Patients with ischemic stroke is often accompanied by inflammtory response. Studies have suggested that toll-like receptor 4 (TLR4) has induced the occurrence,development and of ischemic stroke and secondary brain injury. This article reviews the toil-like receptor 4 signal transduction pathway and its roles in ischemic stroke in order to provide certain basis for the development of TLR4-targeted medication.

Adolescent ; Humans ; Male ; Parasomnias

0.05).The number of vaginal folds and vessle of vaginal natural layers in the Zuogui Pill large dosage group were more than those in the model group(P0.05).Conclusion Zuogui Pill,the compound herbal formula for reinforcing the function of kidney,is not influential on the uterus of ovariectomized female rats.It can delay the vaginal deadness through increasing the local blood supply of ovariectomized rats.

Objective To study the feasibility of tubal reversal after sterilization by laparoscopy.Methods From May 2002 to December 2005,31 patients with tubal ligation received laparoscopic tubal reversal by one-core or two-dot apposition and demixing suture of the serosa.Results The laparoscopic tubal reversal was successful in all the 31 cases.Thirty of the patients were followed up for 8-24 months(mean,16 months);27 of them had intrauterine gestation,3 were non-pregnant;none of them had ectopic gestation.Conclusions Laparoscopic tubal reversal after sterilization can satisfy with the desire and principle of microsurgery.It is feasible for clinical application and has good outcomes.

Objective To investigate the effects of eritoran on the expressions of the inflammatory cytokines interleukin-1β (IL-1β),tumor necrosis factor-α (TNF-α) and interferon-[ (IFN-β) mRNA in the basilar artery after subarachnoid hemorrhage (SAH) in rabbits.Methods Atotal of 36 healthy adult male New Zealand white rabbits were randomly allocated into three groups:SAH (n =12),normal saline (n =12) and eritoran (n =12) groups.A SAH model was induced by injection of autologous arterial blood into cisterna magnatwice.An equal amount of cerebrospinal fluid was displaced with the saline in the normal saline group.An equal amount of autologous non-heparinized arterial blood was injected immediate after the replacementof cerebrospinal fluid in the SAH group.Eritoran 1.5 mg/kg was injected intravenously immediately after the blood injection via the cisterna magna each time in the eritoran group.The food intake and neurological deficit were assessed.The expressions of IL-1β,TNF-α and IFN-β mRNA in the basilar artery were detected by real-time fluorescence quantitative polymerase chain reaction.Results The food intake scores (1.20 ± 0.41 vs.2.20 ±0.61; t =53.073,P =0.002),the neurological deficit scores (1.46 ± 0.32 vs.2.6 ± 0.08; t =306.431,P =0.001),the expressions of IL-1β (1.22 ±0.48 vs.2.38 ±0.06,P =0.000),TNF-α (1.39 ±0.07 vs.3.32 ±0.21,P =0.000) and IFN-β (1.51 ±0.08 vs.2.18 ±0.05,P =0.000) in Eritoran group were all significantly lower than those in the SAH group.Conclusions Eritoran may downregnlate the expressions of inflammatory cytokines IL-1β,TNF-α and IFN-β mRNA in the basilar artery after SAH in rabbits,increasing food intake,and improving neurological deficits.

OBJECTIVE:To explore the clinical role of two-hour(C2)of CsA in allogeneic hematopoietic stem cell transplantation.METHODS:The whole blood CsA concentration of 9 patients of C0 and 12 of C2 were determined by FPIA method . RESULTS: The satisfactory immunosuppressive concentration was found as follow: C0 was 200～400 ?g?L-1and C2 was 500～700 ?g?L-1.Both C0 and C2 could predict the acute rejection and side-effects,but C2 is more effective.CONCLUSION:The factors that affect the whole blood concentration of CsA were complex. CsA blood concentration monitoring can be used to guide rational use of CsA,but C2 is more effective than C0.

