Objective To observe the change of serum thyroid peroxidase antibody(TPOAb) in the patients with Hyperthyroidism and Thyroid gland tumor of different phases.Methods The level of TPOAb was observed,the relation between the changed TPOAb level and reduced thyroid function was studied.Results Among 89 cases,50 cases had normal or slightly elevated TPOAb level.However,after treatment,31 cases showed a raised TPOAb level.Of 19 cases with hypothyroidism or its sub-clinical type.There were 39 cases with positive TPOAb.After the treatment,2 cases changed to negative TPOAb,26 cases lowered,and 3 cases had hypothyroidism.There were 29 cases taking thyroid tablets without hypothyroidism.Conclusion The change of TPOAb level can be observed during the treatment for hyperthyroidism and t hyroid gland tumor.The elevated TPOAb level often predicts the decreased thyroid function.The patients with positive TPOAb should be carefully followed,and for hyperthyroidism patients the treatment should be taken with care.

Objective To evaluate the efficacy of intra-aortic balloon pump (IABP) on elderly patients with acute myocardial infarction (AMI) combined with cardiogenic shock (CS).Methods Among 62 elderly patients with AMI plus CS undergoing percutaneous coronary intervention (PCI),32 patients received IABP before PCI (IABP group) and 30 patients did not (control group).Diastolic blood press ure(DBP),mean arterial pressure (MAP),heart rate,cardiac index (CI),and ejective fraction before and 2 weeks after PCI in the two groups were observed.The short-and long-term therapeutic effects were compared between the two groups.Results The DBP,MAP and CI were higher and heart rate was lower in IABP group than in control group within 24 h after IABP [(64.4± 11.1) mmHg vs.(37.8±15.1) mmHg,(71.4±8.3) mmHg vs.(43.0±10.5) mmHg,(2.98± 0.33) L· min-1 · m-2 vs.(1.99±0.29) L· min-1 · m-2,(90.7±18.7) /min vs.(130.2±50.1)/min,t=7.97,11.83,12.51,4.16,all P=0.000].Two weeks after IABP,LVEF was significantly improved in IABP and control groups as compared with pre-IABP [(46.4±7.2)％ vs.(35.2± 7.2) ％,(39.1±6.8) ％ vs.(33.8±6.7) ％,both P＜0.01],and heart function was improved more significantly in IABP group than in the control group (t=3.91,P=0.000).Death tolls during hospitalization and after leaving hospital,and recurrence of AMI had no significant differences between the two groups (2 cases vs.4 cases,3 cases vs.8 cases,6 cases vs.10 cases,x2 =0.89,3.17,1.72,P=0.346,0.075,0.190).Conclusions IABP can improve the cardiac function in elderly AMI patients with CS after PCI.

Objective To investigate whether the aberrantly expressed HLA class Ⅱ molecules on the follicular epithelial cells of Graves' disease and Hashimoto's thyroiditis present autoantigens. Methods Expressions of HLA class Ⅱ, invariant (Ii) chain and B7 on follicular epithelial cells were detected by labeled streptavidin binding (LSAB) and expression of Ii chain at mRNA level was assayed by in situ hybridization (ISH). Results The expression pattern of HLA class Ⅱ, Ii chain and B7 on epithelial follicular cells from Graves' disease and Hashimoto's thyroiditis is highly heterogeneous. Conclusion Follicular epithelial cells possess the necessary molecular basis for presenting autoantigens and activating T cells, at least in a part of the patients.

Objective:To apply immuno-PCR for detection of anti-Sm antibodies.Methods: Immuno-PCR was established for anti-Sm antibodies in SLE sera using SaHIgG-DNA probe. The experimental conditions were optomized and methological identifieation indicated obvious in crease(×107 ) in sensitivity compared with that of ELISA. The positive rate of anti-Sm antibodies was 54.9% in SLE sera, and significantly higher than that of ELISA. Intra-and inter-CV were 2.3%～4.8% and 3.7%～6.9% respectively. Immuno-PCR was positively correlated with ELISA( p ＜0.001). Therefore, immuno-PCR for anti-Sm antibodies is specific,sensitive,reproducible and practical clinically.

