Objective To investigate the expression of Toll-like receptor 4 (TLR4)in peripheral blood monocytes and its correlation with TNF-α and IL-6 in type 2 diabetes (T2DM)patients with neuropathy. Methods Healthy volunteers (NC,n=44),T2DM without neuropathy (n=44)and T2DM with neuropathy (n=44)were recruited in the present study.The expression of TLR4 mRNA and protein in peripheral blood monocytes was detected by RT-PCR and flow cytometry. ELISA was undertaken to measure the plasma concentration of TNF-αand IL-6. Results The levels of HbA1 c[(9.09±1.62)%vs(8.36±1.10)% vs (5.30±0.89)%],the protein expression of TLR4[(42.02±9.69)% vs (31.27± 6.87)% vs (11.96±5.54)%],the mRNA expression of TLR4[(2.98±1.06)vs (1.74±0.47)vs (1.12 ±0.52)],TNF-α[(8.75±3.14 )vs (6.27±3.64)vs(3.19±1.17)pg/ml]and IL-6[(3.63±1.81)vs(2.60 ±1.14)vs(1.54±0.58)pg/ml]in patients with diabetic neuropathy significantly increased compared with T2DM and NC group;TLR4 showed a positive correlation with TNF-αand IL-6(r=0.631,P <0.0001;r=0.447,P =0.0023). Conclusion TLR4 of monocytes may take part in the occurrence of systemic inflammation and has a close relationship with the development of diabetic neuropathy.

Objective To observe and the clinical characteristics in children with acute traumatic bi-lateral eip dural hematomas,analyze the formation mehc ansi ms and explore the early diagnso is strategies and effective surgical treatment methods.Methods From August 2004 to December 2013,21 cases(17 males,4 females) of pediatric patients with acute traumatic bilateral epidural hematomas were treated in our hospital, and the clinical materials,imaging data and prognosis were summarized and analyzed.Results The 21 pedi-atric patients were aged from 4 months to 16 years,the mean ga e was 6.88 years.Bilateral single epidural hematoma across the superior sagittal sinus was found in 5 cases,bilateral double or more hematomas in both sides of the midline were observed in 16 cases.Initial CT scan showed simultaneous bilateral hematomas in 12 cases;while in 9 cases of bilateral hematomas were found with a delayed onset by the reviewed CT.The admitting glasgow coma score was between 13-15 in 8 cases,9-12 in 11 cases and 3-8 in 2 cases.Surgi-cal treatment was performed in 8 cases,including 7 cases with bilateral operations and 1 case with unilateral operation.Thirteen cases were managed consevr atively.Exec pt one death case, all other children were well er covered to normal lives.Conclusion Delayed contra-lateral epidural hematomas following evacuation of a prior EDH can lead to poor outcome because of usually delayed discovery.Early dynamic CT scans can detect bilateral epidural hematomas and observe their changes in time.Early detectiona nd prompt individual treat-ment should be applied in children with bilateral epidural hematomas to get good prognosis.

Intracellular calcium is one of the crucial signalings that modulate various physiological and pathological processes.Abnormal calcium signaling is closely associated with invasion and migration of neoplasms.Calcium regulates focal adhesion turnover,cytoskeletal reorganization and other processes about tumor cell movement through contacting with multiple downstream proteins,such as calpain,PYK2 and S100 protein family.Several calcium entry channels including store-operated calcium channels and transient receptor potential channels participate in the invasion and migration of tumor cells.Pathological calcium signaling may be a potential target in anti-invasion and anti-migration therapy.

Objective To explore the effects of dexmedetomidine(DEX) on the changes of patient' s cognitive function after undergoing cardiac valve replacement with cardiopulmonary bypass(CPB).Methods Sixty patients to selectively receive cardiac valve replacement with CPB were randomly divided into two groups:DEX group(n =30) and normal saline group(NS group,n =30).DEX (0.5 μ.g/kg bolus and infusion at a rate of 0.5 μg · kg-1 · h-1) was administered to the patients of DEX group,and the patients of NS group were given with equivalent normal saline at the same time.Aortic clamped time,CPB time,duration of anesthesia and PaO2 at 10 min before CPB were recorded.Heart rate(HR),mean arterial pressure(MAP),jugular venous oxygen saturation(SJvO2) and jugular venous oxygen partial pressure(PJvO2) of anesthesia induction(T0),10 min after induction(T1),CPB re-warmed to 36℃ (T2),and 1 h(T3),6 h(T4),24 h (T5),48 h (T6),72 h (T7) after CPB were performed.MMSE were performed 3 days after surgery,the incidence of POCD was calculated.Results There was no statistical significance in aortic clamped time,duration of CPB,anesthesia time and PaO2 at 10 min before CPB (P ＞ 0.05) between both of groups.Compared to TO,SJvO2 and PJvO2 of NS group from T1 to T2,T4 to T7 and DEX group at T1,T4 to T7 were decreased(P＜0.05,P＜0.01).Compared to NS group,SJvO2 and PJvO2 of DEX group from T2 to T3 were increased(P ＜ 0.01).MMSE evaluation and the incidence of POCD of DEX group were better than those of NS group 3 days af ter surgery(P ＜0.05,P ＜ 0.01).Conclusion Cardiac valve replacement with CPB can lead to cognitive impairment in pa tients,dexmedetomidine can ameliorate cognitive function by decreasing oxygen consumption in brain tissue.

