Objective To evaluate the role of rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (ACCP) and anti-keratin antibody (AKA) in patients with rheumatoid arthritis (RA).Methods Serum levels of RF, ACCP and AKA were examined in 82 RA and 56 non-RA patients and their sensitivity and specificity for the diagnosis of RA were exmined. Statistical analysis was performed to test the association between ACCP/AKA and number of tender joints and swollen joints, ESR, CRP, disease activity score (DAS) or Ritchie's articular index (RAI). Results ROC curve was performed for each single auto-antibody and various combinations of any two of the above antibodies. The area under the ROC curve was over 0.5 (P<0.05). The specificity of ACCP and AKA was 91.1% and 92.9% respectively. RF, ACCP and AKA were all sensitive markers for the diagnosis of RA and the sensitivity could be as high as 95.1% when one of these markers was positive. There were statistical differences in the number of swollen joints, ESR and DAS between ACCP positive group and ACCP negative group (P<0.05) and statistical significant difference was observed in tender joint count, swollen joint count, ESR and DAS between AKA positive and negative groups (P<0.05). Conclusion Combined test of ACCP, RF and AKA is useful in routine RA diagnosis.ACCP and AKA may be clinical markers for predicting disease activity and prognosis.

Objective To observe the effects of creatine phosphate sodium on heart function and B -type natriuretic peptide in patients combination with ischemic cardiomyopathy and intractable heart failure .Methods 70 cases of coronary heart disease combined with ischemic cardiomyopathy and intractable heart failure were randomly ( with the random number table ) divided into the control group ( n=33) and the creatine phosphate sodium treatment group (n=37).The control group treated with conventional therapy (digitalis,diuretics,vasodilator,ACEI,et al) ten days;the treatment group with creatine phosphate sodium treatment on the basis of conventional therapy .The symp-tom,sign of the heart failure patients of the two groups before and after treatment were observed .NYHA cardiac func-tional grading were estimated.Echocardiography was used to detect left ventricular end -systolic diameter(LVESD), left ventricular end diastolic diameter ( LVEDD ) and left ventricular ejection fraction ( LVEF ); amino terminal pro brain natriuretic peptide (NT-proBNP) tested by laboratory of the two groups.Drug treatment for 10 days,the chan-ges of the indicators before and after treatment were observed .Results After treatment , compared with the control group[(50.63 ±4.67) mm,(61.30 ±4.58) mm].LVESD,LVEDD of the creatine phosphate sodium treatment [(47.16 ±4.30)mm,(57.92 ±4.30)mm]significantly decreased(t=5.73,4.96,all P<0.01),LVEF[(40.57 ± 4.51)%,(37.63 ±4.53)%]increased significantly(t =5.53,P<0.01).After ten days of treatment levels of NT-proBNP decreased in both two groups [(1 659.±248.18) pg/mL,1 899.3 ±205.45] than before treatment [2 043.46 ±217.04,(2 105.46 ±239.09)pg/mL](t=3.23,3.64,all P<0.05),and the decrease degree of the creatine phosphate sodium treatment group was more obvious than those of the control group (t=4.11,P<0.05). Conclusion Creatine phosphate sodium can improve the cardiac function and left ventricular ejection fraction of ischemic cardiomyopathy and intractable heart failurepatients ,enhance the clinical symptoms of patients .

