Sepsis is essentially a result from immunological dissonance provoked by severe insults such as fulminant infection,severe trauma and extensive burns.It originates from excessive inflammatory responses and develops into immune paralysis or immunosupression.It has been demonstrated that cellular immune response plays a vital role in the pathogenesis of sepsis.In the stage of excessive inflammation,several kinds of immune cells are activated by pathogen-associated molecular patterns (PAMPs) or damage-associated molecular patterns (DAMPs) and subsequently produce a vast number of pro-inflammatory cytokines,while during the stage of immune paralysis,excessive apoptosis could result in decrease of immune cells with functional compromise.Inhibitory or regulatory immune cell subsets eventually dominate the direction of immune response and the production of inhibitory cytokines is enhanced.For clinical practice,surveillance of changes and shift in overall immune function is a basis for immunotherapy,especially to immunomodulation therapy.However,there is still a lack of adequate indexes or markers for integral evaluation of host immune state in the development of sepsis.

Objective To study the relationship between Epstein-Barr virus(EBV) and Hapatocellular carcinoma (HCC). Methods Polymerase chain reaction (PCR) and immunohistochemical staining were applied to detect EBV in paraffin tissue sections from 78 HCC patients. Results EBV DNA was detected in 22 patients (28 2%) by PCR. Immunohistochemical staining of EBV LMP1 revealed that the positive signals were mainly localized in the tumor cells. Conclusions These observations suggest that EBV may pay a role in the development of HCC.

To observe the effect and its potential mechanism of monoclonal antibody to tumor necrosis factor-alpha(TNF? MoAb)on systemic hemodynamics and survival rate after intestinal ischemia/reperfusion (Ⅱ/R). Method: SD rats were subjected to 75 rain of superior mesenteric artery occlusion followed by 6 hours of reperfusion. The animals were treated intravenously with either TNF? MoAb(20mg/kg)or the control protein(albumin, 20mg/kg) 30 min prior to the onset of ischemia. Result: Pretreatment with TNF? MoAb significantly attenuated the decrease in blood pressure and cardiac index compared to controls throughout the 6-hour period of observation(P

Objective:To investigate the risk factors for refeeding syndrome (RFS) in patients with severe stroke.Methods:Patients with stroke admitted to the Neuro Intensive Care Unit, Nanfang Hospital, Southern Medical University and received enteral nutrition support >72 h from January 2013 to July 2019 were enrolled retrospectively. RFS was defined as a new onset of hypophosphatemia within 72 h after the start of nutritional support, that is, blood phosphorus <0.65 mmol/L and a decrease of >0.16 mmol/L from the baseline value. The independent risk factors for RFS were identified by multivariate logistic regression model. Results:A total of 209 patients with severe stroke were included, with a median age of 65 years (interquartile range [ IQR] 53 to 72 years), and 154 were males (73.7%); 136 patients had cerebral infarction (65.1%), 73 had intracerebral hemorrhage (34.9%). The baseline median National Institutes of Health Stroke Scale (NIHSS) score was 15 ( IQR, 11-20), the median Glasgow Coma Scale score was 9 ( IQR, 6-12), the median Acute Physiology and Chronic Health Score was 16 ( IQR, 11-20), the median Nutrition Risk in Critically Ill (NUTRIC) score was 3 ( IQR 2-5), and the median Sequential Organ Failure Assessment (SOFA) score was 4 ( IQR, 3-6); the baseline median serum phosphorus was 1.05 mmol/L ( IQR, 0.90-1.19 mmol/L). A total of 34 patients (16.3%) developed RFS. Multivariate logistic regression analysis showed that male (odds ratio 3.565, 95% confidence interval 1.150-11.053; P=0.028) and patients with higher SOFA score (odds ratio 1.246, 95% confidence interval 1.077-1.442; P=0.032) were more likely to develop RFS. Conclusions:RFS is not rare in patients with severe stroke. Males and patients with severe disease are more likely to develop RFS.

