Objective:To summarize the clinical features of intestinal Beh?et′s disease, so as to provide reference for the diagnosis of the disease.Methods:From April 1 2014 to January 31 2019, the clinical data of 47 patients diagnosed as intestinal Beh?et′s disease at the Second Hospital of Hebei Medical University were retrospectively analyzed, which included initial symptoms, gastrointestinal symptoms, complications, erythrocyte sedimentation rate (ESR), the levels of C reactive protein (CRP), hemoglobin, serum albumin, results of acupuncture test, gastrointestinal involved site and ulcer shape. At the same time, gender differences of clinical manifestations were compared. Chi-square test was used for statistical analysis.Results:Among 47 patients with intestinal Beh?et′s disease, the initial symptoms of 26 (55.3%) cases were gastrointestinal symptoms. Abdominal pain was the most common symptom, the others were diarrhea, anorexia, abdominal distension and perianal abscess, and the incidence rate was 80.9%(38/47), 46.8% (22/47), 42.6% (20/47), 36.2% (17/47) and 2.1% (1/47), respectively. The main complications were gastrointestinal bleeding, perforation and obstruction, and the incidence rates was 40.4% (19/47), 4.3% (2/47) and 4.3% (2/47), respectively. Thirty-seven (78.7%) patients had different degrees of hypoalbuminemia (serum albumin<35 g/L). The CRP level of 36(76.6%) patients increased. The ESR of 36 (76.6%) patients increased. Twenty-two (46.8%) patients had mild anemia (hemoglobin<90 g/L). The acupuncture test was positive in 25 (53.2%) patients. The involved sites of gastrointestinal tract were terminal ileum and ileocecal junction, colon, esophagus, duodenum and jejunum, stomach, and rectum, the proportion was 57.4% (27/47), 27.2% (13/47), 23.4% (11/47), 23.4% (11/47), 17.0% (8/47) and 8.5% (4/47), respectively. All 47 (100.0%) patients had oral ulcers. 62.1%(18/29) patients presented with multiple ulcers under endoscope. The shape of ulcer was round ulcer, irregular ulcer, and longitudinal ulcer, the proportion was 48.3% (14/29), 34.5% (10/29) and 17.2 (5/29), respectively. The incidence rate of genital ulcer of female patients with intestinal Beh?et′s disease was higher than that of male patients with intestinal Beh?et′s disease (85.7%, 18/21 vs. 30.8%, 8/26), and the difference was statistically significant ( χ2=14.189, P<0.01). There were no significant differences between the female group and the male group in the incidence rate of oral ulcer, abdominal pain, diarrhea, and positive rate of acupuncture test (100.0%, 21/21 vs. 100.0%, 26/26; 85.7%, 18/21 vs. 76.9%, 20/26; 42.9%, 9/21 vs. 50.0%, 13/26; 52.4%, 11/21 vs. 58.3%, 14/26, all P>0.05). Conclusions:The common clinical symptoms of intestinal Beh?et′s disease are oral ulcers, abdominal pain, diarrhea and genital ulcer. Female patients with intestinal Beh?et′s disease are more likely to develop genital ulcer than male patients with intestinal Beh?et′s disease. Multiple ulcers are more common under endoscopy, which are round ulcer, irregular ulcer and longitudinal ulcer. The most common sites are the terminal ileum and ileocecal junction, followed by colon, esophagus and other parts.

