Mannan binding lectin (MBL) is an innate immune mediator belonging to the collectin family known to bind to the surface of many viruses, bacteria and fungi. Many researches show that MBL is associated with many autoimmune diseases. Inflammatory bowel diseases (IBD) including ulcerative colitis and Crohn's disease are related with innate individual immunity. This article reviews the recent researches on the association of MBL with IBD.

The mechanism of sudden cardiac death caused by variation in SCN5A is still unclear. Recently, the converging evidences suggest that the dysfunction of regulation mediated by transforming growth factor-β1 in cardiac fibration and reconstruction of cardiac iron channel could be main reason of SUNDS caused by variation of SCN5A. The resent progress of the mechanism of transforming growth factor-β1 in sudden cardiac death caused by variation of SCN5A gene is reviewed in this paper, hoping to provide reference for the research and practice of sudden cardiac death in forensic medicine.

Background:Abnormal immune response is involved in the pathogenesis of Crohn’s disease( CD),and T lymphocytes are the main players in the immune response. Aims:To investigate the relationship between peripheral blood CD3 + ,CD4 + and CD8 + T cells and inflammation-related markers in patients with CD. Methods:Proportions of peripheral blood CD3 + ,CD4 + and CD8 + T cells were measured by flow cytometry in 26 CD patients( including 14 patients in active stage and 12 in remission stage )and 8 healthy volunteers(control group),and their correlation with inflammation-related markers(including white blood cell count,platelet count,ESR,CRP,albumin and hemoglobin) were analyzed. Results:Proportions of CD3 + ,CD4 + and CD8 + T cells were significantly increased in patients with active CD than those with remission CD and controls( P ﹤ 0. 05),however,no significant differences were found between remission CD patients and controls(P ﹥ 0. 05). ESR and CRP in active CD patients were significantly higher than those in controls(P ﹤ 0. 05),while albumin and hemoglobin levels were significantly decreased(P ﹤ 0. 05);albumin in remission CD patients was significantly lower than that in controls(P ﹤ 0. 05). No significant differences in white blood cell count and platelet count were found between active,remission CD patients and controls(P ﹥ 0. 05). Proportions of CD3 + , CD4 + and CD8 + T cells were positively correlated with CRP,and negatively correlated with hemoglobin( P ﹤ 0. 05);CD3 + and CD4 + T cells were positively correlated with ESR(P ﹤ 0. 05). However,CD3 + ,CD4 + and CD8 + T cells were not correlated with white blood cell count,platelet count and albumin level( P ﹥ 0. 05). Conclusions:Proportions of peripheral blood CD3 + ,CD4 + and CD8 + T cells are increased with the increase of disease activity in CD,and are positively correlated with CRP,and negatively correlated with hemoglobin.

BACKGROUND: Multilevel cervical disc herniation accompanying ossification of posterior longitudinal ligament (OPLL) can seriously hurt the spinal cord. Which way of operative approach is more preferable is still uncertain. Whether one-stage combined anterior and posterior operation can achieve better effects remains unclear.OBJECTIVE: To explore the therapeutic effect of one-stage anterior and posterior operation for the treatment of multilevel cervical disc herniation accompanying OPLLMETHODS: Seventeen patients with multilevel cervical disc herniation and OPLL were treated by one-stage anterior and posterior operation at the Department of Orthopaedics, Tongji Hospital, were selected, including 11 males and 6 females, aged 42-74 years,mean aged 51.5 years. X-ray film, CT or MRI before operation showed the cervical cord was compressed by the multilevel herniated cervical discs or the ossified posterior longitudinal ligament. The stability and fusion of the injured segments were observed by regular postoperative X-ray film.RESULTS AND CONCLUSION: All patients were received a 6-36 months follow-up (24.5 months on average). The postoperative JOA scores were (12.88±2.47) points, which was greater than that of preoperatively [(6.41±1.28) points, P<0.05]. The improvement-rate of the spinal function after 6 months included 5 excellent cases, 7 good cases, and 4 fair cases. The excellent-good rate was 71%. All the patients got completely reduction, and all grafts got fused at 3-4 months after operation. The cervical intervertebral height and lordosis were satisfied maintained and there was no complication related to internal fixation breakage, loosening or displacement. It suggested that one-stage anterior and posterior operation can provide satisfied decompression earlier and rebuild the spinal stability in time, which is a safe and effective surgical intervention for multilevel cervical spondylotic myelopathy accompanying OPLL.

