Gut microflora , an important part in maintaining the intestinal homeostasis , can participate in the development of intestinal mucosal immune system , promote the synthesis of secreted IgA ( sIgA) and interact with intestinal immune cells .Gut micro-flora also plays a significant role in the development of inflammatory bowel diseases , irritable bowel syndrome , pediatric allergic disea-ses and other disorders .This paper reviews the advances about the correlation of gut microflora and intestinal mucosal immunity .

Intestinal trefoil factor (ITF or TFF3) is a member of trefoil factor family which is most studied , mainly in the in-testinal tract .TFF3 plays an important role in gastrointestinal mucosal protection and epithelial repair .Action mechanism includes in-teraction with mucin, migration, anti-apoptosis, angiogenesis, immune regulation, interaction with its receptor, etc.Recombinant TFF3 has been approved as a national drug and its therapeutic indications for repair mucosa , prevention and treatment of gastrointesti-nal ulcers and inflammation .Furthermore, the classic TFF3 receptor and signaling pathway is highly valuable to make TFF 3 become an effective treatment for gastrointestinal injury disease .

MiRNA is a small non-coding single stranded RNA(ssRNA)which is made up by 21~23 nucleotide.This ssRNA has a double effect as tumor suppressor genes and oncogenes , and plays an important role in cell proliferation , differentiation and apop-tosis.Pancreatic carcinoma is a highly malignant tumor with poor prognosis and high mortality rate , and the early diagnosis is difficult . In the last decades , growing studies highlighted the interactions between miRNAs and pancreatic carcinoma .This review provides a re-search overview between miRNAs and pancreatic carcinoma .Meanwhile , the significance of Expression Profile in pancreatic carcinoma′s diagnosis ,treatment and prognosis is also discussed .

The hospital grade assessment is an effective approach to measure the comprehensive strength and the overall level of a hospital, and it is also an effective carrier which can promote the standardized management , improve the quality of connotation and accelerate the development of the hospital .This article aims to expound the effective and concrete methods for preparation in the hospi -tal grade assessment by introducing the practice and experience of Jinling Hospital in grade assessement .It also points out that:defi-ning the purpose of the assessment is the fundation , having a thorough grasp of the assessment criteria is the basis , having a compre-hensive knowledge of the hospital is the premise , establishing and implementing the plan strictly is the crux .All these might be helpful to promote the hospital grade assessment .

Doctor-patient relationship is a special relationship between people in special circumstances during a special peri -od, which is directly related to the harmony and stability of society as well as people's quality of life.Values are the fundamental views of people, including the understanding of the nature , composition and standards of values .Doctors and patients are consistent in goals , interests and ideals , having the same objectives to overcome diseases , promote health , and prolong lives .They are essentially unified in values.However, there are some inharmonious phenomena in the relationship between doctors and patients .Efforts should be made to improve the present doctor-patient relationship by the whole society besides doctors and patients , aiming to establish a harmonious doctor-patient relationship of mutual respect , mutual trust , mutual tolerance and mutual cooperation on the basis of common values .

Objective Mycoplasma pneumoniae is one of the main pathogens of community-acquired pneumonia in children and teenagers , which may cause mycoplasma pneumoniae pneumonia ( MPP) .Atelectasis is one of the most common manifestations of MPP.The aim of the article was to evaluate the diagnostic and therapeutic value of fiberoptic bronchoscopy ( FB) in children with MPP associated with atelectasis . Methods Retrospective analysis were made on clinical data and FB records of 99 cases of hospitalized children with MPP associated with atelectasis from August 2010 to December 2012 . Results The positive rate of MP-DNA was 92.9%(92/99) in bronchoalveolar lavage fluid (BALF), and the positive rate of MP-Ab-IgM in serum was 68.7%(68/99).All pa-tients showed obviously bronchial mucosa congestive edema during FB examination .The results are as follows:bronchial phlegm bloc-king in 31 cases (31.3%), lumen inflammatory stenosis in 22 cases (22.2%),mucosal ulcer change in 7 cases(7.1%) and mucous nodular change in 3 cases (3.0%).4 weeks after being treated with bronchoalveolar lavage (BAL), only 3 cases remained in atelec-tasis, the partial and complete re-expansion rate reaching 96.5%(82 of 85). Conclusion The positive rate of BALF MP-DNA de-tection technology for the diagnosis of MP infection is higher than that of serum MP-Ab-IgM examination .Early interventional therapy by FB can shorten the course of disease and promote the lung re-expansion in children with MPP associated with atelectasis .

Objective Hair follicle stem cells (HFSCs) can be cultured in vti ro to differentiate into chondrocytes, osteoblasts and adipocytes .The aim of the article was to investigate the culture method of HFSCs and their adipogenic and osteogenic differentiation potentials. Methods Microdissection and two-step enzyme digestion were applied to obtain HFSCs , and HFSCs are purified by differ-ential adhesion method.The cells were cultured in keratinocyte serum-free medium obtaining 10% fetal bovine serum.Flow cytometry was used to detect CD34、β1-integrin and CK15.The third-generation HFSCs were cultured by osteogenic inductor and adipogenic induc-tor respectively . Results Cultured HFSCs were homogeneous in shape , bearing the property of great refraction and typical cobble-stone-morph.By flow cytometry, the expression rates of CD34,β1-integrin and CK15 were 59.6%, 97.0%and 61.1%.Stem cells were in good growing condition from the third-generation cell growth curve.21 days after being induced by osteogenic inductor, calcified nodules appeared after alizarin red staining, while 14 days after being induced by adipogenic inductor, intracellular lipid droplets could be observed after oil red O staining. Conclusion Cultured HFSCs are chaterized by strong growth capacity and multiple differentiation potential .

