The receptor-interacting protein (RIP) has been identified to play a critical role in necroptosis, which is an inflammatory form of programmed necrosis in trauma, ischemia/reperfusion (I/R), and systemic inflammatory response syndrome (SIRS). Ripoptosome, a newly defined intracellular signaling complex with essential molecule of RIP1, can switch cell death mode between apoptosis and necroptosis. Based on molecular mechanism of RIP-dependent cell death and inflammation, with the understanding of the mechanisms of RIP-dependent apoptosis/necroptosis and its role in inflammation was summed up, and it was found that RIP plays a crucial role in regulating programmed cell death and inflammation. Therefore, further advances in understanding the mechanisms of necroptosis would be important in order to manipulate programmed cell death for therapeutic purposes in I/R injury, trauma, SIRS, and tumor.

Objective To investigate the value of pro-adrenomedullin (pro-ADM) levels for severity as-sessment of community-acquired pneumonia (CAP).Methods 214 CAP patients who were admitted to the emer-gency department were prospectively studied.The levels of plasma pro-ADM were determined using a new sandwich immunoassay.At the same time, procalcitonin, C-reactive protein, interleukin-6 levels, leukocyte count, clinical varia-bles and the pneumonia severity index (PSI) were measured.Results Pro-ADM levels,in contrast to procalcitonin,interleukin-6 levels, increased with increasing of the severity of CAP, which was classified according to the PSI score (P<0.05).In patients who died during follow-up, pro-ADM levels on admission were significantly higher than that in survivors [2.08 vs.4.94 μg/L,Z=-4.081 ,P<0.001].In a receiver operating characteristic (ROC) analysis for survival, the area under the ROC curve (AUC) for pro-ADM was 0.79, which was significantly higher than that for procalcitonin(0.72), C-reactive protein (0.58), interleukin-6 (0.64 ), and total leukocyte count (0.50) and sim-ilar to the AUC of the PSI (0.75).Conclusion Pro-ADM is a useful biomarker for the risk stratification of CAP patients.

The neurotoxin peptide, hainantoxin-Ⅵ (HNTX- Ⅵ), has been isolated from the venom of Chinese tarantula Ornithoconus hainana by a combination of ion exchange chromatography and reverse phase HPLC. The toxin was found to contain 34 amino acid residues with 6 conserved cysteine residues. The effects of HNTX-VI on voltage-gated sodium channels were studied via whole-cell patch clamp techniques. Although several inhibitors of mammalian neuronal sodium channel activation (hainantoxin Ⅰ-Ⅴ) had been characterized from the same venom, the present study indicated that HNTX-Ⅵ had the ability to slow the inactivation kinetics of the sodium channels in Cockroach Periplaneta Americana dorsal unpaired median (DUM) neurons in a similar manner to δ-atractoxins. After HNTX-Ⅵ treatment, steady-state sodium channel inactivation became incomplete, leading to a non-inactivating component at potentials more positive than - 55 mV. The novel function of the tarantula toxin HNTX-Ⅵ not only supplies a useful tool for exploring the gating mechanisms of sodium channels but also provides theoretical foundations for exploiting novel and safe insecticides.

ObjectiveTo study the HIF-1α expression in rats with paraquat poisoning (PQP).MethodsNinety-six healthy SD rats were randomly (random number) divided into 2 groups ( n =48 in each group) : PQP group and control group. The PQP group was further divided into six subgroups as per thedifferent intervals after Paraquat intoxication. Samples from 6 PQP subgroups and control group were taken at 0 h, and 2 h, 6 h, 12 h, 24 h, 48 h, 72 h and 120 h after paraquat administration. Aarterial blood wascollected for blood gas analysis, and the sections of lung tissue were stained with hematoxyhn-eosin and masson's trichrome to detect the trichrome positive area, and HIF-1α was detected by immunohistochemistryAll data were processed with one-factor analysis of variance and Pearson correlation analysis. ResultsTwo hours after paraquat poisoning, the levels of HIF-1α protein and the collagen were both significantly upregulated in the lung tissue in rats with paraquat poisoning. However, the hypoxemia existed until 72h.There was correlation between levels of Masson's trichrome positive area and HIF-1α positive area (r =0. 819, P ＜0. 05 ). There was correlation between the levels of lactic acid in blood gas analysis and HIF-1α positive area (r=0. 761, P＜0. 05. But there was no correlation between levels ofPO2 and HIF-1α positive area (r=-5.24, P＞0. 05). ConclusionsThe level of HIF-1α was up-regulated in rats with paraquat poisoning and it was not associated with hypoxemla.

