Establishment and associated factors of health records among young Chinese migrants

BACKGROUND@#Most Chinese migrants have been faced with obstacles to getting access to local public health services. Young migrants among internal migrants make a major contribution to the economy. However, the establishment of their health records has been ignored. This research was aimed at exploring the status and associated factors of the establishment of health records among young Chinese migrants.@*METHODS@#Data were obtained from the 2017 China Migrants Dynamic Survey (CMDS). Chi-square test and binary logistic regression were performed to investigate the associated factors of the establishment of health records among young Chinese migrants.@*RESULTS@#Approximately 30.2% of young migrants had their health records established in inflow communities. Urban residence, medical insurance (insured), and lower average monthly household income were attributed to the establishment of more health records. Young migrants who were in northeast China and across provinces and immigrated for working or engaging in trade were less likely to have health records established. Young migrants who participated in social activities and public affairs activities and took type of people in touch as natives in the inflow area showed a higher possibility of establishing health records. Meanwhile, receiving health education and hearing about national basic public health services (BPHSs) were beneficial for establishing the health records of more young migrants.@*CONCLUSION@#This study showed that the health records of young migrants had a relatively low establishment rate. Sociodemographic and migration characteristics, health status, public health services, and social integration factors were all related to the health record establishment of young Chinese migrants.

Associations of negative life events and coping styles with sleep quality among Chinese adolescents: a cross-sectional study

BACKGROUND@#Limited published research has examined the relationships of negative life events and coping styles with sleep quality in Chinese junior high school students. We aimed to investigate the prevalence of poor sleep quality and to clarify the role of coping styles between negative life events and sleep quality.@*METHODS@#A cross-sectional study of 3081 students was conducted in Ganzhou City, Jiangxi Province, Southeastern China. Adolescent Self-Rating Life Events Checklist, Simplified Coping Style Questionnaire, and Pittsburg Sleep Quality Index were applied to assess negative life events, coping styles, and sleep quality, respectively. Descriptive analyses, independent-samples t tests, one-way analyses of variance, Pearson correlation analyses, and structural equation modeling (SEM) were applied to analyze the data.@*RESULTS@#The prevalence of poor sleep quality was 26.7%. Negative life events (B = 0.038, P 0.05). The association between negative life events and sleep quality was mediated by negative coping styles.@*CONCLUSIONS@#Our results indicated that poor sleep quality was common in these Chinese adolescents. Negative life events and negative coping style were associated with an increased prevalence of poor sleep quality, while the positive coping style was related to a decreased prevalence of poor sleep quality. A negative coping style mediated the association between negative life events and sleep quality.

The Associations of Family Functioning, General Well-Being,and Exercise with Mental Health among End-Stage RenalDisease Patients

Objective@#This study aims to explore the relationships of family functioning, general well-being, and exercise with psychological distress.Furthermore, we investigated the special roles of general well-being and exercise on the association between family functioningand psychological distress. @*Methods@#Of 769 end-stage renal disease (ESRD) patients participated in the cross-sectional study which consisted of the 12-item GeneralHealth Questionnaire (GHQ-12), the Family APGAR Scales, and the General Well-Being Schedule. The collected data were analyzedusing multiple linear regression analysis and path analysis. @*Results@#The prevalence of psychological distress was 72.3%. Family functioning, general well-being and exercise were associated factorsof psychological distress (p<0.05). The indirect effect of family functioning on psychological distress was partially mediated by generalwell-being (Effect=-0.08, 95% CI=-0.11, -0.04). In addition, the effect of family functioning on general well-being was moderated byexercise (Index=-0.092, SE=0.033, 95% CI=-0.159, -0.029). @*Conclusion@#The prevalence of psychological distress among ESRD patients was high. Family functioning, general well-being and exercisewere associated with psychological distress. Family functioning could affect psychological distress partially by affecting general wellbeing.Furthermore, exercise had a significant moderating effect on the relationship between family functioning and general well-being.Psychiatry Investig 2020;17(4):356-365

Evidence-based recommendation for delaying first bath time of newborn infants / 中国实用护理杂志

Objective:To select and obtain the best evidence for first bathing time of newborn infants after birth so as to provide reference for clinical practice to promote maternal skin contact, newborn ′s skin humidity, breastfeeding, and positive impact on the infant ′s temperature regulation as well as glucose stability. Methods:Using the method of evidence-based nursing, clinical question of optimal time for the first bath of newborn after birth.Relevant research was retrieved by computer search. Johns Hopkins evidence appraisal and recommendation tools were used to evaluate quality of studies and level of evidence.Results:Combined with judgement of clinical professionals,totally 7 evidences selected, including the advantages of delaying the first bath time and retaining fetal fat, improving skin humidity, increasing skin-to-skin contact for mothers and their healthy newborn infants, improving early sucking rate, maintaining neonatal body temperature and blood sugar balance.Conclusions:This study summarized the best evidence for delaying first bath time of newborns and helping clinical nurses and nursing managers decision-making.Through adapting the best evidence to establish neonatal skin barrier protection, improve breast-feeding rate, and further maintain neonatal body temperature and blood glucose balance.

