This study was performed for the output of nitrous oxide (N_2O) after N_2O cessation. The breathing bag with the volume of 3000 ml served as the simulator lung,and 5 patients, ASA grade Ⅰ,aged 18-48 years scheduled for elective surgery,acted as the clinical subiects. After the equilibration of end-expiratory N_2O concentration of 50% was developed,the N_2O administration was cut off,then was expelled with oxygen flow rate at 3L/min or 6L/min. The inspiration-expiration N_2O concentration difference of simulator or patient lung (SC_(I-E) N_2O or PC_(I-E) N_2O)was recorded with an infra-red gas analyser. The N_2O dilution induced by the anesthesia circuit volume and the functional residual capacity, was similar to that by simulator lung,so the clinical output of N_2O in one minute was calculated as followed: N_2O output=(PC_(I-E) N_2O-SC_(I-E) N_2O)?minute volume of ventilation. The results showed that in the first minute after N_2O termination,there was no N_2O output,but from the second to the tenth minute the N_2O output increased gradually and was kept at the high level,additionally,the levels of N_2O output at the oxygen flow rate of 6L/min were higher than those at 3L/min in the corresponding times, respectively. It is suggested that following the withdrawal of 1:1 N_2O-O_2 anesthesia ,the N_2O output is related to the oxygen flow rate,and there is not the occurance of diffusion hypoxia.

Objective To study immunologic mechanism of tiger's urine on patients of rheumatoid arthritis. Method We used ELISA method to detect TNF values of serum; we also used MTT colorimetric method to detect the inhibition of tiger's urine on T－ cell. Result TNF values of RA patient's serums at both active stage and stationary phase before the therapy were higher than those of healthy group; TNF values of patient's serums after the therapy were lower than those before the therapy; tiger's urine had obvious inhibitive action on proliferation of peripheral blood's T－ cell. Conclusion Tiger's urine could inhibit T－ cell's proliferation and TNF's secretion, which may be the important mechanism of curing RA.

Glioblastoma multiforme (GBM) is the most malignant form of glioma, and its treatment through traditional surgery combined with chemotherapy and radiotherapy has limited efficacy. Chimericantigen receptor T-cells (CAR-T) are recombinant receptors for antigen, which, in a single molecule, redirect and mediateantigen recognition, T-cell activation, and, in the case of second-generation chimeric antigen receptors (CARs) costimulation (CD28 or 4-BB), augment T-cell functionality and persistence. CARs are the focus of attention in emerging treatment options for GBM. This article mainly introduces the development process of CAR-T therapy and the recent success of adoptive transfer of CAR-T cells. Effective targets of the treatment of GBM with CAR-T according to this research are discussed as well. Some of the most extensively studied targets on GBM, especially interleukin-13 receptor α chain variant 2, epidermal growth factor receptor-Ⅷ(EGFRⅧ), human epidermal growth factor receptor 2 (ErbB2), and ephrinA2 receptor (ErbA2), and the different characteristics of each kind of alloantigen-specific CAR-T cells, are the basis for CAR-T therapy and indicate their different characteristics or utilities and the prospect of further clinical research. The discovery of selective expression of interleukin-13 receptor alpha 2 in glioma cells more than 20 years ago prompted the clinical trial of CAR-T therapy in stage I GBM tumors, and the therapy was proven safe and effective. EGFRⅧ is a neoantigen presenting only in cancer cells and glioblastoma stem cells. Its presence is correlated with poor prognosis, and a phase Ⅰ/Ⅱ trial is ongoing at different institutes. ErbB2-specific CARs were also expressed in human Tcells.Adoptive transfer of EphA2 (or ErbB2)-specific T cells resulted in the regression of glioma xenografts. Thus, target-specific CAR-T immunotherapy may be a promising approach for the treatment of different target-positive GBM. Finally, we summarize the application value and challenge of CAR-T cell therapy in the treatment of GBM.

