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Objective:To establish and validate a predictive model for treatment failure of peritoneal dialysis-related peritonitis(PDAP)in elderly patients.Methods:Clinical data of peritoneal dialysis(PD)patients who were followed up from January 1, 2013 to December 31, 2019 at four Grade A tertiary hospitals in Jilin Province were collected.A total of 362 elderly patients with PDAP were eventually included as study subjects.Subjects recruited from 2013 to 2017 were used for model construction and the logistic regression model was used to screen risk factors for treatment failure of PDAP in elderly patients.A nomogarm was constructed to predict treatment failure of secondary PDAP using R language.The receiver operating curve(ROC)and calibration curve were used to evaluate discrimination accuracy of the model.Subjects from 2018 to 2019 were used as the cohort for validation of discrimination accuracy of the model.Results:Of 258 PDAP patients in the modeling cohort, 29 experienced treatment failure, including 15 PDAP-related deaths and 14 cases requiring catheter removal.The multivariate logistic regression model showed that types of pathogens( OR=8.849, 95% CI: 1.656-47.269, P=0.011), long dialysis age( OR=1.023, 95% CI: 1.005-1.042, P=0.013), pre-hospitalization antibiotic treatment( OR=5.123, 95% CI: 1.338-19.610, P=0.017), and dialysate white blood cell count on day 5>100×10 6/L( OR=7.085, 95% CI: 2.162-23.217, P=0.001)were independent risk factors for treatment failure of PDAP in elderly patients.For the nomogarm predictive model, the areas under the ROC curve(AUC)in the modeling cohort and the validation cohort were 0.818(95% CI: 0.735-0.902)and 0.762(95% CI: 0.656-0.889), respectively, and the calibration curves were close to a straight line with a slope of 1. Conclusions:Our nomogram predictive model based on types of pathogens, months of dialysis, pre-hospital admission antibiotic treatment, and dialysate white blood cell count on day 5 has demonstrated satisfactory discrimination accuracy for treatment failure of PDAP in elderly patients.
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Objective:To investigate the variation characteristics and influencing factors of HIV/AIDS subtypes in Wuxi city of Jiangsu Province from 2014 to 2016.Methods:HIV/AIDS population in Wuxi city in 2014 was selected as the research object, and the HIV molecular epidemiology and follow-up study were carried out. Collect epidemiological information, extract DNA from blood samples, amplify pol gene fragment by nest-PCR and sequence, use ChromasPro 1.6 software and MEGA 7.0 software to construct the HIV-1 sequence database, and use FastTree2.1.10 software to construct the phylogenetic tree to confirm the subtype; in 2016, the same population was followed up, and the HIV subtype variation was analyzed, and the influencing factors of subtype variation were explored by multivariate logistic regression. Results:A total of 612 HIV/AIDS cases in 2014 and 2016 were collected. The age of the subjects was mainly 30 years old or above (85.46%, 523/612), and the proportion of people over 50 years old was higher (228/612, 37.25%). The main route of transmission was homosexuality, accounting for 49.67%. A total of 1224 samples were detected and CRF01 _ AE、CRF07_ BC、B、CRF08_ BC、CRF67_ 01B、CRF55_ 01B、CRF68_ 01B, 7 subtypes of HIV-1 and 5 unique recombinant types (URFs) was detected. CRF01_ AE and CRF07_ BC was still the main genotype in Wuxi, Jiangsu Province, accounting for 66.75%. There were 29 cases (3.56%) of URFs recombinant strains. During 2014-2016, the variation rate of subtypes was 14.63%, and the most common variation was CRF01_ AE changes to CRF07_ BC(13.95%). Marital status (OR=0.363, 95% CI: 0.137-0.964) and baseline CD4 level (OR=0.414, 95% CI: 0.192-0.891) were associated with subtype variation.Conclusions:The HIV-1 subtypes of HIV/AIDS patients in Wuxi city are diverse and complex, the proportion of recombinant subtypes is rising, the URFs that are difficult to determine the genotype increase significantly, and the variation rate of HIV-1 subtypes among HIV/AIDS infected people is high. It is necessary to strengthen the monitoring of HIV-1 subtypes.
