Natural killer ( NK) cells are important innate effector cells and play a vital role in maintaining homeostasis through potent cytotoxic activity and cytokine production. Recent findings show that NK cells can also shape adaptive immune responses by in-fluencing a variety of immune cells. In addition to direct interactions with other immune cells,NK cells can indirectly stimulate or inhibit adaptive immune response via influencing infected cells and pathogen load. Abundant studies have highlighted the positive regulatory functions of NK cells, while their negative regulatory functions have increasingly attracted attention in recent years. Here, we review recent findings on negative regulation of adaptive immune response by NK cells, discussing the involved effector cells and function mechanism,and demonstrate how this negative regulation influences the overall outcome of adaptive immunity in infection and tumor disease.

In order to study and appraise the application of artificial dermis in repairing skin defect or organization damage, 20 patients underwent artificial dermis transplantation at the Department of Burn and Plastic Surgery, Beijing Jishuitan Hospital from January 2008 to April 2009 were collected. Patients with skin damage or depth portion organization (tendon, joint and bone appears externally) was perform debridement and artificial dermis transplantation, followed by split thickness autoskin transplantation. The survival of artificial dermis and split thickness autoskin was observed. After transplantation, the depth portion organization of patients were covered efficiently, all grafts survived without obvious scar proliferation. The results demonstrated that the prompt application of artificial dermis can reduce the surgery risk, relieve the surgery to damage, and reduce the scar production in repairing organization damage or depth portion organization expose.

OBJECTIVETo study the clinical efficacy of semiextended intramedullary nailing of the tibia using a suprapatellar approach for proximal tibial fractures.

METHODSFrom January 2013 to January 2014, a total of 16 patients with unilateral proximal tibial fractures, 14 males and 2 females, underwent closed reduction and internal fixation with TRIGEN™ META-NAIL™ via the suprapatellar approach. The average age was 42.2 years old (ranged, 26 to 57 years old). Radiographic and clinical follow-up examinations were performed at a minimum of 1 year after surgery. Measurements included surgery time, complications, bone healing time, tibial alignment, knee range of motion, pain scoring (visual analogue scale) and functional outcome (Lysholm knee score).

RESULTSThe average surgery time was (75.7±8.3) minutes (ranged, 65 to 95 minutes). No obvious complications were recorded. Average duration of follow-up was (15.6±8.1) months (ranged, 12 to 24 months). Fifteen patients attained radiological bone union for a mean time of (3.6±1.8) months (ranged, 3 to 5 months). At the final follow-up, all tibial alignments were good, and no patients complained of anterior knee pain. Mean arc of knee motion was (124.4±18.8) degrees for the affected extremity compared with (127.5±16.7) degrees for the contra-lateral knee. The total scores of Lysholm knee score ranged from 77 to 92, average 86.4±12.3.

CONCLUSIONFor proximal tibial fractures,the semiextended intramedullary nailing technique via a suprapatellar approach can obtain satisfactory clinical outcomes with simplicity in reduction and fixation, minimal complications, and good recovery of limbs function.

Adult ; Female ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged ; Tibia ; surgery ; Tibial Fractures ; surgery

Objective To observe whether bone marrow mesenchymal stem cells (MSCs) can promote the repair of IgA nephropathy and to explore its possible mechanism. Methods Sprague-Dawley rats were randomly divided into three groups which were MSCs injection group, normal saline(NS) infusion group and healthy control group. IgA nephropathy model was established by the improving method with BSA +SEB +CCl4 in former two groups. MSCs of SD rats were continuously cultured in vitro and identified with specific surface antigens by flow cytometry and osteogenic and adipogenic differentiation. MSCs were labeled with bromodeoxyuridine (BrdU) in vitro before transplanted. At 1st and 4th week after MSCs injection, the changes of body weight, urine protein, renal function, histopathology and IgA immunofluorescence were observed. MCP-1, TGF-β1 in urine were detected by ELISA. The expression of MCP-1, TGF-β1 in kidney were examined by RT-PCR. The cytokines and BrdU labeled MSCs were detected by immunohistochemistry to observe the disposition in kidney. Results At the end of the first week of MSCs transplantation, MSCs group urine protein (36.86±4.78) mg/24 h, serum creatinine (53.50±6.28) μmol/L, and the NS group urine protein (66.98±5.86) mg/24 h, serum creatinine (82.50±8.36) μmol/L, the differences between two groups were significant (P<0.05). At the same time, the content of MCP-1, TGF-β1 in urine and expression in renal tissue of MSCs group were obviously less than those of NS group (P <0.05). At the end of the 4th week, the body weight, histopatholngy, IgA immunofluorescence of MSCs group were remarkably improved as compared with those of NS group. The content of MCP-1, TGF-β1 in urine and expression in renal tissue, and renal pathological change in MSCs group had no significant differences as compared with those of healthy control group. As the time passed, the disposition of BrdU-labeled MSCs in kidney was taper. Conclusions MSCs injection contributes to renal repair in rat IgA nephropathy. The mechanism may partly depend on adjusting the excretion of cytokines in renal microenvironment and/or other functions rather than completely depend on their differentiation to renal cells.

