Objective Dynamic observation of oxidized low density lipoprotein(Ox-LDL) and thrombus precursor protein(TpP) expressed in patients with acute cerebral infarction ,and explore its clinical significance .Methods To detect the Ox-LDL and the plasma TpP level of 44 patients with acute cerebral infarction (ACI)respectively in acute stage and recovery stage ,and the healthy 30 cases (control group)by using enzyme-linked immunosorbent assay (ELISA) method ,and all the ACI cases were scored by the national institutes of health stroke scale (NIHSS) .To analyze the expression of Ox-LDL and plasma TpP in patients with ACI ,and the relationship with the NIHSS score .Results Ox-LDL and plasma TpP in patients with ACI all increased compared with the con-trol group .Ox-LDL and TpP in acute stage were significantly higher than the corresponding recovery stage and the control group , the difference was statistically significant (P<0 .01) .The levels of plasma TpP were positively correlated with the NIHSS score (P<0 .01) ,and Ox-LDL levels were uncorrelated with the NIHSS score (P>0 .05) .The levels of Ox-LDL were positively correla-ted with TpP in ACI group (r=0 .521 ,P<0 .05) .Conclusion The expression of Ox-LDL and plasma TpP in ACI were increased , Ox-LDL and plasma TpP level in ACI varies with changes of clinical course ,and maybe involved in the coordination and the devel-opment process of ACI ;Plasma TpP may be relevant to the seriousness of cerebral infarction ,and may be arguably used as the measurement of ACI patient′s conditions as well as the prognosis estimation .

Vascular endothelial growth factor (VEGF) has drawn extensive attention from all over the world because of its promising therapeutic prospect. However, recent studies have found that VEGF may promote the occurrence and development of atherosclerosis. The article reviews the molecule characteristics, receptor, expression regulation and function of VEGF, as well as its relationship with atherosclerosis.

Objective To investigate the effect of comb interferon( comb interferon CITF) uniting virazole to cure recurring or non-responding chronic hepatitis C.Methods Hypodermic comb "interferon 15μg,3 times every week,subcutaneously injected,24 weeks course of treatment was adminstered to 74 patients of recurring or non-responding chronic hepatitis C.Clinical symptom,physical sign,ALT,hepatovirus continual response rate and the condition of adverse effect were observed during treatment,chron-culminate,follow to 6 months' withdrawl.Results 72 patients accomplished treatment,HCV-RNA of recurring group and non-responding group to continual negative change rate were 73% and 37% (P＜0.05)after treatment termination,without severity adverse reaction being found.Condusion Comb interferon 15 μg/d combining virazole 900mg/d have better curative effect in curing recurring or nonresponding chronic hepatitis C.

Objective To explore the predictive value of cholinesterase (ChE) in the prognosis of gerontal patients with systemic inflammatory response syndrome. Methods The clinical data of 124 elderly patients with systemic inflammatory response syndrome collected from September 2009 through September 2010 were retrospectively analyzed. All patients were divided into death group and survival group according to the outcome of patients. The cholinesterase ( ChE), albumin, D-Dime, lactic acid and C-reactive protein (CRP) were detected, and the APACHE Ⅱ and GCS scores were documented in the first 24 hours in the ICU. Results There were no significant differences in age, gender, APACHE Ⅱ score and GCS score of patients between death group and survival group ( all P ＞ 0. 05 ), but there were significant differences in lactic acid, D-Dime, albumin, CRP and ChE between two groups ( theP values were 0.011,0.011, 0. 007,0. 008, 0. 000, respectively) . The results of multiple factors regression analysis showed that age, gender,lactic acid, D-Dime, albumin, CRP, APACHE Ⅱ score, and GCS score were not the independent risk factors of prognosis of gerontal patients with SIRS ( the P = 0. 401, 0. 165, 0. 446, 0. 841,0. 615, 0. 120,0. 502, 0. 184, respectively) except ChE ( P = 0. 000) . The receiver operating characteristic curve (ROC) of ChE in the gerontal patients with SIRS showed the area under curve (AUC) = 0.797, SE =0.04, P=0. 000, and the ChE = 103.00 U/L could be a diagnosis point with sensitivity = 0.793, 1-specificity = 0. 258. The correlation analysis showed that the APACHE Ⅱ score, CRP, and albumin were poorly correlated with ChE ( Kendall coefficients were 0. 061, 0. 231, and -0. 090, and theP = 0. 161,0. 000, and 0. 069, respectively ) . Conclusions ChE maybe played a important role in the gerontal patients with SIRS, and could be a predictive index for the prognosis of gerontal patients with systemic inflammatory response syndrome.