Objective The feasibility and effectiveness of bilingual teaching combined with CBL (case-based learning) was evaluated in our study. Methods From 2011 to 2012, 69 students from Shanghai Jiaotong University were randomly divided into Bilingual CBL group (36 students) and Chinese CBL group(33 students). A case of salvage of multiple trauma patients was selected as a text-book case and students' acceptance to textbooks and teachers was assessed. Besides, students' self-evaluation, teachers' evaluation of students, students' achievement in procedures and the final theory test scores were evaluated as the outcome of the assessment. Results Students' acceptance of textbook in Bilingual CBL group is lower than that in the Chinese CBL group(P=0.035). Differences in students' evaluation of teacher (P=0.093), students' self-evaluation (P=0.816), and teachers' evaluation of the student(P=0.812) were not statistically significant. Final written examination scores(P=0.100), operat-ing procedures in tracheal intubations (P=0.489), and cardiopulmonary resuscitation (P=0.764) were not statistically different . Only central venous puncture showed a statistical difference ( P=0 . 011 ) . Conclusions Medical bilingual CBL teaching is feasible, without affecting the original teaching of medical knowledge. Bilingual teaching can improve students' English proficiency and enhance their interest in learning.

Objective To observe the levels of HIF-α and TGF-β in the liver tissue,change of serum transaminase in different phases after paraquat (PQ) toxicity and liver histopathology change in PQinduced liver toxicity of rats models in order to analyze the relationship between HIF-1 α and hepatic toxicity induced by PQ.Methods A total of 48 healthy SD rats were randomly (random number) assigned into 2 groups:PQ poisoning group (n =42,20％ PQ solution,50 mg/kg in 1mL) and control group (n =6,normal saline 1mL).Rats were separately sacrificed and liver tissue samples were harvested at 2,6,12,24,48,72 h and 120 h after PQ administered by gastric lavage.Arterial blood gas (ABG) analysis and serum alanine transaminase were assayed.Liver tissue HE and Masson staining and immunochemistry changes were also investigated.HIF-1α and TGF-β levels were detected by Western blot technique.Results Lactic acid level was significantly higher in PQ group than that in control group at 6 h after PQ exposure (P ＜ 0.05).The level of serum alanine transaminase was increased and significantly higher if PQ group than that in control group at 2 h after PQ poisoning (P ＜ 0.05).The level of HIF-1 α and TGF-β protein in the liver tissue were up-regulated significantly and higher in PQ group than those in control group at 2 h after PQ exposure (P ＜ 0.05).The hepatocytes necrosis and inflammatory cells infiltration were observed around portal area 2 h after PQ poisoning.At 12 h after PQ exposure,the periportal area filled with necrosis of hepatocytes and the necrosis began to extend,and huge amounts of inflammatory cell infiltration were found.Cord-like fibroplasia was found.All the histological changes were around central portal area and were enlarged gradually.Conclusions The results show that there are increased level of HIF-1 α in the early stage of PQ poisoning rats.The liver fibroplasia may be associated with increasing the level of TGF-β promoted by HIF-1α.

To investigate the curative effect of individualized treatment on peripheral facial paralysis. Methods:A treatment group of 121 patients was treated with acupuncture under an individualized plan based on the condition of disease. For a control study,118 patients were treated with conventional acupuncture. The courses of treatment and the curative effects were compared. Results:The cure and marked efficacy rate was 90.9% in the treatment group and 69.5% in the control group. There was a significant difference (P＜0.01).There was also a significant difference in the cure and marked efficacy rate in each courses of treatment between the two groups (P＜0.01). Conclusion:Individualized acupuncture treatment is better in the effect and shorter in the courses than conventional acupuncture treatment for peripheral facial paralysis.

Aim To investigate the effect of resveratrol on proliferation and differentiation in K562 cells. Methods K562 cells were treated with different con-centrations of resveratrol for 6d. The colony number of K562 cells was detected with semi-solid culture assay. Expression of GATA-1 and PU. 1 in K562 cells was re-spectively measured with immunocytochemistry and Western blot. Expression of differentiation related anti-gen, CD11b, CD14 and CD42b, was measured with flowcytometry on K562 cells. Results Resveratrol
could significantly decrease the colony number of K562 cells in a dose-dependent manner, and enhance the ex-pression of GATA-1,PU. 1,CD11b, CD14 and CD42b in K562 cells. Conclusion Resveratrol could inhibit the proliferation and induce differentiation of K562 cells via up-regulating the expression of GATA-1 and PU. 1 protein.

