Objective To investigate the role of CD4+CD25+FoxP3+ in severe Mycoplasma pneumonia among children.Methods One hundred and forty children with M.pneumoniae pneumonia (65 severe and 75 non-severe) who were hospitalized were enrolled along with forty other children as controls.X-ray was assessed.The proportions of peripheral blood CD4+CD25+FoxP3+cells were determined by flow cytometry.Results Both severe and non-severe children had decreased CD4+CD25+FoxP3+cells as compared with control subjects in acute phase (0.87 ± 0.66％ vs.3.88 ± 2.00％,P ＜ 0.01 and 1.17 ± 0.70％ vs.3.88 ±2.00％,P ＜0.01,respectively).The levels of CD4+CD25+FoxP3+cells in severe children were lower than those in non-severe children in acute phase and recovery phase (0.87 ±0.66％ vs.1.17 ±0.70％,P ＜0.05 and 1.66 ±0.85％ vs.3.61 ± 1.45％,P＜0.01,respectively).Both severe children and non-severe children expressed higher CD4+CD25+FoxP3+cells in recovery phase than in acute phase (1.66 ± 0.85 ％ vs.0.87 ± 0.66％,P ＜0.01 and 3.61 ± 1.45％ vs.1.17 ±0.70％,P ＜0.01,respectively).Conclusion The expression of CD4+CD25+FoxP3+Tregs may play a role in the onset of severity of mycoplasma pneumonia and the low express of CD4+CD25+FoxP3+Tregs in children infected with M.pneumonia may increase the susceptibility to severe mycoplasma pneumonia.

Objective Published literatures on the relationship between IL-13 gene polymorphism and the susceptibility of children to bronchial asthma in China were comprehensively analyzed with the use of Meta-analysis to evaluate this relationship.Methods The data were collected from the Medline database,Ovid database,the Cochrane library,and Chinese Biomedical database,and the references of eligible studies were manually screened.Published data related to case-control studies reporting the link between IL-13 polymorphisms and asthma in Chinese children were retrieved through those database.Meta-analysis was conducted to determine whether the IL-13 gene polymorphisms were associated with asthma.Results Eighteen studies were finally accepted for analysis.There were three studies focusing on C-1 112T polymorphism,and six studies focusing on C + 1923T polymorphism,and fourteen studies focusing on G + 2044A polymorphism.There was no evidence to confirm that the genotypes in position IL-13-1112 C/T were associated with asthma in Chinese children [odds ratio(OR) =1.00,95％ CI 0.82-1.22,P =0.98].The OR of asthma for TT/CC genotypes was 1.15 (95 ％ CI 0.57-2.33,P =0.69) and for CT/CC was 1.01 (95 ％ CI 0.82-1.25,P =0.89).There was significant evidence to confirm that the genotypes in position + 1923 C/T were associated with asthma in Chinese children(OR =1.86,95％ CI 1.29-2.67,P =0.000 9).The OR of asthma for TT/CC genotypes was 2.12 (95 ％ CI 1.27-3.56,P =0.004) and for TC/CC was 1.67 (95％ CI 1.18-2.35,P =0.003).There was no correlation between IL-13 + 2044G/A polymorphism and the susceptibility (OR =1.33,95％ CI 0.94-1.88,P =0.11).The OR of asthma for AA/GG genotypes was 1.30 (95 ％ CI 0.76-2.20,P =0.34) and for AG/GG was 1.24(95％ CI 0.90-1.70,P =0.19).Conclusions IL-13 gene + 1923 TT and TC genotypes should be associated with susceptibility of asthma in Chinese children,and the T allele could increase the risk of asthma.No clear relationship was found between the genotype TT/TC at the IL-13-1112 site and the incidence of asthma of children in China,and so was the genotype AA/AG at the IL-13 +2044 site and the incidence.

