Body defence functions are seriously impaired after thermal injury.Neutrophils,the important phagocytic cells against bacterial invasion,are also affected Therefore it is of value to study the functional statue of these cells in the postburn course.Two assays to observe the bactericidal function of neutrophils were adopted: the determination of the amount of H2O2 released and the126I taken by the activated neutrophils in oxidative metabolic processes.The results of the experiments on 2 animal models,inhalation injured dogs and scalded rats (TBSA 30% of third degree burns) with pseudomonas infection,showed that the cell oxidative metabolic response of the neutrophils was severely depressed in the first week postburn,indicating the presence of profound inhibition of the bactericidal function of the cells after thermal injury.In order to verify these results,direct yeast-killing assay was carried out and similar results were obtained.In order to explore the cause of the suppression of the bactericidal function,whether it was due to the presence of suppressive factors in the blood of burn victims,or due to the direct detrimental effect of thermal injury on the cells,further experiments to observe the crossed effects of burned serum on normal cells and normal serum on burned cells were performed.It was demonstrated that serum suppressive factors were present and the direct effects from thermal injury also played a part in suppressing the function

Fibronectin(FN), a blood glycoprotein with non- specific opsonic activity, plays an important role in the process of phagocytosis of macrophages and in the clearance function of reticuloendothelial system(RES) as well. Its level in the circulating blood usually declines in case there is trauma, burn, shock, sepsis or many other diseases probably due to excessive consumption. Then dysfunction of RES and suppression of the body defence mechanism are thus resulted.This paper is to report a simple method to determine the binding activity between gelatin and FN with indirect agglutination assay. Altogether 123 patients suffering from burns, acute peritoneal infections, operative trauma and certain liver diseases were studied. It was found that the serum FN level was closely related with and parallel to the clinical course and severity of the illness. It is suggested that this method for the measurement of serum FN be used as one of the routine assays to reflect the functioning conditions of RES and the defence mechanism of the host.

Objective To summarize the nursing experience on nosocomial infection in elderly patients with intra-aortic balloon pump (IABP) after coronary artery bypass grafting. Methods The clinical data of elderly patients who underwent coronary artery bypass grafting with application of IABP from April 2006 to February 2009 were retrospectively collected and analyzed. Results 29 patients suffered nosocomial infection in all 111 cases. The hospital mortality was much higher among patients with nosocomial infection than in patients without nosocomial infection (19 cases vs 11 cases). 87 positive strains were separated from 29 patients with nosocomial infection, which included 47 strains of gram-negative bacterial, 23 strains of gram-positive bacterial and 17 strains of fungi. Conclusions The nosocomial infection was one of the risk factors for hospital mortality in elderly patients with intra-aortic balloon pump after coronary artery bypass grafting. It is important to take effective nursing strategies to prevent the postoperative nosocomial infection in this population.

Objective To investigate the number of osteoclast (OC) precursor in the peripheral blood of patients with ankylosing spondylitis (AS) and its relationship with serum receptor activator of nuclear factor KB-ligand (RANKL) and Osteoprotegerin (OPG) concentration as well as the disease activity. Methods The peripheral blood mononuclear cells from 8 cases of AS patients and 5 healthy controls were cultured in the medium containing macrophage colony-stimulating factor (M-CSF) (25 ng/ml) and RANKL (40 ng/ml). After being cultured for 14 days, cytochemistry was applied to detect tartrate-resistant acid phosphatase (TRAP) expression and the cells with TRAP expression and ≥3 nuclei were counted and defined as OC. Bone resorption assay was used to demonstrate OC function. ELISA was used to measure serum RANKL and OPG concentration in 23 cases of AS and 17 healthy controls. The relationship was analyzed in AS patients between the number of OC precursors and serum RANKL and OPG concentration as well as the disease activity. The indicators of disease activity were Bath ankylosing spondylitis disease activity index (BASDAI), Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). T test, t' test and Spearman correlation were selec-ted. Results ① Significantly higher OC production was observed in the peripheral blood of AS patients than that of healthy control group. The OC number per ten fields was 10.9±3.4 and 6.2±1.3 respectively (P<0.05); ② There was significant difference between AS patients and healthy controls in serum concentration of OPG and RANKL and the ratio of RANKL/OPG. OPG was significantly higher in AS patients [(157±49) pg/ml] than in healthy controls [(105±20) pg/ml] (P<0.05). RANKL was significantly higher in AS patients [(5.4± 3.8) pg/ml] than in healthy controls [(1.6±0.8) pg/ml] (P<0.05). The ratio of RANKL/OPG was significantly higher in AS patients (0.037±0.026) than in healthy controls (0.016±0.008) (P<0.01 );③Significantly positive correlation was observed between the OC number and the serum concentration of RANKL (r=0.692, P=0.009), the ratio of RANKL/OPG (r=0.813, P=0.001);④ In AS patients, serum concentration of OPG was found to have significantly negative correlation with BASDAI (r=-0.444, P=0.044). Serum RANKL concentration was found to have significantly positive correlation with BASDAI (r=0.543, P=0.011). The ratio of RANKL/OPG was found to have significantly positive correlation with BASDAI (r=0.672, P=0.001). Conclusion ① More OC precursors exist in the peripheral blood of AS patients. These cells may differentiate into osteoclasts, which might play a role in joints destructions in AS;② The mechanism of high OC production is likely to be due to high RANKL concentration which is caused by inflammatory reaction.

