Objective To explore the effect of sublingual immunotherapy (S-LIT) on the balance of Th17/Treg in children with mite allergic asthma. Methods All 124 cases with mite allergic asthma were randomly divided into two groups, the control group (62 cases) was treated with ladder type inhalation, and the treatment group (62 cases) was administered of dust mite drops on the basis of conventional treatment. The peripheral frequency of Th17 cell and Treg cell of all the subjects (before and after treatment) were detected by flow cytometry, the serum cytokine IL-10、IL-17 levels wer analyzed by ELISA. Results After 1 year treatment, the Th17 cells in treatment group (1.50 %±0.87 %) was significantly lower than that before treatment (3.39 % ± 1.58 %), and less than that of the control group after 1 year of treatment (2.42 %±1.32 %) (P <0.01);after 1 year treatment, the proportion of Treg cells in treatment group (4.05 %±1.36 %) was significantly higher than that before treatment (2.33 ± 0.81%), and more than that of the control group after 1 year of treatment (2.87 %± 0.87 %) (P <0.01). After 1 year treatment, the serum IL-10 levels in treatment group (64.76±27.79 pg/mL) was significantly higher than that before treatment (36.32 ± 11.53 pg/mL), and more than that of the control group after 1 years of treatment (50.32 ± 10.97 pg/mL) (P <0.01);after 1 year treatment, the serum IL-17 levels in treatment group (20.45±8.35 pg/mL) was significantly lower than that before treatment (86.48 ± 28.19 pg/mL), and significantly less than that of the control group after 1 year of treatment (46.32 ± 12.43 pg/mL) (P <0.01). After 1 year treatment, the Childhood Asthma Control Test (C-ACT)score in the treatment group (24.35 ± 8.47) was significantly higher than the control group (20.13 ± 6.86) (P <0.05). Conclusions SLIT can decrease airway inflammation and correct the imbalance of Th17/Treg in children with mite, allergic asthma.

OBJECTIVE:To compare the effects of different doses of ramipril on blood pressure and renal function of early di-abetic nephropathy patients. METHODS:A total of 108 patients with early diabetic nephropathy selected from our hospital during May 2014-Dec. 2015 as research objects were divided into group A,B,C,with 36 cases in each group. All groups were given Ramipril tablets,5 mg for group A,2.5 mg for group B,1.25 mg for group C,qd,for 8 weeks. Blood pressure(SBP,DBP)and renal function indexes(24 h urine protein,β 2-microglobulin,UAE)were compared among 3 groups before and after treatment. The occurrence of ADR was also recorded in 3 groups. RESULTS:Before treatment,there was no statistical significance in blood pressure or renal function indexes among 3 groups(P>0.05). After treatment,blood pressures 24 h urine protein,β2-microglobulin and UAE of 3 groups were decreased significantly;those indexes of group A were significantly lower than group B and C,with sta-tistical significance(P<0.05). There was no statistical significance in each index between group B and C(P>0.05). Both hypoten-sion and hypoglycemia occurred in 3 groups during treatment,but were recovered after stopping treatment. CONCLUSIONS:High dose of ramipril(5 mg,qd)shows good effects on early diabetic nephropathy and reduces urinary protein excretion,but doesn't af-fect its safety.

OBJECTIVE To compare the effect with the three methods to disinfect the ventilator circuits.(METHODS) To disinfect the ventilator circuits,three methods were used:A,soaking with chlorine compoud(disinfectant);B:soaking with 0.5% peracetic acid;C,sterilizing with ethylene oxide.Samples were taken to(bacteria) culture before and after disifection in every three methods.Biological supervision and the amount of colony were also taken at the same time.RESULTS The results of bacteria culture pre-disinfection were all positive.The amount of bacteria of ventilator circuits was between 70 000-120 000CFU/cm~2.The eligible rate of biological(supervision) in method C was 100% and its positive rate of bacteria culture was 0%.The eligible rate of biological supervision in method A was 86.25% and its positive rate of bacteria culture was 16.25%.The eligible rate of(biological) supervision in method B was 90% and its positive rate of bacteria culture was 13.78%.It was significant when method C was compared with methods A and B and the value P was less than 0.01.CONCLUSIONS It is(serious) about the pollution in ventilator circuits.The soaking methods are apt to be effected by the factors of(environment) and manual operation.Therefore it could be(ineligible) and being polluted after disinfection.The method of sterilization is the best for disinfection.

