In recent years, the number of ICU survivor is ever-growing with the increase of cure rate. The survivors′ outcome has aroused more and more attentions from medical personnel. ICU survivors tend to experience lasting physical, psychological and cognitive injuries, the post-traumatic stress disorder is one kind of significant psychological injury associated with patients′ critical experience. This review aims to summarize relevant literatures, introduces the prevalence, risk factors, complications, and interventions of ICU survivors′ post-traumatic stress disorder symptom, in order to prevent ICU survivors from post-ICU psychological injury and improve their long-term outcome.

BACKGROUND: Studies have demonstrated that hyperpolarization-activated andcyclic nucleotide-gated cation channels (HCN) 2 and HCN4 are abnormal expressed in ventricular muscle following heart disease, which is closely correlate to ventricular arrhythmia. Bone marrow stem cells (BMSCs) transplantation can improve damaged cardiac muscle; however, its effect on remodeling of ion channel is unclearly. OBJECTIVE: To detect the changes of HCN2 and HCN4 expression in left ventricle following BMSCs transplantation.METHODS: Five Sprague-Dawley (SD) rats, aged 3 weeks, were prepared for BMSCs by Percoll method. Additional 30 health, male, SD rats, were randomly divided into DMEM, cell transplantation, sham operation and control groups. At 4 weeks after model preparation, DMEM culture medium was injected into the infarcted area and surroundings with 5 points in the DMEM group. The 3rd generation of cultured BMSCs (200 μL, with 5×10~6 cells) were injected into rats in the cell transplantation group with the same methods. The mRNA and protein expression of HCN2 and HCN4 gene was detected by RT-PCR and Western blot respectively.RESULTS AND CONCLUSION: In non-infarcted region, the mRNA and protein expression of HCN2 and HCN4 among each groups had no significant difference (P > 0.05). Compared with the control and sham operation groups, mRNA and protein expression of HCN2 and HCN4 in surrounding of the infracted region was elevated in the DMEM group (P < 0.05), which was greater than that of the cell transplantation group (P < 0.05). The mRNA and protein expression of HCN2 and HCN4 was smaller in the center area of infracted region in the DMEM group than that of the control and sham operation groups (P < 0.05), which was similar to the cell transplantation group (P > 0.05). Acute myocardial infarction can increase mRNA and protein expression of HCN2 and HCN4 in infracted region surrounding. BMSCs transplantation may lower the fatality rate of ventricular arrhythmia by reducing HCN2 and HCN4 expression.

Objective:To detect the effects of polysaccharopeptide(PSP) on MyD88-dependent signaling pathway in EAC tumor-bearing mice,and explore the immunomodulatory mechanism of PSP.Methods: Ehrlich′s ascites carcinoma(EAC) C57BL/6 mice were used to establish the animal model for solid tumor.Mice were divided into two groups:WT group and MyD88-/-group.After 22 days of treatment,quantitative real-time PCR( Q-PCR) ,Western blot and were used to detect the related gene and protein expression of TLR4 pathway in spleens,ELISA were used to detect the terminal effect factors secretion eyeball blood from each group.Results:Related genes and proteins of TLR4 pathway in spleen were up-regulated significantly from two groups.Compared with WT group, related genes and proteins in MyD88-dependent pathway(MyD88,TRAF6,NF-κB,AP-1)was down-regulated in MyD88-/-group(P<0.05).Meanwhile,There was no significant change of the related genes and proteins of MyD88-independent pathway(TRAM,TRIF)in MyD88-/-group( P>0.05 ) .The terminal effect factors secretion of IL-2, IL-6, IL-10, TNF-αand IFN-γin MyD88-/-group were decreased significantly compared with WT group(P<0.05).Conclusion:The immunoregulatory effect of PSP on EAC tumor-bearing mice may be implement through the regulation of MyD88-dependent signaling pathway.

