Acomplexcascadeofmoleculareventsisconsiderdtobeinitiatedfollowingcerebralis chemia ,whichincludereleaseofexcitatoryaminoacid ,calciumdyshomeostasis ,freeradicalinjury ,increased cytokines,caspaseactivationandalteredgeneexpression .Thisreviewprovidesanoverviewofmolecular mechanismsinvolvedinpostischemicneuronaldeathandanalysesthepotentialfortherapeuticintervention .

Therapeutic method is an important component of traditional Chinese medicine theory. Research on warming therapy focuses on pharmacology at present. Studying the feature of nerve-body fluid-metabolism-function in cold syndrome is of importance for illustrating the nature of warming therapy and elucidating the function of medication. This review presents the research and development of warming therapy in order to provide enlightenment for the research of therapeutic method from the aspects of traditional Chinese medicine and western medicine.

Objective To investigate the association between microalbuminuria (MA) and high-sensitive C-reactive protein in essential hypertensive subjects. Methods Urinary albumin excretion rate (UAER)and the concentrations of high-sensitive C-reactive protein(hs-CRP) were measured. One hundred and eight patients with hypertension were divided into 2 groups: normoalbuminuria and microalbuminuria group. concentrations of hs-CRP was compared between the two groups , and the association between MA and hs-CRP was evaluated.Results Patients with microalbuminuria were significantly characterized by higher systolic blood pressure (SBP) ,pulse pressure(PP) ,circulating fibrinogen and hs-CRP. Evaluation of bivariate correlation indicated that UAER was positively correlated with SBP , PP , body mass index (BMI) ,Serum creatinine (SCr), fibrinogen and hs-CRP. Multivariate regression analysis demonstrated PP, SCr and hs-CRP were independent risks associated with UAER.Conclusions Microalbuminuria is a sensitive marker in essential hypertensive subjects with early renal injury .hs-CRP is an independent risk associated with UAER ,which suggests that inflammation correlate with early renal injury in essential hypertension.

Pediatrics internship is a bridge that brings medical theory into clinical reality.Cultivate systematic clinical thinking during internship is the key to the growth of clinical doctors.Good outcome has been achieved among these eight-year medical students by using teaching methods such as case discussions,lectures,teacher instructions,which can cultivate proper clinical thinking and make students more active.

Objective Some features, as numbers, morphology and distribution, of the Langerhans cells (LC) with various surface marker infiltrating in the lesion of basal cell carcinoma (BCC) were explored in order to apply some experimental data for assessment of the roles of LCs in the cutaneous tumor immunity.Methods Expression of CD1a, S-100 and HLA-DR on the surface of infiltrating LC of 30 cases of BCC and 15 cases of normal skin tissues were investigated by immunohistochemistry. The expression qualities were studied with computer image analysis system. Results It was observed that CD1a+ LC distributed mainly in tumor nest compared with the control group, CD1a+ LC in BCC revealed morphological changes: the dendrites shortened or disappeared. The density of CD1a+ LC, detected by cell number counting as well as staining strength scanning, showed a statistic difference between the control group and BCC (P ＜0.05). S-100(+)LC spread evenly throughout BCC lesions. The number of cell dendrites as well as its length increased markedly.The cell number as well as the staining strength in BCC lesions increased markedly compared with the control group (P ＜0.05). HLA-DR(+)LC infiltrated mainly around the located tumor. This kind of LC in the lesion did not show significant differences compared with the controls (P ＞0.05). Conclusion LC showed differences between BCC lesion and normal skin tissues. The alterations in numbers, morphology and distribution of LC with various markers in the lesion of BCC supplied special local cellular immunity status, resulting in disable metastasis and good prognosis.

A variety of cytomorphological features, architectural patterns and stromal changes may be observed in malignant melanomas. Hence, melanomas may mimiccarcinomas, sarcomas, benign stromal tumours, lymphomas, plasmacytomas and germ cell tumours. Melanomas may be composed of large pleomorphic cells, small cells, spindle cells and may contain clear, signet-ring, pseudolipoblastic, rhabdoid, plasmacytoid or balloon cells. Various inclusions and phagocytosed material may be present in their cytoplasm. Nuclei may show bi- or multi-nucleation, lobation, inclusions, grooving and angulation. Architectural variations include fasciculation, whorling, nestion, trabeculation, pseudoglandular, pseudopapillary, pseudofollicular, pseudorosetting and angiocentric patterns. Mucoid or desmoplastic changes and very rarely pseudoangiosarcomatous change, granulomatous inflammation or osteoclastic giant cell response may be seen in the stroma. The stromal blood vessels may exhibit a haemangiopericytomatous pattern, proliferation of glomeruloid blood vessels and perivascular hyalinization. Occasionally, differentiation to nonmelanocytic structures (Schwannian, fibro/myofibroblastic, osteocartilaginous, smooth muscle, rhabdomyoblastic, ganglionic and ganglioneuroblastic) may be observed. Typically melanomas are S-100 protein, NKIC3, HMB45, Melan A and tyrosinase positive but some melanomas may exhibit an aberrant immunophenotype and may express cytokeratins, desmin, smooth muscle actin, CD68, CEA, EMA and VS38. Very rarely, neurofilament protein and GFAP positivity may be seen.

