Patients with ischemic stroke is often accompanied by inflammtory response. Studies have suggested that toll-like receptor 4 (TLR4) has induced the occurrence,development and of ischemic stroke and secondary brain injury. This article reviews the toil-like receptor 4 signal transduction pathway and its roles in ischemic stroke in order to provide certain basis for the development of TLR4-targeted medication.

Objective To study the excitability gastrointestinal hormone MTL and inhibitory gastrointestinal hormone SEC expression in the intestinal congestion and the effects of Salvia miltior-rhiza pretreatment at different time limits in 45min of rat hepatic ischemia-reperfusion to explore its possible mechanism and significance. Methods 80 rats were randomly divided into 4 groups: normal control group(CO group), sham-operated group(SO group), injury group(IR group), salvia miltior-rhiza pretreatment group(SM group). Non-invasive artery clamp was used to clip then slacken the he-patic pedicle to produce animal model of ischemia-reperfusion. The clamp time was 45 min. The rats in Salvia miltiorrhiza pretreatment group were injected 40 ml/kg saline with 6 g/kg Salvia Miltiorrhiza from caudal vein 30 min before clamping hepatic pedicle. While in the sham-operated group, the porta hepatis was dissected after laparotomy and hepatic pedicle not clamped. The upper jejunums at differ-ent reperfusion time phases (0 h, 3 h, 12 h, 24 h, 72 h) were made into specimens respectively, and then MTL and SEC immunohistochemical measurement were conducted. Results At 0 min of hepatic ischemia-reperfusion digestive tract congestion, the MTL expression of upper jejunum went down,SEC expression of upper jejunum went up. With the reperfusion time extending, the MTL expression also descended to minimum at 24 h, but SEC expression increased to reach the peak at 24 h. The ex-pression of these 2 hormones gradually returned to normal at 72h. The MTL expression of Salvia milt-iorrhiza pretreatment group was higher, SEC expression of SM group were lower than the IR group in each time phase of reperfusion. Conclusion The intestinal congestive injury caused by liver ischemia can down-regulate the excitability of gastrointestinal hormone MTL and up-regulate the gastrointesti-nal inhibitory gastrointestinal hormone SEC expression at reperfusion to inhibit gastrointestinal motili-ty. Salvia miltiorrhiza preconditioning can partly weaken the descending of jejunal MTL and increasing of the jejunal SEC expression, which may contribute to the early recovery of gastrointestinal motility.

