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.

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.

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.

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.

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.

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]Through the clinical investigation of the conversative treatment of undisplaced femoral necks,to analyze the occurrence of secondary displacement and femoral head necrosis.[Method]The medical records of 216 patients with undisplaced femoral neck fractures who were primarily treated conservatively from January,2000 to January,2004 were analyzed.Among that,186 cases is in accordance with the selected standard,which were consisted of 82 men and 104 women.(the average age 67.5).One hundred and forty-one fractures were given to bed rest in rotation-proof shoes,and walking on the crutches was followed after four weeks.Forty-five patients began to get out of bed with double crutches on the third day.When displacement happened,the operation was carried out.Once X-rays showed the fracture line unclearly,it is considered as bone healing.The early stage of femoral head necrosis was defined by sclerotic region or cyst in the femoral head.[Result]Sixty-eight fractures(36.6%) united and secondary considered displacement occurred in 118 cases(63.4%); the average time was 16 days (2～68 d) after injury when the displacement is found.In all primary healing patients,femoral head necrosis rate was 25%.The discovery time of necrosis was between 4 and 18 months,the most was 36 cases in the interval of 6 to 12 months.As for patients of secondary displacement,92 for closed reduction and hollow screws fixation,and the head necrosis happened in 55 patients(59.8%).The discovery time was from 4 to 18 months,the most in 6 to 12 months was 36 cases.The operation of open reduction and internal fixation with hollow screws was in 26 cases,73% of necrosis rate for it.The time was range from 3 to 12 months,11 case was the most in the period of 3 to 6 months.[Conclusion]Undispalced femoral neck fractures treated conservatively bear higher risk of secondary displacement and femoral head necrosis.In addition with more mortality and general complications,we therefore recommend primary operative stabilization of undisplaced femoral neck fractures.

Background It is widely appreciated that many animal cells rely on the mechanism of regulatory volume decrease (RVD) after swell under the hypotonic environment,which involved in some processes of cellular physiology.But the RVD of lens epithelial cells(LECs) still is being further researched.Objective Present study was to clarify the possible mechanisms and influencing factors in the RVD of LECs.Methods Human LECs line (HLE B-3)were cultured and passaged in DMEM/F12 containing 10％ fetal bovine serum(FBS),and before volume measurement,cells were stuck to the base of a perfusion chamber,Ringer solution osmolality was decreased from 15％Hypo to 45％ Hypo,and the cells stimulated by 45％ Hypo Ringer solution were used as the control group.Some experiments were performed in the presence of high extracellular K+ concentration,chloride or potassium channel inhibitor,experiments were also carried out in the nominal absence of Ca2+,Cl-or HCO-3 to test the effect of a decrease in intracellular concentration of these ions on the cell volume response.The volume changes of living cells were measured by lag-time microphotograph acquisition and analysis system (IPP6.0).Results Time course of cell volume change after hypotonic shock in HLE B-3 cells was observed.The cell swelling was followed by a gradual volume recovery,indicating the presence of RVD was influenced by the hypotonic stress.Under the stimulation of 45 ％Hypo Ringer solution,the rates of RVD were (59.1 ±7.8)％.RVD was correlated positively to the maximum cell volume (r =0.99,P＜0.05)in S shape,and RVD changes were sensitive to alter maximum cell volume in the range of 115％-135％.RVD reduced to (16.5 ± 1.6) ％,(14.7 ± 2.3) ％,respectively after acted by potassium channel inhibitor,TEA(10 mmol/L)and BaCl2(5 mmol/L)as well as chloride channel inhibitor,NPPB(100 μmol/L)and DIDS(100 μmol/L),with significant differences in comparison with the control group(all P＜0.01).RVD decreased by(5.8±1.6)％ and(2.7±0.8)％ in high concentration of K+ in extracellular fluid and the absence of Cl-(P＜0.01).RVD was significantly inhibited under the absence of Ca2+.When the 45％ Ringer solution was pH6.8,the process of RVD delayed.The rate of RVD in the first ten minutes was (0.86±0.24)％/min,showing a significant decline in comparison with (3.24±0.84) ％ / min of pH 7.4 (P ＜0.05).Conclusions HLE B-3 have RVD ability under the hypotonic stress stimulation.A certain intracellular Ca2+ concentration is the premise of RVD activation,and Cl efflux and K+ efflux are the key mechanism of RVD of HLE B-3.Acidic environment of hypotonic solution delays the occurrence of RVD.

To compare the adjuvant therapeutic effect of silicone oil and ointment applied to the lacrimal laser angioplasty.METHODS: Totally, 134 eyes of 102 cases who were diagnosed as lacrimal duct obstruction ( except chronic dacryocystitis) were divided into two groups. Sixty eyes were performed laser plastic operation and silicone oil filling. Seventy - four eyes were adopted laser plastic operation with cloth enzyme dexamethasone eye ointment filling. All patients were followed up for 3 ~ 15mo. The clinical effect and the number of irrigation of two groups were compared 3mo after treatment, and to assess the merits of the method.RESULTS: The efficiency of the silicone oil group was 87% and that of the eye ointment group was 84%. There was no statistically significant difference (P>0. 05). The number of lacrimal duct flushing of the silicone oil group was 7. 20±1. 22 times among postoperative 3mo, and that of the eye ointment group was 7. 96 ± 1. 79 times. The number of lacrimal duct exploration through of the silicone oil group was 0. 62 ± 0. 87 times, that of the eye ointment group was 1. 43 ± 1. 48 times. There was statistically significant differences compared between the two groups (both P<0. 05).CONCLUSlON:The effect of laser plastic operation and silicone oil filling treating obstructive diseases of lacrimal duct is similar to laser plastic operation with cloth enzyme dexamethasone eye ointment, but the postoperative care of the former is more simple. Patients can significantly reduce the frequency of lacrimal duct flushing and lacrimal duct exploration through.

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