ObjectiveToll-like receptor 4 （TLR4）， a receptor for pathogen-associated molecular patterns of innate immunity， is associated with neurodegenerative diseases. Interleukin （IL）-6， IL-1β， and tumor necrosis factor-α （TNF-α） as common pro-inflammatory cytokines and high-sensitivity C-reactive protein （hs-CRP） are related to inflammatory responses. This study evaluated the clinical efficacy and possible mechanisms of therapeutic effects of Fengyintang on early and mid-stage PD with excessive heat generating wind by observing the effects of Fengyintang on the serum levels of TLR4， IL-6， IL-1β， TNF-α， and hs-CRP in the patients with PD. MethodsSixty-eight PD patients who met the inclusion criteria were randomly assigned into the control group and the observation group （n=34）. Both groups were treated with anti-PD Western medicine and the observation group was additionally treated with Fengyintang. Both groups were treated for 8 weeks. Before and after 8 weeks of treatment， the patients in the two groups were measured for their TCM symptom scores， International Movement Disorder Society Unified Parkinson's Disease Rating Scale （MDS-UPDRS） score， Parkinson's Disease Non-Motor Symptom Scale （NMSS） score， Patient Assessment of Constipation Symptom （PAC-SYM） score， Pittsburgh Sleep Quality Index （PSQI）， Hamilton Anxiety Scale （HAMA） score， Hamilton Depression Scale （HAMD） score， and changes in serum TLR4， IL-6， IL-1β， TNF-α， and hs-CRP levels. ResultsOne case in the control group was removed due to loss of visit， and a total of 67 PD patients （33 in the control group and 34 in the observation group） who met the criteria were included for analysis. After treatment， patients in the observation group showed decreases in scores of TCM symptoms， MDS-UPDRS， NMSS， PAC-SYM， PSQI， HAMA， and HAMD （P<0.05， P<0.01）. Moreover， the observation group had lower scores of TCM symptoms， MDS-UPDRS， NMSS， PAC-SYM， PSQI， HAMA， and HAMD than the control group （P<0.05， P<0.01）. The observation group showed higher efficacy in terms of TCM symptoms and MDS-UPDRS score than the control group （Z=-0.57， P<0.05）. The overall response rate was higher in the observation group than in the control group （Z=-0.62， P<0.05， P<0.01）. The serum TLR4， TNF-α， IL-1β， IL-6， and hs-CRP levels of the observation group were lower than those of the control group （P<0.05， P<0.01）. ConclusionFengyintang combined with Western medicine can safely and effectively alleviate the clinical symptoms， reduce the levels of inflammatory factors， improve the quality of life， and delay the disease progression of PD patients by inhibiting peripheral TLR4 expression and thus suppressing the downstream inflammatory response.

Objective:To describe disability rates of dementia in community residents aged 65 years and over in China,and explore related risk factors of disability.Methods:This study conducted an in-depth data analysis of the China Mental Health Survey.World Health Organization Disability Assessment Schedule 2.0(WHODAS 2.0)was used to assess dementia disability,Community Screening Interview for Dementia(CSID)and Geriatric Mental Status Examination(GMS)were used for dementia screening and diagnosing.Univariate analysis was used to calcu-late the weighted disability rates of dementia in population and in patients,and their population distribution.Multiple linear regression and logistic regression were used to analyze the risk factors of the occurrence of dementia disability and its severity.Results:The weighted disability rate of dementia was 2.1％in population,and 38.6％in pa-tients.The disability rates of comorbid dementia in population and in patients were higher than those of patients with only dementia.Female,older age,lower education level,lower economic status,and lower cognitive test scores in CSID had higher disability rates of dementia in population.Female and urban resident had higher disability rates of dementia in patients.Multiple linear regression showed economic status(β=0.11),gender(β=0.11),age(β=0.10),and treatment in the last 12 months(β=-0.20)were statistically associated with WHODAS 2.0 scores.Multiple logistic regression showed female(OR=2.81)and treatment in the last 12 months(OR=2.38)were statistically associated with disability.Conclusions:Persons with low economic status,female and elderly peo-ple are the high-risk groups for dementia disability.It should be paid attention to prevent dementia and its conse-quential disabilities.

