Objective To assess the value of CT in the diagnosis of PRF,and analyze the reason of misdiagnosis. Methods Retrospectively analyze the CT data of ten patients with retroperitoneal fibrosis,which were confirmed by the clinical pathology.All the patients underwent CT scan and enhanced scan.Two experienced physicians using the blind method to evaluate the location, boundary, density, invasion on the surrounding tissue and enhancement of retroperitoneal fibrosis lesions respectively.Results All patients with CT scan findings were retroperitoneal irregular-shaped soft tissue lesions,which was similar to muscle density.6 cases with surrounding the retroperitoneal vessel, 2 cases with expansion and hydrops of renal pelvis and ureter.By enhanced scan,9 cases with different degrees of enhancement,1 case without obvious enhancement.6 cases were misdiagnosed as retroperitoneal schwannoma or lymphoma. Conclusion CT can show the characteristics of retroperitoneal fibrosis. Comprehensively analyze various imaging findings is helpful for the diagnosis of retroperitoneal fibrosis. Misdiagnosis reason is mainly due to retroperitoneal fibrosis is a rare disease,and understanding of this disease in imaging findings is insufficient in the daily work.

Objective To study the selection of the follow-up care and related factors in stroke patients after acute treatment in general hospital. Methods A total of 230 acute stroke patients discharged from January to December, 2015, were reviewed. They were classified with age, modified Rankin Scale (mRS) score, referral options, etc., and the key consideration in the selection were compared. Results There were 125 patients needing referral. Referral increased while mRS worsening (P<0.05). The demand for the continuation of rehabilita-tion was higher in the patients with mRS scores of 0-1 and 2-3 than that of 4-5 (F=4.300, P<0.05), but the latter cared more about medical quality (F=3.464, P<0.05) and hospitalization length (F=3.692, P<0.05). The patients more than 80 years old cared more about medical qual-ity (F=4.630, P<0.05). The patients selecting continuous treatment in our hospital paid more attention on continuation (F=7.590, P<0.001), while those selecting rehabilitation institutions cared more about rehabilitation capacity (F=32.156, P<0.001), and those selecting communi-ty hospitals or nursing home cared more about hospitalization length (F=18.823, P<0.001), easy to visit (F=14.070, P<0.001), etc. Referral information mainly came from the doctors (72.0%), only 28.0% from the patients. Conclusion Severity of disability, age and the prognosis may impact the choice for the following rehabilitation in acute stroke patients. Doctors can do more for reasonable referral recommendations to the patients.

Objective: To understand the effects of different expansion ways on collagen and actin of skin and to provide an experiment foundation for the suitable expansion method clinically. Methods: The rabbits were divided into five groups. The expanders were embedded in experimental group. The sirius-red specific staining method was applied to observe the changes of type I collagen and type III collagen and their proportion. Immunochemistry method was used to detect the expression of actin. Results: 1: In group A, B and C, type I collagen arranged turbulently and was thicker and type III collagen decreased relatively at earlier maintaining period. After 4 week, type I collagen arranged regularly and type III collagen was relatively increased. 2: Comparisons of the area about type I, III collagen: At the same maintaining period, there were no significant difference among the group A,B and C. With the extension of maintaining period, the area of type I, III collagen increased gradually, but there was inclined to stabilize at the fourth week in group A, B and at the third week in group C. Comparison of the proportion of collagen I and collagen III: There were significant difference between group A, B and group D, but no significant difference was observed after the fourth week. There were significant difference between group C and control group, but no significant difference was observed after three week. 3. With the extension of maintaining period, the positive expression rates of actin decreased gradually in group A, B, C. At the same maintaining period, significant difference were observed among group A, B, C. The positive expression rates of actin in group C were lower than that of group A at the same maintaining period. Conclusion: The repeated rapid expansion can not only shorten the clinical period but also promote the quality of skin flap. It is a safe and feasible method in clinic.

Objective To express the anti-IL-1βscfv and soluble TNF receptor 1 (sTNFR1),and analyze their bio-activities.Methods sTNFR1 was obtained by RT-PCR from the total RNA of HeLa cells,and fused with IL-1βscfv by the hinge fragment of IgG molecule.The fusion gene IL-1scfv:TNFR1 was cloned into the expression vector pET27b(+).The fusion protein was expressed and purified from inclusion bodies.Results The ELISA analysis showed that the fusion protein could bind hIL-1β and hTNF-α respectively in a dose-dependent manner,indicating that scfv and sTNFR in the fusion protein can form the correct spatial configuration.The dolt-blot analysis showed that the fusion protein could concurrently bind with hIL-1β and hTNF-α,indicating that the combination of the two parts of the fusion protein does not influence each other for binding to their target molecules.The bioactivity assay showed that the fusion protein could inhibit both the cytotoxicity of hTNF-α on L929 cells and hIL-1β-induced proliferation of L929 cells,indicating that the fusion protein has the ability to neutralize hTNF-α and hIL-1β.Conclusion A bispecific fusion protein IL-1scfv:TNFR1 was successfully constructed.The fusion protein has the ability to inhibit the biological activity of hTNF-α and hIL-1β,and provides a drug candidate for the treatment of rheumatoid arthritis.

