Objective The purpose of this study was to investigate the effects of cardiopulmonary bypass(CPB) on monocyte HLA DR expression and immune function Methods Sixteen ASA Ⅱ Ⅳ patients [mean age (38 5?5 1)yr,mean body weight (42 9?10 2kg)] of both sexes (male 7,female 9) with rheumatic value disease undergoing mitral value replacement (11 patients) and mitral value and aortic value replacement (5 patients) with moderate hypothermic CPB were enrolled in this study Another ten patients undergoing lung lobectomy were used as control group Patients suffering from infection, immuno deficiency or receiving corticosteroid or immunoregulatory drugs were excluded Premedication included intramusallar midazolam 0 1mg?kg -1 and morphine 0 1mg?kg -1 Anesthesia was induced with intravenous midazolam 0 15mg?kg -1 , fentanyl 8?g/kg and vecuronium 0 1mg?kg -1 and maintained with isoflurane inhalation (0 8%～1 2%) and intermittent boluses of fentanyl and vecuronium The total dose of fentanyl was (18 3?3 2)?g/kg in CPB group and (9 6?1 3)?g/kg in control group CPB time was (74 2?22 5) min and aortic clamping time (57 5?19 2) min Blood samples were taken from CVP line before and 5 min after induction of anesthesia, before and after CPB and on the 1st, 3rd and 5th postoperative day for determination monocyte count and percentage of HLA DR + monocytes Results The number of monocytes decreased at the end of surgery but greatly increased on the postoperative days The percentage of HLA DR + monocytes also decreased at the end of surgery and decreased further on the 1st postoperative day but started increasing on the 3rd postoperative day In two patients who developed infection the percentage of HLA DR + monoeytes was lower than the average percentage of HLA DR + monocytes of the other 14 CPB patients In control group the percentage of HLA DR + monocytes also decreased significantly after operation but there was no significant change in the number of monocytes However there was a significant difference in monoeyte HLA DR expression between the two groups Conclusions The changes in monocyte HLA DR expression and monocyte count may be induced by impaired immune response after CPB and dynamic monitoring of monocyte HLA DR expression may help to predict complication of infection after CPB

Objective To examine the expression of a- and ?-defensin genes in human peripheral leukocytes. Methods Fifty-one healthy blood donors were studied. Peripheral leukocytes were stimulated by lipopolysaccharide ( LPS) 100 ng?ml-1 ex vivo. The level of defensin mRNA expression in the leukocytes were assessed after being incubated with LPS for 0 (baseline), 1, 3, 6, 12, 24 h by semi-quantitative RT-PCR. Southern blot analysis and sequencing were used to confirm the identity of defensin gene transcripts. Results Expression of ?-defensin 1-3 mRNA was detected in all donors studied, but no ?-defensin mRNA expression was detected in peripheral leukocytes before LPS-stimulation. Expression of ?-defensin-1 gene was detected in the leukocytes after being incuaated with LPS for 3 h in 45 of 51 donors (88.2% ) and ?-defensin-2 mRNA expression was positive in 20 donors (39.2 % ), but no ?-defensin-3 mRNA expression was detected. The levels of ?-defensin-1 and-2 mRNA peaked at 6 h and started decreasing at 12 h. In contrast there was no significant change in ?-defensin 1-3 mRNA in peripheral leukocytes after LPS-stimulation. Conclusion In human peripheral leukocytes ?-defensin-1 and-2 genes are induced transiently by LPS-stimulation;whereas ?-defensin 1-3 genes are constitutive. The induced expression of ?-defensin-1 and-2 genes show inter-individual variability.

Objective To explore the main reason of secondary barrenness resulted from drug miscarriage before childbearing. Methods Gynecologic examination was performed in 156 patients with secondary barrenness after drug miscarriage. Uterus neck and vaginal smear examination, mycoplasma and chlamydozoon detection, and hysterosalpingograghy were performed in the same time. Results 101 patients (101/156,64.74%) had genital duct inflammation,61 patients (61/156,39.1%) had various degrees of tubal obstruction. Conclusion The main reason of secondary barrenness after drug miscarriage was the tubal obstruction resulted from inflammation, especially chlamydozoon and mycoplasma infection. Drug miscarriage was not so safe before childbearing.