Objective To evaluate the use of isoptin in kidney transplants recipients. Methods The graft acute rejection rate,the cyclosporin A daily dose and its trough level and toxicity,the blood pressure and cardiovascular complications,the serum creatinine and blood sugar were studied in cadaveric kidney transplant recipients both with and without the additional use of isoptin. Results With the additional use of isoptin in 44 cadaveric kidney transplant recipients,the acute rejection rate has not increased.After using isoptin for 2 weeks,CsA blood level has been increased 25.5% whereas the CsA dose been cut down 32.6 %.So,drug expense dropped about 30.0% and CsA toxicity (hand tremble,insomnia) was slightly decreased. Conclusions Isoptin does not inecease the graft acute rejection rate yet makes the CsA dose and its toxicity less.

Objective To explore the effect of oral care on the prevention of ventilator associated pneumonia in patients with severe traumatic brain injury by aspiration of subglottic secretion combined with 2% acetic acid chloride solution. Methods A total of 100 cases of ICU patients with mechanical ventilation for longer than 48 hours were divided into group B and group C using a random number table method according to tracheotomy mechanical ventilation time sequence number from January 2014 to June 2015. Another 50 ICU patients in group A (as the case for retrospective analysis, from April to November , 2013) were treated by routine tracheal suction, normal saline cotton for oral care, group B were treated with aspiration of subglottic secretion, normal saline cotton for oral care, group C were treated with aspiration of subglottic secretion combined with 2% acetic acid chloride solution for oral cleaning. And then VAP occurrence rate, plaque index, plaque clearance were evaluated. Results The incidence rates of early onset VAP in three groups were 14% (7/50), 8% (4/50), 4% (2/50), and incidence rates of late onset VAP were 22% (11/50),12% (6/50), 8% (4/50) respectively, the differences were significant (χ2=3.65, 3.88,P<0.01). The plaque index and plaque clearance rates of the three groups on the third day were 2.14± 0.35, (40.12 ± 13.11)%, 2.10 ± 0.33, (39.17 ± 14.21)%, 1.03 ± 0.24, (60.12 ± 15.07 )%(F=12.21,χ2=3.82,P<0.01);while on the 7th day, they were 1.76 ± 0.47, (41.12 ± 13.34)%, 1.80 ± 0.32, (39.37 ± 12.21)%, 0.99 ± 0.15, (60.33 ± 14.25)%(F=13.14,χ2=4.20,P<0.01). Conclusions The incidence rate of VAP can be decreased by the combination of aspiration of subglottic secretion and oral cleaning with 2%acetic acid chloride solution.

BACKGROUND:There are objections to the efficacy and safety of total hip arthroplasty and artificial femoral head arthroplasty in the treatment of femoral neck fracture.
OBJECTIVE:To assess the efficacy and safety of one-stage total hip arthroplasty and femoral head arthroplasty for > 60-year-old patients with femoral neck fractures.
METHODS:According to the search strategy of Cochrane colaboration network, we searched PubMed (1966 to December 2014), EMbase (1974 to December 2014), Cochrane Library (Issue 3, 2011), China Biology Medicine database(1978 to December 2014), China National Knowledge Infrastructure (1994 to December 2014), VIP database (1989 to December 2014), and Wanfang Database (1979 to December 2014). Twenty-one articles on total hip arthroplasty and hemiarthroplasty for elderly femoral neck fractures were included. Two reviewers independently evaluated the quality of the included studies and extracted the data. In case of disagreement, settlement was made by negotiation. Meta-analysis was performed by RevMan 5.0 software in the included studies.
RESULTS AND CONCLUSION:(1) Literature analysis: five randomized controled studies, three quasi-randomized controled studies, and thirteen retrospective cohort studies were included, containing 2 250 patients. (2) Meta-analysis: No significant differencein rate of dislocation, deep infection rate and mortality rate in 1 year after replacement was detected between total hip arthroplasty and hemiarthroplasty for elderly femoral neck fractures (dislocation rate:RR=1.38, 95%CI: 0.81-2.34; deep infection rate RR=1.12, 95%CI: 0.60-2.11; mortality rateRR=0.90, 95%CI: 0.69-1.18). Reoperation rate was higher in the hemiarthroplasty group than in the total hip arthroplasty group (RR=0.46, 95%CI: 0.32-0.66). Harris score on the affected side between1 and 4 years was significantly higher in the total hip arthroplasty group than in the hemiarthroplasty group (MD=5.64, 95%CI: 2.82-8.46). (3) Results suggested that if physical conditions permit, compared with hemiarthroplasty group, femoral neck fractures patients aged > 60 years old in the total hip arthroplasty group had better hip function, but no significant difference was found in dislocation, deep infection and mortality between both groups.

