Objective To analyze and discuss the clinical value of tuberculosis infection T cell ELISPOT test and tuberculosis antibody test used in bone and joint tuberculosis.Methods The patients with suspected bone and joint TB diagnosed and treated in Xishan people's Hospital of Wuxi City from 2012 to 2014 were selected as the objects of this study.They were taken randomly,which divided into T-SPOT.TB test group and tuberculosis antibody test groups.Each group had 162 per-sons.The patients of T-SPOT.TB test group were tested by tuberculosis infection T cell enzyme-linked immunosorbent spot test,tuberculosis antibody test group were taken tuberculosis antibody test,comparative analysis of the sensitivity and speci-ficity of two diagnostic methods were contrastively analyzed.Results The sensitivity and specificity of T-SPOT.TB test group were 93.43% and 84.00%.The sensitivity and specificity of tuberculosis antibody in the experimental group were 40.44% and 53.85%.There was statistical difference between two groups (χ2 =184.62,7.86,all P <0.05).The false posi-tive rate and the false negative rate of T-SPOT.TB test group were 16.00% and 6.57%.The false positive rate and the false negative rate of tuberculosis antibodies in the experimental group were 26.92% and 59.56%,respectively.There was statis-tical difference between two groups (χ2 =7.86,156.18,all P <0.05).In addition,the positive and negative predictive values of T-SPOT.TB test group were 96.97% and 70.00%.Positive and negative predictive values of tuberculosis antibody in the experimental group were 88.71% and 14.74%.There was statistical difference between two groups (χ2 = 20.27,73.06,all P <0.01).Conclusion Compared to experimental tuberculosis antibody,TB infection of T cells ELISPOT test had high sen-sitivity and specificity in the diagnosis of bone and joint tuberculosis.It’s worthy of spreading.

Objective To discuss the techniques of ureteroscopy in the diagnosis and treatment of ureteral diseases. Methods The authors retrospectively analyzed clinical data ot 92 patients with ureteral diseases undergoing the ureteroscopy. Results The success rate of ureteroscopy was 92 4% (85 of 92). Except for 2 cases with the complications of false urethra, no other complications were seen. Conclusions By the guidance of ureteral catheter, it is a safe and reliable approach to enter the ureteroscope directly or spirally by means of hand-controlled intermittent perfusion dilation. And more stones can be removed by intermittent low-flow perfusion and by the use of ureteral catheter or basket for stone fixation.

Objective To screen an effective method for removing free polysaccharides in polysaccharide-protein conjugate of pneumococcus type 9V(Pn9V),and to optimize the process and verify its stability,so as to use it in the preparation of multivalent conjugate vaccine against pneumococcus.Methods Pn9V-CRM_(197) conjugate was prepared,of which the free polysaccharides were removed by molecular sieve(Sepharose 4FF),ion exchange chromatography(DEAE Sepharose FF),hydrophobic chromatography(GP-Butyl)and ammonium sulfate(AS)salting out. The optimal method was selected by comparing the percentage of free polysaccharides,the recovery rate of polysaccharides and the recovery rate of proteins,and the determined method was optimized for the process. Three batches of conjugates were prepared continuously to verify the stability of the process.Results Both hydrophobic chromatography and ion exchange chromatography reduced the free polysaccharides in Pn9V-CRM197 conjugate to less than 5%. The recovery rates of polysaccharide and protein by hydrophobic chromatography were 34. 7% and 50. 1%,respectively,which were higher than those by ion exchange chromatography(16. 2% and 25. 7%). Hydrophobic chromatography was determined with the optimized process including 1. 1 mol/L AS as the loading buffer,water for injection used for elution,and the conjugate loading of 1. 81 mg protein/mL filler. The free polysaccharide removal rate,polysaccharide recovery rate and protein recovery rate of the conjugates prepared continuously in three batches were good,and the consistency among batches was high. The conjugates had good stability when stored at 2-8 ℃ for 6 months,and the percentage of free polysaccharides increased significantly(F = 5. 83 e~(-32),P = 0. 003)and was more than25% when stored at(25 ± 2)℃ for 6 months,indicating that high temperature storage was not suitable for the conjugates.Conclusion A hydrophobic chromatography process was established to effectively remove free polysaccharides from Pn9V polysaccharide-protein conjugate,which has good stability and provides a reference for the removal of free polysaccharides in other pneumococcal polysaccharide-protein conjugates.

