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 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 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.

10.3969/j.issn.2095-4344.2013.25.018

AIM:To investigate the pathological changes of aquaporin 4 (AQP4) and related proteins in the rats with focal cerebral ischemia injury , and to observe the effect of silent information regulator 1 ( SIRT1) on the AQP4 ex-pression in order to explore the pathological mechanism of cerebral ischemia and brain edema .METHODS: Adult male SD rats were randomly divided into sham group and middle cerebral artery occlusion ( MCAO) model group.The MCAO model group was divided into the 4 time point (6 h, 12 h, 24 h and 48 h) subgroups.The animal model of MCAO was es-tablished by suture method in mature SD rats .The neural symptom score was measured at the corresponding time points . Morris water maze test was used to study the cognitive function .The cerebral infarction volume was evaluated by TTC stai-ning .The changes of brain water content was analyzed by a dry /wet weight method .The morphological changes of the brain tissues were observed under microscope with HE staining .The protein expression of SIRT 1, MMP-9 and AQP4 was deter-mined by Western blot .RESULTS: Compared with sham group , the neural function score of the rats in MCAO model group was significantly elevated .With the increasing reperfusion time , the cerebral infarction volume , brain tissue permea-bility and the brain water content were also increased .The increases in the protein levels of AQP 4 and the related proteins showed apparent changes .The protein expression of SIRT 1 was decreased , while the MMP-9 expression was increased .The most obvious differences of the protein level changes in MCAO-48 h model group were observed (P<0.01).CONCLU-SION:Accompanied with the aggravating cerebral injury after cerebral ischemia , the process of AQP4 expression is activa-ted with the increasing expression levels of MMP-9 and SIRT1.These factors are combined to induce the formation of brain edema.

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.

Objective Under the requirements of dose distribution in target and normal tissue ,five radiotherapy fields are de‐voted to making Intensity‐modulated radiation therapy (IMRT) plan ,thus the IMRT radiotherapy of Nasopharyngeal Carcinoma (NPC) could be underway with the radiotherapy field as few as possible .Methods Through the comparison of the NPC patients′IMRT plans in our hospital ,the angle of fields have been make out with 0° ,75° ,125° ,225°and 285° .At the same time ,this field scheme is compared with projects of front five fields ,behind five fields and share five fields .The result was statistically analyzed . Results In these four field schemes ,the maximum and minimum dose in the target area showed no statistically difference (P>0 . 05) ,while in the average dose ,D95 and normal tissue dose have statistical difference (P<0 .05) .Conclusion Comprehensive com‐parison of the dose distribution in the target and normal tissue in these four field schemes showed that the field scheme with the an‐gles of 0° ,75° ,125° ,225°and 285°could obtain better results ,so this field scheme should be more suitable for local area NPC patient′s IM RT .

Objective: To introduce recent research progress in anti-diarrhea with single Chinese herb and its effective compo-nents. Methods:The references on anti-diarrhea with single Chinese herb and its effective components in recent years were reviewed and analyzed. Results:The researches on anti-diarrhea activity and possible mechanism of single Chinese herbs, such as Terminalia chebula Retz, Fructus mume, Radix Puerariae and Pulsatilla chinensis ( Bunge) Regel, were reviewed. Conclusion: At present, the researches on anti-diarrhoea with single Chinese herb and its effective components have made some progress, while further and wider researches are still needed to explore the underlying mechanisms.

Aplastic anemia (AA)is a serious disease of hematological malignant disease in children.Severe AA is difficult to treat and may lead to high motality.Acquired AA accounts for 95% of all cases,so it′s significant to lucubrate the pathogenesis of acquired AA for clinic diagnosis and therapy.The documents in recent 5 years are collected,and a reviews about the progress of pathogenesis in acquired AA children is provided.