Objective To explore the prognostic role of nutritional benefit assessment (NUTRIC score), nutritional risk screening 2002 (NRS 2002), traditional nutritional laboratory indicators albumin (ALB) and prealbumin (PA) in critically ill patients. Methods A historical-prospective cohort study was conducted. The data of 427 patients admitted to Department of Critical Care Medicine of the Affiliated Hospital of Guizhou Medical University from February 2014 to October 2014 were retrospectively analyzed, and thereafter a follow-up of 275 critically ill patients from November 2014 to April 2015 prospectively enrolled was performed. 261 patients were enrolled finally. Patients were divided into death group and survival group according to 28-day and 90-day outcome, the baseline data, acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score, NRS 2002, NUTRIC score, ALB and PA were compared between the two groups. Logistic regression analysis was used to find risk factors for 28-day and 90-day prognosis. Results ① NRS 2002 score of all the 261 patients were greater than or equal to 3 with 100% nutritional risk. The patients in NUTRIC score 5-9 group had lower ALB and PA, higher NRS 2002 score, longer mechanical ventilation time and length of intensive care unit (ICU) stay, which indicated they were more serious. ② Twenty eight-day mortality was 20.7% (54 died from 261). Compared with survival group, the patients in death group had higher APACHE Ⅱ, SOFA, and NUTRIC scores [29.00 (22.75, 34.25) vs. 24.00 (20.00, 28.00), 10.0 (8.0, 13.0) vs. 9.0 (7.0, 11.0), 6.37±1.84 vs. 5.59±1.64, all P < 0.01], and longer days from hospital to ICU admission and mechanical ventilation time in ICU [1.5 (0, 9.2) days vs. 0 (0, 4.0) days, 6.0 (4.0, 11.0) days vs. 4.2 (2.5, 7.8) days, both P < 0.05]. It was revealed by logistic regression analysis that APACHE Ⅱ score [odds ratio (OR) = 1.089, 95% confidence interval (95%CI) = 1.039-1.141, P = 0.000] and days from hospital to ICU admission (OR = 1.042, 95%CI = 1.014-1.071, P = 0.003) were the independent risk factors for 28-day death in critically ill patients. ③ Ninety-day mortality was 42.5% (111 died from 261). Compared with the survival group, the death group patients were older with higher APACHE Ⅱ, SOFA, NRS 2002, and NUTRIC scores [age (years): 64.44±18.11 vs. 54.25±19.66, APACHE Ⅱ: 27.00 (23.00, 31.00) vs. 23.00 (20.00, 27.00), SOFA: 10.0 (8.0, 12.0) vs. 9.0 (7.0, 11.0), NRS 2002: 5.08±1.47 vs. 4.67±1.41, NUTRIC: 6.32±1.58 vs. 5.33±1.68], ALB was significantly reduced [g/L: 27.70 (23.05, 32.00) vs. 30.73 (26.90, 34.20)], and mechanical ventilation time in ICU was extended obviously [days: 5.7 (3.6, 11.0) vs. 3.9 (2.4, 7.0), all P < 0.05]. It was revealed by logistic regression analysis that old age (OR = 1.019, 95%CI = 1.002-1.037, P = 0.029) and NUTRIC score (OR = 1.211, 95%CI = 0.983-1.491, P = 0.072) were the independent risk factors for 90-day death probability, and ALB probability was the protect factor for 90-day death (OR = 0.954, 95%CI = 0.916-0.994, P = 0.024). Conclusion It was NUTRIC score but not NRS 2002, ALB and PA predicted 90-day mortality in critically ill patients.

Adipocytes ; cytology ; Animals ; Cell Proliferation ; Cells, Cultured ; Flow Cytometry ; Hematopoietic Stem Cells ; cytology ; Rats ; Rats, Sprague-Dawley ; Stem Cells ; cytology

Background C57BL/6andB10R Ⅲareroutinemurinespeciesusedinexperimental autoimmune uveitis (EAU).The inflammation is light for mouse after immunization whereas it is prominent for B10R Ⅲ.ObjectiveThis study was to observe the killing effect of interphotoreceptor retinoid binding protein (IRBP) 1-20-specific T cells on mouse retinal astrocyte.Th1 and Th17 cells effect in the EAU mechanism was discussed.MethodsB10RllⅢ mice and C57BL/6 mice were immunized with IRBP 161-180 and IRBP 1-20 in complete Freund adjuvant (CFA).The infiltrating cells of diseased B10R Ⅲ eyes were analyzed by flow cytometry.IRBP 1-20-specific T cells were isolated from the drainage lymph node and spleen and cultured in IL-2 or IL-23 for Th1 and Th17 cells polarization,respectively.Th1 and Th17 cells cultured for 5 days were seeded on the mouse retinal astrocyte monolayer pretreated with gamma interferon.Cell interaction was observed and the quantity of TNF-α was tested by ELISA.Every test was repeated 6 times and the mean was calculated.The maintenance of experimental animals complied with the Statement of ARVO.ResultsThere were lots of infiltrating cells in the eyes of B10Rm mice after immunization,including 9.5％ IFNγ+ cells,5.1％ IL-17+cells and 41.4％ CD45+ cells.Six days after IRBP1-20 stimulation and cultured by IL-2 and IL-23,44.0％ and 8.0％ cells were IFNγ+,and 1.0％ and 26.0％ cells were IL17+.Twentyfour hours after the interaction between Th1 or Th17 and retinal astrocyte,retinal astrocyte died and detached.The killing effect of Th17 was stronger than Th1.48 hours after co-culture of Th1 or Th17T cells with astrocytes,the concentrations of TNF-α were ( 500± 10 ) and ( 801 ±24 μg/L) μg/L,respectively,with a significant statistical difference (t =-20.36,P =0.00).ConclusionsBoth Th1 and Th17 can kill retinal astrocyte,but Th17 plays a key role in the EAU pathogenesis process.The killing effect is caused by intercellular contact and interaction under the induction of cytokines.

