ObJective To study the effects of flurbiprofen axetil preemptive analgesia on T cell immune functions in postoperative patients with upper abdominal.Methods Seventy-six patients with upper abdominal operation were divided into observation group (40 cases) and control group (36 cases) by random digits table,observation group and control group were given intravenous injection of 100 mg flurbiprofen axetil or 10 ml 0.9％ sodium chloride 10 min before skin incision respectively.Peripheral venous blood samples were collected for the determination of CD4+,CD8+,natural killer cell (NK cell) and CD4+/CD8+ by flow cytometry 1 day preoperative,2 and 48 h postoperative.Results In two groups,the CD8+ and NK cell of 2 h postoperative were lower significantly than those of preoperative (observation group:0.1850 ±0.0550 vs.0.2430 ±0.0856,0.1197 ±0.0673 vs.0.1598 ±0.0775；control group:0.1219 ±0.0571 vs.0.2385 ±0.0847,0.0778 ± 0.0311 vs.0.1621 ± 0.0806,P ＜ 0.05),however,the observation group was significantly higher than the control group (P ＜ 0.05).There was no significant difference in CD4+,CD8+ and NK cell of 48 h postoperative between two groups.Conclusion There are disorders on the T cell immune functions in postoperative patients with upper abdominal,but flurbiprofen axetil preemptive analgesia can improve the T cell immune function.

Objective To investigate the effects of ?-interferon (IFN-? on the expression of costimulatory molecules B7-1 (CD80) and B7-2 (CD86) and Fas/FasL in human retina. Methods Nine human eyes were obtained from the eye-bank of Zhongshan Ophthalmic Center. Six eyes were used for making retinal wholemounts, and 12 retinal wholemounts from each eye were put into the 24-hole culture board which had 2ml DMEM/F12 culture medium in each hole. The wholemounts were divided into 3 groups whose concentration of IFN-? was 0, 200, and 1 000 U/ml respectively. After cultured in 37℃ culture box (95%O2,5%CO2) for 24 hours, the expressions of B7-1 (CD80), B7-2 (CD86), and Fas/FasL on these retinal wholemounts were detected by immunohistochemical method. The retinal wholemounts from 3 healthy people were detected by immunohistochemical method as the control. Results Expression of FasL but not B7-1, B7-2 or Fas was found in the control group, while the expression of B7-1, B7-2 and Fas and increased expression of FasL were found after cultured with IFN-?. Conclusion IFN-? may be involved in the occurrence of ocular immune response and induction of apoptosis via the stimulation of expression of costimulatory molecules and Fas/FasL, which plays an important role in the activation of T lymphocytes.

ObjectiveTo investigate the expression of costimulatory molecules, Fas/FasL, and major histocompatibility complex (MHC)-class Ⅱ antigens in normal ocular tissues.MethodsTwelve eyes were obtained from the eye bank of Zhongshan Ophthalmic Center within 16 to 24 hours postmortem. Six eyes were used for making the retinal wholemounts, and the tissues (iris and ciliary body, choroid, and retina) of the others were used for making the frozen sections. Immunohistochemical staining was carried out on these retinal wholemounts as well as on tissue sections to investigate the exprenion of B7-1 and B7-2 (costimulatory molecules), HLA-DR(MHC class Ⅱ), CD68 (macrophages), Fas/FasL.ResultsThe results of immunohistochemical staining showed the presence of B7-2, FasL, CD68 and HLA-DR in the iris and ciliary body. Expression of B7-1, FasL, CD68, and HLA-DR was found in the choroid while HLA-DR, CD68 and FasL were detectable in the retina.ConclusionExpression of costimulatory molecules, MHC-class Ⅱ molecules and molecules related to apoptosis is different in the iris, ciliary body, choroid, and retina, which may play an important role in the stability of the immunological microenvironment of these tissues.

