Sepsis,a common clinical syndrome,comparing to septicaemia or bacteremia,has a more comprehensive pathophysiological process.Its pathogenesis is complex,including pro-inflammatory/anti-inflammatory cytokine imbalance,intestinal bacterial translocation,immunosuppression,signal pathway activation,etc.Further study on the pathogenesis of sepsis is the theory foundation to explore the new method of sepsis.The diagnosis of sepsis pathogenesis,treatment principles and common virus infection induced sepsis are reviewed in this paper.

Obesity is a major risk factor for the generation and development of diabetes, atherosclerosis, hyperlipidemia and cancer. Obesity is accompanied with remodeling of adipose tis-sue, such as changed cell component and function, angiogene-sis, extracellular matrix remodeling and infiltration of inflamma-tory cells. It is important for the prevention of obesity to study adipose tissue remodeling. This review summarizes recent ad-vances in adipose tissue remodeling.

JCBI is a glioma eell line established in our department. JCBI cells spontaneously produce a factor inhibiting blastogenic responses of mouse thymocytes and the IL-2 dependent T cell growth of mouse spleen lymphoblast, without inhibiting spontaneous proliferation of mouse thymocytes. The inhibiting activity is high after 72 hours of passage. Physicochemical characterization shows that the factor is nondialyzable. partially inactivated at 37℃ 48 hours and almost inactivated at 56℃ 30 min. But the factor is stable at 4℃ for 2 weeks and in freeze-thawing. The molecular weight of the factor is approximately 10 kd as estimated by gel filtration. The factor may contribute to the impaired immunosurveillance and to the cellular immunodeficiency state in the patients.

During 1920-30s,under the push of Kuomintang,Communist Party and social personage,the Chinese village launched a cooperation movement. Although they failed to renew rural areas in China,the farmer autonomy spirit, policy practicality,the educational principles,and the spirit of evidence-based demonstration research embodied in the movement still have an enlightening significance to the construction of the new rural cooperative healthcare system and construction of new-type villages.

Objective To analyze the concentration changes of serum hypoxia stress peptide (HSP)and plasma nitrogen monoxidum(NO)in the entering mountain rapidly man and to explore the importance of HSP and NO in adaptation of man to altitude hypoxia.Methods The levels of serum HSP and plasma NO2-/NO3-were measured from 106 entering mountain rapidly men,105 altitude in habitant,105 altitude immigrant and 104 plain healthy controls,respectively by chromatometry and NO2-/NO3-reagent.Furthermore,the content of serum HSP was determined in 106 entering mountain rapidly men,respectively at the time of 24 h,48 h,76 h,l week and 1 month after entering mountain.Results The level of serum HSP was significantly higher in entering mountain rapidly men than in habitant,immigrant and plain controls(P＜0.05),while there was no statistical difference between in habitant,immigrant and plain controls(P＞0.05).At 24h after entering mountain rapidly,the level of serum HSP was significantly increased and reached the peak.At 48h and 76h,it was slightly decreased,but still maintained a high level.At 1 week and 1 month,it gradually and significantly went down,but was still significantly higher than that in plain controls.Similarly,the level of plasma NO2-/NO3-was significantly elevated in entering mountain rapidly man,compared with inhabitant,immigrant and plain controls(P＜0.05).It was lower in inhabitants and immigrants than plain controls,but the difference was not statistically significant(P＞0.05).Conclusion The present results demonstrated that the levels of serum HSP and plasma NO were significantly up-regulated in healthy adults after en tcring mountain rapidly in order to adapt to altitude stress,and restored gradually to the normal level as time went by.

ObjectiveTo evaluate the application effect of clinical pathways in hospitalized inguinal hernia patients by using the Meta- analysis. MethodsPublished randomized controlled trials (RCT)in hospitalized inguinal hernia patients were searched and screened in CNKI、VIP、CBMdisc and Wanfang datebase under present standards.The quality of the included studies were evaluated and statistically analyzed by RevMan5.0 software. ResultsTotally 16 literatures including 1649 cases were eligible to the criteria (816 in clinical nursing pathways group and 833 in the traditional health education group)altogether.The Meta-analysis showed there were significant difference between the clinical pathway group and the traditional health education group in grasp of health knowledge,rate of patients,satisfaction degree,length of hospital stay and hospitalization expenses. ConclusionsClinical pathways is superior compared with the traditional health education for hospitalized inguinal hernia patients.

