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With the widely use of tourniquet in battlefield, the mortality of limbs bleeding has decreased remarkably. However, torso hemorrhage has become the leading cause inducing battlefield mortality. In present paper, the concept and features of torso hemorrhage were introduced, and the scheme, equipment and techniques of emergency control of torso hemorrhage were also described systematically, including local hemostatic materials, cavity foam materials, hemostasis device and aortic compression technique, etc. At the present stage, it is the key of reducing tactics mortality to actively research and develop the tactical stage equipment and technology for emergency treatment of tactical torso injuries. We should draw lessons from foreign army and positively face the severe challenges on torso trauma to enhance our ability in tactical trauma care. DOI: 10.11855/j.issn.0577-7402.2017.01.01

Insulin resistance (IR) is a complex metabolic disorder related to several diseases including type 2 diabetes (T2DM), hypertension and dyslipidemia. These diseases are all independent risk factors for cardiovascular disease. Lipid metabolism disorder has toxic effects on cells and may cause or aggravate IR in performance of elevated plasma levels of triglyceride (TG) and free fatty acids (FFA), the last one is an independent risk factor for IR. It has been clear that FFA may induce IR by endoplasmic reticulum (ER) stress, oxidative stress, apoptosis and inflammation, although the specific mechanisms remained unknown. The present paper summarizes the related molecules involved in the pathogenic process of IR and its mechanism, might provide a theoretical basis for the molecular mechanism of IR caused by FFA, and therapeutic reference for clinical treatment of IR and prevention of T2DM. DOI: 10.11855/j.issn.0577-7402.2017.01.16

Tissue engineering has been applied to induce pulp⁃dentin complex regeneration, and proposed the con⁃ cept of regenerative endodontics. As a new subject in stomatology, regenerative endodontics promotes root development and pulp regeneration with the combination of dental stem cells, biomaterial scaffolds and growth factors. Clinically, pulp regenerative technique has been used to treat necrosis and periapical periodontitis of immature permanent teeth. Numerous case reports and studies have proved the possibility of pulp regeneration, and regenerative endodontics will become a potential new treatment alternative of dental pulp diseases for dental clinician. In the present paper, we will summarize and analyze the current process and prospective of regenerative endodontics.

Dental implant restoration is an effective way to restore the chewing and aesthetic function for edentu⁃lous. However, dental implant restoration is facing great challenges of the lack of available bone, the maxillary sinus or inferior alveolar nerve vascular bundle, which is often necessary to carry out the related bone augmentation operation. All⁃on⁃Four technique is to use four implants in the anterior part of complete edentulous jaws, the two most anterior im⁃ plants are placed axially whereas the two posterior implants are placed distally angled, to support a provisional, fixed, and immediately loaded prosthesis. The technique avoids the artificial bone substitutes implantation and maxillary sinus augmentation or other bone augmentation surgery. Besides, it could alleviate patients' psychological reaction, postopera⁃ tive reaction, as well as time and money costs. It is considered a feasible treatment method to combine the application of the oblique implant and the axial implant in the treatment of the edentulous patients. This paper will elaborate on the concept of All⁃on⁃Four, the conventional technology, the evaluation research and some new viewpoints.

Polycystic kidney disease (PKD) is one of the monogenic inherited diseases. In PKD, excessive cell proliferation and fluid secretion, and disruption of the mechanisms controlling tubular diameter may all lead to cyst formation. Current evidence has demonstrated that intracellular calcium ion and cAMP imbalance drive both abnormal cell proliferation and apoptosis signal pathway. The present paper summarized the evidence implicating calcium ion and cAMP as central players in the signaling pathway of cell proliferation and apoptosis in PKD, and considered the potential therapeutic approaches targeted to slow cyst growth in PKD. DOI: 10.11855/j.issn.0577-7402.2016.11.13

Primary sclerosing cholangitis (PSC) is a chronic autoimmune cholestatic liver disease, with intrahepatic and/or extrahepatic bile duct diffuse inflammation, fibrosis, focal or segmental stenosis as the main features. Eventually this disease leads to bile duct obstruction, biliary cirrhosis and liver failure. The detection and diagnosis rate of PSC are increasing year by year, thus PSC becomes the hot spot for the study of hepatic inflammatory diseases. In this paper, we especially put our focus on the recent progress about diagnosis and treatment of PSC, and some special cases, including primary sclerosing cholangitis-autoimmune hepatitis (PSCAIH), autoimmune pancreatitis (AIP), ductile of PCS. These should help clinicians make a appropriate diagnosis and give correct treatment for these diseases. DOI: 10.11855/j.issn.0577-7402.2016.11.15

Enamel demineralization usually occurs during orthodontic treatment which is found white spots that affect the esthetic of teeth. Characterized by minimally invasive and painless, infiltration resin can be easily accepted by the patients which blocks the development of caries and improves the appearance of the teeth. This paper discusses the characteristics of infiltration resin such as color stability and micro-hardness.

