Department of Immunology; Institute of Basic Medical Science, CAMS and PUMC, Beijing 100005, China) Objective To study the mechanism of neuroimmunoregulation which is triggered by enhancing immunologic function via Hou Hai acupoint antigen injection. Methods Immunohistochemical method, immunofluorometric method and RT-PCR were used to examine the different distribution of cy tokine immunopositive cells in the brain and expression of cytokines in the spleen of the human IgG sensitized rats recieved acupoint, subcutaneous and normal rats antigen injections. Results In the areas of lateral hypothalamic nucleus (LH) and amygdaloid nuclear complex(AA) , the distribution of cytokines immunopositive cells with acupoint injection group was significantly increased more than that in the subcutaneous injection group. But the expression of cytokines immunopositive cells both by the acu point injection and the subcutaneous injection groups reached their peak value in similar time. Dou ble-labelling results showed that the cytokine immunopositive cells were neurons. In the spleens, the expressions of cytokines, IL-2 and IFN, were significantly increased by acupoint injection more than subcutaneous injection. Conclusions The time course of neuroimmunoregulation is similar in the im munized rats via both acupoint injection and subcutaneous injection of antigens. But the activity of neuroimmunoregulation is not the same in acupoint and subcutaneous injection groups. Neurons of the LH and AA are main source spf teh neruroimunomodulation The effect of enhancing immunlolgic funivtion via Hou acupoin injection is may be more efficent to mobnilize the activity of neitoimmunreguation of immune-asociated brain than moduation the immune system

INTRODUCTION: Spontaneous bacterial peritonitis (SBP) is the commonest complication of liver cirrhosis. Timely and appropriate treatment of SBP is crucial, particularly with the rising worldwide prevalence of multidrug-resistant organisms (MDROs). We aimed to investigate the clinical outcomes of SBP in Singapore. METHODS: All cirrhotic patients with SBP diagnosed between January 2014 and December 2017 were included. Nosocomial SBP (N-SBP) was defined as SBP diagnosed more than 48 hours after hospitalisation. Clinical outcomes were analysed as categorical outcomes using univariate and multivariate analysis. RESULTS: There were 33 patients with 39 episodes of SBP. Their mean age was 64.5 years and 69.7% were male. The commonest aetiology of cirrhosis was hepatitis B (27.3%). The Median Model for End-stage Liver Disease (MELD) score was 17; 33.3% had acute-on-chronic liver failure and 60.6% had septic shock at presentation. N-SBP occurred in 25.6% of SBP cases. N-SBP was more commonly associated with MDROs, previous antibiotic use in the past three months (p = 0.014) and longer length of stay (p = 0.011). The 30-day and 90-day mortality among SBP patients was 30.8% and 51.3%, respectively. MELD score > 20 was a predictor for 30-day mortality. N-SBP and MELD score > 20 were predictors for 90-day mortality. CONCLUSION N-SBP was significantly associated with recent antibiotic use, longer hospitalisation, more resistant organisms and poorer survival among patients with SBP. N-SBP and MELD score predict higher mortality in SBP. Judicious use of antibiotics may reduce N-SBP and improve survival among cirrhotic patients.