The recombinant protein drug usually has a short half-life after intravenous (IV) or subcutaneous (SC) administration. The methods of prolonging the half-life of recombinant protein drug in common use are mainly based on three principles: 1 Amplifying the molecule weight of protein drug; 2 Making use of drug balance in the blood; 3 Reducing Immunogenicity. Three methods were focused on: Analog construction, PEGylation and Albumin fusion technology. The characteristics, half-life and immunogenicity problem of their products in the market and under development are summarized.

Objective Based on the Helical Ventricular Myocardial Band (HVMB) theory proposed by Torrent-Guasp,the ventricular myocardial hand extends from the root of the pulmonary artery to the root of the aorta with two helical coils.This new theory is considered as a revolutionary concept for further understanding the global, three-dimensional and functional architecture of the ven- tricular myocardium. No repot had described techniques for disecting HVMB while keepin～ the integrity of the coronmy artery sys- tern. We explored techniques for dissecting HVMB in swine.Methads 33 fresh swine hearts were randomly divided intoll groups, 3 bearts in each. 160% barium sulfate (type I)suspmmion was injected into the coronary artery system. The coronary arteries were li- gated. The strial tissue was removed following puuing the hearts in boiling water then cooling for several hours. The superficial coro- nary vessels and fat tissue around the atrio-ventricular taxi inter-ventricular sulcus we～'e preserved. Some branches of the left anterior descending artery, distal segment, of posterior descending branch, and middle and distal segment of obtuse marginal branches were mu- tilated appropriately. HVMB dissection was completed with fingers in accordnce with Torrent Guasp' s technique. Results A contin- ued bundle of muscle, originated at the root of pulmonary artery and ended at the root of aorta, was unwrapped along the major dire- tion of the cardiac muscle fiber in all of the 33 hearts with spating of the coronary artery. The swine hearts' ventricular myocandium was cumosed of two loops, with basal loop firm the root of the pulmonart artery to the anterior papillary muscle and apical from the beginning of the anterior papillary muscle to the root tithe aorta. Each loop consisted of two segments: the right segment-coincid- ing with the right ventricular free wall and the left segment-coinciding with the basal d the left ventricular free wall. Posterior papillary muscle, which belongs to the descendant segment, denmrcated the border between the descendent and the ascendant of the HVMB's apical loop. Conclusion Although controversies about the theory of the HVMB remain, we have dissected the HVMB in the swine hearts' ventricular myocardium successfully with sparing of the coronary artery systems. This dissection procedure provides technical information for the studies of associated diseases based on the theory of HVMB.

Objective To investigate the necessity of preoperative use of prophylactic antibiotics in percutaneous transluminal angioplasty (PTA) of lower extremity. Methods A total of 86 patients with arteriosclerosis obliterans of lower extremity (101 invalid lower extremities in total) were enrolled in this study. The patients were prospectively and randomly divided into study group (n=41, 51 limbs) and control group (n=45, 50 limbs). The patients in the study group received intravenously prophylactic antibiotics two hours before PTA, while no antibiotic was employed for the patients in the control group. The improvement of symptoms and the occurrence of infection after PTA in the two groups were compared. Results After PTA, fever was seen in 27 patients, including 12 patients of the study group (29.3%) and 15 patients of the control group (33.3%). Elevation of neutrophil count (>70%) was observed in 6 patients (14.7%) of the study group and in 7 patients (15.6%) of the control group, but the difference between the two groups was not statistically significant (P>0.05). Septicemia occurred in one patient in each group, both were aged patients with diabetes. The post-treatment infection rate in the study group and in the control group was 1.96% and 2.00%respectively, the difference between the two groups was not significant (P>0.05). Conclusion There is no significant correlation between the use of prophylactic antibiotics and the infections after PTA of lower extremity. Therefore, the clinical value of using prophylactic antibiotics for patients with high risk of infection needs to be verified by further randomized controlled trials.

