Objective To explore the expression and significance of chemokine CXC reeeptor (CXCR)3 and CXCR4 and their ligands(CXCL)at the early pregnancy decidua and villi.Methods Decidual mononuclear cells were isolated from the normal decidua of 5-8 weeks pregnant women by lymphocyte separation medium in vitro.CD56+natural killer(NK)cells were purified by dynabeads cell sorter kiL Purity and phenotype of CD56+decidua NK cells were analyzed by fluorescence-activated eell sorter (FACS).Gene expression of CXCR3 and CXCR4 in decidua NK cells and CXCL9,CXCL10 and CXCL12 in early pregnancy decidua and villi was assessed bv RT.PCIZ Protein expression of CXCL9,CXCL10 in normal endometrium and early pregnancy decidua was characterized and quantified by streptavidin-biotin pemxidase chain reaction(SP)immunohistochemistry and computered image analysis system.Correlations between the gray degree of CXCL9 and CXCL10 and the number of CD56+NK cells in upper tissue were analyzed by Spearman's correlation ceefficient rank tesL Results The phenotype of 98.7%decidua NK cells was CD56bright.The genes of CXCR3 and CXCR4 were expressed in decidua NK cells and that of CXCL9 and CXCL1O were expressed in early pregnancy decidua and CXCLI2 in early pregnancy villi.CXCL9 and CXCL10 were expressed in the cytoplasm of surface epithelia,glandular epithelia and stromal cells of early pregnancy deeidua and were not expressed in villi by immunohistochemistry.The gray degree of CXCL9 and CXCL10 in the secretory phase endometrium(56±43,59±47)was stronger than that in the proliferative phase(16±18,8±14,P<0.05)and reached the highest(143±35,158±29,P<0.05)in the early pregnancy decidua.The number of cD+56 NK cell in the secretory phase endometrium(60±20)was more than that in the proliferative phase endometrium(23±4,P<0.05)and was the most in the early pregnancy decidua(114±15,P<0.05).The gray degree of CXCL9 in upper tissue had a positive correlation with the number of CD+56 cells(r=0.88,P<0.05)and that of CXCL10 had a similar pattern to CXCL9(r=0.86,P<0.05).Condusion The interactions between CXCL9,CXCL10 and CXCL12 expressed in decidua and villi and CXCR3,CXCR4 expressed in CD+56 decidua NK cells may influence the CD+56 NK cell recruitment at the maternal-fetal interface.

Objective To compare the differences in curative effect between general treatment model and stroke unit model in the treatment of stroke in the elderly inpatients, to explore the standardized management model, for improving efficacy and reducing the degree of invalidity and mortality. Methods A total of 1200 cases with acute cerebrovascular disease were admitted into our department from April 2002 to April 2007. All patients were randomly assigned either into stroke unit or general ward to receive treatment, and the data of two groups were compared. The key indexes included mortality, hospitalization time, Barthel Index (BI), National Institutes of Health Stroke Scale (NIHSS) and Oxford Handicap Scale (OHS). All the patients or their family members were asked to have the Visual Analogue Scales (VAS). The data of cost and effect were analyzed with SPSS software. Results The complication rate and mortality rate were significantly lower in stroke unit group than in general ward group (P＜ 0.01). The scales of BI, NIHSS, OHS and VAS were significantly better in stroke unit group than in general ward group when discharged (P＜0.05). The hospitalization time was shorter in stroke unit group than in general ward group (P＜0.05). There was no significant difference in the costs of hospitalized patients between the two groups (P＞0.05).Conclusions Stroke unit model can improve the physical activity and life quality of patients and reduce disease mortality without increasing the cost of patients.

Objective To investigate the safety, efficacy and key points of technology of endovascular embolization for ruptured wide-necked aneurysms of anterior communicating arteries. Methods The clinical, DSA imaging, interventional treatment and follow-up data of 35 patients with ruptured wide-neck aneurysms of anterior communicating arteries were analyzed retrospectively. Results Immediate postoperative angiography of the 35 patients found 100% occlusion were achieved in 29 (82.9%), 90% occlusion were achieved in 5 (14.3%), and 80%occlusion was achieved in 1 (2.8%). One patient had occlusion in ipsilateral anterior cerebral artery , whose blood vessel was patent after thrombosis. One patient had intraoperative aneurysm rupture. One patient had cerebral infaraction of anterior cerebral artery after the operation. Clinical follow-up was made from 6 to 60 months , and no aneurysms ruptured was found. 21 patients were followed up for 6 to 60 months with DSA. Two of them experienced recurrence, and they were not treated with supplementary packing. Conclusion Endovascular embolization for ruptured wide-necked aneurysms of anterior communicating arteries is more difficult , but it is safe and effective. Flexible choosing of various kinds of embolism technique and designing the most optimal embolism treatment plan are the keys to the improvement of embolization effect.

