Transcutaneous immunization(TCI),the topical application of antigen and adjuvant directly onto intact skin,which can safely and effectively elicit systemic and celluar immune responses in mice and humans against a variety of antigens,is a novel method of vaccine delivery.Not only the skin has evolved as a barrier to prevent external agents,including pathogens,from entering the body,but also it has a complex and efficient immune system,which includes Langerhans′ cells and dendritic cells.The skin is an attractive target for vaccine delivery.By targeting the body′s natural defense system,TCI attempts to produce an efficient immune response.All these results highlight the likelihood that TCI will play an important role in vaccine applications in the future.

Objective To investigate changes in the expression of prepro-orexin and orexin receptor-1 ( OX1R) following permanent middle cerebral artery occlusion ( MCAO ) with or without preconditioning through electrical stimulation of the cerebellar fastigial nucleus (FNS). Methods Wistar rats were subjected to permanent MCAO and randomly divided into 5 groups: a sham-operated control group (PO), an FNS preconditioning + shamoperated control group (FNS-PO) , an ischemia group, an FNS preconditioning + ischemia group (FNS-PI) and a cerebellar fastigial nucleus injury + FNS preconditioning + ischemia group (FNL-FNS-PI). Each group was divided into 5 subgroups according to the time at which the animals were sacrificed after the MCAO ( 1, 3, 6, 12 and 24 h).RT-PCR was used to detect expression of OX1R mRNA, and ELISA to measure the levels of orexin-A in the hypothalamus and plasma. Results The immunoreactivity of prepro-orexin decreased significantly in the PI groups, with further decreases over time. At the 12th h after MCAO, the immunoreactivity of prepro-orexin reached a minimum.There were significant differences between the rats in the PO and FNS-PO groups. On the contrary, the immunoreactivity of OX1R increased significantly in the PI groups, with further increases continuing over time, peaking at 12 h after the MCAO. There were significant differences between the PO and FNS-PO groups. In the rats with FNS preconditioning (PI-FNS) , the decrease in prepro-orexin and the increase in OX1R were significantly inhibited compared to the PI subgroups at the 6th and 12th hour. There was no significant difference between the FNL-PIFNS group and the PI group. The expression of OX1R mRNA increased significantly in the PI group, with further increases continuing over time, peaking at 24 hours. The plasma levels of orexin-A were not significantly different among the groups, but the levels of orexin-A in the hypothalamus decreased significantly in the PI and FNL-PI-FNS groups, with further decreases continuing over time. At the 12th h after the MCAO the levels were significantly different compared with the PO and PO-FNS groups. While in the rats with FNS preconditioning (PI-FNS) , the decrease in orexin-A level was reversed and there was no significant difference compared with PO and PO-FNS groups. Conclusions The orexinergic system is altered following cerebral ischaemia. FNS preconditioning may be able to regulate these changes.

Objective To construct a fusion protein that used for treatment of resistance and palindromia in leukemia and studied its biological activity. Methods IL-3 and LP gene fragments were amplified by PCR. After enzymatic digestion and T4 ligation, the fusion gene was cloned into expression vector pAYZ. The product was purified by exchange chromatography and anti-Etag affinity chromatography. IL3-G4SLP fusion protein was analyzed by SDS-PAGE and Western blot. Protein biological activity was detected by FACS. Results The fusion protein was expressed as soluble protein by E.Coli 16C9. The protein expression level was about 1 mg/L, its purity was over 95 %, and the expression level was about 1 mg/L. The fusion protein can combined specificely with CD123 on leukemia stem cells. Conclusion Fusion protein IL-3-G4S-LP can target on leukemia stem cells and maybe as a potential drug used for treatment of resistance and palindromia in leukemia.

Objective To evaluate the value of fetal intelligent navigation echocardiography ( 5D Heart) and Virtual Intelligent Sonographer Assistance ( VIS-Assistance ? ) in the display of key diagnostic elements in basic fetal echocardiographic views . Methods The heart volumes data of 209 normal fetuses were collected and then the offline analysis was conducted . Processing of the built-in VIS-Assistance ? for each diagnosis plane was optimized . The display success rate and image quality difference of diagnosis images and diagnosis elements before and after the VIS-Assistance ? processing as well as the repeatability between observers were analyzed and compared . Results Totally 262 fetal heart volume data were collected from 209 fetuses ,and 231 volume data of 182 cases could be used for the analysis ,with the acquiring success rate of 88 .2% . For the display rate of 8 diagnosis sections of the 231 fetal heart volume data before and after VIS-Assistance ? processing ,abdominal transverse section at stomach level showed no significant difference ,while the other diagnostic sections showed significant differences ( all P < 0 .05) ,and the display rate after the processing was higher than that before the processing . For the image quality scores of diagnosis sections before and after VIS-Assistance ? processing ,abdominal transverse section at stomach level showed no significant differences ,while other diagnostic sections showed significant differences ( all P < 0 .01) ,and the image quality scores after the processing were higher than those before the processing . According to Bland-Altman analysis ,95% credibility interval of the total scores of 8 sections measured by different observers before and after VIS-Assistance ? were ( - 0 .17/ + 0 .18 ) and ( - 0 .17/ + 0 .18 ) , respectively ,6 .06% (14/231) and 3 .89% (9/231) of the points were outside the 95% credibility interval , and the rest had high consistency . Conclusions 5D Heart and VIS-Assistance ? technology can significantly improve the display rate of diagnostic section and image quality of element structures , and has high reliability and repeatability in obtaining fetal cardiac diagnosis sections and displaying fetal elemental diagnostic information .

