Objective To study the application value of myocardial markers combined with BNP in the early diagnosis of cardiac dysfunction in patients with sepsis. Methods diagnosed patients 66 cases as the research object of this paper,on the basis of 3~5 days in 66 patients with left ventricular ejection fraction after admission of LVEF > 50% and LVEF < 50% were divided into two groups ,two groups were monitored for 0 days ,3 days , 5 days,12 days LVEF,BNP and TNI. Results the left ventricular ejection fraction LVEF>50%and LVEF<50%two groups:3,5 days when the BNP value was significantly higher than that of non cardiac injury heart injury;cardiac injury group EF was negatively correlated with TNI value ,value and blood 3~5 days EF troponin levels in patients admitted to hospital after the show was negatively correlated;the concentration of EF and patients admitted to the hospital after twelfth days of blood troponin value is displayed as a negative correlation. TNI can directly reflect the cardiac function of patients. Research shows that the BNP value had a significant positive correlation in fifth days and APACHE Ⅱ score. Conclusion the data show that TNI and BNP can directly reflect the sepsis patients with heart dysfunction ,that BNP combined with TNI can effectively evaluate the clinical treatment of severe sepsis and septic shock patients ,prognosis has high significance.

Objective To construct adenovirus vector harboring CTLA4Ig-IRES2-I?B? gene for the study of enhancement blockade of T cell costimulatory pathway. Methods The IRES2 fragment was cloned in to the shuttle plasmid pAdtrack-CMV-CTLA4Ig, and then the human I?B? fragment was constructed with the link of the IRES2 to the pAdtrack-CMV-CTLA4Ig. Subsequently, adenovirus vector harboring CTLA4Ig-IRES2-I?B? was constructed by homologous recombination in E. coli BJ5183, and recombinant vector was packaged and propagated in 293 cells. Results The recombinant CTLA4Ig-IRES2-I?B? adenovirus was constructed by homologous recombination and identified by PCR and restrictive enzyme digestion methods. Conclusion The recombinant CTLA4Ig-IRES2-I?B? adenovirus may be used as a novel immunosuppressive agent for gene therapy in organ transplantation.

Objective To construct a recombinant plasmid DNA containing herpes simplex virus type 1(HSV-1) glycoprotein D (gD) gene.Methods The HSV-1 gD gene was obtained by polymerase chain reaction (PCR) and inserted into TA cloning vector pGEM-T, then cloned into the eukaryotic expression vector pcDNA3.1 to generate pLy-D. The recombinant plasmid pLy-D, which was confirmed by partial sequencing and restriction endonuclease analysis, was transfected into Cos-7 cells and used to inoculate ICR mice via muscular injection. Immunohistochemistry and enzyme-linked immunoabsorbent assay (ELISA) were employed to test the gD expression in transfected cells and the specific anti-HSV-1 antibody in the serum of immunized mice, respectively.Results The gD eukaryotic expression plasmid pLy-D was constructed. Using the immunohistochemistry technique, the gD expression in pLy-D-transfected cells was detected. The ELISA demonstrated that specific anti-HSV-1 antibody could be induced in immunized mice after three times injection.Conclusions We constructed HSV-1 gD eukaryotic expression plasmid pLy-D which could express gD protein in transfected cells and could induce humoral immune response in mice. This observation will be helpful in designing HSV prophylactic vaccine.

Because of development and popularization of the ultrasound techniques, the detection rate of nodal thyroid has increased. Surgery is the long-established therapeutic option. However, due to the surgical trauma, compli-cations and the effect on quality of life, various minimally invasive treatments have been proposed and widely used. A large number of foreign studies have shown that ultrasound-guided percutaneous ethanol injection is a more commonly used minimally invasive way to treat benign pure cystic and predominantly cystic thyroid nodules. This article provides an up-to-date review of the overseas studies and summarized on percutaneous ethanol injection for the treatment of benign cystic thyroid nodules.