Objective:To explore the application and treatment efficacy of less invasive surfactant administration (LISA) and nasal high-frequency oscillation ventilation (nHFOV) in very low and extremely low birth weight preterm infants with neonatal respiratory distress syndrome (NRDS).Methods:A total of 85 very low and extremely low birth weight preterm infants with gestational age ranging between 27-32 weeks who were diagnosed with NRDS in the Second Affiliated Hospital of Zhengzhou University from July 2018 to October 2019 were enrolled.After being stratified by gestational age of >27-29 weeks, >29-30 weeks, >30-31 weeks, >31-32 weeks, the neonates were divided into the LISA group (40 cases) and the intubation-surfactant-extubation (INSURE) group (45 cases) by the random envelope method.The LISA group was subdivided into the continuous positive airway pressure (CPAP) group (25 cases) and the nHFOV group (15 cases) by the same method.The patients in the INSURE group were infused with pulmonary surfactant (PS) through the endotracheal tube under positive airway pressure, and then treated with CPAP after extubation.The patients in the LISA group were first treated with CPAP and injected with PS through the gastric tube.After removing the gastric tube, the patients in the CPAP group were given CPAP-assisted ventilation, while the patients in the nHFOV group were given nHFOV-assisted ventilation or mechanical ventilation if nHFOV-assisted ventilation failed.The feasibility of LISA technology and nHFOV was observed, and the adverse reactions, mechanical ventilation, oxygen duration, hospital stay and the incidence of NRDS complications in different groups of the patients were compared.Results:(1) The mechanical ventilation rate (5.0% vs.22.2%), the incidence of broncho-pulmonary dysplasia (BPD) (20.0% vs.42.2%) and the incidence of periventricular leukomalacia (PVL) (12.5% vs.42.2%) in the LISA group were significantly lower than those in the INSURE group (all P<0.05). There were no statistically significant differences in total oxygen duration, hospitalization duration, intraventricular he-morrhage (IVH), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC) between the LISA group and the INSURE group (all P>0.05). (2) There was no significant difference in adverse reactions between the LISA group and the INSURE group as well as between the CPAP group and the nHFOV group (all P>0.05). (3) The younger the gestational age at birth, the higher the incidence of NRDS complications.Patients in the LISA group had a lower incidence of NPDS complications than patients of the same gestational age in the INSURE group, but the diffe-rence was not statistically significant (all P>0.05). (4) There was no significant difference in the mechanical ventilation rate and the incidence of BPD, IVH, PVL, NEC and ROP complications between the CPAP group and the nHFOV group (all P>0.05). Conclusions:In the treatment of very low and extremely low birth weight preterm infants with NRDS at the gestational age of 27-32 weeks, LISA technology is a safe and effective PS delivery method, which can reduce the mechanical ventilation rate and the incidence of BPD and PVL.The nHFOV can be used as an initial model for respiratory support of NRDS preterm infants with very low and ultra-low birth weight.LISA combined with nHFOV is applicable to the treatment of preterm infants with NRDS.

Objective:To explore the risk factors, clinical features, endoscopic characteristics and the efficacy of antiviral therapy in ulcerative colitis (UC) patients complicated with cytomegaloviremia (CMV) and Epstein-Barr (EB) viremia.Methods:From April 1, 2014 to January 31, 2019, at The Second Hospital of Hebei Medical University, a total of 320 UC patients hospitalized at the Department of Gastroenterology were enrolled. According to the pathogens, the patients were divided into four groups: complicated with CMV and EB viremia group ( n=35), only complicated with CMV viremia group ( n=33), only complicated with EB viremia group ( n=52) and without CMV and EB viremia group ( n=200). Clinical features and the efficacy of antiviral therapy of the patients were retrospectively analyzed. Multivariate logistic regression was used to analyze the risk factors of UC complicated with CMV and EB viremia. Kruskal-Wallis H test, Chi-square test and Fisher exact test were used for statistical analysis. Results:The proportion of patients of age>60 years old (42.86%, 15/35), the rate of glucocorticoid use (51.43%, 18/35) within three months before onset and the inefficacy rate of glucocorticoid treatment (22.86%, 8/35) of UC complicated with CMV and EB viremia group were all higher than those of UC without CMV and EB viremia group (14.00%, 28/200; 24.50%, 49/200; 1.00%, 2/200), and the differences were statistically significant ( χ2=17.062, 10.598 and 29.769; all P<0.01). However, there were no statistically significant differences between UC complicated with CMV and EB viremia group and UC without CMV and EB viremia group in gender, and treatment of 5-aminosalicylic acid (5-ASA), azathioprine and infliximab within three months before onset (all P>0.05). The proportion of patients with fever (54.29%, 19/35), abdominal pain (91.43%, 32/35), hematochezia (94.29%, 33/35), weight loss (28.57%, 10/35), severe disease activity (94.29%, 33/35), total colon involvement (91.43%, 32/35), serum albumin less than 30 g/L (71.43%, 25/35) and hemoglobin less than 100 g/L (48.57%, 17/35) of UC complicated with CMV and EB viremia group were all higher than those of UC without CMV and EB viremia group (13.50%, 27/200; 43.00%, 86/200; 44.00%, 88/200; 13.50%, 27/200; 38.00%, 76/200; 65.00%, 130/200; 18.00%, 36/200 and 18.50%, 37/200), and the differences were statistically significant ( χ2=31.475, 27.945, 32.930, 5.100 and 40.194, Fisher exact test, χ2=44.242 and 15.220, all P<0.01). However, there were no statistically significantl differences in clinical classification and disease course (all P>0.05). The incidence rates of deep ulcer (45.71%, 16/35), irregular ulcer (42.86%, 15/35) and longitudinal ulcer (8.53%, 3/35) under endoscopy of UC complicated with CMV and EB viremia group were significantly higher than those of UC without CMV and EB viremia group (1.50%, 3/200; 3.50%, 7/200 and 1.00%, 2/200), and the differences were statistically significant ( χ2=72.521 and 49.837, Fisher exact test, all P<0.01). The incidence rates of deep ulcer and irregular ulcer under endoscopy of UC complicated with CMV and EB viremia group were higher than those of UC only complicated with EB viremia group (15.38%, 8/52 and 11.54%, 6/52), and the differences were statistically significant ( χ2=9.663 and 11.206, P=0.002 and 0.001). The results of Multivariate Logistic regression analysis showed that severe disease activity, serum albumin level less than 30 g/L, and deep ulcer and irregular ulcer under endoscopy were risk factors of UC patients complicated with CMV and EB viremia (odds ratio=48.519, 44.352, 53.432 and 39.989, 95% confidence interval 9.057 to 587.669, 4.499 to 437.245, 3.302 to 864.670 and 3.418 to 467.910, all P<0.05). The improvement rate of antiviral therapy in UC complicated with CMV and EB viremia group (73.53%, 25/34) was significantly lower than those of UC only complicated with CMV group (96.88%, 31/32) and UC only complicated EB viremia group (95.65%, 44/46), and the differences were statistically significant ( χ2=6.989 and 6.310, P=0.008 and 0.012). Conclusions:UC patients with severe disease activity, serum albumin level less than 30 g/L, and deep ulcer and irregular ulcer under endoscopy are more likely to develop CMV and EB viremia. The more severe the disease, the worse the treatment response, so it is necessary to strengthen the screening to CMV and EB virus infection in UC patients.

