Small molecule antibodies are naturally existed and well functioned but not structurally related to the conventional antibodies. They are only composed of heavy protein chains or light chains, much smaller than common antibody. The first small molecule antibody, called Nanobody was engineered from heavy-chain antibodies found in camelids. Cartilaginous fishes also have heavy-chain antibodies (IgNAR, "immunoglobulin new antigen receptor"), from which single-domain antibodies called Vnar fragments can be obtained. In addition, free light chain (FLC) antibodies in human bodies are being developed as therapeutic and diagnostic agents. Comparing to intact antibodies, common advantages of small molecule antibodies are with better solubility, tissue penetration, stability towards heat and enzymes, and comparatively low production costs. This article reviews the structural characteristics and mechanism of action of the Nanobody, IgNAR and FLC.

[Objectives]To extract Yang Lishan’s description of latent evils ,summarize his arguments, and provide reference for exploring his academic ideology further. [Methods] Use the literature methodology, take“latent evils”and“pestilential pathogen”as keywords, retrieve the related description in Yang Lishan’s book, summarize his main opinions on latent evils. [Results] Yang Lishan wholly refused the theory of latent cold evil turning into pathogenic warm, and he believed that the cause of latent evils is pestilential pathogen, thereby distinguishes warm disease from exogenous febrile disease on etiology level. He described the disease’s quality, afferent pathway, hiding spot, the way out, therapeutic method, prescription and recuperation in details, which are mature enough to form a complete theoretical system. The prescription Sheng Jiang Powder represents experiment with the thought of treating pestilential pathogen with drugs and special medicine for special disease, which makes the etiology of pestilential pathogen to have real directive value. [Conclusion] Yang Lishan’s theory of latent evils has implications in treatment and prevention of epidemic diseases.

OBJECTIVE To sum up the distribution and drug-resistance of pathogens in hospital-acquired pneumonia(HAP) at each stage,and then to offer references for treatments of HAP.METHODS To retrospectively analyze 46 patients whose course was over 30 day and who were in hospital from Jan 2000 to Oct 2005,and to divide course into prophase,metaphase and anaphase,and then to clinically study the drug-resistance and distribution of pathogens in each phase.RESULTS In prophase the most pathogens were Gram-negative bacilli(accounted for 87.5%),in metaphase the Gram-positive cocci were manifold distinctly;and in metaphase and anaphase drug-resistance of Gram-negative bacilli increased distinctly;and the fungi were not detected in prophase,but were positive in metaphase and anaphase.CONCLUSIONS In prophase application of third generation cephalosporin which is more sensitive to Gram-negative bacilli as an empirical antibacterial therapy is right;based on the drug-resistance and distribution of pathogens,the antibacterial drugs and treatment must be readjusted.

Objective To analyse imaging appearances of chest in AIDS and to supply the evidence for imaging diagnosis this lesions. Methods 46 cases of AIDS who had chest X-ray films and CT were collected and their imaging appearances were reviewed. Results 20 cases showed bilateral lung diffuse lesions which were network shadow with mottle, punctate, patchy, nodular and opacification. 10 cases showed unilateral lung field lesions,of them,cavity in the left upper lung was presented in one patient. 5 cases showed thickness or turbulence of texture in bilateral lungs. 11 cases were negative on chest film.Conclusion The characteristics of X-ray film or CT of lung can reflect the chest pathological changes in patient with AIDS.

Objective To study the X-ray signs of pulmonary lymphangitis carcinomatosa (PLC).Methods X-ray and HRCT signs of PLC proved by bronchoscopic or pleural or open-lung biopsy in 37 cases were retrospectively analyzed in order to find out some X-ray signs that suggested the PLC.Results The major X-ray features of PLC included:(1)Multiple thickened bronchovascular bundles in the bilateral lung in 37 cases;(2)Irregular thickened kerley A distributed over the bilateral lung in 28 cases;(3)The reticular and inosculating shadows(kerley C) extensively distributed over the bilateral lung in 19 cases;(4)The multiple irregular thickened kerley B distributed over the bilateral lung in 15 cases ;(5)Pulmonary hilar lymph adenopathy in 18 cases ;(6)Pleurae irregularly thickened in 16 cases;(7)Hydrothoraxes in 9 cases.Conclusion HRCT is the most satisfactory method in diagnosing PLC,but the super-quality thoracic plane film can supply some useful signs of PLC.

