Objective To evaluate the effect of care bundle in improving the hand hygiene compliance of neonatal intensive care unit staffs. Methods We implemented care bundle strategy through QCC activity: strengthening training and management to improve the hand hygiene awareness of the medical staffs, environmental and workflow reform,improving the hand washing method and facilities and creating hand hygiene atmosphere, all staffs participated and supervised each other to ensure right way of washing hands. The hand hygiene compliance rate of medical staff after entering the neonatal intensive care unit (NICU) and before touching the neonates before and after the intervention were compared. Results After care bundle intervention, the hand hygiene compliance rate of medical staff after entering the NICU and before touching the neonates raised obviously from 32.1% to 97.4% and from 92.0% to 99.3%. The occurrence of nosocomial infection reduced from 2.22% to 1.38%. Conclusions Care bundle can significantly improve the hand hygiene compliance of medical staff, and prevent nosocomial infection.

Purpose To observe the effects of the intervention or prevention of astragalus polysaccharide(APS)on type 1 diabetes in non-obese diabetic(NOD) mice. Methods the APS group was compared withthe normal solution(NS)group by the incidence of diabetes, the serum C-peptide levels and GAD-Ab levels,the proportion of CD4 or CD8 T subsets in splencytes, pancreatic histopathology and immunocyto-chemistry.Results It shows that the APS group has lower incidence of diabetes, higher serum C-P levels, decreaseddegree of the lymphocytic inflammation of pancreatic islets, stronger proliferation of CD8 T subsets and lowerratio of CD4/CD8 subgroup in splencytes than those of the NS group. Conclusions It proves thepreventive effects of APS on the onset of type 1 diabetes in NOD mice.

Background: Achalasia is an esophageal motility disorder with unclear etiology. It is characterized by impaired relaxation of the lower esophageal sphincter (LES) caused by irreversible damage to the myenteric plexus of esophagus. Remodeling of lower esophageal smooth muscle has been observed in patients with achalasia. Aims: To investigate the effect of hydrogen sulfide on expression of esophageal remodeling biomarker in animal model of achalasia. Methods: The animal model of achalasia was established by administering benzyldimethyltetradecylammonium chloride (BAC) into the LES in BALB/c mice. Fifteen model mice (treatment group) were administered with sodium hydrosulfide, an exogenous hydrogen sulfide donor, intraperitoneally. The results of esophageal manometry, as well as the expressions of two esophageal remodeling biomarker (actin and elastin, determined by immunohistochemistry) were compared between model mice with or without hydrogen sulfide treatment and the blank control mice. Results: The mouse model of achalasia was established successfully. Compared with the blank control group, the LES pressure and expressions of actin and elastin were significantly increased in model group and treatment group (P<0.05), and the increase was less in treatment group than in model group (P<0.05). Conclusions: Remodeling of lower esophagus is existed in animal model of achalasia. Hydrogen sulfide can inhibit the esophageal remodeling, which provides a theoretical basis for the treatment of achalasia with hydrogen sulfide.

Objective:To investigate the expression of miR-151a-3p in peripheral blood mononuclear cells (PBMCs) of children with lupus nephritis (LN) and its correlation with activity and vascular damage.Methods:A total of 87 children with LN admitted in Hainan Women and Children′s Medical Center from January 2016 to March 2019 were enrolled, including 16 cases of type Ⅱ, 14 cases of type Ⅲ, 34 cases of type Ⅳ, 17 cases of type Ⅴ and 6 cases of type Ⅵ.Besides, additional 40 children with normal physical examination were selected as the healthy control group.The 87 children with LN were divided into the LN stable group (31 cases) and LN active group (56 cases) by using systemic lupus erythematosus disease activity index (SLEDAI) scores.According to different proportions of the medium membrane, the patients were classified into the mild group (25 cases), moderate group (34 cases) and severe group (28 cases). Real time quantitative PCR (qPCR) was used to detect the expression level of miR-151a-3p in PBMCs of each group.The correlation of the expression level of miR-151a-3p in PBMCs of LN children with the SLEDAI score and renal interstitial damage score was studied by Pearson correlation analysis. Results:The expression levels of miR-151a-3p in the LN group, LN active group and LN stable group (0.47 ± 0.06, 0.30 ± 0.04, and 0.75±0.12, respectively) were significantly lower than that in the healthy control group (1.62±0.35) (all P<0.01), and the expression level of miR-151a-3p in the LN active group (0.30±0.04) was significantly lower than that in the LN stable group (0.75±0.12) ( P< 0.01). The SLEDAI score [(14.35±4.60) points vs.(8.25±2.24) points] and renal interstitial damage score [(52.70±6.30) points vs.(34.80±4.10) points] in the LN active group were significantly higher than those in the LN stable group (all P<0.01). The expression levels of miR-151a-3p (0.18±0.02, 0.41±0.05 vs.0.83±0.16) in type Ⅴ-Ⅵ and type Ⅳ groups were significantly lower than that in the type Ⅱ-Ⅲ group (all P<0.01). The SLEDAI scores [(16.50±5.28) points, (12.36±3.74) points vs.(6.40±1.70) points] and renal interstitial damage scores [(62.70±7.40) points, (47.20±5.80) points vs.(25.80±3.50) points] in type Ⅴ-Ⅵ and type Ⅳ groups were significantly higher than those in the type Ⅱ-Ⅲ group (all P< 0.01). The expression levels of miR-151a-3p (0.20±0.02, 0.39±0.04, 0.86±0.18 vs.1.62±0.35) in severe, moderate and mild groups were significantly lower than that in the healthy control group (all P<0.01), and the expression level of miR-151a-3p decreased with the aggravation of vascular damage.The SLEDAI scores [(15.20±5.10) points, (12.85±3.90) points vs.(6.70±1.82) points] and renal interstitial damage scores [(57.30±6.80) points, (51.60±6.30) points vs.(27.20±3.60) points] in the severe and moderate groups were significantly higher than those in the mild group (all P<0.01). The expression level of miR-151a-3p in LN children was negatively correlated with the SLEDAI score and renal interstitial damage score ( r=-0.682, -0.627, all P<0.001). Conclusions:The expression level of miR-151a-3p in PBMCs of LN children is significantly decreased.The declined miR-151a-3p level is closely related to disease activity and vascular damage, and may be involved in the occurrence and development of LN.

