Arthritis, Rheumatoid ; metabolism ; Cells, Cultured ; HSP72 Heat-Shock Proteins ; pharmacology ; Humans ; Interleukin-10 ; metabolism ; Synovial Membrane ; cytology ; drug effects ; metabolism ; Toll-Like Receptor 2 ; metabolism ; Toll-Like Receptor 4 ; metabolism

Objective To explore the methods of the nutritional support of children with severe sepsis.Methods The biochemical index,nutrition index,blood gas,blood routine and 24 hours urinary urea nitrogen of 198 children with severe sepsis were detected after hospitalization.Enteral nutrition,parenteral nutrition,or enteral and parenteral nutrition at the same time were selected for every children according to patients status.Children with parenteral nutrition were divided into glutamine (Gln) group and non-Gln group.Nutrition and metabolism indexes of survival and dead children were detected,including blood glucose,C-reactive protein,hemoglobin (Hb),pH,blood sodium,blood potassium,alanine transaminase,blood urea nitrogen,creatinine,blood lacticacid,lactate clearance rate,blood triglycerides,blood total cholesterol,serum pre-albumin (PA),retinal-binding protein (RBP),serum albumin (ALB) and 24 hours urinary urea nitrogen.The intake of calories were compared between survival and dead children before nutrition support (0 d),3 d and 7 d after nutrition support.Immunoglobulins of Gln group and non-Gln group were compared.Results The nutrition indexes of the survival group were higher than those of dead group [PA (130.0 ± 30.0) mg/L vs (50.8 ±20.5) mg/L,RBP(22.3 ±10.3) mg/L vs (15.7 ±6.7) mg/L,ALB(35.3 ±8.1) g/L vs (28.7 ±6.2) g/L,Hb(113.2 ±27.7) g/L vs (95.3 ±10.6) g/L,IgA(0.40 ±0.03) g/L vs (0.40 ±0.03) g/L,IgM(0.52 ±0.18) g/L vs (0.49 ±0.03) g/L] (P ＜0.05).The intake calories of survival group in 3 d and 7 d after nutrition support were (50.32 ±2.76) kcal/(kg·d) and (65.70 ±3.25) kcal/(kg·d),which were significantly higher than those of dead group [(32.54 ± 1.72) kcal/(kg·d) and (46.12 ± 1.08) kcal/(kg·d)).Among the survival children with parenteral nutrition,the levels of immunoglobulin in Gln group were higher than non-Gln group [IgG(4.93 ± 2.1) g/L vs (4.01 ± 1.03) g/L,IgA (0.31 ± 0.07) g/L vs (0.19 ±0.03) g/L,IgM(0.52 ±0.08) g/L vs (0.32 ±0.10) g/L] (P ＜0.05).Negative nitrogen balance was better in Gln group as(-2.5 ± 1.4) g/d than non-Gln group as (-5.3 ± 1.3) g/d(P ＜0.05).Conclusion Children with severe sepsis manifeste significantly increased metabolic rate and energy consumption,the protein decomposition utilization is greater than the synthetic with negative nitrogen balance.Children with more severe sepsis have lower metabolic indexes,nutrition indexes,and immunoglobulin.It is necessary for children with severe sepsis to use glutamine while having parenteral nutrition.

Objective To evaluate application effects of mind map in standardized training courses for the new nurses.Method 73 new nurses who graduated for 1-3 years were random divided into an experimental group (n=37) and a control group (n=36).Nursing department organized standardized training course for 73 new nurses for one year.The control group used conventional teaching methods,while the experimental group introduced mind mapping in teaching.Effects were evaluated after one year.Results The average scores of both theory and operation examination in experimental group were better than the control group,and there was significant difference between two groups (P=0.002,0.000).The score of critical thinking ability:the total score of experimental group was (303.89 ±23.81),higher than the total score of the control group (280.36 ± 17.22),and the total score and seven dimension score difference had statistical significance(P＜0.05,for all).Besides,the total score of selfstudy ability in the experimental group (126.54 ± 5.65),was higher than those in the control group (116.58-± 6.36),and the total score and four dimension score difference had statistical significance (P＜0.05).Conclusion Using mind mapping in the standardized training courses for nurses can arouse nurses' interest in learning,improve their critical thinking skills and autonomous self-study ability,and enhance the effectiveness of training.

