[Abstract ] Toll like receptor 4 (TLR4) is a key member of the Toll like receptor family , and is a major receptor for lipopo-lysaccharide ( LPS) .After stimulating with LPS , TLR4 activation could cause the release of a series of inflammatory factors , and acti-vate the immune response of the organism .In recent years , LPS/TLR4 signal transduction has been widely studied , and it has become the most important research hotspot in the inflammatory reaction and its control method .In this paper , we review the recent progress of molecules involved in TLR 4 signaling pathway and their regulatory mechanisms .

Aim To establish the standards for evaluation of microcirculation in a rat hind limb ischemia model.Methods Rats were subjected to unilateral femoral artery ligation.After 4 weeks,the regional blood flow in skeletal muscles was measured by fluorescent microsphere assay.Formation of collateral vessels was determined by microangiography.Capillary density was examined by immunostaining for CD34.Results In ischemic limbs,regional blood flow decreased significantly,some collateral vessels formed with typical "corkscrew" appearance,and histological analysis showed lower capillary density.Conclusion Quantitative assessment of microcirculation in a hind limb ischemia model is established.

?AlM: To evaluate the expressions and significances of endoplasmic reticulum stress related protein ( BlP ) , hypoxia-inducible factor-1α ( HlF-1α) and vascular endothelial growth factor ( VEGF) in the retina of diabetic rats.
?METHODS:Seventy-two male Sprague-Dawley ( SD) rats were chosen and divided randomly into 6 groups:normal control 2mo (C2m, n = 12), diabetes mellitus 2mo (D2m, n=12), normal control 4mo (C4m, n=12), diabetes mellitus 4mo (D4m, n = 12), normal control 6mo (C6m, n=12) and diabetes mellitus 6mo (D6m, n=12 ) . The diabetes mellitus mouse were induced by intraperitoneal injection of 0. 1mol/L streptozotocin (STZ, 65mg/kg). The expression of BlP, HlF-1α and VEGF in the retina were detected by enzyme- linked immuno sorbent assay. The location of BlP, HlF-1α and VEGF in epiretinal membranes were investigated by immunohistochemistry staining.
?RESULTS: BlP were significantly increase than control groups in all DM groups with the course of diabetes ( P<0. 01). HlF-1α were detected higher than control groups in all DM groups (P< 0. 05), but there was no statistical significance among treatment groups. VEGF in D4m and D6m groups were higher than control groups (P<0. 05), and there was statistical significance between D4m and D6m groups. BlP can be detected in control groups a little, mainly in the inner limiting membrane and ganglion cell layers. HlF - 1α cannot be detected in control groups, meanwhile it can be detected in all layers in DM. VEGF can be detected in control groups a little, it mainly be detected in inner nuclear layer, outer nuclear layer, around retinal vessel and ganglion cell layers in DM groups.
?CONCLUSlON:The expressions of BlP, HlF-1α and VEGF increase in the retina of diabetic rats than control groups with progressive of diabetes mellitus, both endoplasmic reticulum stress and HlF-1α signal path play important role in the progress of diabetic retinopathy.

Objective To evaluate the role of MCP/DAF expression in the spinal cord in the development of neuropathic pain (NP) induced by chronic constrictive injury (CCI) of the sciatic nerve in rats.Methods Twenty-four Sprague-Dawley rats transfected with MCP/DAF,weighing 200-250 g,were randomly divided into 2 groups (n =12 each) using a random number table:sham operation of transfected rat group (Rsham group) and CCI of transfected rat group (RCCI group).Twenty-four healthy male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 2 groups (n =12 each) using a random number table:sham operation of normal rat group (Nsham group) and CCI of normal rat group (NCCI group).The right sciatic nerve was exposed and 4 loose ligatures wen placed on the sciatic nerve at 1 mm intervals with 4-0 catgut in RCCI and NCCI groups.The right sciatic nerve was only exposed in Rsham and Nsham groups.Paw withdrawal threshold to yon Frey filament stimulation (PWT) and paw withdrawal latency to nociceptive thermal stimulation (PWL) were measured at 1 day before operation (baseline) and 1,3 and 7 days after operation.The animals were sacrificed after measurement of pain threshold on 7 days after operation and the L4,5 segment of the spinal cord was removed for determination of the expression of OX-42 (by immuno-histochemistry) and MCP mRNA and DAF mRNA (by RT-PCR).Results Compared with Nsham group,the PWT and PWL were significantly decreased on 1,3 and 7 days after operation,the expression of OX-42 was up-regulated,and the expression of MCP mRNA and DAF mRNA was down-regulated in NCCI group (P ＜ 0.05),and no significant changes were found in the PWT and PWL on 1,3 and 7 days after operation and expression of OX-42(P ＞ 0.05),and the expression of MCP mRNA and DAF mRNA was up-regulated in Rsham and RCCI groups (P ＞ 0.05).Compared with NCCI group,the PWT and PWL were significantly increased on 1,3 and 7 days after operation,the expression of OX-42 was down-regulated,and the expression of MCP mRNA and DAF mRNA was up-regulated in RCCI group (P ＜ 0.05).Conclusion Up-regulation of MCP/ DAF expression in the spinal cord can inhibit the development of NP in rats and regulation of activation of microglias in the spinal cord is involved in the mechanism.

