Objective To observe the change of the concentration of plasma B-type natriuretic peptide (BNP) before and after treadmill exercise test (TET),and to judge the accuracy of BNP changes ( ABNP)in diagnosing coronary heart disease (CHD). Methods A total of 188 patients with suspected CHD underwent TET and the levels of plasma BNP before and after TET was detected. All the patients were divided into CHD group( group A, n = 96) and non-CHD group(group B, n = 92) according to coronary ar-teriography. Meanwhile, 26 healthy volunteers were enrolled (group C). Results The levels of plasma BNP after TET increased significantly (P<0.01 ). The levels of ABNP of group A were obviously higher than those of group B and C(P<0.01 ). When the levels of △BNP was 8.5 pg/ml, the sensibility, specificity, pos-itive predictive value and negative predictive value of diagnosing CHD was 93.5%, 57.1%, 70.5% and 88.9% respectively. Area under curve (AUC) was 0.815, and 95% confidence interval was 0.768-0.896.Conclusions The levels of plasma BNP after TET increase obviously. It exists higher sensibility and speci-ficity in diagnosing CHD by △ABNP set 8.5 pg/ml.

Objective To investigate the current status of nurses′ work performance and job involvement, and to analyze the impact of nurses′job involvement on work performance. Methods Self-made questionnaires were used to investigate 309 nurses in a 3A military hospital in Beijing. The military hospital is in a high standardization level, which may be properly representative of both military hospitals and 3A hospitals. Results The total score of nurses′work performance was 192.04 ± 31.25. The total score of nurses′ job involvement was 55.48 ± 9.94. The multiple regression analysis showed that the nurses′ work performance would be influenced by staff type, vigor and absorption. Conclusions The nurses′work performance and job involvement were at a high level. Managers should take methods to keep a high level of nurses′job involvement, which may improve work performance.

Objective To evaluate the therapeutic effect of thymosin alpha -1 with glucocorticoid in treat-ment of HBV -related hepatic failure.Methods 130 cases were randomly divided into two groups,they were all giv-en antiviral therapy,protect liver,anti -inflammatory,yellow suit the back support,etc.comprehensive treatment;and patients in treatment group were given thymosin alpha -1 with methyl -prednisone intravenously at the early stage of treating process,and then observed the clinic situation and cure rate of those sufferers,The biochemiccal indicator, PTA and blood serum HBV DNA capacity ending with the period of 4 weeks were tested.Results In both groups,the TBil,TC in serum had apparently improved compared with the baseline after the medication,the difference was signifi-cant (t =3.12,P <0.05 and t =3.05,P <0.05).The time of gastrointestinal symptoms improvement and bilirubin subsided time in treatment group were significantly shorter than those of the control group(t =3.34,P <0.01 and t =4.52,P <0.01 ).During the treatment,there was no significant adverse reaction,and there were no differences between two groups in Alt,PTA,HBV DNA,infection,gastrointestinal bleeding,hepatic encephalopathy and hepatore-nal syndrome.The effective rate of treatment group was 75.2%,which was higher than 50.3% of the control group (χ2 =11.02,P <0.01).Conclusion Patients with HBV -related hepatic failure of short -term application of thy-mosin alpha -1 with glucocorticoid treatment,can quickly improve symptoms,greatly improve the efficiency of survival rate,shortem hospitalization period,reduce side effects and enhance security.

AIM: To prepare and characterize a mouse anti-human CD40 mutant monoclonal mAb. METHODS: Female BALB/c mice of 6-8 weeks old were immunized with CD40 mutant transfectant (L929-CD40mu) as immunogen. The spleen B cells of the mice were fused with Sp2/0 myeloma cells. The hybridoma cells were screened with CD40 mutant transfectant (L929-CD40mu) by FCM. Faststrip analysis was performed to identify Ig subclass of this mAb. The epitope recognized by this mAb was detected by Bio-5C11 competitive assay. Western blot technique was adopted to identify the mAb. The proliferation of tumor cells in vitro was analyzed by MTT assay and apoptosis of tumor cells in vitro was analyzed by PI-annexin V assay. RESULTS: One hybridoma cell line named 10C5 was obtained, which had the property of secreting anti-human CD40 mutant monoclonal antibody continuously and steadily. This mAb specifically recognized human CD40 mutant molecule and induced the apoptosis of tumor cells in vitro. CONCLUSION: One hybridoma cell line which can secret a mouse anti-human CD40 mutant mAb has been prepared successfully. This mAb can inhibit the growth of tumor cells expressing CD40 mutant and induce their apoptosis in vitro.

