Objective To investigate the changes in Toll-like re ceptor 4 (TLR4) and myeloid differential protein-2 (MD-2) gene expression in t he liver of septic rats, and to elucidate the relationship between the expressio n of TLR4/MD-2 mRNA and TNF? mRNA. Methods Sepsis model was reproduced in rats by intraperitoneal injection of LPS (5mg/kg). 80 Wistar rats were randomly divided into 4 groups: normal control and 1h, 2h, 6h after LPS in jection (20 rats for each group). Rats were sacrificed at different time points, and the expression of TLR4/MD-2 mRNA and TNF-? mRNA in the liver was measure d by RT-PCR. Results The expressions of TLR4/MD-2 mRNA and TN F-? mRNA were up-regulated, peaking 1h after LPS injection, and then declined gradually 2~6h after LPS challenge. The expressions at every time point were hi gher than that in control group (P

Objective To investigate the effects of endotoxin on the activation of nuclear factor-kappaB in myocardium, and to explore the molecular mechanism of acute myocardial injury. Methods Forty male Wistar rats were randomly divided into normal control group (n=10), lipopolysaccharide (LPS) 1h, 2h, 6h groups (n=10 for each group). In the latter two groups, LPS was injected into the peritoneal cavity. Tissue samples from the myocardium were collected to determine NF-?B activation by electrophoretic mobility shift assay (EMSA), and the mRNA expression of TNF-? was measured by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) with GAPDH as internal standard. Results The activation of NF-?B (2.173?0.063) and TNF-? mRNA expression (0.292?0.031) could be detected in myocardium in very low values in normal control group rats, while both the activation and expression were up-regulated markedly after LPS challenge, and peaked 2 hours afterwards (37.793?4.785 and 1.182?0.146, respectively). They were down-regulated (17.910?3.791 and 0.901?0.128, respectively) 6 hours after LPS challenge. Compared to normal controls, both NF-?B activity and TNF-? mRNA expression were significantly elevated at various time points following LPS stimulation (all P

ObjectiveTo examine the effect of Xuebijing Injection on the number of T lymphocytes and Toll-like receptors as adjuvant therapy of severe abdominal infections.MethodsA total of 78 patients with severe abdominal infection who were hospitalized in the intensive care unit were divided into control group and treatment group. The patients in control group received conventional therapy alone, while the patients in treatment group received Xuebijing Injection (50 mL twice daily for 2 weeks) in addition to conventional therapy. Blood sample was drawn before and after 2-week treatment to determine T lymphocytes. The peripheral blood mononuclear cells were separated to determine the expression of Toll-like receptors (TLR) 2 and TLR4. The Acute Physiology and Chronic Health Evaluation (APACHE) II score and gastrointestinal function score were recorded before and after treatment.ResultsThe levels of CD3+, CD4+ and CD4+/CD8+ of peripheral blood in the Xuebijing-treated patients were signiifcantly higher than those in control group (P<0.01), but the levels of CD8+ was signiifcantly lower than that in control group (P<0.01). The levels of TLR2 and TLR4 mRNA of the peripheral blood mononuclear cells in the treatment group were signiifcantly lower than those in control group (P<0.01). The APACHE II score and gastrointestinal function score in treatment group were signiifcantly lower than those in control group (P<0.01).ConclusionXuebijing Injection as adjuvant therapy of severe abdominal infection can improve the number of T lymphocytes, and reduce the expression of Toll-like receptors.

In this cross-sectional study, consecutive Chinese Han ethnic inpatients in the Division of Cardiology, the First Affiliated Hospital of Soochow University from January 1, 2010 to December 31, 2013 were included. According to the exclusion criteria, 9 587 patients [1 604 with type 2 diabetes mellitus (T2DM) and 7 983 without T2DM]were obtained for final analysis. Logistic regression model was used to analyze the association of ApoB/A-1 ratio with T2DM and the possible interactions between ApoB/A-1 ratio and other risk factors. The results showed that the distribution of ApoB/A-1 ratio was positively skewed in Chinese Han ethic population. The median of ApoB/A-1 ratio of female was lower than that of male (0.68 vs 0.73,P<0.01). In all groups, the proportion of T2DM was increased with the raised ApoB/A-1 ratio. By the stratification analyses of sex, age, coronary artery disease, and the use of statins, ApoB/A-1 ratio was still correlated with T2DM. There existed significant interactions between ApoB/A-1 ratio and the smoking status or creatinine in T2DM.

Objective To investigate the influence of gender differences on NF-kB activation in livers in septic rats. Methods Total 20 female and 20 male Wistar rats were randomly divided into four groups.Tissue samples of the livers were collected to measure NF-kB activation by EMSA.The level of plasma ALT,TNF-?and estrogen were measured also. Results NF-kB activation in normal male and female rats has no significant difference (P＞0.05).After stimulated by LPS,the level of NF-kB activation and ALT,TNF-?in plasma were markedly upregulated,and the index of female group lower than that in male group (P＜0.01).The level of NF-kB activation in livers and ALT,TNF-?in plasma both in male and female have significantly negative correlation with the level of estrogen in plasma (P＜0.05 ).Conclusion There are significantly gender differences on NF-kB activation in livers in septic rats.Estrogen may decrease the injury of livers in septic rats.

