Animals ; Astragalus membranaceus ; Endotoxemia ; drug therapy ; metabolism ; Interferon-gamma ; analysis ; Interleukin-4 ; analysis ; Male ; Mice ; Phytotherapy ; Plant Extracts ; therapeutic use ; Th1 Cells ; drug effects ; metabolism ; Th2 Cells ; drug effects ; metabolism

0.05).The percentage of CD40 positive cells in CBMC-derived DC was lower than that in PBMC-derived DC[(34.80?7.77)% vs(54.37?9.57)%,P

Objective To investigate the levels of Th1 and Th2 cell in the peripheral and the cytokines (IFN-γ,TNF-α,IL-12,IL-10,IL-4) in the culture medium at different time in the porcine model with multiple organ dysfunction syndrome(MODS) after continuous blood purification(CBP). Methods Twenty-four young porcines were given intravenous infusion of endotoxin to induce MODS, then were randomly divided into 2 groups:CBP group(n = 12) and MODS group without CBP(n = 12). Continuous venovenous hemodiafiltration (CVVHDF) was the main mode for CBP. At baseline, onset of MODS, and 2 h,4 h,6 h after treatment of CVVHDF,we picked the blood respectively to separate the T helper cell using the beads,detected the Th1 and Th2 cell by FACS and detected the cytokines (IFN-γ,TNF-α,IL-12,IL-10,IL-4) in the culture medium by ELISA. Results The MODS group showed a obvious rise in TNF-α,the drop tendency in IL-12,IFN-γ,IL-10,Th1/Th2 ratio, and no significant change in IL-4. After the treatment, the CBP group showed the drop in TNF-α and IL-4;and increase in IL-12,IFN-γ,IL-10 and Th1/Th2 ratio. Conclusion CBP helps to dear immune function,and restore the balance of Th1/Th2 in porcine MODS model.

AIM: To investigate whether glucosylceramide synthase (GCS) regulates apoptosis-related gene bcl-2 expression via MEK/ERK signaling pathway , thus enhancing drug resistance of K 562/A02 human leukemia multidrug resistant cell line.METHODS:siRNA targeting GCS was transfected into K562/A02 cells.Bcl-2, p-ERK and total ERK expression at mRNA and protein levels after GCS knockdown were detected by real-time PCR and Western blotting .After exposed to MEK-ERK pathway inhibitor U0126, the expression of Bcl-2 at mRNA and protein levels also was analyzed by real-time PCR and Western blotting , respectively.The viability of the cells was evaluated by CCK-8 assay.RESULTS:The expression of GCS and Bcl-2, as well as MEK/ERK signaling were significantly inhibited in K 562/A02 cells by GCS siRNA transfection compared with negative control group .Inactivation of MEK/ERK signaling due to U0126 treatment de-creased Bcl-2 mRNA and protein levels in a concentration-dependent manner , and sensitized K562/A02 cells to adriamy-cin.CONCLUSION:GCS may affect the expression of apoptosis-related gene bcl-2 by MEK/ERK signaling pathway , thus regulating multidrug resistance of human leukemia K 562/A02 cells.

Objectives To analysis the main characteristics and changes of the internal death in pediatric intensive care unit (PICU) in the past five years. Methods The clinical data of 330 death cases in PICU internal medicine were retrospectively analyzed from January 2008 to December 2012. Results The mortality rate in PICU dropped from 5.85%to 3.96% from 2008 to 2012. Among 330 death cases, 136 cases (41.2%) were infants, 73 cases (22.1%) were toddlers, 51 cases (15.45%) were preschoolers, and 70 cases (21.21%) were school-age and adolescence. In different years, the differences of distribution of death in different age groups were statistical significance (χ2=6.90, P=0.009). In all years, the infant had the highest death rate. As the time progresses, the death rate of the infant and young children decreases, while the death rate of the school-age and adolescence increases. Among the diseases caused death, the cardiovascular disease was the most common disease (33.94%), followed by hematologic malignancy (31.52%). The difference of distribution of the diseases caused death in different age group was statistically significant (P<0.01). The cardiovascular disease was main cause of death in infant, and the hematologic malignancy was the main cause of death in other three age groups. Within 24 h admission, the pediatric critical illness score (PCIS) had been assessed, 67.49% was critical and 15.48%was extremely critical. The hospitalization time was negatively correlated with PCIS (r=-0.313, P<0.001). Conclusions In the past five years, the mortality in PICU declined year by year. Cardiovascular disease in infancy and hematologic malignancy in non infancy are the leading cause of death in children. Admission in critical or extremely critical condition is the reason of early death in hospital.

