Autophagy is an intracellular degradation system that delivers cytoplasmic constituents to the lysosome and it's involved in the cycle of matter and energy. Meanwhile autophagic cell death is a form of cell death called type-Ⅱ programmed cell death. In recent years, studies have shown that autophagy is involved in pathophysiologies of nervous system disease especially neurodegenerative diseases, ischemia-hypoxia, traumatic brain injury ,seizures.

Mitogen-activated protein kinase (MAPK) signaling pathways are involved in multiple important cellular responses. To activate their downstream protein kinases by phosphorylation is a crucial manner for MAPK family members to fulfill their physiological functions. Downstream of MAPKs, there exist three structurally related MAPK-activated protein kinases (MAPKAPKs or MKs), i.e., MK2, MK3 and MK5. Once upon activated by MAPKs, MKs signal to different cellular targets, to regulate gene expression at the levels of transcription and translation, control cytoskeleton remodelling and cell cycle, and mediate cell migration and embryonic development. Recently, based on the gene knockout studies, the function divisions among different MK subfamily members are gradually clear, leading to tremendous advancements of our knowledge on MKs.

Objective To investigate the clinical effects and complications of modified radical mastectomy and breast conserving operation for breast cancer.Methods 110 cases of breast cancer were randomly divided into the two groups,55 patients in each group,the control group took the modified radical mastectomy,while breast conser-ving operation were carried out in observation group,the clinical efficacy and incidence of complications of two groups were observed and compared.Results The operation time,intraoperative blood loss,length of incision and hospitali-zation time of the observation group were (98.47 ±8.65)min,(82.59 ±4.86)mL,(4.80 ±0.87)cm and (8.66 ± 1.77)d,significantly less than (156.52 ±10.23) min,(125.23 ±6.85) mL,(12.25 ±2.03) cm and (15.23 ± 1.85)d in the control group (t=8.12,7.58,9.88,8.72,all P<0.05);3 years survival rate,the rate of distant me-tastasis and local recurrence rate of the two groups had no significant difference (χ2 =1.35,2.03,1.82,all P>0.05);The incidence of complications of the observation group was 3.63%,significantly lower than 18.18% of the control group (χ2 =8.25,P<0.05).Conclusion Breast conserving operation has a significant efficacy for breast cancer,with less trauma,quicker recovery,fewer complications,which is worthy of extensive promotion and application in clinical practice.

There are some characteristics in the teaching of amateurish adult medical students.As a bridge connecting basic medicine and clinical medicine,pathophysiology is very important in medical education.Aiming at the specialties of amateurish adult medical students,it has very realistic significance for us to explore and reform the teaching methods of pathophysiology,in order to improve the teaching quality and effect.

Humans ; Otitis Media ; microbiology ; Tuberculosis

AIM: To determine whether the 23 - gauge ( 23G ) vitrecomy cutter could replace scissors in conventional 20-gauge ( 20G ) pars plana vitrectomy for treating severe proliferative diabetic retinopathy ( PDR) .
METHODS:Non-comparative interventional case series. Totally 27 eyes of 27 patients with PDR stageⅥ confirmed by funduscopy and B-ultrasound scan were enrolled. They underwent 20G vitrectomy, in which 23G vitrectomy cutter replaced scissors to remove neuvascular membrane. All 27 eyes received complete panretinal photocoagulation, 17 eyes received no tamponade, 6 eyes were 12% C3 F8 tamponade, 4 eyes were filled with silicone oil. The follow up time was 3mo. The operation duration time, iatrogenic retinal tear and retinal bleeding need electric coagulation, best corrected visual acuity ( BCVA) , retinal reattachment were analyzed.
RESULTS: The operative time was 35- 120 ( average 79-19±29. 82) min; intraoperative iatrogenic retinal breaks were detected in 2 eyes (7%). At the end of 3mo follow up, BCVA>0. 1 were in 9 eyes, from 0. 05-0. 1 in 10 eyes,<0. 05 in 8 eyes. Retinal reattached in 25 eyes (93%), still detached in other 2 eyes with silicone oil.
CONCLUSION: The 23G vitrectomy cutter could replace scissors in conventional 20G pars plana vitrectomy for treating severe PDR.

