Objective:To establish a method for determining the immunological activity of ribonucleic acid. Methods: Leucocyte adherence inhibition test ( LAI) was applied, and the important parameters of LAI including the mouse strain, drug concentration, treatment time, content of buffer solution and cell density were researched. The immunological activity of RNAⅠ, Ⅱand Ⅲ was re-spectively determined by the method. Results:Stable and reliable parameters were obtained: the sample concentration was 10 mg· ml-1 , the treatment time was 2 hours, Ca2+ and Mg2+ were necessary for the buffer solution, and the cell density was about 4 × 107 cell·ml-1 . The strain of mouse showed no effect on the results. As a result, the determination method for immunological activity was established. Using the method, the immunological activity of RNA Ⅰ,Ⅱand Ⅲ was determined 3 times, and the results met the re-quirements with RSD below 20%. Conclusion:The method is suitable for determining the immunological activity of RNA.

Objective:To study the application of HL-60 monocyte activation test in the pyrogen detection of vaccines. Methods:HL-60 cells were incubated with the standard pyrogen(endotoxin,zymosan and lipoteichoic acid)solution and the sample solution at different concentrations,and then IL-6 level was detected using ELISA kit. According to the concentration of standard pyrogen solution and the level of IL-6,the standard curve and linear relationship were obtained. Based on the IL-6 value from the sample solution,the pyrogen content of the sample was calculated. The standard pyrogen solution at middle concentration of the standard curve was used as the interference sample,and the interference assay was performed referring to the bacterial endotoxin test in Chinese pharmacopoeia. The pyrogen recovery rate and the content were detected using HL-60 / IL-6 assay in seven kinds of vaccines such as influenza vaccine(Split Virion),inactivated;hepatitis A(live)vaccine,freeze-dried;rabies vaccine(Vero Cell)for human use,freeze-dried;lyophilized human measles and rubella combined vaccine,live;measles and mumps combined vaccine, live; haemorrhagic fever with renal syndrome bivalent vaccine, inactived; group A and C meningococcal polysaccharide vaccine. Results:① The linear relationship between the pyrogen concentration and the IL-6 level was good,and R2 value was 0. 996,0. 993 and 0. 997,respectively. ② The recovery rate of pyrogen in the above vaccines ranged from 50% to 200% . ③ The endotoxin concentration of 10 batches of group A and C meningococcal polysaccharide vaccine was detected using HL-60 / IL-6 assay,and the average value of 6 batches from factory A was 134. 73 EU·ml-1 ,and that of 4 batches from factory B was 40. 75 EU·ml -1 . The pyrogen in the other vaccines was all negative. Conclusion:The HL-60 / IL-6 assay is suitable for the pyrogen detection of the seven kinds of vaccines.

Objective To evaluate the effect of the esophagus invert stripping without opening the thoracic cavity on carci- noma in the inferior pharynx, cervical esophagus or the cardia. Method Eighteen patients with carcinoma in the inferior pharynx, cervical esophagus or the cardia were treated surgically with invert stripping of the exophagus without opening the thoracic cavity. Ten patients received antidromic esophagus invert stripping and the other 8 underwent orthodromic esophagus invert stripping. The esophagus of these patients were replaced with either the stomach (in 15 cases) or the colon (in 3 cases), and complete removal of the pharynx and larynx were performed in 2 cases, both of which received permanent fistulization. Result No death occurred during the operation and the complications included anastomotic leakage (2 cases), injury of the recurrent laryngeal nerve (2 cases), pulmonary infection (3 cases), and incision infection (1 case). The follow-up survey showed that the 1-year, 3-year and 5-year survival rates were 77%, 44% and 22%, respectively. Conclusions This surgical approach reduces the damage of the cardiopulmonary function, which can be meaningful for senior patients and those with cardiac or pulmonary problems. The carcinoma in the inferior pharynx or cervical part of the esophagus should be treated surgically to improve the survival rate, but this approach should be avoided in patients with carcinoma in thoracic part of the esophagus.

Objective To evaluate the effect of the esophagus invert stripping without opening the thoracic cavity on carci- noma in the inferior pharynx, cervical esophagus or the cardia. Method Eighteen patients with carcinoma in the inferior pharynx, cervical esophagus or the cardia were treated surgically with invert stripping of the exophagus without opening the thoracic cavity. Ten patients received antidromic esophagus invert stripping and the other 8 underwent orthodromic esophagus invert stripping. The esophagus of these patients were replaced with either the stomach (in 15 cases) or the colon (in 3 cases), and complete removal of the pharynx and larynx were performed in 2 cases, both of which received permanent fistulization. Result No death occurred during the operation and the complications included anastomotic leakage (2 cases), injury of the recurrent laryngeal nerve (2 cases), pulmonary infection (3 cases), and incision infection (1 case). The follow-up survey showed that the 1-year, 3-year and 5-year survival rates were 77%, 44% and 22%, respectively. Conclusions This surgical approach reduces the damage of the cardiopulmonary function, which can be meaningful for senior patients and those with cardiac or pulmonary problems. The carcinoma in the inferior pharynx or cervical part of the esophagus should be treated surgically to improve the survival rate, but this approach should be avoided in patients with carcinoma in thoracic part of the esophagus.

