The NF-kappaB pathway regulates the expression of over 150 target genes, e.g., cytokines, chemokines, leukocyte adhesion molecules and inducible effector enzymes. Consequently, it plays a crucial role in innate and adaptive immune responses, inflammatory response, stress responses, apoptosis and so on. IkappaB kinase (IKK) is the key of this pathway, and it owns a special structure which consists of catalytic subunit and regulatory subunit. Naturally, the activation of IKK needs the interaction of the two subunits and phosphorylation by its upstream kinases. Actually, there are two methods of activation of the NF-kappaB pathway, and both of the methods need the IKK complex. Given to the crucial role of IKK, researchers have isolated and synthesized amounts of IKK inhibitors, and these provide a great convenience to develop novel anti-inflammatory and anti-tumor drugs.

Objective To evaluate percutaneous endoscopic gastrostomy (PEC) in long-term coma patients at different phases who received trans-nasal feeding in Department of Neurosurgery. Methods A total of 51 patients who received trans-nasal feeding because of long-term coma were randomly divided into 2 groups to undergo PEG at 25-39 days after coma (n =24) or at 40-60 days (n = 27) , respectively. The rates of upper gastrointestinal bleeding, average episodes of bleeding, average hemostatic time, the rates of aspiration and aspiration pneumonia were compared between the 2 groups. Results The rates of upper gastrointestinal bleeding, aspiration and aspiration pneumonia in post-PEG patients were significantly lower than those in pre-PEG patients (P < 0.05). Before the procedure of PEG, the rates of upper gastrointestinal hemorrhage,average episodes of bleeding, rates of aspiration and aspiration pneumonia in 25-39-day group were significantly lower than those in 40-60-day group (P < 0.05). There was no significant difference between 2 groups, in regarding of either hemostatic time, or rates of upper gastrointestinal bleeding, aspiration and aspiration pneumonia after PEG (P > 0. 05). Conclusion PEG may decrease the rates of upper gastrointestinal bleeding, aspiration and aspiration pneumonia in neurosurgical patients receiving trans-nasal feeding because of long-term coma. PEG is preferably performed on 25-39 days of onset to 40-60 days. If there is no contraindication, 25-39 days after coma is likely to be the optimal time for PEG.

Coronavirus Infections ; epidemiology ; Humans

Objective To analyze the epidemiological characteristics of severe fever cases,with thrombocytopenia syndrome (SFTS) in Zhoushan,Zhejiang,2011-2013 and to provide evidence for the development of related strategies for prevention and control of the disease.Methods Data was collected from the studies and related demography of the cases with SFTS in Zhoushan,2011-2013.Clinical and epidemiological characteristics of the cases with SFTS were analyzed descriptively.Results During 2011-2013,45 SFTS cases were reported in Zhoushan city,with fatality rate as 11.11％ (5/45),including 41 cases (91.11％) reported in Daishan county.Most cases aged 50 or over,residing in hilly regions (93.33％).The epidemic peak was seen from May to July (84.44％).Incidence rates of the disease did not show significant statistical differences between males and females.Most cases were farmers (42.22％) and housewives (31.11％).Most patients complained of fever (97.78％),anorexia (91.11％),fatigue (62.22％),chill (44.44％) and other non-specific clinical manifestations but all appeared progressive thrombocytopenia and leucopenia.Sanitation condition of the patients was generally poor.68.89％ (31/45) of cases had farmed,mowed or involved in other outdoor activities in the previous two weeks,with some of them reported having exposed to tick bites.Three events were reported,epidemiologically.Conclusion SFTS in Zhoushan was a infectious disease with natural foci and caused by SFTSV.Ticks might serve as the main vectors for SFTSV,and might cause direct transmission between humans.Improving the environment for living and carrying out essential protective measures in outdoor activities seemed to be significant in decreasing the incidence rate of the disease.

Severe fever with Thrombocytopenia Syndrome (SFTS) is an emerging hemorrhagic fever disease in the rural areas of east-central China,which is caused by SFTSV-a newly discovered bunyavirus.SFTSV is most likely transmitted by tick bites but can also be transmitted within human beings.The onset of SFTS is sudden and with rapid progress,with main clinical manifestations as fever,thrombocytopenia,leucopenia and gastrointestinal and hepatorenal dysfunctions.Some patients may die from multiple organ failure,and the case fatality rate is approximately 10％.In this paper,we use the method of literature review to summarize the recent research progress of SFTS which includes the epidemic distribution characteristics,medium of transmission,host animals,transmission routes and susceptibility in the general population.