Chronic recurrent parotitis (CRP) is a non⁃obstructive parotid inflammation in young children or adults,generally associated with recurrent and intermittent swelling of parotid gland, while children are more susceptible. The etiology of this disease is not clear, clinical manifestations are similar to other diseases, and the effective prevention and control measures are lack currently. This paper reviewed the research progress of the etiology of CRP in recent years, and summarized the role of sialography, ultrasonography and sialoendoscopy in diagnosis and treatment, and summa⁃ rized the main points of diagnosis and differential diagnosis of CRP in children and adults. The relationship and identifi⁃ cation of two kinds of CRP and clinically confusing Sjǒgren's syndrome were analyzed.

Enamel demineralization usually occurs during orthodontic treatment which is found white spots that af⁃ fect the esthetic of teeth. Characterized by minimally invasive and painless, infiltration resin can be easily accepted by the patients which blocks the development of caries and improves the appearance of the teeth. This paper discusses the characteristics of infiltration resin such as color stability and micro⁃hardness.

Ovarian cancer has become a common gynecological malignant tumor. Most of the patients have caught middle or late stage (stage 3 or 4) disease at presentation with poor prognosis. In despite of experienced optimal cytoreductive surgery and chemotherapy, most patients would be hard to avoid recurrence and metastasis of neoplasm, and recurrence and metastasis is the major cause of mortality in patients. Studies have indicated that circulating tumor cells (CTCs) are related to the recurrence and metastasis of ovarian cancer. Detection of CTCs in the peripheral blood might be helpful to predict prognosis of ovarian cancer, and will be effective indicators for monitoring recurrence and metastasis of ovarian cancer. Thus the detection method of CTCs and its clinical application in ovarian cancer have herewith been briefly summarized in the present paper. DOI: 10.11855/j.issn.0577-7402.2016.09.18

Inflammatory bowel disease (IBD) is a chronic non-specific inflammatory disease, its pathogenesis is not clear and its diagnosis is also a big problem in the medical profession. Osteoprotegerin (OPG) is a kind of growth factor receptor, plays an important role in bone metabolism, cell proliferation, cell differentiation, cell death, etc. Some scholars found that OPG can reflect the disease lesion severity, position and type of IBD and predict the sensitivity to glucocorticoid in children with ulcerative colitis. OPG will be expected to become a new indicator for assisting in the diagnosis of IBD. This paper reviews the implication of OPG in the pathogenesis and clinical application of IBD. DOI: 10.11855/j.issn.0577-7402.2016.09.17

Human dental erosion is an irreversible loss of dental structure caused by acid dissolution, which can leads to tooth fracture, clinical crown loss and occlusal disorders. Early diagnosis, timely blocking the destruction of acidic substances and do the corresponding repairment according to the tooth defect is a challenge for dentists. This paper reports a case of porcelain laminate veneer restoration of tooth defect caused by early acid etching with minimal invasive and bonding repair in order to protect and repair the remaining tooth structure.

Third molars, late-eruption permanent teeth in humans, have commonly been extracted in clinical treat⁃ ments. However, with the development of oral medicine, the value of maxillary third molars in clinical treatments, as well as in oral prosthetics, orthodontics, and oral implant applications, has gradually become recognized. This paper summarizes the research on the morphology of the crown, root, root canal and root tip of the maxillary third molar in a review to facilitate related research and clinical treatments

Diabetes is a chronic metabolic disorder caused by relative or absolute insulin deficient or reduced sensitivity of target cells to insulin. Mesenchymal stem cells (MSCs) are adult stem cells with multiple differentiation potential, self-renewable and immunoregulatory properties. Accumulating evidences from clinic or animal experiments recent years showed that MSCs infusion could ameliorate hyperglycemia in diabetes. The research progress of MSCs in diabetes treatment is summarized and a corresponding perspective is herewith proposed in present paper. DOI: 10.11855/j.issn.0577-7402.2016.07.16

The Nme (neoplasm metastasis) gene family was previously known as the nm23 (non-metastatic 23) gene family. The nm23 gene was the earliest tumor metastasis suppressor gene discovered by Steeg in 1988. All products of the 10 members (Nme1-Nme10) discovered so far of the gene family have a nucleoside diphosphate kinase (NDPK) active structure. Proteins encoded by the Nme gene family participate in processes including cellular differentiation, development, metabolism and signal transduction,and play an important role in the development of carcinoma. The Nme1 and Nme2 have been subjects of most relevant studies which show that the Nme1 isclosely associated with cellular differentiation and metastasis suppressor function in tumor. This paper provides an overview of studies in recent years on the Nme(nm23) gene family in oral squamous cell carcinomas.

