJECTIVE: To analyze gene variants in a Chinese pedigree with oculocutaneous albinism (OCA). METHODS: Gene sequencing of the proband and his parents was performed using chip capture high-throughput sequencing and Sanger sequencing techniques, and PolyPhen-2, SIFT, MutationTaster, and FATHMM software were used to predict the function of new variants. At the same time,the pedigree and variant genes of 4 albinism patients from this pedigree were analyzed. RESULTS: Sequencing results showed that the proband's TYR gene (NM_000372) has c.230G>A (p.Arg77Gln) and c.120_121insG (p.Asp42GlyfsTer35) compound heterozygous variants. The proband's father carries c.230G>A heterozygous variant, and the mother carries c.120_121insG heterozygous variant, indicating that the proband's two variants are from his father and mother. The former is a known missense variant, which can cause abnormal or loss of the original function of the protein polypeptide chain. The latter c.120_121insG(p.Asp42GlyfsTer35) is an unreported frameshift variant of the TYR gene subregion (EX1; CDS1). PolyPhen-2, SIFT, MutationTaster and FATHMM predictions are all prompted as "harmful variants". This variant caused the amino acid encoded protein to terminate prematurely, producing a truncated protein, which eventually formed a 76-amino acid short-type TYR protein instead of the 529-amino acid wild-type TYR protein. Through the pedigree analysis, the four patients in the pedigree are all of the same type of compound heterozygous variants, and the disease-causing genes are all from the patient's parents. They belong to a special form of consanguineous marriage within 5 generations. CONCLUSION The compound heterozygous variants of c.230G>A (p.Arg77Gln) and c.120_121insG (p.Asp42GlyfsTer35) of the TYR gene may underlie the disease in this pedigree. The gene sequencing results enrich the variant spectrum of the TYR gene, and has facilitated molecular diagnosis for the patient.
Albinism, Oculocutaneous/genetics* ; Consanguinity ; Heterozygote ; Humans ; Mutation ; Pedigree

Objective To observe the effect of continuous high-volume hemofiltration on target organs function,serum procalcitonin,tumor necrosis factor-α and vascular endothelial damage factors levels in patients with multiple organ dysfunction syndrome (MODS).Methods A total of 54 patients with multiple organ dysfunction syndrome were selected.Observation group was given basic treatment and intermittent hemodialysis therapy,and experiment group was treated with continuous high-volume hemofihration on the basis of the observation group.The levels of target organs function,serum procalcitonin,tumor necrosis factor-α and vascular endothelial damage factors were detected and compared between the two groups.Results After treatment,the indexes of target organs function in both groups were significantly lower than those before treatment (P ＜ 0.05),and those levels of the experiment group were significantly lower than those in the observation group (P ＜ 0.05).The levels of serum procalcitonin and tumor necrosis factor-α in the two groups after treatment were significantly lower than those before treatment (P ＜ 0.05),and those levels of the experiment group were significantly lower than those in the observation group (P ＜ 0.05).The vascular endothelial damage factors levels of the two groups after treatment were significantly lower than those before treatment (P ＜ 0.05),and those levels of the experiment group were significantly lower than those in the observation group (P ＜ 0.05).Conclusion Continuous high-volume hemofiltration can improve the target organs functionof patients with multiple organ dysfunction syndrome,reduce the levels of serum procalcitonin,tumor necrosis factor-α and vascular endothelial damage factors,which can protect vascular endothelial function and enhance the curative effects.

Objective By analyzing the predisposing factors for Ebora virus of medical personnel in Sierra Leone , and to explore the effective measures for prevention and control of infection .Methods A self-designed questionnaire , including general data , related knowledge of infectious disease , Ebola disinfection isolation skills, times of go out for non-work days, form of worship, family social number, etc.The inside and outside the hospital susceptible factors of the Ebola virus were analyzed .Results The secondary school education accounted for 43.69% in the Sierra Leone medical staff , which revealed a low education level .Only 25.29%of them had the knowledge related to the Ebola virus .14.94% had the knowledge of disinfection and isolation.85.06% medical staff went out more than 3 times for non-work days.70.11% people went to the church, and 62.07% lived in groups.Conclusions The knowledge level about predisposing factors for Ebora virus of medical personnel in Sierra Leone and the effective measures for prevention and control of infection was low.The medical personnel had weak protection consciousness and lack the knowledge of disinfection and isolation , which increased the chance of infection in the hospital .At the same time , the local social phenomenon , participation in social group activities more frequently , increased the rate of infection and the spread of Ebola .

Objective:To observe the efficacy of different doses of atorvastatin on the early cardiorenal syndrome caused by chronic heart failure .Methods:A total of 90 patients with early cardiorenal syndrome caused by chronic heart failure were ran‐domly divided into conventional treatment group(group A) ,atorvastatin 20 mg group(group B) and atorvastatin 40 mg group (group C) ,with 30 patients in each group .The patients in group A received therapy of conventional anti‐heart failure agent ,the patients in group B and group C orally received atorvastatin 20 mg/d ,40 mg/d respectively ,based on the therapy of conventional anti‐heart failure agent .Serum creatinine(Scr) and glomerular filtration rate(GFR) ,left ventricular ejection fraction(LVEF) and high sensitivity C‐reactive protein(hs‐CRP) of patients in the three groups ,were detected ,before the treatment ,after 3 months of treatment ,and after 6 months of treatment .And the data were compared among the groups .Results:After 3 months or 6 months of treatment ,levels of LVEF in 3 groups were higher than that before treatment(P<0 .05 ,0 .01) .There was no significant difference among the 3 groups(P>0 .05) .There was no significant difference between the levels of Scr and GFR in group A or group B after 3 months of treatment and those before treatment(P>0 .05) .The levels of Scr and GFR in group C after 3 months of treatment were improved ,while compared with those before treatment ,and the differences showed statistical‐ly significant (P<0 .05) .There was no significant difference among the 3 groups(P>0 .05) .There was no significant differ‐ence between the levels of Scr and GFR in group A After 6 months of treatment and that before treatment(P>0 .05) .The levels of Scr ,GFR in group B and group C significantly improved after 3 months of treatment ,while compared with those before treat‐ment(P<0 .01) .The levels of Scr and GFR in group C after 6 months of treatment ,improved significantly ,while compared with that after 3 months of treatment(P<0 .01) .The levels of Scr in group B and group C were significantly different from that in group A ,after 6 months of treatment (P<0 .05 ,0 .01) ,while the level of Scr in group C was significantly different from that in group B(P<0 .05)and the level of GFR in group C was significantly different from that in group A(P<0 .05) .There was no significant difference between the levels of hs‐CRP in group A before the treatment and after treatment(P> 0 .05) .After 3 months and 6 months of treatment ,the levels of hs‐CRP in group B and group C ,were significantly different from that before treatment(P<0 .01) .After 6 months of treatment ,the level of hs‐CRP in group C ,was significantly different from that after 3 months of treatment(P<0 .01) .After 6 months of treatment ,the levels of hs‐CRP in group B and group C were significantly different from that in group A(P<0 .05 ,0 .01) ,meanwhile there was significant difference between the levels of hs‐CRP in group B and that in group C(P<0 .05) .Conclusions:On the basis of conventional therapy ,atorvastatin could improve the renal function significantly .Its mechanism may be related to the ability of atorvastatin in controlling the inflammatory reaction .The renal function protection of atorvastatin is related to the dose .