Objective To construct a mono-specific bivalent diabody (scFv dimer) gene derived from an anti-anti-idiotypic monoclonal antibody NP48 of Schistosoma japonicum and to express and characterize the protein.MethodsThe mono-specific diabody gene (D) was constructed by SOE (splicing by overlap extension) and using Gly_4Ser as a linker to join the C-terminus of the V_H to the N-terminus of the V_L.D was linked with prokaryotic expression vector pBAD/g. The target protein expression in E.coli TOP10 was induced by arabinose. Then a purification procedure for the target protein was carried out. The antigen binding activity of expressed product was detected with Dot-ELISA. ResultsThe V_H-G_4S-V_L (D) gene was confirmed by sequencing. The pBAD/g-D recombinant were determined by digesting with endonucleases and expected bands were identified. There were less soluble target proteins in the supernantes and higher target proteins in the pellets as inclusion body when separating the D expression proteins. And the insoluble fraction was recovered as a soluble, correctly processed protein by solubilising with 8 mol/L Urea. The molecular weight of the target protein was about 27 kD. The binding activity of the target protein to anti-idiotypic monoclonal antibody NP30 of Schistosoma japonicum was verified by Dot-ELISA. ConclusionThe purified protein from the constructed recombinant pBAD/g-D could interact specifically with antigen NP30. So the constructed mono-specific diabody has the part characteristics of anti-anti-idiotypic monoclonal antibody NP48 of Schistosoma japonicum.

Chinese Center for Disease Control and Prevention published three confirmed novel H 7N9 avain influenza virus in-fection cases on March 31 ,2013 .The disease then spread across China and caused extremely high morbility and mortality , which trig-gered extensive attention .These cases were caused by a novel H 7N9 avian influenza virus which was highly mutable .Once the virus a-dapted to human respiratory epithelium receptors , a pandemic outbreak would occur immediately .This article summerizes the research progress on the H7N9 avain influenza, including epidemiologic characteristics , etiology features, clinical manifestation, detection tech-niques as well as theraputic and prevention strategy .

Objective To investigate the effect of clinical pathway on inpatients for rehabilitation. Methods The hospital expense, the ex-pense for medicine and length of stay in hospital were compared in patients with cerebral hemorrhage, cerebral infarction, spinal cord injury and spastic cerebral palsy before (January 1st, 2012 to April 30th, 2013) and after (May 1st, 2013 to December 31st, 2015) clinical pathway implementation, 50 inpatients for each disease, totally 200 patients. Results The length of stay in hospital reduced after of clinical pathway implementation, in all the diseases (t>5.226, P<0.001), with the decrease of hospital expense for cerebral infarction (t=3.327, P<0.001). There was no significant increase in any expense in the disease (t<1.777, P>0.05). Conclusion The implementation of rehabilitation clinical pathway can reduce the length of stay in hospital for the patients rehabilitation in hospital, without increasing their cost.

Objective:To explore the clinical regularities in acupuncture-moxibustion treatment of cancer pain by reviewing the relevant studies published between 1985 and 2017.Methods:Based on the Chinese Medicine Acupuncture-moxibustion Information Database,quantitative analysis,correlation analysis and Chi-square test were applied to analyze the commonly used acupoints,meridian affiliations and body region distributions,commonly used methods and acupoint correlations,treatment method correlations,the efficacy of acupuncture-moxibustion plus the three-step analgesic ladder for cancer pain,and indicators.Results:Zusanli (ST 36),Ashi point and Sanyinjiao (SP 6) ranked the top on the list of frequency;points from Bladder Meridian of Foot Taiyang and Stomach Meridian of Foot Yangming were often used;points from the lower limbs and back had high frequencies.The most commonly used treatment method was acupuncture-moxibustion plus medication.Acupuncture-moxibustion plus the three-step analgesic ladder showed certain advantage compared with the two methods used separately,and among the integrated methods,acupoint application plus the three-step analgesic ladder produced the most significant efficacy.It took (44.77±55.54) min for the analgesic effect to act and the effect lasted for (12.81±14.59) h.Numerical rating scale (NRS),visual analog scale (VAS) and Karnofsky performance status (KPS) scores all showed significant changes after interventions (all P＜0.01);there was no significant change in the score of quality of life (QOL) after interventions (P＞0.05).Conclusion:Zusanli (ST 36),Ashi point and Sanyinjiao (SP 6) are commonly selected in acupuncture-moxibustion treatment of cancer pain;acupuncture and acupoint application are often used;acupuncture-moxibustion plus the three-step analgesic ladder can boost the treatment efficacy.

Objective To measure the expression of Caspase-3 and P-gp in hepatocellular carcinoma (HCC) and adjacent tissues, and to examine these two proteins' relationships with HCC clinical and pathological characteristics and the associations between the two proteins. Methods The expression of Caspase-3 and P-gp were measured in 50 HCC tissues and adjacent tissues by EnvisionTM immunohistochemistry. HCC clinic and pathological characteristics and follow-up data were also collected and analyzed. Results The expression of Caspase-3 in HCC tissues was significantly lower than that in adjacent tissues(P <0.05). The expression of Caspase-3 in HCC tissues was significantly associated with HCC's Edmonson grade and the presence of hepatitis envelope(P <0.05). On the other hand, the expression of P-gp in HCC tissues was significantly higher than that in adjacent tissues( P <0.05 ). P-gp expression in HCC tissues was significantly correlated with HCC's Edmonson grade and the presence of cirrhosis(P < 0.05 ). The expression of Caspase-3 and P-gp was negatively correlated ( r = - 0. 600,P = 0.000). A better prognosis was observed among HCC patients with either positive Caspase-3 expression or negative P-gp expression(P < 0.05). Conclusion Caspase-3 may promote apoptosis and inhibit the development of HCC, while P-gp may have an anti-apoptosis function and play a role in HCC's drug resistance. P-gp can inhibit the function of Caspase-3 and an absence or low expression of Caspase-3 may be related to apoptosis resistance and multidrug resistance.