Evidence-based recommendation for delaying first bath time of newborn infants / 中国实用护理杂志

Objective@#To select and obtain the best evidence for first bathing time of newborn infants after birth so as to provide reference for clinical practice to promote maternal skin contact, newborn′s skin humidity, breastfeeding, and positive impact on the infant′s temperature regulation as well as glucose stability.@*Methods@#Using the method of evidence-based nursing, clinical question of optimal time for the first bath of newborn after birth.Relevant research was retrieved by computer search. Johns Hopkins evidence appraisal and recommendation tools were used to evaluate quality of studies and level of evidence.@*Results@#Combined with judgement of clinical professionals,totally 7 evidences selected, including the advantages of delaying the first bath time and retaining fetal fat, improving skin humidity, increasing skin-to-skin contact for mothers and their healthy newborn infants, improving early sucking rate, maintaining neonatal body temperature and blood sugar balance.@*Conclusions@#This study summarized the best evidence for delaying first bath time of newborns and helping clinical nurses and nursing managers decision-making.Through adapting the best evidence to establish neonatal skin barrier protection, improve breast-feeding rate, and further maintain neonatal body temperature and blood glucose balance.

Prevalence of hypertension and hypertension control rates among elderly adults during the cold season in rural Northeast China: a cross-sectional study / Journal of Rural Medicine

Objective: The burden of noncommunicable diseases (NCDs) is increasing in China, together with economic development and social changes. The prevalence of risk factors for NCDs, such as overweight/obesity, hypertension, diabetes, and dyslipidemia, is reported to be high even among poor residents of rural areas. We aimed to investigate the prevalence of hypertension among elderly adults in rural Northeast China and the proportion with controlled hypertension among those on antihypertensive medication (hypertension control rate). We also aimed to examine the association of hypertension control with health facilities that provide treatment.Methods: We conducted a community-based cross-sectional study in six rural villages of Northeast China from February to early March, 2012. We interviewed 1593 adults aged 50–69 years and measured their blood pressure. We examined the differences in mean blood pressure between participants who obtained antihypertensive medication from village clinics and those who obtained medication from other sources, using analysis of covariance adjusted for several covariates.Results: The prevalence of hypertension among participants was as high as 63.3%, but the hypertension control rate was only 8.4%. Most villagers (98.1%) were not registered in the chronic disease treatment scheme of the public rural health insurance. The mean systolic blood pressure, adjusted for the covariates, of participants who obtained antihypertensive medication from village clinics was significantly lower than that of participants who obtained medication from township hospitals (by 16.5 mmHg) or from private pharmacies (by 7.3 mmHg).Conclusion: The prevalence of hypertension was high and the hypertension control rate low among elderly villagers during the cold season. As treatment at village clinics, which villagers can access during the cold season seems to be more effective than self-medication or treatment at distant hospitals, improving the quality of treatment in village clinics is urgently needed.

Mutation analysis and prenatal diagnosis for a case of spinal muscular atrophy with respiratory distress type 1 / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To detect potential mutation of immunoglobulin μ -binding protein 2 (IGHMBP2) gene in a two-year-old patient with spinal muscular atrophy with respiratory distress type 1 (SMARD1).</p><p><b>METHODS</b>Genomic DNA was extracted from peripheral blood sample from the patient and her parents, as well as cord blood sample from the fetus. Potential mutations of the coding region of the IGHMBP2 gene was detected with PCR and Sanger sequencing.</p><p><b>RESULTS</b>A heterozygous missense mutation c.1060G>A and a frameshift mutation c.2356delG was detected in the patient. The mutations were respectively inherited from her father and mother. Neither mutation was found in DNA derived from the cord blood sample.</p><p><b>CONCLUSION</b>The missense mutation c.1060G>A and frameshift mutation c.2356delG were probably causative for the disease. Analysis of the IGHMBP2 gene has provided an important clue for the etiology and prenatal diagnosis of SMARD1.</p>

