Clinical epidemiological studies have shown that vitamin D deficiency is associated with infectious diseases, which is confirmed by recent studies implying the role of vitamin D as a key regulator of host defense against infections. Bioactive vitamin D triggers antimicrobial pathways against pathogens in mucous membrane and cells of the human innate immune system. In addition, vitamin D also attenuates excessive inflammation and acquired immunity, and thus limits collateral tissue damage. The observed effects of vitamin D on infectious diseases, particularly airway infections, should be addressed in the management of viral infections. Findings from cross-sectional studies should be confirmed by prospective research. In this review, we summarize the current knowledge regarding the effect of vitamin D on innate and acquired host defense against infections.

Objective To study the relationship between serum C-reactive protein(CRP)levels and insulin resistance(IR)in patients with hyperglycemia and obesity.Methods Fasting plasma glucose(FPG),2h plasma glucose(2hPG),fasting insulin(INS),patient height and weight were measured.Body mass index(BMI)and Homa insulin resistance index(Homa-IR)were calculated.Based on BMI and PG,the participants were divided into 4 groups:normal control group(30 cases),simple obesity group(30 cases),impaired glucose regulation(IGR)obesity group(30 cases)and type 2 diabetic obese group(30 cases).Serum C-reactive protein levels were measured with immunoturbimetric assay.Results(1)CRP and the Homa-IR in other groups were significantly increased comparing with normal control group,with statistical difference observed(P

To evaluate the curative effect of antisense telomerase ODN on malignant glioma cells. The activity of telomerase in 16 fresh malignant gliomas was detected positive by PCR ELISA method. After covered with lipofectin, the 5?mol/L telomerase ODN was incubated with cultured gliomas cells. PCNA, TUNEL positive rate and the phase of cell cycle were detected by FcM per 24h. The results showed: Anti sense ODN inhibited telomerase activity after being applied for 48 hours, and inhibition was complete at 72 hours, The ODN inhibited proliferation of malignant gliomas and promoted their apoptosis markedly at 72 hours. After 96 hours, most transfected glioma cells were stopped to grow at G 2/M phase, and the number of apoptosis cells increased as time went on. The results suggested that anti sense telomerase ODN could inhibit the telomerase activity, and in turn promote aptoptosis of glioma cells and inhibit the growth of the tumor.

Objective Comparing the rejection status between different sources of kidney and immunosuppressive therapy of renal transplantation,to find the effective monitoring of rejection.Methods Retrospective analysis of medical records.Results There was no statistical difference in the rejection rates of kidney transplantation after 1 year between different sources of kidney and immunosuppressive therapy(P>0.05).Blood pressure and body temperature can effectively monitor rejection.Conclusion To reduce the rejection rates of kidney transplantation,a good monitoring and nursing are necessary.

Objective To investigate the clinical effect of forced-air warming system combined with infusion heating technology on recovery quality and cellular immune.Methods Fifty patients scheduled for esophagus cancer resection randomized into two groups (n =25 each):the temperature protection group (group W)and the control group (group C).The intraoperative nasopharyngeal temperature was recorded before induction (T1 ),2 hours after operation (T2 ),the end of operation (T3 ),postoperative 2 hours (T4 ).The anesthesia wakening time,the occurrence of postoperative shivering and infection,hospitalization time were also recorded.Venous blood samples were taken at T1 ,T3 ,two days (T5 )and five days after the operation (T6 )for analysis of T-lymphocyte subsets by flow cytometry.Results Compared with T1 ,the nasopharyngeal temperature was significantly de-creased at T2 ,T3 and T4 in group C, and the nasopharyngeal temperature in group W was significantly higher than those in group C at T2 ,T3 and T4 (P <0.05).The anesthesia wakening time and the occurrence of postoperative shivering in group C was significantly more than those in group C (P <0.05).Compared with T1 ,the percentage of CD4 + cells and CD4 +/CD8 + ratio were significantly decreased and the percentage of CD8 + cells increased in both groups at T3 (P <0.05).Compared with group C at T3 ,the percentage of CD4 + cells and CD4 +/CD8 + ratio were significantly increased and the percentage of CD8 + cells decreased in group W (P <0.05).Conclusion The clinical use of forced-air warming system combined with infusion heating technology can protect the patient??s body tempera-ture,shorten the anesthesia wakening time,reduce the occurrence of postoperative shivering,which protects the patient??s immune function and accelerates recovery after surgery.

