0.5). However, when the flexible bronchoscope was used, foreign bodies dropped into the esophagus in 5 patients. Conclusion The characteristic manifestations was not frequent in the patients with larynx and trachea foreign bodies.History of aspiration was the most sensitive diagnostic tool. The plain chest radiography and fluoroscopy had low positive finding.Therefore, fiberoptic bronchoscopic examination should be performed timely.However, for extraction of foreign bodies, rigid bronchoscope would be the first choice.

Objective To study the relationship of tumor necrosis factor beta (TNF-?) polymorphism with human IgA nephropathy of Chinese Han nationality in Inner Mongolia Autonomous Region. Methods The A→G single base mutation polymorphism in TNF-?1096 locus were analyzed among 80 normal controls and 79 IgA nephropathy patients by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results The genotype frequencies of TNF?* 1/1 and TNF?* 2/2 in IgA nephropathy patients were significantly higher than that in normal controls (x1/12=5.58,P

Objective To investigate the pattern of outpatients traffic,orchestra service resources,and optimize service provision,for a harmonized outpatient service.Methods A baseline survey was made at the outpatient department in 30 days(six hours per day,7:00-11:00,and 13:00-15:00).On such basis,data of the hospital's HIS system within the last five years were called into play for statistics analysis and simulation test,for the purpose of shift scheduling and resources allocation optimization.Results This study discovered each January-February as the valley of clinic visits and each July-August as the peak.52-week data analysis of a year found that the days of daily registrations between 4000-5000 are up to 163 days,those over 5000 are up to 86 days,of which Mondays with over 5000 registrations are up to 35 days.Each Monday is found to be a peak of outpatient visits,with significant drop during Saturdays and Sundays; daily registrations peak between 7:00-10:00 in the morning,while the traffic rises again during 13:00-14:00 in the afternoon,yet up to 26 ％of the morning peak only.Conclusion Statistics analysis of the outpatient service and emergency service at the outpatient department can help identify their patterns of operations,for effective improvement of service provision,alleviation of peak hour workload,shorten patient waiting time and better patient satisfaction.

Objective:To evaluate the safety and reliability of percutaneous management of benign extrahepatic biliary strictures with biliary duct dilatation and large-bore catheter placement .Methods:The clinical data of 17 patients at Shengjing Hospital from Mar 2017 to Mar 2020 was retrospectively analyzed.Results:There were 7 cases of bilioenteric anastomotic strictures and 10 cases of iatrogenic biliary tract injury strictures (6 cases of Bismuth type Ⅰ and 4 cases of Bismuth type Ⅱ). Fourteen of the 17 patients completed the treatment with a success rate of 82.3%.The catheter was gradually upsized to 22-24Fr.Catheters were left in place for 6-9 months (median time 7.6 months). Patients were followed up for 6-28 months (median follow-up time was 19 months), no recurrent stricture occurred.Conculsion:Percutaneous management of benign extrahepatic biliary strictures with bile duct dilatation and placement of large-bore catheter is a safe and effective minimally invasive treatment method.

ObjectiveTo construct the eukaryotic coexpression plasmid CEA/IL-2, and to lay the foundation for further studying CEA nucleiotide vaccine , adjuvant and their effects of special antitumor immunity.MethodsThe eukaryotic expression plasmid (pcDNA3-CEA)containing the gene coding for CEA was obtained by RT-PCR and gene recombination techniques.Using enzymolysis,ligation and other techniques,an eukaryotic coexpression plasmid (pIRES-CEA/IL-2)containing two expression unites of CEA and IL-2 gene connected with internal ribosome site was constructed.ResultsThe coexpression plasmids were transformed into COS7 cells and expression of two proteins were demonstrated by ELISA, and flow cytometer and elecsy.CEA and IL-2 were (23.73?0.26)ng/ml,and(20.17?0.13)ng/ml respectively.ConclusionsThe eukaryotic expression plasmids pIRES-CEA/IL-2 could be successfully constructed and transformed into COS7 cells.Expression of two proteins were demonstrated with no difference on expression.

Objective:To construct the Escherichia coli (E. coli)expression system for preparation of the bone morphogenetic protein-2 (BMP2)with collagen-binding domain (CBD),and to study the methods and conditions for expression, purification and renaturation of CBD-BMP2.Methods:CBD sequence was cloned into the N-terminal of BMP2 sequence, the recombinant vector pet21b/CBD-BMP2 was constructed and transformed into E.coli BL21.The expression of recombinant protein was induced using isopropylβ-D-thiogalactopyranoside (IPTG) at 37 ℃.Ni-NTA chelate chromatography was used to purify CBD-BMP-2.Denaturing CBD-BMP2 was refolded by dilution method using ultrapure water.The refolding CBD-BMP2 was filtered through a 0.22μm microfiltration membrane for degermation.The recovery rate was calculated by the ratio of the protein concentration before and after degermation. The expression, purification, and renaturation of recombinant protein were detected by SDS-PAGE method.The concentration of CBD-BMP2 was detected by BCA assay.Results:The recombinant vector pet21b/CBD-BMP2 was successfully transformed into E.coli BL21,and the recombinant protein was expressed as inclusion bodies in E.coli.The SDS-PAGE results showed denaturing protein was dissolved in supernatant of lysis buffer with 8 mol·L-1 urea and the purified recombinant protein existed in elution buffer B with relative molecular mass about 14 000.Two bands (14 000 and 28 000)were seen in the SDS-PAGE picture,which indicated that the monomer was successfully refolded into dimer by dilution method.The concentrations of recombinant protein before and after degermation were 110 and 80 mg · L-1 , respectively, and the recovery rate was about 73%. Conclusion:The recombinant vector pet21b/CBD-BMP2 is transformed into E.coli BL21 successfully,and the recombinant CBD-BMP2 is expressed and refolded efficiently. The methods of prokaryotic expression system for preparing recombinant CBD-BMP2 protein are established.

