Objective: To prepare and identify recombinant human IL 2/GM CSF(rhIL 2/GM CSF) fusion protein antibodies and to study its specificity and its effect on fusion protein biological activity. Methods: rhIL 2 /GM CSF fusion protein was purified by DEAE Sepharose FF ion exchange chromatography. The purified protein was used to immunize rabbits for the preparation of antisera. The titer and specificity of the antisera were detected by ELISA and Dot ELISA and the biological activity by cell proliferation. Results: The antisera not only reacted with the rhIL 2/GM CSF, IL 2 and GM CSF, but also inhibited the biological activity of the rhIL 2/GM CSF, IL 2 and GM CSF. Conclusion: The obtained antisera can be used to study the structure and function of the rhIL 2/GM CSF.

Objective:hIL 2/mGM CSF fusion gene was constructed and expressed in E.coli.recombinant hIL 2/mGM CSF fusion protein had both biological activity of hIL 2 and mGM CSF.Methods:The hIL 2 and mGM CSF genes were amplified by PCR (splicing by overlap extension,SOE) and ligated with two prolines linkers.Then the fusion gene was cloned into vector pLY4 and PBV220.The recombinant plasmid were transfected into E.coli and expressed.Results:The sequence of hIL 2/mGM CSF fusion gene was correct the hIL 2/mGM CSF fusion protein was highly expressed in E.coli and that comprises 20% of total bacterial protein.The results of biological activity assay showed that the expressed product possessed both of the activities of hIL 2(4.5?10 5 U/mg) and mGM CSF(3.85?10 6 U/mg).Conclusion:Have successful constructed the recombinant hIL 2/mGM CSF fusion protein which possessed bioactivities similar to that of the natural hIL 2 and mGM CSF.

Objective To evaluate the efficacy of integrated traditional Chinese medicine(TCM)and western medicine in treatment of acute exacerbations of chronic obstructive pulmonary disease(AECOPD)combined with respiratory failure,TCM syndromes of spleen-kidney-yang deficiency and phlegm-dampness by comparison between the integrated therapy and simple western therapy in treatment of the disease. Methods 160 patients with AECOPD combined with respiratory failure,spleen-kidney-yang deficiency and phlegm-dampness syndrome in the intensive care units(ICU)of Affiliated Hospital of Chengdu University of TCM and other four hospitals were randomly allocated into two groups in this double-blinded,multicenter,prospective,randomized,controlled trial. In the control group (78 cases),western medicine and placebo were given to the patients,and in the treatment group(82 cases), conventional western medicine plus fei-shuai mistura 25 mL were administered,four times per day,the therapeutic course lasting for 2 weeks in both groups. The all-cause mortality,respiratory failure-cause mortality,improvement of modified Medical Research Council(mMRC)Dyspnea Scale grades,6 minutes walk distance(6MWD),the forced expiratory volume in 1 second/forced vital capacity(FEV1/FVC)were observed in the 28 days after the end of treatment. Results In the comparisons between the control and treatment groups,there were no statistical significant differences in the all-cause mortality〔54.87%(45/82)vs. 64.10%(50/78)〕and the cases of FEV1/FVC(both P>0.05)in the 28 days after the end of treatment;the 28 day respiratory failure-cause mortality was significantly decreased〔19.51%(16/82)vs. 33.33%(26/78),P<0.05〕,the number of patients with mMRC Dyspnea Scale grades (1-2)was obviously increased(22 cases vs. 7 cases,P<0.05),and the number of patients with 6 MWD grades (4-6)was markedly enhanced in the treatment group(21 cases vs. 8 cases,P<0.05). Conclusions The integrated TCM and western medicine has better therapeutic results in improvement of the patients' degree of dyspnea, 6 MWD and respiratory failure mortality than simple treatment with western therapy for treatment of patients with AECOPD combined with respiratory failure, spleen-kidney-yang deficiency and phlegm-dampness syndrome. However,in regard to the effect on pulmonary function and all cause mortality,the integrated therapy for treatment of such patients in short term has no significant effect.

OBJECTIVETo analyze the clinical characteristics of protracted bacterial bronchitis (PBB) in children.

METHODThe clinical data of patients seen from October, 2010 to March, 2014 in Department of Respiratory Diseases of our hospital were retrospectively analyzed. Inclusion criteria were over 4 weeks cough, receiving fiberoptic bronchoscopy, positive bacterial culture and (or) the increased percentage of neutral granulocytes in bronchoalveolar lavage fluid (BALF).

RESULTTwenty eight patients were involved, 26 were male (93%) and two were female (7%). The median age of patients was 8.5 months. The median duration of cough was four weeks. The average length of hospital stay was (8.3 ± 3.9)days. The main clinical feature was wet cough in 28 cases, wet cough with wheezing was seen in 21 cases. The wet cough phase distribution was irregular in 21 cases. The crackles with wheeze (in 21 cases) was main signs of PBB. The percentage of CD3⁻ CD16⁺ 56⁺ cells increased in peripheral blood. The fiberoptic bronchoscopic manifestations of PBB were luminal mucosal edema. Eleven patients also had airway malacia. The neutrophil median in BALF was 0.2. The positive rate of bacterial culture of BALF was 36%. The main bacteria were Streptococcus pneumoniae (50%) and Haemophilus influenzae (30%). The main treatment for PBB patients included amoxycillin/clavulanate potassium and second-generation cephalosporins. The average duration of treatment was (17.3 ± 3.2)days, the prognosis was good.

CONCLUSIONPBB is common in male infants. Persistent wet cough with wheezing was the main characteristic of PBB. PBB is commonly accompanied by immune dysfunction and airway malacia, and the pathogens were Streptococcus pneumoniae and Haemophilus influenzae.

