Objective To investigate clinical significance and the variation of serum interleukin -6(IL-6) ,high-sensitivity C-reac-tive protein(hs-CRP) and T-cell CD40 ligand(CD40 L) in patients with rheumatoid arthritis (RA)(included activity group and stable group) .Methods 90 cases of RA patients in the observation group ,90 cases of healthy volunteers were selected as control group . Enhanced immunoturbidimetric assay was used in measurement of serum hs-CRP .Levels of CD40 L ,IL-6 were detected by enzyme-linked immunosorbent assay .Results BPC ,RF ,ESR ,hs-CRP ,IL-6 and CD40 L in peripheral serum of observation group were sig-nificantly higher than control group ,the differences were statistically significant (P<0 .05) .BPC ,ESR ,hs-CRP ,IL-6 and CD40 L in peripheral blood of patients in RA activity group were significantly higher than patients with RA in stable group ,the differences were statistically significant(P<0 .05) .RF ,ESR ,hs-CRP ,IL-6 and CD40L in peripheral serum of RA patients whose platelet ele-vated were significantly higher than RA patients whose platelet stay normal level ,the differences were statistically significant (t=6 . 070 ,3 .858 ,3 .272 ,3 .217 ,2 .253 ,P<0 .05) .Conclusion Serum hs-CRP ,IL-6 and CD40 L relate to RA inflammation closely .Com-bined detection can observe the condition changes and treatment effect in patients with RA .

Objective To seek out the factors that influenced the mortality of population due to heat wave in Shanghai in summer(15 June-15 September). Methods Daily data of mortality of all causes, meteorological and air pollution in Shanghai in 1998 and 2003 were collected. Multivariate analysis was employed to investigate the relationship between mortality and heat wave intensity, duration, and timing within the summer season and air pollution concentrations. Results The heat wave in 1998 was more severe and caused a higher mortality than that in 2003. In 1998 heat wave, the heat wave duration,timing within the summer season were significantly associated with the daily number of deaths,while in 2003, besides the above two factors the daily maximum temperature also played an important role. Air pollution level slightly increased in heat wave and some factors such as air conditioner number, living space and urban greenbelt area could be used to explain the distinctive difference of heat related mortality between 1998 and 2003. Conclusion High temperature is the crucial factor for the high mortality of population due to heat wave in Shanghai in summer(15 June-15 September) in 1998 and 2003. Using air condition and enlarging living space will help to decrease the mortality.

Objective To compare myocardial protection between cold blood and crystalloid cardioplegia in short aortic cross-clamping(

Objective To find out the occurrence patterns of medical disputes over prosthodontic treatments through surveys and analyses so as to provide basis for the scientific prevention of such occurrences.Methods A statistical analysis was made of the causes of 92 medical disputes over prosthodontic treatments that occurred in the past three years,the data were processed using self-made tables,and the occurrence rates of the disputes were calculated according to their causes.Results The disputes over prosthodontic treatments in the past three years accounted for 22% of the total number of medical disputes over prosthodontic treatments.The cause leading to the most disputes involved medical quality,followed successively by service management,service manners,personal factors on the part of the patients,and charges.Conclusion There are certain patterns for the occurrence of medical disputes over prosthodontic treatments,which can be avoided to some extent if appropriate preventive measures are taken.

As a new interdisciplinary course, the current paper writing course for medical postgraduates exhibits certaln disadvantages. For example, the course does not well target the learners' needs because of the absence of the needs analysis before class;English or biomedical teachers fall to combine English with medicine, thus unable to provide ideal courses. As textbooks are an important means to improve the quality of the course, one way to reform the course is to compile high-quality textbooks by interdisciplinary talents. Meanwhile, the compiling process should be guided by needs analysis as well as the teaching and editing experiences. In addition, the textbooks need to be con-tinuously improved in teaching practice.

