Objective To investigate the influence of acupuncture on promoting rat blastocyst nidation with Cx43 expression at the acupoints silenced, and to relate Cx43 with acupuncture's effects. Methods Ma-ted female rats were randomly divided into five groups: normal control, model, acupuncture, interference-control and interference. Mifepristone was used to induce a model of nidation disorder, and RNA interference technology was used to silence the expression of Cx43 at acupoints. P-Cx43-shRNA (1) was injected locally into the acu-points of rats in the interference group, and P-con-shRNA was injected in the interference-control group. Acu-puncture was administered to the acupuncture, interference-control and interference groups for 7 days. On the 8th day of pregnancy, the quality of blastocysts, pregnancy rates, and the average amount of blastocysts in each group were observed. Results ①The mRNA and protein level of Cx43 at the zusanli (ST36) acupoints in the interference group were significantly lower than in the acupuncture group ( P<0.05, P<0.01). There was no significant difference between the interference-control group and the acupuncture group. ② Compared with the normal control group, the quality of blastocysts in the model and interference groups was bad, and the amount was less. Their size was comparatively small, they were inhomogeneous, poorly distributed and had poor blood supply. The results improved in the acupuncture group and the interference-control group compared with the model group. ③The pregnancy rates in the normal control, model, acupuncture, interference-control and inter-ference groups were 100% , 50% , 75% , 75% , and 50% respectively, but these differences were not statisti-cally significant. ④The average amount of blastocysts in the model and interference groups was significantly less than in the normal group (P≤0.01). Compared with the acupuncture group, the average amount of blastocysts in the interference group was lower (P≤0.05). Conclusion Acupuncture can improve the quality and quan-tity of blastocysts in a rat model of nidation disorder. Local injection of Cx43 shRNA expression vector can si-lence the expression of Cx43 in acupoints and markedly influence acupuncture's effect. This demonstrated that Cx43 was involved in acupuncture's effects.

Objective: To investigate the effects of insulin on the DNA synthesis and cell cycle distribution of human periodontal ligament cells (PDLs). Methods:PDLs were treated with insulin at the doses (U/L) of 0.01～1 000 for 72 h,DNA synthesis of the cells was measured by 3H-TdR incorporation and cell cycle distribution was studied by flow cytometer. Results : Insulin at 1 U/L to 1 000 U/L showed a significant concentration dependent stimulation of 3H thymidine uptake, and the effect of insulin at 100 ～ 1 000 U/L were not statistically different from that at 10 U/L. The percentage of PDL cells in G1 phase during exponential growth was decreased by insulin, while that in S phase and (G2+M) was increased in experimental group. Conclusion: Insulin increases DNA synthesis of PDL cells ,and stimulates the transformation of cells from G1 to S phase.

Objective To observe the differences in functional areas of the brain in response to two different acupuncture techniques using functional magnetic resonance imaging (fMRI).Methods Deqi and non-deqi acupuncture were performed on twenty healthy right-handed volunteers.fMRI was conducted in the process of acupuncture.The experiment adopted a single-chunk design and the procedure contained periods of stimulation and rest.The brain regions stimulated during deqi and non-deqi acupuncture were assessed using xjview software.Results After acupuncture at the Zusanli point (ST36),differences in activity were observed between the deqi and non-deqi groups in the language,sports,perception and limbic systems.Conclusions ①Under deqi conditions,acupuncture at ST36 increases circulation and the activation of brain areas dealing with language,sports,perception and the limbic system.This may be one of the mechanisms by which acupuncture can improve aphasia,coordination and perception.②Under deqi conditions acupuncture at ST36 decreases circulation and deactivates brain areas associated with the limbic system.This may explain acupuncture's analgesia and regulation of autonomic nerve and endocrine function,its amelioration of internal organ functions and regulation of immunologic function.

The paper presented the principles and references for identifying services of the primary health care at townships and villages in Beijing, and proposed the screening criteria for primary health care package in rural Beijing. Studies made have identified the screening results for the package applicable to both townships and villages in Beijing, along with analysis for the rationale, applicability and operability of the package. Moreover, it probed into the assurance conditions for offering primary health care as a reference for other regions in the country.

