Objective To investigate the expression of proliferating cell nuclear antigen (Ki67) in hepatitis B virus (HBV) related hepatocellular carcinoma (HCC) tissue and its correlation with clinicopathological parameters of HBV related HCC. Methods HBV-related HCC patients (n=134) were divided according to Ki67 index (the percentage of Ki67-posi?tive cells) into Ki67 index<10%group (negative group, n=30) and Ki67 index≥10%group(positive group, n=104). The cor?relation of Ki67 index with age, gender, glypican 3 (GPC3), histological grade, BCLC (Barcelona Clinic liver cancer) staging, portal involvement, AFP (AFP), liver function related child-pugh classification data were calculated in both groups. Ki 67 in?dex is set according to the interval score to assess the relationship between Ki67 score and BCLC classification. Results (1) SP staining showed, Ki67 present a trend of increase from normal liver tissue to well-differentiated to medium differentiat?ed tissue to poorly differentiated tissues intensity. (2) In positive group, Ki67 index was correlated with BCLC staging, portal metastasis, histological grade, GPC3 and AFP (P<0.05);By contrast, in negative group, Ki67 index was not correlated with any clinical parameter (P>0.05). (3) Ki67 score increases with the progress of BCLC classification. Conclusion In Ki67 positive group, Ki67 index combined with GPC3, histological grade, BCLC staging, portal involvement, AFP and liver func?tion child-pugh classification can assess the severity of the patients with HCC, which is expected to become an important in?dicator for the HBV-related HCC early diagnosis.

Clinical tutors' personality manifesting during the process of clinical practice and daily communication with medical interns has a series of influences on medical ethics formation of medical interns,including influences of direction,demonstration,contraction,and halo effect.Thus,clinical tutors should pay attention to cultivating a decent moral personality,and hospitals should value the proper combination of moral evaluation and supervision for medical staff in order to achieve the unity of heteronomous morality and self discipline,and effectively promote the formation of decent morality and personality of clinical tutors.

0.05);the preoperative use rate was 8.6% and 65.1%(P0.05);both groups used drug mainly in vein and in single mode.CONCLUSIONS After the implementation of the Guideline the rational use of antibiotics is improved but there are some problems needed to manage further.

Objective To evaluate the effects of propofol on TREM-1 expression in THP-1 cells stimulated by lipo-polysaccharide (LPS). Methods Cells were divided into 7 groups: (1) control group; (2) LPS group that was exposed to LPS in final concentration of 100μg/L;(3) Progroup that was incubated with 100μmol/L propofol;(4-7) groups combined 100μg/L LPS with propofol at different dose of 12.5μmol/L (P1 group), 25μmol/L (P2 group), 50μmol/L (P3 group), 100μmol/L (P4 group) respectively. After 16 hours of incubation, the TNF-α concentration in supernatants were measured by ELISA. TREM-1 expression were examined by FACS and TREM-1 mRNA were detected using qRT-PCR. Results TREM-1 on THP-1 increased significantly in group P3 and group P4 compared with LPS group (P<0.05). The concentra-tions of TNF-αin P3 and P4 (P<0.05) decreased substantially in supernatant compared with LPS group. TREM-1 mRNA transcription level in group LPS rise considerably (P < 0.05) compared to that in control group, and it dropped greatly in group P4 (P <0.05) compared with that in group LPS. Conclusion Propofol could enhance TREM-1 expression on sur-face of THP-1 stimulated by LPS. Propofol reduces TNF-αlevel in culture supernatant. And propofol may restrain TREM-1 mRNA expression.

Objective To evaluate the clinical application of interventional therapy in all kinds of pelvic trauma emergency.Methods There were tolally 16 cases in this paper(13 male and 3 female, 17～45 years old with average 31 years old). All patients had blood loose shock ( different blood pressure drop, limb pulse weakness and so on ). The blood pressure was(50～100)mmHg/(20～60) mmHg before interventional therapy,emergency selective external iliac artery, internal iliac artery and/or bleeding artery embolization and artery occlusion broken operation were performed. After operation pay attention to observe the life physical sign.Results Bleeding of internal iliac artery trunk,internal pudendum artery and obturator artery was in 8,3 and 4 cases respectively;1 case had thrombosis in external iliac artery.After emergency interventional treatment, blood pressure rose again progressively and became stability(90～120) mmHg/(60～90) mmHg,no serious complication presented.Conclusion The interventional treatment is the rapid and reasonable selection to cure the pelvic closed vessal injury and to save life.

Objective To compare the contents of main compounds and the composition of volatile oil from the new hybrid of Amomum villosum Lour. Spring No.1-F4 with those in its female parent Longfruit No.2. Methods Steam distillation, gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS) methods were used for analyzing the content differences of main compounds and compositions of volatile oil between Spring No.1-F4 and Longfruit No.2. Results The contents of volatile oil and bornyl acetate from Spring No.1-F4 and Longfruit No.2 met the standard required by Chinese Pharmacopoeia. The content of volatile oil from Spring No.1-F4 was higher than that of Longfruit No.2, and there were some differences between the two in the composition of volatile oil and their relative contents. Conclusion The effective constituents in Spring No.1-F4, a new hybrid species of Amomum villosum, has reached the standard required by Chinese Pharmacopoeia, which is expected for solving the problems of difficulty in pollination and for improving the yield and quality of Amomum villosum.