Clinicopathologic features of adenoid cystic carcinoma of breast / 中华病理学杂志

Objective@#To investigate the clinicopathologic features and grading of adenoid cystic carcinoma (ACC) of the breast.@*Methods@#Sixteen cases of ACC of the breast were analyzed and graded according to the previous report. Immunohistochemical (IHC) staining was used to detect the immunophenotype, Ki-67 proliferative index and expression of EZH2, and the association with tumor grade and outcome was analyzed.@*Results@#Of the 16 cases, 11 were grade Ⅰ, with the epithelial and myoepithelial cells being arranged into tubular and cribriform structure with no solid component; three were grade Ⅱ, which were composed of mixed tubular, cribriform and solid component (<30%); and two were grade Ⅲ, which showed mainly solid component (>90%) and the tumor cells showed basaloid features with scanty cytoplasm and hyperchromatic nuclei, and mitotic count was>5/10 HPF. Immunophenotypically, the epithelial cells expressed CK7, CK8/18 and CD117; the myoepithelial cells expressed p63 and CK5/6; while the basaloid cells were positive for CK5/6 and CD117.Tubular and cibriform ACC showed low Ki-67 and EZH2 expression, while the two cases of solid variant with basaloid features showed high level of Ki-67 and EZH2 expression. Follow-up data were available in 13 cases with a median follow-up period of 42 months. Lung metastasis occurred after 12 months in one grade Ⅱ case and the patient died of disease after 34 months. Vertebral metastasis occurred after 12 months in one grade Ⅲ case and axillary lymph node metastasis occurred in another grade Ⅲ case. All other patients were free of disease at the end of the follow-up periods.@*Conclusions@#ACC shows morphologic spectrum varying from low to high grade, the latter can may give rise to local and distant metastasis. ACC should not be regarded simply as low malignant potential, and should be graded for optimal treatment.

The overexpression of miR-378 promotes the therapeutic effects of bone marrow mesenchymal stem cell transplantation on myocardial infarction / 中国组织工程研究

BACKGROUND: Recently, miR-378 has been shown to modulate the anti-hypoxia capacity of bone marrowmesenchymal stem cells (BMSCs) and reduce cell apoptosis under hypoxic conditions.OBJECTIVE: To investigate the benefits of miR-378-upregulated BMSC transplantation in a rat model of acutemyocardial infarction.METHODS: Primary rat BMSCs were cultured in vitro. Until passage 3, the cells were infected with the lentiviruscarrying synthetic miR-378 gene fragments. A rat model for acute myocardial infarction was constructed by ligatingthe left anterior descending artery. Thereafter, the animals were randomly assigned to three groups: control group(n=10), BMSCnull group (n=16) and BMSCmiR-378 group (n=16). In the latter two groups, 50 μL of normal salinecontaining 1×107 empty virus-transfected or miR-378-transfected BMSCs was injected into the region of myocardialinfarction, respectively. Only 50 μL of normal saline was injected in the control group. Twenty-four hours later, theapoptosis of transplanted BMSCs was evaluated with TUNEL, and expression level of vascular endothelial growthfactor and transforming growth factor-β was detected using western blot assay. Four weeks after treatment, the leftventricular function of rats was assessed by echocardiography, and then histological and molecular biology analyseswere performed.RESULTS AND CONCLUSION: At 24 hours postoperatively, there were less apoptotic BMSCs and higher expressionlevels of vascular endothelial growth factor and transforming growth factor-β in the BMSCmiR-378 group than in theBMSCnull group (n=6, P < 0.001). Four weeks later, there were more transplanted BMSCs and BMSCs-derivedcardiomyocytes in the BMSCmiR-378 group than the BMSCnull group (n=10, P < 0.001). Moreover, increased new vesseldensity (P < 0.001), decreased infarcted area (P < 0.001), preserved left ventricular ejection fraction (P < 0.05), reducedleft ventricular end-diastolic volume (P < 0.05) were found in the BMSCmiR-378 group, compared with the other two groups.The above parameters were better in the BMSCnull group than the control group (P < 0.05). Overall, the upregulation ofmiR-378 could enhance the capability of BMSCs against hypoxia, and consequently promote myocardial repair afterimplantation, providing a new strategy for cell therapy of myocardial infarction.

