ObjectiveTo explore the diagnostic value of plasma (1, 3)-β-D-glucan test (G test) in diagnosis of invasive fungal infections (IFI) and the influence of albumin on G test.Methods A prospective observational study was conducted. 267 patients admitted to medical intensive care unit (MICU) of Dalian Municipal Central Hospital from January 21st, 2012 to October 31st, 2014 were enrolled. According to IFI guideline, the patients were divided into without IFI group (n= 35), possible IFI group (n = 70), hypotheticle IFI group (n = 145) and proven IFI group (n = 17). G test was examined routinely using microbiology kinetic rapid reader MB-80.The different threshold values were calculated on G test. The difference among G tests, fungal culture and clinical diagnosis were compared. The results of G test ahead of and post albumin administration in each group were compared, and the value of G test for diagnosis of IFI during albumin infusion was evaluated.Results When the cut-off value was 20 ng/L for IFI diagnosis, higher sensitivity (79.8%), specificity (87.9%), and Youden index (67.7%) were found. The positive rates of G test, fungal culture and clinical diagnosis of IFI were 57.7% (154/267), 60.7% (162/267) and 54.3%(145/267) respectively, without showing significant differences (allP> 0.05). The result of G test (ng/L) was not obviously changed after albumin administration compared with that before in without IFI, possible IFI, hypotheticle IFI, and proven IFI groups (without IFI group: 11.25±2.33 vs. 10.99±1.07,t= -1.723,P= 0.085; possible IFI group: 53.14±5.53 vs. 49.22±8.11,t= -0.395,P= 0.693; hypotheticle IFI group: 90.30±9.38 vs. 85.41±10.11, t= 710.500,P= 0.860; proven IFI group: 100.98±19.24 vs. 103.21±17.66,t= 653.000,P= 0.449). Prior to the administration of albumin, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden index were 79.8%, 87.9%, 45.6%, 96.7%, 67.7%, respectively. However, after the administration of albumin, they were 81.5%, 85.7%, 44.8%, 96.5%, and 67.2%, respectively, without significant difference.Conclusions G test is method for early diagnosis of IFI. The sensitivity and specificity are higher with 20 ng/L as the critical value. The result of G test is not interfered by albumin administration.

Objective To investigate the effective route and proper method in transfecting gene into liver graft mediated by adeno-associated virus vector.Methods Three routes including hepatic artery,portal vein and hepatic artery+portal vein,and 3 methods,i.e.routine,circulation and clamping were employed for infusion.The best infusion route and method of gene transfection into liver graft were determined by observing the color change of liver and detecting liver function and transfoetion rate of liver cells.The safety of these methods was evaluated.Results In all the infusion procedures,the color of the liver grafts turned from red to white,no apparent color differenee of the livers and no enlargement nor mottling were observed under surgical microscope.The liver color was back to normal immediately after blood flow was restored.No significantly statistical differences of the ALT values were observed among all the groups(F=0.343,1.265,0.055,P＞0.05).Adeno-associated virus vectors coding for the enhanced green fluorescence protein(AAV2-EGFP)were successfully transfected into liver cells by the 3 infusion routes 1 week later,and the difierences of transfection rates via the 3 routes had no statistical significance(F=0.080,0.091,0.045,P＞0.05).The transfoction rate of AAV2-EGFP was the highest at any time points when using the clamping method,and then followed by circulation method and routine method,with statistical differenee(F=3.880,2.976,5.129,P＜0.05).The transfection rates of AAV2-EGFP were increased progressively and peaked at the 6th week,and then they were decreased gradually.Conclusions Infusion via hepatic artery is the effective route for gene transfection and clamping the vessels can elevate the transfection rate of AAV2-EGFP.All procedures were performed without detectable liver injury.The transfection of gene into liver graft mediated by adeno-associated virus vector is a slow and persistent process.

