Sepsis and septic shock are the major causes of death in intensive care units (ICUs) worldwide. A large amount of studies on their pathophysiology have revealed an imbalance in the inflammatory network leading to tissue damage, organ failure, and ultimately, death. Cytokines, proteases, lipid mediators, vasoactive peptides, and cell stress markers play key roles in pathophysiology of sepsis. Although anti-inflammatory mediators can neutralize the promoting role of pro-inflammatory mediators, but persistent immune regulation may cause host susceptibility to concurrent infections. Therefore, it is a great challenge to seek effective clinical therapy against sepsis. To understand the complicated interplay between pro- and anti-inflammatory agents in sepsis, and their interaction in signal transduction and immune regulation in sepsis constitute vital significance to the prevention and control of sepsis. Summarize the latest findings about mediators associated with sepsis and innate and adaptive immune system at home and abroad in recent years, and illustrate the impact of its effects on sepsis, which may lead to resolution of many unexplored queries in the future.

Objective To explore the effect of cryo/cuff system at different durations on postoperative swelling and pain in patients with knee arthroscopy.Methods Ninety-two patients having undergone knee arthroscopy were divided into 3 groups: the study group(n=31),the control group(n=31)and the blank control group(n=30).The study group were managed with circulating cold compress therapy for 30 mins once every 8 hours 24 hours after operation,the control group with circulating cold compress therapy for 30 mins once every 8 hours 48 hours after operation and the blank control group with routine nursing.The degree of pains was assessed using visual analogue scale and the level of swelling using the difference in the shank circle between the diseased and healthy limbs.Results The study group and control group were both better than the blank group in swelling and pain control(P<0.05). The study group showed no difference in postoperative pains and swelling than the control group(P>0.05).Conclusion Postoperative knee arthroscopy,using cryo/cuff system can alleviate pains and swelling of joints,which is conducive for the early ambulation and promoted rehabilitation.

To explore the experience of the process of Tai Chi exercise.

Objective To evaluate the effectiveness of Tai chi on quality of life of breast cancer patients. Methods Articles from 10 English and Chinese Databases from inception to March 2012 were recalled. 2 researchers independently screened titles and abstracts for eligible trials, methodological quality was assessed according to risk of bias items. Meta-analysis would be used if data available. Results 4 randomized trials with 169 participants were included. All trials had high risk of bias. 2 studies demonstrated significant improvement in Tai chi group for improving shoulder functional capacity which caused by breast cancer. The meta-analysis failed to demonstrate significant effects of Tai chi compared with control interventions (psychological support therapy, standard health care, routine rehabilitation training) in improving quality of life (SMD 0.03, 95%CI: -0.85, 0.91, P=0.94). Conclusion Tai chi is effective on shoulder functional capacity of breast cancer, but not significantly on quality of life.

Objective To investigate knowledge, attitude, and practice of exercise for post-operative breast cancer. Methods 110 postoperative breast cancers were investigated using a self-designed questionnaire which included general condition of patients, knowledge, attitude and practice of exercise after breast surgery. Results The rate of effective response was 98%. The average rate of awareness about postoperative exercise for breast cancers was 87%, and the score of knowledge of intensity and forms of exercise was the lowest, while the announcements of post-operative exercise was the highest. All of the patients presented positive attitude toward exercise, however, some of them indicated that they couldn't insist on it. 41% exercised only in one form, 78% at a low intensity, 41% less than 3 times per week, and 74% at least 30 minutes per session. Only 7% did traditional Chinese medical exercise. Time after surgery correlated positively to general scores (r=0.40, P<0.01), kinds of exercise (r=0.41, P<0.05) and intensity of exercise (r=0.43, P<0.05). Phase of cancer correlated negatively to general scores (r=-0.37, P<0.05) and exercise time (r=-0.38, P<0.05). Conclusion The knowledge on intensity and form of exercise after operation is not popular in post-operative breast cancers.

This study was aimed to evaluate effects of traditional Chinese medicine ( TCM ) five elements music therapy on the quality of life for both senior and non-senior advanced cancer patients , and improve TCM com-prehensive treatment mode . A total of 170 patients were stratified according to 70-year-old in a randomized controlled trial ( RCT ) with a parallel single-blind design . The ratio of patients among three groups was 2:2:1 . In the experimental group , TCM five elements music was given in the treatment . In the positive control group , western music was used in the treatment . And in the negative control group , no music was given in the treat-ment . The treatment was given for 30 min , 5 times per week . And the observation duration was 3 weeks . The Hospice Quality of Life Index-Revised ( HQOLI-R ) , Karnofsky Performance Scale ( KPS ) and Symptom Diary Score recorded by patients were used in the evaluation . The results showed that when comparing HQOLI-R , KPS and Symptom Diary Score before and after treatment among all advanced cancer patients in each group , there was a significant difference before and after treatment in the TCM five elements music therapy group ( P< 0 . 05 ) . But there was no significant difference before and after treatment in the western music therapy group or the negative control group ( P > 0 . 05 ) . It was concluded that TCM five elements music therapy is effective in improving quality of life and subjective symptoms for both senior and non-senior advanced cancer patients . However , the sensitivity of using the Symptom Diary Score as an evaluation index among senior patients still needs to be further proved .

