Objective By using ProtEx~(TM) technology to decorate target cells with an exogenous protein and observe its function for immunomodulation.Methods Donor splenocytes were decorated with chimeric SA-FasL protein.The expression of FasL and its impact on other molecules on the surface of splenocytes was detected.Heterotopic rat heart transplantation was performed from inbred WF rat to ACI rat.According to the different donor splenocytes perioperatively injected into recipients,the recipients were divided into 3 groups:SA-FasL group (n=23),SA group (n=20) and control group(n=10).Heart beating was examined by palpation on daily basis,the cessation was regarded as reiection,while surival over 100 days was considered as graft long-term survival.Diabetes models in C57BL/6 mice were induced by intravenous injection of STZ.Islets from BALB/C mice were decorated by SA-FasL protein,islets transplant was performed from BABL/c to C57BL/6 mice.Based on the different treatments of donor islets,recipients were divided into three groups:islet-FasL group (n=21),islet-SA group (n=21) and islet-untreated group(n=14).Rejection was identified while urine glucose was positive and blood glucose value was over 250 mg/ml for consecutive two days.Urine glucose negative over 100 days was regarded as graft long-term survival.Results The mean exDression rate of FasL in splenocytes was 94.49%±4.27% tested by flow cytometry and FasL showed red color 0n the surface of splenocytes by fluorescent stammg.FasL deeoration did not disturb the expression of CD3,CD4,D8,MHC I and CD80.The long-term survival rate o,f heart transplant showed significant difference between tWO groups(SA-FasL:70% vs SA:25%,P<0.05).67% FasL-decorated islets had normal function 30 days post transplant,and 29%FasL-decorated islets achieved long-term survival,which was significantly differed from the other groups(P<0.05).Conclusion ProtEx~(TM) is a simple,fast,safe and efficient approach for exogenous protein modmcation.Decoration of target cells with Chimeric FasL by this technique plays an umportant role in immunomodulatiorn.

BACKGROUND: Immune function of chemotaxis signal has been a key focus in medical research. However, the immune activation and related action mechanism of chemotatic factor RANTES are unclear.OBJECTIVE: To investigate the immune activation and related action mechanism of chemotatic factor RANTES stimulation on peripheral mononuclear cells.DESIGN: Control Experiment.SETTING: Department of Urologic Surgery, Clinical Medical College, Yangzhou University.MATERIALS: The experiment was performed at the Laboratory of Department of Immunology, University of Louisville from December 2004 to August 2005. Main reagent and equipments included RPMI 1640 complete medium, recombinant human RANTES, anti-CD3 monoclonal antibody, pyrrolidine dithiocarbamate(PDTC),CTLA4Ig, LS500 liquid scintillation counter and FACS Epics XL flow cytometry.METHODS: Peripheral mononuclear cells were collected and stimulated by different concentrations of recombinant human RANTES and/or anti-CD3 monoclonal antibody. Cells with significantly proliferative response were intervened by pyrrolidine dithiocarbamate (PDTC) or CTLA4lg. 3H-thymidine incorporation was used to detect the proliferation of mononuclear cells. Flow cytometry was applied to measure the phenotypes of lymphocytes.MAIN OUTCOME MEASURES: Incorporation efficiency of 3H-thymidine, the ratio of CD4 to CD8, expression of CD25,CCR5 and CD28.RESULTS: Proliferative reaction of mononuclear cells reached two peaks with recombinant human RANTES concentrations of 100 μg/L and 5000 μg/L respectively. The proliferation of peripheral mononuclear cells stimulated by 100 μg/L recombinant human RNATES was significantly higher than that in the presence of 50 μg/L anti-CD3 monoclonal antibody (P<0.05).There were no rivalry or synergistic effect between them.The immune active effects of recombinant human RANTES could be inhibited by PDTC or CTLA,Ig in a dose dependent manner.After RANTES treatment,the level of cell surface CD25 increased (P<0.05) and the CCR5 expression decreased (P<0.05), but there were no significant differences in CD28 expression and the ratio of CD4/CD8 of lymphocytes(P>0.05).CONCLUSION: RANTES has a specific function of inducing the immune activation of mononuclear cells. This special signal works depending on the activation of interleukin-2 signal pathway, CD28 co-stimulatory pathway and nuclear factor-κB,but independent of CD3 activation.

