Objective To study the clinical effects of pulmonary recruitment maneuvers combined with pressure regulation volume control (PRVC) in the treatment of severe respiratory distress syndrome (RDS) in premature infants.Method From July 2015 to September 2016,preterm infants of grade Ⅲ-Ⅳ RDS who received PRVC treatment in neonatal department of Huai'an Maternal and Child Health Hospital were assigned into recruitment maneuver group and control group (without recruitment maneuver) using randon number table.The ventilator parameters were observed at 1,2,6,12,18 h and 24 h after ventilation.Recovery rate,duration of oxygen therapy and ventilation,duration of hospital stay,incidence of second dose of pulmonary surfactant and complications were compared between two groups.Result A total of 18 cases were included in recruitment maneuver group and 19 cases in control group.The recovery rate of recruitment maneuver group was higher than control group (16/18 vs.10/19).The duration of oxygen therapy [(6.6 ± 2.3) d vs.(11.8 ± 3.0) d],duration of ventilation [(4.1 ± 2.3) d vs.(6.4 ± 2.8) d],duration of hospital stay [(26.7 ± 7.0) d vs.(33.0 ± 8.4) d] in recruitment maneuver group were significantly shorter than control group (P ＜ 0.05).The proportion of bronchopulmonary dysplasia (1/18 vs.8/19),retinopathy of premature (1/18 vs.7/19),patent ductus arteriosus that require medication closure (1/18 vs.7/19)and incidence of second dose of pulmonary surfactant (2/18 vs.9/19) in recruitment maneuver group were significantly lower than control group (P ＜ 0.05).While the complication of air leak,necrotizing enteritis,Ⅲ-V grade intracranial hemorrhage showed no significant differences between the two groups (P ＞ 0.05).Conclusion Recruitment maneuvers combined with PRVC in treatment of severe RDS premature infants can improve recovery rate and oxygenation.It can also shorten the duration of oxygen therapy,ventilation and hospital stay.It can reduce the incidence of bronchopulmonary dysplasia and retinopathy of premature.It is worth spreading in clinical practice.reduce the incidence of bronchopuhmonary dysplasia and retinopathy.It is worthy of promotion.

The purpose of study was to evaluate the effect of stopping use of cyclosporine A (CsA) in reversion of donor chimeras of chronic myeloid leukemia (CML) patients relapsed after transplantation. Two CML patients were transplanted with allogeneic peripheral blood stem cells, and relapsed after transplantation, their bcr/abl gene and/or ph1 chromosome showed positive, donor chimeras decreased. For these two CML patients relapsed after transplantation, the use of CsA was stopped immediately, and the patient's body temperature, skin rash, blood picture, liver function and chimeras were planed to observe carefully. The results indicated that acute graft versus host disease (aGVHD) appeared in both patients. A hundred percent (100%) of donor chimeras were then found with bcr/abl gene and/or ph1 chromosome turning to negative in both patients. In conclusion, to stop using of CsA might be effective in the treatment of some CML patients relapsed after transplantation by reversing of donor chimeras and inducing graft-versus-leukemia (GVL) effect accompanied by GVHD.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cyclosporine ; therapeutic use ; Graft vs Leukemia Effect ; immunology ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; genetics ; therapy ; Male ; Neoplasm Recurrence, Local ; genetics ; Peripheral Blood Stem Cell Transplantation ; adverse effects ; Transplantation Chimera ; immunology

