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Biapenem is a carbapenem antibiotic， and can be used for the treatment of sepsis， pneumonia， lung abscess， chronic respiratory lesions secondary infection， complex urinary tract infection and pyelonephritis， etc. This article reviewed the studies on the pharmacokinetics， pharmacodynamics and therapeutic drug monitoring （TDM） of biapenem. The pharmacokinetic parameters of biapenem are not significantly different in healthy subjects， and there is no accumulation after multiple doses of biapenem. However， there are large differences in pharmacokinetic parameters in patients with severe disease and patients with abnormal renal function compared with healthy subjects， which leads to conventional treatment regimens not achieving the desired outcome. In terms of pharmacodynamics， biapenem can improve the rate of reaching the target value by increasing the frequency of administration and prolonging the infusion time. For patients with anuria in end-stage renal disease， dosing intervals can be extended to avoid drug accumulation. However, for patients with severe infection, a daily dose of 1.2 g still can not control infections caused by Acinetobacter baumannii or Pseudomonas aeruginosa, which limits its use in patients with severe disease. It is recommended to implement TDM in severe patients and patients with abnormal renal function， and explore the best dosing regimen for biapenem in combination with pharmacokinetic models to ensure that the time that the free blood concentration of biapenem remains above minimum inhibitory concentration as a percentage of the time between doses （%fT＞MIC） is within the effective range，so that biapenem can exert a greater efficacy in severe patients and patients with abnormal renal function. For medical institutions that cannot carry out TDM， the efficacy of biapenem can be maximized by increasing the frequency of administration and prolonging the infusion time. For infections caused by P. aeruginosa， A. baumannii and Serratia marcescens with high drug resistance rates， it is recommended to combine or replace other antibiotics.
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Breastfeeding is a key factor influencing infants' short- and long-term health, thus making it important to monitor breast function. This article reviews the changes in Na + concentration and Na +/K + value in breast milk during secretory activation and at physiological and pathological conditions, aiming to provide a reference for early clinical assessment and intervention of physiological or pathological changes in the breast during lactation and to improve the outcome of breastfeeding.
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With the development of computer technology and the abundance of spatio-temporal data, Bayesian spatio-temporal model (BSTM) has been developed rapidly, and wildly used by academics to investigate the spatial epidemiological feature of infectious diseases. Hydatid disease is a global natural focus disease that seriously endangers human health. Its epidemic process is complex and affected by many factors. BSTM provides a new method for study of hydatid disease. By modeling, we can not only analyze the influencing factors of hydatid disease, but also can predict the epidemic trend and make the disease distribution map, which is of great significance to public health decisionmaking. Based on a comprehensive review of the literatures, this paper expounds the principles, types and application status of BSTM in hydatid disease.
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ObjectiveTo study the conceptual framework and methodological system of the International Classification of Functioning, Disability and Health (ICF) in occupational therapy and its systematic implementation in clinical practice. MethodsBased on the ICF theory and the policy documents of the World Federation of Occupational Therapists, the conceptual framework of occupational therapy and the systematic implementation in clinical settings based on the ICF framework were analyzed. ResultsThis study constructed a conceptual framework and approach for occupational therapy based on ICF, and clarified the goals, principles, and implementation methods of integrated occupational therapy interventions in rehabilitation services. The goal of occupational therapy interventions was to improve the individual activity and participation through multidisciplinary and cross-cutting implementation of integrated occupational therapy programs to optimize functioning. Occupational therapy was based on the bio-psycho-social model, adhered to the principles of person-centeredness and functioning orientation, and implemented individualized intervention programs in different context. In clinical practice, it was recommended to follow ICF-based standardized process and systematically use World Health Organization Family International Classifications: functioning and unmet needs analysis using ICHI; functional classification, assessment and coding using ICF; disease classification, diagnosis and coding using ICD; intervention of occupational therapies using ICHI to build a systematic occupational therapy service system. ConclusionAn ICF-based occupational therapy concept and methodological system has been built, a comprehensive clinical occupational therapy implementation model has been established, the goal of activity and participation oriented occupational therapy interventions has been clarified, and the systematic, structured, standardized and refined level of occupational therapy has been enhanced.
