Objective To analyze the relationship of serum levels of TSH,thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TGAb) with cytopathologic changes of thyroid fine needle aspiration(FNAB) in autoimmune thyroiditis(AIT).Methods Totally 82 cases of cytologically confirmed AIT including 75 females and 7 males were collected.Levels of TSH,TPOAb and TGAb were tested.After execution of FNAB,features of the cytopathology were observed.Results ① The percentage of positive TPOAb and TGAb were 91.4% and 74.4%,respectively in all the AIT patients.47.6% of the patients had TSH levels within normal range(0.3～5 mu/L).② All of the slides had different grades of lymphocytic infiltration.49.3% had germinal center,32.8% had Askanazy cells,26.9% had plasma cells,22.4% had colloid,and 9% had multinuclear giant cells.③ Lymphocytic infiltration was divided into four degrees.The levels of TSH and TPOAb increased significantly in the extremely heavy lymphocytic infiltration grade than in the others(P

Private cloud is an internal cloud featuring multi-tenant,dynamic configuration and optimization infrastructure,which enables developers to achieve service self-deployment and self-hosting within security coverage of the enterprise data center.This paper introduced the concept of cloud computing.Then it went on to present the private cloud architecture of the hospital by analysis of problems in the hospital including information construction costs,management and maintenance,and information expansion.In the end,the authors analyzed the cloud computing service model,hospital private cloud architecture,along with outcome analysis for hospital private cloud implementations.

Objective To explore the relationship of thyrotropin receptor antibody (TRAb) and soluble intercellular adhesion molecule-1 ( sICAM-1 ) in patients with thyroid-associated ophthalmopathy ( TAO), and the role played by TRAb and sICAM-1 in the pathogenesis of TAO. Method Twenty-three TAO patients were assigned to groups according to the clinical activity score and EUGOGO. All patients were treated with intravenous methylprednisolone pulse. The levels of serum TRAb and sICAM-1 were evaluated by a competitive radioimmunoassay and enzyme-linked immunosorbent assay respectively before treatment and by the end of each methylprednisolone pulse. Results The differernce in serum TRAb levels was associated with activity scores of TAO (P=0. 020). The change in serum sICAM-1 was associated with durations of TAO ( P = 0.015). During methylprednisolone treatment in active TAO patients, the levels of TRAb kept on decreasing gradually and markedly declined after the third methylprednisolone pulse in active TAO patients (P＜0.05). The trends of changes in serum TRAb and sICAM-1 levels were both different in active and inactive TAO patients by tendency analysis. Conclusion TRAb level was related to the activity of TAO and might serve as a significant predictor of response to methylprednisolone therapy. The negative correlation between sICAM-1 levels and duration of TAO corroborates the role played by ICAM-1 during the early stage of TAO. Higher sICAM-1 levels are not expected to be specific to TAO and may not predict a response to methylprednisolone therapy.

Objective To construct an animal model of Graves' disease (GD) by immunizing BALB/c mice with hM12 cells co-expressing major histocompatibility complex (MHC) class Ⅱ molecules and human thyrotropin receptor (TSHR) molecules. Methods BALB/c mice in experimental group (H-2d) were immunized with hM12 cells Intraper-itoncally every 2 weeks for six times, while mice in control group were immunized with M12 cells. Five weeks later, the thyroids were histologically examined, and serum samples were tested for thyroid-stimulating antibodies (TSAb) and thyroid hormone levels. Results One BALB/c mouse in experimental group developed Graves'-like disease. Total T4 and T3 levels in this mouse were above the upper limit of normal, TSAb activity was displayed in its serum. The thyroid histologically showed the features of thyroid hyperactivity including thyrocyte hypercellularity and colloid absorption.None of control mice developed Graves'-like disease. Conclusion An animal model with some characteristics of human Graves' disease was successfully induced and the model will facilitate studies aimed directly at understanding the patho-genesis of autoimmunity in Graves' disease.

