The paper gives an account of the basic concept of supply chain management, puts forward the overall framework of supply chain management in the hospitals department of clinical laboratory, and sets forth the specific process of implementation: analyzing the hospitals environment of market competition and identifying medical market opportunities; defining clinical and patient value; specifying competition strategies; analyzing the entity competitive power; establishing the management procedure of the department of clinical laboratory; implementing various testing steps; evaluating testing quality and performance; and seeking feedback and improvement.

Objective To observe the changes of brain natriuretic peptide(BNP)in patients with myocardial infarction,and to assess the clinical value of BNP in the patients with myocardial infarction.Methods BNP was determined in 91 patients with myocardial infarction and in 90 normal cases,and the difference was studied between the area of myocardial infarction and the number of coronary arteries stenosis.Results BNP(ng/L)(155.03 ± 113.45,71.03 ±37.01)and LVEDd(cm)(5.11 ±0.51,4.56 ±0.43)were significantly increased in patients with myocardial infarction than that in normal cases(P＜0.01),but EF(%)(50.84 ±7.98,57.09 ±6.29)was lower than that in normal cases(P＜0.01).BNP and LVEDd were also significantly higher in patients with wide-anterior myocardial infarction than that in antero-septal,inferior and posterior wall myocardial infarction,but LVEF was lower.Conclusion The BNP level was higher in patients with myocardial infarction,especially in patients with wide-anterior myocardial infarction.BNP was a reliable bio-chemical marker which can evaluate the degree and prognosis of patients with myocardial infarction.

Objective To investigate the relationship between renal sympathetic nerve activity and the severity of heart failure in dogs with chronic heart failure ( CHF) .Methods CHF were induced by ab-dominal aorta constriction.Plasma renin activity ( PRA) , adrenaline ( E) , and noradrenaline ( NE) were determined in 9 dogs with CHF (CHF group) and 3 sham-operated dogs (control group).Results E, NE, PRA, and B-type natriuretic peptide ( BNP) were significantly higher in CHF group than those in con-trol group (all P <0.01).Compared to 10-week post-operation, PRA [(2.08 ±0.08)ng/(ml? h) vs (2.26 ±0.16)ng/(ml? h)], NE [(184.01 ±11.76)pg/ml vs (202.99 ±16.54)pg/ml] and BNP [(85.87 ±11.41)μg/ml vs (100.41 ±9.24)μg/ml] were significantly increased in the 12-week post-op-eration (all P <0.01).PRA [10 weeks post-operation:(2.13 ±0.08)ng/(ml? h) vs (2.02 ±0.05)ng/(ml? h);12 weeks post-operation:(2.38 ±0.09)ng/(ml? h) vs (2.11 ±0.07)ng/(ml? h)] and NE [10 weeks post-operation: (191.75 ±8.40) pg/ml vs (174.33 ±7.08) pg/ml;12 weeks post-operation:(215.69 ±6.26)pg/ml vs (186.36 ±7.98)pg/ml] were higher in high BNP group than those in low BNP group both in 10 and 12 weeks post-operation ( P =0.013, P =0.013, P =0.002, respectively).Con-clusions PRA was increased in dogs with CHF and associated with the severity of CHF.

Objective To study the effects of ischemia postconditioning(IPC) in reducing ischemia-reperfusion injury(IRI) in acute limp ischemia(ALI) and investigate the mechanism.Methods 45 New Zealand rabbits were treated with the method that combined high lipid diets and femoral intima injury by balloon inflation to build up limp atherosclerotic stenosis model,then they were randomly divided into three groups( each group 15 rabbits):control group;IR group and IPC group.Serum creatine phosphate kinase(CK),malondialehyde(MDA),superoxide dismutase (SOD) in three groups were measured before occlusion and 2 hours after sustaining reperfusion.The histological changes of limp skeletal muscle of experimental rabbits were analyzed and TUNEL method was used to access apoptosis of skeletal muscle cells.Results The levels of CK,M DA in IPC group were lower than IR group [ (7.49 ± 0.84)vs (8.19 ± 1.06),P＜0.05],[ (3.67 ±0.36) vs (4.06 ±0.55),P ＜0.05] while SOD level was higher than IR group [ (420.40 ± 30.94 ) vs ( 384.73 ± 44.12),P ＜ 0.05 ] ; The injury of skeletal muscles in I PC group was lighter than IR group and the apoptosis index of skeletal muscle cells was significantly decreased compared with that in IR group[(12.27+2.11)％ vs (16.62 ± 1.44)％,P＜0.01].Conclusion Applying IPC in acute limp ischemia could alleviate IRI and protect skeletal muscles.The mechanism was associated with oxidation resistance enhancing and the effects in reducing apoptosis of skeletal muscles induced by IRI.

