BACKGROUND:Systemic lupus erythematosus is a complex autoimmune disease of unknown origin affecting virtual y every organ in the human body. It is characterized by abnormal activation of T, B lymphocytes. While aberrant T cells provide help to autoreactive B cells, the autoreactive B cells produce a variety of pathological autoantibodies and immune complex deposition, which could infiltrate the smal blood vessels directly or deposit in the vessel wal , thereby causing inflammatory necrosis of the vessel wal s. These changes wil narrow the vascular lumen, and promote thrombosis, leading to local tissue ischemia and dysfunction. Mesenchymal stem cells can regulate the immune disorders, play an anti-inflammatory role, and repair the immune thrombosis.
OBJECTIVE:To summarize the pathogenesis of immune thrombosis in systemic lupus erythematosus, as wel as to introduce the mechanism of mesenchymal stem celltherapy for immunity thrombosis.
METHODS:We searched the PubMed database, Springlink database, ScienceDirect database and HighWire database from January 1990 to June 2013 with the key words of“systemic lupus erythematosus, mesenchymal stem cell, thrombosis, T cells, B cells”in English. An online search of CNKI database, Wanfang database, VIP database from January 1990 to June 2013 was also conducted with the key words of“systemic lupus erythematosus, mesenchymal stem cell, thrombosis, T cells, B cells”in Chinese. A total of 267 literatures were screened out, and 48 documents were included in the review based on the inclusion and exclusion criteria.
RESULTS AND CONCLUSION:Mesenchymal stem cells are multipotential nonhematopoietic progenitor cells capable of multi-directional differentiating into various celltypes. Mesenchymal stem cells can suppress T-lymphocyte activation and proliferation, and inhibit secretion of interferon-γ, interleukin-4. Mesenchymal stem cells can also inhibit the proliferation of B cells and the secretion of pathogenic immunoglobulin IgM, IgG, IgA. Thus, mesenchymal stem cells can regulate immune homeostasis and reduce the deposition of autoantibodies and immune complexes, thereby protecting the blood vessels from injury, reducing the secretion of inflammatory cytokines, balancing the coagulation-anticoagulation, and decreasing thrombosis in systemic lupus erythematosus.

OBJECTIVE To investigate the distribution of commonly encountered pathogenic microbes during the last five years.METHODS A total of 9318 strains of NI pathogens during from Jan 2004 to Dec 2008 were surveyed and analyzed.RESULTS From them the percentage of Gram-positive cocci was 13.6%,the main pathogen was coagulase negative Staphylococcus,Gram-negative bacilli(28.8%).The predominant pathogens were Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa.The drug resistance of NI pathogens was markedly increased.Especially,the rate of drug resistance of P.aeruginosa to imipenem was from 0 to 31.8% in 2005,and that of Enterococcus to vancomycin was 4.0% in 2007.The percentage of fungi was 26.4% and increased sharply year by year.CONCLUSIONS The Gram-negative bacteria play a dominant role in clinics and drug resistance of isolated pathogenic bacteria is a serious problem.Monitoring the trends of pathogenic bacteria′s distribution and drug resistance is very important in guiding the clinical administration of drugs and we should pay attention to fungal infection.

Objective To explore the association between urinary lactate/creatinine ratio and neonatal asphyxia,and to clarify the application value of urinary lactate/creatinine ratio in forecasting the hypoxie-ischemic encephalopathy (HIE)in neonates.Methods Using case-control study design method,40 cases of neonatal asphyxia infants were selected as asphyctic group and 40 healthy infants were used as control group.The urinary lactate/creatinine ratio in the first day after birth, urinary N-Acetyl-β-D-glucosaminidase (NAG)/creatinine and the score of Apgar of 80 infants were detected.The relationship between the urinary lactate/creatinine ratio,urinary NAG/creatinine ratio, as well as the score of Apgar and HIE were analyzed and compared in asphyctic group and control group.Results The Apgar scores at 1 and 5 min in asphyctic group were significantly lower than those in control group (P<0.01). The urinary lactate/creatinine ratio and urinary NAG/creatinine ratio in asphyctic group 1 d after birth were significantly higher than those in control group(P<0.01).There was significantly negative correlation between the urinary lactate/creatinine ratio and the 1-min and 5-min Apgar scores(r=-0.636,P<0.001;r=-0.883,P<0.01),but there was a significantly positive correlation between the urinary lactate/creatinine ratio and urinary NAG/creatinine ratio(r=0.433,P<0.01).Conclusion The urinary lactate/creatinine ratio may have decisive roles in prognosis evaluation of neonatal asphyxia,and so as the important foundation for the prediction of HIE.

