OBJECTIVE To study the dynamic changes and clinical significance of TNF-? and IL-10 of nosocomial infection in patients with severe viral hepatitis.METHODS The study included 40 patients with severe viral hepatitis,their nosocomial infection was treated with antibiotic therapy.Serum levels of TNF-? and IL-10 were measured at baseline and 5 d,10 d and 15 d after the first antimicrobial dose.The patients were divided into 2 groups: infection be controlled group and infection be not controlled group by therapeutic efficacy.RESULTS The serum concentrations of TNF? and IL-10 were elevated in all patients when compared with the healthy control group(P

Objective To investigate the clinical characteristics of 34 systemic onset juvenile idiopathic arthritis (SoJIA) complicated with macrophage activation syndrome (MAS) and analyzed the gene PRF1,UNC13D,STX11,STXBP2 to figure out the genetic pathogenesis mechanism.Methods The clinical characteristics of 34 SoJIA complicated with MAS were analyzed retrospectively and coding sequences of PRF1,UNC13D,STX11 were amplified and tested.The Chi-square test was applied to compare the distribution of alleles and genotypes frequencies between SLE patients and healthy controls.Statistical significance was defined as P value ＜0.05.Results A total number of 34 SoJIA complicated with MAS were included.Boys accounted for 69％(23/34),and the median age was 6 years.85％(29/34) cases had genetic tests and four SNPS loci were detected:PRF1 c.1061 C＞T (rs885822); UNC13D c.659 C＞T (rs3744007); STXBP2 c.1483 T＞cC (rs10001) and STXBP2 c.1616 A＞G (rs6791).Compared with the control group,genotype and allele frequency of PRF1 rs885822 and STXBP2 rs10001 in MAS cases were statistical significantly different (rs885822:allele frequency x2=4.52,P=0.03 ; genotype frequency:x2=5.52,P=0.02.rs10001:allele frequencyx2=21.33,P=0.00; genotype frequency:x2=19.58,P=0.00).There was no statistical significant difference in genotype frequency and allele frequency of UNC13D rs3744007 and STXBP2 rs6791 between the MAS and control group (rs3744007:allele frequencyx2=1.89,P=0.17; genotype frequency:x2=1.59,P=0.45.rs6791:allele frequency x2=l.69,P=0.19; genotype frequency:x2=2.09,P=0.35).Persistent fever,progressive hepatos-plenomegaly,a sharp decline in blood cells counts,pleural effusion,markedly increased serum liver enzymes,hyperlipidemia were the main characteristics.Some children had mucosal bleeding,neurological dysfunction.More than 82％ children had upper respiratory tract infection before the occurrence of MAS.90％ of children were in remission,while three children had multiple organ failure and died.Conclusion MAS is a fatal complication caused by immune disturbance.Early detection and tre-atment is the key to improve the prognosis.The SNP PRF1 rs885822 and STXBP2 rs1001 may be concurrent with the pathogenesis of SoJIA-MAS.The SNP UNC13D rs3744007 and STXBP2 rs6791 may not participate in the pathogenesis of SoJIA-MAS.

Objective To explore the effect of nBiPAP on ET-1 of patients with overlap syndrome.Methods Levels of ET-1 in plasma of 25 cases of OS,20 cases of COPD were analysed by radioimmunoassay,and ET-1 in OS was measured before and after treatment.The relationship between ET-1 with SaO_2 during sleep was analyzed. Results (1)The ET-1 levels in plasma of OS group were significantly higher than those of COPD group before treatment(P