Objective To explore the factors affecting results of alanine aminotransferase(ALT)preliminary screening by using dry chemical method in blood donors,so as to establish standards of ALT preliminary screening and reduce waste of blood. Methods A total of 21 065 blood specimen of blood donors in Blood Center of Maoming City were collected from January to June 2013.The influences of specimen hemolysis,lipidemia,different sample amount and waiting time after adding sample on the detec-tion results of ALT by using dry chemical method were comparatively analysed,and standardized procedures and established appro-priate limits of ALT preliminary screening according to the results.Results The specimen hemolysis affected test results of ALT, which was not obvious when the hemolysis rate was less than or equal to 0.5%.There was no obvious interference of lipidemia on ALT test.When the sample amount was (32±3)μL or the waiting time after adding sample was 10 to 40 seconds,the detection re-sults of ALT were acceptable.The standard limit of ALT was less than or equal to 40 U/L of female and less than or equal to 45 U/L of male.Conclusion Hemolysis,sample amount and waiting time after adding sample can influence the results of ALT detec-ted by using dry chemical method,while lipidemia had no interference on ALT test.Standardizing operation and reasonably setting normal limits standard may ensure the accuracy and stability of determination,save blood resources,further ensure blood safety, which should be worthy of wide application.

Objective To know the situation of the hepatitis C virus(HCV)infection in blood donors of Maoming City,and pro-vide the basic data for recruiting volunteer blood donors and preventing of HCV infection.Methods Blood samples were collected in Maoming blood center,and were detected by using HCV antibodies of different manufacturers and operated by different people.Du-plicate test was used to reexamine the specimens which were reactive in the initial test.Statistical analysis was performed.Results HCV prevalence of blood donors from Maoming was 0.74%.The prevalence of female was slightly higher than the male,but the difference was not statistically significant(P >0.05).The HCV prevalence of civil servant and medical personnel was relatively low-er.HCV prevalence of repeat blood donors was obviously lower than blood donors for the first time(P <0.05).Conclusion HCV prevalence of blood donors in Maoming City was in a relative low level.The risk of HCV infection in people who is younger than 35 years old and at the same time qualified to donate blood is quite low.Establish a stable volunteer blood donor group is beneficial to blood safety.It's necessary to strength the propaganda and prevention of HCV knowledge to population besides civil servant and medical personnel,which would be helpful for the control of HCV infection.

Objective To investigate the clinical significance of nuclear factor ( NF)-κB activation in peripheral blood mononuclear cells (PBMCs) and the serum levels of correlated inflammatory cytokines in children with infant muggy syndrome(IMS).Methods Blood samples from 100 patients with IMS and those from 32 healthy infants( control group)were detected by ELISA for amount of NF-κB activation in PBMCs and for serum levels of interleukin ( IL ) -17,IL-6,tumor necrosis factor ( TNF ) -α and IL- 10 respectively from Jan 2008 to Jan 2011.At the same time,blood samples from 46 out of the above 100 patients with IMS and those from the 32 controls for positive rate of activation of NF-κB in PBMCs were detected by flow cytometry as well.The relationship between all the data and multiple organ dysfunction syndrome( MODS ) were analyzed respectively.Results As compared with that of control group,the percentage of activated NF-κB in PBMCs in 100 patients with IMS detected by ELISA [ ( 11.042 ± 6.792 ) ％ vs ( 4.528 ± 1.378 ) ％ ] and the positive rate of NF-κB activation in 46 patients with IMS detected by flow cytometry [ ( 28.780 ± 13.820 ) ％ vs (7.078 ±5.395)％ ] were both significantly higher ( P ＜0.01 ).The serum levels of IL-17,IL-6 and IL-10were also significantly higher in patients with IMS than those in control group( P ＜0.01 ).The serum level of TNF-α was higher in patients with IMS than that in control group but without significance( P ＞ 0.05 ).The percentage of activated NF-κB [ ( 14.591 ± 7.626) ％ vs ( 8.576 ± 4.851 ) ％ ],the positive rate of NF-κB activation [ ( 36.087 ± 12.056) ％ vs ( 23.590 ± 11.263 ) ％ ],and the serum levels of IL- 17,IL-6,TNF-α and IL-10 were all significantly higher in IMS patients with MODS than those in IMS patients without MODS ( P ＜ 0.01 ).Conclusion The inflammatory factors of NF-κB activation in PBMCs and the high serum levels of IL-17 and IL-6 are potent to cause inflammatory damage in IMS patients,and the serum level of IL-10 is not able to compensate the damage.The activation of NF-κB and high serum levels of IL-17,IL-6 and TNF-α are correlated with MODS.

ObjectiveTo summarize the experience of gastric D2 operation and evaluate the feasibility and safety of peripheral vascular choroid of lymph node dissection.Methods A retrospective study was adopted to analyze the redical D2 operation procedure and operation results 24 advanced gastric cancer cases,summarizing the experience of D2 radical gastrectomy operation for gastric cancer.The number of resected lymph nodes,operation bleeding volume,postoperative complications were analyzed to evaluate the feasibility and safety of operation.Results All 24 cases undergoing D2 radical gastrectomy operation of advanced gastric cancer were successful,and got the R0 resection.A total of 634 lymph nodes were excised in all the cases,averaged 26.42.A totle of 206 metastatic lymph nodes were found,metastasis rate being 32.49％.Operation bleeding volume was averaged 264.58 mL.The postoperative complication rate was 25％,anastomotic bleeding in 1 case,input loop jejunum fistula of esophageal jejunum anastomosis in 1 case,hyperamylasemia and 2 cases reflux esophagitis in 2 cases respectively.Conclusions D2 radical gastrectomy operation of gastric cancer is safe and feasible on the basis of mastering perigastric anatomy and master of lymph node excision technology and anatomical hierarchy separation.