Objective To compare the influence of tracheotomy after two wet fluid on airway and provide the basis for clinical treatment and care. Methods A total of 30 patients with severe brain injury stay neurosurgery tracheotomy were divided into 0.45% sodium chloride group and ambroxol hydrochloride group with 15 cases each by random digits table method, two airway humidification liquid (0.45%sodium chloride,0.9% sodium chloride + ambroxol hydrochloride) were each instilled in the trachea inner sleeve. Blood gas analysis was performed and the levels of serum lung surface active substances related protein-A (SP-A protein), interleukin-6, interleukin-8, tumor necrosis factor-alpha(TNF-α) were measured by enzyme linked immunosorbent assay (ELISA) before 1 d and after 3,7,14 d of tracheotomy. Results There were significant differences in arterial blood oxygen partial pressure, arterial carbon dioxide partial pressure, oxygenation index after 14 d of tracheotomy between ambroxol hydrochloride group and 0.45% sodium chloride group:(110.72±26.75) mmHg(1 mmHg=0.133 kPa) vs.(89.39±21.98) mmHg, (30.44±6.75) mmHg vs. (35.12±7.28) mmHg, 333.23±80.56 vs. 270.93±77.21, t=29.49,-8.63,7.44, P<0.01.There were significant differences in the levels of serum SP-A protein, interleukin -6, interleukin -8, TNF-α after 14 d of tracheotomy between ambroxol hydrochloride group and 0.45% sodium chloride group:(191.34 ±1.21) ng/L vs. (61.92 ±12.0) ng/L, (2.62 ±0.23) ng/L vs. (5.42 ±0.16) ng/L, (124.56 ±2.10) ng/L vs. (185.91 ±1.48) ng/L, (31.32±1.38) ng/L vs.(69.13±1.16) ng/L, t=75.72,-13.51,-23.89,-20.97, P<0.01. Conclusions The airway humidification effect of ambroxol hydrochloride group is better than 0.45%sodium chloride group, it can improve the wetting effect, and better protect the lung tissue, reduce the incidence of lung infection, make it an ideal airway humidification liquid.

Objective To investigate the plantar pressure distribution of the injuried limbs and the healthy side after the operation for Pilon fracture. Methods 31 patients with Pilon fractures were tested with Footscan USB2 system, including the maximum force and impulse of 10 zones of the feet 1 year after surgery. Results Compared with the contralateral feet, the maximum force reduced under the the first metatarsal bone, medial heel, and lateral heel (P<0.05), and it increased under the fourth, and fifth metatarsal bone (P<0.05) of the injured feet. The impulse reduced under the the first metatarsal bone, medial heel, and lateral heel (P<0.05), and increased under the fifth metatarsal bone and midfoot (P<0.05). Conclusion The load decreased on the heel and medial forefoot, and increased on the lateral forefoot of the injured limbs after Pilon fracture, while the lateral forefoot and midfoot tend to be injured.

Enantioselective hydrolysis of 2-carboxyethyl-3-cyano-5-methylhexanoic acid (CNDE) is the key step in chemoenzymatic synthesis of pregabalin. We purified an intracellular carboxyl esterase from Morganella morganii ZJB-09203, which exhibited high enantioselectivity and activity towards CNDE. The carboxyl esterase was purified to electrophoretic homogeneity by ammonium sulfate fraction precipitation, Phenyl Sepharose 6 FF hydrophobic interaction chromatography, anion exchange with DEAE Sephadex A-50 and Bio-Scale CHT column. The purified enzyme was a monomer with molecular mass of 68 kDa determined by SDS-PAGE and gel chromatography. Substrate specificity of the enzyme towards p-nitrophenyl esters suggested that the purified enzyme was an esterase. The optimal reaction pH for CNDE hydrolysis was 9.0, and optimal temperature was 45 degrees C. The esterase was stable between pH 7.0 and 9.0, and at 40 degrees C. The enzyme activity was enhanced by Ca2+, Cu2+ and Mn2+, whereas strongly inhibited by Co2+, Fe3+, Ni2+ and EDTA. Meanwhile, we investigated the kinetic parameters of the esterase towards p-nitrophenyl esters and effect of CNDE concentration on conversion. The present study reported the esterase capable of stereospecific hydrolysis of CNDE for the first time. Our research will provide foundations for industrial production of Pregabalin using the new biocatalyst.
Chromatography, Gel ; Electrophoresis, Polyacrylamide Gel ; Esterases ; metabolism ; Hydrogen-Ion Concentration ; Kinetics ; Molecular Weight ; Morganella morganii ; enzymology ; Substrate Specificity ; Temperature