Objective To compare the phenotypes of abnormal CD4+CD25-Foxp3+ T cells with traditional regulatory T cells (CD4+CD25+Foxp3+) in patients with untreated new-onset lupus (UNoL) and investigate their clinical relevance. Methods The expressions of surface markers (CD25, CD127, CCR4, GITR, CTLA-4) and intracellular marker(Foxp3) on the peripheral blood mononuclear cells from twenty-two UNoL patients were analyzed by flow cytometry analysis, and their clinical relevance were assessed. Results There were no significant differences between CD4+CD25-Foxp3+ and CD4+CD25+Foxp3- T cells in the expressions of GITR, CTLA--4 and CCR4 (P>0.05), but they were significantly lower than those of CD4+CD25+ Foxp3+ T cells in UNoL patients (P<0.01). The percentages of CD127low- in CD4+Foxp3+CD25high,CD4+Foxp3+ CD25low and CD4+Foxp3+CD25+ T cells were (93.8±3.5 )%, (93.7±2.3)% and (92.0±2.1)% respectively (P> 0.05), whereas the expressions of Foxp3 on CD4+CD127low- T subpopulations showed significant differences in CD4+CDI27low-CD25high (91.4±2.6)%, CD4+CD127low-CD25low (71.9±3.3)% and CD4+CD127low-CD25- (9.0± 2.2)% T cells(P<0.01 ). The frequency of CD+CCR4+CD25high T cells correlated negatively with SLEDAI (r=-0.695,P<0.001).and it was significantly lower in lupus nephritis patients(1.10±0.17)%compared with SLE patients without nephritis [(1.61±0.23)%,P<0.01]and healthy controls [(1.75±0.10)%,P<0.01], furthermore,the frequency of CD4+CCR4+CD25low-T cells in lupus nephritis was significantly higher than that in healthy controls[(11.5±2.3)%vs (8.0±1.0)%,P<0.01].Conclusion The increased CD4+CD25-Foxp3+ T cells in the Untreated Newonset Lupus(UNoL)patients mimic activated T effector cells.CD4+CD25high-CD127low-T cells can be used to isolate live CD4+CD25highFoxp3+regulatory T cells.CCR4+regulatory T cells may be involved in the pathogenesis of lupus nephritis.

Adult ; Enchondromatosis ; diagnosis ; diagnostic imaging ; Femur ; diagnostic imaging ; Humans ; Male ; Radiography

Objective To investigate the cognitive dificiency characteristics and the neuro electrophysiological mechanism of sleep disordered breathing(SDB) in school-age children.Methods20 cases of SDB children and 20 cases of normal group at 6-8 years old participated in the continue performance test(CPT-AX).The amplitude and latency of N2,P3 of event related potentials(ERPs) were measured and analysed at Fz leads,and the behavioral results were recorded at the same time.ResultsThere were no significant differences between SDB group and normal group in behavioral correct number (36.10±4.69 vs 35.05±3.49),the reaction time ((523.77±68.73)ms vs (496.59±78.65)ms) and false alarm number (1.0 (0.25,3.75) vs 0.5 (0.00,3.00))(all P>0.05).The SDB group showed significant increase in Go-P3 amplitudes compared with the normal group((10.25±6.46)μV vs (6.56±4.63)μV,P<0.05).The Go-P3 latency in SDB group was significantly prolonged than that in the normal group((438.80±59.72)ms vs (406±36.30)ms,P<0.05),and the Nogo-N2 amplitude in SDB group significantly decreased compared with the normal group ((-12.46±4.75)μV vs (-15.50±3.82)μV,P<0.05).ConclusionThe children aged 6 to 8 years old with sleep disordered breathing consume more resources and time to complete the attention process,like a compensatory response.And during the monitoring process there is a resource shortage that results in obvious defect in process of inhibition.

