Objective To map out the binding site of P195,which is the major protein on the surface of P.falciparum merozoites,to human erythrocytes,and offer a basis for designing malaria vaccine to blockade invasion of merozoites into human erythrocytes.Methods Eight proteins derived from P195 were expressed in E.coli,and purified by Ni-chelare affinity chromatography.There after,the eight fragments and rabbit serums immunized by which were added into culture medium of P.fatciparum in vitro respectively.Twenty-four hours later,the invasion of merozoite to erythrocyte was observed.Results The antibodies which were induced by three fragments of P195,M6(Amino Acid,AA384～595),M7(AA 595～897)and M11(AA 1397～1563)could inhibit the invasion of P.falciparum merozoite into human erythrocytes.Especially,one fragment of P195,M6,had the ability to inhibit the invasion of P.falciparum merozoite into human erythrocytes.Conclusion M6,a fragment of P195 on the merozoite of P.falciparum may contain a domain thought to be involved in the recognition of human erythrocyte.The domain can be used as a candidate antigen for a malaria vaccine.

Objective To investigate the value of urodynamic parameters in diagnosing female bladder outlet obstruction.Methods By follow-up investigation,36 out of 54 patients who underwent transurethral vesical neck incision for female bladder outlet obstruction(FBOO)were proven to achieve good therapeutic efficacy,so the clinical diagnosis as FBOO made before treatment was regarded as correct,as FBOO group.Anther 29 asymptomatic healthy female subjects were selected as controls.ROC curve was used to analyze the urodynamic parameters.Results The area under curve,cutoff for diagnosis and their sensitivity and specificity of the parameters were as follows:Q_ max:AUC=0.823,Q_ max≤15 ml/s(SEN=87%,SPE=81%);PdetQ_ max:AUC=0.826,PdetQ_ max≥28.5 cmH_ 2O(SEN=76%,SPE=72%);A-G value:AUC=0.922,A-G value≥1.1(SEN=86%,SPE=86%).Conclusion When Q_ max≤15 ml/s,PdetQ_ max≥28.5 cmH_ 2O and A-G value≥1.1,FBOO is likely to occur in female.

BACKGROUND: Urinary incontinence can be divided into stress, urgent and mixed types, they can not be easily distinguished only basing on clinical experience, which often result in misdiagnose or improper treatment OBJECTIVE: To discuss the value of urodynamical inspection, especially stress leak point pressure (SLPP) determination in the diagnose of female stress urinary incontinence.DESIGN: Retrospective paralleled comparison observation.SETTING: Center of General Urology Department, Southern Hospital,Third Military Medical University of Chinese PLA PARTICIPANTS: Totally 120 female patients who received medical treatment in the uropoiesis surgical department of the Southwest hospital due to urinary incontinence between January 1996 and May 2002 were enrolled in this experiment.gle was determined and considered as normal if it was ＜100° and abnormal if ＞ 100°. Urethral tilt angle is judged as normal if ＜ 45° and abnormal if ＞45°; Urethrovesical junction (when static state) was judged as normal if not tion: including fulling urinary bladder pressure measurement, static urethral Cystourethrography classification standard: type Ⅰ refers to posterior urethrovesical angle vanished with urethral tilt angle＜45° and the biggest urethra closure pressure＞20 cmH2O; type Ⅱ: refers to posterior urethrovesical angle vanished with urethral tilt angle＞45° and the biggest urethra closure pressure＜20 cmH2O; type Ⅲ refers to normal posterior urethrovesical angle with urethral tilt angle＜45° and the biggest urethra closure pressure ＞20 cmH2O. SLPP classification standard: typeⅠ: SLPP ＞120 cmH2O; type Ⅱ: SLPP of 90- 120 cmH2O; type Ⅲ: SLPP ＜ 60 cmH2O;type Ⅱ/Ⅲ: SLPP of 60 - 90 cmH2O.compared with that of cystourethrographic classification.RESETS: Totally120 patients all remained in the final result analysis.stress urinary incontinence, 64 cases as symptomatic stress urinary incontinence including 28 cases of unstable bladder and 36 cases of low compliclassification: of the 56 genuine stress urinary incontinence, 20 cases were diagnosed as type Ⅰ; 16 cases as type Ⅱ and 10 cases as type Ⅱ/Ⅲ; 10cases as type Ⅲ. Two classification was proved of 100% consistency in type Ⅰ and Ⅲ, and 94.1% and 90.1% in type Ⅱ and type Ⅱ/Ⅲ respectively, difference was not remarkable (P＞0.05).CONCLUSION: SLPP determination can be used to make accurate classification of female genuine stress urinary incontinence, possessing important instructive significance for the treatment.

