Sepsis constitutes a serious threat to human health and represents a major burden to the health care system.Recent years have witnessed a deeper insight into the mechanism of the onset of sepsis,together with some new therapeutic strategies,including early aggressive volume therapy,activated protein C,potentiated insulin therapy,adrenal function replacement therapy,and some new therapeutic targets,which have offered some hope for the management of sepsis.

Medical English teaching plays an important part in medical college,but due to various factors of constraints,medical English teaching is still in the traditional"teacher-centered" teaching mode.The authors have carried out some research and exploration on how to construct the "student-centered" teaching mode in medical English teaching based on their own practice,and made some positive comments and suggestions.

Objective:To observe the clinical effect of moxibustion on Governor Vessel for ankylosing spondylitis (AS) due to kidney yang deficiency.
Methods:A total of 60 patients of AS due to kidney yang deficiency were randomly divided into a treatment group and a control group by random digital table, 30 cases in each group. Both of the two groups were treated by oral administration of Sulfasalazine tablets. Additionally, the treatment group was given moxibustion on Governor Vessel, and the control group was given sham moxibustion. The treatment was given once every other day, 4 weeks constituted one course, 2 courses in total. Before treatment, after 1-course and 2-course treatments, the quantified scores of traditional Chinese medicine (TCM) syndromes and the symptoms scores recommended by AS International Society [including Bath ankylosing spondylitis disease activity index (BASDAI), visual analogue scale (VAS), Bath ankylosing spondylitis functional index (BASFI) and Bath ankylosing spondylitis metrology index (BASMI)] were respectively observed and recorded, and the change of safety item was monitored.
Results:After 1-course and 2-course treatments, the quantified scores of TCM syndromes were obviously improved than those before treatment in the two groups (P<0.05), and the score was improved better in the treatment group than that in the control group (P<0.05). In comparison within the group, there were no statistical differences between the scores after 1-course treatment and 2-course treatment in the two groups (P>0.05). After 1-course treatment, the items of the symptoms scores were improved than those before treatment in the two groups (P<0.05). After 2-course treatment, the therapeutic effect was more remarkable in the treatment group, with a statistical difference between the two groups (P<0.05). During treatment, no obvious abnormality in all safety items was noticed in the two groups.
Conclusion:Moxibustion on Governor Vessel can effectively relieve the clinical symptoms of AS patients, without obvious adverse reaction.

Objective To analyse the mutation types of the NOTCH3 gene with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy(CADASIL). Methods Including 4 probands of CADASIL,10 cases of CADASIL and 4 normal members from 3 CADASIL families and 100 healthy controls were recruited. Genomic DNA was extracted from white blood cell. The amplicons were analyzed by the denaturing high-performance liquid chromatography (DHPLC) technique. The positive samples which identified by the DHPLC were sequenced to determine the specific mutation or polymorphism, respectively. Results Three heterozygous missense mutations including Cys90Arg, Arg141Cys, Cys134Tyr located in the exon3 and exon4 were found in the 4 probands and 10 cases of CADASIL among the 3 families. 15 polymorphisms were also found. 2 members individual from family 1 and 2 were found to carry the same pathological mutations as in their proband but without clinical symptoms. They were identified as preclinical patients. Conclusions Mutation detection of NOTCH3 is the molecular genetic mechanical for CADASIL. The exon3 and exon4 are possible hot mutation spots in Chinese patients. The mutation of Cys134Tyr in exon4 is a novel mutation which has not been reported previously in China.

Objective To evaluate the therapeutic effect of Du meridian moxibustion on ankylosing spondylitis (AS) of kidney yang deficiency type. Method Sixty patients with active AS of kidney yang deficiency type were randomly allocated to treatment and control groups, 30 cases each. The treatment group received Du meridian moxibustion plus oral administration of sulfasalazine tablets and the control group, sham moxibustion plus oral administration of sulfasalazine tablets. Treatment was given once every other day, four weeks as a course, for a total of two courses. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score, the Pain Visual Analogue Scale (VAS) score, the Bath Ankylosing Spondylitis Functional Index (BASFI) score and the Bath Ankylosing Spondilitis Metrology Index (BASMI) score were recorded and laboratory safety indicators were observed in the patients. Result The TCM syndrome score decreased in both treatment and control groups of AS patients at four and eight weeks of treatment (P<0.05). The therapeutic effect was significantly better in the treatment group than in the control group (P<0.05). There was no statistically significant difference in therapeutic effect between different courses (P>0.05). The BASDAI, VAS, BASFI and BASMI scores decreased in the two groups of AS patients at four weeks of treatment (P<0.05). They decreased more in the treatment group at eight weeks of treatment; there were statistically significant differences compared with the control group (P<0.05). The laboratory safety indicators were not markedly abnormal. Conclusion Du meridian moxibustion can effectively relieve the clinical symptoms and does not cause obvious adverse reactions in AS patients. It is a safe and effective way to treat AS.

Objective To investigate the expression of interleukin-17 (IL-17) and matrix metalloproteinase-9 (MMP-9) in non-small cell lung cancer (NSCLC) and their relationship with pTNM staging.Methods IL-17 and MMP-9 expressions in cancer and adjacent tissues were detected from 102 cases of NSCLC by immunohistochemistry.x2 test was used to compare the ratio of their relationship with the pTNM stage.Results IL-17,MMP-9 expression rates in NSCLC cancer were 73.53 ％ (75/102),60.78 ％ (62/102)respectively,IL-17,MMP-9 expressions in different TNM stages were statistically significant correlated (P ＜ 0.05) respectively.The expression of IL-17 and MMP-9 in NSCLC tumor tissue were related statistically (P ＜ 0.05),and adjacent tissues were not related (P ＞ 0.05).Conclusion IL-17,MMP-9 in NSCLC tissues were significant increased,both may be involved in invasion and metastasis of NSCLC,IL-17 and MMP-9 were correlated in NSCLC tumor tissue but not in adjacent tissues.

Objective To measure the effect of panax notoginseng saponins (PNS) on renal cortical tubule cell apoptosis and apoptosis-related genes in early stage after renal trauma and to investigate the protective mechanism of PNS for renal trauma.Methods Seventy-eight Wistar rats were divided into trauma group (n =36),trauma + treatment group (treatment group,n =36),normal control group (control group,n =6) according to the random number table.In treatment group,rats received intraperitoneal administration of PNS (70 mg/kg).Instead,substitute of an equal dose of isotonic saline was used for the rats in trauma and normal control groups.Trauma and treatment groups were subdivided at 1,6,12,24,36 and 48 hours posttrauma,with 6 rats per group.The kidney specimens were extracted at each time point to detect Bax expression in the cortex with immunohistochemistry and in situ hybridization histochemistry.Moreover,the positive expression of Bax was compared among groups and its variation regularity with time were detected.Results In trauma group,mRNA transcription of pro-apoptosis gene Bax increased at 12 hours in the superficial cortex,but increased at 1 hour in deep cortex; protein expression of pro-apoptosis factor Bax showed no apparent reduction within 36 hours in the superficial cortex,but evident decrease within 12 hours in the deep cortex.In treatment group,mRNA transcription of pro-apoptosis gene Bax decreased immediately after treatment in the renal cortex and lasted until 48 h; protein expression of pro-apoptosis factor Bax showed unidirectional reduction until 48 h in the renal cortex.Conclusion PNS inhibits cell apoptosis by down-regulating the mRNA and protein expression of Bax.

Objective To build clinical nursing pathway for artificial abortion operation and explore the effect of this method. Methods The nursing pathway was designed and carried out. The satisfaction degree with nursing, status of patients' awareness about contraception and artificial abortion operation was compared before and after the nursing pathway was implemented. Results Before and after the nursing pathway was implemented,the proportion of missing item of operation record was 0.636 and 0.013, the satisfaction degree with nursing was 77.0% and 92.3%, rate of patients' awareness about contraception and artificial abortion operation was 47.6% and 96.1%. Conclusions The clinical nursing pathway for artificial abortion operation may improve the degree of satisfaction- and the status of patients' awareness about contraception and artificial abortion operation, and decline the proportion of missing item of operation note, it ensures high nursing quality and safety surgery, which is worthy of popularizing.

Object To establish a process for the preparation of QINGXUE JIANGZHI CAPSULE(Hemocathartic Antilipemia Capsule)  Methods The study was carried out by uniform experimental design guided by the content of total organic acid and polysaccharide in the resulting preparation, to optimize the ratio of solvents used for the extraction, time needed for the decoction and alcoholic concentration for precipitation Results The most favorable preparative conditions were: decocting the drug twice with 10 times of water for 60 min each time, and precipitate the product at a concentration of 50% alcohol Conclusion Products prepared by this process ensured the content of total organic acid with no loss of polysaccharides