Objective To retrospectively assess the diagnostic value of nuchal translucency (NT) thickness and facial profile ultrasonic markers [including frontomaxillary facial (FMF) angle,and the ratio of prenasal thickness to nasal bone length (PT/NBL)] for trisomy 21 syndrome in first-trimester fetuses.Methods Ultrasonograhic images of 35 fetuses with trisomy 21 syndrome and 70 gestational age matched normal fetuses were analyzed in first-trimester.NT,FMF angle and the PT/NBL ratio were measured retrospectively in stored images from digital database between January 2012 and December 2015.The diagnostic value of NT,FMF angle and PT/NBL ratio were compared with different combinations.Results (1) The mean NT was significantly higher in the trisomy 21 group than that in controls (t =7.401,P =0.00).The NT above 2.5mm was observed in 20 trisomy 21 fetuses (57.1％) and in 3 normal fetuses (4.3％).(2) The mean FMF angle was significantly higher in the trisomy 21 group than that in controls (t =-5.283,P =0.00).The FMF angle above the 95th percentile (93.6°) was observed in 13 trisomy 21 fetuses (37.1％) and in 1 normal fetus (1.4％).(3) The mean PT/NBL ratio was significantly higher in the trisomy 21 group than that in controls (t =-7.826,P =0.00).The PT/NBL ratio above the 95th percentile (0.93) was observed in 19 trisomy 21 fetuses (54.3％) and in 4 normal fetuses (5.7％).(4) The sensitivity and Youden index for trisomy 21 increased gradually,which were 57.1 ％ and 0.528 by using NT,and 74.3％ and 0.686 by using NT and FMF angle,and 91.4％ and 0.828 by using NT,FMF angle and PT/NBL ratio.There were significant differences in the detection rates of trisomy 21 among the three strategies,while the diagnostic specificity of the three strategies were more than 90％.Conclusions The three parameters are significantly increased in trisomy 21 fetus in first-trimester.First,increased NT was most commonly detected,followed by increased PT/NBL ratio,and increased FMF angle again.Detection rates for trisomy 21 fetuses in first-trimester by ultrasound screening can be significantly improved if combination of all three parameters rather than just one parameter are performed.

Objective To understand the influence of the disease-based hierarchical medical system on inpatients flow covered by the new rural cooperative medical system ( NRCMS) , and that on the funding diversion and medical costs so incurred. Methods One county was selected from the eastern, central and western regions of China respectively, where the disease-based hierarchical medical system has been in place. Policy documents of the three counties were reviewed to analyze such changes as NRCMS inpatients flow, inpatients subsidy diversion, NRCMS fund surplus rate of the current year and medical costs per hospitalization before and after the system was in place. Results A comparison with 2014 found a 1. 26%drop of the out-of-county inpatients of county W of the western region, a 2. 00% increase of township hospitals inpatients of county D in the middle region, and the same ratio of out-of-county and in-county inpatients in county F of the eastern region in 2015. Compared with 2014, the fund surplus rate of county W increased 10. 46%, and the inpatient subsidy ratio of county D decreased 2. 51% for those in out-of-county medical institutions in 2015. Thanks for the quota payment of specific diseases under global budget in county W, the inpatient medical costs per hospitalization dropped at both county and township medical institutions. Conclusions The disease-based hierarchical medical system could optimize the NRCMS inpatients distribution among various medical institutions, conducive for establishment and operation of such a system.

Objective To investigate the effects of xuanzhi analgesic tablets on plasma levels of 6-keto-prostaglandin Flα(6-K-PGFlα) and thromboxane B2(TXB2) in rats with acute blood stasis. Methods Sixty SD rats were divided into six groups randomly, namely normal control, model control, positive control, xuanzhi analgesic tablets at 1. 36, 2. 72, and 5. 44 g·kg-1 groups. The rat model of blood stasis syndrome was caused by subcutaneous injection of adrenaline incorporated with ice-bathing. The effects of xuanzhi analgesic tablet on 6-K-PGFlαand TXB2 were observed. Results Compared with the normal control,plasma level of 6-K-PGFlα was significantly reduced(P<0. 01) and that of TXB2 in the model control was evidently increased(P<0. 01). Three dosages of xuanzhi analgesic tablets significantly raised 6-K-PGFlαlevel(P<0. 05)and lowered TXB2 level (P<0. 05). Conclusion Xuanzhi analgesic tablets significantly adjust plasma levels of 6-K-PGFlαand TXB2in rats with acute blood stasis. Xuanzhi analgesic tablets can coreect the imbalance between PGI2 and TXA2 through increasing 6-K-PGFlαand desearing TXB2 levels.

