Readiness for hospital discharge is an important measure to ensure the safety of patient discharge. Evaluating the readiness for hospital discharge can help medical staff to avoid premature discharge of patients and to reduce the incidence of complications and readmission rate. This paper reviews the concept, content and tools of assessment, and the research interests and fields of discharge readiness, so as to provide help and support for further research.

Objective To study the effect of pentoxifylline (PTX) on acute lung injury (ALI) in murine sepsis induced by intra abdominal infection. Methods Wistar rats were subjected to sepsis caused by cecal ligation and puncture (CLP), and animals were randomly divided into normal controls ( n =6), sepsis group ( n =18), and PTX treated group ( n =18). Pulmonary biopterin, nitric oxide (NO) levels, and pulmonary myeloperoxidase (MPO) activities were measured, guanosine triphosphate cyclohydrolase Ⅰ (GTP CHI), inducible nitric oxide synthase (iNOS), and tumor necrosis factor ? (TNF ?) mRNA expression were determined.Results Early treatment with PTX significantly decreased pulmonary MPO activities and TNF ?mRNA expression at 2 hours after CLP. Meanwhile, pulmonary biopterin, NO, GTP CHI, and iNOS mRNA expression levels were much lower in the treatment group than those in the non treatment group ( P

Objective To observe the change in interleukin-18 (IL-18) mRNA expression in cecal ligation and puncture (CLP) induced sepsis, and to investigate its potential role in the pathogenesis of endotoxemia. Methods Fifty-four Wistar rats were randomly divided into normal group (n=6), CLP group (n=36) and recombinant bactericidal/permeability increasing protein (rBPI 21) treatment group (n=12). Tissue samples from the liver, lungs and kidneys were collected to determine IL-18 mRNA expression. Meanwhile, tissue endotoxin level and the indexes of organ function were also measured. Results After CLP, endotoxin levels in the liver,lungs and kidneys were significantly increased, peaking at 2-12h (P

Objective To investigate the effect of high mobility group box-1 protein (HMGB1) on immune function of peritoneal macrophages in mice. Methods The peritoneal macrophages were isolated from female BALBc mice in vitro. The macrophages were stimulated with different doses of HMGB1 (1, 10, 100, 1 000ng/ml) for 6 hours, or with 100ng/ml HMGB1 for different duration (0, 6, 12, 24, 48, 72 hours). The phagocytosis ability of macrophages was determined by the neutral red dye uptake assay and optical densities of samples were read at 540nm. The cytotoxicity to L1210 cells was measured with MTT assay and was expressed by absorbance at 570nm. The chemotaxis was assayed by using the Costar Transwell cell culture chamber inserts and the cells on the lower surface of the transwell membrane were fixed and counted. The cells were harvested at the indicated time points, fixed, and stained for indirect immunofluorescence, then the expressions of I-Ak MHC class Ⅱ alloantigen on macrophages were determined with flow cytometry. Results The effects of HMGB1 on phagocytic activities, cytotoxicity, chemotaxis and I-Ak antigen expression of macrophages were enhanced in a dose-dependent manner, starting at doses as low as 1ng/ml and with a maximal response at 100ng/ml (P

To investigate changes in Toll-like receptor 2 (TLR2) gene expression in postburn Staphylococcus aureus infection, and its potential signaling mechanism, 68 male Wistar rats were randomly divided into four groups as follows: normal control group (n=6), scald control group (n=6), postburn sepsis group (n=36),AG126 treatment group (n=10) and pyrrolidine dithiocarbamate (PDTC) treatment group (n=10). Tissue samples from the liver, kidney and lung were collected from every group to determine TLR2 and tumor necrosis factor-? (TNF-?) mRNA expression. The results showed that TLR2 mRNA expressions in the liver, kidney and lung from postburn septic animals were up-regulated rapidly, peaking at 0.5-2 hours (P

