Objective To understand use of blood pressure-lowering medications and to identify factors contributing to their compliance among hypertensive patients at a community health-care service center under Huairou County Hospital, Beijing to improve community management for hypertensive therapy.Methods Medical records of hypertensive patients who visited Qiaozizhen community health-care service center in Huairou county, Beijing during June 2008 to May 2009 were analyzed and 849 of them were interviewed using a pre-tested, structured questionnaire with most closed ended questions included to understand their use of anti-hypertensive drugs and its related factors. Results In 849 hypertensive patients under community management, 78.92% percent (670/849) took anti-hypertensive drugs, 72.54%percent (486/670) in good compliance with drug treatment, and 29. 63 percent (144/486) under guidance of their general practitioners or visited secondary-care hospitals or above, 62. 14 percent (302/486) took drugs by themselves and 8. 23 percent (40/486) took drugs following advice by their relatives or other hypertensive patients. The most common used drugs in 503 hypertensive patients who could remember names of the drugs included reserpine compound tablets, reserpine and triamterene compound tablets (302/503, 60. 04% ) and calcium-channel blockers ( 181/503,35.98% ). Overall, blood pressure was under control in ( 289/849,34. 04% ) percent of those with community management, and( 189/486, 38. 89% ) percent of them kept in a good compliance, significantly higher than that in those with poor compliance (48/179,26. 82% ) (P =0. 0032). Results of multivariate logistic regression analysis showed that drug compliance associated mainly with complications of hypertension ( OR of 4. 423 and 95% CI of ORs 2. 141 - 9. 137). Conclusions Drug compliance among hypertensive patients is still poor in rural Beijing, most with reserpine compound tablets.It is necessary to pay more attention to health education among hypertensive patients, particularly about when to start drug-taking and how to take drugs in a scientific way-regularly and complying with physicians'prescription.

At present,all parts of our country and the units are on their own to explore the ways and methods of public health physician training,and to develop a unified national public health standardized training system is particularly important.This study introduces the composition and practice of British public health specialist training and its access system,draws on the successful experience of this system and puts forward some suggestions such as paying attention to the cultivation of clinical basic knowledge,rationally using industry associations and societies and so on from the public health doctor training system,which provides the basis for promoting the establishment of a national public health physician training system.

Objective To investigate the expressions of DKK1,SFRP4 and Wnt1 in cervical squamous cell carcino-ma(SCC), and the clinical significance thereof. Methods There were 76 samples of cervical squamous cell carcinoma were included in SCC group and 36 benign uterine resection specimens were control group (NC). The immunohistochemical meth-od was applied to detect the expressions of DKK1,SFRP4 and Wnt1 in two groups. Results The expression of DKK1 was significantly lower in SCC group than that in NC group (P＜0.05). The expression levels of SFRP4 and Wnt1 were significant-ly higher in SCC group than those of NC group (P＜0.05). There were significant differences in the expressions of DKK1, SFRP4 and Wnt1 between samples of different clinical staging, differentiation, sizes of tumor and lymph node metastasis (P＜0.05). The expression of DKK1 was negatively correlated with SFRP4 and Wnt1 in SCC group (P＜0.05). The expression of SFRP4 was positively correlated with Wnt1 in SCC group (P＜0.05). Conclusion The roles of SFRP4 and Wnt1 are syn-ergistic interactions in the development of SCC. DKK1 is an inhibiting factor of SCC.

Acute promyelocytic leukemia (APL) was considered to be the most rapidly fatal leukemia,because of serve clinical manifestation,high rate of early death and the low cure rate.APL has achieved great success due to the application of ATRA and ATO.Although the complete remission rate is about 90％,the relapse rate has been reported to be as high as 15％-30％.So reducing the recurrence and improving long-time survival have become the focus of the study.Choosing the reasonable treatment after remission is very important.The post remission therapy usually include consolidation therapy and maintenance therapy,but the optimal strategy has been controversy.Therefore,this artical will review the literature of APL in consolidation therapy.

