Objective To investigate the effects of oxymatrine on liver fibrosis and its mechanism. Methods The rat model of liver fibrosis induced by CCl 4 was set up. The effect of oxymatrine anti-liver fibrosis were evaluated by comparing liver weight index, serum/tissue biochemical indices and the change of tissue pathology before and after oxymatrine intervention. The levels of serum HA,PⅢP,LN and Ⅳ-C were also measured before and after oxymatrine treatment. Results In CCL4-induced liver fibrosis model rats, the levels of serum HA,PⅢP,LN and Ⅳ-C significantly decreased(P

Objective To preliminarily study on the values of microembolic signal(MES)monitoring in the evaluation of anti-Platelet agent or anti-Platelet agent+statins in patients with acute ischemic cerebrovascular disease.Methods Among the patients with acute ischemic cerebrovascular disease in the cm'otid system who performed MES monitoring the MES-positive patients were ramaomly allocated into dual antiplatelet group(aspirin 100 mg/d+clopidogrel 75 mg/d)and dual antiplatelet + atorvastatin goup (aspirin 100 mg/d + clopidogrel 75 mg/d +atorvastatin 20 me4d).MEss were monitored by transcranial Doppler ultrasound.Results Among the 60 patients with acute cerebrovascular disease in the carotid system,13(21.7%)were MES positive.in which,6 and 7 were randomly divided into dual antiplatelet group and dual antiplatelet + atorvastatin group respectively.There were no significant differences in the constituent ratios of sex hypertmsion,diabetes,coronary heart disease,smoking,alcohol consumption,and history of previous stroke as well as the age,time from onset to microembolic monitoring,and time from onset to drug intervention between the 2 groups.There were no significant differences in the numbers of microemboli(8.83±1.17/h vs.9.00±1.83/h)before treatment between the dual alltiplatelet group and dual antiplatdet + atorvastatin group (P=0.851);2 and 7 days after treatment,the numbers of micromixfli were 4.17±1.47 and 2.17±0.75/h respevtively in the dutral antiplatelet group,and they were significantly higher than 1.43±0.976 and 0.71±0.488/h)respevtively in the dual antiplatelet + atorvastatin group (P=0.002 and P=0.003).They were followed up for 8 days;and there were 110 ischemic events in both groups.Conclusions The dual antiplatelet agents or those in combination with statins might reduce the number of MES,but when they were used in combination with statins,the number Of MES reduced more significant.However.because there are only a few patients in the study,this conclusion still needs to be further validatod in a large-scale multicenter randomized controlled trial.The MES monitoring has a certain value in the evaluation of anti-platelet drugs or those in combination with statins

Objective To study 18F-FDG PET/CT and enhanced CT in the evaluation of resectability of pancreatic cancer.Methods The 18F-FDG PET/CT and enhanced CT images of patients with pancreatic cancer were analyzed and the results in assessing resectability were compared.The diagnosis of pancreatic cancer and resectability were confirmed by intraoperative findings and histopathology.Results 31 patients with pancreatic cancer underwent surgery.Complete resection of the tumor was successfully carried out in 18 patients.Palliative operations were performed in the remaining 13 patients because the tumors were unresectable.The sensitivity,specificity and accuracy for unresectabilitywere 94.4％,15.3％,61.2％ using enhanced CT,94.4％,38.4％,70.9％ using 18F-FDG PET/CT,and 88.8％,53.8％,71.3％ using a combination of these two examinations,respectively.There was no significant difference between enhanced CT and 18 F-FDG PET/CT.A combination of these two examinations was significantly better than either one of these examinations.Conclusions Either enhanced CT or 18F-FDG PET/CT was useful,and they complemented each other in assessing resectability of pancreatic tumor.A combination of these two examinations was more evaluable than either one of these examinations.

Carotid atherosclerosis is an important pathogenesis of ischemic stroke.Inflammation plays a crucial role in the artery atherosclerotic genesis and development as well as its caused complications.Human CXC chemokine ligand 16 (CXCL16),as a novel chemokine,involves in the formation and development of atherosclerotic plaques.It may be associated with atherosclerotic stroke.

Objective To investigate the genotype of Trp64Arg polymorphism of β3-adrenergic receptor gene and analyze the role ofβ3-adrenerglc receptor gene in the pathogenesis of morbid obesity and metabolic syndrome(MS).Methods PCR-restriction fragment length polymorphism Was used to detect the genotypes of 172 patients with MS,92 patient.with morbid obesity and 92 controls,and some biochemlcal indexes were detected.The association of the polymorohism with morbid obesity and MS Was assessed in case-control study.Resuits No statistically significant differences were found in the frequencies of Trp64Arg of β3-AR among the three groups.Conclusion Trp64Arg polymorphism of β3-AR was not significandy associated with morbid obesity and MS in the Hazak in xinjiang.

