Liver fibrosis is the excessive accumulation of extracellular matrix (ECM) proteins that occurs in most types of chronic liver diseases. Hepatic stellate cells (HSCs) are major sources of the excess ECM deposited in fibrotic liver. Transforming growth factor ? (TGF-?) is considered to play a generic role in the development of tissue fibrosis, as it stimulates the synthesis and deposition of ECM components. Smad pathways are central mediators of signals from the receptors for transfor- ming TGF-? to the nucleus. However, growing biochemical and developmental evidence supports the notion that non-Smad pathways also participate in TGF-? signalling. TGF-? signalling pathways play an important role in regulating tissue homeostasis and have been implicated implicated in diverse pathological conditions. It is oow our challenge to design ways of blocking the fibrosis-specific actions of TGF-? through downstream signalling pathways and mediators without compromising the other activities of this multifunctional cytokine, which is essential for health.

Objective To discuss the injury triage and process during large scale transportation of the wounded during earthquake by understanding injury severity and detecting vital signs of the woun-ded needing long distance transportation in Wenchuan earthquake. Methods Second medical rescue team of Beijing Health Administration finished transportation of 197 patients including 106 males and 91 females at age range of 6-81 years (average 37.5 years). During whole transportation process, we carried out 2 examinations, 4 checkouts and 1 scoring twice per patient and strengthened close collaboration a-mong different sub-transportation teams. Results Of 197 patients, 194 were smoothly transported ex-cept for three who returned to original hospital due to unstable situation on the way of transportation. Of successfully transported patients, 13 stated complaints including pain of affected extremity in seven pa-tients with fractures, chest distress and short breath in two with crush syndrome, aggravated chest pain in two with crush injury of the chest as well as dizziness and sicchasia in two during the course of transporta-tion. In the meantime, monitoring of vital signs and symptomatic treatment were done in all 13 patients who stated complaints. Conclusions Sufficient preparation, strict medical examination, sound medi-cal collaboration, understanding of injury condition, necessary monitoring and treatment, active communi-cation with patients and detailed relay are preconditions to guarantee successful transportation during large scale transportation of the wounded caused by earthquake.

During radiation for head and neck cancers,part of parotids are contained in planning target volume(PTV),which lead to parotids receiving radiation as the same as PTV.Radiation for head and neck cancers will influence the parotids.In the period of radiation,many factors will influence parotids,such as age,primary parotid volume,V10-40,weight and mean radiation dose et al.These factors will result in that the parotid volume reduces nearly 50％ and moves toward the middle line of the body.As a result,the real dose of the parotid receiving is higher than prescription dose.The excretion function of the parotid will be severely damaged after radiation,which will lead to xerostomia and influence the quality of patients life.

Genetic diseases that have shown clinical symptoms in neonatal period are often characterized with atypical symptoms and serious condition, which contributes to difficulties in diagnosis and treatment.With the progress of sequencing technology, the next-generation sequencing technology is gradually applied to the clinical field with its advantages of high throughput, low cost and rapid detection.As one of next-generation sequencing technologies, the whole exome sequencing technology(WES)captures, enriches and sequences the genomic exon regions, and then the large amount of WES data is analyzed by bioinformatics methods and screened to find variant site in gene that causes genetic disease.WES technology has gradually become an important means of diagnosis in neonatal genetic diseases because of its advantages of comprehensive results and short reporting period.

