Objective:To investigate the role and its mechanism of Toll-like receptor4(TLR4) mutation on acute lung injury induced by hemorrhagic shock without resuscitation.Methods:The hemorrhagic shock model of 20 toll-like receptor 4(TLR4) mutant mice and 20 wild type mice(CBA) was reproduced by heart puncture.The lung tissues were collected at 0,1,2,4,and 6 hours after hemorrhagic shock for pathologic analysis,TLR4 mRNA was measured by semi-quantitative reverse transcription-polymerase chain reaction and NF-?B activation was determined by electrophoretic mobility shift assay.Results:The lung neutrophil infiltration and erythrocyte effusion in toll-like receptor 4 mutant mice were milder than those in wild type mice.The expression of TLR4 mRNA and activation of NF-?B were increased following hemorrhagic shock in wild type mice,while there was no significant change in TLR4 mutant mice.Conclusion:TLR4 plays an important role in ALI induced by hemorrhagic shock,and TLR4 mutant alleviates ALI.

Objective] To conclude Yan Zhongqing clinical academic experience. [Methods] Discussed in terms of etiology and pathogenesis, treatment, therapies of Yan Zhongqing teacher using classical treatment of insomnia clinical experience, herbal prescription summed up its characteristics, citing the case evidence. [Results] Yan Zhongqing teacher believes that the main pathogenesis of this disease is not paying for the yin yang, and heart, lung, liver, kidney closely linked to inadequate blood deficiency and liver yang common causes of insomnia are caused clinically. The main syndromes of heart and lung deficiency heat, heart and kidney Huo, heart and liver blood deficiency, lack of liver stagnation of liver-yang, etc., are used to support the heart and lungs, cooling heat; yin and clearing fire, balance between kidney and heart; Yin and Yang blood, Anshen; liver qi, yang Yixin of the law, and achieves better therapeutic effect on clinical practice. [Conclusion] With appropriate clinical prescription of Mr. Yan, the treating method has clinical value.

Objective To explore the criterion of constitution with Yin-deficiency and provide the evidence for further development of establishing the criterion.Method According to reference documents on TCM,a questionnaire on the criterion of constitution with Yin-deficiency was developed and distributed to 51 experts of TCM in Zhejiang province.Results The mean scores of forty-six items ranged from 2.02 to 2.78 and top sixteen symptoms were dry mouth,dry stools,dry throat,feverish palms and soles,thready pulse,constipation,emaciation,yellowish urine,red tongue,rapid pulse,vertigo,thirst with preference for cold drinks,vexation,dry lips,little coating,thirst with frequent drinking.Modes of 46 items ranged from 1 to 4.Coefficients of weight for diagnosis ranged from 0.018 to 0.024 and variance of coefficients were from 0.540 to 1.572.Conclusion Forty-six items could become the content of the criterion of constitution.

The data of 173 cases with acute mastitis were collected and reviewed from January 2010 to October 2012.The liquor puris samples were collected for bacterial culture.And drug sensitive test was performed by Kirby-Bauer method.98 samples were cultured with a positive rate of 56.7％.A total of 98 bacterial strains were isolated,Gram-positive bacteria were 91 strains (92.9％) and Gram-negative 7 strains (7.1％).The most common bacteriun Staphylococcus aureus,accounted for 83.7％ was highly resistant to penicillin and erythromycin with resistant rates of 90.2％ and 86.6％ respectively.And there was no resistance to vancomycin and teicoplanin.

Objective To investigate the clinical value of multi-slice spiral CT (MSCT)in diagnosis of internal abdominal hernia (IAH).Methods The MSCT findings in 1 5 patients with IAH confirmed by surgery were retrospectively analyzed.Results MSCT showed intestinal obstruction in 14 patients with strangulating intestinal obstruction in 8.The typical features of MSCT were as follows:translocated position of intestines (occupying effect),closed loop intestinal obstruction (gathered intestinal loops with different forms),assembled,expanded and translocated blood vessels of mesenteries,and thickened intestinal walls with ischemic edema and abnormal density.Surgical results showed paraduodenal hernia in 2,transomental hernia in 2,transmesenteric hernia in 5,ankylenteron strap hernias in 4,pericecal hernia in 1 and hernia through the Douglas fossa in 1,Intestinal obstruction in 14 and strangulating intestinal obstruction in 8 were also confirmed by surgery.The CT findings of IAH were correlated with the surgical results,and the accurate rate of grading of intestinal obstruction with CT was also consistent with the surgical results (Kappa=0.758,t=3.462,P=0.001).Conclusion IAH can be diagnosed accurately by MSCT in most patients,MSCT is helpful for guiding the surgical programs.

