Objective To investigate the effect of ulinastatin treatment on the inflammatory factor expression and prognosis in patients with ventilator-associated pneumonia (VAP). Methods One hundred patients with VAP were enrolled, and the patients were given the standardized treatment of VAP. The patents were divided into high dose group (33 cases, using the ulinastatin 20 000 U/d), normal dose group (34 cases, using the ulinastatin 10 000 U/d) and control group (33 cases, no using the ulinastatin) by random digits table method. The serum C-reactive protein (CRP), procalcitonin, interleukin (IL)-6 and tumor necrosis factor (TNF)-αlevels at the first, third, fifth and seventh day of diagnosis were detected. All the patients were followed up for 1 month, and the antibiotics treatment time, mechanical ventilation time, ICU stay time and mortality were recorded. Results The CRP, procalcitonin, TNF-αand IL-6 from the first day of diagnosis to the seventh day of diagnosis in 3 groups showed the downward trend, and there were statistical differences (P<0.05). There were no statistical differences in CRP and procalcitonin at the third, fifth and seventh day of diagnosis among 3 groups (P>0.05). At the third, fifth and seventh day of diagnosis, the TNF-α levels in high dose group were (46.02 ± 4.65), (23.88 ± 7.76) and (11.05 ± 2.56) ng/L, the IL-6 levels were (15.53 ± 4.54), (11.33 ± 3.45) and (6.62 ± 2.45) ng/L;the TNF-αlevels in normal dose group were (56.02 ± 6.42), (38.88 ± 9.34) and (27.05 ± 3.42) ng/L, the IL-6 levels were (18.23 ± 2.45), (15.33 ± 4.34) and (11.23 ± 3.34) ng/L; the TNF-α levels in control group were (68.13 ± 4.77), (52.88 ± 7.46) and (42.12 ± 3.76) ng/L, the IL-6 levels were (20.02 ± 3.23), (17.23 ± 2.34) and (15.33 ± 2.33) ng/L. The TNF-αand IL-6 levels at the third, fifth and seventh day of diagnosis in high dose group were significantly lower than those in normal dose group and control group, and those in the normal dose group were significantly lower than those in control group, and there were statistical differences (P<0.05). The mechanical ventilation time, antibiotics treatment time and ICU stay time in high dose group were significantly shorter than those in normal group and control group:(15.34 ± 5.67) d vs. (18.44 ± 6.32) and (22.34 ± 5.21) d, (7.45 ± 2.54) d vs. (10.45 ± 4.56) and (14.43 ± 6.24) d, (18.42 ± 7.45) d vs. (20.43 ± 4.98) and (26.35 ± 5.97) d, and those in normal group were significantly shorter than those in control group, and there were statistical differences (P<0.05). There was no statistical differences in the mortality among 3 groups (P>0.05). Conclusions Ulinastatin can inhibit the expression of IL-6 and TNF-α in patents with VAP, shorten the antibiotics treatment time, mechanical ventilation time, ICU stay time and mortality, and improve prognosis.

Objective To compare the clinical effect of two different kinds of wound dressing on postoperative skin reactions and phlebitis for PICC in critical patients. Methods A total of 313 PICC critical patients were divided into control group (157 cases) and treatment group (156 cases) by random digits table method. After PICC, the control group was attached to transparent dressing, the experimental group was attached to Mepilex, all of the patients were received routine nursing. The incidences of adverse effect, and the degree of local skin pruritus by Visual Analogue Scale(VAS) were compared in two weeks. Results The incidence of skin allergy, infection, and mechanical phlebitis were 24.20%(38/157), 10.83%(17/157), 18.47%(29/157) in control group and 7.69%(12/156),4.49%(7/156), 3.21%(5/156) in treatment group, and there were significant differences between two groups (χ2=13.99, 4.44, 18.83, P<0.01 or<0.05). The score of VAS in control group and treatment group were (4.84±1.29) points and (3.15± 1.82) points respectively, and the difference was statistically significant (t=8.66, P<0.01). Conclusions Application of Mepilex for PICC in critical patients can decrease the incidences of adverse effect, and increase the degree of comfort. It is worth utilizing widely in the clinic.

