The forepassed socialized medicine system for urban workers has many ethical faults. The institutional reform on the social medical insurance for urban workers will readjust the relationships between government, hospitals, employers and patients. It means much to ethics, and impulses the basic health service towards self-determination, duty and justice. But it has some problems about the responsibility of government,the sanction of hospitals and the burden of patients. At last,the paper offers some suggestions for improvement.

Objective To investigate the diagnostic value and the clinical significance of six tumour markers of pleural effusion and serum in patients with lung cancer by detecting tumour marker and pleural effusion cytological examination. Methods Carcinoembryanic antigen (CEA), cancer antigen 19-9 (CA19-9),squamous cell carcinoma antigen (SCC), neuron specific enolase(NSE), cytokeratin 19 fragments(CYFRA21-l)and progastrin releasing peptide (ProCRP) levels in pleural effusion and serum sample from 50 cases of lung cancer and 30 cases of benign lung disease were detected by chemical and enzyme-linked immunosorbent assay.At the same time, the specimen of patients from pleural effusion was examinated by cytological method.According to the data above, the rational clinical diagnosis value were established by ROC curves. Results Six tumour markers in pleural effusion of lung cancer were higher than those of benign lung diseases, CEA,CA19-9, CYFRA21-1 and ProGRP were the highest group (P<0.05). The ratio of CEA, serum CYFRA21-1and CEA levels in pleural fluid and serum (P/S) in the group was the largest area under the ROC curve.Conclusion Pleural fluid CEA, the ratio of CYFRA21-1 and CEA levels in pleural fluid and serum (P/S) is helpful to differentiating benign and malignant pleural effusion diseases.The diagnostic value of pleural fluid CEA is important.

Objective To detect whether trichostatin(TSA) can induce HL-60 differentiation in vitro. Methods MTT method was used to test the effect of TSA on HL-60 cell growth. Cell cycle was tested by flow cytometry. CD11b expression was tested for detecting cell differentiation, RT-PCR was used to detect the mRNA expression of c-myc in the cells treated by TSA. Results Down-regulation of cell proliferation was observed and cells significantly accumulated at the G0 and G1 phase in HL-60 cells treated with TSA( P <0. 01). Dif-ferentiation rate was 15. 24% after being treated by TSA for 48 h. mRNA of c-myc was down regulated in time-dependent manner. Conclusion TSA can inhibit proliferation and induce differentiation in HL-60 cells.

The curative effect of chemotherapy in malignant tumors has been unsatisfactory because of drug resistance and the toxicity of chemotherapeutic drugs. Extensive studies on the metabolism of tumor cells have been undertaken to determine a novel se-lective antitumor drug. An increasing number of studies have demonstrated the close relation between the malignant behavior of tumor tissues and their specialized energy metabolism. Hyper-lipogenesis is one of the metabolic characteristics of the rapid proliferation of tu-mor cells. Stearoyl-coenzyme A desaturase 1 (SCD1) is a critical enzyme in fatty acid synthesis because it catalyzes the conversion of saturated fatty acids into monounsaturated fatty acids. This enzyme is closely related to obesity, fatty liver disease, insulin resistance, and a series of metabolic syndromes. It is also involved in the occurrence and progression of cancer. Determining the function of SCD1 in malignant tumors would provide a new therapeutic target in chemotherapy.

Objective To investigate the comparability of test seven tumor marks results of two electrochemiluminescence immu-noassay analyzer between Roche Cobas E411 and Cobas E601 .Methods According to United States Clinical and Laboratory Stand-ards Institute (CLSI) EP9-A2 document ,E411 was acted as comparison method (X) and E601 was as the experimental method (Y ) .Alpha fetoprotein (AFP ) ,carcinoembryonic antigen (CEA ) ,carbohydrate antigen125 (CA125 ) ,carbohydrate antigen199 (CA199) ,carbohydrate antigen153(CA153) ,total prostate specific antigen(TPSA) and free prostate specific antigen(FPSA) levels of patient samples were tested and the results were analyzed .Results The correlation between the two systems was good and the bias was acceptable in the medical decision level .Conclusion Two systems have good concordance in detecting the seven tumor markers ,w hich can meet the clinical need .

