Aptamers are oligonucleotides or peptides those are able to bind tightly,by their specific three-dimensional shapes,to a variety of targets.Because of numerous merits ( high affinity,high specificity,small size,little immunogenicity,stable structures,and ease of synthesis),aptamers represent a valid alternative to antibodies and become a valuable research tool and show great application to fundamental research,drug selection and clinical diagnosis and therapy.The review describe the applications and the possible applications of aptamers in the diagnosis,treatment and pathogenesis of autoimmune diseases.

Objective To measure the size and area of the vestibule of normal inner ear to provide basic data for further study of the vestibule-related diseases.Methods Two hundred forty patients (480 ears) who underwent temporal bone 64 slices CT scans were enrolled in this study from April 2011 to July 2012.These patients were divided into 4 groups,including Child group (＜ 18 years),Youth group (18-44 years),Adult group (45-59 years),and Elder group (≥ 60 years).The size and area of the vestibules were measured on the multiplanar reformatted images in post-processing workstation.Results There were no statistically significant differences in the size and area of vestibules in sides,genders and among the different groups (P ＞ 0.05),while there were statistically significant differences of those in different positions (P ＜ 0.05).Conclusion The measurements in different planes were as follow:1) In axial plane,the length of vestibule and its 95％ confidence interval were (5.89 ± 0.34),5.22-6.56 mm,respectively; the width (2.47 ± 0.36),1.76-3.18 mm; the area(13.97 ± 1.71) 10.62-17.32 mm2 2) in coronal plane,the length of vestibule and its 95％ confidence interval were (5.10 ± 0.32),4.47-5.73 mm,respectively; the width (2.42 ± 0.21),2.01-2.83 mm; the area (11.30 ± 1.33),8.69-13.91 mm2 ;3)in sagittal plane,the length of vestibule and its 95 ％ confidence interval were(5.27 ± 0.33),(4..62-5.92) mm,respectively; the width (3.72 ± O.35),(3.03--4.41) mm; the area (13.77 ± 1.55),(10.73-16.81)mm2.The volume CT combined with post-processing technology can accurately measure the size and area of the vestibules.The data can provide quantitative basis for diagnosis of the vestibule-related diseases.

Three dimensional contrast enhanced magnetic resonance antiography(3D CEMRA) is an imaging method with the signal produced by shortening the blood relaxation time with gadolinium contrast medium but not with natural blood flow;it is a convenient and practical method with no trauma or radiation.Imaging quality was satisfactory,in which the normal anatomy,lesion site and stenosis of arteries were showed clearly.High quality images of 3D CEMRA mainly depended on the optimal acquisition delay time,proper injection rate,volume of contrast material,reasonable sequence and parameters and operators' skills.3D CEMRA has the similar effect with digital subtraction angiography;it is an effective,fast,comprehensive and reliable technique and is an ideal measurement for diagnosing vascular diseases of extremities.

Objective To investigate the diagnostic value of T-SPOT.TB in patients with fever.Methods T-SPOT.TB was carried out in 456 febrile patients who had no determined reason for fever or who could not be excluded from infection with Mycobacterium tuberculosis.These patients were followed up for their final clinical diagnosis and the diagnostic value of T-SPOT.TB was evaluated using the receiver operating characteristic (ROC) curve.Results In the present study,85 patients were clinically diagnosed with tuberculosis (TB) (including 34 cases of pulmonary TB,24 cases of TB infection defined as T-SPOT.TB positive without TB lesion,but effective with anti-TB treatment,10 cases of tuberculous pleurisy and 17 cases of other extrapulmonary TB) and 371 patients had no definite evidence of Mycobacterium tuberculosis infection (including 42 cases of suspected TB and 329 cases of other diseases).T-SPOT.TB had a high sensitivity of 84.3％ in TB patients and a high negative predictive value of 94.2 ％,but the specificity was 68.1％ and the positive predictive value was 41.4 ％.The Kappa value was 0.380 and the area under ROC curve was 0.762 (95％CI:0.707-0.817).T-SPOT.TB had a higher sensitivity in extrapulmonary TB than in pulmonary TB (88.2 ％ vs 78.1 ％),with the negative predictive values of 95.3 ％ and 92.6 ％,Kappa values of 0.438 and 0.299,and the areas under ROC of 0.791 (95 ％ CI:0.724-0.857) and 0.719 (95％CI:0.623-0.815),respectively.Ninety-nine cases were T-SPOT.TB positive out of 329 patients diagnosed with other diseases.Conclusions T-SPOT.TB test can be used as a method for TB diagnosis in patients without obvious TB lesions.Due to its relatively high negative predictive value,T-SPOT.TB can be used to rule out infection with Mycobacterium tuberculosis.

