Objective To investigate the changes in neutrophil immunophenotypes in neonates with late-onset sepsis and their clinical significance.Methods A total of 42 neonates with late-onset sepsis were enrolled prospectively as sepsis group from Children's Hospital of Fudan University from January 2015 to October 2016,which included 26 preterm infants and 16 term infants.Another 33 neonates without infectious diseases consisting of 20 preterm infants and 13 term infants were selected as control group.According to the severity of sepsis,neonates in the sepsis group were further divided into severe (n=11)and mild sepsis (n=31) subgroups.Expression of CD16 and CD62L on neutrophils was measured by flow cytometry to determine the distribution of neutrophil subsets in neonatal peripheral blood.Differences in the distribution of neutrophil subsets between the two groups and two subgroups were compared using Wilcoxon rank-sum test.Multivariate logistic regression analysis was used to investigate the relationship between neutrophil subsets and the severity of neonatal sepsis.Receiver operating characteristic (ROC) curves were used to assess the diagnostic value of neutrophil subsets for the severity of sepsis.Results Four neutrophil subsets were identified in neonatal peripheral blood,including early-stage neutrophils (CD16-/CD62L-),immature neutrophils (CD16-/CD62L+),mature neutrophils (CD16+/CD62L+) and activated neutrophils (CD16+/CD62L-).Activated [preterm:61.1％ (20.2％-79.4％),term:47.6％ (15.2％-70.1％)] and mature neutrophils [preterm:35.7％ (19.9％-75.8％),term:52.0％ (25.6％-82.8％)] were the dominant subsets in the control group.In preterm infants,the proportion of early-stage [3.5％ (1.7％-9.4％) vs 1.9％ (0.6％-4.0％),Z=-2.501,P=0.012] and immature neutrophils [6.3％ (0.7％-45.5％) vs 0.4％ (0.3％-0.7％),Z=-3.878,P＜0.001] were higher,but that of activated neutrophils [8.3％ (2.3％-49.2％) vs 61.1％ (20.2％-79.4％),Z=2.991,P=0.002] were lower in the sepsis group than those in the control group;same differences were found in the absolute counts of each neutrophil subsets.Among term infants,more immature neutrophils were found in the sepsis group than those in the control group [49 (18-200) vs 13 (5-36)/μl,Z=-2.193,P=0.028].The proportion and the absolute counts of early-stage and immature neutrophils in the severe sepsis subgroup were all higher than those in the mild cases [early-stage neutrophils:5.8％ (3.4％-17.8％) vs 3.0％ (1.4％-7.3％),304 (137-1478) vs 158 (53-321)/μl;immature neutrophils:23.0％ (6.3％-47.0％) vs 0.9％ (0.5％-6.8％),1003 (487-2818) vs 85 (18-275)/μl;all P＜0.05].Multivariate logistic regression analysis showed that the proportion of early-stage neutrophils was associated with the severity of sepsis (OR=1.2,95％CI:1.0-1.4,P=0.012).In addition,the diagnostic value of the proportion of early-stage neutrophils for severe sepsis was the highest when the cut-off value was 3.3％,with the area under the ROC curve was 0.7 (95％CI:0.6-0.9),sensitivity of 81.8％ (95％CI:48.2％-97.7％) and specificity of 62.3％ (95％CI:42.2％-78.2％).Conclusions There are four neutrophil subsets in the peripheral blood of neonates and autoactivation of neutrophils may exist.With the onset of sepsis,neutrophil subsets react differently between preterm and term infants.The proportion of early-stage neutrophils may be correlated with the severity of neonatal sepsis,which may have a predictive value for severe sepsis.

Objective To study the pharmacokinetics of raltitrexed using different ways of drug delivery, including femoral venous infusion, hepatic artery perfusion, hepatic artery injection of lipiodol suspension, hepatic artery perfusion followed by embolization with Gelfoam. Methods According to the administration way of raltitrexed, a total of 40 New Zealand rabbit models with VX2 liver tumor were randomly divided into group A (femoral venous perfusion), group B (hepatic arterial perfusion), group C (hepatic artery injection of lipiodol suspension), and group D(hepatic artery perfusion followed by embolization with Gelfoam). Drug concentration in plasma were determined by using LC-MS/MS method and the pharmacokinetic parameters were calculated. Results After administration of raltitrexed, the Tmax was 5 minutes in all 4 groups. In group A, B, C and D, the values were (5.88±1.39), (7.31±2.60), (9.86±5.10) and (7.19±2.27) respectively, with group C having the longest t1/2 value, which was significantly different with that of group A (P＜0.05); the (ng·ml-1·h-1) values were (2 056.40± 139.17), (1 389.21±180.28), (911.84±105.62) and (1 133.41±181.42)respectively, with the value of group A being obviously higher than that of group B, C and D (P＜0.05) and the value of group C being the lowest; the AUC0-t(ng· ml-1·h-1) values were (5 482.72±1 007.07), (4 156.99±1 475.77), (2 785.13±1 107.36) and (3 903.64±947.25) respectively, with the value of group A being remarkably higher than that of group B, C and D (P＜0.05) and the value of group C being the lowest. Conclusion Compared with the femoral vein infusion way, the ways of hepatic artery infusion, hepatic artery lipiodol suspension injection and hepatic artery perfusion followed by embolization with Gelfoam may promote more raltitrexed to deposit in the tumor area, thus, the curative effect is enhanced, the drug concentration in plasma is lowered and the side effects are alleviated.

