Sepsis is still a major cause of death among neonates and its morbidity rate remain high nowadays.Because of the atypical symptoms and extremely dangerous progress in neonatal sepsis,early diagnosis and treatment are requisite.But the unique biomarkers are lacking meanwhile.Recent study shows that PBEF influences individual susceptibility,severity and outcome in sepsis.This review synthesizes the research of PBEF in neonatal sepsis in order to provide the evidence of reliable biomarker to diagnose and treat neonatal sepsis in the early stage.

Objective To investigate the role and mechanism of signal transducer and activator of transcription 4 (STAT4) in homocysteine (Hcy)-induced proliferation,migration and senescence of human aorta smooth muscle cells (VSMCs).Methods After VSMCs were incubated with Hcy (0-0.50 mmol/L) for various time periods,a CCK-8 assay was performed to determine proliferation activity.Modified Boyden chamber system (Transwell apparatus) was used to examine migration ability.A SA-β-gal staining kit was used to determine senescence status.Western blotting was performed to examine the expressions of STAT4 and phosphorylated STAT4 (p-STAT4) proteins,and ELISA was performed to examine MCP-1 expression.Results Hcy (from 0.05 mmol/L) significantly increased the proliferation of VSMCs (P ＜ 0.05).Hcy (from 0.10 mmol/L) significantly increased the migration of VSMCs (P ＜ 0.05).Hcy promoted the senescence of VSMC in a concentration-dependent manner,and significantly increased VSMC senescence when the concentration of Hcy reached 0.10 mmol/L (P ＜ 0.05).Hcy (from 0.10 mmol/L) treatment significantly increased the expression of p-STAT4 (P ＜ 0.05) and MCP-1 (P ＜ 0.05).Conclusions Hcy increases the proliferation,migration and senescence of VSMCs,probably by the activation of STAT4 pathway.

Objective Accelerated junctional rhythm (AJR) always occur during slow pathway catheter ablation for atrioventricular nodal reentrant tachycardia (AVNRT), the clinical significance of it has not been gotten in agreement. The aim of this study is to search for an association between AJR and ablation target site or tachycardia recurrence.Methods The data of 247 patients with AVNRT who received radiofrequency ablation procedure during April 1995 to October 1999 was analyzed. All these people were divided into two groups (212 patients in the successful ablation group or group 1, 35 patients in the recurrence group or group 2). The AJR was divided into two distinct pattern:type Ⅰ(continuous AJR that persisted until the end of energy delivery) and type Ⅱ (intermit AJR alternated with sinus rhythm during slow pathway ablation, which was eliminated immediately when stopping energy delivery ). Results\ The results showed that patients in group 1 exhibited better AJR response, most of them were seen with type Ⅱ AJR. However most of the people in group 2 had no AJR response throughout energy delivery , few of them had type Ⅰ AJR response. The AJR response of group 1 started relatively earlier than that of group 2(3 2?1 8 vs 5 7?2 5 ,P

Objective To detect biofilm formation and biofilm-associated genes of methicillin-resistant Staphylococcus aureus (MRSA) in clinical isolates. Methods The biofilm were determined by microtiter plate assay (MPA) and congo red agar (CRA) and the biofilm-associated genes icaA,sarA,fnbA,fnbB were detected by PCR in 33 strains of MRSA in clinical isolates. Results Of the 33 MRSA isolates, 29(87.9%) were MPA positive, 16(48.5%) were CRA positive; The icaA gene was present in 39.4% of isolated strains. Furthermore, 69.7% of strains harboured the sarA gene, 39.4% were fnbA positive and 75.8% were fnbB positive. As many as 87.9% strains had the ability to form biofilm in vitro. 44.8% of MRSA formed biofilm in ica-dependent mechanism and 55.2% of MRSA isolates formed biofilm in ica-independent mechanism. Of the biofilm positive MRSA, 75.9% were sarA positive, 37.9% were fnbA positive and 79.3% were fnbB positive. Conclusion Most of the MRSA strains formed biofilm in ica-independent mechanism. fnbB and sarA gene shows higher frequency among the biofilm-associated genes of MRSA, it may infer that most of the MRSA strains biofilm formation are fnbB-mediated. Meanwhile, sarA may be a positive regulator of fnbB, and thus drives the biofilm formation.

