Objective To develop a kinetic chromogenic quantitative method for the determination of endotoxin content in intermediate of pertussis antigen,and to verify the method so as to better control the quality of diphtheria,tetanus,and pertussis vaccine(DTP vaccine).Methods A kinetic chromogenic assay[Limulus Amebocyte Lysate(LAL)]was developed to detect the endotoxin content in the intermediate products of pertussis antigens after detoxification,and verified for the linearity,specificity,accuracy,reproducibility and intermediate precision. The quantitative detection results of kinetic chromogenic assay were compared with those of gel method.Results The absolute value of the linear correlation coefficient（|r|）of the kinetic chromogenic assay was more than 0. 99;under the maximum effective multiple dilution,the interference test recovery of the intermediate was within 50% — 200%,and pertussis toxin(PT)diluted to 10,100 and 1 000 times,filamentous hemagglutinin(FHA)diluted to 3 000,5 000 and 10 000 times,and pertussis adhesin(PRN)diluted to 50,75 and 100 times had no interference effect on the experiment after detoxification;the accuracy verification recovery rates of PT,FHA and PRN were 125%,110% and 99% respectively;and the CVs of reproducibility verification were 7. 21%,8. 31% and 5. 84%,and the CVs of intermediate precision verification were 6. 04%,16. 29% and 12. 23%,respectively.The bacterial endotoxin content of the three batches of pertussis antigen intermediates detected by kinetic chromogenic assay was consistent with that verified by gel method,both of which were less than the limit of bacterial endotoxin in the intermediates of pertussis antigen after detoxification.Conclusion The developed kinetic chromogenic assay has good linearity,specificity,accuracy and precision with accurate detection results,which can be used to detect the endotoxin content in intermediate products of component pertussis antigen after detoxification.

Objective: Intelligent monitoring system of medical equipment can realize the intelligent dynamic management to equipment in the hospital wireless or wired network environment. Methods: Use of communication network, intelligent call, system monitoring and other means of science and technology to design the intelligent micro device state sensor. Results:System is mainly for hospital equipment, which can capture and management of medical equipment data. When the elderly have abnormal condition, it can send information through intelligent system, through identification and location, to realize the construction of equipment state information. Conclusion: Intelligent sensor in the system application can achieve the sharing of resources; realize the whole hand or full coverage of the intelligent health network system, providing an effective guarantee for the health of the masses.

Objective To determine the value of 18F-FDG PET-CT in detecting the primary origin of cancer of unknown primary (CUP).Methods A total of 48 patients (age range 41-82 years,mean age of 57±16 years, 20 females) were retrospectively selected. All patients were diagnosed as CUP and were examined by 18F-FDG PET-CT scan.The patients were divided into cervical lymph node metastasis group (28 cases) and extra-cervical lymph node metastasis group (20 cases) according to different metastasis site.Sensitivity of 18F-FDG PET-CT to detect primary tumor site was compared between these two groups.Results 18F-FDG PET-CT detected primary tumors in 32 of 48 patients (66.7 ％), the cervical lymph node metastasis tumors in 22 of 28 patients (78.6 ％), and extra-cervical lymph node metastasis tumors in 10 of 20 patients (50.0 ％).There was significant difference between cervical lymph node metastasis group and extra-cervical lymph node metastasis group (x2 =4.286,P ＜ 0.05).Conclusion 18F-FDG PET-CT has a high sensitivity to detect primary origin of CUP,especially for patients with cervical lymph node metastasis.

Forty rats were randomly divided into four groups and intraperitoneal injection of 1%lidocaine 400mg/kg (group Ⅰ)、1%lidocaine-?-cyclodextrin 400mg/kg (group Ⅱ)、1%alkalinized lidocaine 400mg/kg(group Ⅰ)and 1% alkalinized lidocaine-?-cyclodextrin 400mg/kg(group Ⅳ) respectively. The results showed that there was a significant difference of lethal time between group Ⅰ and Ⅱ, and no significant difference between gronp Ⅲ and Ⅳ; the times of toxic and lethal effects of group Ⅲ and Ⅳ were shortened markedly as compared to group Ⅰ and Ⅱ. It is concluded that ?-cyclodextrin can postpone the release and absorbance of lidocaine,and alkalizer can weaken this action of ?—cyclodextrin.

Subcutaneous insulin resistance is a condition in which glucose is insensitive to insulin from the subcutaneous tissue,but sensitive to that by intravenous injection.The mechanism of subcutaneous insulin resistance is mainly associated with skin obstruction or delayed entry of insulin into blood circulation.The treatment of the problem involves Aprotinin,anticoagulant and intramuscular injection of insulin.This paper offers an overview of the advances in the researches of subcutaneous insulin resistance.

Diabetic cardiovascular autonomic neuropathy is the most common and troublesome complication of diabetes mellitus.Diabetic cardiovascular autonomic neuropathy contributes greatly to the morbidity,mortality.Factors in the pathogenesis of these complications are altered metabolism,vascular insufficiency,loss of growth factor trophism,and autoimmune destruction of nerves in a visceral and cutaneous distribution.There are studies in progress that suggest cardiovascular autonomic nerves can be induced to regenerate,and the future for patients with diabetic cardiovascular autonomic neuropathy is brighter.