Objective To investigate the predictive value of serum aldosterone and Plasminogen activator inhibitor-1 ( PAI-1 ) levels to the severity of coronary artery lesions and the recent prognosis in acute coronary syndrome (ACS) patients underwent percutaneous coronary intervention(PCI). Methods The study included 160 consecutive patients admitted. All the patients received coronary angiography and were divided into two groups:control group and ACS group. The patients' blood samples were abtained at the root of aortic artery to measure the serum aldosterone and PAI-1 levels. We analyzed their relationship with the severity of coronary artery lesions. The patients were also divided into three groups( high-score group, moderate-score group,low-score group)according to Gensini accumulated points,we analyzed the difference of aldosterone and PAI-1 levels in three groups. The predictive values of aldosterone and PAI-1 to the recent pronosis of ACS patients underwent PCIwere assessed. Results ( 1 )The patients' serum aldosteeone and PAI-1 levels in ACS group were significantly higher than control group( all P <0. 05 ) ;(2)The aldosterone and PAI-1 levels in high-score group were higher than moderate-score group, and moderate-score group was higher than low-score group. (3)The serum aldosterone level in ACS patients was positively correlated with the PAI-1 level ( r = 0.213, all P < 0. 05 ). ( 4 ) Multiple factor Logistic regression analysis indicated that aldosterone, PAI-1 levels were srtong independent predictors for the recent prognosis of ACS patients underwent PCI. Conclusion The aldosterone ,PAI-1 levels in ACS patients were correlated with the severity of coronary artery lesions. Both of them were strong predictors for the recent prognosis of ACS patients underwent PCI.

AIM: Some studies found that the glucose uptake ability of diabetes mellitus mice is stronger after feeding with taurine. Whether the taurine can affect adipocytes or not deserves further studies. This article investigates the effects of taurine on the differentiation of 3T3-L1 preadipocytes and detects the mechanics. METHODS: Experiments were performed in the Laboratory Center of Xiangya Third Hospital of Central South University from July to September 2006. ①3T3L1 preadipocytes were provided by Shanghai Cell Bank of China Academy of Sciences. ②3T3-L1 preadipocytes were cultured in high glucose DMEM medium containing fetal bovine serum of 0.10 volume fraction, 108 u/L benzylpenicillin and 80?1010 U/L streptaquaine. After confluence, cells at 5?107 L-1 were incubated in culture flask, and induced with 0.5 mmol/L IBMX, 0.5 mg/L insulin and 1 ?mol/L dexamethasone. The cells in an experimental group were intervened with taurine, whereas these in a control group were not treated with taurine. Oil O staining was used to observe the development of adipose cells. C3T3-L1 preadipocytes were treated with 10,20 mmol/L taurine respectively for 24 and 48 hours. RNA and protein were extracted in the control group and the experimental group. ③Genes related to adipose cells development was examined by RT-PCR and Western-blot. RESULTS: ①The number of cells stained by oil O was less in the experimental group than the control group in 3T3-L1 preadipocytes treated with 10 mmol/L taurine for 14 days. ②After C3T3-L1 preadipocytes were treated with 10,20 mmol/L taurine respectively for 24 and 48 hours, there were no changes in expression of Insig-2 protein, PPAR, Insing-2, adiponectin, adiponectin receptor, GLUT-4, AP-2 mRNA. CONCLUSION: Taurine inhibits the differentiation of 3T3-L1 preadipocytes, but the mechanics still need to be investigated.

Objective To establish the cell line stably expressing INSIG2 and observe its effecet on fat metabolism after overexpression of INSIG2.Methods The eukaryotic expression plasmid pcDNA3.1(+)-INSIG2 was constructed,which was transfected into 3T3-L1 cells.The expression of INSIG2 and related genes were detected by RT-PCR and immunohistochemistry,the contents of FFA in cell culture medium and adipocyte differentiation were detected by ELISA and Oil Red "O"staining respectively.Results After pcDNA3.1(+)-INSIG2 was transfected into the 3T3-L1 cells,the expression of INSIG1 mRNA and FAS mRNA were down-regulated,the content of FFA in the cell culture medium was decreased and adipocyte differentiation was drepressed.Conclusion The cell line stably expressing INSIG2 was successfully established,the transfected INSIG2 may have a drepressant effect on fat metabolism.

Objective To assess the roles of renalase and renal sympathetic nerve activity in patients with chronic heart failure (CHF). Methods Plasma renin activity (PRA), angiotensinⅠ (AngⅠ), angiotensin Ⅱ(AngⅡ),adrenaline (E), noradrenaline (NE) and renalase were determined in 60 patients with CHF (CHF group) and in 42 healthy cases (control group). Data were compared between patients with mild and serious CHF. Results PRA, E, NE and AngⅠincreased and renalase decreased in CHF group than those in control group. Compared with mild CHF, renalase and left ventricular ejection fraction decreased (P < 0.01, 0.034), while N-terminal pro-B-type natriuretic peptide (NT-proBNP) and PRA significantly increased (P<0.01). Linear correlation analysis showed that renalase was inversely correlated with Log NT-proBNP (r = -0.400, P = 0.002) and Log NE (r=-0.314, P = 0.014). Logistic regression analysis showed that NT-proBNP (OR = 6.963, 95%CI = 1.223 to 39.638), PRA (OR = 3.736, 95%CI = 1.031 to 13.540) and renalase (OR = 0.253, 95%CI = 0.069 to 0.927) were associated with increased NYHA classes. Conclusions PRA would increase while renalase would decrease in patients with CHF. PRA and renalase were correlated to the severity of CHF.

