Objective To evaluate the effects of analytic variations in creatintine measurements on estimated glo -merular filtration rate (eGFR) and the classification of chronic kidney disease ( CKD).Methods A total of 13 157 patients, including inpatients, outpatients and health individual , were enrolled, whose creatinine range from upper reference limit (URL) -12% ×URL to URL +12% ×URL.There were 9 886 males and 3 271 fe-males with an age range of 20 ~89 years.The results of sCr incremented or decremented 4%, 8%, 12% and orig-inal results were divided into 7 groups.The effects of different degree of analytic variation in sCr measurement on eGFR and classification of CKD using eGFR were evaluated .Results When sCr was in the range of URL ±12%×URL, creatintine increased with age, on the contrary, eGFR decreased with age (P <0.05).The mean bias of the results of eGFR compared with the original results of eGFR was increased with the analytic variation of sCr . When the results of sCr had a reverse analytic bias of 12%, the results of eGFR had a forward bias of 16.73%. When sCr results had a forward analytic bias of 12%, the male patients in stage G3 (eGFR in 30 ~59 ml/min/1.73 m 2 ), according to the classification of CKD using eGFR, increased about 20%; while women in this stage could increase by nearly 30%.When sCr results had a reverse analytic bias of 12%, the percentage of female pa-tients in stage G3 could decrease from 38.65% to 10.42%; while male patients could decrease by 7%.Conclu-sion The analytic variation of creatinine change in laboratory testing tolerance range can cause large shift in the distribution of eGFR, which can cause change in the classification of patients .The correct eGFR report relies on the accurate detection of sCr.Routine reporting of eGFR alongside creatintine should pay attention to the detection accuracy of sCr.

A total of 306 fresh human serum samples were randomly selected. Alb concentrations were measured by bromcresol green ( BCG) method, modified bromcresol purple ( mBCP) method, and immunoturbidmetic assay ( ITA) , respectively. GA was measured by an enzymatic method. GA value was expressed as the percentage of GA in the total serum Alb [ GA%(%) =GA/Alb?100%] . When Alb≥40 g/L, the clinical differences between BCG and mBCP, BCG and ITA, and mBCP and ITA were not significant, and there was no statistical difference between GA% BCG and GA% mBCP(P=0. 537); when Alb<40 g/L, BCG had statistical difference between mBCP and ITA ( P<0. 01 ) , and GA% BCG was significantly lower than GA% mBCP ( P<0. 01 ) . No obvious clinical signifi-cance of Alb concentrations was observed measured by BCG, mBCP, and ITA when Alb≥40 g/L. There was no difference in different Alb methods for GA% calculation. When Alb<40 g/L, the consistency of mBCP and ITA was better than that of BCG and ITA, which indicated that mBCP method may be more suitable for the assay of gly-cated albumin value ( GA%) , whereas the GA% may be underestimated if using BCG method for the determination of Alb.

Free-DNA exists in body fluid of cancer patients, and the concentration is much higher than that of healthy people, and the free DNA is characteristic of tumor issue. This article makes a summary about the study of free DNA in cancer patients,such as methylation,gene mutation, microsatellite instability (MSI) and loss of heterozygosity( LOH ). It has important significance for tumor dignosis,assessment of prognosis and recurrence.

It is important that the oral hospital establish a guarantee system of medical graduation clinical practice quality. Having experienced clinical education for many years,the hospital has formed a system in order to achieve objective management and process management organic unification,which can gradually promote the clinical practice quality.

[Objective] To explore the effect of Hujin Granule on liver function and serum fiber index of rats with immune hepatic fibrosis.[Method] Make abdominal injection with pig serum to induce immune hepatic fibrosis model,make intervention with different dosages of the Granule,measure liver function with automatic bio-chemical analyzer,and test serum hepatic fibrosis index with radio-immune analyse.[Result] The AST,ALT,HA,LN,IV-C and PCⅢ contents in rats serum with hepatic fibrosis induced with pig serum rose obviously,the Granule had definite reversion to the indexes above and could raise albumin content in serum.[Conclusion] Hujin Granule has definite prevention to immune liver fibrosis,can reduce fibrosis degree,meanwhile effectively decrease liver cell injure and improve liver function.

