Objective To investigate the effect of immunoglobulin G (IgG) in bullous pempbigoid (BP) blister fluid on the secretion of chemokines by human keratinocytes. Methods IgG was obtained from the blister fluid of patients with bullous pemphigoid and sera of normal human controls, then purified by sequential precipitation with caprylic acid and ammonium sulfate. The immunological activity of blister fluid was tested before and after the purification by BP180 ELISA kit. Keratinocytes were isolated from the foreskin tissue of yong adults, and subjected to primary culture. After 3 passages, the primary keratinocytes were harvested and subcultured in the presence of purified IgG of 0.5, 1, 2, 4 and 8 g/L, respectively, for 24 hours, or IgG of 4 g/L for 3, 6, 12, 24 hours, respectively, followed by the detection of levels of eotaxin, monocyte chemoattractant protein (MCP)-1 and interleukin (IL)-8 in the supemate of keratinocytes by ELISA. Results The valence of IgG remained unchanged after the purification with caprylic acid and ammonium sulfate. Compared with IgG from the sera of normal controls, that from bullous pemphigoid blister fluid sig- nificantly enhanced the secretion of IL-8 by keratinocytes in a time- and dose-dependent manner (both P < 0.01 ). Neither eotaxin nor MCP-1 was detected in the supemate of control IgG-treated, BP IgG-treated or untreated keratinocytes. Condusions The IgG in BP blister fluid has been proved to stimulate the secretion of IL-8 by cultured human keratinocytes, which may be involved in the pathogenesis of BP.

Objective To evaluate the value of serum galactomannan (GM) detection for invasive pulmonary aspergillosis (IPA) diagnosis. Methods The suspicious IPA patients were divided into proven,clinical and possible IPA groups. The patients excluded of IPA were recruited as controls. The serum GM concentration was detected by Platelia Aspergillus double?sandwich enzyme linked immunosorbent assay(ELISA). Re?sults In the 103 patients,there were seven cases diagnosed as proven,nineteen cases diagnosed as clinical and forty cases diagnosed as possible IPA patients. Setting 0.5 as the optimal result for GM detection,the sensitivity,specificity,positive predictive values and negative predictive values of GM were 85.7%,86.5%,55%and 97%,respectively. In non?neutropenia patients combinded with the pulmonary chronic diseases,the sensitivity, specificity,positive predictive values and negative predictive values of GM detection were 71.4%,84.4%,66.75%and 87.1%,respectively. Conclu?sion Index>0.5 for GM test could increase the sensitivity without obvious decreased specificity. GM detection could provide valuable information in patients of non?neutropenia underlying the pulmonary chronic diseases,which had a better sensitivity and specificity versus conventional diagnostic tests.

Objective To observe the kinetics of myocardial during isovolumic relaxation (IVR) in normal subjects during exercise stress testing,and evaluate the relationship between the recovery rate of circumferential strain during IVR and the diastolic function of the heart.Methods Echocardiography was performed in 43 healthy students at rest,at peak stress and at recovery of the exercise test.The ratio of peak early-diastolic mitral orifice flow velocity and peak early-diastolic mitral annular velocity in left ventricular posterior wall (E/e) was measured.The records of the movement in the basal,papillary muscle and apical short-axis views of the left ventricular were stored.The circumferential strain during the end systolic (ES) and the end isovolumetric relaxation (IRA) of the subendocardial and subepicardial layers in the three short axis were analyzed using X-strain software.The circumferential strain recovery rate of the subendocardial and subepicardial layers during the IVR (ENCSrec,EPCSrec) were calculated.The circumferential strain of the subendocardial and subepicardial layers in the three short-axis during ES and IRA phases in different status were compared.The relationship between the circumferential strain recovery rate during IVR and E/e were analyzed.Results The circumferential strain of the basal,papillary level in short axis during ES and IRA phases decreases at the beginning and then increased along with the exercise intensity (P ＜0.05).The circumferential strain of the subendocardial layer is greater than the subepicardial layer in the three shortaxis during ES and IRA in different exercise status (P ＜0.01).The ENCSrec and EPCSrec of the three short-axis increases at the beginning and then decreased along with the exercise intensity (P ＜0.05).The ENCSrec and EPCSrec of 3 short axis are correlated with E/e in different exercise phases (P ＜0.05).Conclusions In normal subjects,the kinetics of circumferential strain during IVR is consisted with the physiological changes of the heart during IVR in different exercise phases.The circumferential strains in different myocardial layers are different during IVR.The circumferential strain recovery rate of left ventricular myocardial during IVR may reflex the diastolic function of the heart.

