Objective To investigate the in-hospital death-related factors for acute encephalocele in patients with craniocerebral injury for craniotomy in order to provide evidence for clinical treatment and prognosis determina-tion.Methods The clinical data of 105 patients with craniocerebral injury occurring acute encephalocele during cra-niotomy were analyzed retrospectively.The correlations of the factors including sex,age,preoperative Glasgow coma scale(GCS)scores,preoperative intracranial pressure(ICP),postoperative pupil status,causes of encephalocel,post-operative GCS scores,postoperative ICP,coagulation mechanism,brain swelling,preoperative hypoxia,preoperative blood pressure and blood glucose were analyzed.Results The prognosis was assessed according to the Glasgow out-come scale(GOS)scores after procedure.There were 77 patients in death group(namely death cases)and 28 patients in survival group.Logistic regression analysis showed that postoperative GCS scores (Wald =14.127,Exp(B)=0.044,95%CI:0.032,0.448),causes of encephalocel(Wald =7.748,Exp(B)=8.183,95%CI:1.825,10.251), postoperative ICP(Wald =7.637,Exp(B)=7.637,95% CI:1.969,8.028),postoperative pupil status(Wald =4.001,Exp(B)=2.499,95%CI:1.019,5.122)and blood glucose(Wald =7.915,Exp(B)=8.891,95% CI:1.790,9.337)were closely associated with the in-hospital death in patients with acute encephalocele in craniocere-bral injury operation(P <0.05).Conclusion The postoperative GCS scores,causes of encephalocel,postoperative ICP,postoperative pupil status and blood glucose could be used as the important indexes for predicting in-hospital death of acute encephalocele in craniocerebral injury for craniotomy.To prevent the intraoperative encephalocele and reduce the intracranial pressure are the important measures to reduce the mortality rate of the patients with acute encephalocele.

Mesenchymal stem cells (MSCs) are multipotent stromal cells derived from the mesoderm that can differentiate into a variety of cell types.Recently,as the study of MSCs in the treatment of various autoimmune diseases is maturing,more and more researchers have advocated the immune function of MSCs and the treatment for dry eye.The rate of dry eye is higher.The duration of therapy in dry eye,especially immune related dry eye,is long,and the therapeutic effect is poor.Dry eye has affected people's quality of life,so it is important to find new methods to treat it.This article reviews MSCs function in dry eye.

Mesenchymal stem cells (MSCs) have good immune regulatory function,can inhibit many immune cell proliferation,direct effects on activation and proliferation of T cell,play a role in immune regulation by Treg cells or by the secretion of soluble factors regulating Thl/Th2 secretion and reaction equilibrium,inhibit the inflammation through the anti-inflammatory,regulation of cytokines expression at the same time,so reduce the expression levels of matrix metalloproteinase-2 and-9,which may promote lacrimal gland tissue damage,and thus play a role in immune regulation.MSCs can reduce the autoimmune dry eye clinical index,recovery secretion function of part lacrimal gland.This article reviews the research advances in inmmmne regulation of MSCs on autoimmune dry eye.

In order to improve the efficiency and quality of medical services,the authors applied the lean production and system simulation into optimizing the transfusion system of a hospital.By means of describing and analyzing the current situation and problems of a transfusion system of the hospital,the paper presented the cause-effect diagram for overlong patient waiting.5W1H and ECRS were adopted to analyze the infusion processes,while Simio was used to simulate the existing infusion system and simulation data so obtained were used to draw a value stream mapping for the system.In line with the ideas of Shojinka and one stream production,nurses deployment and conveyor speed were reconfigured.Based on these ideas,a reform plan is presented and the simulation method is used to verify the outcomes.The study proved that lean production and system simulation can effectively improve the hospital transfusion system,medical efficiency and medical service level.

