After major operation,a series of complicated pathological and physiological changes will occur during the trauma and stress state.The protein synthesis is affected,which results in negative nitrogen balance.In addition,the release of inflammatory factors can damage the capillary endothelial cells and increase the permeability of micrangium,induce vascular colloidal albumin leakage to the extravascular tissue,decrease plasma albumin,make wound edema,eventually lead to postoperative hypoproteinemia.Except for albumin supplement,it should be aimed at the mechanism to control the stress response and reduce the leakage caused by the release of inflammatory factors to solve this problem radically in clinical work.The reports about the causes and treatment of hypoproteinemia after major surgery were reviewed to provide evidence for clinical treatment.

Carbapenem-resistance is an emerging problem in Chinese neonatal intensive care units.Carbapenem-resistant enterobacteriaceae(CRE)can hydrolyze almost all β-lactam antibiotics including carbapenems by producing carbapenemase.There are three groups of carbapenemases, namely Amber A, B and D groups, which have different hydrolytic activities to specific β-lactam antibiotics.Currently, Chinese NICUs have been facing high colonization and infection rates of CRE, with high fatality rate and rapid transmission.The treatment of neonatal CRE infections is extremely difficult.The limited choice of antibiotics, the lack of pharmacokinetic and pharmacodynamic data and the uncertainty of the optimal dose and interval bring great challenges to the effective therapy of neonatal CRE infections.The main antimicrobial agents for CRE in adults and children include carbapenems, ceftazidime/averbactam, fosfomycin, polymyxin, aztreonam, etc., but there are few studies in neonates.Once infants are colonized or infected by CRE, decolonization and treatment are very difficult.Therefore, strict implementation of infection control and neonatal antimicrobial stewardship programs to reduce CRE production, transmission and infection, are the most important measures to cope with the prevalence of CRE.

The morbidity of obesity-related glomerulopathy(ORG) is on the increase in recent years.Studies have demonstrated that the chronic inflammation may play a key role in the pathogenesis of obesity related metabolic dysfunction.LipoxinA4 (LXA4) is an important anti-inflammatory lipid mediator,which is well known as the stop signal of the inflammatory reaction that can promote the resolution of inflammation.This review will provide a survey of recent advances on ORG and LXA4.

Objective: To determine the relationship between serum omentin-1 concentration and bone mineral desity in postmenopausal women, and the adipose influence of tissue on bone mineral density (BMD). Methods: BMD values of 336 participants were measured by dual-energy-x-ray absorptiometry (DEXA) at various skeletal sites: the anteroposterior spine, femeral neck, total hip (T-hip) and total body BMD (TBMD). Body compositions including lean tissue mass (LTM) and body fat mass (FBM) were measured by DEXA. hTe plasma concentrations of adipocytokines (omentin-1, adiponectin,leptin,resistin,visfatin, andapelin) were measured by ELISA. Results: hTe overweight and obese groups had higher T-hip,femerol neck, intertrochanter BMDthan the nomal weight group. Plasma omentin-1 was negatively correlated with anteroposterior spine, femeral neck, trochanter, intertrochanter, T-hip and Ward’s BMD, after adjustment for age, BMI and fat body mass, and the correlation was not significant. Multiple stepwise regression anlysis revealed that lean body mass, menopause duration and estrogen level were the most important variables affecting the BMD and each explained 12.2%–13.7%, 6.9%–13.1%, 0.9%–1.7% of the variance. Serum adiponectin was independently associated with T-hip, lumbar spine and total BMD. Conclusion: Plasma omentin-1 is not significantly correlated with BMD in postmenopausal women. Lean body mass, menopause duration and estrogen level are the most important variables affecting the BMD. Serum adiponectin is an independent predictor of T-hip, lumbar spine and total BMD.

BACKGROUND:Previous study has proved that implantation of the tissue-engineering bone with vascular bundles or sensory nerve tracts can promote bone formation, which may be related to the expression of sensory neuropeptide receptors. OBJECTIVE:To investigate the effect of implantation of tissue-engineered bone containing vascular bundles and sensory nerve tracts on the middle-and long-term expression of calcitonin gene-related peptide type Ⅰ receptor (CGRP1R) in the repair of rabbit large femoral defects. METHODS:Thirty-six New Zealand white rabbits were enrol ed and modeled into 1.5 cm femoral defects, and then randomized into three groups. Bone marrow mesenchymal stem cells (BMSCs) were subjected to osteoblastic induction for 7 days, and then seeded onto the β-calcium phosphate scaffold to construct the tissue-engineered scaffold.In sensory nerve group, the tissue-engineered scaffold was implanted into the defect region, and autologous sensory nerve bundles were implanted into the lateral groove of the tissue-engineered bone;in vascular bundle group, the tissue-engineered scaffold was implanted, and autologous femoral blood bundles were implanted into the lateral groove of the tissue-engineered bone;in blank control group, only the tissue-engineered scaffold was implanted. X-ray examination, immunohistochemistry and real-time PCR were performed at 24 and 48 weeks postoperatively. RESULTS AND CONCLUSION:The X-ray scores in the sensory nerve and vascular bundle groups were significantly higher than that in the control group (P<0.05), but no significant difference was found between sensory nerve and vascular bundle groups. Real-time PCR found that the expression level of CGRP1R mRNA in the vascular bundle group was significantly higher than that in the other two groups (P<0.05), but showed no significant difference between sensory nerve and blank control groups.Immunohistochemistry findings showed that CGRP1R positive expression rate in the sensory nerve and vascular bundle groups was higher than that in the blank control group. These results reveal that implantation of the tissue-engineered bone containing vascular bundles can promote the CGRP1R expression.