Objective To investigate the expression of proteinase active receptor 2(PAR2)protein in hepatocellular carcino-ma(HCC)and portal vessel tumor thrombosis(PVTT)to evaluate its clinical value.Methods Immunofluorescence,RT-PCR and Western blot were used to examine the expression of PAR2 protein in cancer tissue,tumor thrombosis and cancer-adjacent normal tissue from 21 patients with HCC.Results The expression pattern of PAR2 protein was different cancer tissue and cancer-adjacent normal tissue.PAR2 labeling index was significantly higher in cancer tissue and PVTT than cancer-adjacent normal tissue(P <0.05).Although PAR2 labeling index was lower in cancer tissue than in tumor thrombosis,no statistical significance was observed in PAR2 labeling index between them(P >0.05).Conclusion PAR2 is over-expressed in HCC and PVTT.PAR2 expression is re-lated with the development and progression of HCC.

Objective To analyze the risk factors of post-operative respiratory failure in elderly cardiac carcinoma patients.Methods 28 elderly patients with respiratory failure (respiratory failure group) after the resection of cardiac carcinoma and 56 controls (control group) were studied.Preoperative respiratory function,the other complications,the site of incision,intravenous infusion,age of patients and smoking between two groups were compared by Logistic regression.Results Univariate risk factors included MVV<50% ,RV/TLC>50% ,FEV1<1.5L,PEF<70% ,DLCO<80% ,V75<70% ,the venous input,incision at chest.Multivariate logistic regression analysis identified that MVV<50% ,RV/TLC>50% ,FEV,<1.5 L,DLCO<80% were risk factors.Conclusion These results suggested that the patients with risk factors described above need more careful pre and post operative surveillance and management.

ObjectiveTo explore the relationship between sleep quality and glucose level,diabetic complications in elderly type 2 diabetes mellitus.Methods A total of 130 hospitalized elderly type 2 diabetes in our hospital were included in the study. Questionnaires and other related clinical data were collected within one week after admission.Patients were divided into two groups:poor-sleeper group and good-sleeper group according to Pittsburgh Sleep Quality Index(PSQI).ResultsSixty percent (78/130) of these patients were poor sleepers. The following parameters differed in the two groups:the duration of diabetes [ (7.9 ± 1.8 ) years vs ( 7.2 ± 1.5 ) years,t =2.318 ],systolic blood pressure [ ( 148 ± 30 ) mm Hg ( 1 mm Hg =0.133 kPa) vs ( 138 ± 23 ) mm Hg,t =2.037 ],fasting plasma glucose (FPG) [ ( 10.7 ± 2.2) mmol/Lvs ( 9.8±1.9)mmol/L,t =2.410],hemoglobin A1c (HbA1c) [(8.6 ±2.2)％ vs (7.8±2.1 ) ％,t =2.068],high-sensitive C-reactive protein (hs-CRP) [ (5.27 ± 2.34) mg/L vs (4.44 ± 1.76)mg/L,t =2.179 ],ratio of diabetic complications ( 61％ vs 32％,x2 ＝ 4.257 ),percentage of depression ( 20％ vs 8％,x2 =3.722 ),score of life quality [ ( 98 ± 19 ) scores vs ( 89 ± 13 ) scores,t ＝ 2.980 ],and proportion of patients treated with insulin (32％ vs 12％,x2 =4.489). All the above parameters were significantly higher in poor-sleeper group than the good-sleeper group (all P value＜ 0.05 ). Multiple correlation analysis showed that the factors affecting sleep quality were FPG,HbA1c,duration of diabetes,diabetic complications,depression,life quality and insulin application (r =0.213,0.257,0.223,0.335,0.422,0.3451,0.231,respectively ; all P value ＜ 0.05 ).By multivariate logistic regression analysis,the followings were found:FPG (β =1.29,P ＜ 0.05 ) and PSQI (β =1.07,P ＜ 0.05 ) were found to be correlated with HbA1c.With increasing of PSQI,FPG,HbA1c,diabetic complications and life quality were changed significantly( all P value ＜ 0.05 ).The indcpcndcnt risk factors of diabetic complications were duration of diabetes ( OR ＝ 1.32,95％ CI 1.01-2.01 ),HbA1c ( OR =2.01,95％ CI 1.63-2.67 ),hs-CRP( OR =1.12,95％ CI 1.08-1.21 ) and PSQI ( OR =1.71,95％ CI 1.58-2.02).ConclusionsElderly type 2 diabetes mellitus are usually poor sleepers. Sleep quality probably affects blood glucoseregulation, and is closely correlated with the occurrence of complications.In addition,poor sleep quality results in poor life quality.

