Objective To observe the change of expressions of human leukocyte antigen-DR (HLA-DR) ,pattern recognition receptor TLR4(toll like receptor 4) of peripheral blood mononuclear cell( PBMC) with severe sepsis and its relation to clinical outcome. Methods Thirty-five patients with severe sepsis and fifteen healthy volunteers were enrolled into this study. Thirty-five patients with severe sepsis were divided into the improved group (re =25) and the death group (n = 10).The protein expression level of HLA-DR,TLR4 on PBMC was analyzed by flowcytometry. Results The quantity of monocytes(0. 39 ± 0. 30) and the expression level of HLA-DR (10. 25 ± 5. 35), TLR4 (10. 93 ± 5. 66) on PBMC were significantly lower than those in healthy volunteers ( 0. 62 ± 0.41 ) , (59. 28 ±14. 76) and (39. 86 ±8. 55) pre-treat(P<0.01or P <0. 05).Along with the clinical condition improved, the quantity of monocytes and the protein expressions of HLA-DR, TLR4 on PBMC were gradually increased at each timepoint in the improved group. In this group the quantity of monocytes (1. 03 ± 0. 78) and TLR4 expression (36. 68 ± 16. 61 ) turned to the normal range in the 5th day, which were significantly higher than pre-treat (P < 0. 05 ). However,the expression failed to return to normal range at each time point in the death groups and there were no significant difference between each time point ( P > 0.05). Conclusions The quantity of monocytes and the expression level of HLA-DR,TLR4 on PBMC show significant relevance to patients' imnmnological function and the clinical outcome.

BACKGROUND:Acidic fibroblast growth factor (aFGF) possesses good effects on vascularization and osteogenesis.But whether aFGF can promote the vascularization in animals with early-stage avascular necrosis of the femoral head (ANFH) remains unclear.OBJECTIVE:To investigate the vascularization of aFGF composited by partially depreteinized bone (PDPB) in repair of early-stage ANFH.DESIGN,TIME AND SETTING:A randomized,controlled,animal experiment was performed in the College of Life Science,Nanhua University between January 2008 and January 2009.MATERIALS:Ribs from healthy,adult,New Zealand rabbits were prepared into PDPB by a series of physico-chernical methods including degreasing,deproteinization,partial decalcification and freeze drying,aFGF diluted with sterile distilled water was composited by PDPB particles to prepare artificial composite bone.METHODS:A bone window was made at the juncture of femoral head and femoral neck bilaterally in 24 healthy,adult,New Zealand rabbits.Rabbit models of bilateral ANFH were established by removing approximately 50% of cancellous bone and perfusion with 95% ethanol.Successful bilateral ANFH models were randomly divided into a blank group,a simple PDPB group,and an artificial composite bone group.PDPB and artificial composite bone were implanted into the PDPB and artificial composite bone group accordingly.The blank group did not receive any implantation.MAIN OUTCOME MEASURES:At 2,4,and 8 weeks after surgery,ink-injected specimens were prepared for microvessel count and microvessel area analysis.RESULTS:Microvessel number and microvessel area were least in the blank group,followed by simple PDPB group,and lastly the artificial composite bone group.There was significant difference in microvessel number and micrevessel area between artificial composite bone group and blank,simple PDPB groups (P＜0.05).CONCLUSION:Tissue-engineered artificial bone composited by aFGF and PDPB promotes vasculadzation in repair of earlv-staqe ANFH in rabbits.

Objective To investigate the risk factors of adverse pregnancy outcome of women in China by Meta analysis.Methods Meta analysis was used to analyze the influencing factors of adverse pregnancy outcomes from January 2010 to January 2015.According to the inclusion and exclusion criteria,124 articles were retrieved,and 38 articles were excluded.14 papers were included in this study.Results There was strong correlation between fetal abnormalities and adverse pregnancy outcomes.And the maternal history of abortion and adverse pregnancy outcomes were not related.There was strong association between multiple pregnancy,syphilis infection and adverse pregnancy outcome,and there was moderate correlation between the high blood pressure in pregnancy and adverse pregnancy outcome.Abnormal fetal position,the OR value was 3.48 (2.70 -4.43),history of abortion OR value was 1.14 (0.90 -91.44),gestational hypertension OR value was 2.88 (1.69 -4.92),multiple births OR value was 6.40 (2.05 -20.01),syphilis OR value was 5.54 (1.64 -18.64).Conclusion The risk factors of adverse pregnancy outcomes from strong to weak are as follows:multifetal pregnancy,syphilis infection,abnormal fetal position and hyper-tensive disorder complicating pregnancy.

