Objective To study the changes of the number of circulating endothelial cells (CEC) and blood lipid level in critically ill patients and their clinical significance. Methods The CECs were separated by using isopyknic centrifugation method and blood lipid level was determined in 35 critically ill patients and 20 healthy controls. CEC number and blood lipid level were compared between the two groups. And the correlation of CEC number and blood lipid level was analyzed. Clinical data from the critically ill patients was evaluated with acute physiology and chronic health evaluation Ⅱ; the correlation analysis of APACHEⅡscore, CEC number and blood lipid level was made. Results CEC number in the critically ill patients was significantly higher than that in healthy controls(P

Objective To detect and determine the expression and significance of MHC class Ⅰ chain-related gene A/B (MICA/B) and membrane MIC molecules (mMIC) on the bone marrow mononuclear cells (MNC) of patients with acute leukemia (AL). Methods Expression of MICA/B gene was detected by semi-quantitative reverse transcriptaso polymerase chain reaction (RT-PCR) in MIC-pesitive K562 cell line, bone marrow MNC from 10 healthy people and 69 cases of acute leukemia (AL). Expression of mMIC was detected by Western blotting. The differences of the expression of MIC gene and mMIC between AML and ALL were compared. The prognosis was determined by chromosome type between patients with mMIC+ and mMIC-. Results The expression of MIC gene and mMIC could not be detected in healthy people. The expression rate of MICA gene was 49.28% and the MICB gene was 42.03% and the mMIC was 34.78% in patients with AL. In AML group, the expression rate of MICA gene was 60.00%, and the expression rate of MICB gene was 53.33%, and the expression rate of mMIC was 44.44%. But in ALL group, the expression rate of MICA gene was 29.17%, of MICB gene 20.83%, and of mMIC 16.67%. The expression of MICA/B gene and mMIC in AML group were higher than that in ALL group (P<0.05). The prognosis of patients with mMIC+ is better than the ones with mMIC-. Conclusion The up-regnlation of MIC gene and mMIC in bone marrow MNC from patients of AL may have some relationship with the occurrence of AL The expression of MIC gene and mMIC is high in AML and low or devoid in ALL, which would be an possible mechanism that ALL cells were easy to escape killing from NK and CTL cells. Determined by chromosome type, the prognosis of AL with mMIC positive was better than the ones with mMIC negative. MIC might be one of the factors to determine the prognosis of AL.

Objective To study the variety and significance of immune function in lung cancer patients.Methods 68 pretherapy lung cancer patients and 20 healthy volunteers with peripheral blood samples by flow cytometry.Results The proportion of CD+3T cells,CD+4T cells and the ratio of CD4/CD8 decreased in lung cancer patients,while the proportion of CD+8T cells and natural killer cells increased.Serum levels of TNF-α,IL-4,IL-6,IL-10 were significantly increased in patients compared with healthy controls,while the ratio of Th1/Th2 was decreased.(2)The natural killer cells level was negatively correlated with the CD3,CD4,CD8 levels respectively.The CD4 level was negatively correlated with the levels of IL-6,IL-10 respectively.(3)No statistically significant relationship was found between the peripheral blood lymphocyte,Th1-Th2 cytokines and pathological type,lymph node metastasis,distant metastasis.Conclusion Immune suppression was very common in lung cancer patients,particularly cell mediated immunity suppressed markedly.The proportion and function of CD+4T cells decreased significantly.which may resulted from the Th1,Th2 imbalance.Natural killer cells and CD+8T cells increased significantly,but could not prevent tumor development,which may resulted from these factors that suppress immune response in tumor microenvironment.

Objective To explore the effect of apolipoprotein E deficiency on astrocyte destruction in the ex vivo spinal cord slice model. Methods Vibratome-cut transverse spinal cord slices from C57BL/6 postnatal day 7 ApoE -/-mice and wild-type mice were cultured on transwell porous supports. After 7 days in the culture , spinal cord slices were exposed to LPS for 5 days. The expression of AQP4, GFAP and Iba1 was detected by immunofluorescence. The concentration of TNF-α and NO were detected by ELISA and method of nitrate reductase, respectively. Results Marked loss of AQP4 and GFAP staining were shown in LPS-affected groups, not in the control group, and the lesion score was higher in ApoE-/-group than WT-group (P<0.05). In addition, the expression of Iba1 and concentration of TNF-α, NO in the LPS-affected groups were more than that of the control group (P < 0.05), and they were higher in the ApoE-/-LPS group than the WT-LPS group (P < 0.05). Conclusions ApoE deficiency exacerbates astrocyte injury, likely through promoting the release of pro-inflammatory mediators from microglia.

Objective To explore the heredity susceptibility of children to Kawasaki disease (KD) through studying expression and genomic density polymorphism of peripheral erythrocyte complement receptor-1 (ECRI). Methods Thirty cases of KD patients and 28 cases of healthy children were included in this study. The rates of red blood cell (RBC)-C3bRR and RBC-ICR were detected by method described elsewhere. The ECR1 activity and genomic density polymorphism were detected by Hind Ⅲ restriction enzyme digestion polymerase chain reaction-restriction fragment length polymorphism. Results Rates of RBCoC3bRR of KD patients during the acute phase was significantly lower than that of the control group (P < 0.01), and remained lower than the control group during the recovering phase (P < 0.05). The rates of RBC-ICR were significantly higher in KD patients than that of the control group (P < 0.05). Frequencies of HL and LL genotypes of KD patients were more than those of the control group (P < 0.01). A significant difference was found in the frequency distribution of ECR1 genotype between the two groups (P < 0.01). L allele frequency in the patient group was higher than that in the control group. Conclusions Depressed RBC immune function in KD patients may be linked to the high frequency of L allele, which implies the genomic density polymorphism of ECR1 play an important role in determining susceptibility to Kawasaki disease. (J Clin Pediatr,2010,28(2):160-163)

Objective:To explore the effect of family function combined with positive suggestion on self-assessment and quality of life of patients with ischemic stroke.Methods:Totally 120 patients with ischemic stroke admitted to hospital from May 2018 to May 2019 were selected by experimental research method, and they were divided into control group and observation group according to the random alphabet, with 60 cases in each, the control group was given positive suggestion, while the observation group was given family function combined positive suggestion, the Activities of Daily Life (ADL), General Self-Efficacy Scale (GSES), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), the MOS item short form Health Survey (SF-36) were compared before and after nursing and nursing satisfaction.Results:Before nursing, the ADL scores of the observation group and the control group were (34.61±4.36), (35.58±4.82) points, GSES scores were (17.94±2.48), (17.38±2.62) points, SAS scores were (61.82±6.57), (61.37±6.64) points, SDS scores were (63.71±6.65), (63.28±6.94) points respectively, and there was no significant difference between the two groups ( P> 0.05); after nursing, the ADL score of the observation group was (69.85±7.84) points, higher than (58.39±6.72) points of the control group, the GSES score was (24.25±2.69) points, higher than (20.48±2.31) points of the control group, the SAS score was (47.64±4.91) points, lower than (54.52±5.83) points of the control group, and the SDS score was (50.29±5.26) points,lower than (54.15±5.91) points of the control group ( t values were from 3.779 to 8.597, P< 0.05). There was no significant difference in SF-36 score between the two groups before nursing ( P> 0.05), and the improvement of the observation group was significantly better than that of the control group after nursing ( t values were 2.037-3.656, P< 0.05). The nursing satisfaction of the observation group was 90.00% (54/60), higher than 75.00% (45/60) of the control group ( χ2 value was 4.675, P< 0.05). Conclusion:Family function combined with positive suggestion can significantly improve the life ability and self-efficacy of patients with ischemic stroke, relieve anxiety and depression, significantly improve the quality of life, and obtain satisfactory nursing effect.

This paper described main practices and development status of transfusion medicine education at home and abroad. Transfusion medicine education in foreign counties is characterized by early development of discipline construction, complete system of transfusion medicine education, mature model for training transfusion specialists, complete certification system for vocational skills as well as flexible and diverse teaching of transfusion medicine. Our country should learn from the mature experience and practices of foreign countries and speed up the introduction of national policies related to transfusion medicine education; establish a reasonable training model for medical students in blood transfusion major; strengthen the in-service continuing education for blood transfusion practitioners.

Objective:To analyze the risk factors associated with hemorrhagic complications at the puncture site after femoral artery access cerebrovascular interventions and construct a bleeding risk scale.Methods:Two hundred and fifteen patients who underwent femoral artery puncture interventions in the neurointerventional department ward of the First Affiliated Hospital of Zhengzhou University from April to October 2020 were selected for the study, including 60 cases in the complication group and 155 cases in the control group. The patients′ general data, interventional procedure-related data and laboratory tests were analyzed univariately and then incorporated into a binary multi-factor logistic regression analysis to determine independent risk factors, and a bleeding risk scale was constructed according to the regression model.Results:Compared with the control group, there was a statistically significant increase in the incidence of women, diabetes mellitus, use of glucose-lowering drugs, proportion of (anticoagulant/antiplatelet drugs) use and irritability in the complication group ( χ2 values were 4.94-15.81, all P<0.05); age, BMI, HbA1c, prothrombin time activity, and sheath size and operative time were higher than those of the control group, and prothrombin time and creatinine values were lower than those of the control group, with statistically significant differences ( t values of -6.25 to 2.80, respectively, all P<0.05). Multifactorial logistic regression analysis showed that gender ( OR=0.09, 95% CI 0.025-0.302), BMI ( OR=1.736, 95% CI 1.462-2.115), HbA1c ( OR=1.775, 95% CI 1.107-2.845), and use of anticoagulant/antiplatelet drugs ( OR= 0.082, 95% CI 0.015- 0.448) and time to surgery ( OR=1.031, 95% CI 1.012-1.052) were independent risk factors for bleeding complications. In the risk scale: the total score was -3 to 13, and risk existed for a score ≥5. The sensitivity of this scale was 83.3%, the specificity was 92.3%, and the area under the ROC curve was 0.878 ( P<0.001, 95% CI 0.818 to 0.938). Conclusions:Female, high BMI, high HbA1c, anticoagulant/antiplatelet drug use, and long procedure time can increase the risk of bleeding complications at the femoral artery puncture. The predictive model has good predictive performance and can be extended for use.

Objective To evaluate the clinical value of Chinese Multi-Dimensional Health Assessment Questionnaire (MDHAQ-C) in patients with rheumatoid arthritis (RA). Methods From December 2015 to October 2016,four hundred and twelve RA patients were recruited in this study and completed the MDHAQ-C independently and routine assessment of patient index data 3 (RAPID3) was calculated. Then correlations were assessed by Spearman correlation coefficient of RAPID3 with indices of clinical relevance and disease activity to evaluate its clinical values. Results MDHAQ-C is moderately correlated with ESR (r=0.399), CRP (r=0.381), SJC (r=0.499), TJC (r=0.558) (P<0.01), but highly correlation with VAS of pain (r=0.836), VAS of global status (r=0.915) and overall assessment of physician (r=0.784)(P<0.01), and highly correlated with a Spearman's coefficient of 0.784 for DAS 28-ESR, 0.734 for CDAI and 0.682 for SDAI (P<0.001). Conclusion MDHAQ is a reliable, valid instrument for disease activity assessment and a feasible index for clinical settings in Chinese RA patients.

Objective To retrieve,evaluate and summarize the best pertinent evidence on the placement and management of peripheral arterial catheters in critically ill children at home and abroad for clinical references.Methods A systematic search was conducted in related databases on the evidence of the placement and management of peripheral arterial catheters in critically ill children.The spectrum of eligible documents included clinical decisions,guidelines,evidence summaries,systematic reviews,expert consensuses,and norms.The search period was from the establishment of the databases to April 30,2023.The included literature was limited to English and Chinese languages.The quality of the literature was independently evaluated by evidence-based trained investigators and combined with professional judgment to extract information from the literature that met the quality standards.Results A total of 18 articles were included,including 3 guidelines,3 clinical decisions,8 evidence summaries,3 systematic reviews and 1 expert consensus.The best evidence included a total of 27 pieces of evidence in 4 areas,namely the assessment of indwelling peripheral arterial catheters,placement of peripheral arterial catheters,maintenance during the duration of indwelling peripheral arterial catheters,and removal.Conclusion This study summarized the most robust evidence pertaining to the management of peripheral arterial catheters in critically ill children,and provided an evidence-based basis for the standardized placement and management of peripheral arterial catheters in critically ill children.Nursing staff should carefully select and apply evidence according to the actual clinical situation,the wishes of children and parents.