One hundred and sixty non-diabetic patients with cerebral ischemia of primary onset were enrolled in the study. The patients were divided into impaired glucose tolerance (IGT) group and normal glucose tolerance (NGT) group according to the oral glucose tolerance test (OGTT). Carotid atherosclerosis and carotid artery stenosis were examined with vascular Doppler ultrasonic detection. The incidence rates of carotid atherosclerosis in IGT group and NGT group were 87. 5% (70/80)and 63.8% (51/80)respectively (χ2= 12.240,P <0.001);the incidence rates of carotid stenosis in IGT group and NGT group were 63.8% (51/80) and 47. 5 % (38/80), respectively(χ2 =4. 279, P =0. 039);the degree of carotid artery stenosis in IGT group was higher than that in NGT group(χ2= 21.95, P < 0. 01). The results indicate that IGT may be related to atherosclerosis and stenosis of carotid artery in cerebral ischemic patients.

As an income redistribution mechanism, the design of Urban Resident Basic Medical Insurance ( URBMI) should reflect the inclination to take care of vulnerable populations, such as people with chronic diseases and low incomes. Therefore, whether the healthcare services of vulnerable populations have been improved, is the most important indicator to determine the effectiveness of the URBMI. Using the DID model, this paper analyzes healthcare service utilization of invulnerable and vulnerable populations before and after the establishment of URBMI ( including both outpatient and inpatient) , based on the idea that these two populations have different socio-economic and health status. Then, based on the gap between the healthcare service utilization changes of different groups, we can measure the equity in URBMI. The results show that the establishment and implementation of URBMI has indeed narrowed the gap of invulnerable and vulnerable populations with different socio-economic and health status; health-care service utilization of vulnerable populations has increased significantly, and health status has significantly im-proved. From vertical and horizontal perspectives, the results prove that the establishment of URBMI has improved the equity of healthcare service utilization among different populations across China.

Objective To analyze the treatment and pathogenetic condition of chronic heart failure of coro -nary heart disease(CHD) and ventricular arrhythmia (VA).Methods 100 patients with chronic heart failure were collected to observe the treatment of chronic heart failure and pathogenetic condition of VA .Results 44 cases occured VA and 56 cases without VA in 100 patients.NT-proBNP(3 110.00 ±522.00)pg/mL of VA group was sig-nificantly higher than that (2 200.00 ±486.00)pg/mL of non-VA group(t=8.996,P<0.05).LVEF(0.25 ± 0.08) of VA group was lower than that of non -VA group(0.41 ±0.98) (t=11.625,P<0.05).The occurrence (100.00%) of premature ventricular contraction ( PVC) of ≥70mm group in left ventricular internal diameter (LVID) was higher than that of 60 -69mm group (60.87%),50 -59mm group (37.04%),40 -49mm group
(15.38%) with statistically significant(χ2 =5.853,12.532,27.375,all P<0.05).The amount(44.20 ±12.90)mg of use βreceptor blockers of amiodarone group was significantly lower than that of non -amiodarone group(44.20 ± 12.90)mg (t=5.284,P<0.05).Conclusion NT-proBNP of CHEF of CHD and VA patients will improve and amiodarone can reduce the amount of use anti -heart failure drug .

OBJECTIVE: To observe the release mode and the amount of retention in skin of podophyllotoxin liposomes in topical application. METHODS: Two kinds of podophyllotoxin liposome suspension (DPPC liposome and bean lecithin liposome) and podophyllotoxin tincture in same concentration were topically applied on the skin of porkets and the amounts of retention of drug in skin of different preparations were detected with confocal laser scanning microscope.RESULTS: The quantity of retention of podophyllotoxin DPPC liposome in epidermis and superficial layer of dermis was larger than those of other two preparations and the drug concentration in applying DPPC liposome kept higher for 48 hours.CONCLUSION:Podophyllotoxin liposome coated by DPPC is much more targetable to skin and is a fairly good topical preparation for applying on skin.

Objective To explore the peer assisted learning approach combined with micro-teaching in anesthesia internship for oversea students.Methods 60 international medical students were randomly divided into two groups.Students in the control group have peer guidance before routine theatre observation,while students in experimental group discuss micro-teaching of anesthetic skills with each other by watching real time videos from smart phone.Students' subjective attitudes to new approach were evaluated and their final exam score were analyzed.SPSS 1 1.0 was used for data processing and the data was made descriptive analysis,t test and analysis of variance.Results Students in experimental group did better in both theory exam (46.8 ± 4.03) vs.(35.7 ±6.12) and practice exam (35.2 ± 3.20) vs.(27.6± 4.71) than those in control group,and the total scores of two groups were (80.5 ± 7.40) and (63.1 ± 6.81) respectively.These scores all had significant difference between two groups.More students from experimental group than those from control group feel interested in anesthesiology (P＜0.01) and feel confident about exams (P＜0.05);There was no difference between two groups in understanding clinical guideline (P=0.57).Conclusion Peer assisted learning combined with micro-teaching is proved to enhance the quality of anesthesia teaching during internship for oversea undergraduates.

