High mobility groupbox 1 (HMGB1),a highly conserved protein previously known as a DNA-binding protein involved in maintenance of nucleosome structure and regulation of gene transcription,was recently found to act as a potent proinflammatory cytokine during infection responses.Levels of HMGB1 increase in serum and tissues during infection,especially in sepsis.A growing number of studies have demonstrated that HMGB1 is a cytokine that can mediate inflammation and is a potential therapeutic target in experimental models of sepsis.In this article,we will describe the biological function of HMGB 1 and HMGB 1 inhibitors for a potential role of inflammatory disease treatment.

Objective To summarize the prevention and treatment of hand food and mouth disease　(HFMD),especially the severe cases.Methods We analyzed the data including gender,age,time of onset,place of residence,contact history,clinical manifestation,accessory examinations and clinical outcome of 266　HFMD cases hospitalized in our department from Apr to Oct 2009,and identified the clinical and epidemiologic features associated with HFMD.Results Age group ranged from 4 months to 11 years with 87.6％(233/266) of the cases≤5 years.Most cases were resident in rural or suburban area,the number of which　was 3 times as much as urban.Neurological complications were more common,especially in the cases with increases of white blood cell and neutrophil number in peripheral blood.There were 40 cases with etiological examination results.Twelve cases were infected with enterovirus 71 ( EV71 ) and the others were infected with Coxsackievirus A16.Twelve cases with EV71 infection were complicated with meningoencephalitis,encephalitis,encephalomyelitis,one of whom was brain stem encephalitis.Conclusion The high-risk group of HFMD are the children less than 5 years.The suburban and rural are the key areas of prevention and control.The neurological complications are common,especially in the case with EV71 infection and significant increases of white blood cell and neutrophil number in peripheral blood.

Objective To explore the relationship between subclinical hypothyroidism(SCH)and microvascular complications(diabetic nephrop-athy and diabetic retinopathy)in type 2 diabetic patients. Methods According to the condition of complicating with SCH,157 patients with type 2 diabetes were divided into SCH group(40 cases)and the euthyroid group(117 cases). The age,sex,duration of diabetes,smoking status,blood pressure,body mass index(BMI),glycosylated hemoglobin(HbA1c),blood lipid,renal function,thyroid function,urine albumin/urine creatinine, and fundus examination were analyzed and compared between the two groups. The relationship between SCH and microvascular complications in type 2 diabetic patients was explored. Results There was no significant difference of age,sex,duration of diabetes,smoking,blood pressure,BMI, HbA1c,blood lipid,or serum creatinine between the two groups. The incidence of diabetic retinopathy in SCH group was significantly higher than those in euthyriod group(32.5%vs 14.5%,P=0.044);however there was no difference in the incidence of diabetic nephropathy. After adjustment for potential confounding factors(age,sex,duration,blood pressure,BMI,HbA1c,diabetic nephropathy)by multivariate logistic regression analy-sis,SCH was still the risk factor of diabetic retinopathy(OR=2.210,95%CI 1.512-4.117,P=0.032)in type 2 diabetic patients. Conclusion SCH could be a risk factor of diabetic retinopathy in type 2 diabetic patients,and there was no significant effect on diabetic nephropathy.

Objective To investigate the profession development status of intra-veineuse (IV) nurse team in Anhui province, provide the reference and baseline data on intravenous therapy management of province unity standard. Methods Using the cluster sampling method, the questionnaire designed by IV professional committee of Anhui province was used to investigate the status of IV nurse team in 137 hospitals. Results IV nurse in 35 hospitals (25.6%) was accepted the intravenous treatment knowledge training, however no specific provision for training time in 91 hospitals (66.4%). Organization in PICC evaluation was diversified, such as manufacturer (40 accounted for 29.2%), nursing association in province (city)( 38 accounted for 27.7%) and nursing department in hospital (36 accounted for 26.3%). 28 hospitals had PIVAS (20.4%). 62 hospitals established IV nurse team (45.3%), 87 hospitals established IV quality control system (63.5%). Implementation strength was good in the special inspection, the following feedback in standardized operation and adverse events (81 accounted for 59.1%, 72 accounted for 52.6%and 75 accounted for 54.7%, respectively), however, there was no enough emphasis on regular meeting, organization consultation and collection data of regular basis (59 accounted for 43.1%, 52 accounted for 38.0%and 32 accounted for 23.4%, respectively). Conclusions IV nurse team has been preliminarily established in Anhui province, however there are some problems, for example, specialist nurse training and examination is not unified, overall quality control system have not established, external conditions need to be improved. Related departments should actively formulate corresponding countermeasure to promote the healthy development of the IV nurse team.

OBJECTIVE To study the homology of resistant Gram-negative bacteria isolating from the hospitalized patients,hospital environment and hands of medical staffs in intensive care unit(ICU).METHODS To collect and identify 58 clinical resistant Gram-negative bacteria isolates and environment isolates from intensive care units,the same type of Gram-negative bacilli were studied on the homology using plasmid profile,restriction endonuclease profile and enterobacter repetitive intergenic consensus PCR(ERIC-PCR).RESULTS The homology existed between the resistant bacteria of clinical isolates and environment specimens.CONCLUSIONS We found that the multidrug-resistant Gram-negative bacteria derive from a common origin and cause an outbreak in ICU.So medical staff must emphasize the concept of hand hygiene and reinforce the measure of cleaning and sterilization,in order to control nosocomial infection.

