Objective This research was designed to reveal the influence of the new rural cooperative medical system (NRCMS) on anticoagulant therapy of warfarin in atrial fibrillation (AF) patients in Gaochun district,Nanjing city.The reasons of not attending NRCMS and the relationship between NRCMS and the reasons of not correctly anticoagulant therapy were also investigated.Methods We collected outpatients and inpatients in Gaochun district in our hospital who suffered with AF and did not attend any medical insurance except NRCMS.Patients' data of whether enrolled in NRCMS,whether anticoagulated with warfarin,whether measure international normalized ratio and then confine it in therapeutic extent and fundamental data of gender,age etc.were collected by questionnaire.Then,the data were analyzed.Results A total of 1 094 patients were included in our research of which 896(81.9％) patients were enrolled in NRCMS.198 subjects did not attend NRCMS.The most common reason was not getting the message of NRCMS,which covered 104 patients (52.5％).Among the patients without counter indications of warfarin,801 patients did not be anticoagulated,of which 637 were covered by NRCMS and 164 were not insured by NRCMS,which accounted for 71.1％ and 82.8％ of their total respectively.The difference was statistically significant (x2 =11.387,P =0.001).Similar to the nonNRCMS,the most common reason of not accepted anticoagulation in patients covered by NRCMS was taking substitutions,which was hold by 42.9％ patients.All the differences of proportions of patients had recorded reasons with and without NRCMS had no statistical significance except for the proportion of patients who hold the reason of not knowing the necessity of anticoagulation,having difficulty in daily life,and compound reasons.Among the anticoagulated patients,202 cases did not restrict INR in therapeutic range,of which 170 cases were covered by NRCMS and 32 cases were not insured by NRCMS,which accounted for 65.6％ and 94.1％ of their total respectively.The difference was statistically significant (x2 =11.385,P =0.001).The most common reason of not restricting INR in patients covered by NRCMS was did not know the necessity of restricting INR,which was hold by 40.6％ patients.The proportions of patients who did not take anticoagulation with the reason of having difficulty in daily life had statistical difference,while the difference of other reasons did not meet statistical significance.Conclusion There were many patients did not attended NRCMS.NRCMS can improve the proportion of anticoagnlation therapy with or without correct ways.However,there were many patients did not treated with anticoagulation and there were many patients did not restrict INR in therapeutic rainge.Propaganda,health education and directions of health information are needed.

Objective To evaluate the effects of postconditioning with ischema and propofol on retinal injury induced by limb ischemia-reperfusion (LIR) in rats.Methods Twenty-four male Wistar rats were randomly divided into 3 groups (n =8 each) using a random number table:sham operation group (group S),group LIR,and propofol postconditioning + postconditioning + ischemic LIR group (group P + I + LIR).The model of LIR was established by separating and ligating the femoral artery and vein of bilateral hind limbs for 60 min followed by reperfusion.In group P + I + LIR,the animals were subjected to 4 episodes of 60 min ischemia-5 min reperfusion-5 min ischemia-5 min reperfusion and to 4 cycles of propofol 500 μg· kg-1 · min-1 infused intraperitoneally at the same time (during reperfusion)-no propofol infusion during second ischemia.At 120 min of reperfusion,blood samples were collected from the abdominal aorta for determination of serum malondialdehyde (MDA) concentrations.The eyeball was removed and the retina was cut into sections which were stained with H.E.and examined by microscopy.Results Compared with group S,the serum MDA concentration was significantly increased in group LIR,and no significant change was found in the serum MDA concentration in group P + I + LIR.The serum MDA concentration was significantly lower in group P + I + LIR than in group LIR.The structure of retina was normal in group S,oedema was found in all the layers of retina,vacuolar degeneration was observed in the most of ganglionic layers,and the structure disturbance was found in group LIR.The pathological changes of retina were significantly attenuated in group P + Ⅰ + LIR.Conclusion Postconditioning with ischema and propofol can attenuate retinal injury induced by LIR,and the mechanism is related to inhibition of lipid peroxidation in rats.