Objective To confirm the distribution of high arsenic drinking water and the situation of endemic arsenism in Hubei Province, to provide reference basis for prevention and control of endemic arsenic disease. Methods Using typical investigation and sample investigation in 2006 and 2007, the arsenic content of water was detected sampled from 19 counties(cities or communities). And those water samples which were close to or exceeded the stipulated standard were rechecked by the national standard method. Furthermore, the situation of endemic arsenism was investigated in the cities having high arsenic contents of water. Results In 2006,10 028 water samples of 446 villages in 6 counties (cities or communities) were tested, the wells of high arsenic (> 0.05 mg/L) were found in 5 counties (cities or communities) and the proportion of the well that exceeded stipulated standard was 5.29%(530/10 028); In 2007,19 086 water samples of 1282 villages in 17 counties(cities or communities) were tested, the wells of high arsenic were found in 11 counties(cities or communities), and the proportion of the well that exceeded stipulated standard was 1.74%(333/19 086). In these two years, 29 114 water samples were tested, in which 863 water samples were exceeding the stipulated standard. The 2.96% of total wells exceeded stipulated standard and mainly distributed in 179 villages of 12 counties(cities or communities). And the highest arsenic content of water sample was 2.012 mg/L. In the endemic arsenism area, 2 critical, 1 moderate and 1 mild arsenism patients had been found. Conclusions The water of high arsenic content are scattered in Hubei Province and the situation of endemic arsenism disease is mild. Improving water aiming at decreasing arsenic and establishing patient files should be carried out immediately.

Objective To compare the concordance of five automated 25OHD immunoassays with liquid chromatography tandem mass spectrometry method ( LC-MS/MS) .Methods During May to July in 2014, 245 clinical serum samples that requested 25OHD tests were selected, with a total 25OHD range of 2.8 ng/ml-64.0 ng/ml, in which 154 samples did not contain 25OHD2 and 91 samples contains both 25OHD2 and 25OHD3 .To used a LC-MS/MS method that built in our laboratory to measure 25OHD, five commercial automated chemiluminescent immunoassays from Abbott Diagnostics ( A ) , DiaSorin LIASON (B), IDS-iSYS(C), Roche Diagnostics(D), and Siemens ADVIA Centaur(E).Taking the reference method LC-MS/MS as a standard , to compared the concordance and performance of the five automated 25OHD immunoassays.And used the commonly accepted cutoffs for 25OHDdeficiency (<20 ng/ml), and insufficiency ( 20 -30 ng/ml ) , and sufficiency (≥30 ng/ml ) to compare the uniformity of different methods .Statistical analysiswere performed by MedCalc software , Passing & Bablok regression , Bland &Altaman plots and Box and whisker plots were performed to compare the differences of the methods .Results The medium ( range:2.5% -97.5%) 25OHD of the 245 serum samples of the six methods was 23.5 (5.8-44.2) ng/ml(LC-MS/MS),20.6 (7.1-43.5)ng/ml(A),19.0 (5.4-38.0) ng/mL (B),23.0 (10.0-38.1) ng/ml(C),20.1 (5.1 -46.0) ng/ml (D),31.3 (12.3 -71.1) ng/ml (E), respectively .Passing and Bablok regression showed that method B had the best correlation coefficient with LC-MS/MS (r=0.894), while methods A, C and D had relatively small bias compared withLC-MS/MS and method E had the large bias .If the serum samples did not contain 25OHD2 , all the five automated immunoassays correlated well with LC-MS/MS with a correlation coefficient higher than 0.84, and B has the best correlation with LC-MS/MS ( r=0.930 ) .While all the correlation coefficient between immunoassays and LC-MS/MS decreasedwhen analyzing the samplescontaining 25OHD2.Using the clinical cutoffs, A, B, C, D and E had a concordance of 68.6%, 64.9%, 67.8%, 70.6% and 51.8% compared with LC-MS/MS, respectively .Conclusions There are significant differences between different detection systems of 25OHD.All the immunoassays results were affected by the existence of 25OHD2 .The concordance of serum 25OHD resultswas poor between different methods , and it may be necessary to built exclusive cutoffs for different methods.