Objective To explore the possible mechanism of Jianyi Recipe for improving the function of islet cells from the aspects of synthesis,secretion and inactivation of glucagon-like peptide-1 (GLP-1).Methods The diabetic rat model was established by feeding with high-lipid food combined with injection of streptozotocin (STZ).The rats were randomly divided into model group,Jianyi Recipe group,and normal group.The treatment for the rats lasted for 4 weeks.The blood glucose level was detected by the rapid blood glucose meter.The plasma levels of GLP-1 and insulin were detected by Luminex liquid phase protein chip technology.Pancreatic duodenal homeobox-1 (PDX-1) mRNA expression level was detected by quantitative real-time fluorescence polymerase chain reaction (PCR).The level of GLP-1 in ileum L cells was detected by immunohistochemistry,and dipeptidyl peptidase Ⅳ (DPP-Ⅳ)level was detected by enzyme-linked immunosorbent assay.Results Jianyi Recipe could decrease the levels of fasting blood glucose and postprandial glucose (P ＜ 0.05),promote the secretion of insulin (P ＜ 0.05),and increase PDX-1 mRNA expression level in the pancreas of the diabetic rats.Compared with the model group,plasma GLP-1 level,and ileal GLP-1 positive expression area and integrated optical density were increased (P ＜ 0.05) in Jianyi Recipe group,while the differences of serum DPP-Ⅳ levels were insignificant between the two groups (P＞ 0.05).Conclusion Jianyi Recipe maybe regulate the synthesis and secretion of GLP-1 to promote PDX-1 gene expression and insulin secretion,so as to reduce blood glucose in diabetic rats.

To improve the precision of image registration based on corner detection, a relative position function between multiple points to determine matching points accurately. First the corners in images are detected using Harris detector, and clustering method is used to eliminate most wrong matches after coarse screening. Then the proposed relative position function is used as a criterion of precise matching. Finally the image registration process is accomplished by affine transformation. Results show that the proposed algorithm is more effective and accurate than conventional registration algorithm.

Objective To study the association between transforming growth factor-β1 (TGF-β1) polymorphism and type 2 diabetes mellitus in Han population of Shanghai. Methods In this case-control study , 1 234 cases of T2DM patients were recruited and 1 272 healthy individuals were selected as control. Five ml of blood sample was collected from each subject ,from which the whole genomic DNA was extracted.The polymorphism was detected by the Taqman technology. Result Significant association was observed in TGF-β1 T896C genotypes and alleles with T2DM (P = 0.0001 and P = 0.004, OR = 1.18 [1.05 ~ 1.33], respectively). Conclusion The polymorphism of T896C in TGF-β1 gene may be associated with T2DM in Han population from Shanghai.

PURPOSE: At this time, there is uncertainty regarding whether allergen avoidance is the most appropriate strategy for managing or preventing allergies. The purpose of this study was to evaluate the effectiveness of allergen avoidance in the prevention of allergic symptoms in previously sensitized patients and newborns that have the potential to develop allergies. METHODS: We performed online searches of articles published from January 1980 to December 2012 in PubMed and The Cochrane Central Register of Controlled Trials, and selected articles involving randomized controlled trials (RCTs) and allergen avoidance. The parameters used to determine allergenic potential in newborns included the risk ratio (RR) of eczema, asthma, rhinitis, wheeze, and cough. The methods employed to evaluate previously sensitized patients were the standardized mean difference (SMD) of forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate (PEFR). Data quality was assessed using the Jadad scale. RESULTS: A total of 14 RCTs were identified. Meta-analysis demonstrated that allergen avoidance for newborns did not reduce the subsequent incidence of allergic diseases (eczema, P=0.21; rhinitis, P=0.3; cough, P=0.1) but significantly reduced the incidence of asthma and wheezing in high-risk infants (asthma, P=0.03; wheeze, P=0.0004). However, previously sensitized patients who reduced their exposure to known allergens did not show improvement in their lung functions (FEV1, P=0.3; PEFR morning, P=0.53; PEFR evening, P=0.2; PEFR, P=0.29). CONCLUSIONS: Allergen avoidance may not always be successful in preventing allergic symptoms. However, rigorous methodological studies are required to confirm this hypothesis.
Allergens ; Asthma ; Cough ; Eczema ; Forced Expiratory Volume ; Humans ; Hypersensitivity ; Incidence ; Infant* ; Infant, Newborn ; Lung ; Methods ; Odds Ratio ; Peak Expiratory Flow Rate ; Data Accuracy ; Respiratory Sounds ; Rhinitis ; Uncertainty

