Objective To investigate the effects of probiotics on the plasma diamine oxidase (DAO) activity and D-lactate, IL-6 and IL-10 levels in patients undergoing open heart surgery under cardiopulmonary bypass (CPB) , trying to elucidate the mechanism of protective effect of probiotics against CPB- induced injury to intestinal mucosal barrier. Methods Forty ASA Ⅱ - Ⅲ patients of both sexes aged 30-64 yr weighing 40-80 kg undergoing open heart operation under CPB were randomized into 2 groups ( n = 20 each) : control group (group C) and probiotics group (group Y) . Group Y received Jinshuangqi (Bifid Triple Viable containing bifido-bacterium, lacto-bacillus, streptococcus thermophiles) 4 pills 3 times a day for 7 days before operation. Venous blood samples were taken from CVP line before operation (T1 ), at 10 min after aortic unclamping (T2 ) and at the end of CPB (T3 ) and at 2, 6, 18 h (T4,5,6) after operation for determination of plasma DAO activity and D-lactate, IL-6 and IL-10 levels.Results Plasma DAO activity, D-lactate, IL-6 and IL-10 levels were significantly increased after CPB was started at T2-6 as compared with the baseline values at T1 in both groups. Plasma DAO activity and D-lactate level were significantly lower at T2-5 , the plasma IL-6 level was significantly lower and plasma IL-10 level higher at T4,5 in group Y than in group C. Conclusion Probiotics can protect intestinal mucosal barrier in patients undergoing open heart surgery under CPB and attenuate inflammatory response.

OBJECTIVE:To provide reference for rational use of antibacterials. METHODS:Taking 69 hospitals of Beijing, Tianjin,Shanghai,Hangzhou,Guangzhou,Chengdu as samples,the data about the purchase and application of antibacterials in outpatient department were collected during 2009 to 2013,and analyzed in terms of the proportion of the amount of antibacterials in all chemical drugs,the number of antibacterials among top 80% chemical drugs in the list of consumption sum and their variet-ies number,the utilization rate of antibacterials in outpatient prescription,the percentage of two and more antibiotics combination in outpatient antibiotics prescriptions,the proportion of antibiotics use,etc. RESULTS:The proportion of average purchase amount of antibacterials in chemical drugs decreased from 20.97 % in 2009 to 14.17 % in 2013;the number of antibacterials among top 80% chemical drugs in the list of consumption sum decreased from 43 in 2009 to 34 in 2013;the average utilization rate of outpa-tient antibacterials decreased from 23.22 % in 2009 to 16.11 % in 2013;there was statistical significance(P<0.05). The varieties of antibacterials decreased from 78 kinds in 2009 decreased to 54 kinds in 2012(P<0.05),but rise to 66 kinds in 2013;the per-centage of two and more antibacterials combination in outpatient antibacterials prescriptions decreased fron 9.02% in 2009 to 7.35% in 2012 (P<0.05),rise to 12.89% in 2013. The utilization ratio of antibacterials injection in outpatient antibacterials pre-scriptions had no significant change. The utilization of antibacterials in tertiary hospitals from 6 districts was analyzed;cephalospo-rin had ranked the first place,and almost occupied half part of antibacterials but declined;the utilization rate of antibacterials for special use was on the rise. CONCLUSIONS:After 3 years of antibacterials special rectification,and the utilization of antibacteri-als in 6 districts as Beijing have been improved significantly;however,several index have little improvements,and some rebound-ed in 2013,so this activities needs to establish long-term mechanism of continuous supervision.

Aim To evaluate the efficacy of TFU as a precursor of 5-FU on the growth inhibition of human gastric carcinoma cell lines SGC-7901 and MKN-45.Methods In vitro experiments,cell growth inhibition was measured by MTT assay.The rates were compared in the presence and Absence of liver microsomal enzymes.The morphology of apoptotic cells was detected by observation with a fluorescence microscope after staining by using adridine orange/ethidium bromide solution.DNA fragmentation was analyzed by agarose gel electrophoresis and flow cytometry respectively.Western blot was employed to analyze the expression of Bcl-2 and Bax.The in vivo efficacy of TFU was assessed in nude mice bearing tumours.The specimens were re-moved and the in situ cell apoptosis detection kit was employed for TUNEL staining.Results Growth of SGC-7901 and MKN-45 cells was remarkably suppressed by treatment with TFU in the presence of liver microsomal enzymes in vitro,suggesting that TFU might be converted to 5-FU by the enzymes.Similar treatment of TFU induced apoptosis of the cells,which was deduced from typical apoptotic features such as morphology,the formation of characteristic ladder pattern of DNA migration and the accumulation of sub-G1 phase.Furthermore,a significant inhibition of Bcl-2 expression and the up-regulation of Bax were observed after treatment with TFU in the presence of liver microsomal enzymes.Growth of human gastric carcinoma cells was significantly delayed by oral administration of TFU with low side effects.Apoptosis in xenografts was also observed by means of TUNEL staining method.Conclusion Treatment of TFU in the presence of liver microsomal enzymes could promote the inhibition of gastric carcinoma cell proliferation.TFU might sustain release of 5-FU mediated by liver microsomal enzymes.Low dose of 5-FU might trigger the carcinoma cells apoptosis via regulation of Bax and Bcl-2.