Detection of lipids ,lipoprotein and lipid metabolism related indicators is important in the risk assessment and prevention of atherosclerotic cardiovascular disease ( ASCVD ) .Along with the research progress,there are still defects within the established lipid biomarkers and methods ,which need continuous optimization.The ASCVD risk assessment is expected to be further improved as the new biomarkers are coming up.

Objective To study the pathogenic bacteria species and drug resistance rate in the intensive care unit(ICU)in county hospital to guide clinical rational use of antibiotics. Methods 263 various specimens were chosen from January 2013 to December 2013 in the ICU of Zigui County People's Hospital in Hubei Province,these were applied to perform the bacterial culture and identification,and disc AGAR diffusion method was used to test the in vitro drug susceptibility and observe the specimens distribution,pathogenic distribution and the rate of drug resistance. Results In the 263 specimens,the top three isolated were 131 sputum(49.8%),49 blood(18.6%) and 38 ascites specimens(14.4%)respectively,and the pleural effusion was the least isolated with 5(1.9%). A total of 125 strains bacteria were isolated with positive detection rate of 47.5%(125/263). In the 125 strains,80(64.0%) were Gram-negative(G-)bacilli at the pioneer position,and the top four were:Klebsiella pneumonia 23(18.4%), Acinetobacter Baumanni 19(15.2%),Escherichia coli 18(14.4%)and Pseudomonas aeruginosa 12 strains(9.6%). There were 33 strains(26.4%)of Gram positive(G+)cocci including mainly Staphylococcus aureus 25 strains(20.0%);fungi strains were 12,the least(9.6%). The drug resistance rates of the top four G- bacillus were as follows:the rate of Klebsiella pneumoniae to ampicillin sodium was the highest(100%),while its rate to imipenem,meropenem and ciprofloxacin was 0;the rates of Acinetobacter baumannii to tobramycin and ceftriaxone were very high(100%, 92.3%),while to imipenem,meropennem were much lower respectively(26.3%,15.4%);the rates of Escherichia coli to ampicillin sodium and piperacillin were relatively high(88.9%,83.3%),while the rates to amikacin,imipenem, meropennem respectively were 0;the rates of Pseudomonas aeruginosa to ceftriaxone,cefotaxime sodium were very high(both 100%),while the resistant rate to levofloxacin was 0. The G+ cocci had no drug-resistance to linezolid, teicoplanin and vancomycin;the rates of Staphylococcus aureus to azithromycin,clindamycin,erythromycin and penicillin were higher than 80%,and those of Excrement enterococcus to erythromycin,gentamycin,levofloxacin were also higher than 80%. Conclusions The ICU infection of our hospital is primarily respiratory tract infection, the pathogenic bacteria are mainly G- bacilli and the antibacterial drug resistance is very serious. Therefore it is necessary to monitor the trend of bacterial resistance closely,and according to the results of bacteria identification and drug susceptibility,the antimicrobial agents are reasonably chosen to effectively reduce and control the ICU hospital infection.

Objective To investigate the mechanism of gadolinium chloride (GdCl3) inhibiting Kupffer cells (KCs) to suppress acute rejection following liver allograft transplantation in the rats. Methods The rats were randomly divided into control group (A), liver transplantation with GdCl3 pretreatment group (B), and liver transplantation with normal saline pretreatment group (C). The survival rate, liver function, hepatic pathological histology, cytokine level in liver and bile, activity of NF-?B in KCs, and membraneous molecules on the KCs were observed. Results (1) The one-month survival rate in group B was significantly higher than that in group C (P

Objective To summarize the early complications caused by the screws of AO titanium plate in the operative treatment of the displaced intraarticular calcaneus fracture (DIACFs). Methods 60 patients with calcaneal fractures were treated with ORIF (open reduction with internal fixation) using the AO plate. Results All the cases were followed up for 22 months. There appeared 1 case of screw loosening and 2 cases of improper screw location. Conclusion Although the AO titanium plate can improve the anatomic restoration of the calcaneus shape, sufficient preoperative preparation should be made to secure accurate placement of the screws so that the screw problems can be reduced.