It is a strategic choice for a country to build top universities for innovative talents and independent innovative products.Germany,South Korea,Japan and Chinese Taiwan and Mainland are taking great measures to build top universities.In comparison with Project 985 universities under the direct administration of the Ministry of Education of China and world top universities in their environment,research,teaching and disciplines,key construction strategy including integration of distinctive resources to build top university system should be kept up,core competency cultivation,proper development environment and major features should come into being,and scientific HEIs categories should be established in building top universities in China.

Objective:To summarize and analyze the clinical characteristics of different treatment in children with esophageal foreign bodies.Methods:This study collected 246 children with esophageal foreign bodies in our hospital from January 2016 to January 2020, which was divided into endoscopic group and operative group.The general and clinical data of children treated with different treatment were collected and statistical analyzed.Results:There were 222 children in endoscopic group and 24 children in operative group, respectively.The rate of surgery was 9.75%.There were no significant differences in gender and location of esophageal foreign bodies.However, the average age of operative group was(2.92±2.67) years, which significantly younger than that in endoscopic group(4.12±3.37)years( P=0.049). The residence time in operative group(median 29.10 h)was remarkable longer than that in operative group(median 11.80 h)( P<0.001). The proportion of sharpness(50.00%) and corrosive(45.83%) foreign bodies in operative group were more than those in endoscopic group[16.22% and 8.11%( P<0.001)]. Moreover, the occurrence rate of major complication in operative group was 83.33%, which was dramatically higher than that in endoscopic group(0.90%)( P<0.001). Conclusion:The younger and longer residence time of esophageal foreign bodies in children contribute to the rate of operative treatment.Additionally, the sharpness and corrosive foreign bodies increase the risk of surgery and serious complications.

Objective To explore the effect of pulse irrigation combined with autologous blood transfusion on inflammatory markers and thrombosis index, such as C-reactive protein (CPR), erythrocyte sedimentation rate (ESR), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in patients undergoing total knee arthroplasty. Methods 96 patients due to knee osteoarthritis underwent unilateral total knee arthroplasty were randomly divided into experimental group (pulse irrigation combined with autologous blood transfusion after surgery ) and control group (alone autologous blood transfusion after surgery), PT, APTT, TNF-α, IL-6, D-Dimer of two groups at different time points were detected and compared. All patients underwent lower extremity vascular ultrasound examination after operation. Results PT, APTT values were no significant different between two groups (P > 0.05), TNF-α, IL-6 values of day1 and day7 after surgery in the experimental group were lower than the control group(P < 0.05), D-Dimer values of day4 after surgery were lower than the control group (P <0.05), the incidence of deep vein thrombosis (DVT) in the experimental group was lower than the control group (P < 0.05). Conclusion Pulse irrigation combined with postoperative autologous blood transfusion in total knee arthroplasty had no influence in blood coagulation , and can reduce inflammation and the incidence of DVT than alone autologous blood transfusion,thus is beneficial to the patient recover.

Bispecific antibodies have been exploited as both cancer immunodiagnostics and cancer therapeutics, which have shown promises in clinical trials in cancer imaging and therapy. To improve the anti-tumor effect, an scDb (bispecific single-chain diabody) was constructed from the variable domain genes of two scFvs (single-chain variable fragment antibodies) directed against human EGFR (epidermal growth factor receptor) and VEGFR2 (vascular endothelial growth factor receptor 2) extracellular domains. The anti-EGFR/ anti-KDR scDb was constructed into pHEN2 plasmid and expressed in Escherichia coli HB2151 host. After purification by one-step affinity chromatography of IMAC, scDb protein was characterized by Western blotting. The yield of scDb protein was 570 microg per liter medium. scDb bound to EGFR as efficiently as the parental antibody scFv-E10, while a little bit weaker than the parental antibody scFv-AK404R when bound to KDR. In conclusion, the scDb protein could bind both EGFR and KDR specifically and could be applied for further anti-tumor research.