Objective To investigate the efficacy of transarterial chemoembolization (TACE) combined with autologous DC-CIK cells in treating hepatocellular carcinoma(HCC) of BCLC C-stage. Methods A total of 60 cases with HCC in BCLC C-stage were randomly and equally divided into the study group (n=30) and the control group (n=30). TACE combined with autologous DC-CIK cells was employed in the patients of the study group, while only TACE was adopted in the patients of the control group. The immune function, six-month and one-year survival rates were determined, and the results were compared between the two groups. Results In the study group, the blood T lymphocyte subsets of CD3+CD8+ were significantly increased, while CD3+CD4+ were obviously decreased. When compared with the pretreatment levels, the differences were statistically significant (P<0.05). The six-month survival rate of the study group and the control group was 67.9% and 48.1% respectively (P<0.05), and the one-year survival rate of the study group and the control group was 53.6%and 29.6%respectively (P<0.05). Conclusion For the treatment of HCC in BCLC C-stage, the therapeutic effect of TACE combined with autologous DC-CIK cells is much better than that of pure TACE. Therefore, this therapy is an effective treatment for HCC in BCLC C-stage.

Objective To investigate the feasibility,efficacy and key points of individually designed endovascular embolization for ruptured tiny aneurysms of anterior communicating arteries. Methods The clinical,DSA imaging,interventional treatment and follow-up data of 21 patients with ruptured tiny aneurysms (21 aneurysms)of anterior communicating arteries from March 2009 to March 2014 were analyzed retrospectively. Thirteen of them were treated with coil embolization only,6 were embolized with microcatheter-assisted technique,and 2 were embolized with balloon-assisted technique. Results (1)One patient was failed to embolize because of technical reason. Immediate postoperative angiography found that in the other 20 patients:14 were packed densely,6 had residual aneurysm necks. (2)Intraoperative complications:One patient had acute occlusion of ipsilateral anterior cerebral artery,the blood vessel was patent after thrombolytic method;2 patients had intraoperative ruptured aneurysm. (3)The modified Rankin scale (mRS)scores of 20 patients with successful embolization at discharge:0-1 in 14 cases,2 in 4 cases, and 3-4 in 2 cases. (4)Follow-up study:20 patients were followed up for 12 months after discharge. The mRS scores:0-1 in 18 cases,2 in 1 case,and 3-4 in 1 case. Clinical follow-up for 6 to 60 months,no aneurysm ruptured. Fifteen patients were followed up for 6 to 60 months with DSA,one of them recurred,and he was treated with supplementary dense packing. Conclusion Endovascular embolization for ruptured tiny aneurysms of anterior communicating arteries is difficult,but it is feasible and effective. The proficient surgical skill,individualized surgical design and appropriate embolism are the keys to improve the embolization effect.

Objective To explore the characteristics and clinical significance of CD+4 CD+25 Regulatory T lymphocytes and T cell subsets in peripheral blood and malignant pleural effusion from lung cancer patients. Methods Flow cytometry was used to detect the percentage of CD+4 CD+25 regulatory T cells and T cell subsets in peripheral blood from 68 lung cancer patients and 56 healthy persons, and in pleural effusion from 32 lung cancer patients with malignant effusion. Results T lymphocyte subsets in peripheral blood of lung cancer patients in different periods were expressed differently. The percentage of CD+4 CD+25 regulatory T cells in peripheral blood were (19.52±3.32)%, (27.28±8.26)% and (32.31±15.60)% in Ⅰ+Ⅱ, Ⅲ and Ⅳ period lung cancer patients, respectively, and were higher than that of healthy volunteers (11.12±3.32) % (t =31.0040, -7.9688, -4.9770, P ＜0.05). In the lung cancer patients with malignant effusion, the percentage of CD+4 CD+25 regulatory T cells in the pleural effusion was higher than that in the peripheral blood [(34.12±18.63) % vs (26.36± 16.25)%, t =21.164, P＜0.05]. In the lung cancer patients with malignant effusion ,the percentages of CD+4 in peripheral blood and pleural effusion were (25.32±13.45) % and (34.68±12.34) %, were lower than that in healthy volunteers (t =7.3104, 4.8818, P＜0.05), the percentages of CD+56 were (8.24±7.38) % and(11.23± 7.65) %, CD+4/CD+8 were (1.02±0.56) % and (1.32±0.82)%, were lower than (18.23±9.23) % and (1.89± 0.32) % in healthy volunteers, respectively, (CD+56: t =-14.7549, -11.7216; CD+4/CD+8: t =-24.78,-4.4564, P＜0.05). Conclusion The relative increase of CD+4 CD+25 Regulatory T cells may be related to immunosuppression and tumor progression in patients with lung cancer. Conclusion The relative increase of CD+4 CD+25 regulatory T cells may be related to immunosuppression and tumor progression in patients with lung cancer.