Objectives:To study the preparation techniques of gelatin microspheres encapsulated with sodium fluoride and evaluate the anticaries functions in dental plaque model in vitro. Methods:Fluoride gelatin microspheres were prepared by emulsion polymerisation method. The encapsulation rate and drug contents were tested by ISE. In vitro inhibition of demineralization were also examined. Results:The mean size of fluoride GMS was (16.81?8.77)?m.The encapsulation rate was 76.73%.The drug content was 5.61%.The release profile in vitro showed sustained effects. Fluoride GMS can prevent demineralization more efficiently. Conclusions:Fluoride gelatin microspheres may be an promising topical fluoride release system.

Objective To evaluate the home-made occluder in the treatment of VSD and its mid-term and long-term results. Methods From Jan. 2004 to May 2007, percutaneous VSD closure therapy under X-ray monitoring was performed in 78 consecutive VSDpatients, including 43 males and 35 females with an average age of (16.5±8.6) years (ranged 3-37 years). TTE, ECG and Holter examinations were performed in 1 week, 3 months, 1 year and 2 years after the procedure. Results Seventy-three home-made occluder devices with a diameter of 5-16 mm (10.3±3.2 mm) were implanted successfully, with a technical successful rate of 93.6% (73/78). The whole course follow-up were carried out in all 73 successful cases (100%). One week after the procedure ITE detected residual shunt in 8 cases, and three months later the residual shunt was observed in 5 cases. Follow-up check at one and two years after the treatment the residual shunt disappeared completely. For the observation of arrhythmia, occasional atrial premature beats or ventricular premature beats occurred in 28 cases (38.4%) within one week after the procedure, and two patients developed grade Ⅲ complete atrioventricular block at the third day after the surgery. The arrhythmia disappeared after medication of prednisone and nutrient drugs for 4-10 days. Bundle branch blocks were observed in 8 cases (10.1%) at one-year and two-year follow-up. Conclusion For the treatment of VSD, the home-made Amplatzer occluder device is reliable and effective, although a close foUow-up is required after the surgery.

BACKGROUND:Comeal graft endothelial cell density may decline spontaneously at a super-physiological speed after penetrating keratoplasty (PKP),even if no corneal rejection happens,and this is chronic corneal allograff dysfunction (CCAD).OBJECTIVE:To investigate the effects of topical corticosteroid treatment on chronic corneal allograft dysfunction after PKP.DESIGN,TIME AND SETTING:A controlled clinical analysis was performed at the Department of Ophthalmology,Tongji Hospital,Tongji University from May 2004 to May 2009.PARTICIPANTS:A total of 54 patients (eyes) who underwent PKP were included in this study.METHODS:Tobramycin-dexamethasone eyedrops was applied 6 times per day as an initial dosage and tapered during 4 months.Thereafter,drug withdrawal group and long term group were randomly divided.Treatments were ceased in the drug withdrawal group but were continued in the long-term group with a dosage of twice per day till 12 months after surgery.MAIN OUTCOME MEASURES:Corneal graft endothelial cell density was followed up.The mean follow up pedod was 3.12±0.28years.RESULTS:The corneal graft endothelial cell density of drug withdrawal and long term groups was dramatically declined within 36 months after PKP.At every time point,the endothelial cell density was significantly decreased compared to the last follow up (all P＜0.01 ).The endothelial cell density was decreased from (2 428±2.11) cells/mm~2 and (2 791±2.29) cells/mm~2 to (1 424±124) cells/mm~2 and (1 614±114) cells/mm~2 in the drug withdrawal and long-term groups,respectively.There was significant difference in endothelial cell density between the two groups no matter prior to surgery or at each time points after surgery,but the declination trends of two groups were basically the same,indicating that graft loss of endothelial cell density was not impacted by topical corticosteroid treatment after PKP (P＞0.05).CONCLUSION:Chronic corneal allograft dysfunction after PKP is independent of topical corticosteroid treatment.