Vaccination safety and media publicity strategy / 中华流行病学杂志

Due to the over negative report of adverse event following immunization (AEFI) by media,some people began to question the safety of vaccination.Date published since 2005 were collected by literature retrieval,mainly including relative AEFI date,current status of media report of AEFI,public awareness about AEFI.Public concern about the vaccination safety mainly focused on the serious diseases which might be caused,influence on immune system.Media' s over negative reactions to AEFI and lack of related knowledge in general public have led to the public' s concern about vaccination safety.Vaccination is the most economical and effective measure for the prevention of diseases and AEFI incidence rate is very low.Therefore,it is necessary for media to give more positive report about vaccination safety.

Effect of edaravone pretreatment on oxidative stress and inflammatory reaction during one lung ventilation of patients underwent thoracoscopic surgery / 临床麻醉学杂志

Objective To observe the effect of edaravone pretreatment on the lung injury during one lung ventilation of patients undergoing thoracoscopic surgery.Methods Forty male patients diagnosed of lung cancer (aged 47-65 years,height 165-183 cm,weight 64-85 kg,BMI<30 kg/m2 ,ASA gradeⅠorⅡ)who were scheduled for thoracoscopic pulmonary resection surgery were randomly divided into two groups(n =20 each):control group (group C)and edaravone group (group E).In group E edaravone 30mg(dissolution in normal saline 100 ml)was administered within 30 min before surgery.In group C nor-mal saline 100 ml was administered within the same time.PET CO2 and peak airway pressure (Pmax)were recorded during operation,venous blood samples were taken before skin incision and at the end of operation for detection of the concentration of IL-8,IL-10,TNF-α and SP-A.Results There were no significant difference in PET CO2 and Pmax between the two groups..Compared with T1 ,concentration of IL-8,IL-10, TNF-αand SP-A all increased significantly in both groups on T6 (P <0.05).Compared with group C,IL-8, TNF-αand SP-A levels of T6 in group E were lower significantly (P < 0.05 ).There was no significant differences in the levels of IL-10 between the two groups.Conclusion Edaravone can inhibit oxidative stress and inflammatory reaction during one lung ventilation in patients underwent thoracoscopic surgery.

Investigation of use of antimicrobial agents in tension-free inguinal hernia repair during perioperative period / 中国基层医药

Objective To investigate the use of antibacterial drugs in tension -free inguinal hernia repair before and after the 2012 National clinical use of antibiotics special management ,providing the basis for the rational use of antimicrobial drugs and standardized management .Methods Retrospectively investigate the antimicrobial ap-plication in patients undergoing tension-free inguinal hernia repair and discharged from July to September in 2011-2013,and analyzed the timing of administration ,usage,type and treatment time of antimicrobial drugs .Results There were respectively 93.24%,47.76%and 27.59%of patients in the three groups administrated prophylaxis antibacte-rial drugs,and respectively 9.19%,65.67%and 85.08%of patients with indications .The first wound healing rates were respectively 94.59%,98.51% and 96.55%.The rates of reasonable choice of medicines 70.60%,96.88%and 91.67%,respectively;the rates of reasonable timing for medication were 71.01%,81.25%and 70.83%,respec-tively;the rates of reasonable courses of prophylaxis therapy were 33.33%,56.25% and 58.33% respectively. Conclusion The principle of no preventive antibiotics use in tension-free inguinal hernia repair is operable .After en-actment of special management of antibacterial drugs ,the level of preventive medication for tension-free inguinal herni-a repair is improved greatly .However ,it still needs to strengthen the management of antimicrobial prophylaxis timing and overall prophylaxis treatment course .

Meta-analysis of tacrolimus on children with difficult nephritic syndrome / 中国小儿急救医学

Objective To evaluate the effects and safety of tarcrolimus on children difficult nephritic syndrome.Methods Databases including the Cochrane Library,Pubmed,Medline,OVID,CNKI,Wan Fang Data and VIP were searched to collect the controlled trials on tacrolimus capsule published from Jan 2003 to Jun 2013.The quality of the included randomized controlled trials was assessed by Jadad,and the complete remission,the fail,the relapsing rate of 12 month and side effects after treatment were extracted,meta-analysis was performed using RevMan 5.0 software.Results Among 179 articles,6 articles were included,4 of them were English and the other 2 were Chinese.The results of meta-analysis based on stratified therapeutic strategies showed that:(1) comparing with cyclophosphamide,tacrolimus could decrease the fail and relapsing rate of 12 month,but could not increase the complete remission (P ＞ 0.05).(2) Comparing with cyclosporine A,tacrolimus had no difference in complete remission and the relapsing rate of 12 month (P ＞ 0.05),but could decrease the fail.(3) Tacrolimus could increase the complete remission and decrease fail,but had no difference in relapsing rate (P ＞ 0.05).(4) There was no significant difference in relapsing rate between tacrolimus and rituximab(P ＞ 0.05).(5) Tacrolimus had less side effects than cyclophosphamide.Conclusion Tacrolimus have advantages to cyclophosphamide,cyclosporine A and prednisolone,but not to rituximab,and have less side effects than cyclophosphamide.