Lipopolysaccharide(LPS),lipteichoic acid(LTA) and zymosan can be recognized by Toll-like receptors (TLRs) ex-pressing in the inflammatory cells membrane,such as macrophages,monocytes and endothelial cells,and then induce the secretion of pyrogenic cytokines followed by triggering inflammatory reaction. The signaling pathway mechanisms were summarized, including the extracellular signaling cascades from pyrogens to individual TLRs,and intracellular signaling cascades from TLRs to nucleus.

OBJECTIVETo investigate the relationship between positive expression of Her2 and abnormal expressions of beta-catenin and E-cadherin and its implications.

METHODSImmunohistochemistry was used to detect the expressions of Her2, beta-catenin and E-cadherin in 147 samples of human breast carcinoma. The expressions of beta-catenin and E-cadherin were also detected in 19 tissues adjacent to the carcinoma and 17 benign breast lesions as controls.

RESULTSIn breast carcinoma, positive Her2 expression was associated with lymph node metastasis, advanced clinical stage and negative expression of ER and PR (P<0.05). Abnormal beta-catenin expression was associated with positive lymph node status and high histological grade (P<0.01). Abnormality of E-cadherin expression was related to lymph node metastasis and advanced clinical stage (P<0.05). Abnormal beta-catenin expression was directly correlated with abnormal E-cadherin expression (P<0.01). Her2 positivity showed a direct correlation to abnormal beta-catenin expression (P<0.01), and they cooperated in promoting axillary lymph node metastasis in human breast carcinoma (P<0.01).

CONCLUSIONA direct correlation between positive Her2 expression and abnormal beta-catenin expression exists in human breast carcinoma, and positive Her2 expression may have functional interactions with abnormal activation of Wnt/beta-catenin signaling pathway.

Adult ; Aged ; Breast Neoplasms ; metabolism ; pathology ; Cadherins ; metabolism ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; Female ; Humans ; Lymphatic Metastasis ; Middle Aged ; Receptor, ErbB-2 ; metabolism ; beta Catenin ; genetics ; metabolism

OBJECTIVETo investigate the changes of serum reproductive hormones with male aging and to compare the differences in the hormone levels among different age groups or between township and rural males of the same age group.

METHODSUsing cluster and stratified sampling, we recruited 434 healthy old and middle-aged (40-69 years) males, 198 from the township and 236 from the rural communities. We determined the concentrations of serum total testosterone (tT), luteinizing hormone (LH) and sex hormone binding globulin (SHBG), free testosterone (fT), bio-available testosterone (Bio-T), and obtained the testosterone secretion index (TSI) and free testosterone index (fTI). Meanwhile, we included fifty-nine 20-39 years old males from the same communities in a control group.

RESULTSWith the increase of age, the serum tT levels did not change significantly, while the levels of serum LH and SHBG increased, and those of fT, Bio-T, TSI and fTI decreased gradually. Statistically significant differences were found among the four different age groups in all the parameters of reproductive hormones (P < 0.01), except in the serum tT level (P > 0.05). The serum tT level was not significantly correlated with aging and LH (P > 0.05). Serum LH and SHBG had a marked positive correlation with aging, and SHBG with LH (P < 0.01), while fT, Bio-T, TSI and fTI were negatively correlated with aging and the LH level (P < 0.01). Serum LH, TSI and fTI showed statistical differences (P < 0.05), while fT and Bio-T exhibited extremely significant differences (P < 0.01) between the township and rural males in the 40 -49 yr group, and in the same age group, the increase rates of serum LH and SHBG and reduction rates of fT, Bio-T, TSI and fTI were higher in the rural men than in the township residents. However, the results were just the opposite in the 50 - 59 and 60 - 69 yr groups.

CONCLUSIONThe levels of serum LH, SHBG, fT, Bio-T, TSI and fTI changed with aging in a gradientmanner in the old and middle-aged males, but no significant changes were observed in the level of serum tT. There were statistical differences in many parameters of serum reproductive hormones among different age groups or between township and rural males.