Obgective To explore the antimicrobial resistance genotypes and molecular epidemic features of Klebsiella pneumoniae (K.pneumoniae) producing extended spectrum 3-lactamases (ESBLs) in the Pediatric Intensive Care Unit (PICU) of Guiyang Children' s Hospital.Methods Disc diffusion technique (Kirby-Bauer method) and automatic microbiology analysis system were employed to determine the antimicrobial resistance,and Double-disk Diffusion was adopted in the phenotype confirmatory test of ESBLs,and PCR was used to determine the antimicrobial resistance genotypes.Results Among 44 straits of non-repetitive-K.pneumoniae,isolated from the children during hospitalization since April to December of 2013,29 straits (65.9％) were detected.The findings of sensitivity tests showed that 29 strains of ESBLs-producing K.pneumoniae presented a higher rate of sensitivity to carbapenems,cephamycin and quinolones,100％ resistance to penicillin and cephalosporins of the first and the second generations.Fifteen non-ESBLs-producing K.pneumoniae presented 100％ resistance to penicillin.The rate of resistance to 9 kinds of antibiotics (Ampicillin/Sulbactam,Cefazolin,Cefuroxime,Cefamandole,Cefiriaxone,Ceftazidime,Cefepime,Gentamicin,Aztreonam) in ESBLs-producing K.pneumoniae strains(79.3％,100.0％,100.0％,100.0％,100.0％,79.3％,65.5％,41.4％,79.3％) was significantly higher than that of non-ESBLs-producing K.pneumoniae trains (13.3％,6.7％,20.0％,20.0％,0,0,0,6.7％,0) (x2 =17.54,35.51,28.00,28.00,44.00,24.93,17.30,4.18,24.93,all P ＜ 0.05).In 29 strains of ESBLs-producing K.pneumoniae,3 genotypes were detected respectively:93.1％ of SHV (27/29 strains),51.7 ％ of TEM (15/29 strains) and 37.9 ％ of CTX-M (11/29 strains).Five forms of genotype distribution were presented:14 (43.8％) strains carrying single ESBLs gene,5 (17.2％) strains carrying 2 types,19 (31.0％) strains carrying 3 types,and 1 strain had not been genotyped.Conclusions ESBLs-producing K.pneumoniae had been epidemic in PICU of Guiyang Children's Hospital,with multiple antimicrobial resistances and diversification of antimicrobial resistance genotypes.

Objective To explore the application and effects of bone lengthening growth diary in self management of patients after lower limb lengthening. Methods A total of 54 cases applying lower limb lengthening were divided into the experimental group (n=28) and the control group (n=26) with random digit table. The basic treatment was consistent, the control group was given routine guidance, the experi-mental group implemented self- management with bone lengthening growth diary. Self- recognition of disease was assessed and compared between the two groups 12 weeks after operation. Self- efficacy and self- manage ment were assessed and compared between the two groups 2 and 12 weeks after operation. Results The self- recognition of disease in the observation group was better than that of the control group, for patients with higher self- recognition degree (21 cases vs. 10 cases), χ2=8.64, P<0.05, the difference was significantly different. The total scores of self- efficacy and self- management in the observation group were higher than those of the control group,(48. 42±3.43) vs.(34.14±4.13),t=11.750, P<0.01;(55.35±2.69) vs.(42.15±3.67), t=15.130, P<0.01, the difference was significantly different. Conclusions Bone lengthening growth diary plays a beneficial role on self-management of patients with lower limb lengthening.

OBJECTIVETo evaluate the effect and safety of L-carnitine in the treatment of idiopathic oligoasthenozoospermia based on current clinical evidence.

METHODSWe searched the Cochrane Library, PubMed, MEDLINE, EMBASE, CNKI, VIP, CBM and Wanfang Database from the establishment to April 2014 for the published literature on the treatment of idiopathic oligoasthenozoospermia with L-carnitine. We conducted literature screening, data extraction, and assessment of the methodological quality of the included trials according to the inclusion and exclusion criteria, followed by statistical analysis with the RevMan 5. 2 software.

RESULTSSeven randomized controlled trials involving 751 patients with idiopathic oligoasthenozoospermia met the inclusion criteria, and 678 of them were included in the meta-analysis. L-carnitine treatment achieved a significantly increased rate of spontaneous pregnancy as compared with the control group (RR = 3.2, 95% CI 1.74 to 5.87, P = 0.0002). After 12-16 and 24-26 weeks of medication, total sperm motility (WMD = 5.21, 95% CI 2.78 to 7.64, P < 0.0001 and WMD = 9.29, 95% CI 1.28 to 17.29, P = 0.02) and the percentage of progressively motile sperm (WMD = 12.44, 95% CI 4.58 to 20.31, P = 0.002 and WMD = 9.76, 95% CI 3.56 to 15.97, P = 0.002) were remarkably higher than those in the control group, but no statistically significant differences were observed in sperm concentration between the two groups (WMD = 4.91, 95% CI -2.63 to 12.45, P = 0.2 and WMD = 0.93, 95% CI -3.48 to 5.34, P = 0.68). After 12-16 weeks of treatment, the percentage of morphologically abnormal sperm was markedly decreased in the L-carnitine group as compared with the control (WMD = -2.48, 95% CI -4.35 to -0.61, P = 0.009), but showed no significant difference from the latter group after 24-26 weeks (WMD = -4.38, 95% CI -9.66 to 0.89, P = 0.1). No statistically significant difference was found in the semen volume between the two groups after 12-16 or 24-26 weeks of medication (WMD = -0.13, 95% CI -0.43 to 0.18, P = 0.42 and WMD = 0.28, 95% CI -0.02 to 0.58, P = 0.07). No serious L-carnitine-related adverse events were reported in 4 of the randomniized controlled trials.

