Objective To explore the role of adjustable and close persistent peritoneal drain in large ascites and acute renal insufficiency(ARI)in patients with primary nephrotic syndrome(PNS).Methods The adjustable and close persistent peritoneal drain tube were planted in 6 cases with PNS accompanied by large ascites and ARI during December 2005 and August 2006.On the basis of drain,they were treated by prednisone,anticoagulative agent,hypolipidic agent,antibiotics,antioxidant,microcirculation-improving agent and aweto preparation.Results After the treatment,ascites disappeared or decreased.ARI was cured in 5 cases.Among these patients,partial remission(PR)and no respone(NR)to treatment were present in 3 cases respectively during hospitalization.After the follow-up of 3~12 months,the complete remisson(CR)of PNS was found in 2 cases,PR in 3 cases and NR in 1 case respectively.Conclusion The adjustable and close persistent peritoneal drain may be applicable for PNS patients with large ascites and ARI and slight glomerular lesion.It can clear away the superabundant water,mitigate the renal interstitial edema and accelerate the recovery of ARI.It also makes the patients have the opportunity of the treatment which includes predenisone,anticoagulative agent and hypolipidic agent.

Objective To investigate the effects of the zinc finger protein A20 on LPS-TLR4 signaling pathways in severe acute pancreatitis(SAP) rats.Methods 24 SD rats were randomly divided into 3 groups:group A(the sham operation group),group B (the SAP group),group C (the SAP group treated with LPS).SAP model was induced by retro-injection of intraductal 5％ sodium taurocholate into the biliary-pancreatic duct as previously described.The protein expression of A20,TLR4,NF-κBp65 and p38MAPK in pancreatic tissues was evaluated by immunohistochemistry.Results The positive area of A20 in pancreatic tissues was decreased in group B and group C compared with that in group A (t =17.234,19.698,all P ＜ 0.05).On the contrary,the expression of TLR4,NF-κBp65 and p38MAPK in pancreatic tissues were up-regulated(t =15.909,20.432,16.543,18.629,22.105,19.006,all P ＜ 0.05).A20 was decreased in group C than that in group B (t =14.894,P ＜ 0.05),while TLR4、NF-κBp65 and p38MAPK were increased in group C than those in group B (t =14.047,15.582,17.070,all P ＜0.05).Conclusion The expression of A20 reduced and TLR4,NF-κBp65 and p38MAPK enhanced in the pancreas of rats with SAP,which indicated that A20 inhibited LPS-TLR4 signaling pathways which play important roles in the pathogenesis of SAP.

Objective To systematically analyze the relevant scientific literature on the effect of nasopharyngeal carcinoma radiotherapy on thy?roid function and to elucidate the current research status in this field. Methods We searched the relevant literature published over a recent de?cade using the PubMed database,and parameters such as the number of published articles and high?frequency keywords were counted. Cluster analysis of the high?frequency keywords was performed using SPSS software. Results We identified 2928 references and 11 high?frequency key?words. The clustering analysis results identified five main aspects. Conclusion In recently published articles on the effect of nasopharyngeal carci?noma radiotherapy on thyroid function,the high?frequency keywords were clustered mainly in the following five categories:nasopharyngeal carcino?ma radiotherapy,complications of nasopharyngeal neoplasms and etiology of hypothyroidism,radiation dose and side effects,effect of radiation ther?apy on thyroid functional,nasopharyngeal neoplasm pathology,and secondary carcinoma.

Objective:To supply a reference measure,CD8+CD38+ expressin,AST,TBIL,PT were examined in patients with chronic hepatitis B.Methods:CD8+CD38+ expression of peripheral blood lymphocyte in 38 patients with chromic hepatitis B and 14 patients with liver cirrhosis were detected with flow cytometry. AST,TBIL,PT were also measured at the same time with instruments.Results:(1)CD8+CD38+ expression in patients with choronic hepatitis B and liver cirrcosis elevated significantly compared with those in normal controls. But CD8+CD38+ expression in patients with liver cirrhosis was lower significantly than those with chronic hepatitis B.(2)CD8+CD38+ expression in moderate chronic hepatitis B were higher than those in mild chronic hepatitis B. CD8+CD38+,CD8+,CD38+ expression in severe chronic hepatitis B were higher than those in mild chronic hepatitis B. CD38+ expression in severe chronic hepatitis B was higher than those in moderate chronic hepatitis B. CD8+CD38+,CD8+,CD38+ expression in liver cirrhosis was lower than those in mild,moderate,severe chronic hepatitis B. CD8+ expression in liver cirrhosis was lower than those in severe chronic hepatitis B.(3)CD8+CD38+ expression in patients under AST,TBIL,PT abnormal condition were higher than those in patients under AST,TBIL PT,normal condition.Conclusion:The increasing of CD8+CD38+ expression of peripheral blood lymphocyte in patients with chronic hepstitis B,reflect the fact that cell immunolgy was abnormally activated.There was a remarkable correlation on CD8+CD38+ and AST,TBIL,PT. To test expression of CD8+CD38+ of peripheral blood lymphocyte in chronic hepatitis B has very important clinical reference value on patient′s condition development and diagnosis.

