Objective To review the pathogenesis and research prospects in AA.[Methods] In this paper, we summarize the imbalance mechanism of Th1/Th2, and the relationship of fol icular helper T cells(Tfh),Thl7, Th9 ,Th22 with aplastic anemia. [Results]The imbalance of Th1/Th2 cells leads to bone marrow failure. Immunosuppressive therapy can inhibit Th1 cell, restore the balance. The pathogenesis of Tfh, Thl7, Th9 and Th22 is closely correlated with AA. [Conclusion] AA pathogenesis is complex, CD4+cellsubsets is related to the occurrence and development of AA. Detect the levels of immune cells in the serum of patients is beneficial for diagnosis and treatment of AA.

Objective To identify the risk factors associated with incontinence-associated dermatitis (IAD) in ICU patients with enteral nutrition associated diarrhea (ENAD), and to provide information for taking evidence-based preventive measures. Methods We used a case-control study to collect data. Information of the patients (n=55) and controls (n=55) were retrieved from the medical records of 2 intensive care units (ICUs). The patients with IAD and the controls without IAD were matched with age, gender and ward. Information on disease-related information, perineal environment, drug use and nutritional status were collected. Results The simple factor analysis showed that the risks of IAD were related to coronary heart disease (CHD )(χ2=3.96), composite variable for perfusion (χ2=7.33), APACHE II score (χ2=9.87), FiO2 (Z=-2.96), artificial airway (χ2=93.91), ENAD days (Z=-5.45), stool property (χ2=8.46), antibacterial drug use (χ2=5.55), steroid medicine (χ2=11.34) and enteral nutrition days(Z=-3.33), P<0.05. Logistic regression analysis showed that FiO2(P<0.05,OR=1.03, OR95%CI=1.01-1.06), APACHE Ⅱscore(P<0.05,OR=3.12, OR95%CI=1.01-9.64)and ENAD days(P<0.01,OR=1.64, OR95%CI=1.29-2.10)was independent risk factors for IAD. Conclusions The higher of FiO2, APACHE II score over 15 points and the longer of ENAD days, patients are more likely to occur IAD. Early monitoring and prevention of IAD are recommended to promote skin health.

Objective To investigate the relationship between changes of cholinergic system and memory ability impairment in rats long-term exposed to hypoxia-hypercapnia.Methods Forty-eight SD rats were randomly divided into control group,2 weeks hypoxia-hypercapnia group and 4 weeks hypoxiahypercapnia group.The chronic hypoxia-hypercapnia rat model was set up.The memory ability was assessed by eight-arm radial maze.Morphological changes were observed by the HE staining and Nissl staining.Acetylcholine(ACh) content,choline acetyl-transferase (ChAT) activity and acetyl-cholinesterase (AChE) activity in the hippocampus were detected by spectrophotometry,while expression of α7 neuronal nicotinic acetylcholine receptor (α7 nAChR) protein by Western blot.Results Memory ability,especially the working memory was impaired in rats exposed to chronic hypoxia-hypercapnia.And the memory ability decreased more markedly in four weeks group.Compared with those of normoxic rats,the levels of ACh and the activities of AChE and ChAT in the hippocampus of the two weeks group were significantly decreased (ACh:(58.9 ±2.7) vs (47.4 ±3.2) μg/mg (protein) ; AChE:(0.326 ±0.019) vs (0.247 ±0.020) U/mg (protein) ; ChAT:(127.1 ±8.6) vs (90.4 ±6.9) U/g (tissue wet weight),t =7.674,8.139,9.408,all P ＜ 0.05).Compared with the two weeks group,those changes were more obvious in the four weeks group rats (ACh:(47.4 ±3.2) vs (32.5 ±3.2) μg/mg (protein); AChE:(0.247 ±0.020),(0.170±0.019) U/mg (protein); ChAT:(90.4 ±6.9),(55.6 ±6.0) U/g (tissue wet weight),t =9.279,8.036,10.781,all P ＜ 0.05).Compared with the normoxic rats,the expressions of α7 nAChR protein were significantly decreased in two weeks group rats (t =4.481,P ＜ 0.05).Moreover,the expressions of α7 nAChR protein were significantly decreased in four weeks group rats comparing with the two weeks group (t =4.965,P ＜ 0.05).Conclusions An impairment of rat' s memory ability may be induced by hypoxia-hypercapnia,and the injury degree is correlated with the exposure time.Cholinergic system dysfunctions may contribute to the memory function defects in chronic hypoxia-hypercapnia rats.

