The metabolic syndrome (MS) is one of the major risk factors for cardiovascular disease.The pathogenesis of MS is not fully understood.In addition to insulin resistance and central obesity,some other factors such as resting heart rate are also thought to play certain roles.The primary strategy of the intervention is still relying on lifestyle modification including healthy dietary habits.

With reference to the research report of American Medical Association on the healthcare system,the paper analyzed the existing medical service,and probed into the causes of poor quality of care The author staged the six countermeasures highlighting patient-focus,safe,effective,timely,efficient and fair medical service models,in the hope of improving quality of care and ensuring patient safety.

0.05).Seventy patients were followed up from 3 months to 8 years post-operatively,with tumor-free survival in 67 cases,and cervical lymph nodes metastasis in 3 cases.No permanent hypo-parathyroidism or paralysis of recurrent laryngeal nerves occurred.Conclusions Total thyroidectomy is advised for bilateral thyroid carcinoma.It is necessary to emphasize the importance of resection of the central region lymph nodes.

Objective To analyze current situation of incentive mechanism and investigate the countermeasures.Provide the evidence for improving the incentive mechanism of scientific research at the hospital.Methods Questionnaire survey was conducted to investigate current situation and countermeasures of incentive mechanism of scientific research.Database was building using EpiData3.1,and was performed by descriptive analysis.Results 194 questionnaires were available.For the current incentive mechanism,86.5％ respondents thought the content is comprehensive,The over 50 years old,bachelor or below,and clinical examination group thought the content were less comprehensive.Respectively,81％,82.5％,76.2％ of respondents thought stimulation on achievements has positive effect to research,team work,and individual accounted for.The over 41 years old college or bellow,clinical treatment group felt less effect.For improving measures of incentive mechanism,the top three positions of contents were technological reward,high level project and SCI paper;and incentive methods were promotion,material rewards and training.Conclusions Incentive mechanism can promote scientific research to some extent.To further promote scientific research development,individual incentive measures need to be taken,the contents need to be expanded,variety incentive methods need to be used.

Objective To investigate the correlation between drug resistance and β-actamase genes of multi-drug resistance Acinetobacter baumannii (MDR-AB) in neonatal intensive care unit to provide evidence for rational antibiotics administration and nosocomial infection control.Methods Twenty-six MDR-AB strains were separated and collected from clinical specimens.The minimum inhibitory concentrations of 13 antimicrobial agents were determined by agar dilution method.Genotypes of β-lactamase were detected by polymerase chain reaction.Results The resistant rates of the 26 strains to Ceftazidime,Cefoxitin,Piperacillin-tazobactam and Ciprofloxacin were 100.0%.About 80.8% to 96.2% of these strains were resistant to the other antimicrobial drugs.Among the 26 MDR-AB strains,100% (26/26) strains possessed oxa-51,77% (20/26) possessed oxa-23 gene,54% (14/26) carried arnpC gene,both oxa-23 and ampC were identified in 42% (11/26) strains,while oxa-24,oxa-58,imp-1,imp-4 and vim-2 gene were not identified.Conclusions The drug resistance of Acinetobacter baumannii is serious,oxa-23 and ampC are the major plactamase genes carried by MDR-AB in neonatal intensive care unit.

