This article expounds the molecular biological characteristics and signaling pathw ay of Tol -like receptor 2 and investigates its advances in research on the roles of neuronal and blood brain barrier damage after cerebral ischemia.

Objective To explore the significance and methods of surgical treatment of mammary hyperplasia. Methods Patients with mammary hyperplasia were treated by different operative procedures,and cosmetic operations were performed synchronously on some selected patients. Results 523 cases were treated by surgery. All cases were diagnosed as mammary hyperplasia on the pathological examination and were in good condition postoperatively. The results of synchronous cosmetic operation were satisfactory . Conclusions The surgical treatment of mammary hyperplasia should be done if the efficacy was not satisfatory after the therapy combined traditional chinese medicine with western medicine . The operative indications must be defined carefully.

A method based on ultra performance liquid chromatography-tandem mass spectrometry ( UPLC-MS/MS) has been proposed for the determination of coccidiostat residues in chicken skin and fat. The sample was extracted with the combination of methanol, acetonitrile, and acetic acid, and cleaned-up by Sep-Pak tC18 solid phase extraction cartridge. Data acquisition under positive electrospray mode was performed by applying multiple reaction monitoring for both identification and quantification. The limits of detection and quantification for halofuginone and robenidine were 7 μg/kg and 20 μg/kg, respectively. The limit of detection of salinomycin, monensin, narasin, maduramicin, and lasalocid was 5 μg/kg, and limit of quantification was 15 μg/kg. The recovery was 75% to 110% in the spiked concentration range from 15 μg/kg to 200 μg/kg, with intra-day precision lower than 12. 8%, and inter-day precision lower than 13 . 4%.

Objective To explore the etiology of lumbar degenerative spondylolisthesis(DS)by analyzing its CT manifestations.Methods The location,degree and angle of inclination of lumbar facet joints were measured in 125 cases with 131 spondylolisthesis.Results The angle of inclination of lumbar facet joints was

Objective:To observe the clinical effect of wind-expelling method of acupuncture and Chinese herbs for sudden deafness.
Methods:A total of 90 cases with sudden deafness were randomly divided into three groups based upon their visit order and random digital table, an acupuncture plus Chinese herbs (APCH) group, an acupuncture group, and a Western medication (WM) group, 30 cases in each group. The APCH group was treated by puncturing Fengchi (GB 20), Fengfu (GV 16) and Fengmen (BL 12), without retaining the needles, and then by puncturing Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6) and Tianshu (ST 25) with reinforcing technique after arrival of the needling sensation, and the needles were retained for 30 min, plus oral administration of wind-expelling Chinese herbs. The acupuncture group was treated with the acupoints selected by syndrome differentiation in reference to the textbook of Acupuncture and Moxibustion Science. The WM group was treated by intravenous infusion of Alprostadil injection, Adenosine Disodium Triphosphate and Coenzyme A and muscular injection of Vitamin B12 and Vitamin B1. The decibel values of hearing loss before and after treatment were respectively recorded and analyzed comparatively.
Results:In the intra-group comparison after treatment among the three groups, the decibel values of hearing loss all declined, with statistically significant differences (allP<0.05). After treatment, the decibel value of hearing loss in the APCH group was better than those in the acupuncture group (P<0.05) and the WM group (P<0.05). The total effective rate was respectively 83.3% in the APCH group, 60.0% in the acupuncture group and 56.7% in the WM group. The total effective rate in the APCH group was better than those in other two groups (bothP<0.05).
Conclusion:The therapeutic effect was better for sudden deafness by wind-expelling method of acupuncture and Chinese herbs than by acupuncture alone or by Western medication.

Objective To investigate clinical features , outcomes and prognosis gerontol delirium . Methods Patients with gerontol delirium diagnosed between January 2011 and January 2013 were identified by a retrospective review of records in the Nanjing General Hospital of Nanjing Military Command .Totally 132 patients were included , 59 females and 73 males, with a median age of 71.4 years (range 65-97).The diagnostic criteria were based on the DSM-Ⅳ and Delirium Rating Scale.Dementia, depression, mental retardation and other cognitive dysfunction were excluded .General condition of patients , etiology , clinical features , treatment and prognosis were all performed using the SPSS 20.0 for windows.A P value of <0.05 was considered as significant . Results Disturbance of consciousness were observed in all 132 patients.Old age, coma and serious infection in the course , endotracheal intuba-tion and(or) tracheotomy, a variety of basic diseases all come up with poor prognosis . Conclusion Delirium progresses quickly. Etiological treatment can help to control the conditions of delirium .

