This thesis systematically summarizes the experience of Professor YAN Xiao-ping in treating palindromic rheumatism, the following conclusions we have got: ① Palindromic rheumatism is very much like panodynia in Yellow Emperor's Internal Classic, and the treatment of this disease should according to that of panodynia; ②The primary pathological mechanism is the deficiency of spleen and kidney, and the secondary is the invading of wind evil factor accompanying with some other evil factors; ③The treatment principals including: nourishing kidney and spleen for the radical treatment, expelling the evil factor such as wind, cold, dampness and hot, assisting with pungent and warm herbs to through channels when expelling hot and clearing away dampness, moving the blood stasis all the way. Because it is shortage of literatures about this disease, the thesis has some practical significance.

Objective To evaluate the quality of four domestic and three imported fourth-generation HIV diagnostic reagents.Methods The specificity and sensitivity of these assays were analyzed when testing HIV negative samples and HIV-1 RNA positive samples.The relative seroconversion sensitivity index was analyzed when testing BBI seroconversion panels.Results The sensitivity of seven 4th-generation assays were 100％ (95％ CI:99.86％-100％ ),and one sample at the window period of HIV-1 infection were detected as positive.Of the seven assays,one imported assay exhibited the relative largeδ + value (1.0892),and the small δ+ value were found on the remaining six assays (0.0836-0.3003 ).For the samples negative for HIV antibody,varying degrees of false positives were observed on the seven assays ( specificity:97.80％ -99.60％,δ- value:-1.3803 to -0.4778).When testing the BBI seroconversion panels,the relative seroconversion sensitivity index of domestic assays were -0.500-0,however,which of imported assays were -0.600 and -0.700.Conclusion The seven reagents exhibited high sensitivity and specificity.The 4th generation HIV assays can be used as blood screening reagents to find the samples at window period of HIV-1 infection,thus indicating the certain meaning in reducing the transmission risk of HIV-1 for fourth-generation HIV diagnostic reagents.However,the better efficiency to detect HIV-1 early infection was observed on the imported assays than on the domestic assays.

Objective To evaluate the differences between the third and the fourth generations of anti-HIV assays,and different kits within the same generation.Methods A total of 989 HIV-negative samples,185 samples positive for HIV-1 RNA.1st-generation international references of HIV antibodies and samples from 9 sets of BBI seroconversion panels were detected by 8 kits of the third generation and 4 kits of the fourth.Results The fourth generation kits can detect HIV infection earlier than the third generation kits.However,the detected days of HIV infection with different kits of the fourth generation were different whilst no significant difierences were found with difierent kits of the third generation.Furthermore,the capacity of detecting samples with different genotypes for different reagents was different,especially the capacity of domestic reagents on detecting HIV-1 O group and HIV-2 samples was relatively weak.Conclusion These data provided information to improve the quality of anti-HIV diagnostic reagents further.

Objective To establish HIV-1 seroconversion panels with the samples collected by National Institutes for Food and Drug Control ( NIFDC) and to evaluate the window periods of HIV enzyme immunoassay ( EIA) diagnostic kits used for blood screening with them. Methods Serum specimens were collected from different plasma donation stations in China. All suspected HIV infection specimens were screened for HIV by using the nucleic acid amplification testing (NAT), Western blot confirmatory assay and P24 quantitative detection assay. The HIV env gene sequences were amplified by RT-PCR for further confirmation of HIV infection. The PCR products were sequenced and genotyped. The confirmed seroconver-sion panels were used to evaluate the early detection capabilities of the 4th and 3rd generation HIV EIA diag-nostic kits used in blood screening in china. Results A total of 8 sets of HIV seroconversion panels com-prised of 36 samples were confirmed in this study, including 6 sets of AE subtype, 1 set of B subtype and 1 set of unknown genotype. Those seroconversion panels were tested with HIV diagnostic kits produced by 19 different manufacturers. For the early detection of HIV infection, the 4th generation HIV diagnostic kits with a score of 9. 4 points were better than the 3rd generation HIV diagnostic kits whose score was 3. 6 points (P<0. 01, t=8. 547). Some of the domestic 4th generation HIV diagnostic kits were similar to the imported kits in the early detection of HIV infection. In terms of the diagnosis of HIV infection, the HIV-1 NAT was at least 2 weeks earlier than the HIV EIA diagnostic kits. The sensitivity of confirmatory assay was lower than that of the diagnostic kits. Four out of five 4th generation HIV diagnostic kits showed declined signal to cut off ( S/CO ) ratio , indicating the probability of false detection during the second window period . Conclusion Eight sets of NIFDC HIV-1 seroconversion panels were established in this study. With those panels we found that there were differences in the window period between different EIA diagnostic kits used for HIV blood screening.

