Objective To analyze the levels and functions of CD4+T cell subsets in mouse spleen and lung tissues after Streptococcus pneumoniae(S.P.)infection,and to explore the immune regulatory mechanisms S.P.infection.Methods Flow cytometry was used to detect the proportions of CD4+T cell subsets(Th1,Th2,Th17,and Treg cells)in mouse spleen tissues from control group(n=4),S.P.infection at 12 h(n=4),and 24 h(n=4).H&E staining was used to examine lung tissue pathological characteristics.Differential gene sets and functional changes in lung tissues were analyzed after S.P.infection for 2 and 5 days,and immune cell abundance was predicted.Results Significant inflammatory pathological features were observed in the lung tissues of mice after S.P.infection.The proportions of Th1 and Treg cells in the spleen tissues gradually increased after S.P.infection,with Th1 and Treg cell proportions significantly higher than the control group at 24 h post-infection(P<0.05).At 5 d post-infection,only Treg cell proportion was significantly higher than the control group(P<0.05).Functional analysis revealed abnormal activation of IL6,IL10,and IL4/IL13 signaling pathways 2 days after infection,and abnormal enrichment of IL-2 and IL-6/TGF-β pathways 5 days after infection.Conclusion Treg and Th1 cells are key immune regulatory cells in mice following S.P.infection.Modulating Treg cell function mediated by IL-10 and Th1 cell function mediated by IL-2 can improve immune responses after S.P.infection.

Objective:To investigate the short-term therapeutic effect and long-term survival of multiple myeloma patients with extramedullary disease (EMD) in the new drug era.Methods:The data of 74 patients with multiple myeloma diagnosed and treated in Anhui Wanbei Coal and Electricity Group General Hospital from January 2015 to January 2020 were retrospectively analyzed, including 17 patients with soft tissue infiltration (EM-S), 9 patients with bone infiltration (EM-B), and 48 patients without EMD (No-EMD). The short-term efficacy, the 4-year progression-free survival (PFS) rate and overall survival (OS) rate, and their influencing factors in three groups of patients after receiving bortezomib regimen were analyzed.Results:After 3-4 courses of early induction therapy of bortezomib regimen, the overall response rate of patients in the EM-S group was lower than that in the No-EMD group and the EM-B group [58.8% (10/17) vs. 85.4% (41/48), 100.0% (9/9)], and the differences were statistically significant ( χ2 = 13.7, P = 0.036; χ2 = 26.5, P = 0.003), while the difference between No-EMD group and EM-B group was not statistically significant ( χ2 = 12.7, P = 0.211). Survival analysis showed that the 4-year PFS rate of No-EMD group was higher than that of the EM-S group and EM-B group (41.0% vs. 7.6%, 0), and the differences were statistically significant ( χ2 = 10.835, P < 0.01; χ2 = 8.276, P = 0.004). Meanwhile, the 4-year OS rate of EM-S group was lower than that of the No-EMD group and EM-B group (16.5% vs. 54.3%, 59.3%), and the differences were statistically significant ( χ2 = 9.146, P = 0.002; χ2 = 4.066, P = 0.044). Conclusion:The early treatment effect of bortezomib regimen, PFS and OS in multiple myeloma patients with EM-S are poor, while the EM-B has no effect on OS.

Objective To investigate the standard rate and common types of mistakes in ventricular intracranial pressure monitoring in neurosurgery intensive care unit ( NICU ) . Methods A total of 45 nurses were enrolled by convenience sampling method and investigated with assessment criteria developed by Department of Neurosurgery. Results There were 75. 6% nurses conformed to the operation standard, while 24. 4% nurses didn′t. The common types of mistakes were ventricular drainage unclosed before measuring pressure (37. 5%), measuring pressure without zero correction (25. 0%), incorrect zero position (16. 7%), measuring pressure immediately after nursing operations (8. 3%), measuring pressure without patients′head at median position (8. 3%), and tubes obstruction (4. 2%), etc. The different ages, professional (technical) titles and working years of nurses in ICU were the influencing factors of standardized ventricular intracranial pressure monitoring. Conclusions Nurses have some non-standard operation and multiple practice during ventricular intracranial pressure monitoring. More attentions should be paid to provide standardized ventricular intracranial pressure monitoring training for nurses who are young, low occupational title and short of working experience in ICU.

