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 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 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 .

Remarkable progress has been achieved in the transplantation of mesenchymal stem cells (MSCs)for the treatment of liver injury and hepatic failure.However,there are obstacles such as low engraftment capacity,tumorigenesis,and a fibrogenic potential that all hamper the use of MSCs in clinical trials.Therefore,it is worthwhile to talk about the alternatives that will increase the safety and efficacy of MSCs therapy.To date,applications of MSCs-derived hepatocytes,genetically modified MSCs,or MSC-conditioned medium for promoting liver regeneration have shown encouraging results.This review summarizes the current applications of MSCs in the study of hepatic regeneration.

The assessments of oocyte quality were usually needed in assisted reproductive technology and reproduction science.Based upon the changes of structure and biochemistry in the development of oocyte,assessments of oocyte quality mainly comprised the oocyte morphology and its maturity.The assessment method of oocyte quality from nondestructive manner and invasive technique to provide multi-pathway for evaluating the oocyte quality reasonable was discussed.

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 evaluate mini-dose pre-injection test in the use of contrast-enhanced magnetic resonance angiography (CEMRA), and to inspect the possibility of contrast medium peak-time prediction by age, body weight and heart rate.Methods The data from mini-dose pre-injection test of contrast medium before vertebral artery CEMRA were retrospectively reviewed in 55 patients. The linear correlation and regression of the data including age, body weight, heart rate, and the reaching-time, peak-value-time, duration and peak-value-signal of contrast medium was performed by using SPSS software.Results The age (n=55, =62 years old, M=59 years old), body weight (n=55, = 63 kg), heart rate (n=40, =73 beats per minute), peak-value-time (n=55,=17.5 seconds), peak signal intensity (n=55,=472), and duration of contrast (n=49,=10.35 seconds)were analyzed. No statistically significant correlation existed between peak-value-time of contrast medium and the age (r=0.231, t=1.728, P=0.090), body weight (r=0.118, t=0.865, P=0.392), and heart rate (r= -0.046, t=-0.284, P=0.776). The peak-value-time correlated negatively with peak signal intensity (r=-0.322, t=-2.56, P=0.016)and positively with duration of contrast (r=0.658, t=5.99, P=0.000). The peak signal intensity was negatively correlated with body weight(r=-0.356, t=-2.77, P=0.008). The linear regression analysis show b=-0.284, t=-2.285, P=0.026 between peak-value-signal and peak-value-time, b=-0.322, t=2.590, P=0.012 between peak-value-signal and body weight.Conclusion Mini-dose pre-injection test was more helpful to adjust the rate of contrast medium injection and determine the time delay during scanning. But the prediction of contrast peak-time based on age, body weight and heart rate was unreliable.

Objective To investigate the effects of soluble components derived from bone marrow mesenchymal stem cells (BMSCs) on the expression of vascular endothelial growth factor (VEGF) and liver regeneration caused by 70％ portal branch ligation (PBL) in rats.Methods Isolated and cultured BMSCs were lysed by sonication.PBL was performed in male SD rats followed by splenic injection of BMSCs or PBS as control.Animals were analyzed for liver regeneration index,hepatocytes proliferation,hepatic function,histopathological changes,and hepatic genes expression.Expression of VEGF was assessed by Western blot and immunohistochemistry.Results The liver regeneration index increased in the BMSCs group especially 2 and 5 days after PBL compared with the control group (P＜0.05) and reached (51.71±1.62)％ and (76.82±0.81)％ respectively.A 2-fold increase was showed in the PCNA labeling index of hepatocytes in rats treated with BMSCs compared with the control group (P＜0.05).Histopathological findings showed that vacuolar change and sinusoidal congestion were lower in the BMSCs group.Alanine transaminase (ALT) and Aspartate transferase (AST) showed no significant difference between the two groups (P＞0.05).On post operation day 2,hepatic interleukin-6 (IL6),tumor necrosis factor α (TNFα),hepatocyte growth factor (HGF),vascular endothelial growth factor A (VEGFA),and vascular endothelial growth factor 2 (VEGFR2) mRNAs tended to increase in the BMSCs group (P＜0.05) while transforming growth factor β1 (TGFβ1) mRNA decreased (P＜0.05).Western blot showed that the expression level of VEGF in the two groups were equal 2 and 5 days after surgery (P＞0.05).On day 2 post operation,positive VEGF immunoreactivity was present in both pericentral and periportal hepatocytes in the BMSCs group,while only in periportal hepatocytes in the control group.Conclusion These results demonstrate that BMSCs accelerated liver regeneration caused by PBL,which may result from hepatoprotection,enhanced hepatocyte proliferation,and VEGF-mediated angiogenesis early after the operation,potentially creating a new avenue for the study of hepatic regeneration.