Recent studies have shown that complications of cirrhotic portal hypertension often involve multiple organs,which is called multiple organ dysfunction syndrome by some scholars.When muhiple organ failure occurs,there is a significant increase in patients'short-term death rate,and death rate is associated with the number of organs involved.This article briefly describes the physiopothologic mechanisms of portal hypertension and visceral vasodilation and summarizes the pathological changes of vital organs including the heart,lung,kidney,brain,and liver and related pathogenesis.At present,liver transplantation remains the most effective therapy,but it still has some shortcomings.It is pointed out that further studies are needed to investigate the mechanisms of action of each link in disease development,and more targets are needed in the future to prevent and treat multiple organ dysfunction syndrome in patients with liver cirrhosis.

Non-alcoholic fatty liver disease (NAFLD)is a clinical syndrome characterized by hepatic fat deposition, and not caused by chronic heavy drinking and other liver damage factors. The pathogenesis of NAFLD is associated with environmental,genetic,immune and other various factors. Early diagnosis is helpful not only for distinguishing between simple non-alcoholic fatty liver (NAFL)and non-alcoholic steatohepatitis (NASH),but also for grading the extent of NAFLD lesion and delaying its further development. This article reviewed the clinical research progress of non-invasive diagnosis and evaluation of NAFLD.

Objective: To study the effect of cognitive therapy in combination with electromyographic feedback therapy on diabetes patients with depression after cerebral infarction. Methods: 60 patients were randomly divided into study group (n=30) and control group (n=30) , The former received cognitive therapy and electromyographic feedback trainings in addition to regular medication. All patients were evaluated with Hamilton Depression Rating Scales (HAMD),Neurological Function Deficit scale(NFD)?Barthel Index(BI) and FPG (free plasma glucose), 2HPG (plasma glucose after 2 hours of a meal). Results: The improvement of study group was greater than the control group(P

Objective To study the role of early intravenous nutrition given aggressively combined with early minimal feeding on very low birth weight infants (VLBWI),and to evaluate the clinical value of intestinal barrier protein and MicroRNA.Methods All of 62 cases of VLBWI admitted in NICU,the Maternal and Child Health Hospital of Nantong Affiliated to Nantong University from January 2006 to June 2014 were recruited.Sixty-two VLBWI were randomly divided into group A and group B.Thirty infants in group A were exposed to conventional intravenous nutrition.Thirty-two infants in group B were treated with early intravenous nutrition aggressively combined with early minimal feeding.The time of birth weight recovery,days with intravenous nutrition,hospital stay and complications were recorded.The liver and kidney functions,electrolytes,blood gas analysis were monitored.Enzyme-linked immunosorbent method was used to detect intestinal fatty acid binding protein (Ⅰ-FABP),an intestinal barrier protein in plasma.Infection related MicroRNA155 was detected with fluorescent quantitative polymerase chain reaction (RT-PCR).Results Group B was superior to group A in weight loss after birth [(13.70 ± 3.10) ％ vs (5.46 ± 2.64) ％,P ＜ 0.05],shorter recovery time of body weight [(12.20 ± 3.38) d vs (6.82 ± 3.20) d,P ＜ 0.05],fewer days with intravenous nutrition [(29.62 ± 4.16) d vs (20.80 ± 3.20) d,P ＜ 0.05] and shorter hospital stays [(44.60 ± 6.32) d vs (28.91 ± 4.36) d,P ＜ 0.05].Compared with group A,the infants in group B had less complications,including hyperbilirubinemia (31.2％ vs 56.7％),extrauterine growth retardation (34.3％ vs 73.3％),cholestasis (6.2％ vs 23.3％),feeding intolerance (15.6％ vs 53.3％) and necrotizing enterocolitis (0 vs 16.7％) (all P ＜ 0.05).Although Ⅰ-FABP had a higher plasma concentration in group A than that of group B [(9.083 ± 1.059) μg/L vs (7.563 ± 0.739) μg/L],the difference was not significant (t =1.190,P =0.076 4).However,the plasma levels of Ⅰ-FABP in infants with necrotizing enterocolitis were significantly higher than those of group B [(19.500 ± 3.510) μg/L vs (7.563 ±0.739) μg/L,t =5.231,P =0.035 0].The expression of MicroRNA155 in group A was markedly higher than that of group B (2-△△ct were 0.81 ± 0.12 and 0.24 ± 0.08,respectively,P ＜ 0.05).Conclusions Giving aggressive intravenous nutrition early combined with early minimal feeding was safety and effective to VLBWI,which was of benefit to their growth and development,reducing complications and shorting hospital stays.The detection of intestinal barrier protein Ⅰ-FABP and MicroRNA155 is useful for monitoring feeding complications of VLBWI.

