Wuhu City has been exploring,since 2007,an innovative health and medical system featuring both the reform of public hospitals and that of the primary care system.This reform aims at strengthening the public health service system,improving the basic medical service system,speeding up the construction of the medical security system,and improving the drug supply system.It is characteristic of a core,two wings,and four-wheel drive,which tells the essence of Wuhu' s reform practices and outcomes.

Objective To investigate the risk factors of restless leg syndrome (RLS) among male elders.Methods A case-control study between 148 old male RLS patients (case group) and 155 non-RLS male elders (control group) was conducted to investigate the risk factors of RLS.The general demographic data (age,education level,marital status,etc.),lifestyle (including physical exercise,smoking and alcohol) and past medical history were compared between two groups.Univariate analysis and non-conditional multivariate Logistic regression analysis was conducted by SPSS 13.0 software.Results In univariate analysis:there was significant difference in history of Parkinson disease between two groups [8.8％ (13/148)vs.3.2％ (5/155)] (P ＜0.05),but there was no significant difference in smoking,alcohol,physical exercise,history of diabetes mellitus and history of peripheral nerve disease between two groups (P ＞ 0.05).The serum creatinine in case group was higher than that in control group [(103.92 ± 32.07) μ mol/L vs.(85.35 ± 36.14) μ tmol/L] (P =0.000),and there was no significant difference in systolic blood pressure,diastolic blood pressure,hemoglobin,fasting blood glucose between two groups (P ＞ 0.05).Multivariate analysis showed that after adjusting for potential confounders,history of Parkinson disease and peripheral nerve disease,and serum creatinine was the independent risk factors of RLS among male elders.The values of OR(95％ CI) were 5.68(1.046-30.846),4.13(1.109-15.368),1.02(1.014-1.036),respectively.Conclusion Histories of Parkinson disease and peripheral nerve disease and serum creatinine are the independent risk factors of RLS among male elders.

It is well known that the macrophages play an important defensive role in the innate immune system. During recent years, with the introduction of the concept of chronic low-grade inflammatory diseases and their further intensive study, the activation and balance of macrophage, as well as its inflammatory effects in chronic lowgrade inflammatory diseases, such as obesity, type 2 diabetes, atherosclerosis, and non-alcoholic fatty liver, are gradually becoming a hot topic of current research. The present article mainly gives an overview of the important role played by macrophages in the inflammatory effects in these diseases.

ObjectiveTo investigate the expression and significance of CDX2,Ki-67 in adenoma and colorectal adenocarcinoma,and the correlation between CDX2 and Ki-67.MethodsThe expression of CDX2 and Ki-67 was evaluated in the colorectal adenocarcinoma,adenoma and normal colorectal mucosa as control subjects by immunohistochemistry.ResultsThe magnitude of CDX2 were negatively correlated with the level of dysplasia in adenoma(rs=-0.38,P =0.02),and negatively correlated with differentiation,lymph node metastasis,diversion and Dukes stage of cancer in colorectal adenocarcinoma(rs=-0.49,rs=-0.37,rs =- 0.38,rs =-0.37,P =0.01).The expression and relativity of Ki-67 in the samples were contrary to the CDX2.The levels of CDX2 and Ki-67 expression had significant difference between the adenoma and adenocarcinoma,and showed negatively correlation in this two type tissues (rs=-0.69,P =0.00; rs =-0.40,P =0.00).ConclusionsCDX2 may be used as an effective marker to evaluate malignancy degree and prognosis of large bowel neoplasm patient.The levels of Ki-67 expression in colorectal adenocarcinoma are correlated with malignancy degree and clinical stage.The expression of CDX2 is negatively correlated with Ki-67.Combined detection of CDX2 and Ki-67 may be helpful for the judgment of colorectal tumor biological characters.

Objective To investigate the family caregivers of patients with indwelling catheter care behavior .By analyzed its in‐fluencing factors to help caregivers improve the quality of life for patients .Methods Convenience sampling method by visit 70 pri‐mary caregivers of family indwelling catheter for the patient′s .They were investigated with gathering general information and Gen‐eral Self‐Efficacy Scale(GSES) ,following with caregivers awareness questionnaire indwelling catheter .Indwelling catheter care be‐havior questionnaire survey analyze behavior and other items to take care of the relationship .Results The general self‐efficacy and caregiver indwelling catheter cognition ,which account for 73 .9% of the total variance of caring behaviors ,were the important fac‐tors affecting care behaviors .Conclusion There is a big shortage in indwelling catheter home care caregiver knowledge and care be‐haviors .According to above professionals can provide targeted guidance for caregivers .