Objective To examine the association of employment-related events with depression and anxiety in senior college students in China.Methods Altogether 1321 senior college students were recruited from Central South University and the survey was administered anonymously. Anxiety and depression were assessed with the Self-rating Anxiety Scale (SAS) and the Center for Epidemiologic Studies Depression Scale (CES-D), respectively. Employment-related events were reflected by the employment-related options when students were surveyed. Logistic regression was used to estimate the effect of employment-related events on anxiety and depression.Results We collected 1178 valid questionnaires. Taking 50 and 16 as the cutting-point of SAS and CES-D, we found 18.9% and 55.4% of the participants showed symptoms of anxiety and depression, respectively. After controlling confounding factors, those students who had taken the entrance exam of graduate schools and were optimistic for the result, those who had taken the entrance exam of graduate schools but were pessimistic for the result, and those who neither took the entrance exam of graduate schools nor received a job offer, had a higher risk of anxiety than those who would attend a graduate school without exam, and the odds ratios were 2.5, 2.3, and 3.5, respectively. For students' depression, the odds ratios of the three categories mentioned above were 2.0, 1.5, and 2.6, respectively. Conclusion Senior college students who face bad employment-related events are at a higher risk of anxiety and depression.

BACKGROUND:At present, some neurological imaging methods, including MRI, fMRI, 2-(1-(6-[(2-[18F]fluoroethyl)(methyl)amino]-2-naphthyi) ethylidene) malononitrile (18F-FDDNP) positron emission tomography (PET), are helpful but not specific for the diagnosis of Alzheimer disease (AD). 18F-FDG is a special marker of beta-amyloid (Aβ), thus AD can be diagnosed by 18F-FDDNP PET at early period.OBJECTIVE: To evaluate the role of 18F-FDDNP PET in the diagnosis of AD, and establish reliable clinical biological indexes for the diagnosis of AD patients.DESIGN: A controlled analysis.SETTINGS : Department of Geriatric Neurology and Department of Nuclear Medicine, the General Hospital of Chinese PLA. PARTICIPANTS: Patients visiting the General Hospital of Chinese PLA from May 2004 to March 2005 were selected. Informed consents were obtained from all the participants. ① AD group (n =7): (74.88±12.03) years old; Accorded with the criteria related to diagnosis of AD in NINCDS/ADRDA (National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer Disease and Related Disease Association) and revision of Diagnostic and statistical Manual (DSM-Ⅳ, 4th ed.); brain CT or magnetic resonance imaging (MRI) examination displayed that inter-uncus distance of temporal lobes was ≥ 30 mm. ② Vascular dementia group (n =6): (73.83±4.75) years old; Accorded with the diagnostic criteria of NINDS-AIREN (National Institute of Neurological Diseases and Stroke, USA) and DSM-Ⅳ for vascular dementia; Inter-uncus distance of temporal lobes ＜ 30 mm. ③ Control group (n =6): (71.17±3.71) years old; Without rarefaction of white matter; Intelligence examination was normal.METHODS: PET was performed in all the subjects. PET scanner type was SEIMENS ECAT EXACT HR. The tracer selected was 18F-FDDNP which had radiochemical purity higher than 95% and error of radioactivity measurement lower than 10%. The images were collected at 5, 25 and 45 minutes after injection of 18F-FDDNP. Horizontal and coronary tomograms of brain were obtained after reconstruction.MAIN OUTCOME MEASURES: Characteristics of 18F-FDDNP brain PET images.RESULTS: ① In the control group, signs of obvious atrophy of brain were not seen. At about 45 minutes, the radioactivity in cortex and subcortical nucleus groups was essentially cleared and the structures of brain could not be differentiated clearly. ② In the vascular dementia group, brain atrophy and enlargement of ventricular system to various degrees could be seen. The clearance of radioactivity at three time points was similar to that in the control images. ③ In the AD group, the brain was obviously atrophied and the ventricular system was enlarged. The clearance of radioactivity at the three time points was significantly different from the images of other two groups. The radioactivity in cortex and hippocampus was cleared slower. At 45 minutes, the gray matter could still be clearly differentiated from the white matter, but the radioactivity in corpus striatum and thalamus was not higher than that in cortex and much radioactivity retention could be seen in cortex and hippocampus.CONCLUSION: 18F-FDDNP PET brain images can differentiate AD and vascular dementia, and it is an effective imaging index for the diagnosis of AD.