Objective To investigate the possibility of measuring ABO blood group antibody levels using renal cortical tubular epithelial cells (RCTECs) of cynomolgus monkey.Method The primary RCTECs were isolated from cynomolgus monkey kidneys and identified by Western blotting and flow cytometry (FACS).FACS was applied to detect the expression of ABO histo-blood group antigens on RCTECs,the binding of blood group antibodies in human serum to RCTECs,and to compare the difference of measuring ABO blood group antibody levels between using human erythrocytes and RCTECs as target cells.Result The majority of cells derived from the kidney cortex were renal tubular epithelial cells.39.90％-73.80％ of RCTECs were found to express the ABO histoblood group antigens with the capability to bind the human blood group antibodies specifically.The expression level of ABO histo-blood group antigen on RCTECs was not influenced by long-term cryopreservation,and the percentage of B antigen positive cells was 39.90％ before frozen storage and 39.65％ after a 10-month cryopreservation respectively.The normal serum and allergic serum presensitized to synthetic A antigen-keyhole limpet hemocyanin (KLH-A) of cynomolgus monkey were used to compare the abilities of RCTECs and human erythrocytes to detect antibody titers.No agglutination was observed in RCTECs test group.The mean fluorescence intensity (MFI) values of antibody were highest when the dilution fold was lowest (1 ∶ 16) and gradually decreased with increased serum dilution in both serum groups.MFI fell towards baseline value at 1 ∶ 128 dilution in normal serum group while at 1∶8 192 dilution in allergic serum group.Between 1 ∶ 16 and 1∶8 192 dilutions,MFIs of normal serum group were all lower than those of allergic serum.In human red cells test group,obvious agglutination appeared at high concentrations of antibodies,and MFIs reached the peak at 1∶64 dilution in normal serum group and at 1∶32 dilution in allergic serum group,but fluctuated irregularly thereafter.Between 1∶64 and 1∶512 dilutions,MFIs of normal serum group were all higher than those of allergic serum.Data above showed that MFI values in RCTECs group could reflect the levels of blood group antibodies more exactly.Conclusion The RCTECs of cynomolgus monkey express ABO tissue-blood group antigens and would be more suitable to be used to measure ABO blood group antibody levels by FACS.

Objective To investigate the relationship between clinical types and related risk factors in female patients with post-adolescent acne.Methods Female outpatients with post-adolescent acne aged more than 25 years were enrolled from Department of Dermatology of Renji Hospital between January and October 2016.A questionnaire survey was conducted to investigate related risk factors for post-adolescent acne in the females.Skin lesions and clinical types were evaluated by dermatologists.Statistical analysis was carried out by t test for comparison of means between two groups and by chi-square test for comparison of ratios.Results A total of 312 female patients with post-adolescent acne completed the survey,including 268 (85.9％) with mild to moderate acne and 44 (14.1％) with severe acne,241 (77.2％) with persistent acne and 71 (22.8％) with late-onset acne,or 102 (32.7％) with comedonal post-adolescent acne (CPAA) and 210 (67.3％) with papular post-adolescent acne (PPAA).Survey on related risk factors showed that 121 patients reported seasonal factors and 59 (18.9％) patients became worse in summer,and spicy,sweet and fried foods can aggravate the condition in 131 (42％),93 (29.8％) and 85 (27.2％) patients respectively.Other risk factors such as premenstrual period (62.8％,196/312),psychological factors (51.6％,161/312) and exogenous chemical exposures (43.6％,136/312) were complained of by the patients.Furthermore,premenstrual period,diet and constipation were found to be more associated with PPAA compared with CPAA (x2 =4.523,4.068,3.910,respectively,all P ＜ 0.05).Exogenous chemical exposures,such as the use of cosmetics,exposure to polluted air environment and occupational hazards,were more associated with CPAA compared with PPAA,as well as with late-onset acne compared with persistent acne (x2 =6.579,9.057,both P ＜ 0.05).In addition,premenstrual exacerbation occurred more frequently in patients with persistent acne compared with those with late-onset ache (x2 =4.512,P ＜ 0.05).Conclusions The risk factors for the occurrence of female post-adolescent acne are very complex.Premenstrual exacerbation plays a major role in the aggravation of papular and persistent post-adolescent acne,diet and constipation are more associated with PPAA,and exogenous chemical exposures are still be considered in the aggravation of comedonal and late-onset post-adolescent acne.Thus,clinical types should be considered in the diagnosis and treatment of post-adolescent acne in females.

Objective To promote professional training aid on healthcare talents in western China,this paper aims to explore methods and to evaluate the effectiveness of a new training system for underprivileged medical professionals from hospitals of western China.Methods Questionnaires and interviews were conducted to 115 trainees and their employers took part in the Counterpart Support Project.A retrospective analysis was done to evaluate key indicators of the trainees' professional competence.Results More than 90％ of the trainees have seen great improvement on basic healthcare knowledge,clinical skills,and diagnosis and treatment practice.About 80％ the participating hospitals have enjoyed varied degrees of growth in outpatient visits,surgical volume,number of inpatient and operational efficiency.(Increase level from 0％ to 50％) Conclusions Within the frist 3 years of implementation,this new model has been proven effective to enhance participants' overall professional competence,and by tapping into the significant resource of first class hospitals,this model will help greatly promoting the development of healthcare talents in Western China.

