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.

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: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 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 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

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 .

Objective To detect the frequency of peripheral blood CD4+ CD25high Tr and CD4+CD25lowT cells and expression of programmed death-1 ( PD-1 ) on their surface in the patients with systemic lupus erythematosus(SLE) and their clinical signifcance is analyzed.Methods The expression of PD-1 on the CD4+ CD25highTr and CD4+CD25lowT cells was examined in patients with 33 active SLE,18 inactive SLE and 38 healthy controls(HC) by flow cytometry.Clinical manifestations and laboratory findings of SLE were collected.Patients were divided into two groups according to their disease activity.SLE disease activity index(SLEDAI) score≥10 was defined as high disease activity and ＜10 as inactivity.The percentage of CD4+ CD25highTr and CD4+CD25lowT cells and proportions of expression of PD-1 on their surface were compared between not only inactive or active SLE patients and healthy controls (HC),but also between patients with lupus nephritis and without lupus nephritis.Correlation with clincal manifestations and laboratory findings was analyzed.Results (1)The proportions of CD4+CD25highTr and CD4+CD25low T cells were significantly decreased in active and inactive SLE patients as compared with HC.(2)The percentage of CD4+ CD25lowPD-1 +Tr and in active and inactive SLE patients were higher than HC.The proportions of CD4+CD25lowPD-1+ T cells were significantly increased in HC and inactive SLE patients as compared with inactive SLE patients.(3) The proportions of CD4+CD25highPD-1+Tr in SLE patients with nephritis were higher than those in patients without nephritis.But the percentage of CD4+ CD25 lowPD-1 + T cells was significantly decreased in SLE patients with nephritis as compared those without nephritis.(4)A positive correlation was observed for proportions of CD4+CD25highPD-1 + T cells with SLEDAI score.Proportions of CD4+ CD25high Tr,CD4+ CD25low PD-1 + T cells was inversely correlated with SLEDAI score.Conclusion The aberrations of proportions of CD4+CD25highpD-1+,CD4+CD25lowPD-1+,CD4+CD25high and CD4+CD25low T cells were observed in patients with SLE.The abnormality of PD-1 and PD-L1 pathway may play an important role in the function and number of Tr.

Surgery is usually the first choice for patients with lung cancer,whereas the risk increases with age.A comprehensive evaluation of the patients should be applied in order to bring about the best outcome.By convention,the preoperative assessment includes neoplasm staging,cardio-respiratory function assessment, nutritional status assessment,and etc. The surgical planning includes limited resection,video-assisted thoracoscopic surgery and so on.

Objective To study characteristic findings and the diagnostic value of MRI in pituitary stalk interruption syndrome (PSIS). Methods Twenty-one patients with PSIS were included. Small field of view (FOV) MR1 scanning and clinic hormone detection were performed in all patients. Moreover, fluid attenuated inversion recovery (FLAIR)T,1 WI with fat-suppression sequence was performed in 8 cases. The appearance on FLAIR T1 WI and T2 WI were recorded. The shape of pituitary stalk and antehypophysis, and the signal intensity of posthypophysis were analyzed simultaneously. Results Growth hormone deficiency (GHD) was confirmed by clinic hormone detection in all 21 cases. The level of basal GH varied from 0. 03 μg,/L to 1.50 μg/L. The peak value under GH provocation was from 0. 13 μg/L to 4. 14 μg/L, and the GH was absolute default in all patients. Seventeen cases of them were combined pituitary hormone deficiency (CPHD), and 4 cases were isolated growth hormone deficiency (IGHD). The height of antepituitary was in the range from 1 mm to 3 mm, and the average value was (1.9±1.2) mm. Pituitary stalk was absent in 18 cases and showed as linear and discontinuous stalk in the other 3 cases. The high signal intensity was invisible in normal position in all cases, the high signal intensity spot in the region of infundibular recess of the third ventricle was shown in 19 cases, while it could not be found anywhere in 2 patients with diabetes insipidus. Conclusion PSIS often shows characteristic appearance on MRI, and a definite diagnosis can be made by using MRI combined with clinic hormone detection.

The origin of precision medicine was discussed in this article,as well as its advantages and deficiencies at this stage.Tangshen formula was taken as an example to explain a rational and ideal mode of traditional Chinese medical (TCM) precision medicine research under the guidance of TCM theory.In view of the two major problems existing in the TCM modernization research,including the separated strategy among formula-disease-syndrome and independent research approach using genomics,proteomics and metabonomics,critical scientific issues on developing the drug system to biological system research mode and solutions for integrating formula-disease-syndrome were proposed here,and the roadmap and total framework of top design were also provided.The specific methods and the corresponding research results on Tangshen formula at the three stages concluded as formula-disease related,disease-syndrome combinated and formula-disease-syndrome integrated were introduced and summarized.At this time for the innovative breakthrough development of TCM,precision medicine will promote the TCM modernization research,and also will provide a powerful driving force for the establishment of holistic systems medicine.