Objective To investigate the effects of recombinant human augmenter of liver regeneration (rhALR) on renal inflammation in acute kidney injury (AKI) induced by renal ischemia reperfusion (IR). Methods SD rats were randomly divided into sham-operated group,IR group,rhALR1 group (100 μg/kg) and rhALR2 group (200 μg/kg).Both renal pedicles of rats were identified and occluded with microvascular clamps for 60 min to induce acute kidney injury (AKI).Blood urea nitrogen and serum creatinine levels were evaluated using a Hitachi 747 automatic analyzer. For histological examination, sections were stained with HE. The activity of myeloperoxidase (MPO) was detected by spectrophotometer.Expression of TNF-α,ICAM-1,MCP-1 was determined by Western blotting. Results Blood urea nitrogen,serum creatinine levels and the injury of kidney were improved significantly in rhALR group as compared with IR group (all P＜ 0.05).They were improved more significantly in rhALR2 group as compared to in rhALR1 group (all P＜0.05).The protein levels of TNF-α,ICAM-1,MCP-1 and the activity of MPO in kidneys from the sham-operated rats were low,and increased significantly after renal ischemia reperfusion injury (all P＜0.05).After treated with rhALR,the expression of TNF-α,ICAM-1,MCP-1 and the activity of MPO were decreased significantly in kidneys as compared to those in IR group (all P＜0.05),which decreased more significantly in rhALR2 group than those in rhALR1 group (all P＜ 0.05). Conclusions nhALR can protect kidneys from ischemia reperfusion injury in rats.The mechanism may be associated with the inhibition of renal inflammatory cells infiltration and down-regulated expressions of YNF-α,ICAM-1 and MCP-1 in the kidney.

Objective To investigate the association of human leukocytes antigen(HLA)-DR/DQ with oral lichen planus(OLP) in the area of Yangtze River Delta. Methods HLA-DRB1 and DQB1 genotyping of 44 unrelated OLP patients and 150 normal controls were performed by polymerase chain reaction-sequence specific primers(PCR-SSP) method.The data were compared between the OLP group and normal controls,and between different types of OLP patients. Results The frequency of HLA-DRB1*09 and HLA-DRB1*07 alleles were significantly higher in OLP group than those in normal controls(56.8% vs 31.3% and 27.3% vs 13.3%,P

Objective To explore the effect of negative pressure attraction method of brushing and washing apply in oral care of patients with orotracheal intubation.Methods Totals of 82 oral intubation patients in ICU were randomly selected and divided into experience group ( n =42 ) and control group ( n =40 ).The traditional method of oral care was used in control group,while the negative pressure attraction method of brushing and washing was used in experience group,then,the incidence of oral infections,ventilator-associated pneumonia( VAP),dental plaque and oral mucosal injury were observed in two groups.Results The incidence of oral infections,ventilator-associated pneumonia(VAP),dental plaque in experience group respectively were 7.14％,2.38％,4.76％,and that in control group were 22.50％,15.00％,32.50％,the differences were statistically significant ( x2 =3.88,4.18,10.55,respectively; P ＜ 0.05 ),while there was no significant difference in the incidence of oral mucosal injury between two groups ( P ＞ 0.05 ).Conclusions The negative pressure attraction method of brushing and washing can effectively keep the oral clean of patients with orotracheal intubation,reduce the incidence of oral infections and ventilator-associated pneumonia and dental plaque,when compared with the traditional method of oral care.

Objective To investigate the features and significance of pathologic changes in apoptosis of small bowel allograft during acute rejection in rats. Methods All 24 recipients were equally divided into four groups ; group A: nonoperative control; group B: allograft ; group C: isograft, group D: treatment control. The graft samples were harvested on day 3, 5, 7, 10 after transplantation, and subjected to histologic examination . Mucosal thickness, villous height and crypt depth were measured, and apoptotic cells of intestinal mucosa of grafts on day 3,5 and 7 after transplantation were examined. Results The mucosal structure was normal in group A; The degree of the inflammatory infiltrated cells ,intestinal mucosa cell apoptosis and structural injury of mucosa in group B were significantly severe compared with groups C and D. As the post-transplanted time increased, the number of musocal apoptotic cells and the degree of mucosal structural injury were significantly increased. The degree of mucosal structural injury in group C was milder than in group B. A few infiltrated cells and mild edema of mucosa occurred in group D , but no mucosal structural injury was found. Conclusions Inflammatory cell infiltration, mucosal epithelial cell apoptosis and mucosal structural damage are the main pathologic features of small bowel allograft during acute rejection. Dynamic observation of the pathologic changes and cell apoptosis of small bowel graft is of certain value in the diagnosis of acute rejection of small bowel graft and in assessment of the degree of small bowel injury.

