MicroRNAs are small,single-stranded and non-coding RNAs.MicroRNAs modulates gene expression by binding themselves to complementary sites of target genes.It had been discovered that micmRNAs modulate sepsis in multiple levels.Through targeting Ca2+/calmodulin-dependent protein kinase Ⅱ,miR-152 and miR-148 impair innate response and antigen presentation,and also suppress proliferation of antigen specific CD4 + T cells; miR-29 family regulate cellular immunity through setting the threshold in thymic involution; MicroRNA-17-92 plays a causative role in B cell lineage; miR-146 and miR-155 down-regulate proinflammatory cytokines through suppressing components of pattern recognition receptors,while miR-132 through acetylcholinesterase degeneration.miR-124 degenerates mRNA of glucocorticoid receptorαand results in glucocorticoid resistant in treatment of sepsis.Immune regulation of microRNAs in sepsis is briefly described in this paper.

The paper described the necessity of establishing standardized residency training system,and introduced the progress of such training on a unified platform in Shanghai since 2010.In its summary of the success and experiences in Shanghai, the authors proposed to step up three-level management,set up a government-funded risk fund;guarantee income and welfare of residents and encourage their sense of belongings;encourage motivation of clinical teachers to enhance training quality;to build a systematic postgraduate medical education system in alignment with the standardized specialists training.

Cerebralvasospasmisthemostcommonandmostdangerouscomplicationofsubarachnoid hemorrhage (SAH). If it can not be diagnosed and treated early, it w il result in delayed cerebral ischemia and delayed ischemic neurological deficits, and seriously affect the outcomes of patients. SAH can cause oxidative stress and inflammation, causing vasospasm, and leading to brain tissue damage. Numerous studies have show n that the concentrations and activities of numerous metabolites w il change in these pathological physiological processes. Identification of the changes of location, time and trend of these markers has important clinical significance for investigating the mechanism of cerebral vasospasm after SAH and seeking better therapeutic targets. This article review s the molecular markers of cerebral vasospasm after SAH.

Objective To observe the curative effect of Chinese herbal medicine decoction combined with mifepristone in the treatment of uterine fibroids and the effects on hormone levels.Methods 100 patients with uterine fibroids were divided into the treatment group and control group according to random number table, 50 cases in each group.The treatment group was given the liquid form joint mifepristone, the control group was given mifepristone.The two groups were treated for a course of 3 months.The sex hormone levels before and after treatment, the symptoms and signs integral related indicators were compared.The clinical efficacy was evaluated.Results The total effective rate of the treatment group was 84%, which was obviously higher than 66% of the control group (x2=9.88,P<0.05).Compared with before treatment[the control group,LH:(57.2±9.6)U/L,E2:(17.9±6.9)pmol/L,FSF:(32.7±8.5)g/L,P:(17.5±5.2)nmol/L;the treatment group,LH:(56.7±10.2)U/L,E2:(17.3±7.9)pmol/L,FSF:(33.5±7.9)g/L,P:(18.4±3.2)nmol/L], after treatment the levels of sex hormones in the two groups significantly reduced[the control group,LH:(47.5±8.3)U/L,E2:(12.5±3.8)pmol/L,FSF:(18.3±6.9)g/L,P:(14.8±3.2)nmol/L;the treatment group,LH:(38.7±8.1)U/L,E2:(7.5±4.3)pmol/L,FSF:(10.2±5.2)g/L,P:(10.5±4.8)nmol/L],the differences were statistically significant(all P<0.05).Conclusion Chinese herbal medicine decoction combined with mifepristone in the treatment of uterine fibroids has good clinical curative effect, by increasing the body's immunity, lowering levels of sex hormones in the body, inhibition of smooth muscle tissue, thus to narrow the myoma, improve clinical symptoms, it is worthy of promoting.