0.05). Yet, the activity of NF-?B (female: 12.10?2.89; male: 19.53? 2.12) and the level of TNF-? female: (4.10?0.72) ng/ml; male: (6.37?1.29) ng/ml were significantly increased after injection of lipopolysaccharide (P

Objective To explore the clinical results of the arthroscopic acromioplasty in the rotator cuff repair.Methods Sixty-five patients (42 males and 23 females) to receive suture bridge repair under the arthroscopy between May 2012 and May 2014 were selected and randomly divided into an experimental group and a control group.The experimental group was given suture bridge repair with acromioplasty,while the control group underwent the suture bridge repair without acromioplasty.The time of operation was recorded.The range of motion (ROM) of the shoulder,the UCLA shoulder scoring system (ULCA) score,American orthopedic surgeon scoring system (ASES) score,the visual analogue scale (VAS) score and Constant score were observed 3 and 12 months after the operation.Results There were no significant differences in age,sex and the affected side between the two groups.Significant differences were found between the two groups in the duration of the operation (t=-18.5,P＜0.05).There were no significant differences in the ROM and the ULCA,ASES,VAS and constant scores of the shoulder 3 and 12 months after the operation.Conclusion No significant differences were found in the ROM and the shoulder function scoring between giving acromioplasty under the arthroscopy or not.However,the operation time of undergoing acromioplasty under the arthroscopy was longer.

The therapeutic effects of intensive insulin therapy in treatment of traumatic shock combined with multiple organ dysfunction syndrome (MODS) were investigated. A total of 114 patients with traumatic shock combined with MODS were randomly divided into two groups: control group (n=56) treated with conventional therapy, and intensive insulin therapy group (n=58) treated with conventional therapy plus continuous insulin pumping to control the blood glucose level at range of 4.4-6.1 mmol/L. White blood cells (WBC) counts, prothrombin time (PT), serum creatinine (SCr), alanine aminotransferase (ALT), serum albumin and PaO(2) were measured before and at the day 1, 3, 5, 7 and 14 after treatment. The incidence of gastrointestinal dysfunction, the incidence of MODS, hospital stay and the mortality were also observed and compared. After intensive insulin therapy, the WBC counts, SCr, ALT and PT were significantly reduced (P<0.05), but the level of serum albumin was significantly increased (P<0.05) at the day 3, 5, 7 and 14. In the meantime, the PaO2 was significantly elevated at the day 3, 5 and 7 (P<0.01) after intensive insulin therapy. The incidence of gastrointestinal dysfunction, the incidence of MODS, the length of hospital stay and the mortality were markedly decreased (P<0.01). The results suggest early treatment with intensive insulin therapy is effective for traumatic shock combined with MODS and can decrease the length of hospital stay and the mortality.

Objective To observe the clinical effect of headless compression Screw (HCS)under arthroscope in the treat-ment of patella fracture.Methods Nineteen patients of patella transverse fractures were selected,all of them were treated with HCS fixation under arthroscope,reviewed and followed-up after surgery.Results X-ray examination after surgery of 3 -5 weeks found that the fracture lines blurred or disappeared,and the patella articular surface was smooth without displacement.The healing time of fracture was 8 weeks on average after operation;There was no statistical difference in the range of the knee joint in the af-fected side in (135.42±5.82)°and the contralateral side in (139.38±6.55)°(P >0.05);The knee Lysholm score of the last follow-up was 86-100 points[(93.7±4.14)points],which was significantly higher than the preoperative score of 65.7 (P <0.05);There was no fracture displacement in the period of followed-up,drop of internal fixator,fracture and other complications.Conclusion HCS fixation under arthroscope in treatment of patella fracture is effective.The joint function recovered quickly with less complica-tion.It could be one of the effective methods for the treatment of patella transverse fracture.

BACKGROUND:To reduce the amount of bleeding and the amount of hemoglobin after total knee replacement has been a key project in the clinical research in the division of bone and joint. Currently, ice therapy has been widely used in the clinic for tissue sweling and pain due to various physical and chemical factors. OBJECTIVE:To investigate the risk factors of postoperative hemoglobin after total knee replacement and discuss the effects of ice intervention. METHODS: 240 patients with osteoarthritis based on the random draw principles were equaly divided into the treatment group and the control group. The general information, disease status, diagnosis and treatment and prognosis of the two groups were investigated. Al patients were actively subjected to artificial total knee replacement. On the basis of the treatment in the control group, the treatment group received ice intervention at 2 hours after replacement for 7 consecutive days. RESULTS AND CONCLUSION:The postoperative hemoglobin decrease occurred in 34 patients, with the incidence of 14.2% among 240 patients at 7 days after replacement. Multivariate logistic regression analysis results showed that age, no ice treatment, body mass index were the main risk factors for hemoglobin decrease after total knee replacement (P < 0.05). Compared with the control group, the postoperative hemoglobin values of the treatment group were significantly higher (P < 0.05). Hemoglobin decrease values, total blood loss, blood transfusion rate, blood transfusion amount, and pain score at 3 and 7 days after replacement were significantly lower in the treatment group than in the control group (P < 0.05). The knee function excelent and good rate was 96.7% in the treatment group, and 95.8% in the control group, which showed no significant difference (P > 0.05). Results verify that clinical application of total knee replacement facilitated the knee recovery in patients with osteoarthritis, but hemoglobin decrease and bleeding existed. Active ice intervention can reduce the risk and relieve postoperative pain.