Objective:To explore the reference interval of urinary iodine concentration(UIC)/urinary creatinine(UCr) ratio evaluating the iodine nutritional status in early pregnancy women.Methods:A reference interval of UIC/UCr ratio was determined among 5 609 early pregnant women with normal thyroid function, negative thyroid autoantibodies, and no history of diseases or taking drug that may affect thyroid function. Then we verified the reliability of this reference interval in a group of 7 514 women in early pregnancy.Results:We determined the UIC/UCr ratio of 75-149 μg/g as the reference interval. In the reference interval, thyroglobulin antibody(TgAb), thyroid peroxidase antibody(TPOAb), and thyroglobulin(Tg) were all at lower levels, and the overall distributions were approximately U-shaped. The prevalence of thyroid dysfunction, the positive rates of antibodies and the proportion of Tg>40 μg/L were the lowest within the reference interval, while higher on both sides of the interval.Conclusion:The reasonable reference interval of the UIC/UCr ratio in iodine-sufficient regions is 75-149 μg/g in early pregnerty women.

Objective:To identify the epitope of mAb15A11 which is specific against RA associated autoantigen cartilage oligomeric matrix protein ( COMP ).Methods: A filamentous phage library displaying random linear dodecapeptides was used to mapping the epitope of mAb15A11.After three rounds of screenings,40 phage clones were selected at random and sequenced.The specificity of phages was confirmed by enzyme immunoassays.Homology search by ClustalW2 and structure analysis by PyMol to identified the epitope amino acid sequence.Western blot analysis of COMP and ELISA analysis of COMP-derived peptides were used to confirm epitope′s characterization.Results: After repeated screenings using bio-panning method, 2 clones were identified, which interacted specifically with mAb 15A11.Homology search did not find succession consensus sequence within COMP molecular,which indicated that the epitope was not linear.PyMol Structure analysis identified the rationality of conformational epitope.Western blot analysis and ELISA of EDTA-treated COMP further prove an conformational structure of the epitope recognized by mAb 15A11.ELISA analysis of COMP-derived peptides demonstrated both disulfide bonds between 229 C-243 C and 237 C-253 C and every epitope amino acid of 232 G,238 H,240 H,241 A,244 V,247 R and 251 R were essential to the binding of mAb 15A11 with COMP.Conclusion: In this study, the potential B cell antigentic epitopes of mAb 15A11 was identified by phage display library.The epitope amino acids sequence and char-acterization were also recognized.It may have important theoretical value for the study of reaction mechanism of COMP antibody and antigen and may also show application significance in the detection of rheumatoid arthritis.

Background:1 α,25-dihydroxyvitamin D3 [1,25 (OH) 2 D3],the active form of vitamin D,is reported in some studies having antifibrotic potential in liver fibrosis,however,its mechanism is not fully clarified.MicroRNAs (miRNAs) have recently been shown could regulate the proliferation and activation of hepatic stellate cells (HSCs),and are involved in the promotion or inhibition of liver fibrosis.Aims:To explore whether the inhibiting effect of 1,25 (OH) 2 D3 on activation of HSCs is by regulating miRNAs expression.Methods:Literature review and qPCR method were used to screen out the differentially expressed miRNAs between transforming growth factor-β1 (TGF-β1)-stimulated (activated) HSCs and the inactivated HSCs.Then the HSCs were co-cultured with TGF-β1 and the mimic of differentially expressed miRNA,the negative control mimic,1,25(OH)2D3 and DMSO,respectively,and the cell viability and apoptosis were determined by CCK-8 assay and flow cytometry.Results:Expression of miR-146a was down-regulated in activated HSCs (P ＜ 0.05).Compared with HSCs in DMSO group,the expression of miR-146a was significantly up-regulated in HSCs treated with 1,25 (OH) 2 D3;meanwhile,the cell viability was decreased and the apoptosis was increased (P all ＜ 0.05).In HSCs transfected with miR-146a mimic,the expression of miR-146a was up-regulated,the cell viability was decreased,and the apoptosis was increased similarly with HSCs in 1,25 (OH)2D3 group (P all ＜ 0.05).Conclusions:Regulation of miR-146a expression might be one of the important mechanisms of 1,25 (OH) 2 D3 in inhibiting TGF-β1-stimulated HSC activation and inducing apoptosis in HSCs.

