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.

Objective:To evaluate the implementation effects of critical illness insurance of New Cooperative Medical System(NCMS) on the occurrence rate and economic burden of major disease expenditure.Methods:Based on the peasant household data of China Family Panel Studies(CFPS) in 2014.the two-part model was applied to analyze the changes in major disease occurrence and burden after the implement of insurance.Results:NCMS critical illness insurance did not reduce the occurrence of critical disease expenditure,but signally cut down the economic burden of serious illness peasants in central and eastern China.Conclusion:The implementation effect of NCMS critical illness insurance was well in central and eastern China,but was poor in western China;the prevention and health care system of NCMS should be built,while the implementation plans and compensation level of critical illness insurance should be improved in western region.

OBJECTIVE:To establish an HPLC method for the determination of the contents of Decussatin,Bellidifodin,Methylswertianin and Swerchirin in Swertia macrosperma C.B.Clark.METHODS:The determination was performed on VP-ODS C18(150 mm? 4.60 mm,5 ? m),with the mobile phase consisting of methanol-water-phosphoric acid(70∶ 30∶ 0.4),the detection wavelength set at 254 nm,the flow rate at 1.0 mL? min-1 and the column temperature at 20℃.RESULTS:The calibration curves of Decussating,Bellidifodin,Methylswertianin and Swerchirin were in good linearity in the range of 0.172～ 0.86 ? g,0.224～ 1.344 ? g,0.144～ 0.72 ? g and 0.154～ 0.77? g,respectively.The average recoveries were 98.18%(RSD=1.19%),99.32%(1.52%),98.44%(1.23%)and 97.68%(1.57%),respectively.CONCLUSION:The method is rapid and precise,with accurate and reliable results.

Objective To investigate the characteristics of electroencephalograms ( EEGs ) of patients with childhood absence epilepsy ( CAE ) .Methods EEG of 46 patients with CAE were analyzed .Results Of 46 patients,there were 44 cases (95.6%) with guided bilateral symmetry 3Hz spike-and-wave.16 cases were character-ized by multiple spike-and-wave on the 3Hz spike and slow wave;and the centrotemporal spikes was found in 1 case. Additionally,the 3Hzδactivity in occipital region has been traced in 34 cases of these 46 patients.Conclusion In general,the EEGs of CAE patients have typical characteristics ,and few of them showed atypical manifestation ,which must be verified by clinical attention .

ObjectiveTo investigate the neuropsychological characteristics of primary hypothyroidism.MethodSixty patients with primary hypothyroidism were enrolled and 60 euthyroid subjects with age-,gender-,and education-matched served as control.Neuropsychological parameters were determined in all the participants.ResultThe word list learning,figure recall,picture recall,verbal fluency,digit span,and trail making A and B in subclinical hypothyroid patients were impaired as compared with the control (6.0± 1.6 vs 7.6± 1.1,7.3± 1.4 vs 8.6±1.1,9.1±1.9 vs 10.0±0.1,6.7±1.4 vs 9.1±1.2,11.4±2.5 vs 13.3±1.5,11.3±2.2 vs 12.8±1.5,8.0±1.8 vs 9.2±0.8,5.0±1.6 vs 6.7±1.6,12.5±3.8 vs 15.7±2.0,61.1±32.5 vs 41.9±10.6,82.0±40.2 vs 43.2±14.5,all P＜0.05 ).Neuropsychological dysfunctions in all 11 tests were found among moderate and severe hypothyroid patients(26.2±5.0 vs 29.4±4.7,6.3±1.5 vs 6.8±1.4,8.9±2.2 vs 9.9±0.2,28.7±9.7 vs 37.0±6.0,6.4±1.1 vs 9.4±1.3,8.5±1.0 vs 9.4±0.6,11.9±3.0 vs12.9±1.7,8.1±1.8 vs 9.5±1.1,5.1±1.7 vs 6.6±1.5,11.4±2.9 vs 15.1±2.4,55.1±12.2 vs 41.0±11.6,all P＜0.05).ConclusionThe severity of cognitive impairment is accompanied with the decrease of thyroid function,it suggests that the cognitive function must depend on the normal levels of thyroid hormones.