Objective To study the characteristics of its pathologic and neurophysiologic changes of a ani-mal model of cervical spinal cord compression, and to explore the relationship between the severity of spinal cord inju-ry and its functions. Methods Thirty-two rabbits were divided into 4 groups randomly. A catheter was inserted intothe vertebral canal and a balloon was inflated to compress spinal cord in epidural space. According to the diameter ofballoon, the animals were divided into 4 groups (A, B, C, D group), Each group consisted of 8 rabbits. The corti-cal somatosensory evoked potential (CSEP) and motor evoked potential (MEP) were used to assess neurologicalfunction. Motor function behavior was scored before and on 1, 3, 7 and 14 days after surgery. Histological observa-tions were performed, pathological changes were observed by light and electron microscope. Results Spinal cordcompression resulted in a gradual increase of the peak latency and significant decrease of the peak amplitude. The la-tency and amplitude of MEP were changed more dramatically than those of CSEP. The result indicated that MEP wasmore sensitive than CSEP to the compression. Analysis also revealed that the severer the pathologic changes, the lon-ger the latency and the lower the amplitude of the evoked potentials. Conclusion The animal model presented inthis paper was simple and standardized. Evoked potentials as a noninvasive technique have great value in monitoringspinal cord function. The variance of amplitude and the latency in significantly correlate with the degree of compres-sion of the spinal cord.

Objective To study the effects of controlled hypotension with sevoflurane on hymo-dynamics and cerebral metabolic rate of oxygen in neurosurgery.Methods Thirty-seven ASA Ⅰ or Ⅱpatients undergoing elective intracranial surgery were enrolled.The patients were treated with general anesthesia and assigned to two experimental groups,sevoflurane group (group S,n=20)and sodium nitroprusside group (group N,n=1 7).HR,BP,SpO2 and ECG were continuously monitored during operation.Blood samples were taken from radial artery and internal jugular bulb to determine cerebral arteriovenous oxygen differences (Da-jvO2 ) and cerebral metabolic rate of oxygen (CMRO2 ). Results The HR in group S were decreased during hypotension,5 min,10 min,20 min,and 30 min compared with group N (P <0.05).Da-jvO2 and CMRO2 both in two groups were decreased during hypotension(P < 0.05 ),but there was no difference between the two groups.RPP was lower in group S than in group N during hypotension.Conclusion Controlled hypotension with sevoflurane does not increase HR and improves cerebral blood flow-metabolism coupling.

Objective To evaluate the effect of training for therapists based on Kirkpatrick's Four-level Model. Methods Totally 39 ther-apists who completed 2014 Beijing Clinical Shortage of Manpower Training Programs (Therapist) were investigated with Kirkpatrick's Four-level Model, named reaction, learning, behavior and results. Results For reaction level, the total satisfaction was high, but different with the degree of education, especially in the items of Participate in Training, Type of Cases, Organizing on Practice Training, Organizing Case Discussions and Get A Lot of Benefits from the Training (F>4.59, P<0.05). For learning level, the test scores were significantly differ-ent before and after the training (t>9.53, P<0.001). For behavior level, the self-reports of the therapists, and the reports from their depart-ment directors and colleagues all agreed that their ability improved after training (t>4.44, P<0.001). For results level, eleven therapists passed the rehabilitation therapist test, two therapists participated in some researches, and one published an article. Conclusion The thera-pists satisfied in the training, that may improve the ability of therapists to contribute to their organization.

Chronic Disease ; Female ; Humans ; Lead Poisoning ; complications ; Middle Aged ; Occupational Diseases ; Renal Insufficiency ; chemically induced

Objective To analyze the long-term results of fractionated stereotactie radiotherapy(FSRT)for the local residual lesion after the first course of radiotherapy for nasopharyngeal carcinoma.Methods From July 1997 to July 2002,46 patients were treated with FSRT.According to the 1992 Fuzhou staging system,the number of patients was 1,6,30 and 9 with stage Ⅰ,Ⅱ,Ⅲ and Ⅳ disease,respectirely;3,11,27 and 5 with T1,T2,T3 and T4 tumor,respectively;14,16,12 and 4 with N0,N1,N2and N3 disease.Radiotherapy was delivered to tumors with the total of dose 68-70 Gy in 7-8w.Chemotherapy(2 cycles of PVF or POF)was given to the patients with stage Ⅲ and Ⅳ a disease.FSRT was given to the residual disease with the total dose of 18-24 Gy in 3 fractions with an interval of 3-7 days.The reference dose line was 70%-90%.Resuits CR and PR rates in this group were 61%and 39%,respectively.The overall survival rates of each year from 1- to 5-year were 100%,87%,83%,78%and 76%.The 1-,3- and 5-year disease-free survival rates were 100%,93%and 89%;The distant metastasis-free survival rates were 100%,85%and 79%;The local-regional control survival rates were 100%,94%and 91%.Seventeen patients who died during the follow-up period were 1 for local cervical lymph node recurrence,2 for fatal nasopharyngeal hemorrhage,4 for local nasopharynx recurrence,and 10 for distance metastases. Conclusions Fraetionated stereotactic radiotherapy is safe and effective for the patients with residual lesion of nasopharyngeal carcinoma at the primary site after radiotherapy.The optimized fractionation and total dose requires the further investigation.