OBJECTIVE:To provide reference for the rational use of narcotic drugs. METHODS:The utilization of narcotic drugs for inpatients in our hospital during 2012-2014 were collected from HIS,and analyzed statistically in respects of consumption amount,consumption sum,DDDs,B/A,DDC and consumption amount of the different departments,and so on. RESULTS:The quantity and consumption amount of Morphine sulfate sustained-release tablets,Oxycodone hydrochloride sustained-release tablets and Codeine phosphate tablet ranked the first 3 places during 2012-2014. Morphine sulfate sustained-release tablets,Oxycodone hy-drochloride sustained-release tablets and Fentanyl transdermal patch(8.4 mg)steadily occupied the first 3 places in the list of con-sumption sum. In the list of DDDs,Fentanyl transdermal patch and Morphine sulfate sustained-release tablets took up the first 3 places;Morphine hydrochloride injection,Bucinnazine hydrochloride injection and Meperidine hydrochloride injection occupied the last 3 places. B/A value of Morphine sulfate sustained-release tablets and Fentanyl transdermal patch(8.4 mg) in 2012,Oxycodo-ne hydrochloride sustained-release tablets in 2014,Fentanyl transdermal patch(2.5 mg)in 2013 and 2014 were all equal to 1 and synchronized well. Others were all biased. DDC of narcotic drugs kept stable in 3 years,and DDC of Oxycodone hydrochloride sus-tained-release tablets took up the first place,followed by Fentanyl transdermal patch (8.4 mg). Narcotic drugs were consumed in 19 departments,but mainly in the department of oncology and general surgery. In the department of oncology,the consumption amount and sum of oral formulation were both significantly higher than other dosage forms,accounting for more than 88% and 52% respectively. CONCLUSIONS:The variety and dosage form of narcotic drugs could meet the clinical needs and its application is basically reasonable. Besides,the utilization of narcotic drugs in the department of oncology consistent with the basic principles of WHO three steps cancer analgesia treatments.

Objective To explore the relationship between the neighborhood environment and the residents' suicidal risk and provide evidence for suicide prevention.Methods The study sample consisted of 392young suicides (aged 15-34 years) and 416 community living controls from the same areas of China (randomly selected from 16 rural counties in three provinces).Social factors in the village neighborhoods were measured by the WHO SUPRE-MISS scale of Community Stress and Problems.Psychological autopsy methods and multivariable Logistic regression were employed.Two informants were interviewed to collect the information of each subject.Results It was found that there was positive correlation between the community surrounding score and suicide.The community stress and problems was the main risk factor for suicide(Wald x2 =10.036,P＜0.05,OR=1.323).Family disputes,inconvenience transportation,lack of health care and job security,alcohol abuse,and superstition can increase the suicidal risks among rural young Chinese.It was still indicated that relative poverty,suffering from a mental illness(OR=32.346) were the risk factors; but good education,married and good health were the protective factors for suicide.Conclusion Further improving the social assistance system,solving the existing community stress and problems,building better community environment are needed to reduce the stress of community residents.Psychological screening and the community mental health intervention for high-risk groups should be strengthened to improve residents' response capacity to stress.Those measures can reduce the suicide rate of China rural community residents effectively.

A five-step synthetic method of ambrisentan starting from benzophenone was developed.The reaction methods of resolution and substitution were optimized.A stable,facilitating method of detection and efficient resolution reagent,L-phenylglycinamide,was used and helped to obtain highly optical pure intermediates.In the substitution reaction,NaOH was chosen as the base,which is safe and suitable for the industry.This method was mild,easily operated with a total yield up to 31.0％,and may have a good application prospect.

The risk factors of diastolic heart failure include among others: hypertension,diabetes,myocardial ischemia and aging.The underlying mechanisms for this cardiac complication are incompletely understood.With the increase of aging of the population,the prevalence and mortality of diastolic heart failure is rising gradually.It seriously affects the life quality and life span of people.In order to more truly reveal the underlying mechanisms of diastolic heart failure and to develope novel therapeutic strategies,the experimental animal models are extremely important.The present review focuses on providing an overview of the characteristics of these models for the growing number of investigators who seek to understand the pathology of diastolic heart failure.

Objective To compare the inhibitory effects of Butorphanol and Dezocine on Etomidate-induced myoclo?nus. Methods A total of 150 patients with ASA physical statusⅠorⅡ, aged 40-65 yr, with body mass index (BMI) of 20-25 kg/m2, scheduled for elective operations under general anesthesia, were included in this study. Patients were randomly al?located into three groups (A, B and C) with 50 patients in each group. Group A was given intravenous Butorphanol 15 μg/kg for 30 s, group B was given Dezocine 0.1 mg/kg and group C was given equal volume of saline. After 2 min, etomidate 0.3 mg/kg was administrated to three groups. The occurrence and severity of myoclonus were recorded for 2 min after administration of Etomidate. The mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2) and Bispectral index (BIS) were recorded at the time points before induction (T0), 2 min after the experimental drug treatment (T1), and 2 min after Etomi?date treatment (T2). At the same time, the concentration of serum potassium was determined at T0 and 5 min after endotrache?al intubation (T3) respectively. Results The positive incidences of myoclonus were 12%in group A, 22%in group B and 74%in group C, respectively. Compared with group C, the positive incidence rates of myoclonus and myoclonus scales were significantly lower in group A and group B (P<0.05), but no significant difference between group A and group B (P>0.05). Compared with T0, there was no significant difference in the potassium concentration between patients without myoclonus (grade 0) and patients with myoclonus (grade 1 and grade 2) at T3 (P>0.05). There was a significant increase in potassium concentration in patients with grade 3 (P<0.05). There were no significant differences in MAP, HR, SpO2 and BIS values at T0, T1 and T2 between three groups of patients (P>0.05). Conclusion Pre-treatment of Butorphanol (15μg/kg) or Dezocine (0.1 mg/kg) can reduce the Etomidate-induced myoclonus. At the same time, both therapies show no different effects on cir?culation and respiration system.

