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.

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 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

Objective To investigate the effects of Xuebijing on the regulations of tumor necrosis factor-α(TNF-α) 、von Wilebrand factor(vWF)、interleukin-6 (IL-6) and the treatment effectiveness in pulmonary contusion patients.Methods Fifty-one pulmonary contusion patients admitted into the hospital from January 2010 to January 2012 were enrolled in the study and were randomly divided into two groups (treatment group and control group).The levels of the TNF-α、vWF 、IL-6 in the pulmonary contusion patients were measured by enzyme linked immunosorbent assay to investigate the change of the inflammatory cytokines and the treatment effectiveness in treatment group and control group.Results The hospitalization time of treatment group and control group was (19.83 ± 2.35) d,(21.52 ± 2.73) d respectively,the hospitalization time of the treatment group was significantly shorter than the control group,the difference was statistically significant (t =2.38,P ＜0.05) ;The incidence of ARDS was 14.81％ and 41.67％ respectively,the incidence of ARDS of the treatment group was significantly lower,the difference was statistically significant (x2 =4.6,P ＜ 0.05) ;The inflammatory mediators index of the two groups showed as follws:the first day of the TNF-α(181.35 ± 14.25) ng/L,(179.17 ± 16.28) ng/L,the third day of the TNF-α(169.21 ± 16.42) ng/L,(179.18 ± 17.31) ng/L,the fifth day of the TNF-α(131.78 ± 13.02) ng/L,(140.84 ± 14.27) ng/L,the seventh day of the TNF-α (99.45 ± 16.02)ng/L,(110.56 ± 17.09) ng/L;The first day of the vWF (178.73 ± 22.09) ng/L,(177.73 ± 23.02) ng/L,the third day of the vWF (208.46 ± 14.13) ng/L,(220.53 ± 23.02) ng/L,the fifth day of the vWF (252.32 ±15.22) ng/L,(266.40 ±25.79) ng/L,the seventh day of the vWF(201.49 ±9.21) ng/L,(217.27 ±22.68)ng/L;The first day of the IL-6 (172.14 ± 12.41) ng/L,(169.53 ± 13.55) ng/L,the third day of the IL-6 (147.24 ± 16.33) ng/L,(158.41 ±21.04) ng/L,the fifth day of the IL-6(126.36 ± 11.37) ng/L,(137.21 ± 21.23) ng/L,the seventh day of the IL-6 (114.03 ± 10.26) ng/L,(122.16 ± 13.59) ng/L,the differences within the group and between the two groups were significant(within the group:F =206.58,218.57,198.35 respectively,P ＜ 0.01 ;between the groups:F =19.053,17.259,17.235 respectively,P ＜ 0.01).And in the third,fifth and seventh day,3 indicators of treatment groups were lower than the control group (P ＜ 0.01).Conclusion Xuebijing can inhibit inflammatory transmitters,relieve inflammatory reactions,decrease the rate of ARDS incidence,shorten the hospitalization time and help to improve the prognosis of the patients with acute pulmonary contusion.

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.

To evaluate the efficacy of Yupingfeng droppill and western medicine in treatment of allergic rhinitis, 76 patients from Beijing Shijitan hospital during April 2011 to May 2012 were selected and randomly divided into the treatment group (n = 44) and control group (n = 32). The treatment group was treated with Yupingfeng droppill and cetirizine tablets, the control group was treated with cetirizine tablets, the effect of the two groups was observed after 28 days, after treatment, the symptoms and inferior turbinate volume contrast of the two groups were better than before. The obvious effective rate and total effective rate were 84.09%, 95.45% and 46.87%, 56.25% in the treatment group and and control group. The differences in the obvious effective rate and total effective rate were statistically significant between two groups (P < 0.05), Yupingfeng droppill has the curative effect on allergic rhinitis, which is better than simple oral cetirizine tablets.
Adult ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; drug therapy ; Treatment Outcome ; Young Adult

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.

Bring up high quality medical talents with innovative consciousness and practical ability is the aim of high medical ed- ucation.Improving the innovative ability of teachers and quality of teaching with the perfect combination of science and humanities, so as to improve our understanding of the importance and necessity of innovation education,and carry out an overall quality edu- cation which chiefly works for the training of students' innovative consciousness and practical ability during practicing period.