Objective To effectively develop medical instruments selection of hospital integration operating room.Methods The instruments selection was carried out by the purchasing management of medical instrument item.Results Combination of actual cases,the principles of medical instruments selection of hospital integration operating room and the system of item purchase management were given.Conclusion The methods of medical instruments selection of hospital integration operating room can be taken.

Background Researches showed that CD4+CD25+ natural regulatory T cells (nTregs) play an important role in maintaining peripheral immune tolerance, while immunotherapy using in vitro-expanded induced regulatory T cells (iTregs) suppresses allograft rejection in multiple organ transplantation.The inducing method of iTregs still needs to be optimized.Furthermore,the effect of iTregs on grafts of keratoplasty is unclear.Objective This study was to investigate the inducing and expansion method of iTregs and explore its inhibitory effects on corneal allograft rejection.Methods Bone marrow-derived dendritic cells (BMDCs) were isolated from C57BL/6 mice femora and cultured.CD4+ CD25+ T cells and CD4+ CD25-T cells were isolated from mouse spleen and separated using flow cytometry.The CD4+CD25-T cells were divided into negative control group (CD4+CD25-T cells), CD3/ 28 antibody bead group (CD4+CD25-T cells+CD3/28 antibody bead) ,2.5 ng/ml transforming growth factor (TGF)-β1 induced group and 10.0 ng/ml TGF-β1 induced group.The iTregs was formed after induction of different concentrations of TGF-β1 and CD3/CD28 antibody bead (1 : 1).CD3/CD28 antibody bead (1 : 2) , interleukin-2 (IL-2) and TGF-β1 were used to expand iTregs.The phenotype and proliferation of iTregs were assayed by flow cytometry,and the inhibitory effect of iTregs on effector T cells (Teffs) was analyzed by mixed lymphocyte reaction.Allogenic keratoplasty model (C57BL/6→BALB/c) was build,and 0.1 ml iTregs or nTregs suspension or PBS was injected via posterior venous plexus of fellow eyes to assess the graft survival time.The use and care of the mice followed the ARVO statement.Results The CD4+CD25+ T cell proportions were (6±3)％ ,(91±4)％ ,(91±3)％ and (86± 6) ％ in the negative control group,CD3/CD28 antibody bead group, 2.5 ng/ml TGF-β1 induced group and 10.0 ng/ml TGF-β1induced group, showing significant increases in the CD3/CD28 antibody bead group, 2.5 ng/ml TGF-β1 induced group and 10.0 ng/ml TGF-β1 induced group compared with the negative control group (all at P＜0.01).The Foxp3+ T cell proportions of the CD3/CD28 antibody bead group,2.5 ng/ml TGF-β1 induced group and 10.0 ng/ml TGF-β1 induced group were (1.18 ±0.20) ％ , (8.70± 1.80) ％ and (21.80±3.36) ％ , showing significant increases in the 2.5 ng/ml TGF-β1 induced group and 10.0 ng/ml TGF-β1 induced group compared with the CD3/CD28 antibody bead group (both at P＜0.01).Compared with the nTregs, the expression of CD69 was lower, and the expressions of PD-1 and Foxp3 were raised in the iTregs (all at P＜0.01).The proliferation of Teffs were decreased when cocultured with iTregs in comparison with nTregs at 1 : 1,1 : 2,1 : 4,1 : 8,1 : 16 Tregs/Teffs rations (all at P＜ 0.01).The survival time of mouse corneal grafts was 4 weeks with the permanent tolerance of 50％ in the iTregs injected group,which was superior to the 3 weeks survival time and 17％ permanent tolerance in the nTregs injected group(P＜0.05).Conclusions TGF-β1 can induce CD4+ CD25-T cells to form iTregs, which highly express Foxp3.iTregs show a stronger inhibitory effect on the growth of lymphocytes than nTregs, and therefore suppress the graft rejection after keratoplasty.

Objective To evaluate the effects of total glucosides of paeony (TCP) on cell proliferation of and expression of VECF and IL-23 in human HaCaT keratinocytes and their potential mechanisms. Methods MTT assay was performed to detect the cell proliferation of HaCaT cells incubated with various concentrations (0.5 to 312.5 mg/L) of TGP. HaCaT cells were classified into 8 groups, control group without any treatment, TGP groups treated with 6 different concentrations of TGP, SB203580 group treated with TGP of 125 mg/L after 2-hour pretreatment with SB203580 of 10 μmol/L After additional culture, reverse transcription (RT)- PCR and enzyme linked immunosorbent assay (ELISA) were conducted to determine the expression levels of VEGF and IL-23 mRNA and protein, Western blot to test the phosphorylation of p38 mitogen-activated protein kinase (MAPK) in these cells. Results The proliferation of HaCaT cells was promoted by TGP of low concentrations (0.5 and 2.5 mg/L), but inhibited by TGP of equal to or more than 12.5 mg/L, and peaked at the concentration of 125 mg/L. TGP of 0.5 and 2.5 mg/L enhanced the mRNA and protein expressions of VEGF and IL-23, while TGP of 12.5 to 125 mg/L suppressed the expression of VEGF mRNA and protein, and TGP of 62.5 to 125 mg/L downregulated the expression of IL-23 mRNA and protein. The phosphorylation of p38 protein kinase in HaCaT cells was induced by TGP of 125 mg/L in a time-dependant manner. Concretely, the level of phosphorylated p38 kinase in HaCaT cells was 0.3314 ± 0.0245 (peak) at 5 minutes, decreased to 0.2173 ± 0.0189 at 10 minutes (still statistically higher than untreated HaCaT cells) and 0.1664 ± 0.0201 at 30 minutes after treatment with TGP of 125 mg/L. SB203580 attenuated the effect of TGP on p38 phosphorylation, and the level of phosphorylated p38 kinase was 0.1529 ±0.0147 in HaCaT cells pretreated with SB203580 prior to the treatment with TGP. Conclusion TGP can inhibit the cell proliferation of and expressions of VEGF and IL-23 mRNA and protein in HaCaT cells, likely mediated by the p38 MAPK signaling pathway.

