Objective To investigate the roles of a variety of cytokines including transforming growth factor beta (TGF-β),interleukin-6 (IL-6) and interleukin-2 (IL-2) in the differentiation of CD+4 Tlymphocyte cells.Methods T lymphocyte cells either in human peripheral blood or routine spleen were cultured in vitro under different stimulation conditions.Flow cytometry was used to analyze the percentages of CD+4IL-17+ T-helper 17(Th17) cells,CD+8 IL-17+ T cells,CD+4 CD+25 FOXP+3 T regulatory (Treg) cells among activated T cells.Results Differentiation of Treg cells,Th17 cells and CD+8 IL-17+ T lymphocyte cells was enhanced when murine splenic T cells were cultured with TGF-β.The levels of expression were (7.8±2.2)%,(12.6±3.1)%,(10.1±2.6)% ,respectively.Experimental control group was severally same type of T cells without cytokine treatment.The levels of expression were (4.8±0.6) %,(1.7±0.5) %,(1.0±0.4) %,respectively.There were statistically significant differences among them (q=4.09,8.80,9.61.P<0.05 or P<0.01).Under combination treatment with IL-6 and TGF-β,(17.8±5.3) % Th17 cells and (15.0±4.2)% CDCD+8 IL-17CD+ T cells were induced,whereas the levels of Treg cells whose differentiation were restrained were (4.1±1.2) %.The differences were statistically significant compared with the level of same type of T cells in TGF-β group (q=5.03,5.17,5.04,P<0.01).Moreover,combination treatment with IL-2 and TGF-β decreased percentages of Th17 and CDCD+8 IL-17CD+ T cells and increased percentages of Treg cells in T cell population.There was an opposite effect when anti-IL-2 was apphed.The percentages of Th17 and CD+8 IL-17+ T cells were increased and the percentages of Treg cells were reduced The regulation trend of T lymphocyte cells in human peripheral blood was similar with those in routine spleen.Conclusion Various cytokines are of great importance in the regulation of the balance between Th17 and Treg cell.

AIM and METHODS: To study the culture met ho d of human neural stem/progenitor cells, these cells derived from human fetal fo rebrains were maintained and expanded in serum-free defined medium containing ba sic fibroblast growth factors (bFGF), epidermal growth factor (EGF) and B27. Whe n they formed neurosphere, these three factors and supplemented FBS were removed to induce differentiation. Cell were cultured for 12-14 d, then fixed for immun ocytochemistry examination. RESULTS: This period of expansion resulted in a 107-fold incre ase in this heterogeneous population of cells. Upon differentiation, they form n eurons, astrocytes and oligodendrocytes, the three main phenotypes in the CNS. CONCLUSION: These results demonstrate the feasibility of long-t erm in vitro expansion of human neural progenitor cells. The advantages of s uch a population of neural precursors for allogeneic transplantation, including t he ability to provide an expandable, well-characterized, defined cell source, ca n form specific neuronal or glial subtypes.

Objective:To explore the application effect of standardized patient combined with situational simulation teaching in the course of Intensive and Critical Diseases Care among higher vocational college students.Methods:A total of 66 nursing students in direction of intensive care from Batch 2015 and 60 ones from Batch 2016 were selected as the control group and the experiment group respectively. The control group adopted traditional teaching method, while the experiment group adopted the model of standardized patient combined with situational simulation teaching on the basis of traditional teaching methods. Before teaching, we designed the standard cases of the course, set up and trained the standardized patient team members. Then the standardized patient combined with situational simulation teaching was applied to the experimental teaching of the course. At the end of the course, the comparison of the theoretical examination score and the operational examination score of the two groups of students was made, and the self-designed questionnaire survey for the experimental group was used to evaluate the teaching effect.Results:The theoretical examination score [(82.80±4.17) points] and the operational examination score [(85.90±1.85) points] of students in the experiment group were higher than those of students in the control group [(80.74±3.15) points vs. (83.82±1.91) points], with significant differences ( P<0.01). The results of self-designed questionnaire survey showed that more than 90.0% of the students from the experiment group thought that this teaching mode could improve their interest in learning and subjective initiative; more than 76.7% thought that this teaching mode could improve their own abilities such as observation of disease changes, communication, teamwork and clinical thinking; more than 93.3% recognized the application of this teaching mode. Conclusion:The application of standardized patient combined with situational simulation teaching could improve the theoretical knowledge and operational skills of the students, and could also train the students' comprehensive quality such as clinical thinking, emergency handling ability, communication ability and so on, so as to improve the teaching effect.

