Sepsis and septic shock are common critical diseases in the ICU, which have a high mortality and seriously affect the patients'' quality of life.The pathogenesis of sepsis is very complicated and involves the changes in the functions of multiple systems and organs.Recently, the investigation into the potential mechanisms underlying the development of sepsis is becoming a hotspot all over the world.The author presents an overview on the advances in the studies of the pathogenesis of sepsis, relating to the imbalance of inflammatory response, immune dysfunction, abnormal blood coagulation, nerve-endocrine-immunity network, mitochondrial function damage, endoplasmic reticulum stress, autophagy, and genetic polymorphism, in order to provide some theoretical evidence for the prevention and treatment of sepsis in clinical practice.

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ObjectiveTo observe the effect of mometasone furoate on serous eotaxin in children with allergic rhinitis.MethodsThe observation group included 30 cases who got allergic rhinitis and treated by mometasone furoate.The level of eotaxin before and after treatment was detected by ELISA,and was compared with normal children in control group.ResultsBefore treatment,the signs scores of observation group was (9.4 ± 2.3 ),and after treatment was(3.1 ± 1.8),the difference was statistically significant(t =2.148,P ＜0.05).The treatment effect contained 19 cases(63.3％ ) 9 cases(30.0％ ) effective and 2 cases(6.7％ ) ineffective.Before treatment,the level of eotaxin in observation group was remarkably higher than control group [ (221.41 ± 137.96 ) ng/L vs ( 128.71 ± 60.73 ) ng/L,t =- 2.721,P ＜ 0.05 ],after treatment,symptom and sign was mitigated and eotaxin level was remarkably lower than before treatment[ ( 115.50 ± 52.71 ) ng/L vs (221.41 ± 137.96 ) ng/L,t =- 3.661,P ＜ 0.05 ].There was no serious adverse reaction in observation group.ConclusionTreated allergic rhinitis by corticosteroids could inhibit the allergic inflammation and down-regulate the eotaxin level.

AIM: To investigate the protective effects of diltiazem (Dil) on liver, pancreas and small intestines in hemorrhagic-shock canines and its mechanism. METHODS: The canines were bled to a mean arterial pressure (MAP) of 5.33-6.67 kPa for 30 min to produce the model of shock. During the shock, the dogs received water-soluble calcium channel blocker Dil or normal saline. The MAP was kept at the level for 90 min, then the total blood which was bled previously was reperfused . They were observed for 240 min. RESULTS: Dil could significantly elevated MAP of the hemorrhagic-shock canines ( P

ObjectiveTo investigate the relationship between sepsis induced high mobility group 1 (HMG 1) gene expression and endotoxemia in rats. MethodsSepsis was induced by cecal ligation puncture (CLP). One hundred Wistar model rats were randomly divided into four groups: normal control group ( n =10), sham operation (SO) group ( n =10), CLP group (further subdivided into 2?h, 6?h, 12?h, 24?h, 48?h and 72?h post CLP, n =10 in each subgroup), and bactericidal/permeability increasing protein(rBPI 21 ) treatment group (further subdivided into 12?h, 24?h post CLP, n =10 in each subgroup). Tissue samples from the liver, lungs and kidneys were harvested for the measurement of endotoxin concentrations and HMG 1 mRNA expression by RT PCR. Results Compared to normal control and SO groups the HMG 1 mRNA levels significantly increased in tissues during 6～72?h post CLP ( P

OBJECTIVE:To investigate the current situation and developing trend of the drugs for schizophrenia in Guangdong Province.METHODS:The defined daily dose(DDD)system for drug utilization recommended by WHO was adopted.The data of antipsychotic consumption in44hospitals of Guangdong Province during the period2000～2002were col?lected and analysed.RESULTS:The sum of money of consumption of antipsychotics for schizophrenia in Guangdong Province was increasing year by year,and the use of the first generation antipsychotics was declining year by year and the second was increasing.CONCLUSION:The second generation antipsychotics for schizophrenia with good therapeutic effect,less ARDs will occupy the market of antipsychotics.

