Objective:To explore effect of human umbilical cord mesenchymal stem cells(hUC-MSCs)on macrophage M1/M2 polarization.Methods:hUC-MSCs were co-cultured with pTHP-1 cells which were macrophage-like cells induced by PMA and tran-scriptome sequencing data were analyzed.Differentially expressed genes were screened and analyzed by GO and KEGG enrichment analysis.Effect of hUC-MSCs on pTHP-1 cells proliferation was analyzed by cell proliferation assay(CCK-8 and EdU).Flow cytometry was used to verify influence of hUC-MSCs on relative contents of inflammatory cytokine TNF-α and anti-inflammatory cytokine IL-10 in pTHP-1 cells which were interaction with LPS.Effect of hUC-MSCs on M1/M2-related molecular phenotype of pTHP-1 cells was studied by qRT-PCR and flow cytometry.Results:Transcriptome sequencing data analysis showed that M1-related genes TNF-α(P<0.05)and HLA-DRA(P<0.01)decreased to a great extent and M2-related gene ARG1(P<0.05)increased to a great extent in pTHP-1 cells after co-culture with hUC-MSCs,suggesting that hUC-MSCs inhibited macrophage M1 polarization.GO and KEGG analysis showed that these dysregulated genes regulated inflammation and immune response.hUC-MSCs inhibited proliferation of pTHP-1 cells,reduced content of TNF-α and increased content of IL-10(P<0.001).qRT-PCR and flow cytometry showed mRNA expressions of HLA-DRA(P<0.05)and CD68(P<0.01)and CD14+CD11c+M1 macrophage percentage were down-regulated,while mRNA expressions of CD163(P<0.001),CD206(P<0.001)and CD14+CD163+M2 macrophage percentage were significantly up-regulated in pTHP-1 cells after co-culture with hUC-MSCs.Conclusion:hUC-MSCs inhibit macrophage polarization to M1 and promote polariza-tion to M2 in vitro.

The clinical data of 2 children with refractory Mycoplasma pneumoniae pneumonia complicated with intracardiac thrombosis and pulmonary embolism, treated in Tianjin Children′s Hospital from July 2019 to January 2020, were analyzed retrospectively.One patient was an 8-year-old girl, who was admitted to the hospital mainly because of " fever for 5 days and cough for 2 days" . The other patient was a 7-year-old boy, who was admitted due to " intermittent fever with cough for 24 days and chest pain for 1 day" . Both children were complicated with elevated D-dimer levels and positive antiphospholipid antibody.During the treatment, right cardiac thrombosis and pulmonary embolism occurred in both cases, and the manifestations of thrombosis related symptoms were not typical.After the patients received anticoagulation treatment and thrombolytic therapy with urokinase, the cardiac thrombus dissipated and the pulmonary embolism improved.For refractory Mycoplasma pneumoniae pneumonia complicated with intracardiac thrombosis and pulmonary embolism, thrombolytic therapy can be applied to some children in addition to anticoagulant therapy.

Objective:To explore the relationship between the type of mutation and clinical features, prognosis, and clinical characteristics of chronic granulomatous disease (CGD) caused by compound heterozygous mutations in the NCF2 gene in children. Methods:The clinical data of 1 case of neonatal CGD caused by compound heterozygous mutations of NCF2 gene at Tianjin Children′s Hospital in August 2019 was analyzed, and domestic and international literatures were searched to summarize the clinical characteristics, gene mutation type and prognosis of CGD caused by NCF2 mutation. Results:The diagnosis of CGD was confirmed by the presence of compound heterozygous mutations c. 196_197insA (p.Arg66Glnfs23X) and c. 1180T>G (p.Tyr394Asp) in the NCF2 gene, accompanied with the clinical manifestations of fever, cough, multiple clumps and nodules in the chest CT at 25 days after birth, and the neutrophil respiratory burst test stimulation index(SI) 23.This new mutation was not reported in the Human Genetic Mutation Database.The child had a residual portion of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity and was followed up until the age of 9 months with an antifungal drug without recurrent infection.A total of 101 cases of CGD patients with NCF2 gene mutation were reported in domestic and international databases.Totally, 33 cases had SI results, with 22 cases below 3, 11 cases above 3, and 8 cases of missense mutations. Conclusions:c. 196_197insA and c. 1180T>G are new mutations in NCF2 gene that can lead to CGD.CGD patients containing missense mutations in the NCF2 gene may have more residual NADPH oxidase activity.

