DQA1*0501.TSHR peptides of 183～198、195～210、248～263、301～320、343～362 and 357～376 could bind with high affinity to both HLA-DR3 and HLA-DQA1*0501,all of their IC50 values less than(1 ?mol/L),but they could bind to neither HLA-DR7 nor HLA-DQA1*0201 with high affinity.Conclusion Epitopes of TSHR 183～198,195～210,248～263,301～320,343～362 and 357～376 on the TSHR extracellular domain might be the auto-antigens to cause GD.

Objective To evaluate the clinical significance of determination for serum insulin like growth factor binding protein 3 (IGFBP 3) protease activity. Methods Serum IGFBP 3 protease activity in normal persons, parturient pregnant women, acromegalic patients and patients with growth hormone deficiency (GHD) was determined by Western blot technique. Results Serum IGFBP 3 protease activity in parturient pregnant women, acromegalic patients,normaladultsanduntreatedGHDpatientswere (75.2?2.2)%, (68.6?3.9)%, (22.7?3.1)% and (13.4?4.2)% respectively. Serum IGFBP 3 protease activity in GHD increased to (29.0?6.8)% after treatment with recombining human somatropin (rhGH) for six months. Conclusions Serum IGFBP 3 protease activity is modulated by GH and affects serum levels of members of GH IGF Ⅰ axis.

In the process of cultivating TCM clinical postgraduates of TCM clinical college in Shanxi university of Chinese medicine,we emphasized the importance of clinical application ability and innovation ability in scientific research,stressed the clinical practice and check management,to formulate the objective,effective and quantified assessment index system in keeping with the real institution of our college,so as to improve the all-round quality of TCM clinical postgraduates.

Objective To analyze the etiology of fever of unknown origin (FUO).Methods A total of 372 patients with FUO who hospitalized in Capital Medical University Affiliated Beijing Friendship Hospital were retrospectively analyzed from January 2003 to August 2013.All the patients were divided into two groups:group A (January 2003-December 2007) and group B (January 2008-August 2013).Diagnosis rate,duration of hospitalization (days) and time to diagnosis between the two groups were artificially compared.Results Of the 372 FUO cases,336 were positively diagnosed with a diagnosis rate of 90.3％.Infectious diseases were still the primary causes of FUO (60.2％),including 72 cases (32.1％) of tuberculosis.Connective tissue diseases accounted for 12.9％ of the FUO cases,malignancies were 8.3％,and miscellaneous diseases were 8.9％.Yet thirty six patients (9.7％) could not be confirmed until they were discharged from hospital.The duration of fever in patients with malignancies was longer than that with infectious diseases [60.0 (30.0,90.0) days vs 30.0 (20.0,60.0) days,P =0.003].Time to diagnosis of connective tissue disease and malignancies was longer than infectious diseases [(12.0 (7.3,18.8) days and 11.0 (7.0,18.0) vs 5.0 (3.0,8.0) days,both P values =0.000].The duration of hospitalization in group A was longer than that of group B [17.0(12.0,30.0) days vs 14.0(10.0,20.0) days,P =0.000].The diagnosis rate and time to diagnosis of group A were similar with those of group B.The proportion of connective tissue diseases in group A was higher than group B(18.1％ vs 9.2％,x2 =6.201,P =0.013).The proportion of infectious disease,malignancies and miscellaneous diseases was not significantly different between the two groups.Conclusions Infectious diseases are the major causes of FUO,and the most common cause is tuberculosis.Connective tissue diseases and malignancies are the second and third causes of FUO.The duration of fever and time to diagnosis are significantly different between the different origins.

OBJECTIVETo study the value of serum insulin-like growth factor binding protein-3 (IGFBP-3) levels in differential diagnosis of growth hormone deficiency (GHD).

METHODSTo measure serum IGFBP-3 levels by RIA in normal children and adolescents, GHD children and short-stature children without GHD.

RESULTSSerum level of IGFBP-3 in 129 children with untreated GHD and with no pubertal development was 1.6 +/- 0.9 mg/L, which was less than that in normal group of the same age, but overlapped with the normal children in Tanner stage I. After six-month treatment with recombinant human growth hormone (rhGH), serum level of IGFBP-3 in 59 GHD significantly increased from 1.3 +/- 0.7 mg/L to 2.7 +/- 0.9 mg/L, accompanied by an increase of body heights, growth velocities and serum level of IGF-1. Serum level of IGFBP-3 in 55 short-stature children without GHD was 3.3 +/- 2.2 mg/L, which was not significantly different from that in normal group.

CONCLUSIONSerum IGFBP-3 level can reflect the status of GH secretion in children with GHD and is a useful marker for differential diagnosis of GHD.

