Objective To investigate the characteristics of early changes in serum IL-17 and IFN-γ levels in elderly patients with acute myocardial infarction (AMI).Methods 70 hospitalized elderly patients with AMI and 35 healthy people were selected.Serum level of interleukin-17 (IL 17) and interferon-γ (IFN-γ) were assayed by enzyme linked immunosorbent assay (ELISA).Results Serum levels of IL17 and IFN-γ showed increasing trends in elderly patients with AMI as compared with that in control group,but there were no significant differences between the two group [(35.73 30.28) pg/ml vs.(28.70±17.12) pg/ml,(15.29±14.64) pg/ml vs.(11.38±10.10) pg/ml,t=0.144 and 0.138,P=0.365 and 0.377].There were correlations between serum IL-17 and IFN γ levels in patients with AMI and controls(r=0.936 and 0.989,both P=0.00).Serum levels of IL-17 or IFN-γhad no significant differences between AMI patients with well and poor prognosis [(35.43± 34.36) ng/L vs.(36.11±30.16) ng/L,(13.90±13.98) ng/L vs.(15.99±14.14) ng/L,U=0.266 and 0.166,P=0.687 and 0.668].Conclusions Serum IL-17 level has an increasing trend in AMI patients within 24h,but has no statistical significant.Serum IL 17 level has a significantly positively correlation with serum IFN γ level in the elderly,but serum levels of IL-17 or IFN γ have no significant correlations with short term prognosis in elderly patients with AMI.

A number of studies on hospital information system (HIS) and regional information platform have been carried out in different medical institutions since HIS was defined as one ofThe 4 Beams and 8 Pillarsin 2009 , during which good results were achieved and many problems were exposed .The application of electronic medical record (EMR), a key part of HIS, is grealy concerned.The application of electronic medical record system ( EMRS) and related problems were thus described in this paper in order to provide reference for bringing it into a better play, normalizing its management, and reducing its disadvantages.

Objective To observe and analyze the effects of pidotimod on the immunity of Treg/Th17 cells in the children with Henoch-Schonlein purpura (HSP).Methods 60 cases of HSP were selected and randomly divided into the pidotimod treatment group and the conventional treatment group,30 cases in each group.30 healthy children were selected as the control group.The con-ventional treatment group was given the routine therapy,while the pidotimod treatment group was added with oral pidotimod dis-persible tablets on the basis of the routine therapy.The ratios of Treg cell subsets and Th17 cell subsets,the plasma expression lev-els of interleukin-17 (IL-17),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)and interferon inducible protein-10 (IP-10) among 3 groups and the time for rash relief,remission rate of hematuria and proteinuria,recurrence rate within 1 month in HSP children were observed and compared.Results The ratios of Treg cell subsets and Th17 cell subsets after treatment had no statisti-cal difference between the pidotimod treatment group and the control group(P >0.05),while which had the statistical difference be-tween the conventional treatment group and the control group(P <0.05 );the plasma IL-17,IFN-γ,IP-10 and TNF-α expression levels had no statistical differences between the pidotimod treatment group and the control group(P >0.05),but the IL-17 and IFN-γexpression levels in the conventional treatment group were still significantly higher than those in the control group.the remission rate of simple hematuria in the pidotimod treatment group was significantly higher than that in the conventional treatment group, while the recurrence rate within 1 month after treatment was significantly lower than that in the conventional treatment group.Con-clusion The application of pidotimod therapy in the treatment of children with HSP can significantly correct the imbalance of Treg cell subsets and Th17 cell subset,decrease the expression levels of the cytokines such as IL-17 and IFN-γ,suppress the autoimmune reaction so as to achieve the effects of significantly alleviating the impairment of renal function and reducing the short term recur-rence rate,which is benefit for the improvement of prognosis in the children patients with HSP.

We evaluated clinical application effect of gene chip for detection of rifampin (RFP) and isoniazid (INH) resistance in Mycobacterium tuberculosis (MTB).Rifampin and isoniazid drug-resistance gene loci were detected by gene chip with sputum specimens from smear-positive tuberculosis patients and clinical strains,comparing the results of detection.BACTEC MGIT 960 drug susceptibility test results were used as control to evaluate the detection performance of gene chip.The sequences of the polymerase chain reaction products of the rpoB,katG and inhA genes from 999 strains identified as Mycobacterium tuberculosis were determined to confirm the mutations by DNA sequencing.Results showed that 100 cases were identified as nontuberculous mycobacteria by gene chip in the 1 108 cases of smear-positive samples.Among the rest 1 008 samples,there were only 9 cases of microarray results different from BACTEC MGIT960 culture-positive strains,achieving the coincidences of 99.1％.Compared with BACTEC MGIT 960 drug susceptibility test results,the gene chip method displayed a concordance of 98.1 ％ and 94.5 ％ for RFP and INH respectively in the 999 strains.Compared with the DNA sequencing method,the accuracy of gene chip method was 99.6％ for rifampin resistance and 99.8％ for isoniazid resistance.It's concluded that the gene chip technology can quickly and accurately detect rifampin and isoniazid resistance in MTB and can be used directly for the detection of sputum samples.

To meet the challenges of the current evaluation system for the residents , the department of internal medicine of Peking Union Medical College Hospital (PUMCH) developed a new on-line system.This new system, not only solved the problems of the current system , but also had several advantages as manpower saving , real-time update , back-to-back evaluation , convenience in comparison .This promising system is a possible solution to simi-lar problems in other institutions .

