Objective To evaluate the serum Krebs von den Lungen (KL)-6 for the diagnosis of interstitial lung disease (ILD) associated with connective tissue diseases (CTD) and its lung-CT subtypes.Methods Seventy-five CTD patients were employed for this study,44 CTD with ILD and 31 ILD without ILD.The 44 CTD patients with ILD were further divided into different subgroups based on lung-CT imaging and clinical indexes.The enzyme-linked immune sorbent assay (ELISA) was used to measure the serum KL-6 level.For those data that was abnormally distributed,the differences between groups was compared with independent samples nonparametric tests.Results The level of serum KL-6 in the CTD with ILD was significantly higher than that without ILD [(1 118±877) U/ml vs (253±144) U/ml] (Z=-6.047,P＜0.01).By using a criterion of 500 U/ml,our data suggested that the serum KL-6 level was useful for the ILD-CTD diagnosis;the sensitivity,specificity,positive and negative predictive values were 72.7％,87.1％,88.9％ and 69.2％,respectively.The serum KL-6 level,however,showed no statistical differences between ILD subtypes,i.e.,usual interstitial pneumonia (UIP),nonspecific interstitial pneumonia (NSIP) and indeterminate [(1 104±843) U/ml,(1 242±1 039) U/ml,(815±400) U/ml,respectively] (x2=0.35,P=0.84).Our data further showed that the KL-6 level was significantly higher in CTD-ILD patients with intensive lung lesions than those with limited lung lesions [(1 910±918) U/ml vs (459±268) U/ml] (Z=-4.364,P＜0.01).In addition,the KL-6 level was significantly higher in active ILDs than in inactive ILDs[(1 478±917) U/ml vs (598±475) U/ml] (Z=-3.915,P＜0.01).Conclusion The serum KL-6 is a valuable biomarker for CTD-ILD diagnosis and even for the assessment of the extent and activity of lung damage.

The directed molecular evolution of enzyme in vitro can not only improve the efficiency of evolution, but also evolve enzyme according to the investigator's desire. This review summed up the feasible methods of this novel technique.

Objective To study the changes of learning-memory ability and synapse of hippocampus after radiation injuries. Methods Sprague-Dawley rats were grouped according to radiation dose to 20Gy group,30Gy group radiated by linear accelerator and control group were used before radiation and 120 days after radiation. Morris maze test were taken to study the learning and memory ability of rats in each group. Average escape latency and search strategy were scaled and analyzed in each group. The parameters of synapse in CA3 area of hippocampus were studied by using electron microscope and image analyzer. Results AEL of 20Gy group was (41. 17 ±10.76 ) s and score of SS was 27.13 ± 2.34 after 120 days' radiation but AEL of 30 Gy group was (78.49 ± 9.32)s and the score of SS was (23.19 ± 7.65 ) nm. There were significant statistic differences Compared with control group and before radiation (P ＜ 0.05 ). The thickness of PSD of 20 Gy group was ( 22.03 ± 6.84 ) nm after 120days' radiation and (23.19 ± 7.65 )nm in 30 Gy group. There were significant statistic differences compared with control group and before radiation. It was observed that both in 20 Gy and 30 Gy group' s the length of synaptic activity area was shorter,the curvature of synaptic interface was smaller,the width of synaptic cleft and the thickness of PSD was narrower than that of control group. Conclusion There was close relation between the changes of learning-memory ability and synapse of hippocampus after radiation injuries.

Objective To study the chemical constituents of Swertia decora, a traditional herb used to treat hepatitis by the minority.Methods The constituents were separated and purified by column chromatography with silica gel.Their structures were identified on the basis of spectral analysis such as UV, MS, NMR, HMPC, HMQC and by HPLC.Results Three compounds were isolated from the chloroform part and ethyl acetate part of the extracts.Their structures were identified as 1-hydroxy-4, 5, 6, 7-tetra- methoxy -9H-xanthen-9-one (swertiadecoraxanthone-Ⅰ, Ⅰ), 5, 7, 3′, 4′- tetrahydroxyflavone (luteolin, Ⅱ), and 3, 5, 7, 3′, 4′-pentahydroxyflavone (quercetin, Ⅲ), respectively.Conclusion Swertiadecora- xanthone -Ⅰ is a new compound and the other two are found from this plant for the first time.The pentaoxygenated patterns of compound Ⅰ is also found for the first time in the plants of Swertia L.

Objective To study the clinical effect of personalized intervention on elderly patients with colostomy after Miles operation for rectal carcinoma. Methods 114 cases elderly patients with colonic stoma after Miles operation for rectal cancer from June 2014 to January 2016 were divided into control group and observation group by random number method, 57 cases in each. The control group were treated with routine intervention, while patients in observation group was treated with personalized intervention. the self-care ability score before intervention, the incidence of complications, intervention satisfaction and life quality score were compared between the two groups at the same time. Results The total complication rate in the observation group was significantly lower than that in control group ( 5.25% vs 22.80%) (χ2 = 8.36, P = 0.000); the intervention satisfaction of the observation group was significantly higher than that in control group (91.23% vs 75.44%) (χ2 = 6.60, P = 0.010). After intervention, the self-care ability score and life quality score of observation group were significantly higher than that in control group (P < 0.01). Conclusion The personalized intervention can reduce the complications, significantly improve the patients' life quality score and self-care ability, and effectively alleviate the negative situation, improve the patients intervention satisfaction, with a higher development value, it is worth of clinical promoting.

