BACKGROUND: It is proposed that elevated serum homocysteine is an important independent risk factor for ischemic stroke (IS), and 5, 10-methylenetetrahydrofolate reductase (MTHFR) is the key enzyme for homocysteine metabolism. The relationship between genetic mutation of MTHFR and IS remains controversial.OBJECTIVE: To examine the association of hyperhomocysteinemia and two MTHFR gene polymorphisms with IS in Northwest Chinese population.DESIGN: Case-control study.SETTING: Department of Neurology, First Hospital Affiliated to Jilin University, and Department of Neurology, Xijing Hospital, Fourth Military Medical University of Chinese PLA.PARTICIPANTS: Ninety-seven consecutive patients with ischemic stroke (71 males and 26 females) treated between November 2001 and May 2002were recruited, who were diagnosed by CT scan or MRI in the Department of Neurology, Xijing Hospital, Fourth Military Medical University of Chinese PLA. The control group consisted of 94 subjects (58 males and 36 females) without history of ischemic stroke. All the subjects were free of intracranial hemorrhage, cancer, renal dysfunction, and none used multivitamins or estrogen.METHODS: Serum homocysteine was measured by fluorescence polarization immunoassay. Polymerase chain reaction-restriction length polymorphism (PCR-RFLP) method was employed to detect the genotype at the two sites of C677T and A1298C in MTHFR gene.MAIN OUTCOME MEASURES: Serum homocysteine levels and the genotypic frequency frequencies of the two mutations of MTHFR.RESULTS: The 677T allele frequency was 59.3% in IS patients and 44.7% in the controls, showing significant differences (P=0.006), but no difference in 1298C allele frequency was detected between the two groups (22.7% vs 19.7%, P ＞ 0.05). Homozygous 677TT genotype was closely associated with hyperhomocysteinemie (P ＜ 0.01). In multivariate logistic regression analysis,677T gene mutation and hyperhomocysteinemie were all associated with the IS, with an OR of 1.870 and 1.031 (P＜ 0.05), respectively.CONCLUSION: Hyperhomocysteinemie is a risk factor of IS, and C677T mutation significantly increases homocysteine levels, and serves also as an independent genetic risk factor of IS.

Cost-Benefit Analysis ; Early Detection of Cancer ; Humans ; Mass Screening ; methods ; Neoplasms ; diagnosis ; epidemiology ; therapy ; Program Evaluation

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Fingers ; Humans ; Male ; Middle Aged ; Neuralgia ; therapy ; Young Adult

Objective To investigate the effect of propofol anesthesia on stress response and immune function of laproscopic cholecystectomy.Methods Corticosterone,glucose,complement concentrations in plasma of 20 ASAⅠ～Ⅱ patients under propofol combined anesthesia undergoing elective laproscopic cholecystectomy,were respectively determined before anesthesia,operation,gallbladder ablation and after de-intubation.Results After anesthesia,blood glucose increased while C3 and CH50 decreased gradually(P

The fundus lesions appear in early pathological myopia and develops step by step,causing significant visual impairment.The occurrence of choroidal neovascularization is the main cause for the vision loss.This paper gives an introduction to the prevalence,damages,outcomes,affecting factors and treatment for pathologic myopia,and lays emphasis on the progress of medical treatment with anti-vascular endothelium growth factor.

Objective To study the practicality and repeatability of B-mode ultrasonography on diagnosis and score of carotid atherosclerosis. Methods Ninety-nine B-mode ultrasonography pictures of carotid atherosclerosis were obtained from field investigation. According to the established standard(normal scored as 0, other scored as 1 - 7 by the severity), the 99 pictures were diagnosed and scored once together by three trained inexperienced members of the research team. Ten days later, these pictures were diagnosed and scored respectively, by the three members.The diagnostic results were analyzed with statistical methods to test the feasibility and repeatability of this set of diagnostic and scoring system. Results The joint diagnostic results by the three group members were regard as standard with scores 0 in 27 cases, 1 in 27 cases, 2 in 10 cases, 3 in 4 cases, 4 in 13 cases, 5 in 8 cases, 6 in 6 cases, and 7 in 4 cases. Independent diagnostic results by member A was 0 in 29 cases, 1 in 24 cases, 2 in 11 cases, 3 in 2 cases, 4 in 12 cases, 5 in 11 cases, 6 in 6 cases, and 7 in 4 cases. Independent diagnostic results by member B was 0 in 29 cases, 1 in 22 cases, 2 in 14 cases, 3 in 4 cases, 4 in 13 cases, 5 in 5 cases, 6 in 8 cases, and 7 in 4 cases. Independent diagnostic results by member C was 0 in 28 cases, 1 in 25 cases, 2 in 8 cases, 3 in 5 cases, 4 in 14 cases, 5 in 10 cases, 6 in 4 cases, and 7 in 5 cases. Comparison of the 4 diagnostic scores, the difference was not statistically significant(F = 0.019, P ＞ 0.05). Joint diagnostic results of the three members were compared with the standard and correlation coefficient were 0.977,0.987,0.932, respectively(all P ＜ 0.01 ). The correlation coefficient of diagnostic results of each member were 0.969,0.935,0.928, respectively (all P ＜0.01 ). Diagnostic results of each member were consistent with the standard and the compliance rate were 88.9% (88/99) ,90.9%(90/99) and 86.9%(86/99), respectively. Conclusions B-mode ultrasonography is a non-injure method for diagnosis of carotid atherosclerosis in epidemiology investigation. The method is easy to grasp and has a good repeatability.