Objective To study the distribution and drug resistance of pathogens in neonatal septicemia in order to provide clinical guidance for antibiotic usage.Methods This retrospective study analyzed blood culture and clinical data from 83 confirmed neonatal septicemia patients and the blood collection cultures were analyzed.Results A total of 84 strains were isolated from 83 cases of blood specimens,Gram positive bacteria,Gram negative bacteria and fungi were 38(45.2%),41(48.8%),5(6.0%),respectively.Gram positive bacteria was mainly coagulase negative staphylococcus and staphylococcus aureus,which were 13(15.5%) and 8(9.5%) respectively.Gram negative bacteria was mainly Escherichia coli and Klebsiella pneumonia,which were 25(29.8%) and 9(10.7%) respectively.Gram positive bacteria were found high resistance to penicillin G,amoxicillin clavulanate potassium,oxacillin and clindamycin,from 34.2% to 73.7%,but they were sensitive to vancomycin,teicoplanin and linezolid.Gram negative bacteria were found high resistance to ampicillin(82.9%),the constituent ratio of the extended spectrum βlactamases(ESBLs) was 34.1%,carbapenem resistant strains was not found.All fungi were sensitive to azoles.Conclusion Gram negative bacteria are the major pathogens in neonatal septicemia,with high infection rate of Escherichia coli and high constituent ratio of the ESBLs,and antimicrobial agents should be chosen according to blood culture and antimicrobial susceptibility results.

New-onset refractory status epilepticus is a rare and special clinical manifestation with high mortality. About half of the patients have no clear cause. At present, the pathogenesis is unclear, and the treatment plan is controversial. In recent years, it has been found that inflammatory and immune responses of the body may be involved in the pathogenic process, and it is called “inflammatory-immune mediated epileptic encephalopathy” based on the perspective of pathogenesis. There have also been many treatment attempts based on the inflammatory and immunological mechanisms, some of which have achieved satisfactory results. However, most of them are based on the review of small sample cases, and relevant guidelines are still lacking at present. In this paper, the definition, etiology, pathogenesis, clinical manifestations and treatment of persistent status of new-onset refractory status epilepticus are reviewed.

Objective To study the effects of small dosage insulin on intestinal inflammatory responses to endotoxin rats. Method Thirty two male SD rats were randomly divided into 4 groups (n = 8): control group, endotoxin (LPS,6 mg/kg i.p.)group, regular insulin(RI,0.5 IU/kg hypodermic) group and LPS(6 mg/kg i.p) + RI (0.5 IU/kg hypodermic)group. Six hours after LPS or saline injection,all rats were laparotomized to observe the congestion in intestinal mucosa with naked-eyes and photography.Then a segment of intestine was stained with HE to observe the pathological changes. The expressions of IL-6 and TNF-α were detected by RT-PCR.The systemic inflammatory response,blood sugar and food taken in rats were observed simultaneously. Software SPSS 13.0 was used to perform ANOVA and Chi-square test for statistical analysis. Results Compared with LPS group, the differences in hyperemia and inflammatory cell infiltration in intestinal tissue were not noticeable in LPS + RI group. The expression of IL-6 and TNF-α were significantly attenuated in RI + LPS group (P < 0.01). All rats in LPS group manifested systemic inflammatory response syndrome (SIRS) four or five hours after LPS treatment, while there was none in LPS + RI group. Rats in LPS group took less food than rats of other groups while the blood sugar had litter difference in all groups (P > 0.05). Conclusions Small dosage of insulin could reduce intestinal inflammation caused by endotoxemia. Early administration of insulin ould prevent the presence of SIRS while it has no obvious influence on blood sugar.

