Toll like receptors(TLRs) , a pattern conservative receptor superfamily are found on mammalian cell surface over the last decade. TLRs recognize distinct pathogen - associated molecular patterns, which can lead not only to the responses of the innate immunity but also to the development of the antigenspecific adaptive immunity. The expression of TLRs have changed in some carcinomas, besides, microbial composition and drugs mediate the tumor immunotherapy by the way of TLRs signal transduction. Consequently , deep studies on TLRs will provide new approaches for tumor immunotherapy.

ObjectiveTo understand the nursing undergraduates' graduation thesis writing,to provide basis for the revised management plan and improve the overall quality of graduation thesis.Methods A self-designed questionnaire was given to 158 four-year program nursing graduates of Grade 2006 by group and the questionnaires were collected timely and analyzed with SPSS 17.0.Results63.19％ of students thought it necessary to write thesis,86.71％ thought internship beneficial for wrting and 64.6％ hoped to finish the thesis writing before the practice because of great pressure.ConclusionStudents' recognition degree to graduation thesis directly affects the quality of thesis writing.A reasonable teaching plan should be made and school resources should be fully used to improve the quality of thesis writing.

Objective To study the physiological indexes of children receiving cardiopulmonary exercise testing (CPET) in order to provide some data for establishing the normal CPET reference value in Chinese children.Methods One hundred and twenty-eight healthy children underwent the CPET with the standard scheme.All children were divided into 3 groups according to ages:3-6 years old, ＞6-10 years old and ＞ 10-14 years old.The physiological indexes of CPET were collected, including maximal oxygen uptake (VO2max/kg) , oxygen uptake at anaerobic threshold (VO2/kg@AT), maximal tolerance power (Pmax), maximal heart rate (HRmax), peak respiratory minute volume to CO2 (peak VE/VCO2), slope of respiratory minute volume to CO2 (VE/VCO2 slope), maximal tidal volume (VTmax) and the maximal minute ventilation (VEmax).The range in normal values for physiological CPET variables was recorded.Results The VO2max/kg was (31.71 ± 7.31) mL/(min · kg), (31.05 ± 5.96) mL/(min · kg), and (34.10 ±8.72) mL/(min · kg) in the 3-6 years old group, ＞6-10 years old group and ＞ 10-14 years old group of boys.The VO2/kg@AT was (28.32 ± 10.20) mL/ (min · kg), (23.13 ± 9.56) mL/(min · kg), and (22.18 ± 7.72) mL/(min · kg)in the 3-6 years old group, ＞6-10 years old group and ＞ 10-14 years old group of boys.The VO2 max/kg was (29.27 ± 4.19) mL/(min · kg), (30.67 ± 5.59) mL/ (min · kg) (29.18 ± 6.56) mL/ (min · kg) in the 3-6 years old group, ＞ 6-10 years old group and ＞ 10-14 years old group of girls.The VO2@AT was (26.64 ±9.49) mL/(min · kg) ,(20.53 ±7.66) mL/(min · kg) ,(17.83 ±6.49) mL/(min · kg)in the 3-6 years old group, ＞6-10 years old group and ＞ 10-14 years old group of girls.VO2max/kg and VO2/kg@AT did not change with age,there was no gender difference in VO2max/kg(P ＞0.05).VO2/kg@AT of boys was higher than girls in the 3-6 years old group(t =2.351 ,P =0.023).The Pmax,VEmax and VTmax increased with the growth of age(boy: F =49.436,24.290,28.958, all P ＜ 0.001;girl : F =58.287,42.990,28.802, all P ＜ 0.001), but not significant in different gender group(P ＞ 0.05).In boys peak VE/VCO2, VE/VCO2 slope and HRmax were significantly different (F =4.758,P =0.012;F =8.050, P =0.001;F =3.869, P =0.026), however these indexes were not significantly different in girls(all P ＞ 0.05).Conclusions This study provides a set of data for the most important CPET variables in Chinese children.VO2max/kg does not change with age,so it can be used as a valuable parameter in exercise ability evaluation.

