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.

Objective To investigate the effects of aging and the decreased glomerular filtration rate on the prevalence of anemia in elder receiving body check from urban area of Hefei, China.Methods A total of 4547 >60 years subjects received healthy examination in Healthy Center of Anhui Provincial Hospital from January 2005 to December 2007 were enrolled in this study.Anemia was defined as hemoglobin < 120 g/L in men or < 110 g/L in women.Results The prevalence of anemia in the subjects was 4.40% (95% CI: 3.83% -5.05% ) and significantly increased with the aging process and the decline of estimated glomerular filtration rate ( eGFR) .With logistic analyses, increasing age, female, decreased eGFR were major risk factors for anemia Conclusions The morbidity of anemia is 4.40% in old population receiving body check from urban area of Hefei, China.Aging and the decline of eGFR are the independent risk factors of anemia.

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 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.

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 explore the clinical value of wave intensity(WI) curve of the carotid artery in patients with thyroid diseases and its value in evaluating cardiovascular function. Methods All 85 patients with thyroid diseases,including 45 hyperthyroidism and 40 hypothyroidism, were enrolled as case groups,while 270 healthy volunteers were considered as control. All the case groups and control were taken WI test under quiescent condition,and six continuous curves of the carotid artery diameter changes were recorded.Then the parameters of accelerating wave intensity (W1), decelerating wave intensity ( W2), negative area (NA) ,corrected R-W1 and W1-W2,elasticity modulus(Eρ) ,stiffness index(β) ,arterial compliance(AC) and pluse wave velocity(PWV) were calculated. Relationship between those indices and FT3 ,FT4 and TSH were analyzed by Pearson correlative analysis. Results The WI curve appeared differently among different groups,but the vessel elasticity indices did not have statistical significance. Correlation only existed between FT3 and part of the WI parameters. FT3 positively correlated with W1 ( r = 0. 951, P ＜0.01 ), NA( r =0.813, P ＜0.01) and W1-W2' ( r = 0. 887, P ＜0.01 ). And R-W1 ' negatively correlated with FT3( r =-0.878, P ＜0.01 ). Conclusions The WI curve could represent different function status of thyroid,and could be considered as a noninvasive examination for further clinical research,which may help explain the corresponding cardiovascular changes.