Toll-like receptor 4 (TLR4), the natural receptor of lipopolysaccharide(LPS), plays an important role in the regulation of acute inflammation, intracellular signal transduction and cell apoptosis. TLR4 over expresses in both acute inflammation and fibrotic tissues, which suggests that TLR4 may be essential in acute inflammation and subsequent fibrosis. Nowadays, some progress has been made in the exploration of TLR4 in pathogenesis and treatment of liver cirrhosis and pulmonary fibrosis. TLR4 may become a new target in the treatment of human fibrotic diseases including liver cirrhosis and pulmonary fibrosis. The research status of TLR4 in human fibrotic diseases and its future development are reviewed in this paper.

Objective To explore the value of ectopic gastic mucosa imaging in diagnosis of Meckel′s diverticulum.Methods Twenty-five cases suspected of gastrointestinal bleeding underwent conventional ectopic gastic mucosa imaging with 99mT_cO_4-.The diagnostic criteria Meckel′s diverticulum was that abnormal radio active accumulation in the abdomen observed.Results Three cases of ectopic gastic mucosa imaging was positive,and the diagnosis was all confirmed by surgery and pathology examination.The rest 22 cases were caused by other reasons confirmed by affirmative examinations.Conclusions Ectopic gastic mucosa imaging is easy to conduct,safe with no injury to the patients.It can be the first choice of examination in the diagnosis of gastrointestinal bleeding in children.

OBJECTIVETo investigate the clinical outcomes of the posterior C1,2 screw-rod combined with C2 unilateral translaminar screw and contralateral pedicle screw fixation and autogenous bicortical iliac crest graft fusion in treating upper cervical instability with vertebral artery variations.

METHODSFrom June 2008 to December 2012, the clinical data of 12 patients with upper cervical instability underwent C1 lateral mass screws-C2 unilateral laminar and contralateral pedicle screws fixation combined with autogenous bicortical iliac crest graft fusion were analyzed retrospectively. There were 8 males and 4 females with a mean age of 47.5 years (ranged, 16 to 77 years). Patients suffered from occipitocervical activity limitation of motion with pain or not, VAS was 0-7 points with an average of (3.50 +/- 2.71) points. Unilateral vertebral artery hypoplasia was demonstrated by vertebral arteriography (VAG) or CTA in all patients. Cervical X-ray and CT scans were done within 7 days after surgery in order to confirm internal fixation position. Internal fixation loosening and breakage, reduction losing, bone fusion ratio were observed during follow-up.

RESULTSNo nerves and vertebral artery injuries occurred during operation. Cervical pain obviously decreased and VAS was (0.92 +/- 0.90) points. Cervical alignment of 12 patients had well-recovered by X-ray while Atlantoaxial ventral lamina cortex of 1 case was encroached by CT scan without neurological symptom. All patients were followed up for 6 months to 3 years, no internal fixation loosening and breakage, reduction losing were found. All patients obtained bone fusion in 6-12 months after operation.

CONCLUSIONPosterior C1 lateral mass screws-C2 unilateral laminar and contralateral pedicle screws fixation combined with autogenous bicortical iliac crest graft fusion can achieve biomechanical stability and raise the successful rate of bone fusion, while avoiding the risk of vertebral artery injury and overcoming the insufficient of bone fusion during bilateral laminar screws placement as well. Posterior C1 lateral mass screws fixation is a safe and effective additional method in treating upper cervical instability with vertebral artery variations.

Adolescent ; Adult ; Aged ; Bone Screws ; Cervical Vertebrae ; surgery ; Female ; Humans ; Internal Fixators ; Joint Instability ; surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Vertebral Artery ; pathology

