TNF related apoptosis inducing ligand (TRAIL) is a new identified member of TNF family, which selectively kills a broad spectrum of tumor cells, but nontoxic to most normal cells. TRAIL triggers tumor cell apoptosis via death receptor DR4 and DR5 anchored in the cell surface, which is mediated through intracellular induced apoptosis proteins. The major pathway of its action proceeds through the formation of DSIC and activation of caspase8. The apoptotic processes follow two signal pathways, namely the mitochondrial independent activation of caspase3, and mitochondrial dependent apoptosis through the cleavage of BID by caspase8, the release of cytochrome C, the formation of apoptosome, and activation of caspase9 and the downstream apoptosis. In previous researches, it is shown that nontagged TRAIL proved to be noncytotoxic to hepatocytes in monkeys and chimpanzees and to human normal hepatocytes. Thus, the nontagged TRAIL has attracted great attention in recent years as a promising anti cancer reagent.

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 investigate the relationship of proximal femur geometry and hip fracture in elderly women. 　Methods　 We compared proximal femur measurements made from the uninvolved hip of 48 plane anteroposterior pelvis radiographs of elderly women without fracture to those of the contralateral hip in a group of 43 cases with hip fracture. Measurements of Singh index, head diameter(HD), neck diameter(ND), femoral neck length(NL), neck shaft angle(NSA) and cortical thinckness of proximal femur were analyzed. 　Results　 The cortical thickness of proximal femur in hip fracture and without hip fracture groups was (10.9±3.1) mm and (13.2±2.9) mm, and the Singh index below Ⅲ° was 86.05% and 66.67%, respectively. No difference in HD,ND,NL and NSA could be demonstrated.　Conclusions　 Singh index and cortical thickness of proximal femur may be used to predict the occurrence of the hip fracture in elderly women.

Objective The purpose of this study was to research the expression of Twist in cervical cancer tissues and the relationship between its expression and clinicopathologic characteristic, and to investigate the role of twist in cervical cancer invasion, metastasis and progress. Methods Immunohistochemistry was used to detect the expression of the Twist in 78 cases of middle and advanced stages cervical cancer tissue microarray chip. The relationship between its expression and clinicopathological characteristic was analyzed. Results (1) The positive expression of twist in cervical cancer was 56/78 (71.8%);(2) The expression of Twist in cervical cancer was significantly related to tumor histology type, FIGO stage, lymph node metastasis and differentiation degree. With the increase of FIGO stage, the emergence of lymph node metastasis and the decrease of differentiation degree, the expression of Twist increased gradually ( <0.05) . Conclusion The expression of Twist may be closely related to the invasion, metastasis and progress of cervial cancer.

Objective To investigate the features of multiple pelvic injuries (fracture combined with multiple traumas) and their effects on management and prognosis. Methods A total of 233 cases of hemodynamically unstable pelvic fractures were grouped according to the patterns of violence, fracture and associated injuries. They were assessed with measured indexes in physiological state, anatomic injury and blood requirement. Their possibilities of survival (Ps) were also predicted. All the data were statistically analyzed. Results The pelvic fractures were often combined with multiple traumas and frequently resulted from high energy traffic accidents. The correlations among sources of bleeding, amounts of blood loss and hemodynamical changes were disproportional. In unstable pelvic fractures with extra pelvic bleeding, BP and blood requirement were significantly different, and their AIS and ISS of the pelvis were higher and their Ps was lower than in the other groups. Conclusions Multiple pelvic injuries caused by high energy are often highly risky and combined with multiple traumas and several sources of bleeding. A clear and precise assessment of the total injuries and sources of bleeding will help treat the patients with different managements.

Objective To explore the diagnostic value of telomerase activity (TA) and hTERT expression in pleural effusions. Methods According to the final diagnosis, 51 patients with pleural effusion were classified into two groups: malignant group (n=27) and benign group (n=24). Telomerase activity in pleural effusion was measured by TRAP-ELISA. Then the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of telomerase activity for diagnosing pleural effusion were calculated. hTERT in pleural effusion was detected by western blotting analysis. Results TA assay showed that 24 of 27 cases of malignant pleural effusion were found to possess telomerase activity, while 1 of 24 cases of benign one had telomerase activity. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of TA assay for diagnosing pleural effusion were 88.9%, 95.8%, 96%, 88.5%, and 92.2%, respectively. hTERT test showed that 8 of 27 cases of malignant pleural effusion had hTERT expression, while none of 12 cases of benign one had hTERT expression. There was significant difference in diagnosing pleural effusion between two methods (? 2=19.64,P=9.4?10 -5 ). Conclusion Tolomerase activity assay may act as a routine diagnostic method for malignant pleural effusions, while hTERT test may serve as complementary one.

