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.

Objective To probe the differences in clinicopathological features between benign and malignant polypoid lesions of the gallbladder.Methods In this study,1396 PLG cases diagnosed by postoperative pathology between 2007.1 to 2009.12 were enrolled.Cases were divided into three groups according to the pathological classification:1339 cases of benign proliferative diseases ;42 cases of adenoma,15 cases of malignant disease.Comparing the clinical characteristics of the three groups,we screened out the risk factors for malignant transitions.Results Age (F =8.090,P =0.000),size of polyp (F =102.61,P =0.000),single vs multiple lesions (x2 =214.25,P =0.000),concurrent inflammation (x2 =9.362,P =0.009),and stones (x2 =34.022,P =0.000) were significantly different between the three groups.Conclusions Size of polyps over 0.8 cm,age over 60 years,single polyp,accompanied by stones and inflammation were the risk factors for malignancy in gallbladder polypoid lesions.

Endemic arsenicosis is a disease with complex systemic damage,but the mechanism and its control strategy are mostly focused on a single organ or system damage caused by arsenic,and the systemic damage of arsenic exposure remains not fully understood.In recent years,considerable progress has been made in the field of immunology,which made an important contribution for the pathogenic mechanism of various complex diseases,and also brings a new dawn for its prevention and treatment.In consequence,a breakthrough progress is expected to make in aspects of the mechanism and its control strategy of arsenic caused systemic damage from the perspective of immunology.

[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.

Endemic arsenicosis is one of the national key endemic diseases in our country. However, due to obscure mechanism of arsenic poisoning, lack of early diagnostic indicators and specific validated therapy, the ideal control of endemic arsenicosis has not yet been obtained. To date, considerable progress has been made to address endemic arsenic poising and also formed various hypotheses, whereas simultaneously there are some problems and the insufficiency such as unclear relationship among those hypotheses and the gap between mechanism studies and translational application. In consequence, enhancing the interactive effects among various mechanisms of arsenic poising and improving its translational application could have more realistic significance for scientific prevention and control of endemic arsenicosis.

Objective To explore a safe and effective imaging method by the application of 3D contrast-enhanced MR Angiography (3D CE-MRA) with low-or conventional-dose contrast agent to the examination of lower extremity arterial disease.Methods Totally 31 patients suspected with lower extremity arterial stenosis or occlusion underwent 3D CE-MRA examination including one patient had right leg cut due to the disease,of whom,18 ones had conventional-dose contrast agent (38 ml) injected in 1.5T MR machine and 13 ones had low-dose agent (15 ml) injected in 3.0T MR machine.Quality evaluation was carried out for the images by different doses of agents.Results All the patients had no agent allergy occurred,and one patient had left tibia-fibula motion artifact due to involuntary movement.3.0T MR machine with low-dose agent behaved better than 1.ST MR machine with conventional-dose agent in leg imaging,while there were no significant differences between the quality of the images except that of popliteal artery (P＞0.05).Conclusion 3D CE-MRA is an effective and safe method in detecting lower extremity artery disease,and 3.0T MR machine with low-dose agent lays a foundation for clinical diagnosis and treatment.

Objective To compare the efficacy of carotid endarterectomy(CEA)and carotid artery stenting(CAS)for the treatment of high-risk atherosclerotic carotid artery stenosis.Methods We retrospectively studied the surgical outcomes of 58 patients with high-risk atherosclerotic carotid artery stenosis.Among the cases,32 received CEA and 26 underwent CAS.All of the patients were followed up with carotid ultrasonography,CTA or DSA in 30 days,6 months,and 1 year after the procedures,their neurological function was assessed meanwhile.Cumulative incidence of death,stroke,or myocardial infarction within 30 days after the surgical intervention and death or ipsilateral stroke events between 30 days and 1 year were set as the primary endpoint of the study.And the secondary endpoints were the CEA or CAS-correlated complications or severe restenosis within 1 year after the treatment.The outcomes of the two groups were compared.Results The primary endpoint occurred in 3 patients in the CEA group(9.4%)and 4 in the CAS group(15.4%)(?2=0.086,P= 0.769).And the secondary endpoint was found in 4 of the CEA group(12.5%)and 4 of the CAS group(15.4%)respectively(?2=0.000,P=1.000).Conclusions For the patients with high-risk carotid artery stenosis and coexisting conditions,CEA is as safe and effective as CAS.

Objectives:To investigate the clinical outcomes of unilateral percutaneous vertebroplasty(PVP) by using curved injection needle in osteoporotic vertebral compression fractures(OVCFs).Methods:From January 2015 to January 2016,47 patients(14 males and 33 females) with OVCFs were enrolled in this study.The patients were 53-89 years old (66.4±6.5 years),36 cases were single segmental vertebral fracture,11 cases were double segment vertebral fracture.T9 fracture occured in 7 cases,T10 fracture in 7 cases,T11 fracture in 9 cases,T12 fracture in 13 cases,L1 fracture in 12 cases,L2 fracture in 9 cases,and L3 fracture in 1 case.The fluoroscopy time and bone cenent dosage were recorded.The VAS score,ODI,relative height restoration of vertebra and Cobb angle were compared between preoperation and postoperation.The bone cement leakage(venous leakage and perivertebral leakage) and other complications were observed.Results:The average fluoroscopy time was 1.6±0.3nin,the average bone cement dosage was 6.7±1.2ml.Bone cement leakage occured in 11 cases with the rate of 23.4％.The patients were followed up for 3-12 months (6.5±1.3 months).The VAS,ODI,the relative height of injured vertebra and the local Cobb angle before operation,at 2 days after operation and final follow-up were:7.6±1.3,(71.4±3.2)％,0.48±0.21,15.5°±4.2°;2.2±1.0,(27.2± 2.6)％,0.82±0.17,7.2°±2.8°;1.7±0.7,(26.5±2.7)％,0.80±0.15,7.5°±3.7°.At 2 days after operation and final follow-up,the VAS score,ODI score,the relative height and Cobb angle of injured vertebra were significantly improved when compared to those before operation (P＜0.05);There was no significant difference between 2 days after operation and final follow-up(P＞0.05).Conclusions:The advantages of unilateral PVP by using curved injection needleless in OVCFs are less fluoroscopy time,even distribution of bone cement,and less leakage.

[Objective]To examine the difference of proliferation and ?-smooth muscle actin(?-SMA) expression between healing and normal medial collateral ligament(MCL) fibroblasts.[Method]Ten adult,male,Sprague-Dawley rats weighing between 350 and 375 g were used in this study.Normal and healing MCL were cut into small pieces in aseptic conditions,and then placed and cultured in culture chamber.Fibroblasts were passaged with 0.25% trypsin.After 24 and 48 hours incubation,MTT was used to measure the cell proliferation.The production of ?-SMA was measured by Western Blot.[Result]After 24 and 48 hours incubation,healing fib roblasts showed absorbency values of 0.49?0.080 and 0.53?0.07 respectively.II was found that healing fibroblasts proliferated faster than normal fibroblasts(P

[Objective]To examine the effects of TGF-?1 on the production of ?-SMA and extracellular matrix in flexor tendon sheath fibroblasts. [Methods]Sheath fibroblasts were obtained from rabbit flexor tendons.Cell culture was supplemented with 5ng/ml of TGF-?1.After 48 hours incubation,the production of a-SMA was assayed by Western-Blot.The productions of collagen I and fibronectin in supernatants culture were examined using ELISA.[Results]Treatment with TGF-?1 significantly stimulated a-SMA production in flexor tendon sheath fibroblasts (P