Vitamin D status in children with chronic kidney disease / 国际儿科学杂志

Chronic kidney disease (CKD) is a disease that grately threaten the health of children.In China the main cause of CKD in children is glomerular disease.CKD usually supervene cardiovascular diseases,renal anemia,renal osteodystrophy,and affect the life quality of children greatly.In CKD patients,the hydroxylation of 25 (OH) Vitamin D is disordered,and the endogenous synthesis of calcitriol decreased,leading to the reduce of 25 (OH) Vitamin D.This article will summarize the present researches about the level of 25 (OH) Vitamin D in CKD children in order to provide guidance for the treatment of CKD with Vitamin D.

The relationship between human glucocorticoid receptor and steroid-resistant nephrotic syndrome / 中国小儿急救医学

Idiopathic nephrotic syndrome is a common pediatric kidney disease,and glucocorticoid is the first choice to deal with it.However,not all children are absolutely sensitive to it,about 10 to 20 percent are steroid-resistant.Researches have shown that human glucocorticoid receptor is associating with steroid-resistant.This article summarized the expression of glucocorticoid receptor and its gene polymorphism in steroid-resistant children.

The effect of matrine on adriamycin-induced podocyte injury and the function of mTOR signaling pathway / 临床儿科杂志

Objectives To investigate the effect of matrine (MAT) on adriamycin (ADR) induced podocyte injury in vitro and explore the function of the mammalian target of rapamycin (mTOR) protein signaling pathway during the intervention. Methods ADR (1μmol/L) was used to induce the model of podocyte injury and then the podocytes were intervened by 10, 20 and 40μg/ml MAT for 24 hours. The viability and apoptosis rate of podocytes, mRNA and protein expressions of desmin and mTOR were detected. The effect of different concentrations of MAT on ADR-induced podocytes was analyzed. Results Com-pared with the control group, declined viability of podocytes (P<0.001), increased percentage of apoptotic podocytes (P<0.001), and increased expression of damage marker desmin (P=0.002) were observed in ADR group. In ADR group, after intervention with MAT of 10-40μg/ml, increased viability of podocytes (P<0.05), decreased percentage of apoptotic podocytes (P<0.05), and decreased expression of damage marker Desmin were found (P<0.05). The protein expression of mTOR and phosphorylation state of mTOR (p-mTOR) decreased in ADR induced-podocytes (P<0.05), and after intervention with MAT of 10-40μg/ml, the expression of mTOR and p-mTOR increased (P<0.05). The expression of mTOR downstream target protein s6k1 and 4EBP1 mRNA decreased in ADR group (P=0.071), while increased after intervention with MAT of 10-40μg/ml (P<0.05). Conclusions 10-40μg/ml MAT have protective effects on ADR-induced podocytes in vitro. The protection mechanism may be related to mTOR signaling pathway.

Characteristics of boningmycin induced cellular senescence of human tumor cells / 药学学报

Cellular senescence is one of the important steps against tumor. This study was to observe the characteristics of boningmycin induced senescence of human tumor cells. MIT method and clone formation assay were used to detect the growth-inhibitory effect. Cellular senescence was detected with senescence-associated beta-galactosidase staining. Cell cycle distribution and accumulation of intracellular reactive oxygen species (ROS) were analyzed with flow cytometry. Protein expression was detected by Western blotting. The results showed that the growth-inhibitory effect of boningmycin was obviously stronger on human oral epithelial carcinoma KB cells than that on non-small cell lung cancer A549 cells. Comparison to the similar action of doxorubicin, that boningmycin induced the features of cellular senescence in both cell lines, its due to the arrest at G2/M phase and an increase of ROS level. The molecular senescence marker P21 increased significantly after boningmycin treatment at a dosage of 0.1 micromol x L(-1), whereas a higher concentration of it induced apoptosis. The results indicated that cellular senescence induced by boningmycin was one of its mechanisms in tumor suppression.

