OBJECTIVE:To study the effect and its mechanism of dexmedetomidine(Dex)on inflammatory response in septic mice. METHODS:Mice were randomly divided into normal control group,model group,miR-146a inhibitor (50 mg/kg)+Dex (50 μg/kg)group,Dex low-dose,medium-dose,high-dose groups(10,30,50 μg/kg),10 in each group. Except for normal con-trol group,other groups were intraperitoneally injected lipopolysaccharide to induce septic models,intraperitoneally injected rele-vant medicines after 0.5 h. After drug intervention for 6 h,miR-146a expression,IRAK1 and TRAF6 mRNA expressions in periph-eral blood mononuclear cells in each group were detected by real-time fluorescence quantitative polymerase chain reaction method. IRAK1,TRAF6 protein expressions in peripheral blood mononuclear cells in each group were detected by Western blot method. TNF-α,IL-6 levels in serum were detected by enzyme-linked immunosorbent method. RESULTS:Compared with normal control group,miR-146a expression,TNF-α and IL-6 levels,IRAK1,TRAF6 mRNA and protein expressions in peripheral blood mononu-clear cells in model group were increased(P<0.01). Compared with model group,miR-146a expression in peripheral blood mono-nuclear cells in Dex medium-dose,high-dose groups were increased;TNF-α and IL-6 levels,IRAK1,TRAF6 protein expressions were decreased (P<0.05 or P<0.01);while IRAK1,TRAF6 mRNA expressions changed less obviously (P>0.05). Compared with Dex high-dose group,miR-146a expression,in peripheral blood mononuclear cells in miR-146a inhibitor+Dex group was de-creased;TNF-α and IL-6 levels,IRAK1,TRAF6 protein expressions were increased (P<0.05 or P<0.01);while IRAK1, TRAF6 mRNA expressions changed less obviously(P>0.05). CONCLUSIONS:Dex can inhibit the inflammatory response in sep-tic mice. The mechanism may associate with inducing miR-146a expression and inhibiting the 2 important adaptor proteins IRAK1, TRAF6 expressions in Toll-like receptor 4/nuclear factor-κB pathway.

Multinolular and intrahepatic recurrent HCC can originate from intrahepatic metastasis and multiple origins,and their colnal origin is closely related to the clinical diagnosis and treatment.To designate suitable therapeutic strategies according to their colnal origin is a new challenge needs to be tackled urgently.This paper reviews recent progress in the clinicopathological features,molecular diagnosis and clinical outcomes of multiple origin HCC.

Objective To understand the cause and pathogenesis,clinical and pathological features,diagnosis,treatment and prognosis of Casdeman's disease (CD). Methods One patient with CD which has transformed into Hodgkin's lymphoma in the end was analysed and the review were included. Results Castleman' s disease was a lymphoproliferative disorder with benign hyperplastic lymphnodes histologically characterized by follicular hyperplasia and capillary proliferation with endothelial hyperplasia. Based on the characteristic of pathology it was subdivided into three subtypes, hyaline vascular variant, plasma cell variant and mixed variant. The clinical manifestation of CD was multiplicity,including the lymphadenectasis and the involvement of the muhisystem of the body. The early diagnosis was depended on the histopathology,and the different histopathology has the distinct prognosis. The prognosis of local Castleman's disease (LCD) was good but the muhicentric Casdeman's disease (MCD) was poor. Conclusion The different histopathology of CD were determined according to the different clinical manifestations and prognosis.

Objective To study the diagnostic value of single fiber electromyography (SFEMG) in diabetic peripheral neuropathy (DPN).Methods The values of jitter and fiber density (FD) in 36 patients with diabetes mellitus of 2 type were determined by Viking Ⅳ, while conventional nerve conduction studies (NCS) were performed,and the fasting blood glucose and glycosylated hemoglobin A 1C (HbA 1C ) were measured.Results The values of jitter were associated with FD, and both jitter and FD were positively related to HbA 1C .18 cases with abnormal NCS showed increased jitter(11 cases with block),and increased FD in 14 cases; the remaining 18 cases with normal NCS,7 cases with increased jitter(3 cases with block),the increased FD in 5 cases.Conclusion Denervation reinnervation reflected by jitter and FD was associated with the metabolic status. SFEMG could be served as sensitive means to early diagnosis of DPN, and might detect subclinical peripheral neuropathy of diabetes.

