Objective:To construct an immune inhibitor of new TNF-?,C-terminal sequence of new rhTNF-? was replaced with sequence of T-help cell of hen egg-white lysozyme(HEL).Methods:The rhTNF-? mutant was cloned 、expressed and purified.Results:The DNA sequencing analysis showed that the C-terminal sequence of new rhTNF-? mutant was correct.The mutant was inserted into pBV220 expression vector .After the recombinant bacteria was incubated at 42℃ for 4 h,a new band of the protein with relative molecular weight of 1.7 kD was shown on the gel.The band amounted to 30 % of total bacteria protein.Western blot showed that the mutant protein could associated with anti-TNF-? antibody.After the protein was purified by through a column of Q-Sepharose Fast Flow, the purity of the protein was above 90%.The biological activity of the protein was measured with L929 cells.The result showed that biological activity of the protein was totally lost.Conclusion:The experimental evidence demonstrated that the construction of new rhTNF-? mutant was successful.The mutant not only can be associated with anti-TNF-? antibody, but also lose the biological activity of original TNF-?. [

Objective To estimate the prevalence of erectile dysfunction (ED) among the patients undergoing manintenance hemodialysis (MHD), and evaluate the efficacy and the adverse effects of sildenafil for ED. Methods The international index of erectile function questionnaire (IIEF) was used to estimate 22 male MHD cases. ED patients were administered sildenafil with the initial dose of 25 mg/d, then maximum of 100 mg/d for 12 weeks. Results 72. 73% (16/22) of MHD patients complained of ED, and the total effective rate of sildenafil was 87.5% (14/16) with common adverse effects-headache and flushing. Conclusion Sildenafil in MHD patients has similar efficacy and safety as the others.

Interferon ( IFN) plays an essential role in antiviral infection.Interferons are divided into different categories according to their structure and function.People have attached increasing importance to TypeⅠinterferon( IFN-Ⅰ) in light of its unusual antiviral mechanism.This review is intended to shed light on IFN-Ⅰ,including its antiviral function,signal pathway and regulation.

Objective Through the analysis of cases,to improve the cognition of clinicians on extracranial vas-cular embolism diseases(VED)in children.Methods The clinical information included incidence trend,thrombophi-lia,clinical features,treatment and prognosis of 29 children with VED,who were admitted from January 201 1 to Decem-ber 201 5 in Nanjing Children′s Hospital Affiliated to Nanjing Medical University,and retrospectively analyzed.Results The annual rate of VED increased from 0 to 1 .49 per 1 0 000 hospital admissions from January 201 1 to December 201 5.In 29 cases,there were 20 male and 9 female,with an average age of 6.03 years old (2 h -1 3.83 years old).In-fants accounted for >20%(6 /29 cases).The average age of the female,non infected group,rheumatic disease group and venous thrombosis group was higher than that of the male,the infection group,the non rheumatic disease group and the arterial embolization group,but there was no significant difference(all P >0.05).Thrombophilia were as follows:in-fection disease,heart disease,kidney disease syndrome,rheumatoid disease,tumor,and twins embolization syndrome. Risk factors included central venous line,immobility,dehydration,glucocorticoids use,etc.Heart disease was the leading cause of non thrombotic embolism,while other thrombophilic diseases resulted in thrombotic embolism.Pulmonary em-bolism was mainly seen in patients with severe pneumonia,especially mycoplasma pneumoniae pneumonia (MPP ).The older the age,the more typical clinical manifestations,and significantly elevated D dimer,fibrin/fibrinogen degradation products tips VED.Treatment depends on the degree of risk.Thirty -seven point five percent(3 /8 cases)of children with arterial embolism were less than 1 year old,and the mortality 25.00% (2 /8 cases)was significantly higher than that of venous thrombosis 1 7.65%(3 /1 7 cases)and 1 1 .76% (2 /1 7 cases).Conclusion Heart disease mainly cause arterial embolism and infection,while nephritic syndrome and rheumatic disease mainly cause venous embolism.Pulmona-ry embolism is mainly seen in children with severe pneumonia,especially MPP.The risk of arterial embolization is higher than that of venous embolism.

