Acomplexcascadeofmoleculareventsisconsiderdtobeinitiatedfollowingcerebralis chemia ,whichincludereleaseofexcitatoryaminoacid ,calciumdyshomeostasis ,freeradicalinjury ,increased cytokines,caspaseactivationandalteredgeneexpression .Thisreviewprovidesanoverviewofmolecular mechanismsinvolvedinpostischemicneuronaldeathandanalysesthepotentialfortherapeuticintervention .

Therapeutic method is an important component of traditional Chinese medicine theory. Research on warming therapy focuses on pharmacology at present. Studying the feature of nerve-body fluid-metabolism-function in cold syndrome is of importance for illustrating the nature of warming therapy and elucidating the function of medication. This review presents the research and development of warming therapy in order to provide enlightenment for the research of therapeutic method from the aspects of traditional Chinese medicine and western medicine.

Objective To explore the factors affecting results of alanine aminotransferase(ALT)preliminary screening by using dry chemical method in blood donors,so as to establish standards of ALT preliminary screening and reduce waste of blood. Methods A total of 21 065 blood specimen of blood donors in Blood Center of Maoming City were collected from January to June 2013.The influences of specimen hemolysis,lipidemia,different sample amount and waiting time after adding sample on the detec-tion results of ALT by using dry chemical method were comparatively analysed,and standardized procedures and established appro-priate limits of ALT preliminary screening according to the results.Results The specimen hemolysis affected test results of ALT, which was not obvious when the hemolysis rate was less than or equal to 0.5%.There was no obvious interference of lipidemia on ALT test.When the sample amount was (32±3)μL or the waiting time after adding sample was 10 to 40 seconds,the detection re-sults of ALT were acceptable.The standard limit of ALT was less than or equal to 40 U/L of female and less than or equal to 45 U/L of male.Conclusion Hemolysis,sample amount and waiting time after adding sample can influence the results of ALT detec-ted by using dry chemical method,while lipidemia had no interference on ALT test.Standardizing operation and reasonably setting normal limits standard may ensure the accuracy and stability of determination,save blood resources,further ensure blood safety, which should be worthy of wide application.

Objective To know the situation of the hepatitis C virus(HCV)infection in blood donors of Maoming City,and pro-vide the basic data for recruiting volunteer blood donors and preventing of HCV infection.Methods Blood samples were collected in Maoming blood center,and were detected by using HCV antibodies of different manufacturers and operated by different people.Du-plicate test was used to reexamine the specimens which were reactive in the initial test.Statistical analysis was performed.Results HCV prevalence of blood donors from Maoming was 0.74%.The prevalence of female was slightly higher than the male,but the difference was not statistically significant(P >0.05).The HCV prevalence of civil servant and medical personnel was relatively low-er.HCV prevalence of repeat blood donors was obviously lower than blood donors for the first time(P <0.05).Conclusion HCV prevalence of blood donors in Maoming City was in a relative low level.The risk of HCV infection in people who is younger than 35 years old and at the same time qualified to donate blood is quite low.Establish a stable volunteer blood donor group is beneficial to blood safety.It's necessary to strength the propaganda and prevention of HCV knowledge to population besides civil servant and medical personnel,which would be helpful for the control of HCV infection.

Objective To compare the effects of different opportunity internal fixation in treatment of trau-matic flail chest.Methods Clinical data of 53 cases of patients with traumatic flail chest were selected,in which 28 patients were given internal fixation treatment in 72h after injury (early surgery group),25 patients were given sur-gery after 72h(late surgery group),recovery situation(postoperative ventilation time,chest improve time,ICU stay time,extubation time,hospitalization time)of the two groups were observed,respiratory function changes and compli-cations were compared before and after treatment.Results Postoperative ventilation time,chest X -ray improvement time,ICU stay time,extubation time and hospitalization time of the early operation group were (27.4 ±4.8)h, (88.6 ±7.5)h,(3.8 ±0.7)d,(3.2 ±0.8)d,(13.2 ±5.0)d,which were significantly shorter in the late operation group of (40.7 ±5.2)h,(195.3 ±8.0)h,(5.6 ±1.4)d,(5.2 ±1.3)d,(19.8 ±6.4)d,with significant difference (t =7.389,11.204,3.837,3.916,5.261,all P <0.05 ).After treatment,PaO2 ,PaCO2 ,PaO2 /FiO2 ,RR and HR were all significantly improved (early surgery group t =12.497,6.205,4.136,7.381,14.327,all P <0.05;late sur-gery group t =11.976,5.813,4.649,6.892,14.627,all P <0.05),but the indexes between the two groups were not significantly different(t =0.126,0.013,0.002,0.010,0.215,all P >0.05 ).There was no dead case in the two groups,and the incidence of atelectasis,ARDS and thoracic deformity had no significantly different between two groups (P >0.05 ).Conclusion In treatment of traumatic flail chest,early surgical treatment can rapidly improve the respiratory and circulatory function,it can shorten the postoperative recovery time,and does not increase complica-tions.So,when conditions permit,patients should be given early surgical fixation.