Objective To investigate the changes of serum CXCL16 levels in patients with acute cerebral infarction and their relationship with the Trial of Org10172 in Acute Stroke Treatment (TOAST) etiological types of cerebral infarction. Methods The serum CXCL16 levels in 113 patients with acute cerebral infarction were measured by enzyme-linked immunosorbent assay (ELISA), and they were grouped according to TOAST types. The patients between all the subgroups and/or 32 healthy controls were compared. Results The serum CXCL16 levels in patient group were significantly higher than those in control group (2.29 ± 0.21 ng/mlvs.1.75±0.21 ng/ml, t= 12.863, P= 0.000); The serum CXCL16 levels in large artery atherosclerotic (LAA) stroke group were significantly higher than those in small artery occlusive (SAO) stroke group (2.38 ±0.23 ng/mL vs. 2.21 ±0.11 ng/ml, 1 =5. 743, P =0. 000), and both were significantly higher than those in the control group (q = 20. 501, P = 0. 000; q =13. 527, P= 0. 000). In the LAA group, there were no significant differences between the serum CXCL16 levels in ≥2 artery stenosis group and those in only 1 artery stenosis group (2.34 ±0.24 ng/ml vs. 2.46 ± 0. 19 ng/ml, t = - 1.969, P = 0. 054). Multivariate logistic regression analysis showed that CXCL16 (OR =0.972, 95% CI0.956-0. 978, P =0.001)and hyperlipidemia (OR =3.547, 95%CI 1.160-10. 848, P=0. 020) were the independent risk factors for cerebral infarction. Conclusions The serum CXCL16 levels increased in acute cerebral infarction, it closely related with the occurrence of cerebral infarction, and the LAA stroke group was significantly higher than the SAO stroke group.

Objective To investigate the relationship of microembolic signals (MESs) between the degree of symptomatic carotid artery stenosis, ultrasonic characteristics of plaques, peak systolic velocity at the stenotic site and risk factors for stroke. Methods A total of 52 patients with symptomatic carotid artery stenosis were enrolled. MESs of bilateral middle cerebral arteries were monitored and detected by carotid color Doppler flow imaging. Results The positive rate of MESs on the symptomatic sides was significantly higher than that on the asymptomatic sides (28. 8% vs. 4. 5%, P < 0. 05). The positive rate was not significantly correlated with the degree of stenosis, ultrasonic characteristics of plaques, peak systolic velocity on the stenotic sides, and risk factors for stroke. Conclusions MESs mainly occurred on the symptomatic sides of carotid artery stenosis, and they were more closely correlated with unstable plaques.

Purpose Protein is the main influencing factors for diffusion weighted imaging (DWI) signals and apparent diffusion coefficient (ADC), it results in hyperintensity on DWI and low ADC, but not fully matched in clinic. This paper aims to investigate the effect of protein type and concentration on the signal intensity (SI) and ADC of DWI. Materials and Methods Different concentrations of albumin, globulin solution and the mixed solution were created in vitro. DWI was performed on GE 1.5T superconducting nuclear MRI system. Results ① There was a linear negative correlation between the ADC value and the concentrations of protein solution (at 37℃, ra= - 0.849, Pa<0.05; rg= - 0.843, Pg<0.05; at 40℃, ra= - 0.894, Pa<0.05; rg= - 0.819, Pg<0.05);there was a linear positive correlation between the SI of DWI and the concentrations of the albumin solution (at 37℃, r=0.753, P<0.05; at 40℃, r=0.845, P<0.05). There was no correlation between the SI of DWI and the concentrations of the globulin solution (at 37℃, r= - 0.222, P>0.05; at 40℃ , r= - 0.270, P>0.05). ② SI of the albumin solution was significantly higher than the globulin solution at the same concentration and temperature (t=3.96, P<0.001); the ADC values were not statistically different between the albumin and the globulin solution (t=0.61, P>0.05). Conclusion The nature of the cystic fluid can be understood preliminarily through quantitative analysis of the cystic fluid DWI and ADC values, so as to provide theoretical basis for the qualitative diagnosis of cystic lesions in vivo.

Medical insurance payment reform is an important part of healthcare reform in China. Based on the practice and research of China Rural Health Project ( hereinafter referred asHealth XI Project) financed by World Bank (WB) and UK Department for International Development (DFID) implemented in 40 counties of 8 Chinese provinces between 2009 and 2014 , this thesis analyses the principle and feasible policy route of medical payment re-form for the country, by ways of reviewing the policy evolution, and summarizing the process of project pilot from sin-gle mode of payment-a simple mixed payment-to the comprehensive payment system reform and analyzing the advanta-ges and disadvantages of medical insurance payment methods.

