Objective To study the relationship between peripheral blood Toll like receptor 4(TLR4),interleukin-1β(IL-1β)and neutrophil-to-lymphocyte ratio(NLR)and the progression and prognosis of acute pancreatitis(AP).Methods A total of 250 patients with AP were divided into the mild group(121 cases),the moderately severe group(89 cases)and the severe group(40 cases)according to the disease severity.Patients were divided into the poor prognosis group(33 cases)and the good prognosis group(217 cases)based on the prognosis after 5 days of treatment.Peripheral blood levels of TLR4,IL-1β and NLR were compared at different time points,different conditions and different prognosis in patients.The correlation of peripheral blood levels of TLR4,IL-1β and NLR,Ranson score and amylase were analyzed by Pearson correlation analysis.The value of each indicator in the diagnosis of severe AP was analyzed using ROC curve,and multivariate Logistic regression analysis was conducted to identify the prognostic risk factors.Results TLR4,IL-1β and NLR levels in AP patients were higher 24 h after admission than 48 h and 72 h after admission(P＜0.05).Peripheral blood TLR4 and IL-1β levels in AP patients at 24 h after admission increased with the condition became worse.NLR level was higher in the severe group than that in the moderately group or the mild group(P＜0.05).Peripheral blood TLR4,IL-1β and NLR levels in AP patients 24 h after admission were positively correlated with Ranson score at 48 h after admission and amylase level at 24 h after admission(P＜0.05).The area under ROC curve,sensitivity and specificity of the combination of TLR4,IL-1β and NLR at 24 h after admission for predicting severe AP were 0.895,84.53%and 81.69%.Peripheral blood TLR4,IL-1β and NLR levels 24 h after admission were higher in the poor prognosis group than those in the good prognosis group(P＜0.05).Multivariate Logistic regression analysis showed that elevated TLR4,IL-1β and NLR at 24 h after admission were independent risk factors for poor prognosis of patients with AP(P＜0.05).Conclusion Peripheral blood TLR4,IL-1β and NLR in patients with AP are closely related to disease progression and prognosis.Therefore,they can be taken as important monitoring indicators.

Objective: To investigate the relationship between urinary monohydroxylated metabolites of hydroxyl polycyclic aromatic hydrocarbons (OH-PAHs) and lung function, as well as the role of oxidative stress in these associations, so as to provide a scientific basis for air pollution control and policy formulation. Methods: A panel study was carried out among 45 young healthy adults. Four follow up surveys and health examinations were conducted from November 2017 to October 2018 to measure lung function parameters [forced vital capacity (FVC), second forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), FEV1/FVC, and forced expiratory flow between 25% and 75% vital capacity (FEF 25%~75% )], markers of exposure to 7OHPAHs [∑ 7OH PAHs], and markers of oxidative stress[8 hydroxy 2 deoxyguanosine (8 OHdG) and 8 isoprostaglandin F 2α (8 iso PGF 2α )]. The relationship between urinary PAH metabolites and lung function was quantified by linear mixed effects models. Mediation analysis was performed to assess the role of oxidative stress in the relationship between OH PAHs and lung function. Results: The median values of FVC, FEV1, FEVI/FVC, PEF, and FEF 25%-75% were 4.37 L, 3.58 L, 83.00%, 4.38 L/s, and 3.32 L/s, respectively. The results showed that each 1 unit increase in log transformed value of 2 Hydroxyfluorene (2 OHFlu) was associated with a 5.05% decrease ( β %=-5.05%，95% CI =-8.85%--1.09%) in FVC, 4.15% decrease ( β %=-4.15%，95% CI =-7.94%- -0.22% ) in FEV1 and 5.87% decrease ( β %=-5.87%，95% CI =-11.35%--0.05%) in FEF 25%-75% , respectively. Each 1 unit increase in log transformed values of 2 OHFlu and 9 Phenanthrol (9 OHPhe) was associated with a 7.03% decrease ( β %=-7.03%，95% CI =-12.60%--1.11%) and a 7.08% decrease ( β%=-7.08%，95% CI =-13.50%--0.17%) in PEF, respectively. Additionally, urinary ∑ 7OH PAHs had a positive correlation with the levels of urinary 8 OHdG and 8 iso PGF 2α ( r =0.64, 0.69, P <0.01). Meanwhile, the levels of 8 OHdG mediated 17.06% and 15.71% of the association between 2 OHFlu with FVC and FEV1. Conclusion The finding reveales a negative relationship between urinary OH PAHs and lung function among young healthy adults. The 8 OHdG plays a mediated role in the correlation of 2 OHFlu with FVC and FEV1. Active relevant policies are needed to control air pollution and maintain the healthy living conditions of young people.