Objective:To study the sTRAIL levels in chronic hepatitis B(CHB) patients upon nucleoside analogues therapy.Methods:Serial sera of 60 CHB patients before and after nucleoside analogues therapy were collected,among which there were 20 complete responding cases,20 partial responding cases,20 non-responding cases,and 10 healthy people.The level of sTRAIL,IFN-γ and ALT were detected.Results:The level of sTRAIL,IFN-γ and ALT of CHB patients were higher than that of normal group.The sTRAIL level of complete responding group at 4 weeks and partial responding group at 12 weeks were lower than those before therapy,while serum TRAIL of complete responding group were lower than those of partial responding group at 4 weeks.The IFN-γ level of complete responding group at 4 weeks and partial responding group at 12 weeks were higher than those before therapy.ALT levels of all groups in the course of therapy declined gradually and significant difference was observed at different time point.Conclusion:Serum TRAIL level can be used as an early marker for efficacy of nucleoside analogues therapy efficacy in CHB patients.sTRAIL may play a role in restoring immune injury of early anti-viral response in patients with hepatitis B.

Hirudo nipponica Whitman,a Chinese medicine which has a strong effect on platelet aggregation and antithrombin activity,is involved in the studies.The current situation is adverse to the cultivation,development and utilization of H.nipponica.Prior to summarizing the current research status and the unresolved problems and the prospective of H.nipponica,domestic and foreign literatures over the H.nipponica was discussed and judged,aiming at providing a reference for the comprehensive development and utilization of H.nipponica.

Objective To compare the therapeutic effect of conventional treatment and conventional treatment plus external application of Shuangbai Powder for patients with wounded limb injured by venomous snake. Methods One hundred patients bitten by venomous snake were randomized into treatment group and control group, 50 cases in each group. The control group was given conventional treatment including repeatedly washing the wound with hydrogen peroxide, debriding the wound, letting blood and draining toxicity, local blocking with chymotrypsin, wet packing the wounded limb with magnesium sulfate, and injection with anti-venomous serum, tetanus antitoxin, antibiotics, furosemide and energy mixture. The treatment group was given external application of Shuangbai Powder on the basis of the treatment for the control group. Both groups were given the comprehensive nursing of psychological nursing, wound nursing, dietary nursing, defecation nursing and functional nursing. The swelling-subsiding time for the wounded limb and pain scores of visual analogue scale (VAS) in the two groups were compared. Results(1) After treatment, swelling-subsiding time for the wounded limb of the treatment group was shorter than that of the control group, the difference being statistically significant (P < 0.05). (2) After treatment for 4 days and at the end of the treatment, VAS scores of the two groups were decreased compared with those before treatment(P < 0.05), and the decrease of VAS scores in the treatment group after treatment for 4 days was superior to that in the control group (P < 0.05). Conclusion The conventional treatment plus external application of Shuangbai Powder is an effective therapy for patients with wounded limb injured by venomous snake by shortening swelling-subsiding time and relieving pain for the wounded limb .

Objective To evaluate the effect of fingolimod(FTY720) on angiotensin Ⅱ(AngⅡ)-induced renal oxidative stress in rats and its possible mechanisms.Methods Thirty-six male Sprague-Dawley rats were divided into three groups through random number tables:AngⅡ infusion group(twelve rats,infusion of AngⅡvia subcutaneous osmotic pumps),0.9% sodium hydrochloride solution infusion group(twelve rats,infusion of equal volume of 0.9% sodium hydrochloride solution via subcutaneous osmotic pumps) and FTY720 intervention group(twelve rats,intra-gastric administration of FTY720 besides AngⅡ infusion).Urine samples were collected for 24 hours every week.Blood samples and kidneys were collected when rats were sacrificed at day 14 and 28 d respectively.MDA and T-SOD assay Kits were used to detect the concentrations of MDA and T-SOD in serum and kidney homogenates.Renal pathological changes were observed by light microscope.The expression of Nox4 in the kidneys was evaluated by immunohistochemistry.Results Compared with 0.9% sodium hydrochloride solution infusion rats of the same period,AngⅡ-infused rats developed significant proteinuria.The concentration of serum creatinine,urea nitrogen,AngⅡ and MDA were increased(P<0.05),T-SOD was significantly decreased on days 14 and 28(P<0.05),the serum albumin was significantly increased on day 28(P<0.05),while FTY720 partially reversed these changes.The renal tissue of AngⅡ-infused rats presented mesangial cells proliferation,mesangial matrix deposition,tubular epithelial cells effacement,sclerosis and atrophy in part of the glomerular.FTY720 can alleviate these changes.Immunohistochemistry showed that Nox4 was primarily located in the distal tubule.The expression of Nox4 was significantly increased in AngⅡ-infused rats as compared with that of 0.9% sodium hydrochloride solution infused group rats,and FTY720 administration prevented the change effectively.Conclusion AngⅡ-induced renal injury could be attenuated by FTY720 via preventing oxidative stress.

