Objective To systematic review the clinical efficacy and safety of infliximab in treatment of severe alcoholic hepatitis (SAH).Methods The electronic database of PubMed,EMbase,Web of Science,OVID and Cochrane systematic review database,CBM disc and CNKI from building the database until March 2013 were retrieved.With SAH,severe alcoholic hepatitis,infliximab and tumor necrosis factor as key words or free words.Randomized-controlled trials (RCT) on infliximab in treatment of SAH was selected and analyzed by Meta analysis.Results Two RCTs was enrolled,included 56 SAH patients.Infliximab (10 mg/kg) combined with glucocorticoids (40 mg/d) might accelerate death because of the high prevalence of serious infections.Infliximab (5 mg/kg) combined glucocorticoids (40 mg/d) had more tolerability and improved patient's Maddrey scores significantly.Conclusions Existing clinical evidence suggest that it is short of evidence for the clinical efficacy and safety of infliximab.It need guide by large sample of clinically and different doses RCT.

Objective To observe effects of tetrandrine on β-glucan induced RAW 264 .7 cells proliferation .Methods RAW 264 .7 cells model was established .Four methyl thiazol tetrazolium(MTT) was used to detect the effects of different concentrations of tetrandrine on the proliferation of RAW264 .7 cells .The levels of interleukin(IL)-6 ,tumor necrosis factor-α(TNF-α) ,prostaglan-din E2 (PGE2 ) and IL-10 in the culture supernatant were measured by enzyme linked immunosorbent assay(ELISA) .Results MTT results showed that the growth curves of different concentrations of tetrandrine on RAW264 .7 cells had biphasic affections .ELISA results suggested that tetrandrine could inhibit the IL-6 ,TNF-α,PGE2 expressions and promote IL-10 expression .Conclusion Effects of tetrandrine onβ-glucan induced RAW264 .7 cells proliferation are relative to inhibition of IL-6 ,TNF-α,PGE2 expressions and promotion of IL-10 expression .

Objective To analyze the nutritional status of patients with continuous ambulatory peritoneal dialysis and explore reasonable and effective nursing measures.Methods Nutritional assessment was performed in 60 patients with continuous ambulatory peritoneal dialysis,using subjective integrated nutritional assessment,dietary analysis,measurement of biochemical indexes of the human body to analyze the factors that might affect the nutritional status of patients.Results 60 cases of malnutrition occurrd in 20 patients (33.3per cent),mainly due to insufficient protein and energy intake,inadequate dialysis,peritoneal inflammation,metabolic acidosis,psychosocial factors and not using erythropoietin,and so on.Conclusions Measures such as emphasis paid to malnutrition status of continuous ambulatory peritoneal dialysis patients,giving guidance of rational diet,performing full implementation of nursing measures according to the related factors,can improve the nutritional status of patients and improve patients' quality of life.

[ ABSTRACT] AIM: To investigate the differential expression of human leukocyte antigen-G ( HLA-G) isoforms and its receptors in human monocyte line THP-1 after human cytomegalovirus ( HCMV) infection for exploring the role of HLA-G in HCMV escaping the immune response of the organism .METHODS: THP-1 cells were infected with HCMV Towne strain.The expression of HLA-G isoforms at mRNA and protein levels was determined by RT-PCR and Western blot, respectively.The surface expression of HLA-G and its receptors ILT2/ILT4 and the cell viability were analyzed by flow cytometry.The levels of soluble HLA-G (sHLA-G) and IL-10 were measured by ELISA.RESULTS:After infection of the THP-1 cells with HCMV , no obvious apoptosis in the cells was observed , and the viability of the cells was high .A significant up-regulation of HLA-G1,-G3,-G4 and-G5 at mRNA expression level 1 d after infection was found , while the protein expression of HLA-G1 and HLA-G5 isoforms was mainly detected .The expression of HLA-G/ILT2/ILT4 was evi-dently up-regulated 1 d after infection .The level of sHLA-G was significantly increased 1 d after infection as compared with control group (P<0.01).The expression of IL-10 was obviously up-regulated 1 d post-infection as compared with control group.CONCLUSION:The differential expression of HLA-G isoforms and secretion of the receptors ILT 2/ILT4 and IL-10 in the THP-1 cells are induced after HCMV infection .This study provides experimental evidence for evaluating the immune mechanism of HCMV infection .

