Objective To investigate the possible pathogenesis of the cognitive function in unilateral frontal bottom laceration by follow-up study in patients after one month of the onset. Methods MMSE, Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), Montreal Cognitive Assessment (MoCA), Wisconsin Card Sorting Test (WCST) scales were used to evaluate neurocognitie function in 42 patients after one month of onset of unilateral frontal bottom laceration and 45 normal controls. The wave amplitude and the latency of the endogenous composition N2, P3 of P300 were measured at the cognitive potential instrument. Level of AChE was determined by ELISA and active AChE was analyzed by the ration analyses. Stepwise multivariate regression analyzed the correlation of the overall cognitive function and the lever and active of AChE. Results The cognitive test scores in patients were significantly worse than those in normal controls. The ability of recite sentences, fluency of words, reading, understanding language,cognitive transfering decreases in the left frontal bottom laceration patients (Group A, 23 cases), while the ability of attention, action, organization, graphics depicting, abstract epitoming, logical thinking were all seriously impaired in the patients with right frontal bottom laceration (Group B, 19 cases). The latency of the endogenous composition N2, P3 in patients ( Group A: (322. 4 ± 17.0), (410. 1 ± 19.9) ms; Group B:( 308.4 ± 15.6), (385.5 ± 17.4) ms) is more lengthen ( F = 4. 084, P = 0. 018; F = 3.467, P = 0. 038 )than the normal controls ( (268.6 ± 14. 7 ), ( 369. 2 ± 15. 4 ) ms) and the wave amplitude is lower ( F =2. 986 ,P =0. 047 ;F =3. 313 ,P =0. 041 ). The latency of N2 ,P3 in Group A of is more lengthen than Group B, while the wave amplitude is higher. The difference of the active of AChE in patients and control groups had no statistical significance, however, the level of AChE in two groups had statistical significance. The comparison of the active and the total AChE in patients has also not statistical significance. The correlation of the overall cognitive function has the linear regression with the parts of the brain and the level of AChE ( rY1.2 = 0. 584, P = 0. 039; rY2.1 = 0. 726, P = 0. 017 ). The standardized regression coefficients showed the level of AChE has the biggest influence to the overall cognitive function ( |Beta| =0. 3601, rY2.1 =0. 726).Conclusions AChE may be one of the important factors in the cognitive function after frontal bottom laceration. The specific damages of cognitive function in unilateral frontal bottom laceration patients closely relate with the lesion locations in the injured frontal bottom laceration.

Objective To investigate the regulation of immune function in patients with acquired immune deficiency syndrome (AIDS) by the secretion of T cell 1 (Th1) gamma interferon gamma (IFN-γ) in patients with acquired immune deficiency syndrome. Methods From January 2011 to January 2014, 20 cases of laboratory-confirmed AIDS patients were collected for research. Patients with AIDS received highly active anti-retroviral therapy (HAART group), while 20 healthy volunteers were selected as control group. Before receiving highly active anti-retroviral treatment in six months and 12 months , the patients with AIDS were collected in blood study of peripheral blood mononuclear cells (PBMC) in separated culture group and IFN-γ co-culture group for testing culture differential expression of cytokines and immune cells in solution. Results Before treatment in 6 months and 12 months , the supernatants in the cultured alone group and IFN-γ co-culture group by IL-12, IL-21 levels were significantly lower than that in the healthy group (P < 0.05); After treatment in 6 months and 12 months , the supernatants in the IFN-γ co-culture group by IL-12 and IL-21 levels were significantly higher than that in the cultured alone group (PP < 0.05). Before treatment in 6 months and 12 months,the level of IP-10 and CD4 + CD25 + Foxp3Treg cells in the cultured alone group and IFN-γ co-culture group, were significantly higher than the healthy group (P < 0.05); After treatment in 6 months and 12 months, the supernatant in the IFN-γ co-culture group was significantly higher than the average in the cultured alone group in IP-10; CD4 + CD25 + Foxp3Treg cells in the IFN-γ co-culture group were significantly lower than that in the cultured alone group (P < 0.05). Conclusion Patients with AIDS received highly active anti-retroviral therapy can improve the immunity. IFN-γ may further stimulate the secretion of immune cytokine in patients with AIDS.

