OBJECTIVETo construct a lipL32/1-lipL21-OmpL1/2 fusion gene and its prokaryotic expression system, and to establish an enzyme-linked immunosorbent assay (ELISA) using the rLipL32/1-LipL21-OmpL1/2 fusion antigen of Leptospira interrogans for sensitive and specific detection of IgM in the serum of patients with leptospirosis.

METHODSlipL32/1-lipL21-OmpL1/2 fusion genes were constructed using a primer-linking PCR. The target recombinant protein antigens, rLipL32/1, rLipL21, rOmpL1/2 and rLipL32/1-LipL21-OmpL1/2, were expressed and the purified antigens were then immobilized to the surface of microplate wells for ELISA-based detection of IgM in the sera of leptospirosis patients.

RESULTSOf 493 acute leptospirosis patients, 95.7% and 97.8% were positive by rLipL32/1-LipL21- OmpL1/2-IgM-ELISA using different serum dilutions, which was higher than the rLipL32/1-IgM-ELISA (93.1% and 90.3%), rLipL21-IgM-ELISA (90.3% and 87.0%), and rOmpL1-IgM-ELISA (85.6% and 81.1%) (P<0.01). All IgM-ELISAs tested negative against 56 non-leptospirosis patients with typhoid fever, hemorrhagic fever or dengue fever.

CONCLUSIONTrigeminal fusion antigen increases ELISA sensitivity and the rLipL32/1-LipL21-OmpL1/2- IgM-ELISA is a sensitive and specific serological diagnostic method for clinical leptospirosis.

Antigens, Bacterial ; genetics ; metabolism ; Bacterial Outer Membrane Proteins ; genetics ; metabolism ; Enzyme-Linked Immunosorbent Assay ; methods ; Humans ; Immunoglobulin M ; immunology ; Leptospirosis ; diagnosis ; metabolism ; Lipoproteins ; genetics ; metabolism ; Recombinant Fusion Proteins ; genetics ; metabolism

Objective To determine the serum thyroid hormone level of Uygur patients with local Curtin in southern Xinjiang region, to understand the thyroid function of Curtin disease in terms of diagnosis, treatment and prevention and to provide a background information.Methods One hundred and eighty-eight Uygur endemic cretinism were selected as cases [divided into neuval (144), myxedematous (19), mixed type groups (25)], 121 local healthy people as control group, 125 mothers of the case group as mother group from southern Xinjiang region from September 2014 to October 2014, 3 ml venous blood sample was collected of each subject, serum thyroid stimulating hormone (TSH), triiodothyronine (T3), tyroxine (T4), free triiodothyonine (FT3), free tyroxine (FT4), anti-thyroglobulin antibody (A-TG), and thyroid peroxidase antibody (A-TPO) levels were tested.Results There were statistically significant differences of the thyroid function index (T3, T4, FT3, FT4) between the four groups (neural, myxedematous type, mixed type cretinism patients and control groups, F =22.92, 42.58, 38.84, 56.31, 103.29, all P ＜ 0.05).Levels of T3, T4, FT3, FT4 [(2.41 ± 0.48), (118.72 ± 20.92)nmol/L, (5.25 ± 0.98), (15.81 ± 2.60)pmol/L] in neural type patients were significantly higher than those of myxedematous type patients [(1.51 ± 0.73), (39.25 ±16.95)nmol/L, (3.02 ± 1.05), (6.42 ± 1.99)pmol/L], TSH was lower than that of myxedematous type patients [(2.26 ±1.04) vs.(58.56 ± 24.83)mU/L, all P ＜ 0.05];mixed type patients T3, T4, FT3, FT4 [(2.38 ± 0.38), (120.77 ±21.55)nmol/L, (5.14 ± 0.83), (15.58 ± 2.99)pmol/L] were significantly higher than those of myxedematous type patients, TSH was lower than that of myxedematous type patients [(2.83 ± 0.91) vs.(58.56 ± 24.83) mU/L, all P ＜0.05];myxedematous type patients T3, T4, FT3, FT4 were significantly lower than those of control group [(2.53 ± 0.50),(121.93 ± 22.01)nmol/L, (5.49 ± 0.82), (15.93 ± 2.76) pmol/L], and TSH was higher than that of control group [(2.94 ± 1.17)mU/L, all P ＜ 0.05].TSH of neural type patients [(2.05 ± 1.45)mU/L] was lower than that of mother group [(2.27 ± 1.63)mU/L, t =10.57, P ＜ 0.05];T3, T4, FT3, FT4 of myxedematous type patients [(1.81 ± 0.66),(56.73 ± 29.56)nmol/L, (2.97 ± 1.34), (5.95 ± 2.74)pmol/L] were significantly lower than those of mother group [(2.16 ± 0.35), (125.48 ± 24.78)nmol/L, (4.29 ± 0.42), (14.90 ± 2.38)pmol/L], and TSH of mother group [(2.35 ±0.56)mU/L] was lower than that of myxedematous type patients [(57.72 ± 44.69)mU/L, t =7.59, 7.07, 16.07, 10.95,245.23, all P ＜ 0.05].There was no significant difference in comparison of A-TG and A-TPO in the four groups (x2 =1.60, 3.64, all P ＞ 0.05).Conclusion The neural type patients and the mixed type patients have normal thyroid function, the myxedematous type patients have obviously lower thyroid function.