Objective To investigate the effects of chronic high glucose on α-cells glucagon releasing in relation to insulin resistance induced by high glucose. Methods TC1-6 cells, an α-cell line, were incubated separately in DMEM containing high (25.0 mmol/L), medium (11.1 mmol/L) and low (5.5 mmol/L) concentrations of glucose for 1 to 5 days. The secretion and gene expression of glueagon were measured. When TC1-6 cells had been cultured for 5 days, three different concentrations of insulin were added for 6 h and then glucagon secretion was detected. Western blot was used for 1 and 3 days to confirm the effect of high glucose on phosphorylation of Akt in TC1-6 cells. Results (1) Exposure of TC1-6 cells to 11.1 and 25.0 mmol/L glucose resulted in a slight increase of glucagon secretion compared with those incubated with 5.5 mmol/L. However, after 5 days in media containing 25.0 mmol/L glucose, glucagan secretion was significantly increased as compared to cells treated with low glucose [(136.80±10.94 vs 78.62±4.72 ) ng/106 cells, P<0.05]; moreover, in TC1-6 cell cultured with high glucose glucagon mRNA expression was increased significantly. (2) 10-7 mol/L insulin reduced significantly glucagon secretion of TC1-6 ceils exposed to low glucose [(21.59±1.30 vs 55.12±3.86) ng/106 cells], but just scarcely inhibited glucagon secretion of cells incubated with high glucose [(106.58±8.53 vs 117.18±10.55) ng/106 cells]. When insulin concentration was increased to 10-5 mol/L, glucagon secretion of TC1-6 cells in high glucose was also reduced [(46.55±3.72 vs 118.61±10.68 )ng/106 cells]. (3) After treated with 10-5 mol/L insulin for 2h, the levels of Akt phosphorylation in both groups of TC1-6 cells were increased by 180% and 70%, while the level in high glucose group was significantly lower than that in low glucose group. In the presence of phosphoinositide 3 kinase inhibitor, the levels of Akt phosphorylation were both lowered, but the inhibition in low glucose group was more significant than in high glucose group. Conclusion High glucose induces hypersecretion of glucagon, which may be due to the a-cell insulin resistance.

Objective To investigate the efficacy and safety as well as the effects of rituximab on B-lymphocytes and anti-platelet glycoprotein-specific antibodies,in patients with steroid-resistant idiopathic thrombocytopenic purpura(ITP).Methods Twelve steroid-resistant ITP patients,16 to 54 years old,received intravenous rituximab at the dose of 375 mg/m2 once-weekly for 4 weeks.Lab studies included CBC,serum concentrations of IgG,IgM and IgA.CD+3,CD+4,CD+8,CD+19,CD+20 cell numbers were assayed by flow cytometry and anti-platelet glycoprotein-specific antibodies(GP Ⅱ b/Ⅲ a,GP Ⅰ b/Ⅸ)were assayed by monoclonal antibody-specific immobilisation of platelet antigens prior to and following rituximab therapy.Results A complete response(platelet counts ≥100×109/L)was observed in 4 cases,a partial response (platelet counts between 50 and 100×109/L)in 3 cases,a minor response(platelet counts between 30 and 50×109/L)in 2 cases,and non response(platelet counts＜30×109/L)in 3 cases.Responses were sustained 0.5 to 12 months(median 5 months).After 4 weeks of rituximab therapy,anti-platelet glycoprotein-specific antibodies(GP Ⅱ b/Ⅲ a,GP Ⅰ b/Ⅸ)disappeared except one NR patient and CD+19/CD+20 cells were almost depleted in all patients(295.0±86.4)×106/L vs(4.1±2.2)×106/L(P＜0.01).As expected,the T cell counts,and the serum concentrations of IgG,IgM and IgA were not changed after therapy.No severe side effects were observed.Conclusion Rituximab may be an effective and safe treatment for adults with steroid-resistant ITP.

Immunogenicity for medical devices of animal origin is the key and difficult point during immune safety evaluation for these devices. This paper firstly investigated the effect of collagen sponge of animal origin on mouse splenic lymphocyte transformation and proliferation, and then analyzed the influence factors on the MTT method and CFSE method. The results showed that collagen sponge extract cannot significantly induce transformation and proliferation of mouse splenic lymphocyte in vitro.
Animals ; Cells, Cultured ; Collagen ; pharmacology ; Lymphocyte Activation ; drug effects ; Mice ; Porifera ; chemistry ; Spleen ; cytology