Objective To investigate the clinical efficacy of ultrasound-guided and nerve stimu-lator-guided modified fascia iliaca compartment block combined with popliteal fossa sciatic nerve block in patients undergoing unilateral great saphenous varicose veins surgery.Methods Sixty patients, male 32 and female 28,aged 42-76 years,ASA Ⅰor Ⅱ,scheduled for unilateral great saphenous var-icose veins surgery were randomly divided into two groups (n =30 each):modified fascia iliaca com-partment block with popliteal fossa sciatic nerve block group(group N)and epidural anesthesia(group E).Firstly,popliteal fossa sciatic nerve block was performed in group N.Then confirmed iliac fascia and femoral nerve position on the ultrasonic image and the femoral nerve was blocked.The 1% lido-caine 10 milliliters and 0.5% ropivacaine 10 milliliters were injected in the fascia iliaca compartment block from medial border of sartorius to upward site of femoral artery.Meanwhile,the ultrasonic probe was moving inside in the level of inguinal ligament.The SBP,DBP and HR were recorded be-fore block(T0 ),10(T1 ),30(T2 )and 60 minutes(T3 )after block.The block working time and onset time of sensory block,use of ephedrine after anesthesia,anesthesia efficacy and the postoperative ad-verse reactions in the last 48 hours ,including nausea,vomiting,headache and urinary retention, were also recorded.Results Compared with T0 ,the SBP and DBP was significantly decreased at T2 in group E(P <0.05).Compared with group E at the same time,the SBP and DBP was significantly higher at T2 in group N(P <0.05).The onset time of sensory block was significantly shortened and the use of ephedrine after anesthesia was also less in group N(P <0.05 ).Group E was better than group N in the whole anesthesia efficacy (P <0.05),but there was no significant difference in the ex-cellent rate of anesthesia efficacy between the two groups.The incidence of postoperative urinary re-tention was significantly decreased in group N(P <0.05)and there was no significant difference of the rate of nausea,vomiting and headache.Conclusion Modified fascia iliaca compartment block with popliteal fossa sciatic nerve block has excellent anesthetic quality in patients undergoing unilateral great saphenous varicose veins surgery,which ensures more stable hemodynamics less side effects and more indications when compared with epidural anesthesia.

Objective To know the cognition,attitude and needs among middle-aged andaged women with urinary incontinence(UI) in communities. Methods A questionnaire survey wasconducted in 66 middle-aged and aged women with UI in two communities and the results were an-alyzed. Results Most patients lacked the knowledge of UI;UI had impact on their physical andmental heahh.Must patients wished to know about the treatment knowledge,and health education of med-ical staff was the most promising way.The mastering degree of knowledge about disease was not related tothe serious degree of disease and age,but was positively related to education degree and economic income.Conclusions We should publicize the knowledge about UI and provide health education and emotionalsupport to patients.And we should emphasize the training about UI among medical staff.

