Objective:To investigate the value of ultrasonography in the diagnosis of cystic renal cell carcinoma(CRCC).Methods:To review and analyze 32 cases confirmed by histological examination with the complete data and to sum up their characteristic features of ultrasonographic appearance,and then compared with the results of CT.Results:The sensitivity of ultrasonography in the diagnosis of cystic renal cell carcinoma was 75.00%(24/32),CT was 87.50%(28/32),therefore there was no obvious statistical difference between them.Conclusion:Color Doppler ultrasonography has diagnostic value in cystic renal cell carcinoma.

OBJECTIVE To evaluate the detect method of neopterin(Npt) by enzyme-linked immunosorbent assay(ELISA) and discuss the application of Npt in the viral encephalitis.METHODS The Npt was detected by ELISA.The methodology was investigated by sensitivity,precision,rate of recovery,interference and reference value.The npt was detected by ELISA assay in peripheral blood of 50 healthy people,30 cases of cerebrospinal fluid in children with viral encephalitis and 12 cases of cerebrospinal fluid in the control group.RESULTS In this method,within-run CVs were 4.94% and 5.55%;between-run CVs were 5.99% and 6.57%.The sensitivity was 1.08 nmol/L;the rate of recovery was 95.8-107.8%.Various indexes of the methodology coincided with the requirements of clinical laboratory.The reference value of serum Npt was 0-7.84 nmol/L.The Npt of cerebrospinal fluid was(34.09 ? 36.34) nmol/L in the viral encephalitis group,and(4.55 ? 2.89)nmol/L in the control group,and the Npt of cerebrospinal fluid in patient was significantly higher than that in control group(P

Objective To analyze the epidemic characteristics of tuberculosis (TB) cases in Zhejiang province from 2005 to 2014, and to identify the cluster spots.Methods TB notification data in Zhejiang province from 2005 to 2014 were analyzed at county and district level by using spatial scan statistic analysis method, which was showed on the digital map.Results In zhejiang province from 2005 to 2014, a total of 377 707 cases of patients with tuberculosis were reported.The average annual registration rates of the entire province was 72.61/100 000 (range: 28.85/100 000-182.90/100 000).Spatial analysis identified 14 clusters (RR=1.05-1.62) with statistical significance.Temporal analysis revealed that there were clusters between 2005 and 2009 in terms of the notification data on TB cases (RR=1.27,P=0.001).Spatio-temporal analysis identified 6 clusters (RR=1.19-3.55) with statistical significance.Counties and districts included in the first class cluster were similar by using the two different methods-spatial analysis and spatial-temporal analysis.Conclusions There is a descending trend of TB cases notification rates from western to eastern Zhejiang during the study period.The distribution of the TB case notified is not random at spatial, temporal and spatio-temporal levels.

Objective Deleting the cysteine-rich region (22-37 amino acids)of HIV-1 HXB2 Tat protein(whole length is 101 amino acids) to improve its stability and expression level in E.coli and to analyze the immunogenicity of Tat protein without the cystein-rich region [Tat(△C)protein]. Methods Tat DNA deleted the cysteine-rich region (64-111 nucleotides), named as Tat(△C)DNA, was obtained in vitro by PCR and cloned into pET-32a vector. pET-32a-Tat(△C)plasmid and the pET-32a-Tat plasmid were established and transformed into E.coli BL21(DE3) strains respectively to express and purify the protein. Three rabbits were vaccinated with pET-32a-Tat(△C)protein, then testify the reactivity of sera from rabbits by ELISA and Western blot. Results The dense of the purified pET-32a-Tat(△C)protein was 7.12 mg/ml,which was greatly more than pET-32a-Tat protein(1.50 mg/ml). Dimer of pET-32a-Tat protein can be observed just after the protein purification and stored at 25℃ and 4℃ for 7 days, but dimer of pET-32a-Tat(△C)protein was not formed at the same condition. Experimental rabbits were immunized with pET-32a-Tat(△C)protein and produced high titre of anti-pET-32a-Tat(△C)serum(1∶320 000), the antibody can react specifically with Tat(△C)protein, Tat protein (1-101 AA)and synthetic Tat(1-86 AA) protein. Deletion mutation of the cysteine-rich region of Tat protein was first performed in the study. Conclusion The expression level in E.coli and the stability of Tat protein deleted the cysteine-rich region can be increased greatly, and the protein remains good immunogenicity. The results may provide a novel antigen for further development of HIV-1 Tat vaccine.