OBJECTIVE:To provide reference for rational utilization of antibiotics for special use. METHODS:Medical orders of antibiotics for special use in clinical departments of our hospital during 2013 to 2015 were selected from hospital information sys-tem. The consumption sum and its ratio,DDDs,DDC,DUI and the utilization of antibiotics for special use in clinical departments were calculated and analyzed. RESULTS:The consumption sum and its ratio of antibiotics for special use in our hospital during 2013 to 2015 both reduced year by year,decreasing from 21 872 200 yuan(48.00%)to 20 877 700 yuan(39.41%). The consump-tion sum ratio of carbapenems,cephalosporins and anti-deep fungal drugs showed descending tendency. The consumption sum ratio of anti-MRSA antibiotics changed slightly. DDDs of Meropenem for injection always took up the first place in recent 3 years,but the values were decreasing. DUI of Imipenem and cilastain sodium for injection was far less than 1,while those of Panipenem and betamipron for injection,Cefepime sodium for injection and Caspofungin acetate for injection(70 mg/injection)were far more than 1. The types of drug with DUI ranged 0.9-1.1 increased year by year,increasing from 3 types in 2013 (18.75%) to 10 types in 2015 (62.50%). Within 3 years, the utilization ratio of antibiotics for special use always took up the first place in ICU (86.64%-87.78%). CONCLUSIONS:The consumption sum and its ratio of antibiotics for special use in our hospital during 2013 to 2015 decreased year by year,and the utilization of antibiotics for special use become increasingly rational. But,there still are some problems,such as inadequate dose of Imipenem and cilastain sodium for injection,overdose of Panipenem and betamipron for injection,Cefepime sodium for injection and Caspofungin acetate for injection(70 mg/injection).

Objective To screen the plasma differential expressed proteins in patients with Crohn's disease(CD)and ulcerative colitis(UC)using surface-enhanced laser desorption ionizationtime of flight mass spectrometry,and to establish decision trees algorithms.Methods The plasma samples from 24 UC patients,25 CD patients and 25 healthy controls were analyzed with CM10 protein chip.The proteomic spectra of CD,UC and inflammatory bowel disease(IBD)were compared with controls respectively.The differential proteins that significantly altered expression levels were selected to establish decision trees algorithms of CD.UC and IBD and then blind validations were tested.Results In the range of m/z 2000-30 000,differential expressed proteins that changed at least 2-fold between CD and controls were 9.between UC and controls were 5,and between IBD and controls were 11(P＜0.05).The software automatically picked up the m/z 8208 and 8837 as decision trees algorithms for differentiating CD from controls and m/z 6985 for differentiating UC from controls as well as m/z 8208,1752,28840 and 1702 for differentiating IBD from controls.The sensitivities of decision trees algorithms for CD,UC and IBD were 96%,82%and 91%respectively,and the specificities were 100%,85%and 100%respectively.Conclusions The protein of m/z 8208 which has high sensitivity in differentiating CD from controls is worthy of further study.

