Objective To obtain monoclonal antibodies(McAb) against human IgE by recombinant IgE antigen.Methods BLAB/c mice were immunized with recombinant IgE.The spleen cells of immunized mice were used to prepare the McAb by hybridoma techniques.IgE-McAb was selected by indirect ELISA with culture supernatant of hybridoma cells.ELISA blocking assay were employed to identify the function of McAb.Alanine scanning mutagenesis were used to confirm the antigenic epitopes of McAb.Results A monoclonal antibody against IgE(178) was produced.The antigenic epitope of 178 was found to be spatially close to the receptor-binding site.Functional assay revealed that 178 could markedly inhibit IgE binding to receptors.Conclusion A hybridoma cell line secreting IgE-McAb stably was obtained by recombinant IgE antigen,and the IgE-McAb might block IgE binding to receptors via steric hindrance.

Objective: To investigate the effect of space glucose control (SGC) on the quality of blood glucose management in ICU patients with stress hyperglycemia. Methods: A prospective, cross-controlled, quasi-trial was conducted to observe patients with ICU-induced stress hyperglycemia between January 2018 and January 2019. Patients with conventional blood glucose management served as the control group, and SGC blood glucose management was used as the intervention group. The enrolled patients were interchanged between the two groups every 24 h, and the end point was 96 h. The differences in blood glucose management quality indicators between the two groups were compared, including the average blood glucose level, the highest and lowest blood glucose level, the average blood glucose monitoring interval, and the accumulated insulin dosage. SPSS 23.0 was used to analyze the data. The paired t test was used for the normal distributed data. Otherwise, two nonparametric correlation sample tests was used. A P<0.05 was considered statistically significant. Results: A total of 41 patients enrolled in this study during the study period. The average blood glucose value in the intervention group was significantly lower than that in the control group [(8.60 ±1.42)mmol/L vs (10.02 ±1.49)mmol/L, P< 0.01]. The frequency of hyperglycemia was lower than that of the control group (16.59 ±8.56 vs 18.73 ±7.91, P=0.023). The frequency of blood glucose value in the target blood glucose range was significantly higher than that of the control group (53.07±19.11 vs 29.44±19.60, P< 0.01). However, the frequency of hypoglycemia, the frequency of blood glucose monitoring and the accumulated insulin dosage in the intervention group were higher than those in the control group [1 (0, 5) vs 0 (0, 2), P< 0 01; 1 36 ±0 23 vs 1 89 ±0 28, P< 0.01; and (139.61 ±77.06)U vs (107.49 ±64.41)U, P<0.01]. Conclusions SGC can optimize the control of blood glucose in the target blood glucose range, but it can easily lead to mild hypoglycemia, and to a certain extent increases the workload of medical staff.

OBJECTIVE: To analyze the phenotype and genetic basis for a pedigree affected with hereditary coagulation factor XI deficiency. METHODS: Activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB), FXI activity (FXI:C) and the antigen of FXI (FXI:Ag) were determined for the proband and members from his pedigree. Sanger sequencing was used to analyze all exons, exon-intronic boundaries, as well as the 5'- and 3'- untranslated regions of the F11 gene. Suspected variants were verified in her family members and confirmed by reverse sequencing. The impact of the variants on the protein function was predicted by using PolyPhen-2 and SIFT software. The protein structure and amino acid interaction were analyzed by using Swiss-PdbViewer. RESULTS: The APTT, FXI:C and FXI:Ag of the proband and her sister were significantly reduced to 73.0 s, 10.0%, 15.0% and 87.1 s, 2.0% and 11.5%, respectively. APTT of some family members was slightly prolonged, and FXI:C and FXI:Ag also decreased to various extents. DNA sequencing revealed that the proband and her sister have carried compound heterozygous variants of c.738G>A (p.Trp228stop) and c.938G>T (p.Ser295Ile) respectively in exons 7 and 9 of the F11 gene. Her father, sister and daughter were heterozygous for the c.738G>A (p.Trp228stop) variant, while her mother and nephew were heterozygous for the c.938G>T (p.Ser295Ile). Both PolyPhen-2 and SIFT predicted that the p.Ser295Ile variant is likely to be deleterious and can affect the protein function. Modeling analysis indicated that the p.Ser295Ile variant may lead to disruption of a hydrogen bond, resulting in alteration of protein structure and instability. CONCLUSION The compound heterozygous c.738G>A (p.Trp228stop) and c.938G>T (p.Ser295Ile) variants of the F11 gene probably underlie the decreased FXI level in this pedigree.
Factor XI Deficiency ; genetics ; Female ; Genetic Variation ; Heterozygote ; Humans ; Mutation ; Pedigree

Since December 2019, the corona virus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (2019-nCoV) has been reported in Wuhan, Hubei Province. Almost 70% of patients susceptible to 2019-nCoV are over age of 50 years, with extremely large proportion of critical illness and death of the elderly patients. Meanwhile, the elderly patients are at high risk of osteoporotic fractures especially osteoporotic vertebral compression fractures (OVCF). During the prevention and control of COVID-19 epidemic, orthopedists are confronted with the following difficulties including how to screen and protect OVCF patients, how to accurately diagnose and assess the condition of OVCF patients with suspected or confirmed COVID-19, and how to develop reasonable treatment plans and comprehensive protective measures in emergency and outpatient clinics. In order to standardize the diagnosis and treatment of patients with OVCF diagnosed with COVID-19, the authors jointly develop this expert consensus. The consensus systematically recommends the standardized emergency and outpatient screening and confirmation procedures for OVCF patients with suspected or confirmed COVID-19 and protective measures for emergency and outpatient clinics. Moreover, the consensus describes the grading and classification of OVCF patients diagnosed with COVID-19 according to the severity of illness and recommends different treatment plans and corresponding protective measures based on the different types and epidemic prevention and control requirements.