Objective In this study,we determined whether or not cancer-reactive cytotoxic T-lymphocytes(CTLs)could be induced from peripheral blood mononuclear cells(PBMCs)of colon cancer patients by in vitro stimulation with a PAP peptide.Methods The PBMCs of HLA-A24+ colon cancer patients and healthy donors were stimulated with a PAP213-221 peptide in vitro.The PAP-specific IFN-? was measured by ELISA.The cytotoxicity of CTLs were examined by 51Cr release assay.Results IFN-? produced by the PBMCs of 3 of 5 colon cancer patients and 1 of 8 healthy donors after incubation with PAP213-221 peptide pulsed C1R-A2402 cells were significantly higher then that after incubation with HIV peptide pulsed C1R-A2402 cells(P

Objective To observe the effect of early pulmonary rehabilitation (PR) on patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods AECOPD patients (n=97) were randomly distributed into two groups:control group (n=39) and rehabilitation group (n=58). Patients in both groups were assessed when symptom im?proved from acute phase (baseline, T1). Then patients in control group only received pharmaco-therapy and rehabilitation ed?ucation without PR. When symptom was relieved and stable (T2), they were given 12 weeks PR (T3). On the other hand, pa?tients in rehabilitation group underwent a 12-week PR after T1 directly (T2). The lung function parameters, 6 min walking distance (6MWD), MRC scores and CAT scores were observed and analyzed in two groups. Results Until the end of the 12-weeks observation, the value of lung function showed no statistic differences between two groups(either T1 in control group vs T1 in PR group or T2 in PR group vs T2 and T3 in control group. In control group, the value of 6MWD scores of T3 was bet?ter than that of T1 and T2, in PR group(F6MWD=8.762,FMRC=4.432,FCAT=10.266,P<0.05)while MRC, CAT value in T3 of control group were higher than those in T1 and T2 of PR group. At T1, parameters does not demonstrate significant difference between these two groups. Value of 6MWD was higher while MRC and CAT were lower in T2 of PR group than that in T2 and T3 of control group. Conclusion Early pulmonary rehabilitation could improve the mobility and qulity of life, as well as ameliorate the severity of dyspnea in AECOPD patients.

Objective To study the lung protection of ambroxol in general thoracic surgery perioperation for the elderly.Methods Totally 130 hospitalized patients aged (65.1±4.3) years in our hospital during general thoracic surgery were randomly divided into two groups:ambroxol intervention(2 mg/kg,intravenous drip,once/d) and control groups (n=65 for each).The incidenceof pulmonary complications,changes of blood gas analysis before and after surgery and time of hospitalization were compared between the groups.Results The incidence of pulmonary complications was significantly lower in ambroxol intervention group than in control group (9.23％ vs.24.62％,P＜0.05).Blood gas analysis results before and after surgery were improved in ambroxol intervention group[PaO2:(61.32±8.65) mm Hg,(95.07±13.62)mm Hg; PaCO2:(44.15±5.52)mm Hg,(37.28±4.06)mm Hg] as compared with control group[PaO2:(62.11 ± 8.83) mm Hg,(80.37±10.46)mm Hg; PaCO2:(44.39±5.17) mm Hg,(40.73±4.51)mm Hg] (t=3.61,3.75,both P＜0.05).The time of hospitalization was shorter in ambroxol intervention group than in control group [(12.14±0.29) d vs.(15.85±0.62)d,t=3.41,P=0.036].Conclusions Perioperative use of ambroxol in general thoracic surgery in the elderly is worthy of clinical application because of reduction of pulmonary complications and shortness of hospital stay.

Objective To identify objective methods for medical service performance evaluation,and means to improve the efficiency of medical services.Methods By means of collection of medical records from 10 tertiary hospitals in Yunnan in 2012,and Diagnosis-related groups of Beijing version(BJDRGs)as a risk-adjustment tool,medical service performance was made to such hospitals.Results The capacity,efficiency and medical safety of hospital of the hospitals were subject to a comprehensive evaluation of their medical service capabilities.In terms of discharged inpatients and total weight,hospital A were found to be the highest(77 458 cases,104 227.5 respectively),and hospital I the lowest(25 450 cases,38 162.28)among these hospitals in 2012; compared with other hospitals,DRG groups of hospitals A,b and D were found higher,while the case mix index(CMI)of hospitals e and I were higher.The expenditure index of hospital C is the lowest(0.9359,0.8514); the mortality in cases of low risk of hospitals B,c and D were the lowest,while hospital F was the highest.Conclusion DRGs as a risk adjustment tool,can significantly improve the reliability,science and continuity of medical service performance evaluation,providing reliable basic data for hospitals accreditation in Yunnan.

Objective:To investigate the competency of informed consent in new admitted schizophrenia pa-tients.Methods:Fifty-three patients who were consecutively admitted to the hospital and diagnosed as schizophrenia according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision (ICD-10)were recruited and assessed in seventy-two hours.The competence of informed consent was assessed by the MacArthur Competence Assessment Tool-Treatment (MacCAT-T).The insight was assessed by the Insight and Treatment Attitude Questionnaire.The severity of illness was assessed by the Brief Psychiatric Rating Scale (BPRS).Correlations between the competence of informed consent and the factors mentioned above were discussed.Results:Forty-five (84.9%)patients had lower MacCAT-T scores,especially the scores of understand-ing dimension (1.58 ±1.85)and appreciation dimension (2.40 ±1.47).The competence of informed consent was significantly correlated with insight (r =0.73,P <0.01)but not correlated with age,education,duration of illness and BPRS scores.Logistic regression demonstrated that insight (OR =0.69)was a protective factor of competence of informed consent while thought disturbance (OR =1.39)was a risk factor.As to the involuntary admitted pa-tients,34.1% of them had competence of informed consent.Conclusion:The competence of informed consent in new admitted schizophrenia patients is widely impaired especially in understanding and appreciation dimension.The competence of informed consent is correlated with insight and thought disturbance.Voluntary or involuntary hospi-talization does not reflect the level of competence of informed consent.