Objective To investigate the clinical diagnostic values of quantitative DTI and MRS in AIDS-related cerebral tuberculosis. Methods 17 cases confirmed with AIDS and brain tuberculosis,16 volunteers were recruited to perform routine MRI,DTI and MRS sequences. Morphological characteristics of lesions were observed.ADC,FA,rADC,rFA,NAA/Cho,NAA/Cr and Cho/Cr of the lesions solid areas,edematous areas,normal areas and contralateral corresponding normal areas were measured and their variances in different areas were analyzed. Results Significant differences of the values were observed among the three regions of AIDS-related brain tuberculosis,the results of multiple comparisons between the three areas had statistical significances (P <0.05)excepted NAA/Cr between edematous and contralateral areas.ADC,FA,rADC,rFA,NAA/Cho,NAA/Cr on solid areas were lower than that on edematous areas,Cho/Cr on solid areas was higher than that on other two areas.The diagnostic efficiency of rFA value to distinguish solid and edematous areas was the highest by ROC analysis(P <0.05).The normal areas of the two groups had statistical significances(P <0.05)excepted Cho/Cr.Conclusion DTI is valuable to display the lesions micro-structure changes and MRS can reflect the early pathology metabolites changes of AIDS-related tuberculosis.

Objective To investigate the change rules of the lumbar vertebral bone marrow fat fraction(FF)and T2* values at different bone mineral density(BMD)groups,and their relevances and the applications on the diagnosis of the primary osteoporosis. Methods The patients who underwent the dual energy X-ray absorptiometry(DXA)and the routine lumbar MRI scan,mDIXON-Quant scan were collected,and the BMD,T-score,FF and T2* values of L1-L4 were measured.According to the T-score,the vertebral bodies were divided into the normal group,the osteopenia group and the osteoporosis group.The differences of the FF,T2* values and BMD between each group were analyzed by one-way analysis of variance,and their correlations with BMD were analyzed by Pearson correlation,the diagnostic effects of them were evaluated by receiver operating characteristic curve(ROC curve).Results The differences of the FF ,T2 * values and BMD among the three groups were statistically significant (P < 0 .05) .The correlations of the FF and T2 * values with BMD were negative (r = - 0 .628 ,P < 0 .05 and r = - 0 .468 ,P < 0 .05 ,respectively) .The area under curve (AUC) of the FF and T2 * values were 0 .82 ± 0 .03 ,0 .79 ± 0 .03 ,respectively .Conclusion mDIXON-Quant which can accuratly quantify fat content could evaluate the lumbar vertebral bone marrow fat content ,reflect the changes of the bone quality ,provide valuable information for the diagnosis of osteoporosis ,and is helpful to predict the risks of the lumbar fragility fracture.

ObjectiveTo investigate the protective effect of Lycium barbarum polysaccharide (LBP) combined with aerobic exercise (AE) on the liver of rats with nonalcoholic steatohepatitis (NASH) induced by high-fat diet based on the p38 mitogen-activated protein kinase (p38 MAPK)-nuclear factor-κB (NF-κB) pathway. MethodsAfter 1 week of adaptive feeding, 45 Sprague-Dawley rats, aged 8 weeks, were randomly divided into control group (10 rats fed with normal diet) and high-fat group (35 rats fed with high-fat diet). At the end of week 28, the high-fat group was randomly divided into model group, LBP group, AE group, and LBP+AE group, with 8 rats in each group, and intervention was performed for 10 weeks. At the end of the experiment, fasting blood glucose was measure for all rats, and serum samples, liver tissue, and visceral fat were collected. Biochemical kits were used to measure the serum levels of triglyceride (TG), total cholesterol (TC), alanine aminotransferase (ALT), and aspartate aminotransferase (AST); ELISA kits were used to measure the serum levels of fasting insulin (FINS), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and monocyte chemotactic protein-1 (MCP-1); quantitative real-time PCR and Western blot were used to measure the mRNA and protein expression levels of Toll-like receptor 4 (TLR4), p38 MAPK, and NF-κB in liver tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the control group, the model group had significant increases in TG, TC, AST, ALT, FINS, and homeostasis model assessment of insulin resistance (HOMA-IR) (all P ＜0.05), a tendency of increases in the serum levels of the inflammatory factors MCP-1, TNF-α, and IL-6 (all P ＜0.05), and significant increases in the mRNA and protein expression levels of TLR4, p38 MAPK, and NF-κB in liver tissue (all P ＜0.05). Compared with the model group, each intervention group had significant reductions in TG, TC, AST, ALT, FINS, and HOMA-IR (all P ＜0.05), a tendency of reductions in the serum levels of the inflammatory factors MCP-1, TNF-α, and IL-6 (all P ＜0.05), and significant reductions in the mRNA and protein expression levels of TLR4, p38 MAPK, and NF-κB (all P ＜0.05). Compared with LBP group, the LBP+AE group had significant reductions in TG, ALT, FINS, HOMA-IR, MCP-1, the mRNA expression level of TLR4, protein expression levels of p38 MAPK and NF-κB(all P＜0.05). Compared with Ae group, the LBP+AE group had significant reductions in FINS, HOMA-IR, IL-6, MCP-1, the mRNA expression level of TLR4 (all P＜0.05). ConclusionLBP combined with AE may improve inflammation in NASH rats by regulating the p38 MAPK/NF-κB pathway.

