Toll-like receptors ( TLRs) are pattern recognition receptors, which exist in both cell membrane and cytoplasm, and participate in inflammatory reactions. Some studies have shown that TLR2/4-NF-κB signal pathways mediated by TLR2 and TLR4 could regulate the production of inflammatory factor IL-1β, which played an important role in the attack of gouty arthritis. The article focused on the pathogenesis of gouty arthritis, discussed the structure and distribution of TLRs, the ligands and its mediated signal pathways, the validity in the treatment of gouty arthritis using the signal pathways as the target points and the relationship between the signal pathways and gouty arthritis, and reviewed the research progress in Chinese medicines using the signal pathways as the guidance.

Objective:To explore the pharmaceutical care points in advanced lung cancer patients with brain metastases. Meth-ods:Clinical pharmacists participated in the drug treatment process of one case of small cell cancer patient with brain metastases. Pharmaceutical care was carried out from various aspects, including brain metastases treatment, chemotherapy, antiviral therapy and patient education. Results:Cerebral transfer symptoms and quality of life of the patient were effectively improved and adverse reactions were reduced by the pharmaceutical care. Conclusion:By the implementation of pharmaceutical care on the patient, clinical pharma-cists can not only improve their own knowledge base and exploit professional advantage, but also provide suggestions on rational drug use for health care professionals.

Objective To investigate the MRI features of intracranial lymphoplasmacyte-rich meningioma and the corelation between the MRI features and pathologic findings. Methods The MRI and pathologic data of 7 patients with lymphoplasmacyte-rich meningioma were reviewed retrospectively. All cases were proved by surgery and pathological examinations. Results All lesions were solitary. The tumors crawled along meninges in 6 cases and in 5 cases the tumors did not appear as mass lesions. In 2 cases, the tumors appeared as half-moon. The boundary of all of the tumors was unclear, accompanying heavy peritumoral brain edema. The brain invasion can be seen in 7 cases. The lesions showed hypo-isointense signal on T1 WI in 7 cases, hyper-isointense signal in 5 cases and hypo-isointense in 2 cases on T2 WI.Enhancement scan demonstrated marked enhancement in 7 cases. Extensive thickening of the meninges was observed in 6 cases. Pathological results showed that the cells were abundant and diversified, with a great quantity of lymphoplasmacytes, and there were typical meningeal epithelial cells area in the surgical specimen. Conclusion The MRI findings of lymphoplasmacyte-rich meningioma show some features different from other common meningiomas, which would be helpful to the diagnosis and differential diagnosis.

Objective To investigate the clinical manifestation,pathogenesis and imaging features of hemichorea associated with hyperglycemia in primary diabetes mellitus(DM).Methods Analyze the clinical manifestations,the neuroimaging features and the treatment of the three patients with hemichorea induced by hyperglycaemia in primary DM,and review the literatures about this disease.Results All of the three cases had a long history of uncontrolled diabetes,among whom,two were non-ketotic hyperglycemic patients and one was ketotic hyperglycemic patient.All of them had an acute onset hemichorea which was almost continuous during awakeness and ceased during sleep.The early CT findings in this disorder were high density in the caudate nucleus,putamen and/or globus pallidus on the side contralateral to the involved limbs,but showed decreased attenuation or completely resolved in about a month.T1-weighted MR images in all cases showed high-signal intensities without edema or mass effect in the diseased region which decreased after several months,while the T2-weighted images were more variable.Conclusion Hemichorea induced by hyperglycemia often happens in the patients with poorly controlled DM,and both of the non-ketotic hyperglycemic and the ketotic hyperglycemic state can be the cause.In the major affected region-corpora striata,CT shows hyperdense lesions,T1-weighted MR images show hyperintense lesions and T2-weighted images show variable lesions in the early time.

Objective To investigate the renal expression of stem cell factor (SCF) in lupus nephritis (LN) and its correlation with disease activity and renal injury parameters. Methods Histochemical stain was used to examine all renal specimens (LN group n=34, chronic glomerulonephritis n=16, control group n=8). Hyhridization in situ and immunohistochemistry were used to detect the expression of SCF and infiltration of mast cells, macrophages , α-SMA (+) cells in renal tissues of the two groups. SPS software was used for tissue of the control group. However, they increased markedly in lupus nephritis and CGN (t=6.03～14.25, P< 0.01). But there was no significant difference between LN and CGN in SCF and mast cells in renal interstitium. Positive correlation was observed among the expression of SCF and α-SMA and the number of mast cells and macrophages (r=0.47～0.84, P<0.01) at their corresponding locations. The expression of SCF and ot-SMA and the number of macruphages were positively correlated with renal pathological active index, chronic index, albuminuria and the injury of renal interstitium (r=0.34～0.93, P<0.05 or 0.01); meanwhile, it was negatively correlated with Ccr(r=-0.39～0.61, P<0.01). There was significant correlation between SCF, macrophages and anti-dsDNA antibody, complement C3 level, SLE disease activity index (SLEDAI). The number of mast cells in renal interstitium was positively correlated with chronic indexes and the injury of renal interstitium (r=-0.86, r=0.93, P<0.01) and negatively correlated with Ccr (r=-0.56, P<0.01), but not correlated with active index and albuminuria (r=0.27, r=0.23, P>0.05). Conclusion The expression of SCF is widespread in kidney, and it is markedly eorrelated with various kinds of inflammatory cells, renal inherent cells, renal function, and urine protein levels. SCF may be an critical participant in the initiation and progression of renal injuries in human lupus nephritis.