Objective To investigate the protective effects of ethanol extracts of Tadehagi triquetrum ( TTOE) on car-bon tetrachloride ( CCl4 )-induced acute liver injury in mice. Methods Kunming mice were randomly divided into six groups:normal control group ( NC group) ,model control group,bifendate dropping pill group,low-,medium-and high-dose TTOE groups. The liver injury model was established by administration of CCl4 in all the groups except the NC group.The indexes of the liver, spleen and thymus were obtained.The activities of serum ALT,AST,ALP,LDH, albumin and T-AOC were measured.The activi-ties of SOD and GSH-PX and the contents of MDA,NO and GSH and Cyt P450 were also detected in hepatic tissues. Results TTOE at different doses could obviously reduce the indexes of the liver,thymus and spleen,which were (57.13±0.71),(32.44± 0.24),and (27.78±0.16),respectively,in high-dose TTOE group,and there were significant differences between the TTOE groups and model control group (P<0.01).The activities of ALT,AST,ALP and LDH were obviously decreased in high-dose TTOE groups,which were (65.59±8.23),(141.38±15.52),(2 462.4±253.6),(172.51±20.64),respectively,in the TTOE high-dose group (P<0.01).The serum levels of Alb and T-AOC were obviously increased,the contents of NO and MDA significantly decreased and the activities of SOD and GSH-PX and the contents of GSH Cyt P450 in liver tissues profoundly increased in TTOE groups when compared with those in model control group ( P<0.05 or P<0.01) . Conclusion TTOE could protect against acute hepatic injury induced by CCl4 in mice,which may be associated with the decrease in the activities of liver enzymes,anti-oxide free radical effect,decreased NO content and inhibited lipid peroxidation.

Objective To investigate MRI characteristics of subacute combined degeneration(SCD)with secondary spinal canal stenosis.Methods The clinical and MRI imaging data of 56 patients with SCD were collected to analyze the performance characteristics between spinal cord lesions and spinal canal stenosis,which depended on the synergism of lumbar disc bluge or herniation,degenerative thickening of the ligament flavum and posterior longitudinal ligament.Results Among 56 SCD cases underwent MRI scan,45 cases were combined with spinal cord lesions which showed typical signs of SCD.37 patients were secondary spinal canal stenosis with typical signs,but 2 showed no typical signs.8 patients were no secondary spinal canal stenosis and showed typical.9 cases showed neither spinal cord lesions nor secondary spinal canal stenosis.There was significant difference (P <0.05)between relative secondary spinal canal stenosis and spinal anomaly signal.The course of 1 5 cases were shortened after treated by physical in 37 cases of SCD with secondary spinal canal. Conclusion The secondary spinal canal stenosis can cause microcirculation dysfunction of the spinal cord,which is a key factor contributing to the imaging manifestation.