Purpose To investigate the comparison of miR-106a in fresh and paraffin-embedded tissues and its expression in precan-cerous 1esions of gastric cancer. Methods Human gastric cancer tissues inc1uding 30 coup1es of fresh and 40 coup1es of paraffin-em-bedded samp1es were co11ected,quantitative rea1-time PCR was used to detect the expression of miR-106a in these two samp1es. Anoth-er paraffin-embedded samp1es inc1uding 20 cases of precancerous 1esions and 40 cases of gastric adenocarcinoma were a1so co11ected,in situ hybridization was used to assess the expression of miR-106a in these stages. Results The re1ative expression of miR-106a in fresh tissues was 3. 25 ± 1. 99,in paraffin-embedded tissues was 3. 18 ± 2. 14,indicating that the expression of miR-106a in these two sam-p1es has no statistica1 difference(P>0. 05),corre1ation ana1ysis showed that there was a significant corre1ation of miR-106a expression in these two samp1es(rs =0. 998,P<0. 001). The expression of miR-106a was detected in the stage of precancerous 1esions with the positive rate was 70%. The positive signa1s were 1ocated in dysp1astic epithe1ia1 ce11s and appeared as dark b1ue fine granu1es. The positive rate of miR-106a in gastric cancer tissues was 87. 5% and the frequency and extent increased and enhanced compared with pre-cancerous 1esions. Conclusion miR-106a has significant corre1ation in gastric cancer fresh tissues and paraffin-embedded tissues. Detection of miR-106a with paraffin tissues and its ear1y changes in prema1ignant 1esions can provide va1uab1e information for the ear1y diagnosis of gastric cancer.

Objective To explore the treatment of gestational diabetes mellitus (GDM) and the selection of time and pattern for termination.Methods A prospective study on 40 cases of patients with GDM was carried out.The patients' clinical data were analyzed by statistical method.Results There was a significant difference in the neonatal suffocation between insulin treatment combined with diet limitation and diet limitation alone(P0 05). Compared with 37 to 40 gestational weeks, neonatal morbidity obviously increased in 40 gestational weeks (P

The 55th ASH annual meeting published a special report about Hodgkin lymphoma,which mainly contains management of early-stage Hodgkin lymphoma,novel targeted therapy and the optimal treatment of lymphocyte-predominant Hodgkin lymphoma.The therapy of Hodgkin lymphoma should be individualized,in order to improve both PFS and OS.More clinical trials should be designed on the target therapy and the treatment strategy of nodular lymphocyte-predominant Hodgkin lymphoma.

Objective To explore the effect of failure mode and effect analysis (FMEA) method in strengthening the management of critical value of blood specimens in hospital. Methods According to the procedures of FMEA, critical values management team were established, drew flow chart of generating test specimens and crisis value, explored the potential failure mode and failure cause, analyzed the severity, possibility and critical value, and formulate and implement countermeasures according to the research outcome. Results The crisis value of the failure mode fell from 1 320 to 151 after the implementation of FMEA, and rate of decline was 88.56%; number of unqualified blood samples decreased from 510 cases to 78 cases, and the difference is statistically significant (χ2=407.27, P<0.05);critical value processing defects decreased from 85 cases (a total of 236 cases) to 3 cases (a total of 229 cases), and the difference was statistically significant (χ2=91.26, P<0.05). Conclusions FMEA method is helpful to improve the accuracy and precision of critical value management of clinical blood samples, so as to ensure the safety of patients in hospitals.

OBJECTIVE To evaluate the cardiotoxicity of a widen-spectrum antineoplastic drug, gambogic acid, through quantitative multiple cellular phenotypic characterization. METHODS H9c2 cell line was used as a model with doxorubicin (Dox) and amiodarone (Ami) as positive controls, hypaconi?tine as negative control and 0.1% DMSO as normal control. An optimized protocol was established to identify the morphology and function of cell nuclei. The effect of drugs on cell viability, nuclear area (Hoechst33342), mitochondria mass (MitoTracker Deep Red) and cytoplasmic calcium ion mobilization (Rhod2 AM)was studied. EC50 and Z′values were calculated to evaluate the degree of toxicology and to estimate the precision and false-positive rate, respectively. RESULTS Dose-response analysis indicated that EC50 of Dox on cell viability, nuclear area, mitochondrial mass was 0.72, 0.014 and 1.21μmol · L-1, respectively. On the other hand, EC50 of Ami on the parameters of cell viability, nuclear area and mitochon?drial mass was 14.83, 6.72 and 4.54μmol·L-1, respectively with Z′value above 0.5. Hypaconitine decreased the SER ridge of mitochondria. Gambogic acid caused significant mortality of H9c2 cells and induced nuclear shrinkage as Ami did. The EC50 values of cell viability and nuclear area were 0.24 and 1.16 μmol · L- 1. Meanwhile,gambogic acid disturbed the mitochondrial function as indicated by the increased mitochondrial area (EC50=0.44 μmol · L-1), abnormal SER Ridge(EC50=0.99 μmol · L-1) and decreased mitochondrial mass(EC50=1.21 μmol · L- 1). Cellular calcium mobilization was lower than normal (EC50=0.41 μmol · L-1). CONCLUSION The EC50 values of positive controls calculated from our assessment are similar those reported in literature. A multi-parameter and simultaneous evaluation enables a comprehensive analysis of the morphology of nuclei and mitochondria of cardiomyocytes and a preliminary assessment of the mechanisms of toxicity.