Objective To explore the effect of mild hypothermia on tumor necrosis factor alpha (TNF-?),interleukin-1?(IL-1?),interleukin-6 (IL-6) and interleukin-8 (IL-8) in serum of patients with severe traumatic brain injury and its clinical significance. Methods Mild hypothermia was used within 24 hours after injury to keep the rectal temperature at 33℃-35℃ for five days in 23 patients, who suffered from severe brain injury with GCS score of 3-8 (mild hypothermia group). And 21 patients who suffered from severe brain injury with GCS score of 3-8 were taken as control group. The dynamic changes of serum TNF-?, IL-1?, IL-6 and IL-8 at days 1, 2, 3 and 4 respectively after trauma were monitored using ELISA. Results Levels of serum TNF-?, IL-1?, IL-6 and IL-8 were decreased more significantly in the mild hypothermia group than those in the control group(P

With the development of society and medical science,the medical arena should develop with the times,transform medical ethics idea, construct new medical ethics view to unceasingly promote the medical ethics progress and the comprehensive,coordinated, and sustainable development of medical industry.This article discussed the principle,significance and several related problems of new medical ethics view in order to make direct instruction for the constnuction of new medical ethics view.

BACKGROUND:With the development of the research, induced pluripotent stem cel s are applied to the build of disease model, drug screening, regenerative medicine, and many other research fields, and have made significant achievements, especial y in the study of nervous system diseases.
OBJECTIVE:To summarize the recent development of induced pluripotent stem cel s and to raise problems and prospects based on the latest research in this field.
METHODS:The first author searched the PubMed database for articles about the induced pluripotent stem cel s, including reviews, clinical research and basic research, published from January 2006 to September 2014. The keywords were“iPS, induced pluripotent stem cel”, and final y 60 articles were included in result analysis.
RESULTS AND CONCLUSION:Induced pluripotent stem cel research continues to make breakthrough from its discovery by Yamanaka’s team in 2006 to winning Nobel Prize in 2012. Induced pluripotent stem cel research has broad prospects in the disease model construction, drug screening and regenerative medicine. Currently, problems such as reprogramming methods, cel stability, and clinical transformation stil need to be solved, and further researches are necessary.

ObjectiveTo investigate the effect of adaptive support ventilation (ASV) plus lung recruitment maneuvers (LRM) and intermittent positive pressure ventilation (IPPV) on respiratory mechanics, hemodynamics and oxygen delivery in trauma patients combined with acute respiratory distress syndrome (ARDS).MethodsTwenty-eight trauma patients combined with ARDS including 18 males and 10 females at age range of 19-48 years were mechanically ventilated by two modes, ie, IPPV and ASV + LPS.The patient was initially ventilated with IPPV for eight hours, with tidal volume (VT) of 10 ml/kg, PEEP = 0, oxygen delivery speed for 32 L/min and oxygen inhalation concentration of 60％.Then, one of ASV + LRM and IPPV was randomly selected for continual ventilation.There were three levels of positive end-expiratory pressure (PEEP,0,5 and 10 cmH2O).Each level of PEEP was maintained for 60 minutes.During the use of ASV + LRM, continuous positive airway pressure (CPAP) was at 45cmH2O and breath holding continued for 30 seconds.Then, the mode was turned to ASV and respiratory mechanics, hemodynamics and oxygen delivery were measured by using Swan-Ganz catheter, electrocardioscanner and ventilator when each level of PEEP was ventilated for 50 minutes.Results Compared with IPPV mode in the same level of PEEP, ASV + LRM mode had lower peak inflating pressure (PIP),airway plate pressure (Pplat) and intrapulmonary shunt (Qs/Qt) (P ＜ 0.05) but higher oxygenation index (PaO2/FiO2) and oxygen delivery (DO2) (P ＜ 0.05).There was no statistical difference in aspects of MAP, CI and SVRI during ventilation with IPPV and ASV (P ＞ 0.05).ConclusionASV + LPS model is better than IPPV in ventilation for trauma patients combined with ARDS.

Objective To determine the origin of cord serum leptin and its relationship with neonatal anthropometry. Methods Sixty five women and their babies took part in this prospective cohort study. Blood was taken from the women just before delivery and from the umbilical cord of their babies at delivery. Serum leptin was measured by radio immunoassay. Neonatal anthropometric measurements were recorded within 48 hours after delivery. Linear regression analysis was used to explore the relationship between serum leptin concentrations and anthropometric measures and multiple regression analysis then applied to determine which variables remained independently associated with leptin. Results The leptin concentration ( ?s )in maternal serum was (19.93?7.21) ng/mL and in cord blood was (10.50?3.45) ng/mL. Cord leptin levels correlated with placental weight, neonatal birthweight, skinfold thickness and ponderal index but not with maternal leptin levels. The correlation with Placental weight and neonatal birthweight remained significant after multiple regression analysis. Conclusions Relatively big serum leptin concentration gradient between mother and umbilical vessels indicates that placenta might play an important role in leptin production. We hypothesize that leptin might play an important role during pregnancy and fetal development.

