Objective To investigate the effect of continuous renal replacement therapy ( CRRT) on the reg-ulation of Treg/Th17 in patients with severe sepsis,and related inflammatory factors IL-6,IL-17,IL-10,and TNF-α.Methods 60 patients with severe sepsis were randomly divided into two groups,30 cases in each group.The control group received conventional treatment,and the observation group was treated with CRRT on the basis of the control group.Flow cytometry was used to detect the levels of Tregs and Th17 cells,and IL-6,IL-10,IL-17 and TNF-αwere detected by ELISA method.At the same time,the APACHEII score,ICU length of hospital stay were observed and recorded.Results After treatment,APACHE Ⅱscore,ICU length of hospital of the observation group were lower than the control group,there were statistically significant differences(t=4.258,t=4.518,all P<0.05). The expression levels of Th17,Treg and Tregs/Th17 in the observation group were significantly lower than the control group,the differences were statistically significant (t=5.872,4.267,4.285,all P<0.05).The expression levels of IL-6,IL-17,TNF-αin the observation group decreased more significantly than the control group,the differences were statistically significant (t=5.829,5.257,5.983,all P<0.05).But the expression level of IL-10 in the two groups had no obvious change[(35.26 ±18.63) pg/mL vs (35.52 ±20.09) pg/mL,t=2.164,P>0.05].Conclusion CRRT can not only remove the inflammatory mediators of abnormal expression,improve the function of T cells,but also can maintain the balance between Th17 and Treg,improve the immune disorders,and improve the prognosis of sepsis.

Objective To investigate the relationship between infection of helicobaeter pylori(Hp) and iron deficiency anemia(IDA) and to explore effective clinical treatments for patients with Hp associated IDA . Method 1. The Hp infection ratio of 40 chronic gastritis with IDA and 42 patients without IDA were counted up respectively. 2. 36 patients with Hp-positive chronic gastritis were divided into two groups randomly. One group was treated by using Hp eradication therapy in conjunction with oral iron supplement and the other using iron supplement only. The hema-tological parameters before and after treatment are measured and the effectiveness of the treatment was evaluated. Re-sult The Hp infection ratio in chronic gastritis patients with IDA is |figher than that in patients without IDA and the difference is significant. After Hp eradication therapy in conjunction with iron supplement Hb. serum iron and serum ferritin level in Hp associated IDA patients are increased significantly while that for patients treated by using iron sup-plement only have no significant improvement. Conclusion It appears that Hp infection may be related to IDA. When iron supplement treatment has no obvious effect to an IDA patient,lt may suggest a ease of Hp associated IDA. The i-ton supplement treatment has positive effects to IDA patients after Hp eradication.

AIM:To study the effect of intraventricular injection(icv) of histamine(HA) on corticotropin releasing hormone (CRH) neurons activity in paraventricular nucleus (PVN) of hypothalamus. METHOD: Fos ontogenic protein immunohistochemistry and double antigen immunohistochemistry method; semiquantitative reverse transcription-polymerase chain reaction(RT-PCR) method were used. RESULTS: After intraventricular injection of HA, (1) number of Fos immunnoreactive positive neurons in PVN increased significantly; (2) double labeling experiments showed that there were 31 78%?1 59% of Fos immunoreactive cells in PVN expressed CRH simultaneously; (3) the CRHmRNA level in PVN was increased in a dose-dependent manner. CONCLUSION: Central histamine activated CRH neurons in PVN of hypothalamus and increase the expression of CRH gene.

Aiming at the characteristics of biochemistry and the advantages of web-based courses and combining with teaching practice,a kind of web-based courses has been constructed which practices in the internet.The key of construction will be detailed from general design,page design and some design skills.

Objective To compare efficacy of pemetrexed (MTA) combined with cisplatin (DDP) and docetaxel (TXT) combined with DDP in treatment of non-small cell lung cancer (NSCLC).Methods 50 patients with NSCLC from May 1, 2013 to May 1, 2015 in the hospital were seleced and randomly divided into two groups:MTA group (n=25) were received MTA combined with DDP, and TXT group(n=25) were received TXT combined with DDP, for a course of twenty-one days.After treatment, the efficacy of two therapy as well as adverse reactions were compared.ResuIts After treatment, the soluble intercellular adhesion molecule 1 (sICAM-1) and soluble vasccular cell adhesion molecule 1 (sVCAM-1) levels in MTA group were significantly lower than those before treatment (P<0.05), but there were no statistical differences in TXT group, and the above two indicators in MTA group were lower than those in TXT group(P<0.05).There were no significant difference of total efficacy between MTA group and TXT group (20.00% vs.16.00%, χ2 =0.136,P>0.05).The adverse reaction of nausea and vomiting, anemia, low platelet count, neutropenia and alopecia in MTA group was lower than that in TXT group (40.00%vs.72.00%,χ2 =5.195,P<0.05).ConcIusion The efficacy of MTA combined with DDP and TXT combined with DDP in treatment of NSCLC is similar, but the adverse reactions of fomer one is lower.