Linezolid is the first oxazolidinone antibacterial drug approved by the FDA, which can effectively treat various gram-positive bacterial infections, including blood infections, skin and soft tissue infections, community and hospital-acquired pneumonia. It has become one of the most commonly used antibiotics in clinical. In addition to the recently launched tedizolid phosphate (TR701) and contezolid (MRX-I), several oxazolidinone anti-infective candidates are currently under clinical research. This review briefly introduces the oxazolidinone antibiotics that have been marketed and are in clinical trials, and recent progress on the structure optimization of oxazolidinone drugs is also summarized.

Objective To investigate public network attention to air pollution and their desire to prevent haze. Methods Daily Air Quality Index(AQI) and PM_2.5 concentration data and daily Baidu Index data were obtained in 31 provinces of China from January 1^st, 2015 to December 31^st, 2017.The Baidu indexes of air pollution and its protection were used to compose public′s network attention index for analysis on its spatial distribution in the 31 provinces and for linear regression research on air pollution, its protection and its network attention impact factors. Results With Baidu search index, it was noted that the network attention to air pollution was significantly higher than to air pollution protection.And a significant difference was found in the public network attention to air pollution between different provinces.It was found that education and consumption level of residents significantly affected public network attention to air pollution, while AQI and consumption level of residents significantly affected public network attention to air pollution hazards protection behaviors. Conclusions Even though the public has already paid high attention to air pollution, the awareness of air pollution hazards protection behaviors is still weak.Well-designed education campaigns are needed to enhance public awareness of air pollution and motivate the public to take actions to reduce pollution air exposure, especially in those provinces with a high AQI and PM_2.5concentration.

Objective To understand the current situation of pediatric nurses' perceived stress,coping style and professional burnout,analyze the influence of pediatric nurses' perceived stress and coping styles on professional burnout,and to provide references for reducing pediatric nurses' professional burnout.Methods A questionnaire survey was conducted on 415 pediatric nurses from 9 tertiary level A hospitals in Tianjin using general information questionnaires,Chinese Perceived Stress Scale(CPSS),Simplified Coping Style Questionnaire (SCSQ),and Maslach Burnout Inventory(MBI).Results Pediatric nurses'MBI scores were divided into emotional exhaustion score (25.19 ± 9.98) points,depersonalization total score (10.70 ± 4.65) points,personal achievement sense (29.72 ± 9.62) points,and higher degree of burnout.Correlation analysis showed that the perceived stress was positively correlated with emotional exhaustion and depersonalization dimensions,and negatively correlated with the dimension of personal accomplishment (r =0.398,0.236,-0.388,P ＜0.01);positive coping dimensions were negatively correlated with emotional exhaustion and depersonalization dimensions,and positively correlated with the dimension of personal accomplishment(r =-0.544,-0.205,0.608,P＜0.01);negative coping dimensions and emotional depletion and depersonalization dimensions were positively correlated,and negatively correlated with individual achievement dimension (r =0.559,0.298,-0.652,P ＜0.01).Multiple stepwise regression analysis showed that perceived stress and negative coping style had influence on emotional exhaustion,depersonalization,and individual achievement dimension.Positive coping style had influence on emotional exhaustion and personal achievement dimension (R2=0.105-0.501,P＜0.01).Conclusions Pediatric nurses have higher professional burnout.Perceived stress and coping styles have an impact on professional burnout.Pediatric nurses should take more active measures to relieve perceived stress and reduce burnout.