Objective To investigate the changes of immune function and blood coagulation function in pa-tients with pulmonary tuberculosis(PTB)with chronic obstructive pulmonary disease(COPD)and its correla-tion with lung function.Methods 65 cases of PTB patients with COPD were selected as PTB with COPD group,50 cases of patients with PTB were selected as PTB group,another 50 healthy people were selected as control group;the level of immune function and coagulation function were compared between the three groups,and the relationship between immune function,coagulation function and pulmonary function was ana-lyzed.Results The differences of CD3+,CD4+,CD4+/CD8+,TT,APTT,PT,FIB,FEV1,FVC and MMEF between the three groups were statistically significant(P<0.05);The levels of CD3+,CD4+,CD4+/CD8+, APTT,FEV1,FVC and MMEF in PTB group and PTB group with COPD were significantly lower than those in control group,and PTB group with COPD group was significantly lower than that in PTB group,the differ-ence was statistically significant(P<0.05);The levels of TT and FIB in PTB group and PTB group with COPD were significantly higher than those in control group,and PTB group with COPD group was significant-ly higher than that in PTB group,the difference was statistically significant(P<0.05);The results of corre-lation analysis showed that FEV1,FVC and MMEF had significant positive correlation with CD3+,CD4+, CD4+/CD8+,APTT and PT(P<0.05),and negatively correlated with TT and FIB(P<0.05),and there was no significant correlation between FEV1,FVC,MMEF and CD8+(P>0.05).Conclusion The patients with PTB accompanied with COPD have abnormal cellular immune function and abnormal coagulation func-tion,and the level is significantly correlated with lung function.

BACKGROUND: Currently, the materials used in clinical practice to repair cruciate ligament of knee joint contain auto-graft bone- mid 1/3 patella tendon-bone (B-T-B), auto-semitendinous muscle, gracilis muscle and allogenic tissue graft. All of them are limited to a certain degree in clinical application. Therefore, people hope to consistently develop artificial ligaments to take the place of auto- and allografts. OBJECTIVE: To investigate the feasibility to construct artificial biological ligament (ABL) by applying a novel biochemical technique using porcine tendon as the raw material. DESIGN: Research of new biological material. SETTING: Department of Orthopedics, Third Affiliated Hospital of Sun Yat-sen University. MATERIALS: Adult pigs of either gender were provided by the Animal Center of Sun Yat-sen University. Scanning electron microscope (SEM, S-520) was provided by Hitachi, Japan, and micro-controlled electron tension-testing device (Model LWK-10B) by Guangzhou Experimental Devices Factory. METHODS: The experiment was performed at the Animal Center of Sun Yat-sen University from January 2004 to June 2005. ABL was established by means of treating porcine tendon with epoxy cross-linking fixation, diversified antigen minimization process, mechanic enhancement modification and surface activating process. Under aseptic condition, a 6-month-old goat's bone marrow was abstracted, and then the bone marrow matrix stem cells were cultured in ABL stent for 3 weeks. Scanning electron microscope was used to observe structure and compatibility of artificial ligament, and mechanics test was used to analyze biomechanics characteristics of ABL. MAIN OUTCOME MEASURES: Structural features, cell compatibility and biomechanics characteristics of ABL.RESULTS: ① Structural features of ABL: The appearance of ABL was similar to that of the normal human ligament. Histological examination showed that the ABL was collagen fibers with no cells. Electron microscope examination revealed that the ABL was composed of hair-looking and fiber-like objects running uniformly in a certain direction and closely parallel-arranged. ② Cell compatibility: Three weeks after xenogenic marrow matrix cells were cultured on the surface of the ABL, it was noted that cells adhered and the matrix secreted by the cells precipitated around the cells. There were no cells found inside the ABL. ③ Mechanical strength of the ligament: The average diameter of ABL was 5 mm and the mechanical test at a speed of 100 mm/min showed that its averaged tensile limit was 927.19 N and the tension-resistant strength was 47.22 N/mm those were close to the corresponding parameters of the normal goat's ACL. The normal goat's ACL was 5 mm. The greatest tensile load was 807.50 N and the tension-resistant strength was 41.13 N/mm.CONCLUSION:As we used the unique biochemical technique and minimized the xenogenic protein immunogenicity of the porcine tendon, ABL has acceptable biomechanical properties and superior biocompatibility. As a substitute of the ligament in the reconstruction of the ACL, ABL has a promising prospect in clinical applications.

