Our study was based on the book Theory of Epidemic Heat Syndrome. This book was written by Mr. Shao Dengying of Qing dynasty, who was famous in Qing Dynasty on curing virus infection. We described his unique insights in diagnosis and treatment of epidemic heat syndrome in six aspects: the origin, position of epidemic heat invasion, difference between epidemic heat syndrome and typhus, paying attention to the symptoms of epidemic heat, differentiation and treatment from qi, bloods and stomach, and attaching importance to the stomach Qi and kidney essence etc.

Mid-ventricular hypertrophic obstructive cardiomyopathy (MVHOCM) is a rare type of cardiomyopathy thatcan be accompanied by apical aneurysm.We presented here a case report of MVHOCM with cornary artery disease.The sixty-fouryears old man was sent to hospital because of ventricular tachycardia.Large inversion T wave was showed on electrocardiography in the presence of abnormal coronary arteries and normal cardiac enzyme.Echoeardiogmphy showed an hourglass appearance of the leftventricle with an aneurysm in the apex and a pressure gradient between the outflow tract of left ventricle and the middle of the leftventricle was revealed by left-heart catheterization.

To improve 3-ketosteroid-△1-dehydrogenase (KSDH) activity and the transformation level for androst-4-ene-3,17-dione,3-ketosteroid-△1 -dehydrogenase gene (ksdD) from Arthrobacter simplex was cloned into plasmid pWB980 and expressed in B. subtilis WB600 under the control of promoter P43. The molecular weight of expressed enzyme was about 55kDa by SDS-PAGE analysis. The activitities assayed by spectrophotometrical method of intracellular and extracellular soluble enzyme were 110 ± 0.5mU and 15 ± 0.6mU per milligram of protein respectively. The transformation rate of androst-4-ene-3,17-dione by the B. subtilis recombinant cells was 45.3%. Compared with Arthrobacter simplex, the enzyme activity of KSDH expressed in B. subtilis was improved about 30 fold, and the transformation level of androst-4-ene-3,17-dione by the B.subtilis recombinant cells was improved about 10 fold. The recombinant B. subtilis cells used in biotransformation of steroids provided a new way for steroid medicines production.

BACKGROUND:The changes of single cytokine before and after transplantation has no clinical significance in the diagnosis of acute rejection, but the joint monitoring of cytokines is better to determine the immune status of transplanted patients. OBJECTIVE:To observe the dynamics changes of Th1/Th2 cytokines before and after transplantation in order to investigate the clinical significance in the diagnosis of acute rejection. METHODS:It was a prospective cohort study. The Th1 and Th2 cytokine levels in the rejection group and non-rejection group were dynamical y monitored with double-antibody sandwich enzyme-linked immunosorbent assay before, and 3, 7 and 14 days after transplantation. RESULTS AND CONCLUSION:Before renal transplantation, the Th1 (γ-interferon and interleukin-12) cytokine levels in the rejection group were significantly higher than those in the non-rejection group (P<0.05);the Th2 (interleukin-4 and interleukin-10) cytokine levels in the rejection group were significantly lower than those in the non-rejection group (P<0.05). After renal transplantation, there were no significant changes in Th1 and Th2 cytokines levels of the non-rejection group at different time points;the Th1 cytokine levels in the rejection group were increased rapidly at different time points, and reached a peak before acute rejection, and the Th1 cytokine levels at different time points in the rejection group were significantly higher than those in the non-rejection group;the Th2 cytokines were increased gradual y in the rejection group, and reached a peak before acute rejection, and the Th2 cytokine levels at different time points in the rejection group were stil lower than those in the non-rejection group. The results showed that the Th1/Th2 cytokines in the non-rejection group were kept stably before and after renal transplantation, but not in the rejection group, in which, the Th1 cytokines were increased rapidly before acute rejection and the Th2 cytokines were increased gradual y.

Tianjin Medical University set up the module of Early Clinical Practice in the 2012 year's new curriculum system which takes the teaching mode of combining the in-class curriculum and the extracurricular scientific research as well as the social practice.The in-class curriculum refers to the early contact clinical curriculum,namely making the early contact clinical practice training as a compulsory course,which focuses on the cultivation of students' medical professional ethics and the cultivation of doctor-patient communication ability,health promotion and preventive medicine consciousness,to strengthen students' clinical thinking,clinical research ability and basic skills training.The extracurricular part mainly takes the innovation credit project as the instruction,which will make the social practice,scientific and technological innovation activity project,clinical basic skills training comprehensive,and train students' ability of organization plan,communication and coordination,word expression and scientific research ability.