Objective To investigate the effect of ulinastatin (UTI) on endogenous antioxidant systems in the process of myocardial oxidative stress injury induced by paraquat (PQ),so as to elucidate UTI protecting cadiocytes against PQ-induced injury.Methods Thirty Japan white rabbits were randomly (random number) divided into A,a sham control group; B,PQ intoxication model group and C,D,E,three UTI groups as per different dosages of UTI given.PQ (30 mg/kg) was administered by intraperitoneal route to the rabbits of PQ intoxication model and rabbits of three UTI groups.UTI in doses of 15 000,30 000,50 000 U/kg was administered intravenously every day to the rabbits of three UTI groups respectively for 7 days after PQ intoxication.After the rabbits were sacrificed with 10％ chloral hydrate,left ventricles of rabbits were taken.Histomorphological changes of myocardium were observed by using HE staining.Hydroxyproline was measured by alkaline hydrolysis method,myocardial oxidative stress evaluated by 4-hydroxy-2-nonenal (4-HNE) immunohistochemistry staining,transcription levels of transforming growth factor-β1 (TGF-β1),adiponectin,peroxisome proliferator-activated receptor α (PPAR-α),AMP-activated protein kinase-β1 (AMPK-β1),uncoupling protein-1 (UCP-1) were assayed with reverse transcriptionpolymerase chain reaction (RT-PCR).The differences between two groups were analyzed by t test ; for multiple comparisons,data were analyzed by One-Way ANOVA followed by Dunnett' s post hoc test; for two and multiple ranked data comparisons,Mann-Whitney U test and Kruskal-Wallis test were used,and Spearman rank correlation analysis was used to investigate the correlation between UTI dose and transcription levels of endogenous antioxidant.Results Compared with group A,left ventricular cadiocytes in group B became swelled and disarranged,concentration of tissue HYP was elevated to (2.37 ± 0.49),P =0.001;scores of 4-HNE and TGF-β1 mRNA expressions were all upregulated (both P =0.001).Compared with group B,disordered myocytes in UTI treated groups tended towards normal,4-HNE scores in group D and group E descended respectively to (1.83 ± 0.53) and (1.70 ± 0.47),both P =0.001,HYP concentration reduced to (3.51 ±0.39) μg/mg and (3.29 ±0.37) μg/mg (P =0.002; P =0.001),and expressions of TGF-β1 mRNA in these two groups were decreased (both P =0.001).Transcription levels of four endogenuous antioxidant components,adiponectin,PPAR-α,AMPK-β1 and UCP-1,were all augmented in the group E with high dose UTI.The mRNA expressions of these four components positively correlated with the dose of UTI in the myocardium of PQ intoxicated rabbits.Conclusions UTI could protect myocardia against PQ-induced injury by increasing endogenous antioxidant systems.

OBJECTIVE:To observe the occurrence of paclitaxel(PTX)-induced muscle soreness and therapeutic efficacy and safety of diclofenac sodium. METHODS:Among 84 patients with malignant tumor receiving PTX chemotherapy,56 patients suf-fered from PTX-induced muscle soreness,among which 22 female patients suffered from medium and severe muscle soreness and then were randomly divided into group A and B,with 11 cases in each group. Group A was given Diclofenac sodium sustained-re-lease tablet 75 mg orally,once a day;group B was given Paracetamol and tramadol hydrochloride tablets one tablet orally,once a day,and then given Promethazine hydrochloride injection 100 mg subcutaneously,2-3 times a day when muscle soreness could not be born. Treatment course of both groups lasted for 5 d. The distribution of muscle soreness were observed. The onset time and dura-tion of muscle soreness were also observed as well as pain relief and the occurrence of ADR in group A and B. RESULTS:Among 84 cases,the incidence of muscle soreness was 66.67%,among which mild pain accounted for 23.81%,moderate pain accounted for 13.10%,and severe pain accounted for 29.76%. Among 56 patients with muscle soreness,earliest muscle soreness occurred on the day of medication,and most of muscle soreness occurred on 1-3 days after medication,mainly manifesting as sore,activity limitation when severe,associated with fatigue. The pain relief rate of group A and B were 100%,but the incidence of adverse re-actions in group A was significantly lower than group B,with statistical significances(P<0.05).CONCLUSIONS:Diclofenac sodi-um is similar to paracetamol and tramadol hydrochloride in the treatment of PTX-induced muscle soreness,but it is better than paracetamol and tramadol hydrochloride in safety.

Objective:To assess the efficacy of trastuzumab combined with neoadjuvant chemotherapy in the treatment of human epidermal growth factor receptor-2 (Her-2)positive breast cancer patients,and to explore its influencing factors of prognosis of breast cancer.Methods:The clinical materials of 112 Her-2 positive breast cancer patients were collected and they were divided into combined treatment group (trastuzumab + neoadj uvant chemotherapy)and single chemotherapy group (without trastuzumab ). SPSS 1 9.0 software was employed to calculate and analyze their clinical characteristics.The survival rate and prognosis were analyzed by Kaplan-Meier method,Log-rank test, and Cox regression. Results:Among the 112 Her-2 positive breast cancer patients, 23 cases were treated with trastuzumab,89 cases were treated without trastuzumab.The disease-free survival (DFS)in combined treatment group and single chemotherapy group had significant difference (P=0.012).And there was no significant difference of overall survival (OS)between two groups (P=0.064).The HR negative group had 18 (32.7%)patients with 5-level of Miller and Payne (MP)classification which was higher than HR positive group (5/46,10.9%)(P=0.009).In univariate analysis,the tumor size,node status at diagnosis and node status after operation were the influencing factors of DFS in the Her-2 positive breast cancer patients;the tumor size,node status at diagnosis,MP classification and node status after operation were the influencing factors of OS in the Her-2 positive breast cancer patients.The result of multivariate analysis indicated that the tumor size, node status at diagnosis,and with or without radiotherapy were the independent influencing factors of DFS and OS in the Her-2 positive breast cancer patients. Conclusion:The breast lesions in the Her-2 positive breast cancer patients with negative HR are relieved after treated with trastuzumab combined with neoadjuvant chemotherapy. The combination of trastuzumab and neoadj uvant chemotherapy can significantly improve the DFS and has a positive influence in the prognosis of Her-2 positive breast cancer patients.