Objective To investigate the relationship between serum homocysteine (Hcy)and N -terminal brain natriuretic peptide (NT -proBNP)and the severity of coronary artery disease in elderly patients with coronary heart disease (CHD).Methods 129 cases of inpatient with concurrent coronary angiography whose age was over 60 years old were selected as the research object.Serum Hcy and NT proBNP level were detected,and parallel coronary angiography were administrated.Angiography was normal in 24 cases (CONTROL group),while 28 cases were stable angina pectoris(SAP group),non ST segment elevation acute coronary artery comprehensive syndrome group (NSTEACS group)had 47 cases,acute ST segment elevation myocardial infarction group had 30 cases(AMI group).was used to The severity of coronary artery lesions were assessed by Gensini score and the relationship be-tween serum Hcy and NT proBNP levels and coronary angiography in the diagnosis of coronary artery disease severity were analyzed.Results AMI group,the mean serum Hcy and NT proBNP levels[(18.13 ±8.26)μmol/L,(450.45 ± 230.45)pg/mL]were significantly higher than those of NSTEACS group [(16.96 ±9.04)μmol/L,(300.96 ± 170.94)pg/mL],SAP group[(14.35 ±5.31)μmol/L,(130.35 ±85.31)pg/mL]and control group[(10.19 ± 3.18)μmol/L,(65.19 ±40.18)pg/mL](t =5.73、3.64;t =5.53、3.23;t =4.96、3.46;P <0.05).In NSTEACS group,average of Hcy and NT proBNP levels were significantly higher than those of SAP group and control group (t =5.06,3.54;t =4.79,3.25;P <0.05).In SAP group,the average of Hcy and NT proBNP levels were higher than those in the control group (t =5.89,4.23;P <0.05).The levels of serum Hcy and NT -proBNP in patients with cor-onary artery stenosis,double vessel disease and single vessel disease were(16.13 ±7.26)mol/L,(7.29 ±14.35)mol/L, (12.67 ±6.48)pg/mL,(210.45 ±416.45)pg/mL and (160.71 ±140.57)pg/mL,the difference was statistically significant (F =140.25,F =13.15;P <0.05,P <0.01).The levels of serum Hcy and NT -proBNP were signifi-cantly correlated with Gensini score (r =0.342,P <0.05;r =0.962,P <0.01).Conclusion Correlation between serum Hcy,NT -proBNP levels in elderly patients with coronary heart disease and the severity of coronary artery disease and stenosis count is positive.Determining the levels of serum Hcy and NT -proBNP in patients with coronary heart disease and the assessment of the severity of the disease has important clinical significance.

The study aims to develop an LC-MS/MS method for the simultaneous determination of amygdalin and paeoniflorin in urine samples, and to investigate their urinary excretion characteristics in healthy volunteers after intravenous infusion administration of Huoxue-Tongluo lyophilized powder for injection (HTLPI). The urine samples were extracted by methanol, and then separated on a Hedera ODS-2 column with a mobile phase of acetonitrile and 5 mmol · L(-1) ammonium acetate buffer solution containing 0.05% formic acid (20:80). Electrospray ionization source was applied and operated in the positive ion mode using MRM. The method exhibited good linearity over the concentration range of 0.03 -40 µg · mL(-1). The values on both the occasions (intra- and inter-day) were all within 15% at three concentration levels. No matrix effect and carry-over effect were observed. Amygdalin and paeoniflorin were stable in human urine under different storage conditions. Approximately 79.6% of the administered amount of amygdalin was excreted unchanged in urine within 24 h and which was 48.4% for paeoniflorin. The developed LC-MS/MS method can be applied to evaluate the urinary excretion of amygdalin and paeoniflorin.

Objective To explore the personality change in patients with epilepsy during the interictal period and the correlation between clinical features and personality change. Methods One hundred and fifteen patients with idiopathic or cryptogenic epilepsy were chosen as the epileptic group and 42 age- and sex-matched healthy subjects served as controls. All participants were evaluated by Mini Mental Status Examination and Brief Psychiatric Rating Scale to ensure the normality of cognition and mental state.Personality was evaluated by adult version of Eysenck Personality Questionnaire (EPQ)in interictal epilepsy patients and healthy controls.Scores of psychoticism (P),extraversion (E),neuroticism (N) and lie (L)were obtained using computer software. Pearson correlation analysis and logistic regression were used to investigate the scores of EPQ and influential factors.Results P and N scores were significantly elevated in epilepsy patients compared with controls ( P scores:50.48 ± 9.55 vs 46.59 ± 7.28,N scores:51.13 ±12.89 vs 46.83 ± 9.40 ; t =2.374,2.266,both P ＜ 0.05 ),while E scores were significantly decreased (51.74 ± 10.74 vs 60.37 ± 9.84;t =- 4.511,P ＜ 0.01 ).There were no significant differences in L scores.Multivariate analysis showed that disease duration was independently correlated to P scores (β =0.043,P＜0.05),while education was correlated to E scores (β =0.109,P ＜ 0.05 ).There were no significant correlations between personality scores,patient age,gender,age of onset,frequency,seizure type,National Hospital Seizure Severity Scale scores,family history,history of status epilepticus and antiepileptic drugs usage.Conclusions High psychoticism and neuroticism and low cxtraversion scores are correlated to patients with epilepsy during the interictal period.Disease duration is an independent risk factor for psychoticism personality,and education level is an independent risk factor for extraversion personality in epilepsy patients.