BACKGROUND:As for patients with one-side backleg pain who were candidates for surgery treatment of lumbar intervertebral disc herniation, the common treatment includes lumbar vertebral plate opening and decompression, and laminectomy in combination with compression and bilateral pedicle screw fixation. However, these therapeutic approaches are not satisfactory. OBJECTIVE:To explore the feasibility and efficiency of single-side lumbar interbody fusion and unilateral pedicle screw fixation for treatment of lumbar intervertebral disc herniation patients with one-side backleg pain. METHODS:Forty patients with single-side lumbar disc herniation, suffering from unilateral backleg pain, were recruited from Shihezi People’s Hospital, China and were treated with single-side lumbar interbody fusion and unilateral pedicle screw internal fixation. The neurological function of patients was assayed using Japanese Orthopaedic Association score system before and after treatment, the improvement rate and excellent/good rate were calculated. Suk criterion was used to determine fusion status. RESULTS AND CONCLUSION:The mean fol ow-up period for 40 patients was ranging from 6 months to 60 months. Al incisions healed wel , with no infection. The Japanese Orthopaedic Association score after 6 months of treatment was significantly higher than that before treatment (P<0.05), with the excellent and good rate up to 88%. According to Suk criterion, 38 patients achieved bone graft fusion or possible fusion, with interbody fusion rate 95%, as revealed by radiographic and CT evidence. The remaining two patients were detected fusion at 9 months after treatment. Our findings indicate that, single-cage lumbar interbody fusion combined with single-side pedicle screw fixation is the feasible surgical technique and provides satisfactory effects in treating single-side lumbar disc herniation.

Objective To compare the effect of thoracoscopy combined with laparoscopy Mckeown and tradi-tional three incision surgery in radical resection of esophageal carcinoma.Methods 300 patients with esophageal cancer who confirmed diagnosis by gastroscopy and pathology,were randomly divided into the observation group and the control group,150 patients in each group.The observation group was treated by thoracoscopy combined with lapa-roscopy Mckeown esophagectomy,and the control group was treated by traditional three incision surgery.The operation time,intraoperative blood loss,number of lymph node dissection,length of chest tube drainage,postoperative complica-tions,and length of postoperative hospital stay of the two groups were compared.Results There were no significant differences between the two groups in operating time[(282 ±62)min vs.(273 ±64)min,P >0.05],and number of lymph node dissection[(23.2 ±6.6)vs.(21.6 ±6.4),P >0.05],and there were significant differences in intraop-erative blood loss[(262.3 ±44.7)mL vs.(315.2 ±72.6)mL,P <0.05],length of chest tube drainage[(7.6 ± 1.6)d vs.(9.4 ±2.4)d,P <0.05],postoperative complications[16.7% vs.30.0%,P <0.05],and length of hos-pital stay[(10.5 ±2.5)d vs.(14.0 ±2.0)d,P <0.05].Conclusion Thoracoscopy combined with laparoscopy Mckeown esophagectomy can achieve the same efficacy compared with the traditional approach,and it is worth popu-larizing in clinic for reducing intraoperative blood loss,length of chest tube drainage,postoperative complications,and length of hospital stay.

Objective To investigate the influence of erythropoietin in the metabolism of extracellular matrix after myocardial ischemia-reperfusion injury.Methods The langendroff reperfusion system was applied to investigate the protective function of EPO in ischemia-reperfusion condition in rats.The effects of EPO on extracellular matrix were observed by Western blot and signal pathway blocker.The LVEDP and infarction area were observed at the same time.Results EPO significantly improved LVEDP [(19.8±0.2) mmHg vs (35.9±0.2) mmHg,IR group vs EPO +IR group,P＜0.05]and decreased infarction area (35.26%±7.13% vs 62.70%±7.23%,IR group vs EPO+IR group,P＜0.05).The expression of MMPs was significantly decreased and the expression of collagenase Ⅰ/Ⅲ was significantly enhanced by EPO (MMP2 53.2+2.6 vs 21.2+2.5;MMP9 57.6±3.1 vs 19.2±2.6;IR group vs IR+EPO group (P＜0.05);collagen Ⅰ 43.2±2.2 vs 11.4±2.3;collagen Ⅲ 55.3±3.2 vs 18.1 vs 2.3;IR+EPO group vs IR group (P＜0.05).This function can be inhibited by Mek-Erk inhibitor.Conclusion EPO plays a role in the metabolism of extracellular matrix by Mek-Erk signal pathway,which can protect the heart tissue from ischemia-reperfusion injury.

