Objective To investigate clinical significance and the variation of serum interleukin -6(IL-6) ,high-sensitivity C-reac-tive protein(hs-CRP) and T-cell CD40 ligand(CD40 L) in patients with rheumatoid arthritis (RA)(included activity group and stable group) .Methods 90 cases of RA patients in the observation group ,90 cases of healthy volunteers were selected as control group . Enhanced immunoturbidimetric assay was used in measurement of serum hs-CRP .Levels of CD40 L ,IL-6 were detected by enzyme-linked immunosorbent assay .Results BPC ,RF ,ESR ,hs-CRP ,IL-6 and CD40 L in peripheral serum of observation group were sig-nificantly higher than control group ,the differences were statistically significant (P<0 .05) .BPC ,ESR ,hs-CRP ,IL-6 and CD40 L in peripheral blood of patients in RA activity group were significantly higher than patients with RA in stable group ,the differences were statistically significant(P<0 .05) .RF ,ESR ,hs-CRP ,IL-6 and CD40L in peripheral serum of RA patients whose platelet ele-vated were significantly higher than RA patients whose platelet stay normal level ,the differences were statistically significant (t=6 . 070 ,3 .858 ,3 .272 ,3 .217 ,2 .253 ,P<0 .05) .Conclusion Serum hs-CRP ,IL-6 and CD40 L relate to RA inflammation closely .Com-bined detection can observe the condition changes and treatment effect in patients with RA .

Objective To find out the occurrence patterns of medical disputes over prosthodontic treatments through surveys and analyses so as to provide basis for the scientific prevention of such occurrences.Methods A statistical analysis was made of the causes of 92 medical disputes over prosthodontic treatments that occurred in the past three years,the data were processed using self-made tables,and the occurrence rates of the disputes were calculated according to their causes.Results The disputes over prosthodontic treatments in the past three years accounted for 22% of the total number of medical disputes over prosthodontic treatments.The cause leading to the most disputes involved medical quality,followed successively by service management,service manners,personal factors on the part of the patients,and charges.Conclusion There are certain patterns for the occurrence of medical disputes over prosthodontic treatments,which can be avoided to some extent if appropriate preventive measures are taken.

Objective To compare myocardial protection between cold blood and crystalloid cardioplegia in short aortic cross-clamping(

Objective To seek out the factors that influenced the mortality of population due to heat wave in Shanghai in summer(15 June-15 September). Methods Daily data of mortality of all causes, meteorological and air pollution in Shanghai in 1998 and 2003 were collected. Multivariate analysis was employed to investigate the relationship between mortality and heat wave intensity, duration, and timing within the summer season and air pollution concentrations. Results The heat wave in 1998 was more severe and caused a higher mortality than that in 2003. In 1998 heat wave, the heat wave duration,timing within the summer season were significantly associated with the daily number of deaths,while in 2003, besides the above two factors the daily maximum temperature also played an important role. Air pollution level slightly increased in heat wave and some factors such as air conditioner number, living space and urban greenbelt area could be used to explain the distinctive difference of heat related mortality between 1998 and 2003. Conclusion High temperature is the crucial factor for the high mortality of population due to heat wave in Shanghai in summer(15 June-15 September) in 1998 and 2003. Using air condition and enlarging living space will help to decrease the mortality.

