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.

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

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 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 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 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.

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.

BACKGROUND: Severe scald injury leads to a variety of disorders in the immune system. Activated macrophages are known to secrete many kinds of biologically active transmitter, but the relation between the functional disorder of the macrophages and signal transduction after burn injury has not been fully understood.OBJECTIVE: To observe the changes in nuclear factor(NF) -κκB activity and expressions of IκκB-α and tumor necrosis factor(TNF) -α in peritoneal macrophage of mice at different time points after severe scald injury and after the application of specific NF-κκB inhibitor pyrrolidine dithiocarbamate (PDTC), thereby to explore the mechanism of macrophage dysfunction in light of signal transduction.DESIGN: A randomized controlled experimental research.SETTING: State Key Laboratory of Trauma, Burn and Combined Injury.MATERIALS: The experiment was carried out in the State Key Laboratory of Institute of Burn Research, Third Military Medical University during the period from January to June, 1999, using 30 healthy clean-grade Kunming mice of inbred strain.INTERVENTIONS: Common scald injury models(with third degree burn of 15% total body surface area) were established in the mice, which were randomized into 6 groups according to different time points after the injury for observation, namely 0 hour(normal control group) and postburn 2, 6, 12,24 and 48 hours. Peritoneal macrophages were collected at these time points for examining TNF-α content using radio-immunoassay and NF-κκB activity by means of electrophoretic mobility shift assay(EMSA). The expressions of IκκB-α and TNF-α mRNA were determined by immunoblotting method and reverse transcription-PCR, respectively.MAIN OUTCOME MEASURES:Examinations of ① the content of TNF-α, ② NF-κκB activity,③ expression of IκB-α, and ④ expression of TNF-α mRNA.RESULTS: Macrophage secretion of TNF-α was enhanced postburn, reaching the peak level at 12 hours[(1085.65 ± 122.99) ng/L], which was significantly higher than that in the normal control group( t = 14.92, P ＜ 0.01) .Postburn NF-κκB activity significantly increased after the injury, peaking at 2 hours[ (56. 8 ± 7.3)RDU], which occurred much earlier than the peak of TNF-α secretion( t=13. 31, P ＜ 0.01 ). Compared with that in the normal control group, IκB-α expression decreased significantly 2 hours postburn ( t =4. 23, P ＜ 0. 01) to 0. 632 ±0. 086, followed by gradual increase to the peak level to 1. 161 ± 0. 097 24 hours after the burn injury( t = 7.06, P＜ 0. 01) and then by slight decrease to 1. 149 ±0. 167 till 48 hours(t = 4. 82, P ＜ 0.01) . Twelve hours after injury was the time point for intervention with PDTC application, when NF-κκB activity and TNF-α mRNA expression both decreased significantly( P ＜ 0.01 ).CONCLUSION: NF-κB activity and TNF-αmRNA expression decrease significantly after severe scald. At high levels, IκB-α and NF-κκB maintain an interaction for their restriction. After burn injury, NF-κκB signal transduction pathway is involved in the modulation of TNF-α expression in mouse peritoneal macrophage.

Cerebral hemodynamic changes are an important pathophysiologic process for the occurrence and development of Moyamoya disease. Cerebral hemodynamic changes of Moyamoya disease have been a research focus. This article mainly reviews the cerebral hemodynamic parameters and detecting methods, characteristics of cerebral hemodynamic changes in patients with Moyamoya disease and their new progress.