Objective To study the changes of gastrointestinal hormones before and after hepatic ischemia reperfusion and the role of salvia miltiorrhiza pretreatment.Methods The clinical data of 32 patients with hepatic diseases who were admitted to the Wuhan General Hospital of Guangzhou Military Area of PLA from May 2010 to May 2012 were prospectively analyzed.Thirty-two patients with hepatic inflow occlusion were randomly divided into the ischemia reperfusion group (IR group,15 patients) and salvia miltiorrhiza pretreatment group (SM group,17 patients).Patients in the IR group and SM group received partial hepatectomy with hepatic inflow occlusion by Pringle maneuver for 15-20 minutes.Patients in the IR group and SM group were injected with normal saline and salvia miltiorrhiza (30 mL/d) by intravenous drip for 3 days before operation,respectively.Twelve patients with hepatic diseases who received open surgery without block of hepatic inflow occlusion were enrolled in the negative control group (SO group) and 5 healthy volunteers were enrolled in the normal control group (CO group).The changes of the motilin,cholecystokinin,vasoactive intestinal peptide and secretin of the 4 groups were recorded.All data were analyzed using the analysis of variance or LSD-t test.Results The level of motilin of the CO group was (347 ± 14)μg/L.The levels of motilin of the SO group,IR group,and SM group at postoperative 24,48 and 72 hours were (324 ± 13) μg/L,(345 ± 12)μg/L,(345 ± 13)μg/L,(307 ± 10)μg/L,(316 ±9)μg/L,(338 ±13) μg/L,(313 ± 7) μg/L,(337 ± 12) μg/L and (345 ± 12) μg/L,respectively.The level of motilin of the SO group at postoperative 24 hours was significantly lower than that of the CO group (t =5.25,P ＜ 0.05) ; the levels of motilin of the IR group at postoperative 24,48 and 72 hours were significantly lower than those of the SO group (t =10.05,8.09,2.07,P ＜0.05) ; the levels of motilin of the SM group at postoperative 24 and 48 hours were significantly lower than those of the SO group (t =9.83,2.28,P ＜ 0.05),while there was no significant difference in the level of motilin between the SM group and the SO group at postoperative 72 hours (t =0.36,P ＞0.05) ;the levels of motilin of the SM group at postoperative 24,48 and 72 hours were significantly higher than those of the IR group (t =3.80,7.10,2.35,P＜0.05).The levels of cholecystokinin of the CO group was (2.53±0.06)μg/L.The levels of cholecystokinin of the SO group,IR group and SM group at postoperative 24 hours were (3.28 ±0.09) μg/L,(2.52 ±0.09) μg/L,(2.54 ±0.16)μg/L,(4.34 ±0.21) μg/L,(3.63 ±0.31)μg/L,(3.25 ± 0.09) μg/L,(3.71 ±0.28)μg/L,(3.28±0.11)μg/L and (2.53 ±0.09)μg/L,respectively.The level of cholecystokinin of the SO group at postoperative 24 hours was significantly higher than that of the CO group (t =4.33,P ＜ 0.05) ; the levels of cholecystokinin of the IR group at postoperative 24,48and 72 hours were significantly higher than those of the SO group (t =9.32,5.37,2.16,P＜0.05) ; the levels of cholecystokinin of the SM group at postoperative 24 and 48 hours were significantly higher than those of the SO group (t =7.21,3.42,P ＜ 0.05),while there was no significant difference in the level of cholecystokinin between the SM group and the SO group at postoperative 72 hours (t =0.29,P ＞ 0.05) ; the levels of cholecystokinin of the SM group at postoperative 24,48 and 72 hours were significantly higher than those of the IR group (t =5.62,4.63,3.57,P ＜ 0.05).The level of vasoactive intestinal peptide of the CO group was (11.8 ±1.6) tμg/L.The levels of vasoactive intestinal peptide of the SO group,IR group,and SM group at postoperative 24,48 and 72 hours were (21.5 ± 3.8) μg/L,(12.2 ± 1.6) μg/L,(11.9 ± 1.7) μg,/L,(29.7 ± 4.1) μg/L,(22.9±4.2)μg/L,(18.8±2.8)μg/L,(22.4 ±4.1)μg/L,(16.4±2.3)μg/L and (12.1 ±1.6)μg/L,respectively.The level of vasoactive intestinal peptide of the SO group at postoperative 24 hours was significantly higher than that of the CO group (t =3.59,P ＜ 0.05) ; the levels of vasoactive intestinal peptide of the IR group at postoperative 24,48 and 72 hours were significantly higher than those of the SO group (t =6.35,3.22,2.36,P ＜ 0.05) ; the levels of vasoactive intestinal peptide of the SM group at postoperative 24 and 48 hours were significantly higher than those of the SO group (t =5.04,2.33,P ＜ 0.05),while there was no significant difference in the level of vasoactive intestinal peptide between the SM group and the SO group at postoperative 72 hours (t =0.18,P ＞ 0.05) ;the levels of vasoactive intestinal peptide of the SM group at postoperative 24,48and 72 hours were significantly lower than those of the IR group (t =4.27,3.87,2.45,P ＜ 0.05).The level of secretin of the CO group was (75 ± 5) μg/L.The levels of secretin of the SO group,IR group and SM group at postoperative 24,48 and 72 hours were (98 ± 6) μg/L,(76 ± 4) μg/L,(76 ± 4) μg/L,(129 ± 6) μg/L,(102 ±8) μg/L,(89 ± 6) μg/L,(104 ± 8) μg/L,(90 ± 6) μg/L and (74 ± 4) μg/L,respectively.The level of secretin of the SO group at postoperative 24 hours was significantly higher than that of the CO group (t =3.27,P ＜ 0.05) ;the levels of secretin of the IR group at postoperative 24,48 and 72 hours were significantly higher than those of the SO group (t =5.20,2.94,1.77,P ＜ 0.05) ; the level of secretin of SM group at postoperative 24 and 48 hours were significantly higher than those of the SO group (t =4.16,2.54,P＜0.05),while there was no significant difference in the level of secretin between the SM group and the SO group at postoperative 72 hours (t =0.23,P ＞ 0.05) ; the levels of secretin of the SM group at postoperative 24,48 and 72 hours were significantly lower than those of the IR group (t =5.13,4.32,2.87,P ＜ 0.05).Conclusions Gastrointestinal congestion caused by hepatic blocking leads to the decline of the expression of motilin,but the increase of the expression of cholecystokinin,vasoactive intestinal peptide,secretin.Salvia miltiorrhiza may improve micro-circulation,abate gastrointestinal adema,and influence the gastrointestinal hormone expression in an indirect way.