Standardized training of residents is a necessary way for clinical medical personnel train-ing. Residents graduating from medical colleges and universities should accept the standardized, scientific, strict pre-service training, in order to realize role conversion from medical students to hospital physicians. This paper summarizes and analyzes the pre-service training, focusing on the training object, course design, organization implementation, evaluation, questionnaire survey, and puts forward some thoughts and sugges-tions on strengthening and improving pre-service training form, expanding the content of training, and quan-tifying the evaluation of training effect.

Objective: To investigate the level of arsenic exposure in rural drinking water and to assess the health risk caused by exposure to arsenic in Tongzhou District, Beijing Municipality in 2019, so as to provide insights into improving the quality of rural drinking water. Methods: Water samples were collected from self-provided wells in 196 villages of 7 townships in Tongzhou District from April to June, 2019, and the arsenic levels were measured in drinking water according to Standard examination methods for drinking water-Metal parameters (GB/T 5750.6-2006). The carcinogenic and non-carcinogenic risks of arsenic were evaluated in drinking water using the environmental risk assessment model recommended by the United States Environmental Protection Agency (EPA). Results: Totally 520 water samples were collected, and the median arsenic concentration was 0.001 2-0.050 0 mg/L. There were 67 water samples with arsenic levels exceeding the defined standard level (12.88%), and the proportions of arsenic levels exceeding the defined standard level were 57.69%, 17.24%, 12.20%, 6.52% and 1.31% in Songzhuang, Huoxian, Lucheng, Zhangjiawan and Yongdedian townships, and the arsenic levels did not exceed the defined standard level in Majuqiao or Taihu townships. The carcinogenic risk of arsenic was 3.135 7×10-4/a in drinking water, which exceeded the maximum acceptable risk, and the carcinogenic risk of arsenic all exceeded the maximum acceptable risk, with the highest value seen in Songzhuang Township (9.648 2×10-4/a). A high carcinogenic risk of arsenic was seen in men at ages of 60 to 80 years (3.012 8×10-4/a) and in women at ages of 80 years and older (2.949 0×10-4/a). The non-carcinogenic risk of arsenic was 0.696 8 in drinking water, indicating a low risk, and were 1.009 5 and 2.144 1 in Huoxian and Songzhuang townships, indicating a high risk. In addition, a high non-carcinogenic risk of arsenic was seen in men at ages of 60 to 80 years (0.669 5) and in women at ages of 80 years and older (0.655 3). Conclusion There was a high proportion of arsenic levels exceeding the defined standard level in rural drinking water in Tongzhou District, 2019, and there was a health risk, notably with the highest carcinogenic risk seen in residents at ages of 60 years and older. Effective interventions are needed to reduce arsenic levels in drinking water.

Medical microbiology is basic course of medicine.In order to improve teaching quality,we employ discussing-mode education in microbiology.This education style can not only enlighten and train poly-directional thought ability,capacity of bringing forth new ideas and pioneering spirit,but draw close the distance between students and modern life science,which make microbiological course become beginning of exploring microbiology.The employment of education style of discussing microbiology new advance is effective pathway of exploring most suitable high-quality person of talent training.

Objective To investigate the diagnostic values of tumor M2-PK in lung cancer.Methods The concentration of Tumor M2-PK in plasma was detected by ELISA in 106 health controls,77 benign lung disease patients and 92 lung cancer patients.Results TuM2-PK concentration in plasma and the positive rate were singificantly higher in lung cancer(22.1 U/m1,71%)than that in benign lung disease and in health controls(10.5 U/ml,4% and 8 U/ml,3%)(P

The source of seed cells has always been the major problem in cartilage tissue engineering.Bone marrow stromal cells (BMSCs) have gradually become an optimal source of seed cells for cartilage engineering due to their high proliferative potential,multi-lineage differentiation potential and easiness to be obtained with minute trauma.The great challenge is how to get abundant BMSCs with a high purity and how to induce them in vitro into chondrogenic phenotype.This review aims to discuss the various strategies that can induce BMSCs chondrogenic differentiation in vitro so as to offer beneficial reference for constructing cartilage with BMSCs as seed cells.