Objective To investigate the effects of Stichopus variegatus mucopolysaccharide on plasma nitric oxide (NO) and serum endothelin(ET) after angioplasty in rabbits. Methods 50 New Zealand rabbits were randomly divided into four groups: Stichopus group, simvastatin group, model group and normal group. Endothelium of iliac arteries in Stichopus group, simvastatin group and model group were denuded by balloon catheter and the rabbits were fed with 2%cholesterol, 3%lard and 3%yolk mixed forage for six weeks, and then, atherosclerotic stenosis was showed by iliac angiography.When transluminal balloon angioplasty was done, from then on the feeds was changed from high cholesterol to ordinary forage. Stichopus (0.5g?kg -1?d -1) and simvastatin (0.5mg?kg -1?d -1) were given by gastric canal. While NaCl solution (0.9%) was given in model group. All rabbits were fed in separate cages and free drinking. After four weeks since transluminal balloon angioplasty, blood was collected from carotid artery to measure the changes of concentrations of endothelin(ET) and nitric oxide(NO). Examination of pathology by optical and electron microscope were done at same time. Results After four weeks since transluminal angioplasty, the concentration of plasm ET in model group increased significantly compared with the normal group(114.86?24.89 ng?L -1 vs 75.62?9.68 ng?L -1) and serum NO decreased significantly(37.50? 12.79?mol?L -1 vs 106.37?18.01 ?mol?L -1).The concentration of plasm ET in model group was higher than that in the simvastatin groups and Stichopus groups(114.86?24.89 ng?L -1 , 81.08?14.71 ng?L -1 and 83.34?11.41 ng?L -1 ,respectively),and the concentration of serum NO decreased obviously(95.63?8.62 ?mol?L -1,98.80?9.06 ?mol?L -1 and 37.50?12.79 ?mol?L -1,respectively). Conclusion After iliac arterial TA the concentrations of plasm ET were increased and the serum NO were decreased, the endothelial function fell into disorder. The Stichopus variegatus mucopolysaccharide had the effects of improving the endothelial function after angioplasty in rabbits by adjustment of plasm ET and serum NO.

Adenocarcinoma ; pathology ; surgery ; Adult ; Blood Loss, Surgical ; Carcinoma, Squamous Cell ; pathology ; surgery ; Female ; Humans ; Hysterectomy ; adverse effects ; methods ; Middle Aged ; Neoplasm Staging ; Uterine Cervical Neoplasms ; pathology ; surgery

OBJECTIVE To investigate the epidemiological characteristic of lower respiratory infection among the hospitalized patients in Tianlin Community Health Service Center so as to take effective measures to control the infection and reduce the emergence of drug resistant strains.METHODS Totally 6150 cases of patients discharged from our Center during from Jan 2004 to Sept 2006 were collected and among them 141 cases occurred hospital onset of lower respiratory infection and drug resistance was analyzed through contrasting.RESULTS The incidence rate of hospital onset of lower respiratory infection and drug resistance were 2.29% and 58.62%.Among the 141 cases,the incidence rate of ESBLs was 28.36% which mainly produced from Escherichia coli and Klebsiella pneumoniae.CONCLUSIONS Primary affection should actively treated and antibiotics should use rationally according to the drug sensitive cultivation to control the abuse of antibiotics and reduce the emergence of drug resistant strains.