PurposeTo investigate the feasibility of using low concentration contrast agent and low tube voltage in the light and moderate weight's abdominal contrast-enhanced CT scan, in order to find an optimal solution to reduce radiation dose and iodine intake.Materials and Methods Forty patients with light weight whose body mass indexes (BMI) were lower than 20 kg/m2 were randomly divided into group A1 (n=20) and group B1 (n=20). Meanwhile, another 40 patients with moderate weight whose BMI ranged from 20 kg/m2 to 25 kg/m2 were randomly divided into group A2 (n=20) and group B2 (n=20). Low concentration contrast agent and low tube voltage (Visipaque 270 mgI/ml, 100 kV) were used in both group A1 and group A2 in abdominal enhanced CT scan. While both group B1 and group B2 used conventional scan solution (Omnipaque 300 mgI/ml, 120 kV) in abdominal enhanced CT scan. Then the contrast noise ratio (CNR), the image quality score and the effective radiation dose (ED) were compared among the four groups.Results The CNR and image quality score at artery phase and portal phase were neither significantly different between group A1 and group B1, nor between group A2 and group B2 (t=-1.539-0.000,P>0.05). The CNR and image quality score of the liver at artery phase in group B1 were signiifcantly higher than those in group A2 and group B2 (P<0.05).Conclusion The solution of using low concentration contrast agent and low tube voltage in contrast enhanced scan can achieve the same high quality abdominal image with reduced iodine intake and radiation, compared with the application of conventional enhanced scan; BMI has rather great impact on image quality score at arterial phase and little impact on that at portal phase. So it is suggested that the protocol of liver contrast-enhanced CT scan may choose reduction of voltage at portal phase so as to reduce radiation.

Objective To investigate the correlation of multidrug resistance gene 1 (MDR1),NR3C1 gene polymorphisms and clinical risk factors with efficacy,dependence,and resistance of glucocorticoid (GC) in patients with inflammatory bowel disease (IBD).Methods Anti coagulation blood samples of 196 healthy controls and 105 IBD patients received GC therapy were collected.There were 62 ulcerative colitis (UC) and 43 Crohn's disease (CD) in the IBD patients.The number of GC sensitive,GC dependent and GC resistant of UC patients were 36,13 and 13,respectively,and those of CD patients were 24,11 and eight.GC refractoriness included GC dependence and resistance.The genotype of MDR1 C3435T and NR3C1 Bcl Ⅰ of all the subjects was detected by the restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR).The correlation between each genotype frequency,clinical features of patients with IBD and the efficacy of GC treatment was analyzed by Chisquare test,Fisher exact probability method or t test.Results Among UC patients,the disease course of GC refractory group and GC resistant group was longer than that of GC sensitive group ((6.660±1.523)years,(6.500±1.111) yearsvs (3.350±0.697) years,t=2.211,P=0.031; t=2.930,P=0.005).The serum level of C reaction protein (CRP) of GC refractory group was higher than that of GC sensitive group ((47.628±13.913) mg/Lvs (16.854±4.121) mg/L,t=2.121,P=0.047).The chronic relapse type was more common in GC refractory UC patients (Fisher exact probability method,P=0.035),and severe patients were more common in UC with GC resistance (Fisher exact probability method,P=0.021).The white blood cell count of GC resistant and GC refractory CD patient was lower than that of GC sensitive CD patients ((5.710 ± 0.604) ×109/L,(5.878±0.405) × 109/L vs (7.814 ±0.670) × 109/L,t=2.334,P=0.028; t=2.045,P=0.018).Patients with extraqntestinal manifestations was more common in CD with GC resistance (Fisher exact probability method,P=0.035).There was no statistically significant difference in the frequencies of MDR1 C3435T,NR3C1 Bcl Ⅰ genotypes,allelic genes and gene carrier among control group and GC sensitive dependent and resistant group of IBD patients.However,the frequency of MDR1 C3435T gene carrier was significantly different between GC sensitive group and GC refractory group,especially between GC sensitive group and GC resistance group (68.33％ vs 48.89％,x2 =4.051,P=0.044; 68.33％ vs 42.86％,x2 =4.274,P =0.039).Conclusions GC sensitivity of IBD patients with MDR1 C3435T loci T gene carrier was higher than that of IBD patients without T gene carrier.NR3C1 gene polymorphisms was not related with GC resistance and GC dependence.Compared with GC sensitive IBD patients,in GC resistant and GC dependent IBD pantient UC patients with long disease course,chronic relapse type,severe type,high level of CRP and CD patients with low white blood cell count and extra-intestinal manifestations were more common.