During oral treatment, accidental foreign body ingestion not only caused the psychological and physical damage to patient, but in severe case may endanger the patient’s life. This paper focus on this accidental situation by systematic review of literature, in order to alarm the dentists in terms of medical security.

Chemerin is a kind of adipokines discovered in 2007. Chemerin and its receptor CMKLR1 are widely distributed in tissues, especially in white adipose tissues, conducting biological effects in an autocrine/paracrine manner. Experimental and clinical data have indicated that localized and/or circulating chemerin expression are obviously elevated in numerous inflammatory and metabolic diseases. Chemerin plays an important role in inflammatory response, regulating adipocyte differentiation and metabolism, and its expression level is closely related to obesity, abnormal glucose metabolism, hypertension and cardiovascular disease. The biological functions of chemerin in cells and animal models are discussed in present paper in order to further understand the relationship between chemerin and human health and diseases. DOI: 10.11855/j.issn.0577-7402.2016.05.16

Mesenchymal stem cells (MSCs), for their potential of differentiation into cardiomyocytes and easy acquisition, have been used in repair of myocardium tissue and improvement of heart functions after myocardial infarction. However, a vexed problem is the low homing rate of MSCs no matter what delivery methods (including intravenous, intracoronary or endocardial delivery) are used. SDF-1/CXCR-4 signal pathway plays an important role in variety of stem cell homing, and has been employed to enhance the function of SDF-1/CXCR-4 signal pathway for improving the efficiency of stem cell homing. The present paper has reviewed the methods used recent years to enhance the function of SDF-1/CXCR-4 signal pathway and the mechanism of the signal pathway in MSCs homing. DOI: 10.11855/j.issn.0577-7402.2016.05.14

Mild traumatic brain injury (mTBI) caused by blast shock waves (BSWs) is one of the most common injuries among soldiers in the war. Such mTBI can also happen in civilians if exposed to shock waves of accidental explosion disasters, bomb attacks by terrorists and so on. This injury often results in cognitive problems, memory dysfunction and emotional disorder, and these neurological deficits are closely related to the dysfunction or disruption of the blood-brain barrier (BBB). The present paper discusses mainly the relationship between dysfunction or disruption of BBB and inflammatory reaction in mild brain injury associated with explosive shock wave and effects of early intervention of oxidative stress injury, repairing the BBB and blocking inflammation on relieving delayed neurological deficits. DOI: 10.11855/j.issn.0577-7402.2016.05.15

Accidental hypothermia refers to a state of lowering of core body temperature down to 35 ℃induced by drowning, burial in snow and prolonged exposure to cold environment, etc. Hypothermia may affect the cardiovascular system, respiratory system, digestive system, etc. The triad consisting "hypothermia, acidosis and coagulopathy" is an important factor accelerating the death of patients. Early, timely application of rewarming measures is regarded as the basic principle in treatment of hypothermia. A series of rewarming measures, such as infusion of warm fluids, inspiration of warm air, abdominal infusion of warm fluid, instruction of warm fluid into pleural cavity, intravenous infusion of warm fluid, rewarming through ECMO, etc. have been used recently. Advance in research on the classification of hypothermia, its impact to the body and the treatment methods are reviewed in present paper. DOI: 10.11855/j.issn.0577-7402.2016.04.15

With the advent of dental operating microscope, periradicular microsurgery significantly improved success rate of traditional periradicular surgery, which includes periradiacular curettage, apicoectomy and retrograde filling. The present paper summarizes indication, apical sealing inspection, incision and flap design in anterior aesthetic region, and healing criteria for periradicular microsurgery.

Over the past ten years, with the progress of science and technology and improvement of equipment, the root canal treatment level has been promoted rapidly, and the root canal treatment effect has realized qualitative improvement. The 3 elements for the success of the root canal therapy which were the understanding of the root canal, sufficient preparation, close obturation were summarized and analyzed in this paper.

In the 21st century, non traditional security threats have become increasingly prominent, non warfare military activity has become general trend of global military development, and it has become the main activities of the peacetime arm forces in all countries. Therefore, to carry out and strengthen the medical support in non-war military operations is a long-term strategic task of Chinese Army medical service. The concept about non-war military activities and characteristics of medical support, and the existing problems, and measures of establishment of first-line rescue system are presented in this paper. Under the reformation of military affairs, the front-line ambulance system in non-war military action will work closely around the key security such as disaster relief, peacekeeping operations, public health emergencies and major events. It is necessary to learn the advanced experience from developed countries, and continuously deepen medical security work in non-war military operations on the basis of "non-combat" and "war"-oriented concept. DOI: 10.11855/j.issn.0577-7402.2016.01.17

Disastrous blast injury is a rare type injury, but an increasing incidence happened worldwide due to various reasons, often causing mass casualties incidents (MCIs). However, most clinicians have no treatment experience in managing blast injury. The present paper introduces the classification and severity prediction, as well as systematically describes medical rescue strategies for blast injuries, including on-site triage and in-hospital trauma emergency treatments such as trauma emergency care, and emergency care for lung and gastrointestinal tract blast injuries. DOI: 10.11855/j.issn.0577-7402.2015.09.01

This paper describes the ideas of the Chinese technology of cardiopulmonary resuscitation (CPR). The authors believe that its strategy should be based on inheritance of both the essence of CPR technology of both indigenous and western origin, and it should take into consideration of three factors: time, place and population in order to establish a composite mathematical and theoretical foundation of the CPR technology, and to form a guideline of CPR, and eventually establish the CPR system with Chinese characteristic. DOI: 10.11855/j.issn.0577-7402.2015.09.02

Antithrombotic therapy is the cornerstone of the treatment of coronary heart disease. To optimize antithrombotic therapy is one of ongoing efforts made by cardiovascular physicians. The randomized controlled clinical research of high quality in the field of antithrombotic therapy for coronary heart disease is still lacking in our country at present, and it become an important problem to be urgently solved in China. As there are studies with rich research data on antithrombotic therapy for cardiovascular disease domestically, and the differences in the problems involved between eastern and western populations, a preliminary exploration had been done in 2012 in the research center where the author is serving. This paper chiefly reviews the problems of major concern in antithrombotic therapy, our present situation, and treatment strategy based on our experience in clinical research for years. DOI: 10.11855/j.issn.0577-7402.2015.04.01

As a type of nuclear-related protein with various functions, high mobility group protein B1 (HMGB1) plays an important role in the development of liver tumors, particularly in the inflammatory microenvironment. In hepatocellular carcinoma, HMGB1 is an important inflammatory mediator that can promote the development of a series of signaling pathways. Meanwhile, in the inflammatory microenvironment of the tumor itself, HMGB1 can promote inflammation through related signaling molecules, and further cause the development of hepatocellular carcinoma. The mechanism of HMGB1 causing tumor development in the inflammatory microenvironment is a topic of interest for the diagnosis and treatment of tumors. This paper aims to summarize the current roles of HMGB1 in the inflammatory microenvironment of the liver and in the development and treatment of hepatocellular carcinoma. DOI: 10.11855/j.issn.0577-7402.2015.02.15

Warfarin is still the most clinically used oral anti-coagulant despite of its narrow therapeutic index and high risk of hemorrhage. The mean daily dose of warfarin varies widely from patient to patient, and to achieve the same therapeutic effect, the daily dose of warfarin could be varied over 20-fold. The variability in warfarin dosage depends on several factors, including gene polymorphisms, index of body mass, age and other drugs, and these factors compelled the clinicians to individualize warfarin dosage in order to optimize the therapeutic regimen. A number of genes are involved in metabolism of warfarin, such as cytochrome P450 2C9 (CYP2C9), vitamin K epoxide reductase complex subunit 1 (VKORC1), cytochrome P450 4F2 (CYP4F2), gamma-glutamylcarboxylase (GGCX), etc. Of them CYP2C9 and VKORC1 are the emphasis of current researches. The association between the polymorphism of CYP2C9 and VKORC1 and individualized warfarin therapeutic regimen are mainly discussed in this paper. DOI: 10.11855/j.issn.0577-7402.2015.02.16

Local hemostasis is the first step in wound treatment, and effective hemostatic methods could reduce the number of unnecessary casualties. Hemostatic materials need to have good hemostatic properties, excellent biocompatibility, no toxic side effects, no irritation and easy to prepare. The polysaccharide has many advantages, including rich source, simple structures, absorbable and biodegradable, excellent biocompatibility. At present, it has been found that polysaccharide is easy to modify in structure and recombine. This paper summarizes the characteristics and products of polysaccharide hemostatic materials including celluloses, chitosans, alginate, hyaluronic acid, and starch in order to offer the indications for clinical application and further study. DOI: 10.11855/j.issn.0577-7402.2014.12.16

C3 glomerulopathy is a series of diseases of glomeruli mediated by abnormal activation of alternative complement pathway. A series of researches have revealed in recent years that there are diversity and multiplicity of pathogenic mechanism in the pathogenesis of C3 glomerulopathy. The pathogenic mechanism of C3 glomerulopathy may be different in different individuals and types of disease. Congenital genetic defects and/or acquired autoantibodies may be found in the same individual. Individualized therapy should be given to individual patient in order to target different pathogenic mechanisms. Chinese herbal medicine, Tripterygium wilfordii, shows promise as a potential therapeutic agent for C3 glomerulopathy. The pathogenic mechanism and countermeasures for C3 glomerulopathy have been reviewed in present paper. DOI: 10.11855/j.issn.0577-7402.2014.11.15

C3 glomerulopathy is a kind of glomerular diseases mediated by abnormal activation of alternative complement pathway. As diversity and multiplicity of pathogenic mechanism, heterogeneity exists in the clinical manifestation and pathological features of C3 glomerulopathy. The clinical manifestation of the disease may be shown as abnormality in urine, hypertension, hematuria, nephrotic syndrome, nephritic syndrome, renal insufficiency, etc. Membranoproliferative glomerulonephritis, mesangial proliferation, crescent formation, focal segmental necrosis, diffuse hyperplasia and exudative lesions, etc may be found in renal biopsies. Also, the prognosis of C3 glomerulopathy is not uniform. The clinical manifestations and pathological features of C3 glomerulopathy were reviewed in the present paper. DOI: 10.11855/j.issn.0577-7402.2014.12.15

Objective To evaluate the potential correlation between the single nucleotide polymorphism (SNP) of the tumor suppressor gene p53 (rs1042522) and the risk of endometriosis by Meta-analysis. Methods Published case-control studies dealing with the influence of p53 (rs1042522) polymorphism on endometriosis were retrieved from PubMed, Embase, Wan Fang Digital Journal Full-text Database, China National Knowledge Infrastructure (CNKI) and VIP database for Chinese Technical Periodicals (VIP). Meta-analysis was performed by using RevMan5.0 software. Results A total of 7 papers dealing with p53 rs1042522 SNP, and there was a total of 968 endometriosis patients and 1282 controls satisfying the study criteria. Meta-analysis showed that significant differences were found in frequency distribution of GG genotype (OR=0.66, 95%CI 0.45-0.96, P=0.0004) and CC genotype (OR=1.19, 95%CI 0.74-1.91, P=0.002), but no significant difference was found in GC genotype (P>0.05) between the two groups. Significant differences were found in frequency distribution of G allele (OR=0.74, 95%CI 0.66-0.84, P=0.0002) and C allele (OR=1.34, 95%CI 1.18-1.52, P=0.0002) between the two groups. Conclusions The p53 (rs1042522) SNP may be associated with the pathogenesis of endometriosis. Women with GG genotype or G allele may have a lower risk of developing endometriosis, and those carrying C allele maybe significantly liable to suffer from endometriosis. DOI: 10.11855/j.issn.0577-7402.2014.08.05

This paper introduces the proposal of the concept and effect of actual combat on Tactical Combat Casualty Care (TCCC), analyzes the principle and key technology of TCCC, and explores the system construction and military significance of TCCC, so as to provide reference and inspiration for development of our military TCCC. TCCC has played an important role in reducing the wound and death rate in modern war, and is of great significance for the progression of theory and practice on combat casualty care in our army. DOI: 10.11855/j.issn.0577-7402.2015.12.01

The new military reform has put forward multiple challenges to the defense and medical support abilities, so the concept of war wound rescue should be constantly updated. The present paper introduces the concept and development of tactical war wounds rescue, analyze the echelons for war wound care and the characteristics and duty of each echelon in tactical war wounds rescue, summarized the management and update of the "Tactical War Wounds Rescue Guideline". The article also discusses the present situation of war wounds rescue, and the significance in the development and construction the principles of war wounds rescue. DOI: 10.11855/j.issn.0577-7402.2015.11.02