Objective To investigate the change of expression of toll like receptor 4( TLR4)on peripheral blood monouclear cells( PBMC) and clinical significance of sepsis acute kidney injury( AKI) patients. Methods ICU admission diagnosis of sepsis patients from May 2012 to December 2013 in the Zhongxin Hospital of Handan were diagnosed AKI according to the KDIGO guidelines of 2012 and were divided into AKI group and non AKI. Meanwhile,patients with AKI were also divided into group Ⅰ(KDIGO Ⅰ period);group Ⅱ( KDIGO Ⅱ period)and group Ⅲ( KDIGO Ⅲ period)according to the AKI stages. Thirty cases health patients were elected as the control group. The expression levels of TLR4,human leucocyte antigen(HLA-DR)on PBMC with of sepsis patients were detected with the flow cytometry. The levels of interleukin-6(IL-6) and interleukin-10(IL-10)in serum were detected by enzyme linked immunosorbent assay(ELISA). The length of ICU stay,ICU mortality and the APACHE Ⅱ in 24 h were recorded. Results (1)The expression levels of TLR4 in sepsis AKI patients was(34. 45 ± 9. 54),higher than that in patients without AKI and control group ((26. 29 ± 6. 76,10. 72 ± 8. 82;F = 55. 351,P < 0. 01). The expression of TLR4 in sepsis AKI patients was higher than sepsis patients without AKI(P < 0. 05). There was significant difference among sub AKI groups in terms of TLR4(F = 13. 235,P < 0. 01),and it significantly lower in group Ⅲ among three groups.(P < 0. 05 or P < 0. 01).(2)The levels of IL-6,IL-10 in sepsis AKI group were(565. 81 ± 106. 27)ng/ L,(76. 78 ± 12. 33) ng/ L,higher than those in non AKI group and control group((321. 85 ± 76. 62)ng/ L,(38. 53 ± 9. 93)ng/ L;(84. 36 ± 36. 91)ng/ L,(17. 53 ± 6. 08)ng/ L;F = 264. 962,254. 398,P < 0. 01). While,the levels of IL-6,IL-10 in sepsis AKI group were higher than those in non AKI group(P < 0. 05). However,there was no significant difference among three sub AKI groups in terms of IL-6 levels. The IL-10 level in group Ⅲ was highest among three sub AKI groups(P < 0. 05).(3)ICU mortality in sepsis AKI group and non AKI group were 34. 8% and 14. 8%(χ2 = 3. 410,P = 0. 065). Meanwhile,ICU mortality in three sub-AKI groups were 20. 0% ,33. 3% , 57. 1% ,and there was no significant difference(P = 0. 120). The length of ICU stay in non ALI group was(4. 14 ± 1. 65)d,shorter than that in AKI group(10. 52 ± 3. 70)d;t = 8. 201,P = 0. 000). Meanwhile,The length of ICU stay in three sub-AKI groups were(8. 93 ± 1. 81)d,(10. 17 ± 2. 31)d,(14. 71. ± 2. 81)d,and the difference was significant(F = 19. 052,P = 0. 000). APACHE-Ⅱ in three sub-AKI groups Ⅰ,group Ⅱ,groupⅢ were 20. 20 ± 4. 07,21. 00 ± 3. 16,30. 57 ± 2. 44 respectively and the difference was significant(P < 0. 05 or P < 0. 01). Conclusion TLR4 mediated inflammation is involved in the sepsis AKI process. Because the damage degree of AKI is aggravating,immune factors also participate in the development of AKI. And with the decrease of HLA-DR,the probability of RRT increases.

Objective To study clinical characteristics of the patients with enosinophilic gastroenteritis(EG) and analyze the cause of misdiagnosis.Methods 6 cases of EG were analyzed in clinical characteristics,laboratory tests and endoscopy.The clinical characteristics of EG and the possible cause of misdiagnosis were studied.Results ⑴EG have a various clinical manifestation.The mucosal type have the commonest symptoms,such as epigastric pain,diarrhea.The serosal type was presented with abdominal pain,bloating.and ascites,accompanied with nausea,vomiting and low fewer.The patients in the muscular type had bowel obstruction symptom.⑵Enosinophilic counts in peripheral and bone marrow had high level(43 5?20 5)%,and it was related with condition of illness.⑶ESR,CRP and FIB were in normal range,but the IgG was low level.⑷The ascites were effusion with eosinophilia.⑸Endoscopies showed erosion and edema in antrum,duodenum and cecum,accompanied with eosinophilia infiltration in mucosa.⑹The steroid hormone therapy responsion was sensitive and all symptoms were relieved and eosinophils was recovered to normal value within one week.⑺Though their symptom recurrence was probable,good prognosis was got.Conclusions The key point for diagnsos is eosinophilia counts in peripheral blood and ascites.The biopsy of the gastrointestinal tract mucosa is also very important and helpful.

