Objective To study the effect of Toll-like receptor 4(TLR4)on expression of IRF-3 and IFN-? during the inflammatory reaction induced by cerebral ischemia reperfusion in mice. Methods After blockade of TLR4 by TLR4 antibody,expression of TLR4,IRF-3 and IFN-? at the protein level in hippocampus was examined by Western blot,respectively. Mice were randomly divided into sham group,ischemia reperfusion group and TLR4 blocking group in different time points (1,2,3 and 4 day). Results In the right cortex,the expression of TLR4,IRF-3 and IFN-? of I group was distinctly higher than that of S and T group(P

Objective To study the effect of Toll-like receptor 4(TLR4)on the expression of IRF-3 and IFN-β during the inflammatory reaction induced by cerebral ischemia reperfusion in mice.Methods Totally 144 mice were randomly divided into 3 groups:(1)ischemia reperfusion group(I group):the mice were subjected to 12 minutes ischemia by bilateral common carotid arteries(CCA)occlusion,and reperfusion without additional intervention;(2)TLR4 blocking group(T group):after 10 minutes of bilateral CCA occlusion,TLR4 antibody was injected slowly into right CCA within 2 minutes;(3)sham group(S group):no CCA occlusion was performed.At 1,2,3 and 4 d after ischemia reperfusion,the expression levels of TLR4,IRF-3 and IFN-β protein in the cortex was respectively examined by Western blot.Results In the right cortex,the expression levels of TLR4,IRF-3 and IFN-β of I group were distinctly higher than that of S and T gtoup(P<0.05);the expression levels of the 3 protein of T group were significantly higher than those of S group(P<0.05).Conclusion The cerebral ischemia reperfusion could activate TLR4 expression in the cortex of the mice.TLR4 might participate in the cerebral ischemia reperfusion through upregulating the expression of IRF-3 and IFN-β.

Objective To study the expression of double-stranded RNA-dependent protein kinase (PKR) in malignant melanoma and ordinary nevi. Methods The expression of PKR and proliferating cell nuclear antigen was examined in 42 cases of malignant melanoma and 25 ordinary nevi by an immunohistochemical method. Results The positive rate of PKR expression was higher in the patients with malignant melanoma than that in the patients with ordinary nevi (P

Objective To analyze the correlation between body mass index(BMI)and percentage body fat(PBF)in people of dif-ferent nationality and gender,and assess the value of BMI and PBF in the diagnosis of obesity.Methods A total of 925 healthy a-dults who underwent physical examination in the hospital were enrolled in the study,bioelectrical impedance measurement was used to measure the weight,PBF,then analyze the correlation between BMI and PBF in people of different nationality and gender.Results In the normal and overweight population classified by BMI,;In underweight,overweight and obesity people,PBF of Han women were higher than that of Uighur women(P <0.05 ).In people of different gender and ethnic group,PBF was positively correlated with BMI(P <0.05).Using BMI≥28 kg/m2 as gold standard for the diagnosis of obesity,PBF have good sensitivity and low speci-ficity for the diagnosis of obesity in both of the two ethnic groups.Conclusion Compared with Uygur,Han have higher PBF at the same level of BMI.There is a malconformation between BMI and PBF.Evaluation of obesity could not simply rely on BMI,and should be analyzed combined with PBF.

Objective To evaluate the clinical effects and clinical classification of occlusal rehabilitation in elderly patients with abnormal occlusion, and to discuss the diagnosis principles and the practical techniques of the dental prosthesis for occlusal rehabilitation. Methods Forty two elderly patients with abnormal occlusion were treated with occlusal rehabilitation with fixed dentures, fixed-removable dentures and removable partial dentures. Eight patients among them simultaneously had temporomandibular joint(TMJ) disorder. After the clinical procedures including examination, diagnosis, prosthesis design, manufacture, application of occlusal rehabilitation and post-treatment evaluation, the using condition of dentures, patients' satisfaction ratings, TMJ functions and abutment teeth healthy status were examined before and after treatment. Results All the patients were satisfied with their dentures' general functions 1 year after treatment. Compared with the removable partial dentures, the other two types of prosthesis showed better clinical outcomes (χ2=4.15,P<0.05) and compacts on phonation of the dentures (χ2=4.71,P<0.05). In the 8 patients with TMJ disorder, 7 cases were cured completely. The treatment effects of TMJ pain (χ2=0.031, P<0.05)and TMJ click (χ2=0.038, P<0.05)had statistical differences. 30 teeth of the 203 abutment teeth (14.8%) had the problems of periodontal diseases and secondary caries and the incidences of these problems were higher in using removable partial dentures treatment than in the other two methods. Conclusions After the systematic diagnosis and the prosthesis design procedures of occlusal rehabilitation, it is important to choose a proper prostheses for the elderly patients according to their physical and psychological features, which may give the patients satisfactory results.