Objective: To explore the effects of macrophages with high expression of TL1A on the activation and proliferation of HSCs in vitro. Methods: The Bone marrow-derived macrophages (BMMs) and peritoneal macrophages (PMs) from wild type (WT) and myeloid-overexpressed TL1A transgenic mice were isolated, differentiated and activated. HSCs were harvested from activated macrophages culture supernatant (CM). HSCs were detected by immunofluorescence and real-time Q-PCR. And the proliferation was detected by CCK-8 and BrdU assay kit. The levels of IL-1β and PDGF-BB in macrophage culture supernatants were determined by enzyme-linked immunosorbent assay (ELISA). Results: BMMs-derived CM-intervention HSCs were used to detect the expression of α-smooth muscle actin (α-SMA) on the 2nd, 4th and 6th day respectively by immunofluorescence method. There was no significant difference between the two groups on the 2 nd and the 6th day, P > 0.05; On day 4, the CM/Tg group was significantly higher than that of CM/WT group, P < 0.01; the results of CMs derived from PMs were consistent with the above trend. The expression of α-SMA mRNA on the 2nd, 4th and 6th day was detected by real-time Q-PCR method using BM-derived CMs. No significant difference was found between the groups on the 2nd day (P > 0.05).α-SMA mRNA increased further on the 4th and 6th day, and the level of CM/Tg in CM/Tg group was significantly higher than that in CM/WT group (P < 0.05). The detection results of CMs derived from PMs were consistent with the above trend. The results of CCK-8 assay and BrdU assay showed that the proliferation rate of HSCs in CM Tg group was significantly higher than that in CM/WT group (P < 0.01). The CMs derived from PMs were used to interfere with HSCs. And the results were consistent with the above trend. For BMMs, the levels of IL-1β and PDGF-BB in the lipopolysaccharide (LPS) + IFNγ/Tg culture supernatant were significantly higher than those in the LPS+IFNγ/WT group (P < 0.01). For the culture supernatants of PMs Liquid test results consistent with the above trend. Conclusion Macrophages with high expression of TL1A could enhance the activation and proliferation of HSCs by increasing the secretion of IL-1β and PDGF-BB.

