Sepsis is essentially a result from immunological dissonance provoked by severe insults such as fulminant infection,severe trauma and extensive burns.It originates from excessive inflammatory responses and develops into immune paralysis or immunosupression.It has been demonstrated that cellular immune response plays a vital role in the pathogenesis of sepsis.In the stage of excessive inflammation,several kinds of immune cells are activated by pathogen-associated molecular patterns (PAMPs) or damage-associated molecular patterns (DAMPs) and subsequently produce a vast number of pro-inflammatory cytokines,while during the stage of immune paralysis,excessive apoptosis could result in decrease of immune cells with functional compromise.Inhibitory or regulatory immune cell subsets eventually dominate the direction of immune response and the production of inhibitory cytokines is enhanced.For clinical practice,surveillance of changes and shift in overall immune function is a basis for immunotherapy,especially to immunomodulation therapy.However,there is still a lack of adequate indexes or markers for integral evaluation of host immune state in the development of sepsis.

Objective:To investigate the relationship between emotion variability and assessment of psychiat-ric symptoms in middle school students,and validate that by structure equation modeling.Method:A total of 129 junior middle school students aged 13 -15 years were selected and assessed with the SCL-90 scale for psychiatric symptoms,the Adolescent Daily Emotion Regulation Questionnaire (ADERQ)for emotion regulation strategies, daily reconstruction method (DRM)for emotion variability during two weeks.Results:The students had higher positive emotion score than negative emotion score [(2.7 ±0.7)vs.(1.4 ±0.3),P <0.001],and higher negative emotion variability than positive emotion variability [(0.4 ±0.1 )vs.(0.3 ±0.1 ),P =0.012].Positive emotion variability and negative emotion variability were positively correlated with total scores of SCL-90 (r =0.34,0.24;Ps <0.001).Structural equation modeling revealed positive emotion variability,negative emotion variability and e-motion regulation strategy of cognitive appraisal had a direct effect on psychiatric symptoms (the path coefficient were 0.21,0.28,-0.24;Ps <0.001),cognitive immersed strategy had a direct effect on psychiatric symptoms and negative emotion variability(the path coefficient was 0.14,0.13,P =0.037,P =0.041).Conclusions:It suggests that both negative emotion variability and positive emotion variability play an important role in psychiatric symp-toms.

Subglottic pleomorphic adenoma is a rare disease . Surgery is the main curative treatment. To review some clinical cases and to summarize the characteristics and treatment experience of this disease,it is expected that we can provide more clinical thought and therapeutic strategy for subglottic pleomorphic adenoma.
Adenoma, Pleomorphic ; therapy ; Humans ; Hypothermia, Induced ; Rare Diseases

Posttraumatic stress disorder (PTSD) which is also moderately heritable is unique among the mental disorders in that it requires exposure to a potentially-traumatic life even. Many advances have been made in the genetics of PTSD. This paper reviewed 5-HTTLPR, DRD2 and some others gene which associated with PTSD.

Objective To compare the effect of percutaneous intraluminal radiofrequency ablation ( RFA ) combined with biliary stenting and that of percutaneous transhepatic puncture combined with biliary stenting .Methods A total of 56 patients with unresectable malignant obstructive jaundice were reviewed retrospectively .Among them, 25 patients had received percutaneous intraluminal RFA combined with biliary stenting ( RFA group) while another 31 patients had been simultaneously selected for the simple biliary stent implantation ( stent group ) .The changes of the serum total bilirubin ( TB) and direct bilirubin ( DB) before and after 7-14 days of treatment , surgical complications , stent median patency and the median survival were observed.Follow-up information was obtained through telephone reviews or check-up records. Results The technical success rate was 100%.No procedure-related peritonitis or perforation occurred .There were respectively 3 cases with cholangeitis in RFA group and 3 in stent group.All the cases was controlled by effective clinical treatment.There was obvious statistically significant difference after treatment in TB and DB in the two groups (P<0.01, P<0.01).TB and DB fell by (149.05 ±110.71) and (96.93 ±69.12)μmol/L after 7-14 days in RFA group vs (151.40 ±94.47) and (94.21 ±67.36)μmol/L in stent group.The changes of the two groups were of no statistical significances .The stent patenmedian time was 122 ( 9 -550 ) and 157 ( 16 -510 ) d, while the median survival was 125(9-550) and 163 ( 16 -520 ) d.The difference was of no statistical significance .Conclusion Percutaneous intraluminal RFA combined with biliary stenting and percutaneous transhepatic puncture combined with biliary stenting are both safe and feasible therapeutic options for unresectable malignant obstructive jaundice .There is no statistically significant diffference between the two groups in the recent and long-term curative effects .