Objective To investigate whether terminal QRS distortion on the electrocardiogram in acute inferior myocardial infarction could be as a standard for the infarct-related artery,through comparing to coronary angiography.Methods Fifty-seven patients with acute inferior myocardial infarction were enrolled,among which,the right coronary artery (RCA) occlusion (RCA occlusion group) was present in 29 cases,and left circumflex coronary artery (LCX) occlusion (LCX occlusion group) was in 28 cases.The changes of electrocardiogram was analyzed in 12 hours after the acute episode.Results The incidence of terminal QRS distortion in leads Ⅱ,Ⅲ,aVF in RCA occlusion group was 44.8％(13/29) and 39.3％(11/28)in LCX occlusion group,and there was no significant difference (P ＞ 0.05).The incidence of terminal QRS distortion in leads V4R-V5R in RCA occlusion group was 17.2％(5/29) and 7.1％(2/28) in LCX occlusion group,and there was no significant difference (P ＞ 0.05).The incidence of terminal QRS distortion in leads V7-V9 in RCA occlusion group was 6.9％(2/29),which was lower than that in LCX occlusion group[53.6％(15/28)],and there was significant difference (P ＜ 0.05).For identifying LCX as the infarct-related artery of acute inferior myocardial infarction,the sensitivity,specificity,positive and negative value in terminal QRS distortion in leads V7-V9 were 53.6％ (15/28),93.1％ (27/29),88.2％ (15/17),67.5％ (27/40).The area under curve of terminal QRS distortion in leads V7-V9 in identifying LCX as the infarct-related artery of acute inferior myocardial infarction was 0.733 (95％ CI 0.599-0.868).Conclusion Terminal QRS distortion in leads V7-V9 may be of diagnostic value in identifying the infarct-related artery in acute inferior myocardial infarction.

Objective To investigate the differences between prenatal and postnatal ultrasound findings in isolated ventricular septal defects.Methods Totally 244 cases of isolated ventricular septal defect were retrospectively analyzed and followed in one year after birth.All fetus were divided into the correct group and the error group according to the postnatal results.The size and type of ventricular septal defect and ventricular shunt were assessed and analyzed statistically.Results In all of the 244 cases,correct group included 181 cases and error group included 63 cases.There was no significant difference in the type of defects between two groups (P=0.061);there were significant differences in the size of postpartum defect and the velocity of ventricular shunt between the two groups (both P＜0.05),and no significant difference of the direction of shunt between two groups (P=0.408);there were significant differences in the size of defects between the prenatal and postnatal in correct groups (P＜0.05),but the direction of shunt had no significant difference (P=0.087).Conclusion There is certain detection rate in prenatal diagnosis of isolated ventricular septal defect;anatomical characteristics of defect may affect antenatal examination results.There was significant difference between prenatal and postnatal ultrasound in the same lesion.

Molecular technologies are sensitive, fast, and cheap in the study on microbial ecology. However, these methods do not provide information about morphology, number, and spatial distribution of the microorganisms. In contrast, Fluorescence in situ hybridization (FISH) combines the precision of molecular biology with the visual information from microscope, and permits visualization and identification of individual miciobial cells within their natural habitat. FISH not only allows the detection of slow growing microorganisms, but also of yet-to-be cultured. It is useful for many applications in diagnosis and assessment of the population structure of complex microbial communities, and is a powerful tool for molecular ecology studies in microbiology, In this paper, major techniques and progresses of FTSH were described. Its application in microbial ecology, as well as problems , pitfalls, and perspectives of FISH are discussed.

Purpose To analyze the image quality of brain CT with 256-slice wide detector axial scanning mode,routine axial scanning mode and spiral scanning mode,and to provide a more effective brain CT examination method for patients.Materials and Methods The prospective study was conducted on 90 patients accepting routine brain CT examination,and they were randomly divided into three groups.CT examination with 160 mm axial scanning mode,40 mm axial scanning mode and 40 mm spiral scanning mode were respectively conducted using GE Revolution CT.The scanning condition was adjusted to remain constant radiation dose,and then the image quality was analyzed.CT attenuation of gray and white matter,contrast-to-noise ratio (CNR) of white-gray matter and image noise of the three scanning modes were compared.Subjective scoring on image quality of the three scanning modes was also performed.Results On body lateral cerebral ventricle level,there were no significant difference in CT attenuation of gray and white matter and CNR (P＞0.05).On centrum semiovale level,the CT attenuation of gray matter [(31.71 ± 1.82) HU],white matter [(22.97± 1.50) HU] and CNR 2.05±0.42 of 160 mm axial scanning mode was significantly different from the other two scanning modes (F=26.74,47.16 and 3.85,P＜0.05).On centmm semiovale level,image noise of 160 mm axial scanning mode was lower than the other two kinds of scanning methods (F=6.31,P＜0.05),in the basal ganglia and posterior fossa there were no statistically significant differences in the image noise between the three scanning modes (P＞0.05).The subjective score of the three scanning modes all met the diagnostic requirements,and there was no significant difference (P＞0.05).The effective dose and scanning time of 160 mm axial scanning mode was lower than those of the other two scanning modes,and the X-ray utilization was higher.Conclusion 160 mm wide detector axial scanning mode is more suitable for brain CT scan,and it can be used as the preferred scanning mode in the emergency and among non-cooperative patients.