Objective Study the effect of NMDA receptor antagonist GAPA on the [Ca 2+ ]i of the bilirubin precipitated brain tissue. Methods 10 ug/g of GAPA was administrated peritoneally to Gunn rat with bilirubin induced encephalopathy, brain tissue suspensions was prepared, Fura 2/AM was loaded. the neural cytosolic Ca 2+ was measured by flurescence imaging analysis. Results The concentration of neural cytosolic Ca 2+ in bilirubin precipitated brain tissue was significantly more than that in the control group; NMDA receptor antagonist GAPA could significantly decrease the cytosolic Ca 2+ overload. Conclusion Cytosolic Ca 2+ overload was found in the bilirubin precipitated brain tissue. NMDA receptor antagonist GAPA could prevent the cytosolic Ca 2+ overload in bilirubin induced brain tissue.

Objective To study the role of placental leptin in intrauterine cord leptin production and its relationship with neonatal anthropometry. Methods Forty women and their babies were enrolled in this study. Placental tissue was obtained from mothers and assayed for leptin mRNA by reverse transcription/polymerase chain reaction (RT/PCR). Blood was taken from the umbilical cord of the babies at delivery. Serum leptin was measured by radio-immunoassay. Neonatal anthropometric measurements were recorded within 48 hours after delivery. Linear regression analysis was used to explore the relationship between placental leptin mRNA, serum leptin concentrations and anthropometric measures. Results Placental tissue expressed leptin mRNA at comparable or greater levels than adipose tissue. The placenta of the small for gestational age (SGA) neonates expressed leptin mRNA at significantly lower levels than that of the appropriate for gestational age (AGA) neonates (P=0.042), while the placenta of the large for gestational age (LGA) neonates expressed leptin mRNA at significantly higher levels than that of the AGA neonates (P=0.03). Placental leptin mRNA expression levels correlated with leptin concentrations in cord blood (r=0.61), newborn birth weight (r=0.60) and Ponderal Index (r=0.56). Conclusions Placenta provides a source of leptin for the growing fetus, and this placental leptin might be a growth factor in intrauterine fetal development.

Objective To investigate the effect of alteration of CRELD1 gene expression on the related genes in the endocardial cushion development.Methods Over-expression and silence of CRELD1 gene were realized by the construction of lentiviral vector.Afterwards,the lentiviral vectors were used to infect the human fetal lung fibroblasts (HFL)-I.All of the cells were divided into the following 5 groups:the blank control group,the negative control group of interference,the interference group,the negative control group of over-expression,and the over-expression group.Western blot and real-time fluorescent quantitative polymerase chain reaction were applied to examine the mRNA and protein expression of CRELD1,Sox9,Aggrecan,Scleraxis and Tenascin-C.Results The DNA sequences of 2 recombinant plasmids pLV3-shRNA-CRELD1 and pLV4-CRELD1 matched very well with those which were designed according to the DNA sequence analysis.HFL-I was successfully infected with lentiviral vectors and displayed fluorescent green light under inverted fluorescence microscope.The results of real-time PCR detection and Western blot test were consistent:expressions of Sox9 and Aggrecan in the interference group were significantly higher than those in the negative control group of interference,while the expressions of the 2 genes in the over-expression group were significantly lower than those in the negative control group of over-expression.Expressions of Scleraxis increased in both the interference group and the over-expression group when compared with the negative control groups respectively.Compared to the corresponding negative control groups,Tenascin-C expression decreased markedly in the interference group,whereas it increased significantly in over-expression group.Conclusions CRELD1 gene has negative effect on the expression of the related genes Sox9 and Aggrecan in the endocardial cushion development,whereas it has positive effect on the Tenascin-C expression.It serves as a theoretical framework to illustrate the effect of CRELD1 gene on the atrioventricular septal defect.

ObjectiveTo investigate the association between endothelial NO synthase (eNOS) gene G10T polymorphism and the susceptibility of sporadic congenital heart disease (CHD).MethodsThe genotype oneNOS G10T locus was detected and compared in 1323 children with sporadic CHD and 1323 non-CHD children.ResultsCompared with the CC genotype, the AA genotype signiifcantly increased the risk of CHD (adjustedOR=1.42, 95%CI=1.01-2.04). Compared with the CC/AC geno-type, the AA genotype signiifcantly increased the risk of CHD (adjustedOR=1.39, 95%CI=1.08-1.92). Based on stratiifed analy-sis, the AA genotype was associated with the susceptibility of perimembranous ventricular septal defects (adjustedOR=1.56, 95%CI=1.17-2.47).ConclusionsIn Chinese population, theeNOS G10T polymorphism may increase the susceptibility of sporadic CHD.

Objective:To analyze the pulpal prognosis of replanted permanent teeth in children and to examine the associated factors .Methods:The samples consisted of 67 children with 81 avulsed perma-nent teeth treated in Peking University Hospital of Stomatology from 2000 to 2012 .Their clinical data of the replanted teeth were collected , and the follow-up period was no less than 12 months.The pulpal prognosis was classified as pulp necrosis and pulp non-necrosis .Results: The replantation within 30 minutes after avulsion led to the most significant increase in pulpal healing (P<0.05).The dental pulp of 80% ( 4/5 ) young permanent teeth replanted within 30 minutes remained vital , while all the teeth replanted after 30 minutes developed pulp necrosis within 60 days after replantation .Conclusion: The extra-alveolar period significantly affects the prognosis of pulp in immature permanent teeth after replanta-tion.When the extra-alveolar period is more than 30 minutes, the chance of pulp revascularization after replantation is very low , therefore pulp extirpation should be performed .