Epigenetic modification includes DNA methylation, histone modification, non-coding RNA, etc., and is crucial in determining gene expression. A growing number of recent studies have shown that epigenetic regulation may play a central role in the pathogenesis of sepsis. Due to its explicit mechanism and relatively mature technic, DNA methylation has received extensive attention in sepsis-related researches. By examining recent studies on septic DNA methylation mechanism, this review elucidates the key role in sepsis occurrence and progression that DNA methylation plays from etiology, immunology and other aspects, as well as its application potential in the diagnosis, prognosis and treatment of sepsis before pointing out the direction for further research.

Objective To investigate the effects of continuous stellate ganglion block (SGB) on serum thyroid hormone and cortisol levels in patients with severe brain injury.Methods Eighty ASA Ⅱ or Ⅲ patients with severe brain injury aged 22-61 yr undergoing emergency craniotomy were randomly divided into 2 groups ( n = 40 each): control group (group C) received routine treatment only and continuous SGB group (group SGB) received continuous SGB with 0.2% ropivacaine besides routine treatment. SGB was performed on the operated side after induction of general anesthesia and tracheal intubation. An epidural catheter was placed. A bolus of 0.2% ropivacaine 7 ml was followed by continuous infusion of 0.2% ropivacaine at a rate of 2 ml/h. Continuous SGB was maintained for 48 h. Successful SGB was confirmed by increase in skin temperature by ≥1.5℃ behind earlobe on the operated side.Venous blood samples were obtained at 30 min before and 3 and 7 day after operation for determination of serum thyroid stimulating hormone (TSH), triiodothyronine (T3) ,thyroxine (T4) , reverse triiodothyronine(rT3) and cortisol concentrations. Glasgow prognosis score was used to evaluate the clinical results at 3 months after operation. Results Serum T4 , rT3 , TSH and cortisol concentrations were significantly lower while the serum T3 concentration was higher in the SGB group than in group C at 3 and 7 d after operation. The clinical results were significant better in SGB group than in group C according to Glasgow prognosis scores at 3 months after operation. Conclusion Continuous SGB can inhibit the stress response, and improve hypothalamus-pituitary-thyroid gland axis function and is helpful to patient's recovery from injury.

Objective:To evaluate the efficacy and safety of combined cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with lobaplatin and docetaxel for treatment of synchronous peritoneal carcinomatosis (PC) from gastric cancer. Methods:Fifty patients with synchronous PC from gastric cancer were treated by 52 CRS+HIPEC procedures with 100 mg of lobaplatin and 120 mg of docetaxel in 12000 mL of normal saline at (43 ± 0.5)℃for 60 min. The primary and secondary endpoints were overall survival (OS) and perioperative safety profiles, respectively. Results:At a median follow-up of 22.5 months, the median OS rate was 14.3 (95%CI:7.6-21.0) months, and the 1-, 2-, and 3-year survival rates were 58%, 40%, and 32%, respectively. No perioperative deaths or serious adverse events occurred in 12 cases (23.1%). Multivariate analysis indicated that completeness of cytoreduction, nor-mality of perioperative tumor markers, and adjuvant chemotherapy of more than six cycles were independent predictors for improved survival. Conclusions:CRS+HIPEC with lobaplatin and docetaxel could improve the OS and ensure perioperative safety of patients with synchronous PC from gastric cancer.

Objective To explore the relationship between fasting serum concentration of uric acid (SUA)and the secretion of insulin under oral glucose tolerance test(OGTT)in 877 eligible subjects.Methods A 75g OGTT was administrated to all 877 eligible subjects,fasting uric acid,concentration of glucose and insulin of 0,30,60,120 and 180 min utes after OGTT were measured.Subjects were divided into high SUA group (HUA)and normal SUA group (NUA)according the concen-tration of SUA.SPSS 13.0 were used to analyze these data.Results Subjects in HUA had higher concentration of insulin in 0,30,60,120 and 180 min utes than NUA.There were positive correlation between SUA and INS in 0,30,60,120 and 180 min utes,Pearson r-value was 0.107,0.154,0.195,0.157 and 0.112(all P <0.01)respectively.By stepwise linear regression analyze,there were four parameters correlated with SUA:gender(female),INS60,cholesterol (TC),high density lipoprotein (HDL),β-vaule was -0.214,0.194,0.253,-0.119 (all P <0.01)respectively.Conclusion SUA positive correlated with secretion of INS after glycemia burden,SUA may be used as a potential biomark of secretin of INS (especially the concentra-tion of INS 60).

Objective To assess oral health knowledge and behaviors of self-care among HIV infected patients in Yunnan, China. Methods Questionnaire survey was performed to collect the information about behaviors of oral self-care and seeking medical advice and diets of 216 HIV-infected patients who came from the Third Hospital of Kunming. The data were then statistically analyzed. Results Half of the patients were diagnosed over six months. The smoking of the HIV-positive were serious and the gingival bleeding was less, but there was obvious discomfort in oral cavity when eating. In addition,the standard method of cleaning teeth was below 20%, less of 50%patients could clean the oral cavity in time after diet and they didn't replace their toothbrushes timely. Over half of patients asked artificial tooth and exodontias on treatment. Conclusion It is necessary to pay more attention to the oral health knowledge and self-care behaviors of HIV-infected patients so as to improve the quality of life.