Objective To investigate the angiographic manifestation of the proper esophageal artery (PEA),the hish risk factom for the presence of the anomalous PEA in hemoptysis and to evaluate the safety of transcatheter aaefial embolization(TAE) of the PEA using gelatin sponge(GS).Methods Selective esophageal arteriography WSS performed in forty-three patients with hemoptysis,including 15 cases of pulmonary tuberculosis,18 cases of bmnchiectasis,7 cases of posttuberculous bronchiectasis and three cases of lung cancer. One case experienced failure of bronchial arterial embolization. The angiographic manifestation of the PEAs Was studied.The complications of the procedure and clinical results were observed in the patients who underwent TAE using GS.Results Thirty-nine PEAs were catheterized selectively in 37 patients(86.0%).Eighteen anomalous PEAs(46.2%)were catheterized selectively in 17 patients (45.9%).The anomalous PEAs showed tortuosity,dilatation,hyperplasia,shunting with pulmonary artery and anastomosis with the bronchial artery.All lesions involved basal segment of inferior pulmonary lobar. Bronchiectasis Was the most frequent disease for PEA abnormality. No complications occurred and satisfactory curative effect Was achieved with TAE of the anomalous PEAs.Conclusions It is necessary to perform selective proper esophageal arteriography when the lesion involves basal segment of inferior pulmonary lobar in hemoptysis.Supplemental TAE of the anomalous PEA using GS is safe and valuable in the management of hemoptysis.

The stability of pharmaceutical preparations prepared Chinese medicine liposomes by liposome novel technology combined with traditional Chinese herbs is the main contents of quality study, not only affects preparations molding, but also relates to the efficiency and safety of traditional Chinese medicine. From the view of main influencing factors of stability about the Chinese medicine liposomes and combining with literatures published in home and abroad in recent years, the article analyzes, arranges and sums up measures of improving the stability of Chinese medicine liposomes, to provide reference for the study on the preparation of Chinese medicine liposomes.
Drug Combinations ; Drug Compounding ; Drug Stability ; Drug Storage ; Drugs, Chinese Herbal ; administration & dosage ; Hydrogen-Ion Concentration ; Liposomes ; chemistry ; Nanoparticles ; Particle Size ; Quality Control ; Technology, Pharmaceutical ; methods

Objective To explore the CT findings of mucoepidermoid carcinoma (MEC) of the tracheobronchial tree and improve the diagnostic accuracy. Methods The CT images, histopathological and clinical data in 24 patients with pathologically proved MEC of the tracheobroncbial tree were retrospectively analyzed. Results The clinical symptoms included cough, sputum, fever, wheezing, chest pain and hemoptysis. The patient was proved to be low-grade (n=19) and high-grade (n=5) MEC histopathologically. One lesion was located in trachea, 6 in main bronchus, 12 in lobar bronchus and 5 in segmental, subsegmental and distal bronchus. The tumor presented as no-invasive endotracheobronchial well-defined round-like nodule (n=13, locating in lobar and higher bronchus) and columnar sharp (n=3, locating in main bronchus), or intra-and-extraluminal well-defined round-like nodule or mass (n=6, locating in lobar and lower bronchus) and irregular mass with invasive pattern (n=2, high-grade type). The density of lesion was similar to the muscule and the calcification within lesion was showed in 4 patients on non-enhanced CT. The lesion had marked enhancement in 17 patients on enhanced CT. Obstructive changes were found in 20 patients. Conclusion MEC of the tracheobronchial tree is usually low-grade malignancy and locates in main and lobar bronchus with no-invasive well-defined airway mass, marked enhancement and calcification on CT.

OBJECTIVETo explore the correlation among prevertebral hyperintensity (PVH), sagittal canal diameter on MRI and neurologic function of patients after cervical vertebral hyperextension injury without fracture and dislocation.

METHODSThe clinical data of 100 patients with cervical vertebral hyperextension injury without fracture and dislocation were retrospectively analyzed from September 2010 to December 2013. The patients were divided into PVH group and non-PVH group according to the presence of PVH on T2-weighted magnetic resonance imaging. There were 39 patients in PVH group, including 31 males and 8 females, aged from 21 to 83 years old with an average of (58.10 ± 14.78) years; and the other 69 patients in non-PVH group, including 49 males and 12 females, aged from 32 to 77 years old with an average of (55.05 ± 10.36) years. The sagittal disc level canal diameters of subaxial cervical spine were measured on mid-sagittal magnetic resonance imaging. The age, sex, cause of injury, and the segments of spinal stenosis were recorded. American Spinal Injury Association (ASIA) impairment scale and motor score were used to evaluate the neurological status.

