We established an indirect ELISA method using Trichinella spiralis trehalase(TsTRE)protein expressed in prokaryotic cells.The TsTRE gene was amplified by RT-PCR and ligated into the pCold I plasmid,which was expressed in E.coli BL21 competent cells.The rTsTRE protein was purified through affinity column chromatography.The TsTRE protein was localized with immunofluorescence techniques,and the immunogenicity of rTsTRE was detected by westernblotting.Subse-quently,rTsTRE protein was used as a coating antigen to establish an indirect ELISA.We optimized the antigen-coating con-centration,serum dilution concentration,antigen-coating incubation time,type of blocking solution,blocking incubation time,HRP-labeled goat anti-rabbit IgG serum dilution concentration,HRP-labeled goat anti-rabbit IgG serum incubation time and response time of TMB.Subsequently,the critical value,repeatability,sensitivity,specificity and clinical detection rate of the ELISA were evaluated.Immunofluorescence indicated that trehalase was abundant in the rod-shaped body,tail and epidermis of Trichinella spiralis muscle larvae.Western-blot indicated that rTsTRE protein combined with the positive serum of mice infected with T.spiralis for 42 d;the band was approximately 60 kDa.The established indirect ELISA had a positive threshold of 0.384;the intra-run and inter-run coefficients of variation were 5.504％-7.630％ and 4.664％-9.929％,and did not exceed 10％.The lowest detectable titer was 1:1 280.No cross reaction was observed with antibodies to Clonorchissinensis,Schistosoma ja-ponicum,Ascaris suum,Toxocara gondii and Toxocara canis,and the clinical negative detection rate was 0％.Thus,we suc-cessfully expressed the rTsTRE protein.Moreover,the established indirect ELISA method using the TsTRE protein as the coating antigen had good repeatability,sensitivity,specificity and clinical detectability,and can be applied to the detection of clinical samples.

Objective To collect the laboratory parameters and clinical parameters of blood culture positive samples,and analyze the composition and laboratory characteristics of real pathogens by combining with clinical follow-up and anti-infectious treatment outcomes.Methods We conducted a prospective study to isolate the 483 strains of pathogens from 4313 cases of blood samples for clinical examination between March 2013 and March 2015.The results of laboratory and clinical infections were collected for each positive culture and were followed up for clinical follow-up to understand the responsible doctors' experience-based judgment and targeted clinical treatment of antibiotics.After comprehensive analysis we determined the real pathogens and contaminants.Results Of the 483 positive cultures,331 were finally determined as pathogenic ones,accounting for 68.5% of the number of positive isolates; 97 were contaminated bacteria (20.1%); and 55 strains with uncertain pathogenic nature (11.4%).Escherichia coli accounted for the highest proportion (41.2%)of pathogenic bacteria.Coagulase-negative staphylococci took up the highest proportion (75.3%)of the contaminated bacteria.As many as 253 strains (52.4%)were detected from the aerobic or anaerobic bottles.The detection rate of Escherichia coli in anaerobic bottles (23.9%)was higher than that in aerobic bottles (13.8%)(P <0.05).Of 97 strains of positive isolates,only one bottle was reported positive for 90 strains,accounting for (92.8%),and more than two bottles of 7 positive strains,accounting for (7.2%)(P <0.05).34 positive in 24 h (35.1%),77 positive in 48 h (79.4%),the positivebacteria ratio within 48 h (79.4%)was higher than that of bacteria contamination ratio within 24 h (χ2 =38.935, P =0.000),with a significant difference.Conclusion Establishment of contaminated bacteria in blood culture cannot rely solely on laboratory or clinical parameters.It should be combined with the experience of clinicians to determine the clinical response to comprehensive judgments.For the laboratory to determine the presence of contamination,the number of positive bottles and the amount of sun are still two factors of important value.Paying attention to inspection of anaerobic bottles is more conducive to the detection of Escherichia coli.