There is still a certain recurrence rate after extensive lymphadenectomy even to patients with node-negative gastric cancer.It promotes the researchers to use a more sensitive and effective way to track tumor cells which are missed,especially lymph node micrometastases.With the development of detection tech-nology,the diagnostic rate of micrometastasis is significantly increased.There are so many controversies about the impact of lymph node micrometastases that no consensus on the clinical treatment can be reached.In recent years,with the rise of endoscopic therapy,how to balance the relationship between the quality of life and the safety makes the research of micrometastases more urgent.

Objective To clone VEGF gene and construct its eukaryotic expression vector for the evaluation of the possability of VEGF gene therapy in orthopedic disease. Methods Human vascular endothelial growth factor(hVEGF) cDNA was amplified by nested PCR method from the HL60 cells and cloned to expression vector pcDNA 3. The cDNA was identified by enzyme digestion and DNA sequencing. Rabbit osteoblasts were transfered with pCD-hVEGF165 plasmid by lipofectin mediated gene transfer method. The transient expression of VEGF were detected by Streptavidin-Biotin-enzyme Complex(SABC). Results The cloned cDNA was confirmed to be VEGF165 cDNA. It was observed that the expression of human VEGF gene was detected distinctly 72 h after transfering. Conclusion We successfully cloned hVEGF 165 gene and construced its eukaryotic expression vector, which provided the further foundation of VEGF gene therapy for ostenecrosis,bone defeat and fracture.

Autophagy is a vacuolar process of cytoplasmic degradation by lysosomes which ubiquitously occur in all eukaryotic cells.Heightened autophagy is a mechanism of resistance for cancer cells faced with metabolic and therapeutic stress,revealing opportunities for exploitation as a therapeutic target in cancer treament.This article reviews the mechanism of autophagy in cancer and its role for cancer treatment.

Objective To investigate the nursing intervention of pregnant women with antiphespholipid syndrome(APS). Methods In experimental group 40 cases with APS positive and control group 40 cases with APS ACA-negative for comparison. Results The abortion occurred in 6 cases(15. 0%) ,2 cases of stillbirth(5.0%) ,loss of pregnancy(abortion+stillbirth) 8 cases (20. 0%) in experimental group. The abortion occurred in 2 cases (5.0%), no stillbirth in control group. The loss of pregnancy in experimental group were significantly higher than the control group (X2=9. 54, P＜0. 005 ). The rate of positive in ACA-IgG (40. 0%) after treatment lower than before treatment (52. 5 %) (X2 = 3.85, P＜0. 05). The rate of positive in ACA IgM (37. 5%) after treatment lower than before treatment(40. 0)% (X2=3.81 ,P＜0. 05 ). Conclusion The APS positive rate and the loss of pregnancy were closely related. The overall nursing intervention conld improve efficacy and reduce the complications.

Objective To investigate the efficacy to pregnant outcoule with antieardiolipin antibody(ACA) of qualitative and quantitative before treatment and after treatment in women pregnant with antiphospho-lipid syndrome (APS).Methods The heparin combined with aspirin therapy APS 40 patients before and after treatment to momtor the change of ACAIgG,IgM.Results 40 patients were treated 37 eases of live births,success rate were92.5%,the rate of pregnancy loss were3 cases(7.5%);The lever of ACA-IgG and ACA-IgM were(67.63±2.53)u and (49.40±3.64)u beforetreatment andlever of ACA-IgG and ACA-IgM were(23.87±1.54)u and(21.60±2.59)u after treatment.The lever after treatment were significandy Iower than the before treatment(P＜0.01);The level of ACA were overall downward in 40 cases after treatment by dynamic observation;The rate of positive in ACAIgG (40.0)% after treatment lower than before treatment(52.5)%(X2=3.85,P＜0.05);The rate of positive in ACA IgM(37.5)% after treatment lower than before treatment(47.5)%(X2=3.81,P＜0.05).Conclusion Hepfinar treatment combined with aspirinmay be a safe and effective method for patients with APS.