Aspergillus fumigatus,as an opportunistic pathogenic fungus that causes high morbidity and mortality among immunocompromised patients,has aroused wide attention.As a major component of the innate immune system,macrophages play a pivotal role in resisting Aspergillus fungal infection.This review focuses on the contributions of macrophages in Aspergillus fungal infection.

Objective To evaluate the clinical value of serum carcinoembryonic antigen(CEA),neuron specific enolization enzyme(NSE),21-1 non-small cell lung cancer associated antigen(CYFRA21-1),carbohydrate antigen 125(CA125) and ferritin(Fer) in the diagnosis of lung cancer.Methods The levels of CEA,NSE,CYFRA21-1,CA125 and Fer were measured by electrochemlium-inescence in 103 patients with lung cancer,32 patients with benign lung diseases and 40 healthy people.Results The serum levels of CEA,NSE,CYFRA21-1,CA125 and Fer in patients with lung cancer[(110.2±95.5)ng/mL,(50.6±43.4)ng/mL,(32.8±29.5)ng/L,(122.7±110.4)U/L,(854.6±497.2)ng/mL] were significantly higher than those in patients with benign lung diseases and those in healthy people(t=6.21,5.71,6.75,6.62,7.74,P<0.05;t=5.26,4.86,5.81,5.20,6.26,P<0.05).The sensitivity values of CEA,NSE,CYFRA21-1,CA125,Fer and the combined determination containing five tumor markers were 39.81%,24.27%,71.84%,68.93%,77.66% respectively.The sensitivity and specificity of the combined determination containing five tumormarkers were 96.12%,95.00%.Conclusion The joint detection in the diagnosis of lung cancer could improve the sensitivity significantly,to help for early diagnosis of lung cancer,which is value to widely applied in clinic.

Hepatitis C virus (HCV) infection is an important public health issue around the world.Direct-acting antiviral agents (DAAs) have become an important method to reduce HCV infection.DAAs can improve the clinical outcome of antiviral therapy,shorten the course of treatment,and reduce complications and have a wide range of application;therefore,they have great advantages over conventional therapies.Accurate clinical diagnosis has increasing importance in the era of DAAs and guarantees the whole management process of chronic hepatitis C patients from the aspects of disease diagnosis,therapeutic regimens,outcome evaluation,and long-term prognosis monitoring.

Objective To investigate the protective effects of continuous norepinephrine infusion and its mechanism in early stage of lipopolysaccharide induced septic rats.Methods Forty SD rats were randomly divided into 5 groups (an external jugular vein catheterization was performed in every rat a day before intraperitoneal injection):saline control group (n =8),endotoxin group (n =8),low dose norepinephrine therepy group(n =8),middle dose norepinephrine therepy group (n =8),and high dose norepinephrine therepy group (n =8).Saline control group received intraperitoneal injection of 0.9％ saline 10 ml/kg,and then received an infusion of 0.9％ saline 1 ml/h.Endotoxin group animals were intraperitoneal injected with lipopolysaccharide 10 mg/kg,and then received an infusion of 0.9％ saline 1 ml/h.Therapy group animals received an infusion of norepinephrine solution 1 ml/h after being intraperitoneal injected LPS 10 mg/kg.The doses of norepinephrine were 0.06,0.3,0.6 μg/(kg· min) respectively.Blood samples were taken 2 h and 6 h later and the levels of serum TNF-α、IL-1β and IL-10 were detected by enzyme-linked immunoadsorbent assay.The membrane potential and three tricarboxylic acid cycle key enzyme activity [isocitrate dehydrogenase(IDH) and pyruvate dehydrogenase (PDH) activity] of isolated liver mitochondrion were detected 24 h later,and the morphologic changes of mitochondria in liver were observed by electronic microscopy.Results In endotoxin group,the levels of serum TNF-α JL-1 β and IL-10 all increased significantly(P ＜ 0.05) and liver mitochondrial membrane potential,PDH and IDH activity decreased significantly compared with control group(P ＜0.05,P ＜0.01).In the middle dose of norepinephrine therepy group,the levels of serum TNF-α and IL-1β all increased significantly (P ＜ 0.05,P ＜ 0.01),the level of serum IL-10 decreased significantly compared with endotoxin group (P ＜ 0.05) ; In the high dose norepinephrine therepy group,the liver mitochondrial membrane potential,PDH and IDH activity increased significantly compared with endotoxin group (P ＜ 0.05).The mitochondrial ultrastructural changes in every group were not obviously.Conclusion In the early stage of septic rats,reversible liver mitochondrion injury can be observed.Norepinephrine infusion can protect early septic rats through attenuating inflammatory reaction and enhancing tricarboxylic acid cycle key enzyme activity and mitochondrial membrane potential level.

Mechanisms of UV-B-induced apoptotic regulation in yeast Saccharomyces cerevisiae were studied. The results showed that UV-B irradiation indeed inhibited the growth of yeast cells as well as induced extensive apoptosis during 96 h experiment period. However, survival of 96 h irradiated cells remained 10% while most control cells finally dead after re-growth under UV-B irradiation for 12 d. And by exposed to 0.01 mol/L or 0.1 mol/L H2O2 for 30 min, survival rate of 24 h irradiated cells were 3.0-fold or 3.2-fold than control, respectively. By to heat shock for 30 min or 60 min, survival rate of 24 h irradiated cells were 3.5-fold or 9.0-fold than control, respectively.