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Objective:To investigate the incidence, drug sensitivity and drug resistance characteristies, and theraputic effect of staphylococcal peritoneal dialysis-associated peritonitis (PDAP), aim to provide clinical evidences for standardizing treatment therapy of staphylococcal PDAP. Methods:Clinical data of PDAP patients admitted to the Second Hospital of Jilin University, the First Hospital of Jilin University-the Eastern Division, Jilin Central Hospital and Jilin First Automobile Work General Hospital during January 1, 2013 and December 31, 2019 were retrospectively collected. The results of etiology, drug sensitivity and drug resistance of staphylococcal PDAP patients were collected. According to the pathogenic bacteria, patients were divided into staphylococcus aureus group ( n=48) and coagulase-negative staphylococcus group ( n=232). According to the results of methicillin resistance, patients were divided into drug-resistant group ( n=71) and drug-sensitive group ( n=30). The prognosis of antibiotic therapy in each group were compared. Poisson regression was used to test the changing trend of the incidence of staphylococcal PDAP. The changes of drug sensitivity and drug resistance of staphylococcus were compared between 2013 and 2019 by linear trend χ2 test. Results:A total of 1 085 cases of PDAP occurred in 625 patients were screened, and 280 cases of staphylococcal PDAP were finally included. The incidences of staphylococcal PDAP, staphylococcus aureus PDAP and coagulase-negative staphylococcal PDAP were 0.063 times per patient year, 0.010 times per patient year and 0.053 times per patient year respectively. In addition, the incidence of PDAP caused by staphylococcus, staphylococcus aureus and coagulase-negative staphylococcus decreased year by year (all P<0.05). With the change of years, the sensitivity rate of staphylococcus to rifampicin increased, while the sensitivity rate of staphylococcus to moxifloxacin decreased (both P<0.05). The drug resistance rate of staphylococcus to levofloxacin increased ( P<0.05). The staphylococcus aureus group was more prone to refractory PDAP and catheter removal than that in coagulase-negative staphylococcus group, and the recurrence rate was higher than that in coagulase-negative staphylococcus group (all P<0.05). The proportion of vancomycin used during the whole course of antibiotic therapy in drug-resistant group was higher than that in drug-sensitive group ( P<0.05). Conclusions:The incidence of staphylococcal PDAP decreases year by year, and the drug sensitivity characteristics of staphylococcus also change. The therapeutic outcomes of staphylococcus aureus PDAP are worse than that of coagulase-negative staphylococcus.
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Objective:To investigate the clinical characteristics of E. coli peritoneal dialysis-associated peritonitis (PDAP) and the risk factors for its occurrence and treatment failure.Methods:The clinical data of patients with episodes of PDAP in four general hospitals in Jilin Province from 2013 to 2019 were retrospectively reviewed. According to the pathogenic bacteria, the patients were divided into E. coli and non- E. coli groups. The incidence of E. coli PDAP in the last seven years was calculated and the clinical characteristics were compared between two PDAP groups. Logistic regression was used to analyze the risk factors for the occurrence and treatment failure of E. coli PDAP. Results:A total of 693 PDAP episodes/cases were enrolled in this study, including 100 episodes/cases in the E. coli group and 593 episodes/cases in the non- E. coli group. The incidence rate of E. coli PDAP in the four hospitals showed a decreasing trend during 2013 to 2019. Compared with the non-E.coli group, the proportion of diabetic patients and the average blood albumin levels in the E. coli group were lower ( χ2=5.006, Z=-2.992, P<0.05), while the proportion of refractory peritonitis was higher, and the duration of antibiotic therapy was longer ( χ2=6.350, Z=-2.779, P<0.05). Multivariate Logistic regression analysis showed that history of PDAP ( OR=1.577, 95% CI: 1.015-2.448) and low baseline serum albumin level ( OR=0.958, 95% CI: 0.923-0.995) were independent risk factors for the development of E. coli PDAP, while concomitant diabetes was an independent protective factor for E. coli PDAP ( OR=0.538, 95% CI: 0.330-0.876). Moreover, long-term dialysis was an independent risk factor for treatment failure of E. coli PDAP ( OR=1.047, 95% CI: 1.018-1.076). Conclusion:The incidence rate of E. coli PDAP in study institutions has declined in the past 7 years, but the rate of refractory PDAP is still high. The history of PDAP and low blood albumin level are independent risk factors for the occurrence of E. coli PDAP, while concomitant diabetes is an independent protective factor for the occurrence of E. coli PDAP. Long-term dialysis is an independent risk factor for treatment failure of E. coli PDAP.
