Innate immunity plays an important role in inflammatory injury after cerebral ischemia,and inflammasome is considered to be a key factor.Inflammasome is a macromolecular protein complex,can recognize pathogen-associated molecular patterns and damage-associated molecular patterns,and mediate immune inflammatory responses.Studies have shown that cerebral ischemia can induce the acute activation of the NLRP1 and NLRP3 inflammasomes.This article reviews the structure,activation and regulation of inflammasome,and the roles of inflammasome in cerebral ischemia.

Atomoxetine as a nonstimulant medicine was approved by the Chinese Food an Drug Administration and provide a new selection of treatment drugs for attention deficit hyperactivity disorder (ADHD). Tomoxetine is a noradrenaline transmitter reuptake inhibitor which can selectively inhibit synapsis noradrenaline transport protein, strengthen noradrenaline's resupination effect, and increase noradrenaline's activity released by synaptic cleft to improve the symptoms of the ADHD patients. Compared with methylphenidate, atomoxetine does not affect the concentration of the neurotransmitter dopamine and does not induce or increase the Tourettes' syndrome, therefore atomoxetine is more suitable to treat ADHD together with Tourettes syndrome. In this article the treatment of atomoxetine for ADHD, including the indications, dosage as well as adverse reactions and efficacy assessment are reviewed.

There exist a series of problems in heat stroke treatment,such as,pathogenesis is still unclear,clinical classification is too simple and has no intrinsic relation with pathophysiological process and prognosis,missing of indexes for hierarchical diagnosis and prognosis prediction,and lack of targeted therapeutic norms.All of these factors could lead to high mortality and disability by heat stroke.Our research team started an epidemiological investigation of heat stroke since 2002.On the basis of discovering organ injury rule,system info and treatment technology on critical medicine were applied to heat stroke treatment.Research on organ injury mechanism for heatstroke was carried out based on translational medicine idea,and periodic research results were also achieved.A series of key technologies for heat stroke treatment were obtained.These technologies were popularized in 30 hospitals across the country,thus improving ability of heat stroke treatment.

Objective: To investigate the relationship of excision repair cross-complementing 1 (ERCC1), xeroderma pigmentosum group D(XPD), and breast cancer susceptibility gene 1 (BRCA1) polymorphisms with the efficacy of platinum-based chemotherapy for treatment of the patients with advanced non-small cell lung cancer. Methods: A total of 124 patients with advanced NSCLC were routinely treated with platinum-based chemotherapy, and their clinical responses were evaluated. ERCC1 Asn118Asn(rs11615), XPD Lys751Gln(rs13181) and BRCA1 Ser1613Gly(rs1799966) of the patients were genotyped using the TaqMan method. The association of ERCC1 Asn118Asn, XPD Lys751Gln and BRCA1 Ser1613Gly polymorphisms with the patient responses was analyzed using unconditional logistic regression model. Results: It was found that the BRCA1 Ser1613Gly polymorphism was significantly correlated with clinical benefit(P = 0. 014). Patients carrying Gly allele had better clinical benefit than patients with wildtype allele(P = 0. 006). No significant association was found between ERCC1 and XPD polymorphisms with clinical benefit. Furthermore, we found that the three SNPs in NER(nucleotide excision repair) could work together. More variant alleles(ERCC1 T, XPD Gln and BRCA1 Gly) was associated with better clinical benefit(P = 0. 036). Conclusion: The BRCA1 Ser1613Gly polymorphism of NER is associated with the clinical benefit of NSCLC patients receiving platinum-based chemotherapy. Analysis of SNPs of more genes may help to guide drug choosing for chemotherapy.

Objective: To investigate the genetic characterization (evolution, antigenicity, enzymatically active site, and glycosylation site) of the neuraminidase (NA) gene of the novel influenza virus A/H1N1 in 2009 pandemic. Methods: Genetic evolution and amino acid substitutions of the 43 NA gene sequences of influenza virus A of different years were retrieved from GenBank and were analyzed by using MEGA 4.0 software. Results: The new A/H1N1 influenza virus strains and avian H5N1 influenza virus strains had similar antigen sites of the NA genes, sharing a homology of 85%. Amino acid residues at the enzymatically active site of the NA genes were strictly conserved in all influenza virus strains, but the glycosylation sites varied. Conclusion: The NA genes of novel H1N1 influenza viruses may originate from avian H5N1 influenza virus endemic in Asia. The new H1N1 influenza viruses may respond well to the neuraminidase inhibitor treatment.