As research delves deeper into the mechanisms of tumor immune responses,studies reveal the importance of microbial com-munities within the tumor microenvironment in tumor progression and their interactions with the host immune system.Intratumoral micro-biota could influence the tumor microenvironment,thereby promoting or inhibiting tumor growth and development.Despite this import-ance,the specific role of intratumoral microbiota impacting cancer immunotherapeutic efficacy remains largely unexplored.A deeper under-standing of the characteristics and biological functions of tumor-specific microbiota heralds a potential revolutionary innovation in cancer treatment.In this review,we introduce the discovery and sources of intratumoral microbiota,also addressing its composition,and discuss tumor tissue characteristics.Moreover,we briefly review the history of cancer immunotherapy development with a particular focus on the research progress concerning the impact of intratumoral microbiota on cancer immunotherapy.Furthermore,we explore emerging strategies that combine targeting intratumoral microbiota with immunotherapy to enhance immune efficacy,inhibit tumor progression,and improve cure rates,anticipating that this approach could represent a new direction for enhancing treatment outcomes and prospects.

Objective: This systematic review and meta-analysis was undertaken to evaluate the efficacy of antibacterial photodynamic therapy (aPDT) in the treatment of periodontitis in type-2 diabetes mellitus (T2DM) patients and to provide better treatment for patients with T2DM complicated with periodontitis. Methods: The PubMed, Cochrane, Embase, Web of Science, CNKI, CBM, and Wanfang databases were searched for relevant randomized controlled trials (RCTs). RevMan 5.3 was applied for the meta-analysis, and a systematic evaluation was conducted. Results: A total of 8 RCTs were included. The results showed that compared to simple subgingival scaling and root planing (SRP), aPDT assisted SRP had a better effect on improving the probing depth (PD) at 3 months after treatment, The difference was statistically significant [WMD=-0.32,95%CI（-0.45, -0.2）, P < 0.05], but 6 months after treatment, there was no significant difference in the two groups [ WMD=-0.15,95%CI（-0.40, 0.10）,P=0.23]. During the 6-month follow-up period, there were no significant differences in the clinical attachment level (CAL), bleeding on probing (BOP) or hemoglobin A1c (HbA1c) between the two groups (P> 0.05). Conclusion aPDT-assisted periodontal nonsurgical treatment in T2DM patients can improve PD in the short term but has no significant effect on the improvement of CAL, BOP and HbA1c.

Objective To explore the application value of invasive intracranial pressure (ICP) monitoring in children with severe traumatic brain injur (sTBI).Methods A total of 158 children with sTBI in our hospital from January 2012 to March 2015 were collected and retrospectively analysed.According to whether the child recieved invasive ICP monitoring or not,they were divided into the monitoring group (80 cases) and the control group (78 cases).Children in the monitoring group were embed of invasive ICP monitoring device within first 24 h after surgery,and were treated with appropriate measures according to the ICP level.In the control group,the determination of whether needing to recieve head CT and adjusting the treatment program was made based on the clinical symptoms and surgeon′s experiences.The prognosis of children in the two groups were evaluated by Glasgow coma scale (GOS) and compared at 3 months after injury.At the same time,the prognosis of children in the monitoring group with different ICP levels were compared.Results The favorable prognosis rates in the monitoring group and control group were 61.2% and 41.0% respectively,and there was statistically significant difference between the two groups(P<0.05).The mortality rates of children in the monitoring group had statistical difference among different ICP levels(P<0.05).Conclusion For children with sTBI,the invasive ICP monitoring is contribute to dynamically observing the changes in ICP,early detecting changes of conditions,guiding clinical treatment,and improving the prognosis.

Objective To investigate the effects of electroacupuncture (EA) on expression of phosphatase and tensin homology deleted on chromosome ten (PTEN) protein and growth associated protein-43 (GAP-43) in rats with Barrel cortex focal ischemia. Methods 24 adult male Sprague-Dawley rats were divided into sham group (n=8), model group (n=8) and EA group (n=8). The EA group accepted EA at Baihui (DU20) and Fengfu (DU16) acupoints 3 days after modeling, 30 min a time, once a day. They were assessed with Corner Test 1 day before modeling, and 3 days, 7 days and 14 days after medication. The expression of GAP-43 and PTEN around infarct zone were detect with Western blotting 14 days after medication. Results The frequence of turn-right decreased in the EA group compared with that in the model group (P<0.001) 14 days after modeling. The expression of GAP-43 increased in the model group compared with that in the sham group (P<0.05), and increased more in the EA group than in the model group (P<0.05). There was no significantly difference in PTEN expression between the model group and the sham group (P=0.460), and significantly decreased in the EA group (P<0.001). Conclusion EA may inhibit expression of PTEN protein and increase expression of GAP-43, which may be involved in nerve regeneration and functional recovery.

