Proinflammatory cytokines induced by peripheral immune challenge can activate the inflammatory reflex, which results in negative-feedback control of inflammation .Some recent studies revealed that it is the splanchnic nerve , not the vagus nerve , to constitute the efferent arm of the inflammatory reflex .Further researches are needed to iden-tify the neural construction and regulatory mechanism of the inflammatory reflex , which might be harnessed for the treatment of inflammation and the development of anti-inflammatory drugs .

Objective To evaluate the levels of neutrophil gelatinase associated lipocalin (NGAL) in prediction of acute kidney injury (AKI) in children with burn. Methods Forty seven children with burn were selected in this study and thirty healthy children were enrolled as a control group. Levels of blood routine, urine routine, serum creatinine (Scr), serum NGAL (SNGAL), urine NGAL (UNGAL), blood urea nitrogen (BUN) and C-reactive protein (CRP) were measured. Receiver operating characteristic (ROC) curve were used to estimate the AKI diagnostic value of serum NGAL, urine NGAL and Scr. Results On the day of admission, serum NGAL and urine NGAL were significantly increased in patients with AKI , while Scr did not change significantly as compared with those in non-AKI patients and the healthy controls. In AKI group, serum NGAL and urine NGAL were positively correlated with WBC and CRP on the day of admission , and positively related with Scr on the seventh day. ROC analysis showed the AUC of serum NGAL, urine NGAL and Scr on admission were 0.737(95%CI: 0.653 ~ 0.779, P < 0.05), 0.772(95%CI: 0.632 ~ 0.793, P < 0.05), and 0.508(95%CI: 0.454~0.618, P < 0.05) respectively. The cut-off value of serum NGAL and urine NGAL were 318 μg/L (sensitivity of 72.8% and specificity of 81.6%) and 105 μg/L (sensitivity of 75.6% and specificity of 83.7%). Conclusions Elevation in levels of serum NGAL and urine NGAL occurs earlier than that in Scr level in children with burn. Both serum and urine NGAL level can be used as a biomarker for early prediction of AKI.

Objective To explore the efficacy of various retreatment for locally recurrent rectal cancer after radical surgery. Methods Totally 107 patients of locally recurrent rectal cancer, who were admitted from August, 1993 to February, 2002 and retreated, were retrospectively analyzed. Results Thirty-two patients were treated by resection combined with adjuvant therapy (group A), 37 patients underwent resection alone (group B), and 38 patients received adjuvant therapy alone (group C). The medium age of these three groups was 49.3?20.7, 44.4?25.4, 52.9?29.1, respectively. The median survival time of groups A, B, C was 27.8, 14.6, 13.7 months, respectively. The five-year survival rate of group A was significantly higher than that of groups B and C (P

Acute promyelocytic leukemia (APL) is a special subtype of acute myeloid leukemia, characterized by the reciprocal chromosomal translocation of t (15;17)(q22;q21), which generates PML-RARαfusion protein. All-trans-retinoic acid (ATRA) and As2O3 could induce APL cells to differentiation and apoptosis, respectively, making APL become the first curable leukemia. Autophagy is one of metabolic mechanisms to maintain cell homeostasis. Recent studies have showed that autophagy plays an important role in the differentiation of APL cells induced by ATRA/As2O3. Meanwhile, autophagy may affect the sensitivity of APL cells to the pro-apoptotic effect of drugs. Therefore, targeting and regulating autophagy might be a new therapeutic approach of APL and even other leukemia in the future. This article will briefly review the advance of autophagy in APL in recent years.

Objective To explore the efficacy of treatment for locally recurrent rectal cancer after radical surgery. Methods In this study,the management of 107 patients with postoperative locally recurrence of rectal carcinoma admitted from August 1993 to February 2002 was retrospectively analyzed.Results Thirty-two cases were treated by reoperation combined with adjuvant therapy(group A),37 cases underwent ressction alone(group B),38 patients received adjuvant therapy alone(group C).The age of these patients was 49.3±20.7,44.4±25.4,and 52.9±29.1 respectively.The median survival time after treatment was 27.8,14.6,and 13.7 months,respectively.The five year's survival of patients in group A was better than that in group B and group C significantly(P＜0.05).Conclusions The aggressive surgery combined with adjuvant therapy improves the survival of the patients with locally recurrent rectal cancer after radical surgery.

Objective To estimate the prevalence of iron deficiency and its influencing factors in 6 to 12-month-old infants,then more effective community nursing intervention of prevention against iron deficiency can be made.Methods Three hundred and thirty-one 6 to 12-month-old infants had been enrolled by convenience sampling method to complete the investigation.Variables associated with iron deficiency in bivariate analysis were evaluated in Logistic regression models.Results The prevalence rates of iron deficiency in 6 to 12-month-old infants was 34.74％.Anemia,age,feeding patterns and zinc deficiency were independently associated with increased risk for iron deficiency.Conclusions Iron deficiency was common and associated with anemia,low age,feeding patterns and zinc deficiency in a certain community in Tianjin.So effective nursing measures must be made to reduce the prevalence rates of iron deficiency in 6 to 12-month-old infants.

