Sepsis is a severe complication which is usually caused by microbial infection,severe burns or trauma and major operations.Patients with sepsis were usually complicated with systemic inflammatory response and multi-organ dysfunction syndrome,which is the leading cause of death in the intensive care units.However,the main immunoregulatory mechanisms underlying severe sepsis remain unclear,and effective methods for monitoring immune status and immunomodulatory strategies need to be investigated.In recent years,the understanding of the mechanism of sepsis has been developed.Clinicians have learned that immune dysfunction took part in the pathophysiological process of sepsis.Therefore,rational monitoring of immune status in patients with severe sepsis after burns or major operation,seeking effective ways for diagnosis,treatment and intervention are of great significance in decreasing the mortality and improving the life quality.

With rapid progress and dangerous prognosis, traumatic brain injury (TBI) brings great difficulties in the clinical treatment, which becomes a prominent problem for the modern emergency and critical care medicine. In addition to the necessary surgical intervention under special circumstances, there are new understandings about the clinical management measures, noninvasive and invasive monitoring mode of TBI in recent years. This review provides a summary of the monitoring and treatment on the TBI, with our deep understanding of regulatory mechanism underlying TBI, precise modulation might be of clinical significance in preventing secondary damage of tissues and organs, which would be associated with decreases in the disability and mortality of critically ill patients.

OBJECTIVE: To systematically evaluate the application of microcapsuled cell or encystation materials for treating diabetes mellitus at hone or abroad in recent years.METHODS: A computer-based online search of PubMed database was undertaken to identify related articles about the microcapsulated cell or encystation material for treating diabetes mellitus published from 1980 to 2009 by using the key words of "microcapsulation, islet, transplantation" in English. Meanwhile, we search CNKI for relevant articles published between 1999 and 2009 with the same key words in Chinese. The related randomized, controlled, and clinical studies were collected according to conclusion and exclusion criteria.RESULTS: Among 25 articles, there were 46 patients with type I diabetes mellitus, 106 rats, 20 pigs, and 25 monkeys. The experimental results showed that both the microcapsulated islets and non-microcapsulated islets could secrete insulin and decrease blood glucose level. The normal blood glucose level with microcapulated islets could be maintained for a long time.Thus, microcapsule had a great immune isolation reaction.CONCLUSION: After transplantation, microencapsulated islet cells could improve and adjust abnormal glycometabolism of patients with diabetes mellitus; furthermore, the immunoisolation effect of microcapsule could eliminate or relieve the immunological rejection of receptors to allograft or xenograft, while it could also relieve or eliminate dependence on immunosuppressive drugs. Appropriate material of microcapsule, reasonable process, advanced equipment, advanced separation and purification technologies of islet, and suitable site for transplantation could improve the function of artificial islet cell, enhance the anti-machinery and chemical strength of microencapsuiated islet, improve biocompatibility, and prolong survival time.

We analyzed the current situation and problems of biomedical enterprise-universityresearch institute alliance in China.According to the features of the alliance,we put forward strategies in five aspects:to improve relavant legislation,to strengthen macro guidance,to improve the interest mechanism,to innovate the development mode and to broden the financing channels.

There are some widely discussed issues on xenotransplatation, such as animals'moral rights, allocation of medical resources and endangering public health,etc. The article raises four critical ethical issues, e.g. harm-benefit thresholds, informed consent from research patients, informed consent from third-party groups and oversight and approval of clinical trials as the prerequisites to initiation of clinical trials of xenotransplatation.

Objective To evaluate the effect of home-based care alongside with health promotion on Wechat towards disabled centenarians, to provide the basis for improving the home and community based care towards the oldest old. Methods A total of 158 indigious centenarians in Hainan were surveyed and 78 of them who were considered disabled by Barthel criteria were selected and then divided into intervention group (with health education on Wechat platform and nursing visit) and control group (with nursing care handbook) by the serial number of them. The living quality,incidence of adverse health events and positive feeling of family care givers of two group were evaluated and compared after 6 months intervention. Results After 6 months of home- care intervention, significant statistical differences in incidence of adverse health events were found between intervention group and control group, which compromise falls (2 cases vs. 13 cases, χ2 = 8.91, P = 0.00), pain (1 case vs. 17 cases, χ2 = 17.28, P =0.00) and constipation (6 cases vs. 15 cases, χ2 = 4.75, P = 0.03). When it came to positive feeling of care givers, the scores of intervention groupwere (33.44±3.72), (36.46±4.06) points, control groupwere (28.10± 3.25), (28.15±3.15) points, significant differences were found at 3rd and 6th month′s follow-up between two groups, which t value represent 4.955 (P=0.00) and 10.142 (P=0.00), respectively. It also suggested that the differences in living quality of the elderly were statistical significant when refered to discomfortble or pain scored 1.58±0.50 and 2.37±0.63 (t=-6.154,P=0.00), and anxiety or depression scored1.73±0.64 and 2.32 ± 0.70 (t=- 3.889,P=0.00). Conclusions Health education on Wechat platform with nursing visit can enhance the effect of home- based care by improving the living quality, incidence of adverse health events of the elderly and positive feeling of family care givers.

