Objective To investigate the possible roles of cellular immunosuppression induced by phenotypic and functional changes of peripheral CD4+CD25+ regulatory T cells (Tregs) in the pathogenesis of condylomata acuminata. Methods Three-color flow cytometry was performed to examine the expression of transcription factor Foxp3 in, along with several inhibitory membrane molecules, i.e. cytotoxic T lympho-cyte associated antigen-4 (CTLA-4), glucocorticoid-induced TNF receptor family-related gene (GITR) and programmed death-1 (PD-1) on peripheral CD4+CD25+ T cells from 46 patients with condylomata acuminata and 43 normal human controls. Meanwhile, high purity of CD4+CD25+ T cells were isolated from peripheral blood using imrnunomagnetic beads, and stimulated to produce intracellular suppressor cytokines such as interleukin-10 (IL-10) and transforming growth factor-beta (TGF-beta), which were detected by flow tyro-metric analysis. Results The number of peripheral CD4+CD25+ Foxp3+ Tregs increased significantly in patients with condylomata acuminata than that in the normal controls (7.37% ± 2.43% vs 5.96% ± 2.09%,P ＜ 0.001). The expressions of CTLA-4 and PD-1 were 1.86% ± 1.13% and 2.41% ± 1.12%, respectively,in the patients, which were significantly higher than those in the normal controls(1.36% ± 0.90% and 1.70%± 0.97%, P ＜ 0.05 and 0.01, respectively). The number of TGF-beta-positive CD4+CD25+ T ceils from peripheral blood were increased in patients than that in, the controls (1.57% ± 0.91% vs 0.78% ± 0.24%, P ＜0.001). Conclusions Human papillomavirus infection can induce the activation and proliferation of CD4+CD25+ Tregs, enhance the expression of negative costimulatory molecules and secretion of suppressor cytokines, and inhibit antiviral immune response through multiple mechanisms.

Objective To explore the significance of changes of matrix metalloproteinase-9 (MMP-9),interleukin-6 (IL-6),and tumor necrosis factor-alpha (TNF-oα) protein level in the cerebrospinal fluid (CSF) of children with viral encephalitis (VE).Methods The concentration of neuron-specific enolase (NSE),structural proteins 100B (S100B),and MMP-9,IL-6,TNF-α in the CSF of VE children were detected by an enzyme linked immunosorbent assay,and the correlations of them were analyzed.Results NSE,S100B,MMP-9,IL-6,TNF-α protein expression could be found significantly higher than those in the control group,and there were significant differences according to statistics expression trends(all P ＜0.05).The NSE protein expression was significantly positive related with S100B in the VE group (r =0.467,P =0.009),and the concentration was markedly negative related with the duration of viral encephalitis (r =-0.472,P =0.008).MMP-9,IL-6 protein expression were significantly positive related with NSE,S100B respectively (r =0.698,P =0.00 ; r =0.559,P =0.00 ; r =0.812,P =0.00 ; r =0.664,P =0.00).TNF-α protein expression was positive related with CSF S100B(r =0.363,P =0.049),but there was no correlation between TNF-α and NSE (r =0.245,P =0.193).Conclusions The neurons and the neuroglial cells are damaged in the viral encephalitis children.MMP-9,IL-6,TNF-α protein may participate in the pathological damage process of nerve cells in VE children in different degrees.

Objective To investigate the distribution and antibiotic resistance of isolated pathogens in neonatal sepsis. Methods The results of blood culture and drug susceptibility test in neonates sepsis from January 2012 to June 2013 were retro-spectively analyzed. Results One hundred and thirty-two strains were detected in the blood samples, with 100(75.76%)Gram-positive bacteria, 30 (22.73%) Gram-negative bacteria and 2 (1.52%) fungus. Staphylococcus epidermidis, Escherichia coli and Staphylococcus aureus were the three most common pathogens. Gram-positive cocci was strongly resistant to penicillin (100.00%), erythromycin, selectrin and ampicillin/sulbactam (62.50%-100.00%), but still sensitive to vancomycin and teico-planin. The resistance rate of Gram-negative bacilli to ampicillin was 100.00%, and the resistance rate to cefatriaxone, selectrin and cefuroxime was 61.54%-100.00%. The resistance rate to imipenem and piperacillin/tazobactam was lower. Conclusions The selection of sensitive antibiotics should be based on the pathogens and drug resistance testing for the treatment of neonatal sepsis.