Wound healing is a complex and orderly biological process. Any factor hindering its smooth progress will impact the wound healing. A large number of clinical and experimental studies suggested that stress played a very important role in the process and outcome of wound healing. Moderate stress was not only a harmless factor on wound healing, but also beneficial to promote the wound healing. However, excessive stress will certainly affect the speed and quality of wound healing. Although it was clear that the severity of stress positively correlated with the levels of stress hormones, but the exact mechanisms and influential factors remain unclear. The present paper will discuss the possible mechanisms of stress in affecting the wound healing by retrieving relevant domestic and foreign literature, so as to provide a reference for accelerating the rate and improving the quality of wound healing by regulation and control of stress. DOI: 10.11855/j.issn.0577-7402.2014.07.15

Ischemic contracture of the myocardium is a special type of sudden cardiac arrest. Once occurs, it is difficult to resuscitate with the traditional cardiopulmonary resuscitation. However, when it is prevented the very beginning, resuscitation might be successful. In this paper, we would discuss its pathogenesis and pathology, and attempt to formulate a strategy of prevention of ischemic cardiac contracture including blockage of Ca2+ overloading, adopting ischemic preconditioning, giving an optimal dose of epinephrine, and maintenance of a mild hypothermia. This proposition might serve as references for clinicians to combat this clinical problem. DOI: 10.11855/j.issn.0577-7402.2014.02.01

Cerebrovascular disease is the primary cause of disease leading to death in China, of them about 80% cases are due to ischemic stroke. In treatment and secondary prevention of non-cardiac ischemic stroke, the efficacy of aspirin has been extensively verified by clinical studies, and the clinical application of aspirin has been recommended by national guidelines, but its net benefit is still not ideal. It still remains as a controversial problem whether on top of the use of aspirin, a short-term supplement of clopidogrel might result in a better efficacy in the prevention and treatment of non-cardiac ischemic stroke. In present paper, the authors have summarized the efficacy and safety of dual antiplatelet therapy on non-cardiac ischemic stroke by reviewing the guidelines published worldwide in recent years as well as the result of classical clinical trials. DOI: 10.11855/j.issn.0577-7402.2014.02.18

Objective To compare the efficacy in disinfection and pain control of calcium hydroxide paste and triple antibiotic paste (ornidazole, ciprofloxacin and minocycline) used individually or jointly for root canal disinfection. Methods Two hundred and thirty-five patients with chronic apical periodontitis (235 teeth) were involved in the present study and divided into 2 groups: fistula group (n=118) and no fistula group (n=117). Each group was then randomly divided into 4 subgroups: calcium hydroxide paste group, triple antibiotic paste group, calcium hydroxide + triple antibiotic paste group, and camphor phenol group. After regular root canal preparation, root canals of patients in 4 groups were filled with tiny paper ends impregnated with fore 4 different drugs respectively. Visual analogue scales (VAS) of pain were given to the patients with a guide for filling the scale. One week later, both the data of the scales and the effects of root canal disinfection were recorded and analyzed. Results Seven days after treatment, the clinical efficacy of calcium hydroxide paste, triple antibiotic paste and calcium hydroxide + triple antibiotic paste was similar (P>0.05) either in fistula group or in no fistula group, but all better than that of camphor phenol (P

As an important steroid, vitamin D is synthesized mainly from 7-dehydrocholesterol in the skin. When it is carried to the liver and kidney sequentially, it is transformed to 1,25-dihydroxyvitamin D3[1,25-(OH)2D3], which is the most active form of vitamin D. Kidney transplant recipients usually have low vitamin D levels, especially in the early post-transplantation period, possibly due to decreased sunlight exposure and intake of immunosuppressant. Traditionally, the recipients will receive vitamin D supplements to treat the osteoporosis or to maintain calcium and phosphorus homeostasis for a long time in the post-transplantation period. Along with the progress in the study of vitamin D receptors (VDR), extraskeletal effects of vitamin D have received more and more attention. VDR exists in many types of cells including activated T cells and tissues, and it is considered as a base of above-mentioned physiological effect of vitamin D. It also possesses potential effects in immune-modulation and anti-infection as well as regulation of bone metabolism. This paper reviews the recent research progress focusing on the effects of vitamin D in immunomodulatory and non-immunomodulatory aspects in order to provide reference for rational administration of vitamin D. DOI: 10.11855/j.issn.0577-7402.2014.03.17

Semaphorins were initially discovered as "axon guidance" cues in neuronal cells, but are ubiquitously expressed in immune, cardiovascular and respiratory systems. Based on differences of the structures, semaphorins have been categorized into eight subtypes. Semaphorin 7A is a membrane-associated GPI-linked semaphorin and plays an essential role in the vertebrate neuronal and immune systems. In the respiratory system, endothelial semaphorin 7A not only promotes neutrophil migration during hypoxia, but also plays an important role in lung fibrosis. The present paper reviews the physiological characteristics of semaphorin 7A and its effects on the diseases of pulmonary system. DOI: 10.11855/j.issn.0577-7402.2013.12.16