In recent years, along with the in-depth research of Y-STRs, a lot of new loci are found and applied in forensic medicines. To solve some questions, the International Society of Forensic Genetics have published two guidance and recommendations successively concerning the Y-STRs in 2001 and 2005, which clarify contents regarding the term, the nomenclature principle of loci and alleles and the population genetics et al of Y-STRs. This report mainly describes the nomenclature principle of loci and alleles of Y-STRs.

Objective To investigate the correlation between the disease activity and the serum levels of anti-nuclear autoantibodies against various nuclear components in the patients with systemic lupus erythematosus (SLE). Methods Two hundred and twenty five SLE patients enrolled from 2000 to 2002 were evaluated retrospectively. All patients fulfilled the ACR 1997 diagnostic criteria for SLE. The patients were divided into three groups according to the disease activity: mild group (Group A), moderate group (Group B)and severe group (Group C), as assessed with SLEDAI score. These cases were also divided into 2 groups according to the serum levels of anti-dsDNA antibody. 52 out of 225 patients were followed up further. Results ①There was no correlation between the serum level of anti-dsDNA antibody and SLEDAI score, and between the serum level of ANA and SLEDAI score in 225 patients. ②The serum level of anti-dsDNA antibody in group C was higher than that in group A or group B (P 0.05). Conclusions A positive correlation between the anti-dsDNA antibody and the disease activity was found in the severe group of SLE, but not found in the mild or moderate group. Although the renal damage was more commonly seen in those with higher level of anti-dsDNA antibody, but there is no correlation between the level of anti-dsDNA antibody and the degree of renal lesion.

The dynamic changes of the contents of polyamines and excitatory amino acid in the hippocampus during cerebral ischemia and reperfusion were observed in rats.It was found that the content of putrescine was increased and the release of excitatory amino acid elevated during reperfusion,and the increase of putrescine could be stopped when the antagonist of NM-DA receptor of excitatory amino acid,that is,MK-801,was administered.These facts suggest that the metabolic disturbance of polyamines in closely related to the release of excitatory amino acid and modulated by NMDA receptors.The combination of polyamines with excitatory amino acid may play an important role in the ischemic damage of the brain.

Objective To inquire into the forward clinical results of ventricular pacing, dual-chamber sensing, atrial-triggered, and ventricular-inhibited (VDD) Pacemaker in an unipolar lead.Methods 16 patients with the pacemaker were studied from 1993 to 2002, including 12 male patients and 4 female patients at 49 to 75 years old (average age 64 4 7 8 years old). They were in normal sinus rhythmia with complete or high degree atrial-ventricular block. Lead electrode was inserted through subclavian venous access, and the pacemaker was implanted in the same side as the electrode.Results All patients were followed up from 1 to 112 months (average 68 8 6 3 months) after pacemaker implantation. Their heart functions were improved, symptoms disappeared, life quality remarkably improved. Atrial sensing of VDD was good. One patient was died from coronary heart disease with heart failure by following up for 42 months, but the rest were healthy. Conclusions VDD pacemaker implantation was simple, easy to perform if its indication was appropriate. It could alleviate patients symptom and its therapy was effective. We should think highly of using VDD pacemaker, especially at poor region.

Objective To investigate the efficacy of autologous peripheral hematopoietic stem cell transplantation in the treatment of adult dermatomyositis. Methods A 21-year-old patient with dermatomyositis received autologous peripheral hematopoietic stem cell transplantation and was followed up for 6 years. Autologous peripheral hematopoietic stem cells were mobilized by recombinant human granulocyte colony stimulating factor (rhG-CSF) before the transplantation, and the conditioning regimens consisted of cyclophosphamide,methylprednisolone and cyclosporin. Rabbit anti-human T lymphocyte immunoglobulin began to be applied on day 3 after retransfer of stem cells. The improvement in symptoms, physical signs and biochemical indicators was observed, and hematopoietic restructuration and immunity resurrection were evaluated after the transplantation. Results After the transplantation, skin eruption greatly improved and gradually subsided. The muscle force of extremities restored from level Ⅳ before transplantation to level Ⅴ. The level of creatine kinase declined sharply after transplantation, but gradually returned to previous level. Leucocyte count began to decrease on the day of retransfer, and returned to the normal level on day 8. Immune function remained normal before and after the transplantation. Conclusion Autologous peripheral hematopoietic stem cell transplantation is an alternative treatment for severe and refractory dermatomyositis.