Objective To investigate the clinical characteristics and surgical treatment for primary presacral tumors.Methods The clinical data of 42 patients of primary presacral tumors from January 2013 to May 2015 were analysed retrospectively.Results Of the 42 patients,16 cases were asymptomatic while 26 patients had discomfort at the sacral or abdominal region,or difficulty in urinating or defecation.90％ of the cases were digital rectum examination (DRE) positive.Among the 42 patients 36 cases underwent surgical treatment,1 case underwent radiotherapy,5 cases refused surgical treatment.Among those receiving surgical resection,28 cases had trans-abdominal surgery and 4 cases had trans-sacral surgery,while 3 cases had trans-abdominal & trans-sacral surgery,1 case had trans-abdominal and perineal surgery.Tumors were completely resected in 31 cases,and palliatively resected in 5 cases.3 cases suffered from intra-operative presacral hemorrhage.1 case with delayed hemorrhage required surgical intervention.2 cases from incision infection recovered after wound disinfection and dressing.3 cases had postoperative hip or leg numbness;1 case with high fever was cured by intensive antibiotics treatment.Conclusion The low incidence of presacral tumors makes early detection difficult.A diagnosis can be obtained by a positive DRE combined with CT or MRI results.Resection is a therapy of choice after biopsies.

Functional magnetic resonance imaging (fMRI) is a technology combined with function, anatomy and images to evaluate the brain function in real-time, dynamic, non-invasive ways. fMRI has been applied in the rehabilitation after stroke for the assessment and prog-nosis of motor, speech, cognition and sense function, etc.

Objective To study the role of KRX-725,a specific agonist of Sphingosin-1 phosphate receptor 3,S1PR3),in the function and mechanism of S1PR3 in respect of bacterial clearance.Methods Twenty healthy male C57BL/6 mice were randomly (random number) divided into two groups:KRX-725 group and control group.Septic mice model were established by intraperitoneal injection of E.coli (3 × 106),then KRX-725 (10 mg/kg) or the vehicle was administered intratracheally.Forty-eight-hour survival rate (n =12),bacterial colony numbers in peritoneal cavity and blood (n =5),and lung injury (n =3)were compared between two groups.In vitro,the peritoneal macrophages were stimulated by E.coli (cell∶E.coli=1∶10) with KRX-725 or the vehicle treatment.The reactive oxygen species (ROS) levels were detected by CM-H2DCFDA in macrophages.The bacteria clearance function of KRX-725 was observed by gentamicin protection test.Survival rates were analyzed with the Log-rank test.A 2-tailed student's t test was used to compare difference between two independent groups.Results Compared with the control group,the 48-hour survival rate of KRX-725 group was significantly higher (P ＜ 0.05).Bacterialload in the blood and the peritoneal lavage fluid (PLF) was greatly decreased in the KRX-725 group (blood:t =3.17,P ＜0.05;PLF:t =4.07,P ＜0.01).The lung tissues injury was also obviously reduced in the KRX-725 group of 24 hours after the injection of E.coli (lung injury score:KRX-725 group 1.4 ± 0.25;control group 2.4 ± 0.25) (t =2.89,P ＜ 0.05).In vitro,KRX-725 could up-regulate the ROS levels in macrophage at 20 min and 30 min after E.coli injected intra-peritoneally (20 min fluorescent intensity:KRX-725 group 522.9 ± 38.76,control group 385.9 ± 15.90,P ＜ 0.05;30 min fluorescent intensity:KRX-725 group 519.7 ±25.02,control group 384.5 ± 15.28,P ＜0.01).The bacterial load in the KRX-725 treated macrophage were significantly decreased at 3 h and 6 h after E.coli injected intra-peritoneally (3 h:KRX-725 group 286.5 ±98.35,control group 710.8 ± 107.8,P ＜0.05;6 h:KRX-725 group 72.5 ±6.45,control group 205.8 ±66.76,P ＜0.01).Conclusion In vivo,KRX-725 could improve the survival rate of septic mice,decrease the bacterial lioad in the blood and PLF,and reduce the lung injury.In vitro,KRX-725 could up-regulate the ROS level in macrophages and accelerate the bacterial clearance.