Objective To study the short and long-term effects of vocational rehabilitation on the disabled with low job satisfaction.Methods 66 disabled workers were divided into control group (n=32) and treatment group (n=34). The treatment group accepted physical,occupational and psychosocial therapy for 4 weeks. All the workers were assessed with Minnesota satisfaction questionnaire before treatment,3 and 12 months later. Results The total, internal and external satisfaction significantly improved in treatment group after treatment (P<0.01), except the internal satisfaction 1 year later (P>0.05). Conclusion Specific vocational rehabilitation programme may promote the inclusion of disabled workers into the workplace.

Objective To explore rationale and clinical application of simplified modified radical thyroideetomy for differentiated thyroid carcinoma.Methods From Jan.2007 to Jun.2010,349 cases of differentiated thyroid carcinoma received simplified operative procedure based on standard modified radical thyroidectomy.The simplified procedure took a low small collar incision(about 10-12 cm).In separating upper and lower skin flaps,subcutaneous tissues covering posterior triangle of neck and posterior edge of sternoeleidomastoid muscle were spared to protect sensory nerves.Subtotal thyroidectomy Was performed to resect the affected lobe,isthmus,and the majority of opposite lobe without considering the size of primary tumor or whether metastasis to the neck lymph nodes happened.Soft tissues of the mainly metastatic areas(Ⅱ a、Ⅲ、Ⅳ、Ⅴb)were cleared.The accessory nerve was not exposed routinely to avoid stimulation.Lymph nodes metastasis in different areas was recorded respectively.Complications in different operative modes were compared.Results Compared with standard modified radical thyroidectomy,the simplified mode had shorter scar-and no limit of neck mobility.Because of muscles and nerves pemervation,movement dysfunction and abnormal sensation of neck and shoulder decreased obviously.The operation duration was shortened.Cervical lymph node status Was evaluated,which provided basis for prognosis judgment and comprehensive treatment.Conclusions The simplified modified radical procedure has the benefit of decreased trauma while maintains the similar recurrence rate compared to modified radical thyroidectomy.It improvs the life quality of patients.This procedure fits the principle of functional radical neck dissection better.

Objective To investigate the status of work fatigue of the disabled and the healthy so that we get to know their employment quality and compressive strength, and then provide the theory basis for the national policy formulation and vocational rehabilitation. Methods We randomly investigated 280 employees (220 disabled, 60 healthy people) in 3 companies from 3 provinces with Fatigue Impact Scale (FIS). Results There was no statistically significant difference between disabled and healthy people about work fatigue, and also that of 3 domains including psycho-social, cognitive and physical activity. After comparison of 40 items on FIS，the disabled had higher fatigue than that of the healthy in 4 items which belonged to psycho-social domain (P<0.05). Conclusion Disabled people are no less than healthy people in compression capability and working capability. They should believe in themselves, and their family and the employees should have more confidence about their work capability than before. Government should provide some support with them on job retention.

ObjectiveTo investigate the status of job satisfaction and the influencing factors of the disabled in order to know their employment quality.Methods79 disabled employees of one company in Hunan province were randomly interviewed with Minnesota Satisfaction Questionnaire.ResultsThe overall satisfaction scores of 74 disabled workers was 67.78, which inner satisfaction was better than external satisfaction. The most satisfied was job independence and colleagues' relationships and the most unsatisfied was work flexibility and conditions. There were statistically significant differences between gender, age, disabled species and job satisfaction. In personal level, most influencing factors of disabled job satisfaction were gender, age, disability and salary types.ConclusionVocational rehabilitation such as the high-risk population could be performed specifically on the basis of the job satisfaction survey.