Joint -Up Community is crucial to the community health services. Joint - Up is an kind of co -operation, but it is neither the co - operation of bureaucracy nor that of the market model. The new relationship of Joint - Up is based neither on responsibility nor on contract, but on equal partnership. It is vital to solve the ethical plight of health services in country.

Objective To investigate the therapeutic effect of enteral nutrition in patients with severe traumatic brain injury (sTBI) by nasogastric tube and nasointestinal tube.Methods A retrospective case control study was made on 64 patients with sTBI hospitalized from October 2013 to December 2015.The patients were assigned to nasogastric tube group (n=32) and nasointestinal tube group (n=32) according to the random number table, and the same nutrient solution was given to all patients.Eighteen male and 14 female patients aged (37.8±8.7)years were identified in nasogastric tube group, and the Glasgow coma score (GCS) was (4.7±1.3)points.Twenty males and 14 females aged (39.7±6.5)years were identified in nasointestinal tube group, and the GCS was (4.1±1.2)points.Triceps skinfold thickness, body mass index, hemoglobin, level of serum albumin and level of prealbumin were measured and compared between groups before and after operation.Incidence of complications was recorded as well.Results All the above-mentioned indexes of the two groups did not differ significantly before the therapy (P>0.05), but showed significant differences 7 and 15 days after therapy (P<0.05).Incidence of complications in nasointestinal tube group (17 lung infection, nine gastrointestinal bleeding, 11 electrolyte imbalance) was lower than that in nasogastric tube group (seven lung infection, two gastrointestinal bleeding, one reflux esophagitis, four electrolyte imbalance) (P<0.05).Conclusion Nasointestinal tube enteral nutrition is better than nasogastric tube enteral nutrition in improving nutritional status and reducing complications in patients with sTBI.

This article was aimed to explore the effect of acupuncture on HDAC2 activity in peripheral blood of chronic obstructive pulmonary disease (COPD) rats. The COPD rat model was established by cigarette smoking. Acupuncture was given for 3 consecutive weeks. The lung ventilation of rat was detected by equipment. Peripheral blood of rat was taken after 3 weeks. The HDAC2 enzyme activity was detected by fluorescence technology. ELISA was used in the detection of IL-10, IL-8 and TNF-αexpression in peripheral blood. The results showed that after acupuncture treatment, the lung ventilation was obviously increased compared with the model group (P < 0.05). Meanwhile, the HDAC2 activity in the peripheral blood of rat was obviously increased (P < 0.05). However, the expression of inflammatory cytokines IL-10, IL-8 and TNF-α was obviously reduced (P < 0.05). It was concluded that acupuncture treatment had a good efficacy on COPD rat. It indicated that acupuncture treatment might regulate HDAC2 activity to reduce inflammation.

Objective To evaluate the clinical diagnostic value of pelvic floor sEMG in pelvic floor dyssynergia (PFD) by using receiver operating characteristic curve (ROC curve). Methods The pelvic floor sEMG of 90 patients with PFD and 101normal controls were determined by the Glazer protocol.Parameters including amplitude (AVG),coefficient of variance (CV),onset time and median frequency (MF),and the ROC curve werealso investigated. Results Compared to the control group,the PFD group had a higher AVG of pre-baseline (P < 0.05), a lower AVG during Flick and Tonic steps(P < 0.05), and ahigher CV duringTonic and Endurance steps(P < 0.05).The area under curve(AUC) of CV duringthe tonic step was 0.883 withthe best cut-off of 0.355, and with sensitivity of 88.4%and the specificity of 71.1%, respectively; The AUC of CV duringEndurance step was 0.825 withthe best cut-off of 0.305, and with the sensitivity of 84.9%and the specificity of 67.8% , respectively. Conclusion The CVs of the tonic and the endrnace phases can be used as valuable clinical values in diagnosis of PFD.

Objective To investigate the correlation of the 1896 and 1899 mutations of hepatitis B virus (HBV)with the conversion of e antigen in serum and the progression of the disease. Methods 238 serum samples from the patients with HBsAg positive for over six months and HBV-DNA copy number > 5.0 × 102 IU/mL were collected,and the sequence analysis was used to analyze the nucleotide sequences of the 1896 and 1899 sites in the pre-C region of HBV. At the same time,the relevant clinical data and the expressions of HBeAg were collected,followed by Spearman correlation analysis and chi square test with SPSS 20.0. Results Both 1896 and 1899 sites in the pre-C region of HBV were mutated,and the base G was A,which was closely related to the expression of e antigen(P<0.05). Both G1896A and G1899A promoted the e antigen serological conversion ,and the e antigen serological conversion of G1899A was higher than that of G1896A. G1899A was associated with HBV related disease progression (correlation coefficient 0.280,P < 0.05),especially with the incurrence of HCC. Conclusions G1896A and G1899A in the pre-C region of HBV can promote the serological conversion of e antigen.

This study is to investigate the treatment of Jin Chai antiviral capsule for influenza virus FM1/47 (H1N1) infection. The model of pneumonia was established by dropping influenza virus into the nose of normal mice, real-time PCR and Western blot technique were used to detect the virus load and the interferoninducible transmembrane protein3 (IFITM3) in lung of mice at the 1st day, 3rd day, 5th day and 7th day after affected. The results showed that Jin Chai antiviral capsule in large, middle, small dose groups can decrease virus load significantly at each time point, after being affected (P<0.05, P<0.01), Jin Chai antiviral capsule can increase the interferoninducible transmembrane protein3 in lung of mice, large dose groups are significantly higher in expression of IFITM3 compared with model group at each time point (P<0.05, P<0.01). Middle dose groups are significantly higher in expression of IFITM3 compared with model group at the 3th day and the 5th day (P<0.05), small dose groups are significantly higher in expression of IFITM3 compared with model group at the 3th day (P<0.05). It can be concluded that Jin Chai antiviral capsule exerts antiviral effects against influenzavirus by raised expression of IFITM3.

