Objective:To investigate the expression of Toll-like receptors(TLRs)signaling pathway in chronic rhinosinusitis(CRS)with nasal polyps.Method:Gene microarray analysis was used to detect the expression of TLRs signaling pathway in CRS with nasal polyps.Result:Of 19 differentially expressed(two-fold changes),4genes were upregulated and 15 genes were downregulated.Conclusion:The differentially expressed genes in TLRs signaling pathway may exert its effect in the pathogenesis of CRS.In addition,the roles of TLR9 and its agonists need further study.

Objective:To examine the utilization and cost of outpatient care and their influencing fac-tors among middle and aged peasant-workers in China. Methods:The data of China Health and Retire-ment Longitudinal Study ( CHARLS) collected in 2011-2012 were used and the data on peasant-workers aged 45 years and older were analyzed with Two-part Model. Results: The four-week outpatient rate of middle and aged peasant-workers was 13. 7% (407/2 974). The determinants of the rate included gen-der, marital status, economic level, household size, the place of insurance enrollment, self-assessed health and having or having no chronic diseases. The average outpatient cost was (400. 3 ± 56. 7) yuan (RMB) and the median was 138. 0 yuan. Multivariate analyses showed that outpatient costs were higher for those males who lived in Eastern China and worked at the same place with insurance enrollment, with fair to bad self-assessed health and chronic diseases. Conclusion:Allowing higher flexibility for migrants to transfer the new rural cooperative medical system ( NCMS ) between rural and urban areas and thus making reimbursement for medical services provided by undesignated providers received immediately could increase the use of outpatient services.

Objective To evaluate the efficacy and adverse effects of docetaxel combined with 5-fluorouracil in treating patients with advanced gastrice cancer.Methods 130 patients with advanced gastric cancer were randomly divided into observation group and control group,observation group treated with docetaxel combined with 5-fluorouracil,the control group treated with 5-fluorouracil and cisplatin,the clinical efficacy after the treatment was observed.Results The clinical efficiency rate of the observation group was significantly higher than that of the control group,the rate of leukopenia,thrombocytopenia and gastrointestinal reactions of the observation group was significantly lower than the control group,the quality of life scores of the two groups after treatment were all improved,but that of the observation group was significantly higher than the control group,the difference was statistically significant(P ＜ 0.05).Conclusion Docetaxel combined with 5-fluorouracil was effective in treating advanced gastric cancer.It worth further clinical research and application.

AIM:To investigate the expression and the significance of VEGF-C/D in rat cornea after alkali burning as well as the role of lymphangiogenesis in the high-risk corneal transplantation rejection.
●METHODS:The model of alkali burn corneal was made. Different times corneas were taken to electron microscope for vascularization, and examined the expression of VEGF-C/D and VEGFR-3 in l, 3, 5, 7, 14, 28d. The other rat cornea after alkali burn were divided into four parts to penetrate keratoplasty, containing only blood vessels in the cornea ( group A ) , angiogenesis and lymphangiogenesis ( group B ) , lymphangiogenesis degenerating period ( group C ) , angiogenesis degenerating period ( group D ) . ln addition, there are also normal groups ( group N ) to compare the Rl values and survival time of corneal graft.
●RESULTS: Electron microscopy showed that, when the first 7d rat cornea appeared neovascularization after alkali burn, but not lymphangiogenesis. The occurrence of new blood vessels and lymphatic in 2wk. There were no obvious lymphangiogenesis in 5wk and the angiogenesis gradually subside in 8 wk. The expression of VEGF-C/D and VEGFR-3 in the corneas of rats were up-regulated in the third days after the injury, and reached its peaks at 5d. The average survival time of group N, A, B, C, D were (14.25±0.62)d, (9.35±1.02)d, (5.06±1.13)d, (8.71±0.83) d, (9. 44±1. 05)d after transplant cornea. Compared to the rest of the group, group B plant average survival time significantly shortened (P<0. 05), while compared with group B, the survival time of A, C, D groups were significantly longer (P<0. 05).
● CONCLUSION: VEGF - C/D and VEGFR - 3 are expressed significantly after corneal alkali burn. New lymphatic vessels can accelerate high - risk corneal transplantation immune rejection.

