Objective Preparation of specific antibody of neuron protein 14 3 3 and application for the diagnosis of prion diseases. Methods The rabbits were immunized with prokaryotic expressed GST 14 3 3 fusion protein and the collected antiserum was evaluated by ELISA and Western blot assays. Results ELISA revealed that the reactive titer of the prepared antibody against purified 14 3 3 protein was up to 1:4 096 000; Western blot assays confirmed that both prokaryotic expressed,and the natively presenting 14 3 3 proteins in the brain extracts were recognized by the prepared antibody. Two cases of clinically diagnosed Creutzfeldt Jakob disease (CJD)with typical EEG changes showed the positive 14 3 3 protein in cerebral spinal fluid (CSF). Four patients with dementia and narcoma but without typical EEG change were 14 3 3 negative in CSF,three of them being even further tested by brain biopsies without typical histological change of CJD and presentation of protease resistant PrP Sc protein. 35 samples CFS collected from patients without dementia were 14 3 3 negative in CSF. All the results were the same as that of standard 14 3 3 polyclonal antibody.Conclusion Using purified prokaryotic expressed GST 14 3 3 fusion protein as antigen,the specific antibody was elicited in the immunized animals. The prepared antibody can be used in identification of 14 3 3 protein in CSF for the diagnosis of CJD.

Objective To explore the impact and value of 11C-MET PET/CT for high-grade glioma in making conformal radiotherapeutic planning compared with MRI.Methods From October 2011 to September 2013,11C-MET PET/CT and MRI were performed in 25 initial glioma cases and 9 recurrent cases.All 34 cases (19 males,15 females) were classified into initial group (n=17),initial surgery group (n=8) and recurrent group (n=9).GTV was outlined using PET/CT images combined with T1 weighted MRI images.Results 11 C-MET PET/CT optimized radiotherapy targets in 22 cases,including 7 initial cases,8 initial surgery cases and 7 recurrent cases.GTV was consistent with the volume of abnormally enhanced region on T1 weighted MRI (VMRI) in 10 initial cases,GTV＞VMRI in 5 cases,and GTV＜VMRI in 2 cases.GTV＜VMR1 in the initial surgery group.GTV was consistent with VMRI in 2 recurrent cases,GTV＞VMRI in 2 cases and GTV＜VMRI in 4 cases; 1 recurrent case's GTV located largely outside the VMRI.Conclusions There are some differences on locating the lesions of high-grade gliomas between 11C-MET PET/CT and MRI.Using 11CMET PET/CT in sketching radiotherapy target could significantly optimize the high grade glioma's radiotherapeutic planning,which may be more valuable in recurrent or operative cases.

ObjectiveTo investigate the role of magnetic resonance imaging (MRI) in treatment efficacy evaluation of polymyositis and dermatomyositis.MethodsFifteen patients with polymyositis and dermatomyositis underwent MRI of thigh were included.Scores of MRI signal intensity of the diseased muscle of every patient were compared before and after treatment and the correlation between serum creatinkinase (CK) level and muscle strength grade were also compared.Correlations between muscle strength grade and MRI score,as well as muscle strength grade and creatinkinase level were analyzed.Comparisons between groups were tested by t test,and the relationship between muscle strength and clinical data was analyzed by Pearson's correlation analysis.ResultsThe signal score of MRI was counted before and after therapy(2.37±0.62,1.30±0.28,respectively,P＜0.05),and CK level[(3841±3175),(549±338) U/L,respectively,P＜0.05] and muscle strength (15.1 ±2.4,18.1 ±0.9,respectively,P＜0.05) were assessed at the same time.Muscle strength grade was associated with signal score of MRI and serum CK level,there was a strong correlation between muscle strength grade and signal score of MRI(r=-0.890,P＜0.05 ).ConclusionMRI may be a useful tool for clinical efficacy evaluation in patients with polymyositis and dermatomyositis.

BACKGROUND: Ankle fracture combined with deltoid ligament rupture and distal tibiofibular syndesmosis injury occurs occasionally. Its treatment with distal tibiofibular syndesmosis screw fixation or deltoid ligament repair remains controversial. The former appears with poor reduction, broken nails, secondary surgery and other problems.OBJECTIVE: To observe the clinical effectiveness of suture anchor repair for ankle fracture combined with deltoid ligament injury.METHODS: Twelve patients with ankle fracture combined with deltoid ligament injury were selected from the First Affiliated Hospital of Guangzhou University of Chinese Medicine between January 2013 and December 2015. All patients were treated with open reduction, internal fixation, and anchor repair, but without distal tibiofibular syndesmosis screw fixation. The curative efficacy and joint stability were observed.RESULTS AND CONCLUSION: (1) All patients were followed-up for more than 12 months. (2) The modified Baird-Jackson scoring system showed excellent in nine cases, good in two cases, average in one case, poor in none case, and the excellent and good rate was 92%. (3) At 1 year after internal fixation, the X-ray examination showed the malleolus gap and talus slope angle of the affect side were (3.47±0.12) mm and (0.45±0.18)°, and the malleolus gap and talus slope angle of the healthy side were (3.44±0.05) mm and (0.43±0.14)°, and there was no significant difference between two sides (P > 0.05). (4) These results indicate that the suture anchor can repair the anatomy and biomechanics of deltoid ligament with stable ankle joint, and secondary surgery is unnecessary.