Objectives To study the role of IL-17 and IL-23 in non-Hodgkin lymphoma (NHL) by detecting the expression levels of IL-17 and IL-23 in peripheral blood of B-cell non-Hodgkin lymphoma patients treated by RCHOP.Methods T wenty-five patients with B-cell NHL who achieved remission after 6 to 8 cycles of R-CHOP as a NHL group,20 healthy volunteers were recruited as a normal control group.RT-PCR was used to detect the expression levels of IL-17 mRNA and IL-23mRNA in NHL patients and health volunteers.Results The expression level of IL-17mRNA andIL-23 mRNAin the patients with NHL before therapy and the patients with NHL who achieved remission was lower than that in the normal control group (P＜0.05).The expression level of IL-17mRNA andIL-23mRNA in the patients with NHL who achieved remission was higher than that in the patients with NHL before therapy (P=0.001,P＜0.05).Conclusion IL-17 and IL-23mRNA expressions are higher after treated with R-CHOP.The expression levels of IL-17 mRNA and IL-23 mRNA in NHL patients are related with prognosis and efficacy.

Objective To investigate the functional polarization of T cells in children with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Forty five cases of OSAHS children were chosen to undergo tonsillectomy and adenoidectomy.Preoperative analyses of peripheral blood Th1 /Th2 ratio and Tc1 /Tc2 ratio were compared with those of normal children and those of postoperative 6 months for observation of the change of T cells.Th1/Th2 ratio and Tc1/Tc2 ratio were detected by flow cytometry.Results The preoperative ratio of Th1 cells in children with OSAHS was significantly lower than normal children [(9.66 ± 3.73) ％ vs (13.34 ± 4.36) ％,P ＜ 0.05],while the preoperative ratio of Th2 cells was significantly higher than normal children [(3.42 ± 1.64) ％ vs (2.53 ± 1.97) ％,P ＜ 0.05],which made the Thl/Th2 ratio lower than normal children (3.51 ± 1.53 vs 5.41 ±2.17,P ＜0.05).At the 6th month after tonsillectomy and adenoidectomy,the postoperative ratio of Th1 cells was significantly higher than preoperative ratio [(12.99 ± 3.68) ％ vs (9.66 ± 3.73) ％,P ＜ 0.05],while the postoperative ratio of Th2 cells was lower than preoperative ratio [(2.62 ± 1.88) ％ vs (3.42 ± 1.64) ％,P ＜ 0.05],which made the postoperative Th1 /Th2 ratio higher than preoperative ratio (5.15 ± 1.86 vs 3.51 ± 1.53,P ＜ 0.05).There was no significant difference in Tc1 /Tc2 ratio between the OSAHS children and normal children.Conclusions Functional polarization of T cells was abnormal in OSAHS children accompanied by the predomination of Th2 cells and the normal Tc cell polarization.Functional polarization of T cells can return to normal at the 6th month after tonsillectomy and adenoidectomy.

Objective To prepare urokinase plasminogen activator (uPA)-loaded anionic lipid microbubbles (uPA-MBs) for thrombolysis with low-frequency ultrasound in vitro.Methods Anionic microbubbles composing of 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC),1,2-dipalmitoyl-sn-glycero-3-phospho-(l'-rac-glycerol) (DPPG),1,2-distearoyl-sn-glycero-3-phosphoethanol amine-N (succinyl PEG2000) (DSPE-PEG2000) and perfluoropropane (C3F8) were prepared by the mechanical vibration method.Then,the resulting anionic microbubbles were incubated with uPA.uPA-MBs were obtained via electrostatic adsorption.Bubble size and distribution were measured by particle size analyzer.FITC-labeled uPA-MBs were obtained and observed under fluorescence microscope.The surface potential of uPA-MBs and plain microbubbles (P-MBs) were detected by Zeta potential analyzer.Sodium dodecyl sulfonate-polyacrylamide gel electrophoresis (SDS-PAGE) was used for confirming the binding of uPA protein and anionic microbubbles.The encapsulation efficiency of uPA-MBs was determined by bicinchoninic acid (BCA) protein assay kit under three different dosages of uPA (10 000,50 000 and 100 000 U).The thrombolysis efficiency of uPA-MBs combined with low-frequency ultrasound was examined in vitro.Two-sample t test,one-way analysis of variance and Bonferroni test were performed to analyze the data.Results UPA-MBs were successfully obtained with the mean particle size of (1.76±0.29) μm.The surface potential of these bubbles was significantly higher than that of P-MBs:(-36.64±0.21) mV vs (-66.33±2.38) mV (t =21.538,P＜0.05).Fluorescence microscope showed a green shell of FITC-labeled uPA-MBs.The encapsulation efficiency of uPAMBs with the added dosage of 10 000 U was (42.01±2.02) ％,which was significantly higher than those of 50000 and 100 000 U ((33.24±1.95)％ and (33.10±1.65)％ respectively,F=22.340,P＜0.05).The thrombolysis efficiency by saline was (4.09±0.80)％,saline + ultrasound (8.50±1.48)％,MBs + ultrasound (14.27± 1.59) ％,uPA-MBs + ultrasound (35.72±6.31) ％ and uPA (16.87±0.46) ％,respectively (F =48.783,t =-8.613,-7.273,-5.942,-6.908,all P＜0.05).Conclusion Anionic microbubbles can successfully load uPA,and achieve significantly better thrombolysis effect when combined with low-frequency ultrasound.