Objective To investigate the relationship among Helicobacter pylori(H.pylori),CD4 positive cells and CD8 positive cells in gastric mucosa of the AIDS patients with gastritis.Methods Fiftyeight AIDS patients with upper abdominal pain were diagnosed with chronic gastritis through gastroscopy.The gastric biopsies from them were used for H.pylori detection with rapid urease test and Giemsa staining,pathology examination with HE staining,and immunohistochemistry analysis for CD4,CD8 positive cells in Gastric mucosa.And the application of flow cytometry was for the detection of peripheral blood CD4 and CD8 lymphocytes from the patients.Results H.pylori was positive in 26 cases,and negative was in 32 cases.CD8 cell expression in gastric mucosa of the AIDS patients with H.pylori positive was significantly higher than H.pylori negative patients(P＜0.05).There is no difference CD4 cell expression in gastric mucosa between the AIDS patients with H.pylori positive and H.pylori negative patients.Moreover,CD8 positive lymphocytes in gastric mucosa of those patients with H.pyloriinfection were significantly stronger than the CD4 positive lymphocytes.However,the peripheral blood CD4 lymphocytes from the patients with H.pylori infection were more than those from H.pylorinegative patients significantly(P＜0.05).Conclusion The expression level of CD8 cells in gastric mucosal tissues of AIDS patients with H.pylori infection were higher than those without H.pylori infection.The CD4 lymphocytes from the peripheral blood of the patients with H.pylori infection were more than those without H.pylori negative patients.

Objective To investigate the clinical value of tissue and blood long noncoding RNA(lncRNA) detection in the patients with hepatocellular cancer(HCC).Methods The HCC tissue sample,blood sample, suspected HCC puncture sample and blood sample from the persons undergoing healthy physical examination were selected for conducting the study.The six lncRNAs which were more than 5-fold expression amount were picked out in the 338 transcripts with abnormal high expression.The expression amount of lncRNA AK057037 in HCC tissue and serm tissue was detected by using the real time quantitative polymerase chain reaction and in situ hybridization.Then the results were statistically analyzed.Results The six lncRNAs were highly ex-pressed in the tissues and blood of the liver cancer,and the difference was statistically significant(P<0.05). Compared with healthy people,the relative expression of AK057037 in the tissues and blood of the liver cancer increased significantly,and the relative expression level in tumor and paracancerous tissues was statistically significant(P<0.05).As the tumor progresses,the relative expression of AK057037 was further enhanced. There was a higher relative expression in advanced liver cancer especially,and the difference was statistically significant(P<0.05).The results of the receiver operating characteristic curve showed that the area under curve of AK057037 was 0.834(95% CI 0.705-0.918)in the blood specimen,and its diagnostic efficiency was better than that of commonly used nucleic acid marker miR-29a.Conclusion lncRNA AK057037 is highly ex-pressed in HCC sample and blood,and can be used for clinical detection of HCC.

Type Ⅰallergy is one type of allergic reaction mediated by IgE antibody .Simple, rapid and accurate allergen detection method can be used to identify the allergen of patients , which is of great significance for the prevention , diagnosis and treatment of allergic diseases . In this article , different techniques for in vitro diagnosis of allergen specific IgE antibodies in type Ⅰ allergic reactions were described , important factors affecting in vitro diagnosis of allergens were analyzed , and the future development trend of in vitro diagnosis of allergen specific IgE antibodies were prospected .In order to help clinicians to select more suitable in vitro detection methods in the process of in vitro diagnosis of type Ⅰallergy and to better understand the internal relationship between the allergen specific IgE detection report and clinical symptoms.

Objective:To evaluate the effect of gabapentin on myocardial ischemia-reperfusion injury and its mechanism.Methods:Sixty male clean SD rats, aged 10 weeks and weighing 250 g~300 g, were divided into 5 groups ( n=12) with 12 rats in each group by random number table method: Sham group, myocardial ischemia reperfusion group (group I/R), gabapentin group (group Gap), LY294002 group (group LY) and gabapentin +LY294002 group (group Gap +LY). The model of myocardial ischemia reperfusion injury was established by ligation of the left anterior descending coronary artery for 30 min and reperfusion for 120 min. Heart rate (HR), mean arterial pressure (MAP) and the rate pressure product (RPP) were recorded at baseline before ischemia (T 0) for 30 min (T 1) and reperfusion for 120 min (T 2) to evaluate hemodynamic changes during ischemia and reperfusion; The frequency of PVCs and VT/VF were recorded to evaluate the occurrence of arrhythmias during ischemia/reperfusion. TTC staining was used to detect myocardial infarction area. And the protein expression levels of PI3K and Akt in myocardial tissue were detected by Western blotting. Results:Compared with group I/R, the myocardial infarction area, PVCs and VT/VF times, and the protein expression levels of PI3K and p-Akt were significantly increased in group Gap ( P<0.05). Compared with group Gap, the area of myocardial infarction, the number of PVCs and VT/VF, and the protein expression of PI3K and p-Akt were significantly decreased in the group Gap +LY ( P<0.05). Conclusions:Gabapentin can alleviate myocardial ischemia-reperfusion injury, and its mechanism is related to the activation of PI3K-AKT signaling pathway.