Hypermetabolism syndrome,especially in skeletal muscles,is exceedingly common in septic patients.Many studies suggest that the activity of ubiquitin-proteasome pathway is a vital procedure for hypermetabolism of skeletal muscles of septic patients and its activation can be influenced by a variety of factors,such as proinflammatory cytokine and glucocorticoid,etc.Evidences indicate that insulin has played an important role in opsonizing the activation of ubiquitin-proteasome pathway.This paper reviews the regulation effect of insulin to the hypermetabolism of the skeletal muscles of septic patients through ubiquitin-proteasome pathway.

Objective To investigate the level of serum homocysteine(Hcy)in common chronic diseases(diabetes,hypertension, hyperlipidemia,coronary heart disease)and its clinical application value in the community elderly residents.Methods A retrospec-tive study was conducted on the common chronic disease of 1 605 patients who detected Hcy in our center from January 2015 to Oc-tober 2015.Another 117 healthy subjects served as normal control group.Hcy was detected by cyclic enzymatic method.Results The average level of Hcy in serum of patients with diabetes,hypertension,coronary heart disease and hyperlipidemia was higher than that in the health examination group,and the level of Hcy was positively correlated with age(P <0.05).Conclusion The high level of serum Hcy is an important risk factor in common chronic diseases in the community elderly residents,and it should strengthen the examination of Hcy and active intervention to slow down the development of the disease.

The environmental pollution caused by organo tin attracted much concern,at the same time, the methodological study on determination of organo tin in environment made a desirable development, the chromatograph technique was used widely.A more detailed review on application of gas chromatograph and its coupled techniques in the environment organo tin compounds analysis was presented in this paper.

Objective To prepare biodegradable microspheres of Schistosoma japonicum recombinant glutathione-S-transferase. Methods By using the constructed expression plasmid pET28a(+)-SjGST, fusion protein of Schistosoma japonicum recombinant glutathione-S-transferases were expressed in LB by E.coli BL21,rSjGST fusion protein was purified through column of resin,and then the fusion protein concentration was detected; by using an oil-in-oil emulsion-solvent extraction method, the rSjGST biodegradable microspheres were prepared in PLGA (75/25).The properties of microspheres including shape、diameter、diameter’s distribution and span were assayed under microscope. Results The concentration of protein after purification was 8.323 mg/ml, and the microspheres were spherical and showed normal distribution.The diameter was (7.3?1.2) ?m,the span was 0.52,the load of the rSjGST was 7.62%. Conclusion Biodegradable microspheres of Schistosoma japonicum recombinant glutathione-S-transferase are successfully prepared, which provides the basis for further studies on protective immunity of mice.

AIM: To investigate the changes on immunological function in antigen-sensitized mice injected by dermatophagoides farinaeliposomes (DF) subcutaneously. METHODS: BALB/c mice were sensitized with DF antigen injected subcutaneously. After injected by DF liposomes with 1, 3, and 9 ?g?g -1 dosage respectively, the total IgE, total IgG, DF specific IgE(sIgE), DF specific IgG (sIgG), IL-4, and IFN-? were detected by ELISA. RESULTS: The total IgE, sIgE, total IgG, and sIgG in the serum of sensitized mice increased, the level of IFN-? reduced and IL-4 increased. After injected subcutaneously by DF liposomes, the total IgE, sIgE and IL-4 in the serum of mice of all the treatment groups reduced, and IFN-? raised, and the total IgG, sIgG raised in the serum of mice administrated with small and medium dosage, but the low dosage was more obvious. CONCLUSION: DF liposomes have some effects on the immunological function in mite-sensitized mice in the low dosage.

Objective To compare the results of susceptibility testing by European Committee on Antimicrobial Susceptibility Testing (EUCAST)and Clinical and Laboratory Standards Institute (CLSI)broth microdilution methods against Aspergillus isolates.Methods The susceptibilities of 116 Aspergillus isolates were determined for amphotericin B, voriconazole, itraconazole,caspofungin and micafungin according to EUCAST (E.DEF 9.1 )and CLSI (M38-A2)methods.The essential agreement (EA),categorical agreement (CA),very major errors (VME)and major errors (ME)of the two methods were compared.Results The EA was 96.3%-100% between the two methods.The CA ,ME,and VME were 98.8%,0-1.2% and 0 respectively for the susceptibility of Aspergillus fumigatus to voriconazole.The CA,ME and VME was 1 00%,0 and 0 respectively for the susceptibility of Aspergillus fumigatus and Aspergillus niger to amphotericin B,or the susceptibility of Aspergillus fumigatus and Aspergillus flavus to itraconazole.Conclusions The results of susceptibility testing by EUCAST and CLSI broth microdilution methods are well consistent against Aspergillus isolates.