Objective To investigate the imaging features and laboratory detection characteristics of tuberculous meningitis (TBM ) for achieving the purpose of early diagnosis and treatment.Methods Seventy-four patients with TBM in First Affiliated Hospital of Xi'an Jiaotong University from January 2013 to December 2015 were selected as the experimental group and 80 patients of non-TBM as the control group.All cases were performed ADA ,TB-DNA and acid-fast bacilli smear detection in cerebrospinal fluid ,and at the same time ,which was combined with tuberculous infection T-SPOT.TB test and compared with the results of ima-ging examination.Then the application values of various examinations were compared.Results The sensitivity of ADA ,TB-DNA , acid-fast bacilli smear ,T-SPOT.TB and the imaging examination for 74 patients with TBM were respectively 64.86% (48/74) , 33.78% (25/74) ,75.68% (56/74) ,10.81% (8/74) and 54.05% (40/74).The specificity were respectively 75.00% (60/80) , 100.00% (80/80) ,58.75% (47/80) ,100.00% (80/80) and 91.25% (73/80).Conclusion The difference in imaging and laboratory test indicators has a certain guiding significance for TBM clinical diagnosis.Except for clinical routine detection ,other detections should be perfected as far as possible ,conducting the comprehensive analysis can improve the accuracy of diagnosis.

Objective To study effects of early non-invasive ventilation (NIV) application in treating elderly patients with acute left ventricular failure induced respiratory failure. Method Totally 32 elderly patients with acute left ventrieular failure induced respiratory failure, admitted from August 1997 to February 2007, received NIV treatment, and were retrospectively studied. There were 22 male and 10 female, aged (81.5?8.6) yearsdd. The changes of rahs, respiration rate, heart rate, arterial blood gas, cardiac function before and after NIV application were compared. According to the application time of NIV, 32 patients were divided into two groups: group A (early NIV application group, n=17) and group B (non-early NIV application group, n= 15). The time to improve the symptoms, the application time of NIV, cure rates, tracheal intubation rates and mortality were compared between the two groups. Results Thirty of the 32 patients survived, cardiac function was improved from New York classⅣtoⅠ～Ⅱ, respiratory rate, heart rate and blood pressure significantly decreased, PaO_2 and SaO_2 significantly increased and PaCO_2 significantly decreased. The tracheal intubation was performed in 4 patients. The time needed to improve the symptoms and the application time of NIV were significantly different between group A and group B (P

Objective To explore the clinical significance of the blood lactic dehydrogenase(LDH), ?_2-microglobulin(?_2-MG),D-dimer measuring in the diagnosis and treatment of Non-Hodgkin lymphoma. Methods In 40 cases with NHL,LDH was measured by L-P continuous monitoring method,?_2-MG was measured by luminescent immunoassay,D-dimer was measured by immunoturbidimettic assay.Results The levels of the blood LDH,?_2-MG and D-dimer in patients with NHL were higher than those of in the controls(P 0.05).Con- clusion The levels of blood LDH,?_2-MG,D-dimer can be taken as an auxiliary clinical index to diagnose, classify the phase,evaluate the effectiveness of treatment and prognosis in the NHL patients,and have impor- tant clinical significance.