Objective To investigate the distribution of single nucleotide polymorphisms(SNPs) on retinol binding protein 4(RBP4) genes and forkhead box O1 (FOXO1) gene, and their relationships with the occurrence of type Ⅱ diabetes mellitus (T2DM) in Chinese Han population. Methods Totally ten SNPs on RBP4 and FOXO1 were determined in 384 T2DM patients and 384 normal controls by TaqMan probe genotyping and agarose gel electrophoresis methods. And their serum level of fasting blood glucose (FBG), total cholesterol (TC) and trigly- ceride (TG) were also estimated. Results For RBP4, there was no significance for various genetypes and alleles including - 803 G > A, + 5169 C > T, and + 6969 G > C between two groups (P > 0.05). Each genotype had no relationships with T2DM (using adjusted logistic regression models). No haplotype was associated with T2DM. For FOXO1, among seven SNPs typed, significant variation was found in the frequency distribution of rs7324943 G/T in the two groups(χ~2=4.02, P = 0.044), and further stratification analysis showed that in subjects of aged 40 and non-hypertension, there was a higher risk of T2DM in GT heterozygous carriers than in GG homozygous carriers (OR = 1.47, 1.80), T allele carriers showed higher risk than non-T carriers (OR = 1.42,1.79). For rs17592236 C/T, though no significant frequency variation was found between two groups (χ~2 = 0.39, P = 0.401), but in subjects of aged ≤ 40, stratification analysis showed dramatically increased risk of T2DM in CT and TT carriers than in CC carriers (OR = 6.33,10.15), T allele carriers showed 7. 11-fold higher risk than non-T carriers. A haplotype CT related to T2DM susceptibility was also found, which could decrease the risk of its carriers by 28%. Conclusions For BBP4, the polymorphisms of - 803 G > A, + 5169 C > T, and + 6969 G > C had no relationships with T2DM in Chinese Han population. For FOXO1, the polymorphism of rs7324943 G/T,rs17592236 C/T and a haplotype CT were found related to the susceptibility of T2DM in Chinese Han population. Yet further studies are necessary to explain the impact of these polymorphisms on the disease occurrence.

AIM　To Detect the varying of gene expression in cultured dorsal root ganglion cells treated by Nerve Regeneration Factor and explore its molecular mechanism promoting to nerve growth. METHODS　By RT-PCR, the change of gene expression in GAP-43 and NF-L on the cultured DRG cells with Nerve Regeneration Factor were studied during 4 h, 12 h, 24 h. RESULTS　The expression of GAP-43 and NF-L were increased by Nerve Regeneration Factor on DRG′s culture. CONCLUSION　This study indicated Nerve Regeneration Factor may up-regulate the gene expression associated nerve growth on cultured nervous cells.

Objective: To observe the clinical effect of depakine (sodium valproate) in the treatment of childhood epilepsy.　Methods:78 epileptic children were treated with either godilum valproate sustained-release tablets or syrups according to their ages, the control degree of the seizures were observed and reexamination of liver function and blood routine were carried at periodically.　Results: Of the 78 cases, 58 cases (74.4 percent) were completely controlled, 10 cases (12.8 percent) significantly improved, 5 cases (6.4 percent) improved, 5 cases (6.4 percent) remained the same. The total effective rate was 93.6 percent.　Conclusion: Depakine is a new broad-spectrum, easily used anti-epliepsy drug. Its efficacy is significant and there are different dosage forms to be selected and no significant adverse reactions. So depakine is the first selection in treating childhood epilepsy and suited for clinical application.

The incidence of thyroid carcinoma has been increasing in recent years.More and more researchers have paid attention to this field and great achievements have been made year by year.The developments on gene diagnosis and molecular markers of thyroid carcinoma are reviewed in this article.