Objective To explore causes and solutions of false estimates of elevated serum creatinine in patients with Walden‐strom′s macroglobulinemia throug wet chemical enzymatic method .Methods 5 cases of patients hospitalized in the Bethune Inter‐national Peace Hospital were enrolled as subjects from 2010 to 2012 .The large molecular proteins were removal from serum sam‐ples collected from patients with Waldenstrom′s macroglobulinemia by using centrifugal ultrafiltration tube .The serum creatinine levels were detected through using the wet chemical enzymatic method ,wet chemical picric acid method and dry chemical enzymatic method before and after ultrafiltration ,and data were compared .Results Before ultrafiltration ,the levels of serum creatinine of 2 cases of patients with Waldenstrom′s macroglobulinemia detected by using wet chemical enzymatic method differed with those de‐tected by using wet chemical picric acid method and dry chemical enzymatic method .While there were no obvious differences be‐tween levels of serum creatinine detected by wet chemical picric acid method and dry chemical enzymatic method .While ,after ultra‐filtration ,no obvious differences were founded in levels of serum creatinine detected by the thress methods .Conclusion The large molecular proteins should be eliminated when using the wet chemical enzymatic method in the detection of serum creatinine levels , in order to avoid abnormal increase .And the wet chemical picric acid method and dry chemical enzymatic method could also be uti‐lized to determine the accuracy ,and provide reliable determination results .

Objective To clone and express the Tp0453 antigen immuno-dominant epitope fragment of Treponema pallidum (Tp) in Escherichia coli,in an effort to develop serological tests with increased specificity for the diagnosis of syphilis.Methods The gene encoding Tp0453 recombinant outer membrane protein fragment was amplified by polymerase chain reaction (PCR),and inserted into expression vector pQE30 after T-A cloning,then confirmed by restriction map.The constructed recombinant plasmid pQE30-Tp0453 was transformed to E.coli M15 for expression induced by isopropyl β-D-1-thiogalactopyranoside.The expressed product was identified by Western blot,and purified by Ni2+-NTA agarose column chromatography.A double antigen sandwich enzymelinked immunosorbent assays (ELISA) was established by using the recombinant Tp0453 protein to test sera from 48 patients with positive Treponema pallidum particle agglutination test (TPPA),and 40 negative sera as control.Results The PCR amplicon of the target gene was about 490 bp.The recombinant plasmid pQE30-Tp0453 was correctly constructed and successfully expressed in E.coli M15.The expressed product,with a relative molecular of about 21 000,existed in a form of inclusion body,accounting for about 18％ of total somatic protein,and reached a purity of more than 95％ after purification.Western blot showed specific reaction of the expressed protein with Tp positive serum.The ELISA tests with the 88 clinical samples yielded a sensitivity of 97.9％ (47/48),and specificity of 100.0 ％ (40/40).The consistency of results between the ELISA test and the TPPA test was 98.9 ％ (87/88).Conclusion The expressed Tp0453 fragment has showed good immunoreactivity with serum from patients with syphilis,providing the foundation of further development of serological diagnostic kit with increased specificity for the diagnosis of TP infection.

Objective To understand the empiric antimicrobial use in patients with pyelonephritis in a hospital,and pro-vide reference for clinical rational antimicrobial use.Methods Data of 620 patients with pyelonephritis admitted to the nephrology department of a hospital between January 2011 and September 2014 were collected,application of antimicrobial agents,coincidence between empiric antimicrobial use and antimicrobial susceptibility testing results in patients with different diseases and different ages were analyzed.Results Before antimicrobial susceptibility testing results were reported,620 pa-tients use 625 times of antimicrobial agents,5 of whom used two kinds of antimicrobial agents at the same time,8 varieties in 15 types of antimicrobial agents were involved,the most frequently used antimicrobial agents were third generation ceph-alosporins,cephamycins,and fluoroquinolones.The overall,partial,and non-coincidence rate between antimicrobial use and antimicrobial susceptibility testing results were 64.32%(n=402),8.32%(n=52),and 27.36%(n=171)respective-ly.The overall coincidence rate in patients with acute pyelonephritis was higher than those with chronic pyelonephritis (77.61% [n=357]vs 58.79%[n=97],P <0.05).The overall coincidence rate in patients <50 years old and ≥50 years old were 68.12%(156/229)and 75.25%(298/396)respectively,there was no significant different between two groups (χ2 =2.93,P =0.09).Conclusion The non-coincidence rate between empiric antimicrobial use and antimicrobial suscepti-bility testing results is high,measures needs to be taken to improve the empiric antimicrobials use.