Objective To evaluate the effect of tissue-engineered nerve graft combined with tetramethylpyrazine in the repair of ischiadic nerve defect in rats.Methods Fifty-five adult SD rats were allocated into groups A (n =15),B (n =15),C (n =15) and D (n =10),according to the random number table.All experimental sciatic nerves were at the right hind side.After the rats were anesthetized with 10 g/L pentobarbital through abdominal injection,a 1.5 cm nerve sciatic nerve was excised at the point 0.5 cm away from the lower margin of the piriformis.Four grafts were used to bridge the nerve defect,including tissue-engineered nerve transplanted neural stem cells (NSCs) that were cultured in medium containing tetramethylpyrazine for 1 week (group A),tissue-engineered nerve transplanted NSCs that were cultured in tetramethylpyrazine-free medium for 1 week (group B),acellular nerve allograft (group C),and nerve autograft (group D).After operation,group A was administered tetramethylpyrazine for 12 weeks in the operative site.For other groups,the same volume of normal saline was used instead of tetramethylpyrazine.Repair results were detected with the sciatic function index (SFI),nerve electrophysiological evaluation,fluorescent microscopy,horseradish peroxidas (HRP) retrograde tracer and nerve fiber regeneration study.Results At postoperative 2 weeks,no differences were found in SFI and electrophysiological evaluation among the groups,there was an intensive fluorescence in groups A and B and no fluorescence in group C,and large nestin-positive cells were observed in groups A and B.At postoperative 12 weeks,SFI was-17.52 ± 2.41 in group A,-25.74 ± 2.85 in group B,-36.12 ± 3.41 in group C and-15.87 ± 2.26 in group D;electrophysiological evaluation showed nerve conduction velocity of (9.43 ± 0.40) m/s in group A,(7.76 ± 0.31) m/s in group B,(5.87 ± 0.67) m/s in group C and (10.16 ± 0.39) m/s in group D;fluorescence microscope and histological staining showed NSCs could survive in vivo,migrate and differentiate into neurons and gliocytes;HRP-positive neurons were 885.40 ± 19.91 in group A,684.57 ± 38.37 in group B,390.33 ± 43.41 in group C and 941.67 ± 32.54 in group D;regenerated nerve fibers,often myelinated were large in group A.All the measures in group A were better compared to groups B and C (P ＜ 0.05),but didn't differ from those in group D (P ＞0.05).Conclusion Tissue-engineered nerve transplanted NSCs cultured in medium including tetramethylpyrazine can effectively repair rat sciatic nerve defect,and promote peripheral nerve regeneration and lower limb motor function recovery.

Objective To explore the factors influencing health management demand by community residents.Methods Using data from the survey of Health Management Demand by Community Residents in Hangzhou,this paper examined the influence factors with the logistic model from such four aspects as individual characteristics,economic characteristics,health level and health awareness.Results The health awareness poses a positive impact on health management demand;the level of health has a negative impact while income has an inflection point(5 000 yuan per month).However,individual characteristics have no significant effect. Conclusion Such measures as enhancing health management awareness of the residents,building a health management system centering on communities and supported by health management firms,and building health management information platform,can effectively satisfy such demand.

Objective To realize antimicrobial resistance rate of Pseudomonas aeruginosa (P. aeruginosa)and it’s correlation with antimicrobial use density(AUD),and to provide reference for control of healthcare-associated infec-tion.Methods From July 2011 to December 2013,antimicrobial resistance rate of P. aeruginosa isolated from hospi-talized patients and AUD of patients were monitored,and the correlation between them was analyzed.Results AUD of patients decreased from 73.61 in the third and fourth quarters of 2011 to 41.33 in the same quarters of 2013. Corre-lation coefficient of AUD and antimicrobial resistance rate of P. aeruginosa was -0.32~0.88,correlation coeffi-cient of resistance rate of P. aeruginosa to aztreonam and aztreonam use density was 0.88,there was statistical sig-nificance. Conclusion AUD of hospitalized patients revealed a decreasing tendency,suggesting antimicrobial selec-tive resistance should be considered in clinic.