Objective To establish a high throughput phenotypic test for the detection of drug re-sistance in human immunodeficiency virus(HIV)strains. Methods The gene encoding luciferase was in-activated through restriction enzyme digestion and ligation. LacZ gene was used to replace the genes encoding original protease and reverse transcriptase. pol genes were amplified from pSG3△env plasmid and cloned in-to a new backbone plasmid through infusion. The factors that might affect the results of the test were opti-mized. Results The parental backbone plasmid pNL4-3. Lac was constructed,of which the gene encoding luciferase was inactivated and bearing the LacZ gene instead of genes encoding protease and reverse tran-scriptase. Several influential factors including cell numbers(10 000 / well),virus inoculation(200 TCID50 /well)and the concentration of DEAE-dextran(15 μg/ ml)were optimized. The reproducibility of this test was confirmed by testing 12 anti-HIV drugs against 2 pseudovirus strains 8 times,presenting the coefficient of variations(CVs)from 4. 32% to 28. 46% . Six types of pseudovirus were constructed and tested against the 12 anti-HIV drugs,the results of which were compared with those by using the pSG3△env-based pseud-ovirus test. The results of the two tests presented good consistency. Conclusion The high throughput phe-notypic test based on pNL4-3. Lac plasmid,combining the advantages of pSG3△env and pNL4-3 systems, could be used to analyze the drug resistance patterns of HIV-1 infectors and screen new drugs for antiretrovi-ral therapy in a rapid and effective way.

Objective To pan and characterize anti-HIV-1 Fab by the phage antibody library technology. Methods Total RNA were extracted from lymphocytes which were isolated from peripheral blood collected from asymptomatic HIV-1 infected donors with high titer antibody against HIV-1. The genes of heavy chains Fd fragment and light chains of antibody were amplified by RT-PCR. The phagmids pComb3X cloned Fd and light chain genes were transformed into E. coli XL1-Blue by electroporation to construct phage Fab library. By three runs of "absorption-elution-neutralization-enrichment", the clones were induced by IPTG and characterized by ELISA. The positive clones were sequenced and analyzed the sequences. Subsequently, Fab antibodies of these positive clones were induced to expressed and purified, then the recombinant virus neutralization assay was performed. Results A phage Fab library was constructed with 8×106 members, and 11 positive clones were obtained by detecting IPTG-induced-expressing Fabs with ELISA. By analysis of the sequences, 10 light chain genes and 8 Fd genes were ensured to be obtained. Compared with the genes of anti-HIV-1 antibodies in HIV sequence database, the gene sequences we obtained were highly homologous to some patent genes of anti-HIV-1 gp120 antibodies in HIV sequence database( light chains with 60%-90% identity, Fd with 71%-85% identity); The CDRs of these positive clones were determined by comparing the positive clone genes with antibodies' genes in V base database, furthermore, CDRH3 of these positive clones has the length of 12-22 aa. Strand shift had little effect to improving affinity of our Fab clones. Fab antibodies were induced to express at the concentration of ＞ 10 mg/L. Three Fab antibodies neutralize HIV-1 virus to some extent. Conclusion The studies will provide the basis on further study on the anti-HIV-1 Fabs obtained successfully.

Objective To explore the effects of lycopene on lifespan in drosophila and the underlying mechanism. Method Drosophila aged 30 d were reared in medium containing 0,2.5,7.5,22.5 ?g/g lycopene till they all die. The average lifespan and the average maximum lifespan were determined. Male drosophila aged 30 d were divided into control group and experiment group and cultured in medium supplemented with 0,22.5 ?g/g lycopene. The gene expression was determined 10,20 d later. Results The average maximum lifespan of male drosophila was increased with 2.5,7.5 ?g/g lycopene supp-lementation(P

OBJECTIVE:To establish HPLC fingerprints of Miao medicine Ardisia crenata.METHODS:HPLC method was adopted.The determination was performed on Diamonsil C18 column with mobile phase consiste of methanol-water (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was 220 nm,and column temperature was maintained at 30 ℃.The sample size was 10 μL.Using 11-O-(3',4',5'-three-o-galloylhyperin)-bergeninum as reference,HPLC fingerprints of 16 batches of samples were determined.Common identification and similarity evaluation were performed by using TCM Chromatographic Fingerprint Similarity Evaluation Software (2012 edition).Cluster analysis of fmgerprrints was conducted.RESULTS:There were 6 common peaks in HPLC fingerprints of 16 batches of samples.The similarity among 8 batches was more than 0.9.The 16 batches of samples could be clustered into 4 categories.CONCLUSIONS:Established fingerprints can provide reference for identification and quality evaluation ofA.crenata.

