To explore me chanisms of successful induction of autoimmunity by chronic Campylobacter jejuni (CJ-S131 ) infection [3, 4, 5, 6], a chronic mucosal immune response mooe(?) was established by oral immunization of BALB /C mice with formalized CJ-S131 bacteria.in a dosage of 4 xlO8 bacterial cells per mouse, twice a week for 14 weeks, which mimicked the released antigens persistently stimulating the mucosal immune system when mice were chronically infected by C. jejuni. It was also found that the immunized mice demonstrated (?)upus-like autoimmune syndro me, sim ilar, but more severe.to those seen in the mice chronically infected by C. jejuni. It was characterized by (1) significant lymphoproliferation of both mucosal and systemic immune systems; (2) polyclonal activation of B lymphocytes; (3) significantly elevated level of multiple autoanti bodies against ss- DNA, ds- DNA and histones; (4) immunocom plex glomerulonephritisi; (5) chronic inflammation of multiple organs or tissues including the intestine, liver and blood vessels. In the polyclonal activation testin vitro, the levels of total immunoglobulins and autoantibody against DNA in the supernatan ts of the splenic culture cells from the immunized mice were significantly higher than that from the controll mice. The results verified that chronic C. jejuni infection in the gut could induce abnormal. chronic mucosal immune response which led to perturbation of the systemic immune system, resulting autoimmunity or autoimmune syndrom.

KM mice were orally immunized with formalized C. jejuni (CJ-S131 vaccine) for 16 weeks. The production kinetics of autoanti bodies against ss-DNA, ds-DNA, histories and extractable nuclear antigens (ENA) was investigated and two peaks of autoantibody production were observed within 16 weeks after immunizalion. The first peak appeared at 6th week after immunization when the positive percentage of autoantibody against histones (83%) and ENA (67%) was higher than that against ds-DNA (33%) and ss-DNA ( 0 %), and the second peak at 16th week when the positive percentage of anti-ds-DNA (50%) and anti-ss-DNA (83%) antibody higher than that of anti-histones (33%) and anti-ENA (33%) anti body. Natural autoanti bodies against nuclear acid (ds-DNA and ss-DNA) in the controlled mice could be detected, too, by ELISA, which raised with aging but obviously demonstrating individual difference; however, autoanti bodies to nucleoproteins (histones and ENA) could not be detected at the matched times. The results suggested that autoantibody against histones or ENA was more specific for autoimmune diseases than that against DNA, and might be of significance for earlier diagnosis of the systemic autoimmune diseases, e. g. SLE, in clinic.

Five strains of mice (C57BL/6, BALB/c, ICR, KM and SMMC/B) were respectively orally immunized with CJ-S131 vaccine for 16 weeks, Autoantibodies against ss-DNA, ds-DNA, histones, extractable nuclear antigens (ENA)and thymocytes were detected by ELISA or CELIS(?)One or more kind (s) of autoantibody significantly raised in the serum of SMMC/B, KM, BALB/c and ICR mice, but not in C57BL/6 mice. The mean enzyme index (EI) of the autoantibodies of SMMC/B and KM mice was higher than that of ICR and BALB/c. The influence of the sex on the production of autoantibody induced by CJ-S131 vaccine seemed to be demonstrated on the basis of genetic background.It was characterized by (1) autoantibodies raising mainly in the female mice,e.g. in KM mice; (2) one kind of autoantibody or more raising in both male and female mice, as seen in SMMC/B and BALB/c mice; and (3) autoantibody no in male and female of C57BL/6 mice. The results revealed that the profile of autoimmune response induced by CJ-S131 vaccine was different in strains and sex of mice.

