During sepsis, circulating leukocytes are in a hyper inflammatory state, and with the progress of the inflammation, immune cells may become tolerated. Glycolysis and pentose phosphate pathway are up-regulated but oxidative phosphorylation is suppressed in hyper inflammatory cells, whereas during immune tolerance, glycolysis is often down-regulated. In this review, we will summarize the changes of cellular metabolic pathways in monocytes and macrophages during sepsis. We also review how the metabolism of glucose, amino acids, and fatty acids affect the function of monocytes and macrophages in sepsis. Current literature indicated that metabolism plays a significant role in regulating the functions of immune cells in sepsis, which might be a potential therapy for sepsis and deserved further research.

Objective To observe the therapeutic effect of central venous catheter drainage and intrapleural injection of urokinase on tuberculous pleurisy patients.Methods 60 hospitalized patients with tuberculous pleurisy were selected,and they were divided into two groupsby simple random grouping method.Both two groups received 3HRZE/6HR anti-tuberculosis treatment.30 patients in the observation group were treated with central venous catheter drainage and intrapleural injection of urokinase.30 patients in the control group were treated with conventional pleurocentesis.The duration of pleural effussion drainage,incidence of pleural thickening,hospitalization time and expense,and the adverse reaction rate were observed during treatment.Results In the observation group,the curative effect at 1 week was 46.7％,the duration of pleural effussion drainage was (20.5 ± 6.7)days,the incidence rate of pleural thickening was 26.7％,the hospitalization time was (9.4 ± 2.7) days,the hospitalization expense was (6 675.4 ± 1 818.4) RMB,the incidence rate of adverse reaction was 3.3％.In the control group,the curative effect at 1 week was 20.0％,the duration of pleural effussion drainage was (25.1 ± 7.7) days,the incidence rate of pleural thickening was 46.7％,the hospitalization time was (10.3 ± 2.8)days,the hospitalization expense was (7 508.9 ± 1 692.1) RMB,the incidence rate of adverse reaction was 20..0％.There were statistically significant differences between the two groups in the curative effect at 1 week (x2 =4.800,P =0.028),duration of pleural effussion drainage (t =2.484,P =0.016),incidence of pleural thickening (t =4.444,P =0.035) and incidence rate of adverse reaction (x2 =4.043,P =0.044).No statistically significant differences were observed between the two groups in hospitalization time(t =1.270,P =0.209) and expense (t =1.838,P =0.071).Conclusion In comparison to conventional pleurocentesis,the treatment of central venous catheter drainage and intrapleural injection of urokinase for tuberculous pleurisy is markedly efective,it is safe and Worthy of popularizing in clinical application.

OBJECTIVE:To prepare and characterize Fluorescent dye 1,1′-octacosyl-3,3,3′,3′-tetramethylindocarbocyanine iodide(DiR)-loading polyethylene glycol-poly lactic-co-glycolic acid(DiR-PEG-PLGA)nanocapsules,and to evaluate its biocompatibility in vitro. METHODS:Using PLGA and PEG-PLGA as carrier,DiR-PEG-PLGA nanocapsules were prepared by modified ultrasonic emulsification method. The particle size,Zeta potential,morphology,stability and fluorescence in vitro of nanocapsules were detected respectively. MTT assay was used to evaluate cytotoxicity in vitro of nanocapsules to human-derived HL7702 hepatocytes,and hemolysis test was carried out to investigate its hemolysis effects. RESULTS:Prepared DiR-PEG-PLGA nanocapsules were spherical with a clear core-shell structure. The average particle size was(507.53 ± 7.87)nm,polydispersity coetficient of particle size was 0.306 1±0.001 5 and Zeta potential was(-35.20±0.92)mV with good stability within 6 months under 4℃. Fluorescence signal intensity(y)of nanocapsules was increased linearly with DiR mass concentration(x)in vitro. The linear eguation was y=0.345 2x+0.433 4(R2=0.997 3).The toxicity of nanocapsules to HL7702 cells was between 0-1 degree,and no hemolytic effect was observed. CONCLUSIONS:The study successfully prepare fluorescent DiR-PEG-PLGA nanocapsules with high biocompatibility in vitro,which is further expected to become a safe optical drug carrier.

Objective To systematically review the effects of hospital-community integrated management mode in diabetes mellitus. Methods To comprehensively search the database including CNKI, Taiwan Airiti library, WanFang Data, WeiPu Data and PubMed, we manually searched the relevant references of literature for the RCTs on hospital-community integrated management mode in diabetes mellitus, and Meta-analysis was used by software Revman 5. 2, and making descriptive analysis of the outcomes which could not be merged. Results A total of 15 RCTs were included involving 3 in English and 12 in Chinese, and 7 studies with high-quality and 8 of them with low-quality. According to the 11 evaluation focused outcomes indexes, the result of Meta-analysis showed that compared with conventional management, the hospital-community integration mode could effectively improve patients′ biochemical indicators such as glycated hemoglobin (HbA1c)[MD= -0. 39, 95%CI(-0. 56, -0. 22),P<0. 001], fasting plasma glucose[MD=-0. 75, 95%CI (-1. 16, -0. 33),P<0. 001], triglycerides[MD= -0. 36, 95%CI ( -0. 63, -0. 10), P=0.007], high-density lipoprotein (HDL-C)[MD =0. 09, 95%CI (0. 04, 0. 14), P <0. 001], low density lipoprotein (LDL-C)[MD= -0. 15, 95%CI (-0. 23, -0. 06),P=0. 001], but there was no effect on total cholesterol[MD= -0. 27, 95%CI (-0. 58, 0. 03),P=0. 080]. At the same time, the descriptive analysis presented that the model could improve patients′ awareness rate of diabetes health knowledge and promote the correct behavior of medication and regular exercise, in addition it could increase the score of life quality and reduce medical expenses. Conclusions Diabetes hospital-community integrated management can effectively improve the level of blood glucose and blood lipids, reduce the occurrence and development of related complications and provide a reliable basis for the management of diabetic patients. There is a positive impact to improve the patients′ behavior and quality of life, but it requires more randomized controlled studies to be analyzed and verified.