Objective To probe into a doctor-seeking medical management model for China's urban hypertension patients under medical insurance, and enhance the level and quality of medical insurance management. Methods Hypertension patients were surveyed with a structured questionnaire, and the staff at community health centers and medical insurance management centers received qualitative interview. Results The hypertension patients are found to see doctors mostly at community health centers and tertiary hospitals; complaints among hypertension patients for existing medical insurance vary with their areas, mostly targeting on complicated reimbursement procedure, high threshold of medical insurance payment and low level of reimbursement. Recommendation Experiment with the single-disease payment for hypertension, with the total prepayment in per capita and per disease; greater efforts in hypertension control in communities, with more favorable medical insurance policies for communities;elevated collaboration with medical institutions at all levels, and building and standardizing the management information network for hypertension patients.

Objective To proceed deep data mining in large database obtained by Cancer Genome Anatomy Project and to distinguish the difference expression genes of gastric carcinoma.Methods The 300,783 serial analysis of gene expression records from 4 libraries of gastric cancer and 2 libraries of normal gastric tissue in database of the Cancer Genome Anatomy Project were analyzed by digital gene expression displayer.Results The 201 difference expression tags represented 136 genes(54 up-regulated and 82 down-regulated) and 65 ESTs(24 up-regulated and 41 down-regulated) were distinguished,and these genes were involved in biological process and signal transduction pathways,such as cell cycle regulation,cell proliferation and apoptosis.The gene expression profile in whole body normal and cancer tissues of PTMA were constructed by digital Northern based on serial analysis of gene expression database and by virtual Northern based on cDNA database,respectively.Conclusion The difference expression genes of gastric cancer can be distinguished effectively with bioinformatics,and the results will guide our further molecular biology research.If validated by molecular biology experiment,the difference expression genes will be used as molecular targets of gastric carcinoma.

Gene Expression Profiling ; Gene Rearrangement ; Humans ; Lymphoma ; classification ; genetics ; pathology ; Lymphoma, Follicular ; classification ; genetics ; pathology ; Lymphoma, Large B-Cell, Diffuse ; classification ; genetics ; Lymphoma, T-Cell ; classification ; genetics ; Translocation, Genetic ; World Health Organization

Objective To study the changes of cytokine activation in patients with chronic congestive haert failure(CHF) as indicated by plasma levels of C-reactive protein(CRP)and its relation to adrenomedullin(ADM) and endthelin-1(ET-1).Methods The plasma levels of CRP,ADM and ET-1 of 60 decompensated haert failure(DHF) patients group and 30 essential hypertension patients with compensated cardiac function(CCF) group were tested. CRP was determined by immunoturbidometry,ET-1 and ADM were determined by radioimmunoassay.Results The plasma levels of ET-1 ,ADM and CRP of decompensated heart failure group were significantly higher than the compensated cardiac function group;In the decompensated heart failure group,the plasma levels of CRP and ADM were elevated according to worsening of heart failure(NYHA classification) ;In the decompensated heart failure group,the plasma levels of CRP were positively correlated with ADM(r=0.57).Conclusion There is extensive activation of cytokines,ADM and ET-1 in patients with chronic congestive heart failure.Cytokine activation might play a role in the synthesis of ADM,thus contribute to the hum oral regulation of heart failure,but may not be re- sponsible for the activation of ET-1.

Objective To study the correlation of psychological status of nurses experiencing negative events with coping styles and social support.Methods The symptom checklist-90 (SCL-90),the simplified coping style questionnaire (SCSQ),the social science research solutions (SSRS) were used for the investigation among 108 nurses who experienced negative events so as to look into the correlation of their psychological status with coping style and social support.Results The total score by SCL-90 was (194.41 ±35.05).The psychological status and positive coping styles and social support were negatively correlated (P ＜0.05) and positively with negative coping (P ＜0.01).Conclusions The psychological health is at middle to low level and it is influenced by the coping styles and social support.So the administrative should attach great importance to their mental health status and influencing factors of the positive role,help them gain social supports and enhance their subjective sensation of social support.