Background Erythropoietin (EPO) has a protective effect on retinal neurons in many retinal diseases,but regarding the effect of EPO on apoptosis of retinal photoreceptor cells in retinal detachment (RD) is uncompletely clear.Objective This study was to investigate the protective effect of endogenous EPO on photoreceptors in a rat model of RD and explore its possible mechanism.Methods Seventy-two Sprague- Dawley (SD) rats were randomly assigned to control group,RD group,RD+PBS group,RD+erythropoietin soluble receptor (EPOsR) 2, 20, 200ng groups with 12 rats for each group.1.4% hyaluronic acid was slowly injected into the subretinal space to induce RD in rats,and PBS or 2,20 or 200ng EPOsR was then injected into the vitreous space.On day 3 after RD,apoptotic photoreceptors were detected using transferase-mediated dUTP nickend labeling (TUNEL),and caspase-3 activity was assessed by Western-blot and immunofluorescence staining.On day 14 after RD,retinal histopathologic examination was carried out and outer nuclear layer (ONL) thickness was measured under the light microscope.The use of animals complied with the Statement of Association for Research in Vision and Ophthalmology. Results Apoptotic photoreceptors were seen in ONL of rats of the RD group.Apoptotic photoreceptors were gradually increased with the elevation of EPOsR dose in the vitreous cavity.Western blot and immunofluorescence consistently showed that the gray scale of caspase-3 activity was 0.15±0.04,0.49±0.03,0.50±0.07,0.63±0.03,0.69±0.04 and 0.83±0.04 in the normal group,RD group,RD +PBS group,RD+EPOsR 2,20,200ng groups respectively with statistically significant differences (F=76.016;P=0.000),and caspase-3 activity was considerably stronger in the RD+EPOsR 200ng group than the other groups (P＜0.01).On day 14 after RD,the ONL thicknesses in the normal control group,RD group,RD+PBS group,RD+EPOsR 2,20,200ng groups were (47.39±3.39)μm,(33.96±3.54)μm,(31.83±5.21)μm,(31.40±2.63)μm,(24.99±2.06)μm and (19.30±3.71)μm,showing significant differences among these groups (F=44.733,P=0.000).ONL thicknesses the groups treated with different doses of EPOsR were markedly thinner than that of the RD group and RD +PBS group (P＜0.01).Conclusion EPOsR induces apoptosis of retinal cells and enhances the activity of caspase-3 in a dose-dependent manner.Endogenous EPO can protect photoreceptors against anoxia-mediated damage in RD eyes through decreasing caspase-3 activity and inhibiting apoptosis.

OBJECTIVE: To investigate the diagnostic significance of basophil activation test (BAT) in anaphylaxis to non-ionic contrast media through testing the content of CD63, mast cell-carboxypeptidase A3 (MC-CPA3), and terminal complement complex SC5b-9 of the individuals by testing their levels in the normal immune group and the anaphylaxis groups to β-lactam drugs and non -ionic contrast media. METHODS: The CD63 expression of basophilic granulocyte in blood was detected by flow cytometry. The levels of MC-CPA3 in blood serum and SC5b-9 in blood plasma were detected by ELISA. RESULTS: The CD63 expression of basophilic granulocyte in blood, the levels of MC-CPA3 and SC5b-9 of anaphylaxis to non-ionic contrast media and β-lactam drugs were significantly higher than that in normal immune group (P < 0.05). CONCLUSION There is activation of basophilic granulocytes, mast cells and complement system in anaphylaxis to non-ionic contrast media. BAT can be used to diagnose the anaphylaxis to non-ionic contrast media.
Anaphylaxis/diagnosis* ; Basophils/cytology* ; Carboxypeptidases A/metabolism* ; Complement Membrane Attack Complex/metabolism* ; Contrast Media ; Flow Cytometry ; Granulocytes/cytology* ; Humans ; Mast Cells/cytology* ; Tetraspanin 30/metabolism*

Objective To investigate the effect of adopting PDCA circling management in the continuous quality improvement of nursing key indicators.Methods PDCA circling management was adopted to promote nursing quality in 2010 as observation group,while Terminal Quality Control was adopted as the control group in 2009.Some key indexes of nursing quality control were observed,such as the occurrence of patients with falling/falling down from the bed,administration mistake,non-planned extubation,bedsore,patients being lost/suicide.Results Compared with the control group,the incidence of patients with falling/falling down from the bed,administration mistake,non-planned extubation,bedsore,patients being lost/suicide,needle stab in PDCA circling management group was decreased obviously,with significant difference ( x2 =30.315,P =0.000).Conclusions PDCA circling management can significantly improve clinical nursing quality.

OBJECTIVETo investigate the incidence of JAK2V617F gene point mutation in patients with myeloproliferatives diseases (MPD) and its clinical significance.

METHODSGenomic DNA from bone marrow and peripheral blood cells were extracted from 68 patients with MPD. Allele specific polymerase chain reaction was used to amplify the exon 12 of JAK2 gene which harbours V617F mutation. The PCR products were identified by DNA sequencing. JAK2V617F gene point mutation and its impact on peripheral blood cells were analyzed.