Objective To observe effect of scalp acupuncture combined with cognitive rehabilitation training in ameliorating cognitive dysfunction in stroke patients. Methods Eighty-four stroke patients with cognitive dysfunction were randomly divided into a treatment group ( n = 42) and a control group (n = 42 ) . All of the patients in both groups received routine therapy including cognitive rehabilitation training by professional therapists aimed at improving their orientation, perception, attention and thinking. The patients in the treatment group also received prolonged scalp acupuncture, in which the acupuncture needle remained in the scalp for 6 hours. All cases were evaluated using Loewenstein's occupational therapy cognition assessment (LOTCA) before and 10 weeks after treatment. Results The LOTCA scores were significantly different before and after treatment in both groups. The effect in the treatment group was significantly better than in the control group. Conclusions Prolonged scalp acupuncture combined with cognitive rehabilitation training can significantly improve the cognitive ability of stroke patients.

With the application of accelerated rehabilitation surgery mode in metabolic bariatric surgery, the postoperative hospital stay of patients is gradually shortened, but it also leads to the lack of postoperative knowledge of patients after discharge. Adequate guidance on discharge readiness is beneficial for improving the self-management ability of patients and improving dietary, medication and exercise compliance. This paper reviews the status quo, assessment tools, influencing factors and intervention measures of discharge readiness of patients undergoing metabolic bariatric surgery, in order to provide references and ideas for developing discharge readiness evaluation tools and related studies for patients undergoing metabolic bariatric surgery in China.

Objective: To investigate the distribution and resistance of pathogens isolated from blood cultures in patients with hematological malignancies after chemotherapy in Union Hospital of Fujian Medical University so as to understand the real situation of blood stream infection (BSI) and provide the basis for rational use of antibiotics in clinic. Methods: The data of 657 strains isolated from blood culture specimens of patients with hematological malignancies from January 2013 to December 2016 were collected analyzed. Results: A total of 657 cases of blood culture positive bacterial strains were included in the study, involving 410 cases (62.4%) with single Gram-negative bacteria (G^- bacteria) , 163 cases (24.8%) with single Gram-positive bacteria (G⁺ bacteria) , 50 cases (7.6%) with single fungi. The most common 5 isolates in blood culture were Klebsiella pneumoniae (17.5%) , Escherichia coli (17.2%) , Coagulase negative staphylococci (CNS) (14.9%) , Pseudomonas aeruginosa (14.2%) and Staphylococcus aureus (3.5%) . The extended-spectrum beta-lactamase (ESBL) production rates of Klebsiella pneumoniae and Escherichia coli were 25.2% and 55.8%, respectively. ESBL producing strains were almost more resistant than non-ESBL producing strains. The resistance rates of Enterobacteriaceae to carbapenems, piperacillin/tazobactam and tigecycline were lower than 14.0%. The resistance rates of Pseudomonas aeruginosa to a variety of drugs were lower than 12.0%. Tigecycline-resistant Acinetobacter baumannii bacteria were not detected, and the resistance rates of Acinetobacter baumannii to cefixime and cefotaxime were 7.1%. Methicillin-resistant strains in CNS (MRCNS) and in Staphylococcus aureus (MRSA) accounted for 84.7% and 43.5%, respectively. Vancomycin, linezolid and tigecycline-resistant G⁺ bacteria were not detected. Conclusion The pathogens isolated from blood culture were widely distributed. Most of them were G^- bacteria, and the resistance to antibiotics was quite common. Furhermore, vancomycin, linezolid and tigecycline can be chosen empirically to treat patiens who ar suspected to have G⁺ bacterial BSI.

Objective To systematically evaluate the intervention effect of social psychological intervention on the health status of patients with bariatric surgery(BS).Methods 8 databases,including PubMed,PsycInfo,and Embase and Clinic Trials,were retrieved to recruit randomized controlled trials with computer from database establishing time to Sep.2022.Independent quality evaluation was conducted by 2 researchers,and Meta-analysis was performed by the RevMan5.3 software.Results Totally 23 RCTs were included.The meta-analysis showed that psychosocial interventions in BS patients improve emotional eating and binge eating behavior[SMD=-0.44,95％CI(-0.78,-0.09),P=0.010;MD=-5.88,95％CI(-8.65,-3.11),P＜0.001],promote better quality of life[SMD=0.30,95％CI(0.02,0.59),P=0.040]and physical mobility,alleviates anxiety and depression[SMD=-0.37,95％CI(-0.67,-0.08),P=0.010;SMD=-0.59,95％CI(-0.84,-0.33),P＜0.001].However,the effect on improving eating disorders[MD=-0.01,95％CI(-0.19,0.18),P=0.950]is not significant,and subgroup analysis results of different intervention measures and follow-up times showed that there was no statistically significant difference in weight changes between the social psychological intervention group and the control group.Conclusion Psychosocial intervention can effectively improve the mental state and eating behavior of the bariatric surgery patients,improve the quality of life and increase physical activity of patients.However,the effect of intervention on eating disorder and weight change is still unclear.More high-quality clinical studies need to be carried out for further verification.