BACKGROUND:Studies have different views on the effect of repetitive transcranial magnetic stimulation applied in stroke patients for improving motor function.
OBJECTIVE:To evaluate the effect of repetitive transcranial magnetic stimulation on rehabilitation of motor function in patients with stroke.
METHODS:We searched Cochrane Central Register of Control ed Trials, PubMed, ISI Web of science, Medline, EMBASE, China Biology Medicine disc, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodical, Wanfang Data (from database building to July 2013) for randomized control ed trials concerning repetitive transcranial magnetic stimulation on improving motor function in patients with stroke. The included studies were evaluated according to the method recommended by the Cochrane Col aboration. Meta analysis was performed in qualified literatures. The extracted data were analyzed by RevMan 5.1 software and GRADEprofiler 3.6 software.
RESULTS AND CONCLUSION:A total of 23 trials were included (intervention group n=400, control group n=301). Quantitative analysis was conducted in seven studies, and descriptive study was performed in the remaining studies. Meta-analyses analyzed Fugl Meyer Motor Scale and Barthel index. Results showed that Fugl Meyer Motor Scale [SMD=0.48, 95%CI(0.10, 0.86)] and Barthel index [SMD=1.38, 95%CI (0.68, 2.09)] were significantly higher in the intervention group than that in the control group. In accordance with The Grading of Recommendations Assessment, Development and Evaluation, outcome indexes were evaluated, and the two indexes were graded low quality. The current evidence shows that repetitive transcranial magnetic stimulation appears to enhance motor function and activities of daily living of the patients with stroke. Considering the limitations of the included studies, more multi-central randomized control ed trials with large sample sizes and high qualities are required in future to verify the therapeutic efficacy of repetitive transcranial magnetic stimulation on motor function of stroke patients.

To study the mechanism of CAIMA (Computer assisted instant monitoring drug administration), atracurium, a new non - depolarizing muscle relaxant was used in isolated rat diaphragm. The doses and administration rate were precisely controlled by using an improved flowing-bath system. The results showed that with increasing drug concentration, onset time shortened,over-shoot time prolonged, initial recovery rate reduced and onset rate, over-shoot extent and recovery index increased. The over-shoot existed at any pharmacologically effective concentrations and it was positively correlated to drug concentration. As a result of need-dependent and intermittent (pulsatil) drug administration, one maximally profited effect from over-shoot, that is, the effect could be maintained with over-shoot at the administration interval. Hence, the total dose could be dramatically reduced. Furthermore, for a given effect, it needs lower drug concentration with CAIMA than with classical methods and so the effect was nuch more stable.

Objective To compare the clinical efficacy of acupuncture and medicine for the treatment of chronic pharyngitis. Methods Sixty chronic pharyngitis patients were randomized into treatment group and control group, 30 cases in each group. The treatment group was treated with acupuncture mainly on acupoints of Zhaohai(KI6), Lieque(L7), Tiantu(CV22) , Lianquan(CV23), Tianrong(SI17) , Hegu(LI), Yuji (LU10) for nourishing yin to reduce fire and clearing throat. The supplementary acupoints were selected according to the symptoms and physical signs. Acupuncture was performed once a day and 6 times a week. The control group received western medical therapy including pharyngeal application with 1% iodine glycerin preparation and oral use of Cydiodine tablets, 3 times per day. Four weeks constituted one treatment course and the treatment for the two groups covered 2 courses. After treatment, the therapeutic effect was evaluated. The scores of the signs and s ymptoms as well as scores of chronic pharyngitis syndrome discomfort rating questionnaire(CPSDQ) evaluated by visual anal og scale(VAS) were observed. Results (1) The overall effective rate of the treatment group was 93.3%, higher than that of the control group(73.3%), and the inter-group difference was statistically significant (P<0.05). (2) After treatment, scores of the signs and symptoms and VAS for CPSDQ scores in the two groups were reduced as compared with those before treatment(all P<0.05 or P<0.01 ) .The improvement of the scores in the treatment group was superior to that in the control group(all P<0.05 or P<0.01).(3) During the treatment , needling-induced mild pain and bleeding occurred in the treatment group. No acupuncture syncope, stuck needles or allergic and toxic-side effect was shown in the two groups. Conclusion Acupuncture therapy can obviously relieve the symptoms, signs and discomfort in the patients with chronic pharyngitis, and the curative effect is superior to the drugs.

