Objective To investigate the characteristics of inanune status change in sepsis and severe sepsis patients by quantitative analysing the serum concertrations of pro-and anti-inflammatory cytokines. Method Serum of 38 sepsis patients, 32 severe sepsis patients were collected and 15 health individuals were as controls.ELJSA method was used to quantify the serum levels of inflammatory cytokines. The severity of patient's condition was assessed according to the APACHE Ⅱ system, Retolts The serum concentrations of inflammatory cytokines were different among sepsis and severe sepsis patients. In the serum of sepsis patients the pro-inflammatory eytokine were dominant. But in the serum of severe sepsis patients the anti-inflammatory cytokine were dominant.The serum levels of TNF-α, IL-6, IL-1, IL-10 were obviously different among control, sepsis and severe sepsis groups ( P<0.05). The serum levels of IL-1 and IL-10 were significantly correlated with APACHE II scores. The multiple linear regression eqution was APACHE Ⅱ=- 9.393 + (IL-10 x 0.550) + (IL-1 x 0.305) (F =26.198,P<0.001) Conclusions The serum levels of pro-and anti-inflammatory cytokines were significantly different among patients with different stages of sepsis, and the immune status were different. The activation of inflatrmmtory reaction were constant in sepsis patients, while the expression of anti-inflammatory cytokines increased in severe sepsis patients.

Objective To examine the effect of risperidone on the mental symptoms after frontotemporal brain contu?sion. Methods Sixty cases with mental symptoms after frontotemporal brain contusion were recruited from Jan 2009 to Dec 2011 and were randomly divided into control group and treatment group. The patients in the control group were giv?en vitamin B1 60mg/d, while the patients in the treatment group were given risperidone 1mg/d. Both groups were treated for 1 month. Positive and negative symptom scale (PANSS) and symptom scale (TESS) were used to evaluate the efficacy and adverse reactions of treatment. Results The PANSS score was significantly lower in the treatment group than in con?trol group at 1, 2, 3 and 4 weeks following treatment(difference between groups:F=48.12 ,P<0.0001;Time difference:F=290.99 ,P<0.0001; Interaction between group and time: F=11.91,P<0.0001 ). After time-adjustment, the PANSS score was significantly lower in the treatment group than in control group at 2, 3 and 4 weeks following treatment. In the course of treatment, the patients in both groups had varying degrees of headache, nausea, weight gain and Beckoning. These side effects were alleviated through symptomatic treatment. Conclusion Risperidone can significantly improve psy?chiatric symptoms in patients with frontotemporal brain contusion with satisfactory safety.

AIM: To investigate the molecular mechanism by which hypoxia affect the endothelial nitric oxide synthase (eNOS) expression in cerebral artery endothelial cells (CAECs). METHODS: Primary cultured porcine CAECs were exposed to hypoxia for 2 h, 6 h, 12 h, 24 h and 48 h. The eNOS mRNA level was determined by RT-PCR. The level of eNOS protein was detected by Western blotting. After specific PKC inhibitors BIM Ⅰ(1 ?mol/L) and G6983 (1 ?mol/L) were added, CAECs were exposed to hypoxia for 24 h. The effect of hypoxia on eNOS mRNA stability was analyzed after actinomycin D was added. RESULTS: After exposure to hypoxia for 2 h, the levels of eNOS mRNA and protein in CAECs were increased. The levels of eNOS mRNA and protein reached peak after 12 h of hypoxia (about 2 5 fold and 2 0 fold, respectively, compared to control), and remained at higher level even after 48 h of hypoxia. Moreover, hypoxia did not change the stability of eNOS mRNA. The specific PKC inhibitors BIM Ⅰ and G6983 attenuated significantly the effects of hypoxia on eNOS gene expression. CONCLUSION: These results suggest that hypoxia may enhance the expression of eNOS gene in CAECs through PKC signaling pathway, which might be one of the mechanisms of cerebral artery dilation and neuroprotection during cerebral hypoxia.

