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 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.

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 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.

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.

This paper introduced the fair benchmarks of evaluation framework for health system constructed by Daniels, et al, and its developmental application in evaluation of health resource allocation fairness .After introdu-cing the resources rational allocation of public health fair benchmarking fixed framework , this paper assessed the al-location of health resources according to the fixed framework .China has achieved good results in public health serv-ice interventions .But public sector governance , macro economic and social policy environment , factors such as ac-countability may restrict the improvement of the health care system .China's health expenditure allocations have un-fairness between provinces , urban and rural areas and different classes .China can use the new benchmark in the field of public health to promote the reform of health resource allocation fairness , make effective social health strate-gies.

10.3969/j.issn.2095-4344.2013.25.018

BACKGROUND:The establishment of animal pulmonary hypertension models will promote the improvement of clinical diagnosis and treatment on pulmonary hypertension.OBJECTIVE:To analyze and summarize the establishment of animal pulmonary hypertension models.METHODS:The databases of PubMed and CNKI were retrieved with key words of "pulmonary hypertension and animal model".Studies concerning the following aspects were included:using surgery method to prepare animal pulmonary hypertension models;using drug injection method to prepare animal pulmonary hypertension models;animal severe pulmonary hypertension model;pathophysiological comparison between animal models and pulmonary hypertension patients;and drug intervention on animal pulmonary models.RESULTS AND CONCLUSION:The methods for animal pulmonary hypertension models construction including:Surgical shunt,monoerotatine injection,chronically hypoxic and so on,in addition,the animal several severe pulmonary hypertension models which appeared at distal pulmonary artery neointimal lesion formation was reported.Through continuous improvement,they have provided insights into pathological cellular and molecular signaling pathways.However,how closely any of the models simulate to the cellular and molecular pathobiology of human pulmonary hypertension was poody understood.

Objective To investigate the incidence, risk factors and drug-resistance of Pseudomonas aeruginosa infection in intensive care unit (ICU). Methods Totally 171 patients with sepsis admitted in ICU were enrolled. Pathogenic bacteria culture and antimicrobial susceptibility tests were performed. SPSS10. 0 software was used for Logistic regression analysis of the risk factors. Results Pseudomonas aeruginosa infection was confirmed in 37 patients, and 45 strains of Pseudomonas aeruginosa were isolated. Logistic regression revealed that recent antibiotics use ( OR = 4. 291 , 95% CI: 1. 727-10. 662) , length of ICU stay (OR = 1.117, 95% CI: 1.058-1. 181) , mechanical ventilation (OR = 3.400, 95% CI: 1.348-8.579) and central venous catheterization (OR =3. 339, 95% CI: 1.322-8.434) were independent risk factors of Pseudomonas aeruginosa infection. The resistance rate of cefotaxime was the highest (68.9%) and 18 strains (40%) were multidrug-resistant. Conclusions Pseudomonas aeruginosa infection is common in ICU and it is usually multidrug resistant. The rational use of antibiotics and aseptic technique of invasive catheterization are important for the prevention of Pseudomonas aeruginosa infection.