CONCLUSIONThe current evidence indicates that L-carnitine can improve spontaneous pregnancy and semen parameters in the treatment of idiopathic oligoasthenozoospermia, with no serious adverse reactions.

Asthenozoospermia ; drug therapy ; Carnitine ; adverse effects ; pharmacology ; Female ; Humans ; Male ; Pregnancy ; Pregnancy Rate ; Randomized Controlled Trials as Topic ; Semen Analysis ; Sperm Count ; Sperm Motility

OBJECTIVETo investigate the effects of heat shock protein 72 (Hsp72) on the expression of IL-6 and IL-8 and activation of NF-kappaB in synoviocytes from patients suffered from rheumatoid arthritis (RA).

METHODSIL6 and IL8 concentrations in culture supernatants were measured using enzyme-linked immunosorbent assays (ELISA). Nuclear translocation of NF-kappaB and degradation of the inhibitory protein IkappaBalpha were examined using immunohistochemistry and Western blot.

RESULTSHsp72 down-regulated IL-6 and IL-8 production in RA synoviocytes induced by tumor necrosis factor-alpha (TNF-alpha). Hsp72 inhibited nuclear translocation of NF-kappaB and degradation of IkappaBalpha induced by TNF-alpha.

CONCLUSIONHsp72 has an anti-inflammatory effect on RA by down-regulation of IL-6 and IL-8 in synoviocytes, which is mediated through inhibiting the activation of NF-KalphaB signal pathways.

Arthritis, Rheumatoid ; metabolism ; Cells, Cultured ; HSP72 Heat-Shock Proteins ; pharmacology ; Humans ; I-kappa B Proteins ; metabolism ; Interleukin-6 ; metabolism ; Interleukin-8 ; metabolism ; NF-KappaB Inhibitor alpha ; NF-kappa B ; metabolism ; Signal Transduction ; Synovial Membrane ; cytology ; drug effects ; metabolism ; Tumor Necrosis Factor-alpha ; pharmacology

OBJECTIVETo observe whether dendritic cells (DCs) transfected with recombinant adenovirus Ad5F35-LMP2 induces LMP2 specific immunity mediated by cytotoxic T lymphocytes in vitro.

METHODSDendritic cells have been generated in vitro, and cocultured with autologous T cell after the DCs were infected with Ad5F35-LMP2, then the proliferation of the induced T cells and their cytotoxic activity against CNE-2 tumor cells which express EBV-LMP2 protein on membrane were assessed by MTT method.

RESULTSThe dendritic cells could be transfected with Ad5F35-LMP2 and the CTL activated by Ad5F35-LMP2-DC could effectively suppress the proliferation of CNE-2 cells compared with control groups.

CONCLUSIONThe dendritic cells transfected with recombinant adenovirus Ad5F35-LMP2 showed cytotoxicity effect by activating T lymphocytes.

Adenoviridae ; genetics ; Cell Line, Tumor ; Cells, Cultured ; Dendritic Cells ; immunology ; virology ; Epstein-Barr Virus Infections ; immunology ; virology ; Genetic Vectors ; genetics ; Humans ; Immunity, Cellular ; T-Lymphocytes, Cytotoxic ; immunology ; virology ; Viral Matrix Proteins ; genetics ; immunology

OBJECTIVETo investigate the role of the expression of ephrinB2 and EphB4 in non-small cell lung cancer (NSCLC), and their relationship with multi-slice spiral CT pulmonary perfusion imaging.

METHODSThirty-one nodules with pathologically proven NSCLC underwent CT perfusion scan. The perfusion parameters including blood flow (BF), blood volume (BV), peak enhancement image (PEI) were collected. The expression of ephrinB2 and EphB4 in tumor cells and interstitial vasculature were detected by immunohistochemistry. Correlation analysis and trend test were used to assess the relationship between ephrinB2/EphB4 expression and clinicopathological features, and between ephrinB2/EphB4 expression and perfusion parameters.

