180 U/L.CK-MB raised in only 5 cases(15.6%),and the highest was 28 U/L.Of the 218 MPP patients,only the 5 patients(2.3%) with raised CK-MB levels could be diagnosed as myocardial damage complicated with MPP.Conclusions The abnormal ECG is more important than myocardial zymogram in the diagnosis of myocardial damage complicated with MPP.Only higher level of certain myocardial zymogram without abnormal ECG can not be diagnosed as myocardial damage if lack of clinic and other objective evidences for myocardial damage.In watching out for myocardial damage,excessive examinations and treatments shall be avoided if possible.

The ancient discussion and modern clinical application regarding Yingxiang (LI 20) and Neiyingxiang (EX-HN 9) in acupuncture verses are explored. Acupuncture verses are the summary of clinical experiences of acupuncture scholars in the past dynasties, of which the records on application of Yingxiang (LI 20) and Neiyingxiang (EX-HN 9) mainly focused on nasal, facial and head-eye diseases, which is characterized with overall summarization, brilliant exposition, simple language, and distinctive characteristics. Nowadays, based on the ancient usage, the clinical application about these two acupoints is continuously developing. If the ancient acupuncture verses could be understood thoroughly, the clinical practice could be better guided and its effects could be improved.
Acupuncture Points ; Acupuncture Therapy ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Rhinitis, Allergic ; therapy

Objective To explore the value of ectopic gastic mucosa imaging in diagnosis of Meckel′s diverticulum.Methods Twenty-five cases suspected of gastrointestinal bleeding underwent conventional ectopic gastic mucosa imaging with 99mT_cO_4-.The diagnostic criteria Meckel′s diverticulum was that abnormal radio active accumulation in the abdomen observed.Results Three cases of ectopic gastic mucosa imaging was positive,and the diagnosis was all confirmed by surgery and pathology examination.The rest 22 cases were caused by other reasons confirmed by affirmative examinations.Conclusions Ectopic gastic mucosa imaging is easy to conduct,safe with no injury to the patients.It can be the first choice of examination in the diagnosis of gastrointestinal bleeding in children.

Objective To explore the regulatory effect of LPS on the expression of interleukin 27 (IL-27),and uncover the relationships among cyclooxyenase-2(COX-2),prostaglandin E2(PGE2) and IL-27.Methods THP-1 cells were stimulated with different doses of LPS,IL-27 and PGE2 levels in the supernatants were measured by enzyme-linked immunosorbent assay(ELISA) at different time,expression of COX-2 was measured by RT-PCR and Western blot.Results IL-27 can be induced by LPS in THP-1 cells in a time and dose dependent fashion,and IL-27 induces COX-2 mRNA expression,COX-2 protein production,and PGE2 release in a time and dose fashion.Conclusion LPS can stimulate the relase of IL-27 at cell level,and IL-27 can induce the expression of COX-2 and production of PGE2.

OBJECTIVETo economically obtain the Abeta peptide for Alzheimer's disease (AD) research by expressing the Abeta peptide fused with the maltose binding protein (MBP) possessing high solubility in E.coli.

METHODSThe cDNA-coding sequence of Abeta peptide was modified by the addition of a BamH I site at the 5' end and a Hind III site at the 3' end using PCR. The modified sequence was ligated into the maltose-binding protein (MBP) fusion expression vector pMAL-c2 containing an thrombin cleavage site, which was transformed into competent E.coli DH5alpha cells. After identification of the single clones by PCR and DNA sequencing, the recombinant plasmid was transformed into E.coli TB1 and induced to express MBP-Abeta fusion protein. The expressed fusion protein was purified using amylose resin column and identified by SDS-PAGE and Western blotting.

RESULTSThe result of DNA sequencing verified the consistency between the inserted sequence and Abeta (1-42) sequence. SDS-PAGE electrophoresis showed that MBP-Abeta fusion protein was highly expressed in E.coli TB1, and Western blotting demonstrated that the purified fusion protein and the separated Abeta peptide could be recognized by specific anti-Abeta (22-35) antibody.

CONCLUSIONMBP-Abeta fusion protein highly expressed in E. coli TB1 cells with enhanced solubility and the separated Abeta peptide with good immunogenicity obtained may lend support to AD research.

Alzheimer Disease ; genetics ; Amyloid beta-Peptides ; biosynthesis ; genetics ; Escherichia coli ; genetics ; metabolism ; Genetic Vectors ; genetics ; Humans ; Maltose-Binding Proteins ; biosynthesis ; genetics ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; isolation & purification