Objective Try to discover the safe and effective inhibitors of lymphangiogenesis. Methods Lymphatic endotheial cells from pig thoracic duct were isolated and cultured. The observation of specimens by LM and EM was made. The control group, endostatin and PF-4 experimental groups were set. Methods of the scraped line and MTT were used to examine their inhibitive effect on the lymphangiogenesis. Results The P value is

Major breakthrough and challenge that encountered by modern western medicine were described in this article. Some standpoints about the necessity of innovative revolution for the development of traditional Chinese medicine, together with the key points should be bring to the attention during ideological emancipation have been put forward here. Chinese scientists agreed that it is the most appropriate timing for us to establish a new medicine system, which we named Holistic Systems Medicine (HSM). The concept and research contents of Holistic Systems Medicine were also introduced in this article. Finally, a proposal for setting up“China Holistic Systems Medicine development project” was proposed.

Objective To observe the fundus imaging characteristics of different stages of syphilitic posterior uveitis. Methods Retrospective cases series. Forty-six eyes of 32 patients with syphilitic posterior uveitis were included. There were 14 patients (16 eyes) and 18 patients (30 eyes) were assigned to acute stage group (with the course<2 months) and chronic stage group (with the course≥2 months) respectively. All eyes received the examination of indirect ophthalmoscopy, color fundus photography, fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). All patients received regular anti-syphilitic treatment. Color fundus photography and OCT were followed after treatment. The fundus imaging characteristics of different stages of syphilitic posterior uveitis were observed. Results Indirect ophthalmoscopy and fundus color photography showed that in the acute stage group, there were 3/16 eyes with optic disc edema;4/16 eyes with a yellowish, placoid lesion involving the macular. There were only some pigment alterations on the fundus after treatment. In the chronic stage group, there were 4/30 eyes with optic disc hyperemia, 3/30 eyes with cystoid macular edema. After treatment, the optic hyperemia vanished gradually, but there were still some pigment alterations. The FFA images of two groups showed various vascular leakages. In the chronic stage group, patients also showed hyper-fluorescence with cystoid macular edema. The patients with course 2–3 years have more transmitted fluorescence on FFA. OCT showed that all eyes in the acute stage group had lost the ellipsoid zone, with irregular granular reflectivity of the retinal pigment epithelium (RPE) layer, 6 eyes with subretinal fluid in the macular. After treatment, the ellipsoid zone and RPE layer structure recovered gradually. In the chronic stage group, all eyes showed widespread loss of the ellipsoid zone, pigment migration and (or) cystoid macular edema. After treatment, the ellipsoid zone showed partial recovery. The outer ellipsoid zone was still discontinuous in patients with long duration. Conclusions Syphilitic posterior uveitis patients generally had normal fundus, but some cases had a yellowish, placoid lesion involving the macular. FFA showed various vascular leakages, and the chronic stage group showed more transmitted fluorescence. The major OCT change was loss of the ellipsoid zone or with subretinal fluid. After treatment, fundus showed no abnormal manifestations except some pigment alterations;the ellipsoid zone structure recovered gradually in acute stage eyes, partially recovered in chronic stage eyes.

Objective To investigate the effects of Livin antisense oligonucleotide (ASODN) on the proliferation and apoptosis of human leukemia (K562) cells. Methods Specific phosphorothioate ASODN and missense oligonucleotide (MSODN) target Livin mRNA were synthesized and transfected into K562 cells following cationic liposome. The proliferation inhibition of K562 cells was assessed by MTT. The apoptosis rate of each group was detected by Annexin V-FITC. The expression of Livin mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR). Results ASODN at a final concentration of 600 nmol/Lcould inhibit the K562 cells proliferation (IR) was (52.99t2.67) % and the expressions of Livin mRNA (ODR)was (59.75±3.24) %, the apoptosis rate was apparently increased [(36.89±1.08) %] (P ＜0.01); but the difference between Lip-MSODN group, Lip control group and cell control group was not statistically significant (P ＞0.05).Conclusion Livin ASODN may decrease Livin gene expression, suppress K562 cells proliferation effectively, and induce significant apoptosis of K562 cells.

Objective To analyze the prevention and nursing measures of adverse drug reaction in patients with rheumatoid arthritis treated with Tolicizumab.Method The clinical data and nursing measures in 30 patients with rheumatoid arthritis treated with Tolicizumab were reviewed and analyzed.Result All the patients completed the treatment and no infusion reaction was observed in the first 24 hours.Conclusions Comprehensive and intensive assessment is necessary before application of Tocilizumab. Executing standard drug dispensing and injection process,mastering the infusion reaction emergency processing measures and establishing injection related systems are of great significance to observe and treat various adverse reactions in time,ensuring drug effects and safety of the patients.