Bacterial Infections ; drug therapy ; pathology ; Bronchitis ; drug therapy ; microbiology ; pathology ; Bronchoalveolar Lavage Fluid ; Bronchoscopy ; Cough ; Female ; Haemophilus influenzae ; isolation & purification ; Humans ; Infant ; Male ; Respiratory Sounds ; Retrospective Studies ; Streptococcus pneumoniae ; isolation & purification

Objective:To evaluate the feasibility of PET automatic drug infusion system combined with power peripherally inserted central catheter (PICC) for 18F-FDG injection and PET/CT imaging. Methods:Fifty patients with malignant neoplasms who underwent 18F-FDG PET/CT imaging in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine between December 2021 to July 2022 were prospectively enrolled. They were equally divided into power PICC group and peripheral venipuncture group. PET automatic drug infusion system was respectively connected with the pre-established channels of power PICC and peripheral venipuncture for 18F-FDG injection. Each patient underwent a routine PET/CT imaging at 1 h post-injection. The blood glucose, body weight, prescription dose and injection dose were recorded, and SUV max in the liver and cavoatrial junction were measured in both groups. The independent-sample t test was performed to compare the differences between 2 groups. The power PICC tip positions after 18F-FDG injection in power PICC group were observed. Results:The liver SUV max in the power PICC group and peripheral group were 2.54±0.50 and 2.57±0.31 ( t=0.37, P=0.716), and the SUV max of cavoatrial junction in the 2 groups were 1.68±0.25 and 1.63±0.22 ( t=-0.78, P=0.441), respectively. No significant differences were found in blood glucose, body weight, prescription dose and injection dose between the 2 groups ( t values: 0.00-0.13, all P>0.05). The ratios of injection dose to prescription dose in the 2 groups were 0.998 3±0.007 3 and 0.997 6±0.016 5, respectively, indicating high injection accuracy of the injection methods. No obvious drug residue was displayed at the end of catheter, resulting in good imaging quality. All the tip positions after injection were between T5 and T8, in line with the standardization management of power PICC. Conclusion:PET automatic drug infusion system combined with power PICC can be safely used for 18F-FDG injection and PET/CT imaging with less injection puncture.

Objective:To investigate the technical points and clinical application of combined infratemporal fossa approaches (CIFA) by analyzing the clinical results with CIFA for lesions involved skull base.Methods:A retrospective study was performed on 11 patients underwent CIFA for skull base lesions dissection from December 2014 to January 2019 in the department of otolaryngology, Peking Union Medical College Hospital. There were 6 male and 5 female patients, with age range of 16-72 years old and median age of 53 years old. Five patients underwent CIFA Type B and D, and the other 6 underwent CIFA A and B. All patients were followed up regularly by CT and MRI to observe possible recurrence.Results:Among the 5 patients with CIFA Type B and D, 3 were giant cell tumor and 2 were giant cell reparative granuloma, and median maximum cross-section size was 42 mm×46 mm (range from 37 mm×18 mm to 56 mm×53 mm). Among the 6 patients with CIFA Type A and B, 4 were paraganglioma of head and neck, 1 was schwannoma of skull base, 1 was petrous cholesteatoma, and median maximum cross-section size was 43 mm×36 mm (range from 24 mm×22 mm to 63 mm×35 mm). Nine patients underwent complete resection of the tumor in the first stage. In 2 patients, the extracranial parts were removed in the first stage, and the intracranial part was removed in the second stage. Tympanum and ossicular reconstruction were done in one of the CIFA Type B and group D, and 1 year′s postoperative hearing was mild conductive hearing loss. There was no cerebrospinal fluid leakage of all patients. All the 5 patients with normal facial nerve function before surgery recovered to H-B grade Ⅰ to Ⅱ within 3 months after surgery. Among the 4 patients whose preoperative facial nerve function were grade Ⅱ, 2 recovered to grade I after surgery and the other 2 were still grade Ⅱ. For the patient whose preoperative facial nerve function was grade Ⅴ, his postoperative recovery was grade Ⅲ. There was 1 patient whose pre-operative FN function was H-B grade Ⅲ, and the post-operative FN function was grade Ⅵ due to FN resection. Except for 2 cases with cochlear involved before surgery, cochleae of the other 9 cases were preserved. The follow-up time was 14 to 58 months. No recurrence was observed in all patients.Conclusions:The CIFA can safely and completely remove the extensive lesions that invade the skull base, and the facial nerve function can be well protected and recovered intro-and post-operation. Appropriate use of combined IFA can not only achieve good exposure and complete resection of lesions, but also create conditions for functional reconstruction.

Currently, computer-aided implant surgeries include implant placement surgery under the guidance of a dynamic navigation system. With the use of software inherent in the navigation system, doctors can make a preoperative plan including the ideal position of the implant. Then the plan can be accurately transferred to the surgery, during which the real-time condition of the drill and its relationship with the surgical region will be visualized by the surgeon and the drill can be adjusted in a timely manner. Currently the dynamic navigation system is increasingly widely utilized, especially in cases of esthetic zones or surgical sites with important anatomical structures. However, the clinical workflow of the navigation system is complicated, including CBCT taken after the registration device placement, prosthetic-driven 3D design, calibration, registration, navigated borehole preparation and implant placement surgery. Many details should be considered when the device is applied, including implant position design, fixation of the tracking device, registration, and stable borehole preparation under the guidance of dynamic navigation. Therefore, this article introduces the dynamic navigation system into the clinical workflow and evaluates, the effects of the application and the clinical features. The new progress of the navigation system in the field of implantology is demonstrated at the same time, including navigated surgery in fully edentulous arches and in the zygomatic zone. Further improvements in the navigation system in terms of the accuracy and simplification of the workflow are needed in the future.