Enterovirus 71(EV71) infection complicated with neurogenic pulmonary edema (NPE) is an important complication and the main death cause of hand-foot-mouth disease in children. The exact pathogenesis has not yet fully understood. Peripheral sympathetic nervous system hyperexcitability has been recognized, but its central positioning and machanisms are debatable. In recent years, people emphasized the release of cytokines caused by the brainstem injury and/or systemic inflammatory response also plays a very important role in the formation of NPE.The interventions at present are mainly symptomatic treatment in the nervous system involvement, respiratory and circulatory failure. Vaccines are still in the experimental phase of exploration. There is a certain distance from clinical application.

Objective To study the effects of intra-bone marrow injection of donor bone marrow cells in combination with low dose radiation on the immunologic reaction of composite tissue allotransplantation.Methods The inbred SD rats were chosen as donors and inbred Wistar rats as recipients. Overall 40 recipients were classified into 4 groups randomly after allogeneic leg transplantation: group A received transplantation only; group B irradiation in the sublethal level (4.5 Gy?2 at a 4-h interval) and fludarabine (50 mg/kg, i.p.); group C, bone marrow cells were directly injected into the intra-bone marrow cavity of the recipients; group D, using a combination of the injection of fludarabine (50 mg/kg, i.p.), irradiation (4.5 Gy?2, at a 4-h interval) and injection of donor bone marrow cells. The rejection of grafts was observed. 120 days after induction of tolerance the mixed lymphocyte reaction (MIR) and skin grafting were examined to confirm tolerance status. To determine graft-versus-host disease (GVHD), rats in tolerance status were also histologically examined. Results As compared with other groups, mean rejection time and mean survival time of limb allografts were prolonged obviously in group D. Donor-specific tolerance was confirmed in all limb allograft recipients in group D by skin grafting and by MLR, and no signs of GVHD were also histologically examined. Conclusion Using a combination of injection of fludarabine, irradiation in the sublethal level and donor bone marrow cells, we have induced donor-specific immunological tolerance in allogeneic limb transplantation in rats without using any immnosuppressants after the operation.

Objective Molecular targeted drugs have anti-angiogenesis and anti-tumor effects.The study was to investigate the role of sunitinib on treating metastatic renal cell carcinoma ( mRCC) and its long-term efficacy and adverse reactions. Methods From November 2007 to March 2013, 281 mRCC patients were divided into two groups according to their own willingness.102 patients in the experimental group received sunitinib 50 mg per day.Pain score, metastatic focuses before and after targeted therapies were compared.179 patients in control group was treated by immunotherapy.Kaplan-Meier survival analysis was used to draw the survival curves and Cox regression model was applied in multivariate analysis. Results There was no difference between the two groups on baseline (P>0.05).In the experimental group, 78 cases were clear cell carcinoma, with remission rate 29.4%, stablity rate 53.8%and total effective rate 83.2%after treatment;15 cases were papillary renal cell carcinoma, with remission rate 33.3%, stablity ratio 46.7%and total effective rate 80.0% after treatment;9 cases were collecting duct carcinoma, with the remission rate 22.2%, the stablity ratio 55.6% and the total effective rate 77.8% after treatment.The bone scan after 1 cycle of treatment showed 2 cases progressed(10.5%), 5 cases relieved(26.3%) and 12 cases sta-blized(63.2%), the total effective rate of bone metastasis amounting to 89.5%, the effective rate of lung metastasis 81.7%, the effective rate of liver metastasis 60.0%and the effective rate of lymph node metastasis 72.8%.The median overall survival in the experimental group was 28.9 months, 20.7 months in control group(P<0.05).Cox regression analysis showed age, tumor classification, liver, lung, bone and lymph node metastasis were prognostic factors influencing mRCC.The common averse events were white blood cells, thrombocytopenia, neutropenia and hypoalbuminemia. Conclusion Sunitinib for the treatment of mRCC can diminish the metastatic focuses , ease the pain , improve the quality of life, delay the progression of the disease, and prolong the overall survival.

A total of 210 female patients with overactive bladder (OAB) were divided into M receptor blockage (M,n =71),pelvic floor muscle stimulation physiotherapy (S,n =70) and combination (C,n =69) groups.After one course of treatment,the OAB symptom scores were compared to pretreatment values (P ＜ 0.05).After a second course,the overall response rate was 69％ in group S.Pelvic floor muscle stimulation physiotherapy provided excellent sustained outcomes.

Objective To evalute the feasibility of a double hand allogroft to reconstuct the limbs'function. Methods A brain dead donor was chosen under the test of blood group in ABO and Rh,HLA match,PRA and the mixed leukocyte culture.The level of the transplantated hands was 5 cm proximal to the wrists The procedure of the allotransplantation was similar to that of the autologous replantation.The immunosuppressants were taken two days before the operation,in the operation and after the operation. The circulation,the vital signs and the rejection were under the supervision. Results The progress was satisfactory. No rejection was found postoperation.After 10 weeks the callus in both ends of radius and ulna was obvious.After 5 months sensation recovered.After 7 months the internal fixation(plates and screws) was removed and tenolysis was done. Now the recipient could use engrafted hands to wash face,make the bed,wear clothes,brush teeth,peel oranges,eat with a spoon,tie the shoelace slowly,pick up a telephoneor and use the conroller of Television. Conclusions With the immunosuppressive agents,the double hands allograft can survive.The growth rate of bone and nerve is faster than that of autologous replantation.

Objective To explore the indoor air pollution and its health effects in newly decorated rooms. Methods Indoor air sampling was conducted in rooms of 13 newly decorated apartments during the period from the 1st day to the 4th day, the 2nd month and the 6th month after the decoration. The levels of formaldehyde, benzene, o-dimthylbenzene, m-dimethylbenzene, para-dimethylbenzene in air samples were analyzed. An epidemiological investigation on the adverse response of eye and respiratory system was carried out among the family members before and after decoration. Results The levels of formaldehyde, benzene and dimethylbenzene in indoor air exceeded ther related standards more than 2.92 times, 7.4-11.3 times, 58.2-87.1 times respectively, and showed a decreasing trend with the prolongation of time after decoration. The positive rates of shedding tears and sneezing, branchitis or cough, asthma, dizziness among family members were 0%, 3.0%, 3.0%, 0% respectirely before decoration and rose to 24.2%, 7.6%, 6.1%, 7.6% respectively after decoration. Conclusion The indoor decoration resulted in the indoor air pollution by formaldehyde and benzene compounds, the contamination degree showed a positive correlation with the degree of complicated decoration and was associated with the quality of decorative materials. Indoor decoration also resulted in the increasing positive rates of adverse response of eye and respiratory system.

CO2.

Objective To study the effects of air quality on the the respiratory system of pupils. Methods Based on the routine monitoring data of Nanning City from Nanning environmental monitor station , all pupils from three elementary schools which located in heavy polluted area, middle polluted area and light polluted area respectively were investigated. The atmosphere quality was assessed with Shanghai Atmosphere Environmental Index. The illness data were collected by epidemiological investigation, questionnaire and physical examination. Chi-square test and Logistic regression were employed in the statistic analysis. Results The morbidity of bronchitis, pneumonia, asthma, rhinitis, etc. in pupils lived in heavy polluted area was higher than that in light polluted area (P

Objective: To investigate the mechanism that glutamine downregulates the cytokine expression in lipopolysaccharide-stimulated human peripheral blood mononuclear cells.Methods:PMBC were extracted from healthy volunteer by density gradient centrifugation,and stimulated by lipopolysaccharide.The release of TNF-α and IL-10 was analyzed via enzyme-linked immunosorbent assay and p-P38 via western blot. Results:Gln led to an increase in HSP70 expression,and decreased TNF-α、IL-10 release at 4 h after LPS stimulation.The expressions level of TNF-α、IL-10 and P-P38 were decreased after using SB203580.Conclusion:These results indicate that the effect of Gln could attenuate cytokine release in PBMC and might may be related to the inhibition of P38 MAPK.

Objective To analyze the correlation between the resistance of Acinetobacter baumannii and the utilization of antimicrobial agents in the hospitalized patients of Beijng Chuiyangliu Hospital,and provide the basis for clinical rational use antimicrobial agents.Methods A retrospective analysis was conducted for the drug resistance rate and specimen source of the 2 194 strains of Acinetobacter baumannii from 2010 to 2014 in the hospital and DDDs/DUI of antimicrobial agents was analyzed by Pearson correlation.Results The resistance rate of Acinetobacter baumannii was positively correlated with the DDDs and DUI of imipenem/cilastatin(r=0.991,0.994,all P<0.01), and was positively correlated with the DDDs of cefepime(r=0.934,P=0.020).The resistance rate of Acinetobacter baumannii to amikacin was positively correlated with the DDDs of etimicin(r=0.931,P=0.022).The resistance rate of Acinetobacter baumannii was negatively correlated with the DUI of levofloxacin(r =-0.986,P =0.002). Conclusion The resistance rate of Acinetobacter baumannii was high and there was correlation between the drug resistance and the utilization of some antimicrobial agents.