Myasthenia gravis (MG) is a disease of neuromuscular junction and mainly autoimmune in aetiology. The state of thymus is a critical determinant for the prognosis. In this retrospective review study, we aimed at clarifying the relationship between the mode of clinical presentation of MG and the radiopathological classification of the thymus. We identified patients with MG from the database of our medical center from 1988 – 2017. The patients were classified into two groups according to their clinical presentation: those with a typical presentation with diurnal variation, and those with an atypical presentation of persistent weakness or respiratory failure from the beginning. The underlying thymic state was categorized into six groups: normal, abnormal by imaging (if no operation was performed), hyperplasia, benign thymoma, cortical type thymoma, and malignant thymoma. In total, 227 patients (133 females and 94 males) were included in the analysis, of whom 68% were classified into the typical presentation group. The atypical presentation correlated significantly with thymic categories (p = 0.014) and sex (p = 0.026) but not age at onset (p = 0.232). The atypical presentation was more common in the male patients and in those with thymic carcinoma.

Objective To develop a miniature negative pressure aspirator with easy operation,stable negative pressure,low weight,small volume and high portability.Methods A double-faced printed circuit board with a size of 6 cm×4 cm×1 cm was manufactured with the functions of regulating the current and DC/AC conversion.DC vacuum pump and Panasonic li-ion battery pack were used to generate the desired pressure between-0.017 and-0.060 MPa,and mechanically-driven deformation vacuum gauge was involved in manufacturing the aspirator.Two sizes (150 and 200 ml) of drainage bottles were made of medical silica gel.Results The aspirator facilitated negative-pressure therapy when the patient was walking or discharged,which decreased the hospital cost and stay.Conclusion The aspirator gains advantages in stable negative pressure,low power consumption,easy operation and high safety,and thus is worthy promoting clinically.

Objective To investigate the efficacy and tolerability of a recombinant human tumor necrosis factor:Fc fusion protein (rhTNFR:Fc,with a trade name of Yisaipu) in the treatment of moderate to severe psoriasis vulgaris.Methods A multicentre,randomized,double blind,and parallel-controlled trial was performed.One hundred and forty-four patients with moderate to severe psoriasis vulgaris from four centres were randomly assigned and treated with either once-weekly subcutaneous injection of rhTNFR:Fc (50 mg) or oral methotrexate (MTX)(7.5 mg) for 12 weeks.Patients were followed up at 2,4,8,12 weeks after the treatment.Results One hundred and twenty-four patients finished the 12-week course of treat- ment.At 12 weeks after the treatment,a 50%,75%,90% improvement in psoriasis area and severity index (PASI) was achieved by 86.11%,76.39%,52.78% respectively of rhTNFR:Fc-treated patients,and by 63.89%,44.44%,22.22% respectively in MTX-treated patients,and all the three improvement rates were of significant difference between the two groups of patients (all P0.05).Conclusion Compared with MTX,rhTNFR:Fc acts more quickly with a higher cure rate and less toxic reactions in the treatment of psoriasis vulgaris.

For a long time, thymic function could not be monitored, as a consequence of the absence of adequate technology to detect recent thymic emigrants from naive T cells. T cell differentiation in the thymus is characterized by T cell receptor (TCR) rearrangement. During the rearrangement of TCRalpha gene segments, the deltaRec and psiJalpha rearrange to each other to delete the TCRdelta gene and form an extrachromosomal DNA circles, referred to as signal joint T cell receptor excision DNA circles (sjTRECs) or TRECs. TRECs are assumed to have a high stability, they can not multiply and consequently are diluted during T cell proliferation. It was recently suggested that quantitative detection of TRECs would allow for direct measurement of thymic output. In this review TRECs quantification is a powerful method to evaluate the thymic output function in both health and disease, including hematopoietic stem cell transplantation, hematopoietic malignancies, HIV infection and autoimmune disease, and so on is described.
Animals ; Cell Differentiation ; Cell Movement ; Gene Rearrangement, T-Lymphocyte ; HIV Infections ; immunology ; Humans ; Immunity ; Neoplasms ; immunology ; T-Lymphocytes ; physiology ; Thymus Gland ; physiology

OBJECTIVETo study the effect of dexamethasone on airway morphology and on the expression of angiopoietin-1 (Ang-1) and its tyrosine kinase receptor Tie-2 in the airway of asthmatic rats.