Objective:To study the effect of naoxintong capsules combined with nerve growth factor on the serum levels of interleukin-6 (IL-6),matrix metalloproteinase-9 (MMP-9) and S100B of patients with hypertensive intracerebral hemorrhage.Methods:88 patients with hypertensive intracerebral hemorrhage who were treated in our hospital from August 2015 to July 2016 were selected and randomly divided into the observation group and the control group The patients in the control group were treated with nerve growth factor,while the patients in the observation group were treated with naoxintong capsules combined with nerve growth factor.Then the clinical efficacy,GCS,GOS score,serum levels ofIL-6,MMP-9 and S100B were observed and compared between the two groups.Results:After treatment,the total effective rate in the observation group was significantly higher than that the control group (P＜0.05).After treatment,the GCS and GOS scores of the two groups were significantly higher than before,and the GCS and GOS of the observation group were higher than those of the control group (P＜0.05).After treatment,the serum levels of IL-6,MMP-9 and S100B in the two groups were significantly lower than before,and the observation group were lower than those of the control group (P＜0.05).There was adverse reactions in the two groups.Conclusion:Naoxintong capsule combined with nerve growth factor can reduce the serum levels of IL-6,MMP-9 and S100B in patients with hypertensive intracerebral hemorrhage,with obvious clinical curative effect and high safety.

Objective To compare the effects,stress reaction and concentration of ropivacaine in umbilical cord blood of patients who accepted combined spinal epidural analgesia or patient controlled epidural labor analgesia in latent and active phase.Methods After approved by the ethics committee and informed consents from 80 nulliparous parturients who were admitted to Beijing Friendship Hospital,Capital University of Medical Sciences between January to June 2009,and who were term,single,cephalic presentation delivery and ASA Ⅰ-Ⅱ,were divided into two groups randomly:latent phase group (Group L,cervical dilation 0.5-2.5 cm,n=40) and active phase group (Group A,cervical dilation ≥3.0 cm,n =40).Ropivacaine 2 mg and fentanyl 10 μg was administered in subarachnoid space of all patients.Then,patient controlled epidural infusion of 0.1 ％ ropivacaine plus fentanyl 2 μg/ml were administered.Pain scores (visual analogue score,VAS),lower extremity muscle strength,duration of labor,delivery mode,total dosage used,maternal satisfaction,Apgar score (1 min and 5 min) were evaluated; concentration of ropivacaine (high performance liquid chromategraphy) in cord blood,and concentration of cortisol (radioimmunoassay) in maternal venous blood and cord blood were detected.Forty nulliparous parturients without labor analgesia were taken as control group (Group C).Chi-square test and one way analysis of variance was applied for statistical analysis.Results (1) VAS in Group L and Group A were lower than that of Group C when cervix dilated at 7.0-8.0 cm (2.9± 1.4,2.6± 1.5 vs 9.2±0.7,F=201.50,P＜0.01) and fully dilated (4.7±2.2,3.6±2.0 vs 9.1±0.7,F =-62.07,P＜0.01,respectively).(2) Tbe concentration of cortisol in maternal venous blood right after delivery was higher than that before analgesia in all groups,and the change in group C was significantly greater than that in group L and group A [(902±172) μg/L vs (761±125) μg/L and (731±184) μg/L,t =-3.491 and-3.483,all P＜0.01],moreover there was no significant difference between group L and group A (P＞0.05).There were no difference in cortisol concentration of umbilical blood among the three groups [(168±46) μg/L,(159±49) μg/L and (170±86) μg/L,F=0.23,P＞0.05].(3) There was no difference between ropivacaine concentration in umbilical blood of group L and group A [(0.21±0.10) mg/L vs (0.20±0.03) mg/L,t=0.557,P＞0.05].(4) No significant differences was shown among the three groups in the duration of first and second stage of labor,rate of augmentation,neonatal birth weight,Apgar score at 1 min and 5 min (all P＞0.05).Compared with group C,group L and group A had higher rate of vaginal delivery (52.5％ vs 75.0％ and 85.0％,P＜0.05) and lower rate of cesarean section (45.0％ vs 20.0％ and 15.0％,P＜0.05).The duration of analgesia in group L was longer than that in group A [(215±143) min vs (118±50) min,t =3.722,P＜0.01] and the dosage of fentanyl was also higher [(28± 11) μg vs (17±6) μg,t =5.084,P＜0.01].Conclusions Labor analgesia with combined spinal epidural could decrease cesarean section rate and maternal stress reaction without prolonging the duration of labor and inhibiting neonatal stress reaction.Labor analgesia start from latent phase would not increase the concentration of ropivacaine in cord blood.