Objective To probe into the clinical application effect of the transitional care model on alcohol-induced mental disorders.Methods One hundred and two patients with alcohol-induced mental disorders were divided into the intervention group (n =50) and the control group (n =52) patients in group according to block randomization method.The control group received routine care interventions; the patients in the intervention group discharged to home in open wards,received transtional care model intervention and established services file on the basis of routine care.The patients were followed up for 6 months,and were surveyed by medical coping modes questionnaire (MCMQ),social dysfunction screening scale (SDSS) and social support rating scale (SSRS).The complex drink rate and satisfaction were analyzed in patients.Results The differences in the social support,social functioning,coping style and complex drink rate were not statistically significant between two groups in the discharge.The scores of the social support,social functioning,coping style and complex drink rate were respectively (12.68 ± 3.45),(24.68 ± 5.02),(9.88 ± 2.41) in the intervention group six months after discharge,and were better than (10.98 ± 3.47),(20.77 ± 5.90),(6.78 ±2.13) in the control group,and the differences were statistically significant (t =5.63,5.55,14.07,respectively; P ＜0.01).The scores of face,avoid and yielding were respectively (19.86 ±3.68),(10.84 ±1.89),(8.58 ± 2.46) in the intervention group six months after discharge,and were better than (15.84 ±3.65),(16.54 ± 2.88),(13.78 ± 2.47) in the control group,and the differences were statistically significant (t =7.89,9.12,15.75,respectively; P＜0.05).The score of SDSS was (8.21 ±1.91) in the intervention group six months after discharge,and was better than (10.84 ± 2.14) in the control group,and the difference was statistically significant (t =3.87,P ＜ 0.05).The total abstinence rate,the limited drinking rate,the satisfaction of patients were respectively 52.00％,18.00％,98.00％ in the intervention group six months after discharge,and were better than 19.23％,15.38％,84.61％ in the control group,and the differences were statistically significant (x2 =14.504,5.676,respectively; P ＜0.05).Conclusions Transtional care model intervention can improve the patients' social support,social function,coping styles and abstinence rate,and improve the satisfaction of patients and their families.

Objective To explore the application nursing warning mark in psychiatric.Methods Photos of psychiatric patients when they admitted to hospital were collected,and their nursing warning logo were made which including their photos,basic information and colored wax light strips.And patients identification and nursing care providing by nurses were accorded to patients' warning logo.The errors due to adverse event occurded on in-hospital patients and mistaken identification during nursing checkup were compared between before and after the application of warning logo.Results After the application of nursing warming logo,the accident rate of hospitalized patients was significantly dropped from 15.7％ to 6.7％ (x2 =64.39,P ＜ 0.01),the incidence of medication error for identification error was decreased to 0.2％,and no infusion error happened.Conclusions Warning sign can be used as a fast,safe,effective clinical nursing identification tool.

