Objective To explore the enhancing effect of monoclonal antibody coated with anti-human CD3 and CD28 on acti-vation and transformation of peripheral blood mononuclear cell (PBMC)in vitro.Methods Human peripheral blood mononuclear cells were separated.Cells was cultured in vitro,and determined by flow cytometry.The solid phase with CD3 and CD28 antibody was coated and added in.The mature CIK cells were obtained after 12 days culturing.Results The CD4 + cells was lower in group C than those in group A(P <0.05).The CD8 + cells was higher in group C than that in group A and B(P <0.05).There was signifi-cant difference of T4/T8 between group C and group A and B(P <0.05 ).There was significant difference of NK cells between group B and group C(P <0.05).The CD25 + cells was lower in group C than that in group A (P <0.01).Conclusion CD3 antibody solid coated combined with CD28 antibody added to the suspension has more strong activation than both CD3 antibody and CD28 antibody solid coating on peripheral blood mononuclear cell.

Objective To investigate the effects of preconditioning with low-concentration hydrogen peroxide ( H2O2 ) on oxidative stress-induced bone marrow mesenchymal stem cells ( BMSCs ) apoptosis and its mecha-nism.Methods Mouse bone marrow mesenchymal stem cells ( BMSCs) were isolated and purified by differential centrifugation, and were treated with 0,200,250,300, 500 μmol/L H2O2 after preincubation with 50 μmol/L H2O2 or control medium.Apoptosis of these cells was measured by flow cytometry, and the expression of phos-phorylated PI3K, Akt and mTOR was analyzed by Western blot; BMSCs were also primed with PI3K inhibitor LY294002 for 30 min, then preincubated with 50 μmol/L H2O2 or control medium for 12 h before treatment with 300 μmol/L H2O2.Expression of apoptosis proteins Bcl-2, Bax, caspaase-3, cleaved-caspase-3 and the key pro-teins of the PI3K/Akt/mTOR pathway were detected by Western blot .Results H2O2 induced BMSCs apoptosis in a dose-dependent manner ,and pretreatment of BMSCs with low concentration of H2O2 significantly decreased H2O2-induced apoptosis of the BMSCs .Western blot results revealed that preconditioning with low-concentration H2O2 re-markably reversed the decrease in Bcl-2, total and phosphorylated PI3K, Akt and mTOR levels, and increased in Bax, cleaved-caspase-3 expression after high-dose H2O2 treatment.Such effects were antagonized by PI3K inhibitor LY294002 .Conclusions Preincubation with low-concentration H2O2 may indnce resistance of BMSC to oxidative stress, and such effect may be mediated by inhibition of pro-apoptotic proteins and activation of the PI 3K/Akt/mTOR pathway .

Objective To explore the efficacy of honey and recombinant bovine basic fibroblast growth factor(rb-bFGF) in promoting wound healing after the surgery of oral mucosa transplantation,and provide evidence for clinical nursing.Methods Eighty patients who underwent oral mucosa transplant surgery were selected and randomly divided into four groups by random number table method,with 20 cases in each group. Group A was the control group,the oral mucosa wounds were exposed to air and kept clean and dry;in group B, the oral mucosa wounds were treated with honey;in group C,the oral mucosa wounds were treated with rb-bFGF gel;and in Group D,the patients were treated with honey combined with rb-bFGF gel. The wound healing level, eating recovery time,and pain level of four groups were evaluated and compared.Results The comparison in wound healing degree among four groups seven days after surgery was statistically significant different (P<0.05);the wound healing level of group D was better than group B and C (P<0.05);the pain level of patients in four groups was significantly different (P<0.05);the pain level of group D was better than other three groups (P<0.05);the comparison of eating recovery time among four groups was significantly different (P<0.05);the eating recovery time of group D was better than group B and C (P<0.05).Conclusions Both honey and rb-bFGFcan effectively promote the wound healing of oral mucosa. The combination of honey and rb-bFGF,can shorten the eating recovery time,relieve pain,and promote wound healing,so as to improve patients' quality of life.

The clinical features,imaging data and prognosis of 2 patients with spinal cord infarction were summarized.Both patients presented with acute onset paraplegia and urinary retention.Spinal MRI showed high T2 signal and limited diffusion in the spinal cord.Patient 1 had spinal inflammatory changes and disc calcification and herniation at the T6 level.Cervical disc herniation was found in case 2 and the spinal lesions were all adjacent to the spinal infarct plane,but could not directly cause acute or chronic spinal cord compression.The clinical manifestations of two patients were acute stroke events.After the diagnosis of spinal cord infarction was confirmed,anti-platelet aggregation or anticoagulation and rehabilitation therapy were given,and the limb function of the patients gradually recovered to close to normal.The incidence of fibrocartilage embolism(FCE)associated with spinal disc disease is rare,and there is no consensus on treatment.This case provides experience and broadens thinking for the diagnosis,treatment and prognosis of spinal cord infarction.

