Objective: To explore relationship among serum levels of homocysteine (Hcy), interleukin (IL)-10, matrix metalloproteinase (MMP)-9 and infarct volume in patients with acute cerebral infarction（CI）. Methods: A total of 125 acute CI patients were regard as acute CI group, and another 37 healthy subjects were enrolled as healthy control group. Enzyme linked immunosorbent assay (ELISA) method was used to measure serum levels of Hcy, IL-10 and MMP-9 of subjects; according to infarct volume, acute CI patients were divided into small infarction group (≤5cm3, n=47), medium infarction group (5~15 cm3, n=41) and large infarction group (≥15cm3, n=37); changes of levels of Hcy, IL-10 and MMP-9 were compared among all groups. Results: Compared with healthy control group, there were significant increase in levels of MMP-9 and Hcy, and significant decrease in IL-10 level in acute CI group. Compared with small and medium infarction groups, there was significant increase in serum Hcy level [(16.11±3.5) μmol/L, (16.79±3.4) μmol/L vs. (18.5±4.2) μmol/L, P<0.01, P<0.05] in large infarction group； Compared with small infarction group, there was significant increase in serum MMP-9 level [(161±27) ng/ml vs. (238±26) ng/ml, (256±35) ng/ml, P<0.05, P<0.01]；Compared with small infarction and medium infarction groups, there were significant decrease in IL-10 level [(0.60±0.17) ng/ml vs. (0.59±0.15) ng/ml, (0.31±0.12) ng/ml, P<0.01 both] in large infarction groups. Conclusion: Serum levels of homocysteine, interleukin-10 and matrix metalloproteinase-9 are related to onset of acute cerebral infarction, and may reflect risk degree of cerebral infarction.

Although the new methods and new ideas have been introduced into researches on modern syndromes, research levels of syndromes have continued to be broadened and deepened gradually. However, understanding of essential theories and general research methods have not yet achieved a broad consensus in TCM field. The phenomenon is caused by the systematic complex features of syndromes, which are difficult to be explained for a short while, and require progressive understanding and development. It is also related to the reason that current main stream researches on syndromes lack general overview and analysis. All of the above lead to the failure of efficient penetration of all syndrome researches and restrict synergetic development among these researches. This article summarized and analyzed the overview of key field of study on syndromes, and expounded their disadvantages and development suggestions, with purposes to improve future syndrome research field, enrich syndrome research methods, and promote necessary penetration of syndrome researches.

Objective To discuss the influence of sample hemolysis on the biochemical testing results to provide the basis for the laboratory personnel and clinical doctors correctly analyzing the biochemical testing results of hemolytic samples .Methods Serum from non‐hemolytic samples was taken and performed the detection of 48 biochemical items .Then the sample was stirred for indu‐cing the mild ,moderate and severe hemolysis .Centrifugation was conducted at 3 000 r/min for 10 min .Finally the detections of the same biochemical testing items were performed again .The detection results of non‐hemolysis ,mild ,moderate and severe hemolysis samples were statistically analyzed .Results As compared with the non‐hemolytic samples ,the 16‐item detection results in the mild hemolysis samples showed statistically significant difference ,25‐item detection results in the moderate hemolysis samples showed statistically significant difference and 28‐item detection results in the severe hemolysis samples showed statistically significant difference (P<0 .05) ,respectively .Conclusion The sample hemolysis could produce the significant influence on the majority of bi‐ochemical testing items .Therefore ,the sample hemolysis is encountered and the detection results must be reported in the biochemi‐cal detection ,the clear indication should be given in the report for reminding the doctor and patient to arouse attention .The causes leading to the sample hemolysis should be analyzed for avoiding the occurrence of hemolysis phenomenon and ensuring the truthfull‐ness and accuracy of the detection results .