Objective To compare the efficacy of patient-controlled intravenous analgesia (PCIA),patient-controlled paravertebral block (PCPB) and patient-controlled epidural analgesia (PCEA) in patients after lobectomy performed via video-assisted thoracoscope (VAT).Methods Forty-eight ASA Ⅰ or Ⅱ patients,aged 50-64 yr,with a body mass index of 20-25 kg/m2,undergoing elective lobectomy via VAT,were randomly divided into 3 groups ( n =16 each):PCIA group,PCPB group and PCEA group.PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline,The PCA pump was set up with a 2 ml bolus dose,a 15 min lockout interval and background infusion at a rate of 2 ml/h.PCPB solution contained 0.75％ ropivacaine 60 ml in 250 ml of normal saline and the pump was set up with a 5 ml bolus dose,a 15 min lockout interval and background infusion at a rate of 5 ml/h.The PCEA solution contained 0.75％ ropivacaine 50 ml and sufentanil 1 μg/kg in 250 ml of normal saline.The PCEA pump was set up to deliver a 5 ml bolus dose with a 15-min lockout interval and background infusion at 5 ml/h.VAS score was maintained ≤3.Peripberal venous blood samples were obtained before operation ( baseline),and at 24 and 48 h after operation for determination of the plasma cortisol concentration.The side effects were recorded.Results The plasma cortisol concentration and incidence of Somnolence were significantly lower in groups PCPB and PCEA than in group PCIA ( P ＜ 0.05 ).The plasma cortisol concentration was significantly lower in group PCEA than in group PCPB ( P ＜ 0.05).Compared with the baseline value,the plasma cortisol concentrstion was significantly higher after operation in groups PCIA and PCPB ( P ＜ 0.05),while no significant change was found in group PCEA ( P ＞ 0.05).Conclusion Compared with PCIA,PCEA can inhibit the stress response,while PCPB can reduce the stress response with good safety in patients after lobectomy performed via VAT if they can provide the equivalent postoperative analgesia.

Objective To investigate the value of ultrasound diagnosing for hydropneumothorax. Methods In a prospective double-blind randomized concurrent controlled trial. 213 patients doubted pneumotborax were exam-ined with CT, senography and conventional radiography. Results In 213 cases, hydropneumothorax diagnosed in 30 hemithoraces of 30 patients by CT,29 hemitboraces by ultrasound and 22 hemithoraces by X-ray. The sensitivity, nega-tive predictive value,accuracy by ultrasound and X-ray were 96.7% vs 73.3% ,99.8% vs 98.0% ,99.8 vs 98.1% respectively(P<0.05), the specificity and positive predictive value of both ultrasound and X-ray were 100%. Ultra-sound surpassed the X-ray in detecting pneumothorax ( McNemar test P<0.025 ). Conclusion If ultrasound is served to detect pneumothorax, it can make up the defects of the methods commonly used cuxrently.

