The main pathophysiological changes of acute respiratory distress syndrome (ARDS) are massive destruction of pulmonary vascular endothelial barrier, pulmonary edema, infiltration of inflammatory cells, and refractory hypoxemia in severe cases. Pyroptosis is programmed cell necrosis, triggered by caspase and mediated by proteins in a member of conserved protein family Gasdermin D (GSDMD), which manifests as continuous cell expansion until cell membrane rupture, leading to release of cell contents and activation of a strong inflammatory response. Pyroptosis plays a key role in the development of septic ARDS. In this paper, the molecular mechanism of pyroptosis and the related researches on pyroptosis and ARDS are reviewed.

Glabridin (Glab) is an isoflavonoid originally isolated from the roots of Glycyrrhiza glabra L. (Fabaceae). Glab is widely considered to be a phytoestrogen and has been associated with numerous biological properties ranging from antioxidant, anti-inflammatory, neuroprotective, anti-atherogenic effects, to the regulation of energy metabolism. In this paper, a review on its biological activity was reviewed.

ObjectiveTo explore the effect of the early rehabilitation with correction intervention on the stroke patients with unilateral spatial neglect(USN).Methods34 stroke patients with USN were divided into two groups: 17 cases in control group received conventional rehabilitation after stability of their vital signs; another 17 cases in treatment group received early rehabilitation with intervention correction for USN in addition.Results8 weeks after rehabilitation, the scores of the Barthel Index is higher than those of the control group(P<0.01), and the degree of USN of treatment group improved significantly compared to the control group(P<0.001).ConclusionEarly rehabilitation with correction intervention on USN can effectively improve ADL and the degree of USN of patients.

Objective To evaluate the effect and safety of thymosin combined with biapenem in the treatment of severe lower respiratory tract infection of gram negative bacilli.Methods 54 patients with severe lower respiratory tract infection of gram negative bacilli were randomly divided into study group (group A) and control group (group B),group A was treated with thymosin and biapenem,group B biapenem.All patients were treated for 7 ～ 14 days in a course.The clinical effect,treatment time of biapenem,the bacterial clearance rate and adverse drug reaction betweeen two groups were compared.Results The clinical effective rate of group A and B were 84.6％ and 82.1％,respectively,there was no statistical difference (P ＞ 0.05).Treatment time of biapenem in group A and B was (8.2 ±3.4) days and (13.2 ± 3.6) days,respectively,there was statistical difference (P ＜ 0.05).The bacterial clearance rate of group A and B were 86.7％ and 80.7％,respectively,there was no statistical difference between two groups (P ＞ 0.05).Conclusion The treatment time of thymosin combined with biapenem treatment of gram-negative bacilli severe respiratory tract infection was shorter than that of biapenem alone treatment,and it was safe,effective,and worthy of ciinical application.

Objective To investigate the development of ICUs and critical care medicine at secondary and above hospitals in Inner Mongolia.Methods Questionnaire survey of ICUs at secondary and tertiary hospitals in Inner Mongolia Autonomous Region from October 2010 to June 2011.Results There are 76 ICUs at 26 hospitals,including 24 general ICUs and 52 special ICUs; tertiary hospitals average 2.47±0.63 special ICUs,while secondary hospital average 2.23±1.12 special ICUs; 35％ of the ICUs are subject to close-off management; general ICUs at tertiary hospitals account for 1.21％ ± 0.35 ％ of total beds of the hospital,and for 1.98％ ± 0.63％ of secondary hospitals.Regarding the ratio of physicians to ICUs beds,it is 0.75±0.15 at tertiary hospitals,and 0.62± 0.231 at secondary hospitals.As to the ratio of nurses to beds,it is 1.58 ± 0.72 at tertiary hospitals,and 1.36 ± 0.27 at secondary hospitals.Conclusion This survey showed that ICUs in Inner Mongolia Autonomous Region are acceptable in numbers,but are found with problems in insufficient beds,poor staff deployment,obsolete medical equipments and weak technical forces.Therefore,critical care medicine and ICU development should be enhanced during the second round of hospital accreditation in China.