Objective To investigate the risk factors of pulmonary fungal infection in patients with chronic obstructive pulmonary disease ( COPD) .Methods 48 cases of patients with COPD complicated with pulmonary fungal infection in September 2011 to September 2014 in respiratory department of Shaoxing People’s hospital ( observation group) and 48 cases without pulmonary fungal infection of COPD of patients at the same period ( control group) were selected, clinical data of two groups were retrospectively analyzed.The age, sex, antibiotics and hormone usage, serum albumin, mechanical ventilation and complications (diabetes, respiratory failure, heart failure) were compared between two groups.Results The results of sputum culture in the observation group showed that the infection rate of Candida albicans infection was 17 (35.42%), Candida glabrata was 4 (8.33%), Candida tropicalis 3 (6.25%), Aspergillosis was 22 (45.83%) and concurrent infection was 2 (4.17%).The age and sex of the patients between two groups had no statistically significant difference, the levels of serum albumin in the observation group was significantly lower than that of the control group, combined with diabetes, type II respiratory failure and right heart failure of the patients were significantly higher than that of the control group(all P<0.05).The antibiotics use time, hormone use rate and rate of mechanical ventilation in the observation group were significantly better than that of control group, the differences were statistically significant (all P<0.05).The multivariate logistic regression analysis showed that, low serum albumin, long-term use of antibiotics, mechanical ventilation, combined with diabetes and type II respiratory failure were the independent risk factors of nosocomial pulmonary fungal infection in patients with COPD.Conclusion There are many risk factors in patients with COPD complicated with pulmonary fungal infection, low serum albumin levels, long-term use of antibiotics, mechanical ventilation, combined with diabetes and type II respiratory failure are major independent risk factors.It should take active prevention and cure measures in clinic to reduce the possibility of fungal infection.

Objective To study CEREC Bluecam digital impressions in tooth preparation of fixed bridge.Methods Totally 80 patients of tooth preparation of 3 units fixed bridge were divided into experiment group (with CEREC Bluecam digital impressions system) and control group (with traditional method) randomly,and then captured the CEREC Bluecam digital impressions and made the dental models after the tooth preparation.Shoulders width,smooth and continuation of shoulders,paleness of shoulders edge,axial chamfers,axial converge degree,occlusal space and common path of insertion were analyzed.Results In the digital impressions in the equality of shoulders width,smooth and continuation of shoulders,paleness of shoulders edge,axial chamfers,axial converge degree,occlusal space and common path of insertion,the experiment group was better than control group:95.0％ (38 cases) vs.62.5％ (25 cases),92.5％ (37 cases) vs.77.5％ (31 cases),97.5％ (39 cases) vs.75.0％ (30 cases),95.0％ (38 cases) vs.72.5％ (29 cases),90.0％ (36 cases) vs.65.0％ (26 cases),100.0％ (40 cases) vs.52.5％ (21 cases),and 97.5％ (39 cases)vs.75.0％ (30 cases),respectively,all (P＜0.05).In the dental models,the experiment group was better than control group:87.5％ (35 cases) vs.60.0％ (24 cases),97.5％ (39 cases) vs.75.0％ (30 cases),90.0％ (36 cases) vs 62.5％ (25 cases),95.0％ (38 cases) vs 75.0％(30 cases),92.5％ (37 cases) vs 70.0％ (28 cases),100.0％ (40 cases) vs.72.5％ (29 cases),and 100.0％ (40 cases) vs.65.0％ (26 cases),respectively,(all P＜0.05).Conclusions The tooth preparation quality with the CEREC Bluecam digital impressions is better than that of the traditional method.

AIM:To investigate the pathological changes of aquaporin 4 (AQP4) and related proteins in the rats with focal cerebral ischemia injury , and to observe the effect of silent information regulator 1 ( SIRT1) on the AQP4 ex-pression in order to explore the pathological mechanism of cerebral ischemia and brain edema .METHODS: Adult male SD rats were randomly divided into sham group and middle cerebral artery occlusion ( MCAO) model group.The MCAO model group was divided into the 4 time point (6 h, 12 h, 24 h and 48 h) subgroups.The animal model of MCAO was es-tablished by suture method in mature SD rats .The neural symptom score was measured at the corresponding time points . Morris water maze test was used to study the cognitive function .The cerebral infarction volume was evaluated by TTC stai-ning .The changes of brain water content was analyzed by a dry /wet weight method .The morphological changes of the brain tissues were observed under microscope with HE staining .The protein expression of SIRT 1, MMP-9 and AQP4 was deter-mined by Western blot .RESULTS: Compared with sham group , the neural function score of the rats in MCAO model group was significantly elevated .With the increasing reperfusion time , the cerebral infarction volume , brain tissue permea-bility and the brain water content were also increased .The increases in the protein levels of AQP 4 and the related proteins showed apparent changes .The protein expression of SIRT 1 was decreased , while the MMP-9 expression was increased .The most obvious differences of the protein level changes in MCAO-48 h model group were observed (P<0.01).CONCLU-SION:Accompanied with the aggravating cerebral injury after cerebral ischemia , the process of AQP4 expression is activa-ted with the increasing expression levels of MMP-9 and SIRT1.These factors are combined to induce the formation of brain edema.

10.3969/j.issn.2095-4344.2013.25.018

Objective To study the incidence,risk factors and clinical features of patients with acute hepatic dysfunction induced by sepsis. Methods One hundred and sixty patients with sepsis were assigned to two groups according to liver function: sepsis group and acute hepatic dysfunction group. Logistic regression analysis was used to study the risk factors.The comparison of plasma endothelin-1 ( ET-1 ) and sepsis-related organ failure assessment (SOFA) score between two groups was carried out.Results Of 160sepsis patients,25 (15.6％) patients were subjected to acute hepatic dysfunction induced by sepsis.Logistic regression analysis showed that long-term indulgence in wine drunk (OR =4.102,95％ CI 1.288 -13.063 ),history of cardiac insufficiency ( OR =4.109,95％ CI 1.352 - 12.493) and hypotension ( OR =5.833,95％ CI:1.712 - 19.868 ) were the significant risk factors.Though oxygenation index ( PaO2/FiO2),platelet (PLA) and Glasgow coma scale (GCS) were not different between two groups,the total bilirubin (Tbil),direct bilirubin (Dbil),creatitine (Cre),range of blood glucose variation (Rglu),lactic acid (Lac),plasma ET-1and SOFA score in acute hepatic dysfunction group were higher than those in sepsis group. Mortality rate in acute hepatic dysfunction group was higher than that in sepsis group.Conclusions Long-term drunk,history of cardiac insufficiency and hypotension are the risk factors in acute hepatic dysfunction induced by sepsis.Elevated arterial Lac and plasma ET-1 levels,and higher SOFA score in acute hepatic dysfunction group suggest poor prognosis.

Aim To investigate the protective effects of breviscapine(Bre) on myocardial hypertrophy and fibrosis induced by isoproterenol (Iso) in rats and its mechanism. Methods Myocardial hypertrophy and fibrosis model of rats were induced by injection of Iso for 7 days(5 mg?kg -1?d -1,sc).From day 2～15,rats were treated with Bre 12.5 and 25 mg?kg -1?d -1 ip,the NS control and Iso model group received saline injection.On day 15,animals were killed by decapitation,monitored in terms of myocardial indexes (heart weight/boday weight, HW/BW and left ventricalar weight/body weight,LVW/BW);the contents of angio- tensin Ⅱ(AngⅡ),nitric oxide(NO) and hydroxyproline and the activity of Na+,K+-ATPase and Ca 2+-ATPase in left ventricle were assayed with radioimmunoassay and spectrophotometry,respectively. Results Compared with the NS control group, the myocardial indexes, the level of AngⅡ and hydroxyproline in left ventricle were markedly increased and NO content, activity of Na+,K+-ATPase and Ca 2+-ATPase in left ventricle were decreased in Iso model group;treatment with Bre 25 mg?kg -1?d -1 significantly reduced the myocardial index and content of AngⅡ and hydroxyproline in left ventricle,increased the NO content ,enhanced the activity of Na+,K+-ATPase and Ca 2+-ATPase.Conclusion Bre can alleviate myocardial hypertrophy and fibrosis induced by Iso in rats.

In this article we collected 2 embryos and 69 fetuses between 7 and 30 weeks of gestational age and 3 neonates to study the development of the human stomach by histological, histochemical and immunogold-siver methods. In 7-week embryo, the superficial layer of gastric mucosa was stratified columnar epithelium, containing a large amount of glycogen. In 9-week fetus, simple columnar epithelium, gastric pits and glandular buds were observed. At this stage a few parietal cells could be identified at the bottom of the glands. The pyloric glands contained parietal cells as fundic glands. At 13-14 week the muscularis mucosa appeared and the wall of stomach formed definitively as the adult. A few argyrophil cells in antrum and fundus were found at 12-week fetus. They scattered in the surface epithelium and concentrated in the lower portion of the glands. The argyrophil cells were round, pyramidal or spindle in shape. More argyrophil ceils were found in the antrum from 14-week on. At 18-week, the argyrophil cells were most numerous. Some cells possessed processes extending to the basement membrane or parietal cells. Between 15-30 weeks various shaped EC cells in fundus were found, with some open-type endocrine cells. G cells in antrum were mostly rounded and often in groups at 13,16 and 21 week. Developing G cells were observed under EM.