Objective To explore the effect of prenatal inflammation on rat offspring's blood pressure and behavioral performance.Methods Twenty-four time-mated Sprague-Dawley(SD)rats were randomly divided into three groups,i.e.control,zymosan and LPS.On their gestation days 8,10,12,the pregnant rats received i.p.injections of sterile saline,0.79 mg/kg zymosan or 0.79 mg/kg LPS respectively.When the offspring were sixty weeks old,eight pups were chosen randomly for the later study.Their serum TNF-? level was detected by ELISA using tail blood,arterial blood pressure was measured by tail-cuff method,and their behavioral performance was detected in Morris water maze test.At the end of the experiment,the brains were rapidly taken from the sacrificed offspring,cut into sections and stained with H&E method to investigate the structural changes of hippocampus.Results Compared with control group,all offspring from the inflammation groups showed increased serum level of TNF-?,increased systemic arterial blood pressure,long latency in finding the safe platform and decreased number of neurons in CA1 region of hippocampus.Conclusion Prenatal exposure to LPS or zymosan results in hypertension and disturbance of learning and memory.

Objective To compare the changes of 11 cytokines in ankylosing spondylitis(AS)before and after treatment with a loading regimen of infliximab and to evaluate the potential AS related discriminating cytokines and explore their value in diseases activity evaluation and possible association with therapeutic response.Methods This was an open-labeled,phase Ⅱ clinical trial conducted in 2 medical centers.All AS patients were infused with infliximab at week 0,2,6.The dosage was 5 mg/kg.Disease activity parameters were assessed at week 0,2,6 and 10.Eleven serum cytokines were detected using protein chip technique,then,serum IL-6 level wag measured by sandwich enzyme-linked immunosorbent assay(ELISA).Results IL-6 was detected by EHSA.Compared with healthy controls.IL-6 level incregsed markediy in AS(P<0.01).After treated with infliximab,IL-6 level decreased at week 2(P<0.01)and maintained at low level until week 10.Baseline serum IL-6 level was positively associated with AS disease activity index(night pain scores、ESRand CRP)(P<0.01).Conclusion Serum IL-6 level is associated with AS disease activity and may become a useful parameter for monitoring the clinical response of infliximab in AS patients.IL-6 is an important cytokine involved in the pathogenesis of AS.

To investigate the effects of traditional Chinese medicine (TCM) therapy for clearing heat and resolving phlegm on systemic inflammatory response syndrome (SIRS) in acute deterioration stage of chronic obstructive pulmonary disease (COPD) and the serum procalcitonin (PCT) level.

In recent years,the state has a substantial increase in investment in Medical Research.The number of hospital-borne scientific research,funding amounts and types of projects is also increasing..Our hospital scientific management based oriented clinical needs,Construction Institute hospital as a work positioning,the whole process of quality management as the implementation of safeguards.Through a series of positive measures,gradually formed which are consistent with the management of the hospital research and development,and scientific research achievements into clinical practice.The research management changed from passive management model to proactively manage; from the emergency management to the whole process of managing; from the targeted management to guide the management of clinical needs.These measures effectively improve the level of scientific research in hospitals.

Objective To evaluate the efficacy profile of loading dose of anti-tumour necrosis factor (TNF)-α antibody infliximab in the treatment of ankylosing spondylitis (AS) and investigate the parameters that could be used as predicting factors for clinical response to infliximab in AS.Methods This was an open-labeled.mutticenter trial.Subiects eligible for this study were adults with a diagnosis of definite AS.Active disease was a Bath AS disease activity index(BASDAI)≥4 and spinal pain VAS≥4.Infliximab 5 md/kg was infused at weeks 0,2,6.All patients were followed for up to 10 weeks.Logistic regression likelihood ratio tests (univariate and multivariate) were performed to investigate which of the following parameters assessed before treatment were associated with ASAS 20,ASAS 40 and BASDAI 50 response:sex.age.disease duration,HLA-B27,BASDAI,spinal inflammatory (questions 5 and 6 of the BASDAI),spinal pain,night pain,patient global assessment,Bath AS functional index (BASFI),BASMI,enthesis index (EI),presence of peripheral arthritis,chest expansion,ESR,CRP,Bath AS radiology index (BASRI).Results Sixty-three patients (79% were males.90% were HLA-B27 postivie with a median age of 32 years and the median disease duration was 10 years) completed the treatment.The proportion of ASAS 20 responders.ASAS 40 responders and BASDAI 50 at week 10 was 84%,75%,70%,respectively.Univariate and multivariate Logistic regression analysis showed none of the 17 parameters evaluated at week 0 including ESR/CRP,disease duration were predictive for improvement.Conclnsion In this study,a loading regimen of infliximab has demonstrated consistent efficacy and none of the demographic parameters and baseline AS activity parameters are predictors for maior clinical response to infliximab in active AS.

