The Janus kinase/signal transducer and activator of transcription (JAK/STAT) are a major signal transduction pathway in controlling and regulating a number of cytokine-mediated responses, including interferon-?, interleukin-1 (IL-1), IL-6, IL-10 and IL-4. The JAK/STAT pathway is particularly elegant because of its very rapid and simple cytoplasm-to-nucleus signaling. Recently, it has been found that JAK/STAT pathway might also be involved in the regulation of high mobility group box-1 protein (HMGB1), which plays an important role as a potential late mediator of sepsis. Inhibition of the activation of JAK/STAT pathway can down-regulate the gene expression of HMGB1 in vital organs, especially in the liver and lungs. In addition, treatment with JAK/STAT pathway inhibitors can effectively prevent the occurrence and development of multiple organ dysfunction syndrome following sepsis, and the probable underlying mechanism of which involves a reduction of direct or indirect harmful effect of HMGB1. Over the past few years, numerous investigations have contributed to our knowledge of the JAK/STAT pathway and its role in cytokine-mediated abnormality of immune function as well as inflammatory response during sepsis, and it might be helpful in further identifying a potential strategy of intervention for posttraumatic or postburn sepsis. This review summarizes the salient features of JAK/STAT pathway and focuses on the pathophysiological role of JAK/STAT in regulating proinflammatory cytokine activity and HMGB1 expression in vivo.

The present study was performed to investigate the significance and potential role of signal transducers and activators of transcription 3 (STAT3) activation in postburn Staphylococcus aureus sepsis. Seventy one male Wistar rats were randomly divided into five groups: normal controls, scald control group, postburn sepsis group, AG490 (JAK2 inhibitor) treatment group, and rapamycin (RPM, STAT3 inhibitor) treatment group. Tissue samples from the liver and lung were collected to determine activation of STAT3, and interferon ? (IFN ?) mRNA as well as protein expression. The results showed that activation of STAT3 was quickly up regulated at 0 5～1 hour following thermal injury combined with Staphylococcus aureus challenge in the liver and lung, and it gradually weakened after 2 hours. Treatment with AG490 or RPM could inhibit activation of STAT3 at 0 5 hour in the liver and lung. Meanwhile, IFN ? mRNA expression markedly declined at 2 hours after treatment with AG490 or RPM in the liver and RPM in the lung ( P

Objective To investigate the effects of inhibition of nuclear factor-kappa B (NF-?B) by pyrrolidine dithiocarbamate (PDTC) on tissue pro- and anti-inflammatory cytokine expression in rats with postburn Staphylococcus aureus sepsis and its potential regulating mechanism. Methods Thirty-four male Wistar rats were randomly divided into normal control group (n=6), scald control group (n=6), postburn sepsis group (n=12),and PDTC treatment group (n=10). Tissue samples from the liver, kidneys and lungs were collected to determine tumor necrosis factor-? (TNF-?) and interleukin-10 (IL-10) mRNA expression as well as their protein levels. Results Both TNF-? mRNA and protein expressions in the liver, kidneys and lungs of postburn septic animals were up-regulated rapidly at 0.5-2 hours (P

Objective To investigate the effect of rapamycin(RPM)on hepatic interleukin-10(IL-10)gene and acute liver injury in rats with postburn Staphylococcus aureus sepsis.Methods Fifty male Wistar rats were randomly divided into four groups:normal control group,scald control group,postburn sepsis group,and RPM treatment group.Tissue samples from liver and plasma were collected to determine IL-10 mRNA and protein expressions,and liver function parameters were also measured.Results Compared to postburn Staphylococcus aureus sepsis group,in RPM treatment group hepatic IL-10 mRNA expression and plasma IL-10 were significantly increased at 0.5 hour after RPM treatment(P

Objective To investigate the effects of clinical pharmacist intervention in the clinical application of antibiotics combined with the index management.Methods The data of antibiotics usage rate and intensity, the microbial test sample submission rate, and the clean incision preventive usage rate of inpatients and outpatients were analyzed by chi-square test in the same period before (2015) and after (2016) the clinical pharmacist intervention.Results After intervention, the antibiotics usage rate of inpatients and outpatients were lower than that of 2015 (50.02% and 25.72%, P<0.05).In 2016, the usage intensity of antibiotics was 50.59%, while it was 62.39% in 2015.At the same time, the microbial test sample submission rate increased from 13.96% to 27.49%(P<0.05).In 2016, the clean operation preventive usage rate of antibiotics decreased month by month.In the meantime, the reasonable rate of delivery timing, variety selection, and administration time of clean operation preventive usage of antibiotics were on the rise.Conclusions The professional intervention of clinical pharmacistis benefit for the routine, standardization, and professionalization of clinical antibiotics application.It also promotes the rational use of drugs and the progress of hospital pharmacy.