Objective To investigate the accuracy of serum neuron-specific enolase (NSE)predicting malignant middle cerebral artery infarction(mMCAI).Methods A total of 40 patients with acute massive cerebral infarction within 24 hours after symptom onset were recruited.Blood samples were collected at 24,36 and 48 hours after symptom onset.Serum NSE concentration was determined by automatic electrochemiluminescence analyzer.mMCAI was defined as hernia signs in clinical practice,and CT/ MRI showed mass effect.The receiver operating characteristic curve was used to analyze the accuracy of serum NSE concentration in predicting mMCAI at 3 time points.Results Sixteen patients(40%)developed mMCAI.The serum NSE concentration for predicting the accuracy of mMCAI was poor at 24 hours after symptom onset;the serum NSE concentration for predicting the specificity of mMCAI was high (96%)at 36 hours after symptom onset,but the sensitivity was lower(69%);the serum NSE concentration for predicting the specificity(92%)and sensitivity(88%)of mMCAI were high at 48 hours.Conclusions The serum NSE conoentration and its dynamic changes may predict the occurrence of mMCAI,and the predicting time points are appropriate from 36-48 hours after symptom onset.

Objective To investigate the possibility and accuracy of predicting malignant middle cerebral artery infarction (mMCAI) with bedside electroencephalography (EEG). Methods Thirty-five patients with massive hemispheric infarction (MHI) underwent bedside EEG monitoring within 48 h of onset. The EEG indicators were interpreted blindly, and the clinical, laboratory and imaging parameters were analyzed. The patients were divided into mMCAI group and non-mMCAI group according to whether they had occurred mMCAI or not within 7 days of onset. The differences of EEG indicators, clinical, laboratory and imaging parameters between the 2 groups were compared. When the parameters of significant difference and statistical significance appeared the odds ratio (OR) of occurring mMCAI were analyzed, and their accuracy of predicting mMCAI was calculated. Results Of the 35 patients with MHI, 20 were in the mMCAI group and 15 were in the non-mMCAI group. There were significant differences in the EEG indicators (infarction on the contralateral side, including disintegration of occipital α rhythm, generalized slow-wave, dominant frequency wave low amplitude, regional attenuation without delta [RAWOD]pattern, and absence of EEG reactivity), clinical parameters (nausea accompanied with vomiting), and imaging parameters (the infracted area more than the entire MCA territory, and midline shifting 3 to 5 mm at the level of septum pellucidum) between the 2 groups (P < 0. 05). Of those, the risk of mMCAI was the highest in patients with disintegration of occipital a rhythm on the contralateral side of infarction (P = 22. 67, 95% CI 3. 89-132. 10). The sensitivity of predicting mMCAI was 85. 0%, the specificity was 80.0%, the positive predictive value was 85.0%, and the negative predictive value was 80. 0%, which were superior to other EEG indicators and clinical or imaging parameters. Conclusions Bedside EEG indicators can early predict mMCAI, moreover, the predictive accuracy is superior to the clinical and imaging parameters.

Objective To study bioactive metabolite produced by marine actinomyces M326.Methods Based on the index of antimicrobial activity,the relation between activity of metabolite and conditions of culture in different media and time were researched,and the stability of bioactive metabolite treated with different temperatures and pH were obseved,and the bioactive ingredients were extracted and separated by organic solvent and by macroporous resin.Results The GBP medium made by artificial seawater or distilled water were suitable for production of strong bioactive metabolites.The antimicrobial substances were stable under pH 2～11 and were heat-resistant under strong acidic condition.It could not be extracted by usual organic solvent,but could be absorbed by AB-8 macroporous resin under alkaline situation.Conclusion The metabolites have strong activity against gram-positive bacteria and have different antimicrobial activities against gram-negative bacteria and drug-resistant strains moreover,the polarity of antimicrobial substances is strong.

