Bacterial endotoxin elicits dramatic responses in the host including elevated plasma lipid levels due to the increased synthesis and secretion of triglyceride (TG) rich lipoproteins by the liver and the inhibition of lipoprotein lipase. This cytokine induced hyperlipoproteinemia, clinically termed the lipemia of sepsis, was customarily thought to represent the mobilization of lipid stores to provide the fuel for the host’s response to infection. However, since lipoproteins can also bind and neutralize LPS, TG rich lipoproteins (VLDL and chylomicrons) are also components of non adaptive host immune response to infection. The studies are reviewed about the capacity of lipoproteins to bind LPS, protect against LPS induced toxicity and modulate the host response to the bacterial toxin.

The Toll like receptors(TLRs)are essential transmembrane signaling receptors of the innate immune system that alert the host to the presence of a microbial invader.The recent discovery of the TLR has rapidly expanded our knowledge of molecular events that initiate host pathogen interactions.These functional attributes of the cellular receptors provide insights into the nature of pattern recognition receptors that activate the human antimicrobial defense systems.The fundamental significance of the TLR in the generation of systemic inflammation and the pathogenesis of septic shock is reviewed. The potential clinical implications of therapeutic modulation of these recently characterized receptors of innate immunity are also discussed.

Objective To study the neuroprotective effect of sevoflurane on controlled hypotension in patients with coronary heart disease undergoing craniocerebral surgery. Methods Twenty-six patients with coronary heart disease undergoing craniocerebral surgery were randomly divided into two groups,receiving either inhaled 2%-5%sevoflurane plus intravenous sodium nitroprusside (treatment group,n=13) or intravenous sodium nitroprusside 3-8 μg·kg-1 alone (contorl group,n=13) for blood pressure control. The hemodynamic changes were recorded during the operation. Patient satisfaction with surgeons and the duration hospital stay after surgery were recorded. The levels of cardiac troponin I (TNI),creatine kinase-MB (CK-MBM),neuron specific enolase ( NSE) and S100 calcium binding proteinβ( S-100βprotein) in serum were detected at one day pre-operation,the end of the operation,and one day post-operation. Results The duration of hospital stay after surgery was significantly shortened in treatment group [(20. 3±3. 8) versus (23. 9±4. 6) d,P<0. 05) compared with control group. The average heart rate significantly decreased, patient satisfaction significantly increased, and serum levels of NSE and S-100β protein one day post-operation significantly decreased as compared to control group (all P<0. 05). Compared with the day before operation,serum levels of NSE and S-100βprotein in the two groups increased significantly at the end of surgery (P<0. 05),and the levels of TNI,CK-MBM,NSE and S-100βsignificantly elevated one day post-operation (P<0. 05). Compared with the end of operation,serum levels of NSE and S-100βin contorl group incarcerated remarkably (P<0. 05) Conclusion Sevoflurane plays an important neuroprotective role,as evidenced by improving patients' satisfaction,reducing hospital stay after surgery,and maintaining the balance of myocardial oxygen delivery and consumption in craniocerebral surgery patients with coronary heart disease during controlled hypotension. However,it can not prevent postoperative myocardial injury in these patients.

Obiective:To investigate the effect of interleukin-6(IL-6)on apolipoprotein(apo)M expression in a human hepatoblastoma cell line(HepG2).Methods:HepG2 cells were cultured and incubated with different concentrations of IL-6 (0,1.25,2.5,5,10,20,40 and 80 μg/L)for 24 hours.After the incubations,total RNAs were extracted and applied to reverse transcript PCR and real-time quantitative PCR to detect the expression levels of apoM and apoA-I.The effect of IL-1α on apoM expression was also determined.Results:IL-6 significantly inhibited the expression of apoM(F=10.778,P ＜ 0.01).Whereas IL-6 did not influence the expression of apoA-I(F=2.004,P ＞ 0.05).IL-1α(0,1.25,2.5,5,10,20,40 and 80 μg/L)did not decrease the expression of apoM(F=2.038,P ＞ 0.05).Cooclusion:IL-6 inhibits apoM mRNA transcription,which may contribute to the pathogenesis of abnormal lipid metabolism and macrovascular complications in type 2 diabetes.