ObjectiveTo investigate the clinicopathological characristics of mucinous gastric carcinoma (MUC). MethodsFrom 1994 to 2001, 438 gastric cancer patients underwent operation, among them, 36 patients (8 2%) were with MUC. The clinicopathological parameters and prognosis of MUC and non MUC were analyzed retrospectively. ResultsThere were no significant differences in age, sex, tumor site and hepatic metastasis. Patients with MUC had higher rate of serosal invasion, invasive type lymph node involvement, peritoneal dissemination. Patients with MUC were of more advanced stage (stage Ⅲ and Ⅳ:MUC 88 9%,non MUC 73 9%). The 1 year and 2 year survival rate for MUC patients was lower than that for non MUC patients (50 5%?33 1% vs. 74 9%?64 7%). Conclusions The poor prognosis of MUC was correlated with frequent serosal invasion, lymph node involvement, peritoneal dissemination, and advanced stage at the time of diagnosis.

Objective:To explore the mechanism of total saponins of panax notogineseny (PNS) on secretion of TNF-α by macrophages and optimal dosage of PNS in vitro, through observation of the effects of different PNS dosages on nuclear factor-κB (NF-κB) activity and TNF-α mRNA expression of murine peritoneal macrophages (PMΦs) after severe scald.　Methods: The experimental model of 15% TBSA full-thickness scalded mice with vapor was used and PMΦ collected. NF-κB activity was measured by EMSA and TNF-α mRNA by RT-PCR. 　Results: There was a significant increase of the NF-κB activity and TNF-α mRNA expression in the PMΦs following scald, which was inhibited by application of PNS. It was also found that the effects of PNS was dosage-dependent within a certain range of concentrations, with the inhibition effect most obvious at 0.8 mg*mL-1.　Conclusion:PNS probably decreases TNF-α mRNA expression by inhibiting the NF-κB activity of PMΦs.

Objective To study the effect of lesion level and completeness on activities of daily living(ADL) of patients with spinal cord injury(SCI).Methods The functional status of 313 SCI patients were assessed using the Functional Independence Measurement(FIM),and FIM scores were calculated for statistical analysis with different lesion levels and completeness.Results FIM scores presented significant differences among cervical-level group,thoracic-level group and lumbar-level group(P<0.05～0.01).Patient with a high lesion level had lower FIM score.In the same lesion level group,FIM scores presented significant differences between the incomplete SCI patients and the complete ones(P<0.05～0.01).However,the lumbar lesion patients had no significant differences in FIM score between the complete group and the incomplete group(P>0.05).Conclusion FIM can objectively reflect the ADL level in SCI patients with different lesion level and completeness.

To study the dynamic changes of CT perfusion parameters during the first 12 h in the embolic cerebral ischemia models. Local cerebral ischemia model were established in 7 New Zealand white rabbits. All CT scans were performed with a GE Lightspeed 16 multislice CT. Following the baseline scan, further CT perfusion scans were performed at the same locations 20 min, 1-6 h and 8, 10 and 12 h after the embolus delivery. Maps of all parameters were obtained by CT perfusion software at each time point. The brains, taken 12 h after the scan, were sliced corresponding to the positions of the CT slices and stained by 2,3,5-triphenyltetrazolium chloride (TTC). On the basis of the TTC results, the ischemic sides were divided into 3 regions: core, penumbra and the relatively normal region. The changes of all parameters were then divided into 3 stages. In the first two hours (the first stage), the CBV dropped more remarkably in the core than in the penumbra but rose slightly in the relatively normal region while the CBF decreased and MTT, TTP extended in all regions to varying degrees. In the 2nd-5th h (the second stage), all the parameters fluctuated slightly around a certain level. In the 5th-12th h (the third stage), the CBV and CBF dropped, and MTT and TTP were prolonged or shortened slightly in the core and penumbra though much notably in the former while the CBV, CBF rose and MTT, TTP were shortened remarkably in the relatively normal region. We experimentally demonstrated that the location and extent of cerebral ischemia could be accurately assessed by CT perfusion imaging. The pathophysiology of the ischemia could be reflected by the CT perfusion to varying degrees.
Blood Flow Velocity ; Brain Ischemia/physiopathology ; Brain Ischemia/*radiography ; Cerebrovascular Circulation ; Stroke/physiopathology ; Tomography, X-Ray Computed