Objective To explore the mechanisms on the damage in fetus liver,kidney and brain with administration of mifepristone and mesoproseol.Methods 17 specimens were obtained from the women who volunteered to terminate their pregnancy during 10～28 weeks.According to the fetus weight,they were divided into 3 groups.Immunohistochemistery was induced to investigate the expressions of pur-?,HSP70.Results The expressions of pur-? and HSP70 could be observed in both the treatment group and the control group.pur-? and HSP70 are the targets in detecting the damage of DNA.But pur-? was more sensitive than HSP70.The damage on group Ⅱ is the strongest.Conclusion Mifepristone can lead to the damage to lover,kidney and brain in mid-pregnancy.Its damage will be reducing as the growing of fetus.

Objective:To study the effects of transverse abdominis plane block (TAPB) combined with dexmedetomidine on the recovery quality after general anesthesia in cesarean section.Methods:From June 2019 to October 2020, 120 cases of cesarean section in Changsha Maternal and Child Health Hospital were randomly divided into dexmedetomidine group (Group D), transversus abdominis plane block group (group T), transversus abdominis plane block combined with dexmedetomidine (Group TD) and control group (Group C). Before anesthesia induction, local infiltration of 1% lidocaine was performed at the incision of all parturients. Propofol and rocuronium were used for induction under general anesthesia. After delivery of fetus, sufentanil and midazolam were injected intravenously, and propofol was pumped to maintain anesthesia. At the same time, dexmedetomidine was pumped into group D and TD, and normal saline was pumped into group T and C. After the posterior sheath of rectus abdominis was sutured in T group and TD group, two epidural anesthesia catheters were placed to the fascia of transverse abdominis on both sides, and 10 ml of 0.33% ropivacaine was injected respectively. The parturients were sent to postanesthesia care unit (PACU) after the operation. The time from the end of operation to the extubation of tracheal tube, heart rate (HR) and mean arterial pressure (MAP) before operation (T 1), after induction (T 2), after operation (T 3), at the time of extubation (T 4), 10 minutes after extubation (T 5) and at the time of leaving PACU (T 6) were recorded. Steward's wake-up score at T 4, T 5 and T 6, agitation during extubation (Sedation Agitation Scale, SAS score), PACU stay time and pain visual analogue scale (VAS) were recorded. Results:There was no difference in HR and MAP between the four groups at T 1, T 2, and T 3 ( P>0.05), while HR and MAP in group C at T 4, T 5 and T 6 were higher than those in the other three groups ( P<0.05). There was no significant difference in Steward′s wake-up score among the four groups ( P>0.05). The SAS score [(4.0±0.4)point], the time from the end of operation to extubation [(10.1±1.5)min] and stay time of PACU [(21±4.2)min] were the lowest in group TD than those in the other three groups ( P<0.05); the VAS score in group TD [(0.5±0.5)point] and group T [(1.1±0.4)point] were lower than that in group D [(4.1±0.3)point] and group C [(5.3±0.5)point] ( P<0.05). Conclusions:The application of general anesthesia combined with TAPB and dexmedetomidine in cesarean section may improve the quality of anesthesia recovery.

Objective To evaluate the efficacy of ketamine in preventing postpartum depression in patients undergoing cesarean section.Methods One hundred and twenty ASA physical status Ⅰ patieuts,aged 18-38 yr,with body mass index ＜35 kg/m2,scheduled for elective cesarean section,were equally and randomly divided into 2 groups using a random number table:control group (group C) and ketamine group (group K).Postoperative analgesia was performed with sufentanil 100 μg in 100 ml of normal saline,and sufentanil was infused at 2 ml/h (bolus dose 5 μg,lockout interval 15 min) in both groups.In group K,ketamine 4 mg/kg was added to analgesic pump.VAS score was maintained＜3.Before surgery and at 1,3,5 and 42 days after surgery,depressive symptoms were measured using the Edinburgh Postpartum Depression Survey (EPDS),and postpartum depression was defined as EPDS score ≥ 13.Postpartum depression and ketamine-related complications occurred within 3 days after surgery in group K were recorded.Results Compared with group C,EPDS scores were significantly decreased at 1,3 and 5 days after surgery,and the incidence of postpartum depression was decreased in group K.Ketamine-related complications were not found in group K.Conclusion Ketamine (infused starting from the end of operation,lasting for 48 h,total amount 4 mg/kg) for postoperative analgesia can prevent postpartum depression to some extent in patients undergoing cesarean section.

