Objective To observe and analyze the expressions of Toll like receptors (TLRs)of TLR2,TLR4 in peripheral blood mononuclear cells and its correlation with the inflammatory factors levels of the elderly patients with chronic obstruc-tive pulmonary disease (COPD).Methods 80 cases of elderly patients with COPD were selected and divided into the COPD stable phase group and the AECOPD group according to their condition of diseases.43 patients and 37 patients were included into each group respectively.80 cases of healthy elderly people were selected and divided into the smoking group and the non smoking group.41 cases and 39 cases were included into each group respectively.The expression levels of TLR2,TLR4 in peripheral blood mononuclear cells and the serum levels of interleukin-6 (IL-6),interleukin-8 (IL-8),tumor necrosis factor-α(TNF-α)of the objects in all the groups were detected and compared.Results From the AECOPD group,the non smoking group to the COPD stable phase group,the expression levels of TLR2,TLR4 in peripheral blood mononuclear cells of the objects increased significantly gradually and the TLR4 expression level in peripheral blood mononuclear cells of the patients in the COPD stable phase was significantly higher than that in the smoking group (q=2.815~3.754,P <0.05).From the AECOPD group,the COPD stable phase group,the smoking group to the non smoking group,the serum IL-6,TNF-αlevels of the objects decreased significantly gradually and the serum IL-8 level of the patients in the AECOPD group was signifi-cantly higher than that of the other three group (q=5.247~8.175,P <0.05).The expression level of TLR2 in peripheral blood mononuclear cells of COPD patients was correlated with the serum IL-6 level (standardized regression coefficient=0.458),the serum IL-8 level (standardized regression coefficient=0.622)and the serum TNF-αlevel (standardized regres-sion coefficient=0.562)(P <0.05),the expression of TLR4 was correlated with the serum IL-6 level (standard the regres-sion coefficient= 0.478),the serum IL-8 level (standardized regression coefficient= 0.569)and the serum TNF-α level (standardized regression coefficient=0.352)(P <0.05).Conclusion The elderly patients with COPD showed the overex-pression state of TLRs of TLR2,TLR4 in the peripheral blood mononuclear cells.Such increases were correlated closely with the serum levels of the inflammatory factors in the patients.The overexpression of TLRs should involve in the occur-rence and the progression of COPD.

Based on the theories of goals and motivation, the author conducted a study on the management of goals and English achievements, in which the subjects were 470 medical students. Its main purposes were :1. to find out the relationship between motivation, esp. achievement goals and English achievements , 2.to see whether teachers play an important role in stimulating students' study motivation and participating in the management of goals. The findings show that students' English achievements are closely connected with their achievement goals, and teachers' participation in the management of goals and stimulating students' motivation have an active effect on the students' English achievements.

Small cell lung cancer (SCLC) is a highly malignant tumor, which is very sensitive to first-line chemotherapy, but easy to recurrence and metastasis early.So it always has poor prognosis.Second-line therapy for SCLC develops slowly.Topotecan is the only drug approved by US Food and Drug Administration as a second-line chemoradiotherapy.Numerous studies on molecular targeted therapy and immunotherapy are being carried out, but most of them have no or little benefit.Rovalpituzumab tesirine (Rova-T) targeted antibody-drug conjugate (ADC) which is published at the 2016 American Society of Clinical Oncology Annual Meeting shows a good anti-tumor activity, which seems to bring a new dawn of molecular targeted therapy.

Objective To study the mechanism of Chinese Medicine in treating adenomyosis. Methods Thirty-seven patients in the Chinese Medicine treated group (17 cases of adenomyosis) and the control group (20 cases of adenomyosis, non-drug treated) underwent hysterectomy. Endometrium was looked as eutopic endometrium and adenomyosis as ectopic endometrium. Expression of MMP-9 and TIMP-1 in eutopic and ectopic endometrium were measured by immunohistochemical techniques. Meanwhile the levels of CA125 in serum were measured. Results The ectopic endometrium of the Chinese Medicine treated group expressed lower level of MMP-9, higher level of TIMP-1 and lower ratio of MMP-9/TIMP-1 than the ectopic endometrium of the control group (P<0.05). The levels of CA125 in serum were significantly decreased in Chinese Medicine group after treated as contrast with those in control group. Conclusion Chinese Medicine could reduce the level of CA125 and the ratio of MMP-9 and TIMP-1 to prevent the progression of adenomyosis.

regulatory T cell(Treg)is a subset of immunosuppressive Th cell lines with ability to sup-press anti-tumor immunity. Tregs are recruited into local tumor microenvironment by tumor-released chemokine CCL22. Tregs induce Th2-type immune responses which contribute the host ignorance and tolerance to tumor cells via releasing of immunosuppressive cytokines and immunosuppressive receptors. Accumulating evidences indicate that inhibiting Treg can break immune tolerance,and subsequently inhibit the growth and progress of cancer. These discoveries and exploration of Treg provide us a new therapeutic target and strategy with promising clinic application.

