Objective To discuss the changes of serum Th1/Th2 cytokine levels of allergic rhinitis patients and the intervention effect of montelukast.Methods 40 cases of allergic rhinitis patients were selected as treatment group,who were given montelukast tablets (10mg) through the mouth one time daily for 8 weeks.The changes of interferon-γ (IFN-γ) and interleukin-4 (IL-4) in peripheral blood (PB) before and after medical treatment were observed,as well as the clinical curative effect and security.Accordingly 30 cases of healthy people were also selected as the control group.Results The IFN-γlevel in culture supernatant of patients in the treatment group [(8.74 ± 1.37) ng/mL] was lower than that in the control group before the medical treatment [(15.13 ± 3.16)ng/mL],while the IL-4 level of patients in the treatment group [(1.64 ± 0.47) ng/mL] was higher than that in the control group [(0.72 ± 0.21) ng/mL] (t =2..93,3.52,all P ＜ 0.01).After 8 weeks' medical treatment,the IFN-γ level in culture supernatant of patients [(12.36 ± 2.56) ng/mL] increased obviously than that of before [(8.74 ± 1.37) ng/mL],while the IL-4 level [(1.21 ± 0.28) ng/mL] declined obviously than that of before [(1.64 ± 0.47) ng/mL] (t =2.36,2.31,all P ＜ 0.05).The total clinical efficiency of patients in the treatment group was 92.5 ％ (37/40).No serious drug adverse reaction (DAR) appeared during the medical treatment.Conclusion The Th1/Th2 cytokine unbalances in peripheral blood (PB) of allergic rhinitis patients.Montelukast has reliable curative effect with high security,whose mechanism of action has close effect on lowering the IL-4 in peripheral blood (PB),increasing the IFN-γ level in peripheral blood (PB),correcting the balance disorders of Th1/Th2 cytokine,and the transformation of immunity reaction from Th2 to Th1.

OBJECTIVE:To investigate the bacteriological characteristics of nasal secretions of chronic rhinosinusitis(CRS)in our hospital,and conduct drug sensitivity test in order to provide theoretic reference for clinical treatment. METHODS:87 CRS patients underwent nasal endoscopic surgery were selected and the nasal secretions of patients were taken for bacterial culture. Automatic microbial analyzer was used to identify the bacteriological characteristics,and disk diffusion test was adopted for drug sensitivity test. RESULTS:Of 87 patients,bacterial strains were detected from 77 cases of nasal secretions,with positive rate of 88.5%. 112 strains were detected,including 81 strains of aerobic bacterium and 31 strains of anaerobic bacterium,and the most common bacterium were Staphylococcus aureus (20.54%). Antibiotics with the highest sensitivity was moxifloxacin (89.29%), followed by ciprofloxacin(87.50%),vancomycin(87.50%). CONCLUSIONS:The bacterial in nasal secretions of CRS patients has high positive detection rate and mainly are aerobic bacterium. Antibiotics should be used rationally according to the results of drug sensitivity test.

Objective To explore the effect of organizational commitment and leader-member exchange on ethical decision-making in nurses. Methods 520 nurses were questionnaired by the Chinese Employees′ Organizational Commitment Scale,Leader-Member Exchange Scale and the Ethical Decision-making Scale. Results The total scores of organizational commitment and leader-member exchange and ethical decision-making in nurses were respectively (2.11 ± 0.39), (3.54 ± 0.51), (286.62 ± 20.14) points. Pearson correlation analysis showed that the scores of organizational commitment and leader-member exchange were positively correlated with ethical decision-making (r=0.352-0.464,P<0.05). Hierarchical regression analysis showed that leader-member exchange, opportunity commitment and affective commitment, economic commitment could explain 35.3%of the total variance of ethical decision-making in nurses. Conclusions The organizational commitment and leader-member exchange are the influencing factors of ethical decision-making in nurses.

