Objective To construct, express, purify and screen immunosuppressive molecule against human soluble APRIL (a proliferation-inducing ligand). Methods The cDNA of soluble APRIL (sAPRIL) was mutated and TEL Th epitope was added. Mutants was expressed by pQE-80L/DH5? system, identified by SDS-PAGE and Western blotting, purified by Ni-NTA resin. Their activity on stimulating the proliferation of Raji cell was detected. Results Four sAPRIL mutants were constructed and expressed as follows: HEL Th epitope was added at C end (Ⅰ); HEL Th epitope was added at N end (Ⅱ); the last 45-bp DNA was deleted at C end and HEL Th epitope was added (Ⅲ); the first 45-bp DNA was deleted at N end and HEL Th epitope was added (Ⅳ). Specific protein bands according to mutant Ⅰ-Ⅳ were detected by SDS-PAGE and Western blotting. Mutant protein was purified by Ni-NTA successfully. Mutants Ⅰand Ⅱ promoted cell proliferation remarkably, and mutant Ⅲand Ⅳnot. Conclusion Four sAPRIL mutants was constructed and expressed successfully. Immunosuppressive molecule against sAPRIL that can not promote cell proliferation was screened out, and it laid a foundation for further study on their immunosuppressive function.

Objective To evaluate the effect of percutaneous endoscopic gastrostomy ( PEG) on the nutritional status and complication rate in patients with enteral nutrition support.Methods Sixty five patients receiving PEG from January 2008 to December 2014 were enrolled in the study.The nutritional status was examined and the incidence of complications was documented before and after PEG.Results The serum albumin, body mass index (BMI) and arm muscle circumference were (29.2 ±3.2)g/L, (18.0 ± 1.0)kg/m2, (21.1 ±1.9)cm and (32.9 ±3.0)g/L, (18.8 ±1.6)kg/m2, (23.0 ±3.0)cm before and 1 month after PEG, respectively (t=-6.798, -3.202 and -3.957, all P<0.05).Compared to those before PEG, the serum albumin, BMI and arm muscle circumference at 3 and 6 months after PEG were increased to ( 35.4 ±4.9 ) g/L, ( 19.7 ±1.4 ) kg/m2 , ( 24.9 ±2.2 ) cm ( t =-7.845, -7.202,-10.432, all P<0.05) and (37.9 ±3.7)g/L, (20.7 ±1.6)kg/m2, (26.9 ±3.7)cm (t=-14.046,-10.686, -9.827, all P<0.05), respectively.Compared to those with nasal feeding, the incidence of aspiration pneumonia was decreased from 62% ( 40/65 ) to 18% ( 10/57 ) and the incidence of reflux esophagitis was decreased from 51% (33/65) to 19% (11/57) 6 months after PEG, respectively (χ2 =24.3 and 13.5, all P<0.01).Conclusion PEG can improve nutritional status and reduce the incidence of aspiration pneumonia and reflux esophagitis for patients with enteral nutrition support.

Objective To analyze the clinical features,endoscopic characteristics and methods for diagnosis and treatment of ischemic colitis.Methods The clinical data of 56 patients with ischemic colitis were retrospectively analyzed.Results Ischemic colitis occurred more often in elderly patients.Male and female ratio was 1 ∶1.8.The patients often had concomitant basic diseases,such as diabetes mellitus (53.6％,30/56),hypertension (39.3％,22/56),coronary heart disease (32.1％,18/56).The main manifestations of ischemic colitis were abdominal pain (100.0％,56/56) and bloody stools (89.3％,50/56).The lesions revealed by colonoscopy were mainly located in the left colon and distributed in a segmental pattern,and the pathological changes included mucosal edema,congestion,erosion and ulceration.The prognosis was good in most cases.Conclusions Ischemic colitis should be suspected in elderly patients with acute abdominal pain and bloody stools.Early colonoscopy is helpful for accurate diagnosis and appropriate treatment of ischemic colitis.

