Intrauterine growth restriction is a common perinatal complication of major harm to the fetus. In recent years, immunological mechanism has been found in the pathogenesis of intrauterine growth restricition. Abnormal immune mechanism may be the developmental programming of ways to affect the fetal immune function, as well as extrauterine.

Objective:To explore the effect of bifidobacterium on the production and morphology of dendritic cells(DC) in vitro and in vivo.Methods: In vivo,the mice were administrated orally with live bifidobacteria,heat-killed bifidobacteria(1?109CFU/ml),with spent culture supernatant(SCS) or saline normal respectively,and their intestinal samples were used to evaluate the production of intestinal DC by immunohistochemical method.In vitro,the monocyte was induced by heat-killed bifidobacterium alone,to find out whether it could change cell morphology and become DC,Phase-contrast microscope morphological observation was made.On the other hand,normal adult immature DCs were induced by monocyte cultured in granuloeyte macrophage-colony stimulating factor(GM-CSF) and interleukin-4(IL-4),and they were exposed to various dosages of heat-killed bifidobacterium(100ug/ml,10ug/ml) in experimental groups on the 7th day,while the control group was exposed without heat-killed bifidobacterrium,LPS at 1ug/ml was added to some cultures as positive control.The morphology of DC was observed by phase-contrast microscope and electron microscope.Results: Under the microscope,DCs were present in the intestinal lamina propria of mice,the sizes of which were varied and the appearances were irregular.Counting showed that the bifidobacterium could increase the number of DCs in the small intestine of mice.There was significant difference between the control group and the live bifidobacterium group,the heat-killed bifidobacterium group and SCS group(P

Objective To investigate the value of the proximal colon resection in the operation of rectal cancer.Methods 143 cases of rectal cancer in our hospital were selected and randomly divided into observation group (82 cases)and control group (61 cases).The observation group was treated with the excision of the membrane of the colon,and the control group was treated with routine operation.The pathological report of two groups was analyzed,the number of lymph nodes resection and the positive lymph nodes were compared,and the incidence of postoperative complications in the two groups were observed.Results In the observation group,1487 lymph nodes were detected,the average number of lymph nodes was 18.1,the lymph nodes metastasis were 203,and the average number of lymph nodes metastasis were 2.5.No recent complications occurred.The control group of 61 patients,a total of 749 lymph nodes were detected,the average number of lymph nodes detected 12.3,lymph nodes metastasis were 103,the average number of metastatic lymph nodes metastasis were 1.7.No recent complications occurred.There was a significant difference between the average detection rate of lymph nodes in the two groups(P ＜ 0.05).Conclusion The proximal colon resection can improve the resection rate and reduce the residual of positive lymph nodes,which can reduce the recurrence and metastasis of rectal cancer.

Objective To analyze the risk factors for healthcare-associated pneumonia (HAP) in patients with orthopedic injury,provide the basis for making prevention and control measures.Methods HAP occurred in patients with orthopedic injury and admitted to the department of orthopedics of a hospital from June 2011 to May 2015 were investigated retrospectively,risk factors were analyzed by univariate and multivariate logistic regression methods.Results A total of 2 578 patients with orthopedic injury were investigated,92 patients developed HAI,incidence of HAP was 3.57％.107 strains of pathogens were detected,the major were Klebsiella pneumoniae (n =22,20.56％),Escherichia coli (n =14,13.08％),and Acinetobacter baumannii (n =13,12.15％).Risk factors for HAP in patients with orthopedic injury were length of hospital stay≥15 days,smoking history≥3 years,bedridden ≥7 days,associated with underlying diseases,complications,indwelling catheter≥7 days,surgical operation,mechanical ventilation,admitted to intensive care unit,open injury,blood sugar≥11 mmol/L,plasma albumin＜30 g/ L,hemoglobin concentration＜90 g/L,and use of glucocorticoid≥4 days (all P＜0.05).Multivariate logistic regression analysis showed that smoking,bedridden,surgery,mechanical ventilation,glucocorticoid use,and anaemia were independent risk factors for HAP in patients with orthopedic injury.Conclusion The occurrence of HAP in patients with orthopedic injury is related with multiple factors,the major are surgical operation,mechanical ventilation,glucocorticoid use,long term smoking,bedridden,and anaemia.

Objective　To explore the effect of photon on blood biologic components in blood photochemical treatment. Methods　After the blood sample was adjusted to an appropriate density, it was treated with 0.1 nmol/ml 8-MOP (8-methoxypsoralen), 0.1 nmol/ml TFO (triple helix-forming oligonuletide) and UVA (ultraviolet A radiation) at the intensity of 1 800 μW/cm2 for 3～20 min. The changes of biologic activities of major components in blood were measured with automatic blood gas analyzer, platelet aggregation analyzer, blood coagulation analyzer, micropipette aspiration system and assay of poly-lysine adsorption. Results　The oxygen content in blood was increased gradually. The resilience of erythrocyte was enhanced ，but its adhesiveness was decreased. The parameters related to blood coagulation had some changes but all remained within the normal ranges. Conclusion　Under the definite condition of blood virus being inactivated effectively, the nonspecific effect of photosensitive response may improve blood oxygen content, enhance the transfiguring ability of erythrocyte and decrease the blood viscosity, but having no obvious change on blood coagulation.

Objective To prospectively evaluate the risk factors for the decline of residual renal function (RRF) in new peritoneal dialysis (PD) patients.Methods A total of 84 new PD patients in our PD center were included in this study.Clinical comprehensive assessment were made,and regression models was established to analyze the relationship between the decline of RRF and clinical indicators,which included the rate of peritonitis,systolic pressure,diastolic pressure,urine volume,24 h urinary protein,serum albumin,C-reactive protein(CRP),history of diabetes mellitus,and the use of angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blockers (ARB) drugs,cardiac functional grading,sodium and water retention and biochemical indicators.The primary outcome was defined as two consecutive urine volume ≤ 100 ml/24 h.Results The mean follow-up time was (11.7± 1.1) months,primary outcome occurred in 20 patients,accounting for 23.8％,and their average period progressed to the primary outcome was (10.5±2.0) months.The 20 patients had higher ultrafiltration volume [(551.6±328.2) ml vs (294.1±288.0) ml,P=0.001],higher systolic blood pressure [(145.2±16.5) mmHg vs (136.0±13.8) mmHg,P=0.016],worse cardiac functional grading [(1.7±0.8) vs (1.3±0.4),P=0.000],more serious water-sodium retention [(1.0±0.7) vs (0.6±0.5),P=0.012],higher peritonitis rates (35.0％ vs 4.7％,P=0.000),lower Kt/V [(1.7 ± 0.4) vs (2.0 ± 0.3),P=0.003],lower hemoglobin levels [(89.0± 14.9) g/L vs (99.5± 17.8) g/L,P=0.020],higher C-reactive protein levels [(19.4±34.4) mg/L vs(8.7±12.6) mg/L,P=0.017],higher Scr levels [(1 004.6±291.1) μmol/L vs (753.1±254.3) μ mol/L,P=0.000],lower serum calcium levels[(1.86±0.1) mmol/UL vs (2.02±0.2) mmol/L,P=0.000],higher serum phosphorus [(2.1±0.6) mmol/L vs (1.6±0.4) mmol/L,P=0.001] and higher calcium phosphorus product [(3.8±1.1) mmol2/L2 vs (3.1±0.8) mmol2/L2,P=0.010] as compared with those of the patients without the primary outcome.Based on the results of multivariable Cox regression analysis,ultrafiltration volume,cardiac functional grading,peritonitis,Kt/V and serum phosphorus level contributed to the decline of RRF significantly.Conclusion The higher Kt/V in PD patients plays a protective role,the higher ultrafiltration volume,the worse heart function,the more peritonitis rate and higher serum phosphorus predict more rapid declination of RRF.

