Objective To investigate autoantibody against endothelin receptor type A (ENRA-Ab) in patients with systemic lupus erythematosus associated pulmonary arterial hypertension (SLE-PAH).The possibility of autoantibody-mediated pathogenesis in the development of SLE-PAH has also been explored.Methods ENRA-Ab in the serum of SLE-PAH and controls were detected by using a human ETRA epitope peptide-based ELISA.The clinical relevance of ENRA-Ab in SLE-PAH was analyzed.Proliferation of vascular smooth muscle cells (SMCs) and permeability of endothelial cells in vitro under the stimulation of polyclonal ENRA-Ab IgG were assessed.The expressions of PAH-related markers, i.e., 5-HTT, PDGFR-b, VEGF-A and PDGF-B were measured by qPCR.The effect of ENRA-Ab in vivo was also determined in a suboptimaldose monocrotaline-induced model with the assessment of right ventricle hypertrophy index and pathology parameters.Independent t-test, Tukey-Kramer test of variance analysis and Pearson' s correlation analysis were used for statistical analysis.Results ENRA-Abs was presented in a higher occurrence in SLE-PAH (35/85,41％) compared with controls (0/60;0, 13/80, 16％).There was a significant correlation between ENRA-Ab and echocardiograph estimated pulmonary arterial systolic pressure (r=0.392, P=0.002) in SLE-PAH.ENRA-Ab could promote SMCs proliferation, disrupt endothelial barrier and up-regulate PAH-related markers expression,which could be blocked in the presence of ETR antagonist.ENRA-Ab aggravated right ventricle hypertrophy and vascular remodeling in vivo.Conclusion ENRA-Ab is a new biomarker, in SLE-PAH, which may mediate PAH development in SLE.

Objective To establish a rapid method for the clinical detection and identification of fungi in clinical urine samples.Methods DNA was extracted from clinically collected urine sample,and the fungal ribosomal internal transcribed spacer was amplified by polymerase chain reaction (PCR) and followed by pyrosequencing.The fungal species were identified by sequence alignment.Results The identification results were compared between PCR-pyrosequencing and conventional culture method.Among the 1320 urine samples,180 were detected positive by conventional method with the positive rate of 13.6％,while 192 were positive by the pyrosequencing based method with the positive rate of 14.5％.The overall coincidence rate of the two methods was 99.09 ％,with the positive coincidence rate of 100 ％ and the negative coincidence rate of 98.95 ％.The Kappa value was 0.963,suggesting a good consistency.The results of 13 standard strains were consistent with the actual results.Conclusions A rapid culturefree method for the detection of fungi in urine sample has been successfully established.This method is based on PCR-pyrosequencing technology with highly accuracy,sensitivity and reproducibility.It is highly automated,cost effective and with high throughput (96 samples per run).The fungal pathogen in urine is identified by single step test within 3 hours without conventional culture.Thus,it is applicable in the clinical laboratory.

Objective To analyze the effect of lumbar bone marrow composition on bone marrow diffu-sion-weighted imaging(DWI)in healthy adult women.Methods Retrospective analysis was performed on up-per abdominal MRI of 103 adult women.Bone marrow fat fraction of lumbar vertebra was measured according to two-point water-lipid separation technique,and apparent diffusion coefficient(ADC)value of lumbar verte-bra was measured according to DWI image(b=800 s/mm2).The subjects were divided into the high-signal group and the equal-low-signal group according to the signal intensity of lumbar vertebra and adjacent erector spine muscles.The effects of age,lumbar bone marrow fat fraction and menstrual status on the signal intensity and ADC value of lumbar bone marrow diffusion were analyzed.Finally,the correlation between lumbar bone marrow fat fraction and ADC value was analyzed.Results Univariate analysis showed that the lumbar bone marrow diffusion signal intensity and ADC value were affected by age,lumbar bone marrow fat fraction and menstrual status(P＜0.001).Multivariate analysis showed that age(P=0.046)and lumbar bone marrow fat fraction(P=0.005)were the influencing factors of lumbar bone marrow diffusion signal intensity,but men-strual status(P=0.242)was not the influencing factor.In addition,lumbar bone marrow fat fraction(P＜0.001)was the factor influencing the ADC value of lumbar bone marrow,and the two were negatively correla-ted(r=-0.607,P＜0.001),but age(P=0.497)and menstrual status(P=0.082)were not the influencing factors.Conclusion The bone marrow composition of lumbar vertebrae in healthy adult women has significant effects on the signal intensity and ADC value of bone marrow diffusion.

Background The hearing of Chinese young adults is far less sensitive than 0 dB defined by international standards, with the threshold values mostly being at double digits, which is worthy of investigation. Objective To study the influencing factors of hearing threshold measurement. Methods The hearing measurements were conducted in two different ways, one was a standard method performed in a specialized audiometry experiment room, and the other one was an on-site audiometry test which included a daily examination of hearing and an onsite hearing test. From the workers who participated in the occupational health examination, 300 people were randomly selected as experimental subjects, and their hearing was measured in the hearing examination room of the Occupational Disease Prevention and Treatment Institute according to standard methods. A total of 9 766 workers from the General Motors factory were included in the daily group, and their hearing thresholds were measured in the hearing examination room in the factory. There were 4 617 people in the onsite group, and their hearing was measured in the test chamber of our mobile medical vehicle in their factories. The hearing threshold data of the three groups, i.e. experiment, daily examination and on-site, was compared and analyzed. In addition, the environmental noise in the hearing examination room and the mobile test chamber was measured. Results The hearing threshold value of the experimental group was the lowest. Despite this, its dB value remained at double digits at any frequency band. The hearing value of the daily group was in the middle. The onsite group had the highest hearing threshold, which was 58.2% higher than that of the experimental group. As the hearing data was not normally distributed, Kruskal-Wallis non-parametric test was conducted for statistical analysis. It was found that the hearing threshold difference among the three groups was statistically significant at all the frequency band (P< 0.01). The ambient noise level was 23.9-28.3 dB(A) in the hearing examination room, and 32.5 - 67.9 dB (A) in the mobile test chamber. Age and gender were not confounding factors to the results. Conclusion The hearing test method and its environmental noise were able to make the threshold measurements shift up significantly. The environmental noise of the mobile test chamber in the examination vehicle has exceeded the standard and needs to be improved.