Objective To explore the regional reference intervals of biomarkers in umbilical blood for diagnosis of early onset bacterial infection in the healthy term newborns .Methods The umbilical blood samples were collected from 1 476 term newborns in our hospital during January 2012 to October 2013 ,of which 1 191 were healthy infants and enrolled in this study .Then the levels of high sensitive c‐reaction protein(hs‐CRP) ,procalcitonin(PCT) ,interleukin(IL)‐6 ,IL‐8 ,platelet(PLT) as well as white blood cell (WBC) were detected in the umbilical blood .These values were analyzed by SAS 9 .0 ,data were described through upper or lower limits or upper limits respectively .Differences among different subgroups were judged through analysis of Kruskal‐Wallis t test or Mann‐Whitney test respectively .Results The upper limits for hs‐CRP was 3 .1 mg/L ,for PCT was 0 .18 ng/mL ,while the refer‐ence interval for IL‐6 was 56 .6(11 .9-133 .2)ng/L ,and IL 8 was 976 .0(111 .7-2 507 .1)ng/L ,PLT was 242 .0(120 .0-339 .0)× 109/L and for WBC was 12 .9(7 .6-19 .3 )× 10 9/L ,and the value of PLT varied from vaginal delivery group to caesarean section group(230 vs .254 ,Z= 4 .301 ,P< 0 .05);no significant differences were found in these biomarkers among different gestational week specific groups (P>0 .05) .Otherwise ,compared with the regional reference intervals ,CRP and PCT in early onset neonatal sepsis group increased(P<0 .05) ,no significant difference was found for IL‐6 ,IL‐8 ,WBC and PLT (P>0 .05) .Conclusion The reference intervals of biomarkers in umbilical blood for diagnosis of early onset bacterial infection were established which may make great contribution for early diagnosis of bacterial infection for the newborns .

Objective To investigate the related risk factors,clinical features and prognosis of hospital-acquired acute kidney injury (AKI) in intensive care unit (ICU).Methods We retrospectively analyzed 48 patients with both acute kidney injury and multiple organ dysfunction syndrome (MODS),who received renal replacement therapy from October 2006 to February 2011 in our ICU.According to whether the occurrence time of AKI was 48 hours after admission,they were divided into hospital-acquired AKI (HA-AKI) group and community-acquired AKI (CA-AKI) group,with 13 and 35 cases respectively.We compared the differences between these two groups in gender,age,acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ),primary diseases,days of mechanical ventilation,times of renal replacement therapy,number and indicators of organ failure,prognosis,renal function recovery,length of stay in ICU and hospital.Results The mean age of HA-AKI group is ( 64.5 ± 21.4) years,which is older than that in CA-AKI group ( 50.2 ± 17.5 ) years (P=0.022).The top three primary diseases in CA-AKI group are severe infection(42.8％ ),chronic kidney disease (CKD) concurrency of AKI ( 11.4％ ) and multiple trauma without head injury ( 8.6％ ).However severe infection still occupies the first in HA-AKI group ( 30.8％ ),followed by stroke (23.1％,P=0.024),multiple trauma with head injury( 15.4％,P=0.018 ) and gastrointestinal bleeding( 15.4％ ) ;Patients in HA-AKI group with more than four organ failures account for 84.6％,significantly higher than 65.7％ in CA-AKI group (P=0.000).On the first day,the levels of serum sodium ( P =0.036 ) and bicarbonate ( P=0.001 ) in HA-AKI group are higher than that in CA-AKI group,and the urinary volume is more(P =0.046).In HA-AKI group,the level of urea nitrogen on the seven day increases so progressively that it becomes significantly higher than that on the first day(P=0.015),but in CA-AKI group,there is no significant change in the levels of serum creatinine and urea nitrogen after AKI,while the levels of seruum sodium ( P=0.023 ) and bicarbonate ( P=0.030) increase significantly;APACHE Ⅲ score in HA-AKI group after admission 24 hours is significandy lower than that in CA-AKI group(53.2 ±22.8) point vs (89.1±25.7) point,P=0.000),and the length of stay in ICU and hospital and days of mechanical ventilation in HA-AKI group are significantly longer than that in CA-AKI group,but there are no significant differences in times of RRT therapy,prognosis and recovery of renal function.Conclusion APACHE Ⅲ score after 24 hours of admission does not accurately reflect the prognosis of patients with MODS and HA-AKI.There are great differences in age,primary diseases,organ function changes and other aspects of HA-AKI when compared with CA-AKI.