Objective To extract and purify a polysaccharide SEP from eggs of sea urchin Strongylocentrotus nudus. and to determine its purity, molecular weight and immunological activity in vitro. Methods The orthogonal design was employed to obtain the best possible combination of the critical parameters for polysaccharide extraction. By ultrafiltration, DE-AE Sepharose Fast Flow anion-exchange chromatography and Sephacryl S-400 gel filtration chromatography, the deproteinated crude polysaccharide was purified. The homogeneity of SEP was proved by HPLC, polyacrylamide gel electrophoresis and paper chromatography. Its molecular weight was determined by HPGPC in reference to standVd T-series Dextran. Lymphocyte proliferation assay was made to investigate the immuno-modulating activity of SEP. Results and Conclusion The results indicated SEP was a homogeneous polysaccharide. Its molecular weight was about 1950KD. SEP increased remarkably spleen lymphocyte proliferation. The homogeneous polysaccharide SEP showed significantly immunological activity in vitro.

Objective: To determine the impurities in pharmaceutical adjuvant sodium bisulfite. Methods: An IC method was used with a Dionex IonPac AS17-C RFIC analytical column. ECD was used as the detector by gradient elution and the temperature of column was 30℃. Results:Sulfate radical was detected out in all samples. Conclusion:The method is simple and fast with high sensi-tivity, which is suitable for the determination of related substances in sodium bisulfite.

[Objective]To investigate the prognostic value of 18F-FDG PET/CT with different metabolic parameters in newly diagnosed limited-disease(LD)small cell lung cancer(SCLC).[Methods]Retrospective analysis was carried out in the patients between June 2005 to December 2016 in our hospital confirmed of LD SCLC by pathology or cytology and comprehensive imaging. Fifty-four patients were recruited. Record the general characteristics of patients,pre-treatment KPS score,smoking status,weight loss,serum LDH,NSE,OS,PFS. All lesions(primary lesions + metastases)were sketched out within one VOI,and the SUVmax, SUVmean and SUVpeak in the VOI were automatically measured and recorded. The automatic measurement was performed by the fixed threshold method. The thresholds of tumor of MTV and TLG were 40% and 50% of SUVmax. The TLG and MTV were identified as TLG40%,TLG50%,MTV40% and MTV50% respectively. Kaplan-Meier method was used for survival analysis. All the prognostic factors were analyzed by Cox model.[Result]The median SUVmax was 13.92(2.61~43.28),the median of SUVmean was 8.31(1.71~26.85) and the median of SUVpeak was 10.51(1.49 ~ 27.48). The median of TLG40% was 340.22(16.58 ~ 2827.26),the median of TLG50%was 215.645(1.70 ~ 2270.36),the median of MTV40% was 36.71(1.15 ~ 259.47 cm3),the median of MTV50% was 19.65(0.93 ~1900.00)cm3. Univariate and multivariate analysis of metabolic index and prognosis showed that TLG50% was the prognostic factor of OS(P = 0.013),but not of PFS(P > 0.05). The SUVmax,SUVmean and SUVpeak were not the prognostic factors of OS and PFS(P >0.05).[Conclusion]The volume metabolic parameters TLG50%was the independent prognostic factor of the overall survival time of the LD SCLC. The volume metabolic parameters (TLG and MTV) of 18F-FDG PET/CT were related to the prognosis of SCLC ,which could provide the basis for individual chemotherapy.

Objective To investigate the correlation between prostacyclin synthase (prostaglandin I2 synthase, PGIS) gene rs5602 single nucleotide polymorphism and ischemia stroke in Chinese Han population. Methods The patients with ischemia stroke and healthy controls in Chinese Han population were enroled. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI TOF MS) was used to detect the rs5602 polymorphism. Results A total of 297 patients with ischemic stroke (male 177 and female 120) and 291 healthy controls (male 165, female 126) over the same period were enroled. The frequencies of TT genotype (31. 1% vs. 43. 6% ; χ2 = 5. 773, P = 0. 016) and T alele (56. 8% vs. 65. 8% ; χ2 = 5. 793, P = 0. 016) in the male patients with ischemic stroke were significantly lower than those in the male healthy controls. Multivariate logistic regression analysis showed that the rs5602 TT genotype was a protective factor for ischemic stroke in male (odds ratio 0. 260, 95% confidence interval 0. 118-0. 570; P = 0. 001). Conclusions PGIS gene rs5602 polymorphism is associated with ischemic stroke in male in Chinese Han population.