Objective:To investigate the changes in coronal spino-pelvis alignment in patients with developmental dysplasia of the hip (DDH) and effects of total hip arthroplasty on it.Methods:This study included 48 patients (6 males and 42 females) with DDH who underwent total hip arthroplasty from January 2009 to December 2019 at the Department of Orthopaedics, the PLA General Hospital. The average age of patients was 42.81±10.42 years (range, 22 to 61 years), whose follow-up time was 10.31±2.62 months (range, 3 to 18 months). Eleven cases underwent bilateral hip replacements and 37 cases underwent unilateral hip replacements, which included 13 hips in Crowe I, 7 hips in II, 4 hips in III, 35 hips in IV. The coronal spino-pelvic parameters were measured with all patients, including Cobb angle, coronal balance distance (CBD), sacral obliquity (SO), iliac obliquity (IO), hip obliquity (HO), L 5 obliquity (L 5O) and leg length. Results:The interobserver reliability of IO, SO, HO and L 5O in patients with DDH was 0.965, 0.875, 0.912 and 0.934. The interobserver reliability of IO, SO, HO and L 5O was 0.887, 0.889, 0.892 and 0.907. Thirty-three patients diagnosed with DDH had leg length discrepancy, which the incidence was 69% (33/48). The incidence of scoliosis of patients was 58% (28/48). The incidence of pelvic obliquity was 96% (46/48). The preoperative IO was 6.71°±4.62° and the postoperative IO was 3.52°±3.14°, the difference was statistically significant ( t=4.81, P<0.001). The preoperative SO was 6.38°±5.48° and the postoperative SO was 3.72°±3.38°, the difference was statistically significant ( t=3.91, P<0.001). The preoperative HO was 5.32°±5.83° and the postoperative HO was 3.71°±3.62°, the difference had not statistically significant ( t=1.85, P=0.071). The preoperative L 5O was 6.12°±5.46° and the postoperative L 5O was 4.33°±4.71°, the difference had statistically significant ( t=2.15, P=0.037). The preoperative Cobb angle was 11.05°±10.76° and the postoperative Cobb angle was 6.82°±7.76°, which had a statistically difference ( t=4.07, P=0.001). There is no significant difference of preoperative CBD and postoperative CBD, which was 14.22±10.64 mm vs. 13.73±12.58 mm ( t=0.24, P=0.821). Cobb angle was positively correlated with SO and IO ( r=0.61, P<0.001; r=0.57, P<0.001). Conclusion:Causes coronal pelvic obliquity in patients with DDH included leg length discrepancy and hip dislocation. Coronal pelvic obliquity can lead to compensatory scoliosis, which alters the overall coronal spino-pelvic alignment of patients with DDH. However, they can still maintain coronal balance. Total hip arthroplasty could improve the degree of coronal pelvic obliquity significantly and compensatory scoliosis in patients with DDH.