Objective To explore the factors associated with delayed defecation in long-term ventilated patients in intensivecare unit (ICU) and their potential effect on prognosis.Methods A prospective observational cohort study was conducted. The patients admitted to general ICU of the Affiliated Hospital of Qingdao University from October 1st in 2013 to September 30th in 2015 who underwent mechanical ventilation (MV) for ≥6 days were enrolled, and they were divided into early defecation group (< 6 days) and late defecation group (≥6 days). At admission, clinical nutritional support were given as usual, and gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, admission reasons, MV reasons, the usage of morphine and epinephrine/norepinephrine, the highest positive end-expiratory pressure (PEEP), the lowest oxygenation index (PaO2/FiO2) and the lowest systolic blood pressure were collected. Logistic regression analysis was used to analyze the influencing factors of the first defecation time. ICU mortality, the length of ICU stay, central venous catheter (CVC) indwelling time, duration of MV, ICU acquired bacterial infection rate, and the incidence of ventilator associated pneumonia (VAP) were compared between early defecation group and late defecation group. Logisticorgan dysfunction system (LOD) scores and gastric residual volume per day were recorded at the different time of MV.Results Totally 189 patients were enrolled, 39 patients did not satisfied the inclusion criteria and 13 patients gave up treatment or referrals were excluded. Finally 137 patients were enrolled in the analysis, 83 patients in late defecation group and 54 in early defecation group. There were no significant differences in the baseline characteristics such as gender, age, APACHE Ⅱ score, LOD score at 1 day of MV, admission reasons, MV reasons, disgorging and gastric residual volume per day during the first 5 days of MV, enteral nutrition, lactulose treatment in patients with hepatic encephalopathy during the first 5 days of MV, and blood purification treatment between the two groups (allP > 0.05). Compared with the early defecation group, late defecation group had less patients with loose stools or watery stool at first time [15.7% (13/83) vs. 33.3% (18/54)], more patients using morphine and the usage of epinephrine/norepinephrine more than 24 hours [48.2% (40/83) vs. 40.7% (22/54), 42.2%(35/83) vs. 29.6% (16/54)], higher the maximum PEEP level [cmH2O (1 cmH2O = 0.098 kPa): 7.9±3.7 vs. 6.7±3.5], lower the minimal systolic blood pressure [mmHg (1 mmHg = 0.133 kPa): 74.8±28.1 vs. 88.9±30.2] and more severe of hypoxemia [PaO2/FiO2 < 150 mmHg, 54.2% (5/83) vs. 44.4% (24/53)], all of which had significant differences (allP < 0.05). Factors found statistical significances by single factor analysis were enrolled in the multiple regression analysis, which showed that PaO2/FiO2 < 150 mmHg and systolic blood pressure < 90 mmHg were independently associated with a delay in defecation in patients undergoing long-term MV [PaO2/FiO2 < 150 mmHg: adjusted hazard rate: 1.415, 95% confidence interval (95%CI) = 1.061-1.590,P = 0.026; systolic blood pressure 70-89 mmHg:HR = 1.461, 95%CI = 1.164-1.788, P = 0.002; systolic blood pressure ≤ 69 mmHg: adjusted hazard rate= 1.273, 95%CI = 1.010-1.587,P = 0.034). ICU mortality, the length of ICU stay, CVC indwelling time, duration of MV, ICU acquired bacterial infection rate, and the incidence of VAP at 7 days of MV in late defecation group were significantly higher than those of early defecation group [ICU mortality rate: 15.7% (13/83) vs. 7.4% (4/54), the length of ICU stay (day): 17.0 (14.0, 23.0) vs. 15.0 (13.8, 20.0), CVC indwelling time (days): 12.0 (10.0, 14.0) vs. 10.0 (9.0, 11.3), duration of MV (days): 14.0 (10.0, 20.0) vs. 11.0 (9.8, 15.3), ICU acquired bacterial infections rate: 60.2% (50/83) vs. 14.8% (8/54), the incidence of VAP: 32.5% (27/83) vs. 14.8% (8/54); allP < 0.05]. There was no significant difference in LOD score between both groups. The LOD scores at 4 days and 9 days of MV in late defecation group were significantly higher than those of early defecation group (6.41±4.37 vs. 5.21±3.12, 4.33±2.20 vs. 3.50±2.90, bothP < 0.01).Conclusions PaO2/FiO2 < 150 mmHg and systolic blood pressure < 90 mmHg during the first 5 days of MV were independently associated with a delay in defecation in patients undergoing long-term MV. The results suggest that constipation is associated with adverse outcomes in long-term ventilated patients.