ObjectiveTo assess the clinical value of procalcitonin (PCT) in the diagnosis of sepsis in adults.Methods An extensive search for related literature from the Wanfang data, CNKI, VIP, Medline/PubMed, Embase/OvidSP and the Cochrane Library up to December 2014 was performed. The articles, including prospective observational studies or randomized controlled trials, regarding PCT for the diagnosing of sepsis were enrolled. Only patients older than 18 years were included. Patients with sepsis, severe sepsis, or septic shock served as the experimental group, and those with a systemic inflammatory response syndrome (SIRS) of non-infectious origin as control group. The language of literature included was English or Chinese. The quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Heterogeneity, pooled diagnostic odds ratio (DOR), pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, the area under the summary receiver operating characteristic curve (SROC) and subgroup analysis were analyzed with the software of Metadisc 1.4.Results A total of 6 385 published reports were collected, and among them 24 met the inclusion criteria, including a total of 3 107 patients. The studies showed substantial heterogeneity (I2 = 69.4%), and random effect model was used for Meta analysis, showing that the pooledDOR was 10.37 [95% confidence interval (95%CI) = 7.10-15.17]. No evidence of a threshold effect was found (Spearman correlation coefficient = 0.27, calculated by logarithm of sensitivity and logarithm of 1-specificity,P = 0.20). TheDOR values of pooled and each study were not distributed along the same line in forest plots, and Cochran-Q = 78.33,P = 0.000 0, showing that there was heterogeneity in result from non threshold effect. Except for partial heterogeneity caused by non threshold effect, the result of Meta regression analysis including PCT detection method, categories of disease, research location and so on showedP values were all higher than 0.05. Thus, the heterogeneity could not be explained by Meta regression analysis. The pooled sensitivity was 74% (95%CI = 72%-76%), the pooled specificity was 70% (95%CI = 67%-72%), the pooled positive likelihood ratio was 2.79 (95%CI = 2.31-3.38), the pooled negative likelihood ratio was 0.34 (95%CI = 0.28-0.41), and the pooled AUC was 0.83 (95%CI = 0.79-0.87). AUC in medical patients was 0.80 (95%CI = 0.75-0.85), which was higher than that in surgical patients [0.71 (95%CI = 0.65-0.81)].Conclusions Our results indicate a moderate degree of value of PCT for diagnosis of sepsis in adult patients. The diagnostic accuracy in medical patients is higher than that in surgical patients. PCT is a good auxiliary biomarker for diagnosis of sepsis.

Objective To investigate the clinical practice pressure and mental health of medical students with type D personality.Methods Type D Scale-14 (DS14) and Beck-Srivastava Stress Inventory (BSSI) test were applied to 371 medical students to assess the personality types and pressure.The symptom checklist 90 (SCL-90) was used to evaluate the psychological health.Results ①The detection rate of type D personality of medical students was 36.39％.②The average score in BSSI of medical students of type D personality was (99.27± 10.51),which was higher than medical students of non-type D personality (87.60± 11.37),and the difference was statistically significant (t=9.9711,P=0.0000).The medical students' score of type D personality in SCL-90 of 9 factors were all higher than medical students of non-type D personality,but the statistically significant difference were only in the score of depression,anxiety and psychosis-like symptoms (t=2.4409,P=0.0151;t=2.8662,P=0.0044;t=2.7783,P=0.0057).Conclusion In face of the same pressure of medical clinical practice,the medical students of type D personality are more likely to have a heavier psychological burden,and the college should pay special attention to the problem and try to intervene the problem,so as to reduce the pressure caused by a variety of psychological problems.