Objective21 -hydroxylase deficiency ( 21-OHD) patients are at high risk of developing metabolic syndrome.Low dose of glucocorticoid is crucial in the treatment.This study is to investigate the effect of glucocorticoid therapy on potential metabolic disorders.Methods Thirty-two treated and 31 untreated 21-OHD patients were recruited.The components of metabolic syndrome were investigated in both groups.Results Serum testosterone [ (0.61 ±0.12 vs 4.10±0.66) ng/ml,P＜0.01 ],17-(OH) progesterone[ 17-OHP,( 14.83±3.48 vs 48.52±4.72 )ng/ml,P＜0.01 ],dehydroepiandrosterone sulfate[ DHEAS,(55.7±23.6 vs 405.2±65.7 ) μg/dl,P＜0.01 ],and ACTH[ ( 105.8±44.7 vs 617.4± 163.3 ) pg/ml,P＜0.01 ] levels were significantly reduced,whereas body mass index [ ( 23.2±0.9 vs 21.1 ±0.5 ) kg/mz,P＜0.05 ],systolic blood pressure [ ( 120.5 ± 1.3 vs 115.5 ± 1.8 ) mm Hg,P＜0.05,1 mm Hg =0.133 kPa ],serum triglyceride [ ( 1.8±0.2 vs 1.1 ±0.1 ) mmol/L,P＜0.05 ],and homeostasis model assessment for insulin resistance [ HOMA-IR,( 2.07 ± 0.27 vs 1.16 ± 0.12 ),P ＜ 0.01 ] were markedly increased in glucocorticoid treated group.Multivariates regression analysis showed that body mass index was the most important risk factor for HOMA-IR.The correlation of glucocorticoid replacement and HOMA-IR was not observed after adjustment of age and body mass index.ConclusionGlucocorticoid treatment increases body weights,which leads to insulin resistance and metabolic disorders for 21-OHD patients.More attention should be paid to control BMI and metabolic disturbances in 21-OHD patients.

Liquid level detection (LLD) is necessary for eliminating carry-over of needle's outside by limiting the depth the needle probes into liquid in auto clinical laboratory analyzers. This paper listed various demands of liquid-handling system under different situations; reviewed various LLD techniques, such as capacitive, air pressure, mechanical vibration, ultrasound, light reflection, CCD imaging etc.; briefly introduced the working principles, features, and limitation of the LLDs; and recapitulated the characteristics of contact and non-contact LLDs. Lastly, the next generation technique of LLD is prospected.
Automation ; Clinical Laboratory Techniques ; instrumentation ; methods

Objective To investigate the application value of multi-slice spiral CT on the congenital malformation of coronary sinus. Methods MSCT finding of 98 patients with coronary sinus malformation confirmed by surgery were retrospectively analyzed,and the cases were divided into four categories based on the Mantini theory and comparison was made between the diagnosis from ultrasound and CT.A 2 × 2 table for Chi-square test was also used for statistics analysis.Results Among 98 patients,there were 72 patients with persistent left superior vena cava reflowed to right atria through coronary sinus,with 48 patients diagnosed by ultrasound and 72 patients by MSCT; there were 13 patients with anomalous pulmonary venous connection to coronary sinus,with 12 patients diagnosed by ultrasound and 13 patients by MSCT diagnosis; there were 10 patients with unroofed coronary sinus syndrome,with 6 patients diagnosed by ultrasound and 8 patients by MSCT,there were 2 patients with coronary sinus atresia,all diagnosed by MSCT; there were 1 patient with coronary sinus anomaly reflow to left arita.The significant difference between 2 modalities (x2 =22.7,P＜0.01) shows that CT is superior to ultrasound.Conclusion MSCT is much more better than ultrasound in the diagnosis of malformation of coronary sinus and it can provide reliable diagnosis prior to surgery or interventional therapy.

Objective To clarify the value of absorbable barbed suture in closure of galeal. Methods A total of 101 patients had craniotomy treated in Shengjing Hospital of China Medical University from October 2018 to February 2019 were divided into two groups according to the admission date. In the barbed suture group, 45 patients were sutured with QUILL by continuous stitching. In the control group, 56 patients were sutured with traditional stitchingby intermittent suture. Compare the differences in suture speed, average postoperative hospital stay, incision complication rate, and the average hospital costs of the two groups. Results The suture speed in barbed suture group was (0.330 ± 0.012) cm/min , and was significantly faster than that in control group (0.540 ± 0.016) cm/min;the postoperative average hospitalization days in barbed suture group was (10.91 ± 0.62) d, and was significantly shorter than that in control group (12.73 ± 0.41) d, there were significant differences (P<0.05) . However, the complications and hospital costs in two groups had no significant differences (P>0.05). Conclusions The use of absorbable barbed close epicranial aponeuroisiscan improve suture speed, shorten the postoperative average hospitalization days, which is worthy of promotion.

