Objective To investigate the expression of Toll-like receptor 4 (TLR4)in peripheral blood monocytes and its correlation with TNF-α and IL-6 in type 2 diabetes (T2DM)patients with neuropathy. Methods Healthy volunteers (NC,n=44),T2DM without neuropathy (n=44)and T2DM with neuropathy (n=44)were recruited in the present study.The expression of TLR4 mRNA and protein in peripheral blood monocytes was detected by RT-PCR and flow cytometry. ELISA was undertaken to measure the plasma concentration of TNF-αand IL-6. Results The levels of HbA1 c[(9.09±1.62)%vs(8.36±1.10)% vs (5.30±0.89)%],the protein expression of TLR4[(42.02±9.69)% vs (31.27± 6.87)% vs (11.96±5.54)%],the mRNA expression of TLR4[(2.98±1.06)vs (1.74±0.47)vs (1.12 ±0.52)],TNF-α[(8.75±3.14 )vs (6.27±3.64)vs(3.19±1.17)pg/ml]and IL-6[(3.63±1.81)vs(2.60 ±1.14)vs(1.54±0.58)pg/ml]in patients with diabetic neuropathy significantly increased compared with T2DM and NC group;TLR4 showed a positive correlation with TNF-αand IL-6(r=0.631,P <0.0001;r=0.447,P =0.0023). Conclusion TLR4 of monocytes may take part in the occurrence of systemic inflammation and has a close relationship with the development of diabetic neuropathy.

BACKGROUND: Tissue engineering provides a new way for the repair of urinary tissue and organ defects.Urinary tissue engineering has shown a bright prospect.OBJECTIVE: To review the latest research on urinary tissue engineering at national and international level.METHODS: With the keywords of tissue engineering, urology, scaffold, vascularization in Chinese and in English,respectively, a computer-based search for articles published from January 2000 to January 2016 was performed in CNKI and PubMed databases. The articles addressing urology tissue engineering, scaffolds and vascularization were collected,summarized and analyzed.RESULTS AND CONCLUSION: The selection and cultivation of seed cells, scaffold material performance, tissue construction in vitro, and degree of vascularization all make an important influence on the repair of urinary injuries. As different seed cells hold different biological characteristics, we should make full consideration prior to choosing an appropriate seed cell, so as to pave a good foundation for urinary tissue engineering. Scaffolds with good three-dimensional structure can promote the cell growth and proliferation, tissue in-growth and vascularization.Tissue-engineered materials are superior to traditional repair materials, but still on initial stage, and further large scale trials will be necessary. Moreover, some problems needed to be solved, such as the regenerated tissue with incomplete function different from natural tissues, and regeneration failure caused by biological stent rejection.

Objective To study the clinical value of cerebrospinal fluid cytology(csfc)and specific stain in tuberculous meningitis(TBM)-purulent meningitis(PM)and cryptococcal meningitis(CM).Methods The csfc data of 179 patients with TBM,PM and CM were retrospectively analyzed.The samples collected from all of these patients were analyzed by csfc May-Grunwald-Giemsa(MGG)staining,aricine blue staining and Indian ink staining. And the cytospin smears from 70 TBM were simultaneously stained by the immunofluorescence(IF)and immunocytological method to demonstrate the presence of mycobacterial antigen.Results ①TBM group showed a mixed-cell response.At the early stage of disease,the proportion of neutrophilic granulocyte reached 80%,and then reduced gradually.Lyumphoidocyte reaction was the most obvious in 1～2 months.The immunofluorescence(IF)and immunocytological method present a sensitivity of 82.9%and 85.7%,respectively.②Neutrophilic granulocyte was the most cell at acute stage of PM,and it descended quickly once treated with effective antibiotics.③The positive rates to detect CM with csfc MGG,aricine and Indian ink staining were 83.3%,81.8%,and 76.5%,respectively.Conclusion Dynamic observation on cerebrospinal fluid cytology is helpful to boost the differential diagnosis of intracranial infection.

Objective To evaluate the effect of ultrasound-guided quadratus lumborum block (QLB) on the efficacy of postoperative analgesia after caesarean section.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ parturients,aged 20-39 yr,weighing 50-80 kg,scheduled for elective cesarean section under subarachnoid block,were divided into 2 groups (n =30 each) using a random number table:QLB group (group Q) and control group (group C).Ultrasound-guided bilateral QLBs were performed at the end of surgery,the solution was injected into the compartment between quadratus muscle and psoas major muscles,and 0.25％ ropivacaine 1.25 mg/kg was injected to each side in group Q.The parturients in both groups received patient-controlled intravenous analgesia after surgery to maintain the visual analog scale score ≤ 3,and dezocine 5 mg was intramuscularly injected as a rescue analgesic when the visual analog scale score≥4.Bruggrmann comfort scale (BCS) and Ramsay sedation scores were evaluated at 2,4,6,12,24 and 48 h after operation.The consumption of sufentanil during patient-controlled intravenous analgesia,requirement for rescue analgesia,satisfaction score of analgesia,the number of successfully delivered doses (D1) and the number of attempts (D2) were recorded within 24 h after surgery.D1/D2 was calculated.The development of respiratory depression and over-sedation was recorded.The development of QLB-related adverse reactions and postoperative nausea,vomiting,chest tightness and pruritus was also recorded.Results Compared with group C,BCS scores were significantly increased,the consumption of sufentanil was reduced,D1/D2 was increased,the requirement for rescue analgesia was decreased,and the satisfaction score of analgesia was increased (P＜0.05),and no significant change was found in Ramsay sedation score in group Q (P＞0.05).Adverse reactions such as respiratory depression,over-sedation,nausea,vomiting,chest tightness and pruritus were not found in two groups.Adverse reactions such as hematoma and infection at the puncture site or local anesthetic intoxication were not observed after surgery in group Q.Conclusion Ultrasound-guided QLB can enhance the efficacy of postoperative analgesia after caesarean section,reduce postoperative consumption of opioids and raise the comfort degree for parturients.

Objective To evaluate the effect of ultrasound-guided continuous anterior quadratus lumborum block (QLB) on postoperative analgesia in total hip arthroplasty.Methods Fifty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes,aged 65-80 yr,weighing 45-80 kg,scheduled for elective total hip arthroplasty under subarachnoid block,were divided into 2 groups (n =25 each) using a random number table method:ultrasound-guided continuous anterior quadratus lumborum block group (group Q) and routine analgesia group (group R).Anterior QLB was performed at the end of operation in group Q.Patient-controlled intravenous analgesia was performed with sufentanil after operation in two groups.Dezocine was given as rescue analgesic.Ramsay sedation score and the maximum angle for hip flexion and abduction of hip joint were recorded after operation,and the total consumption of sufentanil,requirement for dezocine and occurrence of adverse reactions were recorded within 72 h after operation.The occurrence of QLB-related complications was also recorded.Results Compared with group R,Ramsay sedation score was significantly decreased and the maximum angle for hip flexion and abduction of hip joint were increased at each time point after operation,and the total consumption of sufentanil,requirement for dezocine and incidence of nausea and vomiting were decreased in group Q (P ＜ 0.05).No QLB-related complications were found in group Q.Conclusion Ultrasound-guided continuous anterior QLB can produce better postoperative analgesia and reduce postoperative consumption of opioids with fewer adverse reactions in the patients undergoing total hip arthroplasty.