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Objective To determine the effect of trunk motion control on knee biomechanics during single-leg landing. Methods Twenty male healthy basketball players were recruited. The kinematics, kinetics parameters and surface electromyogram (EMG) of knee joints under trunk motion control during single-leg landing were studied by using Vicon motion Analysis system, Kistler force platform and Noraxon surface EMG system. Results Compared with natural landing, there were significant differences in flexion angle at initial contact moment, peak flexion angle and peak flexion moment during deeply inspiratory landing and landing with a stick, and a significantly larger flexion angle at initial contact moment, a larger peak flexion angle and smaller peak flexion moment were also found. Compared with natural landing, there was no statistical difference in peak valgus angle and peak valgus moment, as well as EMG activity of hamstrings, quadriceps muscles of the knee during deeply inspiratory landing and landing with a stick. Conclusions Deeply inspiratory landing or landing with a stick reduce the risk of anterior cruciate ligament (ACL) injury, and the results provide the theoretical basis for prevention of ACL injuries in basketball players during landing.
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Objective To objectively study the current progress of China Healthcare Improvement Initiative, and its effectiveness and shortcomings for further improvement. Methods Questionnaires were customized by expert consultation and pre-investigation, and distributed by the National Health Commission in April 2018 to the hospitals.Data of 5 469 hospitals were recovered and analyzed with a statistics software for descriptive analysis.Results Implementation progress of the five working systems varied with regions, and rooms of improvement were found in such aspects as outpatient appointment, clinical pathway management and social work system.In 2017, the proportion of outpatient appointments of 5 469 hospitals averaged 19.1%.Progress of the ten major service models also varied, as defects were found in such service models as continuous medical service, intelligent service, and interconnection service.In 2017, only 6.7% of the 5 469 hospitals had put in place hierarchical integrated clinical pathways within their medical alliances.Conclusions Improvement of the medical services calls for not only the efforts of medical institutions themselves, but also top-level design by the local health authorities. In particular, an online information platform should be established for the whole region, to unify the information standards and processes, and corresponding mechanisms and system support are needed.
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Objective To investigate the expression and significance of inducible nitric oxide synthase (iNOS), platelet-derived growth factor (PDGF)-B and lipopolysaccharide (LPS) in rat models with Budd-Chiari syndrome (BCS) . Methods BCS model was established by partial ligation of inferior vena cava in the posterior segment of the liver. The experimental rats were divided into control group (n=20), model group (n=20) and sham group (n=20) . Liver tissues were collected for immunohistochemistry, HE and Masson staining, and the expression levels of iNOS, PDGF-B and LPS were determined. Results The LPS value in model group was higher than that in both control group and sham group (P=0.001) . The mRNA and protein expressions of iNOS and PDGF-B in model group were higher than those in both control group and sham group (P=0.001) . Statistically significant differences in mRNA and protein expressions of iNOS and PDGF-B existed between each other among the subgroups (P=0.001) . In model group iNOS was positively correlated with PDGF-B and LPS; liver fibrosis was positively correlated with LPS and negatively correlated with PDGFB. Conclusion The damage and repair of BCS is a complicated process. The iNOS, PDGF-B and LPS may play different roles in different stages of BCS. How to regulate their balance in liver fibrosis may be a direction that deserves further study.
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Walking disorder is the most common sequela in patients with hemiplegia after stroke.More than half of stroke patients can not walk independently after discharge,and still present a gait asymmetry and slow pace,and other abnormalities.Then,the fall risk is increased.With security concerns,patients are more afraid to walk independently and can not complete the walk in community environment.Therefore,gait rehabilitation is considered as the main goal of stroke rehabilitation.Rhythmic auditory stimulation(RAS)is a new rehabilitation method to improve stroke gait.By elucidating the mechanism of RAS and their effects on stroke gait,the aim of this paper is to explore the effective RAS treatment method for hemiplegic patients,so that RAS is not only used in gait training,but also in real-time assessment of gait in any environment for chronic stroke patients.