Objective To investigate the effect of high mobility group box-1 protein (HMGB1) on inter-leukin-2 (1L-2) and interleukin-2 receptor α (IL-2α) expressions in human T lymphocytes and its potential regulat-ing mechanism in vitro. Method Human T lymphocytes were isolated and suspended, the cells were cultured with 20 μg/mL phytohemagglutinin (PHA) in 5% CO_2 at 37 ℃, recombinant human HMGB1 (rhHMGB1, 0, 10, 100, 1000 ng/mL) was added with the PHA and cultures were centrifuged at 12 and 48 hours for cell collect-ing. Reverse transcription polymerase chain reaction (RT-PCR) amplification was perfomed to determine gene ex-pressions of IL-2, IL-2Rα. IL-2, sIL-2R protein levels in cell culture supematants were measured by ELIZA. Re-sults After coincubated with rhHMGB1 (10, 100, and 1000 ng/mL) for 12 hours, IL-2 levels in cell culture su-pernatants respectively were 0 . 064 ± 0. 017 μg/L, 0.076±0.033 μg/L, and 0.061 ±0.02 μg/L, which were significantly higher compared with the untreated cells (0.045±0.011 μg/L, P < 0.05 or P < 0.01). Mean-while, IL-2 mRNA expression was markedly up-regulated following rhHMGB1 stimulation in various doses (F = 4.6872, P < 0.01). At 48 bourn, however, both IL-2 mRNA expression and protein production tended to de-crease along with an increased dose of dd-IMGB1 stimulationn. IL-2/sIL-2R ratio in 1000 ng/mL rhHMGB1 was markedly lower than that in 10 ng/ml rhHMGB1 (0.036±0.015 vs.0.055±0.017, P <0.05), together with down-regulation of IL-2Rα mRNA expression(P <0.01). Conclusions These data indieated that HMGBI could marked influence the IL-2/IL-2R expression in human T lymphocytes. With the increase in stimulating doses and prolongation of time, HMGBI might down-regulate T cell-mediated immune response of human lymphocytes.

Objective To observe the expression of tumor necrosis factor-α induced protein 8 like-2 (TIPE2) in CD4 + CD25 + regulatory T cells ( CD4 + CD25 + Tregs) and analyze its potential effect on immunosuppressive activity of CD4 + CD25 + Tregs. Methods CD4 + CD25 + Tregs were purified from spleen of the BALB/c mice by using magnetic cell sorting system.The expressions of TIPE2 mRNA and protein in CD4 + CD25 + Tregs were detected by using RT-PCR and Western blot.CD4 + CD25 +Tregs were further infected with the recombinant lentiviruses that carried small interference RNA(siRNA)to knock down the TIPE2 expression.Based on the expressions of cell surface molecules including cytotoxic T-lymphocyte-associated antigen (CTLA)-4 and forkhead/winged helix transcription factor p3 (Foxp3) detected by flow cytometry and the levels of cytokines including interleukin (IL)-10 and transforming growth factor (TGF)-3 examined by ELISA in CD4 + CD25 + Tregs,the functional role of TIPE2 in controlling suppressive activity of CD4 + CD25 + Tregs was analyzed.In the meantime,the proliferation activities of T effector cells were assayed by MTT test. Results A 147 bp TTPE2 gene band and a clear TIPE2 band with a molecular mass of approximately 21 000 in CD4 + CD25 + Tregs were detected by using Westem blot.Cell surface molecule as well as cytokine expressions were significantly down-regulated when the CD4 + CD25 + Treg stimulated and activated by anti-CD3/CD28 was cultured for 24 hours after the siRNA silenced CD4 + CD25 + Treg cells ( P ＜ 0.01 ).Meanwhile,the suppression role of CD4 +CD25 + Tregs on the proliferation activity of T effector cells was weakened obviously ( P ＜ 0.05 ). Conclusions As an important immunoregulatory molecule,TIPE2 not only expresses in the CD4 + CD25 +Tregs,but also affects the immunosuppressive function of CD4 + CD25 + Tregs.

Objective To investigate the effect of co-expression of neuropilin-1(Nrp-1)and transforming growth factor-β(TGF-β)on regulatory T cell(Treg)-mediated immunosuppression. Methods CD4+CD25+Tregs were isolated from the spleens of male Balb/c mice. CD4+CD25+Tregs were blocked with various doses of Nrp-1 antibody(Ab-Nrp-1,0.5,5,10 μg/ml)for 24 hours with anti-CD3/CD28 and lipopolysaccharide(LPS)stimulation, and expression of Nrp-1 and TGF-βwas determined by flow cytometry. Meanwhile,CD4+CD25+Tregs were cultured with different doses of Ab-Nrp-1 for 1 hour,and co-cultured with CD4+CD25-T cell for 12,24 and 48 hours respectively,the proliferative activity of CD4+CD25-T cells was analyzed by microplate reader. Results Compared to control group,the expressions of Nrp-1 and TGF-β were significantly increased under anti-CD3/CD28 and LPS stimulation(both P<0.05),and treatment with Ab-Nrp-1 markedly inhibited the expression of TGF-β in a dose-dependent manner(P<0.05). The normal Treg had the potential to inhibit the proliferation of CD4+CD25-T cells(P<0.05),while various doses of Ab-Nrp-1 had the ability to reverse the immunosuppressive function of CD4+CD25+Treg in a dose-and time-dependent response manner,5μg/ml has the strongest ability,expecially after 24 hours. Conclusion Treg cell plays an important role in mediating immunosuppressive response via membrane associated TGF-β,and co-expression of Nrp-1 can markedly promote the immunosuppressive function.

Objective Intranuclear forkhead/winged helix transcription factor p3(Foxp3) plays a key role in T cell-mediated immunosuppression.The present study was performed to investigate the effects of high mobility group box-1 protein(HMGB1) on Foxp3 gene as well as protein expressions in splenic regulatory T cells(Tregs) and their potential regulating mechanisms in mice.Methods CD4+CD25+Tregs isolated from the spleens of male BABL/c mice by magnetic beads were seeded on 96-well(1?105 cells/well) cell culture plates coated with anti-CD3(1 ?g/ml) and soluble anti-CD28(1 ?g/ml),and the cells were stimulated with HMGB1 at various intervals or at different concentrations.After being stimulated,the Foxp3 mRNA/protein expressions in the Tregs were determined.The time-dependent and dose-dependent responses between HMGB1 and intranuclear Foxp3 expression were analyzed by flow cytometry,and the expressions of Foxp3 mRNA of Tregs were analyzed by quantitative PCR of SYBR GREEN.Results After stimulation with HMGB1,the intranuclear Foxp3 protein and mRNA expressions of splenic Tregs in mice were markedly down-regulated in 24 h to 72 h(P

Objective To study the precision of computer-aided preoperative templating for total hip arthroplasty. Methods Thirty patients (11 males, 19 females; age ranged from 42 to 85 years, mean 56 years) received unilateral total hip arthroplasty from March 2008 to December 2008. Preoperative tem-plating was done with LINK -Preop-PlanTM to compare the size of the planned hip joint with the size of the prosthesis, as well as the discrepancy of the limbs before and after operation. Results The predicted sizes of the prosthesis corresponded well with the actual ones. The cup size of the prosthesis completely matched the actual ones in 19 patients (63%), and the variation was within 1 size in 8 patients (27%) and ≥2 sizes in 3 patients (10%). The stem size of the prosthesis completely matched the actual ones in 19 patients (63%), and the variation was within 1 size in 9 patients (30%) and ≥2 sizes in 2 patients (7%). The variation of the cemented and cementless stem size of the prosthesis was within 1 size in 16 patients (89%) and 12 patients (100%), respectively, with no statistical difference (P > 0.05). The discrepancy of limb length was (9.0±8.5) mm preoperatively and (1.1±2.4) mm postoperatively. Conclusions Preoperative planning is of paramount significance in total hip arthroplasty. Computer-ai-ded preoperative templating can accurately anticipate the type of the prosthesis, which is helpful in correc-ting the discrepancy in leg length.