The anti-DNP and anti-OA IgE antibody responses of six strains of mice immunizedwith DNP-OA conjugate in presence of A1(OH)_3 adjuvant was investigated.Signifi-cant differences of the magnitude of serum IgE were found in anti-hapten and anti-carrier responses among strains.The primary and secondary anti-DNP and anti-OAIgE antibodies were elicited in NIH,BALB/c and DBA/2 mice after immunizationwith 1?g of DNP-OA.Among them NIH mice was the highest responder,whereasLACA,C3H and B6D2F1 mice were poor or nonresponders.In comparison the IgEresponse in BALB/c mice immunized with 1?g and 10?g of DNP-OA,the former de-monstrated a latency of primary response,but two groups had a very similar PCAtiters after 4 weeks of immunization.On the other hand,LACA mice gave a dose de-pendent IgE response.Profound primary and secondary IgE antibody responses can beonly seen in mice injected with 10?g of DNP-OA and PCA titer of anti-DNP washigher than that of anti-OA IgE antibody.However,no difference of IgE antibodylevels in NIH mice can be found between groups immunized with different doses.DNP_(4.7)-OA primed mice gave higher IgE response than that of mice immunized withDNP_3-OA.A prevailing anti-hapten IgE response was observed when higher dose ofDNP-OA conjugates was injected.

Objective: To discuss the therapeutic regimen for warfarin resistant patients with the help of clinical pharmacists. Methods:The pharmacist analyzed the cause of warfarin resistance and provided the dose adjustment for a pulmonary embolism pa-tient. Results:The genotype of the patient was identified as VKORC1-1639AG by gene test. The patient was diagnosed as hereditary warfarin resistance excluding other causes. With the assistance of pharmacist, the problem of warfarin resistant was solved. Conclu-sion:For warfarin resistant patients, clinical pharmacists must definite the reason of warfarin resistant firstly and then carry out the therapeutic strategy. Gene detection may be used as an important guide for warfarin resistance.

Objective To research the trichomonacidal effect of secnidazole benzoate in vitro.Methods Trichomonas vaginalis was cultured in liver extract medium in 96-well microplate.The culture suspension of Trichomonas vaginalis was divided into four groups:secnidazole benzoate, secnidazole, metronidazole and control, with medium as blank control.MTT colorimetric assay was applied to determine the inhibitory effect of secnidazole benzoate on the proliferation of Trichomonas vaginalis.The culture suspension was transfered into test tubes and divided into same groups to observe inhibitory effect by the classical microscopic counting method.Results After 24 h incubation, the proliferation of the parasites was concentration-dependent by secnidazole benzoate(t=9.02, P

Objective To investigate the therapeutic effect of ectopic pregnancy prescription,mifepristone and methotrexate in the treatment of refractory tubal pregnancy.Methods 100 cases of refractory tubal pregnancy from January 2015 to December 2016 in our hospital,according to randomly divided into Chinese and western medicine group(ectopic pregnancy treatment prescription+mifepristone+methotrexate)and western medicine group(mifepristone and methotrexate)50 cases,compared two methods of treatment effect.Results After treatment,the two groups of patients with β-HCG level,ectopic pregnancy mass diameter showed a significant decrease,beta-HCG,ectopic pregnancy mass of Chinese and western medicine group were lower than the diameter of the western medicine group in the treatment of 7,10,14 days,the difference was statistically significant(P<0.05); The success rate of Chinese and western medicine group was 92.00％,which was higher than that of western medicine group(84.00％),but the difference was not statistically significant,failure of conservative treatment of patients were transferred to open surgery.In Chinese and western medicine group,the β-HCG value of blood beta was completely recovered and the disappearance time of ectopic pregnancy was significantly lower than that of western medicine group,and the difference was statistically significant(P<0.05).Conclusion Ectopic pregnancy prescription combined with mifepristone and methotrexate in the treatment of refractory patients with tubal pregnancy can accelerate the β-HCG level,ectopic pregnancy mass diameter reduced,can significantly shorten the treatment time.