Objective To study the protein expression levels of matrix metalloproteinases (MMPs)and their inhibitors in bone tissues of rat femoral head and to explore the relationship between necrosis of femoral head and glucocorticoid.Methods Twenty healthy adult SD rats were randomly divided into glucocorticoid group and control group,with 10 rats in each.Glucocorticoid group was treated with intramuscular injection of hydrocortisone twice a week.The control group received normal saline of the same volume.Four weeks later,bone tissues of left femoral head were collected from each group of rats for HE determination of femoral head necrosis.The expressions of matrix metalloproteinase-1 (MMP-1 ), matrix metalloproteinase-2 (MMP-2 ), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1 ),and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2 )at mRNA and protein levels were detected by RT-PCR and Western blot techniques,respectively.Results The expressions of MMP-1 and MMP-2 at mRNA and protein levels were higher in glucocorticoid group than those in the control group. However,TIMP-1 and TIMP-2 gene and protein expression levels were lower in glucocorticoid group (all P<0.05). Conclusion The expressions of MMPs in bone tissues of rat femoral head in early necrosis were increased,but their inhibitors had decreased expressions. We can draw the conclusion that glucocorticoid-induced necrosis of femoral head may be related to its regulation of the expression levels of MMPs and their related inhibitors.

Objective To assess the value of clinical application of CT pulmonary angiography(CTPA) in diagnosing pulmonary damage of Behcet’s syndrome.Methods 17 patients with Behcet’s syndrome underwent MSCT(Light Speed Plus, GE)with conventional CT scan and CTPA. The two kinds of imaging materials were comparatively studied by chi-square test , and diagnosed by comprehensive imaging appearances. Results The major feature of conventional CT included:bilateral or unilateral pulmonary density were nonhomogeneous in all cases,solitary or multiple pulmonary aneurysmal ecctasia in 9 cases,pulmonary artery growed in 12 cases,irregular and constrictive vascular wall in 6 cases and segmental infiltration in 5 cases.The features of CTPA included:irregular and constrictive pulmonary vascular wall in 15 cases,pulmonary aneurysms in 15 cases,pulmonary artery expansion in 16 cases,pulmonary artery thrombosis in 8 cases.There were statistical differences between conventional CT and CTPA in pulmonary aneurysm and arterial wall changes(?_1~2=5.10,P_10.05).Conclusion CTPA can diagnose pulmonary damage of Behcet’s syndrome in combination with clinic and conventional CT.

Objective To investigate the clilic effects of the compound danshen diwan in menopause women with ST changes and angina.Methods56 menopause women with ST changes and angina were randomly divided into two groups,a controlled group(n=28)with base medicine treatment and a observed group(n=28)with the compound danshen diwan.The change of vasodilation endothelium functon and symptom relief were oberved before and after treatment in all patients.ResultsVasodilation endothelium functon were improved markedly in the observed group while the controlled group had no significantly changes;Meanwhile,the clinic relief rates of the observed group was markedly superor to that of controlled group.ConclusionThe compound danshen diwan would have a positive effect in menopause women with ST changes and angina.

Objective To study the imaging findings of pulmonary lymphangitic carcinomatosis (PLC) and discuss it′s clinical value. Methods The imaging materials of 40 cases with PLC which were proved by bronchoscopic or pleural or open-lung biopsy were retrospectively analyzed, and the clinical application of imaging diagnosis were investigated. Results The primary tumorous pathological types of PLC included:13 cases peripheral type carcinoma of lung,2 cases central type carcinoma of lung,11 cases mammary cancer,6 cases gastric carcinoma,4 cases pancreatic carcinoma,3 cases renal carcinoma,1 case colon carcinoma. The major imaging features of PLC were showed as pleural nodes, lobular core nodes, intralobular small reticular and nodular shadows, small beaded thickened interlobular septums, beaded thickened bronchovascular bundles, tumescent pulmonary hilar and/or mediastinal lymph nodes. Conclusion PLC possess relative imaging feature, particularly HRCT may accurately reflect pathological feature of PLC. Imaging diagnosis is a satisfactory method in diagnosing pulmonary lymphangial metastasis of malignant tumor.

Objective:To determine the microvessel density (MVD) in laryngeal carcinoma and its clinical significance.Method:Thirty-eight tumor specimens were selected from laryngeal cancer patients from January,1994 to March,1996.Histological sections of the tumors were stained immunohistochemically for factor Ⅷ.Using light microscopy,we counted microvessels per 400×field in the most active areas of tumor angiogenesis.Result:①The tumor blood vessels,composed of only one layer of endothelium were mainly distrbuted heterogenously in the interstitial tissue of laryngeal carcinoma with irregular lumen,poorly developed structure.②The MVD in the cancer tissues were statistically higher than that in peritumoral tissues (P＜0.01).③The MVD in the cancer tissues in group of patients with metastasis to cervical lymphonodes were statistically higher than in group without metastasis (P＜0.01),the MVD in the cancer tissues in group of advanced cases (Ⅲ,Ⅳ stages) were statistically higher than that in group of early cases (Ⅰ,Ⅱ stages,P＜0.01).④There was no statistically difference in MVD in the cancer tissue between supraglottic and glottic laryngeal carcinoma patients (P＞0.05).⑤There was no statistically difference in MVD in the cancer tissue among the G1,G2 and G3 group (P＞0.05).Conclusion:The laryngeal cancer blood vessels have some characteristics that don′t appear in normal vessels.It is suggested that tumor angiogenesis can promote tumor growth and metastasis and MVD may be a new prognostic indicator of laryngeal carcinoma.