Objective: To investigate the epidemiological characteristics of pulmonary tuberculosis ( PTB ) incidence and mortality in Zhejiang Province from 2016 to 2020, so as to provide the evidence for formulating the PTB control strategy. Methods: The data regarding the PTB patients in Zhejiang Province from 2016 to 2020 were collected from the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System. The reported cases and deaths of PTB cases were descriptively analyzed by time, population and regions. Results: A total of 129 985 PTB cases were reported in Zhejiang Province from 2016 to 2020, and the overall reported incidence rate of PTB was 45.81/105, with a tendency toward a decline in the reported incidence ( χ2trend=298.899, P<0.001 ) and an annual decline rate of 3.72%. The prevalence rates of rifampicin resistance, positive etiological tests, negative etiological tests and no etiological results were 1.51%, 47.17%, 46.67% and 4.65%, respectively. A total of 546 PTB deaths occurred in Zhejiang Province from 2016 to 2020, and the reported mortality of PTB was 0.19/105, with a tendency towards a decline ( χ2trend=10.818, P<0.001) and an annual decline rate of 11.99%.The prevalence rates of rifampicin resistance, positive etiological tests, negative etiological tests and no etiological results were 1.83%, 82.97%, 13.37% and 1.83%, respectively. The highest reported incidence ( 92.18/105 ) and mortality ( 1.19/105 ) of PTB was found in patients aged 65 years and older, and farmer was the predominant occupation of PTB cases (60 774 cases, 46.75%) and dead PTB cases ( 345 cases, 63.19% ). In addition, the top three cities with the highest incidence of PTB included Quzhou City ( 66.43/105 ), Jinhua City ( 64.24/105 ) and Lishui City ( 53.91/105 ), and the top three cities with the highest mortality of PTB included Quzhou City ( 0.67/105 ), Lishui City ( 0.27/105 ) and Jiaxing City ( 0.26/105 ). Conclusions Both the reported incidence and mortality of PTB appeared a tendency towards a decline in Zhejiang Province from 2016 to 2020; however, the proportion of positive etiological tests increased. Higher attention should be paid to the elderly aged 65 years and older and and farmers, and active screening and health education are recommended; in addition, PTB control requires to be intensified in highly prevalent regions, including Quzhou City, Jinhua City and Lishui City.

Objective To study the clinical effect of pedicle screw fixation in treatment of unstable upper and middle thoracic vertebrae fractures. Methods A retrospective study was performed on 17 cases of unstable upper and middle thoracic vertebrae fractures treated with vertebral pedicle screw system (GSS 全称in 11 cases and USS 全称in six) fixation, posterolateral bone grafting and fusion from March 2001 on. There were one case of T_3, two T_4, two T_5, four T_6, six T_7 and two T_8. Of all, nine cases were with compression fractures, five with fracture-dislocation and three with burst fractures. Results All cases were followed up for 10-38 months (average 21.1 months). During the follow up, the anterior vertebral body height was restored from preoperative 40% to postoperative 91%. Except for four screw malpositions, there was no postoperative neurologic deterioration, screw loose or breakage of the internal fixation, or loss of the normal spine curve and the spinal height of the injured vertebra. Conclusions Pedicle screw fixation is an effective way for treating unstable upper and middle thoracic vertebrae fractures. Correct placement depend on a comprehensive familiarity of pedicle anatomy, appropriate pedicle diameter and entry point and depth can avoid potential risks in placing pedicle screws into the upper and middle thorax.

OBJECTIVE: To study the mechanisms of Tongxia Huayu Decoction (a Chinese herbal decoction for purgation and removing blood stasis) in prognostic improvement for severe acute pancreatitis by early intervention on pancreatic microcirculatory disturbance. METHODS: Fifty-three patients with severe acute pancreatitis were divided randomly into treatment group (n=28) and control group (n=25). Tongxia Huayu Decoction was given to the patients in treatment group in addition to the normal treatment in control group for one week. The clinical symptoms and signs, hemodiastase, urinary amylase, C-reactive protein (CRP) and endothelin (ET) of the patients in the two groups before and after treatment were observed and detected. RESULTS: The total response rate of the treatment group was 98.4%, while that of the control group was 80%, with significant difference between them (P<0.05). There was no significant difference of the contents of hemodiastase, urinary amylase, CRP and ET between the two groups before treatment, while they were significantly decreased after treatment (P<0.01) with more obvious change in treatment group (P<0.01). CONCLUSION: Tongxia Huayu Decoction brings satisfied therapeutic effect on severe acute pancreatitis. The mechanisms may associate with its reducing function on ET releasing so as to inhibit the pancreatic microcirculatory disturbance and acinar cell injury induced by ET.

Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis cases at ages of 60 years and older in Quzhou City, Zhejiang Province, so as to provide the evidence for formulating the pulmonary tuberculosis control strategy among the elderly. Methods: The data pertaining to pulmonary tuberculosis cases at ages of 60 years and older in Quzhou City from 2010 to 2020 were collected through the Tuberculosis Management Information System of the China Disease Prevention and Control Information System. The trends for incidence, population distribution, diagnosis and treatment of pulmonary tuberculosis cases aged 60 years and older were analyzed using a descriptive epidemiological method. Results: Totally 8 754 pulmonary tuberculosis cases aged 60 years and older were reported in Quzhou City from 2010 to 2020, accounting for 47.65% of all pulmonary tuberculosis cases, and the number of pulmonary tuberculosis appeared a tendency towards a rise ( χ2trend=173.320, P<0.001 ), while the incidence of pulmonary tuberculosis showed a tendency towards a decline ( χ2trend=389.820, P<0.001 ), with an annual decline rate of 177.11/105. There were 4 307 smear-positive pulmonary tuberculosis cases, accounting for 58.71% of all smear-positive cases, and the number of smear-positive pulmonary tuberculosis cases showed a tendency towards a rise ( χ2trend=126.320, P<0.001 ), while the proportion of smear-positive cases showed a tendency towards a decline ( χ2trend=21.680, P<0.001 ), with an annual smear-positive rate of 87.14/105. The incidence of pulmonary tuberculosis was 256.94/105 among males and 91.43/105 among females at ages of 60 years and older ( χ2=20.903, P<0.001 ). The highest incidence of pulmonary tuberculosis was seen in patients aged 80 to 84 years ( 235.17/105 ), and farmers were the predominant occupation ( 7 171 cases, 81.92% ), while the highest number of cases was reported in Quzhou City (8 676 cases, 99.11%). There were 7 752 treatment-naïve cases ( 88.55% ), while 5 830 cases with delay in seeking healthcare services, and the proportion of delay in seeking healthcare services showed a tendency towards a rise from 2010 to 2020 ( χ2trend=4.853, P=0.028 ), with an annual mean delay rate of was 66.60%. Conclusion The incidence of pulmonary tuberculosis appeared a tendency towards a decline among patients aged 60 years and older in Quzhou City from 2010 to 2020, and the elderly aged 80 years and older and farmers should be paid more attention.

Objective To construct shifting mutant of cysteine-rich region to 3?@terminal of Tat gene of human immunodeficiency virus type-1 (HIV-1) HXB2 strain, and to analyze the immunogenicity of mutant protein (Tat-cct) after prokaryotically expressed and purified. Methods The cysteine-rich region (nucleotides 64--111) of Tat gene was shifted to 3'terminal of Tat of HIV-1 HXB2 strain by polymerase chain reaction (PCR) and Tat mutant DNA sequence was obtained. Prokaryotie express plasmid pET32a-Tat-cct was constructed and transformed into E. coli BL21 (DE3), then Tat-cct protein was expressed and purified. BALB/c mice were immunized with the fusion protein Tat-cct, and immunogenicity of the immunized serum was detected by enzyme-linked immunosorbent assay (ELISA). Results The recombinant plasmid pET32a-Tat-cct expressed in E. coli BL21 (DE3) and the relative molecular mass of the purified fusion protein was 31 000. The serum antibody titer of mice immunized with Tat-cct recombinant protein was 1 : 1600, which binded specifically with both Tat-ect protein and Tat protein (amino acids 1-101). Conclusions The recombinant protein Tat-cct of Tat mutant strain can be expressed efficiently in E. coli and well retains immunogenicity, which provides valuable information for basic research of HIV-1 Tat vaccine.

Objective To investigate the effects of Pinella's ingredients on the viability of cells, morphology, microstructure, cell cycle and apoptosis in human cervical cancer cell lines. Methods The β-sitosterol and/or total protein of Pinella were incubated at different concentrations with cervical cancer cell line SiHa. The effects of β-sitosterol and/or total protein of Pinella on the viability of cells were tested by MTT assay. The effects of β-sitosterol on morphology, microstructure, cell cycle and apoptosis were studied by phase-contrast microscope, electron microscope and flowcytometry, respectively. Results β-sitosterol could obviously inhibit the viability of SiHa cells in a time-and dose-dependent manner. The total protein of Pinella had no effects on SiHa cells' viability. 20 μmol/L β-sitosterol induced the accumulation of SiHa cells in S phase in the cell cycle. And the percents of apoptosis and necrosis increased. The morphology and microstructure of SiHa cells changed significantly after treated with 20 μmol/L β-sitosterol. Conclusions The total protein of Pinella had little influence on the viability of cervical cancer cells SiHa. The viability of SiHa cells could be suppressed by β-sitosterol. β-sitosterol could induce the accumulation of cells in S phase and the percent of apoptosis and necrosis. The morphology and microstructure changed significantly after treated with β-sitosterol. Therefore, β-sitosterol might be a prospect safe and low toxicity anti-cervical cancer drug.