BACKGROUND:Chronic ankle instability affects normal life severely. Therefore, chronic ankle instability causes more and more attention of experts, and choice of reasonable and effective diagnosis and targeted treatment method for chronic ankle instability in early stage has become an important issue in the clinic.
OBJECTIVE:To review literature research on the diagnosis and treatment of chronic ankle instability in recent years, and to provide reference and evaluation criteria for the diagnosis and reasonable and effective treatment of chronic ankle instability in clinical practice.
METHODS:We searched PubMed database, China National Knowledge Infrastructure, Wanfang database and VIP database for clinical and basic experimental research on chronic ankle instability. Keywords were“chronic ankle, instability, diagnosis, rehabilitation exercises, surgery methods, research progress”in Chinese and“chronic ankle, instability, diagnosis, rehabilitation exercises, surgical methods, research”in English. Total y 40 literatures were analyzed.
RESULTS AND CONCLUSION:Because of the special anatomical features and biomechanical advantages of the ankle, we should first consider the early diagnosis and effective treatment in chronic ankle instability patients. The treatment should focus on the anatomic characteristics, biomechanic characteristics, etiology of chronic ankle and diagnostic methods of the ankle joint. Conservative treatment and rehabilitation exercises after surgery play a major role in the recovery of chronic ankle instability. The use of balance board, tilting board, and climbing machines is an effective rehabilitation exercises for chronic ankle instability. The application of AOFOS-hind foot and ankle fibula reaction time is important for the assessment of functional recovery of the ankle joint. The emergence of arthroscope is an important clinical research direction of ankle surgery. This plays a significant effect on the treatment of chronic ankle instability.

Objective To screen the prevalence of nutritional risk in cirrhotic inpatients by Nutritional Risk Screening 2002 (NRS 2002) and explore the relationship between nutritional risks and outcomes.Methods NRS 2002 was used to identify the nutritional risk of 200 cirrhotic inpatients between May 2010 and May 2011.The Child-Turcotte-Pugh (CTP) grade,fatality,complications,and length of stay within 6 months were followed up to explore the relationship between nutritional risks and outcomes.Results The prevalence of nutritional risk screened by NRS 2002 was 53.5％ in cirrhotic patients.The prevalence of nutritional risk was 39.0％,59.4％,and 60.0％ respectively in patients with CTP grade A,B,and C (P =0.029).Compared with those without nutritional risks,patients with nutritional risks had significantly higher incidences of complications and fatality (P =0.000 and 0.013) and longer hospital stay (P =0.001).Conclusion The nutritional risk increases along with the CTP grade.Patients with nutritional risks tend to have poorer outcomes.The influence of nutrition support on the outcome of patients with liver diseases needs further research.

Objective Statistics and analyze the effect of comprehensive prevention measures for the ventilator associated pneumonia (VAP) morbidity and mortality,and investigate its actual applicate situation in the clinical.Methods Statistics and analyze the clinical date of 183 cases of our ICU mechanical ventilation patients in 2012 (group A),including morbidity,mortality,time of endotracheal intubation,length of stay and the primary pathogenic bacteria,and to compared with the relevant clinical data of 192 cases of our ICU mechanical ventilation patients in 2011 (group B),summarize and analysis the actual applicate situation of the comprehensive prevention measures in the clinical through the data contrast.Results The incidence of VAP in group A was lower than that in group B [31.7％(58/183) vs.58.3％(112/192)] (P ＜ 0.05),but the mortality was no statistical difference in both groups (P ＞ 0.05) ; the endotracheal intubation time and the average length of stay in group A were less than those in group B [6.3 d vs.10.6 d,7.6 d vs.11.9 d](P＜0.05); the main pathogenic bacterium of VAP with mainly gram-negative bacilh.Conclusions Comprehensive prevention measures can effectively reduce the incidence of VAP,but the mortality rate has no significant effect,need further clinical research;comprehensive prevention measures to reduce patients with tube time also confirm its effectiveness.Comprehensive prevention measures are economical and practical,is worth in clinical promotion.

Objective To investigate the efficacy and safety of combination use of diltiazem and nitroglycerin in preventing radial artery spasm in performing coronary angiography via radial artery access. Methods During the period from Dec. 2012 to June 2013 at authors’ hospital, coronary angiography via radial artery access was carried out in a total of 200 patients. The patients were randomly divided into 2 groups: nitroglycerin group (n = 100) and combination group (n = 100). After successful placement of catheter sheath 200 μg of nitroglycerin was injected through the sheath in the patients of the nitroglycerin group, while 200 μg of nitroglycerin together with 2 mg diltiazem was injected through the sheath in the patients of the combination group. The heart rate , blood pressure and electrocardiogram were recorded with an electrocardio-pressure monitor before the injection as well as at 2, 5, 15 and 30 minutes after the injection. The occurrence of radial artery spasm and patient ’s general condition were also under observation. Results Radial artery spasm occurred in 5 patients of the combination group , while it occurred in 13 patients of the nitroglycerin group, the difference between the two groups was statistically significant (P < 0.05). No significant difference in heart rate and electrocardiogram existed between the two groups (P > 0.05). Conclusion For the coronary intervention via radial artery access , combination use of diltiazem and nitroglycerin can more effectively prevent the occurrence of radial artery spasm. Besides , combination use of diltiazem and nitroglycerin has no obvious effect on the heart rate , the blood pressure and the electrocardiogram.