OBJECTIVE: To establish reference values of acoustic rhinometry, rhinomanometry and rhinospirometer in healthy adults in Tianjin area, analyze the effects of age,sex and side on the value, investigate the correlation of the measure values, offer the diagnosis date for test nasal ventilation function in Tianjin area. METHOD: Four hundred and sixty-six healthy adults in Tianjin area were tested. A1 acoustic rhinometry was used to measure the minimum cross-sectional area (MCA), distance of the minimal cross-sectional area to the nostril (DCAN) and the nasal volume from 0-5 cm, 2-5 cm (V5, V2-5); At 150 Pa, 75 Pa and broms, NR6 Rhinomanometry was used to measure unilateral nasal inspiratory resistance (IR)and expiratory resistance (ER), bilateral nasal inspiratory and expiratory resistance (TIR and TER), and differences of the bilateral nasal resistance can be calculated; NV1 Rhinospirometer was used to measure unilateral inspiratory capacity (IC) and expiration capacity (EC), and the nasal partitioning ratio (NPR) can be calculated. Practical measure the distance of nostril to ahead of the inferior turbinate and compare with DCAN. Make the correlational analysis on different index of three exam. RESULT: Reference values of acoustic rhinometry: MCA was (0.45 +/- 0. 16) cm2 for male, (0.44 +/- 0.16) cm2 for female; V2-5 was (3.52 +/- 1.38) cm3 for male, (3.36 +/- 1.22) cm3 for female, V5 was (5.10 +/- 1.47) cm3 for male, (4.86 +/- 1.12) cm3 for female; DCAN have two distance, (2.22 +/- 0.398, 0.53 +/- 0.625) cm was for male, (2.10 +/- 0.37, 0.67 +/- 0.15) cm was for female. No significant gender, side and age differences were shown in MCA, V5, V2-5. Significant gender differences were shown in DCAN but no side and age differences. Reference values of rhinomanometry: Significant gender but no side and age differences were shown in IR, ER, TIR, TER. Reference values of rhinospirometer: IC was (2.06 +/- 1.10) L/20 s for male, (1.37 +/- 0.34) L/20 s for female, EC was (2.15 +/- 1.23) L/20 s for male (1.39 +/- 0.58) L/20 s for female. NPRi was 0.11 [0.05, 0.23],NPRe was 0.11 [0.05, 0.19]. Significant gender but no side and age differences were shown in IC and EC. No gender and age differences were shown in NPRi and NPRe. There was significant correlation found between MCA and IR/ER/IC/EC, IR and IC, ER and EC, Rlr and NPRi/ NPRe. CONCLUSION Acoustic rhinometry,rhinomanometry and rhinospirometer can be useful reference values to evaluate nasal ventilation function, more value will be found if use the three together.
Adolescent ; Adult ; Aged ; China ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; physiology ; Nasal Mucosa ; physiology ; Nose ; physiology ; Reference Values ; Respiration ; Rhinomanometry ; standards ; Rhinometry, Acoustic ; standards ; Young Adult

Objective To examine the value ofprocalcitonin (PCT) in differential diagnosis of bloodstream infections (BSI) caused by coagulase-negative Staphylococcus (CNS) from contamination in Department of Hematology.Methods One hundred and fifty-six patients with bloodstream or intravenous catheter-related CNS infection were included in this study.The patients were treated in Department of Hematology,the First Affiliated Hospital of Soochow University during the period from January 2013 to December 2015.The patients were divided into CNS bloodstream infection group (n=66) and blood culture contamination group (n=90).The two groups were compared in terms of sex,age,diagnosis,length of hospital stay,duration of neutropenia,neutrophil count and lymphocyte count,peak fever,C-reactive protein (CRP) and PCT.The receiver operating characteristic (ROC) curve was plotted with SPSS 21.0 software to analyze the value of PCT in differential diagnosis.Results Age,sex,clinical diagnosis,length of hospital stay,duration of neutropenia,neutrophil count and lymphocyte count did not show significant difference between bloodstream infection group and contamination group (P＞0.05),while peak fever (P＜0.001),CRP (P=0.002) and PCT (P=0.018) were significantly higher in bloodstream infection group than in contamination group.ROC analysis indicated that PCT provided optimal discrimination between these two groups at cnt-offvalue of 0.374 μg/L,with sensitivity of 54.5％ and specificity of 94.4％.The area under the curve (AUC) was 0.830±0.032 (95％ CI:0.767-0.893,P＜0.001).Conclusions PCT may be a good marker for differentiating CNS bloodstream infection from contamination with higher specificity than the commonly used marker CRP.This finding may help clinicians reduce the overuse of antibiotics.