Objective: We investigated experimentally the changes of intestinal immunity following shock and resuscitation after trauma. Method:The experimental model was made in rats, which underwent laparotomy, then bleeding and reinfusing through the right fetmoral artery. Result: The concentration of IgA following shock and resuscitation were significantly higher than that before shock.. The concentration of IgA 24 h following resuscitation was the lowest, and was significantly lower than that at the end of shock.. The endotoxin in portal vein following shock and resuscitation were higher than that before shock.. The endotoxin level 24 h following resuscitation was the highest, and markedly higher than that at the end of shock. Conclusion: The traumatic shock and resuscitation are capable of causing intestinal immunosuppression and endotoxemia.

Objective To analyze implementation outcomes of the new health reform policy at a provincial hospital for the past six months.Methods Trend analysis,factor analysis and ratio analysis approaches were used in monthly surveillance,along with comparative study of the data before and after the reform,to probe into impacts of the new policy on hospital operations.Results Medical income increased by 22.09％,mainly contributed by volume growth (22.28％) of medical services; Medical income dropped by 0.16％ due to pricing policy factors; medicine proportion deceased by 4.84％; following the reform,the income per outpatient and inpatient increased by 12.32％ and 5.35％ respectively.Conclusion Following the drug zero profit policy and rise of the charging standards for medical treatment service at the hospital,the growth of total income mainly comes from growing volume of medical services instead of pricing policy factors.The new health reform is conducive to optimizing the hospital's income structure and raising value to doctors' technical service.

Objective To explore the role of Th17 cells in systemic lupus erythematosus (SLE)with cardiovascular disease (CVD).Methods 61 patients of SLE were collected from September 2011 to March 2013 in the Second Hospital of Hebei Medical University by revised SLE classification standards of ACR in 1997.These patients were divided two groups:22patients of SLE with CVD and 39 patients of SLE without CVD;the control group include 20 healthy.Th17 cells were measured by flow cytometry,IL-1 7 was detected by enzyme-linked immunosorbent assay.The correlation among them and the disease active index were analyzed.Results ①The percent of Th1 7 cells in the group of SLE with CVD,that in the group of SLE without CVD and that in control group were (2.09±0.98)%,(1.75±0.75)% and (0.89±0.44)%,respec-tively.The percent of Th1 7 cells in healthy group were lower than that in SLE with CVD and SLE without CVD group (t=4.717~5.030,P<0.001).The level of IL-17 in the group of SLE with CVD,that in the group of SLE without CVD and that in control group were 85.64±20.76 pg/ml,75.25±28.14 pg/ml and 35.06±6.58 pg/ml respectively,and the serum of IL-17 in healthy group were lower than in SLE with CVD and SLE without CVD group (t=6.275~9.954,P<0.001). There were no significant difference of Th1 7 cells and IL-1 7 between SLE with CVD and SLE without CVD groups (t=1.520,P>0.05;t=1.513,P>0.05).②The level of IL-17 were correlated positively with SLEDAI and the anti-double strand DNA (r=0.393,P=0.008;r=0.558,P<0.001),were correlated negatively with complement C3 (r=-0.423,P=0.005).The percent of Th17 cells in CD4+T cells were correlated positively with SLEDAIand the anti-double strand DNA (r=0.681,P<0.001;r=0.492,P=0.015)were correlated negatively with complement C3 (r=-0.534,P=0.027).Con-clusion The level of Th1 7 cells and IL-1 7 were high in SLE,and they were related with the disease activity.The cardiovas-cular factor had not affect the expression of Th1 7 cells and IL-1 7 in SLE.