With the rapid development of social economy and the improvement of multi-level medical insurance system, the health demand of people continually grow and the content and quality of health demand are more and more diversified. By contrast, the growth of health resources was very slow. The contradiction between supply and demand of health services becomes increasingly sharp and health expenditure growth rapidly. So by systemizing the related concepts and main international practices and enlightenment of managing health demand in developed countries, this article aimed to provide references and suggestions for reasonably managing health demand, standardizing the order of medical treatment and improving the phenomenon ofdifficulty in treatment.

Using objective structuned clinical exammation ,OSCE to access a new resident standardized training , analyze the result and perform stratifying management and teaching based on the result , which may improve the effi-ciency and effectiveness of resident standardized training .

Objective: To investigate differentially expressed protein profiles in B16-F10 grafted melanoma and its metastasis in the lung in order to identify molecular markers of melanoma metastasis. Methods: Differentially expressed proteins in B16-F10 grafted melanoma and its metastatic lesion in the lung were isolated and identified by fluorescence two-dimensional differential gel electrophoresis(2D-DIGE)coupled with matrix assisted laser desorption ionisation time-of-flight mass spectrometry(MALDI-TOF-MS).Some of identified proteins were further confirmed by Real-time PCR analysis. Results: High resolutional images of differential gel electrophoresis were obtained and 9 of 30 differentially expressed proteins (IRatiol≥2,P<0.01)were identified by MALDI-TOF-MS.The expression of Myoglobin(MB),vimentin(VIM),phosphoglycerate kinase 1(PGK1),Triosephosphate isomerase(TPI or TIM),heavy-chain binding protein(BiP),α-enolase,β-actin,γ-actin,and laminin-binding protein were up-regulated in the experimental group compared with the control group.These proteins were involved in the cytoskeletal formation,glycolysis and so on.Real-time PCR analysis showed up-regulation of mRNA expression of PGK1 and TPI in the experimental group(P=0.001 and 0.003),which was in consistent with the resuits of proteomic analysis. Conclusion: A variety of abnormally expressed proteins contribute to the metastasis of mice melanoma.Glycolytic enzymes PGK1 and TPI may be involved in this process.

Objective To investigate the predicting value of serial serum human stromelysin-2 (ST2)testing on prognosis in elderly patients with acute heart failure(AHF).Methods 75 AHF patients aged 60 to 90 were selected in our study who were in Beijing Hospital during 2013.1 ～ 2014.8,blood sampling of serum ST2 took place at admission and 72-96 h later.Moreover,38 healthy people aged 70 to 80 were chosen as control group.Follow-up was performed 1 year after acute attack.We defined the end of observation as recurrence of heart failure or any cause of death.The data was analyzed by SPSS19.0.Results Among 55 AHF patients,sST2 level was higher in patients with endpoint events than those without it on the two moment(P=0.000).And we found that the change in sST2 was higher in patients with endpoint events than those without it(P=0.023);and the percentage change in sST2 was also significantly different(P=0.033).Receiver operator curve analysis of the change in sST2 from baseline to 72-96 h later was strongly reflective of prognosis with area under the curve(AUC) of 0.696(P=0.013).And the change in sST2 Combined with the sST2 level at admission to predict the prognosis of AHF,the result would be more exciting,the area under the receiver operating characteristic (ROC) curve is 0.861 (P ＜ 0.001).The endpoint event rate of the patients whose level of sST2 at admission was below 1408 ng/L and the change level in sST2 below 101 ng/L was 21.4％(3/14),while the data in patients whose level of sST2 at admission is above 1 408 ng/L and the change level in sST2 above 100 ng/L was 85.7％(12/14).Conclusions in elderly patients of AHF,sST2 elevate markedly.The result shows that the level of sST2 may be used to evaluate AHF prognosis.And the change in sST2 are able to predict the prognosis of AHF.Compared with NT-proBNP,serial sST2 testing appears to be a promising candidate for monitoring these patients.

ObjectiveTo analyze the status of DACH1 gene promoter methylation and explore its association with the expression of DACH1 gene promoter methylation and clinical significance of endometrium carcinoma(EC).Methods From February 2004 to August 2008,a total of 80 EC tissue samples with comprehensive surgical pathology staging were collected and used for this study.Twenty normal endometrium tissues in 2008 were abtained from the fractional curettage because of dysfunctional uterine bleeding as control.All samples were confirmed pathologically.Methylation specific PCR (MSP) was performed to detect the promoter methylation of DACH1 gene,and analyze its influence on the expression of DACH1 and the relationship between DACH1 promoter methylation and clinicopathological factors in EC.DACH1 protein expression was detected by western blot.Chi-square test and Pearson test were used for statistical analysis.ResultsThe rate of promoter methylation of DACH1 gene in the EC tissues was significantly higher than that in the normal endometrium issues (30％ vs.5％,P ＜ 0.05).There was an association between the expression of DACH1 and DACH1 gene promoter methylation ( r =- 0.30,P ＜ 0.01 ).There was statistical difference between the methylation of DACH1 and the pathological grade ( P ＜ 0.05 ) or histological type ( P ＜0.05).But DACH1 gene methylation was not related with the age,stage,myometrial invasion depth and lymphnode metastasis (P ＞ 0.05 ).Conclusions DACH1gene promoter methylaion could lead to a decrease or absence in the DACH1 expression in EC.The promoter methylation of DACH1 gene may induce the inhibition of DACH1 expression,which might be one of the mechanisms of DACH1 gene inactivation in human EC.