Objective To study the effects and mechanisms of major immune nutrients and to introduce the progresses of clinical applications about enteral immunonutrition.Methods The related literatures about the effects and clinical applications of enteral immunonutrition were reviewed.Results Infection rate can be reduced and the hospitalization can be shortened as a result of the improved nutritional status and immune competence of patients which can be enhanced by reasonable enteral immune nutrition.Most of the patients suffering from serious diseases can benefit from enteral immunonutrition,such as gastrointestinal cancers,post-transplantation complications,chronic liver disorders,acute pancreatitis and so on.However,as a new nutrition therapy,the clinical use of enteral immunonutrition in critically ill patients is still controversial.Conclusions Enteral immunonutrition plays an important role in the nutritional support of patients with serious diseases,such as gastrointestinal cancers,organ failures.However,much work remains to be done.

Osteogenic differentiation of mesenchymal stem cells (MSCs) is an important link of bone metabolism and bone repair, the mechanism of which is usually complicated. Recent studies have found that BMP, FGF, Wnt, Hedgehog, NELL1, IGF, Notch and othersignaling molecules are involved in the regulation of osteogenic differentiation of MSCs. These signaling molecules themselves have been shown to have a strong ability to promote osteogenic differentiation. They can activate the corresponding receptors by specific ligands, thus initiating the specific signal transduction pathways in the cell, and finally promote the transcription and translation of the genes related to bone formation. Furthermore, all the signaling pathways form a complex network which regulates and influences the osteogenic differentiation ofMSCs. Further researches on the mechanism of the interaction of these signaling pathways is of great significance in promoting the development of bone tissue engineering and the treatment of bone metabolic diseases.

Object:To investigate the expression of cell cyclin G2 (CCNG2) in glioblastoma tissues and to explore the correla-tion of CCNG2 expression with clinicopathological parameters and clinical significance. Methods:Surgical specimens of glioblastoma were collected from a total of 129 cases. The expression of CCNG2 in 109 specimens with complete clinical data was examined via QRT-PCR and immunohistochemistry. Results:The expression of CCNG2 was significantly decreased in higher stages of glioblastoma compared with those in lower stages. Therefore, CCNG2 is inversely correlated with the stage of the disease. The expression of CCNG2 was associated with tumor stage, sensitivity to chemotherapy and radiotherapy, as well as survival times (P<0.05). CCGN2 was not cor-related with gender and age (P>0.05). Conclusion: CCNG2 expression may be associated with the development, treatment efficacy, and prognosis of glioblastoma. In addition, CCGN2 can be used to evaluate the malignant behavior of glioblastoma.

Objective To explore the relationship between Lp (a)level and age,gender in Nanjing area.Methods 8 442 ser-um specimens from examination individuals were collected in the First Affiliated Hospital of Nanjing Medical University in 2014.Lp (a)was measured by immune turbidimetry method.All the subjects were divided into six groups:15~29,30~44, 45~59,60~69,70~79 and ≥80 years old.SPSS21.0 software was used to carry out statistics.Results The Lp(a)level in female [134±197 mg/L (M±QR,the same below)]was higher than that in male significantly (U =8 355 137,P <0.001). LP (a)levels from people of different sex correlated with the age weakly (r =0.154,P <0.001),and increased with age groups.Lp(a)of six groups in male were 106.5± 151.0,119.0± 170.0,128.0± 179.0,159.0±206.0,145.0±200.0 and 162.0± 190.0 mg/L respectively.The difference was statistically significant between between 1 and 2 groups,2 and 3 groups,3 and 4 groups,theU value were 645 152.5,1 006 572.0,197 595.0 respectively;P all<0.05.The difference was not statistically significant between 4 and 5 groups,5 and 6 groups,3 and 4 groups,theU value were 59 127.0 and 15 959.5 respectively,P >0.05.Lp(a)of six groups in female were 128.0 ± 194.0,128.0 ± 187.0,139.0 ± 207.0,157.0 ± 228.0, 173.5±227.0 and 150.0±201.0 mg/L.The difference was statistically significant between 2 and 3 groups,theU value was 641 147,P =0.006,respectively.The difference was not statistically significant between 1 and 2 groups,3 and 4 groups,4 and 5 groups,5 and 6 groups,theU value were 783 676,92 442.5,16 069.5 and 3 038,respectively;P all>0.05.Conclusion Lp (a)level in healthy population in Nanjing area is related to gender and age groups,it is necessary to establish different reference ranges.

Objective To isolate the rat insulin gene enhancer binding protein 1(Islet-1)gene and construct plEGFP-C1-Islet-1 recombinant retroviral expression vector.Methods The cDNA encoding the rat Islet-1 gene was isolated by RT-PCR method,the cDNA was first cloned into PGET-1 TA vector to facilitate the sequence and then subcloned into the retroviral vector plEGFP-C1.plEGFP-C1-Islet-1 was transfected into PA317 packaging cells with lipofectamine 2000.Transformants were selected in medium containing G418.Results A 1 050 bp DNA fragment was obtained by RT-PCR;plEGFP-C1-Islet-1 recombinant retroviral expression vector was identified by restrictive enzymes digestion,PA317 cells transfected with recombinant vector expressed enhancer green fluorescent protein(EGFP).Conclusion The gene encoding the rat Islet-1 is obtained and plEGFP-C1-Islet-1 expression vector is constructed successfully.

