Objective To explore the diagnostic value of serum ischemia‐modified albumin (IMA) ,lipoprotein‐associated phos‐pholipase A2 (Lp‐PLA2) and cardiac troponin I (cTnI) in acute coronary syndrome (ACS) .Methods The levels of serum IMA , Lp‐PLA2 and cTnI were detected in 138 cases of ACS ,including 79 cases of acute myocardial infarction (AMI) ,59 cases of unstable angina pectoris (UAP) ,and the detection results were compared with those in 50 individuals undergoing physical examination(con‐trol group) .The levels of serum IMA ,Lp‐PLA2 and cTnI were compared among various groups .The receiver characteristic curve (ROC) was drawn to evaluate the diagnostic value of IMA ,Lp‐PLA2 and cTnI in ACS .Results The levels of serum IMA ,Lp‐PLA2 and cTnI in patients with UAP and AMI were higher than those in the healthy control group ,and there was statistical differ‐ence between them(t=7 .286 ,8 .589 ,8 .952 ,P<0 .01) .Comparing with the UAP group ,the levels of serum IMA ,Lp‐PLA2 and cTnI in the AMI group were significantly increased(t=4 .063 ,5 .987 ,2 .062 ,P<0 .05) .In the ROC curve analysis ,the area under ROC curve (AUC) of IMA ,Lp‐PLA2 and cTnI were 0 .821 ,0 .843 and 0 .852 respectively .Conclusion The levels of serum IMA , Lp‐PLA2 and cTnI can be used for monitoring and early diagnosis of ACS .

OBJECTIVE:To study the implementation of scoring diseases payment under the control of total budget in some ar-eas of China,and provide reference for the further improvement of the payment. METHODS:Based on the operation process of scoring disease payment in the control of toal budget,the specific practices of Huaian,Nanchang,Zhongshan and Taiwan area, were compared. RESULTS:It showed differences in the control and allocation of total budget,the establishment of scoring diseas-es,the setup of adjustment coefficient,the development of balance methods,the complementary mechanism and the monitor exami-nation setting. CONCLUSIONS:Whether to classify the diseases according to diagnosis and treatment methods,how to setup ad-justment coefficient appropriately,how to reimburse the patients in stages and how to strengthen supervision are worthy of further thinking and exploring.

The microenvironment of lymphoma is an important factor affecting the development of lymphoma, which is involved in regulating the recognition and immune response of lymphoma cells by the immune system. In the era of immunotherapy of lymphoma, the state of microenvironment also affects the effect of monoclonal antibodies, small molecular compounds and other immune targeting drugs on lymphoma cells. Among them, microenvironment-related immune escape is one of the key factors leading to the failure of lymphoma treatment. This article reviews some microenvironment factors such as stromal immune cell subsets, vascular proliferation, hypoxia, immune checkpoint and the recent research progress of immune escape.

Objective To investigate the effect of propofol on the learning and memory function in neonatal rats under hypoxic conditions. Methods Eighty-four 7-day-old SD rats were randomly divided into 6 groups (n = 14 each): propofol + 18% oxygen (propofol-hypoxia, group PH), propofol + air (group PA), propofol +100% oxygen (propofol-oxygen, group PO), 0.9% normal saline (NS) + 18% oxygen (group CH), NS + air (group CA), NS + 100% oxygen (group CO). The rats received injection of intraperitoneal propofol 50 mg/kg or NS 5.0 ml/kg once a day for 7 consecutive days and they were exposed to 18% oxygen, air or 100% oxygen at the end of each injection. SaO2 and respiratory rate (RR) were monitored and recorded after administration. The rats were returned to the cage after recovery of the righting reflex. Six rats in each group were sacrificed 24 h after the 7th injection, and the brain tissues were taken to observe the apoptosis in hippocampal neurons. Morris water maze test was used to test the learning and memory function 2 weeks after administration in the other rats. Results RR was significantly lower and the escape latency at T1.2 longer in group PO than in group CO (P ＜ 0.05). RR and SaO2 were significantly decreased, apoptotic index was increased, the escape latency was prolonged and the frequency of crossing the original platform was reduced in group PA compared with group CA, and in group PH compared with group CH (P ＜ 0.05). Compared with group PO, SaO2 was significantly decreased, apoptotic index was increased, the escape latency was prolonged and the frequency of crosing the original platform was reduced in group PA (P ＜ 0.05). Conclusion Propofol induces apoptosis in hippocampal neurons and decreases the learning and memory function in neonatal rats under hypoxic conditions.

