Objective To compare the sensitivity and specificity of interferon-gamma release assay(IGRA) in the Tibetan and Han patients with pulmonary tuberculosis(TB),and to investigate its clinical application value for screening Tibetan patients with pulmonary TB.Methods Sixty-four Tibetan cases of pulmonary TB,41 Tibetan cases of non-pulmonary TB,40 Han cases of pulmonary TB and 38 Han cases of non-pulmonary-TB in our hospital from April 2013 to April 2015 were selected and performed IGRA.T cells infected by mycobacterium tuberculosis were detected by ELISA.The difference between Tibetan abd Han nationalities was compared.The clinical value of IGRAfor screening Tibetan patients with pulmonary TB was evaluated by calculating the statistical indicators.Results The sensitivity,specificity,positive predictive value and negative predictive value of IGRA for diagnosing Tibetan pulmonary TB were 90.62%(58/64),80.49%(33/41),87.88%(58/66) and 84.62%(33/39) respectively,which for diagnosing Han patients with pulmonary TB were 92.50%(37/40),84.21%(32/38),86.05%(37/43) and 91.43%(32/35) respectively.The sensitivity and specificity of IGRA for diagnosing Tibetan and Han pulmonary TB had no statistical difference(χ2=0.005,P=0.944;χ2=0.018,P=0.893).Conclusion IGRA has high value for early diagnosis of Tibetan pulmonaty TB and is conducive to screening of early pulmonary TB.

This study is to screen 23 blank O/W type microemulsion (ME) samples, that is 15 samples from our laboratory, and 8 samples from literature; compare the conductivity-water content curve (CWCC) method and visual method in determining the critical water content during O/W type MEs' formation, to analyze the deficiency and the feasibility of visual method and to exploxe scientific meanings of CWCC method in judging the critical water content of O/W type MEs during formation. The results show that there is a significant difference between the theoretical feasible CWCC method and visual method in determining the critical water content (P<0.001), and the results judged by conductivity is higher than that by eye-based water content. Therefore, this article firmly confirmed the shortcomings of visual method and suggested that the eye-base "critical water content" may falls into continuous ME stage during O/W MEs' formation. Further more, the CWCC method has theoretical feasibility and scientific meanings in determining the critical water content of O/W type MEs during formation.

Objective:To establish the quality control method for compound Jieyu granules. Methods:Liquorice was identified by TLC. saikosaponin a, Saikosaponin d and rutin were determined by HPLC. Results:The spots on TLC plates were clear without any in-terference. The linearity was achieved within the range of 0. 508-16. 200 μg (r=0. 999 8) for saikosaponin a, 0. 503-16. 100 μg(r=0.999 7) for saikosaponin d, and 0.130-4.250 μg(r =0.999 9) for rutin. The average recovery was 99.7%(RSD =2.03%), 99. 8%(RSD=1. 44%) and 102. 6%(RSD=1. 40%), respectively. Conclusion:The method is simple, reliable and accurate, and can be applied as the quality control method for compound Jieyu granules.

Objective:To evaluate the effect of remote ischemic conditioning (RIC) on left ventricular (LV) myocardial perfusion, myocardial viability, LV remodeling, regional and global LV function serially following acute myocardial infarction (AMI) in Chinese mini-pigs.Methods:AMI was established in 12 Chinese mini-pigs (8 males, 4 females; age: 6-8 months) and they were randomly divided into RIC group ( n=6) and non-RIC group ( n=6). RIC was performed in pigs by blood pressure inflation on the lower limbs for 5 min period and 4 cycles immediately after surgery. A series of myocardial perfusion imaging and gated 18F-fluorodeoxyglucose (FDG) myocardial metabolism PET/CT imaging were performed longitudinally at the 1st, 14th, 28th and 56th days after AMI, and parameters including total perfusion defect (TPD), hibernating myocardium (HM), Scar, left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), summed motion score (SMS), summed thickening score (STS) and changes of these parameters were obtained. Independent-samples t test and Mann-Whitney U test were used to analyze data. Results:Nine Chinese mini-pigs survived after surgery and were performed imaging. Compared to non-RIC group ( n=4), HM at the 28th ((6.0±2.4)% vs (17.0±4.6)%; t=-4.158), TPD 14th-1st ((-11.8±5.4)% vs 9.0%(4.5%, 15.0%); z=2.449), TPD 28th-1st ((-15.3±3.9)% vs (12.0±3.0)%; t=-10.071), TPD 56th-1st ((-18.0±6.5)% vs 9.0%(4.5%, 12.0%); z=2.449), HM 28th-1st ((-10.5±6.9)% vs (8.3±2.1)%; t=-4.507), HM 56th-1st (-15.0%(-17.5%, -8.5%) vs 2.0%(0%, 7.0%); z=2.449) and LVEDV 14th-1st (-0.5(-2.5, 0) ml vs (13.0±4.4) ml; z=2.470) were reduced in RIC group ( n=5; all P<0.05). Conclusion:RIC can improve myocardial perfusion, delay LV remodeling in the acute stage and salvage hibernating myocardium in the subacute stage and chronic stage.