Objective To construct 6 kinds of human soluble proliferation-inducing ligand (sAPRIL) cDNA mutants. Methods Six pair primers according to the cDNA sequence of human sAPRIL for different mutants were designed as follows: HEL Th epitope was added at C or N end, the last or first 45 bp DNA was deleted and HEL Th epitope was added, the last or first 90 bp DNA was deleted and HEL Th epitope was added. Different enzyme site was designed at 5′ end of 12 primers, BamH Ⅰ or SalⅠ or HandⅢ. At the same time, 2 pairs of HEL Th epitope sequence were designed and synthesized, and different incision enzyme sticky end sequence was added at the 5′ or 3′ end of each epitope DNA. Mutant sequences were amplified by 6 pairs primers with sAPRIL cloning plasmid as template. The PCR fragment was digested and then ligated with the HEL Th epitope DNA that had been reannealed. The ligation fragments of the head were ligated with digested pQE80 vector fragment again, and were transformed into DH5? competent cell. Recombinant plasmids were identified by digestion and sequencing. Results Six sAPRIL cDNA mutant DNA sequences were obtained by PCR, and the expression plasmids of sAPRIL cDNA mutants including HEL Th epitope sequence were constructed successfully. The result of sequencing proved that mutations generated as designed fully. Conclusion Six sAPRIL cDNA mutant expression plasmids were constructed successfully.

Objective To evaluate the accuracy of 16-detector row computed tomography coronary angiography in detection of hemodynamically relevant stenosis(≥50%) of the coronary artery. Methods Twenty-six patients undergoing both multi-detector row CT and conventional coronary angiography were included in this retrospective study. CT scan were obtained with collimation of 16 and rotation time of 500 ms. Retrospective electrocardiographic(ECG) gating was used for image reconstrution. The stenosis degree was detected with axial scanning and three-dimensional reformation. Results With the results of conventional coronary angiography as golden standard, the sensitivity, specificity, accuracy, positive predicted value and negative predicted value of the CT angiography in detection of hemodynamically relevant stenosis(≥50%) were 90.0%, 95.5%, 94.7%, 77.6%, and 98.2% respectively. Conclusion Sixteen-detector row computed tomography coronary angiography has high clinical value with evaluating hemodynamically relevant stenosis(≥50%) of coronary artery,and could be a significant guide for diagnosis and therapy of coronary heart disease.

Objective:To investigate the ways of pharmaceutical care performed by clinical pharmacists for the patients with severe infection. Methods:Through deciding the anti-infection therapeutic regimen, providing drug counselling and pharmacy education and focusing on adverse drug reactions, pharmacists offered suggestions for one patient with severe legionella pneumonia complicated with AECOPD. Results:The pharmaceutical care performed by clinical pharmacists could solve the problems and improve the compliance, safety, effectiveness and rationality in the drug treatment of the patient. Conclusion:According to the individual condition of patients, clinical pharmacists can realize their own values through looking for the breakthrough points of pharmaceutical care and participating in clinical practice.

It is estimated that epilepsy, a chronic disorder of the nervous system, affects about 0.5%-2% of the population and about 10%-50% do not respond well to current antiepileptic medications and may not be candidates for surgery. For these patients, the unpredictability of seizure onset is a major cause of disability and mortality. Therefore, anticipation of an imminent seizure would be beneficial to patients because it could provide time for the application of preventive measures to keep the risk of seizure to a minimum. This paper reviews the feasibilities, the progress, existing problems and possible applications in the field of epileptic seizure prediction.
Algorithms ; Diagnosis, Computer-Assisted ; methods ; Electroencephalography ; methods ; Epilepsy ; diagnosis ; physiopathology ; Humans ; Seizures ; diagnosis ; physiopathology ; Signal Processing, Computer-Assisted