Objective To construct and expr es s a recombinant plasmid of nonstructural protein NS3-NS4 of hepatitis C virus ( HCV), and to identify the antigenicity of the expressed protein. Methods A gene region encompassing the nonstructural protei n NS3-NS4 of HCV was amplified by polymerase chain reaction (PCR) from the pUC1 9/HCV template. The recombinant expression plasmid containing the pBV220/NS3-NS 4 sequence was constructed, and the nonfused NS3-NS4 recombinant protein was ex pressed in E.coli DH5? efficiently. The recombinant protein was det ected by SDS-PAGE and ELISA. Results We successfully constructed and expressed the recom binant plasmid in prokaryote. Its antigenicity was detected with 50 standard ser a. Compared with the second-generation diagnostic Kit, the total detection rate was 96%. Conclusion The whole NS3-NS4 protein, a region of dominant immunogenicity, should be the effective component of the HCV diagnostic Kit and provide the clue for developing HCV DNA vaccine.

OBJECTIVE:To investigate the application of fuzzy comprehensive evaluation in formulation screening. METH-ODS:Taking Compound paracetamol and chlorphenamine maleate granules as model drug,based on single factor experiment,L9(34) orthogonal test was used to screen the formulation with the amount of aspartame,hawthorn powder essence,milk powder essence and saccharose as factors,using dissolution rate of caffeine as index. The granules prepared by 9 kinds of formulation in orthogonal test were evaluated with fuzzy comprehensive evaluation in terms of taste,aroma,color and dissolubility. The optimized formula-tion was validated and compared with original formulation. RESULTS:The formulation 5 was the optimal choice in both orthogo-nal test and fuzzy comprehensive evaluation,and obtained same results. Compared with sensory comprehensive score (63.12) and dissolution rate of caffeine (91.3%) in original formulation,two indicators of optimized formulation in 3 tests were 84.00 and 99.07% in average (RSD<2.0%,n=3). CONCLUSIONS:Fuzzy comprehensive evaluation can be used for the formulation screening of sensory evaluation index. It is scientific and accurate.

Objective:Explore the dendritic cells to soak gallbladder carcinoma tissue,to explain the relation dendritic cells and tumor immunity.Methods:Adopt immune histochmistry S-P method.Results:The extent of dendritic cells to soak gallbladder carcinoma tissue is not relate to age,gender and types of pathhistology but negative contact with degree of pathological differentiation (P

Objective In order to know first aid awareness and training needs of non-medical college students in Shiyan city,and to provide the basis for an efficient first-aid training.Methods A total of 1063 non-medical colleges in Shiyan city were surveyed by random sampling method.Results 64.61％ of students awared of their own lack of knowledge of first aid,only 3.8 ％ feel rich;based on the first aid knowledge they obtained at present,46.92 ％ did not hesitate to rescue the stranger.After receiving systematic training,the rate rise to 78.9 ％,68.09 ％ of students worried about their lack of first aid skills were the biggest obstacle for them to implement of rescue;98.3％ of the students asked to undergo first aid training,92.27％ of students like approach first aid skills was hands-on model.33.03％ of students believe that medical schools were the best institutions to undertake emergency training,23.46％ of students chose the hospital.Conclusion Non-medical college students in Shiyan city have a bad awareness for firstaid knowledge and a strong desire for training.It is necessary that relevant departments will formulate targeted training programs to improve college students' first-aid response and improve regional emergency level.

BACKGROUNDTo study the metastatic pattern of thoracic lymph nodes in patients with resectable lung cancer.

METHODSFrom January 1992 to December 2000, radical lobectomy or pneumonectomy and systemic lymphadenectomy were performed in 306 patients with lung cancer. Number, size, colour and hardness of lymph nodes in each region were recorded and neoplastic metastasis was examined by pathology.

RESULTSOut of 4 614 resected lymph nodes from 2 456 regions, 954 lymph nodes from 521 regions were confirmed to have metastasis. The metastatic rates of thoracic lymph nodes and mediastinal lymph nodes were 61.8% and 43.5% , respectively. The metastatic frequencies in regions around the hilar or root of lung (11,10,7,5,4) were higher than those of regions far from the root of lung (9,6,3,2,1). There was a remarkably higher metastatic rate of lymph nodes in small cell lung cancer than that in non small cell lung cancer (P < 0.01 ). The metastatic rate was closely related to size, colour and hardness of lymph nodes (P < 0.001, P < 0.001 , P < 0.001 ).

