High mobility group box l protein (HMGB1) is a highly conserved non-histone DNA binding protein,which is widely distributed in eukaryotic cells.HMGB1 is an important proinflammatory cytokine,involving in various pathological and physiological processes,such as inflammation,neurogenesis and angiogenesis.In the early stage of intracerebral hemorrhage,HMGB1 can induce secondary brain injury,such as inflammatory reaction,neuronal necrosis,and brain edema.However,in the late stage of intracerebral hemorrhage,HMGB1 can promote angiogenesis and neurogenesis,and thus improving neurological function.HMGB1 will become a novel therapeutic target for intracerebral hemorrhage in the future.

HL7 is a widely-applied international standard for medical information exchange. With a HL7 data interface applied to a mainstream fully automatic biochemical instrument, this paper implements the information exchange between biochemical instruments and LIS following HL7 standard. This paper can be referred to when HL7 applied in other instruments.

Objective To construct a prokaryotic expression system of human ferritin L which could be overexpressed in E.coli, and then prepare quality control materials of rFL and evaluate the homogeneity, stability, precision and application value of the rFL.Methods RT-PCR was used to clone ferritin L gene with total RNA from peripheral blood.Ferritin L gene was inserted into plasmid pGM-T to construct subclone plasmid pGM-T/ferritin L, which was identified by sequencing.The recombinant plasmid pET-30a/ferritin L was transformed into E.coli BL21 (DE3) and efficiently expressed under IPTG induction.rFL was identified by SDS-PAGE, and its antigenicity was examined by WB.The concentration of rFL was measured by ACCESS immunoassay system.Fifteen control samples were randomly selected using random number table.The homogeneity and stability of rFL were evaluated by one-way analysis of variance (ANOVA) and a linear regression model, respectively.The uncertainties of homogeneity, stability and the precision were evaluated.Results A prokaryotic expression system of ferritin L was successfully constructed.Sequence analysis showed that the ferritin L gene inserted was identical with the one from GenBank(NM_000146.3).The PCR products were 527 bp long, in complete agreement with length of ferritin L gene.The molecular weight of rFL highly expressed in E.coli induced by IPTG was 19 000 Da.The WB analysis indicated that this rFL protein had good antigenicity.The concentration of rFL(1 000 times dilution) measured by ACCESS immunoassay system was (1115.84±38.38) ng/ml.Homogeneity evaluation of low-concentration QC sample and high-concentration QC sample of rFL showed that there were no statistical significances in the within-groups and between-groups (for high-concentration F=2.336, P>0.05 and for low-concentration F=0.730, P>0.05).A linear regression based on the stability test indicated that there was no statistically significant trend of instability in five and a half months (F=1.755, P>0.05). Precision analysis showed the within-run CV, the between-run CV, the between-day CV and the total CV of high-concentration QC sample were 2.06%, 2.12%, 0% and 2.96% respectively; the within-run CV, the between-run CV, the between-day CV and the total CV of low-concentration QC sample 2.03%, 2.08%, 0% and 2.90%, respectively.Conclusion This rFL for quality control materials with independent intellectual property rights could meet the clinical requirement of homogeneity, stability and precision, and could provide raw materials for preparation of mixed ferritin for quality control.

Objective To summarize clinical results of 29 cases of multi-vessel coronary disease treated by hybrid revascularization.Methods A total of 29 consecutive patients(all male,aged 62.8?9.7 years) with coronary artery disease(two-vessel,n=10;three-vessel,n=19) were treated with minimally invasive direct coronary artery bypass(MIDCAB)(left internal mammary artery to left anterior descending artery,LIMA-to-LAD) and percutaneous coronary intervention(PCI) between January 2000 and April 2005.The left ventricular ejection fraction(LVEF) was 0.576?0.108.Concomitant diseases included hypertension in 23 patients,insulin-dependent diabetes mellitus in 5 patients,chronic obstructive pulmonary disease in 2 patients,and old myocardial infarction in 14 patients.Results The 29 patients received 33 grafts(LIMA: 27 grafts;great saphenous vein: 6 grafts).Balloon angioplasty was carried out in 41 coronary lesions,usually following surgery.The mean number of revascularization was 2.5 per patient.There was no surgery-related complications and mortality.The blood flow in the LIMA was 45?14 ml/min.The chest drainage volume was 274?197 ml.Blood transfusion was required in 2 patients(6.9%).The length of ICU stay was 1.9?0.1 d and the length of hospital stay was 4~11 d(mean,7.5 d).Follow-up for 2.2?0.9 years showed no late death and myocardial infarction.Postoperative New York Heart Association(NYHA) Classification showed Class Ⅰ in 25 patients and Class Ⅱ in 4 patients.Repeated angiography was conducted in 4 patients,which found great saphenous vein graft occluded in 1 patient and stent re-stenosis in 2 patients.Conclusions The midterm results of hybrid techniques for coronary artery disease are satisfactory.Hybrid procedure is beneficial to high-risk patients.The long-term results need further investigation.

OBJECTIVE To improve the managerial level of hospital infection by the hospital infection control system through network information.METHODS The control system was installed software in the doctor workstation to realize the real-time monitoring and early warning on hospital infection.RESULTS The passive situation of previous retrospective investigation was changed and the prospective and dynamic monitoring on hospital infection,was realized to move forward the gateway of hospital infection control,facilitate the timely detection on epidemic trend of hospital infection and the clue of outbreak and substitute the previous operations by hands on data processing,statistical analysis and submitting.CONCLUSIONS Full use of hospital information system can promote the hospital infection management.

