Objective To evaluate the value of plasma soluble urokinase?type plasminogen activator receptor (suPAR)and D?dimer for assessing disease severity and prognosis in patients with traumatic brain injury(TBI). Methods A serial of 112 patients with traumatic brain injury admired to our hospital were divided into mild TBI (GCS score 13~15),moderate TBI(GCS score 9~12)and severe TBI(GCS score 3~8). The levels of plasma suPAR and D?dimer were monitored within 24 h after patient admission. Results The levels of suPAR and D?di?mer in TBI group were obviously higher than those in the control group(15.86±7.33 vs 2.79 ± 0.69,P<0.01;3.50 ± 2.78 vs 24 ± 0.15,P<0.01). The levels of suPAR and D?dimer in the severe TBI group were also obviously high?er than those in the moderate TBI group(P<0.05). Plasma suPAR levels and GCS score had significant negative correlation(r =- 0.854,P < 0.01). D?dimer levels and GCS score showed a negative correlation(r =- 0.738, P < 0.01). Plasma suPAR and D ? dimer was positively correlated(r = 0.753,P < 0.01). The area under the curve of D?dimer(AUC)was larger,0.854,95%CI 0.763~0.945;the AUC of suPAR was 0.801,95%CI 0.698~0.903. Conclusion Higher levels of suPAR and D?dimer in TBI patients is not only relevant to the injury sever?ity ,but also closely to the prognosis.

Objective To investigate the variation of corticotropin-releasing hormone(CRH)in plasma,the mRNA and protein expression of c-Fos and gap junction gene connexin-43(Cx43)in the myometrium of term pregnancy women,and to study the correlations among CRH,Cx43 and c-Fos at onset of labor.Methods 30 cases in labor(L group),30 cases not in labor(NL group)but in term pregnancy, and 30 cases of non-pregnant(NP group)women undergoing hysterectomy due to cervical intraepithelial neoplasia were recruited into this clinical study.Radioimmunoassay was employed to measure the concentration of CRH in plasma;in situ hybridization assay and streptravidin-biotin peroxidase(SP) immunohistoehemical techniques were respectively used to detect the expression levels of c-Fos mRNA,Cx43 mRNA and the corresponding proteins.Results(1)The concentration of CRH in L group(81.8?11.9) pmol/L was significantly higher than that in NL group(34.5?18.6)pmol/L(P

Objective:To understand the responsiveness of community health service institutions in Henan Province. Methods:This research collected information through questionnaire investigations. The object of the investigations is key informants familiar with community health service institutions. Various dimensions of responsiveness within Henan province community health service institutions are determined through a multiple-input pecking order graph. The fuzzy comprehen-sive evaluation method is used to evaluate the level of responsiveness. Responsiveness inequality index is used to measure the distribution of reactions. Results:A total of 431 valid key informants were surveyed. The various dimensions of the questionnaire of Cronbach alpha coefficient was greater than 0. 623;the total scale of the Cronbach alpha coefficient was 0. 850;the correlation coefficient of each dimension of test-retest reliability were greater than 0. 907. The levels of responsive-ness and distribution index were 8. 33 and 0. 2744, respectively;each dimension by order of importance:timely attention>dignity>infrastructure>communication>confidentiality >social support >selective >autonomy. Approximately 50% of key informants considered that vulnerable groups in community health service institutions were sometimes or often treated unfairly. Conclusion:Key informants considered the responsiveness level of overall higher community health service institu-tions in Henan Province was high, and the distribution of responsiveness was relative equilibrium. However, there is a large shortage of infrastructure, privacy protection, doctor-patient communication, etc.