Objective:To express the glycoprotein D of herpes simplex virus type 2 (gD2) in the insect cells,and to determine its immunogenicity.Methods:HSV-2 genome was used as the template for amplification of gD2 extracellular domain fragment gene by PCR.The PCR product was inserted into the vector Bacmind,and the constructed recombinant plasmid gD2-Bacmind was transfected into the sf9 cells to package the recombinant baculovirus.The Sf9 cells were infected by recombinant baculovirus seed derived from the forth passage(P4),the titer of P4 recombinant baculovirus was detected by a plaque assay and the expression of recombinant protein gD2 was determined by Western blotting method.The supernatant of infected cells was collected and purified by Ni-NTA affinity chromatography to obtain the target protein gD2,the purified gD2 protein was used to immunize the BALB/c mice in 0, 2, 4 weeks (gD2 group),and PBS was used as negative control(PBS group);the titers of gD2 specific IgG in serum were detected by ELISA assay.Results: The PCR analysis and sequencing results proved that gD2-Bacmind was constructed correctly.The titer of recombinant baculovirus was 2.0×109 pfu·mL-1,the purified gD2 was about 37 000 with expectation,the percentage of gD2 in total protein was 90%.The average value of Log10 of titer of gD2 specific IgG in serum detected by ELISA assay in gD2 group at the sixth week was 4.34,and there was significant difference compared with PBS group(P<0.01).Conclusion: The gD2 expressed by insect-baculovirus expression vector system has the immunogenicity and can be selected as candidate protein for HSV-2 vaccine.

Objective:To investigate the associations of major depressive disorder with coronary heart disease (CHD)and stroke in Chinese adults aged 30 -79 years.Methods:In 2004 -2008,China Ka-doorie Biobank was conducted in 1 0 geographically defined regions (5 urban and 5 rural)of China.A to-tal number of 51 2 891 participants aged 30 -79 years were recruited in the baseline survey.A laptop-based electronic questionnaire was administrated face-to-face by trained health workers,collecting the general demographic and socio-economic status,dietary and other lifestyle behaviours (e.g.smoking,al-cohol drinking,physical activity),medical history and family history of common chronic diseases.Major depressive episodes (MDE)in the past 1 2 months were assessed with the World Health Organization composite international diagnostic interview-short form (CIDI-SF).The physical measurements included the heights and weights,which were used to calculate the body mass indexes (BMI).Chi squared and t test were used to compare the differences in participants characteristics according to their major depressive disorder.Logistic models were employed to estimate the odds ratios (OR)and 95% CI of their major de-pressive disorder with prevalent coronary heart disease and stroke.Results:Among the 51 2 891 partici-pants,3 281 (0.6%)showed an MDE in the preceding 1 2 months,1 5 472 (3.0%)reported prevalent CHD,and 8 884 (1 .7%)reported prevalent stroke.Major depressive disorder was significantly associa-ted with an increased risk of CHD and risk of stroke.Age-and gender-adjusted ORs (95% CI)were 1 . 80 (1 .53 -2.1 2)for CHD and 2.53 (2.09 -3.05)for stroke.The associations were significant after further adjustment for potential confounders,such as other socio-demographic status,smoking,alcohol drinking,physical activity,and BMI,prevalent hypertension,diabetes as well as family history of cardio-vascular diseases (OR =1 .83,95% CI =1 .54 -2.1 8 for CHD;OR =2.1 9,95% CI =1 .79 -2.69 for stroke).Moreover,gender significantly interacted with MDE on prevalent stroke (P for multiplicative in-teraction =0.01 3).The men with an MDE in the past 1 2 months had the highest risk of stroke in the joint analyses of gender and depression disorder (OR =5.02,95% CI =3.70 -6.82).Conclusion:The findings from this large cross-sectional study suggest that the presence of MDE is a risk factor for both CHD and stroke in Chinese adults aged 30 -79 years,but further prospective studies are warranted to validate the results.

