Objective To observe the variations of the functional states of T helper cells(Th) in peripheral blood of children with mycoplasma pneumoniae pneumonia(MPP) in acute phase,and to explore their roles in the pathogenesis of MPP.Methods Peripheral blood mononuclear cells(PBMC) of 40 MPP children were stimulated with PMA and ionomycin and cultured in vitro for 48 hours.The levels of IL-4,IFN-?,and TGF-?1 in the supernatants of PBMC were detected by ELISA.Results The levels of IFN-? and the ratio of IFN-?/IL-4 of MPP children in acute phase were significantly lower than those of the controls(P0.05).Conclusions The function of Th2 relatively prevails over Th1 in MPP children.The protective or regulative function of Th3 in vivo increases,but the protective regulation of TGF-?1 is insufficient,so the imbalance of Th1/Th2 can not be corrected.The variation of the functional states of T helper cells in acute phase has no relationship with or without the extrapulmonary damage.

In the perspective of medical ethics,doctor-patient relationship is a particular kind of social relations that contains a combination of factors such as biological,psychological and social basis,including certain moral standards and ethical norms formed.Ethical property is a fundamental property of the doctor-patient relationship.In current medical practice,doctor-patient relationship unprecedented tensions,conflicts between doctors and patients,the frequent occurrence of medical trouble,has become the social factors of disharmony and highly attention.In order to make the medical humanity regression and construct a new doctor-patient relationship reflecting equality and cooperation,with medical ethics as the angle of view,the author the author has discussed and demonstrated how to improve doctor-patient ethics accomplishment,rebuild the doctor-patient relationship of trust,reshape the respect for life and personality of medical humanism spirit,safeguard the equality of the subject position of both doctors and patients,and how to provide humane medical services etc.in order to indicate the direction for the deepening of China's reform of the medical system and provides theoretical support.

Objective To assess the cerebrovascular reactivity (CVR) in health subjects and patients with risk factors by means of transcranial Doppler ultrasonography (TCD) with breath-holding maneuver, and its association with risk factors of cerebrovascular disease.Methods The breath-holding index (BHI), which was the percentage increase in middle cerebral artery(MCA)blood flow velocity and was as index of CVR assessment, was detected during breath-holding by TCD and breath-holding technique in 137 patients with various risk-factors of cerebrovascular disease and 87 normal controls.The regression analysis was done between the CVR and risk factors.Results The mean blood velocity before (Vm) and after holding test (Vm′) were significantly lower in group with age of 20-40 years than that of the age of 41-60 and over 60 years(all P

Objective To explore the changes of cerebral vasoreactivity(CVR) in patients with acute cerebral infarction of various clinical subtypes.Methods The 70 patients with acute cerebral infarction were divided into 3 subtypes:atherothrombotic infarction (AI)group(n=22), lacunar infarction (LI)group(n=33), cardiogenic infarction (CI)group(n=15).The mean blood flow velocity (Vm), pulse index(PI), resistance index(RI) in bilateral middle cerebral artery(MCA) were detected, and breath holding index (BHI) was measured by TCD in these patients through breath holding test. All the data were compared with the health controls. Results Compared with normal control group,the Vm,PI and RI were significantly increased (P0.05). Conclusions There are differents in CVR in patients with acute cerebral infarction of various subtypes. The damage of CVR is more obviously in AI and LI group. There is clinical significance for measurement of CVR to evaluate the haemodynamic changes in various subtype of acute cerebral infarction.

Objective To study the influence of anesthesia methoda on early postoperative cognitive function in elder orthopedics patients. Methods Fifty patients aged more than 65 years old with fractured femur randomly received general anesthesia(group G, 28 cases) or unilateral combined spinal epidural anesthesia(group E,22 cases). The assessment of postoperative cognitive {unction referred to the scores that achieved in neuropsychological testing with mini mental state examination (MMSE) by special psychological person on the day before and the first day after surgery. It was considered to he postoperative cognitive dysfunction (POCD) when the score was ≥1 standard deviation(SD). Results The score of MMSE was lower in group G than that in group E on the first day alter surgery(P<0. 05). The incidence of POCD on the first day after surgery was higher in group G than that in group E(42.9% vs. 13. 6%) (P<0. 05). Conclusion Compared to combined spinal epidural anesthesia, more POCD takes place in the eldedy underwent orthopedic surgery under general anesthesia.

Objective To investigate the effects of radix salvia miltiorrhizae on the apoptosis of hepatoeytes during cold preservation and reperfusion injury in rat donor liver. Methods Forty male SD rats were divided into experimental group, control group and sham operation group. The rat model of liver transplantation was established according to the Kamada method. The grafts were preserved in lactated Ringer's solution with radix salvia miltiorrhizae in experimental group and in lactated Ringer's solution in control group for 5 hours, then they were transplanted orthotopically. Six hours after transplantation, the recipients were sacrificed, and the serum ALT and AST were detected by automatic biochemistry analyzer, the hepatocyte apoptosis by TUNEL, the expression of Bcl-2 and FasL protein by flow cytometry. The histopathological changes of the liver grafts were observed under light microscope. Results The levels of ALT and AST in the experimental group were significantly lower than those in the control group after reperfusion. Compared with that in the control group, the apoptosis index of the hepatoeyte was signifieandy decreased in the experimental group ( F = 133.802, P <0.05 ), while the level of Bel-2 protein expression was increased ( F = 91.063, P < 0.01 ). No statistical difference upon FasL protein expression was detected between the 2 groups( F = 1.329, P >0.05). The histopathological injury of the liver grafts in the experimental group was significantly slighter than that in the control group. Conclusions Radix salvia mihiorrhizae inhibits the apoptosis of hepatocytes by increasing the Bcl-2 protein expression during cold preservation and reperfusion injury, so it has a protective effect on the liver graft against ischemia reperfusion injury.