ABSTRACT:Objective To study the effects of weight and anteroposterior diameter-to-transverse diameter ratio on establishing a model of acute myocardial infarction (AMI)in rats without artificial ventilation and changes in left ventricular function after infarction.Methods Healthy SD rats were randomly divided into group A (200-250 g),group B (250 - 300 g),group C (> 300 g),and group D (control group).The left anterior descending (LAD)coronary artery was ligated to establish a model of myocardial infarction under spontaneous breathing condition immediately after thoracic lines were measured.And changes of electrocardiography were recorded after model establishment.At 2 and 4 weeks after AMI,we observed ventricular wall thickness and ventricular wall motion and measured the changes of cardiac function.Histomorphological changes and myocardial ultrastructure of the heart were observed under thoracotomy 2 weeks after operation.The above data were analyzed by SPSS13.0 statistics software.Results ① The first AMI rat model was established successfully after 30 times of experiments, and after 100 times the model’s success rate gradually stabilized at about 83%.② Group B and group C had a higher model success rate than group A (P <0.05),but group B and group C did not differ in modeling success rate (P >0.05).③ There was no association between the rate of rat thoracic line and modeling success rate (P >0.05).
④ Two weeks after thoracotomy,ischemic myocardial color was white,and ventricular wall motion decreased.HE staining revealed that cardiomyocytes disappeared and were replaced by fibrous tissues and collagen.Remnant cardiomyocytes were arranged disorderly and myofibers were fractured,with interstitial damage and hyperplasia of fibrous tissue.Visible muscle cells were sparse and dissolved,the mitochondria had darker staining,blurred cristae, and edema under electron microscopy. ⑤ Compared with group D, 2 weeks and 4 weeks after myocardial infarction,left ventricular end-diastolic diameter (LVEDD)and left ventricular end systolic diameter (LVEDs) increased (P <0.05),but EF values and heart rate dropped (P <0.05).Conclusion By this method,a model of AMI in rats can be established successfully and the heart function is changed.Under the condition of non-artificial ventilation,the weight of rats is an important factor for establishing AMI model.However,we have not confirmed the effect of thoracic lines on establishing AMI model yet.

Objective To investigate the feasibility of inducing neonatal immunotolerance against Graves'disease by gene TSH receptor (TSHR) 289 and its possible mechanism.Methods Neonatal (0-24 h) female BALB/c mice were divided into intraperitoneal injection group,intramuscular injection group,model group,and normal control group.The intraperitoneal group and the intramuscular group were further divided into low-dosage,middle-dosage,high-dosage tolerance groups,and the coresponding control groups.The tolerance groups and the controls were intraperitoneally or intramuscularly pretreated with low-dosage( 1×106 particles),middle-dosage( 1 × 108particles),high-dosage( 1 × 1010 particles)of Ad-TSHR 289 or Ad-lacz respectively.6 to 7 weeks later,the normal control group received intramuscular injection with Ad-lacz; the other groups were immunized with Ad-TSHR289,three times at 3 weeks interval.10 days after the first immunization,serum TRAb was detected.4 weeks after the last immunization,serum TRAb,TT4,splenic CD4 + CD25 + Foxp3/CD4 + were tested,and the thyroid tissues were examinated histologically.Results Ten days after the first immunization,no antibody response against TSHR was detected in the two high-dose tolerance groups,but the TRAb titer in respective controls was significantly higher( P＜0.05 ).4 weeks after the last injection,in high-dose tolerance groups,only 1/10 of mice immunized by intraperitoneal or intramuscular injection elicited anti-TSHR antibody,and no mice immunized intraperitoneally had elevated serum TT4.Two of ten mice challenged intramuscularly showed slightly increased TT4 levels,but the respective controls displayed a strong antibody response( P＜0.01 ) and elevated TT4 level ( P＜0.05 ).The similar percentages of high TT4 and thyroid hyperplasia were found in all groups.Additionally,the frequencies of CD4+CD25 +Foxp3/CD4+in two high-dose tolerance groups were significantly increased as compared to those in controls( P＜0.05 ).The incidence of Graves' disease in the other groups by intraperitoneal or intranuscular injections was not statistically different from those in the corresponding control groups and the model group.Conclusions The immune tolerance against Graves'disease is induced in neonatal mice by either intraperitoneal or intramuscular pathway with specific antigen of TSHR 289,carried by adenovirus vector,and then inhibits Graves' disease in adults. Stimulation with the high-dosage antigen is liable to induce immune unresponsiveness.CD4 + CD25 + Foxp3 +T cells may play an important role in the induction and maintenance of tolerance.

Objective To compare the efficacy of Graves disease animal models induced by thyroid stimulating hormone receptor (TSHR) plasmid DNA (pcDNA3.1-TSHR) and by TSHR A subunit recombinant adenovirus(Ad-TSHR289),and to investigate the influence of duration for preparing animal model induced by Ad-TSHR289 on Graves hyperthyroidism and its related indices.Methods The plasmid group and the adenovirus group were set up respectively.The plasmid group:21 female BALB/c mice were randomly divided into model group (n =12) and control group (n =9).The model group were injected intradermally with pcDNA3.1-TSHR 50 μg,once every 3 weeks,totally 3 times.Then 4 weeks after the last immunization,the mice were euthanized to obtain blood for testing TSHR antibody (TRAb),total T4,and thyroid tissue for histological examination.The controls were injected with the same dose of pcDNA3.1 in the same way.The adenovirus group:52 female BALB/c mice were divided into 10-week model group (n =8),14-week model group (n =10) and 18-week model group (n =8),and the respective controls (n =8,n =10,n =8) were set up.All model groups were injected intramuscularly with Ad-TSHR289,three times at three weekly intervals.Then the mice were euthanized at 4,8 and 12 weeks to test TRAb,total T4 level and to observe the change of thyroid histology.The controls were treated with the same dose of Ad-lacz in the same way.Another 8 mice were scheduled to test the dynamic variation of TRAb before and after the 3 times immunization.Results In the plasmid model group,only two of 12 mice developed weak antibody responses against TSHR,and no elevated total T4 level and no hyperplasia changes of thyroid were observed.In the 10-week model group,all mice had high level TRAb [(807.65 ± 136.33)U/L,Six-eighths mice had hyperthyroidism exhibited hyperplasia changes.In the 14-week model group,the TRAb level [(650.12 ± 192.88) U/L]and the incidence of hyperthyroidism (3/10) were lower than those in 10-week group.Histologically,the degree of thyroid hyperplasia lightened to a small extent,but its positive rate did not decline.In the 18-week model group,only 2 of 8 mice displayed slightly elevated TRAb level,and no mice showed increased total T4 level.Additionally,thyroid tissues of 2 mice were mildly abnormal.Compared with the model groups at different time,the change of antibody levels of the mice for TRAb dynamic observation exhibited the similar trend.Conclusions Being good at repeatability and high incidence of hyperthyroidism,the animal model of Graves disease induced by Ad-TSHR289 is still an ideal research tool presently.The duration of model ean be maintained 18 weeks,and 10 weeks is the best period to snstain characteristic of Graves disease.