BACKGROUND: There are less researches on the relationship of parents'feeding behavior with nourishing and developing status of infants.OBJECTIVE: To study the relationship between the parents' feeding behavior and the nourishing and developing status of infants.DESIGN: A cross-sectional study.SETTING: Center of Maternal and Children' s Health,the First Hospital of Xi'an Jiaotong University.PARTICIPANTS: The study was carried out during January to December in 2002,at the Center of Maternal and Children' s Health,The First Hospital of Xi'an Jiaotong University. A total of 346 infants,aged 0 to 18 months old,were selected from the Fuping county and Chengcheng county of Weinan area by using the stratified duster sampline method. Inclusive criteria: infants with the gestation period between 37 to 42 weeks,without obvious diseases,no congenital abnormality; Exclusive criteria: infants with congenital disease or abnormality. Totally 324 infants,who were in accordance with the above criteria,were divided into 5 groups according to their month age.METHODS: The nursing persons of the infants were called at their houses,and the self-designed "Investigation Tables on Infant's Nutrition"were filled out.MAIN OUTCOME MEASURES: ① Status of slight malnutrition of infants of different month ages; ② Status of nutrition and development of infants,within 4 months, with different feeding behaviors; ③ Effects of beginning time,quality and frequency of complementary food on the nourishing and developing status of infants.RESULTS: In the first 4 months after birth,the rate of breast-feeding was high and the nourishing status of the infants was good. But the nourishing and developing status of infants became comparatively worse after 4 months age,because of inappropriate complementary food. As compared the slight malnutrition infants with normal infants,there were significant differences in the beginning time and kinds of complementary food(P<0.01).CONCLUSION: There is close relationship of the feeding behaviors with the nourishing and developing status of the infants.

Objective To investigate the relationship between abnormal metabolism of aggrecan and joint destruction in patients with rheumatoid arthritis (RA).Methods 140 RA patients with duration less than 24 months were enrolled into this study.The study also included 100 normal controls and 95 patients with other rheumatic diseases.Three monoclonal antibodies (5D4,7D4 and BC-3) of aggrecan were used to detected aggrecan catabolic fragments in serum of RA patients and the other two groups of controls by enzyme linked immunosorbent assay (ELISA),and the correlation of aggrecan catabolic fragments with joint damage were analyzed.Sharp evaluation of hand joints in RA patients were performed at baseline and after one year follow-up.Calculating the area under the receiver operating characteristic curve (ROC) was used to evaluate the sensitivity and specificity of aggrecan catabolic fragments detected in serum of RA patients.Results Both levels of 5D4 fragment and BC-3 fragment of RA group were higher than those of normal control [5D4 of RA:(5.8±2.1) ng/μl,normal control:(2.2±1.3) ng/μl;BC-3 of RA:(11.1±3.4) ng/μl,normal control:(5.0±2.1) ng/μl,F=38.65,24.07,P＜0.001).There was no difference in 7D4 fragment among three groups (F=0.589,P=0.478).Both two fragment levels of RA patients with anti-CCP positive were greater than those patients with anti-CCP negative [5D4:(5.6±1.3) ng/μl vs (4.4±1.1) ng/μl,F=21.23,P＜0.01;BC-3:(12.2±3.9) ng/μl vs (9.3±2.8) ng/μ1,F=27.14,P＜0.01].Linear Regression showed that serum fragments detected by 5D4 and BC-3,and anti-CCP positive were risk factors for Sharp deterioration after one year follow-up.The sensitivity and specificity of combined detection of two aggrecan fragments in serum of RA patients for the prediction of joint Sharp were 56.5％ and 84.2％ respectively.Positive predictive value and negative predictive value are 74.3％ and 70.6％.respectively.Application of areas of ROC to identify the best evaluation of Sharp was 0.798.Conclusion There is positive correlation between aggrecan catabolic fragments in serum and joint Sharp evaluation of RA patients.Detection of aggrecan catabolic fragments in RA patients may predict early joint destruction.

The purpose of this study is to develop glipizide push-pull osmotic pump (PPOP) tablets by using a formulation design expert system and an artificial neural network (ANN). Firstly, the expert system for the formulation design of osmotic pump of poor water-soluble drug was employed to design the formulation of glipizide PPOP, taking the dissolution test results of Glucotrol XL as the goal. Then glipizide PPOP was prepared according to the designed formulations and the in vitro dissolution was carried out. And in vivo evaluation was carried out between the samples which were similar to Glucotrol XL and the Glucotrol XL in Beagle dogs. The range of the factors of formulation and procedure, which could influence the drug release, was optimized using artificial neural network. Finally, the design space was found. It was found that the target formulation which was similar to Glucotrol XL in dissolution test could be obtained in a short period by using the expert system. The samples which were similar to Glucotrol XL were bio-equivalent to the Glucotrol XL in Beagle dogs. The design space of the key parameter coating weight gain was 9.5%-12.0%. It could be concluded that a well controlled product of glipizide PPOP was developed since the dissolution test standard of our product was more strict than that of Glucotrol XL.

