Protein kinase C (PKC) is a serine/threonine kinase, which plays an important role in cell proliferation, differentiation and apoptosis. The activation of PKC has closely correlation to tumorigenesis, development and metastasis. Activation of PKC is one of key link in the cell signal transduction passway, which mediated cellular signals, participated expression of genes, and influenced cell cycles. Therefore, delivering drugs based on anti-cell information may provide a broaden prospect for anti-tumor therapy.

Endemic arsenicosis is a disease with complex systemic damage,but the mechanism and its control strategy are mostly focused on a single organ or system damage caused by arsenic,and the systemic damage of arsenic exposure remains not fully understood.In recent years,considerable progress has been made in the field of immunology,which made an important contribution for the pathogenic mechanism of various complex diseases,and also brings a new dawn for its prevention and treatment.In consequence,a breakthrough progress is expected to make in aspects of the mechanism and its control strategy of arsenic caused systemic damage from the perspective of immunology.

Endemic arsenicosis is one of the national key endemic diseases in our country. However, due to obscure mechanism of arsenic poisoning, lack of early diagnostic indicators and specific validated therapy, the ideal control of endemic arsenicosis has not yet been obtained. To date, considerable progress has been made to address endemic arsenic poising and also formed various hypotheses, whereas simultaneously there are some problems and the insufficiency such as unclear relationship among those hypotheses and the gap between mechanism studies and translational application. In consequence, enhancing the interactive effects among various mechanisms of arsenic poising and improving its translational application could have more realistic significance for scientific prevention and control of endemic arsenicosis.

Objective To investigate the etiology and perinatal outcome of pregnancies complicated with extremely severe thrombocytopenia [ at least two times of platelets count (PLT) < 10 × 109/L during pregnancy]. Methods Clinical data, including basic information, etiology, management and outcomes of pregnant women with extremely severe thrombocytopenia, admitted to Peking University People's Hospital from January 2004 to March 2009, were retrospectively collected. The management of these cases varied according to different etiology and the symptoms: (1) PLT were maitained > 20 × 109/L and hemoglobulin> 70 g/L in those women without spontaneous bleeding; (2) PLT transfusion would be required when PLT< 10 × 109/L or bleeding occur and RBC would be supplied when hematocrit <25% and hemoglobulin <70g/L; (3) Hemoglobulin should be > 70 g/L and PLT >30 × 109/L before cesarean section or delivery;(4) Predinisone and/or intravenous immunoglobulin G (IVIG) would be given in women complicated with idiopathic thrombocytopenic purpura (ITP) when PLT < (20-30) × 109/L or bleeding. PLT would be given if all the above management were failed, or PLT < 10 × 109/L, or bleeding. Women without bleeding would be closely monitored and delivery would be planned. Results (1) Twenty-six cases were identified among 9302 deliveries during the study period (0.28%), with an average of maternal age of 29. Seventeen were diagnosed before conception and 9 during pregnancy. Among the 26 women, half received regular prenatal check in our hospital and the average gestations at diagnosis was 24 weeks and the other half without regular prenatal visits and the average gestations at diagnosis was 32 weeks. Etiology was identified in 24 out of the 26 women, including 14(54%) ITP, 5 myelodysplastic syndrome (MDS), 4 chronic aplastic anaemia(CAA) and 1 systemic lupus erythematosus (SLE). (2) Management: All of the 26 women received blood products. Among the 14 ITP cases, 6 received predinisone and IVIG and 8 only took predinisone. Nine of the 26 patients (35%) had pregnant complications, among which 6 (6/9) were preeclampsia. The overall average gestation at delivery was 36 weeks. Only 2 delivered vaginally with the average blood loss of 83 ml and 23 cesarean sections were performed with the average blood loss of 410 ml. (3) Perinatal outcomes:There were 26 perinatal babies, among which 1 died intrauterine and 25 were born alive (12 preterm infants). The average birth weight was 2877 g. Neonatal severe thrombocytopenia presented in 2 newborns whose mother complicated with ITP. Conclusions The main cause of extremely severe thrombocytopenia during pregnancy is ITP, managed mainly by predinisone and IVIG, followed by CAA and MDS, which may require supportive treatment. Pregnancy complicated with extremely severe thrombocytopenia is not an indication of termination. Better maternal and fetal outcomes can be achieved through proper treatment based on the etiology, intensive care in prevention and management of complications and cesarean section.