Preparation and antitumor immunity of long circulating Nano-Liposome encapsulated tumor specific antigen / 细胞与分子免疫学杂志

AIM: To prepare Nano-Liposome encapsulated MAGE3/HSP70(NL M3H) and study its character and antitumor immunity in mouse. METHODS: NL M3H was prepared by the thin film-dispersion ultrasonic. The shape and size of NL M3H were detected by electron microscope. The encapsulation rate, drug-carrying capacity, stability and the releasing character were tested by Sephedex-G100 gel filtration. The mouse was immunized by NL M3H, and the antitumor immunity was detected by ELISPOT and LDH release assay. RESULTS: The mean size of NL M3H was lower than 100 nm. The encapsulation rate was 38％.The drug content was 0.038 g/L. NL M3H has good stability after stored in 4℃ for 6 months. The releasing profile showed that 74 percent of proteins was released during the first 24 hours in saline. The results of ELISPOT and LDH release assay showed that NL M3H generated tumor specific cytotoxic T lymphocyte(CTL)to damage tumor cel1. CONCLUSION: NL M3H has novel characters, it can generate specific CTL to kill tumor cell, and can be used as new kind of vaccine agsinst tumor.

Two-dimensional electrophoresis for the screening of biomarker in carcinomas of the urinary bladder / 中华检验医学杂志

Objective This study was designed to establish and optimize the two-dimensional gel electrophoresis (2-DE) for the proteome analysis of human Transitional Cell Carcinomas of the Urinary Bladder ,and to established the two-dimensional gel electrophoresis (2-DE) profile of human Transitional Cell Carcinomas of the Urinary Bladder(TCC) of different stages in carcinogenic process. The basic aim is to perform differential analysis and provide a basis for identifying carcinogenesis-associated protein of TCC.Methods After obtaining samples of the normal,invasive tissue,noninvasive tissue,a series of methods Such as sample preparation,electrophoresis parameters,gel concentration,PDQuest 2DE analysis software,peptide mass fingerprint (PMF,MALDI-TOF-MS)were used to analyses these tissues.Results The good 2DE patterns of different tissues including resolution and reproducibility were obtained. After coomassie Brilliant Blue R-250 staining, the average matching ratio was 76%.There was a good reproducibility of spot position in 2-DE map, with average deviation in IEF direction of (0.98?0.26) mm, while in SDS-PAGE direction it was(1.23?0.22) mm. The 2-DE patterns with good quality had been obtained. Ten protein spots chosen randomly from different stages were identified by PMF, some of which were involved in the cell proliferation, differentiation, cycle regulation, and tumor occurrence, such as Heat shock protein-27,SFN etc.Conclusions The results provide a fundamental basis for further study of mechanism of human Transitional Cell Carcinomas of the Urinary Bladder and screening its specific marker.

CD28 and CTLA-4 expressions in the process of mice' T-cell inefficiency induced by staphylococcal enterotoxin A / 解放军医学杂志

Objective To explore the characteristics and regulations of CD28 and CTLA-4 expressions in the process of mice' T-cell inefficiency induced by staphylococcal enterotoxin A(SEA).Methods Twelve mice were averagely divided into three groups(4 each).The mice in group 1 received single injection of SEA,and the mice in group 2 and 3 received SEA injection twice and three times,respectively,with a 3 days interval.Mice were sacrificed at day 1,3,7 and 14 after the last injection,and then the splenic lymphocytes were isolated.The expressions of CD28 and CTLA-4 in cellular membrane and the intracellular expressions of CTLA-4 and IL-2 were detected with flow cytometry.Results In group 1,the CD28 expression in cellular membrane and the intracellular expression of IL-2 were significantly up-regulated,while the CTLA-4 expressions both in cellular membrane and intracellular expression were lower with no obvious changes.In group 2,the expressions of both CD28 and IL-2 were up-regulated slightly,the expressions of CTLA-4 increased significantly both in cellular membrane and intracellular expression,even more increase was the intracellular CTLA-4 expression.In group 3,the expressions of CD28 and CTAL-4 in cellular membrane and the intracellular CTLA-4 expression declined,and at day 7 the intracellular IL-2 expression was undetectable.Conclusions SEA may obviously promote the activation of naive T-cells when initially used to induce the splenic lymphocytes,while multiple stimulations(e.g.3 times) of SEA may lead T-cells to anergy.On the process of inefficiency,the declined IL-2 production may be closely related to the down-regulation of CD28 expression;the up-regulation of CTLA-4 expression may profit inducing inefficiency,but is not on the maintenance of inefficiency.