The cardiovascular system plays a key role in sepsis,and septic myocardial depression is a common finding associated with increased morbidity and mortality.Myocardial depression during sepsis is not clearly defined,but it can perhaps be best described as a global (systolic and diastolic)dysfunction of both the left and right sides of the heart.The pathogenesis of septic myocardial depression involves a complex mix factor of genetic,molecular,metabolic, and structural.Now,the research status on pathogenesis of myocardial depress in sepsis was reviewed.

In order to analyze and judge the condition of critical patients in PICU,and provide an objective basis for the treatment,invasive monitoring of physiological functions as a technology of understanding organs state is particularly important in clinical practice.Due to organ failure,some children require in vitro device to completely or partly replace organ function for a certain time,which can save and restore organ function.In order to reduce the incidence of iatrogenic damage,risk awareness and active prevention are required during these invasive procedures and organ replacement.

Postoperative epidural adhesion is one of the most common causes of failed back surgery syndrome (FBSS), which can lead to back and leg pain or neurological deficit. Prevention of epidural adhesion after laminectomy is critical for improving the outcomes of lumbar surgery. The main origins of epidural fibrosis are raw surface of erector muscles and rupture fibers of intervertebral disc. The main current preventive methods for epidural adhesion include the usage of implants, chemicals and low dose radiation. However, most of them are still in experiment period. There are still controversies on the clinic usage of autograft free fat, ADCON-L, and Mitomycin C (MMC). The optimal implants are characteristics of better biocompatibility, degradable absorption and capability of existing for a certain period in body. The optimal medicine should have good effect on anti-desmoplasia, less side effects and long half-life. Besides, the combination of biodegradable medical film and drug and the mixture of two or more medical films are also the research frontlines of epidural adhesion. Further researches are required to explore new materials and drugs with stable and most favorable effect in preventing epidural adhesion.
Biocompatible Materials ; administration & dosage ; Epidural Space ; pathology ; Humans ; Laminectomy ; adverse effects ; Lumbar Vertebrae ; surgery ; Tissue Adhesions ; prevention & control

Acute Kidney Injury ; etiology ; pathology ; therapy ; Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Anticoagulants ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Consensus ; Female ; Hemofiltration ; instrumentation ; methods ; Humans ; Infant ; Intensive Care Units, Pediatric ; Male ; Multiple Organ Failure ; etiology ; pathology ; therapy ; Practice Guidelines as Topic ; Sepsis ; complications ; pathology ; therapy ; Severity of Illness Index

Objective To assess the efficacy and safety of transurethral bipolar plasmakinetic resection of the prostate(TUPKRP) for the treatment of benign prostatic hyperplasia(BPH).Methods The operation was completed using a bipolar plasmakinetic resection system(CIRCON ACMI).Three trenches were created at 5,7,and 12 o'clock position,respectively,to divide the middle,left,and right lobes of the prostate gland for resection.The bladder neck was widened in overlapping vaporizing swathes to create a wide-necked funnel down to the level of the surgical capsule.The apical tissue was resected to the anterior border of the seminal colliculus.With a F_(20) or F_(22) three-cavity catheter indwelling for 3~5 d,normal saline irrigation was used for 1~2 d postoperatively.Results The duration of the procedure was 20~180 min(53.2?28.7 min),and resected tissue weighed 8~130 g(23.5?21.6 g).The intraoperative blood loss was 10~300 ml(65.4?46.8 ml) and no blood transfusion was required.No perforation of the prostatic capsule or transurethral resection syndrome occurred.The peak urinary flow rate(Qmax) increased from 8.4?1.9 ml/s preoperatively to 18.4?1.8 ml/s 1 month postoperatively(q=55.498,P﹤0.05).The residual urine(RU) decreased from 80.8?59.7 ml preoperatively to 19.5?10.0 ml postoperatively(q=17.287,P﹤0.05). The international prostate symptom score(IPSS) decreased from 25.7?5.5 preoperatively to 5.7?2.4 postoperatively(q=52.969,P﹤0.05).The scores of quality of life(QOL) decreased from 4.4?1.0 preoperatively to 1.1?0.2 postoperatively(q=42.146,P﹤0.05). Conclusions Transurethral bipolar plasmakinetic resection of the prostate for the treatment of benign prostatic hyperplasia is effective and safe,with few complications.

OBJECTIVEThe objective of this paper was to study the expression of related protein and Twist transcription factor of epithelial-mesenchymal transition in oral squamous cell carcinoma (OSCC) tissue and the correlations of OSCC and oral squamous cell carcino-metastasis. The paper also investigated the clinical significance of expression on OSCC.

METHODSThe labels of epithelium materialization (E-cadherin and cytokeratin), stromal labels (N-cadherin), transcription factor Twist protein, and mRNA expression in 30 OSCC tissues were investigated via immunohistochemistry and in situ hybridization. The paper also conducted contrast analysis with clinicopathology.

RESULTSImmunization result showed that the expressions of Twist and N-cadherin in the OSCC group were more significant than those of the normal group (P<0.05). The expressions of E-cadherin and keratin in OSCC were significantly lower than those of the normal group (P<0.05). In the moderate- and low-differentiated group of OSCC, the expressions of Twist and N-cadherin were higher than those of the high-differentiated group (P<0.05). The expressions of E-cadherin and keratin were lower than those in the high-differentiated group (P<0.05). In the lymphatic metastasis group, the expressions of Twist and N-cadherin were higher than those of no-lymphatic metastasis group (P<0.05). The expressions of E-cadherin and keratin were lower than those of the no-lymphatic metastasis group (P< 0.05). Results of in situ hybridization showed that the expression of Twist mRNA in the moderate- and low-differentiated groups of OSCC, T3, and T4 groups as well as that of the lymphatic metastasis group were higher than those of the high-differentiated, T1 and T2 groups, and no-separate lymphatic metastasis group, and the differences were statistically significant (P<0.05).