Objective To shorten the stat test turnaround time (TAT) and improve the quality of service in clinical laboratory.Method Stat test TAT related data of clinical laboratory in Tongji hospital in Wuhan from August 1st to September 30th were collected by laboratory information system and hospital information system.EXCEL and SPSS were used for data analysis.Median and the 90th percentile were calculated for TATs from order to collection, collection to transfer, transfer to reception, reception to inspection and inspection to report.Outlier rates were calculated for TAT from collection to reception, reception to report, and collection to report using 2 h, 2 h, and 4h as target TAT value, respectively.Meanwhile descriptive statistics were calculated for TAT from order to collection in different clinical department, TAT from collection to reception during different collection time frames, and TAT from reception to report during different reception time frames.Results 32 235 stat biochemistry test data were included in this survey.Among three periods cut by collection and reception time, TAT from order to collection were the longest (P50: 681 min,P90:1261 min), followed by TAT from collection to reception(P50:94 min,P90:169 min) and TAT from reception to report(P50:68 min,P90:111 min).TATs from order to collection were longer in gynecological tumor department and organ transplantation department while shorter in infection department and cardiac vascular department.The TATs from collection to reception of specimen collected during 2:00 to 3:59 were longer than other collection time.While the TATs from reception to report of specimen received during 6:00 to 7:29 were longer than other reception time.There was no significant correlation between the amount of emergency specimens collected and TAT from collection to reception in different collection time period.However, the amount of emergency specimens collected was significantly correlated with the TAT from reception to report in different reception time period.Conclusions Analysis of TAT data can be used to identify existing problems and provide improved directions to shorten TAT in clinical laboratories.

Objective To study the gene expression of Wnt signal transduction pathway in experimental liver fibrosis and to investigate its role in liver fibrosis. Methods Liver fibrosis model was induced with carbon tetrachloride in 8 SD rats. Another 8 healthy rats were served as control. The gene expression in liver tissues of models and controls were examined using real time PCR array. The differential gene expression was identified as either up- or down-regulated 2-fold. The expressions of smooth muscle actin (SMA), Wnt4, Frizzled2 and β-catenin in the tissues were examined by immunohistochemistry and Western blot. Results The examination confirmed that 36 genes were differentially expressed, including 25 genes up-regulated and 11 genes down-regulated. Compared with the controls, the expressions of Wnt4, Wnt5 a and W nt11 were up-regulated more than 13.9-, 16.5-and 2.17-fold respectively, while the expressions of Wntl and Wnt3 were down-regulated more than 2.32- and 2.15-fold respectively in fibrotic liver. Immunohistochemistry and Western blot showed that the expressions of SMA, Wnt4 and Frizzled2 in fibrotic liver were remarkably higher than those in normal controls. While the level of phosphorylated β-catenin was decreased. Conclusion Both canonical and noncanonical Wnt signal transduction pathway may involve in the mechanism of liver fibrogenesis.

Objective:To analyze and compare the results and precision of three different methods to measure the surface dose of Intra-operative radiotherapy,and conclude some experience of clinical application in Intra- operative radiotherapy.Methods:The study compared the results of measurement surface dose in phantom through three ways:cylindrical ionization chamber with 3D water scanner,plane-parallel ionization chamber,and MOSFET detector.Results:the measurement results of plane-parallel-chamber and MOSFET detector have a better consistency,and the maximum deviation is -1.13%.The method with cylindrical ionization chamber and 3D water scanner has larger deviation compare to the other two methods,the deviation range from-5.55%to 4.55%.Conclusion:The methods of plane-parallel chamber and MOSFET detector to measure the surface dose of Intra-operative radiotherapy can obtain accurate results.

Objective To investigate the relationship between the polymorphism of transforming growth factor-β1 (TGF-β1 ) gene and risk of chronic hepatitis B virus(HBV)infection progressing to hepatocellular carcinoma(HCC).Methods 120 patients with chronic HBV infection(case group)and 100 age-and sex-matched healthy individuals(healthy control group)were randomly enrolled to this study.The polymerase chain reaction-restriction fragment length polymorphism technique was adopted to detect the single nucleotide polymorphism of TGF-β1 gene(T29C),and made the comparative analysis combined with TGF-β1 mRNA level. Results The risk of HCC occurrence in the patients carrying genotype CC was decreased than that in the patients carrying geno-type TT (OR=0.317,95%CI =0.110-0.913,P =0.033;OR=284,95%CI =0.093 -0.866,P =0.027),the risk of HCC in pa-tients carrying allele C was significantly decreased compared with that in the patients carrying allele T(OR =0.570,95%CI =0.341 -0.953,P =0.032;OR=0.548,95%CI =0.320-0.936,P =0.028).In the HCC group,the patients carrying genotype CC had the lower lever of TGF-β1 mRNA.Conclusion TGF-β1 gene polymorphism(T29C)may be related to the risk of chronic HBV infection progressing to HCC.