Objective:To assess the effects of a 12-month vitamin D 3 intervention on cognitive function and blood inflammatory cytokines in subjects with Alzheimer's disease(AD). Methods:Two hundred and ten AD patients were randomly divided into the intervention and control groups, with 105 patients in each group.The intervention group received vitamin D 3 800 U/day and the control group received a placebo for 12 months.Repeated-measures analysis of variance was used to evaluate the effects of vitamin D and placebo on cognitive performance and blood inflammatory cytokines at baseline, month 6 and month 12. Results:During the follow-up, serum 25(OH)D 3( F=712.086, P<0.001)and 1, 25(OH) 2D 3( F=372.038, P<0.001)concentrations in the intervention group were significantly higher than those in the control group.Changes in FSIQ, VIQ and PIQ between the groups, between different time points and with interaction between the variables taken into account were statistically significant(all P<0.001). Compared with the control group, interleukin-6(IL-6)( F=341.344, P<0.001)and tumor necrosis factor-α(TNF-α)( F=9.580, P<0.001)levels in the intervention group were significantly decreased, and the ratio of Aβ40 to Aβ42 was increased( F=4.617, P=0.010). There were interaction effects between group and time.Except for intervention effects, the baseline concentration of 25(OH)D 3 was positively correlated with scores of FSIQ( β=0.016, P=0.031)and VIQ( β=0.017, P=0.031). Conclusions:Daily oral vitamin D 3 supplementation(800 U/day)for 12 months may improve cognitive function and change inflammatory cytokines in elderly patients with AD.

Objective To explore the distribution of HIV subtype in newly detected people living with HIV from January to November,2015 in Dehong Dai and Jingpo Autonomous Prefecture,Yunnan province.Methods DNA extraction,reverse transcription polymerase chain reaction (RT-PCR) for gag,env,and pol amplification and amplification product sequencing were conducted by using plasmas of newly detected HIV-infected persons.The subtypes were confirmed by analyzing the sequences of 3 genes.Results A total of 963 HIV infection cases were reported during this period,the HIV subtype was confirmed in 499 cases.Unique recombinant form (URF) was the most common subtype (27.1％,135/499),followed by C (26.7％,133/499),CRF01_AE (19.2％,96/499) and others.URF included 4 kinds of combination,of which combination of subtype B and C was most common.HIV subtype distribution differed between the Chinese HIV infection cases and the Burmese HIV infection cases,the proportion of B and C combination was higher in the Chinese cases.Transmission route was the only factor influencing H1V subtype distribution.Conclusions HIV subtype distribution in Dehong was complex.URF was predominant.The HIV subtype distribution differed between Chinese and Burmese under different transmission route.

Heat shock protein A9 (HSPA9), a member of the heat shock protein family, is a putative receptor for Tembusu virus (TMUV). By using Western blot and co-immunoprecipitation assays, E protein domains I and II were identified as the functional domains that facilitate HSPA9 binding. Twenty-five overlapping peptides covering domain I and domain II sequences were synthesized and analyzed by using an HSPA9 binding assay. Two peptides showed the capability of binding to HSPA9. Dot blot assay of truncated peptides indicated that amino acid residues 19 to 22 and 245 to 252 of E protein constitute the minimal motifs required for TMUV binding to HSPA9. Importantly, peptides harboring those two minimal motifs could effectively inhibit TMUV infection. Our results provide insight into TMUV-receptor interaction, thereby creating opportunities for elucidating the mechanism of TMUV entry.
Blotting, Western ; Heat-Shock Proteins ; Hot Temperature ; Humans ; Immunoprecipitation ; Peptides ; Protein Structure, Tertiary

Based on the neurovascular unit(NVU), neurovascular coupling functions as a barrier to maintain the homeostasis of the microenvironment by regulating the signaling and metabolic activity of nerve cells and capillaries. Widely dispersed across the retina, the NVU is essential to preserving its normal physiological function. A disturbance in retinal neurovascular homeostasis produced by a range of factors can result in a variety of retinal disorders, such as diabetic retinopathy(DR), glaucoma, retinitis pigmentosa(RP)and age-related macular degeneration(ARMD). The retina also has a widespread distribution of brain-derived neurotrophic factor(BDNF), which functions to promote neuron growth and repair damage by binding to its receptor TrkB. In recent years, BDNF was found to play a protective role against damage in the early stage of retinal neurovascular homeostasis imbalance, often known as the neurodegenerative stage. It also helps to reduce the production of pro-angiogenic substances of neurological origin and offers a fresh approach for the early detection and treatment of associated eye disorders.