Objective To study the effects of using 25 kDa linear and branched PEI to transfer plasmid DNA pEGFP -C1 (pDNA ,encoding the enhanced green fluorescent protein reporter gene ) to the basilar membrane of the C57BL/6 mice cochlea in vitro .Methods L -PEI/pDNA and B -PEI/pDNA polyplexes were generated in 0 .1M phosphate buffer solution (PBS) or 5% glucose solution .Polyplexes were characterized by transmission electron mi-croscopy .Agarose gel retardation assay was used to determine the plasmid binding ability of L -PEI and B -PEI . The toxicity was investigated by MTT assay .The transfection was firstly evaluated in 293T cell line ,and then the appropriate amount of PEI and plasmid were applied for cochlear explant transfection of P4 mice pups .Results Un-der the same condition ,B -PEI had better transfection efficiency than L -PEI ,but its toxicity was also higher . When generated in PBS ,the polyplexes had lower toxicity than in glucose solution .L -PEI-pDNA nanoparticles could transfect the spiral limbus fibrocytes ,some spiral ganglion neurons and supporting cells ,but the efficiency was low .Conclusion L -PEI could be used as the non -viral vector for the transfection of the cultured basilar mem-brane of P4 mice pups ,but it should be modified to reach higher efficiency .

Objective: To investigate the relationship between the erythrocyte membrane protein gene mutations and the clinical severity of hereditary spherocytosis (HS). Methods: Targeted sequencings were performed on 25 HS patients, correlation between HS mutations and patients’ clinical characteristics were evaluated. Results: A total of 25 HS patients were enrolled, including 13 males and 12 females with median age of 20 (4-55) years, including 9 compensatory hemolysis patients, 9 patients with mild anemia, 3 patients with moderate anemia and 4 patients with severe anemia. Of them, 18 patients (72%) harbored HS-related mutations, including ANK1 mutation in 6 cases, SLC4A1 mutation in 6 cases, SPTB mutation in 5 cases and 1 case with EPB41 mutation. Seven patients (28%) didn’t carry common HS mutations. SPTB and SLC4A1 mutations mainly affected male patients. There was no significant difference between the age of diagnosis (P=0.130) and HGB level (P=0.585) in patients with HS mutation and those without mutation, however, the EMA binding fluorescence intensity (P=0.015), AGLT50 (P=0.032) and EOF minimal hemolytic concentration (P=0.027) were significantly different in these two groups of HS patients. Conclusion To screen erythrocyte membrane protein coding gene mutations could favor the diagnosis of HS, and patients without mutations have mild clinical phenotype.

OBJECTIVE： To set up a standard for evaluating core competency of clinical pharmacists， and to provide reference for competency training and evaluation of clinical pharmacists. METHODS： By Delphi method， the first-level and second-level indicators were summarized and sorted out in three dimensions as research ability， professional ability and comprehensive ability that clinical pharmacists should possess. The second-level indicators were designed as questionnaire items， so as to consult their importance according to Likert 5 grade scoring method. During Jun.-Oct. 2017， 35 experts were selected for the first round of questionnaire consultation， and then the corresponding items were deleted， merged and added. Then the second round of questionnaire consultation was conducted. SPSS 20.0 software was used to input the data of the questionnaire and establish the database， and the experts’ enthusiasm degree， the  authority degree and opinion coordination degree were analyzed statistically. RESULTS： The positive coefficients of expert consultation in the first and second rounds of questionnaire consultation were 100％ and 92.9％； the authority degrees of experts were 0.878 6 and 0.901 9； the coordination coefficients of experts were 0.298 and 0.681， respectively. The evaluation standard for core competency of clinical pharmacists was established finally， involving 16 first-level indicators and 41 second-level indicators. The dimension of research ability contained 5 first-level indexes and 8 second-level indexes （3 “extremely important” indexes in latter ones）； the dimension of professional ability contained 5 first-level indexes and 21 second-level indexes （9 “extremely important” indexes in latter ones）； the dimension of comprehensive ability included 6 first-level indexes and 12 second-level indexes （4 “extremely important” indexes in latter ones）. CONCLUSIONS： The most important core competence of clinical pharmacists is professional competence， and the most important responsibility orientation and work assessment focus is to participate in clinical treatment of patients. Clinical pharmacists should pay attention to communication with medical staff and patients， and establish the concept of lifelong learning. The experts in this consultation and research are highly motivated and authoritative， and have good coordination of opinions. The core competence evaluation criteria can provide a basis for the training and evaluation of clinical pharmacists.