Objective To evaluate the bacteriostasis of sulfamethoxazole(SMZ)combined with trimethoprim(TMP)against My‐cobacterium tuberculosis(MTB) in vitro ,so as to provide basis for clinical application .Methods The minimal inhibitory concentra‐tion(MIC) value of TMP/SMZ against MTB ,including standard sensitive strain(H37Rv) ,clinical sensitive strains(20 strains) and clinical multiple‐drug‐resistance strains(MDR ,30 strains) ,was detected by using MPP observation method .Results The MIC val‐ue of standard strain H37Rv was TNP(0 .5 μg/mL)+SMZ(9 .5 μg/mL) .The growth of 40 strains(accounted for 80% ) of clinical isolates ,including 17 sensitive strains and 23 MDR strains ,could be inhibited by TMP(1 μg/mL)+ SMZ(19 μg/mL) compound . Conclusion TMP combined with SMZ may has good antibacterial activity for strains of MTB in vitro .

ObjectiveTomonitorthehighriskbehaviorsandotherAIDS/STIrelatedfactorsamongmenwhohavesexwithmen(MSM),especiallymalehomosexualsinmainlandChina.MethodsSelf-administratedanonymousmailsurveyswerecarriedoutin2001,andanalyzedwithSPSS.ResultsOnethousandonehundredandnineeffectivequestionnaireswerecollectedfrom30provincesandcities.MostofMSMlivedinbigormedi-um-sizedcities,havinggoodeducation,andbeingyounger.Thenumbersofsamegendersexpartnersweremorethanone.Theyoftenhadcasualsexpartnersandunprotectedintercourse.Inthelastyear,11.45%reportedhavingbeendiagnosedSTI.AmongMSMwhohavebeentestedforHIVantibody,5.45%oftestswerepositive.ConclusionsWhileSTIratehasbeenreachingahighlevel,MSMwithSTIalsohavebeeninfectedwithHIVintheMSMofmainlandChina.OthergroupshavingsexwithMSMareatgreaterriskofSTI/HIVinfection.ItisinurgentneedtopreventandcontrolSTI/AIDSinMSM.

Objective To detect Ureaplasma urealyticum (Uu) and Mycoplasma hominis (Mh) in urogenital tract of healthy elementary and high school students,and to determine the biovars and serotypes of Uu isolates.Methods Urine specimens were collected from 957 healthy school children,including 404 elementary school students,260 junior high school students and 293 senior high school students,and submitted for Uu and Mh culture in selective liquid medium.Thc specimens positive for Uu and (or) Mh culture were subsequently subjected to PCR.The biovars and serotypes of Uu were determined.Results Uu was detected in 4.81％ (46/957) of the school children.Among the 46 Uu positive specimens,32 (69.57％) harbored Ureaplasma Parvum (biovar 1 ),14 (30.43％) Ureaplasma urealytieum (biovar 2); 12 (2.97％) were from elementary school students,including 9(75.00％) cases of Ureaplasma Parvum and 3(25.00％) Ureaplasma urealytieum,8(3.08％) were from junior high school students,including 5 cases of Ureaplasma Parvum and 3 Ureaplasma urealytieum,26 (8.87％) were from senior high school students,including 18 (69.23％) cases of Ureaplasma Parvum and 8 (30.77％)Ureaplasma urealytieum.Mh was positive in 9 (0.94％) school students,including 1 elementary school student,1 junior school student and 7 senior high school students.The detection rate of Uu was significantly higher in females than in males in all the 3 groups (elementary school,junior and senior high school) of students.Conclusions Mh and Uu are commensals in urogenital tract of elementary and high school students without symptoms.Ureaplasma Parvum is the predominant biovar in this population,though Ureaplasma urealytieum accounts for a significant proportion,which implies that Uu is commensal in healthy elementary and high school students,and females are more liable to be colonized than males.

