Objective To investigate the clinical features,treatment and prognosis of Vibrio vulnificus infection in patients with characteristic skin lesions.Methods Clinical data on 23 cases of Vibrio vulnificus infection with characteristic skin lesions collected from 1996 to 2008 in Second Affiliated Hospital Affiliated to Wenzhou Medical College,were analyzed retrospectively.Results There were 23 patients including 15 males and 8 females.Of them,15 had a history of chronic type B viral hepatitis or alcoholic liver disease;17 ate raw oysters before the onset.A rapid onset Was observed in all of these patients,and initial symptoms were dominated by swelling and pain of,as well as bullae and hemorrhagic bulla in lower extremities.Vibrio vulnificus was isolated by culture from blister fluid of 13 patients,from both blood and blister fluid of 9 patients,and from necrotic tissue of 2 patients.Histopathologic examination revealed vacuolar degeneration and necrosis of cells,interstitial neutrophilic infiltrates,and vasculitis.Bacteria were seen in infiltrated neutrophiles.Electromicroscopy showed numerous round or arcuated microorganisms and bacterial flagella in hypodermal cells.Seven patients diagnosed from May 1996 to May 2000 died from this infection,and survival WaS observed after treatment only in 2 out of 6 patients collected from July 2000 to October 2003 and 6 out of 10 patients from May 2004 to October 2008.Conclusions Early recognition of skin eruptions and timely management are essential for the control of Vibrio vulnificus infection and for the improvement in survival among pafients infected with this bacterium.

Objective To investigate the cerebral CT appearances of toxic encephalopathy of tetramine and improve the recognition on this disease. Methods Four cases of toxic encephalopathy of tetramine were collected and their cerebral CT appearances were retrospectively analyzed. Results Cerebral CT appearances in acute phase (within 8 days): (1) cerebral edema in different degree. CT abnormalities consisted of cortical hypodensities and complete loss of gray-white matter differentiation. The CT value were in 11-13 HU, and to be watery density in serious case,(2)subarachnoid hemorrhage. It demonstrated the signs of poisoning hypoxic ischemic encephalopathy in chronic phase. Conclusion The cerebral CT appearances of toxic encephalopathy of tetramine had some character in acute phase and it can predict the serious degree of intoxication, but there was no characteristic findings in chronic phase.

Objective:To investigate the role of TSLP and NF-κB in the pathogenesis of adenomyosis.Methods:Immunohisto-chemistry was employed to detect the expression of TSLP and NF-κB p65 in the endometrial glandular cell and stromal cell of 35 adeno-myosis patients and 20 hysteromyoma patients as control , and analyze the correlation of the two proteins.The concentration of TSLP was measured by specific ELISA in the serum of healthy subjects besides of the patients with adenomyosis and hysteromyoma .Results:TSLP and NF-κB p65 were both positively expressd in the glandular cells and stromal cells of ectopic and eutopic endometrium of patients with adenomyosis , their expression was significantly higher than that of the control group ( P<0.01 ) , and the expression of TSLP and NF-κB p65 in ectopic endometrium was significantly higher than that in eutopic endometrium ( P<0.01 ).There was positive correlation between TSLP and NF-κB p65 in ectopic endometrium.The concentration of TSLP was higher in the serum of patients with adenomyosis.Conclusion:The TSLP is highly expressed in endometrial glandular and stromal cells of patients with adenomyosis , and there is higher level of TSLP in serum , and there is correlation between the expression of TSLP and NF-κB in ectopic endometrium.

ObjectiveTo evaluate the roles of imbalance between peripheral blood T helper 17 (Th17) cells and CD4+CD25+ regulatory T(Treg) cells in the pathogenesis of atopic dermatitis (AD).Methods Peripheral blood samples were obtained from 52 patients with AD aged 2-14 years and 30 age- and sex-matched healthy controls.Flow cytometry was performed to detect the percentage of Th17 cells and Treg cells in peripheral blood.Meanwhile,enzyme linked immunosorbent assay(ELISA) was carried out to detect the serumlevel of interleukin (IL)-6 and transforming growth factor (TGF)-β1.Results The children with AD showed a higher percentage of Th17 cells but a lower percentage of Treg cells in CD3+ T cells compared with the controls (( 1.20 ± 0.41 )％ vs.(0.54 ± 0.28)％,t =2.58,P ＜ 0.05; (2.29 ± 0.67)％ vs.(5.95 ± 0.45)％,t =15.23,P ＜ 0.01 ).Moreover,the serum level of IL-6 was significantly higher,while that of TGF-β1 was lower in patients with AD than in the controls ((5.12 ± 0.45) ng/L vs.(3.89 ± 0.38) ng/L,t =2.59,P＜ 0.05; (57.65 ± 10.78) ng/L vs. (81.18 ± 7.78) ng/L,t =5.41,P ＜ 0.01 ).ConclusionsChildren with AD experience a change in the percentage of Thl7 cells and Treg cells in peripheral blood as well as in the serum level of IL-6 and TGF-β1,and the imbalance between Th17 cells and Treg cells in peripheral blood may contribute to the development of AD.