Objective To evaluate the effect of labor analgesia on the development of postpartum depression.Methods Seventy nulliparous parturients who were at full term with a singleton fetus in vertex presentation,aged 20-35 yr,with body mass index＜27 kg/m2,at 38-41 weeks of gestation,of ASA physical status Ⅰ,were enrolled and divided into 2 groups (n =35 each) using a random number table:vaginal delivery group (group VD) and labor analgesia group (group LA).In LA group,the epidural catheter was placed at L2,3 interspace for combined spinal-epidural analgesia when their cervical dilations were in 2-3 cm.VAS score was maintained below 3 after the analgesia.Parturients completed Edinburgh Postnatal Depression Scale questionnaires 42 days after the labor.The development of depression was recorded.Results The incidence of postnatal depression was significantly lower in LA group (17％) than in VD group (40％).Conclusion Labor analgesia can decrease the development of postpartum depression.

Objective To establish a method for reducing the dose to the eye lens of interventional staff,and provide the data basis for improving radiological protection measures.Methods One piece of interventional equipment coupled with conventional auxiliary protective devices and two types of common neural interventional procedures were selected to monitor 46 and 35 procedures before and after the device modification.The doses to the eye lens of staff were measured with direct-reading dosimeters for analysis of dose trends.Results After modification of the devices,the average dose to the left eye lens decreased from (9.71 ±10.86) to (3.23 ±5.59) μSv for the first operator,from (9.51 ± 12.34) to (0.68 ± 0.78) μSv for the second in cerebral angiography;whereas the dose decreased from (14.83 ± 19.13) to (4.17±4.59) for the first operator and from (14.12±21.76) to (1.23 ±1.57)μSv for the second in embolization procedure,respectively.The left eye lens doses measured before and after the modification showed significant difference (U =-2.760,-2.467,-1.967,-2.655,P ＜0.05).Conclusions The modification of the auxiliary radiological protective devices may effectively reduce the dose to the eye lens dose.This method was shown to be feasible for the improvement of radiological protection of interventional staff.

Objective To investigate the effect of stoma skin care powde combined with skin protective mem-brane in prevention and treatment of secondary eczema after anal fistula surgery. Methods Eighty-three patients after anal fistula operation were divided into test group and control group. On the basis of routine treatment,the pa-tients in test group were used stoma skin care powder combined with skin protective membrane to protect the peri-anal skin. While the patients in control group were treated routinely. The degree of pruritus,the onset time,the number of skin lesions,the area of eczema and the healing time of eczema were observed in two groups 4 d,14 d and 24 d post-operation. Results Patients in test group had lowerdegree of pruritus,later onset time after dressing, less skin lesions,samller area of eczemaand shorter healing time of eczema than patients in control group in the 3 time nodes (all P<0.05). Conclusion Stoma skin care powder combined with skin protective membrane could effec-tively isolatepostoperative wound secretions and anus polyrrhea,and have preventive and therapeutic effects on sec-ondary perianal eczema after anal fistula surgery.

Objective To study the bystander effect of tumor necrosis factor related apoptosis inducing ligand(TRAIL) gene and it's mechanism. Methods Full length cDNA of human TRAIL was transfected into SMMC7721 with binary adenoviral vectors system. RT PCR was used to determine the expression of TRAIL gene. By MTT assay the effects of the TRAIL gene on the proliferation of SMMC7721 was studied; The apoptosis inducing ability of TRAIL gene on SMMC7721 was tested by fluorescence activated cell sorting (FACS). Bystander effect by testing the proliferation of the mixed cells of SMMC7721/TRAIL and SMMC7721 with different ratios, and the mechanism of bystander effect by testing the proliferation of SMMC7721 cultured with media of SMMC7721/TRAIL without cell components were also studied. Results TRAIL gene expressed by binary adenoviral vector system was able to inhibit proliferation(91.2%) and induce apoptosis(29.07%) of SMMC7721, significant difference between TRAIL gene and the other three controls were observed(PBS, LacZ, Bax)( P