Recently accumulating evidence has shown that innate immunity recognition of invading pathogens can be attributed mainly to the Toll-like receptor (TLR) family.TLR signaling can induce the production of proinflammatory cytokines and upregulate expression of costimulatory molecules to provoke rapid activation of innate immuniry. Activated innate immunity subsequently leads to effective adaptive immunity. It, thereby, activites not only innate but ultimately also adaptive immunity. It can mediate activation of many kinds of cells, such as immune cells, hepatocytes et al. Upon binding to its respective ligands, TLR can activate signal transduction cascades leading to activation of transcription factors and protein kinases such as NF-?B and MAPK, and expression of immune response genes. Besides,TLR family may be involved in the pathogenesis of inflammation via recognition of host products. Inhibition of TLR action may work as anti-inflammatory drugs, and possibly also as agents to treat autoimmune diseases.Thus,the increasing understanding of TLR system could be the basis for treating a variety of pathological conditions.

TNF related apoptosis inducing ligand (TRAIL) is a new identified member of TNF family, which selectively kills a broad spectrum of tumor cells, but nontoxic to most normal cells. TRAIL triggers tumor cell apoptosis via death receptor DR4 and DR5 anchored in the cell surface, which is mediated through intracellular induced apoptosis proteins. The major pathway of its action proceeds through the formation of DSIC and activation of caspase8. The apoptotic processes follow two signal pathways, namely the mitochondrial independent activation of caspase3, and mitochondrial dependent apoptosis through the cleavage of BID by caspase8, the release of cytochrome C, the formation of apoptosome, and activation of caspase9 and the downstream apoptosis. In previous researches, it is shown that nontagged TRAIL proved to be noncytotoxic to hepatocytes in monkeys and chimpanzees and to human normal hepatocytes. Thus, the nontagged TRAIL has attracted great attention in recent years as a promising anti cancer reagent.

0.05).FVC increased significantly in week 6 and 12(t=2.762,P =0.008;t=2.255,P =0.029,respectively).There was no statistical significance in FEV_1/FVC between two groups.IC increased significantly in week 6 and 12(t =3.204,P =0.002;t =3.109,P=0.003,respectively).Conclusion Inhaling tiotropium increases IC in patients with stable COPD.As lung function targets judging limit extent of airflow in patients with COPD,FEV_1/FVC and FEV_1(%)are not sensitive in evaluating therapeutic effect of bronchodilators.IC is more reliable than other targets in evaluating therapeutic effect of bronchodilators.

Objective　To investigate the relationship of proximal femur geometry and hip fracture in elderly women. 　Methods　 We compared proximal femur measurements made from the uninvolved hip of 48 plane anteroposterior pelvis radiographs of elderly women without fracture to those of the contralateral hip in a group of 43 cases with hip fracture. Measurements of Singh index, head diameter(HD), neck diameter(ND), femoral neck length(NL), neck shaft angle(NSA) and cortical thinckness of proximal femur were analyzed. 　Results　 The cortical thickness of proximal femur in hip fracture and without hip fracture groups was (10.9±3.1) mm and (13.2±2.9) mm, and the Singh index below Ⅲ° was 86.05% and 66.67%, respectively. No difference in HD,ND,NL and NSA could be demonstrated.　Conclusions　 Singh index and cortical thickness of proximal femur may be used to predict the occurrence of the hip fracture in elderly women.

Objective To investigate the clinical and electromyographic features of peripheral nerve involvement in MS. Methods The clinical and electromyographic (EMG) data of 29 MS patients were evaluated retrospectively.Results 18 (62.1%) patients showed clinical and/or electromyographic abnormalities of peripheral nerves. The clinical symptoms included extremity numbness in 16 cases (88.9%), limb inertia in 11 cases (61.1%), radicular pain in 5 cases (27.8%), autonomic nerve disorder and dysphagia in few patients. Signs included decrease of tendon reflex in 11 cases (61.1%), periphery or root form hypoesthesia in 9 cases (50%), muscle weakness in 7 cases (38.9%), myatrophy in 4 cases (22.2%), and reduced pharyngeal reflex in 1 case (5.6%). There was no difference in age of onset, course of disease, neurologic impairment and prognosis between the patients accompanied with peripheral neuropathy and the patients without peripheral neuropathy. The electromyographic abnormalities included spontaneous potential in 4 cases (13.8%), increased motor unit potential in 8 cases (27.6%), slow MCV in 15 cases (51.7%), slow SCV in 13 cases (44.8%), low amplitude in 9 cases (31.1%), and prolonged distal latency in 5 cases (17.2%). The neuropathies improved by treatment with corticosteroid in the all patients except one.Conclusions Some MS patients may accompany with peripheral nerve abnormalities, which may improve with the recovery of MS. EMG is useful to evaluale the site and degree of peripheral nerve damage.

