Objective To analyze clinical and pathologic features of a rare vascular amyloid deposits of amyloid nephropathy ( VADAN) in 6 patients, so as to improve its diagnosis and treatment. Methods All patients received immunopathology, microscopy and electron microscopy examination, and amyloid types were analyzed. Results There were 3 males and 3 females with ages ranging from 52 to 73 years. Two patients suffered from multiple myeloma. Majority patients had slight albuminuria and hematuria. One patient combined with minimal change glomerular disease presented nephrotic syndrome. One patient combined with IgA nephropathy had albuminuria and hematuria. And one patient had myeloma cast nephropathy with acute renal failure. Kidney biopsy proved amyloid deposits along interlobular arterial wall only in all 6 patients. Two cases secondary from multiple myeloma were κ amyloid, and the rests were λ amyloid. Conclusions VADAN is a rare type of amyloid nephropathy. Its clinical manifestation is different from common amyloid nephropathy. Kidney biopsy will benefit its differential diagnosis.

Objective To compare the effectiveness and safety of different concentrations of elastin-like polypeptides (ELP) as novel submucosal injection material for endoscopic submucosal dissection.Methods Forty healthy New Zealand white rabbits were randomly divided into two groups (n=20).The first group by submucosal injection of different drugs were randomly divide into five groups (n=4).Four concentrations of 50 ku ELP (0.05,0.025,0.012 5,0.005 g/ml) were used separately in each group,while glycerin fructose was used for control group.Each solution (2 ml) was injected into the submucosa through the resected margin,the increase of mucosal thickness and surface changes were observed and recorded at 0,5,10,and 30 min.The subgroup by submucosal injection of different drugs were randomly divide into five groups (n=4).The injection pressure of each solution (2 ml) with the 25-gauge needle was calculated by a manometer,which was connected between the needle and syringe.Results The submucosal uplift heights in groups using the 0.05 g/ml ELP and 0.025 g/ml ELP injection were significantly thicker than that of glycerin fructose (P＜0.05),the 0.012 5 g/ml ELP and glycerin fructose injection showed no significant difference (P＞0.05),whereas the uplift height in glycerin fructose group was thicker than that of the 0.005 g/ml ELP (P＜0.05).The injection pressure correlated with the ELP concentration.The injection pressures of 0.05,0.025,0.012 5,0.005 g/ml ELP solutions were (332±36) kPa,(223±24) kPa,(174±22) kPa and (142±19) kPa,respectively,and that of glycerin fructose was (269±17) kPa.The 0.025 g/ml ELP solution was easily injected into the porcine stomach to create submucosal uplift.The injection pressure of the 0.025 g/ml ELP solution showed significantly lower value compared with that of glycerin fructose (P＜0.05).Conclusions ELP might be a promising agent for submucosal injection for endoscopic submucosal dissection (ESD),and 0.025 g/ml ELP might be efficient concentration for maintaining mucosal elevation,injection pressure and safety.

Objective To understand the species diversity of ectoparasites on Niviventer confucianus in the surrounding areas of Erhai Lake.Methods Small mammals were randomly captured in 12 investigated sites surrounding Erhai Lake with baited mouse cages.The cage-traps were examined and re-baited each morning.Trapped small mammals were brought to the laboratory for identification according to color, body length, ear length, hind foot length.All ec-toparasites on the surface of the hosts were collected and identified.The constituent ratio(C), prevalence(P) and average ectoparasite abundance(A) were used to evaluate the prevalence and density of ectoparasites.Non-parametric Mann-Whitney U-test was used to test differences in the abundance and richness of ectoparasites between female and male hosts.Spearman correlation analysis was used to analyze the relationship between ectoparasites and the body param-eters of hosts.Results Eighty-nine individuals of N.confucianus were captured, of which 79% were found infested with 51 species of ectoparasites, including 31 species of chigger mites, 13 species of mesostigmatid(gamasid) mites, 4 species of fleas and 3 species of sucking lice.Walchia ewingi Fuller(66.2%), Laelaps turkestanicus Lange(38.5%), Paradoxopsyllus custodies Jordan(42.9% ) and Hoplopleura pacifica(80.1% ) were the most predominant species of chigger mites, gamasid mites, fleas, and sucking lice, respectively.Non-parametric Mann-Whitney U-test showed that there was no significant difference between male and female hosts on the species richness and abundance of total ec-toparasites, chigger mites, sucking lice, fleas or gamasid mites.Spearman correlation analysis showed that the abun-dance and species of total ectoparasites, chigger mites, sucking lice, fleas or gamasid mites were not correlated with the body weight of hosts.Conclusion There is a high speices diversity of ectoparasites on N.confucianus.Sucking lice, fleas, chiggers and gamasid mites are the main ectoparasites.