Establishing a comprehensive mechanism for the initiation and review of investigator-initiated trial(IIT) plays an important role in ensuring the scientific validity of clinical research and improving research quality.Since 2021, Zhongshan Hospital affiliated to Fudan University had actively explored improvements in the project management of IIT. The hospital had established a standardized grading review management process, developed an integrated clinical research management system, established a three-level clinical research training system, built a methodological support platform, and formulated research plan templates, gradually formed a standardized grading project approval review management mode. As of February 2024, the hospital had completed 400 quick reviews and more than 400 expert letter reviews based on the integrated clinical research management system. The efficiency and quality of IIT project approval had been improved. At the same time, over 40 academic salons and forums had been held, cultivating a group of young clinical research talents, providing data management training for more than 30 clinical departments, and promoting the improvement of the quality of research protocol. In the future, hospitals should further optimize their information systems, expand the influence of their training systems, enhance the capabilities of their methodological support platforms, and improve the efficiency of the application of clinical research protocol templates, so as to escort the establishment and implementation of high-quality clinical research projects and provide references for other hospitals′ IIT project management.

BACKGROUND:Titanium implants are widely used in clinical practice because of their high strength and good biocompatibility.However,during implantation,bacterial infection and tissue damage environment produce a large number of reactive oxygen species,which can easily lead to delayed tissue healing and surgical failure.Consequently,the development of titanium implants with antimicrobial and antioxidant properties becomes paramount. OBJECTIVE:Considering the potent antimicrobial attributes of copper ions and the remarkable antioxidant qualities of polyphenols,we proposed the fabrication of polyphenol-mediated copper ion coatings on titanium surfaces.These coatings were subsequently assessed for their in vitro antimicrobial and antioxidant properties. METHODS:Nanostructures were generated on the titanium surface using the alkali thermal method.The titanium was immersed in a solution containing tannic acid and copper ions to achieve polyphenol-mediated copper ion coatings.The surface morphology and water contact angle were detected.The loading and release of copper ions were examined using atomic absorption spectroscopy.Staphylococcus aureus was inoculated on the surface of pure titanium sheet(blank group),alkali heat treated titanium sheet(control group),and polyphenol mediated copper ion modified titanium sheet(experimental group)to observe the bacterial survival status.Osteoblast precursor cells MC3T3-E1 were co-cultivated on the surface of three groups of titanium sheets to assess their antioxidant properties and bioactivity. RESULTS AND CONCLUSION:(1)Scanning electron microscopy showed that the polyphenol-mediated copper ion modified titanium sheet had rod-like nanostructures and no cracks on the surface.The surface hydrophilicity of copper ion modified titanium sheet mediated by polyphenol was close to that of pure titanium sheet.Atomic absorption spectrometry results showed a 51%increase in the loading capacity of copper ions after polyphenol mediation,with a uniform release of copper ions.(2)The antibacterial rates of titanium sheets in the blank group,control group,and experimental group were 0%,21.65%,and 93.75%,respectively.The live/dead staining and CTC staining showed that the live bacteria on the surface of titanium plates in the blank group were the most,and the live bacteria on the surface of titanium plates in the experimental group were the least.(3)The results of live/dead staining and CCK-8 assay showed that the three groups of titanium sheets had good cytocompatibility,and the titanium sheets in the experimental group were more conducive to the proliferation of MC3T3-E1 cells.Active oxygen fluorescence probe detection exhibited that compared with the other two groups,the fluorescence intensity of active oxygen on the surface of the experimental group was significantly reduced.The results of alkaline phosphatase and alizarin red S staining showed that the osteogenic differentiation and extracellular matrix mineralization of MC3T3-E1 cells on the surface of titanium sheets in the experimental group were stronger than those in the other two groups.(4)These results show that the polyphenol-mediated copper ion coating has strong antibacterial and antioxidant properties and promotes osteogenic differentiation.