Objective To determine the diagnostic significance of serum Cystatin C (Cys C),neutrophil gelatinase-associated lipocalin (sNGAL),urinary kidney injury molecule1 (uKIM-1) and urinary interleukin-18 (uIL-18) in patients with septic acute renal injury.Methods A total of 62 adult patients with sepsis admitted to the Intensive Care Unit over 24 hours in the Tianjin Hospital between August 2012 and March 2013 were divided into acute renal injury group (n =39) and non-acute renal injury group (n =23) according RIFLE diagnostic criteria.Measurements of Cys C,sNGAL,uKIM-1 and uIL-18 were performed.The diagnostic values of the biomarkers were assessed by comparing their levels between the patients of different groups.Results The levels of Cys C (2.27 ± 0.93) μg/L,sNGAL (275.04 ±79.37) μg/L,uKIM-1 (2.52 ± 1.06) μg/L in acute renal injury group were higher than Cys C (1.19 ± 0.77) μg/L,sNGAL (137.51 ± 99.33) μg/L,uKIM-1 (1.27 ± 0.62) μg/L in non-acute renal injury group (P ＜ 0.05).There was no significant difference in uIL-18 between the acute renal injury group (374.87 ± 70.23) ng/L and the non-acute renal injury group (354.09 ± 66.42) ng/L (P ＞ 0.05).The area under ROC curve for diagnostic values of serum Cystatin C,sNGAL and uKIM-1 in acute renal injury were0.84 (0.74-0.95),0.90 (0.79-1.00),0.87 (0.78-0.96).Conclusions CysC,sNGAL and UKIM-1 might be valid as diagnostic biomarkers of septic acute renal injury.

Objective To investigate the expression of miRNA-16 (miR-16) in breast cancer patients and its effect on the proliferation and migration of breast cancer cells. Methods Polymerase chain reaction (PCR) was used to detect the expression of miR-16 in 30 breast cancer patients. miR-16 mimics was transfected to MDA-MB-231 and MCF-7 cell, and CCK-8 as well as Transwell assay was applied to detect the effect of miR-16 on cell proliferation and migration of MDA-MB-231 and MCF-7 cells. Results Among 30 breast cancer patients, the expression of miR-16 was down-regulated in 23 cases. Cell proliferation and migration of MDA-MB-231 and MCF-7 cells were inhibited significantly after transfection of miR-16 mimics. Conclusion miR-16 is down-regulated in breast cancer patients. miR-16 inhibits significantly the cell proliferation and migration of breast cancer cells in vitro.

Objective: To explore change of heart rate turbulence (HRT) in patients with coronary artery disease (CAD) and its predictive value. Methods: A total of 58 CAD patients were regard as CAD group. The 50 normal persons with negative CAG were regard as normal control group. All subjects received 24h dynamic ECG, CAG and echocardiography examination. Left ventricular ejection fraction (LVEF) and HRT indexes were compared between two groups. Results: Compared with normal control group, there was significant rise in turbulence onset [TO, (-1.34±1.09)% vs. (2.32±0.60)%] and significant reduction in turbulence slope [TS, (11.14±2.27) ms/RR vs. (3.44±0.60)ms/RR] in CAD group, P<0.01 both; in CAD group, along with coronary artery lesion aggravated (single-, double-, multi-vessel coronary disease), there was significant rise in TO [(1.35±0.52)% vs. (2.56±0.83)% vs. (3.01±1.62)%] and significant reduction in TS [(6.49±1.79) ms/RR vs. (3.33±1.02) ms/RR vs. (1.66±0.30) ms/RR], the difference was significant in two-two comparison among all groups, P<0.05 or <0.01; compared with CAD without cardiac event group, there was significant rise in TO [(1.68±0.61)% vs. (2.24±0.24)%], and significant reduction in TS [(5.87±1.22) ms/RR vs. (1.65±0.23) ms/RR] and LVEF[(66.18±2.64)% vs. (56.36±3.34)%] in CAD with cardiac event group, P<0.01 all. Conclusion: Weakened HRT phenomenon exists in CAD patients. HRT can be treated as an index evaluating severity of CAD patients’ condition and an effective predicting index for recurrent cardiac events in CAD patients.

Objective To establish a stable model of intraluminal thread approach in making focal cerebral ischemia/reperfusion modelin rabbit.Methods Forty New Zealand white rabbits were randomly divided into three groups:A,B,and C.Angiography of ICA wasperformed in group A(n=5). Control group B(n=5) was sham-operated.In group C(n=30),the focal cerebral ischemia/reperfusionmodel was made by inserting a wire ( d=0.45 mm ) into MCA through ICA and CCA directly and pulling it out 3 hours later . MRI andneurological deficit score were used to evaluate the effectiveness of models.Results Angiography could show the course and bifurcation of ICA clearly.22 models were successful.The pathological changes were shown on MRI.The neurological deficit score (reperfusion 1 h) were 2.8?0.45.Conclusion The focal cerebral ischemia/reperfusion model made by inserting a wire(d=0.45 mm) into MCA through ICA and CCA directly and pulling it out 3 hours later was stable and fit for imaging research.