Objective To improve the clinical understanding of the disease by retrospective analysing 55 cases of patients with panniculitis. Methods The hospitalized patients with panniculitis were collected from December 2011 to October 2018 in the Shanxi Dayi Hospital Affiliated to Shanxi Medical University. The demographics, clinical manifestations, laboratory examinations and treatments were analyzed and summarized, rate or composition ratio were applied for statistical description of the counting data. Results The proportion of males and females in the 55 patients was 1:2.23, with an average of (53±15) years (18-82 years). A total of 52 cases of nodular panniculitis (including 14 cases of mesenteric involvement) and 3 cases of special type of panniculitis were collected. Patients with nodular panniculitis were often presented with subcutaneous nodules or masses. According to the affected parts, they cowld be divided into skin sub-type and systemic sub-type. Among them, 32 cases were skin sub-type and 20 cases are systemic sub-type. The most frequently involved organs were mesenteric and kidney involvement. Nine of 55 patients was complicated with tumor. Patients with mesenteric panniculitis mainly presented with abdominal pain and bloating, which were mainly diagnosed according to CT findings. Patients with systemic panniculitis could be significantly relieved after treatment with coricosteroids and immunosuppressive agents. Conclusion Panniculitis is an inflammatory disease of unknown etiology. It is frequent in middle-aged and elderly people. It presents with various clinical manifestations and lacks specificity. The diagnosis is mainly based on pathological results. It is easy to be complicated with tumors. When subcutaneous nodules are found, pathological examination should be performed in order to avoid misdiagnosis.

Objective:To comprehensively and systematically retrieve domestic and international research on nurse-initiated protocolized weaning in adult mechanically ventilated patients, clarify its outcome indicators and effectiveness in clinical practice, and identify influencing factors in its implementation.Methods:Employing the scoping review methodology of Arksey and O'Malley, databases in both English and Chinese were systematically searched. Literature was selected based on inclusion and exclusion criteria, with two researchers independently screening, organizing, and analyzing the articles.Results:Eighteen publications were included: seven interventional studies, four qualitative studies, two cross-sectional studies, two on instrument development, and three reviews. Nurse-initiated protocolized weaning was found to be safe and effective, with common clinical outcome indicators including mechanical ventilation duration, weaning time, and ICU length of stay. Significant barriers included the professional knowledge level of nurses, team cooperation, nurses' personal characteristics, and the healthcare providers' underestimation of patients' clinical symptoms. Continuous care, patient involvement, a supportive nursing culture, and recognition of the nurse's role were facilitators of this treatment.Conclusions:Future research efforts should standardize and refine the intervention measures of nurse-initiated protocolized weaning and conduct large-sample, high-quality studies to provide references for the implementation of nurse-initiated protocolized weaning in China.