BACKGROUND:Chronic ankle instability can cause traumatic joint disease and secondary adhesive capsulitis, and even result in permanent dysfunction.
OBJECTIVE: To explicit the forming reason of chronic ankle instability and to investigate the diagnosis and treatment methods of chronic ankle instability based on the biomechanical analysis of the ankle joint.
METHODS: PubMed and Wanfang databases were retrieved for review and basic research papers about the anatomy, biomechanics, diagnosis and treatment of chronic ankle instability published from January 1990 to December 2014. The keywords were “chronic ankle instability, anatomy of ankle joint, biomechanics, therapy, research” in English and Chinese, respectively. After screening, 40 papers were included to summarize the anatomical structure of the ankle joint, mechanism and classification, diagnostic methods, and treatment methods of chronic lateral ankle instability.
RESULTS AND CONCLUSION:Diagnostic methods of chronic ankle instability include ankle varus stress test, ankle anterior drawer test, ultrasonic test, modern imaging detection; and therapeutic methods for chronic ankle instability can be divided into conservative treatment and surgical treatment, and the surgical treatment can be subdivided into non-anatomic reconstruction and anatomical repair of the damaged ligament. Early diagnosis and effective treatment are recommended for patients with chronic ankle instability, and the treatment programs should be determined based on comprehensive analysis of ankle anatomical structure, biomechanical characteristics, pathogenesis, and diagnostic results.

The germs on the hands of medical personnel in medical institutions have become the chief pathogens for hospital infection. These pathogens can be acquired not only from infected wounds or drainage wounds but also from normal and whole skin regions. Hand washing and disinfection is one of the most important measures for preventing hospital infection. The paper describes the definitions of hand washing, hygienic hand disinfection and surgical hand disinfection and discusses the action mechanisms, effects and features of various hand hygiene products currently in use, such as alcohol, hibitane glucose saline and hexachlorophenol. It enumerates a number of problems inhand hygiene, including low rate of hand hygiene observance on the part of medical personel, insufficient attention to hand hygiene on the part of medical institutions, reduction of germs' sensitivity to disinfectants, and the occurrence of contact dermatitis in disinfectant usage. The paper also gives an account of some of the latest strategies and countermeasures aiming at improving the status of hand hygiene, These include ways of lowering the incidence of contact dermatitis, reducing the bad effects of germicides, and raising the rate of hand hygiene observance.

Air Pollutants, Radioactive ; adverse effects ; Environmental Exposure ; adverse effects ; Humans ; Lung Neoplasms ; etiology ; genetics ; Neoplasms, Radiation-Induced ; etiology ; genetics ; Radon ; adverse effects

Objective To investigate the effect and safety of thoracic drainage by central venous catheter in critical patients with pleural effusion. Methods A prospective study was carried out,in which 46 critical patients with pleural effusion admitted to department of critical care medicine were included,and according to the types of their primary diseases to make matched pairs,and they were divided into two groups:conventional drainage control group and central venous catheter drainage observation group(each 23 cases). The drainage effect and complications were compared between the two groups,acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score, quantitative pleural effusion and the counts of white blood cells(WBC)and of platelets(PLT),the levels of prothrombin time(PT),procalcitonin(PCT)and C-reactive protein(CRP),etc. were measured on the baseline and 24 hours after the operation. Results There were no significant differences in the APACHEⅡ score,quantitative pleural effusion,amount and duration of drainage,as well as the levels of WBC,PLT,PT and PCT between group control and observation(all P>0.05). The post-drainage CRP(μg/L)level in group observation was much lower than that in group control(77.26±67.20 vs. 106.13±66.23,P<0.01). There was a trend that the incidence of complication in group control was higher than that in group observation(26.1%vs. 4.3%),but the difference was not statistically significant(P>0.05). Conclusions In the comparison between the conventional drainage and thoracic drainage with central venous catheter,the therapeutic effects for treatment of critical patients with pleural effusion were similar, but the stress was milder and the incidence of complications was lower in the latter group. Therefore,the thoracic drainage with central venous catheter is a safe,effective and alternative method to substitute the conventional drainage for critical patients with pleural effusion.

Objective To explore the effects of fibroblast transdifferentiation for myofibroblast (MFB) in the pathogenesis of systemic sclerosis (SSc) and to explore the antifibrotic mechanism of interferon γ (IFN-γ) in SSc.Methods The fibroblasts derived from the skin lesions of SSc patients and healthy adult controls were cultured in vitro and the MFB proportion in fibroblasts was examined by qualitative and quantitative α-smooth muscle actin (α-SMA) detection.By adding IFN-γ to the culture system with several doses,the influence on fibroblast proliferation and transdifferentiation for MFB in SSc was observed with MTT and enzyme linked immunosorbent assay (ELISA) respectively.Differences in the means of two independent samples were tested by Student' t-test.The means among multiple independent samples were com-pared by ANOVA.Results The means of positive α-SMA in SSc fibroblasts were higher than those in the controls (P＜0.01).With extended culture time,α-SMA levels of the two groups all increased gradually (P＜ 0.01 all),but there were higher α-SMA levels in SSc fibroblasts (24 h:130±19,48 h:183±21,72 h:249± 22) than those in controls (24 h:98±21,48 h:143±16,72 h:174±19) (P＜0.05 all).Although fibroblast proliferation and α-SMA levels were not influenced after adding of IFN-γ 10 U/ml (P＞0.05 all),but IFN-γ at concentration of 100 U/ml and 1000 U/ml could obviously repress fibroblast proliferation and α-SMA levels (P＜0.05 all),and 1000 U/ml had the strongest inhibiting effect at 24,48,72 h.Conclusion The fibroblasts in the skin of SSc patients have a strong potency to transdifferentiate to MFB.Early appropviate dose of IFN-γ could repress fibroblast proliferation and transdifferentiation in SSc.