ObjectiveBoth kilovolt (KV) cone-beam computed tomography (CBCT) and KV radiography can determine set-up errors for patients with head-and-neck cancer.This study is to compare their performance.Methods16 patients with head and neck cancer were enrolled in this study.There were 160 sets of CBCT and corresponding orthogonal radiography images.Through registration of CBCT images with the planning CT images,and registration of radiography images with the digitally reconstructed radiographs,translational set-up errors were determined along left-right (x),super-inferior (y),and anterior-posterior (z) directions.Pearson correlation analysis was performed to evaluate the correlation of the set up errors determined by the two methods,and Bland-Altman plot analysis was used to assess the coincidence of these two methods.ResultsThe Pearson coefficient of correlation along all three directions was less than 0.01,and R2 was 0.95,0.84,0.81 on x,y,z,respectively.That means high correlation for two methods.The Bland-Altman plot analysis showed that the 95％ agreement limits of agreement were within preset 2 mm tolerance (x[ 1.3mm,- 1.2mm],y[ 1.6mm,- 1.1mm],z[0.8mm,-1.4 mm] ),which indicates an agreement exists for two methods.ConclusionsFor determination of set-up errors for patients with head and neck cancer,KV radiography is equivalent to CBCT.Considering CBCT delivers higher dose than KV radiography,but provides more soft tissue information.We suggest to use these two methods combinative in clinic.

Objective To investigate the efficacy and safety of Lipo-prostaglandin E1 (LipoPGE1) in the treatment of non-ST segment elevation acute myocardial infarction (NSTEAMI).Methods A total of 86 patients with NSTEAMI were randomly and equally divided into LipoPGE1 group (n= 43) which received intravenous LipoPGE1 combined with low-molecular-weight heparin,aspirin, clopidogrel and other basic therapy, and the control group (n=43) which received placebo combined with the same therapy. The basic clinical settings, curative effect, main adverse cardiovascular events (MACEs) within 30 days including sudden death, new-onset myocardial infarction and target vessel revascularization, bleeding complications and drug adverse effects were observed. Results There were no significant differences in basic clinical characteristics between the two groups. Compared with control group, the patients in LipoPGE1 group showed. significant improvements of ECG (93.0% vs. 74.4%), angina (95.3% vs. 81.4%, both P＜0. 05), the incidences of left heart failure (2.3% vs. 14.0%) and MACEs within 30 days (4.7% vs.18.6%)(both P＜0.05). There were no serious drug adverse effects. Conclusions The LipoPGE1 combined with heparin, aspirin and clopidogrel is effective and safe in the treatment of NSTEAMI,which could improve the clinical symptoms, distal myocardium perfusion and cardiac function,decrease the incidence of MACEs.

Objective To discuss the blood flow charateristics of normal Couinaud’s hepatic segments by using whole-liver perfu-sion with multi-slice spiral computed tomography (MSCT).Methods 73 patients underwent whole-liver perfusion enhanced CT scans for detection of gastric or pancreas cancer,and some were excluded including metastatic liver tumors in 7,multiple liver cysts (>3 cm in diameter)in 6,cirrhosis in 6,liver operation or splenecormy in 3,intra-hepatic bile duct dilation in 1,and excessive motion artifacts in 4.The final 46 patients with normal liver were included,and the perfusion parameters of liver segments were measured for estimating blood-dynamics condition.Results The hepatic arterial perfusion (HAP)in segment 3 was significantly higher than that in segment 6,7 and 8 (P <0.05),and the HAP in segment 4 was significantly higher than that in segment 7 (P <0.05).The hepatic perfusion index (HPI)in segment 3 was significantly higher than that in segment 7 (P <0.05).All normal liver were classi-fied into two groups (group A:<60 years,group B:≥60 years),and no significant correlation between age groups was found.How-ever,the perfusion parameter values in group A were higher than those in group B.No significant correlation was found between gen-ders.Conclusion Our results suggest that differences exist in normal hepatic parenchyma between liver segments.MSCT whole-liver perfusion imaging can more comprehensively response hemodynamic changes in liver,and provids the imaging basis for clinical evaluation of liver disease.