Recently, many Chinese doctors have treated metabolic syndrome from pathogenic phlegm, dampness, stasis and heat, which not only meets the theory of TCM, but also has achieved good clinical effects, besides the method has been confirmed by animal experiments..

Objective To investigate the function of triggering receptor expresses on myeloid cells receptor-1 (TREM-1) in lymphocyte differentiation and regulation of Aspergillus infected immunosuppressed rats.Methods Cyclophosphamide (CTX) was intraperitoneally injected and Fumigatus spore suspension was inhaled by percutaneous tracheostomy to establish the immunosuppressive invasive pulmonary aspergillosis (IPA) rat model.After 24 h, 48 h, 72 h and 96 h inoculation, rats were sacrificed.Lung tissue specimens, bronchoalveolar lavage fluid (BALF) , and plasma samples were collected.Plasma and BALF sTREM-1, plasma T cell-specific transcription factor (T-box expressed in T cells, T-bet) and eomesodermin(Eomes) were detected by ELISA.Biopsy specimens of lung tissue were used for periodic acid-schiff (PAS) staining and culture.Results The mortality rate of immunosuppressed rats after Aspergillus inhalation for 96 h was as high as 54.4％.Biopsy of lung tissue suggested acute inflammatory cell infiltration, interstitial lung congestion, alveolar structural damage, and visible Aspergillus hyphae in alveoli.Compared with normal control group[(110.50 ± 7.70)ng/L], plasma sTREM-1 in study groups were significantly increased [IPA : (146.77 ± 10.41) ng/L;CXT + IPA at 24 h : (226.00 ± 11.88) ng/L;CTX + IPA at 48 h : (200.77 ± 10.63) ng/L;P ＜ 0.05], so were T-bet levels [IPA : (561.17 ± 7.23) μg/L;CXT + IPA at 24 h : (647.00 ± 33.03) μg/L;CTX + IPA at 48 h : (619.23 ± 87.44) μg/L;control group : (340.03 ± 26.32) μg/L;respectively, P ＜0.05].However, plasma Eomes levels in IPA group, CTX + IPA at 24 h and 48 h were significantly lower compared with that in normal controls [IPA : (7.96 ± 0.65) ng/L;CXT + IPA at 24 h : (3.97 ± 0.35) ng/L;CTX + IPA at 48 h : (4.00 ± 0.74) ng/L;control group : (8.38 ± 0.51) ng/L;respectively,P ＜0.001].Compared with those in CTX + IPA vaccination after 24 h and 48 h, plasma sTREM-1 [(106.67 ±7.64)ng/L;(133.27 ± 32.79) ng/L] and T-bet [(299.64±63.07)μg/L;(398.02 ± 109.22) μg/L] in CTX + IPA at 72 h and 96 h inoculation were significantly lower (P ＜ 0.001).While Eomes [(8.38 ± 0.54) ng/L;(8.40 ± 0.70) ng/L] raised significantly higher (P ＜ 0.001).Compared with the control group, sTREM-1 levels in BALF of IPA + CTX 24 h, 48 h, 72 h, and 96 h groups were consistently high (P ＜ 0.05).Pearson correlation analysis showed that sTREM-1 and T-bet had a significant positive correlation (r =0.91, P ＜ 0.001), yet Eomes was negatively correlated with them (r =-0.788, P ＜ 0.001).Conclusions sTREM-1 in rat plasma and BALF appears highly expressed in immune compromised Aspergillus infected rat model.Plasma sTREM-1 is closely correlated with T-bet and Eomes levels, which suggests that TREM-1 may be involved in lymphocytic regulation and differentiation during fungal infection.

To understand epidemiological characteristics of Marek's disease virus (MDV) prevalent in china currently,3 Marek's disease (MD) strains were isolated and identified from white feather meat chickens vaccined with MDV CVI988 or 814 through necropsy,histopathological observation,virus isolation and IFA detection,named SDAU1501,SDAU1502 and SDAU1503,respectively.vIL8,pp38,MEQ gene of the three strains of MDV were amplified using PCR,and compared with reference strains.The homology between SDAU1501 and SDAU1502 and virulent strains was above 97％,suggesting some features of virulent strains;while meq gene of SDAU1503 lost P amino acid at the 194 th site as that in CVI988,But the distinctive 177 nucleotide insertion mutations was not existed,predicting that it may be a attenuated vaccine strain.New variations of MDV continued and different types of variants emerged,therefore,prevalence and genetic monitoring of MD should be proceeded;meanwhile,more attentions should be given to MDV vaccine development.