Objective To study whether the leakage of polymethylmethacrylate (PMMA) can lead to pulmonary embolism in vertebroplasty (VP), and to observe the correlation of embolism degree with the doses of PMMA. Methods Fifteen canines were randomly divided into 3 groups: group A, B, C, and were injected 0.5, 1.0, 2.0 ml PMMA into the femoral veins, respectively. Before and after the injection, chest CT and angiography of pulmonary artery were performed, the pressure of pulmonary artery was measured, and the blood gas analysis of femoral artery was done. At last, the canines were euthanized and examined and histologically after HE-stained. Results In group C, the pressure of O_2 decreased obviously, and significant difference was found between before and 10 min after injection (P<0.05). The pressure of CO_2 increased quickly in group C, significant difference was detected between before and 1 min after injection (P<0.05). Pressure of pulmonary artery in both group B and C were significantly different between before and after injection (P<0.05). Conclusion The leakage of PMMA can lead to pulmonary embolism. The degree of pulmonary embolism is correlated to the doses of PMMA. The large dose of bone cement leakage can lead to disorder of respiratory function.

Objective To explore the value of 1H-MRS on the evaluation of Alzheimer's disease (AD) with neural stem cells (NSCs) transplantation in an APP-PS1 double transgenic (tg) AD mouse model.Methods NSCs from C57BL/6 mice were cultured and amplified.APP-PS1 tg mice (n =30) aged 12 months were used as the study group,and mild-type mice (n =15) were used as the control group.Animals in the study group were randomized into two subgroups,the AD mice in one subgroup received NSCs transplantation (NSCs group) and in another subgroup received phosphate buffer saline (PBS,PBS group)in bilateral hippocampal CA1.Animals in the control group were not treated.Using a 7.0 T high-fieldstrength MR imager,1H-MRS was performed before and 6 weeks after transplantation to measure the area under the peak of n-acetyl aspartate (NAA),glutamate (Glu),myo-inositol ( mI),choline (Cho) and creatine (Cr) in the hippocampal area,NAA/Cr,Glu/Cr,mI/Cr and Cho/Cr ratio were calculated and compared with histopathological results (including Nissl's staining and electron microscope examination).Comparisons among NSCs,PBS and control groups were conducted by one-way ANOVA.Results NSCs from C57BL/6 mice were cultured successfully. Before transplantation,the mean NAA/Cr,Glu/Cr and mI/Cr in NSCs,PBS and control groups were 0.89 ± 0.05,0.88 ± 0.04 and 1.15 ± 0.05,0.40 ± 0.03,0.39 ± 0.03 and 0.45 ± 0.05,0.67 ± 0.05,0.67 ± 0.05 and 0.52 ± 0.04,respectively,and differences were statistically significant (F =148.918,7.529,59.468,P ＜ 0.01 ). There were no significant differences in NAA/Cr,mI/Cr and Glu/Cr ratios between NSCs and PBS groups before transplantation (t =0.147,0.096,0.207,P ＞ 0.05 ),but the differences were significant compared with the control group (t =0.255,0.467,0.171 and t =0.269,0.527,0.151,P ＜0.05).Six weeks after transplantation,the mean NAA/Cr,Glu/Cr and mI/Cr in three groups were 1.13 ±0.07,0.86 ±0.05 and 1.14 ±0.05,0.45 ± 0.04,0.38 ± 0.02 and 0.44 ± 0.03,0.58 ± 0.04,0.67 ± 0.04 and 0.53 ± 0.04,respectively,and differences were statistically significant ( F =112.092,23.076,44.367,P ＜ 0.01 ).NAA/Cr and Glu/Cr ratios were increased and mI/Cr was decreased in NSCs group,and the difference was significant compared with PBS group at the same time point ( t =0.271,0.071,0.089,P ＜ 0.05 ).There were no significant differences in NAA/Cr and Glu/Cr ( t =0.013,0.012,P ＞ 0.05 ),but there was a significant difference in mI/Cr between NSCs and control groups ( t =0.046,P ＜ 0.05).There were no significant differences in Cho before and after transplantation among the three groups (P ＞ 0.05 ). Nissl's staining showed that the number of neurons in the hippocampal area increased more significantly in tg mice receiving NSCs than that without receiving NSCs.Electron microscopy showed that most hippocampal NSCs in NSCs group were morphologically normal with abundant organelles,while hippocampal NSCs in PBS group were swollen with sparse synapses.Conclusion 1H-MRS is able to display intracranial metabolite changes before and after NSCs in APP-PS1 double transgenic AD mice and has an applicable value in evaluating the therapeutic effect of NSCs on AD.

