Objective To investigate the number and distribution of dendritic cells in normal endometrium of reproductive age during the normal menstrual cycle .Methods Normal endometrial samples were collected from 40 women of reproductive age . 20 endometrium samples at the proliferative phase (day 6th to 10th) and 20 endometrium samples at the window of implantation(day 20th to 24th) were obtained .These patients underwent intrauterine exploration before IVF and ET resulting from tubal resec-tion or male factor infertility .Endometrial tissue was collected with a pipelle aspirator .Sections were stained with hematoxylin-eosin (HE) to identify the morphological characteristics of endometrial tissues .The Envision two-step immunohistochemical staining technique was used to detect the expression of CD1a and CD83 in the endometrium .Normal human skin and tonsil were used as pos-itive control tissues for CD1a and CD83 ,respectively .The serum levels of ovarian steroid hormones were measured to analyze their relationship with the expression of CD1a and CD83 .Results CD1a + DCs were found in all samples of window of implantationand most samples of the proliferative phase (18/20 ,90% ) .DCs showed irregular shape with different processes and were buffy in cell membrane ,mainly in stroma around grand and blood vessels .The density of CD1a + DCs at the window of implantation were (18 .2 ± 5 .76)cells/mm2 ,significantly higher than that at the proliferative phase [(6 .5 ± 4 .05)cells/mm2 ,P < 0 .05] .CD83 was considered as the marker for mature DCs .However ,immunohistochemistry with specific antibody revealed no CD83 + DCs were found in human emdometrium in the present study .During the menstrual cycle ,the expression of CD1a+ DCs in endometrium (the density of CD1a + DCs) correlated with serum progesterone level(r= 0 .630 ,P< 0 .01) .Serum estradiol showed no correlation with the density of CD1a + DCs(P> 0 .05) .Conclusion Increased CD1a+ immature DCs at the window of implantation in endometri-um may play an important role in the establishment of maternal-fetal tolerance .

Objective To discuss the perioperative nursing measures and their effectiveness for patients with malignant airway stenosis who are receiving airway stent implantation once more due to airway re-stenosis.Methods The clinical data of 7 patients,who received airway stent implantation once more due to airway re-stenosis during the period from May 2014 to July 2016,were retrospectively analyzed.The effectiveness of nursing intervention for stent implantation was assessed.Results The symptoms of dyspnea were relieved immediately after the stent re-placement procedure in all the 7 patients,and no severe complications,such as massive hemorrhage,respiratory failure or asphyxia occurred.Conclusion The key points to ensure a successful second airway stent implantation include following measures and preparations:cooperation mode of medical care integration,preoperative individualized psychological intervention,guiding the patients to cooperate with the treatment,ready for in-operation emergency rescue,rapid and effective assistant cooperation for stent placement,and postoperative close observation for the occurrence of respiratory tract infection,bleeding and other complications.

Objective To observe clinical efficacy of probiotics agents in the prevention and treatment of severe pulmonary infection in elderly patients with antibiotic-associated diarrhea (AAD).Methods 60 cases of elderly patients with severe pulmonary infection (more than or equal to 60 years old) were randomly divided into the treatment group ( 31 cases ) and control group ( 29 cases ) , the control group received broad-spectrum antibiotics or using two linked above anti-infection treatment, the treatment group were added with probiotic agent ( lactobacillus complex capsules).The diarrhea, the use of antibiotics and the stool routine, bacteria before and after 5, 10, 15 days of group were observed.Results After 15 days treatment, the number of Escherichia coli in treatment group was lower than that in control group (P<0.05), the number of Bacterium lacticum and Bifidobacterium bifidum in treatment group were higher than those in control group ( P<0.05 ) .The AAD rate in treatment goup was 12.90%, which was lower than 41.38% in control group (P<0.05).There were significant differences in beginning time and duration of diarrhea between two groups (P<0.05). Conclusion The intestinal probiotics reduced induced by antibiotics in elderly patients with severe pulmonary infection , the probiotics agents could redress intestinal flora imbalance, keep the steady state of intestinal flora, and prevent and cure the antibiotic-associated diarrhea.

