Objective To analysis the relationship between blood homocysteine concentration in diabetic retinopathy patients with vascular endothelial cell damage and platelet activation.Methods 80 type 2 diabetes mellitus(T2DM)patients,including 50 no diabetic retinopathy(NDR group)and 30 diabetic retinopathy(DR group)and 30 normal controls were selected to measure the concentration of Hcy as well as circulating endothelial cells(CEC),Endothelin(ET),Yon Willebrand(vWF)and platelet activation markers CD62p and CD63.Results The level of CEC,ET,vWF,CD62p,CD63 and Hcy in T2DM group were,distinctly higher than those of control(P＜0.01),furthermore,the level of these markers in DR group were also higher than that in NDR group(P＜0.01).Blood CEC level Was positively related with ET(r=0.839,P＜0.05),and the same relationship was found in Hcy and CEC(r=0.615,P＜0.05),ET(r=0.642,P＜0.05),CD62p(r=0.623,P＜0.05)and CD63(r=0.542,P＜0.05).Conclusions High blood Hcy,CEC,ET,vWF,CD62p and CD63 level were tighdy related with DR.High level of Hcy,vascular endMermis cell damage and platelet activation maybe play an important role in the pathogenesis of DR.

Objective To analyze the value of the serum BHMT for diagnosis of hepatic injury in patients with acute poisoning.Methods ELISA method was used to detect BHMT in serum samples,and the samples were detected in the sera of normal persons and patients with acute poisoning.Results 300 samples were detected in the sera of normal persons by ELISA method.The average level of human serum B HMT content in 300 samples was 9.02 ng/mL(6.19-12.84 ng/mL),and the 95 ％ medical reference value of BHMT content in healthy people ranges from 0.00 to 28.01 ng/mL.BHMT and ALT were detected in 43 samples from acute liver injury,the Spearman analysis indicating a good positive correlation between BHMT and ALT(rs =0.757 62,P＜0.001).The comparison of the content of BHMT was made between the serum samples from 20 renal damage patient and 20 normal human serum,there was no significant difference in the BHMT content between the serum of patients with renal injury and the normal human serum(P＞0.05).Conclusion The medical reference value range for of serum BHMT content in healthy population ranges from 0.00 to 28.01 ng/mL.There was a good positive correlation between BHMT and ALT.BHMT might not be closely related to kidney injury,while be more specific to liver injure.BHMT could be a better marker of acute poisoning liver injury.

Public-private partnership(PPP)serves as a useful attempt for an adjustment of existing number of public hospitals and incremental development of private hospitals in an effort to implement policies of the health reform and optimize the allocation of medical resources.Investment-OperationTurnover(IOT) is a way to introduce the PPP practice,regarded as an institutional innovation in reforming public hospitals.This paper traced back the IOT model in its development and analyzed its connotation and form,as well as its strengths and weaknesses in a feasibility study,and presented the existing IOT projects in China for reference and open discussion.

Osteoarthritis (OA) is a bone and joint disease caused by multiple factors, which seriously threatens human health. It is mainly manifested as joint pain and dysfunction. In severe cases, it can cause deformity. The mechanism of OA is not very clear, and there is a lack of effective therapeutic drugs; the exploration of etiology, pathogenesis and preventive measures of OA has always been an important research direction in this field. Studies have found that the transforming growth factor-β (TGF-β)/Smad signaling pathway plays a key role in the occurrence and development of OA. This article reviews the research progress of TGF-β/Smad signaling pathway in OA in recent years at home and abroad.

Microcirculation is closely related to occurrence and development of disease, so it is of significance in noninvasive imaging of microcirculatory structure and function in vivo.Photoacoustic imaging is one of the main techniques in microcirculation imaging, which has the characteristics of high contrast, high detection depth and high sensitivity to tissue function.A review of the literature showed that photoacoustic technique can noninvasively image and quantitatively measure microcirculatory structure, vasoconstriction and vasodilation, concentration of hemoglobin, oxygen saturation, blood velocity and direction, oxygen metabolism level in a certain depth of living tissue in real time.Research progress in photoacoustic imaging of microcirculation in subcutis, cerebral cortex, tumor, eye and other tissues is reviewed in this paper.

Objective To analyze the factors related to glare occurred after the phakic intraocular lens (P-IOL) implantation,and to raise the standard for the P-IOL selection.Design Retrospective case series.Participants 104 patients with high myopia underwent P-IOL implantation in Beijing Tongren Hospital.Methods In 104 cases,22 cases (22 eyes) were implanted angle supported Phakic6 designed accord with corneal symmetry,54 cases (54 eyes) were implanted iris fixed Verisyse,and 28 cases (28 eyes) were implanted posterior chamber PRL.Selection of the diameter of P-IOL optics depended on P-IOL diopters.The pupil diameter,the P-IOL optic center position,the pupil and corneal center position were measured with anterior segment optical coherence tomography (OCT).The contrast sensitivity (CS) under different condition (day,day and glare,night,night and glare) and in different space frequency (1.5,3,6, 12,18c/d)were examined with Optec6500 system.Main Outcome Measures Glare incidence,CS,and the influence of pupil diameter and P-IOL location to glare.Results None of the 104 P-IOL eyes occurred glare in day time.59 eyes (56.73%) complained of glare in dime condition.The glare incidence was 63.18% (14/22) in Phakic6 eyes,55.56% (30/54) in Verisyse eyes,and 53.27% (15/28) in PRL eyes (P=0.691).CS of all surgical eyes were improved in day time with or without glare luminous environment (P=0.000).And the CS of halo-complaining eyes was lower than of no halo eyes in night time with or without glare luminous environment (P=0.000).Glare oc- curred more frequently in eyes with the pupil diameter larger than P-IOL diameter in clime condition after surgery (10 in Phakic6 eyes, 20 in Verisyse eyes,12 in PRL eyes,all P