Objective To investigate the nursing professional values of different nursing groups and probe into the influencing factors.Methods By cluster and stratified sampling,a total of 583 participants including nursing students and registered nurses were investigated by Nursing Professional Values Scale.Results Nursing students and registered nurses hold a higher level of nursing professional values.Nursing professional value scores of nursing students were significantly higher than registered nurses.There was statistical difference between different nursing groups.Working years and monthly income were important influencing factors.Conclusions Nursing educators and administers could choose effective methods according to the condition to improve nursing professional values.

Objective To investigate the differences of curriculum designs for undergraduate nursing majors among different TCM colleges and universities;To provide evidence for the development of the accreditation standards for academic quality of baccalaureate degree program in TCM colleges and universities which can be used as the standards for teaching reform. Methods Cultivating plans of 20 TCM colleges and universities for undergraduate nursing majors were collected. Current status and deficiency in curriculum design were obtained through comparative study and statistical analysis.Results The course names were lack of standardization;proportion of Chinese and Western medicine related courses were unreasonable;theoretical and practice teaching were irrelevant;optional courses were greatly inconsistent and irrational. Conclusion The further reform of the curriculum design for the undergraduate nursing majors in TCM colleges and universities is in urgent need, which can be standardized by developing the accreditation standards for academic quality of baccalaureate degree program in universities of Chinese Medicine.

AIM:Activin A,a member of transforming growth factor superfamily,is the negative regulator factor in liver regeneration. In this study,the effects of extract of Ginkgo Biloba on hepatic fibrosis and the expression of Activin A in rats with cirrhosis were investigated. METHODS:The experiment was performed at in the Central Laboratory of Wuhan First Hospital from September 2005 to December 2006. ①Thirty-six male SD rats of(160?20) g were randomized into 3 groups:control group,model group and treatment group. ② Except the rats in the control group,others were intraperitoneally injected with 500 mL/L CCl4 for 8 weeks to establish models of hepatic fibrosis. Meanwhile,the extract treatment group was infused with the extract of Ginkgo Biloba(Chinese drugs preparation laboratory of Wuhan First Hospital,detected by Hubeu Wushi Medicine Industry Co.,Ltd. No. 02-391) daily for 8 weeks. ③After administration,all anesthetized rats were sacrificed. Blood samples were collected for the determination of liver function biochemical indexes. Liver tissue samples were used for histopathological examinations. The expression of Activin A was determined by immunohistochemistry and RT-PCR. RESULTS:All 36 rats were involved in the final analysis. ①The liver function in extract treatment group was significantly improved compared with that in model group. ②The grade of fibrosis in extract treatment group were remarkably lower than that in model group under light microscope. ③The positive staining of Activin A in treatment group was significantly reduced compared with model group. ④The expression of Activin A mRNA in extract treatment group was significantly reduced compared with model group. CONCLUSION:Extract of Ginkgo Biloba can effectively decrease the expression of Activin A in rats with hepatic fibrosis caused by CCl4,and lessen the degree of hepatic fibrosis.

Objective To investigate the conventional ultrasound characteristics of VX2 tumors in fatty liver and normal liver of rabbits,furthermore,to analysis the blood flow characteristics of them with contrast-enhanced ultrasound (CEUS).Methods Rabbit model of fatty liver and normal liver with implanted VX2 tumors were established,and examined using conventional and CEUS.QontraXt quantitative software of CEUS was used.Results The fatty liver models with 20 VX2 tumors and normal liver models with 23 VX2 tumors were successfully developed in rabbits.In conventional ultrasonography,hyperechoic VX2 tumor lesions in fatty liver were far less than them in normal liver (P =0.008).No significant difference was found in iso-echoic and hypoechoic VX2 tumor lesions between two groups (P ＞ 0.05).Compared with normal liver parenchyma,arrival time of fatty liver parenchyma was later,peak intensity was lower (P ＜0.05).There was no significant difference in arrival time,peak intensity,sharpness,area under curve between the VX2 tumors of normal liver and fatty liver (P ＞ 0.05).Conclusions There is a significant difference characteristic in conventional ultrasonography between VX2 tumors in fatty liver and normal liver.Fatty liver blood perfusion effects are lower than normal liver in CEUS.Quantitative parameters of CEUS are more objective and accurate for hemodynamic of VX2 tumors and fatty liver.