To explore the risk factors and features in patients with premature coronary artery disease (CAD) and mature CAD. Methods: General and clinical information was collected from 747 patients who received coronary angiography (CAG) in our hospital from 2015-01 to 2016-02 and the patients were divided into 3 groups based on CAG findings: Premature CAD group, n=138, Mature CAD group, n=364 and non-CAD group, n=245. CAD diagnosis was defined by at least one major coronary artery stenosis ≥50%; premature CAD was defined by the onset age in male<55 years, in female<65 years. Risk factors and features were compared between premature CAD and mature CAD patients. Results: Compared with Mature CAD group, Premature CAD group showed the higher incidences of family history of hypertension, abnormal blood glucose and BMI, increased blood levels of TC, TG, LDL-C, elevated apolipoprotein A and B (APOA and APOB); while the lower ratio for combining hypertension, P<0.05. Multinomial Logistic regression analysis presented the following parameters had the increased risk for premature CAD occurrence: combining hypertension and diabetes (OR=2.98, 95% CI 1.04-8.57), family history of hypertension (OR=3.50, 95% CI 1.28-9.57), abnormal blood glucose (OR=1.98, 95% CI 1.04-3.80) and elevated APOB (OR=36.67, 95% CI 3.51-99.83). The following parameters had the increased risk for mature CAD occurrence: advanced age (OR=1.20, 95% CI 1.15-1.24), male gender (OR=6.22, 95% CI 3.31-11.69), combining hypertension (OR=1.75, 95% CI 1.08-2.82), concomitant hypertension and diabetes (OR=3.25, 95% CI 1.42-7.46) and elevated APOB (OR=16.39, 95% CI 1.74-99.44). Compared with Mature CAD group, Premature CAD group presented the higher ratio of double vessel disease (38.4% vs 22.3%) and lower ratio of multi vessel disease (31.2% vs 48.1%), all P<0.05. Conclusion: The incidences as family history of hypertension, abnormal blood glucose and BMI, elevated APOB were higher in premature CAD patients than mature CAD patients. It is important to conduct targeted prevention to control relevant risk factors.

BACKGROUND: There is no study on starch/polyvinyl alcohol (PVA) as guided tissue regeneration membranes. The guided tissue regeneration membrane with porous structure were prepared, which combined with the advantages of natural polymer and synthetic polymer. OBJECTIVE: To research the effects of the preparation conditions on the properties of starch/PVA membranes. METHODS: The porous membranes of guiding tissue regeneration were prepared mainly by starch and PVA through solution mixing, casting, freezing and drying. The effects of the mass ratio of PVA and starch, solution concentration, and pre-freezing temperature on the properties of the membrane were researched. The surface morphology, tensile strength, porous ratio, water absorbance and cell cytotoxicity were characterized. RESULTS AND CONCLUSION: The aperture of the membrane was 1-50 μm, the porosity was 60%-70%, and the tensile strength was 12-26 MPa. And this membrane had the excellent biocompatibility and hydrophilicity. The pores in the surface were evenly distributed with the solution concentration of 5% and the pre-freezing temperature of -30℃. The more content of starch was, and the larger of the aperture was.

OBJECTIVE:To improve the working efficiency of the drug delivery system. METHODS:The kinds of drugs in delivery system and manual dispensing window were adjusted through comparing the number of prescriptions and drug box dis-pensed by the system and manual window in our hospital before adjustment (Jun. 2014),combining with analysis of EIQ(En-try-item-quantity)-ABC. The improvement effect was evaluated through analyzing related index after adjustment(Aug. 2014). RE-SULTS:The data before adjustment showed the workload of the delivery system was lower than that of manual delivery in term of the number of drug box (P=0.000),and they were similar in term of the number of prescription (P=0.122). The drug delivery system was significantly better than manual delivery in terms of two indexes after resetting the type of drugs in the system(P=0.000). CONCLUSIONS:Optimized delivery system can effectively improve the working efficiency.

Objective To discuss the correlation between the VEGF-C/D expressions in tumor associated macrophage (TAM) and lymph node metastasis in colon cancer. Methods Forty-five colon cancer samples proven pathologically to be adenocarcinoma were stained by immunohistochemical method for VEGF-C/D and CD68. The correlation of VEGF-C/D expressions, macrophage counting and lymph node metastasis were analyzed statistically. Results The expressions of VEGF-C/D were detected in TAMs. VEGF-C expression was obviously higher in the samples with lymphatic metastasis. VEGF-C expression in colon cancer was related to the number of TAMs. Conclusion TAMs are important in the lymph node metastasis, because they can express VEGF-C/D and affect the lymphangiogenesis of colon cancer.

Objective To evaluate the predictive value of modified early warning score (MEWS) and SMART-COP score on mechanical ventilation in patients with severe influenza A H1N1. Methods Fifty cases diagnosed with severe influenza A H1N1 were retrospectively analyzed. The MEWS and SMART-COP score were calculated. The area under the receiver operating characteristic (ROC) curve (AUC) was evaluated using ROC curve. MEWS, SMART-COP score and AUC were analyzed by Z test. Results The AUCs of MEWS and SMART-COP score for predicting mechanical ventilation were 0. 923 and 0. 889, respectively, which were not significantly different (Z=0. 548, P =0. 584).Conclusion Both of MEWS and SMART-COP score are predictive factors of mechanical ventilation in the patients with severe influenza A H1N1.

Objective To evaluate the outcomes of the payment reform at public hospitals in Sanming city.Methods Interrupted time series analysis was used to compare changes of the average days of stay,per capita hospitalization expense,outpatient expense per visit,proportion of medical expense and that of drugs during hospitalization at 21 public hospitals at or above county level before and after the DRGs reform.Results Comparisons before and after the reform found the average days of stay at the original momentum,poor control in curbing the proportion of medical expense and that of drugs during hospitalization,adropping followed by rising trend in the outpatient expense per visit,and minimal drop of the abovementioned proportions.Conclusions The rapid growth of outpatient and hospitalization costs at tertiary hospitals may be incurred by unreasonable cost transfer,structural trend of hospitalization expense makeup,and rationality pending scrutiny.

Tripartite-sector reform (a synergistic reform in public health services,medical insurance and medicine production-circulation) in Sanming city was described in the paper which centers on medical insurance.Tapping full potentials of the medical insurance,the city achieved efficient synergy among healthcare,medical insurance and medication systems.This reform has trimmed out inflated drug pricing to some extent for rooms of maneuver of medical service pricing changes,thus curbing excessive growth of medical costs successfully.The authors proposed areas of further improvements including the relationship between achieving such objective as curbing medical expenditure,and advancement of technical/medical service capacity;that between integrative control of medical insurance expenditure and protection of people's health;the equilibrium of interests between medical insurance,healthcare and medication.All these will contribute to the goal of healthy patients flow and a hierarchical medical system.

Objective To compare the effectiveness and safety of different intracranial stents assisted coil embolization of intracranial aneurysms and to discuss the selection of different stent assisted embolization of intracranial aneurysm.Methods From 2007 April to 2012 April,118 cases (a total of 128 wide-neck aneurysms) with intracranial aneurysms were analyzed retrospectively.This included the use of 70 neuroform,38 Enterprise,and 20 Solitaire AB stents forthe treatment of intracranial aneurysms.The successful use,aneurysm occlusion at the immediate post-operation,and early period of peri-operative complications were recorded from those clinical data in order to assess the effectiveness and safety of the different intracranial stents,which assisted coil embolization of intracranial aneurysms.Rank sum test and x2 test were used for statistics.Results Three aneurysms assisted with Neuroform stent were planted unsuccessfully,and the Enterprise and Solitaire stents were placed successfully.The embolism results of three stents after immediate postoperative angiography aneurysm: Neuroform stent occlusion rate was 40.0％ (28/ 70),the tumor residual rate was 38.6 ％ (27/70),and the partial embolization rate was 21.4 ％ (15/70) ; The Enterprise stent occlusion rate was 42.1％ (16/38),the tumor residual rate was 36.8 ％ (14/38),and the partial embolization rate was 21.1％ (8/38).The Solitaire AB stent occlusion rate was 40.0 ％ (8/20),the tumor residual rate was 35.0 ％ (7/20),and the partial embolization rate was 25.0 ％ (5/20).There were not significant differences in aneurismal occlusion (H =0.12,P ＞ 0.05).Early peri-operative complications results were: Neuroform stent occurred in 7,Enterprise frame in 4,and Solitaire AB stent occurred in 2.There were no significant differences in the incidence of complications in the early period after coiling (x2 =0,P ＞ 0.05).Conclusions Three kinds of intracranial stents assisted embolization of intracranial aneurysms are applied safely and effectively.The stent may be chosen according to morphology of parent artery and stent biological character.

