Toll-like receptor( TLR )is a newly discovered important innate immune receptor and signal transduction transmembrane receptor.By the TLR in the surface of immune cells,body can recognize conserved pathogen-associated molecular patterns,to stimulate the production of cytokine,increased costimulatory molecule expression of antigen-presenting cell,activating T cells,establishing a closely-linked bridge between the innate immunity and acquired immunity.TLR9 is a member of Toll-like receptor family,mainly identify viral or bacterial DNA containing unmethylated CpG dinucleotides.Studies have showed that TLR9 is in the immune system's recognition of EB virus,and it plays an important role in the infection and transformation of the EB virus.This paper reviews the studies of the interaction of TLR9 with EB virus.

Objective To study the relationship between clinical-biological significance and the expression of CD44v6 and Survivin in multifocal papillary thyroid carcinoma (PTC). Methods Immunohistochemical SP method was used to investigate the expression of CD44v6 and Survivin in 47 cases of multifocal PTC and adjacent tissues, and 122 cases of single focal PTC tissues. The expression of CD44v6 and Survivin and the risk factors among different clinical factors were analyzed between solitary PTC and multifocal PTC group. Results Tumor foci were found in 27.8 % (47/169) patients. The patients with multifocal were characterized by a higher ratio of family history of thymid tumor, lymph node metastasis and extra-thymidal extension (χ2 = 4.189, 6.159, 4.079, P ＜0.05), and not related with sex, age, size and the number of the tumors (P ＞0.05).The positive rates of CD44v6 and Survivin were 70.2 % (33/47) and 66.0 %(31/47), respectively, in multifocal PTC, both of which were significantly higher than that in nodular goiter,Hashimoto' s thyroiditis and normal thyroid tissues (χ2 =47.184, P ＜0.05). Overexpressions of CD44v6 and Survivin in multifocal PTC were related to the degree of the infiltration(χ2 = 4.723, P =0.030; χ2 =4.023,P =0.045) and lymph node metastasis (χ2 =5.771, P =0.016; χ2 =5.686, P =0.017), and not related with sex,age, family history and the number of the tumors (P ＞0.05).The expression of CD44v6 was correlated positively with Survivin (r =0.514, χ2 =10.15, P ＜0.01).There was no significant difference in expressions of CD44v6 and Survivin between multifocal and single focal PTC (P ＞0.05).By the sept.2010, the patients with single and mutiple focal PTC were all survival.Conclusion Multifocus is one of the clinical features of PTC.The high expressions of CD44v6 and Survivin in multifocal PTCs relate to the development, invasion and metastasis.

Objective To study the clinicopathology characteristics of chronic lymphocytic thyroiditis (Hashimoto's thymiditis, HT) with occult papillary thyroid carcinoma (occult PTC) in order to improve its diagnostic and therapeutic accuracy. Methods A restrospective analysis was done on the clinical materials of 28 cases of HT with occult PTC from July 1999 to July 2005. All cases were confirmed by operation and pathologic biopsy. Clinical and gross findings were collected. All HE slides were reexamined and immunostains for CK19, galectin-3,and bcl-2 were performed (Envision method). Results In total 189 cases of chronic lymphocytic thyroiditis,28cases (14.8%,28/189)had coexistent occult papillary thyroid carcinoma. There were 19 females and 9 males with median age of 36.7 years old. Normal TSH presented in 11cases (39.3%), high in 8 cases(28.6%), and low in 9cases (32.1%). All tumor diameter was counted for <0.8 cm, 16 cases (57.1%) tumor diameter 0.2～0.5 cm, 12 cases (42.9%) >0.5 cm. Coarse calcification was seen in 6 cases(21.4%) in color ultrasonic exam and CT scans. Follow-up data showed that 28 patients were all alive with no evidence of recurrence or metastasis for 2 to 7 years by December 2007. Conclusion There are no special clinical characteristics in coexistent HT with occult PTC.Coarse calcification in HT in the group of middle-aged women increase the likelihood of the diagnosis. But the diagnosis depends on pathology. Because of the high incidence of occult PTC in HT population, it would be necessary to keep an eye on this particular type of thyroid carcinoma, and multiple sampling in suspected area of HT specimen is advised in the hope not to miss any small tumor in clinical practice.