Objective To reveal the protective effects of atorvastatin against atherosclerosis independent of cholesterol-lowering effect, we investigated the effects of atorvastation on the expression of protein kinase C (PKC) and C-reactive protein in experimental atherosclerosis of rats.Method Fifty female Sprague-Dawley rats were randomly divided into normal diet group (n = 10, control group), vitamin D3 injection and high cholesterol diet group (n = 40). After 8 weeks, vitamin D3 injection and high cholesterol diet rats were randomized to receive either atorvastatin (5 mg. kg-1. d-1) (n = 20, atorvastatin group) or normal diet (n = 20, model group). Another eight weeks later, all rats were killed and part of their aortas were examined by light and electron microscope and the left were removed for western blot analysis to measure PKC; At the begin and end of experiment, serumcollected for lipid and C-reactive protein determining determination.Results Cholesterol, low-density lipoprotein, triglyceride levels in atorvastatin group were significantly lower than those in model group but higher than control group. The pathologic changes in atorvastatin group were less severe than those in model group, there showed no any pathological changes in control group. The levels of C-reactive protein in model group[(18.64 ± 0.94) mg/L] were higher than those in control group [(9.21 ± 0.21)mg/L] (P<0.05). C-reactive protein levels also differed significantly between control and atorvastatin group (12.52 ± 0.65 mg/L)( P<0.05). PKC levels were significantly higher in model group (7786.12 ± 264.75)and atorvastatin group (4267.57 ± 233.94) than in control group (2468.75 ± 145.53)(all P<0.05). But compared with model group, PKC levels were markedly lower in the atorvastatin group ( P<0.01 ).Conclusions Atorvastatin may be useful not only as a cholesterol-lowering agents but also as anti-arteriosclerotic agent that provide vascular protection by inhibition PKC expression and inflammatory reaction.

Objective To identify the histopathological characteristics of multiple organ dysfunction syndrome (MODS) with V. vulnificus in mice. Methods Sixteen healthy KM mice (6～8 week old ) divided randomly into two groups, study group ( n =12) and control group ( n =4) The animal model of MODS was established by received either an intraperitioneal, intramuscular subcuneous inoculum of 4.34?10 6 cfu/0.2 ml of V.vulnificus or intraperitioneal injection of a sterile physiological salt solution (control group). Pathological changes of the man organs were individually obsenved in under election microscope (EM). Results Mortality rates exced 100%, 12/12) in study group after inoculums of mice within 4～8 h, while in 0% (0/0) in the control . The detection rate of V. vulnificus were in 100%(12/12) from blood, hearts, lungs, livers, intramuscularly, subcutaneous in the study group, while in 0% (0/4) after sterile saline intraperitioneal injection. The man histopathological changes were :degeneration and necrosis of the parenchyma cells in the different organs;interstitial swelling, mitochondriondrial injure of multiple organs.These changes were especially obvious in the lungs and myocardeum. Conclusions Above pathological changes suggested that results of MODS caused by V. vulnificus septicemia,the multiple organs failure as an important feature of the fatality of V. vulnificus infections,and my be helpful for researchers investigating of V.vulnificus.

OBJECTIVETo investigate the clinical effect of hemoperfusion combined with hemodialysis in the treatment of severe organophosphate pesticide poisoning.

METHODSNinety-eight patients with severe organophosphate pesticide poisoning who were admitted to the emergency department of our hospital from March 2005 to September 2013 were equally divided into control group and observation group according to treatment methods. The control group was given conventional emergency treatment, while the observation group was given hemoperfusion combined with hemodialysis and the conventional emergency treatment. The clinical outcomes and complications of two groups were compared.

RESULTSIn the control group, 35 patients were cured and 14 patients died, so the cure rate was 71.4%. In the treatment group, 46 patients were cured and 3 patients died, so the cure rate was 93.9%. The treatment group had a significantly higher cure rate than the control group (χ² = 8.611, P < 0.05). And the treatment group had significantly shorter duration of coma (P < 0.01), mean length of hospital stay (P < 0.01), and time to recovery of cholinesterase activity (P < 0.01) and a significantly reduced dose of atropine than the control group (P < 0.01). The control group had significantly more cases of urinary retention than the treatment group (18 vs. 6, χ² = 4.991, P < 0.05). And the control group had more cases of intermediate syndrome, respiratory failure, delayed neurological damage, and rebound than the treatment group.

CONCLUSIONHemoperfusion combined hemodialysis has a good clinical effect and causes fewer complications in treating severe organophosphate pesticide poisoning, so it is worthy of clinical promotion.

Atropine ; Hemoperfusion ; Humans ; Insecticides ; poisoning ; Organophosphate Poisoning ; therapy ; Organophosphates ; Organophosphorus Compounds ; Renal Dialysis ; Time Factors

Metastatic triple-negative breast cancer (TNBC) is the most aggressive type of breast cancer. Combination of systemic chemotherapy and immune checkpoint blockade is effective but of limited benefit due to insufficient intratumoral infiltration of cytotoxic T lymphocytes (CTLs) and the accumulation of immunosuppressive cells. Herein, we designed a lenvatinib- and vadimezan-loaded synthetic high-density lipoprotein (LV-sHDL) for combinational immunochemotherapy of metastatic TNBC. The LV-sHDL targeted scavenger receptor class B type 1-overexpressing 4T1 cells in the tumor after intravenous injection. The multitargeted tyrosine kinase inhibitor (TKI) lenvatinib induced immunogenic cell death of the cancer cells, and the stimulator of interferon genes (STING) agonist vadimezan triggered local inflammation to facilitate dendritic cell maturation and antitumor macrophage differentiation, which synergistically improved the intratumoral infiltration of total and active CTLs by 33- and 13-fold, respectively. LV-sHDL inhibited the growth of orthotopic 4T1 tumors, reduced pulmonary metastasis, and prolonged the survival of animals. The efficacy could be further improved when LV-sHDL was used in combination with antibody against programmed cell death ligand 1. This study highlights the combination use of multitargeted TKI and STING agonist a promising treatment for metastatic TNBC.