Increased catabolism, including reduced protein synthesis rates and increased protein degration rates, is common in patient with trauma and sepsis. There has been a long time search in how to reverse the increased catabolism. Besides nutritional support, people hope manipulation of anti catabolism hormone might reverse or at least ameliorate catabolism. Recent researches indicate that the GH IGF IGFBP axis plays a crucial part in regulating the metabolism of muscle protein on both basal and stress condition. This article aims to review the changes in GH IGF IGFBP axis and its clinical significance associated with trauma and sepsis.

The Non-neuronal Acetylcholine System,including acetylcholine(NNAs),choline acetyltransferase,acetylcholinesterase,muscarinic and nicotinic ACh receptors,has been identified in numerous non-neuronal cells and tissues,including keratinocytes,cancer cells,immune cells and reproductive organs.NNAs is involved in regulation of their function and related to the pathophysiology of several diseases.This review investigates the research progress of NNAs and describes the structure and function of NNAs in different cells,such as glial cell,endothelium,epithelia and lymphocyte.NNAs is not the same as neuronal acetylcholine system,neither is the same in different cells.

Eosinophilic esophagitis(EoE)is a chronic autoimmune inflammatory disease characterized by accumulation of eosinophils in all layers of esophagus and lacking typical clinical manifestations. The pathogenesis has not yet been clarified. Diagnosis is mainly by combined judgment,including clinical manifestation,endoscopy and histopathology. Treatment includes food,drug and surgical therapy. This article reviewed the advances in study on EoE.

Objective:Eph receptors constitute the largest sub-family of receptor tyrosine kinases(RTKs) and have an important role in oncogenic transformation and tumor progression.This study aimed to analyze the aberrant expression of EphA1 gene in gastric cancer and its correlation with clinical parameters,so as to explore the significance of EphA1 in the etiology and progression in gastric cancer.Methods: Expression of EphA1 protein was determined using immunohistochemical staining in 60 gastric cancer patients.Correlation between EphA1 protein expression and clinical parameters was evaluated by statistics.Results: Over-expression was more commonly observed in more advanced patients(P=0.015) and in those with lymph nodes metastases(P=0.032).There was no correlation between EphA1 expression and other clinical parameters.Conclusion: EphA1 gene could promote the progression of gastric cancer.

Objective To investigate the effects of three different concentrations of hypertonic sodium salt (HS) resuscitation on liver injury of rats at the early stage of severe burned.Methods 104 female Sprage-Dawley (SD) rats were randomly divided into five groups: sham group (n = 8), lactated Ringer solution (LR) group (n = 24), 600, 800, 1000 mmol/L HS groups (HS600, HS800, and HS1000 groups,n = 24). Rats in LR group and HS groups were subjected to full-thickness scald with 30% total body surface area (TBSA), and then given liquid resuscitation treatment with LR and the corresponding HS. These rats were sacrificed at 2, 8 and 24 hours post injury to collect blood and liver tissue. Rats in sham group were given simulation of burns without resuscitation, which were immediately sacrificed and the specimens were harvested. The levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected by automatic biochemical analyzer. The levels of liver tissue malondialdehyde (MDA) and superoxide dismutase (SOD) were detected by ultraviolet spectrophotometry. The expression of liver tissue p38 mitogen-actirated protein kinase (p38MARK) was detected by Western Blot.Results Compared with sham group, the levels of ALT, AST, MDA and p38MAPK were increased, and the activities of SOD were decreased in LR group and different degrees in HS groups at each time point after injury. Compared with LR group, the levels of ALT, AST, MDA and p38MAPK were decreased and the activities of SOD were increased in different degrees with HS groups, among which HS600 group changed most significantly [ALT (U/L): 147±52 vs. 227±60 at 8 hours, 138±47 vs. 191±41 at 24 hours; AST (U/L):288±79 vs. 548±237 at 2 hours, 567±167 vs. 841±338 at 8 hours, 515±180 vs. 712±159 at 24 hours; MDA (nmol/mg): 0.287±0.036 vs. 0.395±0.041 at 2 hours, 0.298±0.030 vs. 0.392±0.018 at 8 hours, 0.278±0.033 vs. 0.422±0.036 at 24 hours; SOD (U/mg): 230±16 vs. 159±30 at 2 hours, 251±14 vs. 194±15 at 8 hours, 296±8 vs. 243±11 at 24 hours; p-p38MAPK/p38MAPK (A value): 0.778±0.040 vs. 1.065±0.066 at 2 hours, 0.791±0.046 vs. 0.967±0.041 at 8 hours, 0.733±0.027 vs. 1.020±0.043 at 24 hours; allP < 0.05]. The levels of ALT and AST in HS600 group were significantly lower than those in HS1000 group at 2 hours and in HS800 group at 8 hours. The levels of MDA and p38MAPK in HS600 group were significantly lower than those of HS800 group and HS1000 group, and the level of SOD in HS600 group was significantly higher than that in HS800 group and HS1000 group at each time point after injury. There were no significant differences in all test indicators between HS800 group and HS1000 group at each time point after injury.Conclusions High concentration of HS can reduce the early liver injury in severely scalded rats, of which the curative effect of HS 600 mmol/L is best.