Objective　To investigate the prognostic value of NLR,PLR,PNR and PWR in acute cerebral infarction.Methods　We enrolled 139 patients who were diagnosed with acute cerebral infarction from Chengde Central Hospital from September 2018 to September 2019.Routine blood test results were collected.Patients were divided into mild stroke and moderate-severe stroke groups according to the NIHSS at admission.After three months,subjects were divided into two groups according to the modified Rankin score (mRS),one group with good prognosis (mRS 0~2) and the other with poor prognosis (mRS 3~6).Logistic regression analysis was performed,the ROC curve was used to evaluate inflammatory markers in predicting prognosis.Results　After adjusting for confounders,PLR and NLR in the group with good prognosis were significantly lower than that of the other group (P<0.005),PWR was higher in good prognosis group (P<0.05).In addition,PLR and NLR in the mild stroke group were significantly lower than the moderate-severe stoke group (P<0.05).The ROC curve showed that the area under the curve of PLR and NLR for predicting the prognosis of acute cerebral infarction at 3 months was 0.721 (95%CI 0.630~0.813;P<0.001),0.765 (95%CI 0.678~0.851;P<0.001) and the area under the curve of the PWR is 0.642.Conclusion　NLR and PLR,as new inflammatory indicators,may be independent factors for predicting the prognosis of AIS,and can also be used to judge the severity of stroke.

Objective To detect TOP2A protein expression and gene copy number alterations, and to analyze related clinical and pathological implications in pediatric neuroblastic tumors ( NT ).Methods Immunohistochemistry was used to detect TOP2A protein expression.Fluorescence in situ hybridization (FISH) was used to detect numerical aberrations of TOP2A.Results TOP2A protein was expressed in 59.1%(52/88) of cases, which was associated with differentiation (P=0.006), Ki-67 index (P<0.01) and MKI (P=0.001).Twenty-eight cases (35.0%, 28/88) showed TOP2A gene amplification, which was correlated with the age (P<0.01), clinical stage (P=0.028), high risk group (P=0.001), Ki-67 index (P=0.040) and differentiation (P=0.014).Survival analysis showed that TOP2A expression was related to survival rate.Multivariate analyses showed that TOP2A expression was an independent predictor for poor prognosis (P=0.010).Conclusions More than half of the cases show TOP2A expression, which is more likely associated with NB, high Ki-67 index and high MKI.Cases with TOP2A expression have shorter survivals and poorer prognosis.TOP2A amplification is seen in 35% and likely occurs in patients older than 18 months and at advanced INSS stages (Ⅲ and Ⅳ).As a target of the anthracycline-based adjuvant drugs, TOP2A test can be used to select patient with NT for the therapy.

Attention deficit and hyperactive disorder(ADHD)is a chronic neurodevelopmental disorder characterized by inattention,hyperactivity-impulsivity,and working memory deficits.Social dysfunction is one of the major challenges faced by children with ADHD.It has been found that children with ADHD can't perform as well as typically developing children on facial expression recognition(FER)tasks.Generally,children with ADHD have some difficulties in FER,while some studies suggest that they have no significant differences in accuracy of specific emotion recognition compared with typically developing children.The neuropsychological mechanisms underlying these difficulties are as follows.First,neuroanatomically.Compared to typically developing children,children with ADHD show smaller gray matter volume and surface area in the amygdala and medial prefrontal cortex regions,as well as reduced density and volume of axons/cells in certain frontal white matter fiber tracts.Second,neurophysiologically.Children with ADHD exhibit increased slow-wave activity in their electroencephalogram,and event-related potential studies reveal abnormalities in emotional regulation and responses to angry faces when facing facial stimuli.Third,psychologically.Psychosocial stressors may influence FER abilities in children with ADHD,and sleep deprivation in ADHD children may significantly increase their recognition threshold for negative expressions such as sadness and anger.This article reviews research progress over the past three years on FER abilities of children with ADHD,analyzing the FER deficit in children with ADHD from three dimensions:neuroanatomy,neurophysiology and psychology,aiming to provide new perspectives for further research and clinical treatment of ADHD.