Objective:To compare the clinical efficacy and safety between spleen total resection splenectomy and spleen partial splenectomy in the treatment of patients with traumatic spleen rupture.Methods:84 cases of patients with traumatic spleen rupture from March 2013 to March 2016 were selected and divided into two groups.42 cases in the spleen total resection group were treated with spleen total resection,while the other 42 cases in the spleen partial nephrectomy group were treated with spleen partial splenectomy.The operative effect,the levels of platelet count,serum IgA,IgG,IgM,CD3 +,CD4 +,CD8 +,CD4 + / CD8 + levels before and after treatment,the incidence of complications were compared between two groups.Results:The intraoperative blood loss,exhaust time,length of hospital stay of spleen partial nephrectomy group were shorter than those of the spleen total resection group,but the operation time of research group was longer than that of the spleen total resection group (P＜0.05).The platelet count,CD8+ of spleen partial nephrectomy group were lower than those of the spleen total resection group (P＜0.05).The IgA,IgG,IgM,CD3+,CD4+,CD8+,CD4+/CD8+ of spleen partial nephrectomy group were significantly higher than those of the spleen total resection group (P＜0.05).The incidence rate of complications in the spleen partial nephrectomy group was lower than that of the spleen total resection group (P＜0.05).Conclusion:Spleen partial splenectomy was more effective than spleen total resection in the treatment of traumatic splenic rupture,which had little effect on the platelet and immune function.

A 46-year-old male patient developed scatterred reddish-brown plaques and nodules on the back 6 years prior to the presentation. Then, the lesions gradually spread to the axillary fossa and protothorax, and became indurated with slight itching in winter. Laboratory examination revealed hypergammaglobulinemia. Computed tomography(CT)scan showed multiple nodular or patchy shadows in both lungs, lymphadenectasis in axillary, mediastinal and inguinal regions, and spleen enlargement. Histopathological examination of skin lesions showed granulomatous infiltrates with plenty of lymphocytes, histiocytes and mature plasma cells in the middle and lower dermis with the presence of lymphoid follicle-like structures, but no cell atypia was observed. Immunohistochemical study showed positive staining for CD38, CD138, CD79a, κ and λ light chains. According to clinical manifestations and laboratory examination results, the patient was diagnosed with cutaneous and systemic plasmacytosis.

Objective To evaluate the clinical efficacy of multiple target burst frequency thermocoagulation in treatment of lumbar disc herniation.Methods One hundred and twelve patients suffering from lumbar disc herniation were treated with stepped heating multiple target burst frequency thermocoagulation using of domestic R-2000B radiofrequency ablation machine.The visual analogue scale (VAS) score,Oswestry disability index (ODI) and effect of grade before operation and after operation were compared.Results The VAS score before operation was (7.60 ± 1.12) scores,3 d after operation was (3.10 ± 1.05) scores,6 months after operation was (2.90 ± 0.92) scores,there was significant difference between before operation and 3 d,6 months after operation (P ＜ 0.05).The ODI before operation was 47.6 ± 8.3,3 months after operation was 25.5 ± 6.7,6 months after operation was 23.7 ± 6.2,there was significant difference between before operation and 3,6 months after operation (P ＜0.05).The clinical efficacy:excellent grade was in 66 cases,the good was in 32 cases,the improvement was in 10 cases,the inefficacy was in 4 cases,the excellent and good rate was 87.5％ (98/112).There was no nerve injury,infection or death after operation.Conclusion Multiple target burst frequency thermocoagulation in the treatment of lumbar disc herniation has the advantages of little incision and tissue damage,fast recovery,good clinical outcome,it is worth to clinical practice.

Objective To compare the clinical effects in patients treated with anterograde reamed intramedullary nail (IMN) and dynamic compression plate (DCP) for diaphyseal fractures of the humerus.Methods Forty-seven patients with diaphyseal fractures of the humerus,were divided into two groups by random digits table:IMN group (23 cases) and DCP group (24 cases),IMN and DCP were performed fixation,respectively.After the surgery,perioperative,functional outcomes of shoulder and elbow,postoperative complications between two groups were compared.Results The average follow-up time was (22.3 ± 5.7)months,3 cases were lost in 12-month-follow-up,1 case in IMN group and 2 cases in DCP group.The operation time,intraoperative blood loss in IMN group were significantly shorter than those in DCP group [(67.7 ± 15.3) min vs.(87.0 ± 12.5) min,(106.3 ±57.6) ml vs.(226.7 ±60.2) ml,P＜0.05].The incidence rate of subacromial impingement in IMN group was significantly higher than that in DCP group [18.2％ (4/22) vs.0,P ＜ 0.05].The incidence rate of wound infection in IMN group was significantly better than that in DCP group [4.5％(1/22) vs.22.7％(5/22),P ＜ 0.05].There were no statistically significant differences between two groups in other indexes (P ＞ 0.05).Conclusions DCP has some advantage in perioperative period,but they are comparable in the functional outcomes of shoulder and elbow and complications.