Objective To explore the relationship between the arterial oxygen saturation (SaO2) as a susceptibility risk factor for acute mountain sickness (AMS) in healthy people entering a high altitude area abruptly. Methods A search in Medline, PubMed, Springer, Elsevier and LWW databases was done to collect the reports concerning SaO2 as a susceptibility risk factor for AMS from 2000 to 2010 published in literature abroad, and meta-analysis was performed with RevMan 5.0 software. Results Nine papers concerning the relationship of AMS and SaO2 were retrieved. The heterogeneity test indicated that the nine studies were consistent statistically (Q=12.98, df=10, P>0.05), the data from these nine studies could be analyzed by fixed effect model. After combination of the data, those of 246 subjects with AMS and 557 subjects without AMS were collected. Test of overall effect by fixed effect model showed that the SaO2 was significantly lower in AMS group than in non-AMS group (weighted mean difference was 4.04, 95%CI was 3.36-4.71, P

Myeloid-derived suppressor cells (MDSCs) are a population of innate immune cells that form under pathological conditions, possess outstanding inhibitory function, and exert immune inhibitory function on many kinds of immune cells by different mechanisms, thus resulting in suppression of innate immune function and acquired immune function, and then promoting progression and deterioration of disease. The earliest researches about MDSCs focused on oncology field. In recent years, the researches about immune inhibition of MSCs in non-neoplastic diseases is increasing. The present paper reviews the research progresses of MDSCs in non-neoplastic diseases. DOI: 10.11855/j.issn.0577-7402.2013.10.018

The cardiac lineage arises from the cardiogenic area located in anterior lateral plate mesoderm during gastrula stage. Differentiation of cells in cardiac mesoderm into cardiac progenitor cells was regulated by complex signaling networks involving specific cytokines, inducing signal proteins and the core cardiac transcription factors. Any link of signaling networks influenced by mutation in genetics and changes in environment would lead to a series of congenital heart defects. Therefore, studies of signal transduction mechanism in heart development will give rise to a series of significant theoretical and clinical contributions to the mechanism of development of congenital heart diseases. Recently, it has been proved that a group of early transcription factors, including Nkx2.5, GATA4, Tbx5 and Isl-1, were involved in the complicated signaling networks during heart development. However, the mechanism of most signaling pathways in the networks remains unclear. In the present paper, the recent progresses concerning cardiac progenitor cells, a group of transcription factors, including Nkx2.5, GATA4, Tbx5, Isl-1 and Apelin/APJ pathways, were discussed. DOI: 10.11855/j.issn.0577-7402.2013.11.019

There is still no objective and precise system currently for assessment and evaluation of acute mountain sickness (AMS), which is evaluated mainly at present with Lake Louise Score, a subjective symptom questionnaire. The clinician should rule out other conditions with similar clinical presentations of AMS. Many researchers have focused on the measurement of physiological parameters in a hope to support the assessment of AMS. In such case, the role of blood pressure, heart rate, cardiac output, oxygen saturation, middle cerebral artery velocity become more important in AMS assessment due to their simplicity and noninvasive nature. So, in present paper, the authors will summarize the relationship between physiological parameters and AMS, and discuss the existing problems and the trend of development for further improvement.

Objective To evaluate the therapeutic effect of glucocorticoid in the treatment of HBV-related hepatic failure. Methods Literature was retrieved from Medline, PubMed, EMbase, OUP, Elesiver, BIOSIS, HMIC, CNKI, VIP, WANFANG Database and CBM Database from Jan. 1989 to Jan. 2012 to collect the papers concerning the clinical trials (published in English and Chinese) referring to glucocorticoid treatment and routine treatment for hepatic failure by meta-analysis method. Weighted mean (WM) was applied to evaluate the effect of glucocorticoid on prothrombin time (PT) and total bilirubin (TBil), and odds ratio (OR) was applied to evaluate the effect of glucocorticoid on survival rate, secondary infection and alimentary tract hemorrhage. Results Above-mentioned indexes included 24, 6, 9, 10, and 9 related articles. The effective indexes and 95% confidence interval (CI) were 3.12 (95%CI: 2.53-3.86), –0.48 (95%CI: –0.71-–0.25), –1.01 (95%CI: –1.29-–0.73), 0.80 (95%CI: –0.58-1.10) and 0.59 (95%CI: –0.41-0.85), respectively. Treatment with glucocorticoid decreased the mortality of patients with hepatic failure (Z=10.37, P=0.000), and improved PT and TBil levels (Z=4.10, P=0.000; Z=7.07, P=0.000), but no change was found in incidence of secondary infection and alimentary tract hemorrhage (Z=1.39, P=0.165; Z=1.69, P=0.095). Conclusion Glucocorticoid shows an obvious effect on the prognosis of patients with hepatic failure with no increase in complications.

