Objective: To analyze the efficiency of chronic disease prevention and control of primary health service institutions in Shandong, and provide policy references. Methods:Using CRS and VRS models from DEA to analyze the representative input and output indicators in primary health Service institutions. Results: The overall efficiency of chronic disease prevention and control in primary health service institutions is low, and the actual output was insufficient compared with the target output. Conclusion: Strengthening chronic disease control measures in high-risk group and establishing management mechanism leaded by the goal of chronic prevention and control in order to achieve optimal allocation of resources.

Objective To research the important of prenatal diagnosis and effect of intervention to fetal hydrothorax. Methods The cases of fetal hydrothorax (n=5) were obtained from the Shengjing Hospital,China Medical University between December 2014 and May 2015. All pregnancies were uncomplicated, excluded congenital organic and chromosomal abnormalities during prenatal diagnosis and with a 37 average gestational weeks. The case 1, 2, 4 were unilateral hydrothorax and the case 3, 5 were bilateral. We performed an antenatal thracocentesis to case 1, 2, 3. In case1, the hydrothorax increased rapidly after 5 days, and the patient underwent a cesarean section and ex utero intrapartum treatment (EXIT);in case 2, the fetal heart rate was decreased to 40-50 bpm suddenly during thracocentesis, and we performed an emergent cesarean section and EXIT for the patient; in case 3, the patient underwent thracocentesis and a meanwhile cesarean section and EXIT procedure. We performed a conservative management to case 4, 5, the hydrothorax resolved spontaneously during the pregnancy and after birth, both patients underwent cesarean section. Results All fetuses were survived, the neonates of case 1, 2 and 3 underwent assited mechanical ventilation, thoracic close drainage, then discharged after hydrothorax resolved and feeding tolerance;in case 4, there was no respiratory distress and hospital treatment;in case 5, the neonate underwent assited mechanical ventilation and conservative management, the hydrothorax has resolved gradually. Conclusions The prenatal diagnosis and antenatal intervention (thracocentesis) may play an important role in fetal hydrothorax treatment. In clinical, we should choose different plan according to the gestation weeks and classification of hydrothorax of the patient.

Objective To detect the mutation of A379,we develop a TaqMan fluorogenic probe based amplification refractory mutation system (TaqMan-ARMS) and investigate whether the A379V variant and activity of Lp-PLA2 are the risk factors for CAD.Methods According to the amplification refractory mutation system(ARMS-PCR)combined with a TaqMan fluorogenic probe,we established and evaluated the assay teehnique of TaqMan-ARMS for measuring the genotype of variant.At the same time,we tested the aetivity of Lp-PLA2 in 395 patients with coronary heartdisease and 396 controls,whose clinical information [ages,CHO,GLU,TG,HDL,LDL,Hs-CRP,Lp (a)] were collected.Date was analyzed by using Independent-samples t test,Chi-square test,One-Way ANOVA,Binary Logistic Regression.Results CAD group had significantly higher Lp-PLA2 activity than the controls(31.51 nmol · ml-1 · min-1 ＞21.31 nmol ·ml-1 · min-1,F =16.40,P ＜ 0.001).Comparing the highest quartile of Lp-PLA2 activitv to the bottom quartile,OR was 7.50 (95％ CI:2.34-24.05) after adjustment for various traditional cardiovascular risk factors,including ages,sex,CHO,TG,Hs-CRP,Lp (a) and GLU; the genotype VV of A379V was associated with higher risk of CAD (OR =2.95; 95％ CI:1.22-7.15,P ＜ 0.05).Conclusions The TaqMan-ARMS real time PCR technique is established to analyze A379V genotype.Lp-PLA2 activity is significantly higher in CAD group and is a risk factor for CAD; the genotype VV of A379V is also a risk factor for CAD.

Objective To investigate the significance of variation of concentrations of serum IL-1,IL-6, TNF-α and cyclooxygenase-2 in patients with post-traumatic stress disorder (PTSD). Methods Thirty-two PTSD patients were chosen as the observation group and another 26 normal patients were taken as the control group. The concentrations of serum IL-1,IL-6,TNF-α and COX-2 in patients of both groups were detected by Enzyme-linked immunosorbent assay (ELISA) and Western blot and were compared in these 2 groups. Results The concentrations of serum IL-1 , IL-6 and TNF-α were significantly higher in the observation group than those in the control group (P < 0.01);and the level of COX-2 in the observation group was significantly higher than that of the control group(P < 0.01). Conclusions Abnormal immune states are awared in PTSD patients and the IL-1,IL-6,TNF-α and COX-2 might play an important role in the pathogenesis of PTSD.

Objective To study the effect of Toll-like receptor 4(TLR4)on the expression of IRF-3 and IFN-β during the inflammatory reaction induced by cerebral ischemia reperfusion in mice.Methods Totally 144 mice were randomly divided into 3 groups:(1)ischemia reperfusion group(I group):the mice were subjected to 12 minutes ischemia by bilateral common carotid arteries(CCA)occlusion,and reperfusion without additional intervention;(2)TLR4 blocking group(T group):after 10 minutes of bilateral CCA occlusion,TLR4 antibody was injected slowly into right CCA within 2 minutes;(3)sham group(S group):no CCA occlusion was performed.At 1,2,3 and 4 d after ischemia reperfusion,the expression levels of TLR4,IRF-3 and IFN-β protein in the cortex was respectively examined by Western blot.Results In the right cortex,the expression levels of TLR4,IRF-3 and IFN-β of I group were distinctly higher than that of S and T gtoup(P<0.05);the expression levels of the 3 protein of T group were significantly higher than those of S group(P<0.05).Conclusion The cerebral ischemia reperfusion could activate TLR4 expression in the cortex of the mice.TLR4 might participate in the cerebral ischemia reperfusion through upregulating the expression of IRF-3 and IFN-β.

Objective To observe the effect of Yiqi Huaxian Decoction (YHD) on transforming growth factor ?1(TGF-?1 )mRNA expression in rats alveolar macrophages (AM) and pulmonary interstitial macrophages (IM).Methods Ninety-six Wistar rats were randomized into sham-operation group,model group,YHD (4 g?kg-1?d-1) group,and hydrocortisone (20 mg?kg-1?d-1) group.Bleomycin A5 was injected into the rats' trachea to induce pulmonary fibrosis.AM and IM were isolated for the culturing after modeling for 7 and 28 days.Molecular in-situ hybridization (ISH) was used for the detection of TGF-?1 expression in AM and IM.Results Percentage of cells in AM and IM with TGF-?1 positive expression and the score of optic density were increased in the model group (P

Liver metastasis is the advanced stage of gastric cancer,which is a leading cause of death.Radiofrequency ablation (RFA) is an alternative method of comprehensive treatment in patients with gastric cancer liver metastasis due to its advantages of safety,minimal invasion and repetition.The efficacy of RFA alone,the efficacy of the combined treatment of RFA with other therapies and prognostic factors of RFA in gastric cancer liver metastasis were reviewed in this article.

An indexing system is constructed,based on the implementation of prevention and control technology for chronic non-communicable diseases in community health service institutions,using both literature review and Delphi method,and using the Analytic Hierarchy Process (AHP) to calculate the weight of the indexing system.The system comprises three level-1 indexes,8 level-2 indexes and 33 level-3 indexes.The research proposed a transition from emphasis of therapeutic means to prevention,and emphasis on prevention and control technologies to the high-risk population in the prevention and control technology of chronic non-communicable diseases,along with development of techniques and measures to encourage behavioral changes of the population with chronic diseases.

Objective To evaluate the role of contrast-enhanced ultrasound (CEUS) for preoperative detection of colorectal liver metastases.Methods 42 consecutive patients with colorectal liver metastases confirmed by histopathology after surgery were recruited in the study.They all had undergone preoperative CEUS examination with contrast agent SonoVue.The number,location and size of the hepatic lesions found by CEUS were correlated with postoperatively histopathologic results on a lesion-by-lesion basis.Results 96 liver metastases in 42 patients with colorectal cancer had been resected and confirmed by histophathology.The size of the metastatic lesions ranged from 0.3～8.5 cm [average (2.6 ± 1.8)cm].From one to eight metastatic lesions were detected in one patient.21 (21.9％) metastatic lesions were equal to or less than 1.0 cm.86 of 96 metastatic lesions were correctly depicted by CEUS,with a sensitivity of 89.6％.And the sensitivity for metastatic lesions equal to or less than 1.0 cm was 71.4％ (15 of 21 tumors) by CEUS.35 metastatic lesions were found between the portal venous phase and late phase by CEUS and 19 (54.3％) metastatic lesions among them could not be detected at conventional ultrasound.The curative resection was performed in 37 (88.1％) of 42 patients.With 3 - 39 months follow-up,the intrahepatic recurrence rate within two years was 32.4％ (12 of 37 patients) and the one-year survival rate was 90.0％.Conclusions CEUS is highly sensitive for detecting liver metastases resulted from colorectal cancer,especially for small metastatic lesions.CEUS is helpful to choose reasonable therapeutic strategies and can be regarded as one of the most importantly and noninvasively preoperative imaging modalities.

Objective To investigate the clinical significance of soluble Mer receptor tyrosine kinase (sMerTK) in patients of systemic lupus erythematosus.Methods sMerTK was detected in the serum of 101 SLE patients,96 disease controls and 62 healthy controls (HC) by sandwich enzyme-linked immunosorbent assay (ELISA).The relationships between the serum levels of sMerTK and clinical manifestations,laboratory parameters,disease activity were investigated in SLE patients.Comparisons between groups were tested by t-test and x2 test,Correlation of parameters were analyzed by Spearman method.Results sMerTK levels in SLE patients [(10.6±6.0) ng/ml] was significantly higher than disease controls [(4.4±2.0) ng/ml] (t=9.704,P＜0.01) and healthy controls [(2.8±2.5) ng/ml] (t=11.505,P＜0.01).The concentrations in SLE patients were independent of gender,age and disease duration.The levels of sMerTK were negatively correlated with white blood cell (r=-0.236,P=0.017),hemaglobin(r=-0.354,P＜0.01),platelet values (r=-0.310,P=0.002).Compared with the patients without lupus nephritis (LN)[(9±6) ng/ml],patients with LN had higher concentrations in serum [(11±6) ng/ml],and the difference was statistically significant (t =2.071,P=0.041).In addition,sMerTK levels were also correlated with 24 h-urinary protein level (r=0.293,P=0.013),serum creatinine (r=0.250,P=0.035) and e-GFR (r=-0.201,P=0.045).Furthermore this study indicated that sMerTK was negatively correlated with C3 (r=-0.447,P＜0.01) and C4 (r=-0.357,P＜0.01)level,but positively correlated with anti-dsDNA antibody titers (r=0.360,P＜0.01),anti nucleosome antibody (AnuA) (r=0.264,P=0.016) and SLEDAI (r=0.473,P＜0.01).Conclusion sMerTK level is increased in SLE patients.The concentration may associate with hematology changes and lupus nephritis.It may be an indicator of disease activity.