Objective Changes of thyroid stimulating antibody(TSAb) and thyroid stimulating blocking antibody(TSBAb) in the treatment of anti-thyroid drugs(ATDs), and the effect of ATDs combining with levothyrocine(LT4) on TSAb and TSBAb were analyzed. Methods Using recombinant Trxfus. TSHRn protein and Trxfus. TSHRc protein as antigens, and TSH receptor antibody(TRAb)-N(TSAb binding hot spots), TRAb-C(TSBAb binding hot spots)in the serum of thyroid disease patients were measured with ELISA. The changes of TRAb-N, TRAb-C over 36 months in 117 TRAb-N positive Graves′ patients with hyperthyroidism were analyzed retrospectively. In the course of treatment, 41 cases as A group with ATDs and LT4 treatment, 76 cases as B group with only ATDs, The changes of TRAb-N and TRAb-C were observed in the two groups. Results (1)According to the change of TRAb-N, 117 TRAb-N positive Graves′ patients with hyperthyroidism were different. In group Ⅰ, 10 patients continued to have persistently positive TSAb and continued to have hyperthyroidism, remission rate 0%. In group Ⅱ, 17 patients showed complicated TRAb-N changes, 12 of 17 patients got relapse, 5 of 17 patients got remission, remission rate 29.4%. And in group Ⅲ, with TRAb-N dropping gradually, 15 of 89 patients got relapse, 74 of the 89 patients got remission, remission rate 83.1%. Three groups were significantly different with x2 test(P<0.01). One of the 117 TRAb-N positive Graves′ patients with hyperthyroidism developed TRAb-C positive hypothyroidism. (2)According to combining with and without LT4 during the treatment of ATDs,the patients were divided into 2 groups(Group A: ATDs combined with LT4; Group B: only ATDs). These 2 groups were significantly different in TRAb-N at baseline and 3 months(P<0.01), TRAb-C between two groups were not significantly different in all times(P>0.05). Conclusion TSAb and TSBAb can be used to document TRAb-function, which is significant for us to predict the changes of thyroid function. During ATDs treatment, the temporary early low-dose application of LT4 did not significantly affect TSAb and TSBAb.

Objective To select and express a human thyrotrophin receptor antibody (TRAb) Fab fragment from phage antibody library constructed with phage display technology. Methods With immobilized antigen, the reconstructed humanized TRAb Fab library was enriched by five rounds panning (adsorption-elution-amplification). The TSAb Fab and TBAb Fab fragment were selected by coated fusion proteins of hTSHRn and hTSHRc. The positive clones were identified and selected by Phage-ELISA. TRAb positive clones were identified by PCR and double restriction enzyme digestion. The soluble TRAb (TSAb, TBAb) Fab fragments were expressed. TRAb (TSAb, TBAb) Fab fragments were identified by Western blotting assay. The DNA fragment was sequenced from the positive clones. Results Following five rounds of biopanning, TRAb (TSAb,TBAb) Fab phage antibody was screened. The enrichment effect reached to 77 times and 94 times. The soluble TRAb (TSAb,TBAb) Fab antibodies were expressed from positive clones and identified by phage ELISA. Western blotting analysis showed that the phage displaying Fab had significant binding activity with antigens. These sequence analysis showed that all of the heavy chain Fd gene and light chain gene were derived from human immunoglobulin variable region. The light chain variable region of the monoclonal 48 was homologous to the immunoglobulin light chain Vλ homology of 94.4%, and the heavy chain variable region of the monoclonal 48 was homologous to the immunoglobulin heavy Fd chain VH4 homology of 88.9%. The light chain variable region of the monoclonal 56 was homologous to the immunoglobulin light chain Vλ homology of 95.6%, and the heavy chain variable region of the monoclonal 56 was homologous to the immunoglobulin heavy Fd chain VH3 homology of 84.6%. Conclusion We have successfully selected TRAb (TSAb, TBAb) Fab fragment from a human phage display immune antibody library.

Objective:To study on the mechanism of Chinese medicine in treatment of systematic lupus erythematosus(SLE)and to observe long-term therapeutic effect of Chinese medicine on damage of organs in SLE.Methods:51 cases in-patients and out-patients of SLE from 1999 to 2003 were randomly divided into a treatment group treated with integrated Chinese medicine and western medicine and a control group treated with simple western medicine.Serum intracellular adhesion molecule-1(ICAM-1),adhesion molecule-3(ICAM-3),P-selectin and SLE injury index(SLICC/ACRDI)before and after treatment were observed.Results: ICAM-1,ICAM-3 and P-selectin in the patient of SLE were significantly increased as compared with those in normal persons. After treatment,ICAM-1 and P-seleetin in the treatment group decreased significantly as compared with those control group.The cumulative score of SLE injury index in treatment group was more stable and increased significantly in control group compared with that before treatment.Conclusion:The integrated treatment of Chinese medicine and western medicine with Yangyin Qingre Decoction has significant inhibiting action on the high expression of serum adhension molecule and has significant protective and repairing actions on the injury of organs in the patient of SLE.

