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 efficacy and adverse effects of methotrexate(MTX) and Bacille Calmette Guerin-polysaccharide nucleic acid(BCG-PSN) in the treatment of steroid dependent asthma.Methods Sixty-eight patients with steroid dependent asthma were divided into therapy group and control group.The patients in therapy group were treated with MTX and BCG-PSN,while the control group was given only MTX.The dose of oral steroid daily,symptom scores,peak flow rates(PEF) and expiratory volume in one second(FEV1) were monitored.Results Compared with before treatment,daily steroid dosage and symptom scores of two groups significantly decreased(P0.05),while PEF and FEV1 significantly increased in therapy group(P0.05).Conclusion The combined use of MTX and BCG-PSN may be more beneficial than the single use of MTX for the treatment of steroid-dependent asthma.

Objective To investigate changes of CD~+_4CD~+_ 25 regulatory T cells (CD~+_4CD~+_ 25 Treg) and forkhead/winged helix transcription factor(Foxp3) mRNA in peripheral blood mononuclear cells (PBMCs) from patients with asthma, so as to elucidate the possible roles of CD~+_4CD~+_ 25 Treg in the development of asthma. Methods The peripheral blood samples were collected from 29 healthy controls (normal control group) and 78 patients with asthma which included 30 patients in exacerbation group, 25 patients in persistent group, and 23 patients in remission group. By using flow cytometry and RT-PCR, the CD~+_4CD~+_ 25 Treg ratio and Foxp3 mRNA in PBMCs were detected. Results The CD~+_4CD~+_ 25 Treg ratio and Foxp3 mRNA in PBMCs of exacerbation and persistent group were lower than that of remission group and normal control group (P0.05). Compared with persistent group, exacerbation group had lower CD~+_4CD~+_ 25 Treg ratio and Foxp3 mRNA (P

The changes of CD4(+)CD25(+) regulatory T cells (CD4(+)CD25(+) Treg) and Foxp3 mRNA in peripheral blood mononuclear cells (PBMCs) from patients with asthma were investigated in order to elucidate the possible roles of CD4(+)CD25(+) Treg in the development of asthma. The peripheral blood samples were collected from 29 healthy controls (normal control group) and 78 patients with asthma which included 30 patients in exacerbation group, 25 patients in persistent group, and 23 patients in remission group. By using flow cytometry and RT-PCR, the CD4(+)CD25(+) Treg ratio and Foxp3 mRNA in PBMCs were detected. The CD4(+)CD25(+) Treg ratio and Foxp3 mRNA in PBMCs of exacerbation and persistent groups were lower than that of remission and normal control group (P<0.05). Although the CD4(+)CD25(+) Treg ratio and Foxp3 mRNA of remission group also lower than that of normal control group, there was no significant difference between them (P>0.05). As compared with persistent group, exacerbation group had lower CD4(+)CD25(+) Treg ratio and Foxp3 mRNA (P<0.05). It was indicated that the decrease of CD4(+)CD25(+) Treg ratio and its function in PBMCs may be responsible for pathogenesis of asthma.

Objective To explore ICSI treatment process in the different proportion of oocytes maturation and dosage of gonadotropin affecting embryo quality and clinical outcome. Methods From Jan. to Dec. 2015,we retrospectively analyzed the patients from the center line of ICSI cycle ,divided them into three groups according to the maturity of oocytes. The 3 groups were due to maturity rate of oocytes in 50% in group A(n = 19),50% 0.05). Group A had the best egg rate,high quality embryo rate,clinical pregnancy rate than the other two groups (P < 0.05). In pregnancy and non-pregnancy groups ,the dosage of gonadotropin in the non-pregnancy group was obviously higher than that in the pregnancy group in oocyte maturation in the same proportion interval(P<0.05). Conclusion In ICSI treatment process,the high dose of gonadotropin and rising rates of oocytes maturation are not conducive to the development potential of the egg and clinical outcome,so the dose of gonadotropin and oocyte maturation ratio should be controlled in a certain range to collect and protect the best dominant egg which matches to the state of the patient.

This paper designed an index for the differences in medical service prices and this index therein named the Hospital Price Difference Index ( HPDI) which is used as a quantitative tool for evaluation. During evalua-tion, the paper measured the levels of prices and the factors of influence in 18 public hospitals listed in the Sichuan Province. The results showed that the effect of regulating the levels of prices was reasonable and effective, but was sig-nificantly affected by the internal and external factors. The internal factors have been found to be the medical and clini-cal technologies, and the grade and scale acted as external ones. This paper suggested that the price department should pay more attention on the levels of prices, and hence made a reasonable reform project for the prices by taking the scale of adjustment of prices into account.

Objective To investigate the alterations of regional spontaneous activity in patients with classical trigeminal neuralgia (CTN) during resting state.Methods Twenty-seven patients with CTN (CTN group) and 27 healthy subjects (control group) were recruited and underwent a rest-state functional MRI.The regional homogeneity (ReHo) analysis was used to compare the differences of regional synchronization of spontaneous brain activity.And correlation tests were performed between ReHo values in the abnormal brain areas and clinical metrics (visual analogue scale and disease duration) of the disease.Results Compared with control group (P＜0.05,Gaussian random field correction),ReHo increased in bilateral primary somatosensory cortex (S1) and primary motor cortex (M1),right supplementary motor area (SMA),inferotemporal cortex and cerebellum,left thalamus,limbic lobe,parahippocampa gyrus,middle and superior temporal gyrus in CTN group;ReHo decreased in bilateral insula,prefrontal cortex and orbitofrontal cortex,right frontal medial cortex and superior temporal gyrus,left anterior cingulate area,supramarginal gyrus and cerebellum in CTN group.ReHo values in right frontal medial cortex was negatively correlated with the course of disease (r=-0.45,P=0.03).The ReHo values of left primary sensorimotor cortex were positively correlated with the visual analogue scale scores (r=0.46,P=0.02).Conclusion CTN patients has abnormal functional homogeneity of spontaneous brain activity in regions involved in the pain processing,which can help understanding mechanism of CTN.

