Recently accumulating evidence has shown that innate immunity recognition of invading pathogens can be attributed mainly to the Toll-like receptor (TLR) family.TLR signaling can induce the production of proinflammatory cytokines and upregulate expression of costimulatory molecules to provoke rapid activation of innate immuniry. Activated innate immunity subsequently leads to effective adaptive immunity. It, thereby, activites not only innate but ultimately also adaptive immunity. It can mediate activation of many kinds of cells, such as immune cells, hepatocytes et al. Upon binding to its respective ligands, TLR can activate signal transduction cascades leading to activation of transcription factors and protein kinases such as NF-?B and MAPK, and expression of immune response genes. Besides,TLR family may be involved in the pathogenesis of inflammation via recognition of host products. Inhibition of TLR action may work as anti-inflammatory drugs, and possibly also as agents to treat autoimmune diseases.Thus,the increasing understanding of TLR system could be the basis for treating a variety of pathological conditions.

Objective To differentiate the sequences of Cyt b gene Agkistrodon from its adulterants sold in the market in order to provide molecular evidence for identification of Agkistrodon. Methods Cyt b gene was used to sequence and analyze Agkistrodon and its adulterants sold in the market. Results There was a mixed phenomenon in Agkistrodon species. The differences of Cyt b gene sequence between Agkistrodon and its adulterants sold in the market are significant: the difference rates among the species of Agkistrodon are 0%—0.91%, the difference rates between Agkistrodon and its adulterants are 18.57%—23.78%. Conclusion The characteristics of Cyt b gene sequence can be used as a better molecular marker for authenticating Agkistrodon from its adulterants.

AIM: To observe the effects of Dispel Stasis Decoction(Radix et Rhizowa Salviae multiorrhizae,Rhizoma Sparganii,Rhizoma Curcumae,etc) on TNF-? and E_2 in rats with endometriosis(EMS),and to observe its anti-inflammatory and analgesic effect. METHODS: Endometriosis rat models were made by autograft of endometrium in abdomen.Four weeks after operation,EMS model rats were randomly divided into 5 groups: a model group,3 Dispel Stasis Decoction groups and a danazol group.All the rats were treated for three weeks respectively,and then anaesthetised and killed.The ectopic endometrium's focuses were observed by microscope,the levels of TNF-? and E_2 in the serum of all groups were measured by radioimmunoassay.The method of body twist and ear edema of mouse were used to the analysis the anti-inflammatory and analgesic effect of Dispel Stasis Decoction. RESULTS: The survived graft shrinked and the number of the glanduls decreased in rats of Dispel Stasis Decoction group.The levels of TNF-? and E_2 in the serum were significantly lower than that of the model group.Also,Dispel Stasis Decoction could inhibite the ear edema of the mouse induced by dimethylbenzene and the body twist of the mouse caused by acetic acid notablely. CONCLUSION: Dispel Stasis Decoction inhibited growth of the graft and showed a significant therapeutic effects on EMS model rat.It also has notable functions of anti-inflammatory and analgesic.This may be related to its inhibition of TNF-? and E_2 levels.

