Objective To research the clinical value of serum thyroid peroxidase (TPOAb) in screening thyroid dysfunction in pregnancy.Methods The concentration of serum TPOAb and TSH(thyroid-stimulating hormone) was detected by MEIA and CMIA in 75 cases of pregnant women with thyroid disfunction,and 145 cases of pregnant women without tyhroid dysfunction (as control group).Results There were significant differences in both TSH and TPOAb levels between pregnant women with and without thyroid dysfunction(P0.05). So the normal serum TSH could not completely exclude the thyroid dysfunction in pregnant women.Conclusion TPOAb can be used as a prenatal screening marker for early diagnosis of thyroid dysfunction in pregnancy. From the diagnostic point, TSH can not completely substitute for TPOAb and the abnormal TPOAb can indicate the possibility and risk for autoimmune thyroid disease in pregnant women.

Objective To investigate whether the μ- and δ-opioid receptors were involved in mediating the a ntinociceptive effect of opioid injection into the nucleus submedius (Sm). Methods Nociceptive behavior produced by subcutaneous injection of formalin (65 mmol/L, 50 μL) into the hind paw of the rat was assessed quantitatively using an automated movement detection system. The effects of morphine and selectiveμ- and δ-opioid receptor antagonists microinjected unilaterally into the Sm were determined in the awake rats. Results Morphine (31 mmol/L, 0. 5 μL) depressed the nociceptive behavior elicited by formalin, and this effect was antagonized completely by the selective μ-receptor antagonist β-funaltrexamine (β-FNA, 0. 4 mmol/L, 0. 5 μL) and naloxonazine (0.8 mmol/L, 0.5 μL), and partly by the δ-receptor antagonist naltrindole (0.4 mmol/L, 0.5μL).Administration of morphine into thalamic regions more than 0. 5 mm dorsal to the Sm had no effect on the nociceptive behavior. Conclusion Antinociceptive effects produced by opioid acting on Sm neurons are mediated mainly by μ-opioid receptors, and partly by δ-receptors.

Objective To analyze the clinical significance and features of patient s' with inconsistent antineutrophil cytoplasmic antibodies (ANCA) test results between indirect immune fluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA).Methods ANCA were detected with IIF and ELISA method jointly among 12 386 in-patients and a retrospective analysis on the proportion of clinical features and significance was made in 589 cases with inconsistent results using Microsoft Excel 2007 statistical software.Results Among the 589 patients,68 (11.5％) were diagnosed as vasculitis,in which 51 cases as ANCA-associated vasculitis,and 521(88.4％) were diagnosed as non-vasculitis including 181 connective disease and 340 non-connective diseases in which hypertension and cardiopathy were common.The common inconsistent results of ANCA were p-ANCA/ELISA (-),IIF (-)/anti-MPO (+),IIF (-)/anti-PR3 (+),IIF (-)/anti-PR3 (+) anti-MPO (+) accounted for 24.4％ (144/589),29.5％ (174/589),15.9％ (94/589),18.5％ (108/589) respectively,these accounted for 88.3％(520/589) of total inconsistency.Conclusion The spectrum of diseases and clinical characteristics varies widely and often presents with multiorgan involvement in patients with inconsistent ANCA results.These reasons make it easy to be misdiagnosed.Attention should be paid to identify and different these inconsistency.

Salmonella is a pathogenic bacteria to human and animals ,which can cause seriously complication and death . Salmonella pathogenicity is from the reactions of SP‐1 and SP‐2 T3SS effector proteins .In this paper ,the functions of different T3ss effector proteins in different infection periods is reviewed to provide a reference for further understanding the pathogenesis mechanisms of Salmonella .

Objective To observe the therapeutic effect of Qili Qiangxin capsule combined with glucocorticoid for treatment of patients with dilated cardiomyopathy accompanied by refractory heart failure. Methods A prospective study was conducted. Forty-eight patients with dilated cardiomyopathy and refractory heart failure in Hebei Cangzhou Central Hospital were enrolled,and they were randomly divided into three groups:control group,treatmentⅠand treatmentⅡgroups(each,16 cases). All groups were treated with conventional anti-heart failure western treatment, meanwhile additionally prednisone was given to treatment groupⅠand groupⅡ,firstly 40 mg/d,then the dosage of 5 mg was decreased in every 5 days until reaching 5 mg per day;in treatment groupⅡ,besides the same treatment of group I,the traditional Chinese medicine therapy Qili Qiangxin capsule 4 granules(one capsule 0.3 g)each time and 3 times a day was added,2 months being the therapeutic course in all the patients. The clinical efficacy and cardiac functional indexes,such as the left ventricular end-diastolic volume(LVEDV),the left ventricular end-systolic volume(LVESV),the left ventricular ejection fraction(LVEF)and the plasma B type brain natriuretic peptide (BNP),etc. were observed in 1 week and 2 months after treatment. Meanwhile the electrocardiogram(ECG),aspartate transaminase(AST),alanine aminotransferase(ALT),urea nitrogen(BUN),serum creatinine(SCr),blood routine, urine routine examination and the adverse effects were investigated. Results The total effective rates in treatment groupⅠand treatment groupⅡwere significantly higher than those in the control group〔after treatment for 1 week:81.2%(13/16),81.2%(13/16)vs. 43.8%(7/16);after 2 months:87.5%(14/16),93.7%(15/16)vs. 50.0%(8/16), all P<0.05〕. After treatment,the LVEDV,LVESV and BNP were lowered and the LVEF was increased in the three groups,and the above indexes in treatment groupⅡwere improved more significantly than those in groupⅠ〔LVEDV (mL):142.4±33.0 vs. 174.8±52.5,LVESV(mL):111.6±23.7 vs. 132.4±29.0,LVEF:0.421±0.037 vs. 0.390±0.045,BNP(μg/L):1.944±0.751 vs. 3.038±1.905,all P<0.05〕. Conclusion Qili Qiangxin capsule combined with glucocorticoid may effectively improve the cardiac function and clinical symptoms in near and forward future in patients with dilated cardiomyopathy accompanied by refractory heart failure,thus it may elevate the patients' life quality.