Objective To evaluate clinical application of the gastrocnemius blood vessles as recevier ones to anastomose with free flaps. Methods From June 2005 to July 2011,twenty adult lower limbs were infused with red glue to observe the origin,streching,branches and communication with other blood vessles of the gastrocnemius blood vessles and to measure their outer diameters and pedicle length. Operations were also simulated on these specimens to make the above chacracters of the vessles clear further.CT images of 16 fresh adult lower limbs were got to observe the effects of obstruction of one side of the gastrocnemius blood vessels to the blood supply of the gastrocnemius muscles. Fifty-two free flaps were transplanted to legs with large defects of skin and soft tissues where the gastrocnemius blood vessles were anastomosed with the flaps to supply artery blood and receive vein blood. Results The main blood vessles of the gastrocnemius muscles were medial and lateral gastrocnemius blood vessles. They both origined from the popliteal arteries and communicated with other blood vessles. The pedicles of the medial gastrocnemius blood vessles were 8.0 -13.8 cm in length which averaged 11.1 cm and their outer diameters were (1.8 ± 0.3) mm when they entered the muscles. The pedicles of the medial gastrocnemius blood vessles were 5.4 - 12.3 cm in length which averaged 8.8 cm.The outer diameters of the two accompanying veins were (1.8 ± 0.3)mm when they entered the muscles.When one gastrocnemius blood vessle were obstructed,the gastrocnemius muscles could got enough blood supply by co mmunicating branches between the obstructed vessle and other blood vessles.All the 52 free flaps survived. Through one to two-years follow-up, the defects cured with no infection and the knees' motions were normal. Conclusions With a long pedicle and wide diameter,the medial or lateral gastrocnemius blood vessle can be a reliable alternative used in free flap transplautation for repairing large defects of skin and soft tissues of seriously injured legs with no other choice of blood vessles, which causes unobvious effects to the blood supply of the legs and can simplify the free flap transplantation.

Objective To investigate and summarize the clinical and high-resolution computed tomography(HRCT) characteristics of invasive pulmonary fungal infections(IPFIs)in children.Methods Clinical and HRCT data of 35 cases with IPFIs admitted in our hospital between March 2007 and July 2015 were retrospectively analyzed.The clinical and HRCT characteristics were summarized.Results Thirty-five patients consisted of 23 boys and 12 girls with mean age of(3.2±1.9) years.Host factors included acute leukemia (n=12),primary immunodeficiency disease (n=4),congenital heart disease (n=2),cerebral palsy (n=2),severe influenza A infection (H1N1) (n=2),ichthyosis (n=1),acquired immunodeficiency syndrome(n=1),systemic lupus erythematous (n=1),tubercular meningitis(n=1),mechanical ventilation(n=2).All patients were treated with broad-spectrum antibiotic,ranking by descending order:third-generation cephalosporins (28 cases),carbapenems(19 cases)and vancomycin (18 cases).Seventeen cases were treated with corticosteroids systemically and 12 cases with acute leukemia took antineoplastic medicine.The symptoms of IPFIs were intermittent or persistent fever,cough and rales.HRCT results:nodules (n=25,71.4％),subpleural patchy opacities (n=24,68.6％),mass (＞3cm) (n=4,11.4％),halo sign (n=27,77.1％),cavities (n=8,22.9％),air crescent sign (n=4,11.4％),miliary nodules (n=2,5.7％),pleural effusion (n=14,40％).Conclusion There are certain specific characteristics of IPFIs in children in clinical and HRCT aspects.The possible diagnosis of IPFIs can be made based on clinical and HRCT features.

BACKGROUND:Glycyrrhiza flavonoids can protect muscle tissues against oxidative and inflammatory injuries.
OBJECTIVE:To explore the effects of Glycyrrhiza flavonoids on energy storing and release of adipose tissue by studying expressions of perilipin mRNA and protein in skeletal muscle tissues of rats after exhaustive exercise.
METHODS:Fifty male healthy Sprague-Dawley rats were used and equaly randomized into five groups: quiet control, exercise alone (intragastric administration with saline), exercise combined with low-, moderate-, high-dose Glycyrrhiza flavonoids (intragastric administration with Glycyrrhiza flavonoids) groups, respectively. Perilipin mRNA and protein expressions in skeletal muscle tissues containing gastrocnemius muscle and musculi soleus were determined at 6 weeks after exhaustive exercise.
RESULTS AND CONCLUSION:Expression of perilipin mRNA in rat gastrocnemius muscle in quiet control group was significantly decreased compared with exercise alone and al combined intervention groups (P < 0.05 orP < 0.01). Protein expression of perilipin in exercise combined with moderate- or high-dose glycyrrhiza flavonoids group was significantly increased compared with quiet control group (P < 0.05). Expression of perilipin mRNA in rat musculi soleus was significantly decreased compared with exercise combined with moderate-dose glycyrrhiza flavonoids group (P < 0.05). These findings confirm that Glycyrrhiza flavonoids are benefit for improvement of aerobic metabolism capacity of gastrocnemius muscle through regulating lipolysis pathway.