Objective To explore the effect of responsibility system of family doctors( RSFD) for community management of the patients with diabetic retinopathy ( DR ) .Methods Fifty -two cases with non -proliferative diabetic retinopathy( NPDR) found in annual health examination in community health care centers were selected and randomly divided into intervention group(30 cases) and control group(22 cases).The intervention group received RSFD service mode and the control group received conventional management mode for 1 year.Patients'visual acuity, fundus,fasting blood-glucose(FBG),glycosylated haemoglobin(HbA1c) were observed and compared before and after intervention.Results In this study,the efficacy in improving patients'visual acuity and retinopathy was 73.3%in the intervention group and 45.5%in the control group,there was statistically significant difference between the two groups(χ2 =4.168,P=0.041).Before intervention,the control rates of patients'FBG were 36.4% and 30.0%respectively,and HbA1c was 27.3%and 33.3%.There were no statistically significant differences between the two groups(P>0.05).After intervention,the control rates of patients'FBG and HbA1c were 86.6% and 80.0% in intervention group,and 59.1%and 54.5%in the control group,there were statistically significant differences between the two groups (χ2 =5.147,P=0.023;χ2 =3.861,P=0.049).Conclusion RSFD service mode was conductive to control patients'blood sugar and improve visual acuity and retinopathy,we could disseminate and apply it to manage-ment of DR in community.

Background and purpose:RASSF10 acts as a kind of tumor suppressor in various tumor tissues, but researches in cardiac adenocarcinoma has not been reported. This study aimed to detect the methylation status and expression ofRas-association domain family 10 (RASSF10) in gastric cardia adenocarcinoma (GCA), and explore its role in occurrence and development of GCA.Methods:Methylation speciifc polymerase chain reaction (MSP), reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry method were respectively used to detect methylation status, mRNA expression and protein expression ofRASSF10 in 81 GCA tissues and corresponding normal tissues.Results:The promoter methylation frequency ofRASSF10 in GCA tissues (64.20%, 52/81) was signiifcantly higher than that in corresponding normal tissues (20.99%, 17/81,P<0.05), and was closely correlated with TNM stages, differential degree and lymph node metastasis (P<0.05). RASSF10 mRNA expression in GCA tissues (0.57±0.05) was significantly lower than that in corresponding normal tissues (0.78±0.02,P<0.05), and was closely correlated with TNM stages and lymph node metastasis (P<0.05). Protein expression of RASSF10 in GCA tissues (31.10%, 26/81) was signiifcantly lower than that in corresponding normal tissues (71.60%, 58/81,P<0.05), and was closely correlated with TNM stages, differential degree and lymph node metastasis (P<0.05). The promoter methylation frequency ofRASSF10 in GCA tissues was inversely related to its protein expression.Conclusion:Inactivation of RASSF10 caused by aberrantmethylation in the promoter region may be closely correlated with the GCA tumorgenesis.

Objective: Recent studies have suggested that congestive heart failure(CHF) is related to neuroendocrine system and cytokines,and its activation contributes to myocardial remodeling and leads to the development and progression of CHF.Tumour necrosis factor-?(TNF-?) is one of the most important factors.This study intends to establish the animal model of isoproterenol(ISO)-induced CHF in rats and to study the changes of serum TNF-?.Methods:Male SD rats were randomly allocated to the ISO-induced CHF group(n=50) receiving two subcutaneous injections of 170mg ISO per kilogram of body and the healthy control group(n=10) receiving two subcutaneous injections of 0.25ml normal saline.At 18th week,the hemodynamic parameters including HR,LVSP,LVEDP and ?dp/dtmax were assessed.TNF-? in plasma were all detected.Results:Compared with the control group,the LVSP、?dp/dtmax significantly decreased and the HR,LVEDP enlarged notably in CHF group(P

Objective To investigate the clinic value of procalcitonin( PCT)and c-reactive protein ( CRP)in differential diagnosis for febrile diseases. Methods One hundred and forty patients with febrile diseases in May 2009 to February 2014 in the No. 309th Hospital of People Liberation Army were investigated and analyzed retrospectively. Based on discharge diagnosis,patients were divided into bacterial infection group( n=58),non-bacterial infection group(n=47)and rheumatic diseases group(n=35),another 40 healthy people were served as the control group. Serum PCT and CRP were detected and compared in four groups. One month after backing to normal temperature in all the patients,detected serum PCT and CRP again. Results Serum PCT and CRP level in bacterial infection group,non-bacterial infection group,rheumatic diseases group and control group were(5. 18 ± 1. 92)and(0. 45 ± 0. 22),(0. 34 ± 0. 13)and(0. 16 ± 0. 05)μg/L,(25. 31 ± 4. 24), (1. 94 ± 0. 37 ),( 62. 32 ± 15. 10 ) and( 1. 30 ± 0. 04 ) mg/L respectively. Serum PCT and CRP level in bacterial infection group were significantly higher than that in control group(P﹤0. 01). Even though serum PCT and CRP level in non-bacterial group slightly higher than that of healthy control group,there was no statistical difference(P﹥0. 05). Serum PCT and CRP level in bacterial infection group were significantly higher than that of non-bacterial infection group( P ﹤0. 01 ). Serum CRP level in rheumatic diseases group was significantly higher than that of healthy control group( P﹤0. 01),while PCT level only slightly higher compared with healthy control group(P﹥0. 05). One month after backing to normal temperature in all the patients,serum PCT and CRP level in bacterial infection group reduced significantly compared with that of febrile period( P ﹤0. 01). Serum PCT and CRP level in non-bacterial infection group were no significant change( P﹥0. 05 ),and serum CRP level in rheumatic diseases group reduced significantly( P﹤0. 01 ),while serum PCT were no significant change(P﹥0. 05). Conclusion Serum PCT combined with CRP might be of great importance in the differential diagnosis for febrile diseases.

Objective To compare the diagnostic efficacy of the V/Q scan and CT pulmonary angiography (CTPA) for the detection of acute pulmonary embolism (PE) in elderly patients.Methods Fortyfour patients (age ≥60 years old) with suspected acute PE underwent V/Q scan and CTPA.The diagnosis of PE by V/Q scan was based on the criteria of prospective investigation of PE diagnosis (PIOPED) Ⅱ and the prospective investigative study of acute PE diagnosis (PISA-PED).The final diagnosis was made clinically.The sensitivities,specificities and accuracies of PIOPED Ⅱ,PISA-PED,CTPA and Wills score were calculated and compared using x2 and Fisher's exact tests.Kappa analysis was used to analyze the diagnostic accordance rate of PIOPED Ⅱ and PISA-PED.Results The sensitivities of PIOPED Ⅱ,PISA-PED and CTPA in the diagnosis of PE were 70.00％ (14/20),84.62％ (22/26) and 65.22％ (15/23),respectively (x2 =0.069-1.545,all P＞0.05).The sensitivity of Wills score was significantly lower (23.08％,3/13).The specificity of CTPA (93.75％,15/16) was significantly higher than those of PIOPED lⅡ and PISAPED (80.00％,12/15 and 61.11％,11/18,both P＜0.05).The accuracies of PIOPED Ⅱ,PISA-PED and CTPA were 74.29％ (26/35),75.00％ (33/44) and 76.92％ (30/39),respectively (x2 =0.005-0.070,all P＞0.05).The accuracy of Wills score was significantly lower (52.17％,12/23).The diagnostic accordance rate of PIOPED Ⅱ and PISA-PED criteria was 77.14％(27/35),Kappa=0.547,P＜0.05.Conclusion V/Q scan and CTPA have no significant difference for the diagnosis of PE in the elderly patients.

Objective To evaluate the efficacy of minimally invasive drairage of hematoma in treatment of hypertensive cerebral hemorrhage. Methods 60 patients with hypertensive cerebral hemorrhage were randomly divided into two groups,including the observation group of minimally invasive hematoma drainage, the control group 30 cases, a small bone window intracranial hematoma,observe and compare the two groups of hypertensive cerebral hemorrhage the neurological function recovery. Results The operative time was significantly shorter than that used in the control group. Postoperative mortality, the difference was significant (P

Objective To introduce the techniques and specification of complete-block radical gastrectomy, and to compare with traditional radical gastrectomy in the operative time, surgical costs and postoperative complications. Methods Thirty gastric cancer patients meet the criteria were randomly divided into 2 groups. Group A: complete-block radical gastrectomy;group B: radical gastrectomy. Analysis and comparison were made on tumor site, time consuming of block, the proportion of gastrointestinal reconstruction, operative time, cost of block, pathological TNM stage, length of stay, postoperative complications and postoperative chemotherapy. Results Group A has longer operative time than group B (P<0.05). However, there was no significant statistical difference in the other indicators between these 2 groups. Conclusions Complete-block technology can separate cancer more completely during operation with the advantage of simplicity, low-cost, little effect on the subsequent operation. The incidence of postoperative complications and length of stay with the traditional surgery there was no significant difference.

Objectives:To examine the effect of chloride blocker (NPPB and tamoxifen)on volume sensitive chloride channels in mouse cardiac ventricular myocytes. Methods:Isolated mouse cardiac ventricular myocytes were subjected to whole cell patch clamp to record the hypotonicity activated chloride currents. Results:When the myocytes were exposed to hypotonic solution, an obvious whole cell currents were activated. The currents were inhibited by extracellular NPPB reversibly and significantly. The specific blocker for volume sensitive chloride channel , tamoxifen (50 ?mol/L), could apparently block the activity of this channel in a voltage dependent manner. Conclusions:Mouse cardiac ventricular myocytes process volume sensitive chloride channel which is sensitive to NPPB and tamoxifen.

Objective To investigate the aberrant methylation and expression of growth arrest and DNA-damage-in-ducible 45 gamma (GADD45G) gene in gastric cardia adenocarcinoma (GCA). Methods Bisulfite conversion-methylation specific polymerase chain reaction method (BS-MSP) and immunohistochemistry method were used respectively to detect the methylation status and protein expression of GADD45G in 138 GCA tumor tissues and corresponding normal tissues. Re-sults The methylation status of GADD45G distal promoter (region 1) was not detected in GCA tumor tissues and corre-sponding normal tissues. For GADD45G region 2 and region 3, the BS-MSP results of region 3 were identical to that of re-gion 2. The methylation frequency of proximal promoter and exon 1 in GADD45G island 2 (region 2 and region 3) in GCA tu-mor tissues (49.3%, 68/138) was significantly increased compared to that in corresponding normal tissues (0, P＜0.01). The methylation status of this two sites in tumor tissues was associated with TNM stage of tumors (P＜0.05). The protein expres-sion of GADD45G in tumor tissues was significantly decreased than that in corresponding normal tissues (P ＜ 0.05),and threre was a significant negative correlation with methylation status of GADD45G proximal promoter and exon 1 (rs=-0.398). Conclusion The decreased expression of GADD45G by hypermethylation of proximal promoter exon 1 of the gene may play an important role in gastric cardia adenocarcinoma.

Objective To investigate the promoter methylation status of SFRP1 and SFRP2 gene in gastric cardia adenocarcinoma (GCA). Methods Methylation specific PCR (MSP) method was used to examine the methylation status of the 5' CpG island of SFRP1 and SFRP2 gene in tumors and corresponding normal tissues. Results Methylation frequencies of SFRP1 and SFRP2 gene in tumor specimens were 87.2 % (82/94) and 83 %(78/94), which was significantly higher than that in corresponding normal tissues (14.9 % and 55.3 %, respectively) (P <0.001). Methylation frequencies of SFRP1 in lymph node metastasis group (96.4 %) was significantly higher than that in no lymph node metastasis group (73.7 %). Methylation frequencies of SFRP1 and SFRP2 gene in poor differentiation group were all higher than that in moderate and poor-moderate differentiation groups, but both of them did not show significant difference(P >0.05). 63 cases of GCA showed both of SFRP1 and SFRP2 gene simultaneous methylation, which including 36 cases of lymph node metastasis group, 27 cases of no lymph node metastasis group. Simultaneous methylation frequencies of SFRP1 and SFRP2 gene in lymph node metastasis group was higher than that in no lymph node metastasis group, poor differentiation group was higher than that in moderate and poor-moderate differentiation groups, but both of them did not show significant difference (P >0.05). Conclusion Promoter methylation of SFRP1 and SFRP2 might be related with oncogenesis of GCA and hypermethylation of SFRP1 gene might be related with the malignant behavior of GCA.