BACKGROUND: Cervical spinal cord injury without radiographic abnormality (SCIWORA) is a special type of spinal cord injury. Because of the particularity of children in the period of growth and development on the aspects of anatomy and biomechanics, their injured mechanism and therapeutic method differ from those of adults.OBJECTIVE: To explore clinical feature and therapy of first-episode cervical SCIWORA in children.DESIGN: Retrospective analysis and self pre-and post-control observation.SETTING: Department of Spine Surgery, Second Affiliated Hospital,Harbin Medical University.PARTICIPANTS: Totally 14 patients with cervical SCIWORA, who were treated at the Departmentof Spine Surgery, Second Affiliated Hospital,Harbin Medical University between June 1997 and June 2003. Inclusive criteria: ①patients who had dysfunction of sensation, exercise and sphincter to different degree in clinic, ②patients who had no fracture dislocation after cervical vertebra X-ray plain film and MRI examination. The MRI examination showed the sign of spinal cord injury. T1WI spinal cord became thick. T2WI distributed at strip-shape high-signal region along spinal prosenchyma and spread upward and downward. There were 3 patients with complete spinal cord injury and 11 patients with incomplete spinal cord injury, among the patients with incomplete injury, there were 6 patients with central cord syndrome (CCS), 3 with Brown-Sequard syndrome and 2withfrontal spinal cord injury syndrome.METHODS: Retrospective analysis was performed in 14 children patients with cervical SCIWORA. Thirteen patients were not treated with operation and one patient was treated with cervical posterior atlantoaxial fusion. MAIN OUTCOME MEASURES: ASIA grading before and after treatment in patients.RESULTS: There were 1 dead patient and 13 cases with 3-year follow up averagely. Three patients were with insignificant amelioration, and others had recovery of limb function to different degree. According to ASIA grading standard, before treatment there were 3 cases in A grade, 5 cases in B grade, 5 cases in C grade and 1 case in D grade, and after treatment there were 1 case recovering to B grade, 2 cases to C grade, 5 cases to D grade and 2 cases to E grade.CONCLUSION: Restoration of neurofunction of children with cervical SCIWORA has closely correlation with degree of primary injury of spinal cord. Most of the patients were not treated with operation, and those with obviously instable cervical vertebra can be treated with operation.

10.3969/j.issn.2095-4344.2013.25.024

Objective To investigate outpatients' awareness of the essential medicine system and their intention to use it at county hospitals,analyze the problems in the implementation process and give suggestions.Methods Using questionnaires to survey randomly intercepted patients.Data so acquired were keyed in twice with Epidata 3.0 and SPSS 16.0 was used for analysis featuring descriptive statistics.Results Among the 1064 patients surveyed,only 159 (14.9％)have heard of essential medicines,and the top three ways of awareness were respectively from medical staff,television and Internet; patients pay most attention to drug efficacy in their daily life and the majority of them follow doctors' advices.Conclusion It is necessary to strengthen promotions,formulate diversified publicity strategy,train doctors to guide patients to use essential medicines rationally.

Objective To evaluate the diagnostic value of intraductal ulstrasonography(IDUS)in non-opaque bile duct stones.Methods Between January 2009 and August 2010 in the Department of Gastroenterology at Shanghai 10th People's Hospital,a total of 183 patients(male:102 cases,mean age 69 years； female:81 cases,mean age 71 years)were enrolled,who were suspected of bile duct stones or stenosis which could not be diagnosed by abdominal CT,MRI,and abdominal B-mode ultrasound.All the patients underwent endoscopic retrograde cholangiopancreatography(ERCP)first,and then patients with non-opaque bile duct stones followed by IDUS.Results A total of 134 cases (73.2％)of bile duct stones were diagnosed by ERCP,49 cases(26.8％)were negative.And then the 49 patients underwent IDUS,of whom 24 patients with sand-like stones,11 patients with lowdensity stones,6 patients with ampullary cancer,2 patients with pancreatic cancer,6 patients with sclerosing cholangitis.The diagnostic accuracy of IDUS in the position and quality of bile duct stones was 100％,higher than that of ERCP,which was 80％.After ERCP,pancreatitis occurred in 3 patients and improved after conservative treatment,there was no complications like perforation and bleeding.Conclusion The diagnostic accuracy of IDUS in the position and quality of bile duct stones is high,which can make up for the misdiagnosis by ERCP without increasing the complications.IDUS can provide reliable basis for the diagnosis of clinical bile duct stones.