Objective To investigate the clinical curative effects of duloxetine combined with thioctic acid on diabetic painful peripheral neuropathy. Methods Sixty-two patients with diabetic painful peripheral neuropathy were divided into three groups by random digits table: group A(22 patients, duloxetine combined with thioctic acid group), group B (20 patients,duloxetine group) and group C (20 patients,thioctic acid group). The other treatments were same. All patients were treated for six weeks. The pain remission level and nerve conductive velocity were compared among three groups. Results The pain level in three groups was significantly alleviated after treatment (P ＜ 0.01 ). The general effective rate was 86.4%(19/22),70.0% (14/20) and 50.0% (10/20) in group A,group B and group C,respectively (P ＜ 0.05). Visual analogue scales (VAS) in group A was significantly lower than that in group B and group C from the second week after treatment (P ＜ 0.05 ). Nerve conductive velocity was improved in both group A and group C after treatment (P＜0.01),but there was no significant difference between two groups (P＞0.05). In group B,compared with that before treatment,nerve conductive velocity had no significantly improved after treatment (P＞ 0.05). Conclusion Duloxetine combined with thioctic acid can enhance the clinical curative effects on diabetic painful peripheral neuropathy.

Objective To investigate the effect of inhibition of endoplasmic reticulum stress (ERS) in ischemic preconditioning-induced cerebral ischemia tolerance.Methods A total of 120 adult male SpragueDawley rats were randomly allocated into three groups:sham operation,global cerebral ischemic and ischemic preconditioning groups (ischemic preconditioning for 3 minutes,and global cerebral ischemia for 15 minutes after 2 days).Three time points (day 1,day 3 and day 7) were set.Sugawara method was used to observe the changes of neurological behavior in rats.TUNEL staining was used to observe the conditions of cortical neuronal apoptosis.Immunofluorescence staining and Western blot analysis were used to detect the expression levels of ERS-related protein CHOP,GRP78,and caspase-12.Results The neurological behavior score showed that the sham operation group did not have neurological deficits.Both the global cerebral ischemic group and the ischemic preconditioning group had obvious neurological deficits,and they improved gradually with the passage of time,but after modeling,the neurological scores at each time point in the global cerebral ischemic were significantly lower than those in the ischemic preconditioning group:at day 1∶11.00 ±0.63 vs.14.33 ±0.33 (t =21.74,P＝0.001); at day 3∶ 12.17±0.31vs.15.17±0.48 (t=27.93,P =0.000); at day 7:14.67±0.49 vs.16.33 ±0.33 (t =7.81,P=0.020).TUNEL staining showed that at day 7 after ischemia,the positive cell count per mm2 in the sham operation,global cerebral ischemic and ischemic preconditioning groups were 4.83 ±1.85vs.395.67± 43.43 and 146.17± 27.38 respectively (F=23.62,P=0.001).The ischemic preconditioning group was significantly lower than that in the global cerebral ischemic group (P =0.001).Immunofluorescence staining showed that at day 7 after ischemia,the numbers of positive cells of CHOP (26.50±3.89vs.82.33±4.25; P=0.000),GRP78 (15.00±2.02vs.35.67±2.99; t=0.000),and caspase-12 (22.33 ± 2.76 vs.66.50± 7.25; P=0.000) in the ischemic preconditioning group were significantly less than those in the global cerebral ischemic group.Western blotting showed that at day 7 after ischemia,the expression levels of CHOP (1.22 ± 0.38 vs.3.22 ± 0.51; t =24.50,P =0.001),GRP78 (1.78 ± 0.45 vs.3.16 ± 0.76; t =14.29,P =0.005),and caspase-12 (2.89 ± 0.53 vs.5.96 ± 0.67; t =77.73; P =0.000) in the ischemic preconditioning group were significantly lower than those in the global cerebral ischemic group.Conclusions Ischemic preconditioning demonstrated a neuroprotective effect for the second lethal ischemia,its mechanism may be associated with the relief of ERS and downregulation of ERS-related protein.

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 investigate the change on monoamine neurotransmitter in cerebral cortex motor area of traumatic asphyxia canines and provide scientific basis for its therapy.Methods The model of canine traumatic asphyxia was established,the change on monoamine neurotransmitter in cerebral cortex (motor area) and the products of metabolism during different time were tested with HPLC DC method.Results At 2 h after damage in cerebral cortex 5 hydroxyindolecetic acid (5 HIAA) elevated remarkably; At 8 h after da mage 5 hydroxytryptamine (5 HT), homovanillic acid (HVA) elevated; but there was no obvious change on norepinephrine(NE) and 3,4 dihydroxyphenyl acetic acid (DOPAC).Conclusion The monoamine neurotransmitters might play an important role in the pathological course of secondary brain injury after traumatic asphyxia.The utilization of 5 HT antagonists or compound inhibitor at early stage was a reliable method for treating brain injury after traumatic asphyxia.