Objective To explore the clinical value of combined detection of lysophosphatidic acid(LPA),tumor-specific growth factor(TSGF)and carbohydrate antigen 1 9-9(CA1 9-9)in the diagnosis of non-small cell lung cancer(NSCLC).Methods The ser-um levels of LPA,TSGF and CA1 9-9 in 97 cases of patients with NSCLC(NSCLC group),43 cases of patients with benign lung disease(benign lung disease group)and 50 cases of healthy individuals(healthy control group)were detected,and diagnostic value of combined detection of these three tumor makers in the diagnosis of NSCLC was analysed.Results Serum levels of LPA,TSGF and CA1 9-9 in the NSCLC group were significantly higher than those in the benign lung disease group and healthy control group,had statistically significant differences(P <0.05).The sensitivity and specificity of combined detection of LPA,TSGF and CA1 9-9 was 68.63% and 37.1 7% respectively,and the sensitivity was higher than that of single detection and combined detection of any two of the three indicators.Conclusion Combined detection of tumor markers can improve the sensitivity in the diagnosis of NSCLC, which could provide reliable laboratory references for diagnosing NSCLC.

Objective:To figure out the characteristics of annual medical expenditure for rural residents and its distribution among different population.Methods:The individual annual medical service utilization information was summarized after dealing with the database of the 2014 new rural cooperative medical system by Excel.It prescribed the clustering of medical expenditure by Lorenz curve and Gini index.Descriptive statistics and x2 test were used to compare the characteristics and distribution of the annual medical expenditure among rural residents.The Chi-square test was conducted to compare the differences of the population distribution.Results:The costliest 5％ patients accounted for approximately 68％ of total health care expenditure.The annual total expenditure was 16628 yuan per capita among high-cost population,while low-cost population were 108 yuan.The Gini index of medical expenditure for rural residents was 0.81.Among female and population over 45 years old,the proportion of high-cost population was higher than 5％.People living near provincial road,in flatlands or areas where the ability of township hospital was limited were nore likely to expense higher medical costs,known as 6.40％,5.50％ and 5.80％ separately.Conclusion:Clustering of medical expenditure for rural residents was remarkable,while the expenditure among high-cost,medium-cost and low-cost population were quite different.The elderly,female and primary population living in areas where the ability of township hospitals were limited were more likely to generate high medical costs.

BACKGROUND:Stem cel transplantation has a certain effect in the treatment pulmonary arterial hypertension.
OBJECTIVE:To investigate the effect of bone marrow mesenchymal stem cel s transplantation on the treatment of pulmonary arterial hypertension and to discuss the mechanism.
METHODS:Bone marrow mesenchymal stem cel s were in vitro cultured, purified and amplified by density gradient centrifugation method, and labeled with the fluorescent dye for preparation. Pulmonary arterial hypertension model was established by subcutaneous injection of monocrotaline. One week after modeling, the rats were randomly divided into three groups. Rats in the stem cel transplantation group and pulmonary arterial hypertension group received subcutaneous injection of monocrotaline to establish the pulmonary arterial hypertension model. One week later, the rats in the stem cel transplantation group received sublingual vein injection of bone marrow mesenchymal stem cel solution, the rats in the pulmonary arterial hypertension group were injected with the culture medium without stem cel s, and the rats in the control group were injected with the normal saline in the same dose.
RESULTS AND CONCLUSION:At 2 weeks after transplantation, compared with the mesenchymal-induced pulmonary arterial hypertension rats, the hemodynamic parameters and the ratio of right ventricular/body weight of the rats in the stem cel transplantation group were significantly improved (P<0.05);the degree of pulmonary vascular remodeling was significantly reduced (P<0.05). Fluorescence microscope observation showed that the transplanted bone marrow mesenchymal stem cel s could alive at least 2 weeks in the stem cel transplantation group, and part of the stem cel s could differentiate into pulmonary vascular endothelial cel s. The results show that bone marrow mesenchymal stem cel transplantation can significantly improve the pulmonary vascular and right ventricular structural impairments in the rats with mesenchymal-induced pulmonary arterial hypertension.

BACKGROUND: At present,there are many reports regarding the differentiation of bone marrow-derived mesenchymal stem cells or pancreatic gland stem cells into pancreatic islet β-like cells.But little is about umbilical cord blood-derived mesenchymal stem cells(UCBMSCs)differentiation into pancreatic islet β-like cells in vitro.OBJECTIVE: To investigate whether UCBMSCs can differentiate into pancreatic islet β-like cells in vitro and the optimal inducing condition.METHODS: UCB samples were obtained sterilely from healthy parturients.Nucleated cells were isolated by sedimentation with hydroxyethyl starch and MSCs were obtained by adherent method.Then purified UCBMSCs were induced with epidermal growth factor,β-mercaptoethanol,high glucose,Activin A and hepatocyte growth factor(HGF).Following cell morphology observation,induced cells were identified by insulin immunofluorescence.In addition,insulin secretion and glucose-stimulated insulin release were examined by chemiluminescence immunoassay.RESULTS AND CONCLUSION: After induction,many cells exhibited a round appearance and produced islet-like cell clusters.Immunofluorescence assay showed insulin positive in the treated cells.In addition,chemiluminescence immunoassay demonstrated low expression of insulin and secretion of insulin upon glucose challenge.UCBMSCs can differentiate into pancreatic islet β-like cells in vitro.