Objective To observe the clinical efficacy and influence of atorvastatin and Urinary Kallidinoge-nase on rheology,endothelin and inflammatory mediators in the treatment of elderly patients with acute cerebral infarc-tion,and to guide clinical treatment.Methods 86 patients with acute cerebral infarction were randomly divided into 43 cases of the observation group and 43 cases of the control group.Both groups were given conventional therapy,then the control group were given atorvastatin(20mg/d,qd),the observation group were given atorvastatin(20mg/d,qd) and Urinary Kallidinogenase(0.15PNA /time).2 weeks were set for a course of treatment,NIHSS score and ADL score were calculated before and after treatment.Then endothelin,CRP,IL -1 and hemorheology were measured by phlebotomized when limosis to evaluated the efficacy.Results The high shear whole blood viscosity,erythrocyte ag-gregation index,hematocrit,fibrinogen,erythrocyte sedimentation rate,endothelin,CRP,IL -1 and NHISS of the ob-servation group and control group after treatment were respectively (3.45 ±0.21)mpa/s vs.(4.89 ±0.31)mpa/s, (4.05 ±0.56)vs.(6.43 ±0.63),(33.4 ±3.4)% vs.(39.8 ±3.7)%,(2.43 ±0.72)g/mL vs.(3.18 ±0.64)g/mL,(20.5 ±7.5)mm/h vs.(27.3 ±7.3)mm/h,(58.8 ±5.7)pg/L vs.(70.7 ±7.5)pg/L,(6.68 ±2.96)mg/L vs.(16.78 ±8.97)mg/L,(3.64 ±1.56)ng/L vs.(6.53 ±2.64)ng/L,(8.2 ±3.3)point vs.(15.5 ±6.3)point. Data of both groups were significantly lower than before treatment,(t =5.234 vs.4.267,4.627 vs.3.532,4.872vs.3.726,5.021 vs.3.429,6.046 vs.3.848,10.477 vs.6.818,11.557 vs.6.686,9.267 vs.6.421,12.712 vs. 5.044,all P <0.05).The ADL score were (28.7 ±11.2)point vs.(22.5 ±10.1)point,and the data of both groups were significantly higher than before treatment (t =8.396 vs.5.336,all P <0.05).The high shear whole blood vis-cosity,erythrocyte aggregation index,hematocrit,fibrinogen,erythrocyte sedimentation rate,endothelin,CRP,IL -1 and NHISS of the observation group were significantly lower than the control group(t =3.207,3.388,3.667,3.761, 3.959,3.929,3.884,3.304,3.778,all P <0.05).The ADL score of the observation group were significantly higher than the control group(t =3,447,P <0.05);The total effective rate of the observation group and control group were 95.35% (41 /43 )vs 69.77% (30 /43 ),the difference was statistically significant (χ2 =10.904,P <0.05 ). Conclusion The method contained atorvastatin and urinary kallidinogenase have exact clinical efficacy,can improve neurological deficit assessment and the ability of daily life.Its mechanism may be that it can reduce endothelin levels of inflammatory mediators and improve blood circulation,which is worthy of clinical use.

Objective To explore the diagnostic value of telomerase activity (TA) and hTERT expression in pleural effusions. Methods According to the final diagnosis, 51 patients with pleural effusion were classified into two groups: malignant group (n=27) and benign group (n=24). Telomerase activity in pleural effusion was measured by TRAP-ELISA. Then the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of telomerase activity for diagnosing pleural effusion were calculated. hTERT in pleural effusion was detected by western blotting analysis. Results TA assay showed that 24 of 27 cases of malignant pleural effusion were found to possess telomerase activity, while 1 of 24 cases of benign one had telomerase activity. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of TA assay for diagnosing pleural effusion were 88.9%, 95.8%, 96%, 88.5%, and 92.2%, respectively. hTERT test showed that 8 of 27 cases of malignant pleural effusion had hTERT expression, while none of 12 cases of benign one had hTERT expression. There was significant difference in diagnosing pleural effusion between two methods (? 2=19.64,P=9.4?10 -5 ). Conclusion Tolomerase activity assay may act as a routine diagnostic method for malignant pleural effusions, while hTERT test may serve as complementary one.

The pharmacokinetics/pharmacodynamics ( PK/PD) of antimicrobials aims to establish and evaluate dose-concentration-response relationship, and subsequently to describe and predict the effect-time courses resulting from a drug dose.Nowadays, PK/PD is playing an important role in dosage regimen optimizing, reducing toxicity and drug tolerance of antibiotics.And it is also of great significance in determining susceptibility breakpoints and development in new drug.This paper reviews the progress on PK/PD studies of antibacterial and antifungal agents to provide theoretical basis for safe and effective individual dosage regimens.

OBJECTIVE:To investigate the perioperative prophylactic use of antibacteirals in patients undergoing simple goiter surgery.METHODS:The perioperative prophylactic use of antibacteirals in 240 patients of our hospital undergoing simple goiter surgery was analyzed statistically in respect of drug variety,DDDs,drug combination,medication time,curative effects,adverse drug reactions(ADR)etc.RESULTS:Of the 240 cases,238(99%)received prophylactic antimicrobials,with cephalosporins and quinolones dominating the list in terms of DDDs.The irrational drug use manifested as high proportion of high grade drugs in preventive medication,the prolonged postoperative use of antibacterials,and high rate of combined use of drugs etc.CONCLUSION:It is urgent to intensify physicians' consciousness about rational perioperative use of antibacterials.

Purpose:To analyze the immunophenotype character of malignant lymphoma with bone marrow involvement by means of Flow Cytometry (CD45/SSC gate).Methods:Bone marrow of malignant lymphoma patients was detected by Flow Cytometer(CD45/SSC gate),bone marrow smear was simultaneously performed as control.Results:(1) Bone marrow of 34 malignant lymphoma patients was examined by Flow Cytometry.23 cases were detected to have bone marrow involvement.(2) Among these 23 cases,19 cases were non-Hodgkin's lymphoma(NHL),4 cases were Hodgkin's lymphoma(HL).The highest frequency antigen marker of B cell NHL was CD19 and CD20,T cell NHL was CD7,and HL was CD9.Conclusions:(1)Flow Cytometry(CD45/SSC gate) is a feasible and effective method to detect patients with bone marrow involvement.(2) The antigen marker of B cell NHL is CD19 and CD20,T cell NHL is CD7 and HL is CD9.