Diabetic retinopathy is a highly specific vascular complication of both type 1 and type 2 diabetes.NF-?B can be triggered by oxidative stress and controls several programs of gene expression,the majority of which participate in the host inflammation and immune response.Evidence has accumulated that NF-?B is involved in the development of diabetic retinopathy.NF-?B activation induced by diabetes is associated with the apoptosis found in the pericyte,leukocyte-endothelial interaction,capillary basement membrane thickening,neovascularization and formation of epiretinal membranes.Inhibition of(NF-?B) activation has been suggested as a treatment strategy in diabetic retinopathy.

Objective: To study the status and identify the determinants of outpatient service utilization of rural floating population in Beijing who have different accumulated residence time.Methods: The survey data of rural floating population health and health care services in Beijing in 2014 were used, and the migrant population aged 18 years and above were taken as the research object.Whether to use outpatient service within two weeks was taken as dependent variable, gender, age, education level, self-assessment score of socioeconomic status, accumulated residence time in Beijing, health insurance, average household income, suffering from high blood pressure or diabetes as independent variables.Logistic regression model was used to analyze the influencing factors.Results: The average age of the research object was 36.7 years, with mostly secondary education.The average accumulated residence time in Beijing was 8.4 years.The two-week prevalence rate was 10.3%, the two-week visiting rate calculated by person-time was 6.0%.The Logistic regression model suggested that, socioeconomic status, accumulated residence time and suffering from high blood pressure or diabetes were statistically significant determinants of outpatient service utilization.Conclusion: The research object is a younger and less educated population, their health status is better and outpatient service utilization is lower.It is found that people who have longer accumulated residence time in Beijing have lower outpatient service utilization.This is because people with longer residence time have lower age-adjusted two-week prevalence rate.This is also because people with longer residence time have larger proportion of taking continuous measures under doctor's advice.It does not mean people with longer residence time have lower utilization of medical service.The residence time variable plays the role of proxy variable.It can solve the problem of variables' endoge-neity.At the same time, it can reflect the influence to outpatient services utilization of some determinants,which are not included in the model but varies with residence time.

Objective: Thyroid nodules are common clinical thyroid disorders.The purpose of this study was to investigate the diagnostic value of the clinical characteristics and various parameters of malignant thyroid nodules and the sensitive indexes for their differentiation so as to improve the diagnosis of malignant thyroid nodules and avoid unnecessary procedures or operations.Methods: We retrospectively studied 600 cases of thyroid nodules treated by surgery from 2001 to 2008,divided them into a benign and a malignant group according to the pathological results,and analyzed by multivariate logistic regression the correlation between the nature of thyroid nodules and various factors.Results: Of the 600 cases of thyroid nodules,519(83.47%) were benign and 81(16.53%) were malignant.Clinical symptoms and signs,ultrasonography and CT were all useful in indicating malignancy,especially ultrasonography,whose specificity and diagnostic accuracy were 93.3% and 84.2%,respectively.Multivariate logistic regression analysis revealed a higher rate of malignancy in younger patients with solid or hard nodules,or accompanied with calcification or painless adenophyma in the neck.Conclusion: Clinical symptoms and signs,ultrosonography and CT are of significant value in the diagnosis of malignant thyroid nodules.

Objectives To explore the clinical effect of external fixator combined antibiotic-calcium sulfate packing medullary cavity, VSD continuous drain with negative pressure and local skin flap transposition for the treatment of postoperative infected nonunion after initial debridement. Methods 20 cases of traumatic osteomyelitis from August 2012 to August 2014 were selected and taken antibiotic-calcium sulfate to focal zone. The patients were taken first-stage bone grafting for small bone defects and osteotomy for lengthening for big bone defects. For patients with cutaneous injury, local skin flap transposition was taken. For other patients with partial flap necrosis and non healing wounds, VSD continuous drain with negative pressure was taken. Results Operative incisions of 12 cases were primary healing, two cases were healing by second intention, four cases of flap were survived after local skin flap transposition, and two cases of flap were partial necrosis and healed by second intention. 11 cases of immobilization with external fixator, bone healing was satisfactory in seven cases after osteotomy for lengthening and two cases of bone delayed union in osteotomy for lengthening and recovered after bone transplantation. All patients were followed up for average 19(6-32) months with permatoplasty survived; all the infection of wounds was controlled and relapse-free. The fracture healing period was eight(4-12) month without pin site infection, osteoporosis and deformed healing. But there were 1 cases of knee stiffness and two cases stiffness of ankle joint. Conclusion After initial debridement, taken external fixator and taken antibiotic-calcium sulfate to medullary cavity and fracture ends. The patients were taken first-stage bone grafting for small bone defects and osteotomy for lengthening for big bone defects. For the skin defect after local flap grafting, taken VSD continuous drain with negative pressure for partial necrosis of flap occurred and non healing wounds cases. The method obtained prominent curative effect, reduces the treatment cycle and reduce the complications in the treatment of postoperative infected nonunion.