Reasonable and effective compensation and incentive mechanism is key to maintaining and stimulating incentives of the staff.By means of defining the main problems and defects in the current hospital compensation system in China,performance management is used as the cornerstone for designing the public hospital compensation and incentive mechanism.Resource-based relative value scale(RBRVS) assessment system is called into play to build a compensation management system,which features workload as the basis,technical competency and risk assessment as the reference and balance scorecard as the means.This can build a fair,scientific and reasonable salary distribution system and performance evaluation system,which maximize incentives of the compensation system,and in the end maximize the economic and social benefits of the hospital.

Objective To provide insight into the clinical manifestation,histopathology characteristics,diagnostic and therapeutic methods of primary histiocytic sarcoma (HS) of central nervous system.Methods The clinical,auxiliary examination and pathological data of one patient with intracranial primary histiocytic sarcoma were presented,and relevant literature were reviewed.Results A 55-year-old female had an 2-month history of hypomnesia and unsteady gait.MRI scans showed multiple mass lesions in brain.Biopsies of the brain lesion showed the tumor cells had polymorphism,and abundant cytoplasm was eosinophilic or clear,with large,pleomorphic nuclei.Immunohistochemically,the tumor cells stained positively with CD45,CD68,CD163,Ki67 and Vimentin,but negatively with pan-cytokeratin,epithelial membrane antigen,CD3,CD20,CD79 a,estrogen receptor,progesterone receptor,Melan-A and glial fibrillary acidic protein.Though she had received radiotherapy,the disease progressed and her consciousness deteriorated within 2 months.Conclusions HS should be considered if multiple or single intracranial unexplained lumps are found and the earliest pathological biopsy is required for early diagnosis.There are no effective therapeutic methods for HS and the prognosis is very poor.

OBJECTIVE To investigate the significance of Epworth sleepiness scale(ESS)and modified Epworth sleepiness scale(MESS),and evaluate the feasibility of MESS in assessment of obstructive sleep apnea hypopnea syndrome(OSAHS).METHODS The ESS and MESS of 232 patients with OSAHS was recorded in their first visiting.The scores of ESS and MESS were analyzed with the parameters of polysomnography(PSG). RESULTS Both ESS and MESS can reflect the degree of sleepiness and anoxemia in OSAHS patients,but the MESS was more efficient than ESS.The difference of MESS score between normal group and severe OSAHS group was greater than that of ESS score.CONCLUSION MESS is concerned the living habit of Chinese,and can partly reflect the station of patient with OSAHS.MESS can also be a primary screening method for suspected patients with severe OSAHS.