Objective To construct the eukaryotic expression vector coding HCV gene E2 fused with His-Tag, and to express fused protein in CHO cells for investigating the function of HCV envelope protein E2. Methods The gene encoding HCV envelope protein E2 was amplified from pBRTM/HCV1-3011, a plasmid containing the cDNA of HCV's ORF, by polymerase chain reaction (PCR) method and cloned into the vector pET28(a) containing His-Tag to obtain the fused HCV envelope protein E2 gene fused with His-Tag. The fused gene was cloned into pcDNA3.1 to construct the recombinant plasmid pcDNA3.1-His-E2, which will express the E2 protein, fused with His tag. This recombinant plasmid was transfected into CHO cells by Lipofactamine 2000 reagent. The fused protein was identified by indirect immunofluorescence (IIF) and Western-blot (WB) methods. Result The positive results were obtained when the fused protein of HCV E2 with His-Tag were identified by IIF and WB methods. Conclusion The eukaryotic expression vector pcDNA3.1-His-E2 was constructed successfully and the fused proteins were expressed in cells.

Yeast surface display is a new technology developed in recent years,which displays protein of interest on the surface of yeast cell.It can be used to display complex eukaryotic proteins requiring post-translational processing including glycosylation and efficient folding for functional activity. The basis of this technology, its development,methods of screening,its applications and perspective are mainly described in this paper.

Objective To explore the experience in nursing the patients with esophageal high-grade intraepithelial neoplasia lesions treated with endoscopic submucosal dissection. Method A retrospective analysis was carried out among the patients with esophageal high-grade intraepithelial neoplasia lesions to look into the nursing care to the patients. Results Thirty patients were successfully stripped, and no surgical complication occurred. After intensive care, they were cured and discharged. Conclusion Professional and meticulous care can effectively improve the success rate of endoscopic submucosal dissection and reduce the incidence of complications, and promote the rehabilitation of patients.

Objective To investigate the imaging features of hepatic epithelioid hemangioendothelioma (EHE) and to improve the level of awareness of this disease.Methods A retrospective analysis was conducted on the CT and MRI findings and the clinical data of 16 patients with liver EHE.The diagnosis was made on specimens obtained by liver biopsy or with operation.Six patients received only CT,6 only MRI,4 both CT and MRI,and 4 with DWI sequence.Results 6 of 16 patients with hepatic EHE had a solitary tumor while the remaining 10 patients had multiple tumors.CT scanning on 10 patients showed a heterogeneous mass with low density.In 4 patients,there were small calcifications in the lesions.The lesions on MRI showed a heterogeneous mass with low signal in T1WI and high signal in T2WI and DWI.In 8 patients,during enhanced scanning,the intrahepatic vein and its branches terminated at the edge of the tumor to form the lollipop sign. On the arterial phase lesions with a diameter ＞ 3 cm showed a centripetal enhancement pattern,which is similar to that of a haemangioma.Lesions with a diameter ＜ 3 cm showed ring enhancement and continuous annular enhancement in the portal venous phase and in the delayed phase.The best observation period for the number of lesions was in the arterial phase.Conclusion Hepatic EHE had certain distinct characteristics on CT and MRI,e.g.the lollipop sign,lesions with small calcification,lesions with a diameter ＞ 3 cm with a centripetal enhancement pattern,and lesions with a diameter ＜ 3 cm with continuous ring enhancement on CT scanning.These radiological features help in the diagnosis of the disease.

Objective:To analyze the pay for performance related costs and provide suggestions for further stud-y. Methods:Empirical literatures from inside the country and overseas were collected with a systematic review. Costs were summarized on the basis of three drivers ( performance appraisal, performance improvement and incentive per-formance) . Results:A total of 141 papers, 47 in Chinese and 94 in English were enrolled. Most papers in Chinese were subjected on healthcare facilities while the English ones emphasized on hospitals. Pay for performance may lead to the healthcare service costs, regulation costs and the resources allocation related costs reduction. In addition to these visible costs, a large amount of others hidden from different hospital management levels were also due to pay for performance. Conclusions:(1) Differences in costs could be found from home and overseas experience which per-haps resulted from the pay for performance, the supporting measures and the policy development. (2) More attention should be paid to the quantification researches on the health facilities’ hidden costs. (3) Most available researches fo-cus on pay for performance cost-effectiveness from the society and service purchase but not the providers’ perspective and the hidden costs were also ignored.

By stratified random sampling method, 10 000 residents were investigated with the questionnaire in Fangzhuang community of Beijing, 9497 valid questionnaires were collected with a return rate of 94. 97%. The results showed that two main purposes for patients to use the community health services were to seek consultation (29. 8% ) and to get prescription (28. 2% ). The three main reasons for residents to choose community health services were the convenience, less medical expenses and more clear explanation from doctors, followed by the personal trust in the doctors.