Objective Whether the bone marrow cells (BMC) derived from systemic lupus erythematosus (SLE) could transmit autoimmune disease was studied for the purpose of clarifying the role of BMC in SLE pathogenesis.The effects of bone marrow mesenchymal stem cells (MSC) from SLE and control mice on the SLE BMC-induced symptoms were compared to elucidate the role of MSC in SLE.Methods Six-week-old B6.MRL-Fas mice were randomly divided into 3 groups.One group was transplanted with BMC from the 30-week-old B6.MRL-Faslg mice.One group was co-transplanted with BMC from the 30-week-old B6.MRL-Fasr mice and bone marrow MSC from the age-matched B6.MRL-Faslpr mice.One group was co-transplanted with BMC from the 30-week-old B6.MRL-Faslg mice and bone marrow MSC from the age-matched C57BL/6 mice.Before transplantation,the recipient mice received irradiation by an X-ray source.The levels of serum antinuclear antibody (ANA) and proteinuria were measured with enzyme linked immunosorbent assay (ELISA) and Bradford method every 4 weeks,respectively.The survival rate was recorded.All mice were sacrificed 18 weeks later.Splenic plasma cells,Th1,Th2 and Th17 cells were measured by flow cytometry.Statistical analyses were performed using the independent t test and ANOVA.Results Eight weeks after transplantation,ANA was positive in all the recipient mice.However,there was no significant difference between the three groups (P＞0.05).No proteinuria was observed in all the recipient mice.The mice received BMC from the 30-week-old B6.MRL-Fasr mice and bone marrow MSC from the age-matched B6.MRL-Fasr mice showed an elevated trend of the percentages of splenic plasma cells,Th1,Th2 and Th17 cells compared with the other two groups,plasma cells [(1.05±0.16)％,(0.58±0.11)％,t=2.53,P＞0.05;(1.05±0.16)％,(0.71±0.18)％,t=1.45,P＞0.05],Th1 cells [(6.6±2.2)％,(5.7±1.0)％,t=0.38,P＞0.05;(6.6±2.2)％,(4.0±1.7)％,t=0.96,P＞0.05],Th2 cells [(3.3±0.4)％,(2.1±0.6)％,t=1.76,P＞0.05;(3.3±0.4)％,(2.2±0.6)％,t=1.51,P＞0.05],Th17 cells [(2.30±0.71)％,(1.31±0.31)％,t=1.27,P＞0.05;(2.30±0.71)％,(1.12±0.27)％,t=1.67,P＞0.05].However,there was no significant difference between the groups.The survival rate of the three groups was 43％,43％ and 80％ respectively.And the survival rate of the mice received BMC from the 30-week-old B6.MRL-Fasr mice and bone marrow MSC from the age-matched C57BL/6 mice was significantly higher than those of the other groups.Conclusion Our results indicate that BMC from SLE can transmit autoimmune disease.The bone marrow MSC can not prevent lupus-like presentations induced by BMC from SLE.Transplantation of bone marrow MSC from C57BL/6 mice can significantly elevate the survival rate.

Objective The purpose of this study is to observe the changes of immune cell subsets in lupus mice after umbilical cord mesenchymal stem cells (UC-MSCs) transplantation. Methods B6.MRL-Faslpr lupus mice were randomly divided into the following three groups: the UC-MSCs treated group, the fibroblast like synoviocytes (FLS) treated group and the untreated group. MSC (1×106) or FLS (1×106) were injected into the tail vein of lupus mice respectively. Four weeks after treatment, the spleen index was calculated. The pathological changes of kidney were assessed by HE staining. The frequencies of immune cell subsets in spleen and macrophage in kidney as well as abdominal cavity were analyzed by flow cytometry. Data were analyzed with t test. Results The spleen index of UC-MSCs treated lupus mice [(79 ±9) mg/10 g] and IgG level [(7.5±1.5) mg/ml] were significantly decreased when compared with FLS treated group [(147±23) mg/10 g, t=2.78, P<0.01] [(17.0 ±2.8) mg/ml, t=3.00, P<0.01] and the untreated group [(156 ±16) mg/10 g, t=4.29, P<0.01] [(16.7 ±1.6) mg/ml,t=4.01, P<0.01]. HE staining also showed that the pathological changes of kidney were alleviated after MSCs transplantation. In addition, the frequency of plasma cells in the untreated group [(2.61 2± 0.318)% vs (0.306±0.017)%, t=7.22, P<0.01] and the FLS treated group [(2.412±0.297)% vs (0.306±0.017)%, t=7.07, P<0.01] were markedly higher than MSCs treatment [(0.306 ±0.017)%]. Moreover, the frequency of CD25+Foxp3+/CD4+Treg in the MSCs treated group [(15.08±0.81)%] was significantly increased compared with the untreated group [(8.02 ±0.47)%, t=7.45, P<0.01] and FLS treated group [(8.80 ±0.23)%, t=7.39, P<0.01]. MSCs treatment resulted in a decrease in CXCR5+PD1+/CD4+Tfh and IFNγ+/CD4+Th1 subset, compared with the untreated group [(14.3±1.5)%vs (31.5±3.3)%, t=5.25, P<0.01] [(1.78±0.27)% vs (5.93±1.56)%, t=2.60, P<0.05] and the FLS treated group [(14.3±1.5)%vs (28.8±2.2)%, t=5.49, P<0.01] [(1.78±0.27)%vs (4.88±0.81)%, t=3.61, P<0.01]. The frequency of macrophage in kidney of the MSCs treated group [(3.52 ±0.37)%] was markedly increased compared with the untreated group[(1.58±0.29)%, t=3.25, P<0.01], while neither the IL4+/CD4+Th2 subset nor the IL17+/CD4+Th17subset and the frequency of macrophage in abdominal cavity showed significant changes in the three groups. Conclusion These findings suggest that the therapeutic effects of MSCs on lupus mice may mediate through increasing the frequency of spleen Treg and renal macrophage and decreasing the frequency of Tfh, Th1 and plasma cells.