Objective To study the application of advance simulation check in perimetry. Methods A total of 80 perimetry patients were selected as control group ( traditional method) from October 2013 to December 2013 in Ophthalmology Department. They were divided into middle aged group (aged 30-49) and old age group (aged 50-70) on average because big range of ages. A total of 80 perimetry patients with a visual field analyzer were selected as observation group (advance simulation check method) from January 2014 to March 2014. They were also divided into two groups as the same method. We recorded and compared the examination time and the pass rate of perimetry of two groups. Results The mean time of examination in middle aged patients was (5.35 ±0.45)min in the control group and (5. 27 ± 0. 38) min in the observation group. There was no significant difference in the time of visual field examination between two groups (t=0. 848, P>0. 05). There was a significant difference between two groups in first-pass rate of middle aged patients (65. 00% in the control group vs 90. 00% in the observation group) (χ2 =7. 17, P<0. 01). The mean examination time and first-pass rate of old aged patients were (6.17 ±0.92)min, 62.50% in control group and (5.68 ±0.52)min, 82.50%in observation group. Comparing old aged patients of two groups, the differences were statistically significant (t/χ2 =2. 93,6. 67;P<0. 05). Conclusions Advance simulation examination can improve first-pass rate of middle aged patients and shorten the examination time of older patients. It can improve the examination′quality, save the time, relieve the pain of patients caused by examination and improve work efficiency.

Objective To explore the prognostic risk factors of low level malignant obstructive jaundice treated with transhapetic biliary drainage.Methods The clinical data of 142 patients with low level malignant obstructive jaundice received percutaneous transhapetic biliary drainage management from January 2010 to June 2013 were retrospectively analyzed.The study parameters included gender,age,tumor type,preoperative obstructive time,preoperative infection,drainage method,Child-Pugh grade,serum total bilirubin (TBIL),albumin (ALB),serum creatinine (SCr),the postoperative declining degree of bilirubin and postoperative antineoplastic therapy.The prognostic risk factors were evaluated.Results Single variable analysis showed that preoperative infection (P =0.006),Child-Pugh grade (P =0.004),SCr (P =0.043),the postoperative declining degree of TBIL (P =0.001) and postoperative antineoplastic therapy (P =0.015) were the related factors for survival time.The further Logistic regression analysis showed that preoperative infection (OR =3.729,95％ CI 1.332-6.363,P =0.040),Child-Pugh grade ≥ 10 scores (OR =0.513,95％ CI 0.375-1.276,P =0.018) and postoperative antineoplastic therapy (OR =0.668,95％ CI 0.210-2.026,P =0.038) were the related factors for survival time.Conclusion In treating of low level malignant obstructive jaundice with transhapetic biliary drainage,the preoperative infection,Child-Pugh grade and postoperative antineoplastic therapy may be the important related factors that affect the patient's survival time,to evaluate the prognosis of these patients has important reference meaning.

Objective To discuss the effective nursing method of severe erythema multiforma exudativum children patients complicated with bronchopneumonia.Methods Two cases of erythema multiforma exudativum were reviewed,and the nursing methods were summarized,including protective isolation,care of wound surface,care of intravenous infusions,psychological care,oral care,eyes care,perineal care,care of fever,and discharge instructions.Results Two children patients were both cured.Conclusions For severe erythema multiforma exudativum children patients complicated with bronchopneumonia,proper nursing method and careful observation can decrease the complications and help patients to cure quickly.

BACKGROUND:Study confirmed that the de-epidermized dermis(DED)can be used as dermal substitute and may form epidermal structure after incubating keratinocytes.However,the cell biological activity,tissue structure characteristics and the basement membrane component analysis of dermal substitute have been reported less.OBJECTIVE:To investigate the cell activity and the tissue structure characteristics of DED.METHODS:Skin flap was treated with 56℃ phosphate buffered solution to remove the epidermis,and the dermal cell components were deleted by freezing and thawing with liquid nitrogen to obtain DED.The DED cell activity was detected with tissue culture method,hematoxylin nuclear staining was used to determine the DED cell nuclei,and vimentin immunohistochemistry was applied for fibroblast determinations.The basement membrane and its components were detected using Periodic Acid-Schiff staining and collagen type Ⅳ immunohistochemistry.Van Gieson stain,Weigart stain and those double staining were respectively used to determine DED collagen fibers and elastic fibers.The DED ultrastructure was observed under transmission and scanning electron microscope.RESULTS AND CONCLUSlON:Using tissue culture method,the cultured DED did not exhibit cell growth at 2 weeks.Hematoxylin-eosin staining showed no nuclear in DED,vimentin immunohistochemistry showed no vimentin expressed in DED.Van Gieson staining showed DED collagen fibers were stained as rose red,Weigert staining showed DED elastic fibers were stained as pu rplish black double staining further demonstrated uniform arrangement of collagen fibers and elastic fibers.DED surface and the remaining appendages were strongly positive for Periodic Acid-Schiff staining,and type Ⅳ collagen expression was significant.Transmission and scanning electron microscope results showed that,the DED elastic fibers and collagen overlap arranged with pore intervals,they intercrossed into a network.There is no living cell component in DED,dermal matrix surface and appending organ luminal wall still retain glycogen,type Ⅳ collagen and other basement membrane components,dermal matrix is rich in collagen and elastic fibers.it is a three-dimensional collagen matrix similar to in vivo dermis.