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OBJECTIVE:To explore losses and gains (L&G) and L&G ratio induced by Essential Medicine System in a county. METHODS:By choosing a county in western China as sample area,field investigation was used to collect outpatient and inpatient visits,outpatient and inpatient income,drug income,total length of stay and medical insurance reimbursement criteria in primary medical institutions (township health centers,village health rooms) of the county during 2009-2015. By setting the year 2009 as the baseline year,the drug cost reimbursed by medical insurance was simulated and calculated when Essential Medicine System were not implemented;L&G and L&G ratio of medical insurance were calculated by comparing with actual drug cost reimbursed by medical insurance. RESULTS:The year 2012,in which the sample county fully implemented the Essential Medicine System was the turning year. Medical insurance funds lost in primary medical institutions of the county during 2010-2011(lost 437000,915000 yuan,respectively),but gained during 2012 to 2015(gained 199000,494000,858000,1290000 yuan, respectively);the L&G ratio increased from -0.67％ to 1.21％. For reimbursed outpatient drug cost and inpatient cost,L&G of medical insurance were different. For reimbursed drug cost of village health room and township health center,L&G of medical insurance were also different. CONCLUSIONS:The implementation of Essential Medicine System benefits to medical insurance within the county and Medical insurance funds can be saved.
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Objective To study the effects of missense mutation of H4 Lysine 20,expore the molecular mechanisms,and find some specific interaction proteins,such as H4K20me3 demethyhransferase.Methods Stable HeLaS3 cell line expressed H4 or H4 mutations that fuses a Flag-HA tag to carboxyl(C)-terminal was established by virus infection.Mutations include lysine mutates to methionine and alanine.Harveste cells expressed purpose protein.Staining with propidium iodide (PI) and analyze cell cycle analysis by fluorescence activating cell sorter (FACS).Prepare mono nuclesome (mono-N) of three cells samples and purify associated protein complex by immunoprecipitation assay.Distingwish protein differences by Siliver staining and cut different protein bands for mass spectrometry analysis.Results HeLa S3 overexpressed H4K20M exhibit abnormal phenotype when transfected virus 72h,mainly show abnormal cell and nuclei volume increases,stop growing and no longer split.FACS shows cells overexpressed H4K20M were blocked in G2/M period.Mass spectrometry data shows the expression of PRBP4/7 increases in cells overexpressed H4K20M.Conclusion Histone H4 lysine 20 mutation to methionine block cell cycle,this block is likely to be caused by protein PRBP4/7.
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Objective To explore the relationship between the increase of transmural dispersion of repolarization with ventricular arrhythmia,myocardial infarction degree and coronary events in elderly patients with myocardial infarction at T peak-T end interval in order to provide the guidance instruction for the assessment of prognosis of elderly myocardial infarction.Methods One hundred and twenty cases of senile myocardial infarction in the cardiology department of our hospital were selected,including 73 males and 47 females,the average age was (62.37 ± 11.34) years old.In addition,76 elderly cases of other heart disease were selected as the control group,including 42 males and 34 females,the average age was (59.56 ± 12.64) years old.The T peak-T end interval,dispersion and T peak-T end interval and dispersion after correcting the heart ratein different groups were analyzed.Results The T peak-T end interval,dispersion and T peak-T end interval and dispersion after correcting the heart rate had statistical differences between the control group and AMI group at admission and between the acute stage and recovery stage in the AMI group (P＜0.01);the T peak-T end interval and dispersion before and after correcting the heart rate had statistical differences among the patients with different ventricular arrhythmia (P＜0.01);the T peak-T end interval and dispersion before and after correcting the heart rate had statistical differences among the patients with anterior lateral wall,anterior wall,inferior wall,high lateral wall and multiple vessels infarction (P＜0.01);the case death after correcting the heart rate in different degrees and coronary event occurrence at admission had statistical difference (P＜0.01).Conclusion The T peak-T end interval has a close relation with malignant arrhythmia occurrence,which has an important predictive value for the short term prognosis in elderly patients with AMI.
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Objective To explore the relationship between the increase of transmural dispersion of repolarization with ventricular arrhythmia,myocardial infarction degree and coronary events in elderly patients with myocardial infarction at T peak-T end interval in order to provide the guidance instruction for the assessment of prognosis of elderly myocardial infarction.Methods One hundred and twenty cases of senile myocardial infarction in the cardiology department of our hospital were selected,including 73 males and 47 females,the average age was (62.37 ± 11.34) years old.In addition,76 elderly cases of other heart disease were selected as the control group,including 42 males and 34 females,the average age was (59.56 ± 12.64) years old.The T peak-T end interval,dispersion and T peak-T end interval and dispersion after correcting the heart ratein different groups were analyzed.Results The T peak-T end interval,dispersion and T peak-T end interval and dispersion after correcting the heart rate had statistical differences between the control group and AMI group at admission and between the acute stage and recovery stage in the AMI group (P＜0.01);the T peak-T end interval and dispersion before and after correcting the heart rate had statistical differences among the patients with different ventricular arrhythmia (P＜0.01);the T peak-T end interval and dispersion before and after correcting the heart rate had statistical differences among the patients with anterior lateral wall,anterior wall,inferior wall,high lateral wall and multiple vessels infarction (P＜0.01);the case death after correcting the heart rate in different degrees and coronary event occurrence at admission had statistical difference (P＜0.01).Conclusion The T peak-T end interval has a close relation with malignant arrhythmia occurrence,which has an important predictive value for the short term prognosis in elderly patients with AMI.