Sepsis is the leading cause of mortality in critically ill patients.Studies indicate that immune suppression in sepsis is more often associated with poor outcome.Dendritic cells may contribute largely to the development of immune suppression during sepsis.This article reviews the emerging data indicating the key role of dendritic cells in sepsis induced immune suppression.A deeper insight into the dendritic cell changes during sepsis may provide a powerful weapon against sepsis.

Objectives: To evaluate the influences of enteral nutritfion(EN), parenteral nutrition(PN) and major gastrointestinal operation on HLA DR, CRP and IL 10 level. Methods: A prospective, successive and controlled trial was taken. 39 non infection patients with intestinal fistula and severe acute pancreatitis were divided into EN group ( n =18) and PN group ( n =21). 8 patients with major gastrointestinal operation(OP) were taken as OP group.10 patients admitted with the diagnoses of cholecystopolyp and inguinal hernia were taken as control group. The blood levels of HLA DR, CRP and IL 10 were measured and compared between groups. Results: Compared to control group〔(96.35? 4.282)%〕, OP group〔(60.23? 10.419)%〕 and PN group〔(78.72? 13.21)%〕 had significant decreases ( P

Objective To evaluate spiral CT in diagnosing vascular complications of pancreatitis. Methods The clinical and surgical results and the CT findings of 316 patients with acute or chronic pancreatitis were comparatively analyzed. Special attention was paid to the CT findings of the patients with peritoneal hemorrhage and vascular abnormality. CT Hu of celiac blood effusion was measured. Pseudoaneurysms, phlebothrombosis and venous thrombosis of peripancreatic vessels in CT enhancement were carefully analyzed. Results Acute pancreatitis was found in 275 out of the 316 patients, and chronic pancreatitis in 41 cases. Among those with acute pancreatitis, 20 had peritoneal cavity vascular complications. In the 13 cases of peritoneal cavity hemorrhage(including 5 patients complicated with digestive tract hemorrhage), CT identified 11 with as regional or diffuse slight high density fluid collections, and failed in 2 cases. CT scans detected gastric varices in 4 out of 7 patients with digestive tract hemorrhage. Of those with chronic pancreatitis, CT found celiac artery pseudoaneurysm in one, spleen artery pseudoaneurysm in one and splenic vein thrombosis with gastric varices in one. Conclusions (1)Regional or diffuse slight high or high density fluid collections were common CT findings of peritoneal cavity hemorrhage. (2)Enhanced spiral CT scanning could demonstrate peripanreatic vascular pseudoaneurysms. (3)Varices in gastric fundus and necrosis in pancreatic body and tail often indicate the formation of spleen venous thrombosis.

ObjectiveTo investigate the method of establishing damaged endometrial stromal cells (ESC) model in vitro.Methods ( 1 ) From June to December 2011 ESC from normal endometrim at proliferation phase ( n =8 ) and secretory phase ( n =8 ) were isolated,cultured and identified in vitro.( 2 ) ESC was treated with different concentrations of mifepristone or withdrawal of mifepristone at different time point.The proliferation inhibition percent was measured by cell counting kit-8 ( CCK-8 ). ( 3 ) 0 μmol/L (control group)and 60 μmol/L(experimental group) concentration of mifepristone was added into ESC for 48 hours,then withdrew of mifepristone,continued to be cultured for 48 hours.The morphological changes were observed and apoptosis of ESC in different menstrual cycle were detected by flow cytometry.The mRNA and protein level of vascular endothelial growth factor ( VEGF),caspase-3,8,and 9 were determined by one-step quantitative real-time PCR (Q-PCR) and western blot.Results( 1 ) ESC from 16 specimens of endometrium were all isolated and cultured successfully. (2) The proliferation inhibition rate of ESC was correlated with concentration and duration of mifepristone positively. The proliferation of ESC could be recovered at a range of time after withdrawal of mifepristone.However,when the concentration of mifepristone was 100 μmol/L,the growth of ESC recovered very hardly. (3) The damaged ESC spacing increased,the spindle shape and vacuolization in the cytoplasm were observed in experimental group; the rate of apoptosis of these damaged cells was significantly increased compared with control groups,which were (52 ± 12)％ vs.( 13 ± 5 ) ％ at the proliferative phase and (53 ± 6) ％ vs.( 32 ± 3 ) ％ at the secretory phase ( all P ＜0.05).The relative mRNA level of VEGF was 0.52± 0.12 in experimental group and 1.00 ± 0.17 in control group at proliferation phase (P ＜0.05).And the relative mRNA level of VEGF was 0.19 ±0.03 in experimental group and 0.81 ±0.07 in control group at secretory phase (P ＜ 0.05).The relative level of VEGF protein in the experimental group were both decreased 1.98 and 2.79 folds at the proliferation phase and the secretory phase when compared with those in control group,respectively ( P ＜ 0.05 ).While the relative levels of caspase-3,8,9 mRNA were 5.62 ± 0.65,5.41 ± 0.53,7.22 ± 0.51 in the experimental group and 1.00 ± 0.44,1.00 ± 0.21,1.00 ± 0.32 in control group at the proliferative phase.In the mean time,the relative levels of caspase-3,8,9 mRNA were 10.22 ± 0.72,25.3 ± 1.72,9.48 ± 1.89 in experimental group and 1.42 ± 0.14,1.14 ± 0.28,1.16 ± 0.12 in control group at the secretory phase,respectively (P ＜ 0.05).Compared with the control group,the levels of caspase protein in the experimental group were increased 2.04 and 1.60 folds in caspase-3,4.23 and 1.49 folds in caspase-8,2.65 and 3.5 folds in caspase-9 at the proliferative phase and at the secretory phase,respectively (P ＜ 0.05 ).ConclusionThe damaged model of ESC can be established after 48 hours by the withdrawal of 60 μmol/L mifepristone in treatment of ESC for 48 hours.