OBJECTIVE: To explore the application of the Dexmedetomidine utend drug induced sleep endoscopy. METHOD: Forty-four OSAHS patients diagnosed by PSG randomly were divided into group A (Dexmedetomidine group) and group B (Propofol group), each group of 22 cases. Group A: pump the Dexmedetomidine (1 microg/kg) over 15 minutes. Once the patient reached a satisfactory level of sedation, the electronic nasopharyngoscope was introduced into the nasal cavity group B: the propofol (2 mg/kg) was intravenous injected, use the same exmination after the object patients falling asleep. If not, double the injection dose of the two group. Observe and record the patient vital signs, EEG and sleep time, and handle the complications. RESULT: The study was successfully completed both in group A and B. Mean arterial pressure (MAP) in group B was lower than group A during the examination significantly (P < 0.05). The time falling to sleep in two groups were (13.4 +/- 2.5) min and (6.6 +/- 1.2) min, and the time in group A was much longer than that in group B. The lowest oxygen saturation during the examination in two groups were 0.835 +/- 0.096 and 0.691 +/- 0.095, and the difference was statistically significant. There was no incidence of adverse reactions in two groups. CONCLUSION Compared with propofol, Dexmedetomidine is a safer sleep-inducing drug, and it can be used for clinical sleep endoscopy.
Adult ; Dexmedetomidine ; therapeutic use ; Endoscopy ; Feasibility Studies ; Female ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Male ; Middle Aged ; Propofol ; therapeutic use ; Sleep

OBJECTIVE: This study was designed to develop a rating scale of quality of life (QOL) which fits laryngeal cancer patients after laryngectomy. METHOD: The item pool was developed on the definition of QOL from WHO and the principles and procedures of ddveloping a rating scale. Five methods had been used in the item selection including, such as subjective evaluation methods, discrete tendency, correlation coefficient method, stepwise regression analysis, and factor analysis. The survey was conducted in 126 laryngeal cancer patients after laryngectomy in order to assess the reliability and validity of the rating scale. RESULT: (1) A rating scale of QOL which fits laryngeal cancer patients after laryngectomy including six domains and 27 items is was developed. (2) The split-half reliability coefficient of the scale is 0.802, and the Cronbach' α coefficient is 0.794. (3) It is inferred from the correlation analysis that there are strong correlation between items and their own domains; conversely there are weak correlation between items and other domains. Correlation coefficient is 0.731 between total score and self-rating score. CONCLUSION The reliability and validity of the rating scale is proved to work well.
Aged ; Factor Analysis, Statistical ; Female ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Male ; Middle Aged ; Postoperative Period ; Quality of Life ; Regression Analysis ; Reproducibility of Results

Objective To investigate the iodine nutritional status of the crowd that did not participate in the iodine deficiency disorders (IDD) survey in iodine deficiency areas in Jiangsu Province so as to provide a basis for prevention and control of IDD.Methods Eight to ten years old children were chosen from the counties(cities,districts) of Jiangsu Province that did not participate in the IDD survey and urine samples of students and salt samples of their families were researched.In each county (city,district) one township (street) was selected according to 5 directions of east,south,west,north,center; in each township one primary school was selected and in each primary school 20 children aged 8-10 were chosen half of the male and female,to collect their urine samples and salt samples at their families.Urinary iodine was measured using arsenic cerium catalytic spectrophotometric method (WS/T 107-2006),and salt iodine was measured using direct titration of universal test method in salt industry (GB/T 13025.7-1999).Iodine nutrition criterion of international health organization recommended staindard:children urinary iodine ＜ 100 μg/L as iodine deficiency,100-199 μg/L as iodine appropriate,200-299 μg/L as iodine more than appropriate,≥ 300 μg/L as iodine excess.Results A total of 7 523 urinary samples of 8-10 years old children were collected from 76 iodine deficiency counties (cities,districts),and the median of urinary iodine was 235.0 μg/L.In all investigated counties (cities,districts),the medians of urinary iodine of 22 counties(cities,districts) were 100-199 μg/L,42 counties(cities,districts) were 200-299 μg/L,and 12 counties (cities,districts) were ≥300 μg/L.A total of 7 523 salt samples were collected,and the median of salt iodine was 29.68 mg/kg; Taizhou City had the highest salt iodine median,which was 31.43 mg/kg; and Lianyungang City,the lowest,25.11 mg/kg.The coverage rate of iodized salt was 98.6％(7 417/7 523); iodized salt qualification rate was 98.6％ (7 312/7 417); and consuming rate of qualified iodized salt was 97.2％(7 312/7 523) in 76 iodine deficiency counties (cities,districts).Conclusions The progress in prevention and control of IDD in iodine-deficient areas that did not participate in IDD survey in the past is good in Jiangsu Province; the overall level of iodine nutrition of whole population is adequate.But the median of urinary iodine in some counties (cities,districts) is at a higher level.