Objective To compare the performance of four commercial anti-dsDNA antibody assays,i.e,BioPlex 2200 (BioPlex),Farr radioimmunoassay (Farr),MESACUP DNA-Ⅱ TEST ds [MBL-enzyme linked immunosorbent assay (ELISA)] and Anti-dsDNA-NcX ELISA (IgG) (EURO-ELISA),Antoantibodies Profile Assay Kit (HOB-Chemiluminescent Immunoassay) in disease activity assessment of systemic lupus erythematosus (SLE).Methods SLE patients (n=119) as well as healthy controls (n=200) and disease controls (n=100) were recruited and their serum anti-dsDNA antibodies were detected by BioPlex,Farr,MBL-ELISA,EURO-ELISA,and a standard Crithidia luciliae indirect immunofluorescence test (CLIFT).The consistency between above four methods to CLIFT was analyzed.The correlation of anti-dsDNA antibody level of these four methods to SLE disease activity was assessed.All data analyses were performed with Statistical product and service solutions (SPSS) 16.0 (SPSS.Inc) and GraphPad Prism 4.0.3 (GraphPad).Unless otherwise specified,all data in this study were expressed as mean±standard deviation.Cut-off values of the anti-dsDNA quantification methods were set by the manufacturers.Chi square and kappa coefficients were adopted to assess the agreement determination and correlation analysis between anti-dsDNA level and SLE disease activity (SLEDAI).Receiver-operator characteristic (ROC) curve analysis was used to compare the specificity and sensitivity of the anti-dsDNA assays.Student's t test was adopted for the comparison of anti-dsDNA levels by different methods between SLE and SLE+LN groups.A p value small than 0.05 was considered statistically significant.Results Using cut-off values set by the manufacturers,BioPlex demonstrated the highest overall agreement with CLIFT,while MBL-ELISA and EURO-ELISA showed the highest positive agreement with CLIFT.Disease activity correlation analysis showed that SLEDAI score correlated poorly with anti-dsDNA level in Farr assay,but strongly with the other three assays.Bioplex had a better performance in terms of SLE activity index corelation (r=0.297 6,P=0.001 2).Moreover,anti-dsDNA level differed in SLE patients with renal lupus nephritis in BioPlex assay (P=0.026 8),but not in the other assays.In ROC curve analysis,BioPlex showed the largest area under the curve (AUC) over other assays.Conclusion Bio Plex assay has better sensitivity and specificity than Farr,MBL-ELISA and EURO-ELISA and correlates well with SLE disease activity.

Objective To investigate the safety and efficacy of the modified laparoscopic radical cystectomy and standard pelvic lymph node dissection for female bladder cancer patients.Methods Fortyone female patients with bladder cancer who underwent laparoscopic radical cystectomy(LRC) and standard pelvic lymph node dissection(sPLND) in our hospital from June 2003 to January 2016 were retrospectively analyzed.The patients were divided into two groups according to the surgical procedure.There were 15 patients with ≤ cT2 tumor and 1 patient with cT3 in the modified group.The average age was (62.2 ± 11.5) years.The median BMI was 20.7 kg/m2,ranging 18.4 to 22.2 kg/m2;The ASA level was less than Ⅱ in 9 (56.2％) cases and was level Ⅲ in 7 (43.8％) cases.There were 22 patients with ≤ cT2 tumor and 3 patients with cT3 in the traditional group.The average age was (60.4 ± 12.9)years.The median BMI was 21.7 kg/m2,ranging 18.4 to 23.1 kg/m2.ASA was less than level Ⅱ in 15(60.0％) cases and level Ⅲ in 10(40.0％) cases.All operations are performed under general anesthesia.In the traditional group,the plane between rectus and uterus is separated first.Then open the posterior cervical fornix and cut off the lateral bladder pedicle,cardinal ligament of uterus and urethra.The bladder and uterus are removed together.The sPLND is performed at last.In the modified group,the sPLND is performed first.Then separate the bladder and uterus until the anterior wall of the vagina can be exposed.The bladder and uterus are removed separately.Data of the operation and the complications were collected and analyzed.Results All patients were performed the operation successfully.No open conversion was recorded during the operation.No patient died during the peripheral operative phase.In modified group,10 patients received orthotopic ileal neobladder (OIN),5 patients received ileal conduit and 1 patient received ureterostomy.In traditional group,19 patients received OIN,3 patients received ileal conduit and 3 patients received ureterostomy.No significant difference of surgical method was noticed in those group.The median operative time in modified group and traditional group was 290 min (ranging 265-335 min) and 315 min (ranging 270-380 min),respectively(P ＞ 0.05).The median estimated blood loss in modified group and traditional group was 100ml (100,100) and 200ml (200,400),respectively (P ＜ 0.05).The rate of transfusion in modified group and traditional group was 6.3％ (1/16) and 18.5％ (5/27),respectively (P ＜0.05).The incidence of early complications between two groups showed no statistically difference.No major (Clavien grade 3 to 5) complications occurred in modified group.However major complications occurred in 3 patients in traditional group,followed by 2 neobladder vagina fistula,1 ileal anastomotic stoma fistula.All those complications were cured by operation.All patients were diagnosed urothelium carcinoma.In modified group,the tumor stage included carcinoma in suit in 2 cases,pTa-pT1 in 7 cases,pT2 in 6 cases,pT3 in one case.In traditional group,the tumor stage included pT1 in 12 cases,pT2 in 10 cases,pT3 in 3 cases.The numbers of resected lymph node in modified group and conventional group were 16 (ranging 7-19) and 10 (ranging 7-13),respectively (P ＞ 0.05).Conclusions The modified laparoscopic radical cystectomy and pelvic lymph node dissection for female bladder cancer patients could reduce the blood loss and incidence of neobladder vaginal fistula comparing with the traditional operation.