BACKGROUND: Esophageal replacement or reconstruction should be performed after esophageal resection. There are still no suitable substitutes for esophagus if the conventional esophageal substitutes cannot be used.OBJECTIVE : To investigate the feasibility of applying a pulmonary tissue with vascular pedicle to repair the intrathoracic esophageal defect.DESIGN: A prospective animal investigation.SETTING: Department of Thoracic Surgery, Second Hospital Affiliated to China Medical University.MATERIALS: This trial was carried out in the laboratory of Department of Thoracic Surgery, Second Hospital Affiliated to China Medical University during January 2003 to June 2004. Fourteen adult mongrel dogs of either gender, with body mass of 12 to 18 kg, were provided by Animal Room, Second Hospital Affiliated to China Medical University (License No.SYXK (Liao) 2003-0019).METHODS: Of 14 anesthetized dogs, the middle lobe of right lung was dissected and its right middle lobar bronchus was ligated without damaging pulmonary and bronchial vessels in order to make pulmonary flap. A part of full-layer intrathoracic esophageal wall was resected, which was 4 cm long and 1/2 to 2/3 circled esophageal wall. The defect was patched by pulmonary tissue with vascular pedicle which was inosculated with esophageal cross section. On the 3rd day after operation, intravenous transfusion was performed to maintain nutrition. Qn the 7th day after operation, the dogs were given oral liquid soft food gradually 2 weeks after the operation. The access to the food and the survival of dogs were observed. Every 2 dogs were sacrificed respectively at the 2nd, 4th, 6th, 8th and 10th postoperative weeks. To observe the healing of esophageal defect, light microscope, transmission electron microscope, esophagography and endoscope were used in this study.MArN OUTCOME MEASURES: ①Survival situation and access to food of dogs after operation. ② The healing of esophageal defect of dogs.RESULTS: Three of fourteen dogs died within one week after operation. Eleven dogs survived. ① The survival and access to food of experimental dogs after operation: One dog was alive without problems for more than 170 weeks. The living dogs could be fed orally on the 7th day after operation. ② The healing at esophageal defect of experimental dogs:At the 2nd week after operation, the esophageal defect was covered with collagen layer and inflammatory exudation. A little epithelization was observered at free edge of the anastomosis, which was 1 to 2 layers of stratified squamous epithelium cells. At the 4th to 6th weeks after operation, the internal surface of the defect was covered with 3 to 5 layers of stratified epithelium cells. At the 8th to 10th weeks after operation, the luminal surface of the defect was covered with 6 to 8 layers of stratified epithelium cells. The pathological changs of pulmonary flap mainly included pulmonary alveoli atelectasis and pulmonary fibrosis, and some inflammatory cells without infective focus were observed. In the transmission electron microscope examination, newborn stratified squamous epithelium cells were. found on the surface of pulmonary tissue flap at esophageal defect.CONCLUSION: It is feasible to repair the partial irregular intrathoracic esophageal defect with the autologous pulmonary flap in dogs.

OBJECTIVE: To conduct a quantitative evaluation on pharmaceutical research performance in our department. METHODS: Our department's annual research performance during 2001～2005 was scored by integrated weighting method. RESULTS: The research performance in our department over the five years achieved overall high scoring, especially in 2003 and 2004. CONCLUSION: Integrated weighting method can be used to evaluate pharmaceutical research performance.

Objective To evaluate the safety and efficacy of Holmium laser resection for primary non-muscle invasive bladder cancer (HoLRBt) compared with transurethral resection of bladder tumor (TURBt). Methods Data of 212 patients with primary non-muscle invasive bladder cancer were collected retrospectively. The patients were divided into HoLRBt group(n= 101) and TURBt group (n= 111). The patients in each group were stratified into 3 risk groups (low, intermediate and high risk) according to prognostic factors for recurrence based on EAU guideline. Then, the safety of HoLRBt and TURBt groups were compared, concerning the intraoperative complications and postoperative recovery. Efficacy indicated by recurrence-free survival of the 2 groups was analyzed and compared by Kaplan-Meier technique. Results Patients' demographics including age, gender, tumor characteristics, and recurrence risk of tumor between the 2 groups were comparable(P＞0.05). No obturator nerve reflex occurred in the HoLRBt group. Meanwhile, 7 out of 111 patients in the TURBt group experienced this complication resulted bladder perforation in 3 patients. The proportion of patients needing postoperative bladder irrigation in the HoLRBt group was lower compared to the TURBt group (P＜0.05). HoLRBt was associated with shorter postoperative catheter drainage period (P＜0.05). The mean postoperative follow-up was 34 months (range 18 to 43). Recurrence-free survival after HoLRBt was similar with that of TURBt (P = 0. 283). Conclusions Compared with TURBt, HoLRBt is a feasible, safe and effective alternative for the management of primary non-muscle invasive bladder cancer with similar therapeutic efficacy and fewer perioperative complications.HoLRBt can be widely used in clinical practice in the treatment of primary non-muscle invasive bladder cancer.

Humans ; Infant, Newborn ; Lupus Erythematosus, Systemic ; blood ; Male