Objective:To develop a simple and efficient method for constructing a middle fragment-deleted mutant of MHC class Ⅱ molecule transactivator(CⅡTA)mutant with the 109~(th)to 226~(th) amino acid codons deleted.Methods: Two gene fragments at each end of the deleted CⅡTA gene were obtained by OE-PCR method and were mixed together for 8 PCR cycles without primers to achieve effective overlapping,then 2 primers was added for amplification of the desired fragments.The amplification products were subsequently cloned into eukaryotic vector pIRES for identification.Results: A mutant of CⅡTA with the 109~(th)to 226~(th) amino acids deleted was successfully constructed.Conclusion: This modified OE-PCR technique overcomes some shortcomings of traditional method and is very suitable for constructing mutants with middle fragment deletion,making it worth to be popularized.

American doctor Koretz and his colleagues have collected the documents on randomized control test(RCT) of total parenteral nutrition(TPN) during past 30 years since 1974.With stringent standard,Dr.Koretz et al performed the Meta-analysis to evaluate the efficacy of TPN.This article summarized the result of Koretz's Meta-analysis and also reviewed the efficacy of TPN on some special clinical conditions such as acute pancreatitis,HIV infection,respiratory disease,burns,home TPN et al.The result couldn't determine the curative effect of TPN.TPN is usually not recommended to be routinely applied on hospital patients,but applicable to selective patients.

Objective To explore the curative effect of the single pore video-assisted thoracoscopic surgery and thoracic closed drainage for patients with acute pyothorax by comparing the advantage and disadvantage of two methods.Methods The clinical data of 65 patients with acute pyothorax in our hospital from January 2012 to June 2015 were retrospectively analyzed.Of which 30 patients underwent single pore video-assisted thoracoscopic surgery were as observation group,35 cases received thoracic closed drainage were as the control group.The cura-tive effect of two methods for acute pyothorax was compared by analyzing the result data of two groups.Results The postoperative chest tube indwelling time,length of hospital stay,postoperative antibiotics of observation group were significantly less than those of the control group,the difference was statistically significant(P<0.05).And the incidence of postoperative complications,the proportion of the chronic pyothorax and secondary tube rate of observation group were lower than those of the control group,the difference was statistically significant(P<0.05). Conclusion The single pore video-assisted thoracoscopic surgery is safe and effective for treatment of acute pyothorax, which is worth promoting.

Young Cadre talents in the hospital will be the most important influence factor of the future of the development of Medical care .Their training must includes management , medical skill , science study and so on and be different from the other professions .This study selected the Young Cadre talents of a hospital as the object .And we got the basic condition of the personal , training requirement and the development situation of them , then put for-ward some proposals and methods on how to foster and develop them by these methods below : literature research , questionnaire survey , field survey , statistical analysis , case analysis , interviews with 360 degree and so on .

Objective To identify the expression of long non-coding RNAs(lncRNAs) and their putatively modulated cytokines in human immunodeficiency virus(HIV)-1 infected monocytes and to explore the role of lncRNAs in immunomodulation of HIV-affected host cells.Methods RNAs arrays were used to screen the lncRNAs differentially expressed in HIV-infected monocytes and subsequently confirmed by quantitative real time PCR (qRT-PCR).A siRNA was designed and transfected to the human monocytes, followed by interleukin(IL)-1β, IL-10 and tumor necrosis factor(TNF)-α detection with ELISA.Results The results of the screening assays and qRT-PCR showed that the expression of lncRNA-n266623 was up-regulated in monocytes after HIV-1 infection;the secretions of IL-1β,IL-10 and TNF-α in human monocytes were significantly enhanced following transfection of siRNA targeting lncRNA-n266623 in the monocytes.Conclusion The HIV-1 infection can promote the expression of lncRNA-n266623 which may inhibit the expressions of IL-1β, IL-10 and TNF-α in monocytes and negatively regulate the immune response to HIV-1 infection.