ObjectiveTo summarize the experience of gastric D2 operation and evaluate the feasibility and safety of peripheral vascular choroid of lymph node dissection.Methods A retrospective study was adopted to analyze the redical D2 operation procedure and operation results 24 advanced gastric cancer cases,summarizing the experience of D2 radical gastrectomy operation for gastric cancer.The number of resected lymph nodes,operation bleeding volume,postoperative complications were analyzed to evaluate the feasibility and safety of operation.Results All 24 cases undergoing D2 radical gastrectomy operation of advanced gastric cancer were successful,and got the R0 resection.A total of 634 lymph nodes were excised in all the cases,averaged 26.42.A totle of 206 metastatic lymph nodes were found,metastasis rate being 32.49％.Operation bleeding volume was averaged 264.58 mL.The postoperative complication rate was 25％,anastomotic bleeding in 1 case,input loop jejunum fistula of esophageal jejunum anastomosis in 1 case,hyperamylasemia and 2 cases reflux esophagitis in 2 cases respectively.Conclusions D2 radical gastrectomy operation of gastric cancer is safe and feasible on the basis of mastering perigastric anatomy and master of lymph node excision technology and anatomical hierarchy separation.

Objective To study the expressions of miRNAlet7 and Ras in non-small cell lung cancer ( NSCLC),and their correlations with clinicopathological features and survival time.Methods In-situ hybridization was used to detect the expression of let7,and SP immunohistochemistry to measure HMGA2 in 68 NSCLC cases ( group A) and 20 cases with normal lungs ( group B).Results The positive rate of let7 in group A was lower than that in group B (39.7％ vs 63.2％ ) ( P ＜0.05).The positive rate of Ras in group A was higher than that in group B (66.2％ vs 25.0％ ) ( P ＜0.01 ).The positive rate of let7 was not related to the age,gender,histological type,cell differentiation,and clinical stages of cancer patients(P ＞0.05).The positive rate of Ras was related to smoking,sex,and histological type of cancer( P ＜0.01 ),and was not related to cell differentiation,lymphatic metastasis,and clinical stages of cancer ( P ＞0.05).There was an obvious negative correlation between let7 and Ras( r =-0.627,P ＜0.01 ).The 2-year survival rate of let7-positive group was higher than that of the let 7-negative group ( x2 =4.84,P ＜0.05).No statistically significant difference was found between Ras-positive and-negative groups ( P ＞0.05 ).Conclusions The lower level of let7 expression,and high level of Ras expression have much to do with the carcinogenesis of NSCLC.The level of let7-positive expression is closely related to prognosis; while Ras may act in cooperativity in the occurrence and development of NSCLC.

Objective The present study is to investigate the distribution of endogenous sulfur dioxide (SO2) in severe acute pancreatitis (SAP) rats.Methods Thirty-two SPF male Sprague-Dawley rats were randomized (random number) into sham operation group,SAP rat 3 h group (SAP 3 h),SAP rat 6 hgroup (SAP6h),SAP rat 12 hgroup (SAP 12 h),n=8 in each group.The SAPmodel rats were induced by retrograde cholangiopancreatic infusion of 5％ sodium taurocholate.Rats were sacrified 3 h,6 h or 12 h after treatment.,then we collected pancrease,liver,lung,kidney and serum.The SO2 concentration in each tissue or serum was detected by enzyme-linked immune sorbentassay.Results The concentration of SO2 in tissues of pancreas (1.72 ± 0.14) μmol/g,liver (1.62 ± 0.11) μmol/g,lung (1.65 ± 0.11) μ.mol/g,kidney (1.12 ± 0.06) μmol/g or serum (16.80 ± 1.27) μmol/g in SAP 3 h rats was not significant compared with the sham operation group (P ＞ 0.05 in each group).The SO2 content in the pancreas (1.89 ± 0.17) μmol/g,liver (1.92 ± 0.16) μmol/g,lung (1.91 ± 0.15) μmol/g,kidney (1.30 ± 0.10) μmol /g and serum (14.93 ± 1.00) μmol /g of SAP 6 h was significantly increased compared with sham operation group (P ＜ 0.05 each group).The content SO2 in the pancreas (2.31 ± 0.23) μmol /g,liver (2.22 ± 0.15) μmol /g,lung (2.17 ± 0.07)μmol /g,kidney (1.55 ± 0.15) μmol /gand serum (18.88 ± 1.56) μmol /g of SAP rats reached the peak 12Hafter treatment and was significantly higher compared with the sham operation group (P ＜ 0.05).Conclusions The increase of SO2 concentration in SAP might be,at least in our present opinion,involved into the pathogenesis of SAP rats.