Objective To investigate the effects of multimodal analgesia of parecoxib and fentanyl on perioperative immune functions in patients of hepatocellular carcinoma (HCC).Methods Eighty HCC patients scheduled for hepatectomy were randomly divided into two groups:parecoxib sodium combined with fentanyl group (group P,40 cases) and fentanyl group (group C,40 cases).The percentages of CD3 +,CD4+,CD8+,CD4+/CD8+ T cells,CD3-CD16+ CD56+ (NK),interleukin-4 (IL-4),interferon-γ (IFN-γ) and the ratio of IFN-γ/IL-4 were detected at the following time points:30 minutes before induction of anesthesia (T0),at the end of the surgery (T1),24 h after surgery (T2) and 72 h after surgery (T3).The analgesic effects were estimated by visual analogue scale (VAS) after surgery.Total fentanyl consumption and adverse effects were also recorded.Results The percentages of CD3 + T cells were significantly lower in group C than that in group P at T2 (t =2.155,P ＜0.05).The percentages of NK in group P were recovered nearly to baseline (T0) at T2,which was higher than that of group C (t =2.791,P ＜0.05).In group C,the percentages of CD3 + T cells and NK has not recovered to baseline at T3 (respectively t =3.065,3.231,P ＜ 0.05).In group P,IL-4 serum levels were significantly lower than those in group C,while IFN-γ serum levels were significantly higher than those in group C at T2 (respectively t =2.173,2.100,P ＜0.05).From T2 to T3,the ratio of IFN-γ/IL-4 significantly increased in group P than those in group C (respectively t =3.259,2.203,P ＜ 0.05).VAS scores at rest and on cough in group P were significantly lower than those in group C at 2 h,6 h,12 h and 24 h after operation (respectively t =8.661,9.726,9.147,7.109,P＜0.05;t =8.569,9.614,9.144,8.509,P＜0.05).The total fentanyl consumption in group P was lower than that in group C (t =2.636,P ＜ 0.05).There were no significant differences regarding the incidence of adverse effects between the two groups.Conclusions Perioperative multimodal analgesia of parecoxib sodium combined with fentanyl enhances the analgesic efficacy,and reduces the dosage of opioid consumption,helps recover the cell immunity function of HCC patients after hepatectomy.

Objective To evaluate the effects of flurbiprofen axetil administered at different time points on oxygenation in the patients undergoing one-lung ventilation (OLV).Methods Ninety patients of both sexes,aged 45-64 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective thoracoscope-assisted pulmonary lobectomy,were assigned into 3 groups (n =30 each) using a random number table:control group (group C),preoperative administration group (group F1) and intraoperative administration group (group F2).Flurbiprofen axetil (10 mg/ml) and fat emulsion 10 ml were injected intravenously at 15 min before operation in F1 and C groups,respectively.Flurbiprofen axetil 10 ml was intravenously injected immediately after the beginning of OLV in group F2.At 15 min before operation (T1),15 and 30 min of OLV (T2,3),and 15 min after restoration of two-lung ventilation (T4),airway peak pressure (Ppeak) and dynamic lung compliance (Cdyn) were recorded,arterial blood samples were collected for blood gas analysis.The arterial oxygen partial pressure (PaO2) was recorded,and the oxygenation index (OI) and intrapulmonary shunt (Qs/Qt) were calculated.The concentrations of thromboxane B2 (TXB2) and 6-keto-prostaglandin F1α (6-K-PGF1α) in serum were measured by enzyme-linked immunosorbent assay,and TXB2/6-K-PGF1α ratio was calculated.The development of interrupting OLV due to SpO2＜90％ and postoperative dyspnea,pulmonary infection,atelectasis and length of hospital stay were recorded.Results Compared with group C,PaO2 and OI were significantly increased,and Qs/Qt was decreased at T2,3,the serum concentrations of TXB2 and 6-K-PGF1α were decreased,and TXB2/6-K-PGF1α ratio was increased at T2-4,the incidence of interrupting OLV was decreased (P＜0.05),and no significant change was found in the parameters mentioned above in group F2 (P＞0.05).Compared with group F1,PaO2 and OI were significantly decreased at T2,3,Qs/Qt was increased at T2,and the serum concentrations of TXB2 and 6-K-PGF1α were increased,and TXB2/6-K-PGF1α ratio was decreased at T2-4 in group F2 (P＜0.05).There was no significant difference in the incidence of postoperative dyspnea,pulmonary infection and atelectasis and length of hospital stay between the three groups (P＞0.05).Conclusion Flurbiprofen axetil injected at 15 min before operation can significantly improve oxygenation and prevent the development of hyoxemia in the patients undergoing OLV,however,flurbiprofen axetil administered immediately after the beginning of OLV has no such effect.