Objective:To investigate the effect of synthetic oligodeoxynucleotide containing CpG motifs (CpG ODN) on antibody production to recombinant hepatitis B surface antigen (rHBsAg) or hepatitis B vaccine respectively. Methods:The antigens were injected into the back leg tibialis anterior(TA) muscle of all the mice (Km breed and Balb/c breed) for two times.The serum anti HBs titers were detected by ELISA.Results:The anti HBs titers of additional CpG ODN groups are obviously higher than those of rHBsAg group or vaccine group alone, the antibody persistent time is some longer. Nevertheless, the anti HBs titers of pure breeding mice are significantly higher than those of non pure breeding mice. Conclusion:CpG ODN has enhanced efficacy for anti HBs production in immunized mice and synergetic effect can be observed in alum adjuvant of hepatitis B vaccine.

Objective:To investigate the Th1 type immune response effects of CpG oligodeoxynucleotide(CpG ODN) immunized with recombinant hepatitis B surface antigen(rHBsAg).Methods:The CpG ODN and rHBsAg were injected into the back leg tibialis anterior(TA) muscle of BALB/c mice for two times.The serum anti-HBs IgG sub-class ratio of IgG2a/IgG1 were detected by ELISA.The level of IFN-?,IL-2 and IL-12 in the supernatant of induced splenocyte with bioactived assay.The serum IL-4 and IL-10 level were detected by ABC-ELISA.Results:The anti-HBs IgG sub-class IgG2a titer of additional CpG ODN groups are obviously higher than those of other groups;The result showed that high level of Th1 type cytokines including IL-2,IFN-? and IL-12 were induced in CpG ODN groups,where the level of Th2 type cytokines such as IL-4 and IL-10 were inhibited obviously.Conclusion:CpG ODN has enhanced efficacy of rHBsAg for anti-HBs IgG sub-class production of IgG2a and induced the expression of Th1 type cytokines wherease inhibited the expression of Th2 type cytokines.

Objective:To investigate the effects of lymphocyte proliferation using the synthetic oligodeoxynucleotide containing CpG motif(CpG ODN) as immunal adjuvant immunized with the recombinant hepatitis B surface antigen(rHBsAg) in mice.Methods:BALB/c mice were randomly divided into five groups,injected into back leg tibialis anterior(TA) muscle for two times.The spleen and thymus lymphocytes proliferation was tested by MTT and()~3H-TdR incorporation respectively.Results:Analytical study showed that all groups compared with control the proliferation of spleen and thymus lymphocytes was increased obviously,except the specific proliferation of thymus lymphocyte there didn't obviously difference in CpG ODN plus vaccine group and the vaccine group.Meanwhile,the proliferation of the groups plus CpG ODN was much stronger than the not-CpG ODN groups in all the tests.Conclusion:CpG ODN has the ability stimulating the lymphocyte proliferation in mice obviously anti could have potential adjuvant effectiveness.

Objective To observe the effects of hedysari polysaccharide (HPS) on myocardial fibrosis and the expression of MMP-2/TIMP-2 in model mice of diabetic cardiomyopathy; To discuss the mechanism of action of prevention and treatment of myocardial fibrosis in diabetes.Methods Sixty mice were randomly divided into model group, rosiglitazone group and HPS high-, mediume- and low-dose groups. The normal group was 12 non-transgenic male BKS.Cg-Dock7m+/+Leprdb/JNjumice with the same age. Each group was given relevant medicine for gavage, for 8 weeks. Blood glucose of mice before and after medication 2, 4, 6, and 8 weeks was detected. The levels of MMP-2, MMP-2 and MMP-9 in myocardium were measured by Masson staining. The protein expressions of MMP-2 and TIMP-1 in myocardium were detected by Western blot.Results Compared with the model group, the blood glucose of HPS (high- and medium dose) groups and rosiglitazone group decreased significantly. Masson staining showed that the green fibers in the model group significantly increased and rosiglitazone group and HPS high-dose group decreased compared with the model group. Western blot showed that the expressions of MMP-2 in model group and MMP-2/TIMP-2 ratio were declined significantly, while the expression of MMP-2 was increased and TIMP-2 was decreased significantly, and the ratio of MMP-2/TIMP-2 increased in rosiglitazone group and HPS high- and medium-dose group.Conclusion HPS may reduce the degree of myocardial fibrosis in model mice with diabetic cardiomyopathy. The therapeutic effect of HPS may be to relieve myocardial fibrosis in model mice by increasing the ratio of MMP-2/TIMP-2.