Objective Dickkopf-1 (DKK-1) is an antagonist of the Wnt signaling pathway of bone formation and it is the target gene of TNF.When DKK-1 is inhibited,osteoprotegerin (OPG) would increase,OPG can antagonize bone erosion caused by receptor activator of NF-κB ligand (RANKL).Detection the levelsof serum DKK-1,OPG,RANKL and TNF-α of patients with AS before and after applying TNF-α antagonist,the effects of anti-TNF-α treatment on signaling pathway of bone formation was explored.Methods Medical records and serum samples of 43 AS patients receiving TNF-α receptor-Ⅱ IgG Fc fusion protein for 12 weeks were collected and the levels of serum DKK-1,OPG,RANKL and TNF-α were detected by enzyme-linked immunosorbent assay.Paired t-test and Person's correlation analysis were used for data analysis.Results Disease activity indexes in AS patients with anti-TNF-α treatment,including VAS score,time of morning stiffness,BASDAI,BASFI,ESR and CRP,which were [(2.7±2.0) cm,(7±4) min,1.1±1.1,0.8±1.2,(10±9) mm/1 h and (16±26) mg/L] respectively,were reduced when compared with those before treatment,[(7.6±1.9) cm,(46±33) min,6.0±1.3,4.4±2.0,(39±29) mm/1 h and (76±43) mg/L] respectively,and the differences were statistically significant (P＜0.05).Serum levels of DKK-1,(3.3±1.5) μg/L vs (3.2±1.3) μg/L,OPG,(144±71) pg/ml vs (136±62) pg/ml,and RANKL,(71±37) pg/ml vs (68±30) pg/ml,were not changed (t=14.043,8.031,20.166,13.521,7.679,9.563,all P＞0.05).The levels of TNF-α increased from (1.9±1.3) pg/ml to (55.0±50.6) pg/ml (t=6.951,P＜0.05).There were no relations between DKK-1 and TNF-α,RANKUOPG,patient VAS,duration of morning stiffness,BASDAI,BASFI,ESR and CRP,allP＞0.05.Conclusion Clinical indicators are improved significantly by anti-TNF-α therapy; however,it should not be withdrawal suddenly.There is no relationship between serum levels of DKK-1 and level of inflammation in AS patients.

Objective To discuss the feasibility and safety of sevoflurane inhale anesthesia with portable combined inhalation anesthesia induction device in solving the difficulty of children entering the operation room.Methods One hundred pediatric patients were enrolled into the study.The pediatric patients were randomly divided into two groups,50 cases in each group.Group A was fraught with a new mode of administration,using portable combined inhalation anesthesia induction device with sevoflurane 2 ml before entering the operation room;group B was fraught with a traditional mode of administration,using in-tramuscular injection with ketamine 4-5 ml/kg before entering the operation room.The analog scale of anes-thetic effect,the number of body movement,adverse reaction were compared between the two groups. Results Compared with group B,time of falling asleep and retention time in the operating room was signif-icantly shorter (P <0.01).And body movement during vein puncture decreased significantly (P <0.01). Moreover,the incidence of adverse affect showed significant reduce compared with group B (P < 0.05 ). Conclusion The combined inhalation anesthesia induction device is simple to produce and easy to carry.To solve the difficulty of convoying children into the operating room,combined inhalation anesthesia induction device with sevoflurane is more effective, safer and more humanized way when compared with the traditional one.

Objective To investigate characteristic skin lesions and typical histopathological changes of adult-onset Still's disease(AOSD) for its early diagnosis and treatment.Methods Clinical data were collected from 8 patients with AOSD,and analyzed retrospectively.Results All the patients had transient rashes and persistent papules/plaques during the course of disease.Of the 8 patients,1 had urticaria-like rashes,3 had dermatomyositis-like rashes,and 1 had prurigo pigmentosa-like rashes.Biopsies were carried out at the sites where transient rashes or persistent papules/plaques occurred.Histopathological findings showed necrotic keratinocytes in the upper prickle cell layer,and perivascular infiltration of neutrophils and lymphocytes in the upper dermis.Conclusion The skin lesions and histopathological changes of AOSD are characteristic,which can provide clues to the early diagnosis of AOSD.

Objective To measure the levels of caspase-1 and its downstream factor interleukin (IL)-18 and IL-33 in rheumatoid arthritis (RA) and explore their possible mechanisms.Methods Blood samples were drown from 56 patients with RA and 22 healthy subjects.Serum levels of caspase-1,IL-18 and IL-33were tested by the method of enzyme linked immunosorbent assay (ELISA).Kruskal-Walls and Mann-Whitney test were used to compare the levels of caspase-1,[L-18 and IL-33 and Spearman's correlation test was used for correlation analysis.Results The level of caspase-1 was significantly increased in RA group compared to healthy group [(32±26) ng/ml vs (15±6) ng/ml,P＜0.01].Meanwhile,the active disease groups showed a higher level than the remission group,and level in the untreated group was higher than the treated group [(47±27) ng/ml vs (25±22) ng/ml,P＜0.01].The levels of IL-18 and IL-33 were significantly increased in RA group compared to healthy group [(121±121) ng/L vs (58±33) ng/L,(1032±1011) ng/L vs (510±231)ng/L,respectively,P＜0.05].Meanwhile,the active disease groups had a higher level than the remission group and the untreated group had higher levels than the treated group [IL-18 and IL-33 were (172±139) ng/L vs (97±106) ng/L,(1469±1039) ng/L vs (825±941) ng/L,respectively,P＜0.05].Caspase-1 was correlated withIL-18 and IL-33 (r=0.824,0.854,P＜0.01) and IL-18 was correlated with IL-33 (r=0.800,P＜0.01).But neither of the three factors was related with clinical indexes including disease duration,RF,anti-CCP antibody,tender joints count and swollen joints count.Conclusion Caspase-1 and its downstream factor IL-18,IL-33 increase in RA,and they may play important roles in RA.