BACKGROUND: The free border of meniscus is avascular portion, for which, it is not susceptible for the meniscus to be cured naturally after injury. Therefore, it is necessary to induce fibrous tissue healing probably under certain situation.OBJECTIVE: To adopt tissue engineered cartilage and fibrin adhesive to treat meniscus injury in avascular portion and compare the results.DESIGN: Randomized group division and blank control experiment was designed.SETTING: Animal Laboratory of a Shenzhen Second People's Hospital.green-purplish-blue adult rabbits were selected, randomized into 3 groups,12 rabbits in each, named blank control, fibrin adhesive group(FA group)and tissue engineered cartilage group(TE-C group).METHODS: The experiment was performed in Animal Laboratory of Shenzhen Second People's Hospital from September 2003 to March 2004.Ten baby rabbits borne in 3 to 5 days were sacrificed to collect fibrochondrocytes for culture so as to prepare tissue engineered cartilage containing 12 × 108 L-1chondrocytes. Thirty-six adult rabbits were prepared into the injured model in avascular portion of meniscus (0. 7 × 0. 3) cm with full-thickness laceration. In blank control, no any filler was applied for management; in FA group, fibrin adhesive was infused in laceration; and in TE-C group, tissue engineered cartilage was infused in laceration. Four animals of each of 3 groups were sacrificed in the 2nd, 6th and 12th weeks after operation. Eight menisci were collected in each group each time for gross morphological observation and histological examination.MAIN OUTCOME MEASURES: Gross morphological observation and histological examination in injured meniscus model of rabbit.logical observation in injured meniscus model of rabbit: In blank control, the splits in meniscus were not been healed and tissue filler was not apparent. In FA and TE-C groups, the splits had been filled up with tissue fillers comblank control, 2 to 12 weeks after operation, there was chondrocyte proliferation presented on the border of splits. In FA group, 12 weeks after operation, on the defect border, there were many fibroblastic cells that closely adhered to adjacent tissue, resulting in scar tissue healing. In TE-C group,12 weeks after operation, cartilage cavities and capsule were apparent in the defect and chondrocftes were in cell condensation.CONCLUSION: Tissue engineered cartilage is survived in the acceptors, resulting in fibrocartilaginous healing and specific biological label of chondrocytes. But the remarkable difference presents in collagen arrangement among the repaired tissue, adjacent normal meniscus tissue and normal cartilage.

The effects of mifepristone (RU486) on the productions of plasminogen activator and progesterone in rat granulosa cells and luteal cells were studied by fibrin overlay method and radioimmunoassay method. The results showed that RU486 could significantly antagonize tPA activity and progesterone production enhanced by human chorionic gonadotropin (hCG). Secretion of tPA from luteal cells was significantly promoted by RU486 with or without prostaglandin F2a (PGF2α), but progesterone production in luteal cells was markedly inhibited with the same treatment. With method of tissue culture, the results showed that RU486 was capable of stimulating tPA and urokinase (uPA) activity in endometrium of pregnant rats. These findings indicated that antifertility of RU486 might be partly mediated through plasminogen activator-plasminogen activator inhibitor system.

Objective To evaluate the risk factors for the postoperative acute renal failure requiring dialysis (ARF-D)after heart valve surgery. Methods Adult patients (age≤18 years) underwent valve surgery with preoperative serum creatinine ＜300 μmol/L were included between January 2005 and December 2008. Fifty patients developed ARF-D within 30 days postoperatively (ARF-D group). While random 220 patients had the same operation without ARF-D served as the control group. Univariate analysis and multivariable logistic regression were used to identify risk factors of ARF-D after valve surgery.Results The incidence of ARF-D was 1.78%, and the early mortality rate was 65.5%. Multivariate analysis identified the following independent risk factors of ARF-D: age, previous cardiac surgery, preoperative serum creatinine, NYHA class Ⅳ,and low cardiac output syndrome. ARF-D group had a longer hospital stay and ICU stay than that of the control group ( P ＜0.001 ). Conclusion Conclusion ARF-D had a higher mortality rate and longer hospital stay following heart valve surgery.Age, previous cardiac surgery, preoperative serum creatinine, NYHA class Ⅳ, and low cardiac output syndrome were the independent risk factors of ARF-D after heart valve surgery.

Objective To investigate the incidence and influence factors of stress ulcer SU) in traffic injury patients. Methods Clinical data of 362 traffic injury patients were studied retrospectively.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score was carried out for all the patients.All the patients had gastroscopy and a comparative analysis was done on the SU patients with or without bleeding and the patients without SU. Results The patients with extensive burn in traffic injury were more susceptible to SU as compared with other trauma patients,with statistical difference ( X2 =7.028,P ＜ 0.05 ).The incidence of SU or hemorrhage was increased with higher APACHE Ⅱ score.The incidence of SU hemorrhage in patients with diabetes or cardiopulmonary disease was significantly higher than that in patients without diabetes or cardiopulmonary disease ( P ＜ O.05 ). Conclusions Traffic injury patients should receive routine gastroscopy.APACHE Ⅱ score has some predictive value for SU or hemorrhage.The incidence of SU hemorrhage is also determined by combined factors of underlying diseases and treatment methods.

Objective To explore the clinical significance of detection of plasma microRNA-21,-143 in identifying early esophageal cancer and esophageal non-tumor diseases.Methods The expression of plasma microRNA-21,-143 in 27 cases of patients with early esophageal cancer (esophagus cancer group),25 cases of patients with non-esophageal tumor (non-esophageal tumor group)and in the healthy controls were detected by RT-PCR,and detected the levels of plasma CEA and CA72-4 by the electrochemical luminescence technology,which of changes were analysed to observe the relationship between the changes and the esophageal cancer,the benign esophageal diseases for the two markers.Results The expression of plasma microRNA-21,-143 in the esophagus cancer group were 0.93±0.17,0.27±0.05,which of ones in the non-esophagus cancer group were 0.25±0.03,0.99±0.15,and with those in the control group were 0.23±0.03,1.02±0.15.Compared with those in the non-esophagus cancer group,the expression of plasma microRNA-21,-143 were obviously up or down-regulated with significant differences (t=10.87,11.55,P＜0.01).Compared with those in the control group,which of ones were obviously up or down-regulated with significant differences (t=9.20,9.07,P＜0.01),and with no statistical significances in comparison between the esophagus cancer group and the control group (t=1.39,1.19,P＞0.05).The positiverate of plasma microRNA-21,-143 in the esophageal cancer,non-esophagus cancer group and the control group were,81.4 ％ (22/27),4.0 ％(1/25) and 0 (0/24);85.1％ (23/27),4.0％ (1/25),and 0 (0/24),respectively.The positive rate of microRNA-21,-143 in the esophageal group respectively in comparison with those in the non-esophagus cancer group and the control group were significantly higher,the differences had statistical significances (x2 =31.59,34.39,P＜ 0.01;x2 =34.42,37.23,P＜ 0.01).The expression of two markers in the esophagus cancer group were no statistically significant differences compared with control group (x2 =0.980,0.980,P＞0.05).The sensitivity and specificity of microRNA-21,-143 in early diagnosis on the esophageal cancer were 81.4 ％,97.9 ％ and 85.1％,97.9 ％.The sensitivity of microRNA-21,-143 in the esophageal group were significantly higher compared with those of CEA and CA72-4,the differences were statistically significant (x2 =12.79,P＜0.01;x2 =5.33,P＜0.05;x2 =15.03,P＜0.01;x2 =6.95,P＜0.05).The specificity of microRNA-21,-143 in the esophageal cancer group were no statistically significant differences in comparison with those of CEA and CA72-4 (x2 =1.043,0.000,P＞0.05) and (x2=1.043,0.000,P＞0.05),respectively.The analysis results from the spearman correlation test showed that in the esophageal cancer group,the expression of plasma microRNA-21,-143 had a negative correlation (r =0.658,P＜0.01).Which of ones respectively associated with the levels of CEA and CA72-4 (r=0.607,0.623,P＜0.01 and r=0.579,0.610,P＜0.01).Conclution The detection of expression of plasma miRNA-21,miRNA-143 in the patients with the early esophageal cancer and non-esophageal tumor can provide a new train of thought for pathologic diagnosis of early esophageal cancer.