0.05).The ADCs of low-grade(gradeⅠ～Ⅱ) astrocytomas were significantly higher(P

Objective:To explore the mechanism of complement 5a (C5a) in the pathogenesis of sepsis.Methods:SPF male C57BL/6J mice were selected and divided into sham operation group (Sham group), cecal ligation and puncture (CLP) group and CLP+anti-C5A monoclonal antibody intervention group (CLP+anti-C5a group) according to random number table with 20 mice in each group. A CLP model was reproduced to induce sepsis, and those in the Sham group only underwent laparotomy without ligation and perforation. In the CLP+anti-C5a group, 0.15 mg of anti-C5a monoclonal antibody was injected intraperitoneally immediately after CLP, and in the Sham group and CLP group were given equal amount of normal saline. The cumulative survival rate was analyzed by Kaplan-Meier method. Serum levels of tumor necrosis factor-α (TNF-α), interleukins (IL-12, IL-4), and interferon-γ (IFN-γ) were measured 24, 48 and 72 hours after operation by enzyme linked immunosorbent assay (ELISA). Immunohistochemical staining was used to observe the expression of C5a receptor (C5aR) in lung and kidney tissues 48 hours after operation. The proportions of dendritic cell (DC), regulatory T cell (Treg) and helper T cell 17 (Th17) in splenic mononuclear cells 48 hours after operation were analyzed by flow cytometry.Results:The 7-day cumulative survival rate of mice in the CLP group was significantly lower than that in the Sham group (30.00% vs. 100.00%; Log-Rank test: χ 2 = 47.470, P < 0.001), and the peripheral blood inflammatory mediators TNF-α, IL-12 and IL-4 were increased 24 hours after operation, followed by a significant decreasing at 48 hours, and then gradually increased at 72 hours. IFN-γ gradually increased 24 hours after operation and lasted for 72 hours. Immunohistochemistry showed that a large number of C5aR was expressed in pulmonary and renal endothelial cells 48 hours after operation in the CLP group. Compared with the Sham group, the proportion of DC [(1.80±0.30)% vs. (6.90±1.20)%, P < 0.05] and Treg [(0.38±0.02)% vs. (4.00±0.50)%, P < 0.05] in splenic mononuclear cells was down-regulated in the CLP group, the proportion of Th17 was up-regulated [(0.83±0.08)% vs. (0.32±0.03)%, P < 0.05], and disorder of immune function was found. After anti-C5A monoclonal antibody intervention, the 7-day cumulative survival rate increased significantly compared with the CLP group (54.54% vs. 30.00%; Log-Rank test: χ 2 = 28.090, P < 0.001); TNF-α, IL-12 and IFN-γ were further increased, while IL-4 was significantly decreased; the expression of C5aR in lung and kidney tissues were significantly decreased, and the expression of mature DC cells [(5.10±1.20)% vs. (1.80±0.30)%, P < 0.05] and Treg [(2.58±0.05)% vs. (0.38±0.02)%, P < 0.05] in spleen were significantly increased compared with the CLP group, and Th17 was significantly decreased [(0.54±0.05)% vs. (0.83±0.08)%, P < 0.05]. Conclusion:It is preliminarily concluded that anti-C5A monoclonal antibody may improve the prognosis of sepsis by improving the polarization of mature DC and T cells in the spleen, and C5a plays an important role in the immune regulation of sepsis cells.

