MAPK(mitogen-activated protein kinase) family,which is conserved throughout high eukaryotes,is implicated in multiple cellular processes including cell growth,migration,proliferation,differentiation,survival and development.Pathogen hijacks hosts' MAPK pathways to facilitate its pathogenesis using diverse strategies.To further explore the mechanism underlying interactions between pathogens and hosts' MAPK pathway,is of benefit to our understanding of nature as well as to our fight against pathogen infection.

Objective To evaluate the efficacy of endovascular interventional minimally invasive techniques in treatment of acute brachial artery injury.Methods A retrospective case series study was designed to analyzed data of 16 cases (11 males and 5 females) sustaining acute brachial artery injury treated from March 2011 to August 2016.Mean age was 47.9 years (range,27-66 years).Left upper extremity vascular injury occurred in 7 cases and right upper extremity vascular injury occurred in 9.There were 13 cases of arterial intima injury and 3 of arterial pseudoaneurysm.All patients underwent endovascular therapy including stent implantation and balloon dilatation.Angiography was used to evaluate the repair of brachial artery and the operation time was recorded.Improvements of distal limb arterial pulse and limb ischemic symptoms were observed,and the patients who were followed up with stent lumen stenosis more than 50％ received endovascular treatment again.Results The procedures was successful in all patients,with operation time of 30-75 minutes (mean,45 minutes).After the insertion of a stent,recovered brachial artery blood flow and disappeared pseudoaneurysm were observed on angiography,without occurrence of stent stenosis or contrast extravasation.Symptoms of local pain and numbness were alleviated,and blood supply of the distal brachial artery was improved after operation.All patients were followed up for 3-36 months(mean,16.7 months).The false aneurysm did not recur.Two cases of stent stenosis more than 50％ had a second balloon dilation procedure and the blood flow returned to normal.Stent patency was found in 14 cases with stent stenosis of less than 50％.During the follow-up period,no ischemic necrosis,displacement of the stent or stent fracture were found.Conclusion For acute brachial artery injury,endovascular management exhibits higher technical success rate and good clinical outcome with a low incidence of complications.

Aged ; Atherosclerosis ; complications ; Blue Toe Syndrome ; diagnosis ; etiology ; metabolism ; pathology ; Cell Nucleus ; Cholesterol ; blood ; Color ; Epidermis ; Female ; Humans ; Male

Adolescent ; Adult ; Female ; Histiocytic Necrotizing Lymphadenitis ; diagnosis ; therapy ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Neck ; Young Adult

It is very important to train junior doctors'clinical skills,especially surgical skills.Operation protocol presentations before each surgical procedure provide good opportunities for them to learn these skills,and at same time,this presentation ensures a better surgical outcome as well.Each presentation is prepared under the direction of a senior doctor.A protocol is composed of the patient medical history,physical examination,accessory check up reports,diagnosis and surgical procedure.It is not only a good method for the young doctors to learn but also for their teachers to teach each student individually.

The paper reviews the background and current situation of medical disputes and puts forward the concept of the reaction chain of medical disputes in view of their high occurrence rate and the difficulty in handling them. It discusses the framework, chief content, basic principles and major features of the reaction chain of medical disputes and argues that as a commonly used tool for handling medical disputes, the reaction chain renders it possible to check from the angje of the interests of the patients whether each party involved in the dispute has fulfilled its duties. Intended to improve the professional ethics of the physicians and the quality of medical care and calling on the patients to rebuild their confidence in the physicians, the reaction chain indicates that it is necessary to scientifically analyze the entire process and various influencing factors of medical disputes and bring into play the advantages of integration so as to successfully resolve medical disputes.

Objective To investigate the effect of ondansetron on the development of neuropathic pain in rats following chronic constriction injury (CCI) on sciatic nerve. Methods This research consisted of 3 parts. ①A single bolus of ondansetron was given intraperitoneally 2 h before nerve injury; ②A single bolus of ondansetron was given intraperitoneally on the 7th day after nerve injury; ③Continuous administration of ondansetron was given daily for 35 d; In each part, male SD rats were randomly divided into ondansetron group (0.5, 2, 8 mg/kg), saline group and sham operated group. The paw withdrawal response to thermal stimulation was tested throughout the 35 d following nerve injury. Results Ondansetron administration before nerve injury had no effect on thermal pain threshold in rats of experimental neuropathic pain. ondansetron administration on the 7th day after nerve injury attenuated the descending of thermal pain threshold but did not alter its descending trend in subsequent time period. Daily administration of ondansetron for 35 d attenuated and further delayed the descending of thermal pain threshold significantly in a dose-dependent manner. Conclusion Continuous administration of ondansetron can prevent or at least delay the descending of thermal pain threshold of rats with experimental neuropathic pain after constriction injury.

Objective To investigate the application status of aspirin for secondary prevention among elderly patients with ischemic stroke in some community hospitals in Shanghai,and explore the main causes for inappropriate use of aspirin and the effect of aspirin on the prevention of ischemic stroke recurrence. Methods The cross-sectional investigation was employed,and 223 patients from 10 community hospitals of Shanghai were divided into regularly-received aspirin group(n=98) and irregularly-received aspirin group(n=125).The application status of aspirin was investigated and the relationship between aspirin application and ischemic stroke recurrence was explored. Results Fifty-one cases in irregularly-received aspirin group(40.80%) stopped aspirin use or reduced the dose due to possible adverse effects,which accounted for 22.87% of the total population investigated,and 42 cases in irregularly-received aspirin group(33.60%)were never suggested to use aspirin or only used traditional Chinese medicine.The rate of ischemic stroke recurrence was 30.61%(30 cases) in regularly-received aspirin group,and 49.60%(62 cases) in irregularly-received aspirin group,which existed significant differences between these two group(P

Objective To evaluate the safety and efficacy of homemade patent ductus arteriosus (PDA) closure device for patients with very large PDA. Methods A total of 15 patients (12 females) with very large PDA, underwent transcatheter occlusion with homemade PDA devices. The median age was 21?8 (16-46) years old. The median diameter of the PDA at its narrowest point was 16?3 (13-22) mm. Aortic angiography and measurement of pulmonary pressure were performed before and after the closure of PDA. Repeat echocardiography was performed on each patient at one week, one month and six months after the procedure. Results Fifteen patients underwent transcatheter closure using a device of 23?4 (18-32)mm in diameter, and all of them showed a trace to small shunt by aortic angiography 30 minutes after the procedure. Thirteen patients was successfully occluded with a peak systolic pulmonary pressure decreased from 113?21 mm?Hg to 70?29 mm?Hg (P