Objective To explore the feasibility of the deep convolutional neural network (DCNN) judging the indications and prognosis of the total knee arthroplasty based on the trained DCNN computer learning system.Methods C1FAR-10 DCNN model based on TensorFlow (an open source system,Google,USA) optimized by Alex Krizhevsky were constructed.There were 400 cases with knee osteoarthritis from different databases used for analysis.Three hundred patients underwent total knee arthroplasty,while 100 did not.X-ray of 200 preoperative cases from the 400 cases and their enlarged image (50 times) were applied for training DCNN,while the enlarged images from other 200 cases were used to test the DCNN.The correlation and the regression between judgment of the DCNN and clinical truth were analyzed.The clinical truths were rechecked three times and were confirmed by treatment results.Pearson correlation and linear regression analysis were used.The relation test of the software was only used as a reference.Results There was no significant difference between the baseline of cases for learning and test.After learning 200 cases,the DCNN judged the 10 000 cases enlarged from remaining 200 cases.The correlation between the DCNN judgment and the clinical truth was not significant (r=0.000,F=0.001,P=0.970).False positive was observed in 1 681 cases,false negative in 3 296.After enlarged to 10 000 images,the correlation between the two judgments was significant (F=11 228.735,P=0.000,r=0.727 and R2=0.529).The software detection precision was 0.860.Conclusion DCNN can be applied in judging the indications of the total knee arthroplasty.Large sample size can improve the accuracy of the judgment significantly.

Objective:To investigate the clinical features and treatment status of immune-related myositis (IRM) caused by immune checkpoint inhibitors (ICIs) in order to improve the diagnosis and treatment rate of the disease.Methods:Two cases of IRM combined with the diagnosis and treatment were described and the literature about IRM in the past 10 years was reviewed, and the clinical data of 59 patients were analyzed.Results:IRM was more common in males, with a total of 47 (79.7%). IRM usually occurred after 45 days of medication or after two doses. The clinical manifestations were mainly myalgia and muscle weakness, which were more common in the limbs. The initial symptoms were ptosis and diplopia. Fifty patients (84.7%) had serum creatine kinase (CK) levels higher than twice the upper limit of normal (UNL). In immunological examinations, 18 patients were found to be positive for anti-rhabdoid muscle antibody (AsM-Ab), while most of the myositisspecific antibodies (MSAs) and myositis-associated antibodies (MAAs) were negative. Thirty-four patients (75.6%) had abnormal EMG, and most patients showed myogenic injury. Muscle magnetic resonance imaging (MRI) showed muscle edema and inflammation in 8 patients. Muscle biopsies from 18 (45.0%) patients showed varying degrees of necrotic myofibers. Fifty-seven patients (96.6%) discontinued ICIs after developing IRM, 54(91.5%) received cortico-steroids, and 20(33.9%) received other treatments including intravenous immuno-globulin (IVIG), plasma exchange.Conclusion:IRM can occur in the early stage of ICIs treatment. Electro-myography, muscle MRI and muscle biopsy in suspicious cases can improve the diagnosis rate of the disease. Early use of corticoteroid, IVIG and other immunotherapy can effectively alleviate the disease.

Objective To construct an evidence-based practice model for nurses in preventing deep vein thrombosis(DVT)and provide a scientific and targeted theoretical basis for nurses to carry out evidence-based nursing practice in DVT prevention.Methods Based on the previous evidence-based nursing practice project on DVT prevention after hip and knee arthroplasty,the research team used theoretical analysis and brainstorming to develop a draft of the work model.Expert meetings were organized to validate the content of the draft using the Delphi method,leading to the finalization of the evidence-based practice model for nurses in preventing DVT.Results The Knowledge-to-Action(KTA)framework was selected as the basic framework for constructing the evidence-based nursing practice model for preventing DVT.Theoretical Domain Framework,Theory of Planned Behavior,and Social Cognitive Theory were chosen to explore the influencing factors of nurses'behavior change in preventing DVT through evidence-based practice.The authority coefficient of the participating experts was 0.904,indicating high reliability.The final model consisted of 6 key components:knowledge generation,problem identification,localization and adaptation,knowledge application,sustained knowledge use,and conceptual framework for behavior change through evidence-based practice.Conclusion Based on theoretical analysis and clinical practice,this study developed an evidence-based practice model for nurses in preventing DVT using the expert meeting.The research methodology was scientific,and the content was reliable,providing a theoretical basis for nurses to engage in evidence-based nursing practice for DVT prevention.