Objective To investigate the location and the pathogens of systemic lupus erythematosus (SLE) patients who died from infection.Methods Dead cases of hospitalized SLE patients in Peking Union Medical Hospital from January 1986 to May 2011were retrospectively analyzed.Results Severe infection was an important cause of mortality in patients with SLE.There were 252 dead cases of SLE in total from 1986 to 2011,in which 97 cases died from severe infection.The proportion of patients died from infection was gradually increased during the past 26 years,which was 25.7％,24.1％,31.6％,34.9％ and 60.3％ in 1986-1990,1991-1995,1996-2000,2001-2005 and 2006-2011respectively.Lung was the most common site of infec-t ion,accounting for 65％ of all dead cases.Among the 31cases with identified microorganism,14 patients had single microorganism infection and 17 patients had mixed infections.In the single microorganism infection patients,fungal infection contributed to the cause of death in 9 out of 14 (64％) patients,of which 4,2,1,1,and 1 cases were infected with Pneumocystis carinii, Aspergillus fumigates,Fusarium,Candida tropicalis and Cryptococcus respectively.There were 3 cases of bacteria infection,including 2 cases with Methicillinresistant staphylococcus,aureus and 1case with Klebsiella pneumoniae infection.Two patients died from pulmonary tuberculosis.In 17 patients with mixed infection cases, 14 deaths were caused by bacteria infection,including Acinetobacter baumannii, Eschefichia coli, Enterococcus, Klebsiella pneumoniae,Pseudomonas aeruginosa and Enterobacter cloacae.Eleven patients died from mixed fungus infection,including 6 cases of Aspergillus fumigates,3 cases of Candida tropicalis,3 cases of Pneumocystis carinii,2 cases of Aspergillus flavus,1 case of Soil Aspergillus,2 cases of Candida albicans,1 case of Candida glabrata and Candida Krusei.In addition to bacteria and fungi infection,cytomegalovirus infection occurred frequently in SLE death cases.Conclusions Severe infection has been the most frequent cause of death in SLE patients,in which lung infection is the leading cause.Pneumocystis carinii,Aspergillus fumigates,Acinetobacter baumannii and cytomegalovirus are the major pathogens that cause death in SLE patients.

Objective To investigate the status of diabetes in fasting state on different therapies.Methods 244 type 2 diabetic patients were divided into four groups according to different insulins:60 for insulin pump group(A),64 cases for insulin glargine group(B),59 cases for microinjection pump group(C),61 cases for isophane insulin suspension group.Then the time when blood glucose was up to standard,the usage of insulin and the rate of hypoglycemia were abserved.Results A group was(2.89 ± 1.32)d on the time when blood glucose was up to standard,B group was(3.14 ±1.25)d,C group was(4.91 ±2.81)d and D group was(5.62 ±2.52)d.There were significant differences between A and other groups( P ＜ 0.05 ) on time.There were significant differences between B and C group,B and D group,but there was no difference between C and D group.A group was(30.61 ±2.21) IU/don the usage of insulin,B group was ( 31.12 ± 3.38 ) IU/d,C group was ( 42.25 ± 4.01 ) IU/d and D group was (44.31 ±3.22)IU/d.There were significant differences between A and C group,A and D group,B and C group,B and D group(P ＜0.05)on usage of insulin,but there were no differences between A and B group,C and D group.A group was 3.3％ on the rate of hypoglycemia,B group was 4.7％,C group was 15.2％ and D group was 16.4％.There were significant differences between A and C group,A and D group,B and C group,B and D group ( all P ＜ 0.05 ) on usage of insulin,but there were no differences between A and B group,C and D group.Conclusion Compared to other insulin therapies,insulin pump had obviously superiority,which could be generalized to diabetics in fasting state.