Background:Capsule endoscopy has been demonstrated to be an effective diagnostic tool for small bowel diseases in a series of small sample researches. However,the results need to be verified by large sample studies. Aims:To investigate the diagnostic performance and safety of capsule endoscopy for small bowel diseases. Methods:Consecutive patients undergoing capsule endoscopy for suspected small bowel diseases from May 2008 to Apr. 2013 in Nanjing General Hospital of Nanjing Military Command of PLA were collected and analyzed retrospectively. Results:A total of 573 patients were enrolled,the overall success rate of the examination was 99. 13%(568 / 573)and the overall completion rate was 88. 38%(502 / 568). The mean time of capsule passing the pylorus was 43. 45 min,and that of passing the small bowel was 287. 21 min. The overall detection rate of small bowel lesions was 53. 52%(304 / 568)and the overall diagnostic rate was 51. 06%(290 / 568). Both the detection rate and diagnostic rate in patients with obscure gastrointestinal bleeding(OGIB) were significantly higher than those in patients with obscure abdominal pain and chronic diarrhea(64. 26% and 62. 46%vs. 41. 72% and 39. 07% ,and 32. 14% and 27. 38% ,P all < 0. 05). Small bowel lesions detected by capsule endoscopy included angiopathy(21. 38% ),ulceration(20. 72% ),neoplasms(14. 47% ),erosion(11. 84% ),and Crohn’s disease(11. 18%),etc. Capsule retention occurred in 2. 29%(13/568)of the patients,and one acute intestinal obstruction and 2 perforations were observed. Conclusions:Capsule endoscopy is a safe and effective diagnostic modality for small bowel diseases. OGIB is the most common indication for capsule endoscopy,and capsule endoscopy is also helpful for evaluation of established or suspected Crohn’s disease.

Objective Fecal biomarkers have emerged as an important tool for assessing and monitoring disease activity in patients with inflammatory bowel disease ( IBD) .We aimed to investigate the diagnostic value of fecal neopterin and calprotectin in pa-tients with active inflammatory bowel disease and made comparison with that of serum C-reactive protein ( CRP) . Methods A total of 151 consecutive patients with IBD (84 CD and 67 UC) provided 2 gram fecal samples for the measurement of fecal neopterin( FNP) and calprotectin( FCP) concentrations and 2 milliliter blood samples for the serum C-reactive protein measurement before undergoing a colonoscopy.ELISA was applied in the measurement.Clinical disease activities were scored independently according to the Best Crohn′s Disease Activity Index(CDAI) in patients with CD, while the Modi-fied Mayo Scores in patients with UC.Comaprison was made in the relativity of each fecal marker and IBD activity score, the optimum value of diagnosing IBD acitivity as to each fecal marker, as well as sensitivity, specificity, moreover, receiver operating characteristic curve ( ROC) was drawn.50 healthy volunteers who received a normal colonoscopy were also enrolled as the control group and asked to give a 2 gram fresh stool sample. Results The FNP and FCP concentrations in patients with IBD were significantly higher than those in healthy control group(P<0.05).Both FNP and FCP concentrations differed significantly in clinically active IBD when compared with those in patients with inactive disease( P<0.001) .In CD patients, the correlation coefficients of FNP and FCP with CDAI were 0.55 and 0.59, respectively(P<0.001).In UC patients, the correlation coefficients of FNP and FCP with Mayo scores were 0.74 and 0.77, respectively( P<0.001) .The correlation coefficients of serum CRP in CD and UC patients with clinical scores were 0.49 and 0.60, respectively(P<0.001).The area under the ROC curve(AUC) of FNP and FCP for the diagnosis of clinical activity in pa-tients with CD were 0.75 and 0.80, respectively.The AUC of FNP and FCP in UC patients were 0.85 and 0.90, respectively.The AUC of serum CRP in patients with CD and UC were 0.65 and 0.74, respectively.When combined FNP with FCP, the AUC in pa-tients with CD and UC were 0.85 and 0.92, respectively. Conclusion FNP is a novel reliable and non-invasive biomarker to evalu-ate clinical disease activity in patients with IBD as accurate as FCP, It is advisable to combine FNP with FCP to evaluate disease activi-ty in patients with IBD.