Objective To explore the clinical significance of early invasive mechanical ventilation for acute respiratory distress syndrome (ARDS) caused by thoracic trauma.Methods We retrospectively analyzed the clinical data of 93 patients of invasive mechanical ventilation in those with ARDS caused by thoracic trauma,and divided them into delayed invasive mechanical ventilation group (n =45) and timely invasive ventilation group (n =48) by the time of invasive mechanical ventilation.We compared the blood gas analysis,oxygen index,heart rate,lactic acid,muscle use score of the two groups before and after invasive mechanical ventilation and the differences of mechanical ventilation time,incidence of complications,mortality and length of hospital stay between the two groups.Results Each index of the delayed invasive mechanical ventilation group and the timely invasive ventilation group was calculated:PaO2 (63.2 ± 12.3,74.2 ± 12.1)mm Hg,PaCO2 (39.4 ±8.7,38.9 +7.6) mm Hg,PaO2/FiO2 (196.2 ± 17.8,231.4 ± 18.2),respiratory rate (27.4 ±3.7,21.1 ± 3.4) beats/min,heart rate (117.2 ± 26.8,96.0 ± 25.1) beats/min,accessory muscle use score (2.69 ± 0.15,1.67 ± 0.10),lactic acid (4.23 ± 1.70,2.12 ± 0.80) mmol/L Except for PaCO2,the differences of each index were statistically significant (t values were respectively 4.346,9.420,3.949,5.436,38.809,7.736; P ＜ 0.05).The duration of mechanical ventilation treatment (10.21 ± 1.50,6.47 ± 1.20) d and the length of hospital stay (21.53 ± 1.90,16.32 ±2.10) d of the delayed group and the timely group were significantly different (t values were respectively 12.518,13.318; P ＜ 0.01).The timely group had significantly lower mortality rate (26.7％ (12/45),14.6％ (7/48)),VAP (46.7％ (21/45),22.9％(11/48)),acute gastric mucosal lesions (33.3％ (15/45),12.5％ (6/48)),MODS (40.0％ (18/45),16.7％ (8/48)) than the delayed group (x2 values were respectively 3.86,5.81,4.49,5.70; P ＜ 0.05).There is no significant difference on the incidence of pneumothorax between the two groups (11.1％ (5/45),8.3％ (4/48)).Conclusion Invasive mechanical ventilation is an effective treatment of ARDS caused by chest trauma.Early invasive mechanical ventilation can reduce the mortality rate and shorten the duration of mechanical ventilation and hospital stay of the patients with ARDS after severe thoracic trauma.

Objective To evaluate the clinical effect of ultrasound-guided percutaneous transhepatic cholangial drainage (PTCD) combined with endoscopic retrograde cholangio-pancreatography (ERCP) in treating malignant obstructive jaundice, and to discuss its technical points. Methods A total of ten cases with malignant biliary obstruction were enrolled in this study. After the failure of ERCP treatment, the patients had to be treated with ultrasound-guided PTCD immediately. The guide-wire was inserted into the duodenum through intrahepatic bile duct and common bile duct to connect with ERCP, which was followed by the biliary stent implantation or the removal of physical factors causing obstruction. The clinical results were analyzed. Results Technical success was obtained in all 10 cases. In the patients who underwent a successful guide-wire docking with ERCP the postoperative serum bilirubin was significantly decreased. The main complications were fever, elevation of amylase and transient bloody bile. Conclusion With the help of docking technique the combination use of ultrasound-guided PTCD and ERCP is a new tentative treatment for malignant obstructive jaundice after the failure of initial ERCP treatment. This technique carries promising value in clinical practice as it can significantly increase the success rate of ERCP.

Objective To evaluate the safety and efficacy of endoscopic radial incision (ERI) for benign stricture of upper digestive system. Methods Patients with benign esophageal or gastric stricture (including anastomotic stricture, stricture after ESD and caustic stricture) were enrolled in this study. The stage of stricture, length of the lesion and the thickness of the scar were recorded. ERI (maybe associated with balloon dilatation) were performed. Post-opera-tive symptoms, complications and follow-up were also recorded. Results 7 patients were enrolled and all received ERI, and 4 additional balloon dilatation were done. Dysphagia in all patients relieved. 1 case with hemorrhage oc-curred and relieved with conservative treatment. Majority of the patients got long-term remission after 1~2 times of ERI. Conclusion ERI is safe and effective for benign stricture of upper digestive system. It may prolong the dyspha-gia-free period, worth clinical promotion.

The controversial results of several studies suggest that certain everyday-use chemicals may be linked to breast cancer. ln recent years, extensive researches have been carried out to under-stand breast carcinogenesis and the hedgehog(Hh) signaling pathway has emerged as a critical determi-nant of human breast cancer. Aberrant Hh signaling in adults results in carcinogenesis, angiogenesis, and metastasis. This review is focused on the Hh signaling pathway and chemicals in the regulation of breast cancer development and provide an updated survey of pre-clinical and clinical trials of novel strategies to target them.