Objective To investigate the scavenging abilities of ginkgo albumin to reactive oxygen in vitro, as well as the protection and mechanism of ginkgo albumin on damaged DNA. Methods Lotus Seedpod Procyanidin (LSPC) and bovine serum albumin (BSA) were used as control sample, the effect of ginkgo albumin on removal of superoxide anion was determined by Pyrogallol-Luminol system. Scavenging ability of ginkgo albumin on hydroxide free radical was determined by CuSO4-Phen-Vc-H2O2, FeSO4-Luminol-H2O2, and FeSO4-Luminol systems. Luminol-H2O2 system was used to measure the scavenging effect on hydrogen peroxide. Preventive effect of ginkgo albumin on in vitro damaged DNA was determined by CuSO4-Phen-Vc-H2O2-DNA system. Results Ginkgo albumin possessed a good scavenging potency on reactive oxygen and protection on damaged DNA, but promoted oxidation in the FeSO4-Luminol-H2O2 and Luminol-H2O2 chemiluminescence systems. Conclusion Not every chemiluminescences system is suitable for investigating the antioxidant activity of ginkgo albumin.

Objective:To investigate the role of dendritic cells (DCs) in the anti-CD45RB antibody-induced immune tolerance,and the mechanism of immune tolerance induced by anti-CD45RB antibodies.Methods:DCs were induced by conventional methods(rmGM-CSF,IL-4 and LPS),different doses of anti-CD45RB antibodies were added in the induction process.Then,mature cells were harvested,and flow cytometry(FCM) was used to determine cell phenotypes,cycle and phagocytosis,ELISA method was performed to examine the concentration of IL-12 and the ability of T cell proliferation was observed by mixed lymphocyte culture.Results:The DCs preparation was shown a high expression of CD11C and CD83,a low expression of CD86,with strong proliferative and phagocytic capacity after treated with anti-CD45RB antibody.Its secretion of IL-12 was decreased,and it could less effectively stimulate T cell proliferation after treated with anti-CD45RB antibody.Conclusion:One of the mechanisms of anti-CD45RB monoclonal antibody-induced tolerance is to generate tolerogenic dendritic cells(tDCs),significantly inhibiting the proliferation of T cells.

Objective To design a new vermilion musculomucosal flap to reconstruct the normal appearance of unilateral cleft lip,and to analyze the clinical effects.Methods All patients were repaired with Millard method,and vermilion musculomucosal flap was formed with fixed point method to repair vermilion.Normal function and morphology were recovered by reconstructing lip beads and forming a peak of cupid's bow.Results 78 cases were enrolled in this study.They were followed-up for 6 to 36 months after operation.Except for 6 cases of nasal deformity and 5 mild lift of vermilion of affected side,67 cases obtained satisfied nasolabial form and function,with full decline and symmetry of cupid's bow peak,and well form of nasolabial fold,and natural transition of vermilion,and significance of lip beads,and inconspicuous scars.Conclusions Appling vermilion musculomucosal flap for reconstructing vermilion of unilateral cleft lip has good effect,and it is simple and feasible.It can be a regular surgery method,and is worthy of clinical promotion.

Objective To explore the influence of group psychotherapy on the alleviation of psychiatric nurses' compassion fatigue.Methods A total of 190 psychiatric nurses were investigated by compassion fatigue scale.Forty psychiatric nurses were selected to accept group psychotherapy for 10 times.The scores of compassion fatigue scale were compared before and after group psychotherapy and the influencing factors of therapeutic effect were analyzed.Results Thirty-eight psychiatric nurses had accomplished the intervention and follow-up.Compared with before group psychotherapy,the total scores of compassion fatigue scale and the scores of mental tension,passive behavior,doubtful ability and loss of morale among 6 dimensions after group psychotherapy were improved:(83.28±7.01) scores vs.(102.60±7.24) scores,(2.66±0.42) scores vs.(3.11±0.49) scores,(2.02±0.36) scores vs.(2.55±0.41) scores,(1.99±0.33)scores vs.(2.65±0.38) scores,(1.69±0.34) scores vs.(2.76±0.44) scores,and there were significant differences,P＜0.05.Regression analysis found that the work life,education level were correlated with the deduction rate of the total scores of compassion fatigue scale,t=2.858,3.099,P＜0.01.Conclusion Group psychotherapy can help psychiatric nurses to alleviate their compassion fatigue.

Epithelial-mesenchymal transition (EMT) is a major mechanism in tumor metastasis.As the key regulatory factor,Twist gene plays an important role in EMT,and it can be induced by radiotherapy,chemotherapy and a variety of cytokines.Researches show that tumor cells can get stem cell-like properties via EMT,which can lead to chemo-radiotherapy resistance,tumor angiogenesis and distant metastasis.EMT has a great influence on the prognosis of tumor,and it is expected to become an important target for tumor treatment.

