Objective To study the effects of norepinephrine (NE) on intracellular reactive oxygen species (ROS) production in cardiac myocytes and receptor pathways involved in ROS production. Methods DCFHDA fluorescent probe was used for the assessment of NE induced intracellular ROS production in cultured cardiac myocytes of the neonatal rats. Myocytes were exposed to NE, NE + prazosin, NE + propranolol, and NE + prazosin + propranolol at different time and doses. The changes of fluorescence intensity in cells were measured by flow cytometry. Results NE increased myocyte ROS production in time and dose dependent manners. NE induced ROS production was partially inhibited by prazosin or propranolol, and completely inhibited by prazosin and propranolol together in myocytes. Conclusion NE can induce intracellular ROS production in cultured cardiac myocytes of the neonatal rats in time and dose dependent manners through the mediation of both ? and ? adrenoceptors.

Objective To study the correlation between anatomical measurement and CT measurement of adult occipital thickness so as to provide anatomic evidence for the selection of screw length in occipital-cervical fusion. Methods The occipital thickness was measured on the occipital specimens of 10 normal adults in two ways: direct anatomic measurement and CT measurement. Measurements were made on the basis of the McRac' s line and according to a matrix of 66 points following a grid with one cm spacing. The results of both measurements were statistically analyzed using SPSS 10.0. Results The results of both measurements were highly correlated. The external occipital protuberance was the thickest while the region of cerebellar fossa was the thinnest. The regions two cm lateral to the midline between plane Five and plane Six, one cm lateral to the midline between plane Four and at plane Five, and median between plane Three and plane Four were found to have a thickness of more than eight mm. Conclusions The occipital thickness varies with individuals. CT measurement and direct anatomic measurement are highly correlated. Preoperative CT measurements can be reliable evidence for optimal screw placement before performing occipital-cervical fusions.

This study was aimed to compare the function of dendritic cells (DCs) in patients of Y in-Huang syn-drome and Y ang-Huang syndrome from the peripheral blood of HBV related hepatic failure. Jaundice patients of HBV related hepatic failure were divided into two groups, which were the Y ang-Huang syndrome group and Y in-Huang syndrome group. And a healthy control group was also established. The DCs were separated and cultured in vitro from PBMCs in the peripheral blood. Surface molecules such as HLA-DR, CD80, CD86, CD83 and CD1αwere detected by the flow cytometry. And the level of IFN- α and IL-4 in the supernatant of DCs were also de-tected. The expression difference of inflammatory cytokines and immune cells between Y in-Huang and Y ang-Huang syndrome in patients of HBV related hepatic failure were compared. The results showed that compared with healthy people, the expression rate of DCs phenotype such as HLA-DR, CD1α, CD83, CD80, CD86 in patients of HBV related hepatic failure was significantly decreased (P < 0.01); the excreted factor IFN-α had a significant rising (P < 0.01). Compared to Y ang-Huang syndrome group, the expression rate of CD83 and CD86 in the Y in-Huang syndrome group of HBV related hepatic failure patients was significantly reduced (P < 0.01). And the ex-creted factor of IL-4 had a significant rising in Y in-Huang syndrome group (P < 0.01). Compared to the Y in-Huang syndrome group, the excreted factor IFN-α in the Yang-Huang syndrome group had a significant rising (P< 0.01). It was concluded that DCs function of patients with HBV related hepatic failure in both Y in-Huang syn-drome and Y ang-Huang syndrome group showed low immune function. And the immune function of the Y in-Huang syndrome group was lower. There was excessive releasing of inflammatory factors in the Y ang-Huang syn-drome group. And there was enhanced anti-inflammatory cytokine expression in the Y in-Huang group.

Objective To study the outcomes and problems of comprehensive medical pricing reform in Jiangsu.Methods The business operations,drug proportion and patient′s expenses of 28 pilot hospitals in 1 5 counties of the province before and after the reform were compared,to learn the impacts of the pricing reform on both hospitals and patients.Results Medical revenue and medical service quantity of these hospitals during this period(January to June)of 2012—2014 maintain a fast growth,with lower drug proportions,and patients′expenditure unchanged.Compared with data of the same period in 2012, the total revenue growth rates of the hospitals in 2013 and 2014 were 13.4% and 1 1.1% respectively;and their drug proportions were 44.9% and 42.3%;and the expenditure growth rates for outpatient/emergency service were 5.9% and 3.1% respectively.Conclusions The reform has achieved an initial success.However the pricing system,needs to be further rationalized to build a better price formation mechanism,in line with relevant reforms.