Objective To investigate the clinical efficacy of laparoscopy-assisted radical gastrectomy for gastric cancer.Methods The retrospective cohort study was adopted.The clinical data of 210 patients with gastric cancer who underwent laparoscopy-assisted radical gastrectomy at the Peking University Cancer Hospital between May 2009 and December 2012 were collected.Fifty-two,43 and 115 patients were respectively detected in stage Ⅰ,Ⅱ and Ⅲ of postoperative pathological stage.Laparoscopy-assisted radical distal,proximal and total gastrectomies were selectively performed according to the location and extent of tumors.(1) Overall treatment indicators were observed,including surgical procedure,with or without conversion to open surgery,operation time,volumes of intraoperative blood loss and transfusion,number of lymph node dissected,time to anal exsufflation,duration of hospital stay,occurrence of complications,radical degree of tumors of pathological examination.(2) Other indicators were observed,including pathological features of patients in stage Ⅰ,Ⅱ and Ⅲ [gender,age,body mass index (BMI),scores of American Society of Anesthesiologists (ASA),medicinal complication,location of tumors,degree of tumor differentiation and with or without vascular tumor thrombi],intraoperative and postoperative situations (surgical procedure,conversion to open surgery,operation time,volumes of intraoperative blood loss and transfusion,number of lymph node dissected,time to anal exsufflation,duration of hospital stay and radical degree of tumors),postoperative complications,reoperation,death within postoperative day 30 and during follow-up,3-and 5-year survival rates.(3) Evaluation criteria:stages and classification of tumors were evaluated according to the tumor node metastasis (TNM) classification of malignant tumours (Seventh Edition) published by American Joint Committee on Cancer (AJCC) and Union for International Cancer Control (UICC).Severity of complications was evaluated according to Clavien-Dindo classification.Patients were followed up by outpatient examination,telephone interview and correspondence once every half a year up to December 31,2015,abdominal / pelvic CT,chest X-ray and blood test were performed once every half a year within 2 years and once every year within 2-5 years postoperatively,and gastroscopy was performed once every year.Overall survival time was counted from operation date to end of follow-up or time of death.Measurement data with normal distribution were presented as x ± s and comparison between groups was analyzed using the ANOVA.Measurement data with skewed distribution were presented as M (range) and comparison between groups was analyzed using nonparametric test.Comparisons of count data were analyzed using the chisquare test.Survival curve was drawn by the Kaplan-Meier method,and survival analysis was done using the Logrank test.Results (1) Overall treatment:all the 210 patients underwent successful radical gastrectomy,including 100 undergoing distal gastrectomy,35 undergoing proximal gastrectomy and 75 undergoing total gastrectomy.There were 198 patients undergoing radical gastrectomy and 12 patients converted to open surgery.Operation time,volume of intraoperative blood loss,number of patients with blood transfusion and number of lymph node dissected were (258 ± 54) minutes,(103 ± 86) mL,19 and 29 ± 12,respectively.Postoperative recovery:time to anal exsufflation and duration of hospital stay were (3.8 ± 0.9) days and (17 ± 7) days.Fortyfive patients had postoperative complications and 2 were dead within 30 days postoperatively.R0 and R1 resections were respectively applied to 209 and 1 patients.(2) Comparisons among the patients with the different pathological stage:numbers of patients in stage Ⅰ,Ⅱ and Ⅲ were 9,17 and 36 with tumor located in the upper stomach,3,9 and 22 with tumor located in the middle stomach,40,16 and 47 with tumor located in the lower stomach,0,1 and 10 with tumor located in the cross-region stomach,30,23 and 23 in G1 and G2 of tumor differentiation,21,19 and 92 in G3 and G4 of tumor differentiation,7,13 and 69 with vascular tumor thrombi,respectively,with significant differences in above indicators among the patients in stage Ⅰ,Ⅱ and Ⅲ (x2 =25.990,32.928,35.027,P ＜ 0.05).(3) Intra-and post-operative comparisons among the patients with the different pathological stage:numbers of patients in stage Ⅰ,Ⅱ and Ⅲl were respectively 40,20 and 40 with distal gastrectomy,3,8 and 24 with proximal gastrectomy,9,15 and 51 with total gastrectomy,and number of lymph node dissected were 26 ± 9,29 ± 13 and 31 ± 12 in patients with stage Ⅰ,Ⅱ and Ⅲ,showing significant differences in above indicators among the patients in stage Ⅰ,Ⅱ and Ⅲ (x2 =25.730,F =4.336,P ＜ 0.05).(4) Numbers of patients with postoperative overall complications were 11,8 and 26 in stage Ⅰ,Ⅱ and Ⅲ,showing no significant difference (x2 =0.301,P ＞ 0.05).(5) Of 210 patients,203 were followed up for a median time of 43 months (range,1-80 months) with a follow-up rate of 96.67％ (203/210).Sixty-eight patients were dead till the end of follow-up,including 60 died of recurrence of tumor,2 died of surgical complications and 6 died of other causes.Postoperative 3-,5-year overall survival rates were 96.1％,87.8％,62.4％ and 92.9％,77.5％,52.7％ in patients with stage Ⅰ,Ⅱ and Ⅲ,respectively,with a significant difference (x2 =29.071,P ＜ 0.05).Conclusion Laparoscopy-assisted radical gastrectomy for advanced gastric cancer is at least equivalent to early gastric cancer in the safety,with the satisfactory long-term outcomes.