RESULTSPositive expression of ephrinB2 and EphB4 in the NSCLC group was 83.9% and 71.0%, respectively, significantly higher than that in the internal control group (P < 0.01). The expression of ephrinB2 and EphB4 was consistently in tumor parenchyma but differently in tumor vessels. The expressions of ephrinB2 and EphB4 were positively correlated with lymphatic metastasis (P < 0.05). The expression of EphB4 was negatively correlated with blood flow (BF) and blood volume (BV), respectively (P < 0.05). There was a significant positive correlation between ephrinB2 expression and BF (r = 0.516, P = 0.003), and a positive correlation between ephrinB2 expression and BV (r = 0.448, P = 0.013). The expressions of ephrinB2 and EphB4 were not correlated with PEI (P > 0.05). The values of BF and BV in the high and moderate EphB4 expression groups were significantly decreased compared with that in the negative group (P < 0.01). The value of BF in the high ephrinB2 expression group was significantly increased compared with that in the moderately positive group and negative group (P < 0.01). The value of BV in the high ephrinB2 expression group was significantly increased compared with that in the negative group (P < 0.01).

CONCLUSIONThe CT pulmonary perfusion imaging reflects the density difference of blood vessels with functional lumen, and such difference also depends on the quantity and quality of vasculature with functional lumen.

Adult ; Aged ; Blood Volume ; Carcinoma, Non-Small-Cell Lung ; blood supply ; diagnostic imaging ; metabolism ; pathology ; physiopathology ; Ephrin-B2 ; metabolism ; Female ; Humans ; Lung Neoplasms ; blood supply ; diagnostic imaging ; metabolism ; pathology ; physiopathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Perfusion Imaging ; Pulmonary Circulation ; Receptor, EphB4 ; metabolism ; Tomography, Spiral Computed ; methods

BACKGROUNDEpstein-Barr virus (EBV) is a herpesvirus commonly associated with several malignant diseases including nasopharyngeal carcinoma (NPC), which is a common cancer in Southeastern Asia. Previous studies showed that plasma levels of EBV-DNA might be a sensitive and reliable biomarker for the diagnosis, staging and evaluating of therapy for NPC. There are a few analyses of the levels of EBV-latent membrane protein 2 (LMP2)-specific cytotoxic T-lymphocytes (CTLs) in patients with NPC. This study was conducted to investigate the levels of EBV-LMP2-specific CTLs, EBV-DNA load and the level of CD4(+)CD25(+) T cells in such patients.

METHODSFrom February 2006 to April 2006, 62 patients with NPC, 40 healthy virus carriers positive for EBV viral capsid antigen (EBV-IgA-VCA) and 40 controls were enrolled in the study. We used a highly sensitive ELISPOT assay, real-time polymerase chain reaction (PCR) and flow cytometry to measure the EBV-LMP2-specific CTL response, the EBV DNA load and the level of CD4(+)CD25(+) T cells, respectively.

RESULTSThe EBV-LMP2-specific CTL responses of the samples from the control, healthy virus carriers and patients with NPC were significantly different from the LMP2 epitopes, with the control and healthy virus carrier samples displaying a stronger response in three cases. There were significant differences in EBV DNA load in serum between NPC and the healthy groups; patients with NPC at stages III or IV had significantly higher viral loads compared with those at stages I or II. A significantly higher percentage of CD4(+)CD25(+) T lymphocytes were detected in the patients, compared with healthy virus carriers and healthy controls. Moreover, patients with advanced stages of NPC (III and IV) had significantly higher percentages than the patients with early stages (I and II).

CONCLUSIONSPatients with NPC are frequently unable to establish or maintain sufficient immunosurveillance to control proliferating B cells harboring EBV and to destroy the tumor cells that express immunodominant LMP2 proteins. Controlling the activity of CD4(+)CD25(+) T cells and elevating CD8(+) cells specific for LMP2 epitopes could be an effective immunotherapy for patients with NPC.

Adult ; Antigens, Viral ; immunology ; CD4-Positive T-Lymphocytes ; immunology ; Capsid Proteins ; immunology ; DNA, Viral ; genetics ; Epstein-Barr Virus Infections ; immunology ; virology ; Female ; Flow Cytometry ; Humans ; Immunoglobulin A ; immunology ; Interleukin-2 Receptor alpha Subunit ; immunology ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; immunology ; virology ; Polymerase Chain Reaction ; T-Lymphocytes, Cytotoxic ; immunology ; Viral Matrix Proteins ; immunology