Objective: To explore relationship among serum levels of homocysteine (Hcy), interleukin (IL)-10, matrix metalloproteinase (MMP)-9 and infarct volume in patients with acute cerebral infarction（CI）. Methods: A total of 125 acute CI patients were regard as acute CI group, and another 37 healthy subjects were enrolled as healthy control group. Enzyme linked immunosorbent assay (ELISA) method was used to measure serum levels of Hcy, IL-10 and MMP-9 of subjects; according to infarct volume, acute CI patients were divided into small infarction group (≤5cm3, n=47), medium infarction group (5~15 cm3, n=41) and large infarction group (≥15cm3, n=37); changes of levels of Hcy, IL-10 and MMP-9 were compared among all groups. Results: Compared with healthy control group, there were significant increase in levels of MMP-9 and Hcy, and significant decrease in IL-10 level in acute CI group. Compared with small and medium infarction groups, there was significant increase in serum Hcy level [(16.11±3.5) μmol/L, (16.79±3.4) μmol/L vs. (18.5±4.2) μmol/L, P<0.01, P<0.05] in large infarction group； Compared with small infarction group, there was significant increase in serum MMP-9 level [(161±27) ng/ml vs. (238±26) ng/ml, (256±35) ng/ml, P<0.05, P<0.01]；Compared with small infarction and medium infarction groups, there were significant decrease in IL-10 level [(0.60±0.17) ng/ml vs. (0.59±0.15) ng/ml, (0.31±0.12) ng/ml, P<0.01 both] in large infarction groups. Conclusion: Serum levels of homocysteine, interleukin-10 and matrix metalloproteinase-9 are related to onset of acute cerebral infarction, and may reflect risk degree of cerebral infarction.

Objective To investigate the risk factors of pulmonary fungal infection in patients with chronic obstructive pulmonary disease ( COPD) .Methods 48 cases of patients with COPD complicated with pulmonary fungal infection in September 2011 to September 2014 in respiratory department of Shaoxing People’s hospital ( observation group) and 48 cases without pulmonary fungal infection of COPD of patients at the same period ( control group) were selected, clinical data of two groups were retrospectively analyzed.The age, sex, antibiotics and hormone usage, serum albumin, mechanical ventilation and complications (diabetes, respiratory failure, heart failure) were compared between two groups.Results The results of sputum culture in the observation group showed that the infection rate of Candida albicans infection was 17 (35.42%), Candida glabrata was 4 (8.33%), Candida tropicalis 3 (6.25%), Aspergillosis was 22 (45.83%) and concurrent infection was 2 (4.17%).The age and sex of the patients between two groups had no statistically significant difference, the levels of serum albumin in the observation group was significantly lower than that of the control group, combined with diabetes, type II respiratory failure and right heart failure of the patients were significantly higher than that of the control group(all P<0.05).The antibiotics use time, hormone use rate and rate of mechanical ventilation in the observation group were significantly better than that of control group, the differences were statistically significant (all P<0.05).The multivariate logistic regression analysis showed that, low serum albumin, long-term use of antibiotics, mechanical ventilation, combined with diabetes and type II respiratory failure were the independent risk factors of nosocomial pulmonary fungal infection in patients with COPD.Conclusion There are many risk factors in patients with COPD complicated with pulmonary fungal infection, low serum albumin levels, long-term use of antibiotics, mechanical ventilation, combined with diabetes and type II respiratory failure are major independent risk factors.It should take active prevention and cure measures in clinic to reduce the possibility of fungal infection.