Objective To compare the effect of treating cricopharyngeal achalasia in stroke survivors using transnasal or transoral balloon dilatation.Methods Thirty stroke survivors with cricopharyngeal achalasia were randomly divided into a transnasal and a transoral balloon dilatation group (group N and group O),each of 15.Both groups were given routine swallowing rehabilitation training as well as the transnasal or transoral balloon dilatation.Their heart rate was monitored during the dilatation.Nasal bleeding,mucous membrane swelling and pain were also observed.Their swallowing function was evaluated using the Fujishima Ichiro swallowing efficacy score (FISE) and videofluoroscopy (VFSS) before and after the intervention.Results After the treatment,the average FISE and VFSS scores of both groups had improved significantly comnpared to before the treatment but there were no significant differences between the groups.During the treatment,the average heart rate of group O increased significantly less than that of group N.The treatment acceptance of group O was 98.2％,significantly higher than that of group N (80.1％).One case of mucosal bleeding was observed in group O,and laryngeal edema occurred significantly less often than in group N (9 cases vs.7).The average pain score was also significantly lower in group O.Conclusions Balloon dilatation facilitates swallowing among stroke survivors with cricopharyngeal achalasia.The transoral approach can help to reduce the occurrence of complications such as mucosal bleeding,laryngeal edema and pain,and has better patient acceptance.

On the basis of the existing appointment process, artificial intelligence and Internet of things technologies were introduced to optimize such process. Thanks to the all appointment process management empowered by AI and IoT, patient waiting time is cut short and patient satisfaction enhanced as a result.

Objective:To evaluate the accuracy of lung recruitment maneuver (LRM) combined with brachial artery peak velocity variation (ΔVp) in predicting fluid responsiveness.Methods:Sixty-four patients of both sexes, aged 18-64 yr, with body mass index 19-26 kg/m 2, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, with New York Heart Association class Ⅰor Ⅱ, scheduled for elective open gastrointestinal surgery under general anesthesia, were enrolled in this study.LRM (positive airway pressure was maintained at 30 cmH 2O for 10 s) and volume loading test were performed in sequence after anesthesia induction.ΔVp was measured by ultrasonography at the beginning of LRM.Mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP) and stroke volume (SV) were recorded before LRM (T 1), during LRM (T 2), before volume expansion (T 3) and after volume expansion (T 4). The changing rate of each index before and after LRM (ΔMAP LRM, ΔHR LRM, ΔCVP LRM, ΔSV LRM) and before and after volume expansion (ΔMAP VE, ΔHR VE, ΔCVP VE, ΔSV VE) were calculated.ΔSV VE≥15% was considered to be a positive response after volume expansion, and patients were divided into response group (≥ 15%, R group) and non-response group (< 15%, NR group). Results:There were 34 cases in R group and 30 cases in NR group.Compared with NR group, MAP at T 2 and SV at T 1, 2 were significantly decreased, ΔMAP LRM, ΔMAP VE, ΔSV LRM and ΔSV VE were increased, and ΔVp was increased in group R ( P<0.05). There was a positive correlation between ΔVp and ΔSV VE ( r=0.829, P<0.05), a negative correlation between ΔSV LRM and ΔSV VE ( r=-0.876, P<0.05), and a negative correlation between ΔVp and ΔSV LRM ( r=-0.819, P<0.05). The area under the receiver operating characteristic curve of LRM combined with ΔVp was 0.808, and the cut-off value was 32.3%, the sensitivity 75.3%, and the specificity 88.2%. Conclusion:LRM combined with ΔVp (≥32.3%) can accurately predict the intraoperative fluid responsiveness in patients.

In the theory of "opening-closing-pivoting"， the opening and closing pivot of a portal is used as a metaphor for the operating state of human qi and blood. Opening， closing and pivoting are well functioned together to maintain stable blood pressure， otherwise the imbalance of qi， blood， yin and yang in the body occurs when any of them is abnormal， thereby causing hypertension. During treatment， it is necessary to identify the impaired state of the three functions. If the "opening" is abnormal， it should be treated to restore qi’s function of external defense and distribution. If the "closing" is abnormal， it is necessary to regulate the deficiency and excess state of yang qi and restore the storage function. For "pivoting" disorder， it should be the key to regulate the circulation of qi and blood. Combined with clinical symptoms， the main treatment methods such as "sweat promotion"， "warming"， "clearing"， "purgation"， "supplementation" and "harmonization" are used to restore the function of the "opening-closing-pivoting"， making the blood and vessels of the body unblocked， and qi ascending and descending balanced， in order to achieve the effect of "moving pivot to facilitate opening and closing" and "opening and closing to transport pivot".