Through the literature collection on Chinese marine materia medica,this study analyzed medication rules of Chinese marine materia medica prescription,understood general conditions of Chinese marine materia medica prescription,in order to conduct data mining on medication rules of Chinese marine materia medica prescription.The name of Chinese marine materia medica was used as the search term.Chinese marine materia medica prescriptions were searched in related literatures of Chinese Medicine Code,Chinese Marine Materia Medica,Chinese Materia Medica,Chinese Pharmacopoeia and Great Dictionary of Chinese Medicine.The information was extracted and standardized to construct database for the initial data mining of related information and medication rules of Chinese marine materia medica prescriptions.The results showed that 16715 Chinese marine materia medica prescriptions were screened,which contained 144014 items of data,involving 218 kinds of Chinese marine materia medica.Decoction was the most common dosage form.The amount of Chinese marine materia medica prescription in the Ming and Qing dynasties was the largest.The highest frequency of Chinese marine materia medica in one prescription was 1 to 3 types.The prescription composed all by Chinese marine materia medica occupied 8.065％.Other prescriptions contained the compatibility of Chinese terrestrial materia medica.The prescription containing materia medica half from the sea and half from the land,occupied 7.754％.The Chinese marine materia medica used with the highest frequency in all prescriptions was oyster.The frequently used Chinese terrestrial materia medica was licorice and angelica in Chinese marine materia medica prescriptions.It was concluded that the number of Chinese marine materia medica prescription was large.Its compatibility and clinical application had a certain characteristic,which provided data foundation for the further research and development of Chinese marine materia medica.

Objective:To explore the effect of core muscle strength training intervention on postoperative rehabilitation of patients after total knee arthroplasty, and to provide reference for the rehabilitation of patients after total knee arthroplasty.Methods:A total of 109 patients with total knee arthroplasty who were admitted to Medical Health Group of First People′s Hospital of Xiangshan County from May 2020 to July 2021 were selected as the research objects, and were divided into an intervention group of 54 cases and a control group of 55 cases according to the random number table method. The control group received conventional rehabilitation methods after surgery, and the intervention group received core muscle strength training on the basis of conventional rehabilitation. The intervention time was 6 weeks. The knee joint function, balance function and activities of daily living were evaluated by Hospital for Special Surgery Knee Score, Berg Balance Scale, modified Barthel Index before and after intervention and the results were compared between the two groups.Results:In the end, there were 50 cases in the intervention group and 52 cases in the control group. There was no significant difference in the score of the knee joint function, balance function and activities of daily living before intervention between the two groups( P>0.05). The scores of the knee joint function, balance function and activities of daily living were (74.78 ± 3.12), (46.50 ± 3.82), (92.80 ± 5.17) points in the intervention group, and (72.15 ± 3.31),(44.44 ±3.66),(89.42 ± 4.50) points in the control group, the differences were statistically significant ( t=4.12, 2.78, 3.52, all P<0.01). The knee joint function recovery grade in the intervention group was higher than that in the control group, and the difference was statistically significant ( Z=3.43, P<0.01); the degree of dependence on self-care ability in daily life in the intervention group was lower than that in the control group, and the difference was statistically significant ( Z=3.98, P<0.01). Conclusions:Core muscle strength training can effectively improve postoperative knee function, balance function and activities of daily living in patients with total knee arthroplasty. This program is practical in clinical work and has clinical application value.