Objective To compare the difference of training field of nurse specialist between America and China, and offer proposals to the development of Chinese nurse specialist. Methods Network information resources and citespace were used to conclude and compare training field of nurse specialist. Results The nurse specialist training in America has a mature system meanwhile it is not yet mature in China. Conclusions Reference to the mature development experience of America, combining the actual situation of China, suitable strategy should be developed for the Chinese nurse specialist training.

phological changes in rat liver tissues. TLR4 and NF-κB expression in the liver tissues were measured by im-munohistochemistry . The results showed that compared with the normal group , the serum levels of transaminase ( ALT , AST ) and endotoxin of the model group were higher ( P < 0 . 01 ); and the degree of liver pathology injury was significantly increased; the TLR4 and NF-кB expression were increased (P < 0.01). Compared with the model group, the serum levels of transaminase (ALT, AST) and endotoxin of the experimental group were lower (P < 0.01), the degree of liver pathology injury was significantly lighter; the TLR4 and NF-кB expression were significantly lower (P < 0.01). It was concluded that the WYJDHY granules has a good role in the prevention and treatment of liver injury of rat model of hepatic failure IETM through the downregulation of liver expression of TLR4 and NF-кB in rat liver tissues , reducing serum levels of endotoxin , which may be one of the mecha-nisms on hepatic failure treatment .

Objective To evaluate the geometry of mitral valve and annulus in patients with mitral regurgitation, and to quantify the mitral annular remodeling and motion in ischemic mitral regurgitation (IMR) with mitral valve assessment (MVA) software. Methods Seventeen patients were divided into two groups: IMR group (n=10) and non-IMR group (n=7), and other 11 patients without significant mitral regurgitation (＜2+) and mitral structure abnormality were regarded as control group. The imaging was analyzed offline with Siemens MVA software to measure the annular diameters, annular circumference, anterior and posterior annular length, annular area (MAA) and non-planar angel (NPA). The dynamic changes during the cardiac cycle were calculated. Results Compared with control group, the posterior annular length and NPA significantly increased in IMR group (P＜0.05, P＜0.01). During the systole, the posterior annular and annular circumference paradoxically prolonged in IMR group compared with control group (median Δ posterior annular length: -2.71 mm/m2 vs 0.52 mm/m2, P＜0.05). In all patients of non-IMR group, the geometric character of mitral valve lesions shown in 3-dimensional echocardiography was accordant with surgical findings. Conclusion Three-dimensional echocardiography combined with MVA software provides a useful tool for assessment the geometric character of mitral valve lesions and quantification of mitral annulus remodeling, which is helpful to understand the mechanism of MR and guide surgical treatment.

Objective To investigate the phenotype and the immunoregulatory function of CD8αα+TCRαβ+regulatory T cells in peripheral blood samples from mice.Methods The distribution profile and the phenotype of CD8αα+TCRαβ+regulatory T cells in C57BL/6 mice were detected by flow cytometry.The cytokines released by CD8αα+TCRαβ+regulatory T cells upon the stimulation with anti-CD3 antibody were analyzed by cytometric bead array.The in vitro immunosuppressive activity of CD8αα+TCRαβ+regulatory T cells on activated CD4+T cells was analyzed by using flow cytometry and carboxyfluorescein succinimidyl ester ( CFSE ) .An adoptive cell transfer assay was set up to evaluate the immunoprotective effects of CD8αα+TCRαβ+ regulatory T cells in a mouse model of experimental autoimmune encephalomyelitis ( EAE) .Results CD8αα+TCRαβ+regulatory T cells were detected in liver, spleen and peripheral blood samples collected from na?ve C57BL/6 mice.Compared with CD8αβ+TCRαβ+regulatory T cells, CD8αα+TCRαβ+regulatory T cells showed a memory-activated phenotype of CD25+CD122high CD44high CD62Llow CD69high NK1.1+DX5+.CD8αα+TCRαβ+regulatory T cells could produce IL-2 after 24 hours stimulation with anti-CD3 antibody, followed by producing IFN-γ, TNF-α, IL-4, IL-17A and traces of IL-6 and IL-10. In vitro, CD8αα+TCRαβ+regulatory T cells specifically suppressed the proliferation of activated CD4+T cells ( P<0.01 ).Moreover, they could delay the onset of EAE in mice and reduce clinical score (P<0.01).Conclusion CD8αα+TCRαβ+regulatory T cells were a unique population with immunoregula-tory function, which could be used as a potential therapeutic target in the treatment of autoimmune disease.