Objective To investigate the influence of plasmid spread and ampD mutation to Enterobacter cloacae that leads to the AmpC β-lactamase change from inducible type to constitutive type. Methods The Enterobacter cloacae were isolated from the patients with nosocomial infection. The inducible type isolations and their constitutive type changers were put into the same group. The plasmid ampC gene and chromatin ampD gene in pairs in each group were amplified, sequenced and compared. Results Of 195 patients infected by Enterobacter cloacae of inducible type, 25 (12.82%) were changed to the ones of constitutive high type. In these 25 changed groups, 10 were caused by plasmid spread, 10 by ampD mutation, 1 by both, and 4 by neither. Twelve changed constitutive type strains had ampD significant mutations, in which 7 were frame-shift mutations and 5 were spot mutations. Conclusions The change ratio of Enterobacter cloacae from inducible type to constitutive type is rather high. Both plasmid spread and ampD mutation are possibly the mechanism of such change. Plasmid mediated AmpC β-lactamase spreads among different species and interregionally. The mutation rate of chromatin ampD gene is also higher than the natural mutation rate. These two mechanisms should be considered in clinical treatment.

Restenosis after interventional treatment is the major factor infheneing the result of percutaneous transluminal angioplasty, and it is a hot and difficult research in recent years. Endothelial progenitor cells are a class of proliferation and able to differentiate into vascular endothelial precursor cells, and take part in the repair and angiogenesis after endothelial injury-intimate. It is expected to play an important role in the prevention of vascular restenosis after interventional treatment. In this article, we reviewed the endothelial progenitor cell research overview and advances of prevention of restenosis after interventional therapy in recent years.

Objective To determine the frequency of the cholesteryl ester transfer protein (CETP)-TaqIB polymorphism and investigate its relationship with plasma lipid levels and coronary hert disease(CHD). Methods Two hundred and thirty-eight patients with CHD (CHD group) and 203 age-matched controls( control group) were selected, the CETp-TaqIB mutation was detected by restriction fragment length polymorphism of the CETP gene. Results In the total subjects, the frequency of B1 and B2 alleles were 59.4%(262/441 ) and 40.6%( 179/441 ) respectively. Compared with that in control group, the frequency of CETP genotype BIBI was higher in CHD group [39.9%(95/238) vs 29.6% ( 60/203 ), P<0.05], and the frequency of B1B2 was lower in CHD group [44.1%(105/238) vs 53.7%(109/203), P< 0.05]. Compared with that in the B2 homozygotes, high density lipoprotein cholesterol (HDL-C) and apolipoprotein (apo)A I level were significantly lower in the B1 homozygotes [(1.19±0.36) mmol/L vs (1.38±0.39) retool/L,( 1.17±0.33 ) g/L vs ( 1.30±0.31 ) g/L, P<0.05]. The B 1 homozygotes was associated with higher degree of cononary stenosis than the B2 carriers (P<0.05 ). There was no significant association between CETP-TaqIB genotype and the risk of CHD (P=0.147). Conclusions CETP-TaqIB polymorphism affects the concentrations of lipaproteins. There are significant associations between the B1 homozygotes and lowerHDL-C and apo A I levels. The B1 allele is not an independent risk factor for CHD.

The diagnosis of post-concussion symptoms (PCS) has been a controversial issue because of that its pathogenesis is often involved in both neural damage and psychosocial factors. Recent researches have examined the diagnostic and evaluating value of several available methods or tools, including clinical interview, conventional CT and magnetic resonance imaging (MRI), neuropsychologic testing and neurochemical test. In mild traumatic brain injury (MTBI), there exist diffusive damages to white matter distributed particularly near the gray matter-white matter boundary and in the long white-matter tracts in midline structures. The conventional imaging techniques are unable to detect any positive evidence due to the diffusive nature of these injuries. This paper is to review epidemiologic study, diagnostic criteria and relevant disputes, conventional diagnostic strategy and new MRI techniques, and then evaluate the application and prospective value of them in the diagnosis and rating of PCS and MTBI. Non-invasively quantitative assessments of modern brain imaging technique may be developed to sensitive and promising tools in the diagnosis and forensic evaluation of PCS.

OBJECTIVE To investigate the clinical and pathological characteristics and its diagnosis and treatment of the parotid gland tumor in children.METHODS The clinical data of 77 children with parotid gland tumor treated in Department of Head and Neck,Tianjin Cancer Hospital affiliated Tianjin Medical University from Dec.1985 to Dec.2007 were retrospectively studied.RESULTS Among the 77 cases,51 cases were benign tumor(66.2%),26 cases were malignant tumor(33.8%).Among the benign cases,hemangioma and lymphangioma were the most common diseases,which accounted for 37.3%(19/51).Mucoepidermoid carcinoma(34.6%, 9/26) was the most common malignancy.Sixty seven cases were treated surgically.Among 18 cases of the epithelial malignant tumors,7 cases treated combined with postoperative radiotherapy.During the period of following-up from 1 to 17 years,1 case of pleomorphic adenoma,1 case of malignant myoepithelioma and 1 case of mucoepidermoid carcinoma recurred. CONCLUSION The clinical and pathological features of parotid gland tumors in children were different from those in adults.The hemangioma,lymphangioma and teratoma are rare in adults but common in children.Half of the solid tumors of parotid gland in children are malignant,but only 23.7%in adults. The primary radical operation has great value to the prognosis of children parotid tumor.Although postoperative radiotherapy can reduce the risk of recurrence,oncogenesis in thyroid gland and the adverse effect on the orofacial development of radiotherapy in children need investigated clinically in future.