Objective To investigate the distribution of interstitial cells of Cajal (ICCs) —the pacemaker cells of the gut in the different parts of guinea pig pyeloureteral tract and explore the effect on the contraction of smooth muscle. Methods The ureteropelvic junction, upper ureteral, middle ureteral, lower ureteral tissues harvested from 10 guinea pigs were performed KIT immunofluorescent staining in stretched preparations. Smooth muscle strips of 2 mm?6 mm were dissected from the sites for tone determination. The frequency and amplitude of the smooth muscle were compared among different sites of pyeloureteral tract. Results Cells with positive staining by KIT and with similar morphology to ICCs were found in the entire pyeloureteral tract of guinea pigs. The density of ICCs-like cells in the ureteropelvic junction, upper ureteral, middle ureteral, and lower ureteral tissues were (5.20?0.98), (3.90?0.98), (3.03?0.98) and (2.50?0.81) respectively. The contraction of strips in different sites varied according to the distribution of ICCs. The amplitude and frequency of strips from the ureteropelvic junction and upper ureteral were significantly higher than those from middle ureteral and lower ureteral (P

0 05). SLPP determation is helpful in the assessment of the type of genuine female stress urinary incontinence and is therefore valuable in its management.

Objective:To discuss the effect of pharmacist intervention on the use of antimicrobial agents in the clinical pathway of community-acquired pneumonia ( CAP) in our hospital to standardize the rational medication and promote the rational use of antimicro-bial agents. Methods:Totally 100 bacterial CAP patients in 2013 ( before the intervention) and 2014 ( after the intervention) in the pneumology department were studied. The antibacterial drug cost, total hospitalization cost, use intensity of antimicrobial drugs, hospi-talization time, therapeutic effects and so on in the two groups were observed during the treatment. Results: There were significant differences between the two groups in antibacterial drug cost, total hospitalization cost, use intensity of antimicrobial drugs, hospitaliza-tion time and so on, whereas there was no significant difference in the curative effect. Conclusion:After the pharmacist intervention, the application of antibiotics is more rational, the antibiotics use density and per capita cost are reduced, the hospitalization day is shortened and the value of pharmacists is also improved.

Objective To summarize and analyze the perioperative complications of irreversible electroporation (IRE) ablation in treating tumors at different locations and to discuss their managements. Methods A total of 200 patients with tumors, including pancreatic tumor (n=71), liver tumor (n=64) and other tumors (n =65), were enrolled in this study. All patients received IRE ablation treatment. The perioperative complications were recorded and the data were statistically analyzed. The causes of severe complications and the treatment of complications were discussed. Results None of the patients died during the course of IRE ablation procedure. Severe postoperative complications occurred in the patients with pancreatic tumor or liver tumor, including duodenal artery bleeding in 3 patients with pancreatic tumor, which occurred at 10 days, 11 days and 15 days after IRE ablation respectively, and gastrointestinal bleeding (n =1) and biliary septic shock (n=1) in 2 patients with liver tumor, which occurred at 9 days after IRE ablation, the clinical symptoms were controlled after interventional embolization and/or vascular ligation together with anti-infective therapy. All minor complications were relieved after symptomatic treatment within 14 days. Conclusion IRE ablation has less systemic inflammatory response, and both the intraoperative and postoperative adverse reactions can be easily controlled, besides, IRE ablation has higher clinical safety. Although IRE ablation procedure may damage the internal or peripheral vessels of the pancreatic tumor, this severe complications can be effectively avoided if proper measures are adopted based on the causes of complications. (J Intervent Radiol, 2018, 27: 223-227)