Objective To compare laparoscopic appendectomy to conventional operation for the treatment of appendicitis.Methods In this study 1558 patients diagnosed as appendicitis were divided into group A(laparoscopic appendectomy)and group B(conventional operation)according to the random numbers.In group A,779 patients were treated with laparoscopic appendectomy.In group B,779 patients were treated with conventional open appendectomy.The inhospital data and that of followed-up were compared.Statistical analysis was carried out using SPSS11.5 for Windows.Comparisons between categorical variables and continuous variables were analyzed using the X~2 test and t test.Results The operation was successfully performed in all 1558 patients.The operating time in group A and B were(30±2.2)min versus(30±1.6)min(t=0.00,P>0.05),the blood loss were(15±2.9)ml versus(29±5.2)ml(t=65.62,P<0.05),the bed off activity time were(26±3.1)h versus(51±2.1)h(t=69.95,P<0.05),the bowels'move time were(29±1.6)h versus(52±4.6)h(t=10.92,P<0.05),the hospital stay were(3±0.9)d versus(7±1.2)d(t=74.42,P<0.05),the inhospital cost was (6591±41)yuan versus(4860±32)yuan(t=-12.19,P<0.05),the incision infection rate was 0 and 2.8%(X~2=25.40,P<0.05).Postoperative analgesics were needed in 3.8% and 31.4% (X~2=30.63,P<0.05).All the patients were followed-up from 4.5 years to 9.8 years(average 6.8 years).The development of incision hernia in group A and B was 0 versus 0.64% (X~2=5.01,P<0.05).Conclusions Laparoscopic appendectomy is a therapy of choice for patients with acute appendicitis with advantages of minimal invasion,early recovery,few complications and short hospital stay.

Objective To evaluate the diagnostic value of the spectral CT imaging on the complications after breast augmentations with silicone implants.Methods A lot of 22 cases with breast implants were scanned by the Gemstone spectral imaging (GSI) CT.The original data were loaded in processed workstation, analyzed by GSI analysis software, and then stored the series we needed.The features of the complications after breast augmentations with silicone implants were reviewed retrospectively on the spectral CT images.Results A lot of 44 breast implants scanned in our study and there were 23 breast implants with complications, including 7 breast implants with capsular rupture (6 breast implants with endometrial rupture detected by spectral CT, including 4 breast implants with endometrial rupture, 3 breast implants with outer membrane rupture and leakage), 13 breast implants with capsular contracture (classification according to Baker's classification, 6 in grade Ⅰand 7 in grade Ⅱ), 8 breast implants were moved and 2 breasts had foci of calcification.Conclusions The spectral CT imaging play important role in detecting the complications after breast augmentations with silicone implants by GSI analysis software.

Objective To evaluate systematically the clinical efficacy of surgery combined with anti-TNFalpha in treatment of Crohn's disease (CD) with perianal fistula.Method Database including China Biology Medicine disc,Wan Fang Database,PubMed,Cochrane Library and EMBASE were searched withCrohn's disease,anal fistula,fistula,perianal fistula,surgical procedure,surgery,surgical,anti-tumor necrosis factoralpha,anti-TNF-alpha,TNF-alpha,克罗恩病,Crohn's病,肛瘘,手术治疗,外科手术,抗肿瘤坏死因子α制剂,肿瘤坏死因子,肿瘤坏死因子配体超家族员2”between the database establishment and June 2016.Literatures of retrospective case-control studies about surgery combined with anti-TNF-alpha therapy and single surgery in treatment of CD with perianal fistula were retrieved.Data were extracted and evaluated by 2 independent researchers.Patients who underwent surgery combined with anti-TNF-alpha therapy were allocated into the combined therapy group and patients who underwent single surgical treatment were allocated into the surgery group.The complete healing rate,partial healing rate and recurrence rate after therapy were compared between the 2 groups.Count data were represented as the odds ratio (OR) and 95％ confidence interval (CI).The heterogeneity was analyzed by theI2 test.Result Six retrospective case-control studies were retrieved and total sample size was 598 patients,including 256 in the combined therapy group and 342 in the surgery group.The result of Meta analysis showed that there was no significant difference in postoperative complete healing rate and partial healing rate between the 2 groups (OR =1.36,1.47,95 ％ CI:0.94-1.97,0.56-3.88,P ＞ 0.05),and recurrence rate after therapy in the combined therapy group was significantly lower than that in the surgery group (OR =0.26,95％ CI:0.16-0.44,P ＜ 0.05).Conclusion The complete healing rate and partial healing rate of patients with CD with perianal fistula undergoing surgery combined with anti-TNF-alpha therapy are not superior to that undergoing single surgical treatment,however,recurrence rate after therapy is lower for patients undergoing surgery combined with anti-TNF-alpha therapy.