Objective To explore the safety, efficacy and 1-year follow-up outcome of radiofrequency ablation combined with magnetic navigation assistance system in elderly patients with atrioventricular node reentrant tachycardia (AVNRT). Methods Forty cases of patients with AVNRT identified by the electrophysiological test were enrolled in the study. Twenty cases were ablated with magnetic navigation system. The other 20 cases underwent the conventional catheters operation. With the cardiodrive, the 8 Frablation magnetic Helios I (Stereotaxis Inc, USA) was advanced to the Koch triangle area from the inferior caval vein (IVC). With the assistance of magnetic navigation (AXIOM Artis, Siemens, Germany), the direction of tip and the advancement or retraction of the catheters were regulated. The success rate, the time of procedure, the fluoroscopy time and the 1-year follow-up outcome were analyzed, and the complications of procedure were recorded. Results Forty cases with AVNRT underwent radiofrequency ablation successfully. In magnetic navigation group, 19/20 cases underwent magnetic catheter operation. The cases who failed to finish magnetic catheter operation underwent successfully conventional catheter operation. There was no perforation complication and no significant statistic difference in the success rate between two groups. No recurring case was found in the two groups 1 year later. The total of fluoroscopy time in magnetic navigation group was more than that in standard ablation group [(16.4±2.7) min vs. (11.1±1.0)rain, P<0.01], but the decreasing trend of fluoroscopy time in magnetic navigation group was showed. The operator's fluoroscopy time in magnetic navigation group was obviously less than that in standard ablation group [(4.5±0.6) min vs. (11.1±1.0) min, P<0.01]. Conclusions The radiofrequeney ablation combining with magnetic navigation system has the similar safety and efficacy to the conventional ablation in elderly patients with AVNRT, but the operator's fluoroscopy time was significantly decreased.

Objective·To prepare chitosan-gelatin porous microspheres by high voltage electrostatic method combined with freeze-drying and ionic cross-linking method and investigate the factors that influence the formation of porous medium.Methods·Porous chitosan microspheres and chitosangelatin porous microspheres were prepared using high voltage electrostatic method combined with freeze-drying and ionic cross-linking method,with sodium tripolyphosphate (STPP) as crosslinking agent.Factors that affect the porous structure and pore size of porous microspheres were compared,such as different chitosan-gelatin ratio,freezing temperature,curing time with saturated STPP in 85％ ethanol solution.The morphology,surface and internal structure,particle size of the porous chitosan microspheres and chitosan-gelatin porous microspheres were observe by using light microscope,scanning electron microscope and hematoxylin-eosin staining.Results·Microspheres prepared by freeze-drying with an electrostatic and ionic cross-linking method have open,interconnected and highly macroporous,with good spherical surface.Saturated STPP ethanol solution (85％ ethanol) was chosen as the crosslinking agent to prevent destruction of the porous structure.The order of freeze and crosslinking,cross-linking time and the second freezing temperature,can influence the pore size of porous microspheres.Gelatin and chitosan can form polyelectrolyte complexes,and can also be used as porogen in porous structure.Conclusion·The preparation of porous chitosan-gelatin microspheres via this method has a large pore size (diameter 100-200 μm),suitable for cell growth and the migration.

OBJECTIVE: To establish an enzyme-linked immunosorbent assay (ELISA) method for determining the concentration of adalimumab in human serum to determine the steady-state trough concentration of adalimumab in patients with ankylosing spondylitis (AS) and to study inter- and intraindividual variation. METHODS: Human tumor necrosis factor α (hTNF-α) was coated on the solid phase microplate as the capture antigen, and the sample to be tested was added. The goat anti-human IgG-HRP was used as the detection antibody and TMB was used for color development. The absorbance at 450 nm was finally determined. Forty-seven patients with AS treated with standard dose of adalimumab injection were included. Blood samples of steady-state after 12 to 24 weeks′ treatment were collected to determine trough drug concentrations. RESULTS: The quantitative range of the method was 0.63-20.00 μg•mL-1. The inter-assay and intra-assay precisions were not more than 15% and the average recovery was <110%. The median serum concentration of 47 patients was 10.15 μg•mL-1 (IQR:4.36~13.31 μg•mL-1) and ranged from 0.00-23.71 μg•mL-1 with an inter-individual variation of 63%; the median variation of intra-individuals within 43 patients was 11% (IQR: 8%-17%). CONCLUSION: This method is stable and is suitable for the detection of clinical samples. Pronounced inter- but not intraindividual variation was observed in adalimumab trough levels in steady state. The "reaction therapeutic drug monitoring" based on the steady-state trough concentration will facilitate the adjustment of the dosing regimen.

Monoclonal antibody (mAb) drugs currently are an important field in drug development and playing a wide role in the treatment of autoimmune diseases and tumor. However, interindividual variability of therapeutic response and loss of response during treatment become serious problems in clinic, and the underlying mechanisms are believed to be closely related to drug exposure in patients and immunogenicity. Therapeutic drug monitoring (TDM) of mAb drugs has the potential to guide more effective dosing in individual patients and it has been proved to be helpful when making treatment decisions particularly for tumor necrosis factor inhibitors. This review is to summarize the pharmacokinetic profiles and exposure-response relationship of mAb drugs, so as to provide theoretical basis and research direction for the application of TDM in mAb drugs.

The holding of the national college students' clinical skills competition reflects the importance of medical education for clinical practice training . Although through intensive itemized skills drills, the competitors can complete each individual operation with satisfaction, due to the lack of clinical experience, in the integrated circuit training, they will easily stray into question stemtrap. The concrete analysis of the national college students' clinical skills contest competition reflects the medical students' insufficient recognition of clinical skills, lack of the overall concept of the intensive medical treatment, not flexible and insufficient mastery of the connotation of the clinical skills, which seriously restricts the improvement of clinical education. Therefore this article raises special sugges-tions, referring to training focusing on “Airway and Circulation”, developing the critical care thinking based on the relationship of multi-organ and improving the first-aid capability of the team work, so as to provide reference for the improvement of training effect.