Objective To investigate the effects of extracorporeal membrane oxygenation (ECMO) on survival of adult from acute respiratory distress syndrome (ARDS). Method We searched Pubmed, Embase, Cochrane Library, Web of Science databases to find relevant literatues on ECMO in treatment of ARDS, which are reported from January 1966 to June 2010. Meta analyses was performed. Results Three papers about randomized controlled trial (RCT) of evaluating ECMO in patients with severe ARDS were enrolled for analyses. Meta-analysis of the three randomized controlled trials revealed ECMO did not decrease the mortality of ARDS patients. However, the cumulative meta-analysis of randomized trials showed ECMO had a protective effect on patients with ARDS. The most recent observational studies suggested that ECMO significantly decreased the mortality of ARDS caused by H1 N1 viral pneumonia. Conclusions There is no evidence to prove the benefit of ECMO in patients with ARDS. However, ECMO should be considered to use in early stage of ARDS as a last rescue resort for potentially reversible severe acute respiratory failure. Further investigation of large sample of high quality RCTs is needed.

Objective To assess the feasibility and safety of adjustable loop-based purse-string technique in gastrotomy closure of natural orifice translumenal endoscopic surgery (NOTES).Methods Ten healthy female dogs were used in this study.Transgastric NOTES peritoneal exploration was performed in 5 groups (2 dogs in each) via various sites of the stomach ( greater curvature of the antrum; greater and lesser curvature of the body; anterior and posterior wall of the body).The gastric incision was then closed by using loop-based purse-string technique.Healing of the incision and intra-peritoneal infection were checked by endoscopy,necropsy,bacterial culture and histological examination 2 weeks later.Results The performance of NOTES peritoneal exploration and closure with purse-string technique was successful in ten dogs without significant complications.The mean operation time of closure was 7.3 ± 1.8 min.Minor bleeding occurred in 2 dogs (20％) during the incision of greater curvature of the antrum and body,which was controlled by electrocoagulation.Culture of the ascitic fluid and necropsy revealed no sign of abdominal infection or other complications except for adhesion in 1 dog ( 10％ ).The intact incision was confirmed by endoscopic,postmortem and histological examination,which suggested complete healing of the incision.Conclusion It is easy and safe to use loop-based purse-string technique for closure of multi-regional NOTES gastrotomy.This technology may be used for the repair of gastric ulcer perforation theoretically.

Objective To investigate the clinical features and treatments of pituitary abscess.Method The clinical data of 6 patients with pituitary abscess were examed along with a review of the literature.Results Of 6 patients,headache was presented in 5 patients,hypopituitarism in 4 patients,visual disturbance and/or bitemporal hemianopsia in 4 patients and fever in 1 patient.MRI and CT images showed a cystic sellar lesion with ring enhancement in 5 patients.Preoperative diagnosis of pituitary abscess was made in 2 patients,pituitary adenomas in 3 patients and craniopharyngiomas in 1 patient.All cases were treated surgically by transsphenoidal approach in 5 patients and transscranial in 1 patient.Followed with postoperative antibiotics therapy for 3 weeks,the symptoms were improved postoperatively in all cases.Followed up 8 months to 10 years,1 patient who underwent craniotomy recurred and wag cured by via transsphenoidal surgery.Conclusions The pituitary abscess is easily misdiagnosed.The cystic pituitary lesion should be considered the possibility of pituitary abscess.Transsphenoidal surgery and proper perioperative antibiotics therapy are the keys to the treatment of pituitary abscess.