RESULTSThe incidence of JAK2V617F mutation in 68 patients with MPD was 65.28 %. The positive rate of JAK2V617F point mutation was 77.77 % in patients with PV (36/59), 56.52 % in patients with ET (23/59) and 44.44 % in patients with IMF (4/9). In all groups, the incidence of JAK2V617F point mutation in bone marrow and peripheral blood were equal. Patients with JAK2V617F mutation in PV group had higher counts of white blood cell and hemoglobin in peripheral blood than patients without JAK2V617F point mutation (P <0.05). Patients with JAK2V617F mutation in ET group had higher counts of white blood cell than those without JAK2V617F mutation (P <0.05); there was no significant difference in platelet count.

CONCLUSIONJAK2V617F point mutation can affect the hematologic features, which may be of diagnostic value for MDP with negative BCR-ABL gene.

Adolescent ; Adult ; Aged ; Amino Acid Substitution ; Base Sequence ; Female ; Humans ; Janus Kinase 2 ; genetics ; Male ; Middle Aged ; Molecular Sequence Data ; Myeloproliferative Disorders ; enzymology ; genetics ; Point Mutation ; Young Adult

The study was aimed to investigate the mobilization effect of medium dose of granulocyte colony stimulating factor (G-CSF) in allogeneic peripheral stem cell transplantation and changes of T lymphocyte subgroup in PBMNC before and after mobilization. G-CSF was administered at 600 microg/d (i.e. 300 microg i.v. twice a day) for successive 5 days to 31 matched sibling or unrelated donors for the mobilization. Stem cells were harvested on the fourth day. FACS was used to analyze the NC, MNC and T lymphocyte subgroups. The results showed that the number of NC, MNC, CD34(+) cells and CFU-GM in dose of 600microg/d significantly increased (P < 0.05), compared with 300 microg/d; the time for hematological reconstruction was significantly shortened (P < 0.05); the ratio of adverse effects was not obviously increased (P > 0.05) and the median percentage of CD3(+) lymphocytes before mobilization was 46.96% [(32.36-57.45)%], but 40.94% [(25.31-48.9)%] after mobilization, while the ratio of CD4(+)/CD8(+) did not significantly changed. It is concluded that the administration of G-CSF 600 microg/d in allo-PBSCT has a good effect in the mobilization of PBSC with minor side effects, which can markedly promote hematopoietic reconstitution after transplantation. The relative amount of CD3(+) lymphocytes significantly decreased and the ratio of CD4(+)/CD8(+) remained unchanged, which may lead to alleviation of a GVHD after PBSCT.
Adolescent ; Adult ; Antigens, CD34 ; analysis ; Blood Donors ; Female ; Flow Cytometry ; Graft vs Host Disease ; prevention & control ; Granulocyte Colony-Stimulating Factor ; administration & dosage ; Hematopoietic Stem Cell Mobilization ; methods ; Humans ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; methods ; Recombinant Proteins ; T-Lymphocyte Subsets ; cytology ; drug effects ; immunology ; Time Factors

BACKGROUNDVascular access (VA) dysfunction is a major clinical complication in the hemodialysis population and has a direct effect on dialysis outcome. This study was conducted to explore the role of microinflammation in the VA dysfunction in maintenance hemodialysis patients.

METHODSForty-seven patients (male 35 and female 12) receiving maintenance hemodialysis were included for this study. They were divided into three groups: group 1 (n = 15), patients with initial hemodialysis and new arteriovenous fistula (AVF); group 2 (n = 18), patients treated with hemodialysis for long term with well-functional VA; group 3 (n = 14), maintenance hemodialysis patients with VA dysfunction. Biochemical parameters and serum tumor necrosis factor-alpha (TNF-alpha), interleukin 6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1) were determined. High-sensitivity C-reactive protein (hs-CRP) was determined by latex-enhanced immuno-nephelometric method. Tissues of radial artery were taken from group 1 and group 3 for the histological study. Expression of CD68 and MCP-1 in the radial artery was determined by immunohistochemistry.