RESULTSThe ASIA motor score of the group with PVH was 52.56 ± 31.97 while the ASIA motor score was 67.70 ± 22.83 in non-PVH group (P = 0.013). More patients with intramedullary hyperintensity signal on MRI were observed in the PVH group than in non-PVH group (P = 0.006). There was a significant positive correlation between ASIA motor score and sagittal disc level canal diameter of injury segment (P = 0.003). The neurological status was worse in patients with multi-level sagittal canal diameters below 8 mm.

CONCLUSIONThe PVH and the disc-level canal sagittal diameter of the injury segment are associated with neurological status. The patients with multi-level sagittal canal stenosis are vulnerable to severe cervical spinal cord injury.

Adult ; Aged ; Aged, 80 and over ; Cervical Vertebrae ; injuries ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Spinal Canal ; pathology ; Spinal Cord Injuries ; pathology ; physiopathology

OBJECTIVESince HFMD was designated as a class C communicable disease in May 2008, 18 months surveillance data have been accumulated to December 2009. This article was to describe the distribution of HFMD for age, sex, area, and time between 2008 and 2009, to reveal the characteristics of the epidemic.

METHODSWe analyzed weekly reported cases of HFMD from May 2008 to December 2009, and presented data on the distribution of age, sex, area and time. A discrete Poisson model was used to detect spatial-temporal clusters of HFMD.

RESULTSMore than 1 065 000 cases of HFMD were reported in Mainland China from May 2008 to December 2009 (total incidence: 12.47 per 10 000). Male incidence was higher than female for all ages and 91.9% of patients were <5 years old. The incidence was highest in Beijing, Shanghai, Zhejiang and Hainan. The highest peak of HFMD cases was in April and the number of cases remained high from April to August. The spatial-temporal distribution detected four clusters.

CONCLUSIONChildren <5 years old were susceptible to HFMD and we should be aware of their vulnerability. The incidence was higher in urban than rural areas, and an annual pandemic usually starts in April.

Aging ; Child, Preschool ; China ; epidemiology ; Cluster Analysis ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; Humans ; Incidence ; Infant ; Male ; Sex Characteristics ; Time Factors

Objective To investigate the incidence and relation to primary diseases of the nonbronchial systemic arteries (NBSA) supply to the pulmonary lesions, and to evaluate the clinical value of transcatheter arterial embolization (TAE) of the responsible NBSA for hemoptysis. Methods The aortography and subclavian artery angiography were performed in 139 patients with hemoptysis, including pulmonary tuberculosis in 66 cases (2 cases with post-thoracoplasty, 1 case with post-lobectomy, and 1 case with ventricular septal defect), bronchiectnsis in 41 ( 1 ease with post-lobectomy and 1 case with post- ligation of patent ductus arteriosus), bronchiogenic carcinoma in 15, unknown hemoptysis in 7, silicosis in 3, broncholithiasis in 3, bronchial cysts in 1, empyema in 1, postoperative lung cancer in 1, and chronic pulmonary embolism in 1, respectively. TAE was performed in patients with the discoverable responsible NBSA. The frequency, distribution and relation to primary diseases of the responsible NBSA were evaluated and the clinical results and complications were observed. Follow-up time ranged from 6 months to 5 years. Results Seventy-three patients (52. 5% ) had nonbronchial systemic contributions, including 5 cases of post-thoracotomy with pulmonary lesions, 1 case complicating with ventricular septal defect, 1 ease with post-ligation of patent ductus arterinsns, and 1 case of chronic pulmonary embolism. The total number of NBSA were 181 including posterior intercostal arteries (n = 88), internal thoracic arteries (n = 27 ), inferior phrenic arteries ( n = 21 ), proper esophageal arteries ( n = 20 ), lateral thoracic arteries ( n = 9 ), subscapular arteries ( n = 7 ), eostocervical trunks ( n = 5 ) and thyrocervical trunks ( n = 4 ) . Main responsible NBSA were posterior intercostal arteries (n = 75 ) and branches of subclavian and axillary artery (n =44) in patients with pulmonary tuberculosis, and proper esophageal arteries (n = 16 ) and inferior phrenic arteries (n = 17 ) in bronchiectasis. The clinical result was satisfactory and the bleeding ceased immediately in 69 eases including 19 cases of failed or repeated bronchial artery embolization (the arteries had been obstructive) and 4 cases of the normal bronchial arteries. No severe complications occurred except ipsilateral cerebellar infarction after subclavian artery angiography in 1 case and respiratory failure after internal thoracic artery embolization in another case. Sixty patients were followed up for more than 6 months. The result demonstrated episodic bloody sputum in 16 patients, re-bleeding in 11 and non-bleeding in another after TAE. Eight patients had non-bleeding and 2 patients had episodic bloody sputum who were re- bleeding and underwent repeated TAE. Conclusions The stimulation of adjacent lesions and the cardiovascular diseases with weakened or defected pulmonary perfusion can lead to the responsible NBSA supply to the lung in hemoptysis. During TAE for hemoptysis, the integrity angiograpby and TAE can improve the curative effect.