The pharmacokinetics/pharmacodynamics ( PK/PD) of antimicrobials aims to establish and evaluate dose-concentration-response relationship, and subsequently to describe and predict the effect-time courses resulting from a drug dose.Nowadays, PK/PD is playing an important role in dosage regimen optimizing, reducing toxicity and drug tolerance of antibiotics.And it is also of great significance in determining susceptibility breakpoints and development in new drug.This paper reviews the progress on PK/PD studies of antibacterial and antifungal agents to provide theoretical basis for safe and effective individual dosage regimens.

OBJECTIVE To analyze the reason of hospital infection by meticillin-resistant Staphylococcus aureus(MRSA) popular on the wound surface in burn wards at a hospital located in South China.The methods of prevention and control were discussed.METHODS The MRSA infections on the surface of a wound of patients in burn wards were reviewed and analyzed from Sep 20,2005 to Sep 30,2005.The occurred reasons,distributed characteristics and drug resistance were carried out on the analysis.RESULTS There were 6 cases of MRSA infection on the injured area,from them 4 with third-degree burn,and 2 with moderate burn.The patients were cured completely.There was no blood stream MRSA infection.Vancomycin was used to treat.The fulminant epidemic of MRSA infection in the injured area was related with environment pollution and cross infection caused by the imprecise aseptic operation.CONCLUSIONS The injured area of burn patient is infected by MRSA.which often has strong drug resistance,but the vancomycin is effective.The environment disinfection is important.Medical personnel's standardized aseptic operation should be strengthened.The reasonable use of antibiotics can avoid the cross infection.It is the important method to prevent and control the fulminant epidemic.

Objective To study the influence analysis of patients with anxiety and depression in elderly patients with hypertension antihypertensive effect of psychological intervention combined with Flupentixol and Melitracen Tablets.Methods 60 elderly patients with hypertension accompanied by anxiety and depression in our hospital from January 2014 to December 2016 were selected as the subjects.They were randomly divided into the control group and the experimental group, with 30 patients in each group.The control group was treated with conventional antihypertensive treatment, the experimental group were given psychological intervention combined with treatment of Flupentixol and Melitracen Tablets.The clinical indexes of the experimental group and the control group were compared and analyzed.Results After the corresponding treatment, the effective rate of antihypertensive treatment in the experimental group was 28 cases, and the effective rate of depressurization was 93.3%.The effective rate of antihypertensive treatment in the control group was 21, and the effective rate of antihypertensive treatment was 70%.After treatment, the HAMD score and HAMA score of the experimental group were significantly lower than those before the treatment, and the score of the experimental group was significantly lower than that of the control group, with statistical difference(P<0.05).Conclusion The treatment of elderly hypertensive patients with anxiety and depression in patients with better antihypertensive effect of psychological intervention combined with Flupentixol and Melitracen Tablets, can improve the depression and anxiety of patients in a large extent, high safety, is further applied in clinical significance.

Objective To investigate the clinical and electromyographic features of peripheral nerve involvement in MS. Methods The clinical and electromyographic (EMG) data of 29 MS patients were evaluated retrospectively.Results 18 (62.1%) patients showed clinical and/or electromyographic abnormalities of peripheral nerves. The clinical symptoms included extremity numbness in 16 cases (88.9%), limb inertia in 11 cases (61.1%), radicular pain in 5 cases (27.8%), autonomic nerve disorder and dysphagia in few patients. Signs included decrease of tendon reflex in 11 cases (61.1%), periphery or root form hypoesthesia in 9 cases (50%), muscle weakness in 7 cases (38.9%), myatrophy in 4 cases (22.2%), and reduced pharyngeal reflex in 1 case (5.6%). There was no difference in age of onset, course of disease, neurologic impairment and prognosis between the patients accompanied with peripheral neuropathy and the patients without peripheral neuropathy. The electromyographic abnormalities included spontaneous potential in 4 cases (13.8%), increased motor unit potential in 8 cases (27.6%), slow MCV in 15 cases (51.7%), slow SCV in 13 cases (44.8%), low amplitude in 9 cases (31.1%), and prolonged distal latency in 5 cases (17.2%). The neuropathies improved by treatment with corticosteroid in the all patients except one.Conclusions Some MS patients may accompany with peripheral nerve abnormalities, which may improve with the recovery of MS. EMG is useful to evaluale the site and degree of peripheral nerve damage.