Objective To observe the effects of telmisartan and valsartan on insulin resistance in obese hypertensive patients. Methods Sixty-eight patients with essential hypertension and body mass index ( BMI) ≥25 kg · ( m2 ) -1 were randomly divided into the telmisartan group (33 cases) and valsartan group (35 cases). Blood pressure, fasting serum glucose, fasting insulin (Fins) and insulin resistance (HOMA-IR) were measured before and after 16 weeks treatment. Results Compared with basal levels, SBP and DBP were significantly decreased in both group ( P<0. 01). Fins and HOMA-IR were significantly decreased in telmisartan group [(12. 9±2. 9) mU·L-1 vs. (10. 9±2. 2) mU·L-1 (P<0. 01); (3. 1±0. 7) vs. (2. 7±0. 6) (P<0. 01), respectively], while no such changes were found in valsartan group [(12. 9 ±3. 0) mU·L-1 vs. (12. 7±2. 7) mU·L-1 ( P > 0. 05);( 3. 0 ± 0. 7) vs. (3. 0 ± 0. 7) ( P > 0. 05), respectively]. Conclusion In obese hypertensive patients, telmisartan and valsartan exert similar antihypertensive effect, but telmisartan may have a benefit in insulin resistance in comparison to valsartan.

Objective To identify a suspected Klebsiella variicola strain isolated from a patient with severe septic shock. Methods Sequences of rpoB, gyrA, mdh, infB, phoE and nifH genes were obtained from the clinical isolated suspected Klebsiella variicola strain, and used for constructing phylogenectic trees. Characteristics of phylogenetic trees were used to distinguish Klebsiella variicola from Klebsiella pneumoniae. Results All target gene sequences from this clinical isolated strain constantly formed a cluster with their counterparts from other Klebsiella variicola strains. These clusters were readily differentiated from Klebsiella pneumoniae clusters. Conclusions The clinical isolated strain belongs to Klebsiella variicola class and can cause septic shock. From genetic perspective, Klebsiella variicola is distinctly different from Klebsiella pneumoniae, most of which can be isolated from normal healthy people.

ObjectiveTo investigate left ventricular (LV) radial dyssynchrony and LV rotational change of isolated complete left bundle branch block (CLBBB) and CLBBB with heart failure (HF).Methods Twenty-six isolated CLBBB patients,twenty-four CLBBB patients with HF and twenty healthy controls were studied.Two-dimensional speckle tracking imaging (2D-STI) was applied to short-axis views to calculate LV radial dyssynchrony and LV rotational and twist degree and time to peak rotational and twist degree.ResultsLV radial dyssynchrony and LV rotation and twist degree were intermediately damaged in isolated CLBBB patients and was significantly damaged in CLBBB patients with HF,compared with healthy controls.ConclusionsFor isolated CLBBB patients,even if LV ejection fraction was in the normal range,another parameters of cardiac mechanic had changed and 2DSTI could be used to evaluate these alterations.

Objective: To investigate the biological phenotype and cell cycle distribution characteristics of nasal and/or nasopharyngeal epithelia of TgN(p53mt-LMP1)/HT mice.Methods: The biological phenotype changes(mainly the incidence of precancerous lesion) in nasal and nasopharyngeal epithelial tissues of the generation G4 of TgN(p53mt-LMP1)/HT mice aged 5,11,15 and 18 months were determined by H-E staining,and the cell cycle characteristics of nasal and nasopharyngeal epithelia detected by flow cytometry(FCM).Results: The incidences of precancerous lesion in the nasal and nasopharyngeal epithelia were 0,50%,60% and 75% respectively in the 5,11,15 and 18 mos groups of the positively expressed transgenic mice,and 0 in the four age groups of the negatively expressed ones.Compared with the negatively expressed transgenic mice,the number of nasal or nasopharyngeal epithelial cells was markedly decreased in the G0/G1 phase,but obviously increased in the S and G2/M phases,with the proliferation index(PI) significantly enhanced(P