Objective To investigate the diagnostic value of F wave in diabetic peripheral neuropathy (DPN).Methods F and M wave parameters were measured in 106 patients with diabetes mellitus and 75 normal persons, including the minimum latency, duration, amplitude and area of F wave, and the amplitude and the area of M wave.Results (1) In the 30 patients with diabetes mellitus without peripheral neuropathy, there were 8 cases with prolonged the duration of F wave, 4 cases with prolonged the minimum latency of F wave, 2 cases with increased in the ratio of the area of F/M wave. (2) The minimum latency prolonged of F wave, the ratio of the amplitude of F/M wave and the ratio of the area of F/M wave significantly increased in the 76 patients with DPN, the duration of F wave prolonged in the mild DPN but no one revealed remarkable abnormal. (3) In the controls, the function of upper limit of the minimum latency of F wave (Y) and leg length (X) was Y=12.3+48.8X 2. Conclusion (1) F wave could be served as sensitive index to the early diagnosis of DPN, and might detect subclinical DPN. (2) The proximal nerve segment could be affected without the lesions of the distal nerve segment in patients with DPN, and it suggested that vascular factor plays an important role in the mechanism of DPN.

OBJECTIVE:To explore the mechanism of procyanidins on mitochondrion injury caused by cerebral ischemia reperfusion(IR) in rats.METHODS:Forty-eight Wistar rats were randomly separated into 4 groups including sham operation group,IR model group,procyanidins pretreatment high and low doses groups(400,40 mg?kg-1).After medication for 30 days,the reperfusion model following focal cerebral ischemia in rats was made by thread embolish of MCA,and the rats were put to death 2 h later for sampling of brain tissues.The expression of cytochrome C protein was detected by immunofluorescence method and that of caspase-9 mRNA was detected by RT-PCR technique.RESULTS:There were significantly more cytochrome C and less caspase-9 mRNA in procyanidins pretreatment group than in IR model group(P

By analysing the new requirements of higher medical education curriculum in the new era,making curriculum changes of Nanjing Medical University as an analysed object,the arti-cle analyses the existing problems and shortcomings of China's current medical education course system,puts forward optimizing the course system further by running clear thinking,construction of composite course system,innovating teaching methods,strengthening the building of teaching mate-rials,the establishment of curriculum assessment mechanisms.

Objective To investigate angiogenesis and mosaic vessel in colorectal carcinoma.Methods Forty-nine patients suffering from colorectal carcinoma were studied.Endothelial cell was labelled with monoclonal anti-human CD_~31 antibody,tumor cell was labelled with monoclonal anti-human CEA antibody.Endothelial cell and tumor cell were labelled by double-stained immunohistochemistry.The quantity of microvessel was estimated by counting microvessel density (MVD) at hot spots,and the quantity of mosaic vessels (MV) and double-stained cells were estimated at the same visual field.The relationship between mosaic vessels,microvessel density and Dukes staging were analyzed.Results The MVD in colorectal carcinoma "hot spots" was counted.The MVD of Dukes staging B was 43.98?21.46,staging C was 59.54?26.95,and staging D was 70.80?19.04.MVD increased gradually accompanied by clinical staging.There was statistical difference between staging B and D (P

0.05).The stimulative index(SI)tested by MTT in MLR at stimulator-to-reactor cell ratio 1∶1,1∶10,1∶20,1∶40 and 1∶80 was 2.7,4.1,3.1,2.5 and 1.6,respectively.The proliferation of T cells stimulated by DCs could be detected at all stimulator-to-reactor ratio.Conclusion DCs could be successfully induced from peripheral blood monocyte in the patients with colorectal cancer by AIM-V serum-free media or by traditional FBS-contained media.AIM-V is more suitable for clinical immunotherapy because it can avoid the risk of allergic reaction for clinical purpose.AIM-V might take the place of serum-contained media to culture DCs.According to the results of MLR,DCs could stimulate allogenetic T cells proliferation at all stimulator-to-effector ratio,furthmore the optimal ratio is 1∶10 .

Objective: To ensure the integrity、non-repudiation、authenticity of pictures and relevent messages by making a digital signature for a DICOM file. Methods: By using OpenSSL toolkits and dcmsign of DCMTK toolkits, make a digital sig nature for the relevent messages of DICOM medical image and then save it behind of the DICOM file. Results: We can evaluate integrity、non-repudiation、authenticity of pictures and relevent messages in the DICOM file which has been made a digital signature. Conclusion: To make a digital signature in a DICOM file by using the OpenSSL toolkits and dcmsign of DCMTK toolkits can realize the security when DICOM file transported in remote medical treatment and PACS.