Objective To evaluate contrast-enhanced endoscopic uhrasonography(CE-EUS)in the differential diagnosis of pancreatic diseases.Methods Eighteen patients with suspected pancreatic neoplasms and chronic pancreatitis,which would be finally affirmed with EUS-FNA or histophathologic examinations,as well as five normal control subjects were enrolled and underwent CE-EUS by using ultrasonic contrast agent(sonovue,Bracco Co.,Italy).Characteristics of enhancement including form,echo and enhanced blood perfusion of the target areas were investigated in normal pancreas and various diseased ones.Results By CE-EUS,five cases of normal pancreatic parenchyma were presented as punctiform or claviform enhancement pattern with homogeneous distribution(type Ⅰ-Ⅱ);while two chronic pancreatitis cases were presented as claviform or plaquelike enhancement pattern with inhomogeneous distributition(type Ⅱ-Ⅲ).In addition,thirteen pancreatic carcinomas were presented as inhomogeneous punctiform or claviform enhancement(typeⅠ-Ⅱ)partially with border enhancement and with slow enter-in and fast wash-out phase.However,three benign insulinomas were presented as holo-plaquelike enhancement(type Ⅲ),and 2 with fast enter-in and fast washout phase.Besides,different enhancement intensity was identified in different diseases.Conclusion CEEUS,from which different enhancement pattern,phase and intensity would be shown in various pancreas,is a safe and feasible imaging modality in the differential diagnosis of pancreatic diseases.

Objective:To valuate the treatment value and analyse the effect on the cellular immune functions by studying the differences of T-lymphocyte subsets and CD4+CD25+Treg cells in peripheral blood after adoptive immunotherapy ( dendritic cells and cytokine-induced killer cells,DC-CIK) combined with chemotherapy on MM.Methods:50 patients with MM were randomly divided into two groups.24 patients in chemotherapy group were treated by chemotherapy only,26 patients in joint group were treated by adoptive immunotherapy( DC-CIK) combined with chemotherapy,and the clinical outcomes and the levels of T-lymphocyte subsets and CD4+CD25+Treg cells in peripheral blood between two groups were compared.Moreover,the differences of cellular immune indicators (Th1/Th2,the ratio of AgNOR,and TGF-β)between two groups were also compared.Results: After treatment,quality of life,clinical index and survival in joint group were better than in chemotherapy group( P<0.05);the proportion of CD3+CD8+,the ratios of CD4+CD25+,CD4+CD25+/CD4+and the level of TGF-βof joint group wes clearly lower than chemotherapy group(P<0.05),and the ratios of CD3+CD4+/CD3+CD8+, Th1/Th2 and AgNOR of joint group wes clearly higher than chemotherapy group .Conclusion: DC-CIK combined with chemotherapy could be an effective and promising treatment to patients with MM,and it maybe strengthen the anti-tumor action of bodies by regulating the balance between Th1 and Th2 reaction.

Objective To evaluate the effect of the conspecific bone marrow mesenchymal stem cells (MSCs) infusion on the platelets count and the ratio of CD4+ CD25highCD127low regulatory T (Treg) cells in mice with immune thrombocytopenia and the mechanisms.Method ITP mice models were induced by daily intraperitoneal injection of 200 μL phosphate buffer solution [containing 2 μg rat anti-platelet membrane CD41 antibody (MWReg30)] into female Balb/c mice.MSCs were got from male mice.Then different number of MSCs was injected into ITP mice through the tail veins.After 5,7 and 14 days,the number of blood platelets was counted and the ratio of Treg cells was detected by flow cytometry,and compared with those in the healthy mice.Result Twenty-four h after injection of CD41 antibody,platelet counts were reduced sharply to the lowest point,which was about a quarter of the normal level.Then ITP mice models were induced successfully.Platelet counts were increased after the injection of MSCs.On 7th day after injection of MSCs,the platelet counts were significantly higher than those in control mice,and the greater the degree of injection dosage,the greater the elevated platelets (P＜0.05 for all).The ratio of Treg cells in ITP mice models was significantly lower than in the normal mice.The ratio of peripheral blood Treg cells in ITP mice was increased after injection of MSCs and the higher the dose,the greater the effect (P＜0.05 for all) but did not reach the normal level.Conclusion The conspecific bone marrow MSCs infusion can increase the platelet counts in mice with ITP,which may be related to the increase of CD4+ CD25highCD127low Treg cells.