BACKGROUND:Reduction quality is essential for the healing and function of limb. Traditional X-ray and CT scans have some limitationsin quantitatively and visualy observing the reduction quality of the remnant fracture in three-dimensional displacements. Mimics have advantages in bone rapid modeling and three-dimensional measurement, which offers the chance in quantifying the reduction quality of the displacement in three-dimensional methods.
OBJECTIVE:To measure residual displacement in femoral neck fracture patients with satisfactory reduction by using three-dimensional measurement method, and to evaluate the association between residual displacement and femoral head necrosis.
METHODS:We enroled 141 patients with femoral neck fracture, who were treated in the Third Department of Joint, Affiliated Hospital of Logistics University of People’s Armed Police Force from January 2012 to December 2013. Al patients were divided into undisplaced fracture group (n=44; Garden1&2) and displaced fracture group (n=97; Garden3&4). Based on DICOM data of CT files, three-dimensional models were constructed in each patient. Three parameters were measured: displacement of femoral head’s center, fossa capitis femoris and rotational displacement. Femoral head necrosis was folowed up. The correlation between residual displacement and femoral head necrosis was explored.
RESULTS AND CONCLUSION:(1) The duration of folow-up in those patients ranged from 25 to 43 months. Femoral head necrosis occurred in 7 cases from the undisplaced fracture group and 21 cases from the displaced fracture group. (2) The three parameters (displacement of femoral head’s center, fossa capitis femoris and rotational displacement) were respectively (7.44±2.84) mm, (11.75±4.12) mm and (17.68±8.99)° in the undisplaced group, and (6.51±3.75) mm, (9.34±5.27) mm and (14.67±7.43)° in the displaced group. Except displacement of femoral head’s center, significant differences in the other two parameters were detected between the two groups (P< 0.05). (3) These findings suggest that poor reduction quality is the main factor causing femoral head necrosis. X ray is insufficient to describe the spatial shift and the angle, and has limitations in assessing the reductionquality of femoral neck fracture. Three-dimensional measurement has certain advantages to assess quality of fracture reduction.

Objective To study the clinical application effect of Xuebijing Injection in the treatment of capillary leak syndrome.Methods One hundred patients with capillary leak syndrome in our hospital from January 2013 to April 2016 were selected and randomly divided into the control group and observation group according to the ID number of admission.The two groups were given the Western medicine routine therapy of capillary leak syndrome.The observation group was simultaneously given Xuebijing Injection.The APACHE II score,Mashall score and hemodynamics were compared between the two groups.The disease condition change was dynamically observed.Results The APACHE II score and Mashall score before and after treatment in the observation group were significantly suprior to those in the control group(P<0.05);the peripheral blood circulating endothelial cells (CEC) number at admission in the two groups were higher than the normal level,the CEC content after taking the treatment was gradually decreased (P<0.05),but the CEC content decrease in the observation group was less than that of the control group (P<0.01);were observed before and after the treatment group APACHE II and Mashall score was significantly better than the control group (P<0.05);but the CEC content in the observation group was significnatly superior to the control group(P<0.01);the expressions of vascular endothelial growth factor (VEGF),TNF alpha and interleukin-6 (IL-6) in the observation group were better than those in the control group (P<0.05).Conclusion Using Xuebijing Injection in treating capillary leak syndrome can effectively protect the vascular endothelial cells,improves the living quality of patients and can be popularized and applied in clinical treatment.

AIM:To observe the change of nitric oxide(NO)and hydrogen sulfide(H_2S)in blood and lung homogenate of hypoxic pulmonary hypertension(HPH)rat model,and to discuss the meaning of inhalation sodium nitrite and these factors in the treatment of HPH. METHODS:Fifty healthy male Wistar rats were assigned randomly into 5 groups(10 rats each):normoxia control group(NC),normoxia sodium nitrite group(NNI),hypoxic control group(HC),hypoxic normal saline group(HNS)and hypoxic sodium nitrite group(HNI). The mean pulmonary arterial pressure(mPAP),weight of right ventricle,weight of left ventricle plus septum,and the ratio of the weight of right ventricle to that of left ventricle plus septum(right ventricle hypertrophy index,RVHI)were also determined. The serum level of NO and plasma level of H_2S were measured,and at the same time the levels of NO in the lung homogenate were detected. The structures in pulmonary arteries were examined using optical microscope. RESULTS:After model established,compared to that in the normoxia groups,the body weight decreased significantly in hypoxia groups(P<0.05),although no difference of body weight in five groups before producing model was observed. Compared to that in normoxia groups,the levels of mPAP and RVHI increased significantly in hypoxia groups,and compared to that in hypoxia control groups and hypoxia normal saline group,mPAP and RVHI levels decreased significantly in hypoxia sodium nitrite group(P<0.05). Compared to that in normoxia groups,the serum level of NO decreased significantly in hypoxia groups(P<0.05). NO level in lung homogenate decreased significantly in hypoxia control group and hypoxia normal saline group as compared to that in normoxia groups(P<0.05),and no obvious difference between hypoxic sodium nitrite group and normoxia groups was found. The plasma level of H_2S was decreased significantly in hypoxia groups(P<0.05)as compared to that in normoxia groups. H_2S level increased significantly in hypoxia sodium nitrite group as compared to that in hypoxia control groups and hypoxia normal saline group(P<0.05). Observation under optical microscope,the lumen structure of lung in normoxia control group was normal. No significant change in normoxia sodium nitrite group was found. The proliferation of smooth muscle cells(SMCs),the collagen fiber deposition in the vessel wall and every caliber thickening was observed in hypoxic control group. The same changes were also observed in hypoxic normal saline group. The thickened caliber was relieved significantly in hypoxic nitrite group. CONCLUSION:Pulmonary hypertension and right ventricle reconstitution can be relieved by inhalation of sodium nitrite,and can be regulated by the level of NO and H_2S in rats. Above all,inhalation of sodium nitrite may degrade HPH directly or by affecting the externalization and synthesizing of gas signaling molecule indirectly.