RESULTSSerum hs-CRP in group 3 was significantly higher than those in group 1 and group 2 ((7.40 +/- 2.42) mg/L vs (4.21 +/- 1.62) mg/L and (5.04 +/- 3.65) mg/L, P < 0.01 and P < 0.05, respectively). Serum TNF-alpha in group 3 was significantly higher than those in group 1 and group 2 ((64.03 +/- 9.29) pg/ml vs (54.69 +/- 12.39) pg/ml and (54.05 +/- 7.68) pg/ml, P < 0.05 and P < 0.01, respectively). Serum IL-6 in group 3 was also significantly higher than those in group 1 and group 2 ((70.09 +/- 14.53) pg/ml vs (56.43 +/- 10.11) pg/ml and (60.77 +/- 9.70) pg/ml, P < 0.01 and P < 0.05, respectively). Patients in group 3 had a thicker internal layer of vessels than in group 1 ((0.356 +/- 0.056) mm vs (0.111 +/- 0.021) mm, P < 0.01). Expression of CD68 and MCP-1 in the fistula vessel walls in group 3 were much higher than those in group 1 (P < 0.01). Moreover, serum hs-CRP level was positively correlated with the neointimal hyperplasia, the expression of CD68 and MCP-1 in fistula vessel (P < 0.01, respectively).

CONCLUSIONMicroinflammation might be involved in the dysfunction of AVF in patients with maintenance hemodialysis.

Adult ; Aged ; Arteriovenous Shunt, Surgical ; adverse effects ; C-Reactive Protein ; analysis ; Female ; Humans ; Immunohistochemistry ; Inflammation ; etiology ; Interleukin-6 ; blood ; Male ; Middle Aged ; Renal Dialysis ; adverse effects

This study was aimed to evaluate whether mesenchymal stem cells (MSCs) obtained from patients with myelodysplastic syndrome possess immunosuppressive effect. MSCs from bone marrow samples of MDS patients were isolated, cultured and expanded. MSCs were morphologically analyzed and their immunophenotype were determined by flow cytometry. Various amounts of MSCs were added into one-way mixed lymphocyte reaction. MSCs from MDS patients were tested for their ability to suppress in vitro proliferation of autologous and allogeneic peripheral blood lymphocytes (PBLs). The results showed that 3 x 10(3 - 1) x 10(5) MSCs from MDS patients could inhibit autologuous PBLs proliferation to (66.9 +/- 20.1)% - (30.2 +/- 5.9)% of maximal response, as well as inhibit allogeneic PBLs proliferation to (56.6 +/- 14.7)% - (20.5% +/- 9.7)% of maximal response, as compared with inhibitory ability of MSCs from healthy donors, there was no significant difference (P>0.05). It is concluded MSCs from patients with myelodysplastic syndrome also possess immunosuppressive activity.
Bone Marrow Cells ; immunology ; pathology ; Cell Proliferation ; Cells, Cultured ; Humans ; Immune Tolerance ; Lymphocyte Culture Test, Mixed ; Lymphocytes ; cytology ; Mesenchymal Stromal Cells ; immunology ; pathology ; Myelodysplastic Syndromes ; immunology ; pathology

The aim of this research was to understand the influence of rhG-CSF on the sphingosine kinase (SphK) activity of monocytes. The peripheral blood monocytes were collected from 6 peripheral blood progenitor cell donors on the fifth day of mobilization with rhG-CSF and from 5 blood donors' buffy coats. The mRNA expressions of monocyte G-CSF receptor and SphK were tested with RT-PCR. The changes of SphK activity of monocytes were assayed after being treated with rhG-CSF. The results showed that the two kinds monocytes collected from both blood donors and peripheral blood progenitor cell donors mobilized with rhG-CSF expressed mRNA of G-CSF receptor and SphK. The SphK activity of monocytes collected from blood donors was not changed significantly after being treated with rhG-CSF (P > 0.05). The SphK activity of monocytes collected from peripheral blood progenitor cell donors transiently increased by (39.6 - 87.2)% after being treated by means of rhG-CSF (P < 0.05) without obviously dose-dependent effect. It is concluded that the SphK activity of monocytes collected from peripheral blood progenitor cell donors can be activated by rhG-CSF.
Granulocyte Colony-Stimulating Factor ; pharmacology ; Hematopoietic Stem Cell Mobilization ; Humans ; Monocytes ; cytology ; enzymology ; Phosphotransferases (Alcohol Group Acceptor) ; drug effects ; metabolism ; Receptors, Granulocyte Colony-Stimulating Factor ; biosynthesis ; genetics ; Recombinant Proteins