Objective To explore the safety and therapeutic efficiency of continuous renal replacement therapy(CRRT) without anticoagulation for critically ill children with high risk of bleeding.Methods We retrospectively analyzed 51 patients undergoing bedside CRRT in the PICU of our hospital from December 2007 to July 2015.Patients were divided into two groups induding CRRT with anticoagulation(n=33) or without anticoagulation (n=18).The therapeutic efficiency and complications were compared between two grous.Results Totally 168 CRRT circuits were performed in these 51 patients including 62 (36.9％)circuits without anticoagulation in 18 patients with high risk of bleeding and 106(63.1％) with anticoagulation by heparin.The circuits life of CRRT without anticoagulation was (12.31±6.64) h,which was shorter than that of CRRT with anticoagulation [(17.43±9.97)h] (P＜0.001).The levels of blood creatinine,blood urea nitrogen,C-reactive protein,and lactate significantly improved after both therapies (P＜0.05).PT and APTT did not change in CRRT without anticoagulation for hemorrhagic complications(P＞0.05).APTT[(52.36±5.00)s vs.(76.48±9.02)s,P=0.013] and PLT[(127.3±20.85)×109/L vs.(95.52±15.46)×109/L,P=0.041]were significantly longer in CRRT with anticoagulation by heparin compared with those before treatment.Conclusion CRRT without anticoagulation reduces bleeding risks and achieves an acceptable circuit life.The strategy can be applied as an alternative to critically ill children at high risks of bleeding who need continuous blood purification.

Objective To evaluate the significance of high-frequency oscillatory ventilation(HFOV) used in acute hypoxic respiratory failure(AHRF) children,failing to conventional ventilation.Methods This was a retrospective study of AHRF children ventilated by HFOV from January 2011 to September,2013.All patients were initially treated by conventional mechanical ventilation (CMV),and changed to be treated by HFOV if the patient met to one of the following criteria after the CMV parameters of PIP ＞ 30 mmH2O(1cmH2O =0.098 kPa) or PEEP ＞ 10 cmH2O with FiO2 100％ ∶ (1) SpO2 ＜ 90％ or PaO2 ＜ 60 mmHg (1 mmHg =0.133 kPa) ; (2) severe respiratory acidosis (PaCO2 ＞ 80 mmHg) ; (3) serious air leakage (mediastinal emphysema or pneumothorax).The following parameters were recorded:patient's gender,age,living PICU time,CMV ventilation time,HFOV ventilation time.We reviewed ventilation parameter settings (MAP,△P,F,FiO2),oxygenation index(PaO2/FiO2,OI),arterial blood gas,heart rate,blood pressure at different time points including late CMV(H0),2 h after HFOV(H2),6 h after HFOV(H6),12 h after HFOV(H12),24 h after HFOV (H24) and 48 h after HFOV (H48),respectively.Various indexes at different time points were compared between survival group and death group,oncology group and no-oncology group.Results PaO2 at H2 compared with H0 had significant improvement[76.9(61.9 ～ 128.0) mmHg vs 50.1 (49.5 ～68.0) mmHg,P =0.006] . PaO2/FiO2 at H2,H48 had significant improvement compared with those at H0,H24 [94.9(66.8 ～ 138.9) mmHg vs 68.0(49.5 ～86.8) mmHg,P=0.039; 135.0(77.6～240.0) mmHg vs 90.7 (54.6 ～161.7) mmHg,P =0.023)].All children's systolic pressure,diastolic blood pressure,heart rate at various time points had no difference (P ＞0.05).Compared to death group(n =14),PaO2/FiO2,OI at H6,H12,H24,H48 in survival group (n =9) had significant improvement(P ＜ 0.05).Compared to oncology group (n =10),OI at H2,H6 in no-oncology group(n =10) had significant improvement [(19.2 (13.9 ～ 26.6) vs 33.8 (19.7 ～ 48.3),P =0.049 ; 16.0(8.4 ～27.1) vs 28.9(20.9 ～38.9),P =0.027)],and mean airway pressure between two groups at H2,H6,H12 had significant improvement(P ＜ 0.05).Mortality had no significant differcence between two groups (4/10 vs 10/13,P =0.086).Conelusion HFOV used in children with AHRF which had failed with CMV ventilation can improve the patient's PaO2 and OI.Heart rate and blood pressure are stable during HFOV treatment.Oncology group patients needed higher initial MAP to improve oxygenation than no-oncology group patients when changed to HFOV treatment,but the mortality showed no difference between two groups.