Objective To investigate the effects of early hemofiltration combined with traditional Chinese medicine on nasal feeding on severe acute pancreatitis (SAP) patients. Methods Seventy four patients were divided into traditional Chinese medicine group (group A, 35 cases) and traditional Chinese medicine+hemofiltration group (group B, 39 cases). In group A, patients were given a serious of procedure including fasting, gastrointestinal decompression, fluid resuscitation, inhi-bition of pancreatic secretion, antibiotic prophylaxis, parenteral nutrition and traditional Chinese medicine on nasal feeding;In group B, patients received continuous veno-venous hemofiltration treatment(also called Continuous Renal Replacement Therapy,CRRT) in addition to the procedures receiving by group A. On admission and the first, 3rd, 7th days post-treatment, the scores of acute physiology and chronic health evaluation (APACHEⅡ), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) levels were recorded. Length of hospital stay, local and systematic complications, surgical inter-vention, mortality and hospitalization expenses were compared between two groups. Results On admission, no statistical significance was seen in the hematocrit, white blood cell count, lactic acid dehydrogenase, blood urea nitrogen, blood glu-cose, APACHEⅡscore, Ranson’s score and classification of etiology between these two groups (P>0.05). But APACHEⅡ, TNF-α, IL-6, IL-8 were decreased significantly in group B than in group A, after the first, 3rd, 7th days post-treatment (P＜0.05). Compared with group A, the length of hospital stay, local complications, systemic complications, surgical interven-tion, mortality and hospitalization expense were lower in group B. Conclusion Traditional Chinese medicine on nasal feed-ing combined with early hemofiltration could effectively reduce complications, incidence of organ dysfunction and could im-prove the prognosis of SAP patients.

Objective To investigate the in vitro effects of quercitrin on the proliferation and the cytotoxicity of human γδT cells.Methods Peripheral blood mononuclear cells (PBMCs) were isolated from healthy subjects and cultured with isopentenyl pyrophosphate and IL -2 to induce human γδT cells.The hu-manγδT cells were cultured with quercitrin at various concentrations for 48 hours.CCK-8 kits were used to analyze the in vitro proliferation and cytotoxic activities of γδT cells.Flow cytometry was performed to meas-ure the expression of granzyme B and perforin in γδT cells.The expression of p-ERK, p-Akt and Bcl-2 at protein level were detected by Western blot .Results The percentage of human γδT cells in PBMCs was in-creased from (2.96±1.83)%to (88.94±2.36)%after 10 days of culture.The quercitrin at concentrations of 10 to 80 μg/ml could promote the growth of γδT cells and up-regulate the expression of granzyme B , per-forin, p-ERK, p-Akt and Bcl-2 in a dose dependent manner .The cytolytic activities of γδT cells against co-lonic carcinoma cells ( HCT116 ) were enhanced by quercitrin .Conclusion Quercitrin could promote the proliferation of γδT cells and enhance the expression of granzyme B and perforin at certain concentrations in vitro.ERK1/2 and Akt signal transduction systems might be involved in the process .

Objective To explore the relationship of expression and the effect of preoperative radiotherapy of endothelin-1 (ET-1) and pyruvate kinase M-2 (PKM2) in rectal carcinoma.Methods Immunohistochemical method was used to detect the expression of ET-1 and PKM2 proteins of rectal cancer tissues in 96 cases.The expressions of ET-1 and PKM2 were analyzed with the effect of preoperative radiotherapy in rectal cancer tissue.Results The high expression of ET-1 protein was 59 cases (61.46％).The high expression of PKM2 proteins was 54 cases (56.25％).The high expressions of ET-1 and PKM2 protein were worsen the effect of tumor regressive grade (TRG) than lower expressions of those after preoperative radiotherapy of rectal cancer tissue (P ＜ 0.05).The protein expression of ET-1 and PKM2 were positively correlated (P =0.006).Conclusions The high expressed ET-1 and PKM2 proteins in rectal cancer are closely related to preoperative radiotherapy resistance.ET-1 and PKM2 proteins are expected to become new targets of radiotherapy sensitivity and radiotherapy sensitization of rectal cancer.

The readmission rate within 30 days is an important indicator for evaluating the quality of hospital medical care and services. There are few studies on early readmission of patients undergoing transcatheter aortic valve replacement in China. This article reviews the concept, screening tools, status and main reasons of readmission within 30 days in foreign countries, and analyzes the influencing factors from three aspects of patients, hospitals and society, aiming to build a risk prediction model of readmission within 30 days for patients undergoing transcatheter aortic valve replacement suitable for China's national conditions and provide reference for related researches.