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OBJECTIVE@#To analyze the clinical characteristics and treatment outcomes of the first episode of peritoneal dialysis-associated peritonitis (PDAP) in patients receiving long-term peritoneal dialysis.@*METHODS@#The clinical data of patients with the first episode of PDAP in 4 general hospitals in Jilin Province from 2013 to 2019 were collected retrospectively. According to the duration of dialysis, the patients were divided into long-term (≥36 months) and short-term (< 36 months) dialysis groups for comparison of the clinical data, treatment outcomes and long-term prognostic events.@*RESULTS@#A total of 625 patients with PDAP were enrolled, including 93 on long-term and 532 on short-term dialysis. Compared with those on short-term dialysis, the patients on long-term dialysis had significantly higher hemoglobin levels and lower glomerular filtration rates when the first episode of PDAP occurred (@*CONCLUSIONS@#Compared with those on short-term dialysis, patients on long-term dialysis are prone to gram-negative bacterial infection when the first episode of PDAP occurs with worse treatment outcomes but similar long-term outcomes. Long-term dialysis is an independent risk factor of extubation and treatment failure for the first episode of PDAP, and fungal and mixed bacterial infections are independent risk factors for treatment failure of the first PDAP in patients with long-term dialysis.
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Humanos , Falência Renal Crônica/terapia , Diálise Peritoneal/efeitos adversos , Peritonite/etiologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Objective:To explore the clinical characteristics and treatment outcomes of different types of peritoneal dialysis-associated peritonitis (PDAP).Methods:The clinical data of PDAP patients admitted to the Second Hospital of Jilin University, Second Part of the First Hospital of Jilin University, Jilin Central Hospital and Jilin First Automobile Work General Hospital in Jilin province from 2013 to 2019 were reviewed. According to the type of PDAP, the patients were divided into relapsing group, recurrent group, repeat group and control group, and the baseline data, pathogens culture and treatment outcomes among the four groups were compared.Results:A total of 542 patients with PDAP were enrolled in the study, including 43 cases in relapsing group, 32 cases in recurrent group, 27 cases in repeat group and 440 cases in control group. The median follow-up time was 30.5 (16.0, 50.0) months. The rate of Gram-positive bacteria in repeat group was higher than that of control group (70.37% vs 42.95%, P=0.030); the rate of fungi in recurrence group was higher than that of control group (21.88% vs 3.86%, P=0.006). Compared with control group, relapsing group had a lower cure rate (67.44% vs 83.64%, P=0.048) and a higher relapse rate (23.26% vs 2.27%, P=0.002), and recurrent group had a higher catheter removal rate (28.13% vs 8.18%, P=0.012). Multivariate logistic regression showed that recurrence was an independent risk factor for catheter removal ( OR=5.137, 95% CI 2.105-12.539, P<0.001). The technical failure rates in relapsing group and recurrent group were both higher than those in control group (41.86% vs 17.05%, P=0.002; 46.88% vs 17.05%, P=0.002). Multivariate Cox regression showed that relapse and recurrence were both independent risk factors for technical failure ( HR=2.587, 95% CI 1.525-4.389, P<0.001; HR=3.571, 95% CI 2.022-6.306, P<0.001), and also were independent risk factors for composite endpoint ( HR=1.565, 95% CI 1.045-2.344, P=0.030; HR=2.004, 95% CI 1.269-3.164, P=0.003). Conclusion:Compared with common PDAP, the therapeutic effects and prognosis of relapsing and recurrent PDAP are worse.
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Large area defect of jaw caused by trauma, tumor resection, congenital malformation and periodontitis is a critial situation for oral and craniofacial reconstruction. Recent studies have shown that some exosomes carrying specific biological information play a role in promoting tissue regeneration. Compared to allogeneic stem-cell transplantation, exosomes have lower immunogenicity, and can facilitate storage and quantitative use, thus have great potential in tissue engineering. This article reviewed the regeneration process of jaw bone and the regulatory effect of exosomes transport on bone regeneration, as well as the research progress of exosomes in jaw bone-related diseases.
