Objective To investigate the possible mechanism of aggregation and activation of neu-trophils(polymorphonuclear neutrophils,PMN)in mice with chlamydial pneumonitis. Methods C57BL/ 6 mice were inoculated intranasally with 3×103 inclusion-forming units(IFU)of Chlamydia muridarum(Cm) to induce the murine model of chlamydial pneumonitis. Samples of lung tissues collected at different time points after infection were stained by hematoxylin and eosin for histopathological assessment of inflammation. The levels of myelo-peroxidase(MPO)were detected for the evaluation of PMN aggregation. The mononu-clear cells were isolated from lung tissues. The inflammatory cells were counted with Giemsaˊs staining. CD11b+Gr1+ cell population and CD11b expression in lung mononuclear cells were analyzed by flow cytome-try. The expression of chemokines(MIP-2,LIX,KC and MCP-1)in lung tissues at mRNA level was meas-ured by RT-PCR. Results Chlamydial pneumonitis was induced in mice by intranasal inoculation of 3×103 IFU of Cm. Compared with the mice from control group,large amounts of inflammatory cells including PMN, monocytes and lymphocytes were induced in lung tissues of mice with Cm infection. PMN responded earlier than monocytes to the infection. The levels of MPO were significantly increased in mice with Cm infection and reached the highest level on the 7th day after infection. A decline in MPO levels was observed on the 14th day but the levels were still higher than those on day 0. The percentages and total numbers of CD11b+Gr1+ cells were significantly increased after Cm infection. Moreover,an increased expression of PMN CD11b was also detected by flow cytometry. The expression of chemokines(MIP-2,LIX,KC and MCP-1)was in-creased in lung tissues of mice after Cm infection. The results of the study indicated that Cm infection in-duced the expression of PMN chemoattractants,resulting in the recruitment of PMN. Conclusion The infil-tration and activation of PMN in lung tissues of mice were induced by Cm infection through increasing the ex-pression of chemokines. PMN played an important role in immune responses against Cm infection.

Objective Using evidence-based nursing method to formulate an nursing program for one heat stroke ( HS) with rhabdomyolysis ( RM) and multiple organ dysfunction syndrome ( MODS) patient, who were treated by continuous renal replacement therapy( CRRT) . Methods Based on fully assessing the patients′conditions, the clinical problems were put forward according to PICO principles. The Cochrane library, MEDLINE, PubMed, EBMR inquiry evidence-based medicine databases, National Guideline Clearinghouse, RNAO, CBM, WanFang database, CNKI and Critical Care Medicine Branch of Chinese Medical Association clinical guidelines were retrieved to collect high quality clinical evidence, and then the optimum nursing program was designed in line with patients′conditions and relatives′willingness. Results Ten trials and one application guideline were included. The available clinical evidence displayed that:(1)HS patient with RM should be given CRRT as soon as possible, it could not only reduce core body temperature, but also effectively removed myoglobin and significantly improved renal function; ( 2 ) Femoral vein catheter was the first choice for establishing vascular access;(3)The systemic anticoagulation with un-fractionated heparin should be scheduled for coagulation laboratory examination and closely observed the hemorrhage; ( 4 ) Routine use of intermittent saline flush pipes was not recommended. So finally a nursing plan was made in combination with literature evidence, patients′ condition and relatives′ willingness: we used CRRT early; choose femoral vein catheter;closely observed of hemorrhage and adjusted the dose of heparin according to activated partial thromboplastin time ( APTT) when using systemic anticoagulation with un-fractionated heparin, not used intermittent saline flush pipes. After CRRT and other comprehensive treatment, the patient regained consciousness after seven days. Myoglobin was down to 200 ng/ ml from 1 455 ng/ ml admission, with astable vital signs. Conclusions HS patients with RM should be given CRRT as soon as possible. Femoral vein catheter is the first choice for establishing vascular access. The systemic anticoagulation with un-fractionated heparin should be scheduled for coagulation laboratory examination and closely observed of hemorrhage. Routine use of intermittent saline flush pipes is not recommended.