Objective TO investigate the application of Nutritional Risk Screening 2002 (NRS 2002) and nutrition support in critically ill patients.Methods Totally 172 adult critically ill patients with a hospital stay equal to or above 3 days were consecutively enrolled from a Beijing-hospital from September 2011 to December 2011.Nutrition support was evaluated on a daily basis.NRS 2002,body mass index (BMI),and Acute Physiology and Chronic Health Evalnation Ⅱ (APACHE Ⅱ) were applied to assess the nutritional risks and nutrition status within 24 hours after admission.Results Among all the patients,the rates of nutrition support were 39.5％ and 67.9％ on the 1st and 7th day respectively.The rate of parenteral nutrition (33.6％ ～ 39.5％) was higher than that of enteral nutrition (4.1％ ～ 16.0％).NRS 2002,APACHE Ⅱ score,and BMI showed that 160 patients (93.0％) required nutrition support,but only 103 patients (64.4％) actually received nutrition support,among whom 92 (89.3％) were supplied with nutrition support within 3 days after admission.Conclusions The application of nutrition support in critically ill patients is insufficient in this hospital.Nutrition support is typically provided within 3 days after admission.Parenteral nutrition remains the most common type of nutrition support.

The ethical problems had directly affected the applying and development of organ transplantation.The serious shortage of donors restricted this technique deeply.The analysis on the ethical and moral problem about organ transplantation had been performed from ethical angel.It was proposed that implementation of brain-death legislation,setting up the newly ethical conception and prohibiting the organ business.Voluntary contribution was the first ethical principle in the source of the donor.Medical principles and social standards should be taken into account on the problem of acceptor selection.

Objective To probe the differences and similarities of clinical feature between alcoholic and biliary chronic pancreatitis (CP) and their therapy. Methods Retrospective analysis of the clinical features was made in 110 cases of CP in Peking Union Medical College Hospital from 1991 to 2000. Results ① In 110 cases of CP, the clinical manifestations were abdominal pain (85.4%), diarrhea (22.7%), calcification of pancreas (13.6%), and pseudocyst of pancreas (28.2%); 3 cases (2.7%) complicated with pancreatic carcinoma. ② The frequency of the different kind of clinical manifestations in alcoholic CP was higher than in biliary CP.③The frequency of diarrhea (29.1%),diabetes mellitus (41.9%) and calcification of pancreas (22.6%) in alcoholic CP was also higher than in those caused by bile duct system diseases (16.7%, 19.1% and 9.5%).④The response rate of medical treatment was 81.2%. Conclusions The clinical features and complications are more typical and occur earlier in alcoholic CP than those in biliary CP. With regard to management, medical treatment is less used than surgical therapy.

Neferine, an alkaloid, isolated form Nelumbo nucifera Gaertn,has antiarrhytbmic effect. The present report deals with its action on the ECG in rat & the surface potential of toad sciatic nerve.Neferine could prolong ECG, P-R & Q-T intervals, and widen QRS in a dose-dependent manner, The effects are similar to quini-dine, and dissimilar to tetrandrine. The inhibitory effects of neferine & quinidine on the surface potential of toad sciatic nerve are similar in potency.

Objective To construct a phage antibody Fab library of human antinuclear antibody. Methods Total RNA was extracted from peripheral blood lymphocytes of 4 patients suffering from autoallergic disease, with antinuclear IgG antibody titers in the serum higher than 1∶10 000 as estimated by indirect immunofluorescence technique. Taking oligo-dT as the primers, human immunoglobulin light chains ?/? genes as well as heavy chains Fd genes were reversely transcribed to cDNA by PCR. The ?/? light chains were initially cloned into pComb3Hss vector to construct a human recombinant light chain library, and the heavy chain genes were subsequently inserted into the corresponding sites of ?/?-pComb3Hss plasmid to generate a recombinant ?/?-Fd-pComb3Hss plasmid. The plasmid was then transformed into E. coli XL1-Blue, which was subsequently infected by the helper phage M13KO7. A random recombinant antibody library was expressed on the surface of filamentous phage. Results Human immunoglobulin ?/? light chain and heavy chain Fd genes (660bp) were amplified successfully. The light chain library with the capacity size of 2?104, and the human recombinant Fab antibody library with the capacity size of 4?104 were also successfully obtained. Finally, the phage antibody library of the Fab fragment of human antinuclear antibody, containing 2?109 CFU/ml phage, was constructed. Conclusion A phage antibody library of Fab fragment of human antinuclear antibody is constructed successfully. This research lays a foundation for the preparation for phage library of Fab fragment of human antinuclear antibody, and also paves the way for the advanced assessment for its effect on the immuno-targeting therapy of tumors.