D ue to the negative autopsy and w ithout cardiac structural abnorm alities, unexpected sudden cardiac death (U SC D ) is alw ays a tough issue for forensic pathological expertise. U SC D m ay be asso-ciated w ith parts of fatal arrhythm ic diseases. T hese arrhythm ic diseases m ay be caused by disorders of cardiac ion channels or channel-related proteins. C aveolin can com bine w ith m ultiple m yocardial ion channel proteins through its scaffolding regions and plays an im portant role in m aintaining the depolar-ization and repolarization of cardiac action potential. W hen the structure and function of caveolin are af-fected by gene m utations or abnorm al protein expression, the functions of the regulated ion channels are correspondingly im paired, w hich leads to the occurrence of m ultiple channelopathies, arrhythm ia or even sudden cardiac death. It is im portant to study the effects of caveolin on the functions of ion channels for exploring the m echanism s of m alignant arrhythm ia and sudden cardiac death.

Objective To understand the correlation of enterovirus 71 (EV71), P-selectin glycoprotein ligand-1 (PSG L-1), and scavenger receptor B2 (SCARB2) and to explore the possible pathway and mechanismof EV71 infection by observing the expression of EV71, PSG L-1 and SCARB2 in tissues of infants with brain stemencephalitis. Methods T he organs and tissues of infants with EV71-VP1 positivi-ty in their brain stems were chosen. Expression and distribution of EV71-VP1, PSG L-1, and SCARB2 were detected and compared by immunohistochemistry. Results Strong staining of EV71-VP1 was ob-served in the neuron, glial cells, the inflammatory cells of perivascular cuffing, parietal cells of the gas-tric fundus gland while alveolar macrophages, intestinal gland epitheliumcells, mucosa lymphoid nodule and lymphocyte of palatine tonsil showed moderate staining and weak staining were displayed in mesen-teric lymph nodes and lymphocyte of spleen. PSG L-1 expression was detected in parietal cells of the gastric fundus gland, tonsillar crypt squamous epithelium, alveolar macrophages and leukocytes in each tissue. SCARB2 expression was observed in all the above tissues except the intestines and spleen. Con-clusion T he distribution of EV71 correlates with SCARB2 expression. SCARB2 plays an important role in virus infection and replication. Stomach may be an important site for EV71 replication.

Objective To investigate the current status of ICU delirium management so as to provide reference for the clinical management of ICU delirium.Methods A total of 6 ICU units from two class Ⅲ grade A hospitals in Beijing were selected by convenient sampling. The spot investigation method was used to investigate the delirium management status and effect from June to September 2016.Results Six ICU units had neither developed a complete delirium management system and standardized process, nor systematically evaluated delirium risk factors. When delirium patients had symptoms, delirium was diagnosed according to the clinical experience in 6 ICU units, while specialist consultation was used in 3 ICU units. None of these units used any delirium screening tool. The delirium prevention rate was from 46.2% to 76.9%. The implementation rate of delirium treatment was 65.8%. Among 38 cases of delirium patients diagnosed by medical staff, 25 cases (65.8%) of which were treated. During the study, there were 106 cases of delirium patients; the incidence of delirium was 30.8%; the delirium identification rate of medical staff was 35.8%.Conclusions The normalization of routine monitoring of delirium in ICU is necessary. Prevention and treatment for delirium is inadequate. The effect of delirium management needs to be further improved.

Objective?To determine and analyze the problems of nurses during using printed Intensive Care Delirium Screening Checklist (ICDSC) for evaluating through user requirements analysis, which is necessary for information systems development, so as to provide a basis for developing an ICDSC interactive strategy. Methods?Two methods, the documentation method and task check method, were used to analyze user requirements of printed ICDSC. The retrieval words of documentation method were "ICDSC" and "intensive care delirium screening checklist". This study retrieved documents on using and evaluation of ICDSC publishing in PubMed, Springer, Elsevier, CNIAHL, CNKI and WanFang Data from January 2000 to December 2017. The find what focused on description related to problems of Intensive Care Unit (ICU) nurses during using printed ICDSC. The task check method was used to select ICU nurses as user representatives to assess delirium of four patients cases provided by researchers using printed ICDSC. Each case all perfectly completed 8 appraising tasks from ICDSC assessments. Researchers observed and recorded problems of ICU nurses during fulfilling the task. Nurses' sample size was based on information saturation (till no new information occurred). Results?A total of 7 articles among 144 ones retrieved referred to problems of nurses during using printed ICDSC to assess delirium including time-consuming, failing to understand items, deficiency/inaccuracy in nursing record. A total of 15 ICU nurses were selected in task check method. Results showed that the problems included time-consuming, omitting items, failing to understand items, scoring mistakenly, deficiency/inaccuracy in nursing record. Conclusions?There are problems such as time-consuming, omitting items, failing to understand items, scoring mistakenly and assessed information without inaccurate source in using printed ICDSC. The interactive strategy should be developed according to these problems.