Objective To analyze the image characteristics and clinical value of 18F-FDG PET/CT in patients with extranodal nasal type natural killer/T-cell lymphoma (ENKTL).Methods From January 2012 to March 2016,20 ENKTL patients (12 males,8 females;median age 53 years) who underwent whole-body 18F-FDG PET/CT were enrolled in this retrospective study.Eleven patients were newly diagnosed,and 9 were previously treated.Clinical data were collected for histopathology and bone marrow biopsy,laboratory results,PET/CT and radiological findings such as CT or MRI.The final diagnosis was based on histopathology and immunohistochemistry.Mann-Whitney u test was used to compare the SUVmax of newly diagnosed patients and patients with recurrence or disease progression after therapy.Spearman correlation analysis was used to explore the relation between diameter of tumor-invaded lymph nodes and SUVmax.Results ENKTL could be found in all parts of the body,but more frequently in the nasal cavity,nasopharynx and skin.All lesions showed high uptake of FDG on PET/CT.The SUVmax of newly diagnosed patients was significantly higher than that of patients (n=7) with recurrence or disease progression:6.5(4.3,10.4) vs 5.4(3.4,8.9);u=6 853.500,z=-2.039,P＜0.05).The diameter of tumor-invaded lymph nodes showed weakly positive correlation with SUVmax(rs =0.290,P＜0.01),suggesting that invasion of ENKTL might not be accurately evaluated by the size of lymph nodes.The staging by PET/CT was concordant with clinical final staging in 11 newly diagnosed patients,while the staging by CT or MRI was only correct in 6 patients.Conclusions PET/CT is superior to conventional imaging modalities in diagnosis and staging for patients with ENKTL.Since some lesions might be found in the limbs,limbs should be included in the scan field.

OBJECTIVE:To evaluate the effects of the individualized treatment with GIK(Glucose-insulin-potassium)polarized solution on the discharged surgical patients with hyperglycemia.METHODS:2 287 surgical patients with hyperglycemia(including 125 who had diabetes before hospitalization)receiving individualized treatment with GIK(Glucose-insulin-potassium)polarized solution and who had been discharged from hospital for 1 year were surveyed by questionnaire to collect the data of adverse drug reactions of the polarized solution.RESULTS:None of the patients had secondary diabetes mellitus,hypertension,hypoglycemia or psychological dependence on insulin;0.6% worried about the sequela of GIP;98.5% of the patients who had diabetes prior to hospitalization and have been taking insulin after been discharged from hospital agreed that the symptom of their diabetes was greatly lessened by insulin;100.0% of the patients who had diabetes prior to hospitalization and received no insulin after been discharged from hospital agreed that taking large dose of insulin during hospitalization had no effect on the symptom of their diabetes or hypertension;99.3% of patients received supplemental nutrition of polarized solution;96.9% given hyperglycemia control;38.3% received antiinflammation therapy,5.5% received protective therapy for ? cell function.CONCLUSION:Individual treatment with GIK on the surgical glycemia patients is a safe remedy without sequela.But a few of surgical glycemia patients are afraid of the ADR of the polarized solution,suggesting the importance of publicizing the use of GIK.

OBJECTIVE:To study the effects of soluble cluster differentiation 14 (sCD14) on serum pro-and anti-inflammatory cytokines in mice with serious scald endotoxemia. METHODS: A total of 60 healthy Kunming mice were randomly assigned to sCD14 (5 mg?kg-1) group, treatment control group (normal saline) and normal control group (normal saline). The first two groups were established into scald model (scald of 30% body surface area, Ⅲ degree scald) followed by intravenous injection of the corresponding drugs in every 12 h via vena caudalis for 3 consecutive days. On day 4, the model mice were sacrificed to obtain the serum sample for the detection of levels of proinflammatory cytokines (TNF?, IL-6) and anti-inflammatory cytokines (IL-4 and IL-10). RESULTS: In sCD14 treatment group, serum levels of TNF?, IL-6 were significantly lower than in treatment control group (P

Objective To evaluate the clinical significance and choicing antibiotics of serum procalcitonin (PCT) in acute fe-ver.Methods To make a retrospective analysis of 170 cases of febriledisease from January 2013 to January 2014.According to clini-cal causes of fever, the cases were divided between infectious fever group and non -infected group.The infectious group was divided by bacterial(A group) and viral infectious(B) groups.The bacterial group(A group) was divided by bloodstream infectious (A1) and fo-cal infectious(A2) groups.Tests of blood routine and CRP and PCT before or used antibiotics were analyzed and compared between the different groups.Results The PCT serum concentration of bacterial infectious gloup was higher than the viral infectious group and non-infected group( P <0.01).There wasn't significant difference in the viral infectious group and non -infected group( P >0.05). In bacterial infectious gloup, the area under ROC of PCT was 0.950 and CRP was 0.943, if PCT≥ 0.25ng/ml was regard as the cut-ff value, the sensitivity was 91.6% and the specificity was 93.3% ; if PCT≥ 0.5ng/ml was regard as the cut-ff value, the sensitivity was 95.2% and the specificity was 77.6%.Conclusions PCT tests are helpful to identify bacterial infection in patients with infec -tious fever .The more serious the higher PCT level , the earlier using antibiotics ,it is the most in bloodstream infection.There is an important significance for choicing antibiotics by the guidance of PCT ≥ 0.25ng/ml.