BACKGROUND:In recent years, calcium alginate dressing has been widely used in surgical hemostasis, traumatic hemostasis, postoperative nasal hemostasis and puncture site hemostasis,etc.; however, there are few reports on their hemostatic mechanisms. OBJECTIVE: To preliminarily study the hemostatic mechanism of calcium alginate dressing. METHODS: Human anticoagulant blood was respectively dropped on sodium alginate dressing, nasopore dressing and medical cotton gauze. After 2 minutes, the interaction between materials and blood was observed at the room temperature using scanning electron microscopy. Calcium alginate dressing, nasopore dressing and medical cotton gauze were added in human red blood cel suspensions respectively. After 15 minutes, the interaction between materials and red blood cels was observed using scanning electron microscopy. The red blood cels were suspended by different concentrations (10, 5, 2.5 g/L) of alginate dressing extracts. The erythrocyte sedimentation rate was observed at different time points (30, 60, 120 minutes). Platelets rich plasma was incubated with different concentrations (10, 5, 2.5 g/L) of alginate dressing extract at 37℃, then CD62P positive platelet percentage was measured by flow cytometry after 10 minutes of incubation. RESULTS AND CONCLUSION: Dense fibrin network was formed after calcium alginate dressing contacting with an anticoagulant. A large number of blood cels were recruited. There were only a smal amount of red blood cels and platelets adhesion in the nasopore dressing and medical cotton gauze groups. After the calcium alginate dressing interacting with red blood cels, red blood cel deformability was visible, with a pseudopodia-like change. The red blood cel morphology was unchanged in the nasopore dressing and medical cotton gauze groups. The calcium alginate dressing extract dose-dependently and time-dependently increased the red blood cels aggregation, comparative differences between groups was statisticaly significant(P < 0.01). The calcium alginate dressing extract dose-dependently enhanced the CD62P positive platelet percentage, comparative differences between groups was statisticaly significant (P< 0.01). These results demonstrate that calcium alginate dressing promotes hemostasis and coagulation process by releasing of calcium ions, causing red blood cel aggregation and deformation and activating platelets.

This study was aimed to investigate the effects of high-dose strictosamide injection on cardiovascular sys-tem of anesthetized beagle dogs and to examine the inhibition of strictosamide on ion channels in vitro. Indexes such as changes of systolic blood pressure (Sys), diastolic blood pressure (Dia), mean blood pressure (MBP), heart rate (HR), PR, QRS, QT, QTcb and QTcv at different time points before and after strictosamide injection in dogs were monitored by the polygraph system. The inhibition of strictosamide at different concentrations on hERG potassium channel in CHO-hERG cells and Nav1.5 sodium channel in HEK-293-Nav1.5 cells were measured by whole-cell patch-clamp method. The results showed that compared with the blank control group, Sys, Dia, MBP and HR were obviously declined 15 min after medication in the strictosamide (60, 18 mg·kg-1) group and the vehicle-control group (containing tween-80) (P < 0.05). After medication, all indexes were recovered. Compared to the vehicle-control group, there were no significant differences at different time points in each medication groups. Compared with the blank control group and before medication, the QT interval, QTcb and QTcv were significantly prolonged 15 min af-ter medication in the strictosamide (60, 18, 6 mg·kg-1) group and the vehicle-control group (P< 0.05). When medi-cation stopped, indexes were recovered at certain level. Compared with the vehicle-control group, there were no sig-nificant differences of QT interval, QTcb and QTcv of each medication group at different time points (P> 0.05). The inhibition of strictosamide on hERG potassium channel and Nav1.5 sodium channel were weak with IC50 values of 560.8 μM and > 900 μM, respectively, which were far greater than the positive controls. It was concluded that sin-gle, high-dose intravenous injection of strictosamide may lead to a lower blood pressure, a slower heart rate and a prolongation on the QT interval in beagle dogs, which returned to basal levels when medication stopped. It was spec-ulated that the reduction of blood pressure and the slowing of heart rate were related to tween-80 contained in the vehicle control group. No significant inhibitory effects were detected on hERG potassium channel and Nav1.5 sodium channel in vitro, which suggested that other mechanisms may be involved in strictosamide-induced QT interval pro-longation in animals.

Objective To study the treatment efficacy of auricular point sticking for primary dysmenorrhea in college students, and to seek a convenient effective treatment method for primary dysmenorrhea.Method A total of 144 female college students with primary dysmenorrhea were randomized into an auricular point sticking group, a medication group, and a blank control group to receive the corresponding intervention. The dysmenorrhea intensity score and traditional Chinese medicine symptoms score for dysmenorrhea were used for observation.Result After the intervention, the recovery rate and total effective rate were respectively 64.6% and 91.7% in the auricular point sticking group, versus 39.6% and 70.8% in the medication group. There was a significant difference in comparing the therapeutic efficacy between the auricular point sticking group and medication group (P<0.05).Conclusion Auricular point sticking can produce a significant efficacy in treating primary dysmenorrhea in female college students, without adverse effects and convenient, and has a content long-term efficacy.