Objective To discuss the influence of sample hemolysis on the biochemical testing results to provide the basis for the laboratory personnel and clinical doctors correctly analyzing the biochemical testing results of hemolytic samples .Methods Serum from non‐hemolytic samples was taken and performed the detection of 48 biochemical items .Then the sample was stirred for indu‐cing the mild ,moderate and severe hemolysis .Centrifugation was conducted at 3 000 r/min for 10 min .Finally the detections of the same biochemical testing items were performed again .The detection results of non‐hemolysis ,mild ,moderate and severe hemolysis samples were statistically analyzed .Results As compared with the non‐hemolytic samples ,the 16‐item detection results in the mild hemolysis samples showed statistically significant difference ,25‐item detection results in the moderate hemolysis samples showed statistically significant difference and 28‐item detection results in the severe hemolysis samples showed statistically significant difference (P<0 .05) ,respectively .Conclusion The sample hemolysis could produce the significant influence on the majority of bi‐ochemical testing items .Therefore ,the sample hemolysis is encountered and the detection results must be reported in the biochemi‐cal detection ,the clear indication should be given in the report for reminding the doctor and patient to arouse attention .The causes leading to the sample hemolysis should be analyzed for avoiding the occurrence of hemolysis phenomenon and ensuring the truthfull‐ness and accuracy of the detection results .

Although the new methods and new ideas have been introduced into researches on modern syndromes, research levels of syndromes have continued to be broadened and deepened gradually. However, understanding of essential theories and general research methods have not yet achieved a broad consensus in TCM field. The phenomenon is caused by the systematic complex features of syndromes, which are difficult to be explained for a short while, and require progressive understanding and development. It is also related to the reason that current main stream researches on syndromes lack general overview and analysis. All of the above lead to the failure of efficient penetration of all syndrome researches and restrict synergetic development among these researches. This article summarized and analyzed the overview of key field of study on syndromes, and expounded their disadvantages and development suggestions, with purposes to improve future syndrome research field, enrich syndrome research methods, and promote necessary penetration of syndrome researches.

AIM:To investigate the pathological changes of aquaporin 4 (AQP4) and related proteins in the rats with focal cerebral ischemia injury , and to observe the effect of silent information regulator 1 ( SIRT1) on the AQP4 ex-pression in order to explore the pathological mechanism of cerebral ischemia and brain edema .METHODS: Adult male SD rats were randomly divided into sham group and middle cerebral artery occlusion ( MCAO) model group.The MCAO model group was divided into the 4 time point (6 h, 12 h, 24 h and 48 h) subgroups.The animal model of MCAO was es-tablished by suture method in mature SD rats .The neural symptom score was measured at the corresponding time points . Morris water maze test was used to study the cognitive function .The cerebral infarction volume was evaluated by TTC stai-ning .The changes of brain water content was analyzed by a dry /wet weight method .The morphological changes of the brain tissues were observed under microscope with HE staining .The protein expression of SIRT 1, MMP-9 and AQP4 was deter-mined by Western blot .RESULTS: Compared with sham group , the neural function score of the rats in MCAO model group was significantly elevated .With the increasing reperfusion time , the cerebral infarction volume , brain tissue permea-bility and the brain water content were also increased .The increases in the protein levels of AQP 4 and the related proteins showed apparent changes .The protein expression of SIRT 1 was decreased , while the MMP-9 expression was increased .The most obvious differences of the protein level changes in MCAO-48 h model group were observed (P<0.01).CONCLU-SION:Accompanied with the aggravating cerebral injury after cerebral ischemia , the process of AQP4 expression is activa-ted with the increasing expression levels of MMP-9 and SIRT1.These factors are combined to induce the formation of brain edema.

