To advocate cadaver donation is to advocate the spirit of devotion and scientific research.It has been proved in the development of modern medicine that many problems of medical education and stubborn diseases were solved by necrospy.However,currently the cadavers donated cannot satisfy practical need,mainly because that few people would voluntarily register to donate their bodies,and those among the registered who actually donated are even fewer.This paper analyzes three factors that contribute to the bottleneck in the cadaver donation.And on the basis of present situation,countermeasures are presented to solve the problems.

To investigate the effects of salvianolic acid B (SA-B) on cardiovascular endothelial cell function and platelet activation during myocardial ischemia-reperfusion in rabbits.

Objective: To clarify the predictive value for long-term prognosis of GRACE score and SYNTAX score in patients with non-ST elevation acute coronary syndrome (NSTE-ACS).
Methods: A total of 784 NSTE-ACS patients treated in our hospital from 2009-01 to 2014-01 were retrospectively studied. According to the treatment, the patients were divided into 3 groups: Medication group,n=410, Stent group,n=325 and CABG group,n=49. Based on 2 scoring systems, the patients were divided into another 3 groups: Low risk group, Medium risk group and High-risk group. The relationship between GRACE score and SYNTAX score was studied by Pearson correlation analysis, survival analysis was conducted by Kaplan-Meier method, univariate and multivariate analysis were performed by Cox proportional hazard model, and the area under curve (AUC) of ROC analysis was used to compare two methods.
Results: All 784 patients completed the follow-up study at the median of 47.7 months. Pearson correlation analysis showed that there was a weak positive correlation between GRACE score and SYNTAX score (r=0.40,P<0.01). Survival analysis presented that by GRACE score system, the MACE occurrence rates in Low risk group, Medium risk group and High-risk group were elevated accordingly as 13.81%, 23.64% and 36.55% respectively. And by SYNTAX system, MACE occurrence rates in Medium risk group and High-risk group were 39.29% and 37.93%, which were both higher than that in Low risk group (23.99%), while the scores between Medium and High risk groups were similar,P>0.05. Cox proportional hazard model and ROC analysis indicated that GRACE and SYNTAX scores had the important predictive value for lone term prognosis of NSTE-ACS. ROC analysis of GRACE score, SYNTAX score, the combination of GRACE and SYNTAX scores showed that 3 of them all had good predictive value for MACE occurrence, three of 95% CI had signiifcant overlapping without statistic differences.
Conclusion: GRACE score and SYNTAX score are related, both of them have important while similar predictive value for long term prognosis in NSTE-ACS patients, the combination of 2 scores cannot increase the predictive value. GRACE score is appropriate for the risk stratiifcation in NSTE-ACS patients.

Endoplasmic reticulum (ER) stress is an important mediator causing inflammatory response, which additionally exerts secondary injury after intracerebral hemorrhage (ICH) to influence brain function recovery through a variety of cell signaling and response, to regulate neural cells survival or death. Therefore, further understanding about the relation between ER stress and inflammatory response as well as the signal transduction pathway can provide new therapeutic strategies and evidence for treatment of ICH. The present review summarizes the process of ER stress activation and the relation between inflammatory response and ER stress activation after ICH.

Objective: To discuss the clinical significance of antibacterial peptide LL-37 in the early diagnosis of patients with sepsis in emergency department. Methods: Forty patients diagnosed with sepsis in the emergency department of the Affiliated Hospital of Zunyi Medical College from December 2017 to March 2018 were enrolled as sepsis group. Twenty healthy volunteers were enrolled contemporaneously in our hospital at medical center as healthy control group. Peripheral blood was collected immediately after diagnosis in sepsis group or during physical examination in healthy control group. The expression of antibacterial peptide LL-37 was determined by enzyme-linked immunosorbent assay (ELISA). Meanwhile, serum procalcitonin (PCT) and C-reactive protein (CRP) levels were determined. The differences in antibacterial peptide LL-37, PCT and CRP levels between the two groups were compared. Pearson correlation method was used to analyze the correlation between antibacterial peptide LL-37, PCT and CRP. Receiver operating characteristic (ROC) curve was drawn, and the early individually or jointly diagnostic value of each detected index for sepsis was analyzed. Results: The levels of antimicrobial peptide LL-37, PCT and CRP in peripheral blood of sepsis group were significantly higher than those of healthy control group [LL-37 (μg/L): 1.34±0.69 vs. 0.10±0.06, PCT (μg/L): 46.67±39.51 vs. 0.03±0.02, CRP (mg/L): 129.68±49.83 vs. 3.16±2.85], with statistically significant differences (all P < 0.05). Pearson correlation analysis showed that the expression of antimicrobial peptide LL-37 was positively correlated with PCT and CRP levels (r₁ = 0.835, r₂ = 0.932, both P < 0.01). ROC curve analysis showed that the area under ROC curve (AUC) of LL-37, PCT and CRP for early diagnosis of sepsis was 0.885, 0.963 and 0.983, respectively, and the AUC of combined diagnosis of the three parameters was as high as 0.994, indicating that the value of combined diagnosis of sepsis was greater than that of single diagnosis; when the combined prediction probability of the three parameters was 0.92, the sensitivity was 97.5%, and the specificity was 95.0%. Conclusion Antibacterial peptide LL-37 has certain clinical value in early diagnosis of patients with sepsis, which can be used as early routine monitoring indicators for patients with early sepsis when combined with PCT and CRP.