Objective To explore the application effect of the multidisciplinary collaborations in control of peritoneal dialysis patients with hypertension. Methods A total of 220 cases of peritoneal dialysis patients divided into experimental group and control group (each group had 110 cases) according to the random number table. In which, the control group received routine capacity control and health education with a total of 105 patients finished the study. The experimental group received of multidisciplinary collaborations on the basis of routine capacity control and health education with a total of 107 patients finished the study. Observe changes with knowledge of drugs, medication compliance, self-management behavior and blood pressure of patients before and after the intervention respectively. Results In experimental group,the scores of drug knowledge, medication compliance and self-management behaviors were (0.93 ± 0.49), 0.00 (0.00, 0.25), (2.69 ± 0.25) points before the intervention, 6 months after the intervention were (1.17 ± 0.54), 0.25 (0.00, 0.50), (2.86 ± 0.15) points, the difference between the groups was statistically significant (t=38.60, Z=4.34, t= 2.45, P < 0.01 or 0.05). In control group,the scores of drug knowledge, medication compliance and self-management behaviors were (0.87 ± 0.45), 0.00 (0.00, 0.25), (2.64 ± 0.27) points before the intervention, 6 months after the intervention were (0.89 ± 0.43), 0.00 (0.00, 0.38), (2.73 ± 0.27) points, there was no significant difference between drug knowledge and medication compliance (t=0.44, Z=1.83, P > 0.05), there were statistically significant differences in self-management behavior (t=6.23, P<0.01);there was no difference between the statistical significance between the 2 groups before intervention (t=1.02, Z=1.46, t=1.32, P > 0.05); there was significant difference between the 2 groups after intervention (t=4.11, Z=4.03, t=4.34, P<0.01). Patients in the experimental group with the systolic and diastolic blood pressure were (147.11 ± 14.31), (90.16 ± 13.02) mmHg (1 mmHg=0.133 kPa) respectively, before the intervention; 6 months after the intervention were (139.39 ± 17.05), (83.76 ± 12.52) mmHg respectively, the difference was statistically significant (t=3.59, 2.92, P<0.01). The control group before intervention were (149.56 ± 18.11), (93.56 ± 15.09) mmHg respectively, 6 months after the intervention were (145.14±20.50), (88.14±10.88) mmHg respectively, the difference was statistically significant (t=2.02, 2.72, P<0.05 or 0.01);there was no significant difference between the two groups before intervention (t=1.09, 1.82, P>0.05);6 months after the intervention there was significant difference between the 2 groups (t=2.22, 2.72, P < 0.05 or 0.01). Conclusions Multidisciplinary collaborations have a significant role in patients with peritoneal dialysis, especially in blood pressure control, medication compliance and self-management behavior.

Objective To observe the performance of oral feeding in premature and to analyze its related factors so as to provide a basis for scientific management transforming from tube feeding to oral feeding.Methods This study designed the oral feeding observation table for premature by ourselves based on literature at home and abroad and revised by experts. Prospective observation and record was used to the rate and effects of feeding at the beginning of oral feeding and when the oral feeding was complete in 109 premature of neonatal intensive care unit at a class Ⅲ grade A hospital in Wenzhou from July 2015 to January 2016. The data were analyzed by the SPSS 19.0.Results There were statistically significant differences at the rate and effects of feeding in premature among different gestational ages, birth weight and Cornell medical indexes (P<0.05). When oral feeding was complete, there was a statistically significant difference at the rate of feeding in premature among different birth weight (P<0.05).Conclusions The feeding performance of premature is influenced by the gestational ages, birth weight and Cornell medical indexes at the beginning of oral feeding. With the growing experience in feeding, premature have good feeding performance when oral feeding was complete. Health care providers should select feeding patterns rationally according to the condition of premature and so on and promote the acquisition of independently oral feeding.

Objective To investigate the effects of non-nutritive sucking ( NNS) and oral support on the feeding process and expression of premature infants .Methods Totals of 110 cases of premature infants with feeding difficulty in department of neonatal from June 2014 to January 2016 were researched .They were divided randomly into observation and control group , with 55 cases in each group .The control group was given routine feeding ,and the observation group was added with oral motor function training ,and the non nutritive sucking and oral support were carried out .The feeding efficiency , the effect of feeding , the amount of milk intake , the transition time of feeding , the duration of the first feeding were observed , and the satisfaction of two groups were compared.Results In the observation group , the feeding efficiency , the effect of feeding , the amount of milk intake, the transition time of feeding , the duration of the first feeding were significantly better than the control group ( P<0.05 ) .The satisfaction of observation group was significantly higher than that of the control group (P<0.05).Conclusions Non nutritive sucking and oral support and oral motor function training can effectively improve the oral feeding of preterm infants , and promote the growth of premature infant body mass .