Objective To investigate the adjustment effect of microRNA-155 on CD4+CD25+ regulative T cell (Treg) in peripheral blood of sepsis patients,and to elucidate the role of miR-155 in the pathogenesis of sepsis.Methods A retrospective study was corducted.60 sepsis patients (mild n =20,moderate n=20,and severe n =20)from emergency room or intensive care unit (ICU) of the Fourth Hospital of Jiangsu University were enrolled.20 healthy volunteers were enrolled as controls.Real-time fluorescent quantitation polymerase chain reaction (qRT-PCR) was used to detect the levels of miR-155 and Foxp3 mRNA expressions in peripheral blood.CD4+CD25+ Treg cells in peripheral blood were identified by flow cytometry.Peripheral interleukin-10 (IL-10) was measured by enzyme-linked immunosorbent assay (ELISA).Results The expressions of miR-155,Treg,Foxp3 mRNA and the level of IL-10were higher in the patients with sepsis than those in healthy control group [Treg:(2.89 ± 1.13)％ vs.(2.32 ± 0.91)％,t=10.540,P=0.002; miR-155:1.19 ±0.48 vs.0.80 ±0.33,t=8.605,P=0.006; Foxp3 mRNA:0.18 ±0.08 vs.0.13 ±0.03,t=6.862,P=0.008; IL-10 (ng/L):56.89 ± 17.28 vs.33.24 ± 11.93,t=12.742,P=0.001].These variables were elevated gradually with the elevation of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ)score.The expressions of Treg,miR-155,Foxp3 mRNA and the level of IL-10 were (3.05 ± 1.21)％,1.36 ± 0.79,0.21 ±0.10,(62.82 ±21.38) ng/L in severe sepsis group; they were (2.86 ±0.88)％,1.25 ±0.56,0.17 ±0.08,(56.38 ± 19.65) ng/L in moderate group; they were (2.61 ± 0.87)％,0.94 ± 0.52,0.15 ± 0.05,(45.43 ± 14.40) ng/L in mild group.The values showed significant statistical difference among the mild,moderate and severe sepsis groups (all P＜0.01).Above values were significandy higher in non-survival group than those in survival group [Treg:(3.46 ±1.53)％ vs.(2.85 ± 1.03)％,t=14.250,P=0.005; miR-155:1.41 ±0.85 vs.1.16 ±0.76,t=11.875,P=0.006;Foxp3 mRNA:0.24 ± 0.11 vs.0.17 ± 0.09,t=8.795,P=0.001 ; IL-10 (ng/L):65.47 ± 23.58 vs.51.70 ± 16.86,t=16.313,P=0.001].The expression of miR-155 was positively correlated with the expression of CD4+CD25+ Treg and Foxp3 mRNA (r1=0.635,P1=0.007; r2=0.671,P2=0.005).Conclusion The result of this study suggest that miR-155 is involved in the cell proliferation regulation of CD4 +CD25 + Treg cells,and play some role in the immunological dissonance in sepsis.

Objective To evaluate the clinical efficacy of modified Chen's biliojejunostomy technique in treating hilar cholangiocarcinoma.Methods The clinical data of the patients with hilar cholangiocarcinoma from January 2011 to June 2014 in the PLA general hospital and its first affiliated hospital were retrospective ly studied,and 17 of them underwent modified biliojejunostomy.There were 10 male and 7 female patients with a mean of 65 years old (range 34 ～82).Cases diagnosed as Bismuth-Corlette Type Ⅱ,Ⅲ a,Ⅲ b and Ⅳ were 2,6,4,and 5,respectively.Results Liver segment Ⅳ were resected from 2 patients,segment Ⅳ + Ⅴ from 7 patients and segment Ⅳ + Ⅴ + Ⅰ from 8 patients.No death was observed during the study period.One patient had mild bile leakage,2 patients had cholangititis,and another patient had biliary intestinal anastomotic bleeding.Three patients received resection and reconstruction of the portal vein.Three right hepatic arteries and 1 anterior branch of right hepatic artery were resected in combination with the tumor because of invasion.All the complications were alleviated under conservative treatment.Twelve cases had been followed up for a median time of 16 months (range 3 ～ 24).Two cases had cholangititis intermittently.One case underwent radiotherapy because of local recurrence in 2 years after the surgery.MRCP and relevant enzymes were within the normal range.Conclusion Modified Chen's biliojejunostomy is a simple,effective and safe method,which can be widely used when there are multiple biliary intestinal anastomoses.