Objective To evaluate the clinical value of fetal intelligent navigation echocardiography (5D Heart) in the display of key diagnostic elements in basic fetal echocardiographic views.Methods Using volume probe,3D volume datasets of the 209 normal singleton fetuses in the second and third trimesters were acquired from a four-chamber view.After processing the datasets by using 5D Heart,9 cardiac diagnostic planes were acquired and then the image qualities of key diagnosis elements of the heart and great vessels were graded by 3 doctors with different experiences of performing fetal echocardiography.Results Two hundred and sixty-two volume datasets were acquired from 209 normal fetuses,including 53 volume datasets collected when cardiac apex was in different directions,satisfactory datasets failed to be acquired in 27 fetuses because of the maternal obesity,the artifacts of fetal movement,or other influencing factors.Two hundred and thirty-one volume datasets of 182 fetuses could be used for 5D Heart analyzing and displaying,and the displaying rate of 9 standard diagnostic views was up to 88.2％.No significant difference was found when comparing the grading results of one observer in different periods of time,the grading results between two experienced doctors and the grading results among the experienced doctor and one relatively inexperienced doctor (P ＞ 0.05).Conclusions 5D Heart has high reliability and repeatability in obtaining fetal echocardiographic diagnosis views and displaying fetal elemental diagnostic information.

Objective To explore the effect of comprehensive nursing intervention on patients′ pain and quality of life after endoscopic sinus surgery.Methods A total of 136 cases who were treated with nasal endoscopic surgery were chosen according to inclusion criteria from June 2015 to May 2016 in hospital and were randomly divided into control group and observation group. Patients in the control group received conventional nursing after nasal endoscopic surgery,while the observation group received extra comprehensive nursing intervention after nasal endoscopic surgery. Pain of patients,nursing satisfaction on postoperative 1 day,and improvement of top 5 of SNOT-20 of two groups were compared.Results Postoperative pain of two groups was none and mild,and postoperative pain response of the observation group was better than that of the control group (P<0.01). Top 5 signs of SNOT-20 were nasal congestion,need to blow nose,inattention,runny nose and tiredness. Top 5 signs of observation group were improved more compared with control group(P<0.01). The total nursing satisfaction of observation group was better than that of the control group (P<0.01).Conclusions Comprehensive nursing intervention could effectively improve the pain response of patients after nasal endoscopic surgery and elevate quality of life of patients and their satisfaction to medical care and nursing.

Objective:To investigate the prognosis and influencing factors of secondary cytoreductive surgery (SCS) combined with chemotherapy in the treatment of recurrent ovarian cancer.Methods:A total of 102 patients with recurrent ovarian cancer admitted to our hospital from Jun. 2012 to Jun. 2015 were selected and grouped according to treatment methods. 31 patients who received paclitaxel/carboplatin (TC) chemotherapy were included in the control group, and 71 patients who received SCS combined with TC chemotherapy were included in the observation group. Clinical efficacy and 5-year survival outcome of the two groups after treatment, were compared and factors affecting the prognosis of the observation group were analyzed.Results:The total effective rate, 1-year survival rate, 3-year survival rate, and 5-year survival rate of the observation group were significantly higher than those of the control group. The median survival time of the observation group was 52 months and was significantly longer than that of the control group by 17 months ( P<0.05) ; There was no statistical difference between the death group and the survival group in terms of age, pathological type, tissue differentiation, recurrence tumor size, or location of recurrence tumors. The number of patients with FIGO stage IV, more than 3 recurrent tumors, ascites and residual lesion size >1 cm in the death group were significantly larger than those in the survival group. The serum CA125 level of patients in the death group was significantly higher than that in the survival group. Logistic regression analysis showed that the number of recurring tumors>3, with ascites, and residual lesions>1 cm, and high level of CA125 were independent risk factors for death after SCS combined with TC chemotherapy ( P<0.05) . Conclusions:SCS combined with chemotherapy can effectively improve the therapeutic effect, relieve the clinical symptoms, improve the survival rate of patients, and prolong the survival time of patients. The prognosis of SCS combined with chemotherapy is affected by the number of recurrent tumors, the presence or absence of ascites, the size of residual lesions, and CA125 level. The prognosis and survival of patients can be improved by adopting appropriate treatment.