BACKGROUND: Hyperhomocysteinemia is a new independent risk factor for coronary heart disease (CHD), but its association with cerebrovascular diseases is still controversial. The level of fasting plasma total homocysteine (plasma tHcy) alone is not enough to reveal the effect of hyperhomocysteinemia on cerebral infarction (CI).OBJECTIVE: To explore the association of hyperhomocysteinemia with folacin and vitamin B12 and with CI in young and middle-aged people, as well as the role of methionine loading test in the diagnosis of latent hyperhomocysteinemia.DESIGN: A case-control study, Spearman correlation analysis.PARTICIPANTS: A total of 85 patients were hospitalized within 2 days after the onset of CI at the Department of Neurology, the General Navy Hospital of Chinese PLA, from 2000 to 2003. There were 63 males and 22females aged 29-55 years old with the mean age of (48.74±5.05) years.There were 48 cases of lacunar CI and 37 cases of arterial thrombotic CI.Meanwhile, 44 normal controls, 30 males and 14 females aged 29-55 years old with the mean age of (47.75±6.71), were recruited from the department staff and those who came to the hospital for routine health examination.METHODS: Fasting vein blood of 6 mL was collected from the patients on the 1st day of hospitalization, and 2 mL of the blood was used for detecting the level of fasting plasma tHcy using high efficiency liquid chromatography. Methionine of 0.1 g/kg was taken orally by patients immediately after blood sampling; 4 hours later, the level of loading plasma tHcy was also determined. The remaining 4 mL was used for detecting the level of serum folacin and vitamine B12 with bioradiation assay.MAIN OUTCOME MEASURES: ① The level of fasting and loading plasma tHcy in CI group and control group. ② Incidence of hyperhomocysteinemia in CI group and control group [Hyperhomocysteinemia was confirmed if hyperhomocysteine was higher than 95% of the upper limit of fasting plasma tHcy or 4-hour loading plasma tHey of normal control group, that is, fasting plasma tHcy ＞17.26 μnol/L in males and ＞14.17 μnol/L in females; and loading plasma tHcy should be ＞ 44.57 μmol/L in males and ＞ 40.02 μmol/L in females. ③ The level of serum folacin and vitamine B12 in CI group and control group. ④ Single factor analysis of fasting plasma tHcy and related risk factors.RESULTS: Totally 85 CI patients and 44 normal controls were recruited in this study and all data were statistically analyzed. ① The level of fasting and loading plasma tHcy in CI group and control group: Both fasting and loading plasma tHcy was significantly higher in CI group than in control group [(22.49±9.80), (13.08±2.33) μmol/L; (48.07±11.20), (37.23±3.48)μmol/L, (t=8.409, 8.187, P ＜ 0.01)]. ② Incidence of hyperhomocysteinemia: The incidence was obviously higher in CI group than in control group [68% (58/85), (9%, 4/44), X2=40.628, P ＜ 0.01]. Totally 35 patients (41%, 35/85) had higher fasting plasma tHcy than that of normal controls, and 23 (27%, 23/85) had higher loading plasma tHcy than that of normal controls. ③ The level of serum folacin and vitamine B12 in CI group and control group: They were [(5.73±2.52), (7.14±2.20) μg/L] in CI group,significantly lower than control group [(473.47±190.19), (576.70±212.05) rng/L,(t =3.151, 2.809, P ＜ 0.01)]. ④ Single factor analysis of plasma tHcy with related risk factors: Fasting and loading plasma tHcy was found obviously associated with sex, and folacin and vitamine B12 level (r = -0.306 to 0.488, P ＜ 0.01), but not with other risk factors and neurological deficit scores (r = 0.021-0.173, P ＞ 0.05). Moreover, only plasma tHcy level was proved to have significant positive correlation with fasting blood glucose (r=0.186, P ＜ 0.05).CONCLUSION: Hyperhomooysteinemia is an independent risk factor for CI in young and middle-aged people. Methionine loading test is an essential means for detecting latent hyperhomocysteinemia. Insufficiency of folacin and vitamine B12, two important nutrition factors, may lead to hyperhomocysteinemia and indirectly result in CI.

Objective To evaluate the viability of adipocytes after they are subjected to different compressive stress in vitro for improvement of autologous fat graft and its clinical application.Methods Fat grafts were harvested from healthy patients who underwent liposuction for body contouring.Then the fat grafts were randomly divided into 5 experimental groups,including control group without any compressive stress,and continuous compressive stress groups (0,25,50,75,and 100 kPa),and the glucose transport test was performed at days 1,2,3 and 4.An MTT assay was also performed after 4 days with continuous compressive stress in each group with the same experimental protocol for control.Routine histological examination was done in all groups to examine possible structural destruction after compressive stress.Results As compared with the control group,the glucose transport test showed transported glucose concentration decreased with an increase in compressive stress in all of the other four groups (P＜0.01),and this effect would increase with action time.MTT assay showed absorbance (A492nm) also decreased with an increase in compressive stress in four days (P＜0.05),the similar fndings of MTT assay on the viability of fat grafts in all five groups and correlated with the glucose transport test (r=0.838,P＜0.01).Histology showed significantly distorted and fractured adipocytes and cell injury rate was to raise with an increase in compressive stress.Conclusions Our study demonstrates the harmful effect on the viability of fat grafts with an increase in compressive stress and therefore we should reduce this effect in clinical application of fat grafts.