Objective To investigate the phenotype and the immunoregulatory function of CD8αα+TCRαβ+regulatory T cells in peripheral blood samples from mice.Methods The distribution profile and the phenotype of CD8αα+TCRαβ+regulatory T cells in C57BL/6 mice were detected by flow cytometry.The cytokines released by CD8αα+TCRαβ+regulatory T cells upon the stimulation with anti-CD3 antibody were analyzed by cytometric bead array.The in vitro immunosuppressive activity of CD8αα+TCRαβ+regulatory T cells on activated CD4+T cells was analyzed by using flow cytometry and carboxyfluorescein succinimidyl ester ( CFSE ) .An adoptive cell transfer assay was set up to evaluate the immunoprotective effects of CD8αα+TCRαβ+ regulatory T cells in a mouse model of experimental autoimmune encephalomyelitis ( EAE) .Results CD8αα+TCRαβ+regulatory T cells were detected in liver, spleen and peripheral blood samples collected from na?ve C57BL/6 mice.Compared with CD8αβ+TCRαβ+regulatory T cells, CD8αα+TCRαβ+regulatory T cells showed a memory-activated phenotype of CD25+CD122high CD44high CD62Llow CD69high NK1.1+DX5+.CD8αα+TCRαβ+regulatory T cells could produce IL-2 after 24 hours stimulation with anti-CD3 antibody, followed by producing IFN-γ, TNF-α, IL-4, IL-17A and traces of IL-6 and IL-10. In vitro, CD8αα+TCRαβ+regulatory T cells specifically suppressed the proliferation of activated CD4+T cells ( P<0.01 ).Moreover, they could delay the onset of EAE in mice and reduce clinical score (P<0.01).Conclusion CD8αα+TCRαβ+regulatory T cells were a unique population with immunoregula-tory function, which could be used as a potential therapeutic target in the treatment of autoimmune disease.

Objective To analyze differences of serum proteins measurements by different methods in different systems and investigate whether the assigned serum valued by ERM-DA470k/IFCC can replace ERM-DA470k/IFCC in clinical measurements to promote the harmonization of serum proteins measurements.Methods Serum specimen was collected from 100 medical examination persons in Zhongshan Hospital (Jun 2012; age:27-73; 47 male and 53 female).Serum IgA,IgG,IgM,C3c,C4,TRF and PA of health persons,ERM-DA470k/IFCC and the assigned valued by ERM-DA470k/IFCC were measured by Hitachi 7600 (Roche and DiaSys reagents),Siemens BN Ⅱ (Siemens reagent) and Beckman IMMAGE (Beckman reagent),respectively.ERM-DA470k/IFCC was used as a calibrator to value the mixed serum.Serum proteins results obtained from the same methods were compared by T test and Wilcoxon test,and analysis of variance and Firendman test were used to compare results from different methods.The correlation of two groups was analyzed by linear regression.Results The differences of serum proteins results measured by two immunonephelometries,two immunoturbidimetries and all assays were statistically significant (P ＜0.05),respectively.The serum proteins results measured by two immunoturbidimetries showed good correlation (R2 were all above 0.97 except for C3c).In contrast,the serum proteins results measured by two immunonephelometries show poor correlation (R2 were all ranged from 0.90 to 0.94) except for IgM (above 0.96).The serum IgA,IgG and IgM results measured by different methods show good correlation (R2 were all above 0.95) Based on certified values of ERM-DA470k/IFCC,serum protein results measured by different methods could be harmonized,and got similar results from the assigned serum (P ＞ 0.05).Conclusions There is significant difference of serum proteins results detected by different methods.The ERM-DA470k/IFCC and certified serum can make serum protein results obtained from different methods harmonized.

A total of 68 patients with histologically proven endometrial cancer were preoperatively evaluated with a 3.0 T magnetic resonance (MR) unit.Two radiologists interpreted the depth of myometrial invasion on T2-weighted and diffusion-weighted(DW) MR (b =700 s/mm2) imaging.Myometrial tumor spread was classified as superficial (＜ 50％) or deep (≥50％ myometrial thickness).Statistical methods included Kappa statistics for reader agreement,accuracy assessment and receiver operating characteristic analysis for diagnostic performance comparison.For assessing the depth of myometrial invasion,the diagnostic accuracy,sensitivity and specificity were as follows:T2-weighted imaging-reader 1st,61.8％,60.0％ and 65.2％;reader 2nd,66.2％,64.4％ and 69.6％ ; T2-weighted combined DW imaging-reader 1st,86.8％,84.4％and 91.3％ ; reader 2nd,89.7％,86.7％ and 95.7％.Reader agreement was excellent for T2-weighted combined DW imaging (Kappa =0.818).For assessing deep myometrial involvement,ROC analysis showed that the diagnostic accuracy was significantly higher on T2-weighted combined DW imaging than that on T2-weighted imaging.The AUC (area under the curve) values measured by two readers on T2-weighted and T2-weighted combined DW imagings were 0.626,0.879 and 0.670,0.912 respectively.The addition of 3.0T MR diffusion-weighted to T2-weighted imaging can improve the diagnostic performance of MR imaging in the assessment of myometrial invasion.