Objective:To evaluate the microstructural changes of brain parenchyma in patients with essential hypertension by diffuse kurtosis imaging (DKI) and enhanced T2 star weighted angiography (ESWAN).Methods:A prospective study was performed; 27 patients with essential hypertension, admitted to our hospital from April 2019 to September 2019, and 16 healthy subjects matched with gender, age and education level were enrolled in our study. According to the presence or absence of cerebral microbleeds (CMBs), patients with essential hypertension were divided into essential hypertension with CMBs group ( n=8) and essential hypertension without CMBs group ( n=19). MRI, DKI and ESWAN were performed on all subjects. The mean kurtosis (MK), mean diffusivity (MD) and fractional anisotropy (FA) of bilateral hippocampal gyrus, centrum semiovale, caudate head, posterior limb of internal capsule, thalamus, red nucleus, substantia nigra, pons, and cerebellum were measured. Results:As compared with the healthy subjects, the patients with essential hypertension had significantly lower MK values in the left semioval center, bilateral caudate head, left posterior limb of internal capsule, and bilateral thalamus, significantly higher MD value in the right thalamus, and statistically lower FA value in the left posterior limb of internal capsule ( P<0.05). The essential hypertension with CMBs group had significantly lower MK values in left hippocampus gyrus, left centrum semiovale, bilateral caudate head, left posterior limb of internal capsule, bilateral thalamus, and left substantia nigra, significantly higher MD value in right thalamus, and significantly lower FA value in left posterior limb of internal capsule as compared with essential hypertension without CMBs group and healthy control group ( P<0.05). Conclusion:In patients with essential hypertension, the brain microstructural changes are found in the hippocampus, centrum semiovale, caudate head, posterior limb of internal capsule, thalamus and substantia nigra; these changes are more obvious in essential hypertension patients with CMBs; DKI and ESWAN can effectively assess the early brain microstructure changes in patients with essential hypertension.

Objective:To explore the observation and nursing of patients with acute mass asphyxia poisoning with pulmonary bullae treated by nasal high-flow humidification and oxygen therapy.Methods:Review and summarize the data of 5 patients with acute mass asphyxial gas poisoning with pulmonary vesicles who were admitted to the department of toxicology of this hospital in June 2019 and received nasal high-flow humidification and oxygen therapy. The oxygenation index, airway humidification and prognosis were observed.Results:All the 5 patients were successfully transferred to nasal catheter for oxygen inhalation after nasal high-flow humidification and orygen therapy without intubation. When discharged from the hospital without oxygen, pH: 7.36-7.42, PO 2:82-106 mmHg, PCO 2:32-39 mmHg. All the white blood cells and myocardial enzymes were normal, and there was no brain injury, perinasal skin damage and abdominal distension. Conclusion:Nasal high-flow humidification and oxygen therapy can effectively improve the efficacy of oxygen therapy for patients with acute mass asphyxial gas poisoning with pulmonary vacuoles.

Objective:To explore the observation and nursing of patients with acute mass asphyxia poisoning with pulmonary bullae treated by nasal high-flow humidification and oxygen therapy.Methods:Review and summarize the data of 5 patients with acute mass asphyxial gas poisoning with pulmonary vesicles who were admitted to the department of toxicology of this hospital in June 2019 and received nasal high-flow humidification and oxygen therapy. The oxygenation index, airway humidification and prognosis were observed.Results:All the 5 patients were successfully transferred to nasal catheter for oxygen inhalation after nasal high-flow humidification and orygen therapy without intubation. When discharged from the hospital without oxygen, pH: 7.36-7.42, PO 2:82-106 mmHg, PCO 2:32-39 mmHg. All the white blood cells and myocardial enzymes were normal, and there was no brain injury, perinasal skin damage and abdominal distension. Conclusion:Nasal high-flow humidification and oxygen therapy can effectively improve the efficacy of oxygen therapy for patients with acute mass asphyxial gas poisoning with pulmonary vacuoles.