Aim To investigate whether ulinastatin has a beneficial effect on lipopolysaccharide( LPS) induced acute respiratory distress syndrome ( ARDS ) in rats, and to explore the possible underlying mechanisms. Methods Fifty-six Wistar rats were randomly as-signed into control group, model group( LPS 6,12,24 h groups), ulinastatin group(UTI 6,12,24 h groups), with 8 in each group. ARDS rat model was reproduced by intraperitoneal injection of LPS ( 10 mg · kg-1 ) , The rats in UTI groups were injected ulinastatin (20 000 u·kg-1), The rats in the control group re-ceived an equal volume of normal saline at the same time, rats in each group were sacrificed at 6,12,24 hours after LPS challenge. Plasma and lung tissue sam-ples were collected, Histopathological evaluation, lung wet/dry (W/D) ratio, Tumor necrosis factor-a(TNF-α) , Interleukin-18 ( IL-18 ) , surfactant protein A ( SPA) , malondialdehyde ( MDA ) , nitric oxide ( NO ) and superoxide dismutase( SOD) were analyzed. Immu-nohistochemical method was performed to detect the protein expression of p38MAPK and ERK. Western blot method was used to detect lung phosphorylated p38 MAPK ( p-p38 MAPK ) and pERK protein expres-sion changes. Result In the control groups, lung tis-sue showed a normal structure and clear pulmonary al-veoli under a light microscope. In the model group, ARDS characters such as extensive thickening of the alveolar wall, significant infiltration of inflammatory cells, demolished structure of pulmonary alveoli, and hemorrhage were found. In the all UTI treatment groups, these pathological changes in lung were markedly alleviated compared with those of LPS-in-duced ARDS group. Compared with control groups, lung W/D ratio, tumor necrosis factor-a ( TNF-α) , in-terleukin-18 ( IL-18 ) and surfactant protein A ( SPA ) in plasma ,and lung MDA,NO levels in lung homogenates in the LPS group were increased significantly, while the lung SOD levels in the LPS group were decreased. Compared with the LPS group, lung W/D ratio, TNF-aIL-18 and ( SPAin plasma , and lung MDA levels in lung homogenates in the UTI groups were decreased significantly, while the lung SOD levels in the UTI groups were increased. Immunohistochemistry showed that positive expressions of p38 MAPK and ERK in cy-toplasm and nucleus in the ulinastatin treatment groups were significantly lower than those in the model group. Western blot showed that compared with the control group, the p-p38MAPK and pERK protein expression in LPS group were significantly increased, and the uli-nastatin could inhibit the protein expressions compared with model group. Conclusion Ulinastatin can signifi-cantly ameliorate the lung injury induced by LPS in rats via the intervention of p38 MAPK and ERK signa-ling pathway and reducing inflammation and antioxidant effect.

AIM: To evaluate the influence of radiofrequency (RF) hyperthermia on immunity function in mice. METHODS: The expression pattern of T helper type 1 (Th1) and T helper type 2 (Th2) cytokines in splenocyte culture supernatants, mainly the expression levels of IFN-?, IL-2, IL-4 and IL-10 in splenocyte culture supernatants of mice in tumor-bearing group, surgical resection group, RF therapy group and normal control group were detected by enzyme-linked immunoadsordent assay (ELISA). RESULTS: IL-2 concentration in two weeks after RF therapy group was higher than that in two weeks after surgical resection and normal control groups (P0.05). CONCLUSION: RF hyperthermia may activate the transformation from Th2 to Th1 and facilitate the excretion of Th1 type cytokines that play an important role in the anti-tumor immunity.