Objective:To established a method for the detection of soluble programmed death ligand 1 (PD-L1) protein in serum based on the poly nanoantibody of lumazine synthase(LS).Methods:A dual nanobody-based sandwich ELISA was established with a competitive ELISA to screen nanobodies recognizing different epitopes of PD-L1 as paired antibodies. To improve sensitivity, PD-L1 nanobody P3C8 and lumazine synthase(LS) were fused, and nanobodies were obtained in polymeric forms as sPD-L1 protein captures, so as to develop an LS-displayed polymeric nanobody-based sandwich ELISA (LSNbs-ELISA) method to detect sPD-L1.Results:Compared with the Nbs-ELISA method, the LSNbs-ELISA method is approximately 11-fold more sensitive for sPD-L1 detection. The limit of detections (LODs) of Nbs-ELISA and LSNbs-ELISA for sPD-L1 in serum were 2.87 ng/ml and 0.255 ng/ml, respectively. Both assays were highly specific for the detection of sPD-L1 and did not react with structure-related proteins PD-1, CD27, CD70, CD137, and CD147 when spiked into the human serum.Conclusions:The Nbs-ELISA and LSNbs-ELISA assays both have high sensitivity and specificity for detecting sPD-L1 in serum and could have potential clinical applications.

Objective To investigate the effects of special nursing on outpatients with unstable emotions.Methods Fiftytwo outpatients with considerably unstable emotions were randomly divided into 2 groups;the routine nursing group (the control group)and the special nursing group (the observation group).Scores of Hamilton Depression Scale(HAMD) and Hamilton Anxiety Scale(HAMA) as well as nursing effects both before and after nursing were assessed and analyzed.The scores of Happy Enterprising Individual Questionnaire(HEIQ)were also analyzed.Then,the rates of compliance and satisfaction were compared between the 2 groups.Results Before nursing intervention,there were no significant differences in the scores of HAMD and HAMA,when comparisons were made between the 2 groups.However,after nursing,the scores of HAMD and HAMA for the observation group were all lower than those of the control group,and statistical significance could be seen when comparisons were made between them(P ＜ 0.05).Following nursing intervention,the scores of self-confirmation,attitude towards difficulties and sense of happiness in HEIQ for the observation group were all higher than those of the control group,and statistical significance could also be noticed when comparisons were made between the 2 groups (P ＜ 0.05).Total efficacy rates in HAMA (88.46％) and HAMD (80.77％) for the observation group were significantly higher than those of the control group (76.92％,69.23％).Compliance rate(92.31％)and satisfaction rate(84.62％) for the observation group were all higher than those of the control group (76.92％,73.08％),also with statistical significance (P ＜ 0.05).Conclusion Special nursing could significantly ease the negative emotions of the patients with considerably unstable emotions,and it would help them to adopt a more positive attitude and cooperate actively with the medical personnel of the nursing group.

Objective:To explore the role of matrix metalloproteinase 12 (MMP12) in airway macrophages and pulmonary neu-rogenic substance P ( SP ) in the pathogenesis of asthma by analyzing their relationship in different categories of asthmatic patients.Methods:Twenty patients of asthma remission phase ( remission asthma group ) , twenty ones of mild acute exacerbation asthma (mild asthma group) and twenty healthy adults (normal control group) were included,respectively.After lung function was measured,the numbers of macrophage in induced sputum were counted.The expression levels of MMP12 mRNA and protein in sputum macrophages were detected by quantitative reverse transcription polymerase chain reaction and Western blot.The concentration of sputum SP was assayed by enzyme immunometric assay.Results: ( 1 ) Compared with the subjects in normal control group, forced expiratory volume in 1 second%predicted ( FEV1 ) and forced expiratory flow rates at 50% of the forced vital capacity % predicted ( FEF50 ) were much lower and the numbers of sputum macrophages were much higher in the patients in different asthmatic groups.Compared with the patients in remission asthma group,FEV1 and FEF50 were much lower in the ones in mild asthma group.(2) MMP12 expressions in the macrophages and the concentrations of SP in sputum were significantly increased in the patients in different asthmatic groups compared with those in normal control group;Furthermore,MMP12 and SP in mild asthma group were much higher than in remission asthma.(3) In all patients from different asthmatic groups,mRNA expressions of MMP12 in the macrophages were positively correlated with the levels of sputum SP or the numbers of sputum macrophages,whereas negative correlations between mRNA expressions of MMP 12 and FEV 1 or FEF50 were observed.Conclusion: The regulatory imbalance of macrophages′MMP12 and pulmonary neurogic SP may participate in the pathogenesis of asthma and become the potential targets for asthma therapy.

Objective To study characteristic findings and the diagnostic value of MRI in pituitary stalk interruption syndrome (PSIS). Methods Twenty-one patients with PSIS were included. Small field of view (FOV) MR1 scanning and clinic hormone detection were performed in all patients. Moreover, fluid attenuated inversion recovery (FLAIR)T,1 WI with fat-suppression sequence was performed in 8 cases. The appearance on FLAIR T1 WI and T2 WI were recorded. The shape of pituitary stalk and antehypophysis, and the signal intensity of posthypophysis were analyzed simultaneously. Results Growth hormone deficiency (GHD) was confirmed by clinic hormone detection in all 21 cases. The level of basal GH varied from 0. 03 μg,/L to 1.50 μg/L. The peak value under GH provocation was from 0. 13 μg/L to 4. 14 μg/L, and the GH was absolute default in all patients. Seventeen cases of them were combined pituitary hormone deficiency (CPHD), and 4 cases were isolated growth hormone deficiency (IGHD). The height of antepituitary was in the range from 1 mm to 3 mm, and the average value was (1.9±1.2) mm. Pituitary stalk was absent in 18 cases and showed as linear and discontinuous stalk in the other 3 cases. The high signal intensity was invisible in normal position in all cases, the high signal intensity spot in the region of infundibular recess of the third ventricle was shown in 19 cases, while it could not be found anywhere in 2 patients with diabetes insipidus. Conclusion PSIS often shows characteristic appearance on MRI, and a definite diagnosis can be made by using MRI combined with clinic hormone detection.

Objective To explore the current state-trait anxiety among nurses in children's hospital and supply some scientific references for the decision-making to healthy guidance and occupation behavior for the practioners. Methods Investigations were carried out in 410 female nurses in Guangzhou children's hospital by usage of the state-trate anxiety inventory(STAI).The results were analyzed statistically. Results The STAI of nurses in the children's hospital was higher than that of the norreal control (P ＜ 0.01 ).But no difference existed in the aspect of special anxiety (P ＞ 0.05) between them.The special anxiety of female cadre and technical staff was higher than the nurses in the children's hospital (P ＜ 0.01). Conclusion The high level of state-trait anxiety hinted us that we should pay attention to the anxiety status of nurses in the children's hospitals.