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Objective:The paper aims at developing a method of defining and visualizing the scope of the basic medical insurance pharmacy service, and provides a new way of thinking for the designated pharmacy planning. Methods:Collecting the basic data and information on administrative divisions in the planning area taking equity and efficiency as the guidance, using ArcGIS and its function modules to define and visualize the scope of the medical in-surance pharmacy service. The procedure of issue focus, method improvement, data simulation, expert consultation, methodology perfecting were followed to define and visualize the scope. Results:Forming a whole set of operative pro-cedures of defining and visualizing the scope of the medical insurance pharmacy service based on medical resources allocation standard, and the operation commands and procedures in ArcGIS were clarified. Conclusion:Operating ac-cording to the appropriate method steps, the following can be achieved:(1) The adjacent scope of medical insurance pharmacy service are adjacent to each other but do not overlap or cross;(2) Spatial relations can be clearly and ef-fectively expressed;(3) The shape is flat and regular;(4) The data collected at different times can be comparable in space, providing good prerequisites for medical insurance designated pharmacy planning.
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Objective To observe the clinical safety and efficacy of foscarnet prophylaxis and pre-emptive therapy for cytomegalovirus (CMV) infection in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods Ninety-six patients undergoing allo-HSCT from October 2014 to December 2016 were retrospectively analyzed. Plasma CMV-DNA was monitored with real-time quantitative polymerase chain reaction (RQ-PCR) from beginning to 180 days after transplantation. Foscarnet was used not only for prophylaxis but also for first-line pre-emptive therapy when plasma CMV-DNA turned to positive. Foscarnet was given 60 mg·kg-1·d-1 and 120 mg·kg-1·d-1 respectively in prevention and pre-emptive therapy. Incidences of CMV infection and CMV disease were observed, influencing factors on CMV in faction and the efficacy and safety of foscarnet prophylaxis were analyzed, and survival of patients treated by all-HSCT was evaluated. Results Of the total 96 patients, 42 cases (43.8%) had CMV infection with the median time of 42 days after allo-HSCT. CMV-DNA became negative in 36 patients (85.7%, 36/42) after pre-emptive therapy. Six patients (14.3 %, 6/42) developed CMV disease, including 5 patients with CMV negative and 1 patient died for CMV pneumonia. Haploidentical donor and grade Ⅱ-Ⅳacute graft versus host disease (GVHD) were the risk factors for CMV reactivation (χ2 = 3.834, P< 0.05; χ2 = 16.807, P< 0.001). The side effects of foscarnet prophylaxis were mild without hematologic toxicities. 12 patients (28.6 %) died in 42 patients with CMV infection, and 6 patients (11.1 %) died in 54 patients without CMV infection. The difference of survival rates between both groups was not statistically significant. Conclusion Foscarnet is an effective agent for prophylaxis and pre-emptive therapy in CMV infection after allo-HSCT with mild adverse reactions, especially for patients following with hematopoietic recovering.
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Objective@#To investigate the hot spots and epidemiologic characteristics of hand, foot and mouth disease (HFMD) in Jinan municipality from 2009 to 2016.@*Methods@#Disease reports of HFMD in Jinan from 2009-2016 were collected and analyzed with ArcGis 10.2 to show the hot spot in different villages and towns, as well as clustering analysis and descriptive epidemiology to show epidemiologic characteristics.@*Results@#A total of 89 486 HFMD cases were reported and the reported annual incidence rate was 160.94/100000 during the 7-year period, which increased year by year, and within the whole city, each county was at a higher epidemic level; the curve of incidence is unimodal and the incidence peak occurred mostly between May and August, especially in June; 115 severe cases were reported and the ratio was 0.13%. Of the reported cases, 81.51% were between 1 to 4 years old; 60.36 % were children living scattered. The hot spots were like a circle surrounding the core areas, showing a tendency of increase; the proportion of EV71, CVA16 and other enteroviruses were 33.67%、37.22%and 29.09%, respectively, and they appeared in turn, but severe cases were mostly affected by EV71.@*Conclusions@#The HFMD in Jinan is in a highly prevalent level, with low ratio of severe cases. Seasonal(high in summer) and unimodal; more common among children between 1 to 4 years old, living scatted and in urban and rural linking areas, with the tendency of increasing of hot spots; prevalent pathogens appear in turn.