Objective To investigate the effect of Zidan decoction containing serum on endometrial receptivity in uterine immunity environment,and then to discuss if it's effect on endometrial receptivity through its controlling the expression of cell factors which related to endometrial receptivity.Methods Mice's endometrium tissue samples and uterine Natural Killer (UNK) cells were obtained from pregnant mice on gd 4.5 days and gd 12.5 days.After endometrial glandular epithelial cells,endometrial stromal cells and UNK cells were separated through primary culture,epithelial cells and endometrial stromal cells at rate of 1 ∶ 1 a certain concentration UNK were mixed together and highly purified-cultured.Different concentrations of Zidan decoction was acted on the culture solution.FBS,black and aspirin control group were setup for contrast.The expression of LIF and VEGF which influenced by Zidan decoction in the immunity environment was assayed by Realtime-PCR.Results The expression of LIF and VEGF was significantly increased in the immunity environment of uterine (in 10％ Zidan decoction group,10％ aspirin group and 10％ blank control group:LIF was 2.10±0.20,1.98±0.14,0.90±0.05 separately,and VEGF was 3.17±0.31,2.52±0.09,0.92±0.06respectively,P＜0.05).Conclusion Zidan decoction could improve endometrial receptivity by increasing the expression of cell factor which related to endometrial receptivity with the help ofUNK paracrine.

Objective To study the clinical values of dynamic changes of yon Willebrand factor (vWF) and ADAMTS13 (a disintegrin and metalloprotease with thrombospondin repeats-13 ) in aneurysmal subarachnoid hemorrhage. Methods Twenty-nine patients with aneurysmal subarachnoid hemorrhage admitted to Department of Neurosurgery from April 2010 through April 2011 were enrolled for retrospective study.They could be categorized into 3 sets of grouping:delayed cerebral ischemia group ( DCI group) and non-delayed cerebral ischemia group ( no DCI group ),cerebral vasospasm group ( CVS group ) and no vasospasm group (no CVS group),and good prognosis group and poor prognosis group,and another 20 healthy subjects as control group.All patients were examined with CT,DSA,or/and CTA to identify the intracranial subarachnoid hemorrhage resulted from aneurysm rupture.The exclusion criteria included:(1)the time from onset to admission was longer than 72 hours or patient was in imminent danger of death; (2)patients had surgery,interventiona] or conservative treatment outside the hospital; (3) patients were under the treatment of antiplatelet medicine such as aspirin,clopidogrel,or other anticoagulants such as warfarin,etc ; (4) patients had blood diseases,impaired kidney or liver function,pregnant,or with recent infections.Venous blood were taken one day,4 days and 10 days after SAH to determine plasma concentrations of ADAMTS13 and vWF by using enzyme-linked immunosorbent assay (ELISA). Transcranial Doppler ultrasonography (TCD) was used to measure mean blood flow velocity of middle cerebral artery (VMCA).Glasgow outcome scale (GOS) score was measured before discharge. Data were analyzed by using SPSS version 13.0 software. Results The levels of vWF were significantly higher in DCI group,CVS group and poor prognosis group compared with those in the control group 1 day,4 days and 10 days after SAH.There were differences in vWF between DCI group and no DCI group 1 day and 4 days after SAH ( P ＜ 0.05 ).There were significantly differences in vWF between CVS group and no CVS group,and between good prognosis group and poor prognosis group 4 days and 10 days after SAH ( P ＜ 0.01 ).In DCI group and poor prognosis group,the level of plasma ADAMTS13 was significantly lower 1 day after SAH than that in the normal control group (P ＜0.01) and in the no DCI group (P ＜0.O1 ); and there were no differences in ADAMTS13 between CVS group and no CVS group.Conclusions In the early stage,the increase in plasma vWF and decrease in ADAMTS13 activity are associated with DCI,and the decrease in ADAMTS13 activity can be used to predict the outcome.

Objective To investigate the efficiency and mechanism of differentiation of reprogrammed adipose-derived stem cells (ADSCs) to neurons in vitro.Methods ADSCs from rats were cultured in vitro and then purified and identified.ADSCs at the third passage were divided into three groups:ADSCs without lentivirus-mediated gene transfection (blank group),ADSCs transfected with lentivirus carrying no neurogenin2 (Ngn2) (empty virus group) and ADSCs with lentivirus-mediated transfection of Ngn2 (Ngn2 group).All groups were induced in the medium containing cell growth factor for 15 days.The positive expression of neuron-specific nuclear protein (NeuN) in three groups was detected using immunofluorescence method so as to observe the efficiency of neuron differentiation.Expression variances of Mash1,Hes1 and Dll1 in each group were detected by Western blot analysis and the mechanism of differentiation was also discussed.Results After 15 days of induction,positive expression rate of NeuN in Ngn2 group,empty virus group,blank group was 90.12％,45.34％ and 40.26％ respectively,with significant differences among groups (P ＜ 0.01).Western blot analysis showed that Ngn2 group had a significantly higher expression of Dll1 (P ＜0.01) and obvious lower expressions of Hes1 and Mash1 (P ＜0.01),as compared with empty virus group and blank group.However,there were no significant differences of expression levels of Dll1,Mash1 and Hes1 between empty virus group and blank group (P ＞ 0.05).Conclusions After induction,the ratio of neuron differentiation of reprogrammed ADSCs is increased by almost 99％,as compared with simple ADSCs.The increased dfferentiation of reprogrammedADSCs to neurons may be associated with the inhibition of notch signaling through up-regulating Dll1 and down-regulating Mash1 and Hesl.