Objective To summarize the clinical features of different racial patients with celiac disease (CD) and analyze the disease prevalence,diagnosis and treatment in Chinese population.Methods All the patients were diagnosed as CD and enrolled in Beijing United Family Hospital between January 2005 and July 2015.Clinical data including nationality,age,symptoms,endoscopic and pathological findings,outcome were collected and compared in patients from different countries.Results A total of 87 patients were enrolled including 63 Caucasians,18 Asian patients and 6 Middle East patients.The peak age of disease onset was 40-60 years old.Patients with typical symptoms such as chronic diarrhea and weight loss only accounted for 20.7％ (18/87) and 9.2％ (8/87) respectively.Some patients presented with nonspecific symptoms such as abdominal pain and bloating [32.2％ (28/87)],even constipation [5.7％ (5/87)].13.8％ (12/87) patients were previously diagnosed as irritable bowel syndrome.The incidence of abdominal pain,bloating,diarrhea and constipation between Asians and Caucasians had no statistical significance (P ＞ 0.05);but the proportions of weight loss,growth retardation,iron deficiency anemia and dermatitis herpetiformis in Asian group were significantly higher than that in Caucasian group (P ＜ 0.05).IgA type of anti-gliadin antibody (AGA),endomysium antibody (EMA) and tissue transglutaminase antibody (tTGA) were dominant autoimmune antibodies in patients with CD,which accounted for 58.6％ (51/87),44.8％ (39/87) and 36.8％ (32/87) respectively.The endoscopy showed that the lesion of CD was mainly located in small intestine,with reducing severity from the proximal to the distal small intestine.The lesions of duodenal bulb and descending duodenum appeared more significant in Asian group.Accordingly pathological intestinal atrophy and the degree of intraepithelial lymphocytosis were more severe in Asian patients.All 87 cases took the gluten-free diet (GFD).Eighty-one cases received serological follow up and 8 with endoscopic intestinal biopsy.The celiac disease antibodies in 47 patients turned negative from 6-9 months after GFD treatment,while 34 patients turned negative from 12-18 months after GFD.All patients reported disease remission to some extent.After 1 year GFD treatment,the pathology of endoscopic intestinal biopsy in 8 patients showed significant improvement of villous atrophy and lymphocyte infiltration.Conclusions CD patients with typical clinical manifestations are not the majority.Serological celiac disease antibodies (AGA,EMA and tTGA) have a high diagnostic value.GFD treatment is effective on majority of celiac patients.Clinical manifestations,endoscopy,intestinal pathology,and response to GFD in Chinese patients are not the same as Caucasians.Clinicians need to pay attention to the differential diagnosis.

Objective To investigate the method and efficiency of supracondylar dome osteotomy of femur combined with arthroscopy for the treatment of the adult valgus deformity of knees. Methods From September 2008 to May 2012, 32 patients (35 knees) with valgus deformity of knees were treated with supracondylar dome osteotomy of femur combined with arthroscopy. The study group included 7 male and 25 female (average age: 43 years). The pre-operative HSS knee score was an average of 60.46. The weight-bearing knee joint AP & LAT and the full-length AP view of the lower extremity were examined before and after operation. At the same time , the femoral angle and femoral-tibial angle were measured and evaluated. The internal fixation was taken out in an average in 12 months. All the patients were followed-up and the change of the correction angles , the function of the knee and the condition of bone healing was recorded. Result The follow-up time was an average of 24 months. All the patients got a satisfied correction of the deformity, good bone union and obvious improvement of joint function. The postoperative HSS knee score was an average of 85.40. Conclusion The supracondylar dome osteotomy of femur combined with arthroscopy is a safe, reliable and effective strategy for the treatment of the adult valgus deformity of knees.

OBJECTIVE:To study the protective effects of Li medicine Chushi qufeng decoction on arthritis model rats. METH-ODS:60 rats were randomly divided into normal group,model group,positive group and Chushi qufeng decoction high-dose,me-dium-dose and low-dose groups [45.9,22.95,11.48 g(crude drug)/kg]. Except for normal group,those groups were given chicken type Ⅱ collagen to induce arthritis model. After modeling,normal group and model group were given normal saline intragastrical-ly,once a day,for consecutive 12 d;Chushi qufeng decoction groups were given relevant medicine intragastrically;positive group was given leflunomide 4.5 mg/kg on 1st-3rd day and 1.8 mg/kg on 4th-12th day. The degree of joint lesion in rats were scored. The degree of joint swelling was determined as well as the serum levels of TNF-α,IL-1β and type Ⅱ collagen antibody. RESULTS:Compared with normal group,arthritis index,degree of joint swelling,the serum levels of TNF-α,IL-1βand typeⅡcollagen anti-body increased significantly in model group (P<0.01). Compared with model group,pathological score of positive group and Chushi qufeng decoction high-dose group decreased significantly,and serum levels of TNF-α,IL-1β and type Ⅱ collagen antibody decreased significantly in treatment groups(P<0.05 or P<0.01). CONCLUSIONS:Li medicine Chushi qufeng decoction has cer-tain protective effect on arthritis model rats induced by chicken typeⅡcollagen.