Background:Ulcerative colitis(UC)patients are the high risk population of cytomegalovirus(CMV)infection. CMV infection may aggravate the disease progression of UC,and the prognosis of UC patients with CMV infection may be improved by antiviral therapy. Aims:To systematically evaluate the effects of CMV infection and antiviral therapy on prognosis of UC patients. Methods:PubMed,Cochrane Library,Embase,CNKI,Wanfang,SinoMed and VIP database were retrieved to collect the case-control studies studying the effects of CMV infection and antiviral therapy on prognosis of UC patients. Meta-analysis was conducted by RevMan 5.3 software. Results:Twenty case-control studies were enrolled. Meta-analysis showed that UC patients in CMV infection group were more serious(OR=1.62,95% CI:1.13-2.33),and had larger intestinal lesions(OR=0.63,95% CI:0.43-0.92),higher risks of steroid dependence/resistance(OR=6.13, 95% CI:1.98-19.00)and colectomy(OR=1.64,95% CI:1.14-2.36). Antiviral therapy for UC patients with CMV infection significantly improved the early clinical remission rate(OR =2.08,95% CI:1.03-4.17),decreased risk of colectomy(OR=2.12,95% CI:1.06-4.22). Conclusions:CMV infection can aggravate the progress of UC,enlarge the extent of intestinal lesion,increase the risks of steriod dependence/resistance and colectomy. Antiviral therapy significantly improves the early clinical remission rate,and decreases the risk of colectomy.

Objective To investigate the effects of tumor necrosis factor-related ligand-1A(TL1A)on activation of T helper 9(Th9)cells of colonic tissues in chronic experimental colitis mice.Methods The chronic experimental colitis mice model was established with drinking dextran sulfate sodium salt(DSS).A total of 32 lymphocytes TL1A highly expressed mice and wild type(WT)mice were divided into WT control group, transgene control group,WT modeling group and transgene modeling group.The mice of control groups were administrated with distilled water. The mice of modeling groups received 3% DSS in drinking water discontinuously.The mice were sacrificed on 29 days after modeling.Body mass was measured,length of colon was recorded,scores of gross colon and the disease activity index(DAI)were calculated.The colonic morphological changes were observed by hematoxylin-eosin(H-E)staining.The lamina propria mononuclear cells(LPMC)were isolated and the number of Th9 cells was tested by flow cytometry.The levels of interleukin-9(IL-9)in serum and LPMC were detected by enzyme-linked immunosorbent assay(ELISA).The expressions of IL-9 protein and mRNA of the colonic tissues were measured by Western blotting and real-time polymerase chain reaction(PCR),respectively.T test and single factor analysis of variance were performed for statistical analysis.Results The percentage of body mass loss of WT modeling group was lower than that of transgene modeling group(16.2% ± 1.0% vs 18.9% ± 1.2%),and the difference was statistically significant(t=4.90, P<0.05).The scores of gross colon,DAI and pathology of transgene modeling group were all higher than those of WT modeling group(2.80 ± 0.64 vs 1.60 ± 0.31,2.55 ± 0.20 vs 1.58 ± 0.17,and 11.85 ± 0.86 vs 9.50 ± 0.79),and the differences were statistically significant(t=4.77,10.45 and 5.69,all P<0.05).The number of LPMC in transgene modeling group was higher than that of WT modeling group(3.70×106± 0.28×106vs 2.65×106± 0.32 × 106)and the difference was statistically significant(t= 6.98,P< 0.05).The percentage of Th9 in total CD4+T cells of LPMC in colonic tissues of transgene modeling group was higher than that of WT modeling group(0.54% ± 0.04% vs 0.23% ± 0.03%),and the difference was statistically significant(t= 17.54,P< 0.05).The serum IL-9 level of transgene modeling group was higher than that of WT modeling group((170.23 ± 5.69)pg/mL vs(150.62 ± 6.45)pg/mL),and the difference was statistically significant(t= 6.50,P< 0.05).The level of IL-9 secreted by LMPC of transgene modeling group was higher than that of WT modeling group((265.21 ± 8.76)pg/mL vs (237.58 ± 10.24)pg/mL),and the difference was statistically significant(t= 5.80,P< 0.05).The expressions of IL-9 protein and mRNA of transgene modeling group were higher than those of WT modeling group(1.31 ± 0.09 vs 1.18 ± 0.03,and 8.26 ± 1.13 vs 2.25 ± 0.29,respectively),and the differences were statistically significant(t=3.88 and 14.57,both P< 0.05).Conclusion TL1A high expression in lymphocytes can promote Th9 cells differentiation and IL-9 secretion which involved in the genesis of chronic experimental colitis.