Objective To investigate the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP), laparoscopy, and laparotomy in the treatment of pancreatic duct stones (PDS) by collecting related clinical data, to summarize the experience in selecting treatment regimens for PDS, and to further explore feasible treatment regimens that could maximize and optimize the benefits of PDS patients. Methods A retrospective analysis was performed for the clinical data of 131 PDS patients who were treated in Gongli Hospital Affiliated to Naval Medical University from June 2014 to December 2018, and according to the surgical procedure, they were divided into ERCP group with 69 patients, laparoscopy group with 32 patients, and laparotomy group with 30 patients. Related indices were monitored before and after treatment, and surgical outcome was compared between the laparoscopy group and the laparotomy group. The independent samples t -test was used for comparison of normally distributed continuous data between two groups; a one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t -test or the SNK- q test was used for further comparison between two groups. The Mann-Whitney U test was used for comparison of continuous data with skewed distribution between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups. An repeated measures analysis of variance and the Friedman test were used for comparison of related indices before and after surgery, and the chi-square test was used for comparison of categorical data between groups. Results Among the 131 PDS patients, there were 40 patients with type Ⅰ PDS, 76 with type Ⅱ PDS, and 15 with type Ⅲ PDS. There was no significant difference in the distribution of main surgical methods between the laparoscopy group and the laparotomy group ( χ 2 =1.93, P > 0.05). There were significant differences between the laparoscopy group and the laparotomy group in the dynamic changes of white blood cell count, C-reactive protein, procalcitonin, and Homeostasis Model Assessment of Insulin Resistance after surgery ( F =24.68, χ 2 =227.66, F =45.37, F =106.71, all P < 0.05). Compared with the laparotomy group, the laparoscopy group had significantly shorter time of operation, significantly lower intraoperative blood loss, significantly shorter time to first flatus after surgery, a significantly lower frequency of use of pain-relieving drugs, shorter time to extraction of abdominal drainage tube, lower incidence rates of short-term postoperative complications, and a significantly shorter length of postoperative hospital stay ( t =-4.80, t =-9.43, Z =-6.78, t =-11.59, Z =-6.77, χ 2 =9.24, t =-3.60, all P < 0.05). The incidence rate of short-term postoperative complications was 24.64% in the ERCP group, 28.13% in the laparoscopy group, and 66.67% in the laparotomy group, with a significant difference between groups ( χ 2 =17.12, P < 0.05), and the ERCP group and the laparoscopy group had a significantly lower incidence rate of short-term postoperative complications than the laparotomy group ( χ 2 =15.78 and 9.24, P < 0.05 and P =0.02). The treatment response rate was 91.30% in the ERCP group, 93.75% in the laparoscopy group, and 73.33% in the laparotomy group, with a significant difference between the three groups ( χ 2 =7.70, P =0.02), and the ERCP group and the laparoscopy group had a significantly better response rate than the laparotomy group ( χ 2 =5.56 and 4.77, P =0.02 and 0.03). Conclusion ERCP is the preferred method for minimally invasive treatment of some patients with type Ⅰ/Ⅱ PDS and is safe and effective with few serious complications. Surgical operation is an important method for the treatment of complex PDS, but with complicated techniques and difficult operation. Compared with laparotomy, laparoscopy has the advantages of small trauma, few serious complications, and high abdominal pain remission rate and can significantly shorten the time of operation, reduce intraoperative blood loss, and shorten the length of postoperative hospital stay. Therefore, laparoscopy should be the preferred regimen for the treatment of complex PDS.