BACKGROUND: Orthodontic tooth movement is dependent on reconstruction of periodontium. Osteoclastic bone resorption is the first step of tooth movement. The present study hotspots focus on signal transduction pathway regarding osteoclast differentiation and functional development under stress and on the relationship between periodontal ligament cells and osteoclasts. OBJECTIVE: To set up a simple method to in vitro culture human osteoclast-like cells and to observe the effects of bone resorption-stimulating factors on differentiation, proliferation, and function of osteoclast-like cells, DESIGN, TIME AND STTING: A cytological in vitro controUod observation was performed at the Central Laboratory,Stomatology Hospital, Xi'an Jiaotong University between October 2007 and May 2008. MATERIALS: Umbilical cord blood was sourced from the healthy puerperae who had not suffered from high-risk pregnancy. Freshly prepared fetal femur provided by Laboratory Animal Center, Xi'an Jiaotong University and were used for preparation of bone flaps at 100-200 μm thickness. 1α ,25-(OH)2D3, macrophage colony-stimulating factor (M-CSF), prostaglandin E2 were purchased from Sigma Company, USA.METHODS: Under aseptic condition, umbilical cord blood was collected. Following Ficoll solution separation and centrifugation, supematant was discarded. Umbilical cord blood-derived mononuclear cells were suspended with o -modified minimal essential medium (α-MEM) solution and then inoculated into a 24-well culture plate, in which, coverslips and femoral slices were pre-placed, at a density of 1×109/L, 1.0 mL per well. Five groups were set, blank control, 108 mol/L 1α ,25-(OH)2D3, 10-7 mol/L 1α ,25-(OH)2D3, macrophage colony stimulating factor (M-CSF), and 1α ,25-(OH)2D3+prostaglandin E2 (PGE2). Each group was cultured for 7 days. MAIN OUTCOME MEASURES: Cellular growth morphology was observed under an inverted microscope; osteoclast-like celt formation was examined by tartrate-resistant acid phosphatase (TRAP) staining; and osteoclastic Howship's lacuna was detected by toluidine blue staining. Any cell with TRAP-positive staining and more than two nuclei was considered osteoclast-like cell and counted. RESULTS: After 3 days of culture, cells from the blank control group did not exhibit apparent changes in morphology and quantity. In the remaining groups, mononuclear cells appeared with confluent tendency. After 7 days of culture, a small number of osteoclast- like cells with 2-3 nuclei were found in the blank control group; a great many of multinucleated osteoclast- like cells with 3-20 nuclei were present in the remaining groups. Through the use of optical microscope, osteoclast-like cells could be found for the presence of red cytoplasm, bright yellow nuclei, and TRAP-positive staining in each inducing factor-treated group, in particular in the 108 mol/L 1α ,25-(OH)2D3 group, which displayed osteoclast- like cells exhibiting 14 nuclei, strong TRAP-positive staining, and a relatively big cell body. But no osteoclastic Howship's lacuna was found in any group. Compared to the blank control group, the numbers of osteoclast-like cells were greater in each inducing factor-treated group (F = 9.78, P < 0.01). There was no significant difference in the numbers of osteoclast-like cells between the 108 mol/L 1α ,25-(OH)2D3 and the 10-7 mol/L 1 a ,25-(OH)2D3 groups (P0.05). The M-CSF group and the 1α ,25-(OH)2D3+PGE2 group exhibited significantly less numbers of osteoclast-like cells than the 108 mol/L 1α ,25-(OH)2D3 group (F= 7.46, P< 0.01). CONCLUSION: After in vitro culture of 1α ,25-(OH)2D3, M-CSF, and PGE2, umbilical cord blood-derived mononuclear cells can differentiate into TRAP-positive multinucleated osteoclast-like cells, the 10-8 mol/L 1α ,25-(OH)2D3 being the most effective.

Intrauterine growth retardation (IUGR) is one of the most commonly encountered developmental toxicity, which could lead to perinatal morbidity and mortality, be also extended from the fetus to adulthood, and seriously affect the quality of the population. Caffeine widely exists in a variety of daily beverages and some drugs. Its consumption is increasing year by year. Caffeine intake during pregnancy is one of the risk factors for IUGR. However, its mechanism of adverse outcome based on embryonic research is still unclear. In this paper, the possible mechanisms of caffeine-induced IUGR focusing on 3 important factors-the mother, placenta and fetus were explored. Caffeine's impact on the mother is the chronic activation of renin-angiotensin system; on the placenta, caffeine induces cell damage or the failure of the cell proliferation/apoptosis balance, leading to blockage of blood supply to the placenta; caffeine is also capable of directly affecting fetal development through interfering its neuroendocrine.