Objective To study the risk values of glycosylated hemoglobin ( HbA1c) screening patients with diabetes mellitus(DM) and pre-diabetes(PreD) in different age and sex.Methods HbA1c results from10 840 in Taizhou Hospital in 2012 were retrospectively collected , and CHAID analysis of decision tree was used in preliminary hierarchy .Age was further divided into five groups according to the preliminary results , then one-way ANOVA and linear regression were utilized to determine the differences between age groups and the prediction intervals (PI) of HbA1c,respectively.The upper limit value of 95%PI of HbA1c was set as diabetes risk values ( DRVs).By comparison of the sensitivity of DM patients screening by DRVs in 1 889 cases whose HbA1c were between 6.0%to 6.5%and the upper limit value of traditional HbA1c reference intervals to verify the screening value ofDRVs .Then the DRVs of HbA1c were utilized to screen DM in the population whose HbA 1c is were 6.0%-6.5% in 2008,and followed their re-examination records toverify the screening value of the DRVs toin PreD patients. Results (1) On the basis of the initially root of decisiontree by age , the populationwas divided into 9 groups ( P =0.000, F =231.462).By calculatingthe 95% confidence interval(CI) of each group and merging reasonably,it was finally divided into 5 groups:20-30years,31-40years,41-50years,51-60years and >60years (F=434.342, P=0.000).(2)Using the method of linear regression , the 95% PI of HbA1c of the 5 groups showed as following:20-30 years, males 4.6%-5.9%, females 4.6%-5.9%.31-40 years, males 4.8%-6.0%, females 4.7%-6.0%.41-50 years, males 4.9%-6.2%, females 4.8%-6.1%.51-60 years, males 5.0%-6.3%, females 4.9%-6.2%.>60 years, males 5.1%-6.4%, females 5.0%-6.3%.The traditional HbA1c reference interval was4.8%-6.3%.(3) The screening sensitivity of DM by the upper limit value of traditional HbA1c reference interval and DRVs in group which HbA1c was between 6.0%-6.5% were 34.5%and 48.1%,respectively.(4) Reviewing of the group with HbA1c between 6.0%-6.5% and not diagnosed as DM in 2008, 49 hadnegative DM screening results by using the upper limit value of traditional HbA1c reference interval but were positive in our setting DRVs , and 13 have developed to DM now , which accounted for 26.5%.Conclusion HbA1c DRVs need to be set hierarchically between different age and sex groups as a supplement to the traditional reference interval , which has a great significance for the diagnosis and treatment of DM and also forthe screening and intervention of PreD patients.

Objective:To discuss the regularity of adverse drug reactions induced by statin.Method:82 cases from published articles were retrieved from 1998 to 2008.According to the given standard,the data were statistically analyzed. Result:77 articles carried 82 case reports concerning statins inducing ADRs in the period of 10 years.52 cases were caused by simvastatin.ADRs of statins could involve multiple organs and systems,mainly myopathys.Severe reaction could result in renal failure and even death.Conclusion:A rational use of statins should be strengthened in the clinical practice and strict monitoring in order to prevent and reduce the occurrence of serious adverse drug reactions.

0.05), respectively; 10 cases out of 12 cases performed SAMT and 26 cases out of 33 cases per- formed VATS were operated bullaectomy; the number of recurrence after operation was 2 in VATS and none in SAMT; the average operative cost was ￥ 806 ? 78 in SAMT and ￥ l808 + 447 in VATS(t = 7 .6,P

Objective To explore the application of video-assisted thoracic surgery (VATS) in the diagnosis and treatment of mediastinal tumors. Methods Thirty-four patients with mediastinal tumors underwent VATS from June 1995 to December 2002. The patients comprised 9 men and 25 women, with a mean age 43 9 years (16～74 years). Entered into the study there were 14 cases of thymoma (9 benign thymomas and 5 malignant), 6 cases of neurogenic benign tumors, 5 bronchogenic cysts, 4 teratomas, 2 pericardial cysts and 3 other conditions (metastatic carcinoma, lymphoma and hemangioma racemosum, respectively). Maximum diameter of the tumors ranged 3 5 cm to 6 cm, mean 4 5 cm. Operations were performed under general anesthesia, double lumen endotracheal tube placement and single lung ventilation. The patients were maintained in the lateral decubitus position. Camera port was placed at the sixth or the seventh intercostals space on the midaxillary line. Sites of the other two ports depended upon the location of the tumors. Results Out of the 34 patients with mediastinal tumors, 25 patients underwent tumor removal by VATS alone and 6 patients received VATS combined with mini-thoracotomy, while the remaining 3 patients only underwent biopsy by VATS. Postoperatively, all patients recovered uneventfully, without severe complications or mortality. Conclusions VATS is the first choice for benign mediastinal tumors, typically those in the middle and posterior mediastinum.

Asthma and chronic obstructive pulmonary disease (COPD) are main chronic respiratory diseases in adulthood,which bring a heavy burden to society and economy.The adulthood asthma and COPD originate from childhood.Atopy and certain respiratory viral infection are the risk factors of asthma.Some factors in childhood including premature,childhood asthma,serious lung infection,air pollution,active smoking will damage pulmonary function in adulthood,which contribute to COPD onset.Strategies such as preventing premature birth and controlling asthma will reduce the burden of chrouic respiratory diseases in adults.