CONCLUSIONEpithelium materialization exists in OSCC tissue. Twist can enhance the invasiveness of tumor cell and promote the infiltration and metastasis of OSCC. The combined detection of Twist, E-cadherin, and N-cadherin expressions can effectively predict and estimate OSCC metastasis.

Cadherins ; Carcinoma, Squamous Cell ; metabolism ; Epithelial Cells ; Epithelial-Mesenchymal Transition ; physiology ; Epithelium ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Mouth Neoplasms ; metabolism ; RNA, Messenger ; Twist-Related Protein 1 ; metabolism

Liver fibrosis is a common pathological consequence of a variety of chronic stimuli, including viral, autoimmune, drug-induced, cholestatic and metabolic diseases. Fibrosis is driven by a dynamic process involving increased synthesis of matrix components and a failure of physiological mechanisms of matrix turnover. Activation of hepatic stellate cells (HSCs) remains a central event in fibrosis. HSCs are the main source of extracellular matrix (ECM). Transforming growth factor-beta (TGF-β), which is the fibrogenic master cytokine, can induce the activation of HSCs to produce a large amount of ECM, and is capable of inducing apoptosis of liver cells. RNA interference (RNAi) is a novel gene disruption technology. Studies have shown that small interfering RNA (siRNA) targeting TGF-β1 may inhibit the activation and proliferation of HSCs, suppress ECM synthesis and block liver fibrosis. TGF-β1 siRNA-mediated gene silencing therapy provides a new avenue for liver fibrosis. This review summarizes recent progresses in research on HSCs, TGF-β1 and TGF-β1 siRNA in liver fibrosis.

Objective To compare the ability of Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) in screening cognitive impairment in early stage of Parkinscn disease (PD). Methods The cognitive function of 101 patients with Parkinson disease (Hohen-Yahr stage 1-3) was assessed with MMSE. Ninety-six patients defined as having a normal age- and education-adjusted MMSE score were assessed subsequently with MoCA. The 96 patients were divided into two groups according to cut-off points of 26 of MoCA. The performance of cognitive domain was compared between PD-MCI group (MoCA <26) and control group (MoCA≥26). Results Mean MMSE and MoCA scores (standard deviation) were 27.17 (2.69) and 22.60(4.42) , respectively. 75% of the patients with normal MMSE scores had cognitive impairment according to their MoCA score. The PD-MCI group had lower scores in numerous cognitive domains (visuospatial and executive abilities, naming, attention,language, ab-straction, delayed memory) compared with control group (PD-MCI group: 3.11±1.40,2.56±0.69,5.07±1.05, 1.69±0.85,1.08±0.84, 1.08±1.31 ;Control group:4.75±0.61,2.92±0.28,5.88±0.45,2.46±0.66, 1.92±0.28,3.50±0.78, P<0.05). Predictors of cognitive impairment on the MoCA using univariate analyses were gender, age, education, Hoehn-Yabr stage, Unified Parkinscn Disease Rating Scale, depression severity (HAMD) and hallucination (r was-0.205,-0.209,0.263,-0.352,-0.225,-0.293 and-0.218, respectively). Condusions The MoCA is a more sensitive screening than the MMSE for cognitive impairment in early stage of PD.

Objective To investigate the feature of cerebral glucose metabolism of Alzheimer's disease (AD)and dementia with lewy bodies (DLB).Methods 28 patients with AD and 25 patients with DLB underwent positron emission tomography (PET)with 18 F-fluorodeoxyglucose (18F-FDG)showing glucose metabolism.The region of interest (ROI)was selected from frontal cortex,temporal cortex,parietal cortex,occipital cortex,cerebellum cortex and corpora striata.The 18 F-FDG metabolism ratios between various cerebral regions and cerebellum cortex were compared as an indicator of regional cerebral glucose metabolic patterns.Results The FDG metabolism ratio of parietal cortex and temporal cortex decreased similarly in AD.The FDG metabolism ratio of frontal cortex,parietal cortex,temporal cortex,occipital cortex,dorsal caudate putamen and caudate nucleus in AD was [(0.861 ± 0.173),(0.625 ± 0.149),(0.598 ± 0.185 ),(0.914 ± 0.214),( 1.030 ± 0.084)and ( 0.997 ± 0.102 )].The FDG metabolism ratio of frontal cortex,parietal cortex,occipital cortex,temporal cortex and corpus striatum decreased similarly in DLB.The FDG metabolism ratio of frontal cortex,parietal cortex,temporal cortex,occipital cortex,dorsal caudate putamen and candate nucleus in DLB was [ (0.538 ±0.147),(0.615 ±0.138),( 0.587 ±0.142),(0.415 ±0.107 ),(0.685 ± 0.094)and (0.547 ± 0.103 )].The FDG metabolism ratio of frontal cortex,occipital cortex and corpus striatum decreased more significantly in DLB than in AD (P＜0.01 ).Conclusion There are discrepancies in cerebral glucose metabolism between AD and DLB.These features may be useful in differential diagnosis of these two kinds of dementia.