Ectopic pregnancy (EP) is a common acute abdomen, and the incidence of EP has increased in recent years. The risk factors of EP changed significantly nowadays, and its clinical symptoms have become diversified. The train of thought and means for diagnosis of EP have also broadened and improved obviously, and the therapeutic methods tend towards individualization. The new techniques and drugs are developed unceasingly, and the prognosis and outcome of EP have also improved compared with the traditional level. The present paper would make a general review on the outline and progress of diagnosis and treatment of ectopic pregnancy.

The traditional view is that the heart is a terminal organ. This dogma, however, has been widely questioned with the discovery of adult cardiac stem cells (CSCs). Since CSCs have a highly self-renewal capacity and specific myocardial differentiation potential, nowadays they have been regarded as the most promising type of stem cells used in ischemic heart disease and other replacement therapy of end-stage heart disease. The present paper will focus on current results of scientific research on human adult CSCs and epicardium-derived cell (EPDC), as well as the treatment strategies in the field of cardiac regeneration, and the problems and prospect disclosed in the research.

Objective To evaluate the treatment effect of balloon kyphoplasty (Pkp) and Sky expander kyphoplasty (Sky) on vertebral compression fracture, and provide a theoretical basis for clinical application. Methods The database of Ovid medline, PubMed, Web of science, EMbase and CNKI from Jan. 1995 to Oct. 2012 were retrieved with computer, and relevant journals were manually retrieved, for the collection of the literature of therapeutic studies on treatment of vertebral compression fracture with Pkp and Sky method. The literature collected was then selected according to the inclusion and exclusion criteria, and analyzed by Meta-analysis software RevMan 5.0.25. Results A total of 4 papers were selected based on that criterion, including 146 cases of Pkp group and 83 cases of Sky group. Random effect model analysis showed no significant difference existed between the two groups regarding postoperative anterior height and column height of vertebral body, Cobb angle and pain relieve (SMD=0.50, 95%CI -0.27–1.27; SMD=0.33, 95%CI -0.11–0.77; SMD=0.46, 95%CI -0.74–1.66; SMD=-0.09, 95%CI -0.37–0.18). However, the subgroup analysis showed the effect of Sky was better than that of Pkp on restoring anterior height and column height of vertebral body and Cobb angle. Conclusion No significant difference was found regarding the treatment effect between Pkp and Sky method in the treatment of osteoporotic vertebral compression fracture, but the clinical effect of Sky was better because of fewer complications and lower medical cost.

Acute respiratory distress syndrome (ARDS) is closely correlated with infection. Severe infection, e.g., sepsis and septic shock, can result in ARDS. Ventilator associated pneumonia (VAP) is one of the common complications in ARDS related infection. As regards ARDS related infection, community acquired infection (CAI) is different from hospital acquired infection (HAI) in bacterial spectrum. The former is mainly caused by Streptococcus pneumonia, Hemophilus influenzae, Moraxelle catarrhalis, atypical pathogens and Klebsiella pneumoniae. However, HAI is mainly caused by Pseudomonas aeruginosa, Acinetobacter baumanii, methicillin-resistant Staphylococcus aureus(MRSA), and other drug-resistant bacteria. The drug-resistant bacterial infection not only makes treatment difficult, but also leads to an increase in mechanical ventilation time, length of ICU stay, mortality rate, and medical costs. The present paper has reviewed the relationship between ARDS and infection, therapeutic principles and measures of ARDS related infection, and introduced the optimal strategy of anti-infectious treatment of ARDS.

As a common disease, stroke seriously impairs human health. Interleukin (IL) is an important type of inflammatory mediators, which is involved in the pathogenesis of stroke. With the study of genomics, we discovered that some gene loci of IL were associated with stroke, such as IL-1α-889 C/T, IL-1RN rs380092 and IL-10-1082 G/G. Meanwhile, some gene loci of IL might become independent risk factors of stroke, such as IL-4 C582T and IL4-589C>T. Therefore, the IL gene polymorphism had become a research focus in pathogenesis of stroke. Our paper describes the relationship between IL subtype and its gene polymorphism with stroke. We look forward to provide a useful information for further research.