Objective To investigate the characteristics of pulmonary function and pathological changes in rats with acute lung injury (ALI) and provide experimental basis for further study on the mechanism of ALI.Methods Twenty five male SD rats were randomly divided into the control group (n =5) and acute lung injury (ALI) group (n =20).Lipopolysaccharide (LPS) (4.5 mg/kg) were injected into the ALI group rats to establish the ALI rat model.The rats in control group were given 150 μl isotonic saline.At 12,24,48,and 72 hours after injury,lung function of the rats were tested by Buxco small animal lung function test system,including the dynamic lung compliance (Cdyn),forced vital capacity (FVC),functional residual gas (FRC),quasi static compliance (Cchord),100th millisecond expiratory volume (FEV100),and airway resistance (RI).In addition,the bronchoalveolar lavage fluid (BALF) was collected for detection of protein level and tumor necrosis factor (TNF-alpha)concentration.At the same time,the changes of lung tissues were recorded,and the pathological changes were observed by HE staining.Results Compared with the control group,Cdyn,FVC,FRC,and FEV100 in ALI group were significantly decreased at each time point after injury (P ＜0.05 or ＜0.01),while the airway resistance (R1) in ALI group was significantly increased at 24 and 48 hours after injury (P ＜ 0.01).There was no significant difference in quasi static compliance (Cchord) between two groups (P ＞ 0.05).The protein level and TNF-alpha concentration of BALF in ALI group were increased significantly (P ＜0.05 or ＜0.01) 12-72 hours after injury (P ＜ 0.01).Compared with the control group,the whole lung was dark red in ALI group 12 hours after injury,and the most serious bleeding occurred in the pulmonary hilum area with single or multiple hemorrhagic foci of different sizes.Multiple punctate and focal bleeding of different sizes were seen on the lung surface,which were radially distributed around the pulmonary hilum.The color of lung tissue was gradually restored to normal at 72 hours after injury.Under the light microscope,pulmonary interstitial edema,inflammatory cell infiltration,pulmonary vascular congestion and focal pulmonary hemorrhage were observed 12 h after injury,showing typical ALl pathological changes.The pathological changes were the most significant at 24 hours and reduced obviously at 72 hours.Conclusions A single intratracheal injection of LPS can induce typical ALI pathological changes.There is a similar trend between the pulmonary function indexes,lung pathology characteristics,and the protein level of BALF and proinflammatory cytokine level,suggesting that the pulmonary function test parameters can provide reference for evaluation of ALI.

Critical ultrasonography(CUS) is different from the traditional diagnostic ultrasound,the examiner and interpreter of the image are critical care medicine physicians.The core content of CUS is to evaluate the pathophysiological changes of organs and systems and etiology changes.With the idea of critical care medicine as the soul,it can integrate the above information and clinical information,bedside real-time diagnosis and titration treatment,and evaluate the therapeutic effect so as to improve the outcome.CUS is a traditional technique which is applied as a new application method.The consensus of experts on critical ultrasonography in China released in 2016 put forward consensus suggestions on the concept,implementation and application of CUS.It should be further emphasized that the accurate and objective assessment and implementation of CUS requires the standardization of ultrasound image acquisition and the need to establish a CUS procedure.At the same time,the standardized training for CUS accepted by critical care medicine physicians requires the application of technical specifications,and the establishment of technical specifications is the basis for the quality control and continuous improvement of CUS.Chinese Critical Ultrasound Study Group and Critical Hemodynamic Therapy Collabration Group,based on the rich experience of clinical practice in critical care and research,combined with the essence of CUS,to learn the traditional ultrasonic essence,established the clinical application technical specifications of CUS,including in five parts:basic view and relevant indicators to obtain in CUS;basic norms for viscera organ assessment and special assessment;standardized processes and systematic inspection programs;examples of CUS applications;CUS training and the application of qualification certification.The establishment of applied technology standard is helpful for standardized training and clinical correct implementation.It is helpful for clinical evaluation and correct guidance treatment,and is also helpful for quality control and continuous improvement of CUS application.