The pathophysiological mechanism of ischemic stroke is very complex.Many intracellular and extracellular factors play the important roles in it.Studies have shown that the expression of matrix metalloproteinase-9 (MMP-9) has the changes of quantity,time and space after stroke.These changes are closely associated with the occurrence and development of ischemic stroke.The experimental studies focusing on MMP-9 also have made corresponding effects.The in-depth study of the mechanism of action of MMP-9 is expected to provide a new approach for the diagnosis and treatment of ischemic stroke.

Objective To study the effect of hyperthermia-induced MMP-9 on expression of claudin-1 in in vitro BBB model.Methods BMEC and astrocytes were cultured.An in vitro BBB model was established with its permeability assayed by LY test.The BBB model was randomly divided into 37℃ group,39℃ group,37℃+MMP-9 group and 39℃+MMP-9 group.The permeability of BBB model was recorded at 30,60 and 90 min respectively.Expression of claudin-1 in BMEC was detected by Western blot with immunocytochemical staining.Results The permeability of BBB model was higher in 39℃ group than in 37℃ group (P＜0.05) and was significantly higher in 39℃ +MMP-9 group than in 37℃ group (P＜0.05).The number of claudin-1 positive BMEC was smaller in 39℃ +MMP-9 group than in 37℃ group at the same time points (P＜0.05) and in 39℃ +MMP-9 group than in 39℃ group at 90 min (75.0±12.8/HP vs 97.0±6.1/HP,P＜0.05).The expression level of claudin-1 was lower in 39℃ group than in 37℃ group (P＜0.05) and was significantly higher in 39℃ +MMP-9 group than in 37℃ group (P＜0.05),which further increased with the increasing time.Conclusion Hyperthermia can downregulate the expression of claudin-1 in in vitro BBB model and upregulate the permeability of in vitro BBB model.Adding MMP-9 can further aggrevate the damage of in vitro BBB model,indicating that hyperthermia can aggrevate the damage of in vitro BBB model through MMP-9.

Objective To develop the contents of Family Type Integration of Medical Care and Health Services in Hangzhou based on the Guiding Opinion on Promoting Integration of Medical Care and Pension issued by the State Council,Promotion Measures of Integration of Medical Care and Health Services in Hangzhou issued by the municipal government,and needs of health services for the elderly living in community.Methods The draft was formulated based on literature review,semi-structured interviews and expert meeting.Then,Delphi technique was used to identify the indicators through two rounds of expert consultation among 16 experts.Results The experts' authority coefficient was 0.790,the coefficient of determination was 0.906,and the familiar coefficient was 0.675.The contents of the Family Type Integration of Medical Care and Health Services in Hangzhou consisted of 8 firstlevel indicators,47 second-level indicators.The coordination coefficients of indicators were 0.341,0.222,and 0.426.Coordination of experts opinion had statistical significance (P＜0.01).Conclusion The contents of the Family Type Integration of Medical Care and Health Services in Hangzhou is reliable and scientific,which can be used as a basis for the formulation of items of the family type integration of medical care and health services in Hangzhou.

Objective To analyze the features of health economics in the treatment of leukemia;To evaluate the improvement trend of levels of clinical diagnosis, treatment and management. Methods TCM medical information dtatabase and electronic medical system in Zhejing Province TCM Hospital from January 2010 to December 2015 were retrived. According to inclusion and exclusion criteria, leukemia patients’ materials that met the critiria were screened. The total hospitalization fees, cost of Western medicine, the cost of Chinese patent medicine, cost of TCM decoction pieces, and cost of blood transfusion were set as costs, while white blood cell count, hemoglobin concentration, and platelet count were set as effectiveness indicators for cost effectiveness analysis. Results In patients with low white blood cell count increased unit white blood cell count, patients with high white blood cell count declined unit white blood cell count, patients with low hemoglobin increased unit hemoglobin count and patients with low platelet count increased unit platelet count, the total hospitalization fees, cost of Western medicine, the cost of Chinese patent medicine, cost of TCM decoction pieces, and blood transfusionfor the above increases showed a decreasing trend. Conclusion Health economics advantages in three blood routine indicators after treatment of integrated traditional Chinese and western medicine for leukemia is increasing year by year.

Objective The objective of this study was to provide a way to assess the nutritional status of patients and to afford targeted nutritional supports during the radiotherapy on the basis of the laboratory parameters related to nutrition and chest muscle size in lung cancer patients at the different time.Methods The laboratory parameters were obtained in a cohort of 160 lung cancer patients who received thoracic radiotherapy in our department from March 2012 to November 2015.Fourteen patients who had complete chest CT scan images during radiotherapy were selected to evaluate chest muscles volume.The Chest muscles and its volume were delineated and calculated by CT scan images.Results The levels of(Hemoglobin)HGB,lymphocyte,total protein and albumin were decreased in different degrees during and after radiotherapy,which had the positive correlation with the number and doses of radiotherapy(P<0.05).The changes of hemoglobin and lymphocyte were more obviously among them;these indicators began to recover after 5 weeks of radiotherapy.Chest muscle volume was also the same as the trend of hematological indicators(P>0.05).Conclusion Cancer patients were prone to suffer from malnutrition during radiotherapy.The intake of energy and protein was less than the requirements.We should always take the nutritional status of patients into account and provide targeted nutritional support to improve treatment tolerance and quality of life of patients during radiotherapy.