Objective To analyze antimalarial assosiated retinopathy detected by different methods with of modern ocular fundus examination, and explore screening strategy and the diagnosis of hydroxych-loroquine assosiatedretinopathy according to clinical experience and international guidelines. Methods Full fundus examination was performed in two patients with antimalarial retinopathy. The related literature were reviewed. Results Two patients had bull's eyes maculopathy and abnormal visual fields. Conclusion Clin-icians' alertness to hydroxychloroquine related retinopathy may improve early diagnosis of hydroxychloroquine toxicity. New objective tests are more sensitive than visual fields examination. Visible bull's-eye maculopathy is a late change, and the goal of screening is to recognize toxicity at early stage.

Objective To explore the value of combined use of laboratory indicators for diagnosis of early renal functional damage. Methods Eighty-six patients with various kidney diseases were enrolled in the Second Affiliated Hospital of Guangzhou Medical University. On admission,the serum Cystatin C(Cys C),creatinine(Cr), Urea,etc were determined. The value of using combined laboratory indicators in the diagnosis of renal functional damage was obtained through the analysis of the receiver operating characteristic curve(ROC curve);multiple variable indicators were grouped to establish multiple logistic regression models to be compared and evaluated. Results In the early and late renal injury groups(group B of 32 cases and group C of 12 cases),the serum levels of Cys C,Cr, and Urea were significantly higher than those in the normal renal function control group(group A of 42 cases),the elevation in level in group C being the most significant〔Cys C(mg/L):3.47±0.75 vs. 1.59±1.29,Cr(μmol/L):669±466 vs. 214±173,Urea(mmol/L):21.22±13.10 vs. 11.04±8.24,P<0.05 or P<0.01〕. The areas under the ROC curve(AUC)made by combinations of Cys C,Cr and Urea for the diagnosis of renal damage were 0.908,0.817 and 0.785. In the four different kinds of combination of the indicators,the AUC were sequentially arranged from large to small area as follows:Cys C+Cr+Urea=Cys C+Cr>Cys C+Urea>Cys C>Cr+Urea(0.920=0.920>0.911>0.908>0.809). In this sequence,the AUC made by Cys C+Cr+Urea and Cys C+Cr were equal,both 0.920, whose sensitivity was 75.0%,specificity 100.0%,positive predictive value 100.0%,negative predictive value 80.0%and diagnostic accuracy rate 87.5%. So,Cys C + Cr combination could be used to substitute Cys C + Cr + Urea, and the former clinical diagnostic effect was the best,much higher than that by using AUC whose curve was made by Cys C alone. Conclusion The value of using only one laboratory indicator for diagnosis of patients with early renal functional damage is not high,while applying Cys C+Cr combination can improve the diagnostic effect greatly,and its sensitivity and specificity are higher.

Objective To investigate the diagnostic value of laboratory evaluation of renal injury in early diagnosis index. Methods Eighty-six patients in in-patient and out-patient of the department of urology were tested in serum C (Cys C), serum creatinine (Cr) and serum UREA nitrogen (UREA). According to the diagnostics (sixth edition), we evaluated their values for diagnosis of renal injury by analyzing the characteristics of the work curve (ROC). Results According to the renal function indexes, 3 groups were divided such as group A (normal renal function control Ccr 80 mL/min) or the Cys C, Cr, and UREA in (0.47 ± 0.24) mg/L, (85 ± 14) μmol/L, and (4.55 ± 1.33) mmol/L, group B (a decrease in renal function reserves, and renal insufficiency 20 mL/min or less Ccr < 80 mL/min) of Cys C, Cr, and UREA in (1.59 ± 1.29) mg/L, (214 ± 173) μmol/L, and (11.04 ± 8.24) mmol/L and group C (renal failure and uremia Ccr < 20 mL/min) of Cys C, Cr, and UREA in (3.47 ± 0.75) mg/L, (669 ± 466) μmol/L, and (21.22 ± 13.10) mmol/L respectively. As reducing in Ccr, Cys C, Scr and UREA concentration increased and correlated with Ccr negatively. According to the mazimum Youden index, the critical values of Cys C, Cr, and UREA were 0.90 (mg/L), 115 (μmol/L) and 7.33 (mmol/L) separately, the sensitivity (%), specificity, positive predictive value (%), negative predictive value (%), diagnostic accuracy (%) and the area of the ROC curve (AUC) were Cys C (77.3%, 97.6%, 97.0%, 81.1%, 77.3%, 0.908), Cr (65.9%, 97.6%, 96.5%, 74.1%, 65.9%, 0.817), and UREA (63.6%, 97.6%, 96.4%, 72.8%, 63.6%, 0.785) respectively. The diagnostic accuracy showed that the Cys C > Cr > UREA. Their correspounding ROC curve (AUC) were in the area of 0.908, and 0.785 and 0817. Cys C had the highest AUC (0.908), and achieved a good diagnosis effect. Conclusion Renal damage laboratory indexes of in the early diagnosis, Cys C has a higher sensitivity and specificity to be worth of clinical promotion.