Objective To establish an ELISA for detecting antibody against Aspergillus fumigatus pectate lyase A(anti-PlyA),and evaluate its diagnostic value for invasive aspergillosis (IA).Methods An indirect ELISA for IgG antibody a-gainst PlyA was established using PlyA as coating antigen.The serum from 97 IA patients,80 non-IA patients and 200 healthy donors were tested,the results were compared with anti-DPPV (antibody against Aspergillus fumigatus dipeptidyl peptidase V fragment)and anti-TR (antibody against Aspergillus fumigatus thioredoxin reductase).Results The intra-as-say coefficients of variation of the ELISA method for detecting anti-PlyA was 5.3%,and inter-assay coefficients of variation was 10.9%.The sensitivity and specificity of diagnosis of IA were 62.9% and 90.4%,respectively.The positive rates of an-ti-PlyA in non-neutropenic and neutropenic IA patients were 43.8% and 72.3%,respectively (χ2 =7.493,P <0.05).There was no significant difference between the positive rates of anti-PlyA (62.9%),anti-TR (60.8%),and anti-DPPV (67.0%) (χ2 =0.562,P > 0.05).When combined anti-PlyA,anti-TR,and anti-DPPV,the diagnostic sensitivity for IA patients in-creased to 92.8%.Conclusion An ELISA for detecting anti-PlyA was successfully established.The diagnostic value of these three kinds of antibody was superior in non-neutropenic IA patientsto that in neutropenic IA patients.The combined detec-tion of three antibodies could provide higher sensitivity.

Sankezhen (Berberidis Radix) is a traditional Chinese materia medica,cold in nature and bitter in taste,for treating syndromes of liver,stomach,and large intestinal meridians,in which berberine and berbamine are the major pharmacological components.Sankezhen has been readmitted in Chinese Pharmacopoeia 2010 following the 1977 version as the roots of Berberis spp.e.g.B.soulieana,B.wilsonae,B.poiretii,B.vernae,etc.Recent studies showed that Berberis spp.were potential phytomedicines with multiple spectrums therapeutic effects and various pharmaceutical parts.Here we reviewed Sankezhen in traditional use and phytochemistry,and its major active components berberine and berbamine with potential bioactivities recently discovered,such as antitumor,antidiabetic,antihyperlipidemic,anti-arrhythmic,and neuro-protective activities.It is necessary to mature the quality assessment of Sankezhen as a new admission of Chinese Pharmacopoeia 2010.Other parts of Berberis spp.should be investigated to better develop this herb in medicinal usage.

Objective To assess the clinical application value of color Doppler ultrasound guided puncture in peripherally inserted central catheter (PICC). Methods Thirty-two patients needed long-term intravenous infusion underwent PICC. Color Doppler ultrasound was used to select the puncture vascular,the best puncture point and angle, and the entire process was monitored and guided dynamically, and the initial position of the catheter tip was located. Results Color Doppler ultrasound-guided puncture was successful in all 32 patients, and the successful rate was 100%. The guided puncture time was 22 s to 19 min, and the first puncture succeeded in 30 patients (93.75%). Conclusion Color Doppler ultrasound-guided puncture in PICC can obviously raise the success rate of puncture, shorten puncture time and reduce the complications. It is an easy, safe and certain method.

Objective To analyze the characteristics of benign and malignant breast tumors with 2D and color Doppler ultrasound, and to assess the value of color Doppler ultrasound in the diagnosis of breast cancer. Methods A total of 674 patients (327 malignant and 347 benign) of breast tumor underwent 2D and color Doppler ultrasonogarphy. Two-dimensional ultrasound was used to observe the size, form, margin and internal echo of the tumors;color Doppler was performed to observe the degree of blood flow signal in the tumor, and to measure peak systolic velocity (PSV) and resistance index (RI). Results Totally 671 patients were diagnosed with ultrasound. The size of the tumors were from 0.50 cm×0.41 cm to 5.42 cm×4.10 cm. The ratio of vertical and transverse diameter of 69.11% (226/327) of the malignant tumors ≥1.0. Most tumors (266/327, 81.35%) presented with irregular margin like incised or feet of crab;61.47% (201/327) had microcalcification. Color Doppler found that 92.97% (304/327) of the tumors had blood flow signal;PSV was 15.34-39.76 cm/s, RI was 0.65-0.98, and 91.61% (262/286)≥0.70. Significant differences of the ratio of vertical and transverse diameter, the margin of the tumor, microcalcification and blood flow signal, PSV and RI (P＜0.01) were found between benign and malignant breast tumors. Conclusion The diagnosis and differential diagnosis of benign and malignant breast tumors can be significantly improved with comprehensive analysis of 2D ultrasound, blood flow signal, PSV and RI. Color Doppler ultrasound plays an important role in the diagnosis of breast cancer.

Objective:To study the clinical features and treatment outcome of AIDS associated oral candidiasis.Methods:The clinical data of 31 cases with AIDSassociated oral candidiasis from 201209 to 201303 were studied retrospectively,including general data,clinical features,oral manifestation,CD4 cell count,opportunistic infections,and antifungal therapy outcome,etc.Results:CD4cell count ＜200 cell/μl was found in 30 cases,AIDSrelated multiple opportunistic infection was observed in 29 cases.30 cases hadpseudomembranous candidiasis,1 cases had erythematous candidiasis and 2 cases had pseudomembranous candidiasis with angular candidiasis.After antifungal treatment,the lesion of 8 cases reduced,that of 23 cases disappeared completely,lesion relapse after drugwithdrawal happened in 3 cases.Conclusion:AIDSassociated oral candidiasis was more common in AIDS patients with CD4 ＜200cells/μl,the main clinical form is pseudomembranous type,and with multiple opportunistic infections.The antifungal treatment is effective for the patients.