Drug delivery system targeting immune system plays an important role in the treatment of inflammatory diseases.Drug delivery system targeting immune system could target immune cells or immune organs.It could be divided into active targeting mediated by the interaction of ligand-receptor or antigen-antibody and passive targe-ting mediated by pH;particles and so on.This review summarizes new progress for drug delivery system targeting immune system;which provides a theoretical reference for designing the safe and effective drug delivery system and providing efficient and safe treatment for inflammatory diseases.

Objective To study the characteristics of pharmacokinetics and pharmacodynamics of insulin dry powder inhalation and its relative bioavailability as compared with subcutaneous injection of regular insulin. Methods In this open,single-center,randomized,two-period,cross-over,euglycemic glucose clamp study,18 healthy volunteers(14 men and 4 women),aged(24.9?1.7)years,with body mass index(20.6?1.2)kg/m~2, received the insulin dry powder inhalatin(80 U)or regular insulin(15 U)subcutaneous administration.The blood samples of this study at 0,20,30,40,50,60,70,80,90,100,110,120,135,150,165,180,195, 210,225,240,270,300,330,360,390,420,450 and 480 rain were taken for serum insulin measurement, meanwhile,glucose infusion rates(GIR)were determined per 5 minutes over a period of 8 hours.Results The C_(max)were(57.9?17.8 vs 114.5?29.7)mU/L(tested vs reference preparation),T_(max)were(46.7?45.6 vs 107.8?33.7)min,GIR_(max)were(3.35?0.98 vs 5.17?1.75)mg?kg~(-1)?min~(-1)and T_(GIRmax)were(88.3?17.0 vs 151.9?34.6)min.The relative bioavailability was(10.26?2.25)%,and the relative bioefficacy was(14.33?7.26)%.Conclusion The study shows that insulin dry powder inhalation is absorbed via lungs and its action sets in earlier than that of the regular insulin injected subcutaneously.These pharmacokinetie and pharmacodynamic data may provide a reliabe guide for further clinical trial.

Objective To elucidate the effects of different modes of partial parenteral nutrition (PPN)on immunological function of T-lymphocyte in non small cell lung cancer(NSCLC)patients during chemotherapy.Methods Ninety-three patients with non-small cell lung cancer were randomly divided into three groups:the control group(30 patients),the low dose of PPN(32 patients) and the high dose of NNP(31 patients).Exactly the same chemotherapy was applied to each of three groups.During chemotherapy,three groups were supplied the same diet,the control group received conventional treatment;the low dose group and the high dose group received additional parenteral nutritional support besides diet.The low dose group was given 250 ml 9-AA daily and the high dose group was given 500 ml 9-AA daily.The T lymphocyte subsets CD3~+,CD3~++CD4~+ ,CD3~++CD8~+ and cells were detected respectively before and after chemotherapy.Results In all of the three groups,the percentage of NK cells,CD3~+ and CD3~++CD4~+ cells were decreased significantly before and after chemotherapy(all P＜0.05),In the control and low dose groups,NK cells changed more significantly after chemotherapy(P＜0.01).The percentages of CD3~+,CD3~++CD4~+,CD3~++ CD4~+/CD3~++CD8~+ of the low dose group and high dose group were higher than those of the control group before and after chemotherapy(all P＜0.05),the percentage of CD3~++CD8~+,CD3~++CD4~+/ CD3~++CD8~+ of the low dose group and hight dose group did not change notably(all P＞0.05). Conclusions The chemotherapy on patients with NSCLC will possibly cause malnutrition and immunosuppression.The benefits of giving 9-AA to NSCLC patients who were applying PPN and undergoing chemotherapy may include antagonizing immunological function aggravation,improving nutrition status and improving immunological functions of the T lymphocytes during chemotherapy.

Objective To observe the clinical curative effect and security of the deproteinised calf serum enteric capsules on nerve functions defect caused by cerebral isehemia damage.Methods A randomized,double-blind,multicentric trial design was conducted.Treatment group:based on routine treatment,the patients were given deproteinised calf serum enteric capsules for 90 days.Control group: based on routine treatment,the patients were given placebo for 90 days.The NIHSS,BI,mRS measuring scale were used for evaluation on the 7th,14th and 28th day before and after treatment.BI and mRS measuring scale were used for evaluation on the 90th day.The change of numerical value was inspected before and after treatment.Results Before treatment,there was no significant difference in the NIHSS,BI and mRS measuring scale evaluation between the groups of treatment and control.After treatment,there were significant differences in the NIHSS,BI and mRS measuring scale evaluation between the groups of treatment and control on the 14th and 28th day (P