Objective To investigate the value of IL-27,IL-29 and miRNA-497 in HER-2 positive radioactive particles combined targeted therapy. Methods Sixty-one elderly inpatients with HER-2 positive gastric cancer ascites in the Gaoming District People's Hospital, Wuchuan Municipal People's Hospital and Zhejiang Provincial Tumor Hospital were divided into the two groups. The treatment group(n= 31) was treated by the radioactive particles+ targeted drug Trastuzumab(initial dose 8 mg/kg, maintenance dose 66 mg/kg, once per 3 weeks) for 6 weeks; the control group(30 cases) was treated by targeted drug Trastuzumab (initial dose 8 mg/kg,maintenance dose 6 mg/kg, once per 3 weeks) for 6 weeks. The levels of ascites IL-27,IL-29 and miRNA-497 in the radioactive partcles combined targeted therapy group and control group were detected. Results The levels of ascites IL-27, IL-29 and miRNA-497 after treatment in the treatment group were significantly decreased compared with those before treatment and in the control group,the effective remission rate in the treatment group was 74. 19%, which was higher than 36.67% in the control group, the average median survival time in the treatment group was 155 d, which washigher than 72 d in the control group, the difference was statistically significant. Conclusion IL-27 ,IL-29 and miRNA-497 has the significance of curative effect evaluation and prognosis judgment in the radioactive particles combined targeted therapy for the patients with HER 2 positive gastric cance.

Objective To investigate the bacterial resistance profile of clinical isolates collected in the hospitals across Chuzhou in 2016. Methods Antimicrobial susceptibility testing was carried out by Kirby-Bauer method. The data were analyzed using WHONET 5.6 software according to CLSI 2015 breakpoints. Results A total of 5 465 clinical isolates were collected during 2016, of which gram positive organisms and gram negative organisms accounted for 25.9％ (1 416/5 465) and 74.1％ (4 049/5 465), respectively. Prevalence of MRSA was 37.6％ among S. aureus and the prevalence of MRCNS was 78.1％ in CNS. All Staphylococcus, E. faecalis and E. faecium isolates were sensitive to vancomycin and linezolid. The prevalence of extended spectrum-lactamases (ESBLs) positive strains was 51.2％ in E. coli, 23.4％ in Klebsiella spp. (K. pneumoniae and K. oxytoca), and 23.6％ in P. mirabilis isolates, respectively. The Enterobacteriaceae strains were highly sensitive to carbapenems. The percentage of the P. aeruginosa isolates resistant to the antimicrobials tested was lower than 30％. The percentage of the Acinetobacter strains resistant to meropenem and imipenem was 65.6％ and 67.4％, respectively. Conclusions The situation of antibiotic resistance is still very serious, especially multi-drug or pan-drug resistant strains, which is of great concern.

Objective:To analyze whether patients with myasthenia gravis (MG) have cognitive impairment and changes of brain structure, and explore the possible mechanisms of cognitive impairment in MG patients from the perspective of brain structure.Methods:Twenty-eight patients with MG admitted to Department of Neurology, First Affiliated Hospital of Soochow University from July 2019 to December 2021 were selected as MG group, and 30 family members from MG patients or healthy subjects who underwent physical examination in Physical Examination Center during the same period were selected as healthy control group. Neuropsychological test was used to evaluate the cognitive function. VBM was used to analyze the changes of brain structure on structural MRI (sMRI). Correlations of gray matter volumes of different brain regions with cognitive function between the two groups were analyzed.Results:Compared with the healthy control group, the MG group had significantly decreased scores of Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Clock Painting Test (CDT), and Verbal Fluency Test (VFT), and significantly decreased Rey Auditory Verbal Learning Test (RAVLT) immediate memory and delayed memory scores, while statistically increased time consuming in Making Track Test Part A (TMT-A), and Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores ( P<0.05). Compared with healthy control group, MG group had significantly decreased gray matter volumes of the left orbital superior frontal gyrus, right orbital middle frontal gyrus, right triangular inferior frontal gyrus, left insula, left middle frontal gyrus, right superior limbic gyrus, right anterior cingulate gyrus, right lateral cingulate gyrus, left medial cingulate gyrus, left lateral cingulate gyrus, left medial superior frontal gyrus, and left dorsalateral superior frontal gyrus ( P<0.05). Correlation analysis showed that gray matter volume in the left insula was negatively correlated with time consuming in Stroop Color-Word Test-A ( r=-0.407, P=0.035). Conclusion:Patients with MG may have cognitive decline and gray matter cortical atrophy of some brain regions, and brain areas with gray matter cortical atrophy correspond to areas of cognitive impairment.

