Interferon regulatory factors(IRF)are key factors in interferon induction. IRF4, a member of the IRF family of transcription factors, is expressed in cells of the immune system where it transducers signals from various receptors to activate or repress gene expression. IRF4 expression is a key regulator for the development T helper cell subsets and B lymphocyte differentiation. A series of recent studies have further demonstrated critical functions for IRF4. This review focuses on the recent advances on roles of IRF4, including infection, autoimmune disease and immune malignancy. A better understanding of IRF4 will hopefully provide new biomark and potentially guide the design of novel therapeutic approaches.

MicroRNAs (miRNAs) are small non-coding RNA molecules that negatively regulate gene expression.The miRNAs regulate gene expression by controlling the translation of a specific type of messenger RNA.miRNAs are key epigenetic regulators of gene expression,and miRNAs have been recently identified as key regulatory RNAs with immense significance in numerous biological processes.They actively participate in the modulation of important cell physiological processes and are involved in the pathogenesis of asthma.MiRNAs have been implicated to have a fundamental role in acute and chronic asthma and in airway remodeling by the regulation of multiple signal transduction pathways that are involved in the pathogenesis of asthma.A better understanding of the role that miRNAs play in the diseases could lead to the development of new diagnostic and therapeutic tools.This review highlights the current understanding of the role and regulation of miRNA in asthma.

Objective:To investigate the value and effectiveness of the case-based learning assisted by several internet platforms for medical interns in interactive teaching for undergraduate students in the clerkship of cardiovascular surgery.Methods:Ninety-six undergraduates were randomly divided into control group ( n = 48) and experiment group ( n = 48). The control group received traditional teaching, and the experiment group received case-based learning with the aid of WeChat and Sojump questionnaires. The theoretical and clinic operating scores, classroom atmosphere, learning interest, learning efficiency, learning ability improvement, theoretical knowledge mastery and clinical skills improvement were were compared between the two groups. SPSS 19.0 was used for t test and chi-square test. Results:The clinic operating scores, classroom atmosphere, learning interest, learning efficiency, learning ability improvement, theoretical knowledge mastery and clinical skills improvement were statistically higher in experiment group than in control group ( P < 0.05). Conclusion:The application of case-based learning combined with internet platforms has achieved a good teaching effect in interactive teaching for undergraduate students in the clerkship of cardiovascular surgery and is worthy of popularizing.

The incidence of breast cancer has markedly increased in recent years.Breast cancer has become a major cause of death of adult females.Many studies have shown that glucose metabolism disorders and its connected factors have been closely related to occurrence and development of breast cancer.Regulation of glucose metabolism and related factors may become an important way in prevention and treatment of breast cancer.

Objective: To observe the role of nutritional support in treatment of chylous leakage after thyroid carcinoma operation.Methods: The parenteral nutrition combined with somatostatin and re-operation was used in treatment of 2 cases of chylous leakage after thyroid carcinoma operation.Fluid volume from neck drainage catheter and plasma albumin concentration were determined in 2 cases.Results: Fluid volume from neck drainage catheter rapidly reduced in 2 cases after using somatostatin and parenteral nutrition.1case was cured after conservative treatment.1 case was cured after re-operation combined with nutrition support.Conclusion: By using nutrition support,fluid volume from neck drainage catheter can be obviously reduced and serum albumin or nutritional state improved in chylous leakage patients after thyroid carcinoma operation.

Recently,considerable progress has been made in the treatment of systemic lupus erythematosus(SLE),especially in the clinical use of new immunosuppressive agents,which leads to improved remission rate and life quality.However,plasmapheresis still shows to be necessary in severe lupus with serious complications.With the development of plasmapheresis technology,the efficiency and specificity of antibody adsorption being improved significantly,it played an important role in the treatment of acute stage life-threaten lupus.Here we intend to make a review on the relative improvement of plasmapheresis technology and its clinical use.

MAPKKK (MEKK1 or ASK1)/MAPKK (SEK1 or MKK7)/JNK signal cascade is an important pathway which mediates apoptosis. MAPK phosphotase can deactivate JNK by dephosphorylation of JNK.The interaction between JNK and c-Jun can also be negatively regulated by NO through S-nitrosylation. SGK1 or Akt can result in deactivation of SEK1 through its phosphorylation at the Ser78 site.The c-FLIPL can block this cascade through binding with MKK7.GST Mu1-1 interferes and suppresses MEKK1-mediated apoptosis. GST Pi 1-1 and TRX have a dose-dependent inhibitory effect on ASK1 through forming protein complex. The deactivation of JNK can enhance drug resistance of tumor cells and counteract the injury from a wide variety of stimulus. Here,how these proteins induce deactivation of the pathway and mediate anti-apoptosis has been discussed.

The data from clinical studies have shown that conventional dual chamber pacing results in high percentages of right ventricular apical pacing,which causes electromechanical desynchronization and has been linked to an increased risk of heart failure and atrial fibrillation.Nowadays,we can use some special algorithms to minimize ventricular pacing,promote atrioventricular conduction and improve hemodynamics in patients with pacemakers.This review summarizes the genesis,some algorithms and clinical studies about minimizing ventricular pacing.

The ever tenser physician-patient relationship is one of major social problems in present China,thus the construction of a harmonious physician-patient relationship is one important part in constructing a harmonious society.Medical social workers' involvement into the current physician-patient relationship from the perspectives of case social work,group social work,community social work,and social policy making will serve as a positive motivation for the development of a harmonious physician-patient relationship.

Objective:To investigate the distribution of infection pathogens and their drug resistance in acute severe pancreatitis patients. Methods:Retrospective analysis was made on all pathogenic bacteria and their drug resistance of infection among 78 patients with acute severe pancreatitis patients. Results:Among 78 patients with acute severe pancreatitis 75 patients were cured,3 patients were dead.Of 286 clinical isolates,Gram negative organisms accounted for 61.19%,Gram positive ones 32.17%,fungi(6.64%).They resisted to antibiotics at high degrees.Among 92 strains of gram positive organism,60 were drug-resistance;also 172 strains of gram negative organism,above half were drug-resistance. Conclusion:Patients with acute severe pancreatitis are at high risk of infection.Due to drug-resistance are at high degrees in infection pathogens,effective drainage should be adopted to accelerate treating the infection besides selecting correct antibiotics according to the antibiotic sensitive essay results.