OBJECTIVETo investigate the mRNA expressions of the TNF adapter proteins, including TNF receptor-associated death domain protein (TRADD), Fas-associated death domain protein (FADD), receptor-interacting protein 1 (RIP-1) and TNF receptor-associated factor-2 (TRAF-2) in peripheral blood mononuclear cells (PBMCs) of lupus nephritis (LN) patients of various TCM asthenia syndromes. Methods Fifty-one inpatients with LN were differentiated according to TCM syndrome differentiation, 13 cases of yin-deficiency with inner heat syndrome (A); 26 cases of both qi-yin deficiency syndrome (B), 12 cases of Pi-Shen yang-deficiency syndrome (C). Peripheral venous blood samples from the 51 LN patients and 17 healthy subjects were collected to separate PBMCs. The mRNA expressions of TNF adapter molecules (TRADD, FADD, RIP-1 and TRAF-2), as well as Caspase-3 and interleukin-1beta (IL-1beta) were analyzed by quantitative real-time PCR and the differences among them were compared.

RESULTS(1) As compared with the healthy subjects, expression of TRADD mRNA in patients of syndrome A, B and C was lowered to 0.54, 0.32, and 0.38-fold, respectively (P < 0.05, P < 0.01), showing insignificant difference among the three syndromes; (2) FADD mRNA lowered to 0.79, 0.62, and 0.72-fold respectively, only with significance shown in syndrome B (P < 0.05); (3) RIP-1 mRNA lowered to 0.79, 0.50, and 0.60-fold respectively with significance shown in syndrome B and C (P < 0.01, P < 0.05), and insignificant difference was shown among the three syndromes; (4) TRAF-2 lowered to 0.70, 0.52, and 0.50-fold respectively (P < 0.01, P < 0.01, P = 0.07), significance shown in syndrome B and C (P < 0.01), but with insignificant difference among the three; (5) Caspase-3 elevated in all patients of the three syndromes (all P < 0.01); (6) IL-1beta in syndrome A was apparently lower ed to the normal range and also lower than that in the other two syndromes (both P < 0.05).

CONCLUSIONSExpressions of TRADD, FADD, RIP-1 and TRAF-2 mRNA decreased in all the patients of various TCM asthenia syndromes, the decrement in patients of syndrome B and C was lesser than that in syndrome A. These abnormal low expressions of signal proteins might be the substantial bases for asthenia syndromes of LN patients, and the apoptotic signal mediated by them may involve in the formation of asthenia syndrome in LN.

Adaptor Proteins, Signal Transducing ; genetics ; metabolism ; Adolescent ; Adult ; Case-Control Studies ; Child ; Fas-Associated Death Domain Protein ; genetics ; metabolism ; Female ; Humans ; Leukocytes, Mononuclear ; metabolism ; Lupus Nephritis ; blood ; Male ; Medicine, Chinese Traditional ; Middle Aged ; RNA, Messenger ; genetics ; metabolism ; Receptor-Interacting Protein Serine-Threonine Kinases ; genetics ; metabolism ; TNF Receptor-Associated Death Domain Protein ; genetics ; metabolism ; TNF Receptor-Associated Factor 2 ; genetics ; metabolism ; Tumor Necrosis Factor-alpha ; blood ; metabolism ; Yang Deficiency ; blood ; Yin Deficiency ; blood ; Young Adult