Objectives　To investigate the relationship between homocysteine (Hcy), folic acid, vitamin B12(VitB12),lipids and the carotid artery atherosclerosis(CAAs) and the significance of their levels in predicting cardiac and cerebral vascular events of older patients. Methods　Both sides of the common carotid artery and internal carotid artery were measured by B-mode ultrasound in 74 examinees in A, B, C, and D groups and a control group. With fasting serum, cholesterol, triglyceriade, apolipoprotein AI(Apo AI), apolipoprotein B (Apo B), lipoprotein (a) ［Lp(a)］, creatinine, glucose, folic acid, Vit B12 and Hcy were detected. Results　When carotid artery atherosclerosis became severer, serum Hcy was higher. The levels of the control and A, B, C, D groups were (10.2±3.6) μmol/L, (11.5±4.4) μmol/L, (17.9±4.5) μmol/L, (24.7±10.3) μmol/L, and (41.4±22.3) μmol/L respectively. SNK test showed a significant difference between D and other groups (P>0.05). Folic acid and Vit B12 were negatively correlated with the severity of carotid artery atherosclerosis, but only A and D groups showed statistical significance. Spearman correlation coefficient showed that serum Hcy had significant negative correlation with folic acid and Apo AI(P=0.035 and P=0.000).Multiple linear regression analysis between CAAs and various risk factors showed Apo AI had negative correlation, but Apo B, Lp(a) and Hcy had positive correlation with CAAs, especially Hcy(P=0.009).Conclusion　Hyperhomocysteinaemia is an important risk factor of artery atherosclerosis and the degree of CAAs is highly correlated with Hcy concentration. Hcy, Apo AⅠ,Apo B, Lp(a) are sensitive and reliable indexes for evaluating and predicting CAAs.

BACKGROUND:Thyroid cancer stem cells are one of the reasons for tumor resistance that promotes tumor development. The research of thyroid cancer stem cells has provides a new clinic means for the diagnosis and treatment of thyroid cancer. OBJECTIVE:To overview the discovery, identification, and correlation of thyroid cancer stem cells with thyroid cancer. METHODS:A computer-based online search of PubMed database and Wan Fang database between 1995-01/2014-01 was performed to search related articles with the key words of“thyroid cancer, cancer stem cell, stem cell, cancer suppressor gene”in English and Chinese, respectively. Literatures related to thyroid cancer stem cells were selected;in the same field, the articles published lately in authoritative journals were preferred. RESULTS AND CONCLUSION:A total of 561 literatures were primarily selected, and 57 documents were involved for result analysis according to inclusion criteria. Cancer stem cells have become a focus in the study of carcinogenesis. Stem cells also exist in the thyroid gland and its tumor. At present, there are several ways to isolate and identify thyroid cancer stem cells. The tumor thyroid stem cells are closely related to the occurrence, transfer and treatment of tumors. But whether we can cure thyroid cancer through restraining or eliminating thyroid cancer stem cells is stil unknown that needs further studies.