Objective To investigate the effect of mice gender on the TSH receptor antibody(TRAb)titers, the levels of TT4,and the degree of thyroid hyperplasia by establishing an animal model of Graves′ disease in male and female BALB/c mice. Methods Male and female BALB/c mice were immunized with recombinant adenovirus expressing TSHRA subunit(Ad-TSHR289)to induce Graves′ disease. Animals were injected 3 times at intervals of 3 weeks. All mice were sacrificed 4 weeks after the last injection to obtain blood for measurement of TSHR antibody titers and TT4evels, and thyroid glands for histological examination. Results TRAb positive rates were 100% both in female or male mice. No significant difference was observed in titers of TRAb between them. The incidence of hyperthyroidism in female mice was higher than that in male mice, being 75.0% and 41.7% respectively. There was statistical difference in levels of TT4between females and males(P＜0.01). Mice with high TT4exihibited marked thyroid hyperplasia. Conclusion Despite TSHR antibodies were similar between female and male mice, the incidence and degree of hyperthyroidism showed sex bias in Graves′s animal model. The results indicated that it was easier to induce model in females than in males by immunizing BALB/c mice with Ad-TSHR289.

Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs.

Objective:To systematically analyze and evaluate the predictive performance of 5 assessment scales (Munro Pressure Ulcer Risk Assessment Scale, Norton Scale, Braden Scale, Scott Triggers Scale and Waterlow Scale) for adult intraoperatively acquired pressure injury (IAPI), so as to provide reference for the selection of appropriate assessment scales.Methods:This study is a Meta-analysis. Research on the adult IAPI assessment scale was retrieved through computers in databases such as VIP, WanFang Data, China National Knowledge Infrastructure, China Biology Medicine disc, PubMed, Embase, Web of Science and Cochrane Library. The search time limit was from the establishment of the database to December 2, 2021.Two researchers independently screened the article, conducted quality evaluation and data extraction on the included article, and conducted descriptive analysis on the sensitivity and specificity of each scale. The researchers used RevMan 5.3 software to create a receiver operating characteristic (ROC) curve and calculate the area under the curve.Results:A total of 13 articles were included, with a total of 5 640 cases, and the incidence of IAPI was 8.09% (456/5 640). A Meta-analysis was conducted after merging 8 articles on the Braden scale. After merging, it was found that the sensitivity of the scale was 0.76 [95% confidence interval ( CI) (0.72, 0.81) ], the specificity was 0.53 [95% CI (0.51, 0.54) ], and the area under the ROC curve was 0.70. After a combined analysis of 7 articles on the Munro Pressure Ulcer Risk Assessment Scale, it was found that the sensitivity of the scale was 0.81 [95% CI (0.75, 0.86) ], the specificity was 0.79 [95% CI (0.77, 0.81) ], and the area under the ROC curve was 0.84. After a combined analysis of 4 articles on the Waterlow scale, it was found that the sensitivity of the scale was 0.78 [95% CI (0.69, 0.86) ], the specificity was 0.60 [95% CI (0.58, 0.62) ], and the area under the ROC curve was 0.72. After a combined analysis of 3 articles on the Norton scale, it was found that the sensitivity of the scale was 0.67 [95% CI (0.56, 0.77) ], the specificity was 0.69 [95% CI (0.67, 0.71) ], and the area under the ROC curve was 0.74. After a combined analysis of 3 articles on the Scott Triggers Scale, it was found that the sensitivity of the scale was 0.80 [95% CI (0.68, 0.89) ], the specificity was 0.53 [95% CI (0.50, 0.56) ], and the area under the ROC curve was 0.67. Conclusions:As a special scale for surgical patients, the Munro scale has superior sensitivity, specificity, and area under the ROC curve to other evaluation scales. It is recommended that Operating Room nurses prioritize the Munro scale for assessing the risk of IAPI in adult surgical patients.