This paper aims to find out the use status of medical and sanitary equipment in primary unit. By means of investigating grass-roots health institutions and summarizing practical works, such problems in equipment were detected as standard vacancy, datedness and laggardness, partly absence, nonstandard management, untimely maintenance and low rate of utilization, etc. This paper puts forward some suggestions corresponding to the above disadvantages.

Although tumor immunotherapy has been proposed for many years,the consensus denoting it as an essential approach for fighting against cancer is reached only in recent years. Tumor immunotherapy can be categorized as active and passive ones. In order to successfully cure cancer,safe and efficient active immunotherapy is required. Dendritic cells (DCs)are not only the bridge linking innate and adaptive immunity,but also the key determinants of the quality of adaptive immunity:immunity versus immune tolerance. Therefore,the safe and efficient DC-based tumor-specific and broad-spectral tumor vaccine has an irreplaceable important position in tumor immunotherapy. Because of the high heterogeneity of DCs, the research on DC-based tumor vaccine has encountered a bottleneck. Here,we reviewed the progress in research on DC-based tumor vaccine and related problems needed to be resolved with the incorporation of our experiences.

Objective To study the curative effectiveness of Itraconazole in the treatment of invasive pulmonary aspergillosis following bilateral lung transplantation.Methods One patients undergoing bilateral lung transplantation was readmitted at 8-month postoperatively due to cough, sputum, and fever. Sputum culture reported positive Aspergillus flavus. Chest X-ray manifested bilateral lung infiltration. Chest CT scan showed multiple small cavities. Itraconazole (Sporanox) therapy was performed.Results Sputum smear and culture reported negative aspergillus at sixth of Itraconazole therapy. Patient’s symptoms after Itraconazole treatment for 10 days were improved obviously. Chest CT scan showed the lung lesion still existed. After treatment by Itraconazole, FK506 dosage was decreased from 3 mg, twice a day to 0.5 mg, once a day.Conclusion Pulmonary aspergillosis is an important complication following lung transplantation. Itraconazole therapy can effectively treat invasive pulmonary aspergillosis following bilateral lung transplantation. Blood drug concentration monitoring indicated the dosage of FK506 was significantly decreased after Itraconazole therapy.

Objective To explore the surgical indications and safety of bilateral sequential lung transplantation in 9 cases.Methods Between Jan.2003 to June 2005,9 bilateral sequential lung transplantations were performed in Shanghai Chest Hospital.In 2 cases,the resection and re-transplantation of the second lung was done after ventilation and perfusion in the first lung transplantation.In 6 cases,after the first lung was transplanted,ECMO was established with heparin-bonded circuitry and centrifugal pump and the second lung was transplanted.In 1 case,CPB was used during the transplantation of the second lung.Meanwhile,inhaled nitric oxide(INO) therapy(40 ppm) was performed in 7 cases.Results Severe lung edema occurred in 2 cases,and the patients survived only 12 and 36 h respectively.Six cases with ECMO thereafter rided out the operation successfully.Postoperative days ventilated were 36 to 72 h(mean 48 h).Four patients of them discharged in good conditions and have survived 16,14,11,9 months respectively.One patient died of pulmonary infection and emptysis one month after operation.Another patient died of acute renal failure 3 weeks after operation.The operation performed under the support of CPB was unsuccessful because of heavy hemorrhage and severe acidosis.Conclusions Bilateral sequential lung transplantation is a high risk procedure.ECMO can reduce the risk significantly. Inhaled nitric oxide during and after operation is of benefit to stabilization of hemodynamics and reduce ischemic reperfusion injury.