Objective:To construct a primary health care institutions performance evaluation index system from the perspective of health value orientation under the background of countywide medical alliances construction.Methods:From May 2021 to February 2022, preliminary screening was made on core performance evaluation indexes via literature review; purposive sampling was used to select the dean/vice dean, persons in charge of medical service, and those in charge of public health service responsible for performance evaluation at the community health service center. Then semi-structured interviews were made on the existing performance evaluation and assessment plans as well as existing problems of primary medical and health institutions. Based on the " input-process-output" performance evaluation model, the thematic framework analysis method was used to analyze the interview data, and combined with literature research results, a preliminary performance evaluation index system for primary medical and health institutions was built under the guidance of health value. From March to May 2022, the Delphi expert consultation method was used to evaluate the importance and operability of indexes. The threshold method was used to screen indexes, and analytic hierarchy process was used to calculate the weights of evaluation indexes.Results:The health value oriented performance evaluation index system for primary healthcare institutions included 3 first-level indexes, 9 second-level indexes, and 50 third-level indexes. The first-level indexes were output (0.377 3), input (0.336 3), and process (0.286 4) in descending order of weight. The top three weighted second-level indexes were health manpower(0.177 8), health literacy and health outcomes (0.157 6), as well as responsiveness and satisfaction (0.142 6). The third-level indexes included 17 medical indexes, 16 prevention indexes, and 17 medical prevention integration indexes. The top three weighted indexes for inpatient services were resident satisfaction with medical treatment (0.052 4), medical staff satisfaction (0.050 1), and responsiveness of residents seeking medical treatment (0.040 1); The top three weighted third-level indexes excluding inpatient services were resident satisfaction with medical treatment (0.052 4), medical staff satisfaction (0.050 1), and surplus funds used for personnel incentives (0.045 5).Conclusions:The performance evaluation index system of primary health care institutions built under the health value orientation is scientific, conducive to promoting the health-orientated transformation and improving the efficiency of primary health care services.

Objective To investigate the principles of diagnosis and treatment of non-hereditary bilateral synchronous renal cell carcinoma.Methods This retrospective study analyzed 36 cases of non-hereditary bilateral synchronous renal cell carcinoma in our hospital from January 2008 to December 2016,including 30 males and 6 females.A total of 74 renal tumors were found,in which 34 patients had bilateral single kidney tumor and 2 patients had two tumors in one kidney.The diameter of tumors ranged from 1 cm to 11 cm,with an average of (6.8 ±4.1)cm.The patients that underwent nephron-sparing surgery(NSS) got 4-12 points,with an average of (6.1 ±3.4) points in R.E.N.A.L.score and 3-13 points,with an average of (6.9 ± 3.7) points in Zhongshan score.The patients are classified into 4 groups according to operation methods.In group A,16 patients underwent bilateral NSS,which the preoperative creatinine was 63-103 μmol/L with an average of (80.9 ± 11.4) μmol/L.In group B,7 patients underwent one side of NSS before contralateral radical nephrectomy (RN),which preoperative creatinine was 59-87 μmol/L with an average of (75.7 ± 8.9)μmol/L.In group C,7 patients underwent one side of RN before contralateral NSS,preoperative creatinine was 57-107 μmol/L,with an average of (77.6 ± 19.2) μmol/L.In group D,6 patients underwent one side of NSS or RN and spare the contralateral side,2 of which shifted from NSS to RN after finding tumor invaded pelvis and upper ureter during surgery.Of all the 16 patients with bilateral NSS,4 patients underwent surgery on the side where tumor had a higher score in the first phase and then the side where tumor had a lower score in the second phase,11 underwent surgeries in an opposite order.One patient underwent bilateral NSS simultaneously.Group A,B and C are taken into final analysis.Result All the 30 patients underwent surgery successfully.The operation time of NSS ranged from 60 to 110 min with an average of (88.6 ± 23.6) min and RN ranged from 40 to 90 min with an average of (72.3 ± 21.4) min.The warm ischemia time of NSS was 12-40 mins with an average of (29.5 ± 9.7)min.The creatinine of Group A was 62-117 μmol/L with an average of (89.4 ± 15.8) μmol/L and 57-392 μmol/L with an average of (129.6 ±74.9)μmol/L one month after the first and second surgery respectively.The creatinine of Group B was 64-115 μmol/L with an average of (94 ± 14.4) μmol/L and 93-453 μmol/L with an average of (190.4 ± 117.2)μ mol/L one month after the first and second surgery respectively.The creatinine of Group C was 84-113 μmol/L with an average of (90.1 ± 12.1) μ mol/L and 88-156 μmol/L with an average of (121.4 ± 24.8)μmol/L one month after the first and second surgery respectively.One patient in Group B and C developed lung metastases.One patient in Group B occurred oliguria after the second stage of surgery,and gradually improved after one week of hemodialysis.The creatine showed no significant difference among Group A,B and C before operation,after the first and second stage (P ＞ 0.05).Postoperative hospital stay after the first stage surgery was 3-16 days with an average of (6.7 ± 3.4) d,and 3-16 d with an average of (6.2 ± 3.2)d after the second stage,respectively.Conclusions In principle,bilateral renal tumors should be treated with NSS,wbich can protect renal functions as much as possible.Among patients who can undergo bilateral NSS,the first-stage surgery should be operated on the simpler and easier side to preserve the kidney of one side as much as possible to lay a good foundation for the second stage surgery.Among patients who undergo one side of RN and the other side of NSS,NSS is recommended for the first stage,and RN for the contralateral second stage after the renal function of the operated side was restored.