ObjectiveTo observe the effect of early partial body weight support on walking ability for stroke patients with hemiplegia.Methods60 stroke patients were divided into 3 groups, receiving conventional early rehabilitation: group A (20 cases) received conventional rehabilitation for 8 weeks; group B (20 cases) received 2 weeks conventional rehabilitaion and 6 weeks partial body weight support; group C (20 cases) received 5 weeks conventional rehabilitaion and 3 weeks partial body weight support. Fugl-Meyer Assessment(FMA), Barther Index(BI) and Berg Balance Scale(BBS) were used to assess the effect before and after treatment.ResultsThe socres of FMA, BI and BBS improved in walking function after the treatment(P<0.05). Comparing with groups A and C, group B improved more significantly after treatment (P<0.05), and group C was better than group A (P<0.05). ConclusionPartial body weight support can improve walking function of hemiplegic patients at early stage.

AIM:To investigate the role of B cells in CD45RB antibody-induced transplantation immune toler-ance.METHODS:Single cell suspension was made from the spleen of BALB/c nude mice disposed by CD45RB antibod-y, then mixed cultured with T cells of BALB/c mice and spleen cells of C57BL/6 mice.The Th1, Th2, Treg and Tm cells were monitored by flow cytometry during the culture process .The skin graft model was set up with B 6.μMT-/-mice as re-ceptors and BALB/c mice as donors.CD45RB antibody was intraperitoneally injected into the receptors after transplantation and then CD3+CD45RBhi cells were detected by flow cytometry .In another mixed lymphocyte culture , CD45RB antibody was added, and then B cells were isolated and injected into B6.μMT-/-mice through the tail vein.The heart transplanta-tion model was established with B 6.μMT-/-mice as receptors and BALB/c mice as donors, and then the survival and the migration of B cells to the thymus were observed .RESULTS:When T lymphocytes were co-cultured with B lymphocytes treated with anti-CD45RB monoclonal antibody (mAb) in vivo, the percentages of Th2 and Treg cells were up-regulated and Th1 cells were down-regulated, but Tm cells were not altered as compared with the control .In vivo without B lympho-cytes, anti-CD45RB mAb also down-regulated the expression of CD45RB in T lymphocytes.The reduction was faster and the percentage of CD3 +CD45RBhi T cells was not altered as compared with the control .The B lymphocytes treated with an-ti-CD45RB mAb in vitro prolonged the lifetime of receptor in heart transplantation model but failed to induce complete toler -ance.After recieving B cells treated with anti-CD45RB mAb and allogeneic heart transplantation , B cells migrated to the thymus in B6.μMT-/-mice.CONCLUSION:B lymphocytes play a definite role in the transplantation immune tolerance induced by anti-CD45RB mAb through their affection on T-cell subgroups and also in the central tolerance .However, the induction of immune tolerance can not only rely on B cells .

Objective To investigate the immune regulatory effects of allogeneic bone marrowderived mesenchyrnal stem cells (MSCs) co-transplanted with islets. Methods The 18 diabetic mice were randomly divided into 3 groups: Diabetic group, without any transplantation; Islet transplantation group, in a sterile operation, with 10 μl purified islets (about 200 islets)transplantation to the left renal subcapsule of recipients; Islet + MSCs transplantation group, in addition to transplantation as the former group, 1 × 106 MSCs were given to the recipients via tail vein on 3, 2 and 0 days before islet transplantation. Blood glucose in recipient mice was monitored for 30consecutive days after transplantation. Pathological characteristics of left kidney were analyzed on the day 14 and 28 after transplantation. Th1/Th2, Tc1/Tc2, naive and memory T cells from peripheral blood and bone marrow-derived dendritic cells (DCs) were analyzed by multi-color flow cytometry.Results As compared with the islet transplantation group, blood glucose was significantly reduced,inflammatory cell infiltration decreased in the place of transplantation, graft survival prolonged, the number of Th1 and Tc1 cells was obviously reduced, the number of Th2 and Tc2 cells increased, the ratio of Th1/Th2 and Tc1/Tc2 cells was significantly decreased, the naive and memory T cells were significantly inhibited, the maturity of DCs and the secretion of interleukin-12 decreased in the islet transplantation group. Conclusion Through the immunomodulation on T-cell and DCs function,MSCs can alleviate graft verse host disease and prolong allograft survival.