Objective To investigate the expression of Toll-like receptor 4 (TLR4) of peripheral blood mononuclear cell (PBMC) in the different prognosis of patients with severe sepsis and its relation with endotoxin-tolerant.Methods Thirty-five patients with severe sepsis (severe sepsis group) and 15 healthy volunteers (control group),respectively stayed in ICU 24 h and physical examination in the day measured TLR4 expression of PBMC by flow cytometry and measured the serum of tumor necrosis factor (TNF)-α and interleukin (IL)-10 by enzyme-linked immunosorbentassay.Simultaneous separation of peripheral blood of PBMC,addition of 40 μ g/ml lipopolysaccharide (LPS) cultured for 24 h,and TLR4 expression of PBMC was measured in the same manner and the culture supernatant of TNF-α and IL-10.Results Thirty-five patients with severe sepsis survivor 25 cases (survivor group) and death 10 cases (death group),28 d death rate was 28.6％ (10/35).The TLR4 expression of PBMC in severe sepsis group was significantly lower than that in control group [(11.09 ± 8.90) MFI vs.(33.72 ± 12.59) MFI,P ＜ 0.01],the serum TNF-α and IL-10 in severe sepsis group were significantly higher than those in control group [(96.66 ± 45.33) ng/L vs.(2.53 ± 1.21) ng/L,(149.79 ± 67.15) ng/L vs.(34.56 ± 19.08) ng/L,P ＜ 0.01].There was no significant difference in TLR4 expression of PBMC between survivor group and death group (P ＞ 0.05).The TLR4 expression of PBMC in control group after LPS stimulation was significantly higher than that before LPS stimulation [(50.22 ± 19.23) MFI vs.(33.72 ± 12.59) MFI,P ＜ 0.05],survivor group and death group after LPS stimulation were significantly lower than those before LPS stimulation [(4.55 ± 2.30) MFI vs.(11.21 ±7.92) M FI and (5.46 ± 3.44) M FI vs.(10.15 ± 9.70) MFI,P ＜ 0.01].The culture supernatant of TNF-α,IL-10 in survivor group and death group were significantly lower than those in control group [(22.34 ± 8.27)and (19.49 ±5.35) ng/L vs.(88.70 ±34.21) ng/L,(54.29 ±32.89) and (98.04 ±40.26) ng/L vs.(146.56 ± 52.18) ng/L,P ＜ 0.01],but the culture supernatant of IL-10 in death group was significantly higher than that in survivor group (P ＜ 0.05).Conclusion Different prognosis of patients with severe sepsis have endotoxin tolerance and different inflammatory cytokine secretion abifity.

Objective To test the performance of field blood transportation vehicle from the aspects of heat preservation,refrigeration and oil consumption.Methods Two vehicles without power supply were stowed with maximum load,one with red cell suspension,and the other with frozen plasma.With the environmental temperature higher than 35 ℃ or lower than 25 ℃,related time lengths were detected respectively.Results The holding time of the vehicles was from 1.5 h to 7 h,refrigerating time was from 15 min to 138 min,and a full tank of gasoline was exhausted around 5～7 hours.Conclusion During line-haul,field blood transportation vehicle has to be equipped with additional cooling agents,in case the refrigeration equipment out of work for the reason of gasoline exhaustion.

A good funds budget can optimize efficiency of the research funds. Through the implementation of a National Science and Technology Major Project, the authors analysed the budget management proposed some skills and suggestions for the planning and management of budget.

Objective To observe the expression of tumor necrosis factor-α induced protein 8 like-2 (TIPE2) in CD4 + CD25 + regulatory T cells ( CD4 + CD25 + Tregs) and analyze its potential effect on immunosuppressive activity of CD4 + CD25 + Tregs. Methods CD4 + CD25 + Tregs were purified from spleen of the BALB/c mice by using magnetic cell sorting system.The expressions of TIPE2 mRNA and protein in CD4 + CD25 + Tregs were detected by using RT-PCR and Western blot.CD4 + CD25 +Tregs were further infected with the recombinant lentiviruses that carried small interference RNA(siRNA)to knock down the TIPE2 expression.Based on the expressions of cell surface molecules including cytotoxic T-lymphocyte-associated antigen (CTLA)-4 and forkhead/winged helix transcription factor p3 (Foxp3) detected by flow cytometry and the levels of cytokines including interleukin (IL)-10 and transforming growth factor (TGF)-3 examined by ELISA in CD4 + CD25 + Tregs,the functional role of TIPE2 in controlling suppressive activity of CD4 + CD25 + Tregs was analyzed.In the meantime,the proliferation activities of T effector cells were assayed by MTT test. Results A 147 bp TTPE2 gene band and a clear TIPE2 band with a molecular mass of approximately 21 000 in CD4 + CD25 + Tregs were detected by using Westem blot.Cell surface molecule as well as cytokine expressions were significantly down-regulated when the CD4 + CD25 + Treg stimulated and activated by anti-CD3/CD28 was cultured for 24 hours after the siRNA silenced CD4 + CD25 + Treg cells ( P ＜ 0.01 ).Meanwhile,the suppression role of CD4 +CD25 + Tregs on the proliferation activity of T effector cells was weakened obviously ( P ＜ 0.05 ). Conclusions As an important immunoregulatory molecule,TIPE2 not only expresses in the CD4 + CD25 +Tregs,but also affects the immunosuppressive function of CD4 + CD25 + Tregs.