Objective To compare the sensitivity and specificity of interferon-gamma release assay(IGRA) in the Tibetan and Han patients with pulmonary tuberculosis(TB),and to investigate its clinical application value for screening Tibetan patients with pulmonary TB.Methods Sixty-four Tibetan cases of pulmonary TB,41 Tibetan cases of non-pulmonary TB,40 Han cases of pulmonary TB and 38 Han cases of non-pulmonary-TB in our hospital from April 2013 to April 2015 were selected and performed IGRA.T cells infected by mycobacterium tuberculosis were detected by ELISA.The difference between Tibetan abd Han nationalities was compared.The clinical value of IGRAfor screening Tibetan patients with pulmonary TB was evaluated by calculating the statistical indicators.Results The sensitivity,specificity,positive predictive value and negative predictive value of IGRA for diagnosing Tibetan pulmonary TB were 90.62%(58/64),80.49%(33/41),87.88%(58/66) and 84.62%(33/39) respectively,which for diagnosing Han patients with pulmonary TB were 92.50%(37/40),84.21%(32/38),86.05%(37/43) and 91.43%(32/35) respectively.The sensitivity and specificity of IGRA for diagnosing Tibetan and Han pulmonary TB had no statistical difference(χ2=0.005,P=0.944;χ2=0.018,P=0.893).Conclusion IGRA has high value for early diagnosis of Tibetan pulmonaty TB and is conducive to screening of early pulmonary TB.

Objective To investigate the methods and strategies of therapeutic ERCP in patients with duodenum stricture.Methods Endoscopic procedure,success rate and complications in patients with duodenum stricture who underwent ERCP were retrospectively analyzed.Results In 7276 patients who underwent therapeutic ERCP,duodenum stricture was found in 158 (2.17％),patients with malignant tumor infiltration in 120 and benign stricture in 38.The total success rate of ERCP and biliary drainage was 84.2％,with posture change or guidewire leading method in 96 patients,stylolitic water sac dilation in 33and duodenum metal stent placement before biliary drainage in 4.The procedure was failed in 25 patients.Minor bleeding occurred in 5 patients and no major complication including massive bleeding or perforation was observed.Conclusion ERCP is safe,effective and feasible for patients with duodenum stricture,which can be performed by posture change or guidewire leading method in mild stricture,and stylolitic water sac dilation or duodenum metal stent placement in severe stricture.

[Objective] To investigate the changes of CD4~+ CD25~+ regulatory T cells (Tr) in peripheral blood and their relation with their body mass index (BMI) of children with acute attack asthma. [Methods] Peripheral blood was obtained from 70 children with acute attack asthma, 30 remission children, and 50 normal control children. Then 70 children with acute attack asthma, were divided by normal weight group (40 cases) and overweight group (30 cases). The levels of CD4~+CD25~+Tr of the patients were tested by flow cytometry (FCM), and their BMI were calculated. [ Results] The levels of CD4~+ CD25~+ Tr [(6.17± 1.72)%] in acute attack group were lower than that in remission group [(7.56±1.48)%] or that in the control group [(7.13± 1.48)%] (P<0.05), but no difference between that in the remission and that in the control (P>0.05). The CD4~+CD25~+Tr of asthmatic children with normal weight [(6.34±1.71)%] was higher than that of asthmatic children with overweight [(4.74±1.20)%] (P<0.05). There was a remarkably negative correlation between the level of CD4~+ CD25~+ Tr of asthmatic children [(6.17±1.72)%] and the BMI (16.00±2.14) (r_p=-0.814, P<0.05). [Conclusion] The levels of CD4~+ CD25~+Tr are remarkable decrease in attack asthmatic children, and more decrease in overweight patients. There is remarkably negative correlation between the levels of CD4~+CD25~+ Tr in peripheral blood of attack asthmatic children and their BMI.

Coronary heart disease is a kind of heart disease that is caused by atherosclerosis. The lipid deposition in the vessel wall results in occlusion of coronary artery and stenosis, which could induce myocardial ischemia and oxygen deficiency. Intervention therapies like percutaneous coronary intervention (PCI) and coronary stent improve myocardial perfusion using catheter angioplasty to reduce stenosis and occlusion of coronary artery lumen. Accordingly, intervention therapies are widely applied in clinic to treat ischemic cardiovascular disease, arterial intima hyperplasia and other heart diseases, which could save the patients' life rapidly and effectively. However, these interventions also damage the original endothelium, promote acute and subacute thrombosis and intimal hyperplasia, and thus induce in-stent restenosis (ISR) eventually. Studies indicated that the rapid reendothelialization of damaged section determined postoperative effects. In this review, reendothelialization of implants after intervention therapy is discussed, including the resource of cells contributed on injured artery, the influences of implanted stents on hemodynamic, and the effects of damaged degree on reendothelialization.
Angioplasty, Balloon, Coronary ; Cardiac Catheterization ; Coronary Artery Disease ; therapy ; Coronary Restenosis ; prevention & control ; Endothelium, Vascular ; pathology ; Humans ; Myocardial Ischemia ; prevention & control ; Stents ; Thrombosis ; prevention & control

Heat stroke is a life-threatening condition that can be fatal if not appropriately managed. Although heat stroke has been recognized as a medical condition for centuries, the pathogenesis of heat stroke is not fully understood. This article reviewed the new advance in pathogenesis of heat stroke.