Objective To observe the clinical efficacy of self made Qinchai Kangdu mixture for treatment of infantile EB virus (EBV) infectious mononucleosis and explore its potential mechanism. Methods A prospective study was conducted. One hundred and twenty children with pediatric EBV infectious mononucleosis and traditional Chinese medicine (TCM) syndrome of flaring heat in Qifen and Yingfen in Wuhan Children Hospital were randomly divided into observation group and control group (each, 60 cases). Conventional western medical treatment was given to the two groups for 7-10 days;the observation group was additionally given Qinchai Kangdu mixture which included the following ingredients:Scutellariae Radix 10 g, Bupleuri Radix 10 g, Artemisiae Annuae Herba 10 g, Forsythiae Fructus 20 g, Arctii Fructus 10 g, Paeoniae Radix Rubra 10 g, Cinnamomi Ramulus 6 g, Moutan Cortex 10 g, Trionycis Carapax 10 g, Isatidis Radix 20 g, Citri Reticulatae Pericarpium 10 g, Glycyrrhizae Radix 10 g, orally, once daily for 7-10 days. The times of returning to normal for clinical symptoms and signs, white blood cell count (WBC), peripheral blood abnormal lymphocyte ratio and the level of alanine aminotransferase (ALT) were observed in the two groups. And the clinical efficacy, changes in score of TCM syndrome and adverse reactions were also investigated in the two groups. Results The total effective rate in the observation group was significantly higher than that in the control group [93.33%(56/60) vs. 76.67%(46/60), P<0.05]. In observation group, the duration of fever (days:6.9±2.3 vs. 7.7±3.4), and the recovery times to normal for body temperature (days:2.9±1.4 vs. 4.8±1.7), angina (days:7.2±3.3 vs. 8.0±3.2), lymph node reduction in size (days: 6.6±2.1 vs. 10.2±2.0), enlarged liver bounce back in size (days: 7.8±1.7 vs. 9.6±2.0), WBC (days:7.22±1.78 vs. 10.67±1.97), peripheral blood abnormal lymphocyte ratio (days:7.24±1.86 vs. 11.15±1.65), and ALT (days:8.44±1.83 vs. 11.43±2.65) were all significantly shorter than those in the control group (all P < 0.05). No adverse reactions occurred in the therapeutic course in the two groups. Conclusions Qinchai Kangdu mixture can effectively improve the clinical symptoms of infantile EBV infectious mononucleosis with TCM syndrome of flaring heat in Qifen and Yingfen. The mixture may also promote the enlarged liver and spleen to contract in size at early stage and peripheral blood abnormal lymphocyte ratio and other laboratory indexes return to normal in time.

Objective To compare the efficacy of liposuction and open surgery for patients with accessory breast.MethodsA total of 73 patients with accessory breast,who were treated in our hospital from June 2000 to December 2007,were enrolled in this study and divided into open surgery(June 2000 to June 2004,43 patients with accessory breast at 80 sides)and liposuction(April 2004 to December 2007,30 cases with accessory breast at 58 sides)groups.The outcomes of the patients,operation time,and intraoperative blood loss in the two groups were compared.Results The curative rate of the both groups were 100%.However,the open surgery group had more blood loss [(49.6?13.3)ml vs(28.9?6.9)ml,t=10.836,P=0.000] and longer operation time[(57.4?11.1)min vs(27.3?4.3)min,t=19.597,P=0.000].Conclusions Compared with open surgery,liposuction leads to quicker recovery and less trauma without leaving scars,and thus is more acceptable to the patients.

Objective:To evaluate the clinical value of 16-slice spiral CTA and methods of diagnosis of cerebral aneurysms.Methods: Fifty six cases of cerebral aneurysms with CTA image data were retrospectively analyzed from July 2012 to July 2014. Omnipaque (350 mgI/100 ml) as contrast agent was used in all cases with injection speed of 4.0 mL/s. The methods of VR, SSD, MIP, MPR, CPR and VE were involved in CTA images reconstruction and processing were implemented with workstation ADW4.2. The diagnosis value of cerebral aneurysms with different methods of vessel reconstruction was analyzed.Results: The location and the size of intracranial aneurysms could be clearly showed with 16-slice spiral CTA. The diagnosis time of methods VR and MIP was shortest and the mean time was 4.3 minutes and 5.1 minutes respectively. There was significant difference between the image and actual size in berry aneurysms with SSD method.Conclusion: The synthetic application of multimethod can improve the diagnostic value of 16-slice spiral CTA in cerebral aneurysms.

Objective To explore the T‐SPOT .TB technology in latent tuberculosis infection (LTBI) who immunosuppres‐sive therapy results in screening for latent tuberculosis infection prevention and control to provide a new basis .Methods Applica‐tion of T‐SPOT .TB kit 162 immunosuppressed patients need to be applied to detect M .tuberculosis‐specific T cells ;while doing all cases tuberculin (TST ) skin test ;of which 28 cases of T‐SPOT .TB‐positive patients before screening technique using anti‐TNF‐αbiologics were given prophylactic treatment of anti‐TB drugs for 4 months and followed a year .Results The positive rates and ac‐curacy rate of T‐SPOT .TB assay were 36 .4% and 94 .9% ,while the positive rates and accuracy rate of TSTs were 28 .4% and 69 .6% .The difference between T‐SPOT .TB assay and TST were statistical significance(P < 0 .05) .Through our 28 cases of T‐SPOT .TB positive screening technology ,prophylactic anti‐TB drugs to treat patients for 4 months and 1 year of follow‐up ,no case of tuberculosis occurred .Conclusion These results demonstrate that the performance of T‐SPOT .TB is better than the classic TST for detection of LTBI in patients receiving immunosuppressive therapy for treatment of systemic autoimmune disorders .The T‐SPOT .TB assay will be a useful tool in early and rapid diagnosis of latent tuberculosis infection .T‐SPOT .TB for LTBI patients di‐agnosed with prophylactic anti‐TB drug treatment is necessary ,has important clinical significance .

The ecological balance of intestinal microbiota plays an important role in digestion,absorp-tion,metabolism,immunity and protection against pathogens.Intestinal microbiota can not only regulate the innate immunity of the body,but also can stimulate the immune response by the bacteria itself and its metabo-lites.The imbalance intestinal microbiota may lead to abnormal immune mechanism,and then participate in the occurrence and development of the tumor,especially colorectal cancer.