PURPOSE: At this time, there is uncertainty regarding whether allergen avoidance is the most appropriate strategy for managing or preventing allergies. The purpose of this study was to evaluate the effectiveness of allergen avoidance in the prevention of allergic symptoms in previously sensitized patients and newborns that have the potential to develop allergies. METHODS: We performed online searches of articles published from January 1980 to December 2012 in PubMed and The Cochrane Central Register of Controlled Trials, and selected articles involving randomized controlled trials (RCTs) and allergen avoidance. The parameters used to determine allergenic potential in newborns included the risk ratio (RR) of eczema, asthma, rhinitis, wheeze, and cough. The methods employed to evaluate previously sensitized patients were the standardized mean difference (SMD) of forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate (PEFR). Data quality was assessed using the Jadad scale. RESULTS: A total of 14 RCTs were identified. Meta-analysis demonstrated that allergen avoidance for newborns did not reduce the subsequent incidence of allergic diseases (eczema, P=0.21; rhinitis, P=0.3; cough, P=0.1) but significantly reduced the incidence of asthma and wheezing in high-risk infants (asthma, P=0.03; wheeze, P=0.0004). However, previously sensitized patients who reduced their exposure to known allergens did not show improvement in their lung functions (FEV1, P=0.3; PEFR morning, P=0.53; PEFR evening, P=0.2; PEFR, P=0.29). CONCLUSIONS: Allergen avoidance may not always be successful in preventing allergic symptoms. However, rigorous methodological studies are required to confirm this hypothesis.
Allergens ; Asthma ; Cough ; Eczema ; Forced Expiratory Volume ; Humans ; Hypersensitivity ; Incidence ; Infant* ; Infant, Newborn ; Lung ; Methods ; Odds Ratio ; Peak Expiratory Flow Rate ; Data Accuracy ; Respiratory Sounds ; Rhinitis ; Uncertainty

Objective To investigate the influences of maternal gestational diabetes mellitus (GDM) on amino acid levels in neonates.Methods From June 2016 to May 2017,393 pregnancies diagnosed with GDM in Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University and 3 924 normal pregnancies were enrolled in this study.Clinical data of the gravidas and their newborns were collected.Heel blood samples were collected at 72 to 96 hours after birth.Tandem mass spectrometry was performed to detect the levels of 11 amino acids including alanine,arginine,citrulline,glycine,leucine/ isoleucine/hydroxyproline,methionine,ornithine,phenylalanine,proline,tyrosine and valine in neonatal heel blood.Differences in amino acid levels between the two groups were compared by t test.Influences of GDM on neonatal amino acid levels were analyzed by multivariate linear regression.Results Compared with the healthy pregnancy group,neonates in the GDM group had higher levels of methionine [(21.01 ±6.30) vs (19.93±6.47) μmol/L,t=3.159,P=0.002] and phenylalanine [(47.19±9.19) vs (45.78±8.58) μ mol/L,t=3.076,P=0.002],but lower levels of alanine [(280.51 ±64.54) vs (290.15±68.40) μ mol/L,t=2.678,P=0.007],proline [(147.64±30.64) vs (152.36±33.57) μ mol/L,t=2.680,P=0.007],tyrosine [(85.21 ±29.50) vs (90.60± 33.32) μ mol/L,t=3.089,P=0.002] and ornithine [(101.22±28.79) vs (105.83±30.10) μmol/L,t=2.906,P=0.004].Multivariate linear regression analysis showed that GDM was responsible for the increase of methionine (β=0.69,95％CI:0.02 to 1.37,P=0.044) and phenylalanine (β=1.60,95％CI:0.69 to 2.51,P=0.001),and the decrease of tyrosine (β=-4.98,95％CI:-8.42 to-1.54,P=0.005) and ornithine (β=-3.16,95％CI:-6.30 to-0.02,P=0.048) in neonates.Conclusions GDM neonates has increased of methionine and phenylalanine levels and decreased tyrosine and omithine levels.