Objective To investigate the effects of dexmedctomidine pretreatment and postconditioning on renal ischemia-reperfusion (I/R) injury in rats.Methods Thirty-two male Wistar rats,aged 3-4 months,weighing 220-300 g,were randomly divided into 4 groups ( n =8 each):sham operation group ( group S),I/R group,dexmedetomidine pretreatment group (group Pre) and dexmedetomidine postconditioning group (group Post).The rats were anesthetized with phenobarbital sodium 65 mg/kg.Renal I/R was produced by occlusion of both renal pedicles for 60 min followed by 48 h reperfusion.Dexmedetomidine 50 μg/kg was given intraperitoneally at 30 min before ischemia and at the beginning of reperfusion in Pre and Post groups respectively.The concentrations of serum creatinine and blood urea were determined at 0,24 and 48 h of reperfusion (T1-3).The renal tissues were obtained at the end of reperfusion for microscopic examination and detection of apoptosis by TUNEL assay.Acute kidney tubular necrosis was scored and apoptosis index (AI) was calculated.Results Compared with group S,the concentration of serum creatinine and blood urea at T2.3,and acute kidney tubular necrosis score and AI were significantly increased in I/R,Pre and Post groups ( P ＜ 0.05).Compared with I/R group,the concentration of serum creatinine and blood urea at T2.3,acute kidney tubular necrosis score and AI were significantly decreased in Pre and Post groups ( P ＜ 0.05).Conclusion Both dexmedetomidine pretreatment and postconditioning can attenuate renal I/R injury through inhibition of cell apoptosis in rats.

