Objective: To explore the feasible methods for item selection of TCM syndrome scale.Methods:Elderly hypertension with syndrome of kidney qi deficiency was selected as example.The symptoms and signs of elderly hypertension patients were statistically analyzed with clinical epidemiological investigation on the basis of discussion among focus group and expert consultation.Six selection methods were used,such as correlation coefficient method,dispersion tendency method,factor analysis method,etc.Results:18 Items were selected in the end and constituted the preliminary scale of kidney qi deficiency of elderly hypertension.Conclusion:Only if combine subjective and objective selection methods,use kinds of proper statistical methods and master the scale of preserving items,can we acquire good reliability and validity of scale.

Objective To study the Val247Leu and Trp316Ser polymorphisms of β2-glycoprotein Ⅰ(β2GPⅠ) in systemic lupus erythematosus (SLE) patients and their associations with antiphospholipid antibodies and thrombotic complications.Methods We used DNA sequencing to detect the polymorphisms of Val247Leu and Trp316Ser in 378 SLE patients and 240 normal controls.Anti-β2GP Ⅰ antibodies and anticardiolipin (ACA) were tested by enzyme linked immunosorbent assay (ELISA).Lupus-type anticoagulants(LAC) was performed by diluted Russell's Viper Venom Test.Then the patient group was further analyzed according to APLs (Anti-β2GP Ⅰ antibody,LAC and ACA),thrombosis and obstetrical complications using Logistic regression analysis to confirm whether there are associations between β2GPⅠpolymorphism and those factors.Results For Va1247Leu,the predominant genotype was LL in healthy controls which accounted for 57.08％,while it was VL in SLE patients which accounted for 59.5％ (x2=45.01,P=0.000).Frequency of VV genotype was significantly higher in patients with thrombosis,anti-β2GP Ⅰ,ACA and obstetrical complications (OR=6.79,3.75,2.12 and 3.85,respectively;P=0.000,0.001,0.044 and 0.017,respectively).Those patients with VL genotype tended to have positive anti-β2GPI,LAC,ACA,thrombosis and also obstetrical complications (OR=2.95,1.88,2.47,2.97 and 2.74,respectively;P=0.000,0.007,0.000,0.001 and 0.016,respectively) than those negative ones.The predominant genotype of Trp316Ser was TT,then TS.No correlations could be found between Trp316Ser polymorphism and APLs,neither relation to thrombosis complications.Conclusion The polymorphism of Val247Leu is significantly associated with the presence of APLs,thrombosis and obstetrical complications.Both VV and VL genotype are risk factors for the generation of APLs,occurrence of thrombosis and obstetrical complications.The VV genotype is a high risk factor for thrombosis.Trp316Ser polymorphism does not contribute to the APLs production and also have no correlations with thrombotic complication.

Objective To discuss the X-ray and CT findings of pulmonary air leak in neonates and to improve the early diagnostic ability.Methods The supine anteroposterior chest films of 33 neonates with pulmonary air leak were retrospectively analyzed.A-mong them,spiral CT scanning was performed in 5 cases.Radiographic follow-up was made in 30 cases.Results Pulmonary intersti-tial emphysema was found in 2 cases,pneumomediastinum in 4 cases,simple pneumothorax in 14 cases.Pulmonary interstitial em-physema combined with pneumomediasfinum was detected in 2 cases,with pneumothorax in 4 cases.Pneumomediastinum combined with pneumothorax was displayed in 3 cases.Pulmonary interstitial emphysema combined with pneumomediastinum and pneumotho-rax was found in 4 cases.Among them,medial pneumothorax was shown in 26 side,lateral pneumothorax in 9 side.Conclusion X-ray radiography is the main method for the diagnosis of pulmonary air leak in neonates,and CT can further define the location,range and extent of the disease.