Objective To evaluate the precision,accuracy,linear range and anti-interference performance of HbA1c assay by u-sing Primus Trinity Ultra2 automated analyzer.Methods According to Document EP published in 2004 by American Clinical and Laboratory Standards Institution(CLSI)and relative literatures,the precision,accuracy,linear range and anti-interference perform-ance were evaluated.Results The within-run and between-run CVs of HbA1c determination were both less than that announced by manufacture.In the tests of samples with certain concentrations,all the results were within the verification range respectively.In the linear verification,regression equation between the theoretical and measured values demonstrated that r2 >0.95,and a value was within the range of 0.97-1.03.For Primus Trinity Ultra2 the limit of interference effect didn′t exceed the allowable error at the medical decision concentrations.Conclusion The precision,accuracy,linear range and anti-interference was evaluated of the Primus Trinity Ultra2 automating HbA1c all could meet the manufacture′s declaim and the clinical needs.

Objective To observe the effect of combining virtual reality technology with occupational thera-py in treating children with spastic hemiplegia resulting from cerebral palsy. Methods Thirty-eight spastic and hemiplegic children with cerebral palsy were randomly divided into a treatment group ( n=18) and a control group ( n=20) . Both groups received occupational therapy, while the treatment group was additionally provided with virtual reality-based treatment. The sessions lasted 30 min, 6 times a week for 3 months. Before and after the treatment the upper extremity motor function of both groups was assessed using the fine motor quotients of the Peabody developmen-tal motor scale, the Caroll hand function scale and a activities of daily life scale. Results Before the treatment there was no significant difference between the two groups in terms of any of the measurements. After the 3 months, significant improvement was observed in both groups, but the improvement of the treatment group was significantly greater than that of the control group. Conclusion Virtual reality technology can further improve the motor function of the upper ex-tremities and ability in the activities of daily life beyond that achievable through occupational therapy alone.

Objective To explore the relevance between gait speed and muscle strength of lower extremities, or several kinds of physical functional tests. Methods 341 community-dwelling individuals (160 males, 181 females) aged 65-94 years were selected. They were divided into suspected sarcopenia group (n=137) and normal group (n=204) by their gait speed less or more than 0.8 m/s. It was compared between both groups with the basic physical characteristics, strength of iliopsoas, quadriceps, hamstrings and tibialis anterior, and the scores of One Leg Standing Test, Berg Balance Scale, Functional Gait Assessment, Functional Stretch Test and Timed Up and Go Test. Results The subjects were older in the suspected sarcopenia group than in the normal group. The difference of body weight, height were not statistically significant between groups. The strength of the muscles in bilateral lower limbs was not significantly different between both groups (P>0.05), while the gait speed positively correlated with the strength of iliopsoas, quadriceps and hamstrings (r=0.121-0.227, P<0.05), but not with the tibialis anterior (P>0.05). Gait speed positively correlated with the scores of One Leg Standing Test, Berg Balance Scale, Functional Gait Assessment, Functional Stretch Test (P<0.05), and negatively correlated with the score of Timed Up and Go Test (r=-0.502, P<0.001). The scores of all the tests were significantly different between 2 groups (P<0.05), except that of Functional Stretch Test (P=0.28). Conclusion Sarcopenia diagnosis is not only depended on the strength of muscle of lower extremity, but also their functions.

Clinical data of 12 cases of Trousseau syndrome with cerebral infarction as initial presentation admitted in the neurology department of the Fourth Affiliated Hospital of Hebei Medical University from December 2011 to December 2017 were retrospectively analyzed.Of the 12 patients,4 cases had risk factors for cerebral infarction and 8 ones had no risk factors.There were 2 patients with 1 lesion and 10 patients with two or more lesions in brain imaging.The infarction lesions of 9 patients were located in 2 or more arterial blood supply areas.Ten patients showed an elevated plasma D-dimer level,5 had elevated fibrinogen level,7 showed increased blood platelet count and 8 had increased homocysteine level.Ten cases were confirmed by pathology,2 cases by clinic and imaging diagnosis.The study suggests that multiple lesions with several cerebral arteries involved,high plasma D-dimer and fibrinogen levels may be the clinical characteristics of Trousseau syndrome with initial presentation as acute ischemic stroke and lacking of risk factors.The hypercoagulation state may be the important pathogenesis of this disorder.