Sepsis is one of the most common diseases in the intensive care unit, which receives much concern because of its severe condition, high mortality rate and expensive medical costs. The definition and diagnostic criteria of sepsis are put forward in 1991 for the first time, and are widely accepted and used in clinical medicine. As the progress and development of critical care medicine and clinical pathophysiology, the definition and diagnostic criteria of sepsis are constantly updating, which is cause widely and heated discussion every time.

It has become increasingly appreciated that newborn perceive and respond to pain.For immature preterm and illness term neonates,exposing to repeated and prolonged procedure pain can not only have short-term effects,such as behavioral and physiological variation or stress hormone and pain sensitization alternation,but also can cause long-term impacts including nervous system and pain system plasticity,chronic-pain-syndrome formation,endocrine modulating interference and behavioral,cognitive or emotional disorders.Here we provide a review about the effects of neonatal pain on health of short-term and long-term,and the mechanism of pain is also involved.

Epidemiological studies indicate that obesity is associated with metabolic disorders, such as type 2 diabetes hyperlipidemia and hypertension. Early nutrition, especially during pregnancy and lactation can lead to the permanent programming of system by some adaptive effects in physiological, cellular and molecular levels. These adaptive effects persistently changed the metabolic throughout life, hence resulted in increased risk of obesity and metabolic related disease.This review focuses upon the influence of nutrition in early life on adulthood obesity and researches on their pathophysiological mechanism .

The resting energy expenditure(REE)is mainly used to maintain the normal function of body cells, organs and human awakening state,which is influenced by many factors,such as age,genders,fat distribution and endo-crines. It is important by nutrition support according to the actual REE of individuals. The prediction equation only con-siders a single factor,so it couldn't estimate accurately the energy expenditure. Indirect calorimetry is a better way to know the actual REE and limited to be used in clinics. In this review,it will clarify the different energy needs in clinical populations with more focuses on the obese,premature infant and critical patients so that clinicians can facilitate the adequate nutrition support with minimum negative impacts from under - or overfeeding in these individuals.

The recent researches of air pollution and human health in Liaoning province were summarized in the paper and some considerations for the future study on this subject were put forward, such as the technique of health-based risk assessment in special area, the model of characteristic air pollutants dose-response assessment, the does-response relationship.

Objective To evaluate the effect of community medical intervention on pulmonary function and quality of life (QOL) in the patients suffering from the chronic obstructive pulmonary disease(COPD). Methods Forty five COPD patients in Huazhong University of Science and Technology were recruited and divided into an intervention group( n =23) and a control group( n =22). For those in the intervention group, a series of medical programs were performed during a two year period, including propaganda of quitting smoke, COPD exacerbation prevention approaches, hygienical instruction and rehabilitative exercise. Those in the control were not given the above interventions. Then the pulmonary function and QOL of COPD patients in the two groups were retrospectively analyzed. Results Two years later, significant difference was revealed between the two groups in regard to the average annual decrease rates of FEV 1 and FVC, while the difference in annual decrement of FEV 1 % and FVC% was more remarkable in those with grades I and II COPD in the two groups. QOL was significantly improved in the intervention group as compared with those in the control group. Conclusion Comprehensive community interventions for COPD can improve patients' pulmonary function and their QOL.

Objective To observe the influence of dexamethasone on M1 BMDM and alveolar macrophage differentiation in respiratory syncytial virus ( RSV) infected mice.Methods Culture M1 BMDM and identify its phenotype, observe the effect of DEX on its transcription factors and cytokines; In RSV infected mice, observe the influence of DEX on the transcription factors and cytokines of alveolar macrophage.Results DEX can inhibit IL-6, IL-12, iNOS and IRF5 expression, but promote IL-10, Arginase-1 and IRF4 expression in M1 BMDM and alveolar macrophages of RSV infected mice, made M1 macrophages transform to M2 macrophages.Conclusion DEX can transform M1 macrophages to M2 macrophages in vivo and in vitro, and inhibit inflammation, this may be one of the mechanism of DEX in the treatment of RSV infection.

Objective To observe the safety and efficacy of FOLFOX4 regiment in elderly versus young patients with advanced colorectal cancer. Methods There were 61 patients enrolled in this study, with 28 elderly patients aged 70 years and over, 33 young patients aged less than 70 years.They suffered from advanced/recurrent colorectal cancer and received FOLFOX4 regiment (Oxaliplatin +CF+5-FU). Every 14 days were as a cycle, and the therapeutic safety and efficacy were evaluated after three cycles. Adverse events and response to treatment were compared between the elderly and young patients. Results The main adverse effects were myelosuppression, gastrointestinal disturbance and neurotoxicity. The incidence rate of diarrhea was significantly higher in elderly patients than in young patients, but the most of diarrhea were at grade Ⅰ - Ⅱ. The incidence rates of leucocyte decrease and neutrophil decrease were higher in elderly patients than in young patients (92. 8% vs. 78. 8%, 39.3% vs. 36.3%), but there were no statistically significant differences between them. The incidence rate of neurotoxicity was 46.5% in elderly patients and 36.4% in young patients (P＞0. 05). The recent efficacy rate was 25%, disease control rate was 71.4% and median time-to-progression (TTP) was 6 months in elderly patients and 24.2%, 84.8% and 7 months in young patients (all P＞0.05). Conclusions FOLFOX4 regiment is well-tolerated and effective in both young and elderly patients.

Background and purpose: Fumagillin is an inhibitor of type 2 methionine aminopeptidase that can block blood vessel formation. However, its molecular mechanism and therapeutic value in colon cancer still remain to be elucidated.ln this study, the effect of Fumagillin on the growth of colon cancer was examined. Methods: Twenty mice were divided into 4 groups and injected subcutaneously with 5×10~5/L WiDr or HT-29 cells in 200 μL phosphate-buffered saline (PBS) respectively. After 4 weeks, intraperitoneal injections of Fumagillin (0.1 mg/kg), Cyclo (1 mg/kg), or both were given every 2 days for 4 weeks. The tumor weight and microvessel density (MVD) were examined. Gene-expression profiles were examined by microarray analysis of human umbilical endothelial cells (HUVECs). Results: The Fumagillin-treated mice showed smaller tumor mass and lower MVD-CD105 levels than control ones. In vitro proliferation and tube formation of HUVEC was also significantly decreased by Fumagillin. Microarray analysis of Fumagillin-treated HUVECs showed up-regulation of 71 genes and down-regulation of 143 genes. Expression changes were involved in cell proliferation, migration, adhesion and gene transcription. Quantitative real time-polymerase chain reaction and Westem blot revealed decreased expression of cyclin E2, activated leukocyte cell adhesion molecule (ALCAM), and intercellular adhesion molecule-1 (ICAM-1) genes in the presence of Fumagillin. Conclusion: Fumagillin was found to suppress colorectal cancer growth by suppressing angiogenesis. The down-regulation of cyclin E2, ALCAM and ICAM-1 by fumagillin may be involved in the anti-angiogenesis.

In order to solve the problem of the basic and clinical problems in medical education,Stomatological College of Chongqing Medical University has introduced early clinical education modes through the social practice of volunteer activities since 2009.The teaching modes of Come early into department come early into department and contact early with the patients and a combination of come early into department+contact early with the patients+community dental service were performed.A total of 525 students and 120 teachers in this program were investigated,more than 70％ of the teachers believed the students were improved obviously in doctor-patient communication,clinical practice,and teamwork spirit.Most of teachers and students approved of a combination of come early into department+contact early with the patients+community dental service,which is worth popularizing.