Objective To investigate whether tissue engineered bone with implanted vascular bun-dles can up-regulate release of vascular endothelial growth factor (VEGF) in models of femoral defect in rabbits.Methods Thirty-two rabbits were randomized into 2 even groups.In both groups, a segmental bone defect of 15 mm in length was made at the left femur before a tissue engineered bone was inserted into the defect.In the experimental group, a femoral vascular bundle was implanted into the tissue engineered bone.In the control group, there was no vascular implantation.At 2, 4, 8, and 12 weeks after implantation, samples were taken to determine new bone formation by histology and expression level of VEGF by immuno-histochemistry.Results The new bone formation was significantly higher in the experimental group at the end of 4, 8, and 12 weeks(P < 0.05) .The expression level of VEGF in the experimental group was also significantly higher than in the control group at all time points after operation, and the expression of VEGF peaked at 4 weeks.Conclusion Tissue engineered bone with vascular bundle implanted can up-regulate VEGF release in models of femoral defect in rabbits.

Objective To investigate the inhibitory effects of L. monocytogenes expressing melanomainhibiting activity(MIA)gene on malignant melanoma.Methods The plasmid pERL3-hly-MIA was constructed and used to transform live L.monocytogenes by electroporation.Atier culture.the transformed L.monocytogenes,namely LM-hly-MIA,was harvested for the detection of MIA protein by Westem Blot.A total of 24 mice were divided into three groups,namely control group,LM group and LM-hly-MIA group,to be immunized with physiological saline,L.monocytogenes and LM-hly-MIA,respectively.One day after the immunization.mice were subcutaneously inoculated with 0.1 mL of B16 cells at a concentration of 1×107/mL.One week later.reimmunization was performed.The size and weight of tumors were observed and measured in these mice.Results Enzyme digestion and Western blot confirmed the Successful construction of plasmid pERL3-hly-MIA.The average weight of tumors in mice was 4.33±0.91 gram.3.36 ±0.41 gram and 1.89±0.52 gram,respectively in the control group,LM group and LM-hly-MIA group,respectively(P＜0.05).with the inhibition rates of tumor growth being 22.4%and 61.5%in LM group and LM-hly-MIA group.respectively.Conclusion The attenuated strain of L.monocytogenes expressing MIA gene could evidently inhibit melanoma growth.

Objective To study the application and significance of constructivism theory in pathological experiment teaching.Methods Six classes in total of 198 students majoring in clinical medicine were selected from grade 2009 of Guangdong medical college for research and were divided into experimental group (n=99) and control group (n=99) using random number table.Various teaching methods based on constructivism theory were used in experimental group while conventional teaching methods were applied in control group.The observing ability for specimen and slices,theoretical level and learning behavior of students were assessed with the same standard and anonymous homemade questionnaire survey was executed for students.SPSS 13.0 statistical software was used to analyze the results.The examination results of the two groups were compared using independent samples t-test.The questionnaire survey results of the two groups were compared using Wilcoxon rank-sum test.P＜0.05 represented the difference having statistical significance.Results The observing capability for specimen and slices,theoretical level and learning behavior of students in experimental group were significantly improved (P＜0.01)and the questionnaire survey results demonstrated that there were statistical difference in feedbacks between the two groups and the satisfaction rate was significantly improved in experiment group (P＜0.01).Conclusions Applying comprehensive teaching methods based on constructivism theory can stimulate students' interest and initiative in learning,improve students' learning behavior and learning strategies,and significantly improve the teaching quality.

Objective Compare the complications between laparoscopic and abdominal cervical cancer surgery, and investigate the safety of laparoscopic cervical cancer surgery and complications classified by Clavien-Dindo classification, then analyze the risk factors. Method Clinical data of 215 cases of cervical cancer received surgery from March 2011 to October 2014 was collected, which include intraoperative, postoperative and postoperative fol﹣low-up data. All the cases were divided into two groups: LRH group (n= 116) and ARH group (n= 88), then ana﹣lyze and compare the difference of intraoperative, postoperative complications and postoperative follow-up data be﹣tween the two groups, assess the safety of the two groups, and statistically concluded related independent risk factors. Results The complications of 204 patients were classified into 4 grades. The criticality and morbidity of intraopera﹣tive and postoperative complications have no significant difference between the two groups (P> 0.05). Logistic re﹣gression analysis show that over criticality grade Ⅱ of LRH intraoperative complication related to operating time, over criticality grade Ⅱ of ARH intraoperative complication related to aged over 50 yr, over criticality grade Ⅱ of ARH intraoperative complication related to BMI> 25. Conclusions Through the analysis of laparoscopic operation and the criticality of complications, the safety of the two groups were no difference. The patients with high risk fac﹣tors should be evaluated comprehensively. And strictly grasp the contraindication and indication.

Fructus psoralea is a tonic traditional Chinese herb commonly used in clinic.The chemical constituents of Fructus psoralea are complicated,mainly containing coumarins,flavonoids and monoterpene phenols with various pharmacological effects.Since the increasing number of reports on the toxicity of Fructus psoralea in clinic,the side effects including toxicity on the liver and kidney,as well as skin allergies have gradually attracted attention.The toxicity of Fructus psoralea is produced from ADME (absorption,distribution,metabolism and excretion) in vivo.In this paper,we collected and clarified the studies of ADME of Fructus psoralea in vivo,and summarized recent adverse clinical events and research over its toxicity.We propose to make a thorough study on the toxic material basis of Fructus psoralea and the toxicological mechanism of its extraction,fractions and compounds.The review provided a possible reference and the direction of research for the safe clinical use of Fructus psoralea.