Abstract: Objective To analyze the changes in the pathogen spectrum of severe lower respiratory tract viral infections in children before and during the outbreak of the COVID-19 pandemic, and to explore the epidemiological characteristics to provide a basis for preventing respiratory viral infections. Methods We conducted a retrospective analysis of clinical data from patients with severe viral pneumonia admitted to the pediatric intensive care unit (PICU) of Shenzhen Children's Hospital from January 2017 to December 2021. Taking the outbreak of the COVID-19 pandemic as the cut-off point, it is separated into the period before the outbreak of the COVID-19 pandemic and the period during the pandemic. Virus spectrum and clinical data between the two groups were analyzed using the chi-square test or Fisher's exact probability method. Results A total of 712 cases of severe viral pneumonia were reported, including 469 males and 243 females, with a median age of 1.25 (0.50, 3.83) years. Among them, 495 cases were under 3 years old, and 626 cases were under 6 years old. The median duration of illness before admission to the PICU was 3.00 (2.00, 5.00) days. Hospital-acquired infections were seen in 6.88% of the children. Firty-four children had been hospitalized ≥2 times due to repeated infections. The detected viruses were influenza viruses (IVA and IVB) in 223 cases (160 IVA and 70 IVB), respiratory syncytial virus (RSV) in 215 cases, human rhinovirus (HRV) in 125 cases, adenovirus (ADV) in 91 cases, human parainfluenza viruses (HPIV) in 53 cases, human bocavirus (HBoV) in 34 cases, cytomegalovirus (CMV) in 26 cases, human metapneumovirus (HMPV) in 17 cases, and human coronavirus (HCoV) in 7 cases. A total of 634 cases were infected with a single virus, while 78 cases were infected with multiple viruses. The top three viruses, sorted by age, were as follows: <1 year: RSV, IVA/B, and HRV; 1-<3 years: IVA/B, RSV, and ADV; 3-<6 years and 6-<10 years: IVA/B, HRV, and ADV; 10-<14 years: HRV, IVA/B, and CMV; sorted by time distribution: March-May and June-August: RSV, IVA/B, and ADV; September-November: RSV, HRV, and IVA/B; December-February: IVA/B, RSV, and HRV. Before the COVID-19 epidemic, the top three viruses were IVA/B, RSV, and ADV, while during the COVID-19 epidemic were HRV, RSV, and HPIV. Conclusions During the COVID-19 pandemic, the viral spectrum of severe lower respiratory tract viral infections in the PICU changed. Before the pandemic, IVA/B, RSV, and ADV were prevalent, while during the pandemic, HRV, RSV, and HPIV were more prevalent. The viral spectrum varies among children of different age groups and in different months.

Objective To investigate the probabilities of brain-derived stem cells from fetal rats differentiating into neurons and astrocytes by velvet antler polypeptide(VAP) in vitro. Methods Neural stem cells from E12-14d rats were cultured for 7 days until neural stem cells (NSCs) aggregations were formed into neurospheres. The neurospheres were cultured at different concentrations of VAP, and immunocytochemistry was used to detect the differentiation of neural stem cells. Results The differentiated cells in 50?g/L VAP group are more than that in control group; the number of NSE positive cells in 50?g/L,100?g/L and 200?g/L groups is more than that in control group.Conclusion Neural stem cells can be successfully induced into neurons by VAP in vitro, which could provide a basis for regeneration of nerve system.;

Objective To investigate the relationship between interleukin (IL)-28B gene polymorphisms (rs12979860 and rs8099917) and treatment response in patients with chronic hepatitis C in China.Methods Taqman probes single nucleotide polymorphism genotyping methods were used to detect the genotypes of rs12979860 (C/T) and rs8099917 (T/G) located at IL-28B gene in 105 included patients.The patients were treated with standard doses of pegylated interferon plus ribavirin and were followed up regularly for therapeutic response and adverse reaction.The relationship between IL-28B gene polymorphism and antiviral treatment response of patients were analyzed.Categorical data were analyzed using Pearson chi-square test or Fisher exact test.Results Totally 105 cases were included in our study and 2 cases lost to follow-up because of moving away.Eight-one cases (78.6%) of the remaining 103 patients were CC/TT genotype (CC/TT group) at rs12979860 and rs8099917, 19 cases (18.4%) were CT/TG (CT/TG group) and 3 cases (2.9%)were TT/TG (TT/TG group).No other genotypes were detected and linkage disequilibrium was discovered at the two polymorphism loci (r2=0.11).After 4 weeks of treatment, 35 cases (43.2%) in CC/TT group, 3 cases (15.8%) in CT/TG group and non in TT/TG group achieved rapid virological response (RVR).There were statistically significant differences among three groups (P=0.033).After 12 weeks of treatment, 45 cases (55.6%) in CC/TT group, 6 cases (31.6%) in CT/TG group and none in TT/TG group achieved early virological response (EVR).There were statistically significant differences among three groups (P=0.025).At the end of the treatment, 68 cases (83.9%) in CC/TT group, 10 cases (52.6%) in CT/TG group and only 1 case (33.3%) in TT/TG group achieved end-of-treatment response (ETR).There were significant statistical differences among the three groups (P=0.003).After 24 weeks of follow-up, 62 cases (76.5%) in CC/TT group, 9 cases (47.4%) in CT/TG group and 1 case (33.3%) in TT/TG group achieved sustained virological response (SVR).There were statistically significant differences among the three groups (P=0.014).One hundred and one cases in CC/TT group developed adverse events, among them 19 cases needed clinical treatment.There were 43 cases in CT/TG group developed adverse events and 9 cases needed treatment.Seven cases in TT/TG group developed adverse events and only 1 case needed treatment.There were no statistically significant difference among three groups (χ2=0.139,P>0.05).Conclusions The genotype of rs12979860 (C/T) and rs8099917 (T/G) at IL-28B gene could affect the treatment response in patients with chronic hepatitis C.RVR and SVR are higher in patients with genotype CC/TT, which might help to guide HCV treatment.

Objective To seek a method to correct the bent cartilaginous vault.Methods This study included 18 patients (12 women,6 men,aged 18-45 years) suffering from the bent cartilaginous vault with the various degrees of nasal obstruction from January 2005 to December 2009.A open surgical approach was adopted to allow correction of the dorsal and caudal deviations of the nasal septum without weakening its structural support to the dorsum or nasal tip.The approach depended on full mobilization of deviated cartilage,removal of the deviated part of the quadrangular cartilage,followed by straightening of a caudal septal extension graft and its fixation in the corrected position.Rhinoplasty was performed to correct bent cartilaginous vault.Results A satisfactory result was gained in all clinical cases,except a septum still to remain light tilt (not affect the breathing function).Follwing-up for 3-24 months,all cases dorsum of nose was straighten and nasal septum situated mediately.All patients indicated cosmetic satisfaction of nasal dorsum and tip and improvement in nasal obstruction.No nasal deformity and septum tresis was found in all patients.Conclusions ()pen rhinoplasty is a helpful technique in the treatment of the bent cartilaginous vault.Septal surgery is necessary in the patients with cartilage framework,not only to improve breathing but also to achieve a straight,symmetrical and external nose as well.

Objective To investigate the effects of mechanicl ventilation with lower tidal volume and positive end-expiratory pressure (PEEP) on pulmonary function during laparoscopic surgery in patients with chronic obstructive pulmonary disease (COPD).Methods Forty patients with COPD,aged 60-82 yr,with body mass index of 16-29 kg/m2,undergoing elective laparoscopic surgery,were randomly divided into 2 groups (n =20 each) using a random number table:conventional ventilation group (group Ⅰ) and mechanical ventilation with lower tidal volume and PEEP group (group Ⅱ).Anesthesia was induced with midazolam,sufentanil,cisatracurium and propofol and maintained with iv infusion of propofol,cisawacurium and remifentanil.The patients were endotracheally ventilated and mechanically ventilated.In group Ⅰ,fresh gas flow was set at 2 L/min,VT at 10 ml/kg,and I∶E at 1∶2 during ventilation.In group Ⅱ,fresh gas flow was set at 2 L/min,VT at 6 ml/kg,I∶E at 1∶2 and PEEP at 6 cm H2O during ventilation.PErCO2 was maintained at 35-45 mm Hg in both groups.Airway peak pressure (Pp~),airway plateau pressure (Pplat),airway resistance (Raw) and dynamic lung compliance (Cdyn) were measured at 5 min after intubation (T1),45 min of pneumoperitoneum (T2),and 15 min after the end of pneumoperitoneum (T3).Arterial blood samples were obtained at T1,T2 and T3 for blood gas analysis.Alveolar-arterial oxygen gradiant (A-aDO2),oxygenation index (PaO2/FiO2),respiratory index (RI) and physiologic dead space fraction (VD/VT) were calculated.The extubation time and development of complications were recorded within 48 h after operation.Results Compared with group Ⅰ,Ppeak and Plat at T2 and Raw at T1,2 were significantly decreased,Cdyn at T2 and PaO2/FiO2 at T1-3 were significantly increased,RI,VD/VT and A-aDO2 were significantly decreased at T1-3,and the incidence of hyoxemia,atelectasis and rales was decreased within 48 h after operation in group Ⅱ (P ＜ 0.05).There was no significant difference in the extubation time between the two groups (P ＞ 0.05).Conclusion Mechanical ventilation with lower tidal volume (6 nl/kg) and PEEP (6 cm H2O) can improve the pulmonary function during laparoscopic surgery in patients with COPD.