Objective To explore the effect of methylene blue photochemistry(MB-P)viral inactivation treatment on the expression of microRNA(miRNA)in plasma exosomes,in order to provide a new reference for the quality control of MB-P virus inactivated plasma. Methods Whole blood samples of 11 healthy volunteers were collected from July 2021 to April2022. Fresh plasma from the same person was prepared into two parts,fresh frozen plasma(FFP)and MB-P virus inactivated plasma,respectively. The plasma exosomes were isolated by differential centrifugation,and identified by transmission electron microscopy(TEM)and nanoparticle tracking analysis(NTA). Then the expression profiles of miRNA were detected by microarray technique. Furthermore,four differentially expressed miRNA were verified by qRT-PCR,the target genes of differentially expressed miRNA were predicted by bioinformatics methods,and GO function enrichment analysis and KEGG pathway enrichment analysis were performed on the differentially expressed genes. Results The morphological characteristics and diameters of the extracted vesicles of the two groups were consistent with the characteristics of exosomes. Compared with the control group,there were 14 differentially expressed miRNA in plasma exosomes of MB-P group,of which the expression of six miRNA was up-regulated and eight miRNA was down-regulated. The results of qRT-PCR were generally consistent with the expression trend of microarray. The target genes of differentially expressed miRNA were mainly involved in DNA binding,ion binding,catalytic activity and other functions,and participated in a variety of biological processes such as nucleic acid metabolism,biosynthesis,and transcription regulation. In addition,significantly enriched functional pathways were closely related to viral infectious diseases,tumors,PI3K-Akt signaling pathway,MAPK signaling pathway and so on.Conclusion The expression of exosome miRNA in MB-P virus inactivated plasma was different from that in FFP. The plasma exosome miRNA may be used as a potential reference for the quality evaluation of MB-P virus inactivated plasma.

ObjectiveTo investigate the outcomes of mother a nd baby smaller than 37 gestational age caused by preeclampsia. Method sThe data for 122 preterm birth that was single pregnancy with preecla mpsia in our hospital from January 1993 to December 2002 were collected. The pri nciple of diagnosis and treatment, the outcomes were analyzed retrospectively. T he 122 pregnant women were divided into 3 groups according to their gestational age, more than 28 weeks and smaller than 31 +6 weeks was the first group (28 cases), more than 32 weeks and smaller than 33 +6 weeks was the second grou p (26 cases), more than 34 weeks and smaller than 36 +6 weeks was the thir d group (68 cases). The data were statisted with SAS software.Results The earlier the pregnancy-induced hypertension happened, the earlier the preeclampsia occured, the mean time was 14 03 d, 16 85 d,22 22 d, respect ively, (P0.05), the outcomes of mothers were good. Increasing the gestational age under the cond ition that the occurrene of comptications was not increased, 60 64% pregnant wo men accepted the treatment of improving the maturity of fetal lung. There were n o differences among the three groups at the morbidity of perinatal SGA, intracra nial hemorrhage (P 0.05) .ConclusionWe could improve the outcomes of pret erm birth caused by preeclampsia by enhancing the perinatal care, treating and t erminating pregnancy activey Increasing the gestational age, improving the matur ity of fetal lung would decrease the morbidity of severe RDS and improve the pe rinatal outcome effectively.

OBJECTIVE: To prepare crossed-linked sodium hyaluronate (CHA) gel and study its rheological property. METHODS: CHA was prepared using 1, 4-butanediol diglycidyl ether (BDDE). The linear viscoelastic properties and creep recovery of hyalouronan(HA) and CHA were measured with a rheometer. The influencing factors of rheological properties were analyzed, such as concentration, proportion of cross-linker and temperature. RESULTS: Cross-linked sodium hyaluronate gel was prepared. The viscoelasticity was measured with a pair of 20 mm stainless steel plates at the frequency of 1 Hz and shear-strain of 1 Pa at (25±0.1)℃. As shown by the creep recovery test, CHA had a smaller strain and shorter time to recover to the minimum strain than HA, which showed typical linear viscoelastic and creep recovery properties. CONCLUSION: CHA is a non-Newtonian fluid, which is easy to administer and conforms completely to the requirements for viscoelastic supplementation materials for intra-articular injection. Compared with HA, CHA has more advantageous viscoelastic property and stability.

OBJECTIVETo observe the impacts on endometrial and pregnancy outcomes treated with acupuncture and moxibustion in the patients of in vitro fertilization-embryo transfer (IVF-ET) and explore the application value, of acupuncture and moxibustion in IVF-ET treatment.