ObjectiveTo observe the changes in TSH receptor antibody (TRAb) and soluble intercellular adhesion molecule-1 ( sICAM-1 ) levels after treatment of propylthiouracil ( PTU ) and methimazole( MMI ) in patients with Graves' disease (GD). MethodsOne hundred and six cases of clinically diagnosed patients with GD were divided into PTU and MMI groups( each group, n =53 ). The patients in two groups were regularly followed for 36 months. TRAb and sICAM-1 were measured with ELISA method. Results( 1 ) The general data of two groups were not significantly different before treatment( all P＞0. 05 ). ( 2 ) There was no difference in TRAb positive rates between two groups before treatment. The clinical remission rates between PTU and MMI groups showed no difference (83.02％ vs88.68％ ). The cure rate was higher in MMI group than in PTU group( 58.49％ vs 37.74％, P＜ 0. 05 ). (3) There existed significant differences in TRAb levels determined before and 6, 12, 24,30, and 36 months after treatment( all P＜0. 01 ), being gradually decreased with time( F=275.48 ,P＜0.01 ). TRAb levels between two groups were significantly different( F=5.86, P＜0. 05 ). (4) sICAM-1 levels at 36 months after treatment compared with the baseline in both groups were statistically different (P＜0. 01 ), but no difference was found between two groups.ConclusionsBoth PTU and MMI improve the immune status of patients with GD,and the immunosuppressive effect of methimazole is more evident.

Objective To establish radioiodine therapy in nonthyroid tumor and to investigate 131Ⅰ treatment effect on xenografted ovarian cancer. Methods Based on previous test, xenografted ovarian cancer nude model were established in nude mice. The effects of radioactive isotope 99m TcO-4 imaging and radioiodine 131Ⅰ treatment on xenografted ovarian cancer in vivo were investigated. Results After transferring human sodium/iodide symporter (hNIS) gene, the xenografted ovarian cancer in nude mice was imaged by isotope 99m TcO-4 Moreover,131Ⅰ exerted inhibitory effect on the proliferative activity. Conclusion After the transfection of hNIS gene, 131Ⅰ has inhibitory effect on proliferative activity of xenografted ovarian cancer.

Objective Using recombinant TrxTSHRc protein which contains TSBAb antigen epitope as antigen, an enzyme linked immunosorbent assay (ELISA) was established. The cut-off of positive values of TSH receptor antibody (TRAb) was established. Methods Using recombinant TrxTSHRc protein as antigen, the optimum condition was determined, and the indirect ELISA for detecting TRAb (TRAb-C) in the serum of normal control subjects and thyroid disease patients was established. A total of 1 085 patients and healthy controls were tested for this antibody. Results TRAb-C ELISA mainly detected TSBAb. The A405((-x)±s) value in healthy group was 0. 319±0. 107 with a cut-off value ((-x)±2 s)of 0. 533. The positive rate in thyroid disease patients showed significant deviation, with 66. 01 % in patients with Hashimoto's thyroiditis, 41.68% in newly-diagnosed Graves'disease, 6.98% in simple goiter, 11.1% in subacute thyroiditis, 8.7% in nontoxic thyroid nodular goiter, and 3.2% in thyroid adenoma. Conclusion The TRAb-C ELISA mainly detects TSBAb, which is very valuable for autoimmune thyroid disease, especially for the diagnosis, prognosis and therapy evaluation in Hashimoto' s thyroiditis.

Objective To analyze the clinical significance and correlation factors influencing the serum levels of CA125 and CA199 in patients with chronic nephropathy.Methods Clinical data of 649 hospitalized patients with chronic nephropathy from Jan.to Dec.in 2007 were retrospectively analyzed.The criteria of enrolment were: patients with chronic nephropathy aged below 70 years,tumor excluded by CT and ultrasound,and virus hepatitis and tuberculosis excluded by microbiological examinations.The serum levels of CA125,CA199,albumin,total cholesterol(TC),triglyceride(TG),24h urine protein and urine creatinine(Cr) were determined.The patients were divided into CA125/CA199 positive group and negative group according to the cutoff value of serum CA125 and CA199,and the clinical differences were analyzed by t or ?2 test.The correlation factors influencing the serum levels of CA125 and CA199 were analyzed by multiplicity.Results The ratio of female,nephrotic syndrome(NS),membranous nephropathy(MN) and hydrops of serous cavity were significantly higher in CA125/CA199 negative group than that in positive group(P