ObjectiveTo investigate the influence of positive serum thyroid peroxidase antibody (TPOAb) on pregnancy outcomes in biochemically euthyroid women during gestation.MethodsFrom July 2006 to December 2010,in the prenatal care unit all pregnant women,who had no medical and family history of thyroid diseases,underwent thyroid function screening.Serum TPOAb was tested among those pregnant women with euthyroidism.Pregnancy outcomes,including obstetric complications,neonate birth weight,and Apgar score,were compared between 185 TPOAb positive women and 1417 TPOAb negative women.ResultsCompared with TPOAb negative women,it was more frequent for TPOAb positive women to suffer from various obstetric complications.The prevalences of umbilical cord entanglement ( 18.9％ vs 12.9％,RR =1.47,95％ CI 1.06-2.03,P＜0.05 ),threatened premature delivery or abortion (3.8％ vs 1.0％,RR =3.83,95％ CI 1.57-9.37,P＜0.05 ),intrauterine growth retardation (5.4％ vs 0.8％,RR =6.96,95％ CI 3.00-16.17,P＜0.01 ),and neonatal pneumonia ( 4.9％ vs 1.3％,RR =3.83,95％ CI 1.75-8.40,P＜0.01 ) in the group of TPOAb positive women were higher than those in the group of TPOAb negative women.Apgar score of those newborns whose mothers had positive TPOAb was 9.27 ±1.13 at one minute and 9.44 ± 1.09 at five minutes,being lower than that of the TPOAb negative group (9.49 ±0.69 and 9.68 ±0.52,both P＜0.01 ).The rate of newborns with Apgar score at 7 or less by 5 min in group with positive TPOAb was higher than that of group with negative TPOAb ( 1.6％ vs 0.1％,RR =11.49,95 ％ CI 1.93-68.31,P＜ 0.05 ).ConclusionsThese results indicate that pregnant women with normal thyroid function but positive TPOAb may be liable to increase risk of serious pregnancy outcomes,such as threatened premature delivery or abortion,intrauterine growth retardation,and a lower Apgar score in neonatal.

Objective To explore the multi-modal MRI characteristics of breast cancers in dense breasts.Methods 120 patients with breast cancer shown on mammography underwent breast MRI,which were solitary and confirmed by pathological examination. According to the BI-RADS classification of breast,the 120 cases were divided into two groups including dense type breast and non-dense type one.The differences in morphological features,ADC values (b=1 000 s/mm2 )and time-signal intensity curve (TIC)of the lesions between two groups were analyzed and compared.Statistical analysis was performed using SPSS1 6.0.Results The breast cancers in dense breast were vulnerable to have a spiculated margin (44/68 in the dense breast group vs.1 6/52 in the non-dense breast group,P =0.000).The size of the lesion in dense breast (1.83 ±0.98)cm was bigger than that in non-dense breast (1.40±0.46)cm (P =0.005).The non-mass-like enhancement of the lesion in dense breast was much more than that in non-dense breast (P =0.000).In addition,the average ADC values of the lesion in dense breast (0.89±0.12)×10 -3 mm2/s were lower than in non-dense breast (0.95±0.10)×10 -3 mm2/s(P =0.01 6).Conclusion The breast cancer in the dense breast has different MRI findings in comparison with non-dense breast.

The nutritional status, serum protein, albumin, calcium, zinc, iron, SF, FEP, vitamin A, activity of RBC transketolase, and blood glutathione redu-ctase of 349 normal primigravidas, 30 healthy non-pregnant women and 42 toxemic gravidas were estimated longitudinally from the 1st trimester to delivery. It was noted that serum protein, albumin, Ca, Zn, and Fe decreased markedly in the course of pregnancy. The content of serum vitamin A showed no variation or decrease in the 3rd trimester in 1/3 of the pregnant women observed. Insufficiency of thiamine and riboflavin were noted in 16.7% and 47% of the normal pregnant women respectively. The adequate nutrients intakes in pregnancy were considered to be: Energy, +200 kcal/d; Protein, + 15g/d in the 2nd trimester and +25g/d in the 3rd trimester; Calcium 1000 mg/d in the 2nd trimester and 1500mg/d in the 3rd trimester; Zinc, 20mg/d; Iron 26 or 30 mg/d by supplementation if possible; vitaminA 1000 ?gRE/d; both thiamine and riboflavin 1.8 mg/d.