Exertional heat stroke (EHS) is an emergency with a high mortality rate, characterized by acute onset and identification difficulties. EHS prevention focuses on evaluating the environment by professionals, making preventive measures in advance, identifying internal and external risk factors for the onset of disease, carrying out prior heat adaptation and endurance training, monitoring the status of high risk persons in real time. After occurrence of EHS, the key to success treatment is on-site accurate identification and diagnosis and rapid implementation of effective cooling measures, thus winning time of EHS patients transferred to the hospital for the treatment. This article reviews the current status of EHS prevention and treatment in domestic and foreign from the scene to the hospital. Summarizing the recognition, diagnosis, cooling measures, treatment concepts and principles of EHS, we hope to provide a reference for the rescue of EHS in hospital and outside.

Objective To evaluate the effectiveness and safety of rivaroxaban or enoxaparin in preventing deep vein thrombosis(DVT) and pulmonary embolism (PE) after major orthopedic surgery. Methods A total of 278 patients underwent major orthopedic surgery, from September 2009 to May 2012, were included in this study. One hundred and forty patients (the average age was 72.7 years, 42.8% were male) were treated with oral rivaroxaban, 10 mg/d. One hundred and thirty-eight patients (the average age was 69.9 years, 39.1%were male) were treated with subcutaneous enoxaparin,40 mg/d. Data were compared between two groups. The ending events included venous thrombosis VTE(DVT and PE), wound complica-tions, re-admission,need for blood transfusion,big and minor bleeding events and death. Results There were no signifi-cant differences in the incidence of VTE, blood transfusions and re- admission rates between two groups. The incidence rates of minor bleeding were 2.1%and 5.8%in two groups. There were no pulmonary embolism, severe bleeding or death in two groups of patients.Conclusion There were no significant differences in the incidence rates of VTE or major bleeding areas in patients with oral treatment of rivaroxaban and enoxaparin.Rivaroxaban was safer with a slightly decrease in minor bleeding and wound complications.

Objective To analyse the effect of endoscopic thoracic sympathectomy of palma-plantar hyperhidrosis. Methods Between January 2006 and January 2009,77 cases with palma-plantar hyperhidrosis were operated by thoracoscope. Fifty-two cases of palma-axillary-plantar hyperhidrosis were performed sympathectomy of T2-T4 and 25 cases of palma-plantar were performed sympathectomy of T2-T3.Bilateral procedures were completed in the same position. Results After operation palmar hyperhidrosis and armpits hyperhidrosis all were cured. Of soles, 7 cases were completely dry, 34 cases nearly dry, 32 cases unchanged and 4 cases worse. There was no significant difference in the change of plantar hyperhidrosis between sympathectomy of T2-T3 and T2-T4 (P ＞ 0.05). Conclusions Bilateral single port for endoscopic thoracic sympathectomy produces slighter trauma and patients easily accept it. Plantar sweating can be relieved or nearly relieved in partial patients after thoracic sympathectomy. There is no difference in the effect of plantar hyperhidrosis between sympathectomy of T2-T3 and T2-T4.

Five known compounds have been isolated from the culture of an endophytic fungus Fusarium sp., which was originated in a seagrass Spartina alterniflora. Their structures have elucidated by TLC comparision with standard and spectral methods as ergosterol (Ⅰ), ergosterol peroxide (Ⅱ) cinnamic acid (Ⅲ), para-hydroxyphenylpropionic acid (Ⅳ) and beauvericin (Ⅴ), respectively.

Object To find out which of the 27 ginsenosides isolated from Panax ginseng C A Mey that may inhibit the proliferation of human osteosarcoma cell line U 2OS Methods Effects of each individual ginsenoside on the proliferation of U 2OS cell were studied by determining the viability of cancer cells during culture with or without the presence of the test compound DNA assay was determined by flow cytometry Results Ginsonosides Ro, Rh 1, Rh 2, F 1 and L 8 at concentrations of 5 ?mol/L could obviously suppress the proliferation of U 2OS cells while ginsenosides Rg 1, F 3, Rf, PPT and PT significantly inhibited the cancer cells Flow cytometry revealed that ginsenosides Ro, Rg 1, Rf, F 1, Rh 2 ,PPT and PT induced cell cycle arrest at G 0/G 1 phase with obvious decrease of cell count at S and G 2+M phase Moreover, ginsenosides Rf 1, Rg 1, F 1 and PPT induced significantly high rates of cell death as compared with the control Conclusion These data suggested that ginsenosides inhibited U 2OS proliferation via cell cycle arrest or induction of cell death