AIM: To construct the prokaryotic expression plasmid of His-tagged human high mobility group box 1 fusion protein (hHMGB1) and to express the fusion protein in E. coli for the affinity purification. METHODS: The cDNA coding region of HMGB1 was amplified by PCR from pGEX4T-HMGB1 and cloned into a modified pET14b vector following the routine procedure. After identification by enzyme digestion, PCR and sequencing, the plasmid was transformed into BL21 (DE_3) competent cells, and the His-HMGB1 fusion protein was induced for expression with isopropyl-beta-D-thiogalactopyranoside (IPTG), and further purified by Ni-NTA affinity chromatography. The protein was filtered for sterilization and used to stimulate human umbilical vein endothelial cells (HUVECs). 24 hours later, the cultured supernatant of HUVECs was collected for the detection of cytokines/chemokines with LiquiChip system. RESULTS: The His-HMGB1 fusion protein expression plasmid was identified by enzyme digestion and sequencing. The purified His-tagged fusion protein was analyzed by SDS-PAGE and Western blotting with specific anti-His antibody. It was found that the production of IL-8 from HUVECs was highly induced in a dose-dependent manner by HMGB1. CONCLUSION: The His-tagged HMGB1 fusion protein expression plasmid was successfully constructed, and purified. Recombinant HMGB1 protein has a high bioactivity on the induction of cytokines in HUVECs, which may significantly facilitate the future study of HMGB1 biological functions.

TeamSTEPPS(Team Strategies & Tools to Enhance Performance & Patient Safety)is an evidence-based set of teamwork tools,aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals.It integrates teamwork skills with clinical practice to improve team performance in healthcare services and improve the quality of care effectively.The article introduces the TeamSTEPPS course and its clinical application.

TeamSTEPPS (team strategies and tools to enhance performance and patient safety) defines four core capabilities in teamwork which can be trained: leadership,situation monitoring,mutual support and communication.TeamSTEPPS is a successful medical team training project and its effectiveness has been proved.The application of TeamSTEPPS can provide a new teaching model for general practice training.

ObjectiveTo analyze the changes of imaging and the efficacy of sympathetic cervical spondylosis before and after treatment and discuss the correlation of them.Methods Seventy-one sympathetic cervical spondylosis inpatients who examined by X-ray,CT,transcranial Doppler (TCD) or color Doppler flow imaging(CDFI) were collected.After comprehensive treatment,the efficacy was evaluated according to the recovery of patients' symptoms,and the cases with imaging abnormalities were examined again.Then the correlation between the changes of imaging and the efficacy was analyzed.ResultsAfter treatment,all 71 cases,including 45 cases with excellent efficacy,18 cases with good effect and 8 cases turned effective,showed a fine rate 88.7％ (63/71) and an effective rate 100.0％ (71/71).The rechecked imaging results showed:in 36 lantoaxial subluxation cases by CT scanning,26 cases turned to be normal,6 cases were improved and 4 cases had finally no change; in 68 cases with abnormal X-ray imaging,67 cases were improved and 1 case had finally no change; in 38 cases with abnormal TCD results,24 cases turned to be normal,2 cases were improved,10 cases showed changes and 2 cases had finally no change;in 36 cases with abnormal cervical CDFI results,9 cases turned to be normal,10 cases were improved,15 cases showed changes and 2 cases had finally no change.The analysis of correlation between the changes of imaging and the efficacy showed:changes count by the value 0,r =0.388,t =3.500,P＜ 0.01 ; changes count by the value 0.5,t =0.361,t =3.211,P ＜0.01.ConclusionsThe efficacy of sympathetic cervicalspondylosis has positive correlation with the changes of imaging and the causes of this disease are complex.So complete and well inspection can help the syndrome differentiation treatment and confirm the efficacy.

Objective To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) on paralytic hand and upper limb of stroke patients. Methods 32 patients were randomly divided into the treatment group (n=16) and the control group (n=16). All the patients accepted routine rehabilitation, and the patients in the treatment group accepted TEAS in addition for 6 weeks. They were assessed with Fug1-Meyer Assessment of upper extremities (FMA-UE), motor status scale (MSS) and Modified Barthel Index (MBI) before and 2, 4, 6 weeks after treatment. Results All the measures improved in both groups after 2, 4, and 6 weeks of treatment (P<0.05), while the scores of MBI improved more in the treatment group than in the control group 4 weeks after treatment (P<0.05), and all the measures improved more in treatment group than in the control group 6 weeks after treatment (P<0.05). Conclusion TEAS may promote the recovery of flaccid hand and upper extremity function post stroke.