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Objective:To investigate the protective effect of butylphthalide on the brain of the rats with acute ischemic stroke, and to elucidate its mechanism in the treatment of acute ischemic stroke. Methods:Forty-eight rats were randomly divided into sham operation group, model group (focal cerebral ischemia rat model) and butylphthalide group (focal cerebral ischemia rat model + butylphthalide treatment), with 16 rats in each group.The nerve symptom scores of the rats in various groups were determined, and the brain tissue was stained by HE staining; triphenyl four azole nitrogen chloride (TTC) was used to detect the percentage of cerebral infarction area; Western blotting method and reverse transcription-polymerase chain reaction (RT-PCR) were used to detect the expression levels of hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), matrix metalloproteinase-2 (MMP-2), matrix metalloproteinases-9 (MMP-9), and nuclear transcription factor inhibiting protein kappa B alpha(IκBα), nuclear transcription factor kappa B (NF-κB) p65(NF-κB p65) protein and mRNA in the brain tissue of the rats. Results:In sham operation group, there were no infarction and neurological defect in the brain tissue. Compared with model group, the percentage of cerebral infarction area and the neurological function score of the rats in butylphthalide group were significantly decreased(P<0.01). The structure and distribution of brain tissue cells of the rats in sham operation group were intact and uniform; most of the cells in model group were necrotic, cytoplasmic rupture, nucleus rupture and condensation; a small number of brain cells in butylphthalide group were swollen and necrotic. Compared with sham operation group, the expression levels of HGF, VEGF, MMP-2, MMP-9, and NF-κB p65 protein and mRNA in the brain tissue of the rats in model group were significantly decreased (P<0.01), and the expression levels of IκBα protein and mRNA were significantly increased (P<0.01). Compared with model group, the expression levels of HGF, VEGF, MMP-2, MMP-9, and NF-κB p65 protein and mRNA in the brain tissue of the rats in butylphthalide group were significantly increased (P<0.01),and the expression levels of IκBα protein and mRNA were significantly decreased (P<0.01). Conclusion:Butylphthalide can improve the nerve function of the rats with acute ischemic stroke and reduce the area of cerebral infarction;its mechanism may be related to increasing the HGF level in the brain tissue and promoting the cerebral angiogenesis.
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Objective: To investigate the effects of butylphthalide on the hippocampal neuron apoptosis and p38 mitogen-activated protein kinase (MAPK) signaling pathway in the rats with ischemic stroke, and to elucidate the mechanism of butylphthalide in ischemic stroke. Methods: A total of 102 male rats were randomly divided into sham operation group, model group and butylphthalide group; there were 34 rats in each group. The rats in model group and butylphthalide group were used to establish the focal cerebral ischemia models with modified Zea-Longa method. The rats in butylphthalide group were treated with butylphthalide (4. 5 mg · kg-1) after modeling. The rats in sham operation group were intraperitoneally injected with the same volume of normal saline at the same time points. The morphology of neurons was observed by HE staining. The apoptosis of hippocampal neurons was observed by in situ terminal transferase labeling (TUNED staining. The expression levels of activated caspase-3 (cleaved caspase-3), B lymphocyte tumor-2 (Bel-2), Bel-2 related X protein (Bax), p38, phosphorylation-p38 (p-P38) and MAPK proteins in hippocampus tissue of the rats in various groups were determined by Western blotting method. The expression levels of cleaved caspase-3, Bax, Bcl-2, p38, and MAPK mRNA in hippocampus tissue of the rats in various groups were determined by reverse transcription-polymerase chain reaction (RT-PCR). Results: The neurons in the hippocampal CA1 area of the rats in sham operation group were well aligned and the nuclei and cell membrane were normal. In model group, the neurons in the hippocampal CA1 area were disordered, the cells were swollen and burst, and the nuclei had pyknosis. In butylphthalide group, the structure of some neurons in the hippocampal CA1 area returned to normal. Compared with sham operation group, the number of neurons in the hippocampal CA1 area of the rats in model group was significantly reduced (P<0. 01), and the apoptotic index of neurons was significantly increased (P<0. 01). Compared with model group, the number of neurons in hippocampal CA1 area of the rats in butylphthalide group was significantly increased (P<0. 01), and the apoptotic index of neurons was significantly decreased (P<0. 01). Compared with sham operation group, the expression levels of cleaved caspase-3, Bax, p-p38 and MAPK proteins in hippocampal tissue of the rats in model group were significantly increased (P<0. 01), and the expression level of Bcl-2 protein in hippocampal tissue of the rats in model group was significantly decreased (P<0. 01); compared with model group, the expression levels of cleaved caspase-3, Bax, p-p38 and MAPK proteins in hippocampus tissue of the rats in butylphthalide group were significantly decreased (P<0. 01), and the expression level of Bcl-2 protein in hippocampus tissue of the rats in butylphthalide group was significantly increased (P<0. 01). Compared with sham operation group, the expression levels of cleaved caspase-3, Bax and MAPK mRNA in hippocampus tissue of the rats in model group were significantly increased (P<0. 01), and the expression level of Bcl-2 mRNA in hippocampal tissue of the rats in model group was significantly decreased (P<0. 01); compared with model group, the expression levels of cleaved caspase-3, Bax and MAPK mRNA in hippocampus tissue of the rats in butylphthalide group were significantly decreased (P<0. 01), and the expression level of Bcl-2 mRNA in hippocampus tissue of the rats in butylphthalide group was significantly increased (P<0. 01). Conclusion: Butylphthalide can inhibit the apoptosis of hippocampal neurons in the rats with ischemic stroke by inhibiting the p38 MAPK signaling pathway in the hippocampus tissue.