Objective To study the effects of selenium(Se) and protein on cardiac morphology and expression of cellular glutathione peroxidase(GPX1 ) and mitochondrial thioredoxin reductase(TR2) in rat myocardial tissue.MethodsSixty healthy weaning male Wistar rats were randomly divided into four groups by two factors two levels factorial design(n =15).Drinking water was divided into two levels of Se-deficient(0 mg/L) and Se-adequate (0.25 mg/L); diet was divided into two levels of protein-deficeient (10％ protein and 0.008 mg/kg Se) and protein-adequate(20％ protein and 0.015 - 0.026 mg/kg Se).The rats were killed after feeding for one year.Pathological changes in myocardial tissues were observed under light microscope.The expression of GPX1 and TR2 in rat myocardial tissue was detected by immunohistochemistry and Western blotting.Results Compared between groups,the difference of the rate of myocardial necrosis in rats was statistically significant(x2 =11.04,P ＜ 0.05),in which Se-deficient protein-deficient group [66.7％ (8/12) ] was significantly higher than Se-adequate proteinadequate group [ 7.1％ ( 1 / 14),x2 - 11.06,P ＜ 0.05 ].GPX 1 positive rates in Se-deficient protein-deficient group,Se-adequate protein-deficient group,Se-deficient protein-adequate group and Se-adequate protein-adequate group were 0(0/12),81.8％(9/11 ),10.0％(1/10) and 100.0％(14/14),respectively,in rat myocardial tissue determined by immunohistochemistry.Of which,Se-adequate protein-deficient group and Se-adequate protein-adequate group were significantly higher than Se-deficient protein-deficient group and Se-deficient protein-adequate group(x2 =12.88,8.14 and 35.89,32.60,all P ＜ 0.05).The positive expression rates of TR2 in rats myocardial tissue of the four groups were 0(0/12),81.8％(9/11),0(0/10) and 100.0％(14/14),respectively.Of which,Se-adequate proteindeficient group and Se-adequate protein-adequate group were significantly higher than Se-deficient protein-deficient group and Se-deficient protein-adequate group (x2 =28.67,18.25 and 35.89,32.60,all P ＜ 0.05).The four groups'results of the overall mean of the relatively value of protein expression of GPX1 in cardiac tissue by Western blotting were 0.87 ± 0.13,1.18 ± 0.13,0.95 ± 0.13 and 1.74 ± 0.23,respectively.Through analysis of variance of factorial design,the effects of Se and protein on protein expression of GPX1 in the heart were statistically significant(F=124.93,43.16,all P＜ 0.05).And there was interaction between them(F=24.10,P＜ 0.05).The four groups'results of the overall mean of the relatively value of protein expression of TR2 in cardiac tissue by Western blotting were 0.63 ± 0.19,0.97 ± 0.24,0.55 ± 0.08 and 1.03 ± 0.31,respectively.Through analysis of variance of factorial design,the effect of Se on expression of TR2 in the heart was statistically significant(F =36.97,P ＜ 0.05).Conclusions Adequate Se and protein diet can increase the levels of GPX1 and TR2 in the heart compared to deficient Se and protein diet,can enhance anti-oxidizing ability,protect the myocardial endothelial cells,reduce degree of myocardial injury,and the combined effects of both are better.

Objective To explore design and clinical application of activity of daily living scale for psychiatric inpatients (ADLPI).Methods 120 psychiatric inpatients were randomly divided into two groups,the observation group and the control group,each with 60 cases.ADLPI and ADL were respectively used in two groups when patients were admitted into and left the hospital.Two groups' scores were compared.Results When patients were admitted into the hospital,ADLPI of two groups had no statistically significant differences (P ＞0.05).When patients left the hospital,ADLPI of the observaton group was (82.40 ±6.040) while that of the control group was (71.30 ± 13.725),and the difference was statistically significant (t =0.681,P ＜ 0.05).ADL scores of two groups had no statistically significant differences (P ＞ 0.05),while ADLPI scores had statistically significant differences (t =-10.413,P ＜ 0.05).Conclusions ADLPI can objectively and truly reflect the psychiatric inpatients' daily living ability,and the standards are objective,accurate and easy to learn.ADLPI has passed the clinical test and has preferable results run by examination,thus worthy promoting.

Objective To investigate the clinical manifestations of patients with pulmonary artery hypertension (PAH) associated with hereditary hemorrhagic telangiectasia (HHT). Methods This retrospective analysis summarized the clinical features of 6 patients with PAH associated with HHT hospitalized at department of cardiology in Cardiovascular Institute and Fuwai Hospital between January 2006 and May 2009. Results The mean age of the 6 patients (3 male) was 34 years (8 -67years). Recurrent epistaxis were present in all patients, there were 4 patients with severe PAH and 2 patients with moderate PAH. All of the six patients with PAH associated with HHT were misdiagnosed at the first hospital visit.Clinical symptoms were significantly improved in 4 patients and remained unchanged in 2 patients combined hepatic venous malformation post medical therapy. Conclusions Misdiagnosis for patients with PAH associated with HHT is a common phenomenon in daily clinical practice. Patients could benefit from the corresponding medical therapy after the establishment of the correct diagnosis.

