Objective To investigate the effect of dyslipidemia on retinol binding protein4(RBP4) and their correlation in type 2 diabetes(T2DM ) patients .Methods A total of 55 patients with T2DM were selected into T2DM group ,51 healthy persons were selected into control group .Serum total cholesterol(CHOL) ,high density lipoprotein cholesterol(HDL-C) ,low density lipoprotein cholesterol(LDL-C) ,triglyceride(TG) ,apolipoprotein A1(ApoA1) ,apolipoprotein B(ApoB) ,glucose(Glu) and RBP4 were detected by automatic biochemical analyzer ,and compared between the two groups ,the relationship between TG and RBP4 was analyzed .Re-sults The levels of serum RBP4 in patients with T2DM was significantly higher than that of control group .Positive correlation was observed between RBP4 and TG in patients with T2DM (r=0 .333 ,P=0 .013) ,however ,no correlation was found in patients in control group(r=0 .065 ,P=0 .614) .Serum RBP4 in patients with TG>1 .70 mmol/L were significant higher than those patients with TG≤1 .70 mmol/L (P=0 .011) .Conclusion High level of serum RBP4 was observed in patients with T2DM ,and positive correlated with TG ,which means level of RBP4 might be affected by TG .

Metabolic surgery has brought new hope for obese T2DM patients. Control of long‐term complications and integrated management after metabolic surgery are important for patients to obtain a long‐term benefit. Cooperation of multidisciplinary teams plays an indispensable role in this systemic work.

On the basis of a retrospective summary of the policies for foreign-invested hospitals in China,this paper analyzed the main issues facing wholly foreign-owned hospitals and suggested a basket of strategies to promote the development of such hospitals in China (Shanghai)Pilot Free Trade Zone.

Objective .To evaluate the role of cystatin c in the risk judgement of coronary artery disease. Methods 77 patients with coronary artery disease were involved in the study.They were divided into two groups:Group 1 were patients with angiographically diagnosed coronary artery disease ( CAD) with their first acute coronary syndrome ( n=55);Group 2 were patients who had clinically diagnosed coronary disease but were negative on angiog-raphy ( n=22) .Serum Cys C levels in the two groups and the correlation to CAD were analyzed.Results Serum Cys C levels in patients of Group 1 were higher than that of Group 2 [(1.23 ±1.07)mg/L vs.(0.71 ±0.32)mg/L,P=0.002],but no significant difference was found between the two groups in crea levels [(123.76 ±80.44)μmmol/L vs.(117.63 ±65.43)μmmol/L,P=0.230].A ROC analysis revealed that there was a significantly higher risk of ACS above a cystatin c level of 0.875mg/mL (sensitivity:84.3%,specificity:38.8%).A similar analysis carried out for eGFR did not find any significant cut-off points above which risk of ACS was higher.Conclusion The data showed that a high level of cystatin c level is a risk factor for ACS.This could play an important role in the early diag-nosis and prevention of adverse cardiovascular events.

Objective To survey health management cognition of residents in Shanghai city communities,and to analyze the causes,and to put forward related suggestions.Methods In October of 2013,this study was conducted in communities of Shanghai central district (Xuhui District),urban border area (Minhang District),and suburban area (Jinshan District); 800 residents from each health management cognition outpatient clinic (400 people from each of hospitals and community health service center),totally 2 400 residents were studied and investigated in the communities of Shanghai city,and 2 082 questionnaire were received (the questionnaire recovery rate was 86.75％).We used stratified random cluster sampling method,and self-designed investigation form,and did pre-experiment.The Survey included:Whether family doctors need to carry out the evaluation work about risk factors,to implement health management for school students,to implement health management for people over 60 years old,to implement the elderly health management for pension agencies,to implement special crowd health management for special people;conduct questionnaire of demand level for different population groups (type,age,gender,marital status,retirement,occupation,level of education and medical insurance form).Results The research results found that,when asked about the family doctor whether to carry out risk assessment,family doctor whether to implement special health management,whether family doctors need to teach health management to students, whether family doctor should undertake the health management work for the people over the age of 60,whether family doctors should implement special health management,whether a person thinks that it is indifference (9.3％,7.4％,3.8％,6.2％ and 5.7％) and unnecessary (3.6％,4.4％,2.5％,4.2％ and 3.9％)in the minority,the majority of people believe that they need (51.1％,52.9％,57.2％,55.6％ and 55.3％),then the general (24.5％,18.9％,12.4％,18.0％ and 16.5％) and very necessary (11.5％,16.4％,24.1％,16.0％ and 18.6％).Among them,the occupation,whether retired or not,level of education,medical insurance form and different age groups had different cognition and demand level for health management work.Conclusion To Strengthen the health management training,to take specific health management services according to different groups of people and to improve community health management services are very important.

[Objective] To study the difference between stable angina(SA) and unstable angina(UA) on monocyte chemoattractant protein-1(MCP-1)and homocysteine(HCY)concentrations, to define its clinical meaning to angina. [Method] Select 67 cases of UA and 65 cases of SA, take 60 normal persons of similar age as healthy control group; col ect the vein blood within 12h at the last attack of UA group, col ect the vein blood in early morning for SA group and control one; measure serum MCP-1 and HCY with ELISA method. [Result] The MCP-1 and HCY levels had difference among al groups, among which, groups UA and SA were higher than control one, with difference of statistical meaning; while UA group was higher than SA group, with difference of statistical meaning. [Conclusion] In angina patients, the serum inflammatory factors MCP-1 and HCY levels are higher than healthy persons, UA higher than SA patients;to test MCP-1 and HCY levels is helpful to identifying and screening high-risk angina patients.

The onset of irreversibility of cardiovascular diseases caused by obesity has showed a rising trend,the underlying cause of the disease is the endothelial damage.Injury caused by obesity through four aspects:systolic and diastolic imbalance,anticoagulant and procoagulant imbalance,growth factors and growth factor imbalances and endothelial progenitor cell changes in endothelial damage.This paper reviews the reason and the mechanism of the endothelial damage through the change of the endothelial factors and progenitor cells.

The theme of this article lies in how to preserve the anus or restore the anal function in the treatment of middle or lower rectal cancer in order to avoid abdominal artificial anus,on the basis of not violating the principles of radical resection.From August 1995 to October 2004,86 cases of rectal cancer were operated with radical resection,48 of which preserved anus.Based on close observation of the patients,postoperative anal function seems the best in those with Dixon's anterior approach.if transplantation of the gracilis muscle is successful,satisfactory function restoration is always possible.Many scholars ever reformed Dixon's resection with lots of operative procedures,such as Bacon's resection.Because stapler can join rectal and anal together at any location,Bacon's resection is seldom adopted in clinical practice.The indications for anus preserving operation are as follows:①early or middle stage disease with localized lesion not invading beyond the muscle layer of the bowel;②no metastatic regional lymph adenopathy and;③adenocarcinoma at high or moderate degree of differentiation.It is suggested that different types of operative procedures are adopted according to the location of the lesion.

A pressure swing adsorption nitrogen generating device for producing nitro- gen enriched gas from compressed air was discussed.Utilizing the feature of the molecular sieve carbon with the property of selective adsorbing oxygen and ni trogen,the device enriches the product nitrogen at gas phase,and uses the gas lower in concentration than the product nitrogen for flushing residual gas,it help molecular sieve carbon with desorption.

The pathological findings in 3 cases of liver transplantation in primary he-patocarcinoma were reported .Possible pathological causes such as the rejective reaction, necrosis of the liver, formation of the biliary sluge, infection and relapse of carcinoma were discussed.