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Objective This study aims to understand the characteristics of the time sequence of ICR mouse first mandibular molar tooth germ development through dynamic observation.Methods Tooth germ of Embryos (E11.5,E12.5,E13.5,E14.5,E15.5,E16.5,E17.5 and E18.5) and postnatal (PN1,PN2) mice were obtained.The heads (E11.5-E15.5) and mandibles (E16.5-PN2) of mice were dissected,fixed and embedded for serial sections and HE staining.All the results were assessed under light microscopy.Results The tooth germ underwent various development stages including the bud,cap and bell stages.Mouse odontogenesis was initiated at E11.5.Proliferation of oral epithelium formed the bud stage at E13.5.Then the cap stage was observed at E14.5-E15.5 and the bell stage was appeared beginning from E16.5.The pre-dentin was observed at PN1,as well as the dentin at PN2.Conclusions Establishing the regular development pattern of the first mandibular molar of ICR mice will provide a reliable basis for the future use in the specific tooth germ developmental research.
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In order to explore tick proteins as potential targets for further developing vaccine against ticks, the total proteins of unfed female Dermacentor silvarum were screened with anti-D. silvarum serum produced from rabbits. The results of western blot showed that 3 antigenic proteins of about 100, 68, and 52 kDa were detected by polyclonal antibodies, which means that they probably have immunogenicity. Then, unfed female tick proteins were separated by 12% SDS-PAGE, and target proteins (100, 68, and 52 kDa) were cut and analyzed by LC-MS/MS, respectively. The comparative results of peptide sequences showed that they might be vitellogenin (Vg), heat shock protein 60 (Hsp60), and fructose-1, 6-bisphosphate aldolase (FBA), respectively. These data will lay the foundation for the further validation of antigenic proteins to prevent infestation and diseases transmitted by D. silvarum.
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Animals , Female , Rabbits , Antigens/chemistry , Arthropod Proteins/chemistry , Electrophoresis, Polyacrylamide Gel , Ixodidae/chemistry , Molecular Weight , Tandem Mass SpectrometryABSTRACT
<p><b>BACKGROUND</b>Herpes simplex virus thymidine kinase phosphorylates ganciclovir to ganciclovir monophosphate, which is then converted to ganciclovir triphosphate by endogenous cellular nucleoside kinases. The ganciclovir triphosphate acts as a DNA chain terminator due to the lack of a functional 3'-OH group and terminates the process of DNA replication, hence leading to cell apoptosis. At present, HSVtk gene usually acts as suicide gene to kill tumor cells. The aim of this study was to investigate the selective cytotoxicity of the herpes simplex virus thymidine kinase/ganciclovir (HSVtK/GCV) suicide gene system controlled by the a-fetoprotein (AFP) promoter on hepatocellular carcinoma (HCC) cells in vitro.</p><p><b>METHODS</b>pAFP-HSVtk-IRES2-EGFP recombinant plasmid vectors driven by the AFP promoter were constructed. HL-7702 liver cells, HUH-7 HCC, and HepG2 HCC were transfected with the recombinant plasmids. HSVtK gene expression was detected using Western blotting analysis. HepG2 cells line stably expressing HSVtk gene was selected by G418 reagent. The cytotoxicity of HSVtK/GCV suicide gene system on hepatoma cells was measured by CCK-8 reagents when different doses of ganciclovir were added.</p><p><b>RESULTS</b>Plasmid pAFP-TK-IRES2-EGFP-expressed HSVtk gene was constructed successfully. HSVtk gene expression level was significantly higher in AFP-positive hepatoma cells than in AFP-negative liver cells. After G418 selection, a HepG2 cells line stably expressing HSVtk gene was acquired. With the increase of the dose of ganciclovir the optical density at 450 nm of HepG2 cells stably expressing HSVtk gene gradually decreased (P < 0.05).</p><p><b>CONCLUSION</b>The HSVtK gene-specific expression in hepatoma cells as well as the cytotoxicity of the suicide gene system in HepG2 cells provided the basis for the targeted gene therapy of HCC.</p>