Chromatography, Gas ; methods ; Humans ; Toluidines ; blood

To investigate the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) for di-agnosing low choledochal joint and its complications. MRCP results of 29 low choledochal joint patients con-firmed were analyzed retrospectively, and then compared with those by endoscopic retrograde cholaniopancreatography (ERCP). MRCP could display clearly the location of low choledochal joint, and the patients with complications involved 4 ones with cholecystolithiasis, 5 ones with cholangiolithiasis, 15 ones with cholecystolithiasis and cholangiolithi-asis, 3 ones with Mirizz syndrome, 2 ones with pancreatitis, 1 case with carcinoma of head of pancreas after cholecystec-tomy and 1 case of Vater ampullary carcinoma. Interoperative and ERCP findings proved that MRCP could be used for the diagnosis of low choledochal joint and its complications with no missed diagnosis. MRCP can be involved for the diagnosis of low choledochal joint and its complications, and thus can be used for preoperative planning and treat-ment of the complications.

Objective To evaluate the effect and the anti-tumor mechanism of nucleoside combination on human hepatoma cell line Bel-7402 with Arg-Gly-Asp sequence labeled by ultrasmall superparamagnetic iron oxide (RGD-USPIO).Methods The tumor cells Bel-7402 of logarithmic phlyhase were divided into experimental group and control group,treated with 1 mmol/L nucleoside combination and 1640 medium respectively.The two group were co-cultured for 48 h,and were added RGD-USPIO and co-cultured for 6 h.Then the two groups were proceeded with MR scanning,and the signal intensity of T2WI were measured.After extraction of the total RNA and protein of experiment group and control group,the expression of integrin avβ3 was detected using real-time PCR and Western blot.Results The T2WI signal intensity of experimental group (997.35±42.83) was higher than that of control group (241.05±15.36,t 28.79,P＜0.01).Compared with control group,the expression of integrin αvβ3 mRNA in experimental group was (0.22±0.02) times (t=4.50,P＜0.01).According to Western blot,the protein bands of experimental group were relatively lighter than that of control group,the expression of integrin αvβ3 in experimental group was lower (t =11.88,P＜0.01).Conclusion Nucleoside combination has anti-tumor effect by inhibiting integrin ligand-receptor binding,and the anti tumor mechanism may be related to the induction of tumor cell apoptosis.MR molecular probes can conveniently and accurately evaluate the anti-tumor effect of nucleoside combination on Bel-7402 cells.

AlM:To evaluate the efficacy of retrobulbar injection of triamcinolone acetonide ( TA ) combined with 577nm laser macular grid photocoagulation for the treatment of cystoid macular edema.
METHODS: Fifty-eight cases ( 66 eyes ) with cystoid macular edema caused by different diseases were recruited in this study. The included patients were treated with both retrobulbar injection of triamcinolone acetonide and 577nm laser macular grid photocoagulation. The best corrected visual acuity, macular thickness, fundus and intraocular pressure were observed in the 1wk, 1 and 3mo after the treatment in all of the included cases.
RESULTS: After treatment, all of the 66 eyes showed cystoid macular edema partially or completely subsided according to optical coherence tomography and fluorescence fundus angiography; 54 eyes ( 82%) visual acuity improved, 12 vision remained the same.
CONCLUSlON: Retrobulbar injection of triamcinolone acetonide combined with 577nm laser macular grid photocoagulation has good curative effect, simple operation procedure and rare complications in the management of cystoid macular edema.

Objective To investigate the clinic results of treatment of distal tibiofibular fractures by in- direct reduction and plate fixation through inferior fibula.Methods Between 2002 and 2005,32 cases of distal tibiofibular fractures were treated with indirect reduction and plate fixation through inferior fibula.According to the AO/ASIF classification,there were 17 cases of type A,nine cases of type B,and six cases of type C.Twenty of them also received iliac autograft through a limited median incision at the lower tibia to repair their lateral tibial defects.After operation their ankle joints were fixated at 90?with piaster brace and cast for three months.The bone union,wound and the function of the ankles were observed after surgery.Results All the patients were followed up for an average of 16 months.The average bone union time was 14 weeks.No nonunion,screw loosening,broken plate,or infection of the wounds was found in this series.The excellent and good rate was 84.4% according to Mazur's ankle joint function scoring.Conclusion Indirect reduction and plate fixation through inferior fibula is a satisfactory technique in the treatment of distal tibiofibular fractures.