Objective To compare the clinicopathological features between two kinds of obesity-related glomerulopathy (ORG). Methods Twenty-three patients with obesity-associated glomerulomegaly (OB-GM) and 22 patients with obesity-associated focal and segmental glomerulosclerosis (OB-FSGS) diagnosed by renal biopsy during 1998 to 2008 in our center were enrolled in this study. A retrospective analysis of clinical and pathological data was carried out. Results (1) All the patients in these two groups were with abdominal obesity. Most of them were middle-aged male. There were no significant differences in gender, age, body mass index and waist circumference between these two groups (P>0.05). The mean course of disease in OB-FSGS group was significantly longer than that in OB-GM group[(21.7±29.7) vs (6.8±9.3) months,P<0.05]. (2) Metabolic syndrome was found in the most patients of these two groups, but there were no significant differences in the levels of serum glucose, triglycerides, HDL-cholesterul, uric acid and blood pressure between them(P>0.05). (3) The 24-hour urinary protein and Ser level in OB-FSGSgroup were significantly higher than those in OB-GM group[(2.49±1.58) vs (0.83±0.87) g/d, P<0.05; (102.09±25.07) vs (87.84±20.63) μmol/L, P<0.05]. The serum albumin level, creatinine clearance and urinary osmotic pressure in the former were significantly lower than those in the latter [(38.67±7.00) vs (44.05±3.55) g/L, P<0.01; (95.78±37.83) vs (128.72±31.20) ml/min, P<0.01; (678.72±91.76) vs (840.69±133.88) mmol/L, P<0.01]. (4) The mean glomerular diameters of both OB-FSGS group and OB-GM group were increased, whose difference was not significant [(204.3±23.1) vs (205.3±14.3) μm, P>0.05]. Conclusion There are significant differences in the mean course of disease, 24-h urinary protein excretion, serum albumin level and renal function between these two different kinds of ORG.

Objective To understand the species,species distribution,the dominant species and their interspecies interaction of chigger mites on Eothenomys miletus(a dominant species of rats)in Yunnan.Method The rats were captured with mouse traps in 16 counties(or cities)during 2000-2004.All mites on the surface of two auricles of the hosts were collected and identified.The patch index(m*/m)and the coefficient of association(V)were adopted to judge the spatial distribution patterns and interspecies interaction of the dominant chigger mite species among different individuals of the rats(E.miletus).Results 1157 individuals of E.miletus were captured from 16 counties(citys).37613 chigger mites(belonging to 3 subfamily,9 genus and 80 species)were collected from the auricles(body surface)of 1157 rat hosts with a high “overall mite infestation rate”(68.2%)and “overall mite index”(32.5).Six species of mites were found dominant on E.miletus:Leptotrombidium scutellare,Leptotrombidium sinicum,Helenicula simena,Leptotrombidium eothenomydis,Herpetacarus hastoclavus and Leptotrombidium hiemalis.The distribution of the chigger mites among different individuals of E.miletus showed an aggregation pattern.Both positive and negative association existed between each two dominant species of chigger mites.Conclusion The species composition of chigger mites on Eothenomys miletus is complex with abundant individuals,which reflects a high species diversity of the mites.The main species of chigger mites tend to an aggregation on the body surface of E.miletus.