Objective To evaluate the effects of anterior approach preperitoneal repair for inguinal hernia with modified Kugel mesh.Methods Clinical data of 35 cases receiving inguinal hernia repair with modified Kugel mesh from May 2004 to June 2006 were reviewed.The critical surgical procedures:the hernial sac was dissected at high position,then reversed and reduced into abdominal cavity;a 10 cm?10 cm preperitoneal space was dissociated around the internal ring,into which a modified Kugel mesh was placed.The mesh was fixed to the conjoined tendon by superior tape,and to the shelving edge of inguinal ligament by inferior tape.Results The operation time was(47?10)min.No analgesic requirement in any case.The postoperative hospital stay was(6?4)days.All the wounds healed uneventfully without any seroma or infection.No recurrent case was found in the follow-up of 1-25 months(mean:13.2 months)in the 35 cases.Conclusions Modified Kugel mesh used in inguinal herniorrhaphy causes less pain and swelling response to the wound,therefore it is quite suitable for repairing Ⅲ and Ⅳ type hernia.

Objective To evaluate the methods and outcome of laparoscopic degradable bio-patch repair of umbilical hernia in adults. Methods From January 2003 to October 2008, 21 adult patients underwent elective laparoscopic patch repair of umbilical hernia. There were 15 women and 6 men. The mean age was 56 years old (range of 36-73). The diameter of hernia ring was from 3 to 7.5 cm averaging at 5.2 cm. All patients received general anesthesia. Preoperative bowel preparation routinely started one day before the operation. The patients received prophylaxis systemic antibiotics 30 minutes before the operation. An appropriate size of prosthetic patch (Composix E/X, Bard, USA) was that extended the defect margin for about 3-5 cm. The mesh was then inserted into the peritoneal cavity and spreaded flattening, with the polyplypylene side facing outside and it's center coinciding with that of the defect. The mesh was fixed to the abdominal wall with staple tacks in two rings, which was 3-5 cm along the hernia ring and 1-2 cm along the edge of the mesh. Results There was no conversion to open repair. The operative time was 30 to 96 rain and the average was 52 min. Two patients suffered from a transient postoperative tympanites and which subsided 2 to 3 days after the operation. One patient had a severe pain in the repair area around the umbilical and underwent oral medicine treatment, which disappeared one week after operation. There was no seroma and incision or mesh infection occurred. The postoperative hospital stay was 3 to 8 days and the average was 4. 2 days. The follow-up time was 3 months to 5 years and the average was 32 months. No ileus or hernia recurrence during the follow-up. Conclusion Laparoscopic patch repair of umbilical hernia in adults is a safe and effective procedure.

Abstract Sepsis and related syndromes are the major cause of multiple organ failure and death in patients with critical illnesses.Neuroendocrine dysfunction has long been thought to be an important event in sepsis.In clinic,optimal management of the hormones could alleviate severe complications in sepsis.In this article,we review the dysfunction of neuroendocrine system as well as autonomic nervous system in sepsis,and summarize the respective therapy strategies.

Objective To study the prognosis of hepatoblastoma (HB) in children.Methods Retrospective analysis on the clinical data and follow-up of children with HB admitted from September 2010 to February 2015 and sum up the clinical outcome and prognosis.Results Thirty-six children with HB (23 males and 13 females) were enrolled. The median age on diagnosiswas 20 months. Allthe36 patients received follow-up, the median follow-up time was 37 months (7~71 months).(1) Of the 36 patients, 8 died. The prognosis of patients with stageⅠorⅡwas signiflcantly better than those with stage Ⅲ or Ⅳ(P<0.05). The prognosis of patients with fetal type was signiflcantly better than those with other subtypes (P<0.05). (2) Serum AFP level of 35 newly diagnosed cases increased, AFP level of survivors returned to normal after treatment. Of the 8 died patients, 3 patients had AFP elevated when relapsed, 5 cases had a persistently high AFP level after adjuvant chemotherapy. The levels of LDH, CRP, and AST at diagnosis had signiflcant influence on the prognosis (P<0.05).Conclusions Serum AFP can be a monitoring indicator for recurrence and prognosis of hepatoblastoma. POG / CCG staging, pathology classiflcation are key points when assessing the prognosis of hepatoblastoma. The prognosis of patients with high levels of LDH, CRP, and AST might be worse.

Objective To analyze the situation and trend of the application of antibacterial drugs in the case of typeⅠincision operation in our hospital.Methods A total of 1 964 patients in our hospital from 2010 to 2014 were randomly selected,and the changes of antimicrobi-al drugs during the treatment period were analyzed.The surgical site infection probability and antimicrobial application rules in typeⅠincision surgery in 3 years,including probability,category,first time and duration of drug use,and the relationship between antibacterial drugs and typeⅠincision infection were analyzed.Results Application of antibacterial drugs in typeⅠincision operation probability decreased significant-ly,and the surgical infection probability decreased year by year,with statistically significant difference(P<0.05).The first application of an-tibacterial drug time was more reasonable,the choice of antimicrobial drugs were mainly one generation or two generation of Cephalosporin. There was a significant increase in the probability of stopping medication within 2 days after surgery,and the difference was statistically signif-icant(P<0.05).Conclusion The application of antibiotics should be strictly applied to the application of the indications for the use of anti-biotics.To understand the scope of application of antimicrobial drugs,and should try to shorten the use of time,control of infection during peri-operative period,reduce drug resistance.