Sepsis,a common clinical syndrome,comparing to septicaemia or bacteremia,has a more comprehensive pathophysiological process.Its pathogenesis is complex,including pro-inflammatory/anti-inflammatory cytokine imbalance,intestinal bacterial translocation,immunosuppression,signal pathway activation,etc.Further study on the pathogenesis of sepsis is the theory foundation to explore the new method of sepsis.The diagnosis of sepsis pathogenesis,treatment principles and common virus infection induced sepsis are reviewed in this paper.

Glutamate is the primary excitatory amino acid in the mammal brain. Glutamate transporters perform the regulation of glutamate levels in synaptic cleft. If the glutamate transporters should not be expressed, stopped working, or gone into reverse releasing glutamate from the cytoplasm, there would be an extracellular build up of glutamate. Defective glutamate uptake has been suggested to be important in connection with amyotrophic lateral sclerosis, Alzheimer's disease and Parkinson's disease.

Induced pluripotent stem (iPS) cell based on recently developed stem cell reprogramming technique holds great hope for regenerative medicine,in vitro disease modeling and drug evaluation.Recent progress on clinical hematology includes in vitro generation of hematopoietic progenitors and mature blood cells from somatic cells,iPS cells derived from chronic myeloid leukemia cells for the better understanding of the resistance mechanisms of bcr-abl inhibitor imatinib,and moreover,correction the monogenic inherited disease using gene-targeted strategies.However,whether the iPS cells can fully replace human embryonic stem cells still needs further investigation.

Metabolic syndrome is a condition associated with multiple metabolic abnormalities.With improvement in economic situation,increasing prevalence of metabolic syndrome is seen in adults and children.Fetal origins of adult disease is one of the hot topics.In this paper,the relationship between intrauterine environment,birth weight and metabolic syndrome are reviewed.

Obesity is a major risk factor for the generation and development of diabetes, atherosclerosis, hyperlipidemia and cancer. Obesity is accompanied with remodeling of adipose tis-sue, such as changed cell component and function, angiogene-sis, extracellular matrix remodeling and infiltration of inflamma-tory cells. It is important for the prevention of obesity to study adipose tissue remodeling. This review summarizes recent ad-vances in adipose tissue remodeling.

Objective Statistics and analyze the effect of comprehensive prevention measures for the ventilator associated pneumonia (VAP) morbidity and mortality,and investigate its actual applicate situation in the clinical.Methods Statistics and analyze the clinical date of 183 cases of our ICU mechanical ventilation patients in 2012 (group A),including morbidity,mortality,time of endotracheal intubation,length of stay and the primary pathogenic bacteria,and to compared with the relevant clinical data of 192 cases of our ICU mechanical ventilation patients in 2011 (group B),summarize and analysis the actual applicate situation of the comprehensive prevention measures in the clinical through the data contrast.Results The incidence of VAP in group A was lower than that in group B [31.7％(58/183) vs.58.3％(112/192)] (P ＜ 0.05),but the mortality was no statistical difference in both groups (P ＞ 0.05) ; the endotracheal intubation time and the average length of stay in group A were less than those in group B [6.3 d vs.10.6 d,7.6 d vs.11.9 d](P＜0.05); the main pathogenic bacterium of VAP with mainly gram-negative bacilh.Conclusions Comprehensive prevention measures can effectively reduce the incidence of VAP,but the mortality rate has no significant effect,need further clinical research;comprehensive prevention measures to reduce patients with tube time also confirm its effectiveness.Comprehensive prevention measures are economical and practical,is worth in clinical promotion.