Objective The action mechanisms of Qingfei Oral Liquid ( QFOL) in the treatment of respiratory syncytial virus ( RSV) infection need to be studied more deeply.The aim of this study is to examine the expressions of interleukin ( IL)-10 and IL-17 in the lung tissue and those of Treg and Th17 in the spleen tissue of RSV-infected mice before and after treated with QFOL, and to explore the action mechanisms of QFOL from the perspective of the Treg/Th17 cy-tokines balance. Methods Fifty BABL/c mice were equally ran-domized to five groups: blank control, RSV model, Ribavirin, low-dose QFOL, and high-dose QFOL.Models of RSV ( long strain) infec-tion were made in the latter four groups.At 48 hours after viral activa-tion, the mice of the control and RSV model groups were treated intragastrically with 0.9%normal saline and those in the Ribavirin and QFOL groups with Ribavirin at 0.0025 g/mL and QFOL at 1.33 g/mL and 4 g/mL, respectively, all for 72 hours.Then all the mice were killed and the lung tissue harvested from 5 animals in each group for pathological analysis, while the levels of IL-10 and IL-17 in the bronchoalveolar lavage fluid of the other 5 detected by ELISA.The expressions of the cytokines Treg and Th17′in the spleen from 4 mice in each group were determined by flow cytometry. Results Compared with the RSV models, pathologic changes were significantly re-duced in the mice of the QFOL, Ribavirin and control groups (P<0.01), the expression of IL-10 remarkably up-regulated in the low-dose QFOL, high-dose QFOL, Ribavirin, and control groups ([39.21 ±1.57] vs [43.54 ±1.03], [46.64 ±0.48], [47.83 ±0.87], and [50.44 ±1.04] ng/L, all P<0.01), while the level of IL-17 markedly down-regulated ([70.96 ±0.53] vs [55.92 ±0.83], [33.66 ±0.70], [21.92 ±1.38], and [9.42 ±0.59] pg/mL, all P<0.01).The expressions of Treg/Th17′were significantly in-creased in the low-dose QFOL, high-dose QFOL, Ribavirin, and control groups (2.89 ±0.52, 6.38 ±0.36, 3.95 ±0.26, and 3.54 ± 0.85) as compared with that in the RSV models (0.96 ±0.16) (all P<0.01).Both low-and high-dose QFOL groups showed statisti-cally significant differences from the Ribavirin group in the levels of Treg, Th17, and Treg/Th17 (P<0.05). Conclusion QFOL can regulate the balance of Treg/Th17, increase the expression of IL-10 and decrease that of IL-17 in the lung tissue of RSV-infected mice, which further proves the efficacy of QFOL in the treatment of RSV-induced pneumonia.

Objective: To investigate the current situation of stressors and job burnout among surgical residents and to explore the influencing factors, so as to provide evidences for reducing stress and relieving job burnout. Methods: The stressor scale and job burnout scale were used to investigate the stress and burnout of 145 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2016 to June 2019, to understand the existence of stress and job burnout in surgical residents, and analyze the linear correlation between each dimension of stressors and each dimension of burnout. There were 132 males and 13 females, who were (26.62±1.45) years old, ranged from 22 to 30 years. SPSS19.0 software was used for statistical analysis. The measurement data of normal distribution were expressed as Mean±SD Counting data were expressed by frequency and constituent ratio. Pearson correlation analysis was used to analyze the linear correlation between each dimension of stressors and each dimension of job burnout. Results: The total score of surgical resident stress was 2.51±0.57. The scores of social factors and workload were higher in each dimension 3.02±0.58 and 3.00±0.62, respectively. The burnout survey showed that 7 residents (4.8%) had severe burnout. In the dimension of emotional exhaustion, there were 14 residents with severe burnout. In the dimension of cynicism, there were 21 residents (14.5%) had severe burnout. In the dimension of reduced personal accomplishment, there were 19 residents (13.1%) of mild burnout and 17 residents (11.7%) of severe burnout. Further analysis of the linear correlation between each dimension of stressors and each dimension of burnout showed that most of them were positively linear correlated. In particular, emotional exhaustion and workload (r=0.411, P<0.05), reduced personal accomplishment and social factors (r=0.429, P<0.05) had a relatively large correlation coefficient. Conclusions The stress and burnout of surgical residents were at a high level. In order to reduce the stress and relieve the burnout, it is necessary to strengthen the residents′ self-management and improve the social support system.

ObjectiveTo establish a novel assay for HIV-1 p24 ultrasensitive detection based on Gold Nanoparticle Probe (GNP) and PCR.MethodsSandwich ELISA method was established by a pair of anti-p24 monoclonal antibodies (mAbs),1G12 and 1D4,and was used to detect recombinant HIV-1 p24 antigen.The bio-barcode DNA was 47 bp,selected from genome of Arabidopsis,and formed double-stranded DNA by hybridization with the capture DNA (complementary with bio-barcode DNA) modified with sulfhydryl.Then double-stranded DNA were conjugated on the surface of 1D4-modified gold nanoparticles by sulfhydryl,and the Gold Nanoparticle Probe was produced.1G12 was precoated in the micropaltes,and in the presence of target recombinant HIV-1 p24 protein,a sandwich immuno-complex would form by adding GNP.Then the bio-barcode DNA in the immuno-complex were released by heating as detection signal,and consequently characterized by the polymerase chain reaction (PCR) with synthesized special primers and analyzed by 4％ agar gel electrophoresis,so HIV-1 p24 antigen could be evaluated.The sensitivity comparison between the new assay and ELISA can be done.ResultsSandwich ELISA was used to quantify HIV-1 p24 antigen by monoclonal antibodies 1G12 and 1D4,and the limit of detection (LOD) was 1000 pg/ml.The new GNP assay was established by the same pair of antibodies,combined with PCR and agar gel electrophoresis,and was used to indirectly detect HIV-1 p24 antigen.The band intensity of PCR products paralleled with the quantity of HIV-1 p24 antigen,and the limit of detection (LOD) could reach down to 1 pg/ml.ConclusionThe new assay based on GNP and PCR was efficient in the detection of HIV-1 p24,which is at least 3 orders of magnitude more sensitive than traditional ELISA.