Objective To evaluate the effects of modified early goal directed therapy (EGDT )on the prognosis of patients with septic shock .Methods Clinical data of 116 patients with septic shock admitted to ICU during January 2011 to March 2013 were retrospectively analyzed .Patients were divided into modified early goal‐directed therapy group (n=57) and traditional early goal‐di‐rected therapy group (n=59) according to different methods of treatment ,the patients′28‐day survival rates of these 2 groups were compared .Modified early goal‐directed therapy are divided into survival group (n=46) and non‐survival group (n=11) according to 28‐day prognosis .Acute physiology and chronic health evaluation Ⅱ (APACHEⅡ ) score ,sequential organ failure assessment (SOFA) ,multiple organ dysfunction syndrome (MODS) score and other relevant indicators of survival group and non‐survival group were compared .Results The 28‐day survival rate in modified early goal‐directed therapy group had increased approximately 18 .9% higher than that of the traditional early goal‐directed therapy group(P< 0 .05) .The APACH Ⅱ score ,SOFA score and MODS score in non‐survivors were significantly higher than those of survivors in modified EGDT group ,which were[(29 .36 ± 1 .57)d vs .(24 .30 ± 3 .27)d] ,[(13 .45 ± 0 .52)d vs .(12 .78 ± 1 .33)d] ,[(9 .00 ± 0 .00)d vs .(4 .04 ± 1 .94)d]separately .And vaso‐pressors time and mechanical ventilation time was significantly longer in non‐survivors than survivors(P<0 .05) .Conclusion Mod‐ified early goal directed therapy could improve 28‐day survival rate ,and it show s beneficial effects on outcome of critical patients w ith septic shock .

Objective To improve the diagnostic accuracy of nonpalpable calcified breast lesions by establishing a Logistic multivariate prediction model to assess the probability of benign/malignant breast lesions.The proposed model is based on the clinical and BI-RADS-X-ray imaging features of patients with nonpalpable calcified breast lesions.Methods A total of 147 nonpalpable calcified breast lesions were analyzed retrospectively.Firstly, based on the personal experience,the X-ray imaging data of lesions were analyzed to obtain the BI-RADS categorization, and the ROC curve was plotted by comparison with pathology.Then the univariate and multivariate analysis was performed on the clinical and X-ray imaging features of pathology to select the independent factors related to benign/malignant features.Further,a Logistic regression model was built,the suitable cut-off point was determined, and the ROC curve was obtained.Finally,the comparisons of the diagnostic accuracy of breast lesions were made between the method using the BI-RADS categorization and the method using the Logistic regression model.Results The AUC of the BI-RADS method was 0.867 9.The univariate analysis showed that there exist statistical differences among clinical features of patients(age,location,and quadrant),as well as the BI-RADS-X-ray imaging features (distribution,morphological and gland density).Also,by using the multivariate Logistic regression equation,the statistical differences among age,quadrant and morphological difference can be observed.The AUC using the built Logistic regression model was 0.906 3.Conclusion The diagnostic accuracy of breast lesions using the Logistic model is higher than that using the BI-RADS categorization method.Therefore, the proposed model is valuable for obtaining accurate diagnosis of breast lesions.

Objective To investigate the effect of the operational treatment for periampullary carcinoma.Methods The data of 53 operative patients were retrospectively analyzed. Among the 24radical operations, PD was performed in 23 cases ,PPPD in 1 ;the palliative operation was performed in 29 cases. Results Among the 24 radical operaions, the overall mortality was 8.3% (2/24), no operational death. The postoperative morbidity was 15 cases,including 5 cases of pancreatic fistula. Median length of hospital stay was 26 days. Conclusion Continual improvement of operative technique and sufficient perioperative management were the keys to increasing the effect of the operational treatment.

Objective To investigate the impact of aging and weight bearing on cartilage endplate morphology and chondrocyte apoptosis in rats. Methods The bipedal rat model (n=45) was developed by forelimb amputation and special breeding methods. The normal rats of the same age served as the control group (n=40). When the rats became 3, 6, 9, and 12 months old, 8 rats randomly selected from each group were sacrificed and paraffin-embedded mid-sagittal sections of the L4-5 spine were obtained. Sections were stained with hematoxylin and eosin and the TUNEL procedure was performed. The numbers of apoptotic cells and viable cells in the cartilage endplates of the intervertebral discs were counted, the thickness of the cartilage endplate was measured and the degree of impairment of the cartilage endplate was evaluated. Results Apoptosis first appeared in the cartilage endplate, then increased with aging and resulted in a remarkable decrease in cell density. The apoptotic rate of chondrocytes within the cartilage endplate of the bipedal rat model group was significantly higher than the control group at the 6-month time point. A statistically significant difference was observed in the bipedal rat model group between the 6-month time point and 9-month time point (P<0.05). Correlation analyses indicated that there was a highly negative correlation between the number of the viable cells of the cartilage endplate and the degree of the cartilage endplate degeneration (r=-0.97, P<0.05). Compared with the naturally aged group, the bipedal rat model group experienced more severe degeneration in the structure of the cartilage endplate, more obvious thickening of the cartilage endplate's calcified layer, and more defects in the structure of the cartilage. Conclusions Besides aging, weight bearing is probably a key factor of the increase of chondrocyte apoptosis and the degeneration of vertebral cartilage endplate.