The changes of CD4+CD25+ regulatory T cells (CD4+CD25+ Treg) and Foxp3 mRNA in peripheral blood mononuclear cells (PBMCs) from patients with asthma were investigated in order to elucidate the possible roles of CD4+CD25+ Treg in the development of asthma. The peripheral blood samples were collected from 29 healthy controls (normal control group) and 78 patients with asthma which included 30 patients in exacerbation group, 25 patients in persistent group, and 23 patients in remission group. By using flow cytometry and RT-PCR, the CD4+CD25+ Treg ratio and Foxp3 mRNA in PBMCs were detected. The CD4+CD25+ Treg ratio and Foxp3 mRNA in PBMCs of exacerbation and persistent groups were lower than that of remission and normal control groups (P＜0.05). Although the CD4+CD25+ Treg ratio and Foxp3 mRNA of remission group were also lower than that of normal control group, there was no significant difference between them (P＞0.05). As compared with persistent group, exacerbation group had lower CD4+CD25+ Treg ratio and Foxp3 mRNA (P＜0.05). It was indicated that the decrease of CD4+CD25+Treg ratio and its function in PBMCs may be responsible for pathogenesis of asthma.

BACKGROUNDIt has been known that there are declines of dendritic cell (DC) count and its function in the peripheral blood of patients with non-small cell lung cancer (NSCLC), which are remarkably related to the proceeding and prognosis of NSCIC. The aim of this study is to investigate the relationship and clinical significance between the DC subsets (CD11c+DC and CD123+DC) and immunology state of patients with advanced NSCLC.

METHODSFlow cytometry was used to detect DC subsets, T cell subsets, NK cell percentage in the peripheral blood of 40 patients with advanced NSCLC and 10 healthy controls.

RESULTSThe expression of CD11c+DC (0.38%±0.18%) in the peripheral blood of advanced NSCLC patients, was decreased significantly compared with that of normal controls (0.66%±0.24%) (P < 0.01). The expression of CD123+DC in the peripheral blood of advanced NSCLC patients was (0.28±0.17)%, with no significant difference compared with that of normal controls (0.27%±0.11%) (P > 0.05). The percentage of CD3+ T cell and CD4+/CD8+ of patients with advanced NSCLC were significantly lower than those of normal controls (P < 0.01 and P < 0.05), and the percentage of CD8+ and NK cell of patients were higher than those of normal controls (P < 0.05). The correlation analysis showed that CD123+DC percentage was positively correlated to CD3+T cell percentage (P < 0.05) and negatively correlated to NK cell percentage (P < 0.01). The expression of DC subsets correlated with KPS and chemotherapy history of patients (P < 0.01).

CONCLUSIONSThe advanced NSCLC may induce significant decreasing expression of CD11c+DC and may induce significant decrease of immunology state. There are close relationship among the expression of DC subsets and the immunology state of patients as well as the clinical biological behaviors of patients with advanced NSCLC.

Objective: To understand the mortality and influencing factors on injecting drug users (IDUs) with HIV/AIDS, in Guizhou province, 1996-2015. Methods: A retrospective cohort study was conducted on IDUs with HIV/AIDS that were reported through national comprehensive HIV/AIDS information system, in Guizhou province during 1996-2015. Cox proportional hazard regression model was used to analyze the influencing factors on the mortality of HIV/AIDS. Results: A total of 3 958 cases of IDUs with HIV/AIDS were recruited in this study, with all-cause mortality rate of 44.01% (1 742/3 958) and total mortality rate of 7.80/100 person-years, respectively. The median survival time between diagnosis and death was 8.08 years. Mortality rate was 3.57/100 person-years in the group receiving antiretroviral therapy (ART). The mortality appeared to be 4.08/100 person-years in the group who were on methadone maintenance treatment (MMT). Data from the multiple regression analysis indicated that factors of gender, ethnicity, age when HIV/AIDS diagnosis was made, CD₄⁺T lymphocyte (CD₄) count at the first testing, ART and MMT were significantly associated with deaths among these people. The risk of death in females was 0.82 times (95%CI: 0.69-0.98) higher than that in males. The risk of deaths among the ethnic minority subjects was 1.39 times (95%CI: 1.21-1.60) higher than that of the Hans. The risk of death appeared to be 2.44 times higher (95%CI: 1.07-5.56) in the over-50-year of age group than in the <20 year-old group, when HIV/AIDS was diagnosed for the first time. The risk of death in CD₄ ≥500/μl group in the first time was 0.27 times (95%CI: 0.22-0.32) more than CD₄ <200/μl group in the firs time. The risk of death in cases who were treated with ART or MMT was 2.83 times (95%CI: 2.45-3.26) and 1.35 times (95%CI: 1.15-1.59) higher than those who did not receive any treatment, respectively. Conclusion Higher risks on death seemed to be related to the following factors: being male, older age at the time of diagnosis, lower CD₄ at diagnosis, not on ART or MMT among the IDUs with HIV/AIDS in Guizhou province, between 1996-2015.