Objective To investigate status and risk factors of drug resistance of smear-positive pulmonary tuber-culosis (TB)patients in Hunan Province,and provide reference for the prevention and control of drug-resistant TB. Methods 1 935 Mycobacterium tuberculosis (MT)complex strains identified by 20 TB prevention and control insti-tutes in Hunan Province between 2012 and 2014 were collected and performed drug susceptibility testing,and influ-encing factors associated with drug resistance of TB were analyzed statistically.Results Of 1 935 MT complex strains,1 207 (62.38%)were sensitive to 6 kinds of antituberculosis drugs,728 were drug-resistant strains,overall drug resistance rate was 37.62%;467 (24.13%)were multidrug-resistant (MDR)strains,64 of which were exten-sively drug-resistant (XDR)strains,XDR rate was 3.31 %,resistance rates from high to low were as follows:isoniazid(INH)29.32%,rifampicin(RFP)25.84%,streptomycin(SM)20.73%,thambutol(EMB)9.00%,ofloxa-cin(OFX)7.83%,and kanamycin(KM)2.21 %.Multivariate logistic regression analysis showed that patients hav-ing a history of treatment,aged 20-39 and 40-60 years old were risk factors for drug resistance and MDR of pul-monary TB.Among patients who failed in retreatment,OR (95% CI )of resistance to INH,RFP,SM,EMB, OFX,KM,and MDR were 13.5(9.9-18.4),21 .2(15.2-29.5),5.3(3.9-7.2),11 .9(7.6-18.7),7.6(4.6-12.6),7.9(3.6-17.5),and 25.0(17.7-35.1 )respectively;among patients who had recurrence,OR(95% CI ) of resistance to INH,RFP,SM,EMB,OFX,and MDR were 7.4(5.5 -10.0),10.3 (7.4 -14.2),3.5 (2.5 -4.8),7.3(4.5 -11 .9),4.1 (2.5 -6.8),and 12.2(8.7 -17.1 )respectively;among patients who failed in initial treatment,OR (95% CI )of resistance to INH,RFP,SM,EMB,and MDR were 7.6 (4.7 - 12.3 ),9.8 (5.9 -16.0),4.1(2.5-6.8),12.1(6.5-22.7),and 11 .4(6.9-18.9)respectively.Among patients aged 20-39 years old,OR (95% CI )of resistance to INH,RFP,SM,and MDR were 2.5 (1 .8 -3.4),3.6(2.5 -5.2),2.9(2.0-4.1),and 4.1(2.8 -6.1 )respectively;among patients aged 40 -60 years old,the OR (95% CI )of resistance to INH,RFP,SM,and MDR were 2.2(1 .6-3.0),3.1(2.2-4.4),2.3(1 .6-3.2),and 3.3(2.3 -4.7)respectively. Conclusion Drug resistance of smear-positive pulmonary TB patients is serious in Hunan Province,patients receiv-ing anti-tuberculosis treatment and aged between 20-60 years old have high risk for drug resistance and MDR.

BACKGROUNDThe Xpert MTB/RIF showed high sensitivity and specificity in previous studies carried out in different epidemiological and geographical settings and patient populations in high-burden tuberculosis (TB) countries. However, there were little data obtained by validation or demonstration study of the assay in China. In this study, the performance of Xpert MTB/RIF was investigated in two county-level laboratories in Hunan Province, China.

METHODSConsecutive patients with suspected pulmonary tuberculosis (PTB) and suspicion for multidrug-resistant tuberculosis (MDR-TB) were enrolled. For each patient suspected to have PTB, three sputum specimens (one spot sputum, one night sputum, and one morning sputum) were collected and each sputum was tested with smear microscopy, Löwenstein-Jensen (LJ) culture, and Xpert MTB/RIF test. For comparison across subgroups and testing methods, 95% confidence intervals were calculated. All analyses were done with SPSS 16.0, and P < 0.05 was regarded as significant.

RESULTSFor case detection, the sensitivity of Xpert MTB/RIF was 100% for smear- and culture-positive TB and 88.6% for smear-negative and culture-positive TB; the overall sensitivity was 94.5% for all culture-positive patients. The specificity was 99.8%. The sensitivity of Xpert MTB/RIF assay was 22.0% in clinical TB patients and the specificity reached 100.0% in the group of patients who are infected with nontuberculous mycobacteria. For the detection of rifampin resistance, the sensitivity of MTB/RIF RIF-resistance detection was 92.9%, and the specificity was 98.7%. Of the 26 Xpert MTB/RIF-positive and RIF-resistant patients confirmed by LJ proportion tests, 20 (76.9%) patients were infected by MDR-TB.

CONCLUSIONSThe Xpert MTB/RIF assay is a highly sensitive and specific method for diagnosis of TB and RIF resistance, which will enable it to have the potential to be used in county-level laboratories and lead to the reduction of the infectious pool and improvements in TB control in China. Further evaluations in county-level laboratories for implementing the assay are still required.

Adult ; Antibiotics, Antitubercular ; therapeutic use ; China ; Female ; Humans ; Male ; Middle Aged ; Rifampin ; therapeutic use ; Tuberculosis ; diagnosis ; drug therapy ; Tuberculosis, Multidrug-Resistant ; Tuberculosis, Pulmonary ; diagnosis ; drug therapy ; Young Adult