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Objective The purpose of this research is to use modern statistical methods,to analyze the rules of cointment by Prof.Yang Zhimin treating yang deficiency and fatigue state patients,to increase the pertinence and to improve the clinical efficacy.Methods This paper analyzed 62 cases of Prof.Yang Zhimin in the treatment of the patients with yang deficiency and fatigue state from October 2010 to January 2013.The analyses were frequency analysis and association rules.Results Among the patients with yang-deficiency and fatigue,193 Chinese medicine were used.The monkshood was the highest frequency.Dampness-transforming medicine accounts for about 22.2％ in the top 36 frequency of medicine.Based on analyzing association rules,we found that the compatibility of medicine which were used more frequently came from Sini decoction,Danggui Sini decoction and Jinkui Shenqi pills,such as "monkshood and dried ginger","monkshood and roasted liquorice","dried ginger and roasted liquorice","monkshood and angelica","monkshood and comel","monkshood and prepared rehmannia root" and "monkshood and yam".Futhermore,we found two new core prescription.One was Qian Yang Dan combined with Sini decoction consist of "monkshood,roasted liquorice,dried ginger,fructus amomi".The other one was Tu Si Jian consist of "yam,semen cuscutae,angelica,roasted liquorice".Conclusions "Invigorating spleen and kidney","warming yang and dissipating dampness" and "hiding yang and Seeking Yang in Yin" are the habits and rules of the ointment medication by Prof.Yang Zhimin treatingyang deficiency and fatigue state patients.
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Chlamydia psittaci is a causative agent of psittacosis,which can infect a wide range of hosts including birds and humans.However,information regarding C.psittaci infection in pigeons is scarce.In the present study,a total of 399 fecal samples from pigeons were collected from Jilin Province,northeastern China,between March and May 2015,and examined by nested PCR amplification of outer membrane protein A (ompA) gene.The overall Chlamydiosis prevalence was 5.01％ (21/399),with 3.19％ in Changchun City and 9.40％ in Jilin City.Furthermore,breed was the major risk factor associated with Chlamydia infection in pigeon,boiler pigeons had a prevalence of 7.49％,whereas no C.psittaci was detected in racing pigeons.Sequence analysis of the ompA gene revealed that all the identified isolates represented C.psittaci genotype B.Our results firstly indicated the presence of zoonotic C.psittaci in boiler pigeons in Jilin Province,northeastern China,and effective measures should be implemented to reduce the risk of C.psittaci transmission from pigeons to humans.
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Objective To investigate the effects of dexmedetomidine on postoperative cognitive dysfunction (POCD) in patients with obstructive sleep apnea. Methods A total of 50 patients with obstructive sleep apnea were divided into 2 groups: a dexmedetomidine group and a control group. Dexmedetomidine and 0.9% saline solution were given before and during the operation in the dexmedetomidine group and the control group respectively. MMSE scores were estimated at different time, and the concentration of serum S100β and NSE were detected before anesthesia at 3 h, 6 h, 24 h and 48 h after operation. Results One day after surgery, MMES score decreased significantly in both groups,of which MMES was notably higher in the DEX group than that in the control group (P<0.05). In both groups, S100βand NSE levels were significantly higher at T2, T3 and T4 than those at T1, and were the highest at T3 (P<0.05). S100β and NSE levels were significantly lower in the DEX group than those in the control group (P<0.05). Conclusion Dexmedetomidine can reduce the incidence of POCD in patients with obstructive sleep apnea. Its mechanism may relate to neuroprotection.