Objective To analyze the clinical features and pulmonary radiological findings of primary anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis (AAV).Methods Clinical data of 271 ANCA positive primary AAV patients admitted in Shanghai Ruijin Hospital from January 2003 to November 2015 were retrospectively analyzed.Among 271 patients,there were 211 myeloperoxidase (MPO)-ANCA positive cases (MPO subgroup),52 proteinase 3 (PR3)-ANCA positive cases (PR3 subgroup),and 8 dual positive cases (dual subgroup) according to ANCA classification.The demography,clinical characteristics,pulmonary radiological manifestation and renal function were compared among three subgroups.Results MPO subgroup had more renal (x2 =4.968,P =0.026) and constitutional symptoms (x2.=8.901,P =0.003) than PR3 group,while PR3 group had more ENT symptoms (x2 =19.843,P ＜ 0.001),cough (x2 =6.623,P =0.010),hemoptysis (x2 =8.656,P =0.003),dyspnea (x2 =5.127,P =0.024),buccal and ocular mucosal symptoms (x2 =4.818,P =0.028) than MPO group.In lung radiology,interstitial manifestations were displayed more frequently in MPO than PR3 group (x2 =4.237,P =0.040),while pulmonary nodules was more frequent in PR3 than MPO group (x2 =4.503,P =0.034).Dual subgroup tended to have more nervous,respiratory and renal impairment.Renal function showed that MPO subgroup had higher creatinine (Z =-5.529,P ＜ 0.001),urea (Z =-4.646,P ＜ 0.001) and uric acid levels (Z =-2.331,P =0.020) than PR3 subgroup.Dual subgroup had higher creatinine (Z =-3.251,P =0.001) and urea (Z =-2.882,P =0.004) levels than PR3 subgroup,but there was no difference with MPO subgroup.Conclusion There are significant differences in both clinical and pulmonary radiological manifestations between the MPO and PR3-ANCA subgroup of primary AAV.

Objective:To observe the influences of Xuenaoxin capsule on the levels of endothelin(ET)and calcitonin gene-related peptide(CGRP)and neurological deficit extent in patients with acute cerebral infarction.Methods:A randomized, positive drug controlled clinical trial design was used,59 cases of acute cerebral infarction with qi stagnation and blood stasis syndrome were randomly divided into treatment group(30cases)and control group(29cases).The treatment group was treated with Xuenaoxin capsule,3 times a day,4 pills each time and the control group was treated with Nimodiping,3 times a day,20mg each time.Both groups had 14 days as a treatment course.The changes of levels of endothelin(ET)and calcitonin gene-related peptide(CGRP)in plasma as well as neurological deficit were measured and compared.Results:The plasma ET in treatment group (57.658?14.877)pg/L were significantly lower than those in control group(70.456?17.059)pg/L,but the plasma CGRP(84.404? 8.705)ng/L was higher than that in the control group(78.402?10.699)ng/L on the 14th day.The differences were both significant (P=0.0032,P=0.0213).The results showed that the total effective rate of Xuenaoxin capsule on improving clinical symptoms of patients with acute ischemic stroke was 76.67%and very superior to that of Nimodiping(P=0.0035).Conclusion:Xuenaoxin capsule could reduce neurological deficit extent,and improve the prognosis of patients with acute cerebral infarction by means of regulating ET and CGRP.

Objective ToinvestigatethevalueoftheoptimalCNR monoenergeticimagesofportalveininpredictingesophagealGgastric varicealbleeding(EVB).Methods FortypatientswithlivercirrhosisandportalhypertensionunderwentcontrastGenhancedspectral CTscan.TheoptimalCNR monoenergeticimagesand70keV monoenergeticimagesoftheportalveinphasewereselectedtocompare theimagingquality.TheconsistencyoftheoptimalCNR monoenergeticimageswithendoscopyforesophagealGgastricvaricealwas analyzed by Kappa test.A ccording to the E V B history ,the patients w ere divided into bleeding group and nonGbleeding group.T he ROCcurveswerecalculatedtoassessthevaluesofthemainportalvein(MPV)anditstributariesdiameterstopredictingEVB.Results TheCNRandobjectivescoreoftheoptimalCNR monoenergeticimagesweresignificantlyhigherthanthoseofthe70keVimages(P＜0.05).TheoptimalCNR monoenergeticimageshadgoodconsistency withgastroscopeintheclassificationofesophagealGgastric variceal(k＝0.769).ThereweresignificantdifferencesofthediametersofMPV,intrahepaticleftbranchofportalvein(LPV),splenic vein(SV)andleftgastricvein (LGV)betweenthebleedinggroupandnonGbleedinggroup (P＜0.05).ROCcurveanalysisshowed thattheincidenceofEVBwashighestwithasensitivityof76.92%andaspecificityof85.71%,whentheLGVwasgreaterthan6.1mm. Conclusion TheoptimalCNR monoenergeticimagesofportalveincouldimprovetheimagingquality,andLGVdiametershouldbe ariskindicatorforpredictingEVBinlivercirrhosis.