Objective To assess the value of diffusion weighted imaging (DWI) in monitoring therapy effect of neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer.Methods The prospective study included 26 lesions in 24 patients with LABC undergoing NAC.MRI was conducted before chemotherapy,after the first cycle of chemotherapyand after all cycles,including conventional MRI and DWI.All patients were confirmed by pre-treatment fine needle aspiration biopsy (FNAB),and postoperative histopathological prout.All lesions were divided into two groups of pathological complete response (pCR) and non-pCR.We evaluated ADC value and its changes in pathological complete response difference between the groups and complete remission in each testing point.Results Before chemotherapy and after the first cycle of chemotherapy,the ADCmean andADCmin had no statistically significant difference hetween pathologic complete response group and non-complete remission.After the whole chemotherapy,both of them had statistically significant difference;pathological complete response (pCR) and non-pCR early ADCmin value rate were (16.78 ± 22.70) ％ and (12.37 ± 10.09) ％respectively.No statistically significant difference was seen (P =0.53).Preoperative ADCmin value rates were (91.41 ± 45.83) ％ and (29.74 ± 22.96) ％ respectively,which were statistically significant (P =0.00) Conclusion ADC which is measured from DWI can be used to assess early response to NAC in breast cancer lesion,but cannat predict pCR or non-pCR for all cycles of chemotherapy on the first cycle.

Objective To investigate the level of serum cancer antigen 125 (CA125) and lactic dehydrogenase(LDH) and clinical features of patients with non-Hodgkin lymphoma(NHL), and the correlation between the level of serum CA125 and LDH. Methods Forty patients with NHL were studied and the variances of the serum CA125, LDH level before treatment were analysed. Results A higher serum of CA125was associated with clinical phase,group,hydrothorax and ascites,intemational prognostic index (IPI), and had weaker positive correlation to LDH. Conclusion Measurement of serum CA125 had important clinical significance to the patients with NHL especially to the patients with hydrothorax and ascites.

Objective To investigate the placental transfer and neonatal effects of dexmedetomidine during the cesarean section under general anesthesia.Methods Thirty-eight nulliparous parturients,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 22-37 yr,weighing 56-82 kg,who were at full term with a singleton fetus,scheduled for elective caesarean section under general anesthesia,were randomly divided into 2 groups (n=19 each) using a random number table:dexmedetomidine group (group D) and normal saline group (group N).In group D,dexmedetomidine was infused in a loading dose of 0.6 μg/kg starting from 10 min before induction of anesthesia,followed by an infusion of 0.4 μg · kg-1 · h-1 until peritoneal closure.Group N received the equal volume of normal saline.Blood samples were collected from the maternal artery (MA),umbilical vein (UV),and umbilical artery (UA) for blood gas analysis and for determination of plasma dexmedetomidine concentrations (CMA,CUV and CUA) by high-performance liquid chromatography-mass spectrometry,and CUV/CMA and CUA/CUV were calculated.Apgar scores were recorded at 1 and 5 min after delivery,and the occurrence of respiratory depression was also recorded.The I-D interval (the time from administration of anesthetics to delivery) and U-D interval (the time from incision of the uterus to delivery) were recorded.Results There were no significant differences in the blood gas analysis parameters in blood samples collected from the MA,UV and UA,I-D interval,U-D interval,and Apgar scores between the two groups (P＞0.05).No neonatal respiratory depression was found in both groups.In group D,CMA,CUV and CUA were 471±119,359±88 and (321±78) ng/ml,respectively,CUV/CMA was 0.76±0.06,and CUA/CUV was 0.89±0.03.Conclusion Although the metabolism of dexmedetomidine is little after easy placental transfer,dexmedetomidine has no adverse effects on the newborn during the cesarean section under general anesthesia.