Objective: in order to provide rapid and reliable method. Methods: Encoded Annexin Ⅴ cDNA was amplifyed from U937 cDNA libary by PCR and then subcloned into E coli expression vector. MS2-Annexin Ⅴ fusion protein could be overexpressed in E　coli. The MS2 bacteria protein could be removed by thrombin digestion.The mature Annexin Ⅴ was obtained by ion exchange chromatography and the FITC labled Annexin Ⅴ could be used in the detection of apoptosis. Results:Up to 37% of the total bacterial proteins was rhAnnexin Ⅴ as showed by SDS-PAGE. The purification of Annexin Ⅴ is over 99%. The FITC labled Annexin Ⅴ could efficiently detect apoptosis. Conclusion: We successfully established the technique procedure of obtaining a large quantity of Annexin Ⅴ and provided the basic routine for popularizing the detection of apoptosis' with high effciency.

ObjectiveTo observe the effect of early rehabilitation on motor function, high-sensitivity C-reactive protein (hs-CRP), interleukin-1（IL-1） and interleukin-6（IL-6） in patients with acute cerebral infarction (ACI). Methods160 patients with ACI were randomly divided into rehabilitation group (n=80) and control group (n=80), who accepted early rehabilitation and routine medicine or medicine only, respectively. They were assessed with modified Edinburgh-Scandinavian Stroke Scale (MESSS) and their peripheral level of hs-CRP, IL-1 and IL-6 were detected before and 1, 2, 4, and 8 weeks after treatment. Results4 and 8 weeks after treatment, the level of hs-CRP, IL-1 and IL-6 were lower in rehabilitation group than in control group（P＜0.05）, as well as the scores of the MESSS （P＜0.01）. The incidence of improvement is more in rehabilitation group than in control group（P＜0.05）. ConclusionEarly rehabilitation can reduce the expression of hs-CRP, IL-1 and IL-6, and improve the neurological function in patients with ACI.

Liver resection is the main method of treatment of hepatic space-occupying lesion, and pleural effusion is one of the common complications. With the technological development in recent years, this paper analyzes the pleural effusion after liver resection from the aspects of hypoproteinemia, diaphragm defects, inflammatory response, portopulmonary shunt, and hepatitis B immune complex deposition, summarizes the causes of pleural effusion after liver resection and its preventive measures, and explores the effective ways to reduce the incidence of pleural effusion after liver resection, with the purpose of providing guidance for future clinical practice.

Objective:To explore the correlation between early pupillary light reflex reduction and delirium in mechanically ventilated patients receiving sedation in the Intensive Care Unit (ICU) .Methods:From December 2020 to March 2021, convenience sampling was used to select 97 ICU patients with mechanical ventilation who received sedation in the China-Japan Union Hospital of Jilin University as the research subject. On the second to fourth days of the patient's stay in the ICU, the quantitative pupillary light reflex (q-PLR) and pupillary contraction velocity (CV) of the patients after photostimulation were measured by an automatic infrared pupillometer with a frequency of two times a day. Patients were assessed using the Richmond Agitation-Sedation Scale (RASS) . When the RASS score was≥-2, the patient was screened for delirium using the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) with a frequency of two times a day. According to the screening results, patients were divided into delirium group and non-delirium group.Results:The incidence of delirium in 97 ICU mechanically ventilated patients who received sedation was 58.76% (57/97) . Binomial Logistic regression showed that q-PLR on the second day was an influencing factor for delirium in mechanically ventilated ICU patients receiving sedation ( P<0.05) . Conclusions:Early pupillary light reflex reduction is associated with delirium in mechanically ventilated ICU patients receiving sedation.