Objective To explore the sedation and analgesia effect of dexmedetomidine (DEX) in patients with multiple trauma during mechanical ventilation.Methods Eighty cases of multiple trauma patients under mechanical ventilation treated from September 2016 to March 2017 were analyzed by retrospective case-control study.There were 58 males and 22 females with an age range of 18-60 years (mean,41.87 years).The injury severity score (ISS) was (18.45 ±4.53)points.The patients were treated with sedation and analgesia,and they were divided into two groups according to the sedative drugs.DEX composite tartaric acid butorphanol were used in 40 patients as DEX group.Midazolam composite tartaric acid butorphanol were used in 40 patients as Midazolam group.The degree of sedation score (Ramsay score) were compared between groups.The time from initial drug use to effective sedation achievement,daily wake-up time,mechanical ventilation duration,emergency intensive care unit (EICU) time,dosage of tartaric acid butorphanol,heart rate,blood pressure changes,and incidence of delirium were compared.Results (1) Two groups could both reach the target of sedation.DEX group had shorter daily wake-up time,shorter mechanical ventilation time and shorter length of EICU stay compared with Midazolam group (P ＜ 0.05).(2) The time to achieve satisfied sedation after initial usage in Midazolam group was shorter than that in DEX group (P ＜ 0.05).(3) DEX group had smaller tartaric dosage of acid butorphanol,and lower incidence of delirium compared those in Midazolam group (P ＜ 0.05).(4) The comparison of systolic blood pressure,diastolic blood pressure,heart rate within either group showed significant difference before and after sedation (P ＜ 0.05),but had no significant difference between two groups (P ＞ 0.05).Conclusions For multiple trauma patients with mechanical ventilation,DEX can attain sedation and analgesia and shorten daily wake-up time,mechanical ventilation time,and length of hospital stay.DEX can reduce the dosage of analgesic (butorphanol) and the incidence of delirium.Blood pressure and heart rate are associated with small variations before and after sedation.

The etiology of hemophagocytic lymphohistiocytosis (HLH) is complicated and difficult to diagnose, unexplained HLH often with hematological malignancies. Invasive biopsy can help to find etiology, the results may be affected by the technique and the location of the puncture site. Multiangle puncture can improve the success rate, but the corresponding risk increases. A patient with HLH was admitted to Affiliated Hospital of Zunyi Medical College. The etiology was unknown. Active symptomatic support treatment was conducted, at the same time, finding the evidence of viral infection, autoimmune disease related detection, blood culture, bone marrow puncture smear and spleen biopsy were performed respectively to find the pathogen basis. Spleen hemorrhage was not being controlled after spleen biopsy in patients, and emergency splenectomy was adopted to stop bleeding for saving lives. Finally, the patients died of low protein, pulmonary edema and respiratory failure. The bone marrow puncture and spleen biopsy failed to provide the basis for tumor invasion, while the spleen pathological slices plus immunohistochemical indicate diffuse large B cell lymphoma (DLBCL) after splenectomy, which was identified as malignant tumor-associated hemophagocytic syndrome. Underscoring the high risk of bleeding after tumor-associated splenomegaly puncture and the importance of having emergency plans. Through analyzing the clinical characteristics, diagnosis and treatment of this patient, we hope to improve the clinicians' understanding of HLH and lymphoma.

Hematoma expansion in patients with spontaneous cerebral hemorrhage leads to poor prognosis. Thus, identifying relevant prognostic factors and constructing and applying models of hematoma expansion can help for early intervention and improve prognosis. In this paper, the prediction mechanism, validity, limitation and related prediction factors of several prediction models with good development prospects in recent years are reviewed to provide references for clinical diagnosis of spontaneous cerebral hemorrhage.

Acute respiratory distress syndrome (ARDS) is considered to be a pulmonary manifestation of systemic inflammatory response syndrome (SIRS), often occurring as a complication of disease, and worsening the prognosis of patients. In recent years, the incidence of trauma has increased year by year. Severe trauma can lead to SIRS, which is one of the common risk factors of ARDS. The spleen is the largest peripheral immune organ of the body, containing a large number of immune cells and secreting inflammatory factors. The inflammatory factors play an important role in the formation of traumatic ARDS. In recent years, the benefits of treating ARDS by inhibiting spleen-induced inflammatory response have gradually been discovered, providing new ideas for the treatment of ARDS. Therefore, the research status of spleen-mediated inflammatory response in traumatic ARDS is of great significance for the prevention and treatment of traumatic ARDS. This article reports the spleen-mediated systemic inflammatory response, the role of inflammatory mediators in the development of ARDS, and the current state of research on ARDS treatment to explore new approaches to the prevention and treatment of traumatic ARDS.

Traumatic brain injury (TBI) is one of the diseases with high morbidity,mortality,and disability,which seriously endangers human health.Primary and secondary injuries caused by TBI are cascade reaction of various pathophysiological interactions.Because of its many injury factors and complex mechanisms,the treatment and therapeutic effect of TBI are limited at present.In recent years,animal experiments and clinical studies have shown that stem cell therapy could alleviate TBI-mediated neurological damage to a certain extent.Therefore,activation of endogenous neural cells response and transplantation of exogenous stem cells may be new strategies for TBI treatment.This article reviews the research progress of activation of endogenous neural cells response and transplantation of exogenous stem cells after TBI,and focuses on the therapeutic effects and possible mechanisms of stem cell transplantation in TBI treatment.