Objective To study the relationship of age and high risk behaviors (HRBs) related to HIV/AIDS among men who have sex with men (MSM) in China. Methods One thousand one hundred and nine anonymous questionnaires were collected from MSM in 1999. Univariate analyses were applied to clarify the relation of the age and HRBs. Results The numbers of accumulative partners and oral intercourse behavior were higher in 35 ~ 44 age group (P

Objective To detect the expression of Livin,an apoptosis-inhibiting protein,and Smac,an apoptosis-promoting protein,in basal cell carcinoma (BCC) lesions.Methods Skin specimens were obtained from the lesions of 80 patients with BCC and normal skin of 30 human controls.Immunohistochemical SP method was used to detect the pmtein expression of Livin and Smac in these specimens.Chi-square test was conducted to compare the expression rate of Livin and Smac protein between the lesional and control specimens.The relationship between the protein expression of Livin and Smac in BCC was analyzed by Spearman correlation coefficients.Results The expression rate of Livin protein was significandy higher (77.50％ vs.3.33％,x2 =49.04,P ＜ 0.001),while that of Smac protein was statistically lower (46.25％ vs.100％,x2 =26.47,P ＜ 0.001),in BCC than in the control specimens.No significant difference was observed in the expression rate of Livin or Smac protein between nodular ulcerative and pigmented BCC specimens (75.41％ vs.80.00％,x2 =0.001,P ＞ 0.05; 47.54％ vs.40.00％,x2 =0.28,P＞ 0.05) or between nodulocystic and pigmented BCC specimens (73.58％ vs.80.00％,x2 =0.03,P ＞ 0.05; 45.28％ vs.40.00％,x2 =0.13,P ＞ 0.05).There was a negative relationship between the protein expression of Livin and Smac in BCC lesions (r =-0.432,P ＜ 0.01).Conclusion The upregulated expression of Livin and downregulated expression of Smac may be invoved in the occurrence and development of BCC.

Objective To describe and analyze the clinical and laboratory findings in a group of children diagnosed with scleroderma at Beijing Children's Hospital in the last 10 years.Methods The clinical charts of children with scleroderma in the Rheumatology Department at Beijing Children's Hospital,between January 2002 and October 2013 were reviewed.All of them fulfilled the classification criteria for juvenile sclerodema,both systemic scleroderma (SSc) and localized scleroderma (LS) types.T test was used for comparison between the two groups.Results Forty-six patients were enrolled and were diagnosed as scleroderma.Seven patients(15％) suffered from SSc and 39 patients(85％) were LS.Mean age-at-onset of LS was (5±4) years old.The male to female ratio was 1.2:1.Mean age-at-onset of SSc was (9±4) years old.All patients were female.The lesions found in LS were linear scleroderma (54％),mixed morphea (36％),generalized morphea (8％),and panclerotic morphea (3％).Twenty-six patients had internal organs involved.Three patients with nerve system involvement was found in en coup de sabre (ECDS).Systemic involvement included lung and gastrointestinal tract primarily.The heart,nerve system,kidney,eye involvement was also found.One girl had SSc combined with renal crisis.Antinuclear antibodies were positive in 77％ of LS patients and 100％ of SSc patients.Rheumatic factor was positive in 6 patients (15％),5 patients had joint involvement.Tests for anti-Scl-70 antibodies were positive in 5 (71％) patients with SSc.The most common drugs used were methotrexate and prednisone.Conclusion In this study,LS is common in children.SSc is more severe than LS.Multi-center and large sample study is needed to know the characteristics of juvenile scleroderma in China.

Objective To explore the clinical manifestations,diagnosed main points,laparoscopic trestment strategy of ectopic appendicitis.Methods The 19 clinical data of ectopic appendicitis,from April 2011 to April 2015 in our hosipital,were retrospective analysised,and we sum up the clinical manifestation,diagnosis and treatment,laparoscopic exploration indications and the technique of laparoscopic appendectomy.Laparoscopy exploration and laparoscopic appendectomy were made on all patients under general anesthesia by tracheal cannula.Results Of 19 patients,16 cases by ultrasonic examination get correct diagnosis before operation,of which the ultrasound diagnosis rate is 92.63％,3 limitations of acute peritonitis patients were preoperative misdiagno~s,they were the right kidney stones,acute cholecystitis and the right side of the annex inflammation;there were 2 patients converted to open operation,and the transfer rate is 10.53％.The blood loss of the operation is about 5-20 mL.They were ambulant after 9 hours,in full flow diet after 12 hours,and the average hospitalization time is 4 days.One patient,no other long-term complications were found postoperatively follow-up of 12 to 18 months,were poke holes in infection,and the complications of laparoscopic surgery is 5.27％.Conclusions Ectopic acute appendicitis has no specific clinical manifestation,and is easy to misdiagnosis.In the auxiliary examination,ultrasound is the first choice for the diagnosis of ectopic appendictis.Laparoscopy exploration and laparoscopic appendectomy are the ideal treatments of emergency treatment of ectopic appendicitis,and are worth of clinic application.