Objective To understand the relationship between childhood non-intentional injury and socio-economic status (SES) in Jiangxi province. Methods Nearly 100 000 households were selected by PPS sampling method, in Jiangxi province. All children aged 0-17 years in selected households were surveyed using an 'injury questionnaire'. SES was calculated under the World Bank method. Results 98 335 children were surveyed and the identified number of non- intentional injury cases was 5429 and with 52 fatal cases. The morbidity was 5.52% and mortality was 52.88/100 000. The mortality of children with higher SES was lower than that of other groups but without statistical significance. The morbidity of moderate injury increased with the increasing SES, also without statistical significance. However, the morbidity of severe injury in male children decreased with the increasing SES. Rates of moderate injury morbidities of fall and road traffic injury also increased with the increasing SES. Moderate injury morbidity caused by animals decreased with the increasing SES. Severe injury morbidity of fall decreased with the increasing SES. Conclusion The morbidity of injury in children was affected by the SES and the relationship between injury and SES varied along with the results of different types of injuries.

Objective To observe the effects of electro-acupuncture ( EA ) on learning, memory and the morphology of hippocampal neural tissues in rats with a model of chronic cerebral ischemia.Methods One hundred and twenty male Sprague-Dawley rats were used. Chronic cerebral ischemia models were successfully established in 104 of them, and those rats were randomly divided into an EA group and a model group with 52 rats each. These were further subdivided into 1,2, 4 and 6 week subgroups with 13 rats in each. The EA group was given EA. The changes in spatial learning and memory ability were observed using a Morris water maze. The morphological changes in hippocampal nerve tissue were observed by HE staining.Results The escape latency in the EA group was significantly different from the model group at the 2nd, 4th and 6th week. The nerve cells in the dentate gyrus were more tightly and consistently lined-up and had rich layers, and the structures in the EA group were better than in the model group.Conclusions EA can improve spatial learning and memory and promote the repair of injury after cerebral ischemia.

Objective To observe the phosphorylation of Smad3 in hyperplastic scar fibroblasts (HSFs) induced by hematoporphyrin monomerthyl ether (HMME) followed by photodynamic therapy (PDT).Methods Fibroblasts were isolated from the hypertrophic scar tissues of 10 patients and subjected to culture in vitro.After 3-5 passages,the HSFs were divided into 4 groups:control group receiving no treatment,PDT group pretreated with HMME of 4 μg/ml followed by PDT,HMME group induced by HMME alone,and laser group irradiated with laser alone.Fluorescence microscopy was used to observe the expression of Smad3 after immunofluorescent staining with anti-Smad3 antibody,and Western blot to detect the expression of Smad3 and phosphorylated Smad3 in these HSFs.Paired t test was conducted to compare the difference in Smad3 and phosphorylated Smad3 expression between these groups.Results The total fluorescence intensity of Smad3 was similar between these groups,but the intranuclear fluorescence signal was significantly weaker in the PDT group than in the control group.The level of phosphorylated Smad3 was statistically decreased in the PDT group compared with the control group (0.20 ± 0.02 vs.0.92 ± 0.15,P ＜ 0.05),but no significant difference was observed between the HMME group and laser group (P ＞ 0.05).Conclusion PDT may inhibit the proliferation of HSFs via attenuating the phosphorylation of Smad3.