BACKGROUND:Mesenchymal stem cel s are multipotent progenitor cel s that can be isolated from the bone marrow, adipose tissue, umbilical cord blood and so on. Mesenchymal stem cel s possess strong immunosuppressive effects on both innate and adaptive immunity.
OBJECTIVE:To summarize the immunomodulatory properties of mesenchymal stem cel s for T lymphocytes, B lymphocytes, natural kil er cel s and dentritic cel s and prospect its therapeutic implication.
METHODS:PubMed and CNKI databases were searched for relevant literatures published from 2000 to 2015. The key words were“mesenchymal stem cel s, immunomodulator, T cel s, B cel s, NK cel s, dendriticc cel s”in Chinese and English, respectively. Then, 61 papers were included and further analyzed.
RESULTS AND CONCLUSION:The immunomodulatory effects of MSCs on lymphocytes, B lymphocytes, natural kil er cel s and dentritic cel s were elicited by cel-cel contact and soluble cytokines. But mesenchymal stem cel s from different sources hold different immunomodulatory effect on immune cel s. When we use mesenchymal stem cel s in clinic, some important factors, such as isolation methods, cel sources, colonization sites, should be taken into account. In order to ensure the clinical safety and effectiveness, there are stil many problems to be further studied before mesenchymal stem cel s can be widely used in clinic.

Objective To determine the biological characteristics of human embryonic MSC (hMSCs) and their potential ability of differentiation, and to investigate the survival and distribution of hMSCs after transplantation into the kidney of newborn mice. Methods hMSCs were derived from 4-7 week-old embryos, then primary culture was done. The biological characteristics of hMSCs were detected by immunohistochemical methods and flow cytometry. Their differentiation potential was determined by coculture with conditioning medium. The survival and distribution of PKH-26-stained hMSCs in mice were observed by laser scanning confocal microscope. Results Flow cytometry and immunochemistry staining revealed that the expression of CD29, CD44, CD90, SH-2, OCT-4 was positive significantly, and CD34, CD45 was negative. The cells could be induced to differentiate to osteocytes and adipocytes under special conditions. After transplantation for 1 month, PKH-26-stained hMSCs still existed in the kidney of mice and co-localized in tubular epithelium by confocal microscope. Conclusion hMSCs derived from the early human embryo have the ability of proliferation and differentiation with low immunity, and may be involved in the development of renal tubule in newbem mice.

Objective To observe whether the intravenously transplanted homologous bone marrow mesenchymal stem cells (MSCs) can migrate to the impaired pancreas tissue in the rats with acute necrotizing pancreatitis (ANP). Methods MSCs were isolated from bone marrow of male Sprague-Dawley (SD) rats and adhered to the culture plate in vitro. Female rats were divided randomly into 3 groups:normal transplantation group, ANP transplantation group, ANP group with 10 rats in each group. ANP was induced by intraperitoneal injections with L-arginine. Both transplantation group received MSCs infusion through tail vein. 72 h later, the rats were sacrificed, the pancreas, heart, liver and kidney tissues were harvested, and the morphological changes were examined and scored, the characteristics of migration of MSCs to pancreas were detected with the expression of sry gene of Y chromosome by using chromogenic in situ hybridization (CISH). Results Rapid proliferation occurred in isolated MSCs after culture for 3 ～ 5 days and colonies were formed. After 3 generations, CD29 + CD44 + CD45-cells accounted for over 95% of all the cells. There ware massive tissue necrosis, inflammatory cells infiltration in the pancreas of ANP group, the pathological score was 10.31 ±0. 85, which were significantly higher than that in ANP transplantation group (7.30 ±0.79, P ＜ 0.05). Sry gene could be detected in the pancreas, heart, liver and kidney tissues. In addition, scattered distributed sry positive cells were observed in the normally transplanted pancreatic tissue, lots of sry positive cells were observed in the ANP transplanted pancreatic tissue, and they were located in the most injured areas.Conclusions The inflammatory pancreatic tissue has the ability of recruiting MSCs in vivo, which can alleviate local inflammation.

The purpose of this study is to evaluate the embryotoxicity of alkaloids in Senecionis Scandentis Hebra on in vitro cultured mouse embryos. Mouse whole embryo culture (WEC) was applied in this study. Post-implantation (8.5 d) mouse embryos were isolated from their mothers, and cultured in medium of immediately centrifuged serum (ICS) with different concentrations of seneciphylline (target concentrations were 100, 50, 25 and 12.5 μg x mL(-1)) or senkirkine (target concentrations were 50, 25 and 12.5 μg x mL(-1)) for 48 h. After culturing completed, the development and organic morphodifferentiation of the cultured embryos were evaluated microscopically. Treatment with seneciphylline and senkirkine had adverse effects on the development and organic morphodifferentiation of embryos. The effect also had clear dose-response. Alkaloidals in Senecionis Scandentis Hebra had embryotoxicity on cultured embryos, which indicated that pregnant people exposed to Senecionis Scandentis Hebra may get potential risk on fetus.