Objective To study relationship between preprocedural white blood cell count(WBC) and long-term patency of stent implanted in the subelavian artery.Methods Data of 113 cases with stents implanted in the atherosclerotic SUbclavian arteries in Anzhen Hospital,Beijing during January 2005 to January 2008 were analyzed.Student t-test was used to compare the difierence in WBC count between those with patency and those with stenosis after the procedure and chi-square test was used to compare the difference in stent pateney between those with higher and lower WBC counts.Results There Was significant difference in WBC counts between 102 cases with patency and 11 cases with stenosis of the stents after implantation(t=-5.051.P<0.001).Percentage of patency ofthe stents in 36 cases witll higher WBC count(>7.195×109/L)was significantly higher than that in 77 cases with lower WBC count(≤7.195× 109/L)before the procedure(P=0.001).Among 113 cases with stents implanted,109 cases(96.5%) could keep their stents patent one year after implantation,and 60 cases(89.6%)could keep stents patent three yeats after implantation.Conclusions In addition to those traditional factors associated with long-term patency of stents after their implantation,inereased WBC count alSO associated with stenosis or occlusion of the stents after the procedure.

This thesis mainly expounds the design ideas and the realization methods of medical statistics question database management system.Specifically speaking,the function modules,data structure and business processes of the system are designed based on the analysis of questions,test papers and the needs of system functions.We choose Visual Basic 6.0 to develop the system interface,establish the question database with Access 2003,and make use of Word 2003 to output documents.This system can achieve the separation of teaching and testing effectively which can make examinations more normal and scientific.

Objective To observe the role and mechanism of CO-releasing molecules (CORMs) -2in the injured lung induced by ischmia-reperfusion (IR) of hind limbs of rat.Methods The rat model of lung injury was made by ischemia in hind limbs of rat for two hours and then reperfusion for two hours as well.There were 40 SD rats randomly ( random number) divided into 5 groups ( n =8 ),namely sham ischemia-reperfusion (I/R) group,sham I/R + CORM-2 group,I/R group,I/R + CORM-2 group and I/R + DMSO (Dimethylsulfoxide) group. Rats in sham I/R group underwent laparotomy without infrarenal aorta occlusion.The lung tissue structure,polymorphonuclear neutrophil (PMN) count,wet-to-dry weight ratio (W/D), malondialdehyde (MDA) content, myeloperoxidase (MPO) activity, intercellular adhesion molecule-1 ( ICAM-1 ),nuclear IκBα degradation and NF-κB activity in the lung were measured.Results Compared with the sham I/R group,the number of PMNs in lung,W/D,MDA content,MPOactivity,ICAM-1 and NF-κB activity significantly increased in I/R group,whereas nuclear IκBα decreased (P ＜ 0.01).Compared with the I/R group,the number of PMNs in lung,W/D,MDA content,MPO activity and ICAM-1 significantly decreased in I/R + COMR-2 group ( P ＜ 0.01 ), while nuclear IkBαincreased. Conclusions These data demonstrate that CORM-2 attenuates limb I/R-induced lung injury by inhibiting ICAM-1 protein,NF-κB pathway and the leukocytes sequestration in the lung following limb I/R in rats,suggesting that CORM-2 could be used as one of the most valuable therapeutic agents.

ObjectiveTo evaluate prognostic factors and the surgical results of pulmonary carcinoid tumors.Methods We retrospectively reviewed the medical records of 62 patients who were diagnosed as pulmonary carcinoid tumors between January 2000 and October 2010 at Department of Thoracic Surgery,Shanghai Chest Hospital.The following information was available for each of the 62 patients:age,sex,pathological type,and TNM stage.ResultsThere were no operative death.The 3-year and 5-year survival rates after surgery were 92.1％ and 77.8％,respectively.Of the 62 patients,42 were diagnosed as typical carcinoid tumor,and among them,4 patients (8.3％) had lymph node metastases.Their 3-year and 5-year survival rates were 97.8％ and 94.7％,respectively.The remaining 20 patients were diagnosed as atypical carcinoid tumor,and among them,6 patients (37.5％) had lymph node metastases.Their 3-year and 5-year survival rates were 84.4％ and 58.8％,which were statistically significant compared with typical carcinoid tumor( P =0.0047 ).There was significant difference in survival rate between the patients with lymph node metastases and the patients without lymph node metastases (P =0.0048).CondusionThe main risk factors affecting survival rate of those patients who were diagnosed as pulmonary carcinoid tumors were pathological types and lymph node metastases.