Objective To explore the methods for the evaluation of the uncertainty of the determination of hardness in water. Methods A certain water sample was analyzed for the hardness according to EDTA-Na2 volumetry ruled by the Sanitory Standard for Drinking Water(2001).The mathematical model of the determination of hardness in water was established based on JJF1059-1999. The variance composition of the relative uncertainty was analyzed. The procedure of the evaluation of every uncertainty component was described in detail. Results The hardness in the water sample was 137 mg/L calculated according to mathematical model established in this study. The relative uncertainty and the expand uncertainty of the detection of hardness in the water sample were 0.008, 3 mg/L respectively. The expression of the uncertainty in the determination of hardness was (137?3)mg/L. Conclusion This method presented referable value for the evaluation of the uncertainty of volumetry determination method of hardness in water.

OBJECTIVE:To observe the efficacy and safety of atorvastatin in the treatment of hypertension with unstable angi-na. METHODS:80 patients with hypertension with unstable angina were randomly divided into control group and treatment group. All patients were given anti-platelet aggregation and other conventional treatment;based on it,control group was orally treated with Amlodipine besylate tablet 5 mg,once a day+Metoprolol tartrate controlled-release tablet 25 mg,twice a day+Isosorbide dini-trate injection 10 ml by intravenous infusion,twice a day;treatment group was additionally treated with Atorvastatin calcium tablet 20 mg,orally,qd. 3 months was a treatment course,and it lasted 6 courses. Clinical efficacy,and systolic blood pressure,diastol-ic blood pressure,angina frequency and duration,changes of TC,TG,LDL,HDL levels before and after treatment and adverse reac-tions in 2 groups were observed. RESULTS:Total effective rate in treatment group was significantly higher than control group,the difference was statistically significant(P<0.05). After treatment,systolic blood pressure and diastolic blood pressure in 2 groups were significantly lower or shorter than before,the difference was statistically significant(P<0.05),however,there was no signifi-cant difference between 2 groups(P>0.05);angina frequency and duration were significantly lower than before,and treatment group was lower than control group,TC,TG and LDL in treatment group were significantly lower than before and control group, HDL was higher than before and control group,the differences were statistically significant(P<0.05),there was no significant dif-ference between before and after treatment in control group(P>0.05). There was no significant difference in the adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Based on the conventional treatment, atorvastatin can effectively reduce the long-term angina frequency and duration of patients with hypertension with unstable angina,improve the ischemia myocardial and reduce the lipid levels with good safety.

Objective To explore the diagnostic value of MRI in female non-genital origin masses in pelvis.Methods The MRI features of female non-genital origin masses confirmed by surgery pathology in 15 patients were analyzed retrospectively.Results Preoperative MRI showed that 10 masses were mixed type,3 masses were solid,and other 2 masses were cystic,5 masess were mis-diagnosed as genital origin tumors.Pathological results revealed the masses in 6 patients from digestive system,5 from abdominal and retroperitoneal tumor,and other 4 from other tumors,including small intestine stromal tumors in 4 patients,sigmoid colon ade-nocarcinoma in 1,mucinous cystadenoma of the appendix in 1 patients,mesenteric liposarcoma in 1 schwannomas in 2,retroperitoneal fibromatosis in 1,hibernoma in 1,gossypiboma in 2,lymphatic cyst in 1,and lymphoma in 1.Conclusion Female non-genital origin masses in pelvis are easily misdiagnosed as ovarian tumor before operation,and other clinical features should be paid attention in or-der to reduce misdiagnosis.

Congenital bile duct dilatation may occur in any part of the biliary tree,and the diagnosis and treatment of lesions involving the intrahepatic bile duct is the most challenging issue.Surgical operation plays a dominant role in the management of congenital bile duct dilatation,with the purposes of relieving symptoms and preventing disease progression and malignant transformation.Surgical principles are radical resection of lesions and reconstruction of unobstructed bile drainage.Hepatectomy is the main surgical procedure for congenital bile duct dilatation with involvement of the intrahepatic bile duct,and liver transplantation can be used for diffuse lesions.Therefore,we believe that hepatectomy and early intervention will maximize patients' benefits.