Objective To explore the clinical value of combined detection of CA15-3, TSGF, OPN and CA125 in the diagnosis and treatment of breast cancer. Methods The serum specimens from 187 patients with breast cancer (cancer group) were collected, tumor markers CA15-3 and CA125 were detected with electrochemiluminescence method, TSGF was detected with chemocolorimetry, and OPN was detected with enzyme-linked immunosorbent assay. Compared with 50 cases of patients with benign breast disease (control group), The relationship between these marker and clinical stage, recurrence and metastasis of breast cancer were analyzed. Results The serum levels of CA15-3, CA125, TSGF and OPN in cancer group were significantly higher than those in control group (P ＜0.05). Four markers in high clinical stage(Ⅲ and Ⅳ stage)[(83.21±28.67), (89.13±32.34), (278.66±137.23) U/ml and (97.4±11.7) ng/ml, respectively] were higher than those in low stage( Ⅰ and Ⅱ stage) [(60.03±19.35), (58.21±17.56), (155.79±113.11) U/ml and (77.5±10.81) ng/ml,respectively] (P ＜0.05), and those in lymphnode metastasis patients and in recurrence patients were significantly higher than those in corresponding groups (P ＜0.05). The sensitivity and specificity of the combined detection of four tumor markers were 96.3 % (180/187) and 80.0 % (40/50), respectively. The average time of combined detection of serum tumor markers was 2 months ahead of the mammographic features in the recurrence patients with breast cancer. Conclusion The dynamic combined detection of CA15-3, TSGF, OPN and CA125 are better markers for monitoring recurrence and metastasis of breast cancer,which are benefit to early diagnosis and interference.

Objective To prepare sustained-release danshensu microcapsules by spray drying.Methods Encapsulation efficiency of different coating materials was compared.The spray process was optimized using a central composite design for two variables to obtain microcapsules with microcapsules yield.Furthermore, in vitro release of danshensu microcapsules was determined.Results PVA was chosen as coating material and the ratio of coating material to core material was 3:1.The inlet air temperature was 190℃,the feed flow rate was 36 r/min,encapsulation efficiency was 85.0%,and microcapsules yield was 56.1%.The particle size of more than 70%microcapsules was between 6—12?m.Conclusion The optimized conditions of spray drying are reasonable,danshensu microcapsules can be used as sustained-release preparation.

Objective To investigate the therapeutic effect of stage treatment of severe complicated injuries in palmar forearm and wrist.Methods From March 2008 to Novemler 2011, eleven cases with skin lost combined with fracture and lost of flexor tendon, ulnar radial arteries, median and ulnar nerves,and some of them had fracture of ulnar and radius were treated in the first stage with vacuum sealing drainage after emergency debridement and tissue repair. Secondary microsurgical repair was performed after the VSD was removed. The lost of median and ulnar nerves was repaired with transplantation of sural nerve,and the wound was repaired with free flaps and complex tissue flaps. Results Eleven cases were treated with vacuum sealing drainage for 7 to 10 days.Infections were under control,wound areas reduced and most wound areas were covered by granulation tissues.Flaps and skin grafts were survived.After postoperative follow-up for 3 to 36 months (average 13 months),three cases was received flexor tendolysis.As result,the blood circulation of hand was good, the sensor of injured nerve was higher than S3, and there was a good functional rehabilitation of hand muscles. Conclusion Using vacuum sealing drainage after emergency debridement and tissue repair, there was a good repairing effect of secondary repair with flaps and skin grafts for severe complicated tissue defect in palmar forearm and wrist,and it is an effective choice of operation.

Objective To investegate the effect of phosphorylated-P38 MAPK(mitogen-activated protein kinase) on the expression of caspase-3 in the substania nigra (SN) of MPTP-induced mouse model of(PD). Methods Mice were randomly divided into MPTP model group, which were treated with MPTP and inhibitor group. Once a day for 5 days; control group was treated with saline and DMSO as much as the model group received per day for 5 days. The behavioral were observed, immunohistochemistry and Western blot for TH, caspase-3 and phosphorylation of P38 MAPK were used to observe the change of positive cell number and the expression level in the SN of midbrain. Results Compared with the mice in control group, the model group showed typical symtoms of PD with decreased numbers of TH-positive neurons and the protein level of TH in SN of the midbrain by about 60% and 65% respec-tively(P<0.01) , the numbers of caspase-3 and phosphorylation of P38 MAPK immunoreactive cells and their protein level in the SN of the midbrain increased markedly (P<0.01). After giving SB203580, the above changes were reduced obviously (P <0. 01). Conclusion In the mouse model of subacute Parkinson's disease induced by MPTP, phosphorylated-P38 MAPK regulated caspase-3 in the SN of midbrain, the specific P38 MAPK inhibitor SB203580 is neurologically oprotective to the mouse model.

