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.

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 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 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.

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.

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.

Injury of choledocho-pancreatico-duodenal junction refers to the penetrating injury of the bile duct, pancrea-tic duct or duodenal wall in the region of ampulla of Vater. It is often caused by improper operation of surgical instruments, and may lead to leakage of bile, pancreatic or duodenal contents into retroperitoneal space and chemical corrosion in a wide range of retroperitoneal soft tissue, which result in severe secondary infection or even death. Leakage of contrast media, hypertrophy of tissue and anatomical changes were the evidences for injury of choledocho-pancreatico-duodenal junction. Injury of choledocho-pancreatico-duodenal junction can be. divided into 4 types, and treatment selected according to different types of injury is neces-sary for the prognosis of patients.

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 current status of diagnosis, treatment and referral of pulmonary tuberculosis in general hospital. Methods Statistical reports of hospital work, notification forms of tuberculosis (TB) cases on the internet, registration book of laboratory sputum mgcobacteria examinations, statistical reports of X-ray examinations for outpatient department, referral forms for mycobacteria patients, medical records for hospitalized patients at the respiratory ward of the People's Hospital, Peking University during August 2005 to July 2006 were reviewed and analyzed. Results In outpatient pulmonary department, there were 45 055 visitors during the period of August 2005 to July 2006,and 4960 of them (11.0%) had their chest X-ray examined, 1 512 (3.4%) had sputum mycobacteria examined with smear-positive in 24 cases, 189 (0.4%) were referred to specialized TB dispensaries for further diagnosis and 183 with notification forms with a notification rate of 96.8%, and 30 (0.1%) were finally diagnosed as TB after hospitalization with an interval less than 14 days between onset of symptoms and diagnosis in 27 of the 30 (90.0%) and 26 were referred to a specialized TB dispensary (86.7%) for treatment. Conclusions On general, detection, diagnosis and referral of TB in People's Hospital of Peking University are in a good situation.However,more aUenfion should be paid to the following aspects：① quantity and quality of sputum myeobacteria examinations for outpatients should be improved further,②chest radiograph reading by radiologists and clinicians need to be improved,and ③consciousness of early detection for TB need to be enforced in physicians by bronchoscopy and pathological diagnosis,especially in those with complicated and difficultly diagnosed smear-negative TB.

Owing to the continuous improvement of surgical techniques and multiple adjunctive therapy,postoperative convalescence of patients has reached great achievements.There are,nevertheless,many problems left for us to discuss.Fast-track surgery employs a variety of methods,such as neodoxy of oral bowel preparation,intraoperative anaesthesia and fluid management,maintenance of body temperature,early ambulation,pain relief etc,to reduce the morbidity of operative stress,complications,and suffering of patients,as well as accelerating the postoperative convalescence so as to shorten the time patient spend in hospital.Fast-track surgery develops a"patient-centered"attitude,and establishes an ultimate goal as giving full benefit to patients when they are in hospital.