Objective:To investigate the expressions and clinical significances of SMO , STAT3 and MMP-9 in triple negative breast cancer ( TNBC) .Methods:The expressions of SMO , STAT3 and MMP-9 were immunohistochemically detected in 33 cases of TNBC, 30 cases of mammary hyperplasia and 18 cases of normal breast tissue , and the relationships among SMO , STAT3 and MMP-9 and clinicopathological parameters and prognosis of TNBC patients were analyzed .Results:In TNBC and mammary hyperplasia tissue , the positive expression rates of SMO were 90.9%and 60.0%,the positive expression rates of STAT3 were 96.9% and 73.3%, the positive expression rates of MMP-9 were 90.9% and 36.7%, respectively, however, expressions of them were completely absent in normal breast tissue .The significant correlations were observed between expressions of SMO , STAT3 and MMP-9 in TNBC, mammary hyperplasia and normal breast tissue (P<0.05).The expression of SMO and STAT3 was correlated with superior histologic grade and tumor stage .The expression of MMP-9 was correlated with metastasis of lymph node .The positive correlation was manifested between SMO and STAT3(r=0.361,P<0.05),between SMO and MMP-9 (r=0.633,P<0.01),between MMP-9 and STAT3 (r=0.803,P<0.01) in TNBC.The survival time of TNBC patients was correlated with SMO expression and pTNM (P<0.05).Conclusion:SMO, STAT3 and MMP-9 may play important roles in development of TNBC and may be an important therapeutic target in TNBC .

Objective To investigate the value of three-dimensional contrast-enhanced ultrasound (3D-CEUS) in diagnosing the hepatic artery complications after liver transplantation.Methods A total of 26 liver transplant donors or recipients suspected with hepatic artery complications were examined by color Doppler ultrasound, two-dimensional contrast-enhanced ultrasound ( 2D-CEUS ) and 3D-CEUS.The successful reconstruction rates of 3D-CEUS and the three-dimensional image quality of reconstructed hepatic arteries were evaluated.Results In the 26 patients, 21 hepatic arteries could be visualized with a successful reconstruction rate 81%.The three-dimensional images of hepatic arteries by 3D-CEUS were continuous.The coronal ( Z-axle) , fine or circuitous branches or tributaries could be visualized well.The segmental hepatic arteries origin could be determined and the spatial relationship of vessels could be visualized definitely.Conclusions The 3D-CEUS images are intuitive , three-dimensional and clear , and have clinical application value in diagnosing of hepatic artery complications after liver transplantation.

Objective To investigate the ultrasonograms of biliary sludge and its relationship with the prognosis of patients after liver transplantation.Methods Ultrasonograms of 36 patients with biliary sludge after liver transplantation were retrospectively analyzed.These patients were divided into two groups according to the different treatment outcomes:poor prognosis group and favorable prognosis group.The characteristics of initial ultrasonograms of biliary sludge when they were found at first time compared between two groups .Results Biliary sludge combined with ischemic-type biliary lesions accounted for 95% ( 19/20 ) in poor prognosis group while 13%(2/16)in favorable prognosis group.There was significant difference between two groups (P<0.05).In favorable prognosis group , biliary sludge was found locating in hepatic hilar region in all 16 cases (16/16) and the sludge had clear boundaries dissociated with bile duct walls were observed in 14 cases (14/16).There was no incrassation of bile duct walls in hepatic hilar region , nor dilation of intrahepatic bile ducts observed in 14 cases ( 14/16 ).In poor prognosis group , biliary sludge was observed widespread not only in hepatic hilar region but also in intrahepatic biliary ducts in 10 cases ( 10/20 ) , and the boundaries between sludge and bile duct walls were vague in 15 cases (15/20).Obvious incrassation of bile duct walls in hepatic hilar region was observed in 16 cases (16/20), and dilation of intrahepatic bile ducts was observed in 19 cases (19/20).There were significant differences in the above 4 ultrasound features between two groups (all in P<0.05).Conclusions There are differences in the ultrasonograms of biliary sludge between different prognosis groups.Biliary sludge combined with ischemic-type biliary lesions suggests a poor prognosis , which may need more active interventional treatments.

Objective To study preliminarily on the value of real-time three-dimensional contrast-enhanced ultrasound (RT-3D-CEUS ) for the diagnosis of hepatic artery complications after liver transplantation.Methods From April to July in 201 4,a total of 1 8 liver transplant recipients were examined 29 times,by color doppler ultrasound,contrast-enhanced ultrasound (2D-CEUS)and RT-3D-CEUS.The successful rate of RT-3D-CEUS was calculated.And the image quality and the diagnosis of hepatic artery complications were evaluated.Results In the 29 times of RT-3D-CEUS examination,the successful rate was 93% (27 /29).The image quality of RT-3D-CEUS got 3 points for 1 4 times,2 points for 1 3 times and 1 point for 2 times.In 6 cases who were diagnosed hepatic artery stenosis by RT-3D-CEUS,4 cases were first diagnosed by RT-3D-CEUS and confirmed by CTA,and 2 cases were diagnosed by CTA or DSA before RT-3D-CEUS.Conclusions The RT-3D-CEUS examination can get intuitive and clear images,which has clinical application value in evaluating hepatic artery complications after liver transplantation.