The changes of immune system following stroke mainly includes the local inflammatory responses of brain tissue and the systemic immunological changes, The former may exacerbate brain damage following stroke, the latter may increase the susceptibility to infection, and thus impact on brain function recovery and prognosis. Stroke interferes with the normal balance between the nervous system and the immune system, and its mechanism remains unclear. This article reviews the stroke-indnced immunological alterations and their mechanisms,as well as the corresponding treatment strategies in clinical practice.

Iodine is an essential trace element,its physiological function is realized through thyroid hormone,both iodine deficiency and excess have influences on human health.After 20-year implementation of universal salt iodization in China,the iodine deficiency disorders have been controlled effectively,while the problem of iodine excess emerged.Because of different geographical environment,dietary habits and physiological status,some people did exposed to high level of iodine.In recent years,domestic and foreign scholars carried out series of researches aiming at disclose the effects of iodine excess on human health.The health problems induced by high iodine intaking are goiter,hyperthyroidism,hypothyroidism,autoimmune thyroiditis and thyroid cancer et al.Therefore,when preventing and treating iodine deficiency,iodine excess should also be avoided,so as to achieve the ideal goal of adjust measurements according to local conditions,classification guidance,and scientific iodine supplementation.

Objective To evaluate the outcomes of endoscopic sinus surgery (ESS) for children with chronic rhinosinusitis, who had no response to medication. Methods A total of 112 children (aged 12 to 17 years) with chronic rhinosinusitis caused by abnormal anatomy of the nose cavity were treated by ESS in our hospital. Septorhinoplasty was performed on the patients under an endoscope. Conchoplasty, adenoidectomy, or nasal polypectomy was performed simultaneously if necessary. Results The patients were followed up for 6-23 months (mean 13 months). The symptoms of rhinosinusitis disappeared in 110 patients (98.2%); whereas the other 2 patients showed no obvious improvement after the operation. Conclusions By using microinvasive ESS combined with conchoplasty, children with rhinosinusitis caused by abnormal anatomy that does not respond to medication could be cured.

Poly (ADP-ribose) polymerase-1 (PARP-1) is a ribozyme that widely exists in the cukaryotic cells.It plays important roles in the maintenance of genomic stability and the regulation of gene transcription and other physiological processes.PARP-1 is overactivated after ischemic brain injury,and PARP-1 gene knockout mice or PARP-1 inhibitor can reduce brain injury in a variety of models of cerebral ischemia.Therefore,PARP-1 plays important roles in the pathophysiologic processes of ischemic brain injury.The investigation of the effect of PARP-1 in cerebral ischemia contributes to further understanding the pathophysiologic mechanism of stroke and finding a new therapeutic target.

Objective To discuss the short-term outcomes of uncemented APL stem hip hemiarthroplasty for unstable intertrochanteric fracture in elderly patients.Methods From July 2008 to December 2011,26 cases of intertrochanteric fractures were treated by hemiarthroplasty using uncemented APL stem.There were 10 men and 16 women with a mean age of 82.5 years (range,75-94 years).According to EvansJensen classification system,16 cases were type Ⅱ fractures,the other 10 were type Ⅲ.Results The mean operation time was 56 min (range,48 to 72 min).The average blood loss during the operation was 360 ml (range,240-600 ml).One of the patients died in the perioperative period,2 died during the follow-up.The other 23 patients were followed up with an average of 21.5 months (range,12-42 months).The patients were encouraged to walk with aid about 2-3 weeks postoperatively.Three months after the operation,the walking ability were almost recovered to pre-injury level in 21 cases.The acetabular wear,the prosthetic loosening and subsidence were not found.The complications included 1 case of cerebral infarction,1 case of deep venous thrombosis,2 urinary infection,1 skin ulcer due to the long-term use of cortical steroid and 2 heterotopic ossifications.According to Harris hip score,12 cases were classified as excellent,10 cases as good and 1 case as fair.Conclusion Hemiarthroplasty using uncemented APL stem is an effective way to treat the unstable intertrochanteric fracture in elderly patients.The quality of life of the elderly patients can be improved due to early mobilization after the surgery.

Objective:To investigate the complications of traumatic optic neuropathy and to call the surgeons' attention to precaution. Method:Retrospectively analysis of 122 cases patients with traumatic optic neuropathy and 3 cases were analyzed in detail including 1 case with purulent meningitis, another 1 case with internal carotid artery pseudoaneurysm and the other 1 case with internal carotid artery cavernous sinus fistula. Result:Most of the patients had the complications of orbital fracture, maxillofacial fracture, ocular and craniocerebral injury. A few of patients had other injuries all over the body. The case with purulent meningitis was cured with antibiotics. The case with internal carotid artery pseudoaneurysm was cured with neurosurgery. The visual acuity of the both cases were improved. The case with internal carotid artery cavernous sinus fistula died of severe hemorrhea. Conclusion: The patient with traumatic optic neuropathy has the possibility of severe cranial disorders,orbital fracture, maxillofacial fracture and injuries of viscera or limbs. It should be paid mare attention and treated accordingly.