Objective To understand the status of endemic cretinism in Southern Xinjiang,and to put forward effective measures for diagnosis,prevention and control of the disease.Methods Follow-up visits were carried out to patients of endemic cretinism that at risk from 2006 to 2009,eliminating death and emigration cases of previous findings,increasing new cases,and all of the patients were conducted epidemiological survey and physical examination.Research contents included the history of patient's general situation,cousin marriage,family history,physical examination including mental retardation,hearing speech disorders in patients with thyroid function,nervous system disorder,thyroid palpation,low performance and cretinism faces,at the same time,a 3 ml venous blood sample was used to determine the thyroid function index.Results Totally 216 cases of endemic cretinism patients from 16 counties of Southern Xinjiang were confirmed,including 122 males and 94 females,aged between 11-20 years old.Neural endemic cretinism patients (167) were in the majority;its main performances were mental retardation,hearing speech disorders and nervous system disorders.Gummy swollen endemic cretinism patients(22) had thyroid hypofunction,but no nervous system disorders.Hybrid endemic cretinism patients (27) had manifestations of the neural and gummy swollen.Thyroid function index inspection results showed that the neural and hybrid endemic cretinism patients triiodothyronine [(2.41 ± 0.48),(2.38 ± 0.38) nmol/L],thyroxine [(118.72 ± 20.92),(120.77 ±21.55) nmol/L],free triiodothyronine [(5.25 ± 0.98),(5.14 ± 0.83) pmol/L],and free thyroxine [(15.81 ± 2.60),(15.58 ±2.99) pmol/L] were higher than those of gummy swollen patients [(1.51 ± 0.73),(39.25 ± 16.95) nmol/L,(3.02 ± 1.05),(6.42 ± 1.99) pmol/L,all P ＜ 0.05],but thyroid stimulating hormone [(2.26 ± 1.04),(2.83 ± 0.91) mU/L] was lower than that of gummy swollen patients [(58.56 ± 24.83) mU/L,P ＜ 0.05].Gummy swollen patients bad typical hypothyroidism,which was conformed to clinical manifestations,and all three types of patients had low thyroid antibody positive rate.Conclusions Southern Xinjiang is the prevalence area of endemic cretinism,the work of prevention and control has a long way to go,in addition to the need to improve the environmental iodine deficiency,it is urgent to improve the level of people's economy.

Objective To investigate the correlation of endothelial inflammation in patients with acute myocardial infarction (AMI)with no-reflow and severity of coronary lesion.Methods A total of 120 patients with AMI were all treated with percutaneous coronary intervention (PCI).The patients who had intraoperative no-reflow were in case group (n=40).The patients who were also treated by PCI but did not have no-reflow in the same period in our hospital served as the control group (n=80).According to the results of coronary angiography, no-reflow group patients were divided into three subgroups:single lesion group (n=14),two-lesion group (n=10), and three-lesion group (n=1 6 ).We monitored these patients’immediate postoperative endothelial microparticles (EMPs)and soluble intercellular adhesion molecule-1 (sICAM-1 )levels in both groups with flow cytometry and ELISA methods.Results In the case group,immediate postoperative EMPs and sICAM-1 levels in the blood circulation were significantly higher than those in the control group.EMPs area and sICAM-1 area under the curve in the case group were 0.755 and 0.701,which showed that EMPs and sICAM-1 levels had a good correlation with the occurrence of non-reflow in AMI patients after PCI.Gensini score and EMPs level rose with the increase of the lesion counts,and the level of EMPs was positively correlated with Gensini score.Conclusion In patients with AMI,the EMPs and sICAM-1 levels can well predict the occurrence of no-reflow and are of some value in predicting the severity of coronary lesion.

Based on the current situation of pediatric surgery practice teaching in Qilu Hospital of Shandong University, 10 mind maps of common clinical diseases made by Imindmap 11 were applied to the practice teaching and teaching assessment through WeChat public platform. Mind map not only revealed the relationship between related disciplines and reappeared the clinical thinking process, but also greatly improved the enthusiasm and efficiency of interns' learning, and trained their innovative spirit and practical ability. At the same time, as a formative evaluation method, mind map facilitates teachers to evaluate and improves teaching activities. What’s more, it effectively improves the quality of teaching, and is worth promoting in clinical teaching.

Objective:To explore the influence of family function on the psychological resilience of mothers of premature infants.Method:Totally 2 836 mothers of premature infants who met the inclusion criteria were investigated with general information questionnaire, family APGAR index (APGAR) and Connor-Davidson resilience scale (CD-RISC) in three third-class A general hospitals and two specialty hospitals in Ningxia.SPSS 23.0 software was used for statistical analysis.Pearson correlation was used to analyze the relationship between psychological resilience and family function of preterm mothers.Hierarchical regression was used to analyze the impact of family function on psychological resilience of preterm mothers.Results:Total score of resilience scale in mothers of premature infants was (68.38±16.59) and the total score of family function was (9.07±1.53). There were 1 550 cases with good family function and 1 286 cases with family dysfunction.The total score of psychological elasticity and the score of all dimensions in the group with good family function were higher than those in the group with family dysfunction( P<0.05). The total score of psychological elasticity ( r=0.771, P<0.01) and self-improvement ( r=0.410, P<0.05), tenacity ( r=0.492, P<0.01), optimism( r=0.438, P<0.05) were positively correlated with family function.Stratified regression analysis showed that cooperation( β=1.016) and intimacy( β=0.389) were the important influencing factors of preterm mothers' psychological resilience ( P<0.05). Conclusion:Psychological resilience of mothers of premature infants is closely related to their family function.Good family function can help mothers of premature infants improve their psychological resilience and promote their mental health.