Objective To evaluate an effective and feasible quantitative evaluation table of traditional Chinese medicine (TCM) syndrome differentiation, and to observe the effect of combination of TCM syndrome differentiation and standard bundle therapy in patients with septic shock. Methods A prospective randomized controlled trial was conducted. The septic shock patients with acute deficiency syndrome admitted to department of critical care medicine of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 1st, 2016 to December 31st, 2017 were enrolled. The patients were randomly divided into control group and Shenfu group. The patients in both groups received early application of standardized bundle therapy; those in Shenfu group received 60 mL Shenfu injection infusion in addition for 7 days. The TCM syndrome score was evaluated by classification and scoring method of TCM symptoms. The circulation and tissue perfusion, severity of disease, organ function, inflammation response, adjuvant treatment and 28-day mortality were compared between the two groups. Results A total of 50 patients with septic shock were enrolled in the analysis, 25 in control group and 25 in Shenfu group. The markedly effective rate of TCM symptoms score in Shenfu group was significantly higher than that in control group [60.0% (15/25) vs. 16.0% (4/25), P < 0.01]. There was no significant difference in all parameters before treatment between the two groups. After treatment, the observation indexes of both groups were improved. Compared with control group, the mean arterial pressure (MAP) in Shenfu group increased more significantly [mmHg (1 mmHg = 0.133 kPa): 13.0 (2.5, 28.5) vs. 6.0 (0, 13.5)], the lactate (Lac) and procalcitonin (PCT) decreased more significantly [Lac (mmol/L): 0.8 (0.1, 3.7) vs. 0.5 (-0.6, 1.7), PCT (μg/L): 2.0 (0.7, 32.3) vs. 0 (-1.8, 3.8)], activated partial thromboplastin time (APTT) was shortened more significantly [s: 8.5 (0, 12.9) vs. 0 (-7.2, 10.0)], and interleukins (IL-2 receptor and IL-6) levels decreased more significantly [IL-2 receptor (ng/L):1 031.0 (533.0, 1 840.0) vs. 525.5 (186.0, 1 166.8), IL-6 (ng/L): 153.1 (21.4, 406.8) vs. 35.1 (16.3, 110.1)] with significant differences (all P < 0.05). There was no significant difference in the use time of vasoactive drugs, duration of mechanical ventilation, severity of the disease or 28-day mortality between the two groups. However, the use time of vasoactive drugs in Shenfu group was shorter than that in control group (days: 5.48±4.81 vs. 8.28±7.83), and the 28-day mortality was decreased [8.0% (2/25) vs. 20.0% (5/25)]. Conclusions TCM syndrome score is helpful to evaluate the effect of TCM syndrome differentiation and treatment, and it is effective and feasible in clinical application. Septic shock patients treated with TCM syndrome differentiation and treatment combined with standard bundle therapy were significantly improved in circulation, tissue perfusion, coagulation function and inflammation reaction.

Objective: During the 2016 winter season, GII.2 norovirus(NoV) suddenly emerged in China. To elucidate its mechanism of epidemic, this study focused on characteristics of binding between the P protein of capsid and histo-blood group antigens (HBGAs). Methods: The research object was GⅡ.2 ZTX strain which had an outbreaks by the end of 2016 in Beijing. Recombinant prokaryotic expression plasmid was constructed, and the expression of virus P protein was determined and purified. The P protein characteristics of binding to HBGAs was studied through saliva and oligosaccharide binding experiments. Results: Soluble P protein was successfully obtained, and combined with type A, B, AB saliva. Conclusions The result illuminate the combination with new outbreaks of NoV and salivary types, which provided a basis for its pathogenic mechanism and prevention and control measures.

Objective To report a case of Costello syndrome complicated by curis laxa,and to make a molecular genetic diagnosis.Methods Clinical data were collected from a case of Costello syndrome complicated by cutis laxa.Skin tissues were resected from the patient,and peripheral blood samples were obtained from the patient's parents and 150 unrelated healthy controls.Genomic DNA was extracted from these samples,and all the exons and their flanking sequences of the HRAS gene were analyzed by DNA sequencing.Results The 13-month-old female patient presented with growth retardation,severe malnutrition,coarse facial appearance,severely loose skin over the limbs,and decrease or disappearance of subcutaneous fat.A heterozygous mutation c.34G ＞ T (p.Gly12Cys) was detected in exon 2 of the HRAS gene in the patient,but not in her parents or 150 unrelated healthy controls.Conclusion The c.34G ＞ T (p.Gly12Cys) mutation in exon 2 of the HRAS gene may be responsible for Costello syndrome in the patient.

