Bacterial endotoxins (LPS) are not only the major constituents of the outer membrane of Gram-negative (G -) bacteria, but also the toxic determinants for G - infection, which is closely related to human health and the development of diseases. Pattern recognition receptors (PRR) have been considered to be the important initial steps for cellular recognition of LPS and consequent initiation of LPS responses. Scavenger receptor, CD14, toll-like receptors, ?2-integrins and L-selectin have been shown to be involved in the clearance of LPS or LPS activation. LPS receptor may be a complex of multiple components. Different individual response to LPS is related to gene background. The gene polymorphism of LPS receptors and LPS-induced cytokines have been shown to contribute to LPS sensitivity, susceptibility and prognosis of sepsis.

With the continuous improvement in weaponry, especially explosive weapons, blast injury has become one of the most common war injuries. Underwater blast injury is a common war injury during combat around islands or fighting for beach-head. The wounding effects of underwater blast wave and the characteristics of underblast injury are quite different from that produced in air due to special physical features of water and the underwater pressure. We have investigated the injurious effects of underwater blast wave and its dose-effect relationship. In addition, some protective measures have been tested to prevent or alleviate underwater blast injury. All of these primary results have provided both experimental and theoretical foundation evidence for further researches in respect to the diagnosis, emergency care and protection against underwater blast injury.

Objective:To investigate the clinical efficacy and safety of montelukast combined with mometasone furoate in the treat-ment of children with allergic rhinitis. Methods:Totally 91 children with allergic rhinitis were randomly divided into the observation group (n=46) and the control group (n=45) according to the random number table. The control group was given mometasone fu-roate, while the observation group was treated with montelukast additionally. Both groups were treated for two weeks. The symptom scores including nasal congestion, sneezing, itchy nose and runny nose, serum level changes of IL-4, IL-12 and IgE and adverse drug reactions before and after the treatment in both groups were evaluated and compared. Results:The total effective rate in the observation group (93. 48%) was significantly higher than that in the control group (75. 56%, P<0. 05). Compared with those before the treat-ment, the symptom scores in both groups were decreased after the treatment (P<0. 05), and those in the observation group were lower than those in the control groups (P<0. 05). After the treatment, the serum levels of IL-4 and IgE in both groups were significantly de-creased when compared with those before the treatment, while the IL-12 levels were increased significantly (P<0. 05), and the chan-ges in the observation group were more significantl than those in the control group (P<0. 05). There were no serious adverse drug re-actions during the treatment course in both groups. Conclusion:Montelukast combined with mometasone furoate in the treatment of al-lergic rhinitis shows more notable efficacy with higher security.

Since the identification of BCR-ABL fusion gene and the advent of targeted tyrosine kinase inhibitors (TKI), patients with chronic myeloid leukemia (CML) have been "walking" on the path of chronic disease for around twenty years. In recent years, the second - and third -generation TKI have provided further protection for the long-term survival of CML patients. However, TKI discontinuation and the prognostic situation of a small number of patients with TKI resistance or carrying poor prognostic genes are still hot issues in CML-related researches. This article reviews the research progress of CML at the 62nd American Society of Hematology Annual Meeting.

Objective To review the application of trauma and injury severity score (TRISS) and a severity characterization of trauma (ASCOT) in the outcome evaluation of trauma care and their research advances.Data sources Both Chinese- and English-language literature searched by using MEDLINE/CD-ROM (1985-1996) and Index of Chinese-Language Literature (1985-1996).Study selection Over fifty papers and reviews published over the past ten years were selected.Results and conclusion TRISS can be employed for different purposes, that is, preliminary outcome-based evaluation (PRE) and definitive outcome-based evaluation (DEF). TRISS is a method which is now the most extensively used for the outcome evaluation of trauma. Even so, it still has some shortcomings, e.g., trauma can not be given the weights that should be given, and the section of age is too simple. ASCOT is also a physiologic and anatomic combined method for the evaluation of injury severity and outcome. To some extent, this method obviates the shortcomings of TRISS in the calculation of probability of survival (Ps) with injury severity score (ISS). Therefore, ASCOT is considered to be superior to TRISS in the evaluation of Ps. However, TRISS is still now more extensively used than ASCOT just because ASCOT was recently developed.

BACKGROUND: There exists a close relationship between the expression of scavenger receptor(SR) and CD14 and the endotoxic lung injury. To further detect the expression of these two receptors and their relationship is helpful to disclose the receptor mechanism of lung inflammatory disequilibrium so as to provide a possible theoretical foundation for sepsis therapy.OBJECTIVE: To investigate the expression of CD14 and SR in murine alveolar macrophages and their effect after trauma and traumatic endotoxin challenge.DESIGN: Randomized and controlled experimental study.SETTING: Fourth Laboratory(a state key laboratory), Trauma, Burns and Combined Injury, the Research Institute of Field Surgery, Daping Hospital,the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was completed in the Research Institute of Field Surgery of Daping Hospital of the Third Military Medical University of Chinese PLA from August 2001 to November 2001. Totally 63 Kunming mice with murine alveolar macrophages were used in the experiment.METHODS: The experimental animals were randomly divided into three groups including control group, trauma group and traumatic endotoxin challenge group. The model mice with both femur fracture and endotoxin challenge were used. Endotoxin at a dose of 5 mg/kg was injected one hour after fracture via tail vein and the dynamic expression of CD14 and SR in murine alveolar macrophages (AM) was detected.RESULTS: Six hours after trauma, the expression of CD14 and that of SR in AM showed the tendency of up-regulation and down-regulation respectively. Furthermore, the post-traumatic endotoxin challenge induced CD14up-regulation and SR down-regulation drastically. Correlation analysis indicated that CD14 and SR showed a significantly negative relationship.CONCLUSION: The study suggested that the dual modulation of CD14 and SR in AM is possibly related with the change of "self-control" to "out of control" of inflammatory reactions in the lungs after endotoxic challenge. The dual regulation of the effective antagonists CD14 and SR are helpful in further understanding lung injury and its repairing mechanism.