BACKGROUND: Hyperhomocysteinemia is a new independent risk factor for coronary heart disease (CHD), but its association with cerebrovascular diseases is still controversial. The level of fasting plasma total homocysteine (plasma tHcy) alone is not enough to reveal the effect of hyperhomocysteinemia on cerebral infarction (CI).OBJECTIVE: To explore the association of hyperhomocysteinemia with folacin and vitamin B12 and with CI in young and middle-aged people, as well as the role of methionine loading test in the diagnosis of latent hyperhomocysteinemia.DESIGN: A case-control study, Spearman correlation analysis.PARTICIPANTS: A total of 85 patients were hospitalized within 2 days after the onset of CI at the Department of Neurology, the General Navy Hospital of Chinese PLA, from 2000 to 2003. There were 63 males and 22females aged 29-55 years old with the mean age of (48.74±5.05) years.There were 48 cases of lacunar CI and 37 cases of arterial thrombotic CI.Meanwhile, 44 normal controls, 30 males and 14 females aged 29-55 years old with the mean age of (47.75±6.71), were recruited from the department staff and those who came to the hospital for routine health examination.METHODS: Fasting vein blood of 6 mL was collected from the patients on the 1st day of hospitalization, and 2 mL of the blood was used for detecting the level of fasting plasma tHcy using high efficiency liquid chromatography. Methionine of 0.1 g/kg was taken orally by patients immediately after blood sampling; 4 hours later, the level of loading plasma tHcy was also determined. The remaining 4 mL was used for detecting the level of serum folacin and vitamine B12 with bioradiation assay.MAIN OUTCOME MEASURES: ① The level of fasting and loading plasma tHcy in CI group and control group. ② Incidence of hyperhomocysteinemia in CI group and control group [Hyperhomocysteinemia was confirmed if hyperhomocysteine was higher than 95% of the upper limit of fasting plasma tHcy or 4-hour loading plasma tHey of normal control group, that is, fasting plasma tHcy ＞17.26 μnol/L in males and ＞14.17 μnol/L in females; and loading plasma tHcy should be ＞ 44.57 μmol/L in males and ＞ 40.02 μmol/L in females. ③ The level of serum folacin and vitamine B12 in CI group and control group. ④ Single factor analysis of fasting plasma tHcy and related risk factors.RESULTS: Totally 85 CI patients and 44 normal controls were recruited in this study and all data were statistically analyzed. ① The level of fasting and loading plasma tHcy in CI group and control group: Both fasting and loading plasma tHcy was significantly higher in CI group than in control group [(22.49±9.80), (13.08±2.33) μmol/L; (48.07±11.20), (37.23±3.48)μmol/L, (t=8.409, 8.187, P ＜ 0.01)]. ② Incidence of hyperhomocysteinemia: The incidence was obviously higher in CI group than in control group [68% (58/85), (9%, 4/44), X2=40.628, P ＜ 0.01]. Totally 35 patients (41%, 35/85) had higher fasting plasma tHcy than that of normal controls, and 23 (27%, 23/85) had higher loading plasma tHcy than that of normal controls. ③ The level of serum folacin and vitamine B12 in CI group and control group: They were [(5.73±2.52), (7.14±2.20) μg/L] in CI group,significantly lower than control group [(473.47±190.19), (576.70±212.05) rng/L,(t =3.151, 2.809, P ＜ 0.01)]. ④ Single factor analysis of plasma tHcy with related risk factors: Fasting and loading plasma tHcy was found obviously associated with sex, and folacin and vitamine B12 level (r = -0.306 to 0.488, P ＜ 0.01), but not with other risk factors and neurological deficit scores (r = 0.021-0.173, P ＞ 0.05). Moreover, only plasma tHcy level was proved to have significant positive correlation with fasting blood glucose (r=0.186, P ＜ 0.05).CONCLUSION: Hyperhomooysteinemia is an independent risk factor for CI in young and middle-aged people. Methionine loading test is an essential means for detecting latent hyperhomocysteinemia. Insufficiency of folacin and vitamine B12, two important nutrition factors, may lead to hyperhomocysteinemia and indirectly result in CI.