Objective To compare the similarities and differences of the five detection methods used in the detection of fungi in vaginal secretions,and find the most sensitive、the most specific、the fastest、the most cost effective and the simplest method used in the detection of fungi in vaginal secretions.Methods A total of 442 patients were selected from the Department of Gynecology of Shenzhen OCT Hospital from May 2016 to August 2016.The vaginal secretion of 442 specimens was detected by using the methods of fungi culture、saline and KOH suspension method,Gram stain,Wright''s stain and Vaginitis Multi Test Kit.In these five methods,Fungi culture were using as gold standard to evaluate the specificity,sensitivity,negative predictive value,positive predictive value and accuracy of the other four methods.Results Using the fungus culture method to detect 442 cases of vaginal secretion,we found the positive rate of mycotic infection was 34.8%(154/442).Compared with the fungi culture method,the Specificity of saline and KOH suspension method was 97.9%,the sensitivity was 64.9%,the negative predictive value was 83.9%,the positive predictive value was 94.3% and the accuracy was 86.4%;the Specificity of Gram stain was 96.5%,the Sensitivity was 83.1%,the negative predictive value was 91.4%,the positive predictive value was 92.7% and the accuracy was 91.8%;the Specificity of Vaginitis Multi Test Kit was 84.7%,the Sensitivity was 46.8%,the negative predictive value was 74.8%,the positive predictive value was 62.0% and the accuracy was 71.5%;the Specificity of Wright''s stain was 96.9%,the Sensitivity was 78.6%,the negative predictive value was 89.4%,the positive predictive value was 93.1% and the accuracy was 90.5%.Conclusion Gram stain could be the most sensitive and specific method in the four methods,with highest accuracy,and the the fastest,the most cost effective and the simplest method for the detection of fungi in vaginal secretions.The accuracy of detecting fungi in vaginal secretions could be improved by the combination of Gram stain method in clinical work.

Objective To explore the related factors with plasma neuropeptide Y in 180 normal healthy people by stepwise regression analysis. Methods Right ventricular end-diastolic diameter(RVDD),inter-ventricular septum end-diastolic thickness(IVST),left ventricular end-diastolic diameter(LVDD),left ventricular posterior wall end-diastolic thickness(LVPWT),ejection fraction(EF),strole volume(SV),cardiac output(CO),cadiac output index(CI),stroke volume index(SI) and plasma neuropeptide Y were measured respectively by echocardiography and immunoradioassay in all subjects. In addition,we examined the height,weight,blood pressure,heart rate and subcutaneous fat thickness in every subjects. Results The plasma neuropeptide Y wasn't significant difference in different gender and age(P≥0.05). The plasma neuropeptide Y of healthy population was normal distribution and the 95% of confidence interval 70.27 to 190.61,and 99% of confidence interval was 51.23 to 209.65. Conclusion The EF,height,LVST,diastolic blood pressure,CO,SV and subcutaneous fat thickness were the major related-factors of neuropeptide Y in plasma. The EF and height were negatively correlated with plasma neuropeptide Y,and other five factors were postive correlated with it.

Problem-based learning(PBL)brought many changes in the teaching model of medical education.This article explored the clinical application of PBL combined with picture archiving communicate system(PACS)in medical imaging education.Through comparing the results before and after periodic study,PBL was verified to motivate the students'learning interest.Enthusiasm of autonomic learning and problem analysis ability of students increased evidently,which provided a substantial basis for continued learning.