Objective To investigate the risk factors for hospital-acquired pneumonia (HAP) in a neurological intensive care unit (NICU).Methods The patients aged ≥ 18 years admitted in NICU of Nanfang Hospital for ≥ 48 hours from May 2010 to April 2011 were enrolled.The possible risk factors,including the general information,the worst Glasgow Coma Scale (GCS) score,as well as Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ scores within 24 hours in NICU,whether the occurrence of HAP,whether with some underlying disease or symptoms within the time of study and using specific drug therapy or invasive procedures were investigated retrospectively.The duration of continuous medical interventions was recorded at the same time,and the continuous variables were quantified and stratified.Results A total of 243 patients were enrolled,and 50 (20.6％) of them developed HAP.Univariate analysis showed that the proportions of coma (44.0％ vs.29.0％ ;x2 =4.091,P =0.043) and APACHE Ⅱ score ≥ 15 (60.0％ vs.38.9％ ;x2 =7.232,P =0.007) in the HAP group were significantly higher than those in the non-HAP group.There were significant differences in using antacids (＜ 6 d: 38.0％ vs.19.7％ ; ≥ 6 d: 18.0％ vs.25.9％ ; x2 =7.521,P =0.023),sedatives (＜2 d: 30.0％ vs.37.3％ ; ≥2 d: 46.0％ vs.28.0％ ;x2 =6.064,P =0.048),blood products (＜3 d: 24.0％ vs.9.8％ ; ≥ 3 d: 6.0％ vs.7.3％ ; x2 =7.150,P =0.028),endotracheal intubation (＜ 5 d:24.0％ vs.10.9％ ; ≥ 5d: 26.0％ vs.15.5％ ; x2 =10.698,P =0.005),mechanical ventilation (＜ 4 d:6.0％ vs.7.8％ ; ≥ 4 d: 30.0％ vs.7.8％ ; x2=,P =0.000) and indwelling nasogastric tube (＜ 7 d:56.0％vs.37.3％ ; ≥7d: 42.0％ vs.44.6％ ;x2 =10.410,P =0.005) between the two groups.Multivariate logistic regression analysis showed that mechanical ventilation ≥ 4 d (odds ratio [OR] 6.481,95％ confidence interval [CI] 2.522-16.654; P=0.000),indwelling nasogastric tube ＜7 d (OR 12.504,95％ CI 1.614-96.869; P =0.016) and using antacids ＜ 6 d (OR 2.271,95％ CI 1.042-4.949; P =0.039) were the independent risk factors for HAP in NICU patients.Conclusions Mechanical ventilation,indwelling nasogastric tube and using antacids are the independent risk factors for HAP in NICU patients,and thus it needs to take targeted measures.

0.05),and the levels of Fib and D-dimer were obviously higher but AT-Ⅲ was obviously lower in 2 NS groups than those in normal control group(P

The effects of different vitamin E(VE) containing diets on lipid peroxi-dation and the degree of liver damage in rats were observed in the model of liver necrosis induced by galactosamine(D-GAL).The results were as follows: After 8 weeks, the basic levels of VE in plasma and liver tissue of the group fed VE-supplemented diet were significantly higher than that of the group fed normal VE diet, in the company with a significant lower basic plasma MDA level. At each time interval after D-GAL injection, the plasma and liver VE levels were found higher in the VE-supplemented group, and the content of GSH as well as the activities of SOD, GSH-Px, HPT were maintained satisfactorily while the MDA content and OCT, m-AST activities were very significantly lowered and the pathological changes of the liver were not so severe as compared with that in the normal VE diet group. It was noteworthy that the changes of almost all the parameters metioned above in the group fed VE-deficient diet went to an opposite direction to the VE-supplemented group. The results indicated that the VE-supplemented diet has a good liver protective effect, which may be established on the increased VE content and suppressed lipid peroxidation in the liver. VE-deficient diet could sharply reduce the VE content in the body and significantly intensify the susceptibility of liver to the harmful agents.