Objective To study the therapeutic regimen for the simple third or fourth grade of traumatic spleen rupture in patients with hemorrhagic shock. Methods A total of 58 patients with traumatic spleen rupture complicated with hemorrhagic shock admitted between January 2012 and June 2016 were enrolled for analysis. The causes of the casualties suffering from closed abdominal injuries including 31 traffic accident, 13 falling down from a height, 8 tumbling on the ground, 2 beaten trauma and 4 other traumatic injuries. All the patients were divided into the conventional surgery group or proximal selective spleen artery embolization (PASE) group. Comparisons of surgery and postoperative relevant parameters between two groups were analyzed, and the curative effects of the two kinds of treatments was evaluated. Results There were no statistically significant difference in age, sex, degree of spleen rupture, systolic blood pressure, heart rate, and hemoglobin concentration between two groups (P＞ 0.05). The time consumed for operation (T1),the time required for systolic blood pressure recovery (T2), and the allogeneic blood volume capacity (V2) transfused in PASE group were significantly lesser than those in the conventional surgery group (P＜0.05), however there was no difference in the autologous blood volume reinfusion (V1) (P＞ 0.05). Furthermore, the incidence of fever, infection of incision, ileus, ICU treatment, time required fro intestinal function time and hospital stay in PASE group were significantly lesser than those in conventional surgery group (P＜0.05), but the incidence of left upper abdominal pain in PASE group was higher (P＜0.05). Conclusions Selective spleen artery embolization can rapidly stabilize hemodynamics, and shorten the operation time. It also can reduce the complications and allogeneic blood use, shorten recovery time and hospital stay. It is a preferential choice for treatment of traumatic spleen rupture with shock, and worth popularizing in clinical.

Objective:To investigate whether autophagy in the inflammatory environment of thrombotic antiphospholipid syndrome (APS) drives polymorphonuclear neutrophils (PMNs) to release neutrophil extracellular traps (NETs) and whether IFN-λ1(IL-29) has a function of inhibiting NETs-related thrombin production.Methods:PMNs isolated from peripheral blood of healthy volunteers were in vitro stimulated by serum samples of patients with active APS. IL-29 and 3-methyladenine (3-MA) were used to regulate NETs release and autophagy. NETs expression was evaluated by immunofluorescence technique (IFT) and flow cytometry (FCM). Autophagy-related proteins were detected by Western blot. The levels of thrombin-antithrombin (TAT) complexes were determined by enzyme-linked immunosorbent assay (ELISA). Results:The percentages of NETs released from PMNs of healthy volunteers after stimulation with serum samples of APS patients were (22.8±3.1)% according to IFT and (10.1±2.7)% according to FCM and used as control group. IL-29 and 3-MA inhibited the release of NETs from PMNs stimulated by serum samples of APS patients and the percentages of NETs were (5.3±2.2)% and (4.9±2.4)% detected by IFT, and (2.1±1.3)% and (2.7±1.4)% by FCM, respectively. There were significant differences with the control group ( q=9.89, 10.67, 11.74, 9.61, all P<0.01). IL-29 inhibited the expression of LC3B, but promoted the expression of p62 on PMNs of healthy volunteers after stimulating with serum samples of APS patients, and the differences with the group without IL-29 pretreatment were statistically significant [LC3B/GAPDH: (0.28±0.03)% vs (0.77±0.06)%, q=8.65; p62/GAPDH: (0.63±0.05)% vs (0.33±0.03)%, q=4.78; both P<0.01]. IL-29 and 3-MA reduced the levels of NETs-related TAT complexes from (7.6±0.6) ng/ml to (3.1±0.5) ng/ml and (4.7±0.4) ng/ml, respectively ( q=6.34 and 5.15, both P<0.01). Conclusions:Autophagy was involved in the formation of NETs and subsequent coagulation cascade activation in PMNs of healthy subjects after stimulation with serum samples of APS patients with thrombosis. IL-29 suppressed the production of NETs and NETs-associated thrombin by inhibiting autophagy.