Objective To compare the enhancement characteristic of the gallbladder diseases and to evaluate the diagnostic efficacy in differential diagnosis of the gallbladder diseases between contrast-enhanced sonography (CEUS) and contrast-enhanced computed tomography (CECT).Methods Seventy-two patiens with gallbladder lesions were examined by CEUS and CECT before operation and all final diagnoses were confirmed by surgery and/or pathological diagnosis.Results 1)In early phase,84.6％ (33/39) and 79.5％ (31/39) of benign diseases showed hyper-enhancement on CEUS and CECT,and 97.0％ (32/33) and 87.9％ (29/33) of malignant diseases showed hyper-enhancement on CEUS and CECT respectively (P =0.250).In later phase,91.2％ (31/34) and 88.2％ (30/34) of benign diseases showing hypo-enhancement (P =1.000),and 100％ of the malignant diseases showing hypo-enhancement on CEUS and CECT respectively.2)The time of enhancement from hyper-to hypo in CEUS for benign and malignant diseases were (39.9 ± 15.7)s and (29.9 ± 5.6)s respectively (t =3.61,P =1.000).3)The inhomogeneous enhancement on CEUS and CECT were 41.0％ (16/39) and 53.8％ (21/39) in the benign diseases respectively (P =0.063),84.8 ％ (28/33) and 97.0 ％ (32/33) in the malignant diseases respectively(P =0.125).4)The destruction of the gallbladder wall on CEUS and CECT are 87.9％ (29/33) and 90.9％ (30/33) respectively(P =1.000).5)The accuracy,diagnostic sensitivity,specificity of CEUS and CECT were 91.7％(66/72) and 87.5％(63/72),97.0％(32/33) and 93.9％(31/33),87.2％(34/39) and 82.15％ (32/39) respectively (P =0.250,1.000,0.500).Conclusions The enhancement pattern of the gallbladder diseases on CEUS and CECT were much similar.CEUS has equal diagnostic efficacy in comparison with CECT,but CEUS can supply more diagnostic information than CECT.

Objective To evaluate expression and significance of TLR4 and NF-κB on inflammatory injure after intracerebral hemorrhage in rats .Methods 60 Sprague Dawley maleness rats were randomly divided into Sham group ,12 h ,24 h ,72 h and 7 d af-ter ICH group(12 s) .The ICH was induced by injection of autologous blood in rats .The behavioral changes were detected by neu-rologic deficit score .The water content of the brain was used to evaluate brain edema changes .Number of TLR4 and NF-κB positive cells by Nissl staining and the expression of protein determined by immunohistochemistry and Western blot .Results After ICH 12 h ,expression of TLR4 and NF-κB positive cells around the hematoma were expressed ,with the extension of the time ,expression was gradually increasing ,and after ICH 72 h the expression of protein were the highest .Cerebral edema and severe neurological damage occurred .Western blot shows the amount of TLR4 expression and NF-κB were in line with the result .Conclusion After in-tracerebral hemorrhage in rat causing inflammatory injure of brain tissue around the hematoma .TLR4 may activate the expression of NF-κB involved in the secondary inflammatory injure after intracerebral hemorrhage in rats .

Objective To investigate the features of hepatic angiomyolipoma(AML) on contrast enhanced ultrasound (CEUS). Methods Ten pathologically proved AML lesions in 9 patients were evaluated by using baseline ultrasound and CEUS. CEUS was performed with contrast pulse sequencing technique and the contrast agent of SonoVue. Results On baseline ultrasound, 7 lesions exhibited mixed echoic,which was obvious hyperechoic combined with partly of hypoechoie; 3 lesions exhitited obvious hypereehoic. On color Doppler flow imaging artery signals were detected in all lesions. And the lesions had plenty or slightly plenty of artery supply,with resistive index about 0.53 4±0.10 (0.48~0.62). On CEUS, in the arterial phase, 9 lesions exhibited hyper-enhanced. In the portal phase, 5 lesions exhibited iso-enhancement,1 lesion was slightly hyper-enhancement and 3 lesions was hypo-enhancement. In the late phase 6 lesions were iso-enhancement and 3 lesions were hypo-enhancement. One lesion was all hypo-enhancement in all three phases. Conclusions There are some characteristic manifestations of hepatic AML in CEUS, which are helpful for the diagnosis of hepatic AML in a way,but we still need more experiences.