ObjectiveTo investigate the changes of major causes of death of patients with systemic lupus erythematosus(SLE).MethodsDeath cases with SLE from January 1986 to May 2011 in Peking Union Medical College Hospital were retrospectively analyzed.ResultsOut of 3554 patients with SLE,252 patients died,including 223 women and 29 men.The mortality rate was 7.2％ among female and 6.2％ among male,the overall mortality rate was 7.1％.The mortality rate in SLE patients had dropped steadily in the past 25 years,but there was a mild increase of mortality in 2006-2011 compared with that in 2001-2005 (5.7％vs 5.3％ ).In addition to infection,neuropsychiatric lupus and lupus nephritis had become the most common causes of death in SLE patients during the past 25 years.Furthermore,diffuse alveolar hemorrhage,severe pulmonary hypertension,coronary heart disease,thrombocytopenia,interstitial lung disease,lupus pneumonia,gastrointestinal hemorrhage, intestinal obstruction and multiple organ failure were the common causes of death,accounting for 4.4％,4.4％,3.2％,2.8％,2.4％,2.0％,2.0％,1.2％ and 1.2％ of all the death cases respectively.From 1986 to 2005,infection,neuropsychiatric lupus and lupus nephritis were the most common causes of death in patients with SLE,whereas the cases dying from lupus nephritis had decreased obviously and severe pulmonary hypertension had become the third most frequent causes of death during the past 5years.From 1986 to 1990,lupus nephritis,infection and neuropsychiatric lupus accounted for 31.4％,25.7％and 25.7％ of death cases respectively.From 1991 to 1995,lupus nephritis,infection and neuropsychiatric lupus accounted for 27.6％,24.1％ and 24.1％ respectively.From 1996 to 2000,infection,neuropsychiatric lupus and lupus nephritis took up 31.6％,21.1％ and 15.8％ respectively.From 2001 to 2005,infection,neuropsychiatric lupus and lupus nephritis took up 34.9％,20.6％ and 7.9％ respectively.From 2006 to 2011,infection, neuropsychiatric lupus and pulmonary hypertension accounted for 60.3％, 11.8％ and 7.4％ respectively.The mortality in the first year was the highest in the whole disease course,accounting for 32.5％ of patients.Deaths caused by neuropsychiatric lupus and infection happened most frequently during the first year,accounting for 41.9％ and 32.9％,whereas deaths caused by lupus nephritis occurred most frequently 10 years later,accounting for 32.3％.Age and gender had significant association with the major causes of death.The male patients took up 50.0％ of the total patients dying from coronary heart disease,in which 75.0％ of patients were older than 50 years.ConclusionInfection,neuropsychiatric lupus and lupus nephritis are the three most common causes of death in SLE patients fron 1986 to 2005.Severe pulmonary hypertension has become the third most frequent causes of death during the past 5 years instead of lupus nephritis.Severe infection has increased significantly and has been the leading cause of death in SLE patients in recent 5 years.

Objective To evaluate the detection value of serum (1,3)-β-D glucan (G-test) and galactomannan (GM-test) combined with sputum fungal culture in the early diagnosis of invasive fungal infection(IFI) in intensive care unit(ICU) patients.Methods Inpatients with high risk factors for IFI in the ICU of the Affiliated Hospital of Xuzhou Medical University between January 2015 and December 2016 were chosen,they were divided into 3 groups according to the diagnostic criteria of IFI:IFI group(including confirmed and clinically diagnosed cases),suspected IFI group,and non-IFI group.The results of serum G-test,GM-test,and sputum fungal culture in three groups of patients were analyzed,early diagnostic value in IFI with combined three tests was evaluated.Results A total of 264 ICU patients were investigated,IFI group,suspected IFI group,and non-IFI group were 56,43,and 165 cases respectively.Among 56 cases of confirmed IFI,46,39,and 34 were positive for G-test,GM-test,and fungal culture respectively.The sensitivity,specificity,positive predictive value,and negative predictive value of combined three detection were 98.2％,82.4％,65.5％,and 99.3％ respectively,positive likelihood ratio,negative likelihood ratio,and Youden index were 5.58,0.02,and 0.98 respectively.The sensitivity and negative predictive values of combined three detection were both higher than those of single G-test,GM-test,and sputum fungal culture (all P＜0.05);but specificity and positive predictive value of combined three detection were not significantly different from single G-test,GM-test,and sputum fungal culture(all P＞0.05).Conclusion The combination of G-test,GM-tests,and sputum fungal culture can improve the sensitivity of early diagnosis of IFI in ICU patients,and guide the clinicians in the early treatment of IFI.