Immunological imbalance is the foundation for the development of liver damage or fibrosis.Therefore,the treatment of liver disea-ses not only relies on regenerative medicine for cellular replacement,but also depends on immunoregulation.The immunological basis of liver injury and repair,the immunological basis of multipotent stem cells for allograft,and the research advances in the immunoregulatory effect of stem cells in the treatment of liver diseases demonstrated that multipotent stem cells,especially mesenchymal stem cells,have low immuno-genicity and cause immunosuppression,with the immunological basis of allograft;in addition,they can improve the local immune microenvi-ronment of the liver by immunoregulation to reduce the liver injury caused by immune response.It is suggested that multipotent stem cells, which meet the requirements of cellular replacement and immunoregulation in the liver,will become an ideal treatment of liver diseases.

In this paper,we summarized nursing care of 9 patients with cytokine release syndrome after receiving the chimeric antigen receptor T cells immunotherapy.Key points of nursing care were as follows:comfortable and effective antipyresis,preventive rehydration,multiple methods of blood oxygen saturation improvement,iatrogenic pressure ulcer prevention,frequent vital signs monitor,close observation of level of cytokine and inflammatory factors,timely and accurate medication,formulating personalized nursing plan according to patients' condition,close collaboration between doctors and nurses.At last,8 patients recovered and were discharged,and 1 case died due to multiple organ dysfunction syndrome.

BACKGROUND: Studies about the mechanism of laser occlusion on the varicose great saphenous vein are rare.OBJECTIVE: To explore the ultrastructural changes of the great varicose saphnous vein after it was occluded with laser.DESIGN: An observational study.SETTING: Laser Department of the General Hospital of Chinese PLA .PARTICI PANTS: There were 42 patients with varicose great saphenous veins that were occluded with laser in clinic of the General Hospital of Chinese PLA from January to April 2004. The inclusive criteria: There must be obvious vein tangles beneath the undystrophic skin at ankle without apparent thrombus inside the vein. The patients involved should be voluntary to take part in the study. Finally 9 patients were enrolled in this study.INTERVENTION: The great saphenous vein was intravenously occluded with laser of 810 nm and the working power was 12 W and the exposure time was 1 s. The occluded vein sample was taken out 3 hours after the occlusion.MAINOUTCOME MEASURES: The ultrastrncture of the occluded vein was observed histopathologically. Normal vein and prereatment varicose vein served as control.RESULTS: The normal vein wall can be divided into 3 layers: the internal layer was composed of the simple endothelial cells; the median layer was composed of the smooth muscle cells, elastic fibers and collagenous fibers; the external layer was composed of the loose connective tissues. However, the internal layer of the varicose vein was incomplete, and the endothelial cells were loosely connected. The smooth muscle cells became hyperplasic, hypertrophic or atrophic. The elastic fibers decreased in number in contrast to the increase of collagenous fibers. After laser occlusion, in the vein lumen there was a large number of blood cells. The platelets became flattened with pseudopods and adhered to collagenous fibers. The endothelial cells and smooth muscle cells near the lumen were damaged and the cytoplasma leaked and fused with extracellular matrix. Broken collagenous and elastic fibers could be seen near the lumen and some were observed in the lumen. There was no structure change in the external layer and adjacent elastic fibers and collagenous fibers.CONCLUSION: Laser occlusion damaged the internal layer and part of median layer of the varicose vein, caused aggregation of the blood cells in the lumen and promoted the adhesion of platelets to vein walls.

Objective To evaluate the capability of internal transcribed spacer (ITS) region sequencing analysis to identify clinical isolates of filamentous fungi.Methods A total of 267 filamentous fungi isolates collected from clinical specimens were analyzed by ITS region sequencing analysis.Alignment of acquired sequences with known sequences in GenBank and MycoBank was conducted to identify the species of those isolates.Results ITS sequences of the 267 isolates were amplified successfully.Among these isolates, 53.9％ (144/267) were identified to species level and 44.2％ (118/267) to genus level.Only five isolates were failed to be identified at genus level as they shared >95％ homology in ITS sequence with multiple genera.Conclusion ITS region sequencing analysis is preferred for identification of clinical isolates of filamentous fungi at genus level for its high universality and great capability.When species-level identification is required, some informative DNA markers besides ITS region should be included accordingly.