Objective To use a simple bedside technique to verify the pathophysiological mechanism of pulmonary hypertension (PH) in different races. Method The Valsalva maneuver (VM) was performed in patients referred to a specialty PH clinic. The blood pressure response of patients to VM was in different fashions. The blood pressure (BP) was measured by using cuff and stethoscope. When the cuff was inflated to 15 mmHg above the systolic pressure, sound could be heard by auscultation during VM and when the cuff was deflated the sound disappeared over 3 heart beats which was considered as abnormal BP response, and less than 3 heart beats defined as normal BP response. The right heart catheterization in patients with PH as a part of the standard evaluation. Results This study included 84 patients with a mean age of (63 ± 16) years. Those with abnormal BP response to VM had higher pulmonary artery wedge pressure (PAWP) [(22.5±6.6) vs. (11.9±4.3) mmHg, P ＜0.0001] and lower pulmonary vascular resistance [(5.8 ± 4.0) vs. (8.1 ± 4.6 ) WU, P = 0.01]. Blood pressure response to VM did not correlate with mean pulmonary artery (PA) pressure [(46.2 ± 9.9) vs. (43.4 ±10.4) mmHg, P =0.20] or cardiac index (both 2.4 ± 0.6 L/min/m2). The abnormal BP response to VM had high sensitivity (89.4%), specificity (86.1%) and accuracy (86.9%) for determining PAWP＞ 15 mmHg.Conclusions BP response to Valsalva maneuver provides important information about left heart filling pressures in patients with PH.

Objective To apply electrical impedance tnmography that is a new evaluation ap-proach to monitor the development of retroperitoneal injury. We used retroperitoneal inject blood model in pigs to study the feasibility on monitoring retroperitoneal bleeding and to provide premise in theory and practice for clinical application. Methods Five pigs were used on the experiment. We insert a vessel into the retroperitoneal and inject blood to simulate retroperitoneal bleeding. Sixteen electrodes were atta-ched on the abdominal region circumference of pigs and used for electrical current injection and surface voltage measurement. Then the monitoring images were performed by electrical impedance tomography. Results The images of electrical impedance tomography retroperitoneal inject blood model of five pigs were clear, the minimal impedance scale was decreasing significantly as the bleeding volume increasing and the images were changed significantly too. The computerized tomography and the dissecting results confirmed the blood was limited in retroperitoneal. Conclusions The establishments of pigs retroper-itoneal inject blood model was successful. The images of electrical impedance tomography retroperitoneal inject blood model were clear with significant contrast. It's feasible to use electrical impedance tomography system to monitor the retroperitoneal bleeding. This technique may become a useful tool for monitoring ret-roperitoneal injury in intensive care patients.

Objective To evaluate the safety and effect of one-way barbs line (absorbable sutures v - locTM180) in primary suturing of laparoscopic choledocholithotomy. Methods From July 2014 to June 2015, clinical data of 86 cases performed primary suturing in laparoscopic choledocholithotomy by the same performer were retrospectively analyzed. The patients were divided into three groups, One-way barbs line continuous full-thickness suture group (A group), ordinary absorption line continuous full-thickness suture group (B group) and ordinary absorption line discontinuous full-thickness suture group (C group). The bile duct suture needed time, intraoperative blood loss, postoperative eating time, postoperative hospital stay and postoperative bile fistula were compared. Results All the 86 cases underwent successful operation without T tube, and none of them received alternative open operation. Compared with group B and C, time needed for bile duct suturing in A group have statistical significance. There was no significant difference in the intraoperative blood loss, postoperative eating time, postoperative hospital stay between the three groups (P > 0.05). The incidence of postoperative bile fistula in A group were none. The incidence of postoperative bile fistula in B group was 1 case, the incidence of postoperative bile fistula in C group was 2 cases.Conclusions The method of one-way barbs line continuous full-thickness suture were simple and secure in primary suturing of laparoscopic choledocholithotomy.