Objective To discuss the jointly therapeutic effects of 6％ hydroxyethyl starch 130/0.4 (voluven) and furosemide on acute lung injury induced by paraquat (PQ) in swine.Methods The ALI/ ARDS models were established with 20％ PQ (20 mL) intraperitoneal injection in 18 healthy female piglets and randomly divided into three groups: voluven group (A), furosemide group (B) and voluven + furosemide group (C) (n =6 in each group).The heart rate (HR), mean arterial pressure (MAP), extravascular lung water index (ELWI), pulmonary vascular permeability index (PVPI), partial pressure of carbon dioxide (PaCO2) and oxygenation index (PaO2/FiO2) among the three groups were carefully measured by PICCO (pulse indicator continuous cardiac output) before modeling (baseline), just aftermodeling (t0), and 2 h (t2), 4 h (t4), 6 h (t6) and 8 h (t8) after trearment.Needle biopsies of lung tissue were made before modeling and at t0 and t8 and prepared for microscopy observation after Hematoxylineosin staining method (HE staning).Repeated measurement data were compared among repeated measures by the ANOVA and the difference between groups was compared by one-wey ANOVA.Results (1) The HR and MAP of all animals increased obviously while the oxygenation index declined significantly at modeling just made (t0) compared to those before modeling (all P ＜ 0.05).At the same time, the HR and MAP of A and B groups were significantly lower than those of C group after treatment (all P ＜ 0.05), while the oxygenation index of A and B were significantly higher (all P ＞ 0.05).(2) The ELWI and PVPI of all animals increased obviously at modeling just made (t0) compared to those before modeling (all P ＜ 0.05).The ELWI and PVPI were decreased after treatment.And at the same time, the ELWI and PVPI of A and B groups were significantly lower than those of C group after treatment (all P ＜ 0.05).(3) The alveolar tissue showed obviously injured changes at modeling just made (t0).The injury was relieved 8h after trearment, which was most markedly in group C.Conclusions With the combination of 6％ hydroxyethyl starch 130/0.4 and furosemide administered, the acute lung injury induced by paraquat poisoning can be effectively relieved, promoting gas exchange, and improve oxygenation.

Objective To measure the angular velocity and perpendicular ground reaction force of the ankle joint under different heights with half-squat jumping in parachute training simulation,providing a reliable experiment basis for the preventing of ankle injury.Methods A total of 18 volunteers participated in this study.The experimental group included 9 male with experience of parachute landing,while the other 9 male without experience of parachute landing were assigned to the control group.Each subject was instructed to jump off a platform with a height of 30 cm and 60 cm and land on a hard surface in a half-squat posture.The dynamic landing process was recorded with a high speed camera and the biomechanical data was collected and analyzed,including perpendicular ground reaction force,angular displacement,velocity and acting time.Results From 30 cm's height,the ankle angular displacement of the control group was significantly larger than the experimental group (25.73°± 8.13° vs 20.05°± 12.27°,P ＜ 0.05).The perpendicular ground reaction force of the control group was significantly smaller than the experimental group (3 372.4±748.6 N vs 5 181.5±1 726.2 N,P ＜ 0.05).The acting time of the control group was significantly longer than the ex perimental group (0.049±0.015 s vs 0.012±0.004 s,P ＜ 0.05).The buffer time of the control group was significantly shorter than the experimental group (1.397±0.746 s vs 1.737±0.451 s,P ＜ 0.05).From 60 cm's height,the ankle angular velocity of the control group was significantly higher than the experimental group (25.45± 15.01 °/s vs 16.51 ±4.18 °/s,P ＜ 0.05).The perpendicular ground reaction force of the control group was significantly smaller than the experimental group (4 616.0±1 124.7 N vs 7 119.5±2 307.4 N,P ＜ 0.05).The acting time of the control group was significantly longer than the experimental group (0.048±0.013 s vs 0.015±0.006 s,P ＜ 0.05).The buffer time of the control group was significantly shorter than the experimental group (0.922±0.347 s vs 1.617±0.547 s,P ＜ 0.05).Conclusion Jumping from different heights,the experinental group was larger in perpendicular ground reaction force but smaller in the angular velocity and displacement than the control group.There was a shorter acting time and a longer buffer time in the experimental group than the control group.