Objective: To study the glucose,insulin,Cpeptide response and relative safety after orally taking different doses of fructose in type 2 diabetes.Methods: 10 patients with type 2 diabetes,were given 50 g glucose,10 g fructose+40 g glucose,30 g fructose+20 g glucose,40 g fructose+10 g glucose,50 g fructose respectively,the serum glucose,insulin,C-peptide,lactic acid,uric acid,heart ratio and blood pressure were measured at 0 min,15 min,30 min,60 min,120 min and relative safety was observed at the same time.Results: The serum glucose,insulin,C-peptide were significantly lower than 50 g glucose group,the insulin,C-peptide decreased 14.30%,23.73%,40.42%,58.48% and 4.62%,14.32%,7.62%,29.33% in 10F+40G group,30F+ 20G group,40F+10G group and 50F group when compared with 50G group,which showed dose-response relationship.The glycemic index was 91.8,62.4,43.6,37.5 in 10F+40G group,30F+ 20G group,40F+ 10G group and 50F group.No adverse effect was observed during the test.Conclusion: It is beneficial to the protection ? cells of pancreas to orally take different doses of fructose.Fructose taken orally may influence the serum lactic acid.

Objective To investigate the efficacy and safety of autologous cryopreserved platelet transfusion in the management of thrombocytopenia after chemotherapy in hematological malignancy.Methods A total of 40 patients diagnosed as hematological malignancy with complete remission were equally assigned into study group and control group.During chemotherapy interval in the study group,when platelet counts exceeded 120 × 109/L,autologous platelets were collected with CS3000 Cell Separator and cryopreserved at-80℃ with 5％ dimethylsulfoxide.When platelet counts dropped below 15 × 109/L after chemotherapy,autologous platelets were thawed with 40℃ water bath and transfused back to each patient.In the control group,when platelet counts dropped below 15 × 109/L after chemotherapy,allogeneic fresh platelets were transfused.Median loss during the freeze-thaw-wash procedure in study group was observed,and the 1 h,24 h corrected count increments(CCI)were calculated in the both groups.The hemostatic effects and adverse reactions were also observed.Results In the control group,1hCCI and 24hCCI were (19.3 ±6.1)× 109/L and(12.2 ± 7.0)× 109/L,respectively,with the effective rate of 80％ and the transfusion reaction rate of 45％.Totally 20 collection and transfusions were finished in the study group.A total of(3.4-8.5)× 1011 platelet were obtained in each collection.Platelet recovery after freezing and thawing was(73.51 ±9.03)％(62％-83％).1hCCI was(17.4±7.6)× 109/L,24h CCI was(10.5 ±5.8)× 109/L and the effective rate was 85％.There was no significant different between the two groups (P ＞ 0.05).The transfusion reaction rate was 15 ％,which was significantly lower than that of the control group(P ＜ 0.05).Meanwhile,adverse reactions were occurred less in the study group.Conclusion This study demonstrates that autologous cryopreserved platelet transfusions can be safely administered for supporting thrombocytopenia in hematological malignancy patients undergoing chemotherapy.

Objective To assess the clinicopathological and confocal microscopic features of porokeratosis.Methods This study included 186 patients with porokeratosis.The clinical and pathological findings from the patients were retrospectively analyzed.Confocal laser scanning microscopy(CLSM)was used to observe the lesions of disseminated superficial porokeratosis in 16 patients.Results Most of the patients had characteristic lesions of porokeratosis,i.e.,papules or plaques with a thread-like elevated border.Comoid lamella was observed in all of the cases,which was unassociated with sweat glands or hair follicles in most cases(171/186),and located in sweat pore or hair follicles in a few cases(15/186).There were dyskeratocytes as well as vacuolized and degenerated basal cells beneath the cornoid lamella.Varying amounts of lymphocytes and melanophages were observed in the superficial dermis.Amyloid was deposited in the papilla dermis in 2 cases.CLSM showed dyskeratocytes in a characteristic arcuate arrangement in spinous cell layer.Conclusions The CLSM images of porokeratosis are consistent with its histopathological manifestations,and CLSM may serve as a sensitive and specific noninvasive method for the diagnosis of porokeratosis.