Objective:To screen the new candidate molecules interacting with protein kinase Wee1B by yeast two hybrid system, and to analyze their interaction with Wee1B in the early stage of mouse fertilized eggs by bioinformatics.Methods:The plasmid pcDNA3.1/V5-His-TOPO-Wee1B wild type encoding mouse Wee1B gene was used as template to construct bait plasmid pGBKT7 Wee1B and the bait plasmid pGBKT7-Wee1B was transformed into yeast competent cells at SD/Trp (SDO),SD/Trp/X-α-Gal (SDO/X)and SD/Trp/X α Gal/AbA plates (SDO/X/A)plates to detect the toxicity and self-activation ability of yeast and its expression in yeast using Western blotting method.The yeast cells containing pGBKT7-Wee1B were fused with human ovary cDNA library, the yeast plasmid transformation of Escherichia coli positive clones were sequenced after identified by yeast transformation.BLAST analysis was carried out in GenBank,and its effect on the development of mouse fertilized eggs was deduced according to the gene annotation.Results:The double enzyme digestion analysis and sequencing analysis results showed that the pGBKT7-Wee1B bait plasmid was successfully constructed.The plasmid was transformed into the yeast,and there were no clones in the SDO/X/A plates.The pGBKT7-Wee1B and pGBKT7 empty vectors were transformed into the yeast,the bacteria were inoculated on the SDO plates,and the clones were uniformly grown on the two SDO plates.The positive clones were picked and expanded in culture,the protein was extracted and Western blotting showed that pGBKT7 Wee1B was expressed in the yeast.The bait plasmids were fused with human ovary cDNA library and the positive clones inserted into the fragment were identified by PCR. Nine proteins which interacted with Wee1B protein kinase were screened out by sequencing and blast analysis,and the proteins which could be closely related to the development of mouse oocytes and the development of fertilized eggs were analyzed by bioinformatics analysis.Conclusion:Using the yeast two hybrid system from human ovary cDNA library,nine interacting proteins with Wee1B protein kinase are screened and these screened proteins may regulate mouse oocyte maturation and early embryo development through interacting with Wee1B.

Objective To evaluate Western blot analysis in diagnosing limb-girdle muscular dystrophy type 2A (LGMD2A). Methods The clinical records including their pathological and biochemical results of 4 patients with LGMD type 2 were reviewed. Histochemical and immunohistochemical staining were performed on muscle biopsy specimens from the four patients. The expressions of dysferlin and calpain-3 in muscles were analyzed by Western biol. Results All 4 LGMD patients shared some common clinical features, such as dorsal muscular atrophy of lower limbs and remarkably elevated CK. The immunohistochemical results showed partial or complete deficiency of dysferlin staining in all 4 LGMD patients. However, Western blot revealed that the calpain-3 protein in the muscle of patient 1 was completely absent, who was later diagnosed with LGMD2A. The other 3 patients had complete dysferlin deficiency with reduced calpain-3 expression and they were confirmed to be LGMD2B. Conclusions Western blot analysis of calpain-3 and dysfcrlin can be used to differentiate LGMD2A which shows absence of calpain-3 from other LGMD types which show dysferlin deficiency. Western blot is an invaluable method in clinical diagnosis of LGMD2A.

Objective To screen the splicing isoforms of estrogen receptor βin the Beagle hypothalamic -pituitary -gonadal axis.Methods For ERβmRNA CDS sequence of eight exons, primers were designed confined to the CDS sequences of two sequential exons.Beagle hypothalamus, pituitary, ovary and uterus tissue cDNA were used as template, and corresponding sequences were amplified by PCR.PCR products were sequenced and aligned in the NCBI web site.The correct gene was then analyzed with DNAMAN comparative analysis software and handwork checking up, thus got the ERβsplicing isoforms of Beagle. Results Four beagle ER beta splicing isomers were obtained:exon 4 complete skipping ER βisomer (300 bp missing), two kind of Beagle ERβisoforms with partial exon 4 and partial exon 5 complicated missing (isoformⅠ334 bp missing and isoformⅡ265 bp missing), and exon 7 complete missing ERβsplicing isoforms (181 bp missing).Exon 4 complete skipping and exon 7 complete missing isomers had been obtained full length coding sequence, and the other two splicing isomers were partial coding sequence.Conclusion This project gained four ERβsplicing isomers of Beagle, and that will lay an important foundation for further study of their roles in the Beagle reproductive regulation mechanism.

OBJECTIVETo explore the clinicopathological characteristics and imaging features of lung adenocarcinoma with a micropapillary pattern (MPP).

METHODSEighty cases of pulmonary adenocarcinoma with a micropapillary pattern treated in our hospital from July 2011 to December 2012 were selected to retrospectively analyze their clinicopathological characteristics and imaging features.