Objective To investigate the effects of β-blockers on cardiac protection and hemodynamic in patients with septic shock. Methods A prospective randomized controlled trial was conducted. Forty-one patients with septic shock in accordance with early goal directed treatment and met the target within 6 hours,and admitted to intensive care unit (ICU)of Affiliated Huxi Hospital of Jining Medical College from January 2012 to January 2014 were enrolled. The patients were divided into treatment group (n=21)and control group (n=20)by random number table. The patients in both groups were given the standard treatment,esmolol was giving to patients in treatment group in order to control the heart rate (HR)below 100 bpm within 2 hours,and the patients in control group only received standard treatment. The changes in hemodynamic parameters〔mean arterial pressure(MAP),central venous pressure(CVP), HR,cardiac index(CI),stroke volume index(SVI),systemic vascular resistance(SVRI),global end diastolic volume index(GEDVI)〕,biochemistry metabolic of tissue〔central venous oxygen saturation(ScvO2),lactic acid(Lac)〕,and cardiac markers 〔troponin I (cTnI)〕before and 12,24,48,72 hours after the treatment were recorded. Results①Before treatment,the hemodynamic parameters,tissue metabolism index and cTnI had no significant differences in both groups (all P>0.05).②The hemodynamic parameters after treatment in the control group showed no significant difference compared with that before treatment. HR and CI in the treatment group were gradually declined after treatment,SVRI and GEDVI were gradually increased. There were significant differences in HR,CI,SVRI,and GEDVI between treatment group and control group from 12 hours on〔HR(bpm):93±4 vs. 118±13,CI (L·min-1·m-2):3.3 ±0.8 vs. 4.5 ±0.6,SVRI (kPa·s·L-1·m-2):159.2 ±27.4 vs. 130.5 ±24.2,GEDVI(mL/m2):668 ±148 vs. 588 ±103,P<0.05 or P<0.01〕. MAP,CVP and SVI in the treatment group showed no significant changes. ③Lac after treatment in both groups was decreased slowly,Lac (mmol/L)at 12 hours after treatment was significantly decreased compared with that before treatment (control group:8.8 ±3.2 vs. 9.8 ±3.4,treatment group:9.5±3.1 vs. 10.5±4.1,both P<0.05). The Lac of control group and treatment group were 2.5±1.2 and 2.7±1.1 at 72 hours after treatment,and there was no significant difference between two groups (all P>0.05). The ScvO2 was not decreased in both groups.④Compared with before treatment,cTnI in the control group was gradually increased,peaked at 72 hours,and that in the treatment group was gradually increased,peaked at 24 hours and then gradually declined. Compared with control group,the cTnI (μg/L)in the treatment group was decreased significantly at 24,48,72 hours (1.15 ±0.57 vs. 1.74 ±0.77,0.93 ±0.52 vs. 2.15 ±1.23,0.52 ±0.36 vs. 2.39 ±1.17,all P<0.01). Conclusionsβ-blockers (esmolol) can improve cardiac function and myocardial compliance,reduce the myocardial injury in patients with sepsis shock. Although β-blockers can decrease cardiac output,it has no influence on the circulation function and tissue perfusion.

Objective To provide the basis for clinical treatment and prevention of Stenotrophomonas maltophilia infection ,ana‐lyze the characteristics of the bacteria infection and drug‐resistant strains of the area children .Methods Statistical analysis of 52 ca‐ses detected Stenotrophomonas maltophilia culture positive patients clinical data from September 2011 to September 2012 ,and the antibiotic susceptibility test results .Results Clinical data analysis showed that patients infected with Stenotrophomonas maltophilia had no difference on age and gender ,in the detection department was given priority to with of NICU and PICU ,82 .7% of infected children with SMA had a history of invasive procedures ,95 .92% of children with SMA had a history of penicillium carbon alkene drug use ,infection SMA patients in hospital for a long time with an average of (22 .3 ± 19 .0) days .Laboratory data analysis showed that Stenotrophomonas maltophilia main detection in sputum specimen type (63 .5% ) ,four kinds of commonly used clinical drug re‐sistance was higher ,sulfa drugs up to 21 .9% .Conclusion Stenotrophomonas maltophilia infection in children is closely related to carbapenem drug use and the invasive operation ,drug resistance in severe cases ,the rational use of antibiotics are crucial to treat‐ment .