Objective To investigate the function of the left ventricular (LV) myocardial regional contractility in hyperthyroid by measuring the LV rotation and torsion using speckle tracking imaging (STI).Methods 58 patients with hyperthyroidism had accepted 131 I treatment the first time and cured and improved after treatment for 6 months were enrolled.According to the course of disease,they were divided into two groups:Group A,duration less than 6 months,28 cases;Group B,duration more than 6 months,30 cases.30 normal cases age and gender matched were enrolled as control group.LV peak rotation and torsion of endocardium and epicardium at basal and apical of levels were measured using STI in groups A and B before and after treatment,and correlation with cardiac function and structure parameters,heart rate,blood pressure,and the thyroid hormone were analyzed.Results ①Comparing group A and group B before and after treatment with control group,there was no statistically significant in the LV structure and function parameters (LVDd,LVDs,IVSd,PWd,LVEF) (P ＞0.05).②As for LV peak rotation of endocardium and epicardium at apical levels (EN PAR,EP-PAR) before treatment,group A was higher than the control group (P ＜0.05),group B was lower than the control group (P ＜0.01);After treatment,group A has improved (P ＜0.01),group B has improved only in EP-PAR (P ＜0.05),and there was no statistically significant compared with the control group (P ＞0.05).③ LV peak torsion of endocardium and epicardium (EN-Ptor,EP-Ptor) in group A was higher than the control group before treatment (P ＜0.05),group B was lower than the control group (P ＜0.01) ;After treatment,group A has improved (P ＜0.05),group B has only improved in EP-Ptor(P ＜0.05),and comparing with the control group,there was no statistically significant (P ＞0.05).④LV peak apical rotation and LV torsion were positively correlated with systolic blood pressure,heart rate,E-peak,A-peak,LVOT-V in different degree (P ＜0.01 or P ＜0.05),but no correlation with FT3,FT4,TSH (P ＞0.05).Conclusions Myocardial contractile function strengthens in early patients with hyperthyroidism and lessens with the extension of the course.Have not yet appeared heart diseases in patients with hyperthyroidism whose myocardial regional systolic function had changed,short duration can recover after treatment,but the long duration can not restore completely.Change of myocardial motion of patients with hyperthyroidism is associated with blood flow dynamics.

Objective To evaluate the effects of high frequency ultrasound in the assessment of vascular function during exercise in healthy subjects. Methods Forty-nine healthy subjects were enrolled in this study. The parameters of vascular function were measured at different stages (rest, exercise peak and recovery). Compliance coefficient (CC), distensibility coefficient (DC), stiffness indexα, stiffness indexβand pulse wave velocity (PWV) were measured by RF-Data technique of ultrasound vascular measurement (quantitative arterial stiffness, QAS). Endocardium-circumferential strain (EN-CS), epicardium-circumferential strain (EP-CS), endocardium-circumferential strain rate (EN-CSR) and epicardium-circumferential strain rate (EP-CSR) were collected by two-dimensional speckle tracking imaging (X-strain). The correlation between EN-CS, EN-CSR, EP-CS, EP-CSR and CC, DC, stiffness indexα, stiffness indexβand PWV were analyzed. Results At different stages (rest, exercise peak and recovery), CC were (1.436±0.448), (1.041±0.432) and (1.191±0.467) mm2/kPa DC were (0.040±0.016), (0.031±0.013) and (0.034±0.013) 1/kPa. CC and DC signiifcantly decreased at exercise peak (F=12.99 and 7.65, both P<0.01). At different stages (rest, exercise peak and recovery), PWV were (5.037±0.798), (5.845±1.165) and (5.683±1.367) m/s, stiffness indexαwere 2.298±0.633, 3.303±1.697 and 3.092±1.533, stiffness index β were 4.762±1.284, 6.794±2.515 and 6.158±3.089. PWV, stiffness index α and stiffness index β significantly increased at exercise peak (F=9.21, 13.24 and 12.33, all P<0.01). At different stages (rest, exercise peak and recovery), EN-CS were (7.825±2.445)%, (9.105±4.234)%and (6.271±2.527)%, EN-CSR were (0.831±0.276), (1.219±0.556) and (0.765±0.282) s-1, EP-CS were (6.894±2.465)%, (7.936±3.628)%and (5.489±2.306)%, EP-CSR were (0.714±0.247), (1.019±0.414) and (0.656±0.237) s-1. EN-CS, EN-CSR, EP-CS and EP-CSR signiifcantly increased at exercise peak (F=25.92, 43.76, 21.22 and 47.98, all P<0.01). EN-CS, EN-CSR, EP-CS and EP-CSR were positively correlated with PWV, stiffness indexαand stiffness indexβ(r:from 0.253 to 0.494, all P<0.05), negatively correlated with CC and DC (r:from-0.234 to-0.562, all P<0.05). Conclusions CC, DC, stiffness indexα, stiffness indexβ, PWV, EN-CS, EN-CSR, EP-CS and EP-CSR all can relfect the changes of vascular function during exercise. Properly exercise has positively direct effect on vascular elasticity.