Adolescent ; Biomarkers ; blood ; Body Height ; drug effects ; Child ; Diagnosis, Differential ; Female ; Human Growth Hormone ; deficiency ; therapeutic use ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; blood ; Insulin-Like Growth Factor I ; metabolism ; Male ; Recombinant Proteins ; therapeutic use

Clinicopathological data of 15 patients with pyloric early cancer and precancerous lesions, who received endoscopic submucosal dissection (ESD) in Zhejiang Cancer Hospital from March 2011 to January 2020 were retrospectively analyzed. Postoperative pathology showed 7 cases of low-grade intraepithelial neoplasia, 3 cases of high-grade intraepithelial neoplasia, and 5 cases of early gastric cancer. R0 complete resection was achieved in all patients. The mean operation time was 55.2 min (35-78 min). One patient had delayed postoperative bleeding, and no other complications such as bleeding, perforation or abdominal pain occurred in other 14 patients. No recurrence, metastasis or pyloric stenosis was found during the follow-up of 31.3 months (1-106 months). ESD is safe and effective for early cancer and precancerous lesions in the pylorus.

Objective To establish an HPLC quantitative method for the content determination of baicalin in Kangdeling capsule .Methods The chromatography column was Agilent Tc-C18-WR (4 .6 mm × 250 mm ,5μm) ,and the column temper-ature was 30 ℃ .The mobile phase consisted of acetonitrile and 0 .5‰ phosphoric acid (26 ∶ 74 ) .The flow rate was 1 .0 ml/min ,and the detection wavelength was 265 nm .Results The retention time of baicalin was about 16 min .The calibra-tion equation was Y=22 114 .67 X -112 836 .7(r=0998 8)with good linearity in the range of 5 .410-108 .2 μg/ml for baicalin . The average recovery was 98 .78% while RSD were 0 .74% .Conclusion This method is simple ,time-saving and accurate which could be used to routine analysis of baicalin in Kangdeling capsule .

Zhejiang University began to recruit eight-year clinical students since 2005. Since then, Zhejiang University learned from the experience of foreign medical education, reformed and innovated and formed a distinctive curriculum system and training pattern for eight-year medical training, that named as "Doctoring". "Doctoring" is a course that focuses on the education of students' comprehensive quality and ability. Its main contents are the basic knowledge about human health, disease and medical development. With the use of advanced and scientific teaching concept and teaching mode, students were able to study the doctor-patient communication and interpersonal skills, and use medical knowledge and practice skills required for clinical work. And the students also had the opportunity to demonstrate the ability to solve problems in the foundation of life-long learning. "Doctoring" is more than a simple course for teaching medical professional knowledge.

Objective:To understand the ethical misconduct of Chinese medical researchers and its influencing factors, so as to provide a reference for regulating such misconduct in clinical research.Methods:From September to November 2021, a stratified random sampling method was adopted to select medical researchers from the China Clinical Trial Registration Platform as interview objects, and semi-structured interviews were made on ethical misconduct and its influencing factors in clinical trials. The interview data were analyzed using NVivo11 software.Results:A total of 28 interviewees were included, 57%( n=16) of whom holding that medical researchers accept research ethics passively in most cases. The influencing factors of ethical misconduct of medical researchers are summarized into 7 secondary nodes and 43 tertiary nodes, including 248 reference points. The environmental factors included poor ethical supervision, great research pressure information asymmetry between subjects and researchers, and insufficient ethical atmosphere, including 54, 40, 38, and 29 reference points respectively. The self-factors included lack of ethical knowledge, weak ethical awareness, and individual characteristics of researchers, including 48, 21 and 18 reference points respectively. Conclusions:The attitude and behavior of clinical research ethics of Chinese medical researchers are generally in the transitional stage from passive acceptance to positive compliance, and there are many factors influencing ethical misconduct. In order to further standardize the ethical behavior of medical researchers, the authors suggest relevant authorities to improve ethical review and supervision, establish systematic ethical training, improve the scientific research environment, and actively carry out clinical trials and science popularization.

OBJECTIVETo evaluate the effects of early tangential excision on the prevention of the progression of deep partial thickness burn wound.

METHODSTwelve burn patients with deep partial thickness burn wound were enrolled and received tangential excision of the burn wound within 24 postburn hours (PBHs). The histological samples were harvested from the wound before and 5 - 7 postoperative days (PODs) after the operation and the wound without operation 5 - 7 postburn days (PBDs). The samples were observed by means of HE staining, Masson's staining and the labelling of Vimentin antigen positive cells by immunohistological skill.

RESULTSThe inflammatory reaction of the burn wound without operation aggravated progressively along with that of disease and the tissue necrosis area enlarged. And the residual skin appendages disappeared due to the enhanced inflammatory reaction. The brown area expanded and light green area shrinked by Masson's staining. The Vimentin antigen positive cell count decreased significantly. But in the burn wound being performed tangential excision within 24 PBHs, focal inflammatory reaction exhibited evident ligher than that in burn wound without operation. Moreover, there appeared fresh granulation formation and partial epithelial coverage with no enlarged necrotic tissue area in the operated wound when compared with that in non-operated wound (P < 0.05). Furthermore, the light green area exhibited no obvious shrinking by Masson's staining and the Vimentin antigen positive cell count was much more in the operation area than that in non-operative area (P < 0.05).

CONCLUSIONIt might be beneficial to the host to perform tangential excision within 24 PBHs, which could remove burn wound necrotic tissue in time and hamper the progression of tissue degenerative injury. The healing process of deep partial thickness burn wound was therefore accelerated.

Adult ; Burns ; complications ; metabolism ; pathology ; Female ; Humans ; Male ; Necrosis ; Vimentin ; analysis ; Wound Healing