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.

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.

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.

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 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.

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.

ObjectiveTo investigate the effect of intrathecal (IT) Ro25-6981 (a selective NR2B receptor antagonist) on focal cerebral ischemia-reperfusion (I/R) injury in rats.MethodsSixty healthy male SD rats weighing 280-320 g in which IT catheter was successfully implanted without complication were randomly divided into 4 groups ( n ＝ 15 each):group sham operation (group S) ; group focal cerebral I/R(group I/R) ; group I/R + Ro25-6981 (group Ro) and group I/R+ normal saline (group NS).The right middle cerebral artery was occluded for 2 h with a nylon thread with rounded tip which was inserted into right internal carotid artery and advanced cranially until resistance was met in groups I/R,Ro and NS.In group Ro Ro25-6981 100 μg/10 μl was injected IT at 0,2,23 h of reperfusion,while in group NS NS was injected IT instead of Ro25-6981.Neurological dificit was assessed and scored (0 ＝ no deficit,3 ＝ severe deficit) at 24 h of reperfusion.The infarct size was determined by 2,3,5-triphenyl tetrazolium chloride staining.ResultsIT administration of Ro25-6981 significantly reduced cerebral I/R-induced infarct sized and neurological deficit score in group Ro as compared with groups I/R and NS.ConclusionRo25-6981 injected IT can protect the brain against local cerebral I/R injury.

Objective To assess the enteral iron and energy intake of premature neonates during hospitalization in neonatal intensive care unit(NICU).Methods This retrospective study enrolled 208 premature neonates admitted in the NICU of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine within 48 hours after birth from January 2012 to December 2013.The following data were recorded for all infants:clinical basic information,the amount of formula iron intake in milk,enteral and parenteral nutrition intake as well as oral iron supplementation.Results The amount of enteral iron intake in the 1st,2nd,3rd,4th week after birth and at discharge was (0.2 ± 0.3) mg/(kg · d),(0.9 ±0.7) mg/(kg · d),(1.2 ±1.0) mg/(kg · d),(1.5 ± 1.1) mg/(kg · d),and (2.2 ± 1.1) mg/(kg · d),respectively,which accounted for 10％,45 ％,60％,75 ％ and 110％ of the recommended iron intake.The energy intake in the 1st,2nd,3rd,4th week after birth and at discharge was (13.2 ± 14.8) kcal/(kg · d) (1 kcal =4.184 kJ),(46.0 ± 32.6) kcal/(kg · d),(62.2 ± 38.1) kcal/(kg · d),(71.3 ± 38.2) kca]/(kg · d) and (105.3 ± 32.1) kcal/(kg · d),which accounted for 11.0％,38.3％,51.8％,59.4％ and 87.8％ of the recommended intake,respectively.Lower enteral iron and energy intake after birth occurred in the premature infants with lower birth weight,especially those with anemia who had significantly lower enteral iron intake than the normal neonates in the first 2 weeks after birth.Conclusions Enteral iron and energy intake among premature neonates were insufficient,especially during the first 2 weeks after birth.It is necessary to develop and implement more effective nutritional support to improve the nutritional status of premature infants.

This study was designed to discover filovirus entry inhibitors in a drug library of commercial medicines. One thousand and six hundred drugs were screened using the ZEBOV-GP/HIV model, a pseudovirus formed by an HIV-core packed with the Zaire Ebola virus glycoprotein. We identified 12 gonadal hormone drugs with inhibitory activities in ZEBOV-GP/HIV entry at final concentration of 10 μmol x L(-1). Among them, three drugs exhibited strong activities with IC50 < 1 μmol x L(-1), such as toremifene citrate (IC50: 0.19 ± 0.02 μmol x L(-1)), tamoxifen citrate (IC50: 0.32 ± 0.01 μmol x L(-1)) and clomiphene citrate (IC50: 0.53 ± 0.02 μmol x L(-1)); seven drugs had moderate activities with IC50 between 1 and 10 μmol x L(-1), such as estradiol benzoate (IC50: 1.83 ± 5.69 μmol x L(-1)), raloxifene hydrochloride (IC50: 3.48 ± 0.07 μmol x L(-1)), equilin (IC50: 4.00 ± 9.94 μmol x L(-1)), estradiol (IC50: 5.26 ± 9.92 μmol x L(-1)), quinestrol (IC50: 6.36?5.37 gmol-L1), estrone (IC50: 6.87 ± 0.03 μmol-L1) and finasteride (IC50: 9.94 ± 0.45 μmol x L(-1)); two drugs, hexestrol (IC50: 14.20 ± 0.55 μmol x L(-1)) and chlormadinone acetate (IC50: 24.60 ± 0.36 μmol x L(-1)), had weak activities against ZEBOV. Further, toremifene citrate, tamoxifen citrate, clomiphene citrate, raloxifene hydrochloride and quinestrol could block both pseudovirus type Sudan ebola virus (SEBOV-GP/HIV) and Marburg virus (MARV-GP/HIV) entries.

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.