Esters ; urine ; Humans ; Phthalic Acids ; urine

Objective To investigate the curative effects of the traditional surgical method of posterior pedicle Schanz screw fixa-tion with partially stripping injured paravertebral muscle in treating thoracolumbar fracture .Methods 52 cases with thoracolumbar fracture underwent posterior pedicle Schanz screw fixation to partially strip injured paravertebral muscle from January ,2010 to Jan-uary ,2012 .The patients were divided into partially stripping injured paravertebral muscle group (32 cases) and traditionally strip-ping injured paravertebral muscle group(20 cases) .The blood loss ,postoperative drainage ,kyphosis postoperative 3 d VAS scores , vertebral height correction rate ,Cobb angle correction ,Oswestry dysfunction indexes were copmared .Results Comparing with tra-ditionally stripping injured paravertebral muscle group ,the partially stripping injured paravertebral muscle group has better effect in transperative blood loss ,postoperative drainage and postoperative 3 d VAS scores ,the differences were statistically significant .But there was no statistical significance between the two groups in vertebral height correction rate ,kyphosis Cobb angle correction ,Os-westry dysfunction indexes .Conclusion Partially strip injured paravertebral muscle has less painful than traditional surgery does , being safe and effective with small invasion and easy to recover .

AIM: To investigate the effects of external counterpulsation (ECP) on nitric oxide (NO) and nitric oxide synthase (NOS) and the expression of NOS gene in myocardial infarction canines. METHODS: Nineteen healthy dogs were randomly divided into three groups ie. controls, ischemia group, ischemia and ECP group. Serum NO concentrations and myocardium NO levels and NOS specific activity were determined by modified nitrate reductase method. The protein synthesis of sub-type NOS including inducible NOS (iNOS) and endothelial NOS (eNOS) of myocardial tissue were also determined by immunohistochemical method. The constitutive NOS (cNOS) mRNA was measured via in situ hybridization. RESULTS: 120 and 180 minutes after the ligating of LAD, serum NO concentration in ECP groups were higher than those in ischemic groups (P

[Objective]To investigate the molecular mechanism of abnormal platelet activation induced by platelet O2 ·- and H2O2 levels in type 2 diabetes mellitus.[Methods]The platelet parameters in patients with type 2 diabetic patients and normal controls were measured;Immunofluorescence technique was used to observe the platelet morphology changing;Flow cytometry was used to detect platelet intracellular O2 ·- and H2O2 content in two groups,then with platelets in normal controls treated with NADH/PMS system and H2O2 respectively,platelet activation positive percentage was observed. Standard Western blot analysis protocols were used to detect expression difference of Catalase and type 2 super-oxide dismutase(Mn-SOD)in platelets.[Results]The MPV in the group of type 2 diabetic patients was significantly higher than in the normal control group(P < 0.001),but there was no statisticdifference in PLT,PDW,PCT between two groups. Immunofluorescence results showed that morphology of platelets in type 2 diabetic patients changed contrast to normal group. Through flowcytometry detection,the content of mitochondrial O2·-and H2O2 of platelet in type 2 diabetic patients were obviously higher than in normal group(P<0.05),whereas no significant difference in cytoplasmic O2·-. We adopted NADH/PMS system and H2O2 to treat platelets of normal group,heightened activated positive percentage were observed which described O2 ·- and H2O2 can significantly promote platelet activation(P<0.01). Western blot results showed that expression of Catalase in platelet of type 2diabetes patients decreased,while the expression and activity of Mn-SOD had no difference.[Conclusion]It is diabetic platelet Catalase expression decreased that may lead to Diabetic platelet mitochondrial O 2 ·- and H2O2 level increased ,thus regulating aberrant activation of diabetic platelet.

OBJECTIVETo evaluate efficacy of continuous blood purification (CBP) in childhood severe sepsis through the analysis of organ function, inflammatory mediators and prognosis.

METHODForty-seven children with severe sepsis aged 29 days -16 years who were treated in PICU of Shanghai and Zhejiang five hospitals during October 1, 2011 and September 30, 2012 were enrolled; 30 cases treated with CBP were recorded as logged group , 17 cases without CBP as unlogged group. Changes in the cardiovascular, respiratory function, renal function, inflammatory markers, PRISM score III, PCIS and survival were observed and compared between the two groups at baseline (d0), first days (d1), second days (d2), third days (d3), fifth days (d5).

RESULT(1) Cardiovascular function: In d3 and d5, heart rate (HR) and mean arterial pressure (MAP) were improved as compared to unlogged group (121, 119 vs. 138, 137; 71, 80 mmHg vs. 63, 62 mmHg, P < 0.05), with no statistical significance in arterial blood lactate concentration. (2) Oxygenation index (PaO₂/FiO₂) and arterial oxygen saturation (SaO₂) increased as compared to unlogged group, but did not reach statistical significance. (3) Blood urea nitrogen (BUN) and creatinine (Cr) were improved as compared with unlogged group from d1 (P < 0.05). (4) Inflammatory mediators did not show significant differences. (5) Twenty-eight days survival rate: logged group was 70.0%, unlogged group was 52.9%, but the difference was not statistically significant (P = 0.242).

CONCLUSIONCBP can improve circulatory function, oxygenation, and renal function in children with severe sepsis. No evidence was found that CBP could decrease the level of inflammatory mediators, improve critical score and 28 days survival rate.

Adolescent ; Blood Pressure ; Blood Urea Nitrogen ; Child ; Child, Preschool ; Creatinine ; blood ; Female ; Heart Rate ; Hemofiltration ; methods ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Pediatric ; Male ; Oxygen ; blood ; Oxygen Consumption ; Prognosis ; Prospective Studies ; Sepsis ; physiopathology ; therapy ; Survival Rate ; Treatment Outcome