Objective To summarized the projects received and funded in the fields of emergency and intensive care medicine/trauma/burns/plastic surgery from National Natural Science Foundation of China (NSFC) during 2010-2013,put forward the thinking and perspective of this future trend in these fields.Methods The number of the funded project and total funding in the fields of emergency and intensive care medicine/trauma/burns/plastic surgery from NSFC during 2010-2013 had been statistical analyzed,in the meantime,the overview situation of various branches in basic research and further preliminary analysis the research frontier and hot issues have been analyzed.Results ① The number of funded project were 581 in H 15 of NSFC during 2010-2013,total funding reached to 277.13 million RMB,including 117 projects in H 1511 (emergency and intensive care medicine/trauma/burns/plastic surgery and other science issue),96 projects in H1507 (wound healing and scar),88 projects in H1502 (multi-organ failure),71 projects in H 1505 (burn),61 projects in H 1504 (trauma) ② The top 10 working unit for project funding in the field of Emergency and intensive care medicine/trauma/burns/plastic surgery present as Third Military Medical University (70),Shanghai Jiao tong University (69),Second Military Medical University (40),Chinese PLA General Hospital (36),Forth Military Medical University (35),Zhejiang University (22),Sun Yat-Sen University (18),Southern Medical University (14),China Medical University (11),Capital Medical University (11) respectively,the number of funded project positive correlated with funding.③ The funded research field in H15 covered almost all important organs and system injury or repair research,our scientists reached a fairly high level in some research field,for example,sepsis,trauma,repair,et al.Sepsis was funded 112 projects in H15 for 4 years,the growth rate became rapid and stable comparing to shock,burns and cardiopulmonary resuscitation funded projects' number.emergency and intensive care medicine/trauma/burns research fields related to heart,lung,bone/cartilage/muscle,stomach/intestinal/liver,brain/spinal cord/peripheral nerve and other tissues/organs.The number of funded projects in plastic surgery related research fields in angioma and flap related projects were down below to 3 projects,but the number of funded project in wounds,scar repair related research field were more than other fields relatively.④ In frontier and research hot issue,the funded rate represent as 23.8％,21.4％,19.0％ and 23.9％ in stem cell related research fields in 4 years respectively.The funded rate average to 20.9％ in epigenetic related research fields for four years,the funded rate achieved to break through zero in autophagy related research fields,the total rate raised to 32.6％ from 2011 to 2013.Conclusions The funded number and funding were raised rapidly in the fields of emergency and intensive care medicine/trauma/burns/plastic surgery from NSFC.The application for each proposal should be focus on concise or upgrade the scientific issues to improve the quality.The depth or systematic in content and interdisciplinary research fields (e.g.immunology) should be paid attention to.Sepsis,trauma and burns will be the main stream direction in future in the fields of emergency and intensive care medicine/trauma/burns/plastic surgery.The fields of wound healing and scar,surface organ defects,damage,repair and regeneration,surface tissue/organ transplantation and reconstruction,craniofacial deformities and correction are important develop directions in future work.

Objective To explore a time series based meta-analysis of randomized clinical trials (RCTs) and observational studies which examined differences in mortality in acute-on-chronic liver failure (ACLF) patients treated with artificial liver support system(ALSS) or not.Methods Medline,Embase,Ovid,and Cochrane library database was systemically searched up to December 2014.The outcome measure was mortality at different follow-up endpoints.Relative risks (RRs) were pooled for analysis.Results Ten studies,involving a total of 1682 ACLF patients,among whom 842 were treated with ALSS.ALSS was found to reduce the risk of 1-month and 3-month mortality for patients with ACLF by nearly 16.4％ and 13.2％,respectively.Randomized trials and observational studies provided good internal and external validity,respectively.Conclusions ALSS therapy could reduce short-term mortality in patients with ACLF.Clinical utility of this system for survival benefit may be implied.

Objective:Eph is the largest member of the family of receptor tyrosine kinases (RTK). Hypermethylation of CpG island is an important mechanism leading to down-regulation of EphA7 in gastric cancer. The objective of this study is to investigate the expression level of EphA7 in gastric carcinoma and its roles in the development,progression and prognosis of gastric carcinoma. Methods:The expression level of EphA7 transcript in gastric carcinoma specimens and normal mucosa tissues was detected using real-time RT-PCR. Results:The expression level of EphA7 in gastric carcinoma was divided into three groups according to the expression rate in gastric cancer tissue and matched normal mucosa. Statistics analysis showed that the expression of EphA7 is significantly related to age and stage. Overexpression of EphA7 has a tendency to relate to metastasis. Conclusion:EphA7 is differentially expressed in gastric carcinoma specimens. Overexpression of EphA7 may play a role in the development and progress of gastric carcinoma.

Objective: To investigate EphA7 protein expression of gastric carcinoma cells and its clinicopathological parameters.Methods: The expression level of EphA7 protein in gastric carcinoma and normal mucosa was detected using immunohistochemical staining.Results: The overexpression of EphA7 protein in gastric carcinoma was significantly related to age(P=0.016) and stage(P =0.033).Conclusion: EphA7 was differentially expressed in gastric carcinoma cells.