OBJECTIVE: To explore whether MRI fusion technology (combined T2-weighted imaging [T2WI] and fat-suppressed T2WI [T2WI-(FS)]) improves signal differences between anal fistulas and surrounding structures. MATERIALS AND METHODS: A total of 32 patients with confirmed diagnoses of anal fistula were retrospectively studied. All available T2WI and T2WI-(FS) images for each patient were used to generate fusion image (T2WI-(Fusion)) based on the addition of gray values obtained from each pixel via an MR post-processing work station. The discriminability of fistula, perianal sphincter, and perianal fat in T2WI, T2WI-(FS), and T2WI-(Fusion) images was quantified with Fisher's scoring algorithm. For subjective visual image assessment by researchers, five-point scale scores were determined using a modified double-stimulus continuous quality-scale test to evaluate T2WI-(FS), T2WI, enhanced axial three-dimensional-volumetric interpolated breath-hold examination (3D-VIBE), and T2WI-(Fusion) sequence images. The differences were subsequently compared. RESULTS: Mean Fisher scores for fistulas vs. sphincters obtained from T2WI-(Fusion) (F(Fusion-fistula) = 6.56) were significantly higher than those from T2WI (F(T2WI-fistula) = 3.35) (p = 0.001). Mean Fisher scores for sphincters vs. fat from T2WI-(Fusion) (F(Fusion-sphincter) = 10.84) were significantly higher than those from T2WI-(FS) (FS(FS-sphincter) = 2.57) (p = 0.001). In human assessment, T2WI-(Fusion) showed the same fistula discriminability as T2WI-(FS), and better sphincter discriminability than T2WI. Overall, T2WI-(Fusion) showed better discriminability than T2WI, T2WI-(FS), and enhanced 3D-VIBE images. CONCLUSION: T2WI and T2WI-(FS) fusion technology improves signal differences between anal fistulas and surrounding structures, and may facilitate better evaluation of anal fistulas and sphincters.
Anal Canal ; Diagnosis ; Fistula ; Humans ; Magnetic Resonance Imaging ; Rectal Fistula ; Retrospective Studies

Objective:To summarize the scientific research management response strategies and practices of designated hospitals under the prevention and control of new coronary pneumonia, provide reference for the scientific and technological management of public health emergencies in domestic hospitals.Methods:Take the hospital scientific research management response under the prevention and control of the new coronavirus pneumonia epidemic in 2020 as an example, discuss and summarize the response strategies and mechanism establishment, work practice and existing problems of designated hospitals in the research management of prevention and control of public health emergencies represented by COVID-19 from the aspects of management system, resource integration, project operation, and scientific and technological service.Results:As a designated hospital of COVID-19 in Beijing, Youan hospital has actively carried out scientific and technological research on epidemic prevention and control while successfully completing patient treatment, established a scientific and efficient scientific and technological research management system, and integrated resources to form an efficient project operation mechanism, Providing a full range of scientific management services, providing policy and material guarantee for the rapid and high-quality completion of scientific and technological research on epidemic prevention and control.Conclusions:The scientific and technological research on public health emergencies has the characteristics of demand-driven, focused on key points, collaborative research, scientific decision-making, In order to carry out the research work smoothly, it is particularly important to form a benign interaction, straighten out the system, do a good job in long-term planning and layout, and establish a scientific and efficient research and management mechanism.

Objective:To investigate the clinicopathological features,immunophenotype,and prognosis of head and neck spindle cell squamous cell carcinoma(SCSCC)to improve the understanding and diagnosis of this tumor.Methods:Clinicopathological data collected from January 2012 to December 2022 at the First Affiliated Hospital,Air Force Military Medical University from 20 patients with head and neck SCSCC were retrospectively reviewed for histological morphology and immunophenotype.In situ and fluorescence in situ hybridization were performed to detect EBV-encoded ribonucleic acid(EBER)status and MDM2 gene amplification,respectively.Results:The median age among the 20 SCSCC cases was 67 years with a male-to-female ratio of 4∶1.Tumor locations were laryngeal(35.0%)and sinonasal(30.0%).SCSCC presented as polypoid or exogenous growths(61.5%),often with surface ulceration(90.0%).Histologically,sarcomatoid growth pat-terns were exhibited in 75.0%of the patients(n=15),while the remainder showed granular tissue-like or angiosarcomatoid patterns.Most tumors(65.0%)displayed components of conventional squamous cell carcinomas,with a predominant occurrence of high to moderate dif-ferentiation(91.7%).In terms of immunohistochemistry,AE1/AE3 was expressed in 83.3%(15/18)of cases,while p63 and p40 expression rates were 62.5%and 66.7%,respectively.All cases were negative for EBER.The Ki-67 proliferation index ranged 10%-70%.Overall,33.3%(1/3)of the cases showed MDM2 gene amplification.Among these,the median follow-up time for 18 patients was 18.3 months(range:1-92 months),with 6 survivors and 12 deaths.Conclusions:Head and neck SCSCC is more prevalent among elderly male smokers,predominantly exhibits a polypoid growth pattern,and does not display human papillomavirus or Epstein-Barr virus infection.Diagnosis requires a compre-hensive evaluation of clinical and pathological features and immunophenotype.Surgical resection is the primary treatment method.