Objective:To explore the influence of diabetic self-management education on blood glucose control and inflammatory factor levels in inpatients with diabetes mellitus (DM).Methods:A total of 168 DM patients,who hospitalized in department of endocrinology in 163rd hospital of Chinese PLA from Jun 2012 to Jun 2013,were ran-domly divided into self-management education group (self-management group,n=88)and routine health education group (routine management group,n = 80).Self-management group received self-management education course namely AADE7TM ,provided by full-time DM health education staff,including healthy eating,being active,monito-ring,taking medication,problem solving,healthy coping and reducing risks,while routine management group re-ceived routine DM health education.Blood glucose control,changes of levels of myeloperoxidase (MPO),tumor necrosis factor-α(TNF-α)and intercellular adhesion molecule-1 (ICAM-1)were examined before and after interven-tion.Results:Compared with before intervention,there were significant reductions in levels of fasting blood glucose (FBG),postprandial blood glucose (PBG)and glycosylated hemoglobin (HbA1c)in both groups after interventions (P <0.05 all).Compared with routine management group,there were significant reductions in levels of FBG [(7.1 ±1.3)mmol/L vs.(6.0±1.1)mmol/L],PBG [(9.5±1.6)mmol/L vs.(8.8±1.4)mmol/L]and HbA1c [(7.9 ±1.5)% vs.(7.2±1.1)%]in self-management group,P <0.05 all.Before discharge,there were significant de-crease in inflammatory factor levels in both groups compared with before intervention (P < 0.05 all).Compared with routine management group after intervention,there were significant decrease in inflammatory factor levels [TNF-α:(201.0±57.3)pg/ml vs.(100.7±49.2)pg/ml,ICAM-1:(25.2±3.6)ng/ml vs.(18.2±2.9)ng/ml] in self-management group,P < 0.05 both.Conclusion:Self-management education provided by full-time diabetic health education staff is superior to routine diabetic health education method in controlling blood glucose and decrea-sing inflammatory factor levels,indicating it can improveβcell function and relieve insulin resistance.

10.3969/j.issn.2095-4344.2013.25.018

Objective: To analyze effect of ulinastatin on patients’ inflammatory factors level during cardiopulmonary bypass valve replacement surgery. Methods: Chosen patients accept cardiopulmonary bypass valve replacement surgery between 2011 to 2013 as research subjects, randomized to receive Ulinastatin as observation group and volume of saline as control group, testing inflammatory levels and pulmonary ventilation function difference. Results: One hour after CPB and 1h after the end of CPB, TNF-α, IL-6 level as well as A-aDO2 level of observation group were lower than control group; (2)A-aDO2 levels were positively correlated with TNF-α, IL-6 levels. Conclusion: Ulinastatin can effectively reduce cardiopulmonary bypass valve replacement surgery preoperative inflammatory cytokine levels, reducing the impact on pulmonary ventilation function, inflammatory levels and pulmonary ventilation function was negatively correlated.

It is difficult to interpret the infection after glucocorticosteroid treatment because glucocorticosteroid will lead to increased peripheral blood neutrophils.Procalcitonin (PCT) is a major biomarker,which can be used as the basis for early diagnosis of severe bacterial infections.The level of PCT is not inhibited by glucocorticosteroid.PCT can be used to interpret infection as systemic use of glucocorticosteroid

ObjectiveTo investigate the expressions ofβ-catenin and glycogen synthase kinase 3 beta(GSK-3β) proteins in the gastric carcinomas and to elucidate their clinical significance.Methods The expressions of β-catenin and GSK3-β proteins were analyzed with immunohistochemistry staining of gastric tissue array in the normal gastric mucosa (n =48),paracancerous tissues ( n =24),and primary cancer tissues ( n =48).ResultsThe positive expression rate ofβ-catenin and GSK-3β in gastric carcinomas was 66.7％ and 35.4％,respectively,and β-catenin protein expression in carcinomas was higher than normal and paracancerous tissues ( x2 =65.455,P ＜ 0.05 ).The expression of β-catenin was correlated with cell differential degree,pTNM stage,histological type,lymph node memtastasis,and nerve invasion,respectively ( x2 =4.713,8.242,13.662,11.658,4.550,P ＜ 0.05 or P ＜ 0.01 ).The positive expression rate of GSK3βin carcinomas was lower than normal and paracancerous tissues ( x2 =26.968,P ＜ 0.05).The expression of GSK-3β was correlated with cell differential degree,histological type,and lymph node metastasis,respectively (x2 =3.868,9.665,9.872,P ＜ 0.05 or P ＜ 0.01 ).The expression of β-catenin was negatively correlated with the expression of GSK-3βprotein in the gastric carcinoma tissues ( r =-0.493,P =0.001 ).ConclusionsGSK3-β and β-catenin might play important roles in the progression,differentiation,infiltration,lymph node metastasis of gastric carcinoma,and might be the indicators for diagnosis of a gastric carcinoma.