Objective To investigate the effects of high dose atovastatin administration on platelet activity and ventricular remodeling of patients with ST-Segment elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention (PCI).Methods A total of 260 STEMI patients who hospitalized in our Department of Cardiology from June 2012 to December 2013 was enrolled and randomly divided into two groups:controlled group (n =140) and high dose atorvastatin group (n =120).Indicators of platelet activities including mean platelet volume (MPV),platelet large cell ratio (P-LCR),blood CD62p,and glucose protein Ⅱ b/Ⅲa (PAC-1) were measured before and 48 hours after PCI.TIMI myocardial perfusion grade (TMPG) after PCI was recorded and patients accepted ultrasound cardiogram (UCG) examinations 5 ～7 days after PCI and 6 months after discharge.After PCI,Patients were followed up for 6 months,statin-associated liver impairment,myopath and major adverse cardiac events (MACE) happened during follow-up periods were recorded.Results MPV,P-LCR,CD62p,and PAC-1 in patients of high dose atorvastatin group were less than controlled group and TMPG were better than controlled group [(12.96±1.73)fl vs (14.18 ± 1.86)fl,P ＜0.05;(29.12 ±5.83)％ vs (30.66 ±6.12)％,P ＜ 0.05;(45.36±5.24)％ vs (48.44±4.75)％,P ＜0.01;(74.61 ±5.57)％ vs (78.55±5.78)％,P ＜0.01].Six months after PCI,UCG examination showed that Left ventricular end-diastolic volume (LV-EDV),left ventricular end-systolic volume (LVESV) and left ventricular mass index (LVMI) in high dose group were less than controlled group while the left ventricular ejection fraction (LVEF) was higher than controlled group [(110.46 ±8.86)ml vs (112.61 ±8.5)ml,P ＜0.01;(60.16 ±6.13)ml vs (63.52 ± 5.54)ml,P ＜0.01;(1O1.69±4.35)g/m2 vs (103.96 ±4.17)g/m2,P ＜0.05;(50.08 ±3.78)％ vs (48.47 ± 4.12) ％,P ＜ 0.05].After 6 months of follow-up,the incidence rate of statin-associated liver impairment and myopathe had no significant difference between two groups and Kaplan-Meier survival analysis showed patients of two groups had significantly different cumulative non-events survival rates (91.7％ vs 82.4％,Log rank =4.409,P =O.036).Conclusions Loading dose atorvastatin before PCI combined high maintenance dose after PCI can inhibit platelet activation and improve myocardial perfusion levels of patients with STEMI underwent primary PCI.It also can reduce Left ventricular remodeling and improve patient's prognosis without increasing side effects.

Objective To investigate the association of insulin resistance (IR),blood pressure variability (BPV) and the severity of acute coronary syndrome (ACS),and assess the effect of percutaneous coronary intervention (PCI) on recent prognosis.Methods A total of 260 patients diagnosed as ACS and hospitalized in our department of cardiology from December 2009 to December 2010 were enrolled in the study.There were 93 cases of unstable angina pectoris ( UAP),84 of non ST segment elevation myocardial infarction and 83 of unstable angina pectoris.The subjects were divided into two groups according to 24 hour systolic blood pressure coefficient of variability (24 h SBP-CV) levels:high-CV group (24 h SBP-CV ＞11.5,n =130) and low-CV group(24 h SBP-CV ＜ 11.5,n =130).The differences in HOMA-IR and the severity of coronary artery diseases between the two groups were compared.The association of major adverse cardiac events within 6 months after PCI treatment,and IR as well as BPV was analyzed.Results Compared with the low-CV group,ACS patients in the high-CV group had obviously higher HOMA-IR levels (5.7 ± 1.2 vs 4.0 ± 1.4,P ＜0.01 ),more multivessel diseases (49.2％ vs 33.3％,P ＜0.05) and B2/C type coronary diseases (48.5％ vs 27.7％,P ＜0.01 ),and higher coronary Gensini scores (59.7 ± 17.5vs 43.8 ± 18.6,P ＜ 0.01 ).Multi-factors logistic regression analysis indicated that both 24 h BPV-CV and IR were independent predictors for MACE incidence within 6 months after undergone PCI ( P ＜ 0.05 or P ＜0.01 ).Conclusions IR and BPV were obviously associated with the severity of coronary artery diseases in ACS patients.IR and 24 h BPV-CV were valuable in predicting recent prognosis of ACS patients.