Objective To investigate the distribution and antimicrobial resistance of Coagulase-negative staphylococci ( CoNS) isolated from cerebrospinal fluids in neurosurgical patients.Methods CoNS strains isolated from cerebrospinal fluids of neurosurgical patients were collected from Beijing Tiantan Hospital of Capital Medical University during January 2013 and December 2015.CoNS infection was diagnosed according to the standards of US Centers for Disease Control and Prevention, and the distribution and antimicrobial resistance of pathogenic CoNS strains were analyzed. Results A total of 19 756 cerebrospinal fluid specimens were collected and 1 386 bacterial strains were isolated, in which 650 (46.9%) were CoNS.Among 650 CoNS strains, 130 were diagnosed as the pathogen, and the top 4 CoNS species were Staphylococcus epidermidis (77/130, 59.2%), Staphylococcus hominis (18/130, 13.8%), Staphylococcus haemolyticus (11/130, 8.5%) and Staphylococcus capitis (9/130, 6.9%).The rest 520 CoNS strains were contaminating strains.According to antimicrobial susceptibility test, there were 103 strains of methicillin-resistant CoNS (MR-CoNS) accounting for 79.1% (103/130).And among 77 Staphylococcus epidermidis isolates, 67 were MR-CoNS strains (87.0%) .More than 90.0%Staphylococcus epidermidis isolates were sensitive to vancomycin and linezolid, and the rest CoNS strains were also highly sensitive to these two antibacterial agents.Conclusions CoNS plays an important role in post-surgery infection in neurosurgical patients, and Staphylococcus epidermidis is the dominant CoNS species.Most CoNS strains are methicillin-resistant, but are highly sensitive to vancomycin and linezolid.

Objective: To explore the therapeutic efficacy and safety of chemotherapy sequential epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) for advanced non-small cell lung cancer (NSCLC) patients with EGFR-TKI acquired resistance. Methods: The clinical features of 96 advanced NSCLC patients with EGFR mutation positive and EGFR-TKI acquired resistance from January 2013 to December 2016 were retrospectively reviewed. Forty-five patients who received chemotherapy sequential EGFR-TKI were enrolled in observation group, and another fifty-one who accepted chemotherapy alone were enrolled in control group. The objective response rates, disease control rates and adverse effects were compared between two groups. Results: Compared with that of the control group, the objective response rate of the observation group was significantly higher [24.4% (11/45) vs.11.8% (6/51), P=0.037], the disease control rate was also significantly increased [77.8% (35/45) vs.52.9% (27/51), P=0.023], the progression free survival was obviously prolonged [(7.4 ± 2.0) months vs.(4.5 ± 1.2) months, P=0.029], the incidence of rash in adverse reactions was significantly increased [35.6% (16/45) vs. 7.8%(4/51), P=0.008]. There were no significant difference in the side effects between the two groups (P > 0.05). Conclusions Compared with chemotherapy alone, chemotherapy combined with sequential EGFR-TKI could bring better clinical efficacy for NSCLC patients with EGFR-TKI acquired resistance, and the adverse effects could be tolerated.