Objective To observe the effects of ursolic acid (UA) on the activation of nicotinamide adenine dinucleotide phosphate oxidase (NOX) and the downstream signaling pathways in platelet derived growth factor (PDGF) activated rat hepatic stellate cell (HSC-T6).Methods Rat HSC-T6 cells were divided into blank control group (no treatment),UA control group (50 μmol/L UA),PDGF group (10 μg/L PDGF),UA intervention group (50 μmol/L UA + 10 μg/L PDGF),diphenyleneiodonium intervention(DPI) group (20 μmol/L DPI+ 10 μg/L PDGF),SB203580 (p38 mitogen-activated protein kirase(p38MAPK) inhibitor) intervention group (10 μmol/L SB203580 + 10 μg/LPDGF),LY294002 (phosphatidylinositop 3 kinase(PI3K) inhibitor) intervention group (10 μmol/L LY294002 + 10 μg/L PDGF) and rosup positive control group (5 μg/mL rosup).Except rosup positive control group,the expression of type Ⅰ collagen at mRNA level of each group was detected by fluorescence quantitavepolymerase chain reaction (RT-PCR).The expression of membrane protein p47phox (except rosup positive control group),PI3K(except rosup positive control group and SB203580 intervention group),p-protein kinase B (p-AKT,except rosup positive control group and SB203580 intervention group) and phosphorylated p38 mitogen-activated protein kinase (p-p38MAPK,except rosup positive control group and LY294002 intervention group) were tested by Western blot.Except SB203580 intervention group and LY294002 intervention group,the fluorescence intensity in the cells of each group was analyzed with active oxygen detection kit and fluorescence microplate reader.Single factor analysis of variance and LSD test were performed for comparison between groups.Results Type Ⅰ collagen at the mRNA level of PDGF group (3.74±0.32) was higher than that of blank control group (1.00±0.00) ; Type Ⅰ collagen at the mRNA level of UA group (0.21 ±0.02) was lower than that of blank control group,UA intervention group (1.02 ± 0.12),DPI intervention group (1.09±0.21),SB203580 intervention group (1.18± 0.27),and LY294002 intervention group (1.15 ± 0.26) were all lower than PDGF group,and the differences were statistically significant (t =15.667,-4.501,-15.553,-15.154,-14.642 and -14.813,all P＜0.05).p47phox at the protein expression level of PDGF group (1.98±0.53) was higher than that of blank control group (1.00±0.00) ; that of UA group (0.48±0.10) was lower than blank control group; those of UA intervention group (0.95 ± 0.26),DPI intervention group (0.99 ± 0.28),SB203580 intervention group (0.93±0.31),and LY294002 intervention group (1.07±0.19) were all lower than PDGF group (t=4.209,-2.234,4.424,-4.252,-4.510 and-3.909,all P＜0.05).The protein expression level of PI3K of PDGF group (2.27±0.46) was higher than that of blank control group (1.00±0.00); that of UA intervention group (0.14 ± 0.07) was lower than PDGF group and blank control group; that of UA group (0.14±0.07) was lower than blank control group; those of DPI intervention group (0.53±0.25) and LY294002 intervention group (0.35±0.14) were all lower than PDGFgroup (t 6.205,8.208,-2.003,4.202,-8.502 and-9.831,all P＜0.05).The protein expression level of p-Akt of PDGF group (2.54±0.49) was higher than that of blank control group (1.00± 0.00); those of UA intervention group (0.74± 0.20),DPI intervention group (0.94 ± 0.37) and LY294002 intervention group (1.17±0.41) were all lower than PDGF group; that of UA group (0.59± 0.15) was lower than blank control group (t=5.927,-6.928,-6.158,-5.273 and-1.578,all P＜ 0.05).The protein expression level of p-p38MAPK of PDGF group (1.98±0.35) was higher than that of blank control group (1.00±0.00); those of UA intervention group (0.68±0.28),DPI intervention group (0.63±0.27) and SB203580 intervention group (0.67 ± 0.29) was all lower than PDGF group; that of UAgroup (0.28±0.13) was lower than blank control group (t=4.897,-6.479,-6.727,-6.529 and-3.561,all P＜0.05).The level of active oxygen of PDGF group (105.57±7.51) was higher than that of blank control group (69.60±8.63) ; those of UA intervention group (64.56±9.11),DPI intervention group (65.75 ± 6.62) was lower than PDGF group,UA group (29.84 ±3.19) was lower than blank control group (t=6.368,-7.288,-7.071 and-7.255,all P＜0.05).Conclusion UA could inhibit membrane displacement of NOX subunit p47phox and reduce active oxygen production in PDGF induced rat HSC-T6 cells,and then block phosphorylation of PI3K Akt,p 38MAPK signal pathways and inhibited the expression of type Ⅰ collagen at mRNA level.