ObjectiveTo summarize the short-term effects o f Symmetry aortic co nnector in off-pump coronary artery bypass grafting (OPCAB) operation. MethodsTwo hundreds and four patients suffering from coronary artery d isease underwent OPCAB from September 2002 to June 2003. Among the 204 patients, saphenous vein grafts were used in 167 patients and Symmetry aortic connectors were adopted in 100 of them.ResultsOf 142 connectors used, 2 connectors fai led and manual r epairs were required in 3 cases because of anastomotic leakage, the success rate being 96 5% (137 of 142). The number of proximal anastomosis was (1 4?0 5) per case and the number of distal anastomosis (3 5?0 8) per case. The proximal a na stomotic blood flow was (46 5?22 3) ml/min. The fitting time for connectors w as (4 0?1 1) min, and anastomoses were all accomplished within 10 seconds. The op eration time was (3 2?0 4) hours. The operative death rate was 1% (1 of 100). R e-operation of thoracotomy was required in 1 case because of bleeding but not an astomotic bleeding. No myocardial infarction or stroke occurred in the peri-oper ative period. The postoperative drainage amount was (547?247) ml. The blood tra nsfusion rate was 36 0% (36 of 100). The postoperative hospital stay was (7 8 ?1 6) days.ConclusionsSymmetry aortic connector can be saf ely and effectively used in coronary artery bypass grafting operations, with satisfactory short-term clinical effects. The procedure may shorten operation time, avoid aortic clampi ng, and lower the incidence of stroke.

Objective To summarize the mid-term outcomes of minimally invasive direct coronary artery bypass (MIDCAB). Methods A series of 33 patients underwent MIDCAB from November 2000 to April 2003: 29 of them received MIDCAB only and 4 received the hybrid approach operation (combining MIDCAB of the left anterior descending artery with percutaneous coronary intervention of the remaining diseased coronary arteries). Out of the 33 cases, conventional MIDCAB was carried out in 25 cases, 4 underwent thoracoscopy-assisted operation and 4 received the surgery with the assistance of the AESOP robot system. Results No operation-related deaths or complications were seen in the study. The extubation time was (7.5?1.9) hours, the chest drainage volume was (274?197) ml, the blood transfusion rate 9.1% (3/33) and the postoperative hospital stay (6.9?1.7) days. Follow-up in all the 33 cases for (24.3?5.7) months revealed no long-term deaths and the recurrence rate of angina was 9.1% (3/33). Postoperative coronary angiography in 4 cases found 1 case of 50% stricture of anastomosis and 3 cases of anastomotic patency between the anterior descending artery and left internal mammary artery. Postoperative catheter revascularization was required in 2 cases (6%). Conclusions The mid-term outcomes of MIDCAB is satisfactory.

Early lymph node metastasis is a common clinical phenomenon in many human cancers, which is associated with both aggressive disease and poor prognosis. Clearly, treatments to specifically block dissemination through the lymphatic network would be desirable either as independent therapies or as adjuncts to existing chemotherapy. At the present stage the target vessels for invasion by lymph-metastasizing tumor cells include preexisting tissue lymphatics abutting the tumor mass through either coincidence or mutual chemoattraction, as well as new lymphatic vessels that proliferate either within or around the tumor as a result of lymphangiogenesis. The lymphangiogenesis is regulated primarily by the lymphangiogenic growth factors VEGF-C and VEGF-D generated by tumor cells or host cells including tissue macrophages. Nevertheless, it remains controversial as to whether this metastasis-enhancing effect simply results from an increase of the number of target vessels due to mitogenesis or from other properties of the newly dividing tumor lymphatics.

Objective To investigate the thyroid hormone changes and their relationship with the state of severity in critically ill patients. Methods Ninety-two patients with no thyroidal illness syndrome admitted to the ICU from January ,2009 to December,2009 were enrolled in this study. The common situations and the score of acute physiology and chronic health evaluation Ⅱ were assessed on addmission. We measured the thyroid hormone levels on the day after admission and analysed whether thyroid hormone levels were related to disease severity. Results The thyroid hormone levels in septic shock group [TT3 (1.16 ± 0.24) nmol/L, TT4 (68.93 ± 24.11) nmol/L, FT3 (3.76 ± 0.21) prnol/L, FT4 (16.40 ± 2.74) pmol/L, TSH (1.58 ± 1.01) mU/L] were significantly lower than those in non-septic shock [TT3 (1.50 ± 0.25) nmol/L, TT4 (91.70 ± 21.90) nmol/L, FT3 (4.24 ± 0.45) pmol/L, FT4(17.98 ± 3.28) pmol/L, TSH (2.43 ± 2.76) mU/L] (P ＜ 0.05). The serum thyroid hormone levels of free triiodothyronine (FT3) ,free thyroxine (FT4) were related to the score of APACHE Ⅱ in septic shock(P ＜ 0.05).Conclusions The levels of thyroid hormone were significantly lower in critically ill patients than the control group and had positive correlation with the disease severity.

OBJECTIVE:To standardize the writing of outpatient prescriptions and set up monitoring mechanism on rational use of antibiotics and drug costs.METHODS:A total of 400 prescriptions collected from 8 departments(50 from each department)of our hospital in the fourth quarter of 2005(before the examination)and from first to fourth quarter in 2006(after the examination)were examined statistically according to Inspection Items and Writing Requirements of Clinical Prescriptions,Guiding Principle of Rational Application of Antibiotics in Hospital,Principles of Classified Management of Antibiotics which were formulated by our hospital.RESULTS:Before prescription examination,the qualified rate of prescriptions was only 57.5%,but rose to an average of 85.6% after the examination.CONCLUSION:To include the standardized writing of prescriptions and reasonable application of antibiotics in the assessment of hospital comprehensive goals was proved to be an effective management method.