OBJECTIVE:To observe the clinical efficacy and safety of flunarizine combined with salvianolate in the treatment of acute migraine. METHODS:A total of 72 patients with acute migraine were randomly divided into control group(36 cases)and observation group (36 cases). Based on routine treatment,control group was given Flunarizine hydrochloride capsules orally,10 mg for 65 year-old and below once a day,5 mg for more than 65 year-old once a day. Observation group was additionally given Flunarizine hydrochloride for injection 200 mg intravenously,once a day,on the basis of control group. Both groups were treated contineously till cured or for 2 weeks. Clinical efficacy,onset time,recovery time,VAS score,frequency and duration of head-ache attack,ADR were observed in 2 groups. RESULTS:In the course of treatment,the two groups did not terminate and fall off, and all of them completed the treatment. The total response rate(97.22%)of observation group was significantly higher than that (86.11%)of control group;onset time and recovery time of observation group were both shorter than those of control group,with statistical significance (P<0.05). Before treatment,there was no statistical significance in VAS score,frequency or duration of headache attack between 2 groups (P>0.05). After treatment,VAS score,frequency and duration of headache attack in 2 groups were all significantly lower than before,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLU-SIONS:Based on routine treatment,flunarizine hydrochloride capsules combined with Salvianolate injection show significant effica-cy for acute migraine with good safety.

Objective To investigate the prenatal diagnosis and postnatal management of fetal hydronephrosis.Methods One hundred and two cases (87 unilateral and 15 bilateral,with a total of 117 kidneys) of fetal hydronephrosis in singleton pregnancy were diagnosed by prenatal ultrasonography in Jinhua People's Hospital between January 2011 and December 2014.During pregnancy and postpartum,all cases were routinely examined by genitourinary ultrasound for the classification of severity of hydronephrosis.The age of gestation at diagnosis of fetal hydronephrosis,the classification of hydronephrosis and postnatal follow-up outcome were recorded and retrospectively analyzed by descriptive statistical analysis.Results Of the 102 pregnancies,the mean gravida age and gestational age at diagnosis of fetal hydronephrosis was (28.1 ± 3.7) years (20-39 years) and (30.44-4.9) gestational weeks (16-40 gestational weeks),respectively.One hundred and two cases (35 right,52 left and 15 bilateral) of fetal hydronephrosis were diagnosed by antenatal ultrasonography.In the second trimester,59 cases (11 bilateral) of fetal hydronephrosis were diagnosed,including 28 mild (five bilateral),24 moderate (three bilateral),four severe (one bilateral) and three terminated ones.In the third trimester,43 cases (four bilateral) were diagnosed,including 22 mild (two bilateral),17 moderate (one bilateral),two severe and two terminated ones.All these patients were re-examined by ultrasonography at 48 hourspostpartum,and hydronephrosis was still present in 41 cases (five bilateral),including 19 grade 1 (two bilateral),11 grade 2 (two bilateral),seven grade 3 and four grade 4 (one bilateral).From the second and third trimester to postnatal period,there were 18 (two bilateral) and 23 (three bilateral) cases of hydronephrosis,respectively.The regression rate of prenatal hydronephrosis was 53.8％ (63/117),including 64.3％ (45/70) in the second trimester and 38.3％ (18/47) in the third trimester.During postnatal follow-up period,two cases (6.7％,2/30,unilateral) of grade 2,four grade 3 (4/7,unilateral) and four grade 4 (one bilateral) underwent surgery.Eleven cases of grade 3-4 hydronephrosis (one bilateral) were followed up and nine kidneys were treated with surgery due to ureteropelvic junction obstruction (6/9),ureter stricture (1/9),vesicoureteral stricture (1/9) and posterior urethral valves (1/9).Conclusions Although the majority of cases of fetal hydronephrosis spontaneously regress,postnatal hydronephrosis should be monitored timely and continuously by ultrasound.In particular,grade 3-4 hydronephrosis should be followed up to evaluate renal functions.If hydronephrosis presents with symptoms,progressive aggravation,pathological obstruction,or differential renal function ＜ 40％,early surgical intervention should be provided to improve renal functions.