Objective To compare the effectiveness of enteral nutritional emulsion (TPF-D) and enteral nutritional emulsion (TP) in patients with chronic wound and diabetes (CWD). Methods Totally 20 CWD patients in Beijing Jishuitan Hospital from June 2008 to June 2010 were enrolled in this study. Enteral nutritional emulsion (TP) was used for the first 5 days ( TP group) and enteral nutritional emulsion (TPF-D) was used for the second 5 days (TPF-D group). Changes of mean amplitude of glycemic excursions (MAGE), insulin dosage, and prealbumin (PA) were compared between TPF-D group and TP group. The adverse effects and post-operational complications were also observed. Results The every-day MAGE was (2. 56 ±0. 35) mmol/L in TPF-D group, which was significantly lower than that in TP group [ (3.23 ± 0. 42) mmol/L] ( P = 0. 01 ). The mean insulin dosage was (9.6 ± 1.7) U in TPF-D group, which was significantly lower than that in TP group [ ( 12. 2 ± 2. 5 ) U ] ( P =0.03 ). The increase of PA showed no significant difference between TPF-D group [ ( 12.7 ± 3. 3) mg/L] and TP group [ ( 13.4 ± 2. 8 ) mg/L ] ( P = 0. 08 ). No enteral nutrition-related adverse effect or post-operation complication was noted. Conclusion Compared with TP, TPF-D is more suitable for the CWD patients.

Objective To explore the efficacy of trazodone replacement treatment on benzodiazepine drugs dependence and effect of cognitive function on senile patients.Methods 51 senile patients with benzodiazepine drugs dependence were assigned with dosage tacho-decrement and replaced by trazodone.The patients were discontinuanced taking benzodiazepine in 14 days and taken at a draught of trazodone before retiring about 6 months.Clinical effect and side effects were assessed with the Pittsburgh sleep quality index (PSQJ) and treatment emergent symptom scale(TESS) before and after treatment.Cognitive function was evaluated with Wechsler intelligence scale for adult-Chinese revised (WAIS-RC) and Wechsler mermory scale for adult-Chinese revised ( WMS-RC ) once before and after treatment.Results The scores total PSQJ( ( 13.17 ± 3.70),( 11.05 ± 3.48 ) ),the sleep quality( (2.36 ± 0.33 ),( 1.91 ± 0.29 ) ),daily function disorder,sleep disorder were significantly lower than before treatment while the other factor scores were not significantly changed.Trazodone wes effective without severe side effects and dependence.The study group showed significantly lower scores in learning,calculation,the signs of figure,wood puzzles,long-term memory,short-term memory,immediate memory,memory quotient in the assessment of cognitive function than after treatmemt (P ＜ 0.05 ).Conclusion Trazodone is an ideal medicine to senile insomnia.

Objective To investigate the value of combination of B-flow imaging and spatio-temporal image correlation in prenatal diagnosis of congenital heart diseases. Methods Volume images of 50 normal fetuses and 14 fetuses with congenital heart diseases were recruited in the study. Surface mode was used to reconstruct the volume images. Results Sixty-three and twenty-six qualified volume images were obtained in 50 normal fetuses and 14 fetuses with congenital heart diseases respectively. All volume images were reconstructed successfully and showed the spacial relationship of cardiac blood vessel directly. Conclusions The combination of B-flow imaging and spatio-temporal image correlation was feasible and useful in prenatal diagnosis of congenital heart diseases.

This paper presents the general principles and usual problems involved in the development of Institutional Review Board in research institutions. And suggestions are made in this regard. Meanwhile, it discusses two common difficult issues involved in ethical review.

Objective To evaluate the efficacy of aerosol inhalation ofXiyanpingversus ribavirin for the treatment of respiratory tract infections in children.MethodsPubMed, Embase, Cochrane database of Systematic Reviews, CNKI, cqvip and wanfangdata were searched. The randomized controlled trials(RCTs) of aerosol inhalation ofXiyanpingversus ribavirin injections for the treatment of respiratory tract infections in children were incuded. The quality of trials was evaluated and data analyses were performed with the Cochrane Collaboration’s software RevMan 5.0.Results A total of 7 trials were included, involving 857 patients(437 treated withXiyanping, 420 treated with ribavirin). Both of the clinical cure rate(50.11%vs. 40.71%) and clinical effective rate(91.08%vs. 75.95%) in theXiyanping group were significantly higher than those in the ribavirin group, withOR(95%CI) 1.49(1.13 to 1.97) and 3.54(1.87 to 6.71), respectively.Conclusions Aerosol inhalation ofXiyanping superior to aerosol inhalation of ribavirin for the treatment of respiratory tract infections in children. Owing to the poor quality and the small sample size of included trials, more larger good quality CRTs are required to confirm this conclusion.

Objective To confirm the performance of rate method for detecting ALT in blood donors to verify that it meets the requirements of ISO15189 .Methods according to the requirements of CNSA‐CL02 :2012 the Medical Laboratory Quality and Abili‐ty Recognized Standards and the Blood Station Technical Operation Regulations(edition 2012) ,the precision ,accuracy ,sensitivity , reportable range ,biology reference interval and measurement uncertainty of the detection system were verified .Results The intra‐batch imprecision for the ALT quality control serum and 2 concentrations of blood donor sample detected for 20 times and 20 d was<5 .0% and the inter‐batch imprecision was <6 .7% ;the correct estimates passed the external quality assessment results of the original Ministry of Public Health in 2014 and calibration results analysis .The relative bias was less than 1/2 of CLIA′88 permissi‐ble error;the regression equation of reportable range obtained by the linear regression was Y =0 .995 1X -5 .618 4 ,r=0 .999 7 (R2 =0 .999 4) ,the results within the detection range were correct ;the biological reference interval was 0 .0 -32 .7 U/L and the measurement uncertainty was (74 .90 ± 3 .32)U/L .Conclusion The performance indexes of ALT detection method conform to the expected requirements of ISO15189 .This method can be used as a blood screening test method in laboratory .