Objective To explore the correlation between B lymphocyte activation and CD154 expression and lupus anticoagulants (LAC) in patients with systemic lupus erythematosus (SLE). Methods Sixty newly diagnosed SLE patients (SLE group) and 32 healthy controls (control group) were involved. The expressions of CD27 and CD154 in peripheral blood were determined by flow cytometry, and the positive expression rates were computed. The LAC was determined by activated partial thromboplastin time, and the LAC ratio > 1.20 was positive. Results The positive rate of CD27, expression intensity of CD27, positive rate of CD154 and expression intensity of CD154 in SLE group were significantly higher than those in control group: 0.047 ± 0.021 vs. 0.035 ± 0.014, 0.387 ± 0.185 vs. 0.214 ± 0.091, 0.191 ± 0.108 vs. 0.101 ± 0.081 and 0.049 ± 0.018 vs. 0.022 ± 0.012, and there were statistical difference (P<0.05 or <0.01). Among patients with SLE, the LAC positive was in 28 cases, and the LAC negative was in 32 cases. The positive rate of CD27, expression intensity of CD27, positive rate of CD154 and expression intensity of CD154 in SLE patients with LAC positive were significantly higher than those in SLE patients with LAC negative: 0.055 ± 0.023 vs. 0.037 ± 0.014, 0.444 ± 0.179 vs. 0.329 ± 0.123, 0.218 ± 0.101 vs. 0.158 ± 0.044 and 0.058 ± 0.035 vs. 0.020 ± 0.009, and there were statistical differences (P<0.05). Conclusions The B lymphocyte activation and CD154 abnormal expression correlates with generation of LAC in patients with SLE. It provides a basis for the further study on intervening the generation of LAC and reducing the risk of thromboembolism.

Objective To investigate the correlation between CT grading and prognosis of hypoxic-ischemic encephalopathy(HIE),and with the diagnostic value of CT findings and followed-up.Methods 49 neonates from 1 month to 1 year with HIE whose CT findings and followed-up results and clinic were retrospectively analyzed.Results Among 49 cases,the clinical follow-up showed that the hypodense foci induced by HIE were absorbed and disappeared completely within 1～3 months after birth.10 neonates presented external hydro-cephalous at 1～3 months after birth and then that was absorbed after 6 months to 1year of age.In 3 months,the part poor moderate HIE in the neonates might cause the leukomalaria,while severe HIE might cause the cerebral malaria and atrophy within 1 month after birth.Conclusion The prognosis of HIE is closely related to the degree of abnormal manifestations on CT.Intracranial lesions were favorable in the mild HIE,good in the moderate ones and bad in the severe ones.If there were bleeding in ventricles,the prognosis would be more poor.

Objective To explore the role of clinical pharmacist in individualized treatment of hypertension.Methods A patient withH hypertension receiving pharmaceutical care from clinical pharmacists was retrospectively analyzed.Results Patient's MTHFR (C677T) gene type was TT homozygous.Clinical pharmacist suggested doctor modify treatment,and then patient's plasma homocysteine dropped from 61.5 to 16.0 μmol·L-1,and blood pressure dropped from 173/ 111 mmHg(1 mmHg =0.133 kPa) to 130/80 mmHg.Conclusion Clinical pharmacist provides individualized treatment for patient with hypertension to ensure the safety and effectiveness of the drug by genotyping.

Objective To establish the Cookie Theft Test for Chinese norms. Methods 29 normal participants and 17 patients with stroke finished the Cookie Theft Test. The language samples were analyzed in 7 different indexes which are incorrect statement (IS), dysfluencies (DF), providing structure support (PS), repetitions (RP), content units (CU), elaborations of content units (EC) and irrelevancies (IR). Besides, the total words of language samples were counted. The scores of normal participants in 8 indexes were regarded as norms. And the scores of patients in 8 indexes were used to test the validity of the norms. Results The test-retest reliability was r(IS)=0.92, r(DF)=0.89, r(PS)= 0.98, r(RP)=0.84, r(CU)=0.96, r(EC)=0.88 and r(IR)=0.99, respectively. 12 out of 17 patients were distinguished by the norms. Conclusion The norms of Cookie Theft have acceptable reliability and validity and can be applied to clinical diagnoses and scientific researches