Objective To compare the potentiality of opa typing versus Neisseria gonorrhoeae multi-antigen sequence typing (Ng-MAST) in discrimination of N. gonorrhoeae isolates, and to investigate the consistency of genotypes of N. gonorrhoeae between patients and their sex partners. Methods N. gonor-rhoeae was isolated from patients and their sex partners who attended sexually transmitted disease clinics of the Affiliated Union Hospital of Tongji Medical College, Huazhong University of Science and Technology from February 2006 to August 2007. All isolates were cultured on Thayer-Martin agar and GC-based choco-late agar, and identified by Gram stain and oxidase reaction. Totally, twenty-four strains of N. gonorrhoeae were isolated form 12 pairs of male-female sex partners. Genomic DNA was isolated from the strains, and subjected to PCR amplification of opa gene as well as pot and tbpB genes, opa typing and Ng-MAST typing were utilized to differentiate the 24 strains respectively. Results The 24 isolates were classified into 10 sequence types (ST) by Ng-MAST typing, and 12 opa types (OT) by opa typing. A novel genotype identi-fied by Ng-MAST (217-86% homologisation 178), was unique in China. Conclusions Both ST and OT of N. gonorrhoeae strains are identical between patients and their corresponding partners except for one pair of partners, 45/46, suggesting that gonorrhea is transmitted to each other by contiguity between sex partners. Opa typing is likely to be more potential than Ng-MAST in genotyping of N.gonorrhoeae strains.

In order to investigate the role of Caspase-3 and Bax in the pathogenesis of lichen planus, immunohistochemistry was used to detect the expression of Caspase-3 and Bax in skin lesions of the patients with lichen planus and skin tissues of normal subjects. The results showed that positive rate of Caspase-3 and Bax expression in lichen planus were significantly higher than that in normal skins (both P<0.05). Meanwhile, there was a obvious correlation between the increase of Caspase-3 and that of Bax in lichen planus. The expression of Caspase-3 and Bax might play an important role in the development of lichen planus.

The inhibitory effects of (-)-epigallocatechin-3-gallate (EGCG) on the invasion of human malignant melanoma cell line A375 and the possible molecular mechanisms of this effect were investiaged. A375 cells were pretreated with 20μg/mL EGCG for 24,48 and 72h respectively and the E-cadherin expression was detected by Western blot analysis. A375 cells were also pretreated with different concentrations of EGCG (1,5,10 and 20μg/mL) for 72h and the expression of E-cadherin was measured by RT-PCR. The adhesion and invasion of A375 cells were tested by cell-matrigel adhesion assay and matrigel invasion assay respectively. The results showed that EGCG could significantly up-regulate the expression of E-cadherin time- and concentration-dependently (both P<0.05). Statistical analysis showed that A375 cells invasion was inhibited by EGCG and correlated with the up-regulation of E-cadherin expression. It was suggested that EGCG strongly inhibited invasion of A375 cells, and the inhibition mechanism was possibly associated with the up-regulation of E-cadherin expression.

In order to investigate the role of MMP-9 and TIMP-1 in the pathogenesis of systemic sclerosis, the expression of MMP-9 and TIMP-1 was immunohistochemically detected in skin lesions of the patients with diffuse cutaneous systemic sclerosis, skin lesions of the patients with limited cutaneous systemic sclerosis, and skin tissues of normal subjects. The results showed that the expression of MMP-9 in lesions of diffuse cutaneous systemic sclerosis was significantly lower than that of normal skins (P＜0.05). However, no significant difference in the level of MMP-9 in the limited cutaneous systemic sclerosis and normal skin was found. Meanwhile, the expression of TIMP-1 in lesions of diffuse cutaneous systemic sclerosis and limited cutaneous systemic sclerosis were significantly higher than that of normal skins (both P＜0.05). It was suggested that the expression of MMP-9 and TIMP-1 might play an important role in the development of systemic sclerosis.