Objective Mapping the sites of earliest activation in AF patients with rheumatic heart disease. Finding out the ratio of AF originate from the pulmonary veins. Methods There were 9 patients with valvular atrial fibrillation (1 male, 8 females age (42?13) years, histories of rheumatic heart disease (11?9) years, and mitral valve area 1.01?0.02 cm2) involved in the research. 3 patients had organized thrombus in left atrial appendage. 6 patients with persistent AF received anticoagulation therapy (warfarin 2 or 3 weeks) and drug cardioversion (amiodarone 400 mg, three times per day, for 7 days) before procedures, while other 3 patients with paroxysmal AF received neither anticoagulation therapy nor drug cardioversion. All patients received percutaneous balloon mitral valvotomy (PBMV). After finished PBMV, four multipolar electrode catheters were placed in the high right atrium (HRA), coronary sinus (CS), left atrium (LA) and pulmonary veins (PVs). S1S2 and S1S2S3 programmed stimuli were delivered in HRA, CS, LA and PVs respectively. For the patients who failed to induce AF, burst stimuli were used. Results 11 AF generating sites, which induced by S1S2 and S1S2S3 programmed stimuli, could be confirmed by identification of the earliest regions of atrial activation for the first AF cycle. However, 1 AF obtained by 260 ms RR interval burst stimuli, affirmed by shortest activation cycle length. All confirmed 12 AF original sites were original as following: RA (n=4), LA (n=1), CS (n=2); PVs (n=5). Among the 5 PVs original sites, 3 was from left superior pulmonary vein, while the other 2 were from right superior pulmonary vein and left inferior pulmonary respectively. Conclusion PVs could be the ectopic origin of valvular AF.

Objective:To explore the anti-diabetogenic effect of antibody blocking portion of chemokine receptor-5 antibody(CCR5) molecule.Methods: The severe combined immunodeficient NOD(NOD.Scid) mice,injected i.p.with splenocytes from nonobese diabetic mouse,were randomly divided into 2 groups(8 of each group): anti-CCR5 Ab group and PBS group.The mice in anti-CCR5 Ab group were treated with a specific polyclonal antibody,targeting the first extracellular loop of CCR5,and PBS group was treated with PBS.Blood glucose levels were measured to observe the anti-diabetogenic effect of the antibody.Histological examination and ELISA analysis were also performed.Results: Within 70 d,all of the control mice developed diabetes while 5 of the 8 mice treated with anti-CCR5 Ab were diabetes-free.The difference of inflammation score between 2 groups was significant(P

Objective:To study the influence of dietary restriction on the expression of insulin signaling pathway genes in mouse adipose tissue. Method:Twenty four C57BL/6 male mice of 2 w age were subjected to either AL (ad libitum) or DR (dietary restriction, 40% from AL) randomly until sacrificed.Then the epididymis fat pads were weighed, and their insulin signaling gene expression was detected by Oligo Insulin Signaling Pathway Microarray (SuperArray), and two of the differentially expressed genes, NPY and AKT3 were validated by Real Time PCR. Results:Dietary restriction significantly reduced the weight of epididymis fat pads and 31 (20 up, 11 down regulation) of 96 insulin signaling pathway genes were differentially expressed. The results of Microarray coincided with that of Real Time PCR. Conclusion:The differential regulation on the expressions of insulin signaling pathway gene may be the important molecular basis of dietary restriction.

Covered in the paper are reform efforts made by the hospital on the HIS system amid the pilot programs total prepaid and mcdicine-drug separation trials in Beijing.Findings of the programs revealed defects of the HIS system,for example measures for refusal of payment of non-compliance items,and real-time reimbursement for patients.In view of these setbacks,the hospital made further attempts to the system in such aspects of the fundamental maintenance,rational drug usage and new problems,for the purpose of successful completion of the pilot programs at the hospital.Discussions were also made as to how to adapt the HIS system to total prepaid and the separation reforms,aiming at helping those not yet initiated with the reforms,and the information sharing of patient diagnosis/treatment records and social insurance payment at all hospitals in Beijing.