Objective To investigate the features of familiar facial palsy,ophthalmoplegia and dysphagia characterized by autosomal dominant inheritance in a family and to discuss the classification and pathogenesis of the disease.Methods Clinical,electrophysiological,pathological examinations were performed and blood samples were obtained from 5 patients and 26 family members.PCR protocol was used to identify a certain gene. Results In the 5 patients receiving physical examination,all had ptosis,external ophthalmoplegia,facial paralysis,dyphagia,hoarseness,decreased pharyngeal reflex;4 had amyotrophy of muscle of tongue,temporal nuscle,masseter and muscles of distal lower limbs;3 had proximal limb asthenia and distal limbs amyotrophy.Compared to those of oculopharyngeal muscular dystrophy(OPMD)with similar symptoms and signs,both electrophysiological manifestation and pathological findings of the family members supported the diagnosis of muscular dystrophy,but the(GCG)6(GCA)3GCG in the first exon of PABPN1 mutated neither in normal family members nor in patients.Conclusions This family presents clinical manifestations somewhat resembling to those of OPMD and distinctive to other disorders,but has a totally different genetic background from OPMD.It may be a new subtype of muscular dystrophy.

BACKGROUND: Interleukin-1 (IL-1β) and intercellular adhesion molecule-1 (ICAM-1 ) can mediate neutrophilic infiltration, which is closely relevant to cerebral ischemia-reperfusion injury.OBJECTIVE: To investigate the effect of physcion on cerebral inflammatory reaction after ischemia-reperfusion injury.DESIGN: A completely randomized study based on animals.SETTING: Neurological department in a university hospital.MATERIALS: From September to December 2003, the study was conducted in the Animal Laboratory, Hebei Staff and Workers Medical College. Totally 91 healthy male SD rats, supplied by Laboratory Animal Center of Hebei Medical University, were used in the experiments. They were divided into sham operation (SO) group, ischemia-reperfusion group, normal control group, 20 mg/kg physcion group and 40 mg/kg physcion group.Each of the former two groups would be divided into 4 subgroups named as the 6th-hour-after-reperfusion group, the 12th-hour-after-reperfusion group, the 24th-hour-after-reperfusion group and the 48th-hour-after-reperfusion group. Each of the latter two groups were divided into 2 subgroups named as the 12thhour-after-reperfusion group and the 24th-hour-after-reperfusion group. Each subgroup contained 7 rats.INTERVENTIONS: Middle cerebral artery occlusion model (MCAO model) was applied, and IL-1β was measured by radioimmunoassay and ICAM-1 was detected by immunohistochemical staining.MAIN OUTCOME MEASUREMENTS: The IL-1 β level and the positive expression of ICAM-1 in the rats' cerebella were observed.RESULTS: Cerebral ischemia-reperfusion injury in the rats reached its peak 6 hours after reperfusion, and then it decreased gradually. In the 12-hour-after-reperfusion subgroup amd the 24-hour-after-reperfusion subgroup of the 40 mg/kg physcion group, and the 12-hour-after-reperfusion subgroup of the 20 mg/kg physcion group, IL-1β in the injured parts of the cerebella decreased dramatically, compared with MCAO model controls ( P＜ 0.01 ). In the normal control group and SO group, a small quantity of ICAM-1 was detected in rat' s cerebral cortex, and some fulvous staining substance was observed in the plasma and membrane of cerebral vascular endothelium cells. In the cerebral ischemia-reperfusion injury group, positive staining substance could be observed 24 hours after the reperfusion, then darkened gradually (integral absorbency value: 31.89 ± 4.38, area density value: 0. 018 5 ± 0. 003 1). In the 12-hour-after-reperfusion subgroup of the 40 mg/kg physcion group (integral absorbency value: 13.33 ±6. 12, area density value: 0. 007 6 ± 0. 002 2) and the 24-hour-after-reperfusion subgroup of the 40 mg/kg physcion group (integral absorbency value: 20.04 ±4.65,area density value: 0. 012 9 ±0. 003 6), and in the 24-hour-after-reperfusion subgroup of the 20 mg/kg physcion group (integral absorbency value:23.73 ±4.51 area density value: 0. 014 1 ±0. 003 8), expressions of ICAM-1 around the infarctions significantly decreased as compared with those in the MCAO model controls respectively ( P ＜ 0.01 or P ＜ 0.05).CONCLUSION: Physcion tends to decrease the expressing of IL-1β and ICAM-1 in a cerebellum after ischemia-reperfusion injury, thus, it may help alleviate the ischemia-reperfusion injury.