Objective To evaluate the application of partial cpsA-cpsB serotype prediction system as a serotyping method for streptococcus pneumonia.Methods Ninety-four isolates in this study were provided by Microorganism Research Room of Beijing Pediatric Research Institution,Beijing Children's Hospital Affiliated to Capital Medical University.The quelling test was applied to determine gold standard of serotypes of isolates.Polymerase chain reaction (PCR),sequencing,sequence data management and alignment were implemented previously.Results Eighty-three out of all 94 isolates were serotyped by quelling reaction,and 11 isolates were non-serotype isolates.Among the 83 isolates,67 (80.72％) isolates got positive PCR results and 60 (89.55％)isolates got results consistent with gold standard or containing gold standard.Among 12 isolates belonging to 19F,10 isolates were correctly predicted,and 2 isolates were predicted to be 6A,23F/10A.Among 19 isolates belonging to serotype 19A,1 isolate was predicted to be 35 F/47F,and the other 18 isolates were correctly predicted.Among 10 isolates belonging to serotype 14,9 isolates got results consistent with gold standard,and 1 isolate was predicted to be 19A.All 7 isolates belonging to serotype 6B were predicted to be 6A/6B and 4 isolates belonging to 23F were predicted to be 23F/10A.3 of 11 (27.27％) non-serotype isolates got positive PCR results and were predicted to be 6A/6C,6A/6B,19A.Conclusions Partial cpsA-cpsB sequencing system is a useful method for detecting streptococcus pneumoniae serotypes.

OBJECTIVE: To investigate the dynamic trends of activities of matrix metalloproteinase (MMP)-2/9 and protein expressions of their inhibitors-tissue inhibitor of matrix metalloproteinase (TIMP)-1/2 during the progression of pulmonary fibrosis in rats so as to get insight of the roles played by MMP-2/9 in lung injury and fibrogenesis. METHODS: Forty-eight SD rats were randomly divided into normal control group (n=18) and bleomycin (BLM)-treated group (n=30). The pulmonary fibrosis was induced by intratracheal injection of BLM once. At the consecutive time of 1 day, 3 days, 1 week, 2, 3, and 4 weeks after intoxication, the lung-to-body weight ratio was calculated and the inflammation and collagen deposition in lung tissue were checked by HE and Masson stainings respectively. Meanwhile, the content of hypdroxyproline (Hyp) in lung tissue was assayed with Jamall's method, the protein expressions of MMP-2/9, TIMP-1/2 were examined by Western blotting, and the activities of MMP-2/9 were detected by gelatin zymography. RESULTS: The histopathological changes in lung tissue in the BLM-treated group from 1 day to 2 weeks after intoxication presented local lesions, broadened alveolar wall and septum, infiltration with lots of inflammatory cells and few of fibroblasts inside alveolar space and septum. At this early stage in the BLM-treated group, the lung-to-body weight ratio was increased significantly, the protein expressions and activities of MMP-2/9 were obviously increased especially for activity of active MMP-2, and the protein expressions of TIMP-1/2 were also increased gradually, as compared with those in the normal control group. From 3 to 4 weeks after intoxication in the BLM-treated group, the alveolar structure was damaged, parts of the alveolar space collapsed and replaced by collagens and fibroblasts, and the alveolar wall and septum obviously widened with remarkable fibrotic characteristics, as compared with those in the normal control group. Meanwhile, the lung-to-body weight ratio and the activities of MMP-2/9 were decreased in the BLM-treated group as compared with those in the same group at 2 weeks after intoxication, but the content of Hyp and the protein expressions of TIMP-1/2 were both increased dramatically, especially at 4 weeks after intoxication. CONCLUSIONS: During the lung fibrogenesis induced by BLM in rats, the alveolar inflammation is the most important alteration with enhanced MMP-2/9 activities in the early stage. While in the late stage, the main change is displayed as pulmonary fibrosis, characterized by increased TIMP-1/2 and declined MMP-2/9 activities.

Objective To explore the risk factors of hyperbilirubinemia in late preterm infants. Methods Clinical data of 211 cases of late preterm infants with hyperbilirubinemia and 246 cases of late preterm infants without hyperbilirubinemia were retro-spectively analyzed between 2011 and 2012. The risk factors of hyperbilirubinemia were filtered. Results Twenty-seven cases of late premature infants with hyperbilirubinemia were severe. Hospital stay less than 3 days, birth asphyxia history, small for gestatio-nal age, head hematoma, delivery injury, hypoalbuminemia, polycythemia, infection, hemolytic disease, feeding intolerance, and fe-tal excretion delay were associated with hyperbilirubinemia (P<0.05). Rural origin, pregnancy-induced hypertension syndrome and premature rupture of membrane were also associated with hyperbilirubinemia (P<0.05). Multivariate logistic regression analysis showed the history of birth asphyxia , fetal excretion delay, hypoalbuminemia, pregnancy-induced hypertension syndrome were risk factors of hyperbilirubinemia in late preterm infants (OR=2.35-4.05). Pregnancy-induced hypertension syndrome and hemolytic dis-ease were risk factors of severe hyperbilirubinemia in late preterm infants (OR=5.74, 73.64). Conclusions Neonatal asphyxia, fetal excretion delay, hypoalbuminemia and pregnancy-induced hypertension syndrome are risk factors of hyperbilirubinemia in late pre-term infants. Strengthening the management of pregnancy-induced hypertension syndrome and the treatment of newborn hemolytic disease can reduce the occurrence of severe hyperbilirubinemia in late preterm infants.