Objective To explore the association of NH2-terminal pro-B-type natriuretic peptide ( NT-proBNP) with the risk of type 2 diabetes.Methods One hundred and twenty-six impaired glucose regulation( IGR) participants from Diabetic Identification Center of Tianjin Metabolic Diseases Hospital were included.NT-proBNP was measured in plasma samples collected from participants at baseline condition.Results At baseline, NT-proBNP was inversely associated with body mass index, waist circumference, fasting glucose, insulin and low-density lipoprotein-cholesterol( LDL-C) levels.During a follow-up of 2 years, 51 participants reported a new diagnosis of diabetes from OGTT.Baseline quartiles of NT-proBNP were inversely associated with diabetes risk, even after multivariable adjustment.Theadjustedrelativerisksfordiabeteswere1.0(reference),0.83(95%CI0.74-0.96),0.78(95%CI 0.68-0.90), 0.74 (95%CI 0.64-0.87) for the 1st, 2nd, 3rd, and 4th quartiles of baseline NT-proBNP, respectively ( P<0.01 ) .Conclus ion In IGRpopulation , lowlevels of NT-proBNP were associated with a significantly increased risk of type 2 diabetes.

Objective:To explore therapeutic effects of sodium nitroprusside (SNP) combined verapamil on no-reflow during percutaneous coronary intervention (PCI).Methods: A total of 106 patients, who suffered from no-reflow during PCI in our department from Jan 2011 to Dec 2013, were selected.According to random number table method, patients were divided into SNP group (n=55, received SNP based on routine treatment) and combined treatment group (n=51, received verapamil based on SNP group).Cardiac troponin I (cTnI) level before and 16h~18h after PCI, cardiac function indexes after 12-month follow-up, incidence of major adverse cardiovascular events (MACE) were measured and compared between two groups.Results: Compared with before PCI, there were significant rise in cTnI level in both groups on 16~18h after PCI, P=0.001 both;compared with SNP group, there were significant reductions in cTnI level [(1.31±0.44)μg/L vs.(0.11±0.02)μg/L] and percentage of cTnI>0.10μg/L (94.5% vs.54.9%) in combined treatment group, P=0.001 both.Compared with SNP group after 12 months, there was significant rise in left ventricular ejection fraction [(62.29±3.06)% vs.(65.65±3.94)%], and significant reductions in left ventricular end-diastolic dimension[(50.24±3.73)mm vs.(47.60±4.72)mm] and left ventricular end-systolic dimension [(33.29±2.11)mm vs.(31.00±4.33)mm] in combined treatment group, P<0.05 all.There were no significant adverse reactions during hospitalization and follow-up in both groups.Conclusion: When no-reflow occurs during PCI, intracoronary injection of SNP combined verapamil can improve cardiac function, and its safety is good, which is worth extending.