Objective To investigate the efficiency of biological function of AT rich interaction domain 1A (ARID1A) gene silenced by small interfering RNA (siRNA) on ovarian clear cell carcinoma ES2 cell line. Methods (1) The three pairs ARID1A gene siRNA interference fragments siN1 (ARID1A-705), siN2 (ARID1A-1513), siN3 (ARID1A-2282) and one pair negative control were respectively designed, and transfected into ES2 cells by RNA interference max reagent transiently. Reverse transcription (RT)-PCR and western blot methods were used to detect the expression of ARID1A mRNA and protein in ES2 cells transfected with interference fragments respectively. So as to select the best silencing effect of siRNA interference fragment(that was siN3),and then was used in the following experiment. (2) The following experiment were divided into three groups, namely siN3 transfection group, negative control group and blank control group. The proliferative activity of three groups of cells after transient transfection ( 6, 24, 48, 72, 96 hours) was assessed by cell counting kit-8 (CCK-8) assay and expressed as absorbance (A) value; the apoptosis rate of three groups of cells transfected transiently with interference fragment was measured by flow cytometry with annexin V/propidium iodide (PI) staining;the ability of cellular invasion of three groups of cells transfected transiently with interference fragment was tested by transwell experiment;the expression of nuclear factor-kappa B (NF-κB), membrane type-1 matrix metalloproteinase (MT1-MMP) and matrix metalloproteinase-2 (MMP2) protein in ES2 cells transfected transiently with interference fragment was measured by western blot. Results (1) The RT-PCR results showed that the ARID1A mRNA relative expression levels in ES2 cells after transfected transiently with siN1, siN2 and siN3 were 0.007 8±0.005 7, 0.006 8±0.000 3 and 0.002 8±0.000 3 respectively. They were all apparently lower than that in the negative control group (0.034 6 ± 0.001 3;all P<0.01). The western blot results showed that the expression levels of ARID1A protein were 0.439 4±0.000 7, 0.424 4±0.005 0 and 0.386 0±0.005 8 respectively. They were also lower than that in the negative control group (0.732 4 ± 0.030 3; all P<0.01). The siN3 with the highest transfection efficiency was selected to use in the following experiment. (2) The CCK-8 method showed that the proliferative activity of siN3 transfection group cells after transfected transiently at 6 hours was not statistically significant difference compared with those in negative control group and blank control group (0.506 ± 0.010, 0.491 ± 0.006, 0.498 ± 0.009, respectively; all P>0.05). However, the proliferative activity of siN3 transfection group cells after transfected transiently at 24, 48, 72, 96 hours were higher than those in negative control group and blank control group (all P<0.01). The flow cytometry results showed that the apoptosis rate of siN3 transfection group cells was (20.0±3.9)%, which was significantly lower than those in negative control group and blank control group [(31.5 ± 5.0)%, (34.0 ± 4.2)%, respectively;all P<0.05]. The transwell experiment showed that the penetrated cell counts of siN3 transfection group was 60.4±2.9, which was apparently higher than those in negative control group and blank control group (54.2 ± 3.5, 52.1 ± 3.8, respectively; all P<0.01). Western blot experiment showed that the relative expression levels of NF-κB, MT1-MMP and MMP2 protein in siN3 transfection group were respectively 1.85 ± 0.16, 0.37 ± 0.08, 1.38 ± 0.11, which were apparently higher than those in negative control group (0.93±0.11, 0.17±0.05, 0.86±0.06;all P<0.05) and blank control group (0.94 ± 0.04, 0.15 ± 0.08, 0.85 ± 0.10, respectively; all P<0.01). Conclusions It would be to promote the cell doubling time, reduce cell apoptosis and increase the invasive capability in ES2 cells that ARID1A expression was down-regulating by ARID1A mRNA interference. The invasion mechanism may be related to the activation of NF-κB signal transduction pathway, up-regulation of MT1-MMP expression and then promoting the invasion of tumor cells via the up-regulation of MMP2 expression.