OBJECTIVE:To observe thc usefulness of Utilin S in treatment of chronic obstructive pulmonary disease(COP- D). METHODS: In a random control design, trial group was given Utilin S 1. 72ug im, qw. on the basis of conventional treat- ment. Control group was given conventional treatment alone. RESLLTS: The clinical effect. symptom and immune indices of trial group were all better then those of control group. CONCLUSION: Utilin S, as a immunostimulant. has a good accessory therapcutic effect on COPD.

Objective To study the effect of surface electromyogram-triggered electrical stimulation on lower limb function in hemiplegic stroke patients. Methods Thirty hemiplegic stroke patients were divided into a treatment group ( 15 cases) and a control group ( 15 cases). Both groups were given conventional rehabilitation training.Additionally, the treatment group was given surface electromyogram-triggered electrical stimulation training, while the control group was given common low frequency electrical stimulation. Brunnstrom's recovery stages, the Fugl-Meyer assessment (FMA) and electromyographic parameters were assessed before and after 3 courses of treatment. Results After treatment both groups had significantly higher Brunnstrom and FMA scores and better integrated electromyograms(iEMG), but the effects in the treatment group were significantly better than in the control group. Conclusions Surface electromyogram-triggered electrical stimulation training can provide satisfactory rehabilitation of lower limb function in hemiplegic stroke patients.

Objective To investigate the cell morphology and immune phenotypic characteristics in Uygur and Han patients with myelodysplastic syndrome (MDS) in Xinjiang Uygur Autonomous Region.Methods Bone marrow smears of 67 cases diagnosed as MDS were systematicly observed and recorded,flow cytometry (FCM) was used to test the immunophenotyping.Results There were abnormal hematopoiesis in different extent in granulocyte series,erythron series and megakaryocytic series of all patients.Occurence of pathological hematopoietic performance in Uygur patients with MDS was similar to that in Han,granulocyte series [52 cases (77.6 ％)] ＞megakaryocytic series [44 cases (65.7 ％)] ＞ erythrocyte series [36 cases (53.7 ％)],the differences in two groups were not significant (x2 values 1.02,0.30,0.02,respectively,all P ＞ 0.05).The changes type of pathological hematopoietic performance in two groups were similar,single garden nuclear megakaryocyte [36 cases (53.7 ％)],false Pelger nuclear anomaly granulocyte [36 cases (53.7 ％)],erythroid gigantic young cell change [33 cases (49.3 ％)],granulocyte cell particles reduced or absent [27 cases (40.3 ％)] etc.The result of FCM showed that along with the progressive change of RA/RAS to RAEB/RAEB-t,the expression ratios of mature CD15 were decreased,while the expression ratios of early stage CD117 and CD34 were raised gradually (x2 values 6.23,12.06,8.95,7.37,8.95,8.08,respectively,all P ＜ 0.05),the differences in two groups were not significant (x2 values 0.715,0.024,0.146,respectively,all P ＞ 0.05).Meanwhile,Uygur patients with MDS has great expression of CD56 and Han had HLA-DR,there were significantly differences in two groups (x2 values 3.91 and 3.90,respectively,both P ＜ 0.05).Conclusion Occurence of pathological hematopoietic performance in Uygur patients with MDS are similar to that in Han.Most MDSs has two or more levels of pathological hematopoietic performance.The differences of immunophenotype characteristics in two groups are partially significant and test of immunophenotype are helpful in the diagnosis,classification,prognosis of MDS.

OBJECTIVE To study the aminoglycosides modifying enzyme genes and detect resistance of the Acinetobacter baumannii in burn unit.METHODS The susceptibility of the A.baumannii strains to 11 antibiotics were tested by K-B method.The aminoglycosides modifying enzyme genes were analyzed using polymerase chain reaction(PCR).RESULTS The resistance rate to antibacterials was as follows:to TZP 61.85%,SCF 23.69%,CAZ 64.48%,FEP 63.17%,IPM 63.17%,AK 56.58%,and to CIP 73.69%.In 76 strains of A.baumannii,48 strains(63.16%) were with aac(3)-Ⅰ,39(51.32%) with aac(6′)-Ⅰ,and 46(60.53%) with ant(3″)-Ⅰ,others were negative.The total test rate of aminoglycosides modifying enzyme gene was 63.16%.CONCLUSIONS There are not only multi-drug-resistance but also 63.16% aminoglycosides modifying enzyme genes of the A.baumannii isolated from burn unit.

Objective To analyze the characteristics of dysplasia in patients with myelodysplastic syndromes (MDS),and identify the risk factors for evolution of MDS to acute leukemia.Methods According to the WHO criterion 2008 of MDS,98 cases were included.As the characteristics of dysplasia,cell morphology,cytogenetics and flow cytometry were analyzed in these patients.Results To the last follow-up,27 of 98 patients transformed to acute myeloid leukemia,including M2 (15 cases),M4 (10 cases),M6 (2 cases).Patients with abnormal Pelger-Hu(e)t had significantly higher risk for evolution of MDS to leukemia,when compared to those without Pelger-Hu(e)t (23/67 vs 4/36,x2 =4.87,P =0.03).Auer corpuscle and small nuclear pathological were also the risk factors of developing to leukemia (19/37 vs 8/61,x2 =16.87,P =0.000; 21/57vs 6/46,x2 =9.14,P =0.003,respectively).37 patients died,the median suvival time was 26 months (95 ％ CI 13-38) for patients with abnorrnal Pelger-Hu(e)t,19 months (95 ％ CI 11-26) for patients with Auer corpuscle,13 months (95 ％ CI 6-19) for patients with small nuclear pathology,respectively (x2 =11.05,13.04,21.05,P =0.001,0.000,0.000).Conclusion Abnormal Pelger-Hu(e)t,Auer corpuscle and small nuclear pathology are indentified as the risk factors for evolution of MDS to leukemia,and they are the infavorable predictors of survival.