Objective:To compare the difference of epileptiform discharges detection in patients with epilepsy between the 25 electrodes electroencephalogram (EEG) system proposed by the International Federation of Clinical Neurophysiology in 2017 and the previous 19 electrodes EEG system.Methods:Patients suspected of epilepsy or with confirmed epilepsy who need a follow-up EEG were collected in Zhongshan Hospital, Fudan University from March 2018 to November 2019, and conventional video-EEG recording was performed on all patients for two hours with the standard 25 electrodes EEG system. Two neurophysiologists reviewed the recordings blindly using the 19 electrodes system and the 25 electrodes system, marking the epileptiform discharges and their amplitudes. Finally, the data were statistically analyzed.Results:A total of 403 patients were included in the study, in which 263 cases were diagnosed as epilepsy, including 129 cases of generalized epilepsy, 115 cases of temporal lobe epilepsy, 13 cases of frontal lobe epilepsy, two cases of parietal lobe epilepsy and four cases of occipital lobe epilepsy. In 115 temporal lobe epilepsy patients, 76 (66.09%) and 100 (86.96%) records were detected epileptiform discharges by the 19 or 25 electrodes EEG system respectively, and the difference was statistically significant (χ2=13.939, P<0.001). While in patients with non-temporal lobe epilepsy, there was not statistically significant difference between the two systems. In 76 patients whose temporal epileptiform discharges were detected by the two systems, the amplitudes of epileptiform discharges in the newly-added inferior temporal electrodes (F9/F10, T9/T10, P9/P10) and the original temporal electrodes (F7/F8, T7/T8, P7/P8) were (61.53±22.64) μV and (48.25±20.90) μV, respectively, with statistically significant difference between the two groups ( t=5.486, P<0.001). In patients with abnormal [79.59% (39/49) vs 61.22% (30/49), χ2=3.967, P=0.046] and normal [95.45% (42/44) vs 70.45% (31/44), χ2=9.724, P=0.003] imaging, the ability of the 25 electrodes EEG system to detect epileptiform discharges was higher than that of the 19 electrodes EEG system. Conclusion:The 25 electrodes EEG system can significantly improve the detection ability of temporal epileptiform discharges in patients with epilepsy, which is recommended for regular use to increase the detection ability of temporal area abnormal wave and assist the diagnosis and treatment of epilepsy.

Objective:To know the work status of clinical pharmacy in medical institutions of Guizhou province. Methods:Ques-tionnaires were used to analyze the situation of clinical pharmacy in 108 medical institutions of Guizhou province. Results: A total of 246 questionnaires were taken back, and among the 231 valid questionnaires were received including gradeⅡor above hospitals. The main contents of clinical pharmacy work carried out in medical institutions included 7 aspects: pharmacists ’ participation in ward rounds, which accounted for 47. 11%; pharmacists’ participation in case consultation, which accounted for 16. 65%; pharmacists’ participation in teaching practice, which accounted for 38. 84%; pharmacists’ participation in prescription evaluation and analysis, which accounted for 72. 73%;pharmacists’ participation in antimicrobial drug monitoring and drug use evaluation, which accounted for 62. 37%;pharmacists’ participation in drug counsultation and education, which accounted for 58. 68%;pharmacists’ participation in adverse drug reaction monitoring and supervision, which accounted for 77. 32%. Conclusion:The development of clinical pharmacy in Guizhou province still lags behind, and the number of clinical pharmacists is insufficient, which can’ t meet the growing demand for personalized medicine. In particular, the development of clinical pharmacy is restricted by the limited pharmaceutical service. The cog-nition degree of pharmacist group in Guizhou province has been improved. However, the number and the service quality of clinical pharmacists need to be improved further.

One yeast strain, which was isolated from 256 natural samples, was found to be able to utilize D-xylose effectively. On the basis of assimilation physiological and molecular biological tests, the yeast strain was identified as a strain of Candida tropicalis. Furthermore, metabolic engineering breeding strategy was applied to change the metabolic flux in order to increase ethanol productivity. In this study, the C. tropicalis was used as the host strain and the plasmid pYX212-XYL2, which was formerly constructed for over expression of XYL2 gene encoding xylitol dehydrogenase (XDH) from Pichia stipitis, was used as the backbone of the recombinant vector. A hygro gene was inserted into downstream position of XYL2 gene, meanwhile, the result plasmid pXY212-XYL2-Hygro transformed into C. tropicalis by electroporation. Thus, a recombinant yeast C. tropicalis XYL2-7 was obtained through hygromycin B resistance screening and its specific XDH activity was 0.5 u/mg protein, which was 3 times more than that of the parent strain. Additionally, the recombinant yeast was applied in the fermentation of xylose. Compared with the parent yeast, it was concluded that the xylitol yield in the broth decreased by 3 times, however, the ethanol yield increased by 5 times. The feasibility of ethanol production from xylose by C. tropicalis was firstly studied in this paper. These research results are helpful to advance the bioconversion of renewable resources (e. g. straw, wheat bran, and husk) to fuel ethanol.
Candida tropicalis ; genetics ; metabolism ; D-Xylulose Reductase ; genetics ; metabolism ; Electroporation ; Ethanol ; metabolism ; Fermentation ; Pichia ; enzymology ; genetics ; Recombination, Genetic ; Xylose ; metabolism