Objective: To prepare manganese-doped carbon quantum dots (Mn-CDs) dual-modal nanoprobe for fluorescent-magnetic imaging, and evaluate its characteristics and potential on fluorescence imaging and MRI. Methods: Mn-CDs were synthesized at 150 ℃. The form, diameter, component, fluorescent capability, T₁ relaxation rate, stability and cytotoxicity of Mn-CDs in vivo were verified. The fluorescence imaging of HO-8910 tumor-bearing mice was performed on small animal imager, and the whole-body enhanced imaging was performed on 3.0 T MRI scanner. One-way analysis of variance was used to analyze the data. Results: The Mn-CDs with the diameter of (4.64±0.85) nm showed a well-defined spherical morphology. The fluorescent spectra of Mn-CDs exhibited that the excitation maximum was at 360 nm and the emission maximum was at 440 nm. The T₁ relaxation rate was (3.26±0.04) mmol·L^-1·s^-1. The Mn-CDs had good stability of fluorescent and magnetic imaging capability at 0, 0.25, 0.5, 0.75, 1.0 and 2 months at room temperature with no significant differences of fluorescent and magnetic signals (F=1.566 and 0.987, both P>0.05). After injection of 200 μl Mn-CDs (15 g/L), mice were all alive and had no viscera damage. The tumor could be observed obviously on fluorescence imaging at 5 min. Enhanced MRI showed that the tumor was unevenly enhanced and Mn-CDs were mainly cleared away through urinary system. Conclusion Mn-CDs are stable and have good potential on fluorescence imaging and MRI, which provides a promising multimodal imaging method for tumor detection and monitoring.

Objective? To sum up the experience on application automated dispensing cabinet (ADC) in ward drug administration to improve the management level and work efficiency. Methods? From January to December 2017, a total of 22 wards used the cabinets in Peking University International Hospital. The drug administration had three categories including usual, base and narcotics drugs. We compared the time of getting drug before and after applying ADC by counting the mean of single time of getting drug in temporary medical order through the year. Results? Among 22 wards, the time of getting drug in temporary medical decreased from (17.55±3.92) min to (3.73±0.83) min after applying ADC with a statistical difference (t=16.160, P＜ 0.01). Besides, there was no adverse event caused by getting drugs mistakenly after applying ADC. Conclusions? ADC uses the intelligent management in ward drug administration which can improve working efficiency of nurses, realize refined management of drugs, improve medication safety of patients and reduce the waste of drugs.

Objective To explore the effects of erythropoietin (EPO) on the expression of signal transducer and activator of transcription (STAT) 1,phosphorylated STAT1 (P-STAT1),STAT3,P-STAT3 and cell apoptosis in rat models of focal cerebral ischemia-reperfusion.Methods Eighty male SpragueDawley rats were randomly and evenly divided into four groups by completely random design method: shamoperation (group A),cerebral ischemia-reperfusion (group B),cerebral ischemia-reperfusion ± saline (group C) and cerebral ischemia-reperfusion ± EPO (group D).The model of focal cerebral ischemiareperfusion injury was established by blocking the left middle cerebral artery.All rats underwent MRI for the detection of the changes of infarct area between 2 h post ischemia and 24 h of reperfusion.Western blot was used to observe the expression of STAT1,P-STAT1,STAT3,P-STAT3.Terminal oxynucleotidyl transferase mediated dUTP biotin nick end labeling (TUNEL) was used to evaluate the cell apoptosis including the relative area (ROI area/whole brain area of the same layer × 100％) of abnormal signal region,relative optical density (rOD) and apoptotic index.One-way analysis of variance and q test were used to analyze the data.Results On T2WI imaging,rats in group B and group C presented large hyperintense areas in the cortex and subcortex of left hemispheric ((28.00±4.60)％ and (29.70±4.80)％ respectively).Group D presented less hyperintense areas in the cortex and subcortex of left hemispheric compared with group B and group C ((21.10±2.40) ％; F=11.285,P＜0.01).The expression of STAT1 and STAT3 proteins was not significantly affected by ischemia-reperfusion and EPO intervention compared with normal brain tissue (F=0.806,1.558,both P＞0.05).However,the level of P-STAT1 was low in group A (rOD =0.75±0.13) but increased after cerebral ischemia-reperfusion.Compared with group B and group C,P-STAT1 expression was lower in group D (B-D: 2.08±0.15,2.05±0.16,1.92±0.05; F=3.274,P＞0.05).The level of P-STAT3was also low in group A (rOD=1.02±0.09).Compared with group B and group C,P-STAT3 expression in group D was significandy higher (B-D: 2.22±0.13,2.04±0.14,4.21±0.21 ; F=40.719,P＜0.01).The apoptotic index of group B and group C was (42.00±1.30)％ and (41.20±2.50)％,respectively,which was significantly higher than that of group D ((20.90± 1.46) ％ ; F=378.704,P＜0.01).Conclusion Intraperitoneal injection of EPO can reduce the cerebral ischemic area and the number of apoptotic cells in the ischemic penumbra in rat ischemia-reperfusion models through increasing P-STAT3 and decreasing P-STAT1 levels.