Objective To investigate the effects of leptin on Th17 cells and the possible mechanism. Methods The leptin-deficient ( ob/ob) mice and their homologous wild-type mice were used in the study.The percentages of Th17 cells in peripheral blood samples, spleen tissues and lymph nodes were measured by flow cytometry ( FCM) analysis.The splenic CD4+T cells, separated from the ob/ob mice and the wild-type mice by using magnetic beads,were respectively cultured with leptin at various concentrations and with anti-leptin neu-tralization antibody to evaluate the effects of leptin on Th17 cells.The quantitative real-time PCR was performed to analyze Th17 cell-related cytokines at transcriptional levels.The levels of IL-6 and IL-17A in the supernatants of CD4+T cell culture were measured with Luminex technology.Results Compared with the wild-type mice, the ob/ob mice showed lower percentages of Th17 cells in both peripheral blood samples and spleen tissues (0.49%±0.03%vs 1.29%±0.1%, 1.56%±0.22%vs 2.47%±0.11%).There was a decrease in the percentages of Th17 cells upon the in vitro treatment of CD4+T cells from wild-type mice with anti-leptin antibody.The per-centages of Th17 cells were increased in a dose-dependent manner upon the in vitro treatment of CD4+T cells from ob/ob mice with leptin.Moreover, the levels of IL-17A and IL-6 and the transcriptional levels of RORγt, IL-17A and IL-6 in leptin deficiency group were lower than those of wild-type group, but were increased upon the treatment with leptin.No significant difference with the transcriptional levels of TGF-βand IL-23 was ob-served between the two groups with and without intervention.Conclusion Leptin deficiency seriously hampered the generation of Th17 cells in mice and resulted in a decreased expression of RORγt, IL-17A and IL-6 at mRNA level.The treatment of CD4 T cells with leptin might promote the generation of Th17 cells through up-regulating the transcription of RORγt and IL-6.

Objective:To investigate the association between LPHN3 andattention-deficit/hyperactivity disor-der(ADHD)in Chinese Han children.Methods:Based on the Diagnostic and Statistical Manual of Mental Disor-ders,Fourth Edition (DSM-IV)diagnosis criteria,921 normal controls and 1052 ADHD children were included in the study.The Clinical Diagnostic Interview Scale (CDIS )was used to assess symptoms and ADHD sub-types.ADHD was divided into three subtypes,namely ADHD inattentive type (ADHD-I),ADHD hyperactive-im-pulsive type (ADHD-HI),and ADHD combined type (ADHD-C).The ADHD rating-scale was used to assess ADHD symptoms.Including inattentive symptoms,hyperactive symptoms,impulsive symptoms and ADHD total symptoms.Three single nucleotide polymorphisms (SNPs)of LPHN3 were genotyped.Case-control studies were conducted to investigate the association of each SNP with the ADHD and the subgroups using chi-square test.Results:rs11131347 was associated with ADHD P <0.05,OR =0.86(0.76 -0.98)],but the difference didn't survive significance after corrections,The frequency of minor allele C in cases and control was0.409 vs.0.445.For different genders,rs11131347 was significantly associated with ADHD boys [P <0.05,OR =0.82(0.71 -0.96)], The frequency of minor allele C in cases and control was0.402 vs.0.449.For different subtypes,rs11131347 was associated with ADHD-C [P <0.05,OR =0.85(0.74 -0.98)]and ADHD-C boys[P <0.05,OR =0.82(0.70 -0.97)],but none of the difference survived significance after corrections,The frequencies of minor allele C in cases and control were respectively 0.407 vs.0.445 and 0.401 vs.0.449.Genotypes distribution analysis indicated that rs11131347 was associated with ADHD in general (recessive model,P <0.05),ADHD boys (additive model,P <0.05;dominant model,P <0.05;recessive model,P <0.05),ADHD-C(recessive model,P <0.05)and ADHD-C boys (dominant model,P <0.05 ),however,none of the difference survived significance after correc-tions.rs11131347 was nominal associated with impulsive scores(P <0.05).Conclusion:These findings suggest that the polymorphism of LPHN3 is probably involved in the pathological mechanisms of ADHD and its core symptoms of impulsivity.