Objective To investigate the clinical features and effective treatment of patients with severe type A H1N1 flu in Wenzhou. Methods The clinical data of 42 hospitalized patients with severe type A H1N1 flu were analyzed and the clinical features were summarized. Results A total of 42 patients with severe type A H1N1 flu all began with fever and cough. The symptoms of expectoration, pharyngalgia, chilly accounted for 92. 9%, 90. 5% and 42. 9%, respectively. The peripheral leucocyte counts were normal or reduced. C-reactive protein and erythrocyte sedimentation rate levels both increased in 30 patients (71.4%). About 95.2% (40/42) patients had changes of pulmonary imaging. All of the patients were treated with oseltamivir and effective antibiotic drugs as well as symptomatic management. No patients was treated with glucocorticoid. The patients with underlying diseases were given proper treatment. Three cases were treated with antifungal therapy and 3 pregnant patients were timely terminated of pregnancy. Conclusions Severe type A H1N1 flu progresses rapidly and the lower respiratory tract is involved soon after onset. Therefore, the patient should be diagnosed early and treated promptly after presenting fever, which will lead to good prognosis.

Anti-cancer drug bleomycin (BLM) can cause acute lung injury (ALI) which often results in pulmonary fibrosis due to a failure of resolving acute inflammatory response. The aim of this study is to investigate whether toll-like receptor (TLR) 2 mediates BLM-induced ALI, inflammation and fibrosis. BLM-induced dendritic cells (DCs) maturation was analyzed by flow cytometry and cytokine secretion was detected by the ELISA method. The expression and activity of p38 and ERK MAPK were determined with Western blotting. The roles of TLR2 in ALI, inflammation and fibrosis were investigated in C57BL/6 mice administered intratracheally with BLM. The results demonstrated that BLM-administered mice had higher expression of TLR2 (P<0.001) and its signaling molecules. Blocking TLR2 significantly inhibited the maturation of DCs and reversed BLM-stimulated secretion of cytokines in DCs, such as IL-6 (P<0.001), IL-17 (P<0.05) and IL-23 (P<0.05). TLR2 inhibition attenuated BLM-induced increase of inflammatory cells in bronchoalveolar lavage fluid (BALF), and reversed the immunosuppressive microenvironment by enhancing TH1 response (P<0.05) and inhibiting TH2 (P<0.001), Treg (P<0.01) and TH17 (P<0.01) responses. Importantly, blocking TLR2 in vivo significantly protected BLM-administered mice from pulmonary injury, inflammation and fibrosis and subsequently increased BLM-induced animal survival (from 50% to 92%). Therefore, TLR2 is a novel potential target for ALI and pulmonary fibrosis.

Objective:To explore the clinicopathological factors in node-negative colon cancer patients with synchronous liver metasta-ses and to improve the efficiency of follow-up and rate of early diagnosis for high-risk patients. Methods:Clinical data of 140 colon cancer patients who underwent operation from January 2008 to December 2012 in Beijing Cancer Hospital were analyzed. The high-risk variables associated with synchronous liver metastases were subjected to univariate and multivariate analyses. Results:Synchro-nous liver metastases developed in 13 out of the 140 node-negative colon cancer patients. Eight out of those 13 patients (61.5%) ex-hibited complications with incomplete colon obstruction, and 6 cases underwent surgical treatment for both primary tumor and liver metastases. Both univariate and multivariate analyses revealed that preoperative abnormal serum carcinoembryonic antigen levels (≥5 ng/mL) and vascular invasion were significant independent risk factors for synchronous liver metastases. Conclusion:The risk of syn-chronous liver metastases for colon cancer patients with negative lymph node is slightly high. Vascular invasion and abnormal preoper-ative CEA levels are significant independent risk factors for synchronous liver metastases. Specific examination of livers is necessary for the special cohort at the time of diagnosis or after operation to avoid misdiagnosis.

AIM: To explore the effect of physcion (P) on the level of IL-1? and expression of ICAM-1 and caspase-3 during cerebral ischemia-reperfusion injury. METHODS: The 91 healthy adult SD rats were selected, and were randomly divided into normal group, sham-operated group, cerebral ischemia-reperfusion group (model), low-dose physcion (PLD) and high-dose physcion (PHD) treatment group. The level of IL-1? was detected by radioimmunoassay. The expression of ICAM-1 and caspase-3 was detected by immunohistochemistry. The changes of tissue pathology were also investigated. RESULTS: The level of IL-1? reached the peak at 6 h after ischemia-reperfusion (IR). The protein expression of ICAM-1 and caspase-3 reached the peak at 24 h after IR. The level of IL-1? and the protein expression of ICAM-1 and caspase-3 in PHD group decreased obviously compared with those in model group (P