Objective To explore the relationship of catheter-directed thrombolysis and deep venous thrombosis.Methods We analyzed 2267 consecutive central venous catheter attempts from January to December in2006.Results 18 patients had deep venous thrombosis,and several studies have identified factors associated with mechanical complications of central venous catheter.These factors include illness,the use of drug,mobility.Conclusion It is very important to prevent and cure deep venous thrombosis and decrease incidence of death of knowing many risk factors and clinical symptoms of catheter-directed thrombolysis.

Objective: To tease relevant research on the ethical review of Traditional Chinese medicine in Chi-na and reveal hot topics and trends in the field.Methods: Taking the academic papers included in the domestic database on ethical review of Traditional Chinese medicine as literature samples,the BICOMB and SPSS22.0 soft-ware were used for document information mining,and the high-frequency keywords were analyzed used co-word clustering and thematic strategic diagram.Results: A total of 78 documents were retrieved,and 17 high-frequen-cy keywords were used.The four major hotspots in the field of ethical review of Traditional Chinese medicine in-cluded: institution building and system certification,GCP ethics optimization,ethical principle research,trial scheme design and project quality management.Conclusion: In recent years,the ethical review of Traditional Chi-nese medicine has been explored by scholars and institutions in China from multiple perspectives,and further re-search can be strengthened combined with the current weak areas,in order to increase the overall level of ethical review of Traditional Chinese Medicine.

Objective To analyze problems existing in our scientific research methodological service process in our hospi-tal and realize the continuous improvement of service quality through project management .Methods We took the method of PDCA cycle management model and combined with the project management tools (such as fishbone diagram brainstorming method was used to perform causal analysis ,adopting the Gantt chart making project plan ,using SMART principle to set the target theme ,etc .) ,by using some strategies such as improving the standard of service system for departments ,establishing a professional and partitioned service flow ,adjusting the division of labor according to professional specialties ,communicating and learning to optimize solutions regularly ,equipping with professional technicians to improve operation and maintenance secu-rity of service platform ,etc .Results We completed the three target themes of service quality improvement about "shortening the period of service statistics analysis report","improving the accuracy of scientific research design"and"reducing the number of service data platform problem report".Conclusions The adoption of PDCA cycle management can effectively improve the quality of scientific research methodological service in the hospital .

Candida albicans as a pathogen of great clinical significance can widely colonize in many ecological niches of human body, especially in the immunocompromised population. Currently, antifungal drugs that can be used in clinical treatment are very limited. However, the genome of Candida albicans has a high rate of mutation, which can help it quickly develop resistance to antifungal drugs. Therefore, drug resistance in Candida albicans remains a great threat to clinical practice. This article focused on the frequent loss of heterozygosity (LOH) events in Candida albicans, summarized the association between LOH and other genomic variants and discussed the relationship of the frequency of de novo mutations, heterozygous status of key drug resistance genes and reproductive pattern with antifungal drug resistance.

Objective: To understand the changes of serum transient receptor potential channel 1(TRPC1) in patients with vascular depression. Methods: 58 patients with vascular depression, 49 patients with major depressive disorder and 38 healthy controls were recruited.The TRPC1 of all subjects were detected by ELISA.Patients with vascular depression and patients with primary depression were scaled by HAMD-17.The level of TRPC1 was contrasted in different ages groups and in different nosogenesis (cerebral infarction, ischemic cerebrovascular disease, old cerebral hemorrhage, cerebral microbleeds, vascular risk factors, etc.) of vascular depression.The relationship between TRPC1 level and severity of depressive symptoms was further analyzed. Results: (1)The level of TRPC1 of serum((643.76±118.43)pg/ml) was decreased in patients with vascular depression compared with that in healthy controls ((712.48± 98.75) pg/ml). The level of TRPC1 in patients with vascular depression over 60 years ((601.43±113.55)pg/ml)was lower than that in patients with major depressive disorder over 60 years ((626.32±125.46)pg/ml) and healthy controls over 60 years((721.84± 99.62)pg/ml) .(2) Among the various causes of vascular depression, the level of TRPC1 in patients with cerebral infarction, ischemic cerebrovascular disease and cerebral microbleeds was significantly lower (P<0.05). (3) The levels of TRPC1 in the patients with vascular depression (r=-0.962, P<0.05) and patients with major depressive disorder (r=-0.674, P<0.05) were negatively correlated with HAMD-17 score. Conclusion The level of TRPC1 is lower in patients with vascular depression, which is more obvious in patients with cerebral infarction, ischemic cerebrovascular disease, and cerebral microhaemorrhage.The lower the level of TRPC1, the more severe the depression.The neuroprotective effect of TRPC1 is reduced in patients with vascular depression.The TRPC1 can be used as a biomarker for vascular depression.