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 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 .

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.

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.

10.3969/j.issn.2095-4344.2013.25.018

Objective To study the incidence,risk factors and clinical features of patients with acute hepatic dysfunction induced by sepsis. Methods One hundred and sixty patients with sepsis were assigned to two groups according to liver function: sepsis group and acute hepatic dysfunction group. Logistic regression analysis was used to study the risk factors.The comparison of plasma endothelin-1 ( ET-1 ) and sepsis-related organ failure assessment (SOFA) score between two groups was carried out.Results Of 160sepsis patients,25 (15.6％) patients were subjected to acute hepatic dysfunction induced by sepsis.Logistic regression analysis showed that long-term indulgence in wine drunk (OR =4.102,95％ CI 1.288 -13.063 ),history of cardiac insufficiency ( OR =4.109,95％ CI 1.352 - 12.493) and hypotension ( OR =5.833,95％ CI:1.712 - 19.868 ) were the significant risk factors.Though oxygenation index ( PaO2/FiO2),platelet (PLA) and Glasgow coma scale (GCS) were not different between two groups,the total bilirubin (Tbil),direct bilirubin (Dbil),creatitine (Cre),range of blood glucose variation (Rglu),lactic acid (Lac),plasma ET-1and SOFA score in acute hepatic dysfunction group were higher than those in sepsis group. Mortality rate in acute hepatic dysfunction group was higher than that in sepsis group.Conclusions Long-term drunk,history of cardiac insufficiency and hypotension are the risk factors in acute hepatic dysfunction induced by sepsis.Elevated arterial Lac and plasma ET-1 levels,and higher SOFA score in acute hepatic dysfunction group suggest poor prognosis.

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

A high incidence of esophageal cancer exists in China. Surgical resection remains the dominant therapeutic intervention for patients with operable esophageal carcinoma. However, alternative strategies are actively applied to reduce the frequency of post-op-erative local or distant disease recurrence and to prolong survival. These strategies include neoadjuvant and adjuvant therapies. This review discusses the current knowledge, as well as available data and information, with regard to neoadjuvant and adjuvant therapies for patients with locally advanced esophageal cancer.