Objective To explore the differentiation of allogeneic naive T cells to regulatory T cells (Tregs) and T helper (TH) 1/2/17 cells by coculture with bone marrow-derivedimmature dendritic cells (irnDC).Method Bone marrow-derived imDC were cultivated from Balb/c mice.Lipopolysaccharide-stimulated DC were harvested as mature dendritic cells (mDC) and unstimulated cells were collected as imDC.Then irnDC or mDC were cocultured with allogeniec naive T cells,respectively.TH1 cytokines [interferon-γ (IFN-γ) and interleukin (IL)-2],TH2 cytokines (IL-4 and IL-10),and TH17 cytokine (IL-17) of co-cultured cells were detected by enzyme linked immunospot assay.CD4+ Forkhead box p3 (FoxP3) + Treg proportion in CD4+ cells in the co-cultured system with IL-2 and transforming growth factor-β1 (TGF-β1) was analyzed by flow cytometry.Result As compared with mDC,na(i)ve T cells cocultured with imDC secreted much less IFN-γ (11.67 ± 2.18 vs.182.00±23.71,P＜0.01),IL-2 (26.67±2.96 vs.318.30± 18.62,P＜0.01),IL-4 (17.00±3.78 vs.45.33±3.48,P＜0.01),IL-10(7.00±1.00vs.158.70±10.90,P＜0.001) and IL-17 (0.66 ± 0.33 vs.238.30 ± 24.39,P＜0.001).Furthermore,imDC induced more CD4+ FoxP3+ Tregs than mDC after adding IL-2 and TGF-β1 in the coculture system for 7 days (22.70 ± 1.53 ％ vs.5.42 ± 1.27％,P＜0.01).Conclusion imDC are more effective to induce na ve T cells to Tregs,but not differentiate to TH 1/TH 2/TH 17 cells.These findings provide in vitro experimental evidence for induction of transplant tolerance by adoptive transfer of imDC.

Objective To investigate the prevalence of drug-resistant mutations in reverse transcriptase and protease coding regions of HIV-1 in treatment-na(i)ve patients. MethodsPlasma specimens were collected from 88 patients from Zhejiang, Shanghai, Henan and Anhui. The entire protease gene and the first 1-251 amino acids of the reverse transcriptase gene were amplified by RT-PCR from viral RNA and sequenced. The sequences were analyzed with HIV drug resistance algorithm, and phyligenetic analyses were performed by PHYLIP software. SPSS 13.0 was used for statistical analysis, and Fisher' s exact test was performed to compare the proportions of each subtype between the groups. Results79 gene sequences were obtained, subtyping analyses indicated that 68.4％ (54/79) were subtype B, followed by CRF01 _AE 24.8％ (22/79), CRF07_BC2.5％ (2/79),andCRF08_BC1.3％ (1/79). 7 (7/79,8.9％)presented with primary mutations associated with resistance to antiretroviral drugs, mutations conferring primary resistance to nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors ( NNRTIs ) were detected in 3 ( 3. 8％ ) and 4 ( 5. 1％ ) cases, respectively. Protease inhibitors (Pls)associated primary resistance mutations were not found.Conclusion Antiretroviral drug resistant mutations have been found in treatment-na(i)ve patients with HIV-1 infections, while the prevalence level is low, which indicates that drug resistance test is not necessary for most HIV-1infected treatment-na(i)ve patients.

Oxaliplatin-loaded nanostuctured lipid carriers (OP-NLC) were prepared by ultrasonic emulsification method. And its optimal prescription was selected by orthogonal design. The laser light scattering technique, zeta potential analyzer, TEM, DSC, XRD and HPLC were employed to study the physicochemical parameters of OP-NLC, which displayed in terms of particle size, zeta potential, crystalline, drug loading and encapsulation efficiency. The results showed that OP-NLC had an average diameter of (111 +/- 20) nm, zeta potential of (-27.4 +/- 13.1) mV, encapsulation efficiency of (77.4 +/- 2.5) % and drug content of (0.8 +/- 1.5) mg mL(-1). TEM, DSC and XRD indicated that OP-NLC was spherical and the drug was dispersed as nanoparticles by means of non-crystalline. The in vitro release test showed that the drug could be sustained-released from NLC in buffer solution (pH 4.5) after a burst release in initial phase.