Objective To investigate the characteristic of intravascular catheter-related infections (CRI) in Peking University Third Hospital in 2009. Methods The clinical and microbiological features of CRI were analyzed retrospectively. Results Two hundred and nineteen catheters were examined. Twenty-nine CRI cases were confirmed with colonization, 7 were insertion site infection and 6 were catheter-related bloodstream infections (CRBSI) by quantitative catheter culture method, but no CRBSI was diagnosed by differential time to positivity (DTTP) method. The incidence rates of CRBSI in intensive care units (ICU) were 0. 99- 3.03 per 1000 catheter-days.Among the colonized strains, 51.72 % were Gram-positive cocci, 20.69 % were non-fermenting bacilli (NFB), 13. 79% were Enterobacteriaceae and 10. 34% were Candida. One neonatal CRBSI was caused by Leuconostoc mesenteroides. Most of bacterial isolates were drug resistant. Seventy-seven percent of adult patients were older than 60 years and most of them had chronic underlying diseases.All of the 9 neonate patients were preterm neonate and 7 of them were extremely low birth weight infants. Conclusion There is a certain amount of CRI occurred in Peking University Third Hospital in 2009 and the intravascular catheter management should be enhanced.

Objective To analyze the MR signs of primary subdural extramedullary tumors so as to improve the correct diagnostic rate.Methods MR signs of 40 cases with primary neoplasms of extramedullary were studied retrospectively.All cases were verified by surgery. Results Neurinoma,neurofibroma,meningioma,lipoma and teratoman had specific MR features in location,size,shape,edge,signal and enhancement change. Conclusion Primary subdural extramedullary tumors can be correctly diagnosised.

Objective To analyse MRI findings of multicentric craniopharyngioma and improve knowledge to it. Methods MRI and Gd-DTPA enhanced SE T 1WI scaning were performed in 4 cases of multicentric craniopharyngioma proved by surgery and pathology before operation, PDWI scaning were performed in 2 cases.Results MRI manifestations of multicentric Craniopharyngioma is the tumors of Parenchymal -predominant mixed in the sella turcica region or Suprasellar region as the center focus in 4 cases, and different cystic focus were also found in the di-temporal lobe,the basis of anterior cranium fossa,the anterior part of third ventricle,the pontine cistern, the caudate nucleus.Cystic-Parenchymal focus has low-iso mixed signal on T 1WI and high-low mixed signal on T 2WI;cystic focus of the tumors had different signal,signal ranges form low up to high on T 1WI,while high signal on T 2WI and from iso-signal to high on PDWI. After Gd-DTPA enhanced,annular wall enhancement were seen on cystic focus,Parenchymal focus appeared as uniform enhancement.Conclusion The multicentric craniopharyngioma growth performance is multi-origination growth with the sella turcica region or suprasellar region center, the MRI signal specialty of craniopharyngioma is related to ratio of cystic-consolidated and the contents of the cystic fluid.

OBJECTIVE:To compare clinical efficacy and safety of olanzapine and quetiapine for mental disorders elderly pa-tients. METHODS:120 elderly patients with mental disorders were randomly divided into olanzapine group and quetiapine group, with 60 cases in each group. Olanzapine group was given Olanzapine tablet orally with initial dose of 2.5 mg,qd,and then increas-ing to maximal dose 15 mg according to disease condition,qd;quetiapine group was given Quetiapine tablet orally with initial dose of 50 mg,qd,increasing to maximal dose 400 mg according to disease condtion,qd. Both groups received 6 weeks of treat-ment. Clinical efficacy of 2 groups were compared as well as PANSS and the quality score of life before and after treatment,and the occurrence of ADR. RESULTS:PANSS and the quality score of life were improved significantly in both groups,with statisti-cal significance (P>0.05);but there was no statistical significance between 2 groups (P>0.05). There was no statistical signifi-cance in clinical efficacy between 2 groups(P>0.05). The incidence of lethargy,hypotension and bradycardia in quetiapine group were significantly lower than in olanzapine group,while the incidence of tachycardia was significantly higher than olanzapine group,with statistical significance (P<0.05). CONCLUSIONS:Olanzapine and quetiapine are similar to each other in the treat-ment of mental disorders elderly patients;both of them can effectively improve the quality of life,and ADR induced by quetiapine is slighter than that induced by olanzapine.