OBJECTIVE: To summarize the cause and mechanic of inflammation reaction induced by medical biomaterials in the body.DATA SOURCE: A computer-based online search of Pubmed database was undertaken to identify the relevant articles published from January 2004 to December 2008 in English with the key words of "biomaterials, inflammation, mechanism".Meanwhile, with Chinese articles were retrieved from CNKI database between January 2005 and December 2008 with the key words of "biomaterials, inflammation, mechanism".DATA SELECTION: Articles concerning the cause and mechanic of inflammation reaction induced by medical biomaterials were included. Articles addressing physical and chemical features and mechanics of medical biomaterials were excluded.MAIN OUTCOME MEASREUS:①After the material implants in vivo, inflammatory cell and material adhering.②Cell factor expression.RESULTS: After initially examined 70 literatures were obtained. According to inclusion and exclusion criteria, the reasons and the mechanism related to the medical biological material in host in vivo for causing the inflammation were analyzed. Along with the tissue engineering development, various new high-polymer medicine biological materials with good biological compatibility,the biological activity and the biodegradation absorption function are emerging unceasingly. The biomedicine material was used to repair or substitute damage organization and the organ, and to cause function recovery. The infection was still the serious complication following the medical biological material was implanted. The mechanism of biomedicine material-induced infection is: complement in blood adhere the biological material surface, which causes collection and adherence of integrin-mediated leukocytes, release of cytokines and growth factors from adherent monocytes/macrophages, resulting in the occurrence of biomedicine material-related infection. To prevent the medical biological material-related inflammation, we should first embark from the material itself, and seek for some to respond the small medical material to the host inflammation.CONCLUSION: The success of material implantation depends on the medical biological material relevant inflammation. The production of biomaterial-related inflammation is action results of inflammatory cell, inflammation factor, complement as well as enzyme, oxygen free radical. Material surface microstructure, chemistry and dielectric and so on immediately influence inflammatory cells on material response.

Methylenetetrahydrofolate reductase(MTHFR),a key enzyme in methionine-folic acid metabolism,participates in the synthesis of thymidine monophosphate(TMP) and purine as an indirect donator of methylium.It plays an important role in maintaining the normal level of homocysteine and DNA repair and replication.The MTHFR gene mutation decreases the activity of enzymes,increases the homocysteine level of blood plasma,and induces abnormal DNA methylation and various diseases.This review focuses on the structure and function of the MTHFR gene,its polymorphism and the relationship between its polymorphism and congenital heart disease.

OBJECTIVE:To evaluate the economical efficiency of alogliptin for type 2 diabetes and provide clinical evi-dence for related researches. METHODS:Retrieved from Cochrane Library,Pubmed,EMBase,CNKI,VIP,Wanfang,CBM database up from the start of the database to Mar.,2014,RCTs about alogliptin combined with traditional antidiabetic agents regimen vs. traditional antidiabetic agents regimen in the treatment of type 2 diabetes mellitus were included. Based on the sec-ondary analysis method of literatures,Effectiveness indexes and treatment course were extracted from the literatures,from the perspective of patients,and daily treatment cost was used to calculate the cost;cost-effectiveness analysis was adopted to evalu-ate the economical efficiency of alogliptin combined with traditional antidiabetic agents regimen vs. traditional antidiabetic agents regimen. RESULTS and CONCLUSIONS:6 literatures which met inclusion criteria were included. When alogliptin com-bined with metformin treatment lasted for 12 weeks,the decrease value of HbA1c as effect index showed poor cost-effective-ness;when treatment course increased to 26 weeks,the rate of qualified HbA1c as effect index showed poor cost-effectiveness. When the price of alogliptin decreased by 10% or the effects of trial group was the upper limit of 95%CI,the cost-effective-ness was superior to metformin regimen group. 12 weeks of alogliptin combined with pioglitazone treatment showed better cost-effectiveness than pioglitazone alone using the decrease value of HbA1c as effect;when treatment course increased to 26 weeks,the treatment showed poor cost-effectiveness;when treatment conrse increased to 26 weeks,using the rate of qualified HbA1c as effect indes,the results of sensitirity analysis showed that cost-effectiveness of trial group was better than that of pio-glitazone alone group as the apper limit of 95% CI. When alogliptin combined voglibose treatment lasted for 12 weeks,the de-crease value of HbA1c as effect index showed superior cost-effectiveness to voglibose regimen group. It is suggested to develop alogliptin pharmacoeconomics research based on RCTs and pharmacoeconomics research about improving diabetes patients’ long-term living quality.