Objective To investigate the efficacy and safety of combination use of diltiazem and nitroglycerin in preventing radial artery spasm in performing coronary angiography via radial artery access. Methods During the period from Dec. 2012 to June 2013 at authors’ hospital, coronary angiography via radial artery access was carried out in a total of 200 patients. The patients were randomly divided into 2 groups: nitroglycerin group (n = 100) and combination group (n = 100). After successful placement of catheter sheath 200 μg of nitroglycerin was injected through the sheath in the patients of the nitroglycerin group, while 200 μg of nitroglycerin together with 2 mg diltiazem was injected through the sheath in the patients of the combination group. The heart rate , blood pressure and electrocardiogram were recorded with an electrocardio-pressure monitor before the injection as well as at 2, 5, 15 and 30 minutes after the injection. The occurrence of radial artery spasm and patient ’s general condition were also under observation. Results Radial artery spasm occurred in 5 patients of the combination group , while it occurred in 13 patients of the nitroglycerin group, the difference between the two groups was statistically significant (P < 0.05). No significant difference in heart rate and electrocardiogram existed between the two groups (P > 0.05). Conclusion For the coronary intervention via radial artery access , combination use of diltiazem and nitroglycerin can more effectively prevent the occurrence of radial artery spasm. Besides , combination use of diltiazem and nitroglycerin has no obvious effect on the heart rate , the blood pressure and the electrocardiogram.

BACKGROUND:Chronic ankle instability affects normal life severely. Therefore, chronic ankle instability causes more and more attention of experts, and choice of reasonable and effective diagnosis and targeted treatment method for chronic ankle instability in early stage has become an important issue in the clinic.
OBJECTIVE:To review literature research on the diagnosis and treatment of chronic ankle instability in recent years, and to provide reference and evaluation criteria for the diagnosis and reasonable and effective treatment of chronic ankle instability in clinical practice.
METHODS:We searched PubMed database, China National Knowledge Infrastructure, Wanfang database and VIP database for clinical and basic experimental research on chronic ankle instability. Keywords were“chronic ankle, instability, diagnosis, rehabilitation exercises, surgery methods, research progress”in Chinese and“chronic ankle, instability, diagnosis, rehabilitation exercises, surgical methods, research”in English. Total y 40 literatures were analyzed.
RESULTS AND CONCLUSION:Because of the special anatomical features and biomechanical advantages of the ankle, we should first consider the early diagnosis and effective treatment in chronic ankle instability patients. The treatment should focus on the anatomic characteristics, biomechanic characteristics, etiology of chronic ankle and diagnostic methods of the ankle joint. Conservative treatment and rehabilitation exercises after surgery play a major role in the recovery of chronic ankle instability. The use of balance board, tilting board, and climbing machines is an effective rehabilitation exercises for chronic ankle instability. The application of AOFOS-hind foot and ankle fibula reaction time is important for the assessment of functional recovery of the ankle joint. The emergence of arthroscope is an important clinical research direction of ankle surgery. This plays a significant effect on the treatment of chronic ankle instability.

ObjectiveTo investigate the effects of X-linked inhibitor of apoptosis (XIAP) siRNA or XIAP antagonist Embelin on the growth inhibition and apoptosis of hepatcellular cancer cell line HepG2,which was treated by tumor necrosis factor-related apoptosis (TRAIL). Methods HepG2 cells were tranfected either by XIAP siRNA or a negative control,followed by treatment with TRAIL,Embelin or a combination of the two.XIAP expression,cell growth,and caspase-3 activity were determined by Western blot,MTT assay and fluorescent caspase-3 assay,respectively.Cleaved PARP expression levels of were measured by Western blot.ResultsThe XIAP protein expression was significantly downregulated by transfection with XIAP siRNA.Compared with the negative control,the XIAP siRNA significantly inhibited the growth of HepG2 cells treated by 100ng/ml(6.8％ ±1.2％ vs.11.8％±4.0％,P＜0.05)and 1000 ng/ml (18.9％ ±2.0％ vs.26.6％ ±1.5％,P＜0.01)by TRAIL.TRAIL-induced caspase-3 activation and PARP cleavage were also increased significantly by XIAP siRNA transfection.In addition,Embelin also significantly inhibited cell growth (P＜0.01),activation of caspase-3 (P＜ 0.01) and TRAIL-induced PARP cleavage.Conclusions Both XIAP siRNA and Embelin may potentially contribute to clinical treatment of hepatocellular carcinoma.