Objective To explore the assessment and intervention categorized for patients with permanent colostomy′s continue nursing problem based on the Omaha system. Methods Developing permanent colostomy′s continue nursing problem assessment form in the framework of Omaha system, using this assessment form to evaluate 46 patients′continue nursing problem and choose appropriate interventions. Results A total of 46 patients on the day of discharge had a total of 260 continue nursing problems. There were 5.7 nursing problems averagely for every patient. Incidence of more than 50%of the nursing problems had personal care, role change, mental health, sleep and rest, digestion- hydration and social; potential continue nursing problems was 90. There were 1.97 nursing problems averagely for every patient. The main potential continue nursing problems were two, respectively was colostomy complications and colostomy surrounding skin complications. Continue nursing intervention had a total of 727. There were 15.8 continue nursing interventions averagely for every patient. The most frequent interventions were for physiological and psychosocial domain. Conclusions Omaha Question Classification System can fully assess permanent colostomy′s continue nursing problem andset corresponding nursing intervention strategiesaccording to Omaha intervention system. More attention should be paid to psychosocial and health-related behavior problem. The most frequent interventions were health education, guidance, counseling and monitoring.

Xiyanping is used to treat infectious diseases with antibiotics in clinic. The aim of this study is to investigate the mechanism of Xiyanping through studying the effect of the combination of Xiyanping with Cefazolin on the chemotaxis and phagocytic function of peripheral blood neutrophils in mice. Ten healthy mice were in control group. Forty healthy mice in experimental group were infected with staphylococcus aureus, and were randomly divided further into four groups, i. e. model group, Xiyanping group, Cefazolin group and combination group (Xiyanping with Cefazolin). Mice in the control group and model group were given normal saline (NS) through abdomen while those in other groups were given Xiyanping, Cefazolin, and Xiyanping with Cefazolin, respectively. The chemotaxis of peripheral blood neutrophils was detected with the transwell method, and the phagocytic function of peripheral blood neutrophils was analyzed with flow cytometry (FCM). In the present study, there was no significance on the chemotactic index of peripheral blood neutrophils in all the groups (P > 0.05). The actual phagocytotic rate and index of peripheral blood neutrophils in the blank group, Xiyanping group, and the combination group were significantly higher than those of the model group and Cefazolin group (P < 0.05). However, those were not significant in the blank group, Xiyanping group, and the combination group (P > 0.05) or between the model group and Cefazolin group (P> 0.05). Our results suggested the combination of Xiyanping and Cefazolin could enhance the therapeutic effect by improving the phagocytic function of peripheral blood neutrophils.
Animals ; Anti-Bacterial Agents ; pharmacology ; Cefazolin ; pharmacology ; Chemotaxis ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Mice ; Neutrophils ; cytology ; drug effects ; Phagocytosis ; Staphylococcal Infections ; immunology ; Staphylococcus aureus

Objective To explore the clinical head nurses'effective competence through interviewing nursing supervisors by in depth interview method and to provide reference for constructing training content for clinical head nurses in Macau and Guangzhou.Methods In depth interview was carried out among 8 nursing supervisors from 2 hospitals in Macau and 9 nursing supervisors from 2 tertiary hospitals in Guangzhou.Content analysis was utilized through organizing records and then forming written documentations.Results The themes were drawn after the interview,which were good moral character accomplishment,good communication skill,prospective and creative thinking,favorable executive ability.Forwardlooking and innovative were significantly different in Macau and Guangzhou.Conclusions The effective clinical head nurses' competence is multi-faceted,the results can provide reference for selection,evaluation and training for head nurses.

AIM: To investigate the effect of FAK - related non - kinase ( FRNK) on the expression of membrane - type matrix metalloproteinase -1 ( MT1 - MMP) in hepatic stellate cells ( HSC). METHODS:FRNK were trans-fected into HSCs by cationic liposome method. The protein levels of FRNK in HSC were assayed by Western blotting. The levels of MT1 - MMP were determined by RT - PCR for mRNA and by Western blotting for protein, respectively. RESULTS: The up -regulated expression of FRNK protein was observed and it was at 48 h after transfection that the FRNK protein content was the highest ( P < 0.05 ). The expressions of MT1 - MMP mRNA and protein were also up - regulated by the transfection of FRNK, and it was at 48 h after transfection that the MT1 - MMP protein content was significantly increased. CONCLUSION: The mRNA and protein of FRNK were over - expressed in HSC transfected with the gene of FRNK. The inhibitory effect of FRNK on the collagen synthesis in HSC may be through the up - regulation of MT1 - MMP.