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Objective To design a nursing checklist for continuous renal replacement therapy in ICU patients and to apply it to clinical settings. Methods A nursing checklist for continuous renal replacement therapy was de-signed through reviewing guidelines and literatures. The checklist was used in ICU patients treated with continu-ous renal replacement therapy,and nursing situation (including operation time,operation quality,etc.) was compared before and after application of the checklist. Results After applying the nursing checklist for continuous renal re-placement therapy,the nursing procedures were standardized,the operation time was reduced,and operation quality was improved. Conclusion The application of nursing checklist in nursing management of continuous renal replace-ment therapy helped to standardize continuous renal replacement therapy operating procedures,improve efficiency and quality at work,and ensure patient safety.
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Objective To investigate the olanzapine and quetiapine quetiapine in the treatment of Alzheimer's disease patients of different clinical effects and influence on the swallowing function of patient.Methods According to the order of visits to the author departments were 73 cases of Alzheimer's patients were divided into group A(37 cases) and group B(36 cases).Patients in group A were treated with olanzapine in the treatment of, and group B with quetiapine in the treatment, the time of the two groups of patients are 12 weeks, to observe the differences of the two groups during the treatment of swallowing function indexes and clinical efficacy.Results After treatment, the MMSE scores of two groups of patients compared with pre-treatment, there was no statistical significance and BEHAVE-AD score before treatment significantly decreased ( P <0.05 ).Post-treatment, the patients in two groups of MMSE, BEHAVE-AD score difference does not have statistical significance.The difference of clinical efficacy between two groups post-treatment was not statistically significant.Watian drinking water test score of two groups Post-treatment, SaO2 decreased value compared with those pre-treatment significantly increased (P<0.05).After treatment of two groups of patients Watian drinking water test score difference does not have statistical significance, and post-treatment, patients in group B of SaO2 decreased value lower than that in group A ( P <0.05 ).Mild dysphagia, two cases of moderate swallowing dysfunction occurred in twenty-six patients in group A, group B with mild swallowing dysfunction occurred in twenty-one patients, A group of swallowing dysfunction more serious than group B serious ( P <0.05 ) .Conclusion Olanzapine and quetiapine quetiapine in the treatment of patients with Alzheimer's disease clinical effect quite, patient's swallowing function cause some adverse effects, effects of olanzapine is more serious.
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Objective To investigate the effect of butylphthalide on Nrf2 signaling pathway after cerebral ischemia-reperfusion in rats and neuroprotective effect.Methods A model of middle cerebral artery ischemia-reperfusion injury in rats was induced by suture method.The rats were randomly divided into 4 groups:a sham operation,an ischemia-reperfusion,a low-dose (100 mg/kg) butylphthalide,and a high-dose (400 mg/kg) butylphthalide.Neurological deficit score was performed at 24 h after referfusion.Western blotting was used to detect the Nrf2 expression,the superoxide dismutase activity and malondialdehydecontent in the ischemic brain tissue.TUNEL assay was used to detect the nerve cell apoptosis.Immunohistochemical staining was used to detect the expression of cleaved caspase-3.Results Butylphthalide significantly upregulated the Nrf2 protein expression with a dose-dependent manner (P ＜ 0.05),increased superoxide dismutase activity (P ＜ 0.05),decreased malondialdehyde content (P ＜ 0.05),decreased numbers of cleaved caspase-3 positive cells and apoptotic cells (P ＜ 0.05).Conclusions Butylphthalide may play a significant neuroprotective effect after cerebral ischemia-reperfusion injury in rats.Its role may be associated with the upreglation of Nrf2 signaling pathway and enhancing antioxidant activity
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Objective:To analyze the impact of NBP on the expression of HSP 70 and TLR4 in the rat with ischemia-reperfusion.Methods:The 144 rats were divided into 3 groups,Sham group,IR group and NBP group.The 3 groups were divided into 4 groups again according to the time of reperfusion (6h,12h,24h and 48h).The intraluminal ischemia-reperfusion model was made by improved Longa.When the model was made successfully ,the rat in NBP group was gave oral NBP immediately while the IR and Sham group was gave oral NS.The neurological deficit scores , number of apoptotic cells , expression of HSP70 and TLR4 were compared during the 3 groups.Results:The neurological function ,apoptosis,the expression of HSP70 and TLR4 in NBP group at any reperfusion time were statistical lower than in IR group.In all the infusion periods,apoptotic cells in IR and NBP group were significantly higher than that in the Sham group.In all the infusion periods ,the positive cells in IR and NBP group were significantly lower than that in the Sham group.Conclusion:NBP can protect the function of neuron by improving the inhibition of HSP 70 and TLR4.