Objective To explore the relationship between cervical lesions in patients with high -risk human papilloma virus(HPV)infection and serum interleukin -1 beta(IL -1 ),interleukin 2(IL -2),interleukin 10(IL -10).Methods 180 cases of cervical lesions were treated in our hospital from August 2013 to August 2015. Among them,105 cases were infected with HPV,and 75 cases were not infected by HPV.The serum levels of IL -2, IL -10 and IL -1βwere observed in two groups,and compared the levels of serum IL -2,IL -10 and IL -1βin patients with different DNA hr -HPV load,the correlation between DNA hr -HPV load and IL -1β,IL -2 and IL -10 levels was analyzed.Results The levels of IL -1β,IL -10,IL -2 were (0.85 ±0.23)ng/L,(182.35 ± 10.02)ng/L,(38.97 ±5.23)ng/L in patients with HPV infection,the levels of IL -1β,IL -10,IL -2 in patients without HPV infection were (0.62 ±0.18)ng/L,(305.42 ±11.13)ng/L,(25.18 ±3.16)ng/L.The levels of IL -1β,IL -10 were significantly higher in HPV group than in without HPV infection group,the level of IL -2 in HPV group was significantly lower than that of uninfected HPV group,and the differences were statistically significant (t =7.222,20.328,-7.558,all P <0.01).There were significant differences in the load of DNA hr -HPV between different pathological changes of cervical lesions,and the DNA hr -HPV load increased significantly with the increase of the degree of disease(t =6.214,19.097,33.906,6.952,6.274,all P <0.05).IL -1βand IL -10 levels from high to low were DNA hr -HPV load volume >1 000,100 -1 000 and <100,IL -2 levels from high to low were DNA hr -HPV load <100,100 -1 000 and >1 000.DNA hr -HPV load was positively correlated with serum IL -1βand IL -10 levels in patients with cervical lesions and HPV infection(r =0.452,0.422,P =0.035,0.019),and nega-tively correlated with IL -2 level(r =-0.398,P =0.027).Conclusion hr -HPV infection is closely correlated with serum IL -1β,IL -2,IL -10 levels in cervical lesions patients,IL -1,IL -2 and IL -10 can be used as impor-tant index for clinical monitoring.

Objective To explore the change of copeptin in plasma and its significance in patients with intracerebral hemorrhage combined with stress ulcer.Methods Eighty patients with intracerebral hemorrhage were collected.Forty-nine patients of pure intracerebral hemorrhage and 31 patients of intracerebral hemorrhage combined with stress ulcer were included.Thirty healthy people were taken as controls.The level of copeptin in plasma was measured and compared in all subjects.Results The level of copeptin in plasma in patients with pure intracerebral hemorrhage and intracerebral hemorrhage combined with stress ulcer was significantly higher than that in controls:(303.684 ± 68.691),(527.034 ± 74.111) ng/L vs.(121.460 ± 53.364) ng/L,and the level of copeptin in plasma in patients with intracerebral hemorrhage combined with stress ulcer was significantly higher than that in patients with pure intracerebral hemorrhage.The differences were statistically significant (P ＜ 0.05).Conclusion The level of copeptin in plasma in patients with pure intracerebral hemorrhage increases significantly,and it is much higher in patients with intracerebral hemorrhage combined with stress ulcer.