Objective:To explore the effects of hospital-community-family continuous nursing mode in patients with chronic heart failure (CHF) .Methods:Totally 140 CHF patients admitted to Hefei First People's Hospital from November 2020 to October 2021 were selected by convenience sampling and divided into the control group and the observation group according to the random number table, with 70 cases in each group. Patients in the control group was given routine cardiovascular care, while patients in the observation group received hospital-community-family continuous care on this basis. The scores of Minnesota Living with Heart Failure Questionnaire (MLHFQ), Self-Care of Heart Failure Index (SCHFI) and Health Promoting Lifestyle Profile-Ⅱ (HPLP-Ⅱ) were compared between the two groups of patients at admission and 3 months after discharge.Result:At admission, there was no significant difference in the scores of MLHFQ, SCHFI and HPLP-Ⅱ between the two groups ( P>0.05) ; 3 months after discharge, the score of MLHFQ in the observation group was lower than that in the control group, and the scores of SCHFI and HPLP-Ⅱ were higher than those in the control group, with statistically significant differences ( P<0.01) . Conclusions:The hospital-community-family continuous nursing model can improve the self-care ability, health behavior and quality of life of CHF patients, which is worth promoting in clinical practice.

Objective:To explore the team construction and treatment strategy of the Diabetic Foot-Multidisciplinary Team.Methods:The clinical data of 19 patients with severe ischemic diabetic foot treated by our Diabetic Foot-Multidisciplinary Team Center from Apr 2021 to Mar 2022 were collected, and the overall amputation rate, above-ankle major amputation rate, minor amputation rate and mortality, Diabetic Foot-Multidisciplinary Team consultation discipline participation rate and treatment participation degree were retrospectively analyzed.Results:Nineteen patients (15 males and 4 females) were enrolled, aged 26 to 94 (68.6±14.2). All were with severe ischemic diabetic foot ulcer:Rutherford grade 5 or up and dysfunction in 2 or more organs. Complications included arteriosclerosis obliterans of the lower extremities in 18 cases, heart diseases in 18, hypertension in 15, and renal insufficiencies in 10. The overall amputation rate was 36.8%, major amputation rate in 21.1%, minor amputation rate in 15.8%, and mortality rate was 15.8%. A total of 16 disciplines participated in Diabetic Foot-Multidisciplinary Team; the main participating disciplines were vascular surgery (19 times), endocrinology (12 times), and cardiology (11 times). The main treatment disciplines were vascular surgery (14 times), plastic surgery (3 times), and cardiology (2 times).Conclusion:For the diagnosis and treatment of diabetic foot, it is necessary to set up a multidisciplinary team as early as possible to control the causes of diabetic foot ulcer, prevent the recurrence of diabetic foot ulcer, reduce the mortality and amputation rate, and improve the quality of life of patients.

Objective:To explore the clinical and molecular basis for a Chinese pedigree affected with Complete androgen insensitivity syndrome (CAIS).Methods:A CAIS pedigree presented at Tianjin Medical University General Hospital between 2019 and 2021 was selected as the study subject. Clinical data of the proband was collected, along with peripheral blood samples from the proband and her family members. Chromosomal karyotyping, sex-determining region of the Y chromosome ( SRY) testing, and next-generation sequencing (NGS) were carried out for the proband, and candidate variant was verified by Sanger sequencing of her family members. Prenatal diagnosis was provided for the sister of the proband. This study was approved by Medical Ethics Committee of the Tianjin Medical University General Hospital (Ethics No. IRB2023-WZ-070). Results:The 18-year-old proband, who has a social gender of female, underwent laparoscopic examination, which showed no presence of uterus and ovaries. The karyotype of peripheral blood sample was 46, XY, with SRY gene detected. NGS indicated that the proband has harbored a heterozygous c. 1988C>G (p.Ser663Ter) variant of the AR gene. Sanger sequencing confirmed that her mother and sister had both harbored the same variant, whilst her father and younger sister were of the wild-type. Prenatal diagnosis revealed that her sister′s first fetus had harbored carried the same variant, which had led to termination of pregnancy. Her second fetus did not carry the variant, and a healthy boy was born. Based on guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was classified as likely pathogenic (PM2_Supporting+ PM4+ PP3_Moderate+ PP4). Conclusion:The c. 1988C>G (p.Ser663Ter) variant of the AR gene probably underlay the CAIS in the proband. The accurate diagnosis of sex development disorders will rely on the physicians′ thorough understanding of the clinical symptoms and pathogenic genes. Genetic testing and counseling can enable precise diagnosis, prenatal diagnosis, and guidance for reproduction