Objective:To investigate the satisfaction degree of surgical resident in standardized training and to explore the existing problems and influencing factors. It provides references for improving the system and quality of standardized training.Methods:The Self-designed Satisfaction scale was used to investigate the satisfaction degree of 137 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2015 to June 2018. There were 108 males (78.8%) and 29 females (21.2%). The mean age was (26.78±1.83) years. The measurement data of normal distribution were expressed as mean ± standard deviation. Counting data was expressed by frequency and constituent ratio. The differences between groups were analyzed by t test and one-way anova.Results:The overall satisfaction score of the surgical residents to the standardized training was 3.71±0.83, among which the residents scored the highest on the working condition (4.12±0.67), while the training effect (3.53±0.85) was the last in all dimensions. The overall satisfaction of third-year residents was lower than that of first-year and second-year residents, and the differences were statistically significant ( F=3.27, P=0.04). The scores of first-year residents in standardized management was higher than that of second-year and third-year residents, and the difference was statistically significant ( F=3.30, P=0.04). The scores of professional degree postgraduate in overall satisfaction, standardized management and research training were higher than those of enrolled resident, and the differences were statistically significant ( P<0.05). The score in enrolled resident (3.78±0.85) was higher than that of professional degree postgraduate (3.44±0.63)in the dimension of salary, and the difference was statistically significant ( P=0.02). Conclusion:Surgical residents expressed satisfaction with the general condition of standardized training, training condition, research training, training effect and postgraduate salary were still need be strengthen.

Objective:To investigate the current situation of job burnout and depression among surgical residents, with a view to reduding or alleviating the burnout and depression of surgical residents.Methods:The job burnout scale and depression scale were used to investigate the burnout and depression of 137 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2016 to January 2019, there were 108 males and 29 females, aged (26.57±1.77) years, and the age ranged from 23 to 28 years. The distribution differences of the incidence of job burnout and depression in gender, time status and the correlation between the three dimensions of job burnout and depression were analyzed. The measurement data were expressed as mean±standard deviation ( Mean± SD). Counting data were expressed as percentage(%). The differences in the distribution of job burnout and depression in gender, time and status were analyzed by chi-square test. Pearson correlation analysis was used to analyze the correlation among the three dimensions of job burnout and depression. Results:Of the 137 surgical residents, 10 (7.3%) had severe job burnout requiring intervention . In the emotional exhaustion dimension, 67 (48.9%) had mild burnout, 53 (38.7%) had moderate burnout, and 17 (12.4%) had severe burnout. In the cynicism dimension, 86 (62.8%) had mild burnout, 37 (27.0%) had moderate burnout, and 14 (10.2%) had severe burnout. In the reduced personal accomplishment dimension, 64(46.7%) had mild burnout, 43(31.4%) had moderate burnout, 30(21.9%) had severe burnout. The results of the depression survey showed that 27 (19.7%) of the 137 surgical residents were depressed. There were no statistically significant differences in the incidence of job burnout in gender, time and status( P>0.05). There were no statistically significant differences in the incidence of depression in gender and status( P>0.05). The incidence of depression was higher among 1-year residents (14, 35.0%) than among 2-year (8, 15.7%) and 3-year(5, 10.9%) residents ( P<0.01). Depression is associated with emotional exhaustion, cynicism and reduced sense of achievement ( r=0.248, r=0.301, r=0.201, respectively, P<0.05). Conclusions:The job burnout and depression of surgical residents are not optimistic. There were differences in the time distribution of depression incidence, among which the incidence of depression is higher among the residents in the first year. The occurrence of depression is positively correlated with three dimensions of job burnout.