Objective To determine the diversity of Porphytomonas gingivalis lipopolysaccharide (LPS)induced IL-1β,TNF-αand IL-6 levels in THP-1 cells and the associated Toll-like receptors(TLR).Methods P.gingivalis strain ATCC33277 LPS (Pg-LPS)was prepared using phenol-water method and then identified by both infrared spectrometry and limulus test.The levels of IL-1β,TNF-α and IL-6 secreted by THP-1 cells under inducement of Pg-LPS were quantitatively detected using commercial ELISA kits.The bloc-king test using TLR2 or TLR4 monoelonal antibody(McAb)plus the ELISA were used to determine the types of Pg-LPS binding TLR on the surface of target cells.In this study.a commercial LPS from E.coli strain O111:B4(E-LPS)was used as the contr01.Results When 1彬ml ofPg.u,s induced THP.1 ceHs for0.5,6 and 6 h.or l∥rnl ofE-LPs induced for 6,24 and 24 h,respectively,tIIe levels ofTNF.a,IL-1B and IL广6 were in.creased obviously(P<0.01).However,the maximal concentration of tlle t11ree cytokines induced by Pg.LP$ were similar to that induced by E-LPS(P>0.05).tLR2 or TLR4 McAb could block the effects of Pg-LPS in-ducing THP-1 cells to secrete IL-1β and IL-6(P<0.05),where as only TLR2 McAb displayed the inhibition of TNF-α secretion(P<0.05).On the contrast,only TLR4 McAb showed the effects blocking the three cytokines secretion in the THP-1 cells under inducement of E-LPS(P<0.05).Conclusion Pg-LPS shows a slight high-er activity inducing THP-1 cells to secrete IL-1β,TNF-α and IL-6 than E-LPS.TLR2,but not TLR4,is the major receptor of Pg-LPS on the target cells to mediate the secretion of the three cytokines.

Objective To evaluate the effect of Chinese gentian extracts on the proliferation of,apoptosis and phosphorylation of epidermal growth factor receptor (EGFR) in HaCaT cells induced by epidermal growth factor (EGF).Methods Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferation of HaCaT cells pretreated with EGF of 20 μg/L for 24 hours followed by 24 hours of treatment with various concentrations of Chinese gentian extracts.Flow cytometry was carried out to detect apoptosis in HaCaT cells pretreated with EGF of 20 μg/L for 24 hours followed by 4 hours of treatment with different concentrations of Chinese gentian extracts.Western blot was conducted to measure the level of phosphorylated EGFR in HaCaT cells treated with different concentrations of Chinese gentian extracts for 24 hours followed by treatment with EGF of 20 μg/L for 10 minutes.Results Chinese gentian extracts inhibited the proliferation (r =-0.991,P ＜ 0.01),but promoted the apoptosis (r =0.996,P ＜ 0.05) of HaCaT cells induced by EGF in a dose-dependent manner.At the same time,the extracts suppressed the phosphorylation of EGFR in HaCaT cells induced by EGF,and the suppressing effect increased with the rise in the concentration of the extracts.Conclusions Chinese gentian may inhibit the proliferation,but promote the apoptosis of keratinocytes by decreasing EGFR phosphorylation and blocking relevant intracellular signaling pathways.

OBJECTIVE To study the antimicrobial sensitivity of pathogens isolated from diabetic foot patients. METHODS Totally 102 diabetic foot patients were enrolled from Jun 2000 to Dec 2007 in our hospital.Specimens such as pus and wound exudate were collected for culture.Pathogenic spectrum and antimicrobial sensitivities were investigated. RESULTS From 70 cases 109 strains of pathogenic bacteria were isolated,of which 61 were Gram-positive bacteria,43 Gram-negative bacteria and 5 fungi.Thirty-seven patients were with single microbial infection and 33 patients with polymicrobial infection and 28 of 33 patients were with Wagner′s grade 3 and upwards.According to susceptibility test,multi-drug resistance was found.Gram-negative bacteria were sensitive to imipenem and ?-lactamases inhibitor,and Gram-positive bacteria were sensitive to vancomycin,chloramphenicol,and cephalosporin. CONCLUSIONS The pathogenic bacteria in diabetic foot infection distribute extensively and some of them are multi-drug resistant.The key to the treatment of diabetic foot infection is early combination application of sensitive antimicrobial agents.