METHODSForty-five Sprague-Dawley rats were randomly divided into control, asthmatic, and dexamethasone-treated asthmatic groups. Asthma was induced by repeated sensitization and challenge with ovalbumin in the latter two groups. The dexamethasone intervention group received an intraperitonea injection of dexamethasone (2 mg/kg) before asthma challenge. Immunohistochemistry was used to measure the expression of Ang-1 and Tie-2 in the airway. Airway thickness was estimated by a computerized digital image analyzer.

RESULTSAirway thickness in the asthmatic group (33.9333+/-8.3791 micro m2/micro m) increased significantly compared with that in the control group (21.1333+/-2.7740 micro m2/micro m) (P<0.01). The dexamethasone intervention group also showed increased thickness of the airway (27.4000 +/- 4.6105 micro m2/micro m) compared with the control group (P<0.01), but the airway thickness in the dexamethasone intervention group was significantly reduced compared with that in the untreated asthmatic group (P<0.01). The expression of Ang-1 (103.9487+/-8.2914 vs 76.0320+/-3.7728; P<0.01) and Tie-2 (99.2307+/-8.1913 vs 75.3153+/-3.7321; P<0.01) in the airway increased significantly in the asthmatic group compared to controls. The expression of Ang-1 and Tie-2 in the airway of the dexamethasone intervention group (90.6180+/-5.2339 and 86.6633+/-3.7321, respectively) was statistically higher than that in the control group (P<0.01) but statistically lower than that in the untreated asthmatic group (P<0.01). Ang-1 and Tie-2 expression in the airway was positively correlated with the thickness of airway (r(Ang)-1=0.719r(Tie)-2=0.746P<0.01). There was also a positive correlation between Ang-1 and Tie-2 expression (r=0.742P<0.01).

CONCLUSIONSThe expression of Ang-1 and Tie-2 in the airway increased in asthmatic rats and was positively correlated with the thickness of the airway. Ang-1 and Tie-2 may participate in the process of airway remodeling in asthma. Dexamethasone can decrease the expression of Ang-1 and Tie-2 in the airway and relieve the changes of airway morphology.

Angiopoietin-1 ; analysis ; physiology ; Animals ; Asthma ; metabolism ; pathology ; Female ; Lung ; chemistry ; pathology ; Rats ; Rats, Sprague-Dawley ; Receptor, TIE-2 ; analysis ; physiology

Objective To understand the current health literacy level of students in a medical university and its influencing factors, so as to provide references for health education of medical college students. Methods By means of random stratified cluster sampling, health literacy questionnaire survey was conducted among 1 428 students in three grades of a medical university. Ratio and constituent ratio were used to describe the resuls. Chi-square test was used fot comparison among groups. Logistic regression was used to analyze the influencing factors. Results The percentage of sampled undergraduates in Hebei who had met the health literacy criteria was 57.18%.The percentages of students who had met the health literacy criteria on health concepts and the basic knowledge, and on healthy lifestyles and behaviors, and on the basic health skills were 58.68%, 30.88%, 65.48%,respectively. The health literacy of female college students was higher than that of males. There were statistically significant differences in health literacy among subjects of different grades, majors, fathers with education and fathers with different occupations ( 2=27.748, 46.525, 19.327, 30.779, all P<0.01). Logistic regression analysis showed that girls' health literacy was higher than boys' (OR=1.521, 95% CI:1.160-1.993). The health literacy level of students from different majors was in order of clinical medicine, nursing, pharmacy and other majors; The health literacy of the children with highly educated mothers was higher than that of the children with less educated mothers. Conclusions Overall level of health literacy of students in this school is higher than that of undergraduates nationwide. Medical colleges should focus on cultivating healthy lifestyles of medical students, so as to improve the overall health literacy of college students.