Aim To study the effects of ginsenoside-Ro on cell proliferation and cytokine production in murine splenocytes. Methods The effect of ginsenoside-Ro on murine splenocytes proliferation was studied using [3 H] thymidine incorporation assay. Effects of ginsenoside-Ro on the production of cytokines interleukin-2 (IL-2), interferon-γ (IFN-γ) and interleukin-4 (IL-4) from murine splenocytes were detected by ELISA method. Effects of ginsenoside-Ro on mRNA level of Th1 cytokine IFN-γ and Th2cytokine IL-4 were evaluated by reverse transcription polymerase chain reaction (RT-PCR) analysis.Results Ginsenoside-Ro showed no mitogenic effect on unstimulated murine splenocytes. It enhanced the proliferation of Con A-induced murine splenocytes and the production of IL-2 at concentrations of 1 - 10decreased the production and expression of Th1 cytokine IFN-γ in Con A-induced murine splenocytes at regulating the production and expression of Th1/Th2 cytokines in murine splenocytes.

Objective:To determine expression levels of ubiquitin C-terminal hydrolase-L1 (UCH-L1) and serum glial fibrillary acidic protein (GFAP) in patients with acute cerebral infarction and their clinical significance.Methods:A total of 80 patients with acute cerebral infarction in Chongqing Cancer Hospital from January 2014 to February 2016 were enrolled as an observation group.Another 80 healthy people served as a control group.The expression levels of UCH-L1 and GFAP in the 2 groups were detected.Results:Sensibility and specificity for UCH-L1 and GFAP were 75.0％,87.5％ and 81.3％,90.0％,respectively.Receiver operating characteristic curve areas of UCH-L1 and GFAP were 0.670 and 0.757,respectively.There were no significant significance in age,gender,drinking,smoke,diabetes,and hyperlipidemia in the 2 groups (P＞0.05).High blood pressure rate in the observation group was higher than that in the control group (P＜0.05).Spearson/Pearson analysis showed that serum UCH-L1 and GFAP levels were positively correlated with hypertension,but they were negatively correlated with sex,age,diabetes,hyperlipidemia,alcohol consumption,smoking,and other factors.General data at different time in the observation group was not statistically different (P＞0.05).The expression levels of UCH-L1 and GFAP in the observation group was higher than that in the control group (P＜0.05).UCH-L1 and GFAP levels at different time in the 2 groups were not statistically different (P＞0.05).UCH-L1 and GFAP levels in the light,medium,and heavy groups were higher than those in the control group (P＜0.05),while UCH-L1 and GFAP levels in the medium and heavy groups were higher than those in the light group (P＜0.05).There was significant difference between levels of UCH-L1 or GFAP and infarction size at different time in the observation group (P＜0.05).The results of Pearson correlation analysis showed that the levels of serum UCH-L1 and GFAP were positively correlated (r=0.634,P=0.001).Conclusion:The levels of serum UCH-L1 and GFAP are significantly increased at the early stage of acute cerebral infarction,and they have a certain correlation with the severity of cerebral infarction,which can provide a basis for early clinical diagnosis and treatment.

Objective To observe the anti-tumor effects of Agrimonia Pilosa Ledeb(APL) ,a Chinese herbal medicine ,on hepato-cellular carcinoma cells in vitro and investigate the underlined mechanisms preliminarily .Methods APL water extracts were pre-pared .SMMC-7721 cells were cultured with the medium containing different concentrations of APL water extracts ,and at different time points ,cell viabilities were measured by the MTT assay and inhibitory rates (IR) were calculated ;cell morphologic changes were observed under a light microscope ;apoptotic ratios were measured by flow cytometry ;and the expressions of Bcl-2 and P53 proteins were examined by immunocytochemistry .Results After the cells were cultured with the medium containing APL water ex-tracts for 24 h ,48 h and 72 h ,no obvious effects were found on the cell proliferation in 5 mg/mL group and 10 mg/mL group ,but IR were 0 .5% ,23 .9% and 27 .5% in 20 mg/mL group and 23 .3% ,51 .7% and 71 .6% in the 40 mg/mL group ,respectively .In the groups with effects on the cells proliferation ,morphological characteristics of apoptosis were obvious ,and the cell apoptotic ratios were 19 .5% and 23 .0% in 20 mg/mL group and 33 .4% and 42 .7% in 40 mg/mL group at 48 h and 72 h .The expressions of Bcl-2 protein were 71 .9% and 58 .5% in 20 mg/mL group and 47 .9% and 26 .5% in 40 mg/mL group at 48 h and 72 h ,and the ex-pressions of P53 protein were 22 .9% and 50 .6% in 20 mg/mL group and 48 .7% and 83 .7% in 40 mg/mL group at 48 h and 72 h . Conclusion The water extracts of APL are able to inhibit proliferation and induce apoptosis of SMMC-7721 cells dose-time depend-ently in vitro ,which might be associated with the expression changes of Bcl-2 and P53 protein .