Objective To study the expression law of zinc finger protein A20 mRNA of mouse liver tissues in the process of trauma with lipopolysaccharide (LPS) infection. Methods A total of 95 healthy mice (either sex, from Kunming, Yunnan province) with a mean body weight of 21 g (18-24 g) were randomized into 4 groups: control, trauma only (Group A), LPS only (Group B) and trauma plus LPS (Group C). The models with closed fracture of bilateral spines as well as endotoximia were made. The expression characteristics of zinc finger protein A20 mRNA of liver tissues were measured by reverse transcription-polymerase chain reaction (RT-PCR) and all result data expressed as total gray ratio of A20 mRNA to GAPDH mRNA (?s). Results In the control group, the A20 mRNA expressed at a low level. There was low expression of zinc finger protein A20 in the Group A at various time points, with no significant difference compared with the control group. After LPS infection, the expression of A20 mRNA in the Group B was elevated more obviously than that in the control group at 0.5 hour, reached peak during 0.5-2 hours and decreased after 2 hours. But expression of A20 mRNA at each time point was higher in the Group B than that in the Group A. In the Group C, after LPS infection, the expression of A20 mRNA was elevated more significantly than that in other two groups 0.5 hour, reached the highest level during 0.5-2 hours, much higher than that in the Group B (P

The uncontrolled inflammatory response is commonly seen and plays an important role in the pathogenesis of post traumatic complications. Bacterial endotoxin or lipopolysaccharide (LPS) is one of the most potent mediators in inducing uncontrolled inflammatory response.Several LPS associated receptors have been identified on the surface of monocytes/macrophages, which are shown to be initial factors to recognize LPS and trigger inflammatory response. Scanvenger receptor (SR), CD14and toll like receptor4 (TLR4)act as high affinity or sensitive LPS receptorS. SRhas been shown to be responsibe for clearance and neutralization of LPS by macrophages,whereas CD14 and TLR4have been foand to be important receptors mediating cell activation induced by LPS. TLR2, ? 2 integrin and L selectin have been considered to be low affinity LPSreceptors, and they may play an important catalytic role in LPS induced pro inflammatory and anti inflammatory responses as "secondary LPS receptors". In addition, TLR4 might be the receptor pathway through which LPS could activate blood endothelial cells. Down regulation of defense receptors such as SR and up regulation of excitatory receptors such as CD14, TLR4, and TLR2might be an important mechanism to turn monocytes/macrophages into effector cells (release of pro and anti inflammatory mediators) during the course of infection. Further investigation of transmembrane LPS signaltransduction mechanisms. might help discover some novel strategies for effective control or modulation of uncontrolled inflammatory response.

Objective To study the dose-effects relationship of underwater blast injury. Methods Sixty-one adult mongrel dogs were exposed to underwater explosion of 200g, 500g, and 1 000g of TNT, respectively. The physical parameters of blast wave were recorded by PCB pressure transducers (USA). Survival or death was observed 6 hours after injury. Correspondingly, the relationship between the physical parameters and injury severity was analyzed. Results Twenty-three among 61 dogs died after injury, the mortality rate was 37.70% (23/61). The main reasons of death were severe lung bleeding, lung edema, perforation of gastrointestinal tract, and rupture of liver and spleen. Half lethal (5/10) impulse of underwater blast wave was 337.7?14.3kPa?ms. The impulses resulting in mild, moderate, severe, and critical underwater blast injuries were 140.46?34.2, 199.2?25.2, 247.8?69.6, and 478.7?183.8kPa?ms, respectively. Conclusion The physical parameters were well related to the injury severity in underwater blast. The early main treatment consist of active and effective management of severe lung injuries, perforation of gastrointestinal tract, and rupture of liver and spleen.

Objective To design and prepare an RNA interfering vector for effectively inhibiting the cellular expression of zinc finger protein A20 and observe the effect of A20 gene silence on cellular inflammatory response. Methods Specific RNA interfering oligonucleotide fragments (ASRF) were designed and synthesized artificially and the A20 RNA interfering vector pSUPER-EGFP-A20 siRNA constructed. Human monocyte cell line THP1 was used to infect the pSUPER-EGFP-A20 siRNA by means of genetic transfection technique; then, silence rate of cellular A20 was analyzed by real-time polymerase chain reaction (PCR). In the meantime, the activity of nuclear transcription factor nuclear factor-κB (NF-κB) and the level of tumor necrosis factor-α (TNF-α) in culture supernatant were measured by ELISA. Results Of two specific inhibitory oligonueleotide fragments of A20, the fragment M59465-385R/F had a higher inhibition to A20 expression, with rate of A20 gene silence of 83.86%. Preliminary application showed that after A20 gene silence, the activity of NF-κB was increased by 78.13% and the level of TNF-α in cell culture supernatant was increased by 49.30%. Conclusions Vector of A20gene silence with a high efficiency is obtained successfully. Preliminary application indicates that the expression of A20 can down-regulate the degree of cellular inflammatory responses.