CMV,HHV-6,HHV-7 and HHV-8 DNA in unstimulated whole saliva from 245 HIV-infected subjects and 30 healthy controls were examined by nested-PCR assays.Prevalence of CMV,HHV-6,HHV-7 and HHV-8 in saliva of HIV-infected subjects was 34.7%, 83.3%,70.2% and 14.3% respectively,that of the controls 10.0%,56.7%,70.0% and 0% respectively(between 2 groups,P <0.01).There was no difference of detection rates of the four HHVs in saliva between HIV patients with HAART(n =100)and non-HAART (n =145)(P >0.05).Multi-infection was observed in all subject.

[Objective]To investigate the expression change of miR-134 in methamphetamine(MA)-induced neuronal injury in PC12 cells and its effect on neuronal excitability and understand the pathogenesis of methamphetamine-induced neuronal injury.[Methods]PC12 cells in the logarithmic phase were divided into control group and MA group. The MA group was treated with 800μmol/L MA to establish the model of neuronal injury. The cellular injury was observed under microscope. The neuronal apoptosis was detected by Hoechst3342/PI double staining,and miR-134 expression was measured by using real-time quantitative PCR (Real time-PCR). Furthermore,we constructed miR-134 interference vector and observed its effect on evoked action potential.[Results]The cultured PC12 cells were damaged under the 800 μmol/LMA treatment ,and neurites became shorter ,the apoptotic cells were evidence. Real time-PCR showed that miR-134 expression was increased after MA treatment. Electrophysiological data showed that the evoked action potential increased after miR-134 interference.[Conclusions]High concentration of MA can induce neuronal damage and apoptosis and also increase miR-134 expression. While silence miR-134 expression can increase neuronal excitability.Our study provides an experimental basis for elucidating the possible mechanism of MA-induced neuronal injury and the role of miR-134 in neurotoxicity and neuronal excitability.

Objective To study the effect of chloral hydrate on click sound evoked auditory brainstem re-sponse (ABR) in healthy adult guinea pig .Methods A total of 20 healthy wild type albino male guinea pigs were se-lected for ABR assessment with click sound stimulation conscious and cholral hydrate anesthesia conditions .The ABR threshold was determined according to the wave that presents highest occurrence rate under different stimulus intensity .The latency ,interpeak latency of each wave at 90 dB peSPL stimulation as well as the amplitude of waveⅡ ,Ⅲ ,Ⅳ under different stimulus intensity were recorded .Results The ABR threshold in chloral hydrate anes-thesia was 25 .50 ± 2 .76 dB peSPL and at the waking state was 28 .5 ± 3 .66 dB peSPL from control group (P>0 .05) .The latencies of each wave recorded under chloral hydrate anesthesia state were prolonged compared to those of under waking state ,wave Ⅲ ,Ⅳ and Ⅴ had significance differences (P<0 .05) ,but wave Ⅰ ,Ⅱ had no significant differences (P>0 .05) .The interpeak latency between wave Ⅰ - Ⅴ ,Ⅲ - Ⅳ ,Ⅳ - Ⅴ in chloral hydrate anesthesia were longer compared to those of under waking state with significant differences (P<0 .05) ,while interpeak latency between Ⅰ - Ⅱ ,Ⅱ - Ⅲ had no significant differences (P> 0 .05) .The amplitude and occurrence rate of wave Ⅱwere the highest among all the waves in both experimental group and control group .The amplitude of wave Ⅱ and Ⅲ in chloral hydrate anesthesia was higher than that of the waking state under acoustic stimulation conditions ofhigh intensity(P<0 .05) while the amplitude of wave Ⅳ was lower than the waking state (P<0 .05) .Conclusion The chloral hydrate anesthesia may be able to apparently lengthen the ABR latencies of wave Ⅲ ,Ⅳ ,Ⅴ and affect the amplitude .This effect should be considered during the assessment of ABR under anesthesia state in guinea pig ;The ABR threshold of guinea pig could be determined according to the wave Ⅱ because it 's highest occurrence rate .