METHODSOne hundred and fourteen patients of IVF-ET treated with standard long-term program at luteal phase were randomized into an observation group and a control group, 57 cases in each one. In the observation group, at the beginning of ovulatory induction, moxibustion was applied to Shenque (CV 8) and acupuncture was to Zhongji (CV 3), Guanyuan (CV 4), Qihai (CV 6), Zigong (EX-CA 1), Xuebai (SP 10), etc. till the transfer time for one session of treatment. Totally, 3 sessions were required. In the control group, no intervention of acupuncture and moxibustion was applied. The endometrial morphology, subendometrial blood flow index, the levels of serum estradiol (E2), progesterone (P) and luteinizing hormone (LH) on the day of injection of human chorionic gonadotropin (hCG), the dosage and time of gonadotropin (Gn), oocyte count, high-quality embryo number, embryo cultivation rate and clinical pregnant rate were observed in the two groups.

RESULTSThe A type endometrial proportion on hCG day and high-quality embryo rate in the observation group were higher than those in the control group, indicating the significant differences (both P< 0.05). The difference in endometrial thickness on hCG day was not significant between the two groups (P> 0.05). In the observation group, endometrial hemodynamic index (peak systolic blood velocity/end-diastolic blood velocity, S/D), resistive index (RI) and pulse index (PI) were lower than those in the control group (P<0. 01, P<0. 05). The levels of serum E2 and P on hCG day in the observation group were higher than those in the control group (both P<0. 05). The differences were not significant in Gn dose, Gn medication time, numbers of follicles >1. 6 cm on hCG day, oocyte count, embryo cultivation rate and clinical pregnancy rate and LH level on hCG day between the two groups (all P>0. 05).

CONCLUSIONIn IVF-ET treatment, acupuncture and moxibustion affect estrogen level on hCG day, improve high-quality embryo rate, endometrial blood flow state and morphology so that the endometrial receptivity is increased and the method is expected to be the assistant therapeutic approach for the improvement of IVF-ET outcome.

Acupuncture Therapy ; Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; physiopathology ; therapy ; Moxibustion ; Pregnancy ; Pregnancy Outcome ; Young Adult

Objective To observe the clinical curative effect of sijunzi decoction composite with shenqi pills in the treatment of spleen and kidney yang deficiency syndrome in patients with primary hypothyroidism(hypothyroid-ism).Methods 62 spleen kidney yang deficiency patients with hypothyroidism were randomly divided into 30 cases in the control group and 32 cases in the treatment group.Patients in the control group were given L-thyroxine tablets orally,once a day;patients in the treatment group were given sijunzi decoction combined with shenqi pills for decoc-tion,daily 1 agent,3 times a day orally,on the basis of the control treatment group.Two groups treatment cycle were 4 months,and the clinical efficacy of the two groups were observed.Results The treatment group total effective rate was 96.9%,which was higher than that in the control group 80.0%(χ2 =4.402,P<0.05);before and after treat-ment,TCMsyndrome scores were significantly decreased in the two groups (t=21.40,25.40,all P<0.01)and treatment group decreased more significantly(t=4.30,P<0.01 ).Before and after treatment,TSH,FT3,FT4 in the two groups were significantly improved (control group:t=5.31,1.14,4.13,treatment group:t=6.27,1.85,6.08,all P<0.01),and the degree of improvement in treatment group was more obvious compared with the control group (t=1.33,0.67,278,all P<0.05).Conclusion Sijunzi decoction and shenqi pills can significantly improve the clinical symptoms of primary hypothyroidism of spleen-kidney yang deficiency type in addition to thyroid function and blood lipid,indicating that this method is capable of achieving satisfactory clinical effects in treating primary hypothyroidism of spleen-kidney yang deficiency type.

Objective To investigate the clinical and pathological features of prostate cancer with low level of serum prostate-specific antigen (PSA) in elderly patients.Methods Data of 328 patients with prostate cancer were retrospectively analyzed.Clinical and pathological data of 4 prostate cancer patients with low serum PSA level were analyzed.Potential risk factors and diagnostic methods of prostate cancer with low serum PSA level were discussed based on the clinical data combined with literatures.Results Mean age of the 4 patients was 71.3 years.Mean PSA value on admission was 1.96 μg/L.2 patients had abnormal digital anal examination results.2 patients were pathologically diagnosed as adenocarcinoma after puncture,among which 1 had duct adenocarcinoma,and the other 2 patients were pathologically diagnosed as neuroendocrine carcinoma after puncture.2 patients with neuroendocrine carcinoma of prostate were treated with endocrine therapy,and the other 2 patients were treated with radical prostatectomy plus auxiliary endocrine therapy.Conclusions Prostate cancer with low serum PSA level has an insidious onset,which is prone to miss the diagnosis.It should be paid sufficient attention for the diagnosis,and monitoring of prostate cancer is independent on PSA.Prostate cancer with low serum PSA level should be diagnosed in combination with some basic examinations such as serum free prostate specific antigen,prostate specific antigen density and digital rectal examination,et al.