Objective: To investigate the detection of HIV/AIDS cases in medical institutions in Tianjin Municipality from 2005 to 2021, so as to provide insights into optimization of HIV antibody testing strategies in medical institutions. Methods: All data pertaining to individuals receiving HIV antibody tests in medical institutions in Tianjin Municipality from 2005 to 2021 were collected from the information systems in medical institutions and the HIV/AIDS Prevention and Control Information System of Chinese Disease Prevention and Control Information System. The positive rate of HIV antibody and epidemiological characteristics of HIV/AIDS cases in medical institutions were analyzed. Results: The number of HIV antibody tests increased from 86 102 person-times in 2005 to 1 369 345 person-times in 2021 in medical institutions in Tianjin Municipality, with annual increase by 18.88%. The positive rate of HIV antibody increased from 2.44/104 to 2.85/104 (P<0.05), with annual increase by 2.79/104. Both the proportion of the number of HIV antibody tests and the number of HIV/AIDS cases detected by medical institutions in the whole city appeared a tendency towards a rise (P<0.05). A high positive rate of HIV antibody was seen in sexually transmitted disease clinics (53.69/104) and other testing services (12.25/104), and the highest positive rate of HIV antibody was seen in individuals at ages of 20 to 39 years (5.40/104), while the positive rate of HIV antibody was higher in men (5.84/104) than in women (0.53/104) (P<0.05). A total of 3 610 HIV/AIDS cases were detected in medical institutions in Tianjin Municipality from 2005 to 2021, with a median age of 38 (interquartile range, 24) years. Of all HIV/AIDS patients, there were 3 277 men (90.78%), and men who have sex with men was the predominant transmission route (63.46%), while the proportion of late identification of HIV/AIDS cases was 65.60%. In addition, the proportion of timely detection for the first CD4+T lymphocyte count testing increased from 23.81% in 2005 to 71.54% in 2021 (P<0.05). Conclusions The number of HIV antibody tests and positive rate of HIV antibody appeared a tendency towards a rise in medical institutions in Tianjin Municipality from 2005 to 2021. The HIV/AIDS cases were predominantly identified in sexually transmitted disease clinics and other testing services, and were predominantly men.

Objective: To understand characteristics of men who have sex with men (MSM) who applied for HIV antibody self-testing reagents through "AIDS self-testing" column of a WeChat official account named "Dark Blue Public Health Center" in Tianjin City, so as to provide insights into exploring online modes of HIV antibody self-testing for MSM. Methods: Data of MSM who were 18 years old or above, currently lived in Tianjin City, had sex with men in the past six months and applied for HIV antibody self-testing reagents through "AIDS self-testing" column from May 2018 to December 2022 were collected. Demographic characteristics, results return and positive findings were descriptively analyzed. Results: Data of 2 064 MSM were collected, including 1 052 MSM aged 20 to 29 years (50.97%), 1 522 unmarried MSM (73.74%), 545 workers (26.41%), 1 385 MSM with college education or above (67.10%), and 315 MSM without testing for HIV antibody in the past (15.26%). A total of 6 470 self-testing reagents were applied, and 5 942 testing results were returned, with a return rate of 91.84%. There were 33.28% (687/2 064) of the applicants applying for 66.32% (4 291/6 470) reagents multiple times. There were 73 MSM with positive results, accounting for 1.23%. Conclusions The MSM applying for HIV antibody self-testing reagents through "AIDS self-testing" are mainly young and highly educated, including some who have never tested for HIV. However, attention should be paid to duplicate applications and the return rate should be increased.