RESULTSAmong the 80 cases of lung adenocarcinoma with MPP, there were 38 cases of stage I (47.5%), 12 cases of stage II (15.0%), 25 cases of stage III (31.3%) and 5 cases of stage IV (6.2%). There were 14 cases of moderately differentiated (17.5%) and moderately/poorly differentiated (82.5%) tumors. Sixty-three cases had pleural involvement, vascular invasion, involving the bronchial wall, invasion of large vessels, nerve invasion, and lymph node metastasis (at least one of them) (78.8%). Immunohistochemical staining revealed that both positive rates of TTF-1 and CK7 were 100%, and that of pulmonary surfactant apolipoprotein-A (SPA) was 84.0%. Imaging examination revealed hilar or mediastinal lymph node enlargement in 15 cases (18.8%). but the pathology confirmed hilar or mediastinal lymph node metastasis in 36 cases (45.0%). Lung CT imaging showed that the majority of the cases were peripheral type, and only a few of central type, and most cases were solid lesions, with lobulation, spiculation, pleural indentation, and vascular convergence sign, while there were few ground-glass opacity sign and vacuole sign.

CONCLUSIONSLung adenocarcinoma with MPP component often presents with early invasions of pleura, blood vessels, lymphatic vessels, and lymph nodes. Imaging manifestation of this cancer mainly shows as peripheral and solid lesions, often with lobulation, spiculation, pleural indentation, vascular convergence sign, but GGO and vacuole signs are unusual. Overexpression of TTF-1, CK7 and SPA, and elevated CEA level are associated with clinical staging of the disease.

Adenocarcinoma ; diagnostic imaging ; metabolism ; pathology ; Adenocarcinoma, Papillary ; diagnostic imaging ; metabolism ; pathology ; Adult ; Aged ; Aged, 80 and over ; Apolipoproteins A ; metabolism ; Carcinoembryonic Antigen ; metabolism ; DNA-Binding Proteins ; metabolism ; Female ; Humans ; Keratin-7 ; metabolism ; Lung Neoplasms ; diagnostic imaging ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Retrospective Studies ; Tomography, X-Ray Computed ; Transcription Factors

Objective:To explore the status quo and influencing factors of caregivers' perception of nurses' empowerment behavior in children with type 1 diabetes mellitus (T1DM) , and to provide scientific basis for focusing on and efficiently empowering caregivers of children with T1DM.Methods:This study was a cross-sectional survey. A total of 360 children with T1DM who were admitted to 2 tertiary hospitals in Zhejiang Province from January 2019 to May 2020 were selected by the convenient sampling method. General information questionnaire, Patient Perceptions of Patient-Empowering Nurse Behaviors Scale (PPPNBS) and General Self-Efficacy Scale (GSES) were used to investigate and analyze the influencing factors. A total of 360 questionnaires were issued and 347 valid questionnaires were recovered, with an effective response rate of 96.4%.Results:The PPPNBS score of caregivers of 347 children with T1DM was (185.85±50.05) . Multiple linear regression analysis showed that the course of the disease, the age of the caregiver, the education background of caregivers and self-efficacy sense were influencing factors of perception of empowerment behavior of caregivers of children with T1DM ( P<0.05) . Conclusions:The perception of caregivers of T1DM children with nurses' empowerment behavior is at a moderate level. The course of the disease, age of caregivers, the education background of caregivers and self-efficacy are the influencing factors in perception of caregivers' empowerment behaviors of T1DM children. Medical staff should formulate targeted intervention measures based on the influencing factors of the perception of empowerment behaviors to improve the perception of nurses' empowerment behaviors by caregivers of patients.

In order to obtain the lead compound for treatment of rheumatoid arthritis (RA), in this study, therapeutic efficacy of three bispecific antibodies (BsAB-1, BsAB-2 and BsAB-3) against both hIL-1beta and hIL-17 were compared on CIA model mice. First, by ELISA method we compared the binding capacity of the three bispecific antibodies to the two antigens. The results showed that all three antibodies could simultaneously bind both antigens, among these antibodies, BsAB-1 was superior over BsAB-2 and BsAB-3. CIA model was established with chicken type II collagen (CII) and developed RA-like symptoms such as ankle swelling, skin tight, hind foot skin hyperemia. The CIA mice were treated with three antibodies once every two days for total of 29 days. Compared with the CIA model mice, the RA-like symptoms of the antibody treated-mice significantly relieved, while the BsAB-1 treated-mice were almost recovered. CII antibody level in the serum and cytokines (IL-2, IL-1beta, IL-17A and TNF-alpha) expression in the spleen were examined. Compared with the CIA model mice, all three antibodies could significantly reduce CII antibody and cytokine expression levels. BsAB-1 antibody was more potent than BsAB-2 and BsAB-3. In summary, BsAB-1 is superior over BsAB-2 and BsAB-3 in amelioration of RA symptoms and regulation of CII antibody production and pro-inflammatory cytokine expression, therefore, BsAB-1 can be chosen as a lead compound for further development of drug candidate for treatment of RA.