OBJECTIVETo investigate the influence of background color on veneered In-Ceram and Cercon dental ceramics including Vita In-Ceram Electroformed Alumina (AL2), Electroformed Zirconia (Z21), Cercon base color Zirconia and Cercon base Zirconia.

METHODSThe colorimetric values of all the materials on noble metal, Ni-Cr alloy, silver amalgam and resin background were measured with a spectrocolorimeter, and the color difference among the groups was calculated.

RESULTSAfter veneered, the color difference of Z21 Electroformed Zirconia was more distinct against the background of silver amalgam than against the backgrounds of noble metal and resin, but the color differences of the 4 veneered dental ceramics against different backgrounds were unidentifiable by human eyes (δE<1.5).

CONCLUSIONAfter veneered, AL2 electroformed alumina, Z21 electroformed zirconia, Cercon base Zirconia and Cercon base color Zirconia are less influenced by the background color, and covering the background color is therefore not necessary.

Objective To explore the clinical efficacy and indications of kyphoplasty with movement and secondary en?largement of balloon for the compression fracture of vertebral body with ruptured posterior wall. Methods A retrospective analy?sis was carried out on the data of 29 patients (10 males, 19 females;age range:55-86 years old;mean age:71 years old;29 verte?bral bodies in total) who suffered from compression fracture of the thoracolumbar spine and below, and underwent kyphoplasty through the movement and secondary enlargement of balloon within the vertebral body and were followed up from January 2011 to November 2014. These patients had backache, accompanied by lowered support, limitation of movement, no symptom of nervous lesion on both lower extremities and no past history of balloon kyphoplasty. All fractured vertebral bodies were at T 11 or below, in?cluding 1 case at T11, 4 cases T12, 11 cases L1, 9 cases L2 and 4 cases L3. The causes of injury included fall (19 cases), car accident (8 cases) and unknown reasons (2 cases). All patients underwent kyphoplasty with the movement and secondary enlargement of bal?loon within the vertebral body. Photos were taken immediately after the surgery, at 1 month, 3 months, 6 months and 12 months, and these patients were assessed and analyzed in terms of vertebral height, Cobb angle, visual analogue score (VAS) and Oswestry disability index (ODI). Results The operation time (including the formation and solidification of bone cement) of 29 patients was 40 to 65 min and the mean time was 55 ± 7 min;the blood loss during operation was 2 to 15 ml and the mean blood loss was 5 ± 2 ml;the injected volume of bone cement was 2.5-7.5 ml and the mean volume was 5.5±0.5 ml. Post?operative pain was relieved and ambulation was performed under the protection of lumbar orthosis brace. Statstical analysis was conducted on VAS, ODI, vertebral height and Cobb angle before operation and at 1 month, 3 months, 6 months and 12 months after operation, showing statistically significant differences. X ray examination found that there was no alternation or displacement of bone cement location, and no change in vertebral morphology, the vertebral height and cobb angle remained the post?operative status, and posterior wall rupture of the vertebral body was recovered well. CT revealed that the morphology of bone cement was irregular and closely integrated with bone substance, and no cavity or fissure was seen. Conclusion Kyphoplasty with movement and secondary enlargement of bal?loon within the vertebral body has a good, definite clinical efficacy in treating compression vertebral fracture with incomplete pos?terior wall of the vertebral body without obvious displacement of fractured bone and symptom of nervous lesion on both lower ex?tremities. This surgery is easy to operate, and has an immediate analgesic effect, which could recover vertebral height as well as re?duce kyphosis deformity and improve patient’s prognosis.