AIM:To investigate the immunomodulatory effect of astragalus saponin(AS)on macrophages and explore the mechanism of its immunomodulation.METHODS:By adding different concentrations of AS into cultured mouse peritoneal macrophages in vitro,the influence of AS on the synthesis of nitro oxide(NO)was detected by NO kit(enzymatic method).MTT assay was used to determine the cytotoxicity of macrophages induced by AS.The morphological changes of macrophages were observed under transmission electron microscope.LSCM and specificity fluorescent probe Fluo-3/AM were applied to observe the change of Ca2+ in macrophages induced by AS.RESULTS:AS significantly increased NO synthesis,enhanced the effects of mouse peritoneal macrophages on killing carcinoma cells.Cell surface projection exhibited multiplication,becoming thickening and growth longer via transmission electron microscope.Increase in intracellular Ca2+ in macrophages was also observed.CONCLUSION:AS enhances the immune function of macrophages by increasing NO synthesis and enhancing cytotoxicity.The increased intracellular Ca2+ may be the mechanism of immunomodulatory effect of AS.

Objective To understand the present situation of safety organizing and quality of nurse work life in pediatric intensive care unit(PICU),and to discuss the relationship between safety organizing and quality of nurse work life.Methods A total of 279 PICU nurses in eight hospitals in Zhejiang were selected by the safety organizing scale (SOS)and quality of nursing work life(QNWL).Results The score of SOS was (45.23 ±10.88)points,and the score of QNWL was (159.46 ±33.60)points.There was a positive correlation between safety organizing and quality of nurse work life(r =0.256,P <0.05).Conclusion The nurse managers should improve the level of quality of nurse work life by safety organizing.

Objective To explore the analgesic effect of ropivacaine combined with sufentanil in epidural anesthesia on walk on painless labor.Methods 134 cases of maternal pregnancy were selected and randomly divided into two groups.61 cases were treated with conventional delivery,73 cases in the experiment group were treated with walk on painless labor.The visual analogue scale and improved Bromage classification score were compared at the first stage of labor,the second stage of labor,the third stage of labor.Results Compared with the control group,the rate of cesarean section was higher(P<0.05),The visual analogue scale was higher at the first stage of labor,the second stage of labor,the third stage of labor,the duration of labor were lower at the first stage of labor,the second stage of labor,the third stage of labor(P<0.05),and there was no significant difference between the two groups in the motor nerve block.Conclusion Ambulatory labor analgesia on maternal effect significantly,can significantly reduce the pain degree of maternal birth process and deliverry time,postpartum less complications.

Objective To investigate the inducible ability of plasmid DNA carrying a RU486 regulatory system.Methotis Plasmid pRS22 containing RU486 regulatory system,liver specific promoter and transgene IL-12 was injected into mice by hydrodynamic injection.RU486 was injected intraperitoneally into mice at difierent time points after plasmid administration.The IL-12 1evel in serum was tested by an ELISA kit.The distribution and inducible expression of pRS22 in mice were assayed by measuring DNA,RNA and protein levels by PCR,RT-PCR and immunohistochemical staining.Resuits To determine the duration of the activity of plasmid pRS22,mice injected with 10μg of pRS22 were treated repeatedly with 250μg/kg of RU486 per 7 days after hydrodynamic injection of plasmid.IL-12 expression in serum abruptly increased to peak was detected at 10 h after induction and declined to baseline on day 6.Though peak values of IL-12 decreased gradually after each induction,IL-12 in serum could be induced until 15 weeks after plasmid administration.A total of 5μg of pRS22 was injected into mice to detect the effect of different induction manners on the IL-12 expression.The mice were treated with RU486 per day or per 2 days iil 6 days,respectively.The induction per 2 days resulted in a wavelike pattern of serum IL-12 expression with peak lev-els on the day of induction alternating with lower values on the following day.In contrast,sustained levels of IL-12 could be achieved by administering RU486 per day.Plasmid DNA and GLp65 mRNA were detected in liver of mice with or without RU486 until at least day 28 after plasmid administration.However,IL-12 p35 mRNA was detected only in the liver of mice with RU486 induction.IL-12 immunohistochemical staining in liver demonstrated that IL-1 2 expressed predominantly in the hepatocytes near the surface of liver or between the central vein and portal area after induction with RU486.In contrast,no IL-12 expression was observed in the hepatocytes after induction with sesame oil.Conclusion Tight temporal and spatial control of transgene IL-12 expression could be achieved by RU486 regulatory system driven by liver specific promoter.

Objective To explore the clinical features of drug hypersensitivity syndrome(DHS). Method Retrospective analysis of 18 cases of DHS was made in detail including clinical situation, laboratory examination, treatment instance,duration and prognosis. Results The earliest symptoms of all patients were skin rash and fever, which occurred in 2 to 8 weeks after the administration of the drugs, accompanied with superficial lymphadenopathy in 13 patients, liver dysfunction in 14 patients, renal impairment in 11 patients, leukocytosis in 13 patients and eosinophilia in 10 patients. The skin lesions were multiform. The common eruption was purpura-like erythemas, accompanied with swelling and repeated desquamation. The suspected drugs were as follows: allopurinol in 11 cases, carbamazepine in 4 cases, phenytoin in 2 cases and minocycline in 1 case. Corticosteroid was the first line of treatment Conclusions DHS is a clinical syndrome to have characteristic symptom and a relatively severe disease. It is crucial to discontinue the suspected drugs promptly and to start sufficient dose of corticosteroid.