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Objective:To grasp the distribution of fine antigenic epitope profiles of nucleoprotein (NP) and glycoprotein (GP) fragments of Crimean-Congo hemorrhagic fever virus (CCHFV) and to clarify the value of dominant antigenic epitopes in laboratory testing of Crimean-Congo hemorrhagic fever (CCHF).Methods:In a minimal synthetic short peptide consisting of 8 amino acids was segmentally expressed by CCHFV YL04057 strain using a modified bio-peptide synthesis method from 2014 to 2021 in the laboratory of Xinjiang University, College of Life Sciences. Using CCHFV polyclonal antibody or monoclonal antibody 14B7 (IgM) or CCHFV-positive sheep serum as antibodies, the minimal antigenic epitopes (BCEs) with antigenic activity on NP and GP fragments were identified by immunoblotting, and the obtained BCEs with sequence polymorphism were spatially clustered with CCHFV from different regions using the neighbor-joining method to determine the combination mode of BCEs with geographical correlation of regional distribution, to explore its application in establishing serological diagnosis. A prokaryotic expression plasmid (pET-32a), an E. coli expression plasmid (pGEX-KG) and a prokaryotic expression plasmid with an incomplete glutathione (GST188) tag (pXXGST-ST-1) were used to construct and express six dominant antigenic epitopes of different peptide lengths on NP fragments, and an indirect Enzyme-linked immunosorbent assay (ELISA) was established. CCHF sheep serum identified by immunofluorescence assay (IFA) was used as a control, and the specificity, sensitivity and overall compliance of the recombinant proteins with different peptide lengths of antigenic epitopes with IFA assay results were statistically analyzed. Results:CCHFV, NP and GP fragments had a total of 30 antigenically active BCEs, among which the core intermediate fragment NP2 (aa 170 th-305 th), which had a concentration of antigenic epitopes in the NP fragment, has 6 BCEs, and the NP1 (aa 1 st-200 th) and NP3 (aa 286 th-482 nd) at both ends have 9 BCEs; the Gc (aa 1 st-558 th) and Gn (aa 533 th-708 th) fragments of the GP fragment have 14 BCEs and a long antigenic peptide (AP) containing 15 amino acids, and the amino acid sequence homology of the NP fragment BCEs was 97.1% and that of the GP fragment BCEs was 89.1%. There was a significant difference ( P=0.0281, P<0.05). Among the 9 BCEs with sequence polymorphism in the GP fragment, 6 combined BCEs from GnEc1, GnE2, GnE4, GcE3, GcE6 and GcAP-4 (Ap) could cluster 15 CCHFV strains from different regions of the world into 5 geographical taxa, AsiaⅠ, AsiaⅡ, AficaⅠ, AficaⅡ and Europe. The constructs expressing PET-32a-NP (full length), PGEX-KG-NP2 (aa 170 th-305 th), pGEX-KG-NP2-1 (aa 235 th-275 th), PGEX-KG-NP2-1-1 (aa 237 th-256 th), pXXGST-1-NP2-1-2 (aa 250 th-265 th) and PGEX KG-NP2-1-3 (aa 260 th-276 th), six recombinant proteins CCHFV NP rabbit polyclonal antiserum (pAb) Western Blotting reaction positive, 33 sheep sera tested by IFA XHF as a reference, the sensitivity of the assay established by indirect ELISA using the recombinant proteins constructed from two fragments of NP2 and NP2-1 as antigens. The sensitivity, specificity and overall compliance were the best, with 73.4% (11/15) and 66.7% (10/15) for sensitivity, 100% (18/18) and 94.4% (17/18) for specificity, and 87.9% (29/33) and 81.8% (27/33) for overall compliance. Conclusion:CCHFV NP and GP are distributed with a high number of BCEs with antigenic immunoreactivity, among which the dominant antigenic epitopes are of high value in the laboratory serological diagnosis of CCHF.
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Objective:To investigate the relationship between monocyte to high-density lipoprotein cholesterol ratio(MHR)and the thrombolysis in myocardial infarction(TIMI)risk score in elderly patients with ST elevation myocardial infarction(STEMI).Methods:This was a prospective clinical trial.A total of 152 patients admitted to Tangshan Workers' Hospital were enrolled between January 2015 to February 2018.Of these, 102 STEMI patients undergone primary percutaneous coronary intervention(PCI)were selected as the STEMI group and 50 patients with angiographically normal coronary arteries were selected as the control group.The STEMI patients were divided into two subgroups based on TIMI risk scores.The relationship between MHR and TIMI risk scores in patients with STEMI was analyzed.Logistic regression was used to analyze whether MHR could be used as an independent predictor of acute STEMI and high TIMI scores.Results:The MHR level was significantly higher in the STEMI group than in the control group( P<0.05)and was significantly higher in the high TIMI score subgroup than in the low TIMI score subgroup( P<0.05). In multivariate Logistic regression analysis, MHR was an independent predictor of high TIMI scores in acute STEMI(P<0.05). In correlation analysis, there was a significant positive correlation between MHR and TIMI score in STEMI patients( r=0.396, P<0.01). The ROC curve showed that the area under the curve of MHR was 0.815(95% CI: 0.734-0.896, Z=7.613, P<0.01). When the MHR optimal cut-off value was 2.380, the sensitivity was 55.22% and the specificity was 97.14%. Conclusions:MHR is significantly associated with the TIMI score in patients with STEMI.MHR may be used as a supplementary parameter for assessing the prognosis of STEMI patients.
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Objective To understand the compliance of antihypertensive drug use in patients with hypertension.Methods A retrospective analysis was conducted among 218 patients with hypertension to understand their drug use compliancy and influencing factors,including side effect of the drugs,drug type,educational level,economic status and drug use length.Results The factors including disease course,drug type,drug use length and drug side effects,the economy status,educational level,awareness of hypertension related knowledge and psychological reaction could significantly influence the compliance of antihypertensive drug use.Among the patients surveyed,86.67％ of them with poor drug use compliance had only an educational level less than senior high school,77.33％ had poor awareness of hypertension related knowledge.Conclusion The antihypertensive drug use compliance in patients with hypertension is directly related to the outcome of the disease in clinical treatment.It is necessary to take effective measures to improve the treatment compliance and maintain normal blood pressure level of the patients.
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Objective To explore the effect on prognosis of attenuated plaque (AP)in patients with acute coronary syndrome (ACS)after percutaneous coronary intervention(PCI).Methods This study was a prospective study which included 225 ACS patients who admitted to the cardiology and met the conditions between January 2009 and December 2011.Clinical data,intravascular ultrasound characteristics of plaque, blood flow in coronary angiography and cardiovascular complications within 30 days after PCI were recorded.The main form of follow-up was telephone follow-up,supplemented by patient follow-up and out-patient follow-up.Endpoint was major adverse cardiac events (MACE).Kaplan-Meier method was used to estimate survival rate.The survival difference between the two groups was compared using the Log-Rank test.Results Extravascular elastic membrane area (EEMA),plaque area (PA),plaque burden,remodeling index in AP group were significantly increased than those in non-AP group.Corrected TIMI frame count (CTFC)immediately after the balloon dilatation was significantly higher in AP group than in non-AP group. Recent overall complications were more frequently documented in AP group than in non-AP group,but long-term follow-up outcome of MACE-free survival curves showed no significant difference between the two groups.Conclusions Recent prognosis,not long-term prognosis,is affected by attenuated plaque in ACS patients after PCI,which help to stratify risk further and guide treatment in ACS patients.