OBJECTIVE: To analyze the effects of Astragalous Injection on oxidative stress and micro-inflammatory status in patients undergoing maintenance hemodialysis (MHD). METHODS: Sixty MHD patients were included and randomized into treatment group and control group, with another 10 healthy volunteers as normal control. The patients in the treatment group were treated with Astragalous Injection and the patients in the control group were treated with normal saline for 12 weeks. A spectrophotometric method was used for the measurement of plasma concentrations of oxidative parameters including advanced glycation end products (AGEs), advanced oxidation protein product (AOPP), malondialdehyde (MDA) and vitamin E (Vit E). The content of C-reactive protein (CRP) was evaluated by enzyme-linked immunosorbent assay. RESULTS: Compared with the normal control group, the plasma levels of AGEs, AOPP, MDA and CRP were significantly increased, while plasma level of Vit E was significantly decreased in MHD patients ( P<0.01). After Astragalous Injection treatment, the plasma levels of AGEs, AOPP, MDA and CRP were decreased as compared with the control group ( P<0.01), while there was no significant difference in plasma Vit E level between the treatment group and control group. CONCLUSION: There exist oxidative stress and micro-inflammation in MHD patients. Astragalous Injection can ameliorate the accumulation of oxidative products and micro-inflammatory status, but it has no significant effect on plasma Vit E level.

Objective To explore the effect of the rational-emotive-behavior therapy (REBT) on mood, cognition and activities of dailyliving (ADL) of patients with poststroke depression (PSD). Methods 80 PSD patients were divided into control group (n=40) and observationgroup (n=40). Both groups were given Prozac (20 mg/d) for 8 weeks, and the observation group received REBT (3 times per week, 20min every time) additionally. Hamilton Rating Scale for Depression (HAMD), Mini Mental State Examination (MMSE) and Barthel Index(BI) were evaluated before and after treatment. Results After 8-week treatment, the scores of HAMD in two groups reduced significantly(P<0.01), and the scores of MMSE and BI increased significantly (P<0.01). The scores of HAMD were lower in the observation group thanin the control group (P<0.05), and the scores of MMSE and BI were higher in the observation group than in the control group (P<0.05). TheBI score was related with sleeping disorder in control group (P<0.05). The BI score was both related with sleeping disorder and somatizationin the observation group (P<0.05). There was no significant difference in the extent of effectiveness on depression between two groups(P>0.05), but there was the trend that the efficacy of the observation group was better than the control group. Conclusion REBT combinedwith antidepressant drugs can better relieve the symptoms of depression and improve cognitive function and ADL of PSD patients. The improvementof somatization and sleep disorders by REBT has a relationship with the enhancement of ADL.

Objective To investigate procalcitonin (PCT) and C reactive protein (CRP) expression in patients with puerperal infection after cesarean section and its clinical significance.Methods From January 2014 to January 2016,134 cases of cesarean section puerperal infection patients in our hospital were enrolled in observation group,according to 1∶3 matching,we selected 402 cases of cesarean section without puerperal infection as the control group.Then the levels of PCT and CRP in two groups were detected.Results CRP and PCT levels of 24 h,48 h and 72 h of the patients in the observation group were (13.16 ± 1.06)mg/L and (1.05 ±0.42)g/L,(15.15 ± 1.50)mg/L and (1.67 ±0.31)g/L,(16.01 ± 2.32) mg/L and (2.10 ± 0.92) g/L respectively,significantly higher than the control group (P ＜ 0.05);72 h CRP and PCT levels of pelvic cavity peritonitis patients were (17.13 ± 1.46)mg/L and (2.81 ± 0.97) g/L respectively,significantly higher than that in patients with vulvovaginal and cervicitis,endometritis and fallopian tube (P ＜ 0.05);72 h CRP and PCT in patients with endometritis and fallopian tube inflammation were (15.89 ± 1.06) mg/L and (2.06 ± 0.83) g/L,significantly higher than that of vaginal and Cervicitis Patients (P ＜ 0.05).Conclusions CRP and PCT increase rapidly in patients with puerperal infection after cesarean section,and there are a certain relationship with puerperal infection disease and they are of certain clinical application value.

Objective To observe any short-term analgesic effect of using heat stimulation at acupoints for treating migraine headaches without aura.Methods Totally 120 migraine patients were randomly divided into an observation group and a control group,each of 60.Both groups was given 5mg of Sibelium orally each night for 4 weeks.The observation group additionally received heat and pain stimulation at the Feng Chi,Shuai Gu,Yang Ling Quan,Wai Guan,Tai Yang and Yin Tang acupoints.The heat was in 0.3 s pulses at 54.5° with an inter-pulse interval of 10 s.Each acupuncture point was stimulated 5 times in rotation for a total of 20 min daily for 4 weeks.The frequency of headache attacks,their duration,their intensity rated using a visual analogue scale (VAS),accompanying symptoms and responses to a migraine-specific quality of life questionnaire (MSQ) were recorded before and after the treatment.Results After the treatment there was significantly greater improvement in the observation group compared to the control group in terms of headache frequency,headache duration,VAS ratings,and accompanying symptoms.The observation group also improved significantly more in terms of the average limitation dysfunction score,dysfunction score and emotion score on the MSQ.Moreover,the total effectiveness rate of the observation group (95.0％) was significantly higher than that of the control group (80.0％).During the treatment,no adverse reactions were found in terms of heart rate or blood pressure,and no abnormal manifestations such as infection,redness or swelling were observed at the stimulation sites.Conclusion Heat and pain stimulation at acupoints has a significant short-term analgesic effect on migraine without aura.Such treatment is safe and reliable,with few side effects.It provides a new treatment method for migraine patients and is worthy of clinical promotion and application.