OBJECTIVE To survey the effect of the intervention measures according to the guiding principle of antibiotics rational use. METHODS The data of medication of two groups of patients in Mar 2004 and Mar 2005 were collected respectively,and the condition of antibiotics use was compared. RESULTS In comparison with that in Mar 2004 the average in-hospital days and antibiotics costs in Mar 2005 were reduced remarkably;the percentage of antibiotics use was much lower;the ratio of the rational use of antibiotics increased notably(P

To explore the correlation between nucleated red blood cell (NRBC) count and perinatal asphyxia in neonates.Full-term newborns born from May 2011 to November 2012 were recruited and divided into perinatal asphyxia (n =40) and normal (n =30) groups.Apgar score was recorded immediately at delivery.The umbilical arterial blood was also collected into anticoagulant-treated tube and NRBC was counted by Japan OlympusCX41 biological microscope.NRBC count for perinatal asphyxia group [(10.70 ± 2.61)/100 WBC] was significant higher than that for normal group [(2.67 ± 0.35)/100 WBC].A statistically significant negative correlation existed between NRBC and umbilical arterial blood pH,Apgar score at 1 min,BE value (r =-0.802,P ＜ 0.05 ; r =-0.639,P ＜ 0.05 ; r =-0.566,P ＜ 0.05).Associated with perinatal asphyxia in neonates,NRBC may be used as a simple index for assessing the severity of neonatal perinatal asphyxia.

Objective: To investigate the interaction between mental elasticityand occupational stress and depressionin female nurses and the mediating effect of mental elasticity, as well as the functioning way of mental elasticity in occupational stress-depression. Methods: From August to October, 2015, cluster sampling was used to select 122 female nurses in a county-level medical institution as study subjects. The Connor-Davidson Resilience Scale (CD-RISC) , Occupational Stress Inventory-Revised Edition (OSI-R) , and Self-Rating Depression Scale (SDS) were used to collect the data on mental elasticity, occupational stress, and depression and analyze their correlation and mediating effect. Results: The 122 female nurses had a mean mental elasticity score of 62.4±15.1, which was significantly lower than the Chinese norm (65.4±13.9) (P<0.05) ; the mean depression score was 41.0±7.7, which was significantly higher than the Chinese norm (33.5±8.6) (P<0.01) , and the incidence rate of depression of 52.5%. Mental elasticity was negatively correlated with occupational stress and depression (r=-0.559 and -0.559, both P<0.01) . Occupational stress and the two subscales mental stress reaction and physical stress reaction were positively correlated with depression (r=0.774, 0.734, and 0.725, all P<0.01) . After adjustment for confounding factors, occupational stress had a positive predictive effect on depression (β=0.744, P<0.01) , and mental elasticity had a negative predictive effect on depression (β=-0.221, P<0.01) . The analysis of mediating effect showed a significant direct effect of occupational stress on depression and a significant mediating effect of mental elasticity (a=-0.527, b=-0.227, c=0.744, c’=0.627; all P<0.01) , and the mediating effect of mental elasticity accounted for 16.08% of the total effect. Conclusion As a partial mediating variable, mental elasticity has an indirect effect on the relationship between occupational stress and depression and can alleviate the adverse effect of occupational stress and reduce the development of depression.

Objective:To analyze the current status of referral of stroke inpatients and explore the characteristics of the referral network in Changsha, for the reference to improve and promote the hierarchical medical system of stroke.Methods:Data of the inpatient medical record of stroke patients and the annual reports of medical institutions in Changsha in 2018 were collected from the health statistics network direct reporting system of Health Commission of Hunan province, for analysis of the referrals of inpatients in different medical institutions. Social network analysis was adopted to analyze the density, centrality and K-core of the referral network of stroke inpatients.Results:A total of 82 medical institutions for stroke inpatients were included with 2 859 referrals of patients. Most of the referrals were made between tertiary hospitals(1 515), especially within hospitals of a stroke alliance(1 123). The density of referral network was 0.613.Tertiary hospitals were in the center of the network, the entry points of secondary hospitals were in the center of the network and primary medical institutions were located at peripheral positions. Most of the tertiary hospitals in the 15-core(14, 72.68%), 12 of them were the units of Hunan Stroke Alliance.Conclusions:Tertiary hospitals played an important role in the region, secondary hospitals were able to receive patients referred by tertiary hospitals, but few patients were transferred to primary care institutions; The primary medical institutions failed to play due roles in the referral network. The establishment of stroke alliances could promote the cooperation of hospitals in the alliance, but the division of labor and cooperation among different levels of medical institutions in the region needed to be further optimized.