Objective To evaluate the safety and efficacy of one-stage endoscopic sphincterotomy plus laparoscopic cholecystectomy for the treatment of patients who have concurrent gallstones and CBD stones.Methods We conducted a prospective study from Mar 2008 to Nov 2011 in our department.A total of 63 consecutive patients of concurrent gallstones and CBD stones were included and divided into two groups:31 patients in test group first underwent ERCP and EST to remove CBD stones,and then during the same general anesthesia underwent laparoscopic cholecystectomy (LC) ; while 32 patients in control group first underwent ERCP and ES,and then LC 3-5 days later.Results The stone clearance rate in test group and control group were 96.9％ and 96.7％ (P ＞ 0.05),respectively.The postoperative lung infection rate in the test group and the control group were 7.1％ and 16.1％ (P ＜0.05),respectively.The length of hospital stay (LOS) of the two groups was (7.5 ± 1.7) days and (12.6 ±2.5) days,respectively (P ＜ 0.05).The total expense of hospitalization was (￥) (2 356 ± 126) and (￥) (37 056 ± 152),respectively (P ＜ 0.05).Conclusions One-stage laparoendoscopic management of patients with concurrent gallstones and CBD stones is safe,effective and more economic approach than two-stage treatment for patients suffering from concurrent gall stone and choledocholithiasis.

Objective To observe the iffectiveness of comprehensive rehabilitationinterventions on stroke patients with unilateral spatial neglect (USN). Methods A total of 245 cases if strijd were examined to diagnose USN. Of the 245 patients,86 cases were diagnosed as being with USN, and divided into a control group(n=43 cases) and a treatment group (n=43 cases) randomly. The control group was treated with Bobath and Rood techniques in addition to routine clinical medical interventions, while the treatment group was treated with a comprehensive rehabilitation protocol for USN in addition to the same interventions for the control group. Both groups were assessed with regard to motor, balance function, walking performance, and USN severity as well as the activities of daily living (ADL) performance. Results After 8 weeks of treatment,both groups improved, but there showed a significantly statistical difference between the 2 groups in terms of Fugl-Meyer motor function scores (P＜0.01), balance function scores (P＜0.01) Holden walding function classifications (P＜0.01), Barthel index(P＜0.001) and USN severity scores(P＜0.01). Conclusion Comprehensive USN rehabilitation intervention could improve motor, balance, walking functions and ADL performance and alleviate the USN severity in stroke patients with USN.

OBJECTIVETo compare the differences in the clinical efficacy on Alzheimer's disease between acupuncture and medicine.

METHODSOne hundred and forty-one patients were randomized into an acupuncture group (72 cases) and a medicine group (69 cases). In the acupuncture group, the needling technique for benefiting qi, promoting blood circulation, regulating mind and improving intelligence was used at Shenting (GV 24), Baihui (GV 20), Fengchi (GB 20), Wangu (GB 12), Danzhong (CV 17), Zhangwan (CV 12), Qihai (CV 6), Xuehai (SP 10) and Zusanli (ST 36). The supplementary acupoints were selected according to the symptoms and physical signs. Acupuncture was given once a day and 6 treatments were required for a week. In the medicine group, the choline sterase inhibitor, donepezil (aricept) was prescribed for oral administration, 1 tablet (5 mg) each time, once every night. Four weeks later, the dose was increased to 2 tablets (10 mg) each time. In the two groups, the treatment of 4 weeks made one session and 4 sessions were required. The changes of scores before and after treatment in the minimum mental state examination (MMSE), the activity of daily living scale (ADL), Alzheimer's disease assessment scale-cognition (ADAS-cog) and the digit span (DS) were observed.

RESULTSAfter treatment, scores of MMSE and DS were increased as compared with those before treatment (both P < 0.05) and scores of ADL and ADAS-cog were reduced as compared with those before treatment. The score differences in MMSE, ADL, ADAS-cog and DS before and after treatment were significant in the two groups (all P < 0.01).

CONCLUSIONThe needling technique for benefiting qi, promoting blood circulation, regulating mind and improving intelligence significantly improves the overall function, cognition and activity of daily life in the patients of Alzheimer's disease and the efficacy is better than donepezil.

Activities of Daily Living ; Acupuncture Points ; Acupuncture Therapy ; Aged ; Aged, 80 and over ; Alzheimer Disease ; psychology ; therapy ; Cognition ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome