Objective To investigate serum NK cell levels in HBeAg positive early pregnancy women with immune activation.Methods Fifty four HBeAg positive pregnant women admitted in Taizhou People's Hospital from September 2010 to April 2013 were enrolled in the study.Among them,the serum HBV DNA load decreased ≥2 log at 12 weeks after pregnancy in 24 cases (immune activation group) and HBV DNA did not decrease in 30 cases (immune tolerance group).The serum level of alanine aminotransferase (ALT),total bilirubin,HBeAg,HBV DNA load and NK cells were measured.Results At week 12 of gestation,the mean ALT levels and ALT abnormality rate in immune active group were higher than those in immune tolerance group [(146.7 ±93.1) vs.(44.1 ± 14.7) U/L,t =2.95,P＜0.05,50.0％ vs.6.7％,x2 =4.97,P ＜0.05].There was no significant difference of HBeAg level between two groups before pregnancy,while HBeAg level in immune activation group was lower than that in immune tolerance group at week 12 week of gestation [(291.8 ± 170.5) vs.(443.7 ± 289.9) S/CO,t =2.81,P ＜0.05].The percentage and absolute number of NK cells in immune activation group were higher than those in immune tolerance group [(26.7 ±9.1)％ vs.(17.1 ±7.8)％,t =2.52,P ＜0.05 and (370.9 ±136.4)/μl vs.(213.2 ±97.8)/μl,t =2.38,P ＜0.05,respectively].Conclusions In HBeAg positive early pregnant women with immune activation,the inhibition of HBV DNA might be associated with the activation of NK cells.

Objective To analyze the curative effect of super-early keyhole surgery in treatment of hypertensive cerebral hemorrhage. Methods Clinical data of patients with hypertensive cerebral hemorrhage who received treatment in our hospital from April 2010 to October 2012 were retrospectively analyzed. Patients were divided into the observation group ( keyhole surgery group) and the control group ( routine group) by different therapeutic methods. The operation time, rate of hematoma clearance, postoperative complications, and recovery of neu-ral function of the two groups were compared. Results The observation group had a shorter operation time than the control group, and the difference was statistically significant(P<0. 001). There was no singnificant difference between the two groups in rate of hematoma clear-ance at the time of tube drawing(P>0. 05). The observation group had less postoperative complications than the control group, and the difference was statistically significant(P<0. 05). The observation group had a lower rate of metabolic disorders than the control group with a statistically significant difference(P<0. 05). Patients of the observation group had a higher scores of SSS than patients of the control group 28 days after operation, and the difference was statistically significant(P<0. 05). 6 months after operation, the observation group had a bet-ter ADL than the control group, and the difference was statistically significant(P<0. 05). Conclusion Super-early keyhole surgery which has less intraoperative injury, postoperative complication, and metabolic disorders, can achieve a better effect than routine operation. And it is of better neural functional recovery.

Objective To summarize the clinical features of the allergic bronchopulmonary aspergillosis (ABPA) in children,in order to improve the understanding for ABPA and make early diagnosis and treatment of the disease.Methods A retrospective study was performed on ABPA patients diagnosed in Department of Respiratory Medicine,Beijing Children's Hospital Affiliated to Capital Medical University from March 2010 to December 2013.The clinical features,laboratory results,image characteristics and the prognosis information were reviewed.Results Eight ABPA cases met the diagnostic criterion.All patients were school-age children (7 years and 2 months to 13 years and 8 months old).Cough (8 cases),productive sputum (8 cases),wheezing (5 cases),fever (4 cases) and hemoptysis (3 cases) were the main clinical features.Six of the 8 patients showed eosinophilia.IgE level was elevated in 7 patients (1.000-5.000 IU/L).All 8 patients were allergic to aspergillus fumigatus,while only 2 cases were positive in sputum culture for aspergillus fumigatus.CT scans showed pulmonary opacities in all 8 cases,while 7 patients had typical central bronchiectasis.Seven patients were treated with the regimen,which included glucocorticosteroid,antifungal agents (voriconazole or itraconazole) and regular bronchoscope.The symptoms of all treated patients relieved,the total serum IgE level and eosinophil cell count decreased spontaneously after the therapy.Conclusions ABPA is rare in children and the clinical features are non-specific.If the patient has elevated total IgE level in serum and eosinophilia,especially in patients with underling diseases,ABPA should be suspected.The positive result of specific antibodies to aspergillus fumigatus and central bronchiectasis on the radiology may give the suggestive diagnosis.ABPA patients generally have good response to the therapy of glucocorticosteroid and antifungal agents.

Anaphylaxis is the most severe clinical presentation of acute systemic allergic reactions.The occurrence of anaphylaxis has increased in recent years, and subsequently, there is a need to continue disseminating knowledge on the diagnosis and management, so every healthcare professional is prepared to deal with such emergencies.This updated position document keep guidance aligned with the current state of the art of knowledge in anaphylaxis management including definition, diagnostic criteria, severity grading, elicitors and cofactors, acute treatment and long-term management of anaphylaxis.Intramuscular Adrenaline continues to be the first-line treatment for anaphylaxis.After an anaphylaxis occurrence, patients should be referred to a specialist to assess the potential cause and to be educated on prevention of recurrences and self-management.

Bronchial asthma is the most common chronic respiratory disease in children.With the increasing use of inhaled corticosteroids, asthma deaths in the world have decreased by nearly two thirds.Mortality of childhood asthma is very low, ranging from 0 to 0.7/100 000, however, most of risk factors of asthma death could be avoidable.Risk factors of asthma death include poor asthma control, poor treatment compliance, insufficient medicine prescribed by doctors, insufficient monitoring of lung function, mental and psychological problems, food allergy, insufficient recognition and treatment of asthma exacerbation, improper use of β 2-receptor agonist, insufficient application of asthma action plan, et al.The mortality and risk factors of asthma in children were reviewed, which could support further improving asthma management strategies.

Objective:To analyze the death rate of asthma among Chinese people aged 0-19 years in 2018 and the trend of asthma mortality between 2008 and 2018, in order to guide the research of asthma control management and prevention strategy, and reduce the mortality of childhood asthma in China.Methods:Data from the national disease surveillance points system (DSPs) was adopted.The mortality rates of 0-19-year-old people in different age groups, genders, places of residence and geographical regions from 2008 to 2018 were calculated, and the national death toll of asthma was estimated as well.The annual percentage change (APC) and average annual percentage change (AAPC) were calculated, and the death rate of asthma among Chinese people aged 0-19 years in 2018 and change trend of asthma mortality from 2008 to 2018 were analyzed.Results:In 2018, there was no significant gender diffe-rence in asthma mortality among Chinese people aged 0-19 years among different age groups, places of residence and geographical regions(all P>0.05). From 2008 to 2018, the mortality rate of people aged 0-19 fluctuated from 0.023/100 000 to 0.046/100 000, the highest mortality rate was in 2009 and 2012, and the lowest was in 2018. It was estimated that the total number of deaths among people aged 0-19 years reached the highest in 2009 (148 cases) and the lowest in 2018 (70 cases). It is estimated that the total number of deaths among people aged 0-19 years in China from 2008 to 2018 was 1 158 cases.From 2008 to 2018, the total mortality rate of asthma in Chinese population aged 0-19 years decreased significantly (AAPC=-7.6%, 95% CI: -10.4%--4.7%). There was a significant decrease in male group(AAPC=-7.4%, 95% CI: -12.5%--2.0%), female group(AAPC=-7.5%, 95% CI: -12.7%--2.0%), 1-<5 years old group(AAPC=-11.4%, 95% CI: -17.9%--4.5%), 15-19 years old group(AAPC=-14.4%, 95% CI: -24.8%--2.6%), rural group(AAPC=-9.0%, 95% CI: -13.1%--4.8%) and central areas(AAPC=-13.1%, 95% CI: -24.0%--0.5%), with statistical significance(all P<0.05). Conclusions:The total mortality of asthma in 0-19-year old population decreased significantly from 2008 to 2018.The mortality rate of asthma in 0-19-year old people in China is at the low level around the world.

ObjectiveTo investigate the activation of MAPK signal pathway in multiple myeloma and the regulation of BLyS expression levels through MAPK signal pathway; preliminarily study the role of MAPK signal pathway in the up-regulation of BLyS expression levels induced by IFN-γ.MethodsActivated MAPK pathway were detected by Western blot,while the expression of BLyS were detected with RT-PCR and Western blot,and Western blot investigated the effect of MAPK pathway on BLyS expression levels induced by IFN-γ.ResultsIn addition to the expression of ERK,JNK,p38,p-JNK was also expressed in MM cell lines,the MAPK pathway inhibitor targeting JNK SP600125 can down-regulate the expression of BLyS,and its activator anisomycin can up-regulate the expression of BLyS.SP600125 restrained the proliferation and survival of MM cells.ConclusionJNK/SAPK pathway was activated in MM cells; The activated degree of JNK/SAPK pathway and the expression level of BLyS was positively correlated.JNK/SAPK pathway play an important role in the up-regulation of BLyS expression levels induced by IFN-γ.

OBJECTIVETo describe a HPLC method for assessing betaine in Fufang Guilu granule.

METHODThe content of betainephenaxcyl bromide in Fufang Guilu granule was determined by HPLC. The analytical column was a shim-pack CLC-ODS (6.0 mm x 150 mm) filling a 5 microm stationary phase; The mobile phase consisted of acetonitrile-water(35:65) with 0.1 mol x L(-1) NaClO4; The flow-rate was 1 mL x min (-1); The detector was set at 254 nm.

RESULTThe calibration curve was linear over the range of 0.09-0.585 microg (r = 0.9997). The average recovery of the method was 98.4%, RSD 2.5% (n = 5).

CONCLUSIONThe results showed that this method was reliable and accurate, and can be used for quality control of Fufang Guilu granule.

Betaine ; analysis ; Chromatography, High Pressure Liquid ; methods ; Codonopsis ; chemistry ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; Lycium ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control ; Reproducibility of Results

Objective To investigate the impact of accountable and kindred-like nursing and the practice of quality care.Methods 100 primiparas who gave birth three months before the accountable and kindred-like nursing were selected as the control group,while 100 primiparas who gave birth three months after accountable and kindred-like nursing were selected as the observation group.Tow groups' understanding of health education knowledge and skills,satisfaction with nursing when discharged,nomination rate of the most satisfactory nurse and compliance behavior after discharged were compared.Results In the observation group,62 cases had fully understood,28 had basically understood and 10 had not understood the health education knowledge when discharged,while in the control group the numbers were respectively 30,56 and 14.In the observation group,75 cases had fully understood,19 had basically understood and 6 had not understood the health education skills when discharged,while in the control group the numbers were respectively 28,58 and 14.The understanding of health education knowledge and skills were much better in the observation group than in the control group,and the differences were statistically significant (x2 =21.13,44.40,respectively; P ＜0.05).After being discharged,the compliance behaviors including pure breastfeeding,newborn massage and baby swimming of the observation group were also better than the control group (49 vs 27,58 vs 27,47 vs 18,respectively),and the differences were statistically significant (x2 =9.93,20.14,19.16,respectively; P ＜0.05).There were no significant differences in infant buttock nursing between two groups (P ＞ 0.05).The satisfaction of nursing and nomination rate of the most satisfactory nurse were also much higher in the observation group (99 vs 93,82 vs 53,respectively),and the differences were statistically significant (x2 =10.86,19.17,respectively ;P ＜ 0.05).Conclusions Accountable and kindred-like nursing can enhance the effect of health education,compliance behaviors,so as to improve the satisfaction degree of puerperants and their families with nursing service.

OBJECTIVETo analyze the risk factor of infection for complex tibial plateau fractures after operation.

METHODSTotally clinical data of 293 patients with complex tibial plateau fractures underwent open reduction and internal fixation were retrospectively analyzed from September 2010 to March 2015, including 199 males and 94 females, ranging in age from 17 to 80 years old with an average of 47.3 years old. The possible risk factors such as gender, age, smoking, diabetes, type of fracture(open/closed), classification of open fracture(Gustilo-Anderson classification), classification of soft tissue injury in closed fracture (Tscherne-Gotzen classification), fracture classification(Schatzker V/VI), osteofascial compartment syndrome, ASA score, anesthesia, timing of surgery, operative time(<=150 min/>150 min), surgical approach, combined approach or not, internal fixation site were studied. The multivariate Logistic regression model was used to analyze the risk factors.

RESULTSTwelve patients were infected of all 293 patients after operation, the infection rate was 4.10%. Univariate analysis showed that fracture type(χ ² =14.496,=0.001), fracture classification(χ²=4.560,=0.033), osteofascial compartment syndrome(χ²=15.631,=0.001), operative time(χ²=11.233,=0.001) were correlated with complex tibial plateau fractures postoperative infection. Multivariate analysis showed that open fractures(χ²=9.696,=0.002) and osteofascial compartment syndrome(χ²=9.119,=0.003) were complex tibial plateau fracture risk factors for infection after operation.

CONCLUSIONSOpen fractures and osteofascial compartment syndrome are risk factor of complex tibial plateau fracture for infection after operation. While through debridement for open fracture patients, early diagnosis and promt treatment for osteofascial compartment syndrome could reduce incidence of infection.