Objective To investigate the potential effect of Lactobacillus acidophilus (L. acidophilus) on prevention and treatment of neonatal mice infected with human rotavirus (HRV). Methods Sixty 4-day-old kunming mice were randomly divided into control group. HRV infected group, L. acidophilus pretreated group (treated before HRV infection ) and L. acidophilus treated group(treated after HRV infection). The manifestation and pathological changes in small intestine of neonatal mice were observed. The HRV antigen in the feces and intestines were measured by ELISA and fluorescent-focus assay, respectively. Results The severity and duration of diarrhea as well as mortality in L. acidophilus pretreated group and treated group were lower than those in HRV infected group. The duration of HRV-antigens shedding following infection was considerably prolonged in HRV infected group compared to that in L. acidophilus pretreated group and treated group. Furthermore, decreased expression of HRV antigen and little pathological changes in intestinal mucosa were found in L. acidophilus pretreated group and treated group when compared with HRV infected group. Conclusion L. acidophilus may be used as an alternative approach for the prevention and treatment of neonatal mice infected with HRV.

Objective To study whether mannitol renal injury can be prevented by administering small dose dopamine without withdrawing mannitol.Methods Thirty adult rabbits were divided into three groups at random: control group(normal saline,NS),non-prevented group [20% mannitol 2g/kg+NS 4.6g/(kg?min),twice a day];prevented group(20% mannitol 2g/kg+dopamine 4.6g/kg min,twice a day).The changes of Bun,Cr,Na+ and K+ were observed.After the experiment the nephridial tissues were made into histological sections,the pathological changes were observed through microscope.Results The contents of Bun and Cr in blood of the non-prevented group were obviously elevated since day 8 and the difference was significant compared to the control group;the contents of Bun and Cr in the prevented group exceeded significantly those in the control group since day 9 between the non-prevented group and the prevented group.There was no significant difference before day 10.Since day 10,the difference became significant.No abnormality was found in the histological section of the control group.Both the renal tubular epithelial cells of the prevented group and non-prevented group were swollen and the renal tubular luminas were confined;however,the pathological changes in the non-prevented group were more severe than those in the prevented group.Conclusion It is effective to administer small-dose dopamine early to protect renal function.

The incidence of iron deficiency anemia and its therapeutic measures were studied in 559 children (aged 6 months to 3 years old) in Shijiazhuang city, Hebei province. The results showed that the incidence of iron deficiency anemia(IDA) was 53.85% and iron deficiency was 48.11%. Most of IDA occurred before 2 years of age and mild in character.No differences in hair Fe and Zn content were noted between anemic and unanemic children, but hair Cu was lower significantly in anemic children than in unanemics (Pyears old), group D under combined measures of A and B, group E as control. According to Hb re-estimated 2 months after treatment, A,B,C group had the same better therapeutic result than group E, but no combined effect was seen in group D.

Transcranial Doppler can be used for diagnosing,monitoring,identifying the site of arterial occlusion,selecting appropriate cases for thrombolysis,and monitoring arterial recanalization during intravenous thrombolysis,and intra-arterial and intravenous thrombolysis with recombinant tissue plasminogen activator,The continuous monitoring of low frequency transcranial ultrasound has the effect of assisted thrombolysis;however,there are still controversies on the frequencies used in clinical practice.Transcranial Doppler assisted with microbubble contrast agent may further enhance the effect of thrombolysis.

ObjectiveTo explore the relationships among atrial natriuretic peptide (ANP) and cerebral vasospasm (CVS) following subarachnoid hemorrhage (SAH) and hyponatremia.MethodsPlasma ANP levels and serum natrium and blood flow rate of intracal major arterial were assessed at different times (1 to 3 days, 7 days and 14 days after SAH) in 42 patients with SAH. Correlation analysis was carried out among plasma ANP, blood sodium level and blood flow rate of intracal major arterial.Results28 patients had CVS. Plasma ANP levels in CVS patients significantly elevated compared with non-CVS and control subjects (P<0.05). Hyponatremia in CVS patients also significantly elevated compared with non-CVS subjects (P<0.05). Plasma ANP level had significant negative relationship with serum natrium level at the 7th day and 14th day (r2=-0.778,r3=-0.653;P<0.01,P<0.05) in SAH patients. Plasma ANP level had significant positive correlation with middle cerebral artery mean flow velocity on the 7th day (r3=0.702,P<0.05) in SAH patients. Middle cerebral artery mean flow velocity had significant negative relationship with serum natrium level on the 7th day and 14th day (r2=-0.693,r3=-0.653 , both P<0.05) in SAH patients.ConclusionANP might cause hyponatremia following SAH and play an important role in pathogenesis of earlier period CVS.