Objective:To provide a normal reference range for anogenital distance (AGD) in full-term neonates and to investigate factors possibly affecting neonatal AGD.Methods:Neonates with gestational age ≥37 weeks who were delivered in the Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from November 2017 to March 2019 were enrolled.General information on mothers and newborns were collected and neonatal AGD were measured.The distance from the male anus center to the base of the scrotum was determined to be the male AGD, and the distance from the female anus center to the posterior labia was recorded as the female AGD.The effects of maternal and neonatal factors on neonatal AGD were analyzed.Results:A total of 1 078 newborns were included, including 586 males and 492 females.Male AGD [(22.90±3.80) mm] was significantly greater than female AGD [(11.80±2.10) mm] ( t=22.316, P<0.05). The AGD of singleton neonates was significantly greater than that of neonatal twins [males: (23.01±3.82) mm vs.(21.18±1.88) mm, females: (11.89±2.08) mm vs.(10.98±1.75) mm, t=26.185, 18.326, all P<0.05]. Neonatal gestational age, birth weight, head circumference and length were significantly associated with AGD (all P<0.05). Maternal factors (including age, height, weight, body mass index, gravidity, parity, occupation, etc.) were not significantly associated with neonatal AGD (all P>0.05). The AGD of 10 children with genital malformation was significantly smaller than that of males with normal genital appearance [(22.89±1.99) mm vs.(23.55±3.78) mm]( t=15.362, P=0.006). Conclusions:The reference ranges of AGD in full-term males and females in Shanghai are(22.90±3.80) mm and (11.80±2.10) mm, respectively.The neonatal gestational age, birth weight, head circumference and length may be the intrinsic factors affecting neonatal AGD.

To study validity and reliability of the modified elbow attachment (mEA) of Biodex. Methods 25 healthy volunteers participated in the study. The tester A used mEA and standard elbow attachment (sEA) separately to test right elbow flexor and extensor of these volunteers within a day. The tester B used mEA to assess the same muscles of the same volunteers 3 days later. The correlation between mEA and sEA were analyzed to test the validity and reliability of mEA. Results mEA was highly correlated with sEA in all isokinetic test data (P<0.05). The interclass correlation coefficients (ICC) were more than 0.75 in most isokinetic test data (P<0.05). Conclusion The mEA has a good validity and reliability.

ObjectiveTo investigate the effects and molecular mechanism of endoplasmic reticalam stress (ERS) on albumin-induced apoptosis in renal proximal tubular cells (HKCs). MethodsWestern blot was performed to detect the relationship of the expression of glucose-regulated protein 78 (GRF78) and CCAAT/enhancer-binding protein-homologous protein (CHOP) with the action time and concentration of haman serum albumin (HSA). Expression levels of CHPO mRNA and protein in HKCs after CHOP siRNA transfection were examined by real-time fluorescence quantitative PCR and Western blot respectively. Annexin-V-FITC and PI doable staining cytometry was used to detect the apoptosis of HKCs induced by HSA and influenced by CHOP siRNA. Results(1)After HKCs were stimulatde by 0, 5, 10, 20 g/L albumin for 24 hours respectively, the expression of GRP78, CHOP and HKCs apoptosis were increased with the albumin concentration (P<0.01). After HKCs were stimulated by 20 g/L albumin for 0, 6, 12, 24, 36 hours respectively, the expression of GRP78 was up-regulated at 6-hour, while CHOP and HKCs apoptosis were increased at 12-hour, and significant differences were found among groups (P<0.01). (2) CHOP siRNA significantly inhibited albumin-induced HKC CHOP mRNA and protein expression, as well as HKC apoptosis (P<0.01). ConclusionsRenal tubular cells exposed to high protein load result in EBS. ERS may subsequently lead to tubular damage by activation of pro-apoptosis factor CHOP.

Objective: To investigate the utilization status of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) in 11 hospitals of Zhejiang province from 2009 to 2015, and to analyze the use rationality.Methods: The doctor's advice in 40 days annually was collected in 11 hospitals of Zhejiang province from 2009 to 2015, and the drug consumption, frequency of utilization (DDDs), defined daily cost (DDC) and drug utilization index (DUI) were analyzed for the patients with lung cancer treated with EGFR-TKI.Results: Icotinib, erlotinib and gefitinib were the three prevalent EGFR-TKIs used in Zhejiang province, and icotinib started to be used in clinics in 2013.The overall cost of EGFR-TKIs increased year by year during 2009 and 2015, and the total amount of sales increased by 4.67 times in 2015 when compared with that in 2009.Generally, the DDDs value of erlotinib showed a decreasing trend, however, that of icotinib and gefitinib rose year by year during 2009 and 2015.Erlotinib had the highest DDC followed by gefitinib and icotinib.The mean value of DUI of the three targeted drugs was about 1.Conclusion: The utilization of EGFR-TKI is reasonable in 11 hospitals of Zhejiang province with increasing comsuption.