Objective To explore antitumor effect of 131I-Trastuzumab on human epidermal growth factor receptor(HER) 2 overexpressing breast cancer cells and investigate its possible mechanism.Methods The expression levels of HER2 of three different breast cancer cell lines (BT474,MCF-7,HCC1937) were detected with immunofluorescence.Trastuzumab was labeled with 131I using the Iodogen method and 131I-Trastuzumab was isolated with ultrafiltration membrane,then the labeling efficiency,radiochemical purity and immunoreactivity were measured.The effects of 131I,Trastuzumab and 131I-Trastuzumab on viability of BT474 cells were evaluated with cell counting kit-8 (CCK-8) assay.The levels of total Akt and phosphorylated Akt (p-Akt) were detected with Western blot analysis.One-way analysis of variance (ANOVA),ANOVA for factorial design,Bonferroni correction and Pearson correlation analysis were used for data analysis.Results The expression level of HER2 in BT474 cells was much higher than those in HCC1937 and MCF-7 cells.The labeling efficiency,radiochemical purity and immunoreactivity of 131I-Trastuzumab were (89.71± 2.93)％,(91.80±1.43)％ and (58.84±3.35)％ respectively.131I (4.625 GBq/L),Trastuzumab(125.0 rmg/L) and 131I-Trastuzumab(4.625 GBq/L) exhibited a dose-dependent cytotoxicity against BT474 cells (r =-0.964,-0.912,-0.618;all P＜0.05).The cell viability of 131I-Trastuzumab treated gourp (34.73％ ±5.03％) was significantly lower than those of 131I and Trastuzumab treated groups (64.36％± 1.51％ and 58.09％±4.14％;t=10.373 and 8.180,both P＜0.05),and the cell viability of control group was (100.00±4.54)％.131I-Trastuzumab shown a positive multiplicative interaction between 131I and Trastuzumab (F=9.226,P＜0.05;CDI =0.929).Western blot results showed that there was no significant difference of total Akt expression among the control group,131I group,Trastuzumab group and 131I-Trastuzmab group (F=0.208,P＞0.05).P-Akt expression in both Trastuzumab group and 131I-Trastuzumab group were much lower than those of control group and 131I group (t=12.524,15.984,7.347,10.807;all P＜0.05),while there was no significant difference of p-Akt expression between Trastuzumab group and 131I-Trastuzumab group(t =3.460,P＞0.05).Conclusions 131I-Trastuzumab may kill HER2 overexpressing breast cancer cells more effectively than Trastuzumab alone.The underlying mechanism may be attributed to that 131I-Trastuzumab may enhance the radiosensitivity by the inhibitory effect on PI3K/Akt pathway and thus exert synergistic effects with 131I.

Objective To investigate the G protein-coupled receptor kinase 2 (GRK 2) level in peripheral blood lymphocytes with cardiac func-tion in elderly patients with acute myocardial infarction. Methods This study enrolled 40 patients with acute ST-segment elevation myo-cardial infarction (STEMI) and 40 patients with unstable angina. All patients were 65 years or older. Cardiac function was evaluated by echocardiography, and the GRK 2 level in peripheral blood lymphocytes was measured. Patients with STEMI were followed up for 2 years. Results The GRK 2 level in peripheral blood lymphocytes was significantly higher in patients with STEMI than in patients with unstable angina, and was negatively correlated with left ventricular ejection fraction, cardiac output, stroke volume, and left ventricular fractional shortening. The GRK 2 level was significantly elevated in some patients with acute STEMI and poor cardiac function. Conclusions In-creased GRK 2 level in patients with acute STEMI may contribute to poor myocardial systolic function and myocardial remodeling. Meas-urement of the GRK 2 level in peripheral blood lymphocytes may assist in the evaluation of cardiac function and myocardial remodeling in elderly patients with acute STEMI.

Objective To evaluate the recognition and uptake of transglutaminase 3 (TG3) by dendritic cell-specific intercellular adhesion molecule 3-grabbing nonintegrin (DC-SIGN) receptors on the membrane surface of DC-SIGN-transfected human embryonic kidney (HEK) 293T cells and monocytederived dendritic cells (MDDCs).Methods The eukaryotic expression vector pGCMV-enhanced green fluorescent protein (EGFP) containing DC-SIGN gene fragments was transfected into HEK293T cells to prepare DC-SIGN-EGFP-HEK293T cells by using liposome transfection method.CD14+ monocytes were isolated from peripheral blood samples by magnetic bead-based negative selection,and then were induced by granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4) to prepare MDDCs.Laser confocal microscopy and flow cytometry were performed to evaluate the recognition and uptake of TG3 protein by DC-SIGN receptors on the surface of HEK293T cells and MDDCs.MDDCs treated without Alexa Fluor 647 dye-tagged TG3 served as blank control group,and those treated with Alexa Fluor 647 dye alone served as negative control group.Results After co-culture with TG3 for 3 hours,laser confocal microscopy and flow cytometry both showed that TG3 could be recognized by and uptaken through DC-SIGN receptors into HEK293T cells and MDDCs.Flow cytometry also revealed that the binding of TG3 to MDDCs could be partially blocked by DC-SIGN blocking antibodies.Neither the negative control group nor the blank control group showed the recognition and binding of TG3 to HEK293T cells and MDDCs.Conclusion TG3 can serve as a kind of autoantigen to be recognized and bound by DC-SIGN receptors,followed by uptake by dendritic cells.