OBJECTIVE:To observe the efficacy and safety of aerosol inhalation recombinant human interferon α1b in the treat-ment of bronchiolitis in children. METHODS:60 children with bronchiolitis were randomly divided into low-dose group,high-dose group and control group. All children were given tracheal suctioning,phlegm dispersing and other symptomatic treatment. Based on it,low-dose group was given recombinant human interferon α1b 1-2 μg/(kg·times),adding into 3 ml 0.9% Sodium chloride injec-tion,compression aerosol inhalation,twice a day;high-dose group was given recombinant human interferon α1b 3-4 μg/(kg·times), adding into 3 ml 0.9% Sodium chloride injection,compression aerosol inhalation,twice a day;control group was given ribavirin 10-15 mg/(kg·d),adding into 5% Glucose injection at ratio of 1∶1 by intravenous infusion,once a day. The treatment course for all groups was 5-7 d. Clinical efficacy,disappearance time of cough,respite,rale and three depressions,hospitalization time and incidence of adverse reactions in all groups were observed. RESULTS:Disappearance time of cough,respite,rale and three depres-sions and hospitalization time in high-dose group were significantly shorter than low-dose group and low-dose group shorter than control group,the differences were statistically significant(P<0.05). Total effective rate in high-dose group was significantly high-er than low-dose group and low-dose group higher than control group,the differences were statistically significant (P<0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Based on conventional treatment,both efficacy and safety of aerosol inhalation recombinant human interferonα1b in the treatment of bronchiolitis in children are good.

Progestagen-associated endometrial protein (PAEP) gene mainly expresses in the secretory phase endometrium and decidua in early trimester of pregnancy.In recent years,it is reported that PAEP is abnormally expressed in many kinds of tumors,such as breast cancer,endometrial carcinoma,ovary cancer,stomach cancer and melanoma.PAEP gene plays an important role in tumorigenesis and tumor development.The application of PAEP gene as an indicator for clinical diagnosis,prognostic and therapy needs further studies on the influence of PAEP gene on tumor biological behaviour.

Objective To investigate the effects of butylphthalide on brain edema,blood-brain barrier permeability and RhoA expression in cortex in focal cerebral infarction in rats.Methods A total of 220 male Sprague Dawley rats were divided into a control,a model and a butylphthalile group (40 mg/kg,once a day,gavage) according to the random number table method.A model of rat focal cerebral infarction was induced by photochemical method.At 3,12,24,72,and 144 h after modeling,wet-dry weight method and Evans blue extravasation method were used to detect the brain water content and blood-brain barrier permeability.At 24 h after modeling,immunohistochemical staining and Western blot were used to detect the expression of RhoA protein in the periinfarction cortex.Results Compared to the control group,the brain water content (except at 6 h) and blood-brain barrier permeability in the model group and the butylphthalide group were increased significantly (all P ＜ 0.05).The immunohistochemical staining and Western blot suggested that the RhoA expression in the periinfarction cortex was upregulated significantly (all P ＜ 0.05).Compared to the model group,the brain water content and blood-brain barrier permeability at different time points in the butylphthalide group were decreased significantly (all P ＜ 0.05).The expression levels of RhoA were also decreased significantly (P ＜ 0.05).Conclusions Butylphthalide may reduce the brain edema of focal cerebral infarction in rats,inhibit disruption of the blood-brain barrier,and down-regulate the expression of RhoA.

ObjectiveTo investigate the association between nucleotide polymorphisms ofGRIN3A gene and clinical characteristic of Kawasaki disease (KD) in children in Han population in central Chinese.MethodsA case-control study was performed. A total of 191 children with KD were recruited and 217 healthy children were served as controls. The distribution of SNP was determined by PCR-RFLP. Arterial lesions were detected by echocardiographic.ResultsThe distribution of three genotypes (CC, CG, GG) in SNP (rs7849782) was statistically difference between KD and control groups (P=0.034), and C allele was associated with KD susceptibility (OR=1.46, 95%CI: 1.10-1.92,P=0.007). In children with KD, the polymorphism of SNP loci was signiifcantly associated with oral mucosa lesions and coronary artery lesion (P<0.05), but not associated with conjuncti-val hyperemia, hand-foot edema, rash, and lymphadenopathy (P>0.05). The polymorphism of SNP loci was also associated with the levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) (P<0.05).ConclusionThe ploymorphism of SNP loci ofGRIN3A gene (rs7849782) was associated with the susceptibility of KD. The C allele was the risk factors. The poly-morphism of SNP was associated with oral mucosa lesions and coronary artery lesion, and may affect the levels of ESR and CRP.