Objective: To investigate the comorbidity of myopia and scoliosis among primary and secondary school students in Tianjin, and to analyze the school environment risk factors contributing to these health issues, so as to provide a scientific basis for development effective prevention measures. Methods: A total of 41 654 primary and secondary school students from 16 districts of Tianjin were selected by stratified random cluster sampling from September to October 2023 to screen for myopia and scoliosis. Univariate analysis was performed to examine the data, followed by a bivariate multivariate Logistic regression model and cumulative effect analysis to explore the influencing factors of their comorbidity. Results: In 2023, the prevalence of comorbidity of screening positive myopia and scoliosis among primary and secondary school students in Tianjin was 2.65%. The prevalence was higher in suburban areas (3.26%) compared to urban areas (2.02%), higher among females (3.81%) compared to males (1.59%), and highest in high school students (6.17%) compared to middle school (4.19%) and primary school students (0.44%) (χ2=62.23, 198.69, 953.19, P<0.01). Logistic regression analysis showed that the number of physical education classes ≥3 per week, the number of eye health exercises at school ≥2 per day, outdoor activities between classes, teachers reminding to pay attention to reading and writing posture and strict eye standing posture were negatively correlated with the comorbidity of screening positive myopia and scoliosis (OR=0.66, 0.77, 0.71, 0.78, 0.74, P<0.05). Reading or electronic screen while lying or lying on the stomach was positively associated with the comorbidity of screening positive myopia and scoliosis (OR=1.77, P<0.05). Cumulative effect analysis showed that the cumulative score (4-7, 7-9, ≥10) was negatively correlated with the comorbidity of screening positive of myopia and scoliosis (OR=0.65, 0.55, 0.52, P<0.05). Conclusions The school environment support and students personal behavior habits in school are related to the comorbidity of comorbidity of screening positive myopia and scoliosis. Prevention and control of myopia and scoliosis should improve the environmental factors related to students health in school.

OBJECTIVE: To carry out prenatal diagnosis for a fetus with normal ultrasonographic finding at 20 weeks' gestation but a copy number variant(CNV) of 13q indicated by non-invasive prenatal test (NIPT). METHODS: Karyotyping analysis and chromosomal CNV assay were carried out on the amniotic fluid sample. Parental peripheral blood sample was collected for chromosomal analysis. Detailed fetal ultrasound scan was carried out to rule out structural abnormalities of the fetus. RESULTS: The fetus was detected with a heterozygous 10.14 Mb deletion at 13q21.1q21.32, which has originated from the phenotypically normal mother. No apparent karyotypic abnormality was detected in the fetus and its parents. No ultrasonic abnormality was found in the fetus. CONCLUSION Both the fetus and its mother have carried a heterozygous 10.14 Mb deletion at 13q21.1q21.32 and presented normal phenotypes.Combined with literature review, the segmental deletion was judged to be a benign variant.
Female ; Genetic Counseling ; Humans ; Karyotyping ; Pedigree ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography, Prenatal

OBJECTIVE: To explore the genetic etiology in four patients with hyperbilirubinemia, and discuss the correlation between clinical characteristics and molecular basis. METHODS: The data of clinical manifestation and auxiliary examinations were collected. Genomic DNA of the four patients was extracted and analyzed by next-generation sequencing using the panel including genes involved in hereditary metabolic liver diseases. Suspected variants were verified by Sanger sequencing. RESULTS: All of the four patients were males with normal liver enzymes. It was revealed that all the patients had heterozygous variants, among which c.3011C>T, c.2443C>T and c.2556del were the variants which have not been reported previously. CONCLUSION All of the patients were diagnosed as Dubin-Johnson syndrome (DJS) caused by ABCC2 gene variants. The novel variants add to the spectrum of genetic variants of the disease. Because of the favorite prognosis, precise diagnosis can greatly reduce the psychological pressure of patients and avoid excessive treatments. At the same time, it could provide pertinent genetic counseling for the families.
DNA ; Female ; Heterozygote ; Humans ; Jaundice, Chronic Idiopathic/genetics* ; Male ; Multidrug Resistance-Associated Protein 2 ; Multidrug Resistance-Associated Proteins/genetics* ; Phenotype