Objective To investigate the influences of age and sex on the expression of serum antinuclear antibody (ANA) and its titer level.Methods The serum ANA in 993 people aged 60 years and over were detected and titer of positive serum were analyzed. They were divided into different groups according to age and sex. Two hundred healthy cases aged less than 60 years were collected as control group. Results The serum ANA positive rate was increased with age and it was significantly higher in people aged 60 years and over than aged less than 60 years (29. 1% vs. 14.0%, x2=5. 074, P=0. 025). The serum ANA positive rates were 24.1%, 30. 5% and 33.6% in people aged 60-69 group, aged 70-79 group and aged above 80 group. Among people aged 60 years and over, the positive rate was 35.8% in female group, which was higher than in male group (22. 4%) (x2= 21. 179, P=0. 05). The titre levels of the positive samples were increased with age. In control group, the samples with 1 : 100 titre was 57.1% among the positive samples, which was higher than in the elderly group (36. 3%). And in control group, the samples with 1 : 3200 titre was 0 among the positive samples, which was lower than in the elderly people group (7.6%). The ANA preliminary screening in people aged 60 years and over showed that the titre level was less than 1 : 320-1: 1000 in female and less than 1 : 100-1: 320 in male. Its specificity could be up to about 90%. Conclusions The serum ANA positive rate in people aged 60 years and over is affected by age and sex. The positive rate is higher in female than in male and it is increased with age. It suggests that 1 : 320 to 1 : 1000 could be taken as ANA preliminary screening critical value in female and 1 : 100 to 1 : 320 in male.

Hepatocellular carcinoma (HCC) with a diameter > 5 cm is defined as large HCC. Hepatic resection is the first choice for solitary large HCC with intact capsule and without satellite nodules. The key to successful large HCC resection is to judge the resectability and estimate the remnant liver function preoperatively. Moreover, the liver must be exposed and dissociated adequately, and familiarity with the anatomy of the liver is crucial. Choosing the right technique of hepatic blood flow occlusion and avoiding excessive resection of the liver are important elements. Special attention should be paid to the efficacy of liver transplantation for patients with large HCC exceeding Milan criteria, h is advisable to resect large HCC actively.The hepatic resection is safe and feasible in selected patients with large HCC.

Objective To explored the mental stress situations and the relationship between mental stress, coping style and self-efficacy beliefs of the highland training recruits, and suggestions about mental health education of the recruits to be proposed.Methods The solider mental stress self-reported questionnaire, simplied coping style questionnaire, and generalized self-efficacy beliefs scale were administrated to 256 recruits from 3 companies have been randomly selected in a military training base of Qinghai province.Results The mental stress of the recruits included tension, sleepless, physical and mental exhaustion.The mental stress was significant positive correlation with negative coping style( r=0.349, P＜0.01 ), and significant negative correlation with active coping style( r= -0.179, P＜0.01 ), and with self-efficacy beliefs( r= -0.210, P＜0.01 ).Meantime selfefficacy beliefs was significant positive correlation with active coping style( r = 0.532, P ＜ 0.01 ).Negative coping style and self-efficacy beliefs could significantly predict mental stress.Conclusion Through these ways which improving the self-efficacy beliefs and instructing them to use suitable coping style may help the recruits reduce the mental stress.

Based on the traditional Chinese medicine ( TCM ) theory of correspondence between man and the universe and supporting yang in spring and summer, acupoint sticking therapy has a good clinical effect in respiratory diseases treatment in summer . Its mechanism may be involved in regulating immune function , in-hibiting inflammatory response , scavenging oxygen free radicals and inhibiting protease-antiprotease imbalance , which need to be further studied and identified .

Pulmonary asthenia is one of the chronic consumptive lung diseases because of the weakness of pulmonary lobe. It would be the outcome of many chronic lung diseases with poor prognosis. In recent years, preventing and treating pulmonary asthenia by traditional Chinese medicine (TCM) has been one of the research focuses and some fruits have been received. This paper summarized pulmonary asthenia from the aspects of etiology and pathogenesis, syndrome differentiation, TCM treatment so as to provide theoretical basis and proofs for treatment of pulmonary asthenia by TCM.