OBJECTIVE:To systematically review the efficacy and safety of salmeterol and fluticasone propionate aerosol in the treatment of AECOPD and provide evidence-based reference for the clinical treatment. METHODS:CJFD,Wanfang database, VIP,CBM,Cochrane Library,PubMed and EMBase were retrieved to collect the randomized controlled trial(RCT)of efficacy and safety of salmeterol and fluticasone propionate aerosol in the treatment of AECOPD. After information collection and quality evalua-tion,Meta-analysis was performed by using Rev Man 5.1 software. RESULTS:There were totally 17 RCTs,including 2 872 pa-tients. Results of Meta-analysis showed FEV1[SMD=0.47,95%CI(0.41,0.53),P<0.001],FEV1/FVC [SMD=1.08,95%CI(0.76, 1.39),P<0.001],FEV1 percentage of predicted value[SMD=0.83,95%CI(0.60,1.06),P<0.001] and incidence of adverse reac-tions [RR=1.38,95%CI(1.02,1.87),P=0.03] in test group were significantly higher than control group,with significant differenc-es. CONCLUSIONS:Salmeterol and fluticasone propionate aerosol has good efficacy in the treatment of AECOPD,can better im-prove patients’lung function and the safety needs to be improved. Due to the limit of research methodology,it remains to be fur-ther verified by large-sample and high-quality RCT.

Objective To explore the perioperative nursing of patients from high altitude earthquake-stricken regions. Method The perioperative nursing histories of 18 patients from high altitude earthquake-stricken regions were retrospectively analyzed to summarize the nursing experience.Results No wound infection,crush injury or complications occurred.Sixteen patients had good functional recovery,1 patient was at the stage of recovery about limb movement and another one was also at the recovery period from lumbar vertebral burst fracture complicated with nerve injury.Conclusion Close observation,psychological nursing and functional exercise are important for improved success rate of treatment for the patients from the earthquake-stricken regions.

Objective To explore the 5,10-methylenetetrahydrofolate reductase (MTHFR) and 5-methyltetrahydro-folate-homocysteine methyltransferase reductase ( MTRR ) gene polymorphisms among the Han women in Zhangjiagang city .Methods A total of 4008 Han women were recruited .Their oral epithelial cells were collected to extract genome DNA in order to detect gene polymorphisms of MTHFR and MTRR using fluorescence quantitative PCR.Then the results were compared with those in other cities in China .Results The genotype frequencies of MTHFR C677T CC, CT and TT among Zhangjiagang women are 32.2%, 49.5%and 18.3%, respectively.The C allele frequency is 64.3%, T allele frequency is 35.7%.The genotype frequencies of MTHFR A1298 C AA, AC and CC are 68.7%,28.7% and 2.5%, respectively .The A allele frequency is 80.8%, C allele frequency is 19.2%.The genotype frequencies of MTRR A66 G AA, AG and GG are 54.4%, 38.5%and 7.1%, respectively . The A allele frequency is 76.3%, G allele frequency is 26.4%.Conclusions The MTHFR, MTRR polymorphism distribution of Han women in Zhangjiagang city is region specific.

Objective To investigate the parental origin for a rare case of complete hydatidiform mole and coexisting fetus and to discuss its diagnosis and differential diagnosis.Methods Tissues from the fetus,mole and placenta were collected and pathology analysis and chromosome analysis were done.The DNA from the fetus,mole and parents' peripheral blood leukocytes was amplified with five short tandem repeat (STR) markers (D4S2460,D18S488,D21S2039,DXS1205 and DYS219) at the same time to confirm the parental source of the hydatidiform.Results (1) Casereport:A 27-year-old woman,gravida 1,para 0,was found high risk for neural tube defects at 20 weeks of gestation.At 24+5 weeks of gestation,ultrasound examination demonstrated a normal fetus,a normal placenta and a huge mass with a multicystic appearance attached to the placenta with an obvious demarcation.The fetus died at 26 weeks of gestation.Serum human chorionic gonadotropin-β(β -hCG) level decreased obviously during the first two weeks after artificial induction,but elevated at the third week,and β-hCG titers fell to normal after 2 courses of chemotherapy.Fetus autopsy showed no structure abnormality.Histopathologic examination of the hydatidiform showed swelling of chorionic villi with hyperplasia of the trophoblast and formation of central cisterns suggesting of a twin pregnancy consisting of a complete hydatidiform mole and coexisting fetus.(2) Genetic analysis:The karyotype analysis of the normal placental villi was 46,XY; the cell cultures of fetal cartilage tissue and hydatidiform were failed.STR analysis showed that the fetus was diploid from biparental source;the mole was androgenetic source.And the mole had locus both from Y and X chromosome of the father,so it was heterozygous.It was suggested that this case was derived from one single oocyte fertilized with three spermatozoas.Conclusions STR analysis could be used to confirm the diagnosis of complete hydatidiform mole and coexisting fetus and to find the pathogenetic rnechanism.