ObjectiveSurgical radiofrequency (RF) ablation has recently been one of the most effective means to treat chronic atrial fibrillation(AF).However,about 20％ to 30％ patients have shown recurrence of AF during the follow-up period.This study retrospectively analyzed AF recurrence rate in those patients who underwent valve replacement procedures combined with RF ablation to treat AF in our department during the last three years.We compared the information and clinical date in the sinus rhythm(SR) group with in the AF recurrence group to analyze the relationship between various preoperative risk factors and operation failure.The aim of this study is to provide evidences to select patients who can benefit most from this type of surgery and to reduce their surgical risk and hospital charges.MethodsFrom June 2006 to June 2009,52 patients with rheumatic heart disease (RHD) and chronic AF underwent RF ablation concomitant with valve replacement in our department by a same surgeon with the same method.Preoperative and intraoperative data was retrospectively collected and all patients were followed up longer than six months to determine the type of heart rhythm.Operation failure was defined as showing any rhythm except normal sinus rhythm by electrocardiogram.We divided all patients to the SR grope and AF grope.Univariate and multivariate statistical analysis was used to compare the data between the two groups in pre-,intra- and postoperative period.Results There was only one case in-hospital mortality ( 1.9％ ).None mortality,re-exploration for bleeding and pacemaker implantation for malignant arrhythmia was shown during the mean follow-up period of 14 months (9-35 months).At the last follow-up,sinus rhythm was shown in 71.2％ (37/52) patients.In univariaye analysis,the left atrial diameter,AF duration,left ventricular end diastolic volume and aortic cross-clamp were predictors of recurrence of AF.Age,left ventricular ejection factor,cardiopulmonary bypass time showed no significant difference between the two gropes.Multivariate analysis showed that AF duration was the independent risk factor of recurrence of AF after the bipolar radiofrequency ablation procedure.ConclusionRF ablation concomitant with valve replacement is an effective way to treat AF for those patients who need open heart surgery at the same time.Patients with normal SR may gain a better life quality.Preoperative duration of AF was the independent risk factor of AF recurrence.The longer the duration of AF is,the worse the efficacy of this procedure to restore normal SR is.

Objective To investigate the effects of eritoran on the expressions of the inflammatory cytokines interleukin-1β (IL-1β),tumor necrosis factor-α (TNF-α) and interferon-[ (IFN-β) mRNA in the basilar artery after subarachnoid hemorrhage (SAH) in rabbits.Methods Atotal of 36 healthy adult male New Zealand white rabbits were randomly allocated into three groups:SAH (n =12),normal saline (n =12) and eritoran (n =12) groups.A SAH model was induced by injection of autologous arterial blood into cisterna magnatwice.An equal amount of cerebrospinal fluid was displaced with the saline in the normal saline group.An equal amount of autologous non-heparinized arterial blood was injected immediate after the replacementof cerebrospinal fluid in the SAH group.Eritoran 1.5 mg/kg was injected intravenously immediately after the blood injection via the cisterna magna each time in the eritoran group.The food intake and neurological deficit were assessed.The expressions of IL-1β,TNF-α and IFN-β mRNA in the basilar artery were detected by real-time fluorescence quantitative polymerase chain reaction.Results The food intake scores (1.20 ± 0.41 vs.2.20 ±0.61; t =53.073,P =0.002),the neurological deficit scores (1.46 ± 0.32 vs.2.6 ± 0.08; t =306.431,P =0.001),the expressions of IL-1β (1.22 ±0.48 vs.2.38 ±0.06,P =0.000),TNF-α (1.39 ±0.07 vs.3.32 ±0.21,P =0.000) and IFN-β (1.51 ±0.08 vs.2.18 ±0.05,P =0.000) in Eritoran group were all significantly lower than those in the SAH group.Conclusions Eritoran may downregnlate the expressions of inflammatory cytokines IL-1β,TNF-α and IFN-β mRNA in the basilar artery after SAH in rabbits,increasing food intake,and improving neurological deficits.