Objective To identify the expression of long non-coding RNAs(lncRNAs) and their putatively modulated cytokines in human immunodeficiency virus(HIV)-1 infected monocytes and to explore the role of lncRNAs in immunomodulation of HIV-affected host cells.Methods RNAs arrays were used to screen the lncRNAs differentially expressed in HIV-infected monocytes and subsequently confirmed by quantitative real time PCR (qRT-PCR).A siRNA was designed and transfected to the human monocytes, followed by interleukin(IL)-1β, IL-10 and tumor necrosis factor(TNF)-α detection with ELISA.Results The results of the screening assays and qRT-PCR showed that the expression of lncRNA-n266623 was up-regulated in monocytes after HIV-1 infection;the secretions of IL-1β,IL-10 and TNF-α in human monocytes were significantly enhanced following transfection of siRNA targeting lncRNA-n266623 in the monocytes.Conclusion The HIV-1 infection can promote the expression of lncRNA-n266623 which may inhibit the expressions of IL-1β, IL-10 and TNF-α in monocytes and negatively regulate the immune response to HIV-1 infection.

Objective To investigate the effects of ch1D1, an anti-CD86 chimeric antibody, on autoreactive B lymphocytes isolated from patients with systemic lupus erythematosus ( SLE) . Methods Flow cytometry analysis was performed to measure the expression of CD86 on the surface of B cells isolated from patients with SLE and to analyze the effects of ch1D1 on the activation of CD4+T cells. The method of magnetic bead sorting was used to separate B cells, NK cells and CD4+T cells from PBMC collected from healthy subjects and patients with SLE for subsequent experiments. Antibody-dependent cell-mediated cyto-toxicity (ADCC) and complement-dependent cytotoxicity (CDC) that were mediated by ch1D1 were meas-ured with LDH release assay. Effects of ch1D1 on the secretion of auto-antibodies and the proliferation of CD 4+ T were detected by ELISA and 3 H -thymidine ( 3 H-TdR) incorporation assay, respectively. Results The levels of CD80 (68. 08±14. 28 vs 46. 10±12. 14, n=24, P<0. 000 1) and CD86 (44. 72±14. 90 vs 13. 99±10. 74, n=24, P<0. 000 1) expressed on the surface of B cells isolated from patients with SLE were significantly higher than those from the healthy subjects, suggesting the abnormal activation of B cells. Com-pared with the negative control group and the murine monoclonal antibody 1D1, ch1D1 was more effective in mediating the ADCC and CDC responses (P=0. 017 2, P=0. 038 8). Activated T cells significantly en-hanced the secretion of auto-antibodies by B cells isolated from patients with SLE. Compared with the nega-tive control group, the enhanced secretion of auto-antibodies was significantly inhibited by treatment with ch1D1 (P=0. 001 9). Moreover, ch1D1 significantly inhibited the proliferation and activation of CD4+T cells induced in patients with SLE (P=0. 002 4, P=0. 049 5). Conclusion ch1D1, the anti-CD86 chim-eric antibody, could effectively mediate the ADCC and CDC responses against autoreactive B cells isolated from patients with SLE, inhibit the secretion of auto-antibodies and suppress the proliferation and activation of auto-reactive CD4+T cells. It might be a potential immunotherapy agent for the treatment of SLE.

OBJECTIVETo systematically evaluate the environmental exposure information of coke oven workers, we investigated the concentration and size distribution characteristics of the particle matter (PM) in the top working area of coke oven.

METHODSThe aerodynamic particle sizer spectrometer was employed to collect the concentration and size distribution information of PM at a top working area. The PM was divided into PM ≤ 1.0 µm, 1.0 µm < PM ≤ 2.5 µm, 2.5 µm < PM ≤ 5.0 µm, 5.0 µm < PM ≤ 10.0 µm and PM>10.0 µm based on their aerodynamic diameters. The number concentration, surface area concentration, and mass concentration were analyzed between different groups. We also conducted the correlation analysis on these parameters among groups.