Objective To investigate the safety of autologous blood component transfusion during cesarean section in patients with Rh (D)-negative blood group.Methods Thirty ASA Ⅰ or Ⅱ patients of Rh (D)-negative blood group, aged 20-35 yr, weighing 50-80 kg, undergoing elective cesarean section, were enrolled in this study.After lactated Ringer' s solution 7 ml/kg was infused, blood was obtained from radial artery at a rate of 60-80ml/min, and blood volume was maintained by simultaneous infusion of 6% hydroxyethyl starch 130/0.4 at the same rate. The collected blood was subjected to two cycles of autologous blood component separation. Blood collecting during each cycle was stopped 15 s after red blood cells were separated. The autologous blood was infused when the blood loss≥20% of blood volume. The autologous blood was infused after suture of the uterus when the blood loss < 20% of blood volume. The parameters of maternal vital signs and fetal heart rate were monitored. Hypotension and tachycardia were recorded during autologous blood collecting. SpO2 was monitored routinely. Venous blood samples were taken before blood collecting (baseline), at the end of blood collecting, before autologous blood transfusion, 24 h after operation for determination of Hb, Hct, Plt, PT, APTT, INR and Fib. Umbilical arterial blood samples were obtained after delivery for blood gas analysis. Apgar score was recorded at 1 and 5 min after birth. Blood loss and allogeneic blood transfusion were also recorded. Results No hypotension and tachycardia occurred during the process of blood collecting and the fetal heart rate was within the normal range. Compared with the baseline value, there were no significant differences in SpO2 , Hb, Hct, Plt, PT, APTT, INR and FIB value at the other time points. The pH value and concentrations of base excess and lactate were within the normal range.The Apgar score was (9.0 ±0.8) and (9.2 ± 0.8) at 1 and 5 min after birth respectively. The blood loss during operation was (405 ± 28) ml and no patients received homologous blood transfusion. Conclusion The safety of autologous blood component transfusion is good during cesarean section in Rh (D)-negative blood group patients.

AIM: To investigate the effects of PAR-2 agonist peptide on the proliferation and cytosolic calcium concentration ([Ca~(2+)]_c) in human hepatoma cells HepG2. METHODS: Human hepatoma cell line HepG2 was cultured. The cells were treated with PAR-2 agonist peptide SLIGKV-NH_2 and the reverse PAR-2 agonist peptide VKGILS-NH_2, respectively. The [Ca~(2+)]_c of hepatoma cells were measured by microfluorimetric techniques based on calcium indicator fura-2/AM. The influences on proliferation of hepatoma cells were determined by MTT method. The changes of cell cycle were evaluated by flow cytometry, and the changes of cyclin D1 mRNA expression were detected by RT-PCR. RESULTS: After treated with 50 μmol/L SLIGKV-NH_2, a rapid rise of [Ca~(2+)]_c in HepG2 cells was induced (P<0.01), percent S phase, G_2/M phase and proliferation index (PI) of HepG2 cells were elevated (P<0.01), and cyclin D1 mRNA expression was significantly upregulated (P<0.01). The proliferation rates of HepG2 cells treated with 1-50 μmol/L SLIGKV-NH_2 were significantly increased, and the effect was in a dose-dependent manner (P<0.01 or P<0.05). No statistical significance of the difference between VKGILS-NH_2 and control group was observed (P>0.05). CONCLUSION: PAR-2 agonist peptide induces the rise of [Ca~(2+)]_c in HepG2 cells, upregulates the expression of cyclin D1 mRNA, accelerates the progress of cell cycle, promotes the synthesis of DNA and the proliferation of hepatoma cells via activating PAR-2 in vitro.