Objective:To explore the diagnostic value of 18F-deoxyglucose (FDG) PET/CT dual-time-point imaging (DTPI) in the diagnosis of aortic grafts infection (AGI). Methods:Forty-two patients with suspected AGI were prospectively recruited in this DTPI study from October 2014 to October 2021. There were 35(83%) males and 7 females, mean age (54±15) years old, range 22-79 years old. PET/CT image quality was scored as 5 grading scale. Semi-quantitative analysis of DTPI data was performed using maximum standardized uptake value (SUVmax) of suspected AGI lesions. The percentage of SUVmax change between initial and delayed images were recorded as retention index (RI). Management of Aortic Graft Infection Collaboration (MAGIC) criteria were used as the diagnostic reference criteria for AGI.Results:According to the MAGIC criteria, 27 patients (64%) were positive for AGI, and 15 patients (36%) were negative. The mean RI of AGI was higher than that of non-AGI ones[(26.7±18.9)% vs. (6.4 ±18.8)%, P<0.01]. The sensitivity, specificity, and accuracy of initial SUVmax ≥6 with the presence of AGI was 88.9%, 73.3%, and 83.3%, respectively. Delayed SUVmax ≥6 improved the sensitivity (96.3%) and accuracy (88.1%) for diagnosing AGI. DTPI with 15% increment as the optimal cut-off value of RI improved the specificity (93.3%) and accuracy (90.5%) for diagnosing AGI. Fifteen (56%, 15/27) AGI patients had improved image quality grading on the delayed images, leading to more accurately delineating the detailed extent of the infected aortic graft. Conclusion:18F-FDG PET/CT DTPI has better diagnostic performance for AGI than conventional Single-time-point PET/CT imaging by improving image quality as well as enhancing delineation of infected aortic graft extent.

Objective:To serially characterize the myocardial perfusion, myocardial hibernation and left ventricular (LV) function as well as LV remodeling in progressive coronary artery stenosis in Chinese mini-pigs.Methods:In 8 Chinese mini-pigs (5 males, 3 females; age: 10 months), chronic progression of coronary stenosis and finally occlusion was established using Ameroid constrictor implantation at the 1 cm below the bifurcation of the first diagonal branch of the left anterior descending (LAD) artery. Serial gated 99Tc m-methoxyisobutylisonitrile(MIBI) SPECT/CT, gated 18F-FDG PET/CT imaging and coronary angiography (CAG) were performed before surgery and at the 1st, 4th and 8th week after surgery. Longitudinally, total perfusion defect (TPD), LV ejection fraction (LVEF), LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), summed motion score (SMS), summed thickening score (STS) and hibernating myocardium (HM) were analyzed. Repeated measures analysis of variance, Kruskal-Wallis rank sum test and Bonferroni correction method were used to analyze data. Results:One mini-pig died of infection after the Ameroid constrictor implantation. In the remaining 7 mini-pigs, TPD was progressively increased with time prolonged (0, 12.0%(0, 33.0%), (41.1±23.7)% and (49.3±24.5)%; H=17.03, P=0.001); Compared with HM before the surgery (100%), HM was gradually reduced from the 1st (21.0%(6.0%, 100%)) to the 4th (18.0%(3.0%, 33.0%)) week after surgery, and then increased to the 8th week after surgery ((23.0±15.4)%; H=13.09, P=0.004), but there was no significant difference between the 1st and 4th week, or between the 4th and 8th week after surgery (both P>0.05 (Bonferroni correction method)). Accordingly, LVEF gradually decreased ((73.7±8.4)%, (63.7±19.1)%, (53.7±14.6)% and (49.9±15.4)%; F=6.22, P=0.004). LVEDV (9.0(6.0, 21.0), (31.4±16.3), (32.9±17.4) and (36.4±17.5) ml; H=8.58, P=0.035)and LVESV ((3.8±3.2), (15.9±15.3), 12.0(10.0, 17.0)and (19.3±10.9) ml; H=10.51, P=0.015) gradually increased. SMS and STS continuously increased as well ( H values: 16.49, 13.33, P values: 0.001, 0.004). Conclusions:With the progression of coronary artery stenosis to occlusion, myocardial perfusion is gradually decreased, while the global and regional LV function, LV remodeling are gradually aggravated, and HM is gradually reduced. After the chronic coronary artery occlusion, myocardial perfusion has a trend to be improved and HM is gradually recovered.

Objective To synthesize the natural cyclopeptide auyuittuqamide A by Fmoc-based solid phase linear synthesis and liquid phase cyclization. Methods Using 2-chlorotriphenylmethyl chloride (CTC) resin as the solid support, 1,3-diisopropylcarbodiimide (DIC) and 1-hydroxybenzotriazole (HOBt) as the condensing agents, 9-fluorenylmethoxycarbonyl (Fmoc) to protect amino acids were assembled in sequence, and then the linear peptide bearing the protected groups was obtained in presence of trifluoroethanol (TFE) cutting reagent. The protected linear peptide was cyclized with the aid of benzotriazole hexafluorophosphate (PyBOP) and 1-hydroxybenzotriazole (HOBt) in dichloromethane (DCM) solution, followed by trifluoroacetic acid (TFA) deprotection to obtain the cyclic peptide, auyuittuqamide A that was purified by preparative HPLC and characterized by HR-MS and 500MHz ¹H-NMR. Results The purity of auyuittuqamide A was more than 95% and the total yield was 5.48%. Conclusion This method has simple synthesis steps and high yield. It is the first to establish a fully synthesis method for the natural cyclic peptide auyuittuqamide A, which lays the foundation for further research of auyuittuqamide A.