Aim: To study the effects of astragaloside IV on experimental ventricular remodeling in mice and its mechanism from matrix metalloproteinase aspect.Method: Ventricular remodeling in mice was induced by con-secutively subcutaneous injection of isoproterenol for 14 days.Astragaloside IV(40,80 mg/kg)and propranolol(40 mg/kg,positive control)were administered by gavage to mice.Echocardiography was used to observe the left ventricular end diastolic diameter(LVIDd),left ventricular end systolic diameter(LVIDs),fractional shortening(FS)and ejection fraction(EF).The myocardial pathological pattern was detected by HE staining.Expressions of matrix metalloproteinases(MMP2,MMP9)and tissue inhibitor of metalloproteinases(TIMP1,TIMP2)mRNA in myocardium were detected by RT-PCR.Activities of MMP2 and MMP9 were assayed by zymography.Results:Compared with those of control mice,LVIDd and LVIDs were increased,FS and EF were decreased in the model group.Myocardial injury and fibrosis existed in histop at hological slices of the model group.In addition,the mRNA expressions and activities of MMP2 and MMP9 were increased in the model group.However,there were no markable changes to TIMP1 and TIMP2.Treatment with astragaloside IV reduced LVIDd and LVIDs,increased FS and EF,attenuated myocardial injury,and down-regulated mRNA expressions and activities of MMP2 and MMP9 compared with the model group.Conclusion: Astragaloside IV can greatly improve ventricular remodeling and dysfunction via decreasing MMP2 and MMP9 mRNA expression and activities in cardiac ventricles.

Objective To evaluate and analyse the morphological structure in late pregnancy women of pelvic hiatus by appli-cation of transvaginal three-dimensional ultrasound .Methods The 60 cases pregnant women who were checked pregnant weeks for 31 to 40 weeks from January 2012 to December 2014 came to our hospital were chosen as the observation group ,and other 60 cases women who were nulliparous women because of irregular menstruation at the same period treatment as control group .All patients underwent transvaginal three-dimensional ultrasound examination by observed the morphological structure of pelvic hiatus in each period ,and the research object of pelvic hiatus left and right diameter ,anteroposterior diameter and area were compared and meas-ured between the two groups .Results (1)The normal pelvic hiatus morphology was rhombic column crack-like structure ,but the observation group who had 43 .33% abnormal pelvic hiatus morphology and there was kind oval ;(2)The observation group were pelvic diaphragm hiatus of left and right diameter ,anteroposterior diameter and area were significantly larger than the control group in three conditions of the resting period ,anal contraction period and tension period ,and the difference was statistically significant(P< 0 .05) ;all the research object of the pelvic diaphragm hiatus left and right diameter ,anteroposterior diameter and area were de-crease in the anal contraction and increases in tension period for compared with the resting period ,so the difference was statistically significant (P< 0 .05) .Conclusion The three-dimensional ultrasound can be clearly observed the morphology of the female pelvic diaphragm hiatus ,and can be effectively evaluated .The late pregnancy women who will be significantly increases of pelvic dia-phragm ,occurs the relaxation phenomenon and some abnormal morphology for compared with nulliparous women .