Adult ; Age Factors ; Aged ; Aging ; metabolism ; China ; Humans ; Luteinizing Hormone ; blood ; Male ; Middle Aged ; Rural Population ; Serum Albumin ; metabolism ; Sex Hormone-Binding Globulin ; metabolism ; Testosterone ; blood ; Urban Population ; Young Adult

Objective To explore the strategies of desensitization treatment for ABO incompatible (ABOi) related living-donor kidney transplantation .Methods A retrospective analysis was performed for 14 recipients undergoing ABOi related living kidney transplantation from July 2015 to December 2018 .The clinical outcomes and expenditures of desensitization treatment before and after optimizing desensitization were compared .Results After desensitization treatment , 14 recipients successfully underwent ABOi-kidney transplantation . Within 2 weeks post-transplantation , blood group antibody rebounded to 1:64 in only 1 recipient .Within 1 week post-transplantation ,the serum creatinine levels decreased to 85-165 μmol/L in 14 recipients .Thirteen patients stabilized after 1 week while another patient had an elevated level of serum creatinine at Day 12 post-operation and renal allograft function recovered after treatment . Two cases of rejection were diagnosed by clinical manifestations and 1 case was confirmed by pathological biopsy . Five cases of programmed renal allograft biopsy indicated critical or suspected acute T-lymphocytic rejection within 1 year .Thirteen cases (92 .6％ ) demonstrated varying degrees of peritubular capillary deposition of C 4d .One case developed BK viral uropathy within 1 year and four patients of pulmonary infections requiring hospitalization were cured after treatment . During an early stage , the incidence of postoperative infection was 57 .14％ and declined to 14 .29％ after optimized desensitization .The expenditure of early desensitization treatment was (27004 .86 ± 10719 .85) yuan and (10612 .29 ± 8143 .05) yuan after optimization .And the expenditure of optimized desensitization was significantly lowered (P<0 .05) . During follow-ups ,renal allograft function of 14 recipients remained decent .And the survival rate of recipient/allograft was 100％ up to the statistical cut-off point .Conclusions Both desensitization strategies may achieve the goal of desensitization for ABOi kidney transplantation and the outcomes are excellent .The expenditure of desensitization treatment is significantly lowered after optimization .

December 2019 witnessed the outbreak of COVID-19 in Wuhan, Hubei province of China, which has soon spread nationwide and across national borders, posting a menacing pandemic threat. Children are themselves highly susceptible infectious diseases in normal times not to mention an epidemic period. Coupled with the high incidence of seasonal influenza, it is imperative to strengthen epidemiological screening of children, along with effective isolation, treatment, prevention and control measures. In view of specifics of the hospital, the authors proposed to further improve the medical emergency procedure, strictly enforcing screening and isolation regulations, and standardizing medical procedure. They also proposed scientific layout and use of the infection wards. These measures are designed to control the epidemic and protect the safety of medical staff.

OBJECTIVETo study the feasibility of using Narcotrend (NCT) in monitoring the anesthetic depth during endotracheal intubation in sevoflurane anesthesia.

METHODSThirty ASA I-II patients (aged 20-49 years) undergoing gynecologic surgery under general anesthesia with tracheal intubation were randomized into sevoflurane group (n=15) and sevoflurane plus rocuronium group (n=15). In the former group, anesthesia was induced with sevoflurane at the primary concentration of 8% till the final end expiratory concentration reaching 2 MAC(minimum alveolar concentration) for 3 min, followed then by tracheal intubation and further observation of the indicators for another 3 min. The patients in sevoflurane plus rocuronium group received identical anesthesia procedures except for the administration of intravenous injection of rocuronium (0.6 mg/kg) after the loss of eyelash reflex. The NCT, BIS and hemodynamics were recorded during the process.

RESULTSNo significant differences were noted in NCT, bispectral index (BIS), MAP and heart rate before tracheal intubation between the two groups (P>0.05). The NCT and BIS increased significantly after tracheal intubation in sevoflurane group (P<0.05), but remained below 60. No significant changes in NCT and BIS occurred during intubation in sevoflurane plus rocuronium group (P>0.05). The mean arterial pressure (MAP) and heart rate were significantly increased in both groups after tracheal intubation in comparison with those before tracheal intubation (P<0.05), but the increment in sevoflurane group was significantly greater (P<0.05).

CONCLUSIONNCT may reflect the changes of the anesthetic depth resulting from the nociceptive stimulus of tracheal intubation in sevoflurane- induced anesthesia. NCT and BIS can not serve such a purpose in combined anesthesia with sevoflurane and rocuronium.

Adult ; Androstanols ; administration & dosage ; Anesthesia ; Anesthetics, Intravenous ; administration & dosage ; Hemodynamics ; Humans ; Intubation, Intratracheal ; methods ; Methyl Ethers ; administration & dosage ; Middle Aged ; Monitoring, Intraoperative ; methods ; Young Adult