Objective To investigate the clinical features of neonatal invasive fungal infection(IFI) so as to guide diagnosis,prevention and treatment of IFI.Methods Seventy-six neonates with IFI admitted to the Neonatal Intensive Care Unit (NICU) at Children's Hospital of Fudan University from 2004 to 2014 were included in the study.Pathogens,clinical manifestation,risk factor exposure,laboratory findings,complications,and clinical outcome of neonatal IFI were analyzed.Results Seventy-six cases were diagnosed as IFI between 2004 and 2014,with an yearly increasing trend.Sixty-eight patients were premature infants (89.5％).Of the 76 cases,except one with unknown birth weight,11(14.7％),34(45.3％),20(26.7％)and 10 (13.3％) cases had birth weight ＜ 1 000 g,(≥ 1 000-＜1 500) g,(≥ 1 500-＜2 500) g and ≥ 2 500 g,respectively.The pathogens were mainly Candida (74/76,97.4％),including 26 cases of Candida albicans (34.2％).However,the incidence of non-Candida albicans infection was increasing.Candida guilliermondii was the most common in nonCandida albicans,accounting for 29.2％ (14/48).All Candida albicans were sensitive to fluconazole.One strain of Candida glabrata was resistant to fluconazole.The most common risk factors included use of broad-spectrum antibiotics(93.3％,56/60),parenteral nutrition(70.0％,42/60),central vein catheterization(53.3％,32/60),invasive ventilation(40.0％,24/60) and history of abdominal surgery(21.7％,13/60).Clinical manifestations of IFI included temperature instability,frequent apnea,increased requirement of respiratory support and feeding intolerance.Among all cases,six were diagnosed as central nervous system infection.Of the patients who received cranial MRI,46.8％(22/47) showed multiple abnormal signals in cerebral parenchyma.Fiftytwo patients were cured and seven patients died before discharge,including one death due to fungal infection.Conclusions There is an increasing trend of IFI cases in NICU,especially in premature infants.Non-Candida albicans has become the main pathogenic fungus.There are no specific clinical manifestations in neonatal IFI.Use of broad-spectrum antibiotics,parenteral nutrition and central venous catheterization are common risk factors,and preventive measures should be taken in high-risk infants.In addition,IFI in neonates may affect important organs such as central nervous system,thus early treatment is necessary in suspected patients.

Objective A kind of quantitative C reactive protein (CRP) test kit was developed with colloidal gold lateral flow method. Method The kit was prepared with double antibody sandwich technology, and by material optimization and strict process control to improve performance. Quantitative assay was realized by a specialized lateral flow reader. The kit performance was evaluated with series of tests and clinical trial. Results The kit was developed with functional sensitivity≤1 mg/L, linear range 1-200 mg/L, CV<15%and with stability of 12 months. 220 samples clinical trial showed 98.6%of coincidence rate. Pearson Correlation coefficient r is 0.987, which showed no significant difference in performance compare with control kit. Conclusion A quantitative CRP test kit was developed with easy to operating and good stability, Which can be used for point of care testing or laboratory testing.

Objective According to the analysis on nonconformities which were found from on-site assessmentin medical laboratory ISO15189accreditationcarried on byChina National Accreditation Service for Conformity Assessment(CNAS) during years 2004to 2013,to study current status of quality management in domestic medical laboratory.Methods By means of retrospective analysis, nonconformities found in 171 times of on-site audit of 133 clinical laboratories in ISO15189 accreditation during 2004 to 2013 were collected and then classified according to requirements of ISO 15189.Results Among 1 501 nonconformities involved in 171 times of on-site audit, management and technical requirements accounted for 28.5%(428) and 71.5% ( 1073 ) respectively.The mainly clauses of nonconformity were 4.3 ( 26.2%) and 4.6 (12.6%) in management requirements and 5.3 ( 25.2%), 5.4 ( 13.1%), 5.5 ( 16.0%) and 5.6 (20.2%)in technical requirements.The mainly subclauses of technical requirements were 5.3.2, 5.3.7, 5.4.3, 5.4.9, 5.5.2, 5.5.3, 5.6.1, 5.8.3 and 5.8.10.Conclusion The weakness for the medical laboratory quality management is mainly process control(5.4, 5.5 ,5.6), laboratory equipments (5.3), document control (4.3) and external services and supplies (4.6), which werethe main directions need to be improved in current medical laboratory quality management.