Objective:To analyze the early identification, clinical characteristics, diagnosis and treatment of gestational hypertension crisis combined with adrenal disease.Methods:The clinical data of 23 patients of HCP complicated with adrenal disease admitted from Jul. 2009 to Jul. 2019 were retrospectively studied. The clinical characteristics, imaging characteristics, treatment and clinical transfer were studied.Results:The occurrence of all the 23 cases were acute. Among them, 16 cases had eclampsia combined with Cushing’s syndrome, 4 cases were pregnancy combined with primary aldosteronism (PA) and extreme hypokalemia, and 3 cases had eclampsia combined with pheochromocytoma (PHEO) . After admission, the patients were given symptomatic support treatment for sedation, analgesia, blood pressure control, dehydration, cranial pressure reduction, electrolyte balance and spasmolysis, and patients with severe preeclampsia and preeclampsia terminated their pregnancy in time. After treatment, 3 patients gave live birth, 12 received postpartum surgical treatment and 10 received drug treatment. The clinical symptoms improved and imaging examination suggested the lesions in the brain narrowed and disappeared, except one patient had major cerebral hemorrhage and died of multiple organ failure.Conclusions:In case of HCP and severe hypokalemia, relevant examinations should be improved in combination with symptoms to comprehensively diagnose whether it is complicated with adrenal diseases. The treatment methods and process of HCP with adrenal diseases need to be optimized, so as to judge the timing of termination of pregnancy, and minimize the impact on mother and fetus.

OBJECTIVETo investigate the association between the polymorphisms of [c.-2922(C)2-3 and IVS6+ 18insG] in the NURR1 gene and Parkinson's disease (PD) in a Han population from Sichuan province.

METHODSPCR, allele-specific PCR (AS-PCR) and restriction fragment length polymorphism (RFLP) were used to determine the genotype of each subject.

RESULTSThe two polymorphic sites in 241 PD patients and 236 controls with matched age, gender and ethnicity were analyzed. In the IVS6+ 18insG site, the difference of genotype frequencies of 3G/3G, 3G/2G and 2G/2G was not statistically significant. However, the 3G/2G genotype frequency was significantly higher in the PD with age of onset being < 50 years than that in controls (chi (2)= 6.537, P= 0.011; OR= 1.913, 95%CI: 1.159-3.158). No significant differences were found in allele and genotype frequencies of the c.-2922(C)2-3 site in the promoter region between the PD and controls (P= 0.766).

CONCLUSIONThis study suggested that the IVS6+ 18insG polymorphism may be associated with genetic susceptibility of PD with age of onset being < 50 years and the c.-2922(C)2-3 site in the promoter region may not be a risk factor for PD in authors' patient group.

Adult ; Age of Onset ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Case-Control Studies ; DNA-Binding Proteins ; genetics ; Ethnic Groups ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Nuclear Receptor Subfamily 4, Group A, Member 2 ; Parkinson Disease ; genetics ; pathology ; Polymorphism, Genetic ; Sex Factors ; Transcription Factors ; genetics

OBJECTIVETo investigate the frequencies of three polymorphisms in DJ-1 (g.168-185del; SNP405, refSNP ID:rs3766606 and 293 G/A) and their association with sporadic Parkinson's disease.

METHODSAn association study was performed to determine the genotype of each subject using polymerase chain reaction, restriction fragment length polymorphism and sequence analysis in 192 patients with sporadic Parkinson's disease and 198 healthy controls.

RESULTSIn the g.168-185del locus, the Ins/Ins genotype was common and the frequency of Del allele was very low (0.38%). The SNP of 293G/A was not detected in both groups. In the SNP405 G/T site, the GT genotype frequency was significantly higher in patients with age of onset before 40 years than in controls (18.75% vs 5.54%, P=0.004, OR=6.30 95%CI:1.96-20.18).

CONCLUSIONThe results suggest that the frequencies of the g.168-185del and 293G/A polymorphisms might be different between Chinese and European. The SNP405 GT genotype might be a risk factor for sporadic Parkinson's disease with early age of onset in Sichuan Han population.

Adult ; Age of Onset ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Case-Control Studies ; China ; Female ; Gene Frequency ; Genotype ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; Male ; Middle Aged ; Oncogene Proteins ; genetics ; Parkinson Disease ; genetics ; pathology ; Polymorphism, Genetic ; Protein Deglycase DJ-1