Objective: To study the effects of chromium on glucose and lipid metabolism and gene expression in diabetic rats.Methods: Male Wistar rats were assigned to three groups:normal control(NC), alloxan-induced diabetic control group(DM), and DM with chromium supplementation group(DM+Cr). Cr 200 ?g/(kg bw?d) was supplemented orally for 60 days. At the end of the treatment, the blood glucose, lipid and serum insulin were measured, and the changes in gene expression among three groups were studied by mRNA differential display technique.Results: Blood glucose in DM+Cr group decreased significantly than that before experiment. The levels of serum TG, TC, LDL-C and AI in DM+Cr group were lower than those of DM group, while the serum HDL-C levels were higher. Serum insulin was not improved obviously in DM+Cr group. 11 cDNA fragments larger than 400 bp expressed differences in skeletal muscles between DM+Cr group and DM group and were isolated, 4 of which expressed higher in DM+Cr group, while the rest expressed higher in DM group.Conclusion: Chromium supplementation could partially improve the disorders of glucose and lipid metabolism, and have an impact on some gene expression in diabetic rats, which may contribute to the regulating effects on its disorders of metabolism.

Objective To compare the characteristics and differences of the activation of the brain regions between the digital memory span task and digital working memory task.Methods 12 right-handed volunteers participated in a test of 7-digit memory span and a test of 2-digit working memory respectively, while the functional MR imaging (fMRI) data were recorded by a Seimens 1.5 T MR machine. Two control tasks were performed respectively and stimulation paradigms was block-design. SPM 99 was used to analyze the data and to localize the activated brain regions.Results The Brodmann area (BA) 6, 9 and 47 regions in the frontal lobe, the BA 7 and 40 regions in the parietal lobe, the cingulate gyrus, the hippocampus structures, the striatum and the cerebellum were activated by both tasks in comparison to their control tasks. Bilateral BA 18 and 19 regions of the occipital lobe without hemisphere predominance were the most activated regions by the digital memory span task, and the BA 37 region of the temporal lobe was also activated. However, the frontal lobe with left predominance was the most activated region by the digital working memory.Conclusion Different brain regions play distinct roles in different short-term digital memory tasks, and might be involved in different stages. The fMRI is a good tool for exploring the process of digits in the brain.

Objective To evaluate the pathogenesis and disease progression by detecting the expression of Serum High mobility group protein 1 (HMGB1) and TLR2 in monocytes of patients with systemic lupus erythematosus (SLE).Methods Forty patients with SLE were selected randomly,20 patients were in active disease group and others were in stable disease group.The expression of HMGB1 in the serum of these cases were detected by enzyme linked immunosorbent assay (ELISA) and TLR2 on CD14+ monocytes in the peripheral blood were detected by FCM.The correlation between these indexes and clinical,laboratory indexes about SLE were analyzed using one-way ANOVA,and Kruskal-Wallis test.Results The expression levels of HMGB-1 in serum was [(48.9±11.3) μg/L] in the active group,while that was [(14.8±1.9) μg/L] in the stable group was,and [(13.5±3.6) μg/L] in the control group.HMGB1 in the active SLE group was significantly higher (P＜0.05) when compared with that of the stable and control group.The expression of TLR2 in the peripheral blood mononuclear cells was [(96.7±1.3)％] in the active group,[(83.5±9.1)％] in the stable group,and [(83.3±9.9)％] in the control group TLR2 in the active SLE group was up-regulated when compared with the stable and control groups (P＞0.05).There were positive correlation between the serum levels of HMGB1and TLR2 in the peripheral blood mononuclear cells (r=0.551,P＜0.05).Conclusion The expression levels of HMGB-1 in serum and the expression of TLR2 in peripheral blood mononuclear cells may participate in the pathological processes of SLE.