CONCLUSIONSMost of neoplastic metastasis of lymph nodes spreads from proximal to distal areas, lower to upper regions, and from the hilar to the mediastinal. A few mediastinal lymph nodes show a skipping pattern. It is necessary to perform systemic lymphadenectomy during pulmonary resection.

Background The concentrations of disinfection by-products (DBPs) are varied by different water sources, disinfectants, or treatment processes in Wuxi, and the associated health risks are also different. Objective To understand the levels of trihalomethanes (THMs) and haloacetamides (HAcAms) in drinking water in Wuxi, and their variations by water sources, seasons, disinfectants or treatment processes, aiming to provide technical support for ensuring the safety of drinking water. Methods In dry period (December 2019) and wet period (July 2020), the finished water and tap water (from the beginning, middle, and end of the drinking water distribution network) from 12 centralized water treatment plants in Wuxi were collected to detect the concentrations of THMs and HAcAms in water samples. A purge and trap-gas chromatography-mass spectrometry method was applied to detect trichloromethane (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and tribromomethane (TBM), and a solid-phase extraction-gas chromatography-mass spectrometry method to detect dichloroacetamide (DCAcAm), trichloroacetamide (TCAcAm), bromochloroacetamide (BCAcAm), dibromoacetamide (DBAcAm), bromodichloroacetamide (BDCAcAm), dibromochloroacetamide (DBCAcAm), and tribromoacetamide (TBAcAm). Analyses and comparisons were made on the concentrations of THMs and HAcAms in drinking water by water sources (the Yangtze River/the Taihu Lake/reservoir), wet/dry seasons, disinfection methods (liquid chlorine/sodium hypochlorite), and treatment processes (conventional treatment/conventional+advanced treatment). Results A total of 96 drinking water samples were collected in Wuxi. THMs were positive in all the water samples (100%), with concentration ranging from 1.027 to 40.225 μg·L⁻¹ and the M (P₂₅, P₇₅) concentration being 24.782 (17.784, 30.932) μg·L⁻¹. None of the 4 THMs exceeded the standard limit of the Standards for drinking water quality (GB 5749-2022 ), and the order of the 4 THMs concentrations from high to low was TCM > BDCM > DBCM > TBM. Five of the 7 HAcAms were detected, the total concentration ranged from 0.137 to 3.288 μg·L⁻¹, and the M (P₂₅, P₇₅) was 0.808 (0.482, 1.704) μg·L⁻¹. The DCAcAm concentration was the highest (2.448 μg·L⁻¹), followed by BCAcAm, while TCAcAm and DBCAcAm were not detected. The M (P₂₅, P₇₅) of the total concentration of THMs in the drinking water from the Taihu Lake was 33.353 (26.649, 36.217) μg·L⁻¹, that of the Yangtze River was 27.448 (24.312, 31.393) μg·L⁻¹, and both were higher than the level of the reservoir [16.359 (2.305, 21.553) μg·L⁻¹] (P<0.05), while the M (P₂₅, P₇₅) of the total concentration of HAcAms in the drinking water from the Taihu Lake was 0.616 (0.363, 0.718) μg·L⁻¹, which was lower than those of the Yangtze River [0.967 (0.355, 2.283) μg·L⁻¹] and the reservoir [1.071 (0.686, 1.828) μg·L⁻¹] (P<0.05). There were no statistically significant differences in the total concentrations of THMs and HAcAms between wet season and dry season, or between different disinfection methods (P>0.05). The M (P₂₅, P₇₅) concentrations of THMs and HAcAms in drinking water after advanced treatment process involving ozone, activated carbon, and membrane were 20.565 (3.316, 27.185) μg·L⁻¹ and 0.623 (0.452, 1.286) μg·L⁻¹ respectively, and were lower than the corresponding values after conventional treatment process, 28.740 (23.431, 35.085) μg·L⁻¹ and 0.934 (0.490, 2.116) μg·L⁻¹ respectively (P＜0.05). Conclusion The concentrations of THMs and HAcAms in drinking water in Wuxi are generally at a low level. The levels of controlled THMs meet the requirements of national standards, and the levels of uncontrolled HAcAms as new DBPs are up to μg·L⁻¹. The concentrations of the two kinds of DBPs in drinking water vary by water sources. The concentrations of THMs and HAcAms produced by the advanced treatment process are lower than that by the conventional treatment process.