Objective To investigate the prognostic value of acute beart block (AHB) after percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods Ninety-four HOCM patients underwent PTSMA were included in this study. Twelve-lead electrocardiograms were obtained during and post PTSMA. Association between clinic events and incidence of post-PTSMA AHB was analyzed. Results AHB was induced in 26 patients by PTSMA and disappeared in 11 patients shortly post PTSMA, subacute intraventricular conduction disturbances was seen in 11 (42.3%), subacute I°AVB in 2(7.7% ) and subacute Ⅲ°AVB in another 2 (7.7%) patients. Among 68 patients without AHB during PTSMA, intraventricular conduction disturbances was evidenced in 14 patients (20.6% ), I°AVB in 2 (2.9% ) and Ⅲ°AVB in 1 patient (1.5%) after PTSMA. AHB patients with subacute heart block were associated with poor prognosis (conduction block duration was 42.00 h) while patients without AHB was associated with benign prognosis even with new onset of subacute heart block (conduction block duration was 7.33 h, P <0.01). Conclusion Patients with AHB during PTSMA are at higher risk for subacute heart block, especially intraventricolar conduction disturbances. AHB patients with subacute heart block were associated with poor prognosis and longer recovery time conducting system.

OBJECTIVETo summarize the experience of diagnosis and treatment of esophageal leiomyoma.

METHODSClinical data of 52 patients with esophageal leiomyoma were analyzed from 1993 to 2002.

RESULTSAbout 54% patients in this group had difficulty of food intake. The diagnostic accuracy of gastrointestinal barium meal series, computed tomography, gastric endoscope and endoscopic ultrasonography (EUS) for esophageal leiomyoma was 64% 44% 27% and 90% respectively. All patients received operation, resection of esophageal leiomyoma by videothoracoscopy (VAS) and endoscope were performed in 6, 9 patients respectively. The remaining 37 patients received regular open operation,in whom 32 cases received enucleation of esophageal leiomyoma, 5 cases received partial esophageal resection and esophageal-gastric anastomosis. No serious complications occurred except only one case needed operation again because of bleeding.

CONCLUSIONEUS is an effective method for diagnosing esophageal leiomyoma. VAS and endoscopic treatment should be considered for suitable cases in order to reduce the trauma.

Esophageal Neoplasms ; diagnostic imaging ; surgery ; Female ; Follow-Up Studies ; Humans ; Leiomyoma ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Thoracoscopy ; Ultrasonography

OBJECTIVETo explore a new technique for repair of alveolar cleft by sutural distraction osteogenesis.

METHODSNine 8-weeks mongrel dogs were used in this study, three being in the control group, six in the experimental group. Alveolar cleft model was created surgically in all animals. Two weeks later, a U-shaped distractor made of Ni-Ti memory alloy wire was insterted into the premaxilla to distract the mid-premaxillary suture. When the premaxilla of the cleft side approached the ipsilateral maxilla, periosteoplasty of the alveolar cleft was performed. The distractor was removed at two weeks after periosteoplasty. The results were evaluated clinically, radiographically, morphologically and histologically.

RESULTSThe cleft model in dogs was stable and similar to the human alveolar cleft. In experimental dogs, the premaxilla was moved gradually toward the maxilla so that the cleft was closed. The distracted mid-premaxillary suture showed a gradually widened traingle, with its tip being posterior. The density of the distracted traingle suture was increased gradually. Bony repair was achieved completely at the cleft three months post-periosteoplasy. The morphology of the mid-premaxillary suture was restored.

CONCLUSIONThe alveolar cleft could be repaired by the technique of mid-premaxilla suture distraction.

Alveoloplasty ; methods ; Animals ; Dogs ; Maxilla ; surgery ; Models, Animal ; Osteogenesis, Distraction ; methods