Transcutaneous immunization (TCI) is a novel immunotherapy approach that induces systemic immune responses via topical application of antigens and adjuvants onto the skin.It is a safe and effective method,and is expected to serve as an attractive alternative to traditional vaccination.TCI induces immune responses in different directions,but the exact mechanism of skin immune tolerance is still unclear.Most studies on TCI are based on animal models.However,there are structural differences between animal skin and human skin,so more researches are needed to achieve the translation of TCI from bench to bedside.Not all vaccines are suitable for cutaneous inoculation,so vaccines for TCI should be evaluated for their safety and efficacy.Various reformed vaccine delivery systems are needed to be further explored in related diseases.

The nature of medicine is the unity of natural science and humanities.Due to historical and current causes,humanism spirit is lost seriously in medicine.This article aims to analyze the reason of humanism spirit loss and put forward some ways to rebuild humanism spirit in medicine.

Objective To observe the effect of ginsenoside Rb 1 and Re on cardiomyocyte apoptosis and expression of Bcl-2, Bax, Bad and Fas gene proteins after acute ischemia and reperfusion in rats and elucidate the possible mechanisms. Methods The ischemia-reperfusion heart model was made by ligating the left anterior descending branch of coronary artery in Wistar rats. The apoptotic cardiomyocytes were confirmed with transmission electron microscopy and counted with in situ nick labeling (TUNEL) method and light microscopy. The expression of Bcl-2?Bax?Bad and Fas gene proteins were studied by immunohistochemical staining. Mean optical density (OD) value of the gene proteins expression were quantitatively examined by image analysis system. Results A.The apoptotic cardiomyocytes were not observed in the sham-operation group. The number of the apoptotic cells were 134.45?45.61/field in the ischemia- reperfusion group, 51.65?13.71/field in the ginsenoside Rb 1-treated group and 90.66? 19.22/field in the ginsenoside Re-treated group, respectively. The differences were significant among the three groups (P0.05), but Bax?Bad and Fas gene expression were decreased significantly in the ginsenoside Rb 1 and Re-treated group as compared with the ischemia-reperfusion group (P

Objective To systemically review the efficacy and safety of heparin for treatment of sepsis.Methods Database search of IM/MEDLINE,Cochrane Library,SCIE,CBM,CNKI,VIP Data,WanFang Data (from January 2000 to June 2012) was conducted.The quality of included randomized controlled trials (RCTs) about heparin for treatment of sepsis was assessed,and relevant data were extracted according to the inclusion and exclusion criteria.Then meta analysis was performed using RevMan 5.1.Results 17 trials with 1 167 participants were included.The results of meta-analysis showed:compared with the control group,heparin significantly decreased 28-day mortality in patients with sepsis [odds ratio (OR) =0.59,95％ confidence interval (95％CI) 0.45-0.77,P=0.0001] ; heparin did not deteriorate coagulation disorders,but corrected sepsis-induced platelet (PLT) count reduction [mean difference (MD) =13.94,95％ CI 10.15 to 17.72,P＜0.000 01],while it had no significant effect on the activated partial thromboplastin time (APTT) and prothrombin time (PT,APTT:MD=-3.18,95％CI-6.88 to 0.53,P=0.09; PT:MD=-0.68,95％ CI-1.48 to 0.12,P=0.09).There was no significant difference between the two groups in the incidence of bleeding either.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score of heparin group was significantly lower than that of the control group (MD=-2.58,95％CI-3.29 to-1.87,P＜0.000 01),and the incidence of multiple organ dysfunction syndrome (MODS) was significantly lower than that of the control group (OR=0.32,95％CI 0.17 to 0.61,P=0.000 6).In addition,heparin could shorten intensive care unit (ICU) stay (MD=-4.43,95％CI-6.79 to-2.07,P=0.000 2),whereas it showed no significant effect on the total length of hospital stay.Conclusions Heparin can ameliorate sepsis,and has high degree of safety and lower hospital expense.Due to limitation of the quality of included studies,larger sample and well-designed RCTs are needed to further support this conclusion.

Coagulopathy is very common in patients in intensive care unit (ICU) and often indicates organ dysfunction or underlying diseases.The application of traditional methods assessing the patients' coagulation status in ICU is limited because they can not reflect the whole process of coagulation.Thromboelastography (TEG),a point-of-care (POC) assay of coagulation,fibrinolysis and platelet function,developed in recent years has been widely used in organ transplant and cardiovascular surgery and so on.However,there is no standard for the use of TEG in ICU.The development and application of TEG in sepsis,multiple trauma,guiding blood transfusion,extracorporeal membrane oxygenation (ECMO),and anticoagulation monitoring were addressed in this review,and its value and application prospect in ICU were analyzed.

Liver Imaging Reporting and Data System was released online in 2011 by America College of Radiology (ACR) for standardizing the performance,interpretation and reporting of CT and MR imaging examinations of the liver in patients at risk for hepatocellular carcinoma.This article overviewed the profile of this system,its updated version and recent progress on its clinical application.