Objective To analyze the distribution and drug resistance of pathogens isolated from blood culture specimens in a grade 3A hospital so as to provide a basis for the prevention and control of bloodstream infection ,and rational antibacterial drugs use .Methods A total of 3 241 blood culture results in our center from June 2014 to September 2016 were analyzed retrospectively . The blood samples were cultivated with the BacT/ALERT 3D and VersaTrek instruments .The bacterial identification and antibiotic susceptibility tests were conducted with VITEK‐2 Compact and ARIS 2X instruments .Results Among 3 241 blood culture speci‐mens ,99 strains of pathogenic bateria were isolated with the positive rate of 3 .1% ,including 42(42 .4% ) strains of Gram‐negative bacteria ,54(54 .5% ) strains of Gram‐positive bacteria and 3(3 .0% ) strains of fungus .The top three of Gram‐negative bacteria were in turn Eescherichia coli ,Klebsiella pneumonia and Pseudomonas aeruginosa ;the top three of Gram‐positive bacteria were in turn coagulase‐negative staphylococcus (CNS ) ,Staphylococcus aureus and streptococcus pyogenes .Enterobacteriaceae remained 100 .0% sensitivity to imipenem ,meropenem ,piperacillin/tazobactam and amikacin .The resistance rate of Gram‐positive bacterium to vancomycin ,linezolid ,teicoplanin and gentamycin was 0 .0% ,the rest had different degrees of drug resistance .Conclusion Ee‐scherichia coli ,CNS and Staphylococcus aureus are the most frequent pathogenic bacteria of the blood stream infection in our hospi‐tal .Pathogens show different resistance to different kinds of antibacterial agents .Clinic should rationally select the antibacterial a‐gents according to the drug susceptibility test results so as to slow down the generation of drug resistance bacterial strains .

Objective To evaluate the prevalence of NI in the SICU at our hospital. Methods 181 NI patients in the SICU were retrospectively analysed during Jan 1996～Dec 2000.Results The average NI rate was 9.81%. The major sites of NI were respiratory tract(36.96 %),thoracic/abdominal cavity(25.47 %)and bloodstream infections(9.32 %).The difference in major pathogens of infections in different sites reached statistical significance. For respiratory tract, thoracic/abdominal cavity and bloodstream infections,bacteria were the most common pathogens. Fungi were the moat frequent isolate from urine and stool. Mixed infection proportion was 52.25 %. The most common pathogens were Enterococci, Methicillin resistant Staphylococci、 Pseudomonas Aecruginosa、Escherichia Coli、Candida Albicans and Candida Tropicalis. Conclusions The most common pathogens of NI in SICU are different in different infection sites. The pathogens were complicated and most strains are antibiotics resistant. So it is important to establish NI control and to understand the changes of pathogens so as to prevent the infection.

Objective To investigate the relationship between serum omega-3 polyunsaturated fatty acid (ω-3PUFA) and insulin resistance(IR) in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease (NAFLD). Methods This trial involved 51 patients of type 2 diabetes mellitus with NAFLD (G4 group), 50 patients of type 2 diabetes alone(G3 group), 45 patients of NAFLD alone (G2 group) and 42 healthy control subjects (G1 group). Serum ω-3PUFA profile was analyzed with capillary gas chromatography. Insulin resistance was assessed by homeostasis model assessment (HOMA-IR). ALT, AST, γ-glutamyltransferase(GGT) and serum lipids were measured. Results The levels of HOMA-IR were higher in G4 group than those in G3, G2 and G1 group(4. 90 ± 2. 54 vs 2. 38 ± 1.23, 2. 20 ± 1.15, 1.13± 0.42;P<0.05). The level of ALT, AST, GGT, TC, TG, LDL-C were higher in G4 group than those in G3, G2 and G1 group(P < 0. 05). The level of ω-3PUFA was signifieantly lower in G4 group than those in G3, G2 and G1 group(5.68 ±2.02 vs 7. 17 ±2. 38, 6.97±2.32, 10.08±2.76;P <0.05). ω-3PUFA cocentration was negatively correlated with HOMA-IR, TC, TG and LDL-C (r = -0.491, -0. 376, - 0. 462, - 0. 408, P < 0. 05). Conclusions Serum ω-3 PUFA is significantly decreased in patients with type 2 diabetes mellitus and NAFLD. Serum ω-3PUFA is negatively correlated with insulin resistance. ω-3PUEA plays a very important role in the development of diabetes mellitus and NAFLD.

The association of the serum phospholipid fatty acid components with high-sensitivity C reactive protein in patients with metabolic syndrome and type 2 diabetes mellitus was investigated.Saturated fatty acid in patients with metabolic syndrome and type 2 diabetes mellitus was increased (45.98±1.55 vs 42.05±2.04,P＜0.01),while polyunsaturated fatty acid was decreased(42.38±1.93 vs 46.60±2.06,P＜0.01),and high sensitivity C reactive protein was significantly increased[(6.36± 1.28 vs 0.79±0.45) mg/L,P＜0.01)].