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Humans , Apoptosis , Genetics , Carcinoma, Hepatocellular , Genetics , Cell Line, Tumor , Fetal Proteins , Genetics , Ganciclovir , Pharmacology , Hep G2 Cells , Liver Neoplasms , Genetics , Promoter Regions, Genetic , Genetics , TransfectionABSTRACT
Objective To explore the potential mechanism of Fasudil hydrochloride pharmacologic postconditioning that alleviated acute myocardial ischemia/reperfusion injury (MI/RI) in rats,narrowed the scope of infacted myocardium,and inhibited cell apoptosis.Methods Ninety rats were randomly and averagely divided into 5 groups:sham group,ischemia/reperfusion (I/R) group,ischemic postconditioning (IPost) group,fasudil hydrochloride (FH) group,and FH and PI3K inhibitor (LY294002) (FH + I) group.The expressions of Rho associated coiled-coil forming protein kinase-1 (ROCK-1),Bcl-2,Bax,Caspase-3,Akt,and P-Akt in rat myocardial cells were determined.Results Compared to I/R group (ROCK1:2.94 ± 0.13),ROCK1 expression was not changed in IPost group (ROCK1:2.79 ± 0.11),FH group (ROCK1:2.83 ± 0.10),and FH + I group (ROCK1:2.85 ± 0.26).Compared to I/R group (Bcl-2:1.11 ± 0.12,P-Akt:1.09 ± 0.06,Bax:1.74 ± 0.06,and caspase-3:1.32 ± 0.12),the expressions of Bcl-2 and P-Akt in FH group (Bcl-2:1.76 ± 0.08,and P-Akt:1.73 ± 0.05) and IPost group (Bcl-2:1.74 ± 0.06,and P-Akt:1.37 ± 0.05) were all significantly higher than those in I/R group (P ＜ 0.05),while the expressions of Bax and caspase-3 in FH group (Bax:0.98 ±0.14,and caspase-3:0.97 ±0.06) and IPost group (Bax:0.97 ±0.11,and caspase-3:1.07 ±0.08) were all significantly lower than those in I/R group (P ＜0.05).Compared to FH group,the expressions of Bcl-2 and P-Akt in FH + I group (Bcl2:1.05 ±0.12,and P-Akt:1.21 ±0.06) were decreased (P ＜0.05),while the levels of Bax and caspase-3 (Bax:1.61 ±0.11,and caspase-3:1.42 ± 0.11) were increased (P ＜ 0.05).Conclusions The mechanism of FH postconditioning was associated with the inhibition of ROCK activity,and the activation of PI3K-Akt pathway.
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Subolesin (4D8), the ortholog of insect akirins, is a highly conserved protective antigen and thus has the potential for development of a broad-spectrum vaccine against ticks and mosquitoes. To date, no protective antigens have been characterized nor tested as candidate vaccines against Dermacentor silvarum bites and transmission of associated pathogens. In this study, we cloned the open reading frame (ORF) of D. silvarum 4D8 cDNA (Ds4D8), which consisted of 498 bp encoding 165 amino acid residues. The results of sequence alignments and phylogenetic analysis demonstrated that D. silvarum 4D8 (Ds4D8) is highly conserved showing more than 81% identity of amino acid sequences with those of other hard ticks. Additionally, Ds4D8 containing restriction sites was ligated into the pET-32(a+) expression vector and the recombinant plasmid was transformed into Escherichia coli rosetta. The recombinant Ds4D8 (rDs4D8) was induced by isopropyl beta-D-thiogalactopyranoside (IPTG) and purified using Ni affinity chromatography. The SDS-PAGE results showed that the molecular weight of rDs4D8 was 40 kDa, which was consistent with the expected molecular mass considering 22 kDa histidine-tagged thioredoxin (TRX) protein from the expression vector. Western blot results showed that rabbit anti-D. silvarum serum recognized the expressed rDs4D8, suggesting an immune response against rDs4D8. These results provided the basis for developing a candidate vaccine against D. silvarum ticks and transmission of associated pathogens.