Objective To study the distribution and drug resistance of pathogens in neonatal septicemia in order to provide clinical guidance for antibiotic usage.Methods This retrospective study analyzed blood culture and clinical data from 83 confirmed neonatal septicemia patients and the blood collection cultures were analyzed.Results A total of 84 strains were isolated from 83 cases of blood specimens,Gram positive bacteria,Gram negative bacteria and fungi were 38(45.2%),41(48.8%),5(6.0%),respectively.Gram positive bacteria was mainly coagulase negative staphylococcus and staphylococcus aureus,which were 13(15.5%) and 8(9.5%) respectively.Gram negative bacteria was mainly Escherichia coli and Klebsiella pneumonia,which were 25(29.8%) and 9(10.7%) respectively.Gram positive bacteria were found high resistance to penicillin G,amoxicillin clavulanate potassium,oxacillin and clindamycin,from 34.2% to 73.7%,but they were sensitive to vancomycin,teicoplanin and linezolid.Gram negative bacteria were found high resistance to ampicillin(82.9%),the constituent ratio of the extended spectrum βlactamases(ESBLs) was 34.1%,carbapenem resistant strains was not found.All fungi were sensitive to azoles.Conclusion Gram negative bacteria are the major pathogens in neonatal septicemia,with high infection rate of Escherichia coli and high constituent ratio of the ESBLs,and antimicrobial agents should be chosen according to blood culture and antimicrobial susceptibility results.

BACKGROUND: Serious scalding leads to dysfunction of each aspect in immune system, and activated macrophage can secret many bioactive transmitters. The relationship between macrophage dysfunction and signal conduction after scalding is unclear at present.OBJECTIVE: To observe the alternation of tumor necrosis factor- alpha(TNF-α) at different time points after scalding and the activity of nuclear factor κB(NF-κB) and alternation of protein kinase C (PKC) after the application of specific modulator H-7 to explore whether PKC participates in the modulation of TNF-α in macrophage on signal conduction level for the clarification of some mechanisms of macrophage dysfunction.DESIGN: A randomized controlled experimental study by employing experimental animals as subjectsSETTING: An institute of burn research of a military medical university MATERIALS: The study was conducted in the Laboratory (state) of the Institute of Burn Research, Third Military Medical University of Chinese PLA between January and December 1999. Experimental animals were 32 healthy clean inbreeding Kunming white mice.METHODS: 15% Ⅲ scalding was created in mice for the establishment of routine scalding model. Mice were randomly divided into 6 groups according to different time points before or after scalding, I.e. 0(normal control group), 2, 6, 12, 24, or 48 hours group. Celiac macrophages were collected for the detection of TNF-α content by radioimmunoassay, NF-κB activity by electrophoretic mobility shift analysis (EMSA), and membrane or plasma PKC activity by isotope analysis.MAIN OUTCOME MEASURES: ① TNF-α content; ② NF-κB activity; ③Membrane or plasma PKC activity RESULTS: After scalding, macrophage excessively secreted TNF-α and reached its peak of (1 085.65 ± 122.99) ng/L at 12 hours, which was significantly higher than that of control group( t = 14.92, P ＜ 0.01 ).Compared with control group, membrane PKC activity increased after scalding, which significantly heightened to(231.80 ± 31.66) nmol/min · g at 2hours( t = 7. 930, P ＜ 0.01 ), slightly decreased to close to normal level of (174.29±16.80) nmol/min· gat 6hours(t=2.531, P ＜0.05), and rapidly elevated at 12 hours [512. 10 ±33.42) nmol/min · g] and 24 hours [ (454.70 ± 21.06) nmol/min · g] to reach its peak of(530.49 ± 28.54)nmol/min. G at 48 hours( t = 29.42, 28.03, 30. 19, P ＜ 0. 01 ). Correlation analysis of the alternation between TNF-α and membrane PKC indicated a significant positive correlation( r = 0. 796 4, P ＜ 0. 05) . As indicated by EMSA image, NF-κB activity significantly elevated after scalding. Twelve hours after scalding was set as modulation point, NF-κB activity was significantly inhibited by the application of H-7.CONCLUSION: The secretion of TNF-α and the activities of PKC and NF-κB are significantly activated in celiac macrophage after scalding, and PKC-NF-κB signal pathway participates in the modulation of TNF-α expression, which provide experimental data for the modulation of immune function and rehabilitative intervention during scalding.serious scalding.