Objective To screen the influencing factors of hepatitis C cirrhosis patients progressing to hepatocellular carcinoma(HCC)using commonly used laboratory testing indicators,establish a prediction model using these indicators and validate them.Methods A total of 231 patients with hepatitis C cirrhosis and 179 patients with hepatitis C HCC hospitalized at the First Affiliated Hospital of Xi'an Jiaotong University between June 2020 and May 2023 were enrolled as the training set,and 105 patients with hepatitis C cirrhosis and 86 patients with hepatitis C HCC hospitalized between June 2023 and February 2024 were enrolled as the validation set.The routine laboratory test indexes of the study subjects in the two groups within the training set were compared,and logistic regression analysis was applied to screen the independent predictors of hepatocellular carcinoma occurrence.Receiver operating characteristic(ROC)curve was used to construct the curve model and validate the model.Results The age,male ratio,ALT,AST,AFP,WBC,NEU,MO,PLT,MPV,PDW,Fbg,NLR and PLR levels of the HCC group were higher than those of the cirrhosis group in the training set(H=-9.07～-2.19),while the levels of INR and LMR were lower than those of the cirrhosis group(H=-4.49,-2.65),and the differences were significant(all P＜0.05).The differences in TP,eGFR,LY and AST/ALT values between the two groups of patients were not significant(H=-1.46～-0.15,all P＞0.05).Multifactorial Logistic regression analysis showed that age(OR=1.048,95％CI:1.023～1.074),Male(OR=1.467,95％CI:1.413～1.765),AST(OR=1.010,95％CI:1.002～1.019),NEU(OR=1.186,95％CI:1.018～1.382)and Fbg(OR=2.245,95％CI:1.639～3.076)were independent risk factors for hepatocellular carcinoma patients(all P＜0.05),and these five independent risk factors were used to construct the HCC column-line graph prediction model,with the AUC for the training set and the validation set AUC(95％Cl)were 0.813(0.771～0.854)and 0.712(0.639～0.784),respectively,and the Hosmer-Lemeshow test showed a good fit of the model with P=0.650 for the training set and P=0.310 for the validation set.Conclusion The prediction model of HCC based on age,gender,AST,NEU and Fbg can have good predictive efficacy and clinical application value.

Objective: To investigate the self-reported prevalence, clinical characteristics, complications of allergic rhinitis (AR) and the sensitization of outdoor air pollen allergens in children in the Inner mongolia grassland region. Methods: A multistage, stratified and random clustered sampling with a face-to-face interview survey study in children from 0 to 17 years old was performed together with 10 common allergen skin prick tests (SPT) and measurements of the daily pollen count in 6 regions in the Inner mongolia grassland region from May to August of 2015. SAS 9.4 software was used for data analysis. Results: A total of 2 443 subjects completed the study. The self-reported prevalence of AR was 26.6%. The prevalence of boys was higher than that of girls (28.8% vs 24.3%, χ²=6.157, P<0.05). Subjects from urban areas showed higher prevalence than rural areas (34.7% vs 18.8%, χ²=79.107, P<0.05). There was significant regional difference in the prevalence of AR among the six areas investigated (χ²=221.416, P<0.05). The main clinical symptoms of AR were sneezing (88.2%) and nasal congestion (78.6%). Among combined diseases, asthma accounted for 16.5% (107/650), rhinoconjunctivitis accounted for 47.9% (311/650). The peak season of AR was April and July, with the top SPT positive allergens of Artemisia species and chenopodium in this area. Conclusions The prevalence AR in children in the Inner mongolia grassland region is extremely high. Sneezing is the main clinical symptom. Rhinoconjunctivitis is the most common combined disease. High summer and autumn pollen exposure is the main cause of AR.