Objective To explore the correlation between thyroid nodules and uric acid levels and to find their gender differences.Methods A total of 68 056 subjects in a regional medical physical examination center of Shanxi Province from January 2013 to June 2015 were enrolled in this study.All the participants′ general information and parameters were recorded.Thyroid nodules were detected by color Doppler ultrasonography.Results The total prevalence of thyroid nodule was 35.5%, 30.7% in males and 40.0% in females.The prevalence of single nodule was 50.1%, and multiple 49.9%.Compared with no nodule group, thyroid nodule group tended to be older, with higher BMI, and with a worse metabolic status(all P<0.01).The uric acid levels were lower[(352.37±78.14 vs 357.70±77.51) μmol/L, P<0.01] in thyroid nodule group in male and higher[(260.22±61.91 vs 253.91±59.18) μmol/L, P<0.01] in female.Conclusion Thyroid nodules may be associated with metabolism and inflammation.In males, hyperuricemia group had lower, while in females, hyperuricemia ones were with a higher prevalence of thyroid nodules.

Objective:To explore the clinical application effect of cluster strategy in the Neonatal Intensive Care Unit (NICU) to prevent urinary tract infection (UTI) in very low birth weight infants.Methods:This study was a historical control study. The cluster sampling was used to continuously selected very low birth weight infants admitted to the Children's Hospital of Fudan University from January 2019 to December 2020 as the research object. Starting from January 2019, very low birth weight infants who met the criteria were continuously included as the control group for 11 consecutive months, and the traditional routine methods were used for the prevention of UTI. From December 2019 to January 2020, two consecutive months were the training period for the new prevention strategy. Starting from February 2020, very low birth weight infants who met the criteria were included as the intervention group for 11 consecutive months, and the cluster prevention strategy was adopted (hand hygiene, hip skin nursing, oral nursing, bedside nursing supplies management, personnel training, monitoring and detailed evaluation) . The incidence of UTI in the two groups of children were compared, and the bacterial species and bacterial spectrum of UTI in very low birth weight infants were observed.Results:During the study period, 72 cases of UTI occurred in the control group and 793 cases in the hospital, with the incidence rate of 9.1%. In the intervention group, 28 cases of UTI occurred, and there were 633 cases in the hospital, with an incidence rate of 4.4%. Logistic regression analysis showed that the positive rate of urine culture without clustering strategy was 2.719 times that of the intervention group [ OR=2.719, 95% confidence interval: (1.640, 4.506) ]. UTI in very low birth weight infants were mainly caused by Gram-negative bacilli, of which Klebsiella pneumoniae ranked first (30%, 30/100) . Conclusions:The cluster nursing strategy for very low birth weight infants can effectively reduce the incidence of UTI, and it is worthy of clinical application.

This study was aimed to investigate the effects of different stimulatory factors on proliferation and function of cytokine induced killer (CIK) cells. Peripheral blood mononuclear cells (PBMNC) were separated by Ficoll-Hypacue gradient. According to supplement of different stimulatory factors (CD28 mAb, IL-15 and IL-21), the experiment was divided into five groups:control group (CIK), CB28+IL-15+IL-21 group, IL-15+IL-21 group, CD28+IL-15 group and CD28+IL-21 group. Effects of different stimulatory factors on the proliferation of CIK cells were assayed by an automated hematology analyzer. Changes of granzyme B,perforin and CD107a were detected by flow cytometry. IL-10, IL-12, INF-γ and TNF-α were quantified by ELISA. Cytotoxicities on lung cancer cell line A549, breast adenocarcinoma cell line MFC-7 and human melanoma cell line HME1 were examined by lactate dehydrogenase release method. The results showed that there were significant differences among different groups. The highest proliferation index on days 10 was observed in group CD28mAb, IL-15 and IL-21(255.3 ± 6.3), which was higher than control group, IL-21+IL-15 group and CD28 mAb+IL-21 group (166.6 ± 13.5, 199.4 ± 15.0 and 228.8 ± 16.6) (P < 0.05). The expression of perforin in CD28 mAb+IL-15 group was higher than the other groups. The expression of perforin,GranB and CD107a of costimulatory groups was higher than control group. The cytotoxicities of CD28 mAb+IL-15 group on A549, MFC-7 and HME1 cells (82.2%, 59.3% and 70.6%) were much higher than that of control group (60.9%, 49.6% and 48.4%) (P < 0.05). The highest IFN-γsecretion was found in CD28 mAb, IL-15 and IL-21 groups. It is concluded that there are significant difference of proliferative capacity, cytokine secretion and cytotoxicity after being activated by different stimulatory factors. Adding corresponding stimulatory factors into the culture system displays a great value for target cells culture.
Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cytokine-Induced Killer Cells ; cytology ; drug effects ; Humans ; Interferon-gamma ; metabolism ; Interleukin-10 ; metabolism ; Interleukin-12 ; metabolism ; Interleukin-15 ; pharmacology ; Interleukins ; pharmacology ; Tumor Necrosis Factor-alpha ; metabolism