Objective To improve the clinical oncology practice ability of professional degree postgraduates,and to explore the role of using standardized patients (SP) in problem-based learning (PBL) teaching method.Method Fifty-two professional degree postgraduates who studied clinical oncology in 2016 and 2017 in our department were taken as the research object,of which 26 were in the experimental group,26 were in the control group.In the experimental group,SP was used in PBL teaching method.In the control group,the traditional PBL teaching method was performed.After the end of the training course,data were analyzed using SPSS 19.0 software,count data and measurement data were analyzed using chi square test and t test to carry out the significant test between the two groups of data,the training effect was compared between the two groups.Results The score marked by experts in the experimental group was higher than that of the control group [(80.27 ± 6.41) vs.(74.77 ± 7.59)],the difference was statistically significant.The results of questionnaire survey showed that the experimental group was significantly higher than the control group in terms of patient satisfaction,clinical skills and participation in teaching activities (P＜0.05).Conclusion Introducing the SP into PBL teaching method could not only make PBL lively but also make SP teaching deeply.The organic combination of PBLand SP in the training process could improve the clinical oncology graduate students' abilities of clinical thinking,practice,doctor-patient communication,problems treatment,and humanistic care.This teaching model is worth promoting in the teaching of clinical oncology for profes-sional degree postgraduates.

Objective:To investigate the knowledge, attitude and practice status of ophthalmic nurses on prevention and control of intraocular infection in grade Ⅲ class A hospitals.Methods:A self-made questionnaire was used to investigate the knowledge, attitude and practice of 236 nurses on prevention and control of intraocular infection in the ophthalmology department of 8 grade Ⅲ class A hospitals in Zhengzhou from January to June 2020. The correlation between the knowledge, attitude and practice were analyzed by Pearson correlation analysis and the influencing factors of each term were analyzed by multivariate Logistic regression.Results:The scores of knowledge, attitude, practice of all nurses were (26.08 ± 2.46), (67.45 ± 8.48), (50.31 ± 6.67) points, and the scoring rate were (87.0 ± 8.2)%, (84.3 ± 10.1)%, (83.9 ± 9.8)%, respectively. The scores of each dimension of knowledge, attitude and practice were significantly positively correlated ( r values were 0.26-0.42, all P<0.05), respectively. Multivariate Logistic regression analysis showed that education background, professional title and training experience of infection were the influencing factors of knowledge score ( P<0.05), education background, professional title, training experience of infection and demand were the influencing factors of attitude score ( P<0.05), and nursing age and work post were the influencing factors of practice score ( P<0.05). Conclusions:The level of knowledge, attitude and practice of ophthalmic nurses in grade Ⅲ class A hospitals on prevention and control of intraocular infection is overall good. Hospital management department still needs to make reasonable management countermeasures according to personnel characteristics to improve the knowledge, attitude and practice level of ophthalmic nurses and to reduce post-operative intraocular infection.

Objective To classify traumatic triangular fibrocartilage complex(TFCC)injury based on 3.0T MR.Methods A total of 46 patients with definite history of wrist trauma admitted were collected.All patients underwent MRI scanning within 3 days after trauma,and the MRI findings were classified as follows according to the Palmer classification criteria:the focal structures of triangular fibro-cartilage(articular disc)(TFC)injury,the horizontal of the articular disc tear,injuries of ulnar styloid attachment and ulnar fovea attach-ment in TFC,ulnolunate and ulnotriquetral ligaments injuries,injury of the radial sigmoid notch junction,meniscal homologous inju-ry.The presence of TFCC injury was eventually confirmed by surgery in all patients.Results Of 46 patients,38 patients could be classified by Palmer,and there were 10 cases with type ⅠA,23 cases with type ⅠB,3 cases with type ⅠC and 2 cases with type ⅠD.A total of 8 patients were not suitable for Palmer type,and there were 3 patients with horizontal tears in the articular disc and 5 patients with meniscus homologous injuries.Conclusion The 3.0T MR can not only show various subtypes of Palmer classification,but also refine and supplement the classification based on the original classification,such as the injuries of ulnar styloid attachment and ulnar fovea attachment at the ulnar end of the articular disc,horizontal tear of the articular disc,meniscus homologous injury,etc.