Objective Epicardial fat volume ( EFV) was a risk factor for coronary heart disease ( CHD) , but there is little research regarding the relationship of EFV with insulin resistance ( IR) and CHD in patients with metabolic syndrome ( MS) .The aim of the article was to explore the effect of EFV in patients with MS on CHD and IR . Methods Patients with MS treated by percutane-ous coronary angiography ( CAG) in our hospital from February 2013 to August 2013 were recruited in this study .The data of height , weight, waist circumference(WC) and hip circumference(HP) were recorded.EFV were measured by MSCT.Fasting blood samples were collected for blood biochemical test . Results EFV in patients with MS was in positive relation with IR index (IRI)(r=0.335, P<0.001) and CHD (r=0.321, P<0.05), and the correlation still remained when the influences of WC and body mass index (BMI) were excluded.Logistic regression analysis showed that EFV was an independent risk factor for CHD (P<0.05), while linear regression analysis indicated EFV , BMI and LDL-C were the risk factors for IRI .ROC curves analysis proved EFV and BMI had diag-nosis value for IRI, and the areas under curve of EFV were 0.755 and 0.679 (P<0.05) respectively. Conclusion EFV is an in-dependent risk factor for CHD and IRI in patients with MS , and EFV has an advantage over BMI in the diagnosis value of IRI .

Objective Though paraquat (PQ) is highly toxic, there is still no effective treatment for PQ poisoning .The aim of the article was to study the protective effect and mechanism of the p 38 mitogen-activated protein kinase ( MAPK) inhibitor SB203580 on PQ-induced acute lung injury in rats . Methods 72 SD rats were randomly divided into three groups ( n=24 ): normal saline (NS) group, PQ poisoning group and p38 inhibitor SB203580 intervention (PQ+SB) group.The arterial blood gas analysis, lung wet and dry ratio (W/D),the expression of tumor necrosis factor-α(TNF-α), the superoxide dismutase (SOD) level and the pathological changes of lung tissues were recorded at different time points after drug intervention . Results On the 1st , 3rd, 5th days after drug intervention in PQ group, the alveolo-arterial oxygen partial pressure difference (PA-aO2) [(45.67 ±4.17), (68.78 ±6.63), (80.23 ±7.12 ) mmHg ], the lung tissue TNF-αexpression (14.63 ±3.10], [18.24 ±2.98], [16.22 ±2.79] pg/mg) and W/D ([4.931 ±0.034], [5.020 ±0.064], [5.079 ±0.016]) in-creased gradually to a peak on the 3rd day, while the SOD level de-creased respectively on the 1st , 3rd, 5th days after drug intervention ([175.26 ±7.98], [167.57 ±8.05], [160.24 ±6.78] U/ug) (P<0.05).Compared with PQ group, PQ+SB group got a decrease in the PA-aO2([80.23 ±7.12] vs [44.17 ±4.16]), the lung tissue TNF-αexpression ([16.22 ±2.79] vs [9.48 ±2.72]) and W/D ([4.805 ±0.070] vs [5.079 ±0.016]) (P<0.05), while the pulmonary SOD level increased in comparison with PQ group ([125.89 ±6.65] vs [160.24 ±6.78]) (P<0.05). Conclusion The p38MAPK inhibitor SB203580 plays a certain protective role in PQ-induced acute lung injury by reducing inflammation and improving antioxidant capacity .

Objective Traumatic hemorrhagic shock ( THS) is frequently complicated by liver injury , and IL-1βis one of the important inflammatory factors involved in this process .We ob-served changes of liver injury-related indexes in the rat model of THS and investigated the effects of AS-1, the mimic of the TIR/BB loop of Myd88, an important molecule of the IL-1βsignal pathway, on liver injury triggered by ischemia/reperfusion following THS and resuscita-tion ( THSR) in rats. Methods Thirty-two healthy male SD rats
were randomly divided into groups A (THSR), B ( THSR+AS-1), C (THSR+dissolution medium), and D (control).For those of the first three groups , fracture was induced in the left tibia , the mean arterial pressure reduced to 30 mmHg by bloodletting from the femoral artery and maintained at 30-40 mmHg for an hour , and then the rats resuscitated by infusion of blood and Ringer′s solution in proportion at a uniform speed in 30 min.Before resuscitation, the rats in group B were treated with AS-1 (160 mg/kg), group C with dissolution medium, and group D left untreated .At 3 hours after resuscitation in groups A , B and C, and at 3 hours after 2.5h-our in-tubation in group D , we detected the activity of ALT , the levels of AST , IL-1βand TNF-α, and the activity of MPO in the left liver , and observed pathological changes in the liver by light microscopy . Results Compared with group D, groups A, B and C showed ev-ident liver injury and significant increases in the activity of ALT (87.55 ±6.8 vs 206.13 ±23.67, 110.45 ±18.20 and 210.73 ± 28.43), AST (327.03 ±36.23 vs 621.00 ±40.61, 409.13 ±63.53 and 600.25 ±44.05), the levels of IL-1β(327.03 ±36.23 vs 621.00 ±40.61, 409.13 ±63.53 and 600.25 ±44.05) and TNF-α(93.51 ±9.86 vs 214.13 ±21.24, 145.25 ±12.42 and 206.50 ± 36.97), and the activity of MPO (0.90 ±0.21 vs 1.72 ±0.12, 1.20 ±0.11 and 1.67 ±0.14) (all P<0.05).The above indexes were remarkably lower in group B than in A and C, (all P<0.05), but with no significant differences between the latter two groups (P>0.05).Conclusion TIR/BB-loop mimetic AS-1 can attenuate ischemia/reperfusion-induced liver injury after THSR in rats by decrea -sing the levels of IL1-βand TNF-αin the serum.