Objective To study the value of methionine loading test (MLT) in the mild vascular cognitive impairment (VCI) after acute cerebral infarction.Methods The fasting plasma homocystine (Hcy) level and homocystine level after MLT were measured by high-performance liquid chromatography methods.We chose 240 patients with normal level of fasting plasma Hcy (normal group),159 patients with normal level of Hcy after MLT,81 patients with hyperhomocysteinemia after MLT (hyperhomocysteinemia group),and 112 patients with fasting hyperhomocysteinemia (fasting hyperhomocysteinemia group) in this study.The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were conducted in normal,hyperhomocysteinemia and fasting hyperhomocysteinemia groups on admission,at 7d,14 d,30 d after treatment.Results Logistic regression analysis showed that the increased level of Hcy might be an independent risk factor for VCI [OR:1.285,95％CI:1.038-1.265,P＜0.05].The scores of MMSE and MoCA were lower in patients with fasting hyperhomocysteinemia and patients with hyperhomocysteinemia after MLT than in patients with normal fasting plasma Hcy at 7 d,14 d and 30 d after treatment (P＜0.01 or 0.05),while the scores had no significant differences among the three group on admission (P＞0.05).There were no significant differences in MMSE and MoCA scores between patients with fasting hyperhomocysteinemia and patients with hyperhomocysteinemia after MLT on admission,7 d,14 d and 30 d after treatment (P＞0.05).Conclusions Hcy may be an independent risk factor for VCI.The MLT can discover the dormant vascular risk factors for VCI,which offers a valuable detection method for early intervention and prevention in the clinical medicine.

Objective To isolate specific humanized anti-D-dimer scFv(single chain Fv) antibody from scFv phage libraries. Methods Isolate anti-D-dimer positive clones from Tomlinson I + J phage libraries by three rounds of panuing, then sequence monoclonal genes by bideoxy-mediated chain termination and express soluble scFv antibody; Pick out anti-D-dimer antibodies with high specificity and affinity by ELISA.Results After three rounds of selection from human scFv phage libraries Tomlinson I and J, 38 monclonal specific anti-D-dimer scFv fragments were selected. By polyclonal and monoclonal phage ELISA and gene sequencing, 20 different full-length monoclonal scFv phages were identified, the result of soluble scFv ELISA showed that 20 full-length monoclonal scFv were expressed smoothly. According to the result of soluble scFv ELISA, in 5 scFv antibodies with high value of A450 selected, 3 scFv antibody fragments showed high specific and affinity. Conclusion Antibody phage display was an effective, rapid method to isolate anti-D-dimer antibodies with high specificity and affinity.

Objective To provide the data of mandible and zygomatic arch, including the space distance of mandible angles, depth and length of zygomatic arch, by direct measurement and related analysis at home position of corpse in Chinese Han for medical aesthetics. Methods The vernier callipers were used to directly measure the every indexes of mandible and zygomatic arch in the formalin-fixed male and female adult corpses (50 each) and to proceed the related analysis. Results The results showed that male mandible thickness was (12.60?1.26) mm, mandible height (33.60?3.35) mm, mandible length (77.60?7.80) mm , width of mandible ramus (34.80?3.50) mm, height of mandible ramus (67.20?6.70) mm, depth of zygomatic arch (9.54?1.19) mm, length of zygomatic arch (40.60?4.97)mm, and thickness of mandible angle (12.20?0.67) mm in male; Mandible thickness was (10.70?0.98) mm, mandible height (29.40?2.64) mm, ramus of mandible height (74.00?7.07) mm, width of mandible (31.10?3.04) mm, height of mandible ramus (64.00?5.53) mm, depth of zygomatic arch (8.67?1.09) mm, l ength of zygomatic arch (36.50?4.59) mm, and thickness of mandible angle (13.80?1.28) mm in female. Conclusions The breadth between bilateral angle of mandible could come to reckoning the depth of zygomatic arch, the length of zygomatic arch and other indexes of mandibles. Those data are useful in aesthetics and preparation of the compound.

Objective To explore the possible effect of the plasma homocysteine level on the risk of recurrent cerebral infarction patients by follow-up research in hope for finding a new theoretical evidence for the therapy and the prophylaxis of cerebral infarction.Methods We determined the free plasma total homocysteine(tHcy)of 151 patients with acute cerebral infarction and 52 age-and gender-matched healthy controls by high-performance liquid chromatography,then we divided the patients into hyperhomocysteinemia (Hhcy)group and no hyperhomocysteinemia(Nhhcy)group according to the outcome.Within a 5-years follow-up period,we observed the recurrence of cerebral infarction in the 2 groups.Results There was no statistical deference in common information between Hhcy and Nhhcy group.But the recurrence rate of the Hhcy group,being 44.26%,was significantly higher than 12.22%of Nhhcy group(P