Objective To explore the mid-term efficacy of biological type,long-stem artificial caput femo-ris replacement operation in the treatment of unstable senile intertrochanteric fracture.Methods 73 patients accepted the treatment of biological type long-stem artificial caput femoris replacement operation,and 64 cases were followed. After 3 months of operation,these 64 patients were divided into four groups which marked as A,B,C and D according to the Berg balance scale(BBS).Accordingly,54 patients that in grade A,B and C would be brought into in long-term follow-up study.54 cases include 25 male patients and 29 female patients with an average age of 81.6 years old who aged from 73 to 94 years old.According to Evans-Jensen classification,28 cases were Evans-JensenⅡand the left 26 cases were Evans -JensenⅢ.Results The follow-up period was in the range of 24 to78 months (mean 42months).During this period,except the 9 death cases,there was no case of femoral trochanteric ununited fracture, femoral prostheses loosening or dislocation of hip joint.In total,3 cases occurred with loss of fixing wire,4 cases occurred with acetabular wear,one case was experienced prosthesis adjacent fracture and three cases of heterotopic ossification.According to the Engh standard,all femoral prostheses got osseous fixation.The rate of excellent and good result were 88.9%with in which excellent in 23 cases and good in 17 cases.Conclusion The application of biological type long-stem artificial caput femoris replacement in the treatment of unstable senile intertrochanteric fracture can achieve satisfactory mid-term efficiency.

On the basis of analysis of the current status and future tendency of development of the health services industry in Shanghai,the authors identified key problems and bottlenecks.Thus they made clear the target positioning and principles of the industry,and proposed the basic ideas and pattern of the industry in the 13 th five-year plan period,focusing on such fields as private and high-end healthcare services,traditional Chinese medicine services,public health services,commercial health insurance,and other related industries.In the end,corresponding supporting polices were proposed.

Objective To study the effect of TLR4 activation with LPS on BMP9-induced osteogenic differentiation of immortalized mouse embryonic fibroblasts ( iMEFs).Methods The activation of TLR4/NF-κB signaling path-way was detected by ICC.iMEFs were treated with LPS,BAY11-7082,Adnovirus GFP and BMP9.The early osteo-genic differentiation capability of iMEFs was detected by ALP staining and quantitative assay .The later osteogenic differentiation capability was detected by alizarin red S staining .The expression of later osteogenic differentiation marker gene OCN and OPN were detected by PCR and Western blot .The change of p-Smad1/5/8 was detected by Western blot.The expression of Runx2 and Dlx5 were detected by PCR and Western blot .Results LPS can effec-tively stimulate TLR4/NF-κB signaling pathway .TLR4 activation inhibited BMP 9-induced osteogenic differentiation . BMP9-induced osteogenic differentiation related gene and Smad 1/5/8 signaling activation were inhibited by TLR4 activation .The inhibition effect was partly reversed by BAY 11-7082 ( P<0.05 ) .Conclusions TLR4 activation with LPS can inhibit BMP9-induced osteogenic differentiation of iMEFs cells via NF-κB signaling pathway .

Objective To verify whether iron can accelerate the process of liver fibrosis in rats. Methods The rats were divided into control group, high fat diet group, high iron group, high fat diet and high iron group, high fat diet and de?iron group, each with 24 rats. The rats were allowed to freely take normal diet and high fat diet, while the high iron rats, high?fat diet plus high iron rats received intramuscular injection of 50 mg/kg iron dextran every other day;high?fat di?et plus de?iron group rats received tail intravenous injection of 30 mg/kg deferoxamine one month before death, 3 times/week. 8 rats were selected at 4th, 5th, 6th month of intervention, to detect serum hyaluronic Acid (HA), collagen type IV ( COL?IV) , laminin ( LN) , procollagen III ( PC III) , and observe pathological changes in the liver with Masson staining. Results At 5th month of intervention, serum HA level of the high?fat diet plus high iron group was significantly higher than those of high fat diet group and control group. At 6th month of intervention, serum COL?IV and LN levels of the high?fat diet plus high iron group were significantly higher than those of the high fat diet group. At 6th month, serum PC III level was 1. 63 time of those of the high fat diet group. At the 6th month, liver tissue of high fat diet plus high iron group ap?peared collagen deposition revealed by Masson staining, which was not the case in other groups. Conclusions Iron can accelerate high fat?induced liver fibrosis.