Objective To isolate specific humanized anti-D-dimer scFv(single chain Fv) antibody from scFv phage libraries. Methods Isolate anti-D-dimer positive clones from Tomlinson I + J phage libraries by three rounds of panuing, then sequence monoclonal genes by bideoxy-mediated chain termination and express soluble scFv antibody; Pick out anti-D-dimer antibodies with high specificity and affinity by ELISA.Results After three rounds of selection from human scFv phage libraries Tomlinson I and J, 38 monclonal specific anti-D-dimer scFv fragments were selected. By polyclonal and monoclonal phage ELISA and gene sequencing, 20 different full-length monoclonal scFv phages were identified, the result of soluble scFv ELISA showed that 20 full-length monoclonal scFv were expressed smoothly. According to the result of soluble scFv ELISA, in 5 scFv antibodies with high value of A450 selected, 3 scFv antibody fragments showed high specific and affinity. Conclusion Antibody phage display was an effective, rapid method to isolate anti-D-dimer antibodies with high specificity and affinity.

Objective To study the value of methionine loading test (MLT) in the mild vascular cognitive impairment (VCI) after acute cerebral infarction.Methods The fasting plasma homocystine (Hcy) level and homocystine level after MLT were measured by high-performance liquid chromatography methods.We chose 240 patients with normal level of fasting plasma Hcy (normal group),159 patients with normal level of Hcy after MLT,81 patients with hyperhomocysteinemia after MLT (hyperhomocysteinemia group),and 112 patients with fasting hyperhomocysteinemia (fasting hyperhomocysteinemia group) in this study.The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were conducted in normal,hyperhomocysteinemia and fasting hyperhomocysteinemia groups on admission,at 7d,14 d,30 d after treatment.Results Logistic regression analysis showed that the increased level of Hcy might be an independent risk factor for VCI [OR:1.285,95％CI:1.038-1.265,P＜0.05].The scores of MMSE and MoCA were lower in patients with fasting hyperhomocysteinemia and patients with hyperhomocysteinemia after MLT than in patients with normal fasting plasma Hcy at 7 d,14 d and 30 d after treatment (P＜0.01 or 0.05),while the scores had no significant differences among the three group on admission (P＞0.05).There were no significant differences in MMSE and MoCA scores between patients with fasting hyperhomocysteinemia and patients with hyperhomocysteinemia after MLT on admission,7 d,14 d and 30 d after treatment (P＞0.05).Conclusions Hcy may be an independent risk factor for VCI.The MLT can discover the dormant vascular risk factors for VCI,which offers a valuable detection method for early intervention and prevention in the clinical medicine.

Objective:To examine the ultrastructure of resin-infiltrated sclerotic dentine following the application of an all-in-one self-etch dentin adhesive. Methods:Naturally-occurring, non-carious cervical sclerotic lesions on 10 extracted premolars were bonded using an all-in-one self-etch dentin adhesive(Adper Prompt L-Pop,3M ESPE, St Paul, USA).Artificially prepared wedge-shaped lesions were also made in 10 extracted sound premolars and restored using the same adhesive as the controls. The morphological change of dentin surface conditioned by the adhesive and the dentin-resin interface were studied by SEM.Results:Most dentinal tubules were obliterated by rod-like sclerotic casts in the non-carious cervical lesion, the sclerotic casts could not be totally dissolved by the self-etch adhesive. After restoration the resin tags were fewer and shorter in sclerotic dentin than those in sound dentin.Conclusions:Bonding to sclerotic dentin is different from that to sound dentin, and may be compromised by the fewer resin tags.

Objective To evaluate the effect of the plasma homocystine (Hcy) after methionine loading test (MLT) on the recurrence of ischemic vascular event,including cerebral infarction,transient ischemic attack (TIA),acute coronary syndrome,other vascularembolism,in cerebral infarction patients.Methods The fasting plasma homocystine (FHcy) and homocystine after MLT (PHcy) levels were measured by high-performance liquid chromatography.383 cerebral infarction patients with normal Hcy level were selected and divided into hyperhomocysteinemia after MLT (PHcy) group (n=135) and non-hyperhomocysteinemia after MLT (NPHcy) (n=248).Recurrence rates of ischemic vascular events within a 5-years follow-up period was observed.Results The levels of FHcy,PHcy and △Hcy (PHcy level subtracted FHcy level) were higher in males than in females in the two groups (all P＜0.05).The recurrence rates of cerebral infarction/TIA,acute coronary syndrome and other vascular embolism events were higher in PHcy group than in NPHcy group within the follow-up period (all P＜0.05).By forward stepwise logistic analysis,we found that the increased PHcy and △Hcy levels were the independent risk factors for recurrent ischemic vascular events [odds ratio (OR):0.509,2.107,95％ confidence interval (CI):0.286-0.904,1.185-3.745,both P＜0.05].Conclusions PHHcy may be an independent risk factor for recurrence ischemic vascular events in cerebral infarction.