Adjuvants, Immunologic ; chemistry ; pharmacology ; Anti-Inflammatory Agents, Non-Steroidal ; chemistry ; pharmacology ; Clerodendrum ; chemistry ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Phytotherapy ; Urinary Tract Infections ; drug therapy

OBJECTIVE:To establish the quality standard of Yanyan pills.METHODS: The constituents such as Lysimachia christinae,Radix et Rhizoma Glycyrrhizae and Radix Astragali were identified qualitatively by TLC,and the content of caffeotannic acid in L.christinae was determined by HPLC.RESULTS: The TLC spots were distinctive and well-isolated.The linear range of caffeotannic acid was 0.036～0.18 ?g(r=0.999 9)with an average recovery of 100.8%(RSD=0.67%,n=6).CONCLUSION: The established standard is applicable for the quality control of Yanyan pills.

Objective To investigate if immunological factors associated with the false HIV screening test results in RA.Methods Subjects who attended the Rheumatology Outpatient Clinic -Internal Medicine Unit of Guanghua Integrative Hospital , from October 2013 to October 2014, who met the American College of Rheumatology /European League Against Rheumatism Criteria for RA were recruited for the study . 100 subjects with RA were recruited.Each patient underwent clinical examination and blood sampling for assessment of serum HIV screening test and Rheumatoid factors ( RF-IgA, -IgG, -IgM) and anti-cyclic citrullinated protein antibodies (anti-CCP) were purified from the plasma and detected by ELISA , Samples were collected and processed using standard protocols and were stored in the same freezer before analysis . RA patients were divided into two groups based on the titters of RF and anti -CCP:RF <18 U/ml/anti-CCP <25 U/ml group and RF >300 U/ml /anti-CCP >500 U/ml group.HIV screening tests were determined by three methods: ELISA、Immuno-colloidal Golden Method and ECLIA.The positive results were confirmed by the Changning Centers for Disease Control , Shanghai through western -blotting test.Results 100 samples detected by ELISA and Immuno-colloidal Golden Method were given negative results , 16 positive results existed in ECLIA group.There were1,12,3 positive cases in RF-IgM <18 U/ml, RF-IgM and RF-IgG >300 U/ml group(2.7%,32.4%,13.6%;P <0.01).In anti-CCP <25 RU/ml and >500 RU/ml groups there were 2 and 4 positive results(4.7%,24.6%;P <0.01).Conclusions Different HIV screening test methods would give different results , according to operation requirement using second method to determine the HIV screening result.HIV False-positivity was associated with the titers of anti -CCP and RF in RA.

Objective To investigate the percentages of T follicuLar helper cells (Tfh)and interleukin-21(IL-21)in the plasma of patients with rheumatoid arthritis,and the immunological mechanism of Tfh cells in the development of rheumatoid arthritis. Methods According to ACR and DAS28,patients with rheumatoid arthritis were divided into low,moderate and high activity group.The percentages of CD3 + CD4 + CXCR+ 、CD3 + CD4 + ICOS+ and CD3 + CD4 + CXCR+ ICOS+ Tfh cells were detected by Flow Cytometry.While the levels of IL-21 、RF-IgM and anti-CCP in plasma were measured by ELlSA test.The analysis was performed by t-test and Spearman′s correlation analysis.Results The expression of CD3 + CD4 + CXCR+ ICOS+ Tfh cells in PBMCs of rheu-matoid arthritis was significantly higher than that in the normal controls(P <0.05).Meanwhile the results of the three rheumatoid arthritis groups(low,moderate and high activity groups)showed that the expression of Tfh increased accordingly(P <0.05).The expression of Tfh in rheumatoid arthritis was positively related with the levels of IL-21 ,ESR,CRP,RF and anti-CCP respectively. Conclusion The expression of Tfh and IL-21 increases significantly and is closely related to the disease activity in rheumatoid ar-thritis.The results indicate that the abnormality of Tfh may play an important role in the pathogenesis of rheumatoid arthritis.