Objective:To retrieve, evaluate, and sum up the evidence on target temperature management in stroke patients, and summarize the best evidence.Methods:Based on the "6S" pyramid model, clinical practice guidelines, expert consensus, evidence summary, and systematic review on target temperature management in stroke patients were searched from top to bottom in British Medical Journal Best Practice, UpToDate, Joanna Briggs Institute Evidence-Based Health Care Center, Guidelines International Network, Agency for Healthcare Research and Quality, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses' Association of Ontario, American Heart Association, American Stroke Association, European Stroke Organization, Medlive, Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, WanFang Data, VIP and China Biology Medicine Disc. The search period was from database establishment to October 7, 2022. Two researchers received evidence-based nursing training independently evaluated the quality of the article, extracted, integrated, and summarized the best evidence.Results:A total of 12 articles were included, including three clinical practice guidelines, four systematic reviews, and five expert consensuses. 24 best pieces of evidence were summarized from five aspects, involving target temperature population, target temperature implementation, complication monitoring, nutritional support, and prognosis evaluation.Conclusions:This study adopts an evidence-based approach to systematically summarize the best evidence for target temperature management in stroke patients, which can provide the best decision-making basis for clinical medical and nursing staff to manage temperature in stroke patients, further standardize temperature monitoring and management, and offer scientific basis for future research and practice.

Objective To explore the current status of traditional Chinese medicine(TCM)research on alopecia areata(AA)and arogenetic alopecia(AGA),analyzing the clinical syndrome and treatment characteristics,and providing reference for TCM clinical diagnosis and treatment.Methods Search for research literature on traditional Chinese medicine treatment of hair loss in CNKI,Wanfang,and VIP separately.Removing duplicates through Notexpress and using CiteSpace and VOSviewer software for bibliometric analysis.Furthermore,focusing on the RCT research of traditional Chinese medicine internal treatment for AA and AGA,the data mining methods were used to analyze the pathogenesis,treatment methods,and prescriptions of traditional Chinese medicine.Results There are a total of 2954 literature on the treatment of hair loss by traditional Chinese medicine,with clinical research being the main research type.Among them,the main pathogenesis of AA is liver and kidney deficiency,qi and blood deficiency,etc.Commonly used herbs includes Polygonum multiflorum,Rehmannia glutinosa,Chuanxiong,Poria cocos,and Ligustrum lucidum,while the pathogenesis of AGA is mainly dampness heat accumulation,yin deficiency dampness heat,etc.,with commonly used herbs such as Platycladus orientalis,Alisma orientalis,Poria cocos,hawthorn,and Coix seed.Meanwhile,AA and AGA both pay more attention to the use of tonifying drugs in their treatment.Conclusion There is a growing trend in literature on the treatment of hair loss with TCM,and there are differences in the pathogenesis and treatment methods between AA and AGA in traditional Chinese medicine.It is worth further reference in the prescription and medication of clinical treatment of hair loss.

ObjectiveBy exploring the volatile components， polysaccharide composition and changes in the contents of five carbohydrate components of Polygonatum cyrtonema rhizoma before and after processing， and then the effect of yellow rice wine on the odour formation of P. cyrtonema rhizoma was investigated. MethodThe volatile components of P. cyrtonema rhizoma before and after processing were detected by headspace gas chromatography-mass spectrometry（HS-GC-MS）， and sample data were subjected to principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA） using SIMCA 14.1， then the differences between these components of P. cyrtonema rhizoma before and after processing were screened according to the principle of variable importance in the projection（VIP） value>1. Crude carbohydrate components in raw and wine-processed P. cyrtonema rhizoma were subjected to oxime and silylation， the carbohydrate components were analyzed by gas chromatography-mass spectrometry（GC-MS/MS）， and the relative contents of various components were calculated by peak area normalization， then quantitative analysis of four carbohydrate components was also carried out. ResultA total of 23 volatile components were identified from the raw products and the wine-processed products， including 15 components in raw products and 20 components in wine-processed products. Among them， 2-methylbutyraldehyde and isovaleraldehyde had a sweet odor and their contents increased after processing， but the contents of hexanal and caproic acid decreased， new components such as 2-acetylfuran and 5-methylfuranal were produced after processing. PCA and OPLS-DA results showed that there were significant differences between raw products and the wine-processed products， a total of 13 differential compounds were screened out， of which 7 showed an upward trend in relative content and 6 showed a downward trend. A total of 7 carbohydrate components， including 5 monosaccharides and 2 disaccharides， were identified in raw products and the wine-processed products. The results of determination showed that the contents of fructose， glucose， mannose and sucrose in P. cyrtonema rhizoma increased after wine-processing， and their increases were 4.54， 1.51， 2.93， 3.66 times， respectively. ConclusionAfter processing， the increase of aromatic flavor of P. cyrtonema rhizoma may be related to the increase of the contents of aldehydes such as 2-methylbutyraldehyde and isovaleraldehyde， while the decrease of raw flavor may be related to the decrease of the contents of volatile components such as hexanal and hexanoic acid， the increase of sweet flavor may be related to the increase of the contents of monosaccharides and oligosaccharides such as fructose and sucrose.