Objective To explore the accuracy and feasibility of infrared computer navigation for femur,tibia tunnel positioning in arthroscopic anterior cruciate ligament (ACL) reconstruction.Methods Data of patients who had undergone ACL reconstruction using infrared computer navigation from January 2012 to June 2013 were retrospectively analyzed.There were 26 males and 9 females,with an average age of 26.8 years old.35 patients were with concomitant meniscal injury 21 cases,and 3 cases with medial collateral ligament injury.All patients were treated with gracilis and semitendinosus knit stitch as grafts,and bone ends were made with hydroxyapatite extrusion screws,door-shaped nails and porous plate.Results The mean follow-up time was 16 months.The rate of postoperative femoral tunnel site measurements was 63.8％±6.6％,and tibial tunnel site measurements was 45.7％±4.2％.1 patient appeared heterotopic ossification in tibia tracker pinhole 3 months after surgery,and the joint activities was normal.Lachman test:there were 1 case with Ⅱ degree,30 with Ⅲ degree,and 4 with Ⅳ degree before operation,and 33 with Ⅰ degree,1 with Ⅱ degree,1 with Ⅲ degree after operation.The KT-1000 test was from 6.47±0.75 mm preoperatively to 1.01±1.14 mm postoperatively.Preoperative knee laxity differences was more than 5 mm in 32 cases,3-5 mm in 3,and after operation they were 0-3 mm in 31,3-5 mm in 2,and less that 0 mm in 2 cases.Lysholm score and Tegner scores were from preoperative 52.74± 10.91 points and 4.64± 1.34 points to postoperative 93.97±4.13 and 6.56±0.81 points.ROM was from 85.6°± 11.2° to 118.3°±5.7°;33 cases were without flexion and extension limited; two cases had knee flexion,extension limitation less than 10°.After straight leg raising training and proprioception functional training for 6 months,the knee ROM returned to normal.Conclusion Infrared computer assisted navigation system for arthroscopic ACL reconstruction is to navigate through the use of anatomical landmarks and kinematic data,kinematic data by detecting and recording the knee,selected a secure tunnel site,viable surgical method,you can make femur,tibia tunnel position more accurately,good curative effect evaluation.

Hepatocellular carcinoma (HCC) development is closely related to overexpression of tumor promoters or down-regulation of tumor suppressors.The mammalian sirtuin family was found to be a nicotinamide adenosine dinucleotide (NAD/NADH)-dependent histone deacetylase (HDAC),which implicated in the regulation of critical biological processes through deacetylation modifying on histone and nonhistone.SIRT1 can regulate metabolism,aging,inflammation and cancer progression.In particular,more and more evidence proves that SIRT1 can act as a tumor promot er in hepatocellular carcinoma through deacetylation on tumor suppressors.On the other hand,SIRT1 can strongly suppress metabolic syndrome-associated liver cancer in the mouse model.This review will discuss the expression of sirtuin family member in liver cancer and its clinical significance.

Objective To evaluate the mucosal microvascular morphological changes in superficial nasopharyngeal carcinoma (NPC) and its clinical value under narrow band imaging (NBI).Methods From 2015.01 to 2016.01, 182 patients at high risk for NPC received biopsy of superficial nasopharyngeal lesions due to the existence of irregular vessel under NBI while they were examined with electronic nasopharyngolaryngoscope quipped with white light mode and NBI mode. Compared the mucosal microvascular morphological characteristics of different diseases based on pathological result and evaluated the diagnostic efifcacy of NBI.Result Under NBI, the mucosal microvascular morphological characteristics of nasopharyngeal carcinoma under NBI mode were of that concentrated brown spots (CBS, 38.24 %) and irregularly dilated branching vessels (IDBV, 41.18 %) with demarcation line (DL, 52.94 %). In addition, IDBV were the main microvascular pattern in fresh NPC cases (57.89 %,P = 0.000), while CBS were the main microvascular pattern in post-radiation local recurrent NPC cases (60.00 %,P = 0.000). The sensitivity, speciifcity, positive predictive value, negative predictive values and diagnostic coincidence rate of NBI in NPC screening were 79.41 %, 95.95 %, 81.82 %, 95.30 % and 92.86 %, respectively.Conclusion NBI endoscopy is a promising tool for improving the early diagnosis of NPC by detecting mucosal microvascular morphological changes in superifcial NPC.

Objective To develop a mobile doctor system to improve the efficiency of ward rounds and enhance the quality and safety of medical services.Methods The system had the mobile intelligent terminal as the hardware platform and wireless LAN as the network platform.Three-layer architecture containing user layer,logic layer and Web Service data interface layer was also involved in to facilitate the doctor to execute patient data browse,inquiry and etc at any time.Results The doctor might perform medical records inquiry with the system and then provide precision diagnosis and treatment,so that the satisfaction of the patient was enhanced greatly.Conclusion The system eliminates the needless manual execution of medical prescription,and increases the efficiencies of medical staffs.

Adolescent ; Adult ; Blast Injuries ; complications ; Deafness ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult