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 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 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 clarify the relationship between epidermal growth factor receptor (EGFR) mutations and the clinicopathologic features of primary lung adenocarcinomas in Xinjiang.Methods:The mutations of EGFR gene at exons 18 -21 in 59 cases (including 15 cases of Uighur and 44 cases of Han) of lung adenocarcinoma tissues,which were obtained from surgical resection,were detected by amplifica-tion refractory mutation system (ARMS)method.And the relationships among mutations,race and clini-copathologic features were analyzed.Results:The frequencies of EGFR mutations in lung adenocarcinoma were 20% for Uighur,which was lower than that in Han (54.5%),P <0.05.The deletion mutations at exon 19 were seen in 2 of 15 Uighur cases and 9 of 44 Han cases.EGFR mutations were present,inclu-ding exon 21 L858R in one Uighur case and 12 Han cases,exon 18 G719X in two of 44 cases of Han, exon 21 L861Q in one of them.On histological type,the frequencies of EGFR mutation in alveolar pre-dominant adenocarcinoma was 71% (22 /31),which was higher than both that in solid predominant and mucinous carcinoma (6.7%,20% respectively).According to statistic analysis,EGFR mutations were without correlation with the patient’s gender,age,location,gross type,smoking status and lymph node metastasis(P >0.05).EGFR mutation was more frequent in well-differentiated cancer,mainly in acinar carcinoma,while poorly differentiated adenocarcinoma and mucous adenocarcinoma were lower.Conclu-sion:There was a difference of EGFR mutation in primary lung adenocarcinoma between Uighur and Han in Xinjiang,perhaps reflecting ethnic genetic variation,which is worth further analyzing.EGFR mutation was commonly detected in well or middle differentiated adenocarcinoma,mainly in acinar carcinoma.

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.

Purpose To investigate effect of valsartan on expression of Notch pathway and production of extracellular matrix. Methods Urine protein and production of extracellular matrix were measured after diabetic mice were treated with valsartan. The levels of Jag-ged1, Notch1, Notch intracellular domain 1 (NICD1), transforming growth factor-β1 (TGF-β1), TypeⅣcollagen and Laminin were determinated by immunohistochemistry, Western blot and real-time PCR. Results Valsartan suppressed urine protein and production of extracellular matrix in diabetic mice (P<0. 05). Valsartan also inhibits overexpression of Jagged1, Notch1, NICD1, TGF-β1, Type Ⅳ collagen and Laminin in glomerular tissues of diabetic mice (P<0. 05 or P<0. 01). Conclusion Valsartan inhibits activa-tion of Notch pathway in glomerular tissues of diabetic mice, inhibits production of extracellular matrix in glomerulus and delays glomer-ulosclerosis.

Objective To explore the application of PBL (Problem - Based learning) mode in fami-ly peritoneal dialysis training to improve the teaching effects of peritoneal dialysis training. Methods The PBL mode was applied in every peritoneal dialysis training lesson, the teaching effects were evalued af-ter a lesson immediately. Results The PBL mode would be helpful to inspire patients' and their family members' interest to learn the knowledge of peritoneal dialysis training.It was also helpful in knowledge un-derstanding, knowledge mastering and establishment of treatment confidence. Conclusions The PBL mode was an important way to improve the teaching effects of peritoneal dialysis training and realize the teaching objective. It is worth applying in practice of peritoneal dialysis training.

An integrated retrieval platform for online biomedical literature citations with the functions of one-stop retrieval, automatic removal of duplications, automatic grouping, and rapid output of standard citation report, was constructed on the basis of CMCI, with the C/S structure as its model and the NET framework as its development platform, in order to solve the problems of different citation databases in our library, such as inconsistent retrieval methods, inconsistent displaying methods of retrieval outcomes, and non-standard citation description, which can thus improve the efficiency of searching and citing biomedical literature.