To observe metabolic abnormalities, histology changes and eNOS expression of aorta in type 2 diabetes rat.And to observe intervention effect of rosiglitazone.Methods 80 male Wistar rats were randomized to control group, high diet group, diabetes group, and rosiglitazone treatment group (diabetes plus rosiglitazone treatment).Type 2 diabetes models were developed and rosiglization group was treated with rosiglitazone .Six weeks and twelve weeks after treatment with rosiglitazone, blood glucose, endothlin and nitric oxide were tested.Histology changes of aorta in different groups were observed under microscopy .Meanwhile the protein and mRNA expression of eNOS in aorta were examined.Results 1)Compared with control group, ET in high fat diet group, diabetes group and rosiglitazone group increased significantly , and the level of NO decreased significantly at 6 week and 12 week.At 12 week, ET in diabetes group increased, and NO decreased significantly than that of high fat diet group and rosiglitazone group.2)Histology changes were observed in high fat diet group , diabetes group and rosiglitazone group at 12 week.3)Compared with control group, protein and mRNA expression in high fat diet group , diabetes group and rosiglitazone group were down regulated at 6 week and 12 week.And protein expression in diabetes group was down regulated than that in rosiglitazone group .Conclusions Rosiglization can ease the endothelial dysfunction in type 2 diabetes rat.

Objective To investigate the clinical effect of free pre-expanded scapular skin flap for repairing of large size facial and cervical scar .Methods 15 patients suffering from post-burn facial and cervical scar contractures were treated in the Department of Plastic Surgery of Second Affiliated Hospital of Kunming Medical University.The reconstruction was performed in two operative stages .First, the skin incision were made paralleling with the descending branches of the circumflex scapular artery near posterior axillary line and the scapular skin flap was elevated .A 300 to 400 ml kidney -shaped expander was implanted under scapular region skin .The expansion began 1 week post-operatively.After the expander was fully expanded and could supply sufficient flap , the facial and cervical scar was resected and the contracture was released .The pre-expanded scapular flap was harvested and transferred to repair the defects.Then the facial vascular anastomosis with circumflex scapular vascular was performed .The expander was removed and the wound was closed directly .Results The expansion time ranged from 2 to 4 months with the average time of 2.8 months.The flap size ranged from 14 cm ×7 cm to 25 cm ×14 cm. All flaps survived post-operatively and wounds at donor sites healed primarily .The face and neck have good appearance .Conclusions Pre-expanded scapular skin flap is suitable for repairing of larger face and neck scar with good color and thickness match .Expanded skin flap can provide large size flap , leaving less morbidity at the donor sites .

Objective To investigate the clinical effect of free pre-expanded scapular skin flap for repairing of large size facial and cervical scar .Methods 15 patients suffering from post-burn facial and cervical scar contractures were treated in the Department of Plastic Surgery of Second Affiliated Hospital of Kunming Medical University.The reconstruction was performed in two operative stages .First, the skin incision were made paralleling with the descending branches of the circumflex scapular artery near posterior axillary line and the scapular skin flap was elevated .A 300 to 400 ml kidney -shaped expander was implanted under scapular region skin .The expansion began 1 week post-operatively.After the expander was fully expanded and could supply sufficient flap , the facial and cervical scar was resected and the contracture was released .The pre-expanded scapular flap was harvested and transferred to repair the defects.Then the facial vascular anastomosis with circumflex scapular vascular was performed .The expander was removed and the wound was closed directly .Results The expansion time ranged from 2 to 4 months with the average time of 2.8 months.The flap size ranged from 14 cm ×7 cm to 25 cm ×14 cm. All flaps survived post-operatively and wounds at donor sites healed primarily .The face and neck have good appearance .Conclusions Pre-expanded scapular skin flap is suitable for repairing of larger face and neck scar with good color and thickness match .Expanded skin flap can provide large size flap , leaving less morbidity at the donor sites .