[Objective] To recommend an ideal method for extracting Ⅰ-collagen from cortical bone.[Method]The cortical bone of pig was splitted into small pieces after the soft tissues were cleaned up.The bone pieces were gradually dehydrated in alcohol,defatted in aether,decalcificated in hydrochloric acid,redefatted in chloroform:methanol(1:1,v/v)and became soft.The soft pieces were disintegrated into demineralized bone matrix(DBM)powder in a high speed mill.The osseins were extracted respectively by enhanced pepsin digestion method or alkali-solution method after the DBM powder was treated with desolving,centrifuging,dialyzing and lyophilization.The product got by enhanced pepsin digestion method was further confirmed.The extraction rate and appearance,viscosity and solidification of both products were analyzed and compared.[Result]The collagen produced by extraction of enhanced pepsin digestion method was confirmed to be I-collagen by analyzing amino-acid composition,protein electrophoresis,relative moleculas weight and max wavelength about light absorption.The extraction rate of Ⅰ-collagen by enhanced pepsin digestion method was(94.0?14.96)% as comparision with by alkali-solution method(57.8?4.96)% and the viscosity test of acetic and solution at the concentration 0.03%(w/v)was 3.71 and 2.81 respectively.At the condition of 37?,pH 7.35~7.45,the collagen solution extracted by enhanced pepsin digestion method solidified and changed into a glue 10 minutes later,while the product solution by extraction with alkali-solution was still like a sticky liquid.[Conclusion]Ossein extracted from cortical bone with enhanced pepsin digestion method is a realⅠ-collagen.Compared with alkeli-solution extraction method,the enhanced pepsin digestion extraction method has advantages of higher extraction rate,better purity,better viscosity and fine solidification of the product,and is a choice to prepare the Ⅰ-collagen from cortical bone.

Objective To explore the anti-inflammatory and anti-angiogenic effect of miR-15a in diabetic retinopathy(DR).Methods High glucose model(HG)was established by treatment with 25 mmol/L glucose in human retinal pigment epithelial cell line HARPE-19,and HARPE-19 cells treated with 5 mmol/L glucose served as control(LG).HG group and LG group were divided into 4 subgroups:miR-15a mimic group,NC-mimic group,miR-15a inhibitor group and NC-inhibitor group.Cell proliferation ability was detected by MTT proliferation assay.Cell migration ability was detected by cell scratch assay.The relationship between miR-15a and ASM was identified by 3′UTR luciferase reporter assay.miR-15a,ASM,VEGF,IL-1β,IL-6,TNF-α mRNA expression was detected by RT-PCR method.Results In NC-mimic cells and NC-inhibitor cells,the expression of miR-15a in HG group was significantly lower than that in LG group(all P<0.05).The expression level of ASM mRNA in miR-15a mimic group was significantly lower than that in NC-mimic group (P<0.05),the expression level of ASM mRNA in miR-15a inhibitor group was significantly higher than that in NC-inhibitor group (P<0.05).The cell scratch width in miR-15a mimic group was significantly higher than that in NC-mimic group(P<0.05).The cell scratch width in miR-15a inhibitor group was significantly lower than that in NC-inhibitor group(P<0.05).The absorbance value in miR-15a mimic group was significantly higher than that in NC-mimic group(P<0.05),the absorbance value in miR-15a inhibitor group was significantly lower than that in NC-inhibitor group(P<0.05).In NC-mimic cells and NC-inhibitor cells,the mRNA expression levels of VEGF,IL-1β,IL-6 and TNF-α in HG group was significantly higher than those in LG group(all P<0.05).Conclusion miR-15a downexpression induces inflammatory reaction and angiogenesis in retinal cells.miR-15a is involved in the pathogenesis of DR by dual regulation of inflammation and angiogenesis.

Objective To explore the effect of family doctor contracting service combined with drug therapy on the quality of life of patients with hypertension. Methods Selected in May 2016 to May 2017 in a city in a district of three community health service center clinics diagnosed with hypertension in patients with 840 cases, were given amlodipine besylate tablets treatment, and the implementation of conventional health management And community intervention. According to whether or not to accept the family doctor contract service is divided into observation group (a total of 435 cases) and the control group (a total of 405 cases). Health status questionnaire (SF-36) was used to assess the quality of life before and after the intervention, and the blood pressure control and quality of life improvement were compared between the two groups before and after treatment.Results There was no significant difference in the blood pressure level between the two groups before treatment. The systolic and diastolic blood pressure in the observation group were better than those in the control group (P<0.05). There were no significant differences in physiological function, physiological function, physical pain, general health, mental health, energy, social function, affective function and total score of SF-36 before treatment. The scores of the observation group were significantly higher than those of the control group before and after treatment. The difference was statistically significant (P<0.05). Conclusion Family doctor contract service combined with drug therapy can effectively control the patient's blood pressure levels, improve the quality of life.

Objective To investigate the influence of Zengshiling oral liquid on gastric emptying,plasma motilin (MOT) and small intestine propulsion of young rat. Methods Experiment animal were divided into five groups randomly:control group,large dose of Zengshiling oral liquid group,normal dose of Zengshiling oral liquid group,small dose of Zengshiling oral liquid group and Motilium group. The rats were gavaged by 0.9% of NaCl and corresponding drug. 7 days later,gastric emptying was assayed by phenol red,plasma MOT levels and carbon powder propelling rate of small intestine were also assayed. Results The rate of gastric emptying of Zengshiling oral liquid groups were significantly higher than control group (P