Objective To investigate doctor-patient communication skills status and the influencing factors so as to pu forward to develop the proposal.Methods We selected undergraduate students in fourth grade which participated in the 2012 Shanghai Jiaotong University School of Medicine OSCE examinations before practice of clinical medicine by cluster sampling 1 and we selected four western and chinese medicine hospitals randomly sample 2,which are three level of first-class hospitals in Shanghai.We design the questionnaire and observe sampling with the SEGUE framework.Application of SPSS 13.0 data for statistical analysis,descriptive statistics analysis,u test,t test,ANOVA,rank sum test and correlation analysis method.Results The test with SEGUE framework shows that the scores of samplingl were 12.54 points(out of 24),the score rate is low which was 52.25％,and in the score rate of the dimensions,the end of inquiry dimension is 4％ which is the lowest.There are significant statistical differences between different groups of influencing factors such as Medical occupation interest score and so on.There is no statistically significant difference between the SEGUE score of traditional Chinese medicine and western medicine clinical Intern.The communication skills of western medical students are higher.Doctor-patient communication skills related factors such as recognition of the importance of doctor-patient communication skills and other groups are statistically significant,the correlation coefficients are very small which is between 0.1 and 0.3.Conclusion The overall level of doctor-patient communication skills on clinical internship are not high,through the guidance and training on the occupation interest of medical students,we can strengthen the recognition of the importance of doctor-patient communication skills,so that we will improve the doctor-patient communication skills for the medical students.SEGUE framework should be used to routine medical students communication skills evaluation.

The pathogenic and therapeutic effect of gut microbiome is a hot topic in recent years .Many researchers gradually focused on the relationship between the eating disorder and the gut microbiome .The gradual in-depth studies show that gut microbiome can intervene in the host′s metabolic state by multiple approaches to regulate appetite and bring new inspiration for the treatment of dis -eases.In this article, we review all important findings in this field and discuss the mechanism how gut microbiome effects appetite regu -lation.

Autophagy is an important homeostatic cellular recycling mechanism responsible for degrading injured or dysfunctional cellular organelles and proteins in all living cells. Aging is a universal phenomenon characterized by progressive deterioration of cells and organs due to accumulation of macromolecular and organelle damage. Growing evidences indicate that the rate of autophagosome formation and maturation and the efficiency of autophagosome/lysosome fusion decline with age. Dysfunctional autophagy has also been observed in age-related diseases. Autophagy disruption resulted accumulation of mutated or misfolded proteins is the essential feature of neurodegenerative disorders. However, in cancers, fibroproliferative diseases or cardiovascular diseases, autophagy can play either a protective or destructive role in different types of disease, and even in different stages of the same disease. The review will discuss the cellular and molecular mechanisms of autophagy and its important role in the pathogenesis of aging and age-related diseases, and the ongoing drug discovery strategies for therapeutic intervention.
Aging ; Autophagy ; Drug Discovery ; Humans ; Lysosomes ; metabolism ; Neurodegenerative Diseases ; Phagosomes ; metabolism ; Protein Folding

Objective To investigate the approach of diagnosis and therapy of particular tracheal bronchus foreign body.Methods The clinical materials of 26 cases cured in our department were analyzed retrospectively.Results All foreign bodies of cases were taken out successfully.Among them,the foreign bodies of 18 cases were removed from glottis;the foreign bodies of 4 cases were pulled out via laryngoscope;the foreign bodies of 3 cases were drawn away through tracheotomy by endoscopy and 1 case was moved out by bronchofibroscopy.Only 1 case had lung edema and then was cured by proper treatment.Conclusion Considering that the particular foreign bodies in tracheal bronchus are complicated sometimes,the diagnosis and therapy should be treated appropriately according to different situation.Furthermore,properly choosing surgical appliances and the approaches of anaesthesia and surgery is also critical.

Objective To summarize the experience of early management in elderly patients with serious burning in order to raise cure rate. Methods Elderly patients (63 cases) with serious burning (burned area exceeding 30% or Ⅲ? area exceeding 10% ) admitted from 1990 to 2002 were retrospectively studied. Patients were divided into two groups according to the admission date, before and after January 1, 1996 since new management was extensively applied after 1996. These measures consisted of rapid and adequate fluid resuscitation, early enteral feeding and autograft after eschar excision. Results The incidence of sepsis and MODS was 38.7% and 19.4% respectively after 1996. It was evidently lower than the group before 1996(65.6% vs 43.8%, P

Objective To explore whether the neurons induced from mesenchymal stem cells(MSCs) have synapse function or not.Methods Passage 4-5 MSCs in good shape was induced by Salvia miltiorrhiza with optimized protocol for several times,and then the observation under inverted phase contrast microscope,immunofluorocytochemistry and the measurement of neurophysiological function were carried out.Ca2+ influx and synapse function were detected with laser-scanning confocal microscopy(LSCM),taking 50 mmol/L KCl as stimuli to evoke action potential.Results The cells that had been induced for 5 h at 4th time from MSCs,looked like neurons and displayed that the processes stretched out to form complex net.Immunofluorocytochemistry presented that the rate of TUJ-1 expression was(96.7?2.8)% and that of synaptophysin was(96.2?2.1)%.When the neuron-like cells were stimulated by high concentration of KCl,intracellular Ca2+ influx enhanced quickly.When the neuron-like cells were stimulated by high KCl solution for the first time,SynaptoRed-C2 anchored onto the membrane,and after the second excitation,the fluorescence intensity decreased quickly.Conclusion The neuron-like cells derived from MSCs that are induced by salvia miltiorrhiza with optimized protocol have synapse function.