Chronic cerebral hypoperfusion (CCH) may result in neurovascular unit (NVU) injury,causing cognitive impairment.The NVU consists of neurons,glial cells,vascular cells and extracellular matrix.The damage of NVU can induce the blood-brain barrier dysfunction,abnormal cell signaling,as well as cognitive impairment.However,its molecular mechanism is unclear.Thus,investigating the role of NUV in CCH-induced cognitive impairment may provide a theoretical basis for the novel treatment of cognitive impairment.

Objective To investigate the changes of antibiotic resistance and its correlations with antibiotics use density (AUD) in intensive care unit (ICU) after implementation of antimicrobial stewardship. Methods Data on AUDs and synchronous antibiotic resistance in ICU of the Affiliated Hospital of Taishan Medical University during 2010 and 2014 were retrospectively reviewed.Autoregressive integrated moving average ( ARIMA) model was used to identify the correlation between AUDs and antibiotic resistance.Results The total AUD which stood at 163.46 DDDs· 100 person-1 · d-1 in the year 2010 decreased to 68.20 DDDs · 100 person-1 · d-1 in 2014, and the most significant decreases were found in quinolones, imidazole, carbapenems, aminoglycosides, other beta lactam and macrolides. Synchronously, a wide range of improvements in antibiotic resistance of major pathogens were also observed from 2010 to 2014, and the improvements were positively correlated with the decrease of AUDs.However, antibiotic resistance in 2014 was not significantly improved compared with that in 2013. The rate of ciprofloxacin resistance in Pseudomonas aeruginosa and the resistant rates of amikacin, imipenem, and meropenem in Acinetobacter baumannii even increased in 2014.Conclusions With the implementation of antimicrobial stewardship, antibiotic consumption in ICU was decreasing, and antibiotic resistance rate in major pathogenic bacteria was decreasing.But the rebound in antibiotic resistance in some types of bacteria was also observed and should be put on enough caution.

BACKGROUND:Sports-induced cartilage injury is very common; due to the poor self-healing capacity of the cartilage, cartilage repair has always been a difficult problem.
OBJECTIVE: To review the features of different seed cels in tissue-engineered cartilage construction and to explore the application of tissue-engineered cartilage construction in the repair of sports-induced cartilage injuryin vitro.
METHODS:We searched PubMed database, Wanfang database and CNKI database for articles related to tissue-engineered cartilage repair of sports-induced cartilage injuries, as wel as stem cels and scaffold materials used in tissue-engineered cartilage construction. Totaly 190 articles were retrieved, and finaly 47 articles were included in result analysis after repetitive studies were excluded.
RESULTS AND CONCLUSION: Bone marrow mesenchymal stem cels under different conditions can differentiate into chondrocytes, and have better potential of chondrogenic differentiation compared with adipose-derived mesenchymal stem cels and umbilical cord-derived mesenchymal stem cels. But, their safety stil needs to be further studied. Good scaffolds cannot only induce stem cel differentiation, but also be the key to cartilage construction. Composite materials are the future direction of the scaffold research.