Objective: To investigate the variation of γδ T cells from healthy human peripheral blood(PB)and neonatus cord blood (CB)in proliferation and subtypes with isopentenyl pyrophosphate(IPP), and to acquire enough γδ T cells possessing distinct characteristics for experimental study.Methods: Mononuclear-cells from peripheral blood and cord blood induced by IPP were stained separately with monoclonal antibodies,which were fluorescein-labeled,and then used for assaying the expressing condition of surfaco molecules,as well as to evaluate the variation of γδ T cells on the percentage, subtypes and pbenotypes by FCM.Results:γδ T cells only account for a small proportion in both PB and CB.However,there was a significant difference in the heterogeneity between peripheral blood and cord blood γδ T cells.Vγ9Vδ2 T cells were dominant in peripheral blood γδ T cells.Most of Vγ9Vδ2 T cells in fresh isolated PBMC were central memory-type(CD27~+ CD45RA~-)and effector memory-type(CD27~-CD45RA~-)with IPP, PB γδ T cells proliferated strongly;The effector memory-typo(CD27~-CD45RA~-)turned into the main subtype in all Vγ9Vδ2 T cells,and HLA-DR and B7 molecules were highly expressed on the populations.But the cord blood γδ T cells showed rather complex subgroup heterogeneity,and Vγ9Vδ2 T cells were almost na(i)ve-type(CD27~+ CD45RA~+); Though γδ T cells were expanded(the percent of γδ T cells was increased),and Vγ9Vδ2 T cells were differentiated towards central memory-type and effector memory-type on day 14 with IPP,most of γδ T celLs still remained in the phase of na(i)ve-type(CD27~+ CD45RA~+).Conclusion:Tbere lies great differences of γδ T cells in quantity and subtypes between healthy person peripheral blood and neonatus cord blood.Peripheral blood γδ T cells can be activated and proliferated with IPP, while cord blood γδ T cells have the potential to deferentiate into director memory-type which can be used for experimental and clinical study with the synergy of corresponding cytokines.The immuno-regulation and effector function will be reported in other papers.

Objective:To explore the association between interleukin(IL)-28B single nucleotide polymorphisms and natural outcome of hepatitis C virus.Methods:The IL-28B rs12979860 locus was genotyped in 266 HCV infected volunteer blood donors(107 spontaneous cleared and 159 chronic infection) and 97 healthy controls using Sanger sequencing assay.The difference in rs12979860 genotypes and allele frequencies between the six groups(107 spontaneous cleared and 159 chronic infection,266 HCV infection and 97 healthy controls,159 chronic infection and 97 healthy controls) were analyzed by statistics.Results:159 HCV chronic infection,107 spontaneous cleared and 97 healthy controls,were shown more CC genotype,accounting for 83.6%,95.3%and 86.6%,respectively, while the CT genotype accounted for 16.4%,4.7%and 13.4%respectively.No TT genotype was found.The CC/CT genotype was not significant difference between HCV infection and healthy controls,chronic infection and healthy controls(χ2=0.204,P=0.652;χ2=0.406,P=0.524),but between chronic infections and spontaneous clearance had statistically significant(χ2=8.474,P=0.004),the frequence of C allele in spontaneous cleared was higher than HCV chronic infection(χ2=7.949,P=0.005).Conclusion: The gene polymorphism of IL-28B rs12979860 is not related to HCV susceptibility,but there are differences in chronic infection and spontaneous cleared,showing the C allelic in favor of HCV spontaneous cleaed.

Mycoplasma pneumoniae pneumonia (MPP) is caused by Mycoplasma pneumoniae infection with respiratory tract infection with pneumonia.Recently,the incidence of MPP has been increasing year by year,and the age of onset has an earlier trend.It is easy to recur after the infection of Mycoplasma pneumoniae (MP).The MP not only can cause respiratory disease,but also cause a wide range of extrapulmonary manifestations.Part of patients have rapid progression of disease and severe illness.Nowadays,the pathogenesis of MPP is not yet completely clear.It may be related to the direct adhesion and invasion of MP in the respiratory epithelium,toxic injury,and immunological mechanism.At present,a large number of studies have confirmed that the immune disorder and immune imbalance play a vital role in the development of MPP.This article reviews the latest research on the immunological mechanisms associated with Mycoplasma pneumonia.

Objective To study the effectiveness and safety of abdominal lifting and compression method in patients sufferred from cardiac arrest (CA).Methods According to the inclusion and exclusion criteria,72 patients from Hainan People's Hospital and Zhengzhou People's Hospital were enrolled for study of abdominal lifting and compression (ALC) method from January 2014 to June 2015.The markers of respiratory and circulatory performance of all patients were recorded,and re-collected after CPR with ALC.In addition,the data of demographics and clinical signs of patients were collected.The rates of restoration of spontaneous circulation (ROSC) and successful resuscitation were calculated.Differential analysis of singlegroup design univariate quantitative and qualitative data was carried out.Results A total of 72 patients were included finally.The ROSC rate was 15.3％ (11/72) after using ALC equipment,and there was no statistically significant difference in rate of ROSC (P =0.566) between ALC and pre-test (13.0％).However,compared with NT group resuscitated without using ALC method or with using chest compression method,the rate of ROSC was significantly improved in the ALC group (15.3％ vs.O.1％,P ＜ 0.01).Conclusions Abdominal lifting and compression CPR equipment is stable,portable and safe in practice.Abdominal lifting and compression CPR method has its prominent role in saving patients from respiratory and cardiac arrest,and it is sufficient to overcome the disadvantages of conventional CPR method.