Objective: To investigate the effect of phosphocreatine (PCr) on angiotensin II (Ang II) induced proliferation and collagen synthesis of cardiac ifbroblasts in neonatal rats with its mechanism.
Methods: The cardiac ifbroblasts (CF) from neonatal rats were cultured in vitro and were divided into 4 groups.①Control group, the CF was cultured in non-serum DMEM,②Ang II group, the CF was cultured with Ang II at (1×10-6) mol/L,③PCr treated group, the CF was cultured with PCr at 10 mmol/L, and④Ang II+PCr group. The CF cell cycle percentage was detected by lfow cytometric assay, myocardial collagen content was observed by VG staining and protein expression of phosphorylated extracellular signal-regulated kinase (pERK1/2) was detected by immuneohistochemistry.
Results: ① Compared with Control group, the CF in Ang II group showed increased percentage of S phase and decreased percentage of G0/G1 and G2/M phases, increased collagen content and pERK1/2 protein expression, all P<0.01.② The CF cell cycle, collagen content and pERK1/2 protein expression were similar between Control group and PCr treated group, all P>0.05. ③ Compared with Control group, Ang II + PCr group had elevated pERK1/2 protein expression, P<0.01, while the CF cell cycle and collagen content were similar with Control group, P>0.05.④Compared with Ang II group, the CF in Ang II + PCr group had increased percentage of G0/G1 and G2/M phases, decreased percentage of S phase, decreased collagen content and pERK1/2 protein expression, all P<0.01.
Conclusion: PCr may partially inhibit Ang II induced CF proliferation and collagen synthesis which might be related to the inhibition of excessively activated ERK1/2. Therefore, PCr could improve Ang II induced myocardial ifbrosis in neonatal rats.

Objective To investigate the effects of triptolide on lipopolysaccharide (LPS)-induced acute lung injury in rats.Methods Sixty-five male SD rats weighing 200-250 g were randomly divided into 5 groups: control group (group C,n =5),LPS group (group L,n =15),different doses of triptolide groups (groups TP1-3,n =15).In group C normal saline was injected iv and 1％ DMSO injected intraperitoneally(ip).In group L LPS 5 mg/kg was injected iv and 1％ DMSO injected ip.In groups TP1-3 LPS 5 mg/kg was injected iv and triptolide 25,50 and 100 μg/kg was injected ip respectively.Blood samples were collected at 1 h before administration and 1,3,6 and 12 h after administration for blood gas analysis.The animals were sacrificed at 12 h after administration.TNF-α concentrations in serum and bronchoalveolar lavage fluid (BALF) were determined by ELISA.The lungs were removed for microscopic examination,evaluation of diffuse alveolar damage (DAD) score and determination of W/D lung weight ratio and the expression of Toll-like receptor4 (TLR4) protein and mRNA.Results Compared with group C,PaO2 was significantly decreased at 3,6 and 12 h after administration,DAD score and W/D lung weight ratio were increased in groups L and TP1-3,TNF-α concentrations in serum and BLAF were increased,expression of TLR4 mRNA and protein was up-regulated in groups L,TP1 and TP2,whlie TNF-α concentrations in serum and BLAF were significantly decreased,expression of TLR4 mRNA and protein was down-regulated in group TP3 ( P ＜ 0.05).Compared with groups L and TP1,PaO2 was significantly increased at 6 and 12 h after administration,DAD score,W/D lung weight ratio and TNF-α concentrations in serum and BLAF were decreased,expression of TLR4 mRNA and protein was down-regulated in groups TP2 and TP3 ( P ＜ 0.05).There was no siginificant difference in blood gas parameters,DAD score and W/D lung weight ratio between group L and group TP1 and between group TP2 and TP3 ( P ＞ 0.05).Compared with group TP2,TNF-α concentrations in serum and BLAF were significantly decreased,expression of TLR4 mRNA and protein was down-regulated in group TP3 (P ＜ 0.05).The lung pathologic injury was reduced in groups TP1-3 as compared with group L.Conclusion Triptolide can attenuate acute lung injury induced by LPS in a dose-dependent manner in rats,and the inhibition of up-regulation of TLR4 expression and release of TNF-α may be involved in the mechanism.