BACKGROUND: The strength and elasticity of general starch can be enhanced dramatically after plastic blends. The major characters of this material are magnitude molecular weight, many enwinded points, extreme containment of small molecules,and great gelation ability. It can be used as a biodegradable replacement of alginate. Furthermore, by adding osteoinductive factors, thermoplastics starch (TP) can be used as an organic engineering material, which can provide dual functions:anti-bleeding and bone formation. TP can also be used as intraoral tissue formation membrane and burn dressings.OBJECTIVE: To evaluate the bio-safety of TP through a cytotoxicity test.DESIGN: A controlled observation.SETTING: Beijing Research Institute of Traumatology and Orthopaedics; Beijing Jishuitan Hospital; Beijing University of Chemical Technology; Peking Univesity School of Stomatology.MATERIALS: The experiment was conducted at the laboratory of Beijing Research Institute of Traumatology and Orthopaedics from April to October in 2006. TP sample was obtained by plasticization of corn starch (12 wt % water content) with glycerol in a Haake Rhenmix at 110℃ and with 80 rounds per minute for 25 minutes, elongation at break from 115.3% to 245.3%. It was prepared by Beijing Key Laboratory for Preparation and Processing of Novel Polymeric Materials, Beijing University of Chemical Technology. Mouse fibroblast L-929 cell strain was provided by the cell bank of Peking University Health Science Center.METHODS: 1 × 107 L-1 cell aqueous suspension was cultured into leaching liquor ( 50% ), serving for TP group, and routine culture medium served for negative control group. Effect of TP on relative growth rate of L-929 cell strain was quantitatively measured by MTI" assay. The cytotoxicity of TP was evaluated according to GB/T16175-1996. Morphological changes and proliferation of cells were observed after2, 4, and 7 days of culture in the medium through an inverted phase contrast microscope.MAIN OUTCOME MEASURES: Cytotoxicity, morphological changes and proliferation of cells, and cell relative growth rate.RESULTS: Cytotoxicity: After 2 and 4 days of incubation, the absorbance (A) value was lower in the TP group than in the negative control group. After 7 days of incubation, the A value was significantly higher compared to negative control group (P＜0.01). It indicated that after 2 and 4 days of incubation, the cytotoxicity in the TP group was larger than in the negative control group, while after 7 days of incubation, it was on the opposite. All the test time, TP's cytotoxicity grade ranged from 0 to 1. Morphological change and proliferation of cells: After 2 days of incubation, both groups of cells were not extended to the outside of the scope, with a majority shape of being round, triangle, and quadrangle in the TP group or fusiform cells in the negative control respectively. Four days later, there were gaps among cells in the TP group, while in the negative control group, there were hardly any distance between cells and some cells piled up. Seven days later, cells in starch medium suddenly grew up to such a degree that all the cells lapped over and presented with more bloom than the negative control. Cell relative growth rate: After 2, 4, and 7 days of incubation, relative growth rate increased with time, being 85.63%,82.22%, and 113.05%, respectively.CONCLUSION: TP has no evidence of cytotoxicity and has good bio-safety.

Objective To investigate the effect of intravenous injection of 20% lipid emulsion on neurotransmitters imbalance in central nerve system induced by local anesthetics.Methods Thirty adult Sprague-Dawley rats were randomly divided into two groups:normal group (group C,n =10) and local anesthetics group (group L,n =20).Based on different treatment,the rats in group L were assigned into two subgroup:control group (group S,n =10)and 20% long-chain lipid emulsion in-jection group (group I,n =10).The rats of group L were injected with 0.75% levobupivacaine at 50μl/min from the right ventricle of brain.When convulsions wave of electroencephalogram EEG ap-peared,20% long-chain lipid emulsion was administrated continuously 0.25 ml·kg-1 ·min-1 (group I)or normal saline (group S).The rats in group C were without any treatment.All the rats were con-tinously monitored by EEG,ECG and SpO 2 .The primary outcome included seizure duration and threshold and rats’mortality of postoperative 24 h.Secondary outcome included the concentrations of neurotransmitters GABA and Glu in cerebrospinal fluid,expression of NMDAR1 in cortex,Glu/GA-BA concentration ratio (Glu/GABA),and analysis the correlation between expression of Glu and NMDAR1.Results The convulsion time and mortality of rats in group S were significantly increased compared with those in group I (P <0.05).The seizure threshold of levobupivacaine was much lower in group S than group I (P <0.05).Compared with group C,the concentrations of Glu and GABA in cerebrospinal fluid,expression of NMDAR1 in hippocampus and Glu/GABA significantly increased in groups S and I(P < 0.05 ),and at same time these data in group S were significantly higher than group I (P < 0.05 ).There is a positive correlation between concentration of Glu in CSF and expression of NMDAR1 in hippocampus (r =0.884,P <0.01 ).Conclusion Intravenous infusion of 20% long-chain lipid emulsion can effectively improve neurotransmitters imbalance in central nerve system induced by intraventricular injection of local anesthetics.