As a new biomarker and a member of transforming growth factor super family,growth differentiation factor-15 (GDF-15) is increased in some pathological situations,and plays a positive role.Increasing evidence from animals and clinical trials has indicated that GDF-15 is a promising biomarker to be used for diagnosis,screening,risk stratification and prognosis evaluation in acute coronary syndrome,heart failure and pulmonary vascular diseases.However,there are still numerous challenges and problems need to be resolved in the future,such as appropriate cut-off value in diagnosis and risk stratification in different cardiovascular diseases,improvement in sensitivity and specificity,and combinational application with other biomarkers.

A continuous noninvasive method for blood pressure (BP) estimation by pulse wave transit time (PWTT) is described. A constant linear relation is available between PWTT and BP, but characteristic parameter for the relation is different for different persons. According to hydrostatics, BP in some vessel changes with different body postures. In this paper, the difference, i.e. △BP, between two BP values with different body postures is gained. ECGs and surface pulse waves are also obtained, and then values of PWTT are calculated. Through the A BP and PWTT acquired above, parameter b of BP equation can be determined, and then parameter a is computerized through the measurements and one BP value. Thus a BP equation is got, which can be used to estimate BP values through continuous measurement of PWTT. Compared with the value from invasive BP measurement, the value from this method has an error rate less than 5%. The method is feasible for noninvasive continuous BP monitoring.

Objectives To investigate the expression of TGF-?receptors and signaling protein SMADs mRNA in psoriatic lesional and nonlesional skin,and to analyze their role in the pathogenesis of psoriasis.Methods Expression of TGF-?receptorⅠ,TGF-?receptorⅡmRNA and different SMADs(SMAD2,3,4,6,7)mRNA was investigated by real time PCR method in lesional and nonlesional skin of13psoriatic patients and10normal controls.Results The mRNA expression of TGF-?receptors and all kinds of SMADs was significantly down-regulated in psoriatic lesional skin compared with normal skin con-trols(P0.05).Conclusions There is down-regulated TGF-?pathway in psoriatic lesional skin,which may further indicate that lack of TGF-?mediated growth inhibition might play an important role in the pathogenesis of psoriasis.

Objective To investigate the experience of microinvasive surgical occlusion of ventricular septal defect (VSD).Methods A total of 142 children with VSD was given microinvasive surgical occlusion from March 2009 to December 2013 at our hospital.There were 90 males and 52 females,the age ranged from 8 months to 11 years,and body weight from 7 kg to 35 kg,and ventricular septal defects were divided into membranous type,film cycle headquarter type,pulmonary valve type,and muscle type.The diameter of VSD was 2 ～ 10 mm.Under general anesthesia,an incision was made in the lower part of sternum or intercostals space,and a special occluder was inserted to close the ostium via right ventricle puncture under the guidance of transesophageal echocardiography.Results A total of 139 cases had successful occluded with a 97.8％ of successful rate,using blocking umbrella 4 ～ 12#,including 25 eccentric umbrella.Two cases were operated under extracorporeal circulation because of aggravated aortic valve insufficiency.One case without handled muscular ventricular septal defect combined atrial septal defect for guide wire pass muscular defect failed.Full set did not have death and third degree A-V block.Conclusions Microinvasive surgical occlusion is easy to handle,operation-time short,and relative broad for the closure of ventricular septal defect.It has a fast recovery and good effectiveness with a beautiful outlook and safety.

In the perspective of medical ethics,doctor-patient relationship is a particular kind of social relations that contains a combination of factors such as biological,psychological and social basis,including certain moral standards and ethical norms formed.Ethical property is a fundamental property of the doctor-patient relationship.In current medical practice,doctor-patient relationship unprecedented tensions,conflicts between doctors and patients,the frequent occurrence of medical trouble,has become the social factors of disharmony and highly attention.In order to make the medical humanity regression and construct a new doctor-patient relationship reflecting equality and cooperation,with medical ethics as the angle of view,the author the author has discussed and demonstrated how to improve doctor-patient ethics accomplishment,rebuild the doctor-patient relationship of trust,reshape the respect for life and personality of medical humanism spirit,safeguard the equality of the subject position of both doctors and patients,and how to provide humane medical services etc.in order to indicate the direction for the deepening of China's reform of the medical system and provides theoretical support.

Androgen has broad biological effects. Androgen and its receptor exist widely in the cardio-cerebrovascular system and play an important protective effect in the multiple aspects of the occurrence and development of ischemic cerebrovascular disease (ICVD). In addition to involving in regulating the risk factors for ICVD, such as atherosclerosis,dyslipidemia, hypertension, coagulation-fibrinolysis abnormalities, obesity, and diabetes, androgen also has neuroprotective effect. This article reviews the protective effect of androgen in ICVD.

This study was aimed to define the scope of traditional Chinese medicine (TCM) informatics standards. The basic construction of three-dimensional profiling framework includes TCM business domain, elements of TCM informationization and specificity level. The clinical informatics standards development was stated as an example to demonstrate the application method of this three-dimensional profiling framework.

Objective To investigate health equity status of urban dwellers with different social stratification and provide evidence for health promotion.Methods 1,007 urban dwellers were surveyed in Zhejiang province in a stratified sampling based on their income,occupation and education,with their health equity analyzed.Results The proportion of urban dwellers to participate in social health insurance reached 97.5％,a proportion of statistical significance (P＜0.05).The two-week prevalence rate and two-week attendance rate of urban dwellers of different social stratification has no significant difference,but the rate of sickness without attending was significantly negatively correlated to social stratification.The proportion of no visiting because of poverty was 23.1％ in the lower social class,3.2％ in middle and lower class,and 0％ in the middle and upper class,a difference being statistically significant (P＜0.001).The outpatient clinic of first choice and ranking of the hospital was positively correlated to social stratification.Conclusion There is health inequity for urban dwellers with different social stratification,for which the government should pay more attention to lower social class.

Cerebral venous thrombosis (CVT) refers to thrombosis of the intracranial veins and sinuses, which is a rare type of cerebrovascular disease.Due to this highly variable and nonspecific clinical presentations, CVT can be difficult to diagnose.Understanding the pathophysiology and etiology of CVT helps to understand its clinical symptoms and imaging findings and guide the treatment.This article reviews the related advances in the pathophysiology and etiology of CVT.

Objective To investigate the preventive effect of thin foam dressings(Allevyn Thin)combined with ice compress on facial plastic postoperative swelling and to summarize the nursing key points.Methods Sixty patients after facial plastic surgeries in our department were randomly divided into the observation group and the control group with 30 cases in each group.In the control group,ice packs wrapped with sterile gauze were placed on the patients’ wound dressings postoperatively and fixed properly for 30 to 40 minutes with an interval of 30 minutes,6 to 10 times a day for 72 hours postoperatively.In the observation group,thin foam dressing was stick to the wounds,followed by ice compress as in the control group.The facial swelling degrees of both groups were compared on day 3 and day 7 postoperatively.Result The swelling degree in the observation group was significantly smaller than that of the control group(P<0.01).Conclusion Thin foam dressings combined with ice compress can effectively improve the postoperative early swelling of patients receiving facial plastic surgery and therefore it is worthy of clinical popularization and application.