Objective:To explore the correlation between the level of heart rate deceleration (DC), serum homocysteine(Hcy), the scope and extent of coronary artery lesion in coronary heart disease patients with hypertension.Methods:From January 2019 to October 2019, 103 coronary heart disease patients with hypertension who were diagnosed and hospitalized in cardiovascular department of Binzhou Central Hospital were selected as coronary heart disease(CHD) group, and 52 patients with simple hypertension were selected as control group.The serum Hcy levels of the two groups were measured and analyzed.The DC value and the difference of the two groups were analyzed.The degree of coronary artery lesion was evaluated by the number of coronary artery lesion and Gensini score.The relationship between DC, Hcy and the degree of coronary artery lesion was analyzed.Results:Compared with the control group, the DC value of CHD group was significantly lower [(6.02±1.97)ms vs.(4.97±1.59)ms, t=-3.989, P<0.05], and the serum Hcy level was increased [(11.46±4.38)μmol/L vs.(16.79±6.31)μmol/L, t=4.260, P<0.05]. In the CHD group, the DC values and Gensini scores of the patients with single vessel lesion, double vessel lesions and three vessel lesions were (5.52±1.34)ms, (5.06±1.29)ms, (4.39±1.19)ms, (21.35±17.10)points, (26.93±18.18)points, (49.39±30.14)points, respectively.The DC value of patients with three vessel lesions was lower than that of patients with single vessel lesion( F=7.349, P<0.05), and the Gensini score was higher( F=13.487, P<0.05). There were no statistically significant differences in DC value and Gensini score between patients with three vessel lesions and those with two vessel lesions and those with single vessel lesion( P>0.05). The serum Hcy levels of patients with single, double and three vessel lesions were (14.67±5.97)μmol/L, (15.85±6.29)μmol/L and (16.97±7.13)μmol/L, respectively.The difference among the three groups was statistically significant ( F=12.427, P<0.05). There was a negative correlation between DC and Gensini score( r=-0.310, P<0.05), and a positive correlation between serum Hcy and Gensini score( r=0.369, P<0.05). Conclusion:The DC value and Hcy level in coronary heart disease patients with hypertension are significantly decreased, which are closely related to the degree of coronary artery lesion.

OBJECTIVETo compare the prognostic value of different models in patients with early-stage diffuse large B-cell lymphoma (DLBCL).

METHODSEarly-stage DLBCL patients diagnosed from January 2000 to December 2012 were analyzed retrospectively. All patients received with at least 2 cycles of immunochemotherapy R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) with or without radiotherapy. The prognostic value of international prognostic index (IPI) , revised IPI (R-IPI) and enhanced IPI (NCCN-IPI) was compared.

RESULTSNinety-seven cases of early-stage DLBCL were included in the study. The median age was 58 years (15-88 years) with a median follow-up of 34.7 months (range 7.3-77.4 months). The expected 5-year overall survival (OS) for entire group was 82%. There was no patient in the high risk group according to IPI or NCCN-IPI. According to IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 95%, 38% and 60%, respectively. According to R-IPI, the 5-year OS in the very good, good, and poor risk groups were 93%, 75% and 60%, respectively. According to NCCN-IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 92%, 85% and 29%, respectively.

CONCLUSIONNCCN-IPI would be of an ideal prognostic model for early-stage DLBCL patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Murine-Derived ; Antineoplastic Combined Chemotherapy Protocols ; Cyclophosphamide ; Doxorubicin ; Humans ; Immunotherapy ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; Middle Aged ; Prednisone ; Prognosis ; Retrospective Studies ; Rituximab ; Vincristine ; Young Adult