OBJECTIVE:To study the hepatoprotective effect of the extract of Sabia parviflorawall(SPS) on mice with experimental liver injury.METHODS:The liver injury models were reproduced in mice with CCL4 and Paracetamol(AAP),respectively with the activities of serum ALT and AST measured.RESULTS:The activities of serum ALT and AST were all reduced to a certain degree in mice with liver injury induced by either CCL4 or Paracetamol(AAP).CONCLUSION: SPS exhibited certain hepatoprotective effect.

This paper explores the social care for HIV-infected people and patients in Shanxi Province,detailed as two parts including medical assistance and living assistance.And the purpose of this paper is to reflect the status of comprehensive prevention and treatment of AIDS in Shanxi Province,and find out the emerging priorities and challenges in work to provide references for relevant research.

ObjectiveTo determine the effect of unfractionated heparin (UFH) on lipopolysaccharide (LPS)-induced expression of granulocyte colony-stimulating factor (G-CSF), and the role of Toll-like receptor 4 (TLR4) signaling pathway in this process.Methods Human pulmonary microvascular endothelial cells (HPMECs) were cultured in vitro, and the cells between passages 3 and 5 were used in the experiments. ExperimentⅠ: the cells were divided into four groups as follows: control group, LPS stimulation group (LPS 10μg/mL), LPS+ 0.1 U/mL UFH group, and LPS+ 1 U/mL UFH group. HPMECs in UFH groups were treated with 0.1 U/mL or 1 U/mL UFH 15 minutes before LPS stimulation, and HPMECs in control group were treated with an equal volume of phosphate-buffered saline (PBS) instead. The concentrations of interleukin-6 (IL-6) and G-CSF in cell culture supernatants were determined by enzyme linked immunosorbent assay (ELISA) 24 hours after LPS challenge to detect the effect of UFH on HPMECs. ExperimentⅡ: HPMECs were treated with 5μg/mL of rhodobacter sphaeroides LPS (LPS-RS, antagonist for TLR4) 4 hours before the addition of PBS or LPS. The concentrations of IL-6 and G-CSF in cell culture supernatants were determined 24 hours after LPS stimulation to detect the effect of TLR4 on LPS-induced HPMEC injury. ExperimentⅢ: HPMECs were divided into four groups as before: control group, LPS stimulation group, LPS+ 0.1 U/mL UFH group, LPS+ 1 U/mL UFH group. Treatments to cells were the same as experimentⅠ. The protein expression of TLR4 in HPMECs was determined by Western Blot 1 hour after LPS stimulation to detect the effect of UFH on TLR4.Results① Compared with control group, the levels of IL-6 and G-CSF in LPS stimulation group were increased [IL-6 (ng/L): 655.9±58.3 vs. 75.5±18.2, G-CSF (ng/L): 388.7±36.2 vs. 35.3±12.6, both P< 0.05]. Compared with those of LPS stimulation group, in LPS+ 0.1 U/mL UFH group and LPS+ 1 U/mL UFH group, the levels of IL-6 and G-CSF were significantly decreased [IL-6 (ng/L): 518.2±64.6, 489.1±75.6 vs. 655.9±58.3, G-CSF (ng/L): 298.8±41.0, 273.4±33.2 vs. 388.7±36.2, allP< 0.05]. The results indicated that 1 U/mL UFH had better results, though there was no statistical significance between the results of two UFH groups.② LPS-induced up-regulation of IL-6 and G-CSF levels was prevented by LPS-RS [IL-6 (ng/L): 139.1±37.6 vs. 655.9±58.3, G-CSF (ng/L): 73.7±19.7 vs. 388.7±36.2, bothP< 0.05]. LPS-RS alone had no effect on cytokines [IL-6 (ng/L):118.2±42.1 vs. 75.5±18.2, G-CSF (ng/L): 48.4±26.8 vs. 35.3±12.6, bothP> 0.05].③ Compared with control group, the protein expression of TLR4 (grey value) in LPS stimulation group was significantly upregulated after 1 hour (0.87±0.23 vs. 0.36±0.12,P< 0.05). UFH with 0.1 U/mL and 1 U/mL lowered TLR-4 protein expression induced by LPS (0.68±0.18, 0.62±0.26 vs. 0.87±0.23, bothP< 0.05).ConclusionsThe expressions of IL-6 and G-CSF were increased obviously in LPS treated HPMECs. UFH might take its therapeutic effect through TLR4-dependent pathway.

Service recovery as a theory of services marketing has gradually been applied to hospital services. By expounding the concept, significance and principle of service recovery, the paper puts forward some strategies that ought to be adopted in service recovery: ①preventive strategy; ②timely strategy; ③ the strategy of cultivating the employees capability of on the spot service recovery; ④ the strategy of laying stress on follow up and anticipation and prevention of errors.