Objective To explore the clinical head nurses'effective competence through interviewing nursing supervisors by in depth interview method and to provide reference for constructing training content for clinical head nurses in Macau and Guangzhou.Methods In depth interview was carried out among 8 nursing supervisors from 2 hospitals in Macau and 9 nursing supervisors from 2 tertiary hospitals in Guangzhou.Content analysis was utilized through organizing records and then forming written documentations.Results The themes were drawn after the interview,which were good moral character accomplishment,good communication skill,prospective and creative thinking,favorable executive ability.Forwardlooking and innovative were significantly different in Macau and Guangzhou.Conclusions The effective clinical head nurses' competence is multi-faceted,the results can provide reference for selection,evaluation and training for head nurses.

ObjectiveTo evaluate the IL-17 expression in HIV/tuberculosis-coinfected patients and its role in the pathogenesis of this coinfection.MethodsFifty-four HIV infected patients were divided into three groups:simple HIV infected group,HIV with latent tuberculosis infection (HIV+ LTBI) group and HIV coinfected with active tuberculosis (HIV+ ATB) group.The whole blood intracellular cytokine staining was performed and samples were then detected by BD FACSCanto.The expressions of CD4+ IL-17+ T cells and CD4+ IFNγ+ T cells were analyzed using FACSDiva software.Comparison between groups was done by independent sample t test.ResultsThe CD4+ T cell count and viral load among these three groups were comparable.There were no significant difference of the expression of CD4+ IL-17+ T cells between simple HIV infected group and HIV+ LTBI group (1.40 ± 1.01) ％ vs (1.29±0.86) ％,(t=0.336,P＞0.05),but both of these two groups were much higher than HIV+ATB group (t=3.680,t=2.516,P＜0.05).There were no significant differences of the expression of CD4+ IFNγ+ T cells among these three groups [(32.8±24.0)％ vs (40.3±1 21.9) ％ vs (46.1±31.2)％,(t=-0.939,t=-1.602,t=-0.646,P＞0.05)].ConclusionThe Th17 response is down-regulated in HIV/tuberculosis-coinfected patients,which may play an important antitubercular role in the pathogenesis of coinfection.

Objective To investigate the effects of club mode of health education on social support of breast cancer patients and their spouses.Methods A total of 100 breast cancer patients who underwent modified radical mastectomy and their spouses in Suzhou Municipal Hospital from May 2012 to March 2013 were randomly divided into the intervention group and the control group with 50 cases respectively. Patients and spouses in the intervention group were involved in the club, while in the control group patients and spouses received routine nursing care. Perceived social support scale (PSSS) and social support ratings scale (SSRS) were used in the questionnaires for patients before the intervention and at the 1st month, 3rd month, 6th month after the intervention.Results In the intervention group, the score of the support on the patients out of family was (29.80±5.77) at the 1st month after the intervention; the total score of perceived social support was (57.22±5.26) at the 3rd month after the intervention; the score of support from family was (26.59±2.51) at the 6th month after the intervention. All of those scores were significant higher than those in the control group (F=6.391, 0.304, 7.435;P<0.05). At the 3rd month after the intervention, the score of the social support on the spouses were (45.02±6.40) in the intervention group and (39.17±7.77) in the control group. The difference between the two groups was statistically significant (F=1.250,P<0.05).Conclusions The club mode of health education can effectively improve the social support status for breast cancer patients and their spouses.