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 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 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 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.

Objective To explore the application effect of ICU checklist of medical cooperation on prevention of ventilator-associated pneumonia. Methods Totally 728 patients with mechanical ventilation from July 2015 to July 2016 in ICU were assigned to the experimental group with using of the checklist; and 685 patients with mechanical ventilation from June 2014 to June 2015 were set as the control group who did not use the checklist. The incidence of ventilator-associated pneumonia and medical cooperation were compared before and after the implementation of the checklist. Results The incidence of ventilator associated pneumonia were 6.72% (46/685) and 3.02% (22/728), the intervention strategy execution rates were 63.36% (434/685) and 84.89% (618/728) before and after the application of checklist, there was significant difference between two groups (χ2=10.51, 86.03, P<0.01). Medical cooperation (doctors and nurses) and satisfaction scored 18.53 ± 2.39, 21.91 ± 2.16, 30.93 ± 2.18 and 26.71 ± 2.21, 28.64 ± 2.55, 45.33 ± 1.74 before and after the application of checklist, there was significant difference between two groups (t=6.14, 14.25, 2.39, P<0.01 or 0.05). Conclusions The application of checklist can improve the medical cooperation on prevention of ventilator-associated pneumonia management, reduce the incidence of ventilator-associated pneumonia, improve medical cooperation, nursing satisfaction and the management efficiency, which is worthy of popularization and application.

Objective To study the values of MR total spine mobitrack(MTSM) technique in acute spinal trauma and spinal cord injury.Methods 71 patients with trauma in cervical vertebra,thoracic vertebra and lumber vertebra underwent MTSM scan.Results All 71cases obtained clear images of total spine and spinal cord,of which,2 cases were normal,69 cases showed fractures of vertebrae(including 36 cases showed fracture of single vertebrae,33 cases showed fractures of multiple vertebraes).69 cases with fracture of vertebrae,accompanied with 12 articles of vertebral body slippage,the 15 segments of spinal cord injury and the 19 places of the ligaments bruise.Conclusion MTSM technique is good to show the location and quantity of vertebral trauma and will greatly improve the diagnostic accuracy.

OBJECTIVE:To evaluate the economic value of Shenqi fuzheng injection combined with chemotherapy vs. chemo-therapy alone for non-small lung cancer(NSCLC),and to provide reference for drug payment and clinical treatment. METHODS:By prospective cohort design,516 patients with non-small cell lung cancer from 11 hospitals were selected as subjects according to the sale distribution of Shenqi fuzheng injection in district and hospital;267 cases of Shenqi fuzheng injection combined with che-motherapy and 249 cases of chemotherapy alone formed naturally according the clinical therapy plan. The cost-effectiveness and cost-utility analysis were conducted using FACT-L score,KPS score and ZPS score as effect index,QALYs as effectiveness index observation period of 21 d. RESULTS:5 dimensions FACT-L score:the patients of Shenqi fuzheng injection combined with chemo-therapy group could be effectively improved,and the cost-effectiveness ratio was lower than chemotherapy alone group;KPS score:the cost-effectiveness ratio of Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone group (1 632.44 vs. 11 145.30),and incremental cost-effectiveness ratio was 448.69. ZPS score:Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone(-17 398.77 vs. 384 513.00). Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone group in average cost per 1 QALYs(1 313 326 yuan vs. 13 374 365 yuan). CONCLUSIONS:Compared with chemotherapy alone group,Shenqi fuzheng injection combined with chemo-therapy can effectively improve the quality of life,and it is worth of spending more money on Shenqi fuzheng injection from the perspective of the pharmacoeconomics.