Objective To investigate the features and diagnostic value of computed tomography ( CT) in cys-titis glandularis .Methods The CT images and clinical data of 9 patients with cystitis glandularis confirmed by histol-ogy were studied retrospectively .Results The characteristics of cystitis glandularis ( location,shape,density and the relationship with adjacent tissues)were clearly displayed on CT.The lesion was located in the bladder trigone(n=5), right anterior wall(n=1),left posterior wall(n=2),diffuse lesion(n=1).According to the shape,8 lesions showed mass type,the range of these lesions were limited and some lesions were combined with cystic degeneration ,only one lesion showed a diffusely thickened bladder wall .After enhancement ,CT value increased from 14.0-45.0 HU to 25.0-62.0 HU.Conclusion CT has high sensitivity and accurate in diagnosis of cystitis glandularis .

Objective To investigate the characteristics and risk factors of occupationai exposure to bloodborne pathogens among health care workers (HCWs),and evaluate prevention and treatment countermeasures.Methods Record Form for Occupational Exposure to Bloodborne Pathogens Among Health Care Workers was used for retrospective survey on the occurrence of occupational exposure to bloodborne pathogens in a hospital between January 1,2013 and December 31,2015.Results A total of 246 cases of blood/body fluid occupational exposure occurred.The main occupational exposure population were nurses (n =95,38.62％);occupational exposure mainly occurred in wards(n =148,60.16％);the main mode of occupational exposure was sharp injury(n =219,89.02 ％);the main opportunity of occupational exposure of HCWs was surgical accident(n =69,28.05 ％);the main exposure source was hepatitis B virus(n =123,50.00 ％);none of HCWs developed infection after local treatment and prophylactic medication.Conclusion Medical institutions should strengthen the training for HCWs about occupational exposure to bloodborne pathogens,enhance protection awareness,standardize operation procedures,and improve working environment,so as to minimize the occurrence of occupational exposure.

ObjectiveTo analyze the expression of osteopontin (OPN) and interleukin-17 (IL-17)and study the roles in the pathogenesis of chronic severe hepatitis B.MethodsTwenty patients of acute on chronic liver failure were collected from the infection disease in-patients department of the First Affiliated Hospital of Medical College,Zhejiang University from 2009 to 2010,and 40 health controls were from medical examination center during the same period.Meanwhile,Balb/C mice were used for ConA injection to induce fulminant hepatitis and the plasma,serum and liver tissue of mice were collected.OPN and IL-17concentrations were measured using ELISA kits.PBMC were separated and cultured with anti-TNF-α or TNF-α.Supernatants were collected for analysis of OPN and IL-17.Differences between groups were evaluated by using a Student's t test and the relationship between IL-17 and OPN were evaluated by Pearson correlation.ResultsIn chronic severe hepatitis B group,levels of OPN and IL-17 were markedly higher than those of healthy control,respectively.(42.4 ± 12.9 vs 10.6 ±4.8 pg/ml; 1460.1 ±523.1 vs 472.8 ±67.5 ng/ml) ( t =2.387,3.570,P ＜ 0.05).The level of OPN in blood and liver reached peak at 6 hours at 12 hours after ConA injection,respectively.The level of IL-17 in blood and liver was significantly increased after ConA injection.IL-17 were positive correlated with OPN levels (R2 =0.582,P =0.026).TNF-α can increase the level of OPN secreted by lymphocytes.ConclusionsOPN and IL-17 levels in peripheral blood of hepatitis B patients are closely related to the hepatitis B degree.TNF-α can increase the level of OPN secreted by lymphocytes.