Sepsis refers to the infection caused by systemic inflammatory response syndrome.Sepsis is one of the leading causes of death in critically ill patients in the ICU and its morbidity and mortality are increasing year by year globally.According to statistics,in China,the incidence of sepsis in ICU is 8.68％ and the mortality rate can be as high as 44.7％,therefore,severe sepsis in the field of medicine to become one of the problems to be overcome.MicroRNAs (miRNAs) play an important role in the pathogenesis of sepsis through the TLRs / NF-κB signaling pathways,which play an important role in immune regulation.In this review,the progress of miRNAs involved in TLRs signaling pathway in sepsis is reviewed.

Objective To observe and compare the efficacy and safety between propofol-fentanyl and propo- fol-ketamine for anesthesia of artificial abortion.Methods 450 ASA physical statusⅠandⅡpatients scheduled for elective artificial abortion were randomized into three groups:P group were given intravenous normal saline 2ml be- fore propofol(n=150) ;PF group were given intravenous fentanyl 1?g/kg then propofol(n=150);PK group were given intravenous ketamine 0.4mg/kg then propofol(n=150).Total dose of propofol,extinction time of lash reflex, heart rate(HR),mean arterial pressure(MAP),pulse oxygen saturation(SpO_2),time to open the eye when called, time of full recovery(answering correctly and walking unaided),discomfort,awareness during operation,self-feeling were recorded.Analysis of date was with SPSS 12.0.P＜0.05 was considered significant.Results No episodes of nausea,vomiting,cardio-cerebral syndrome or awareness were noted in all patients;Total dose of propofol,and extinc- tion time of lash reflex in P group were significantly more than those in PK or PF group(P＜0.05),but there was no difference between PK and PF group;MAP,minimum HR and SpO_2 during operation were obviously lower than preoperation or postoperation in those in P or PF group,minimum HR and SpO_2 during operation in P group were significantly lower than in PF or PK group;Minimum HR and SpO_2 during operation in PK group were lower than preoperation,but its decrease extent was less than that in P or PF group(P＜0.05);Time to eye opening in PF or PK group was significantly less than that in P group(P＜0.05);Time to full recovery were not different in three groups;Incidence of pain on injection in PF group(10%)or PK group(8%)was obviously lower than P group (80%);Incidence of coughing and moving during operation in PF group(8%)or PK group(6%)was obviously less than P group(30%);No difference were noted with respect to degree of comfort,time of full recovery,bleeding vol- ume during operation,time to operation.Conclusion Painless artificial abortion can be preformed effectively and safely with propofol-fentanyl or propofol-ketamine,propofol-ketamine especially fits for painless artificial abortion compared with propofol-fantanyl.

Citrus aurantium is one of the most common traditional Chinese medicines. In this paper, the chemical components, content determination and pharmacological actions of C. aurantium were summarized for the comprehensive utilization of its resources. Because of the complicated resources of C. aurantium, only one single component as index couldn't reflect the quality and effects and comprehensive evaluation which concluding multiple components should be established in the future quality control. In recent years, the pharmacological effects research of C. aurantium has made tremendous progress, and it is important to explore new drugs from the development and utilization of the active ingredient of C. aurantium. In recent years, the pharmacological effects research of C. aurantium has made tremendous progress, and it is important to explore new drugs from the development and utilization of the active ingredient of C. aurantium.
Citrus ; chemistry ; Medicine, Chinese Traditional ; Plant Extracts ; pharmacology

Objective To analyze the evolution of acetabular morphology changes of different Crowe types among adults with developmental dysplasia of the hip through standard hip 3D CT reconstruction.Methods From June 2010 to January 2013,there were 62 patients with 68 hips (8 hips of 6 male cases,56 female cases of 60 hips) diagnosed as acetabular dysplasia in our hospital,with an average age of 53.7±5.8 years old (range,47-59 years).According to Crowe classification,there were 14 cases (17 hips) of Crowe type Ⅰ,17 cases (17 hips) of Crowe type Ⅱ,15 cases (17 hips) of Crowe type Ⅲ,and 16 cases (17 hips) of Crowe type Ⅳ.Through standard hip 3D CT reconstruction,Harris nest in the pelvic side 3D image was marked,and the coronal and horizontal position of acetabular rotation center was determined by using the cross axis; secondly,in the anteroposterior 3D image (by gray level adjustment to the shape of X ray perspective effect) through Ranwant triangulation,sagittal position of the center of rotation of the hip joint was determined; finally,the acetabular rotation center in the acetabular horizontal reconstruction plane.The bone stock of anterior and posterior columns of acetabular was observed and acetabular anteversion,front cover angle,rear cover angle and medial wall thickness were measured.Results 1) With Crowe type increased,acetabular anteversion angle gradually increased as well,and there was a positive correlation between them with statistically significant (P＜0.05) except in Crowe Ⅰ and Ⅱ group.2) With Crowe type increased,anterior acetabular coverage angle was significantly decreased; the mean anterior acetabular coverage angle of Crowe Ⅲ and Ⅳ groups was less than 50°.3) With Crowe type increased,posterior acetabular coverage angle was decreased significantly as well the mean posterior acetabular coverage angle of Crowe Ⅲ and Ⅳ groups was less than 90°.4) With Crowe type increased,acetabular medial wall thickness was increased significantly.Conclusion Adult acetabular morphology changes between different Crowe types in patients with developmental dysplasia of the hip.For acetabular reconstruction of Crowe Ⅰ and Ⅱ,we could make full use of the acetabular bone stock of anterior and posterior column; for acetabular reconstruction of Crowe Ⅲ and Ⅳ,we could moderately shift the acetabular center superiorly and (or) medially.

10.3969/j.issn.2095-4344.2013.25.007

Objective To investigate and compare the argumentativeness and attitudes towards thinking and learning between clinical nurses in general adult wards and wards for patients requiring particularity healthcare for the identification and development of core communication skills.Mettods “Argumentativeness Scale” and “Attitudes toward Thinking and Learning Survey” in Chinese were used to measure a convenience sample of 504 clinical nurses in seven hospitals.Results The scores in items reflecting rationality,positivism,empathy and acceptance in 247 nurses in wards for particularity heahhcare were significantly different from those nurses working in internal medical wards for adults with internal medical problems.Conclusions To develop harmonious interpersonal relationships in nurses,we should strengthen competencies in emotional regulation and rational thinking in nurses in wards for adults with in-ternal medical problems.

Objective:To study the expression levels of nuclear factor kappa B, Bcl-2 associated K and TNF-αproteins to discuss the effects of NF-κB and Bak proteins in the pathogenesis of UC.Methods:Eighty clean grade of adult Sprague-Dawley( SD) rats were used,male and female in half and then rando mly selected sixty as the model group,another twenty as the control group.SD rats model were manufactured by a compound method:Trinitrobenzene sulfonic acid ( TNBS )+ethanol.We observed and assessed colonic mucosa by the general morphology and histological changes.To applicated immunohistochemistry and RT-PCR methods to detected the protein and mRNA expression levels of NF-κB,Bak and TNF-αin the model groups and the control group and to analysed their relationships.Results:The successful rate of making model was 97%.The number of inflammatory cells in the model groups more than the control(P<0.01).Group immunohistochemical and RT-PCR,NF-κB and TNF-αproteins and mRNA in UC colon epithelium cells and inflammatory cells were higher than the control(P<0.01).Bak protein in inflammatory cells were lower than the control(P<0.01),but there was no statistical significance in epithelial cells(P>0.05).The expression levels of NF-κB,TNF-αincreased as the histological grade increased(P<0.05),however,the expression level of Bak decreased(P<0.05).NF-κB in colonic mucosa of rats with UC had a significantly positive correlation with that of TNF-α(r=0.892,P<0.01),and negatively correlated with that of Bak(r=-0.793,P<0.01).Conclusion:The levels of NF-κB and Bak may be related to the occurrence and development of UC.

Objective To report the clinical features a nd pathologic findings of 1 case of mixed epithelial and stromal tumor of the ki dney. Methods The patient who had a 20-year history of taking oral contraceptive was a 50-year-old woman with pain in left flank asso ciated with hematuria for half a year.CT and MRI revealed an 8 cm?6 cm cystic a nd solid mass located in the upper pole of the left kidney.A diagnosis of cystic renal carcinoma was made before operation.Radical left nephrectomy was performe d in July 2004. Results The upper pole of the left kidne y was found severely adhesive with peripheral tissues du- ring operation.Gro ssly,the tumor exhibited a 7.9 cm?8.9 cm?9.0 cm multilocular cyst full of coff ee- colored mucoid fluid with varying size ranging from 0.5 to 2.0 cm.Focall y thick-walled cysts with solid areas were seen.Microscopic findings showed the tumor was composed of a mixture of stromal elements formed by spindle cells and epithelial elements that were variable in cell types including cuboidal,columna r and hobnail cells.Differentiation of gastrointestinal tract was found in epith elial elements.Thick-walled blood vessels and distinctive bands of smooth muscl e cells were present in the stromal elements.Immunohistochemical staining reveal ed that the epithelial component was positive for AE1/AE3,and stromal component was positive for ER,PR,and SMA.No specific treatment was given and the patient w as free of signs of recurrence 8 months after operation. Conclusions Mixed epithelial and stromal tumor of the kidney is recognized to b e a kind of benign neoplasm.Differentiation of gastrointestinal tract in epithel ial elements is rare.It should be distinguished from any other benign and malign ant tumors in the kidney.

Evidence has indicated that low doses of anti-tumor regimens can induce cell apoptosis in vitro, although different regimens induce apoptosis by different mechanism and pathway. In recent years, new tumor treatment strategy has been mainly focused on inducing tumor cell apoptosis. The present review discusses the advantages and disadvantages of inducing tumor cell apoptosis. The benefit of inducing apoptosis is not to cause inflammatory reaction, but as its disadvantage, it inhibits immune responses, and the phagocytosis of apopotic bodies may result in horizontal transfer of genes (including oncogenes and other oncogenic materials), which can be one of the causes of tumor relapse. This paper proposes that the tumor treatment strategy should be turn into promoting tumor cell necrosis and inducing anti-tumor immune responses.
Antineoplastic Agents ; therapeutic use ; Apoptosis ; drug effects ; Humans ; Necrosis ; chemically induced ; Neoplasms ; drug therapy ; immunology ; pathology

Adult ; Female ; Humans ; Male ; Occupational Diseases ; Organometallic Compounds ; poisoning