BACKGROUND:A variety of cel growth factors are involved in skeletal muscle regeneration; moreover, these factors cooperate with each other to promote muscle repair and regeneration. OBJECTIVE:To explore the synergy mechanism of a variety of cel growth factors in promoting damage repair. METHODS:By using literature survey, Wanfang, CNKI and PubMed databases were searched for articles related to exercise-induced muscle damage and repair using the keywords of “cel growth factor; skeletal muscle damage;repair; fibroblast growth factor” in Chinese and English, respectively. Research achievements related to exercise-induced muscle damage, molecular biological characteristics of cel growth factors and skeletal muscle injury repair are discussed. RESULTS AND CONCLUSION: Basic fibroblast growth factor plays a basic biological role to promote cel proliferation and angiogenesis, which is the strongest cytokine known to promote cel growth and reflects a very important role in skeletal muscle repair. Epidermal growth factor is synthesized by monocytes and ectodermal cels, which is prominent to stimulate the division and proliferation of a variety of tissues and cels, enhance cel movement, division and synthesis of interstitial protein. Insulin-like growth factors are a family of insulin-like growth factor 1-related and insulin-like growth factor 2-related peptides, which can promote muscle protein synthesis, promote muscle cel proliferation and differentiation, and participate in skeletal muscle regeneration and repair, thereby accelerating wound healing of the muscles. Neurotrophic factor is a kind of trace soluble substances around sensory neurons and produced by neuron-targeted cels, which can specificaly promote neuronal growth and maintenance, and promote skeletal muscle repair. But studies on the synergy mechanism of a variety of cel growth factors in the repair of exercise-induced muscle damage are just at the initial stage, and further research is necessary.

BACKGROUND:The artificial joint has gone through nearly a century of history from the beginning of design to the clinical application. The forerunner of artificial joints is artificial hip joint. With the skiled technological application in clinic, the design, application and improvement of wrist, shoulder, knee and other artificial joints have been promoted. OBJECTIVE: To summarize the application progress and performance characteristics of artificial joint materials in exercise-induced articular cartilage injury. METHODS: PubMed (http://www.ncbi.nlm.nih.gov/PubMed), Wanfang database (http://wanfangdata.com.cn/) and China National Knowledge Infrastructure (http://www.cnki.net/) during 1980 to 2015 were retrieved by the first author. “Sports; Cartilage Injury; Artificial Joint” were taken as the key words in English and Chinese, respectively. Retrieved data were analyzed and summarized. The artificial joint materials commonly used at home and abroad were introduced and analyzed one by one. The clinical advantages and disadvantages of various materials were analyzed from the view of materials science. The surface treatment methods commonly used for artificial joints were described. The direction of the artificial joint research was pointed out from a development perspective. RESULTS AND CONCLUSION:The surface modification of titanium aloys can obtain surface ceramic layer with good performance, and can effectively improve the anti-wear properties of titanium aloys. The filing and modification of ultra-high molecular weight polyethylene can obtain joint composites with good anti-wear properties that can effectively reduce the production of ultra-high molecular weight polyethylene wear particles and the biological response induced by ultra-high molecular weight polyethylene wear particles. Further research and improvement of ceramic artificial joints wil be the future direction of development of artificial joints.

Objective To observed the analgesia and adverse reactions of continuous patients-controlled in-terscalene analgesia with patient-controlled intravenous analgesia for the shoulder arthroscopic surgery.Methods 40 patients with ASA Ⅰ ~Ⅱ anesthesia in general anesthesia for the shoulder arthroscopic surgery were selected and randomly divided into the two groups,20 cases in each group.They were continuous patients-controlled interscalene analgesia(PCNA)and patient-controlled intravenous analgesia (PCA).PCNA with 0.2% ropivacaine +saline to 100mL,background parameters 4ml/h,a single dose of 0.5mL,lock 20min.24 hours after dosing.PCA with fentanyl lmg +tropisetron 5mg +saline to 100mL,background parameters 2mL/h,a single dose of 3.5mL,lock 20min.Record the VAS score 6h,12h,24h,48h after surgery,and adverse side effects of postoperative dizziness,nausea,vomiting and itchy skin.And the patient's analgesic satisfaction survey 48h after surgery.Results PCNA after surgery 6h,12h, 24h,48h in VAS score was significantly lower than the PCA(P <0.05).PCNA were dizziness,nausea,vomiting and the incidence is lower than the PCA,the difference was statistically significant(P <0.05).The PCNA of patients sat-isfaction was 100%,the PCA of patients satisfaction is 75%,the difference was statistically significant(P <0.05). Conclusion In the postoperative analgesia of shoulder arthroscopic surgery,the analgesic effect and patient satisfac-tion of continuous patients-controlled interscalene analgesia are better than patient-controlled intravenous analgesia. And the dizziness,nausea,vomiting is lower.