Objective To evaluate analgesic effect of dexmedetomidine (DEX) combined with ropivacaine in single sciatic nerve block after total knee arthroplasty (TKA) with continuous femoral never block.Meth ods One hundred and twenty patients,ASA physical status Ⅰ ～ Ⅱ,who underwent unilateral TKA were randomly allocated into two groups:group D (DEX with ropivacaine);group R (ropivacaine only).Both groups experienced spinal-epidural anesthesia.Continuous femoral nerve block was performed after operation.Rest and movement visual analogue score (VAS),Ramsay sedation scores were recorded.In addition to the date of the analgesia drug dose,the pressed times of PCA,the mobility of knee joint and the force of quadriceps femoris were obtained at different points of time.Results Rest Pain scores (RVAS) of the group D were lower at time point 8,12,24,36,48 h and Ramsay sedation scores were higher at time point 4,8,12 h than that in the group R (P ＜ 0.05).The analgesia drug dose and the pressed times of PCA reduced in the group D.The range of motion (ROM) was better in the group D at 1 d,2 d after operation (P ＜ 0.05).There was no significant difference in the force of quadriceps femoris in both groups.Conclusion Dexmedetomidine combined with ropivacaine in single sciatic nerve block after TKA provided better analgesia when continuous femoral nerve block was performed.Meanwhile,analgesia lasted longer and did not increase the motor nerve blockade.

Objective To explore the characteristics of respiratory tract microbiota and its clinical significance in children with protracted bacterial bronchitis (PBB).Methods Twelve children aged from 5 months to 2 years old with PBB (PBB group) and 12 age-matched tracheomalacia(TM) children (TM group) were included in this study,who were admitted into the Respiratory Department of Shenzhen Children's Hospital.Their bronchoalveolar lavage fluid (BALF) samples were collected.Bacterial DNA was extracted from their BALF samples and the 16S rRNA V3-V4 region was sequenced by using Illumina MiSeq TMII system,and the findings were analyzed by bioinformatics methods.Results Principal component analysis revealed the difference in microbiota composition between 2 groups.Compared with TM group,PBB group exhibited lower microbial diversity:the Shannon indices were also 1.683 ± 0.703 and 2.324 ± 0.142 for PBB group and TM group respectively,and the differences were also significant(all P ＜ 0.05),and the Simpson indices were 0.416 ± 0.216 and 0.191 ± 0.025 for PBB group and TM group,respectively,and the differences were also significant (all P ＜ 0.05).The relative abundance of Actinobacteria was significantly lower in PBB group [(0.215 ± 0.228) ％] than that in TM group [(3.028 ± 0.592) ％] (P ＜ 0.01).The proportions of beneficial genera obviously decreased in PBB group,including Lactococcus [(13.464±7.319)％ in PBB group,and (44.784 ± 5.020)％ in TM group,P ＜0.01],Lactobacillus [(0.153 ±0.076)％ in PBB group,and (0.313 ±0.060)％ in TM group,P＜0.01],andArthrobacter [(0.024 ±0.018)％ in PBB group,and (2.970 ±0.584)％ in TM group,P＜0.01].On the other hand,the relative abundances of opportunistic pathogenic genera increased in PBB group significantly,including Haemophilus [(14.319 ± 29.532) ％ in PBB group,and (0.047 ± 0.127) ％ in TM group,P ＜ 0.Ol],Pseudomonas [(10.406 ± 25.439) ％ in PBB group,and (7.228 ± 0.948) ％ in TM group,P ＜ 0.01],and Escherichia [(0.432 ±0.441)％ in PBB group,and (0.055 ±0.035)％ in TM group,P ＜0.01].Conclusion These findings confirmed the existence of respiratory tract microbiotia dysbiosis in PBB,which probably was one of the pathogenetic mechanisms for PBB.

Objective To evaluate the efficacy of transfrontal neuroendoscopic surgery in the treatment of chronic subdural hematoma.Methods Analysis of clinical data of 80 cases of chronic subdural hematoma.According to the surgical method,40 cases were divided into traditional external drainage of parietaltuber,40 cases were divided into transfrontal neuroendoscopic small bone window hematoma removal.The treatment efficiency,hematoma recurrence rate,operation time and intraoperative blood loss were compared between the two groups.Results Treatment efficiency of neuroendoscopic group was 95.0%,significantly higher than drainage group 75.0%,hematoma recurrence rate one month after surgery of neuroendoscopic group was 5.0%,significantly lower than that in drainage group 25.0%,operation time of neuroendoscopic group was(54.1±7.5)min,longer than that of drainage group(40.7±9.4)min,the differences were statistically significant(P<0.05).The intraoperative blood loss of neuroendoscopic group was(30.1±4.5)mL,compared with(27.1±6.4)mL in the drainage group,the difference was not statistically significant(P>0.05).Conclusion Transfrontal neuroendoscopic surgery can significantly improve the efficacy of chronic subdural hematoma,and hematoma recurrence rate is extremely low.It is worthy of clinical application.