RESULTSWe found the number and surface area concentration of top area particulate was negatively correlated with particle size, but mass concentration curve showed bimodal type with higher point at PM = 1.0 µm and PM = 5.0 µm. The average number concentration of total particulate matter in the top working area was 661.27 number/cm³, surface area concentration was 523.92 µm²/cm³, and mass concentration was 0.12 mg/m³. The most number of particulate matter is not more than 1 µm (PM(1.0)), and its number concentration and surface area concentration accounted for 96.85% and 67.01% of the total particles respectively. In the correlation analysis, different particle size correlated with the total particulate matter differently. And the characteristic parameters of PM2.5 cannot fully reflect the total information of particles.

CONCLUSIONThe main particulate matter pollutants in the top working area of coke oven is PM1.0, and it with PM(5.0) can account for a large proportion in the mass concentration of PM. It suggest that PM1.0 and PM(5.0) should be considered for occupational health surveillance on the particulate matter in the top area of coke oven.

Air Pollutants, Occupational ; analysis ; Coke ; Humans ; Occupational Exposure ; analysis ; Particle Size ; Particulate Matter ; analysis ; Workplace

normal pregnancy and RSA (P=0.0250).Compared with women with normal pregnancy, those with RSA showed significantly decreased levels of Arg-1 ( P=0.0474) and suppressed activities of MDSCs against CD8+T cell proliferation (P=0.0230).Conclusion The MDSCs might play an important role in the main-tenance of maternal immune tolerance.Decreased number and inhibited function of MDSCs in the peripheral blood of women with RSA might be responsible for the development of RSA.

Combined with the practice of curriculum reform in Xuzhou Medical College for for-eign clinical medical students, this paper discussed its experiences in compiling the teaching syllabus, programming rational courses, increasing practical class hours, establishing corresponding elective courses, taking various teaching methods and using flexible testing mode.

OBJECTIVE: To find out the clinical characteristics of Meniere's disease in flight aircrew and discuss relevant principles of clinical aviation medicine, in order to summarize experience in medical evaluation of aircrew. METHOD: Collect the data of 35 cases that were diagnosed with Meniere's disease from 1966 to 2011 in our hospital and analyze the clinical characteristics, diagnosis and flight conclusion of them. RESULT: Among the 35 cases, 34 patients complained of vertigo. 27 patients complained of tinnitus and 21 patients complained of hearing loss. (1) 18 cases manifested typical symptoms of Meniere's disease (paroxysmal vertigo, fluctuating neurosensory hearing loss, tinnitus and ear fullness); (2) 7 patients showed the symptoms of vertigo and tinnitus, not complaining of significant hearing loss (after inspection. 4 of them proved the low-frequency hearing loss); (3) 7 patients only manifested as vertigo; (4) 2 patients manifested as tinnitus and hearing loss. 1 patients manifested only hearing loss. On the basis of the diagnostic criteria of Meniere's disease formulated hy Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery. 22 patients were diagnosed with definite Meniere's disease, 2 patients were diagnosed with probable Meniere's disease, 11 patients were diagnosed with possible Meniere's disease. For patients with definite Meniere's disease and probable Meniere's disease, the phases of the disease were: 11 cases of phase I, 7 case of phase II and 6 case of phase III. The flight conclusion of all the 35 patients was permanent grounding. The time from the attack of the disease to receiving the conclusion of permanent grounding fluctuated from three months to 11 years. CONCLUSION The diagnosis of Meniere's disease of flight aircrew must he cautious. For patients with atypical symptoms of Meniere's disease, the diagnosis should be made in the case of completely ruling out other possible diseases. Once be diagnosed, a patient should normally be flight unqualified. The flying waiver would he recommended only under exceptional circumstances. The criterion of waiver condition need to be further explored in the future.
Adult ; Aerospace Medicine ; methods ; Humans ; Male ; Meniere Disease ; diagnosis ; Middle Aged

There are a lot of medical colleges which carry out foreign student medical education in our country. On the basis of clinical theory situation and problems of foreign students medical education,Xuzhou Medical College implemented a number of reform measures and achieved good teaching effect.These measures included writing new syllabus of oversea students and reforming multiform teaching methods and the pattern of examination and evaluation for clinical theory.