Objective: By constructing the cash flow model, it proposed the premium adjustment mechanism of critical illness insurance(CII). Methods: Based on the practical data of critical illness insurance in China, it established some actuarial assumptions and cash flow model to simulate and analyze premium adjustment mechanism of CII. Results: ( 1) Because of the deterioration of critical illness incidence rate and the change of market interest rates , CII guaranteed premium usually resents pricing risk, which showed that the cash flow is negative, sometimes accumulated cash is negative; (2) based on the criteria of insurance cost adjustment, it is suggested that when the loss rate reached more than 70%, which could permit the insurance company adjust the premium, if the loss rate reached more than 80%, it needs to compulsory the insurance companies to adjust premium. Conclusion: The study proposes the mechanism of CII premium adjustment, provides guidance for practice.

Objective:To investigate the diagnostic value of diffusion weighted imaging and 1H magnetic resonance spectroscopy for the neonatal hypoxic ischemic encephalopathy (HIE).Methods:37 cases of patients with neonatal hypoxic ischemic encephalopathy admitted in our hospital were selected as the study group,another 40 healthy neonates were selected as the control group,both groups of neonates underwent diffusion-weighted imaging and 1H magnetic resonance spectroscopy,ordinary MR1 and diffusion weighted imaging findings of neonates in the study group were observed,the neonatal cerebral metabolic compounds relative concentration were observed and compared between two groups.Results:The detection rate of diffusion-weighted imaging was significantly higher compared with the ordinary MRI (P＜0.05).The relative ratio of brain metabolic compounds NAA/Cr of study group were obviously lower than those of the control group,while the Cho/Cr,MI/Cr,Glu-Glr/Cr,Lac/Cr were significantly higher (P＜0.05).Conclusion:Diffusion weighted imaging combined with 1H magnetic resonance spectroscopy could improve the diagnostic accuracy of neonatal hypoxic ischemic encephalopathy,the analysis of the concentrations of brain metabolic compounds could contribute to evaluate the severity of HIE.

Objective:To evaluate the safety and efficacy of antiplatelet therapy of ticagrelor on patients suffering from acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary in-tervention. Methods:In the study, 96 patients suffering from acute ST segment elevation myocardial infarction onset within 12 h undergoing primary percutaneous coronary intervention from May to October in 2013 were randomly divided into ticagrelor group (n=48) and clopidogrel group (n=48) by using the method of random number table. Ticagrelor and clopidogrel antiplatelet treatment were used before and after operation. Their baseline data, coronary artery disease characteristics, platelet count, adenosine diphosphate(ADP)-induced platelet inhibition rate by thrombelastograph after 5 days of treatment, the major adverse cardiovascular events of the follow up for 6 months and bleeding complications were observed and compared in the two groups. Re-sults:The differences between the two groups of patients with their baseline data, the features of coronary ar-tery lesions, platelet count before and after 5 days of treatment had no statistical significance (P>0. 05). ADP induced platelet inhibition rate [(80. 2 ± 10. 7)%] after 5 days of treatment in ticagrelor group was sig-nificantly higher than that in clopidogrel group [(75. 3 ± 12. 1)%, P<0. 05]. The two groups of patients were followed up for 6 months, 8 cases of major adverse cardiovascular events occurred in clopidogrel group, 2 ca-ses of major adverse cardiovascular events occurred in ticagrelor group, and there was significant difference between the two groups (P<0. 05). The two groups (7 cases of 48 patients in ticagrelor group vs. 3 cases of 48 patients in clopidogrel group ) had no statistically significant difference in bleeding complications ( P>0. 05). Conclusion: Antiplatelet therapy of ticagrelor on patients suffering from acute ST segment elevation myocardial infarction undergoing emergency PCI has good efficacy and safety.

Objective To explore the effects of the stromal cell-derived factor on chemotaxis of cord blood ACl33+ cells.Methods The optimal SDF-1 concentration is detected in Transwell system.Migration was calculated from the number of cells found to have passed through an 8-um pore size polycarbonate membrane.Results The chemotactic rate of fresh cord blood AC133+ cells increases along with the concentration of SDF-1,however,it tends to be stable when the concentration of SDF-1 reaches 150 ng/ml.There is no difference in the chemotactic rate of cord blood AC133+ cells between the group with CXCR4-blocking antibody and the group without SDF-1.Conclusion Transwell Plate can simulate the phenomenon of cell crossing endothelium.The chemotactic rate of cord blood AC133+ cells increases progressively along with the concentration of SDF-1,however,the chemotactic rate tends to equability when SDF-1 reaches a certain concentration.The chemotactic rate does not have a marked change while continuing to increase the concentration of SDF-1.There is no difference in the chemotactic rate of cord blood AC133+ cells between the group using CXCR4-blocking antibody and the group without SDF-1.

SUMOylation is a post‐translational modification involved in various cellular processes .SUMO‐specific protease (SENP) regulates SUMOylation by removing SUMO from conjugated substrates (deSUMOylation) and promoting maturation of SUMO precursor .In order to express Giardia lambia (C2 strain) SENP catalytic domain in E .coli ,the full‐length open reading frame of SENP was amplified by PCR from Giardia lamblia genome DNA .The PCR product about 1 620 bp was cloned into cloning vector pGM‐T .Sequencing result showed the sequence of SENP in C2 strain was identical with that in Gi‐ardia WB strain .Bioinformatics analysis showed that SENP protein possessed a 372 aa discontinuous ULP catalytic domain at C‐terminal .The catalytic domain of SENP was cloned into prokaryotic expression vector pET‐28a(+ ) .The recombinant vector pET‐28a(+ )‐SENPc was transformed into E .coli Rosetta(DE3) ,then the recombinant SENPc protein was expressed by IPTG induction .SDS‐PAGE and Western blot using anti‐His Tag antibody showed that the expression product of SENPc was a fusion protein with a molecular weight of 43 kD .The successful prokaryotic expression and bioinformatics analysis of Giardia lamblia SENP protein provide basis for further functional study of SENP .

Objective To develop an easy-to-use nomogram to assist clinicians in predicting major postoperative morbidity in those non-small-cell lung canccr patients who underwent VATS lobectomy.Methods A perspective multi-center study was developed to analyze the major postoperative complications of 612 non-small-cell lung cancer patients who underwent VATS lobectomy.Muhivariable logistic regression was used to model postoperative morbidity and built the nomogram to accurately predict the major complications.Results There were 606 (99％) survivors and 6 (1％) mortality.A total of 32 patients suffered from major complications.Using logistic regression to predict major complications,preoperative model for ASA score,age ≥70 years and operation time ＞ 150 nin were found to be the significant predictors(P ＜ 0.05) of morbidity and were included in our model.Conclusion We propose a nomogram to enable clinicians to better estimate morbidity in patients with VATS lobectomy.

OBJECTIVETo determine whether there are differences in both the right hepatic vein (RHV) morphology and the size of the angle between the inferior vena cava and the RHV in patients with membranous obstruction of the inferior vena cava (MOVC),in healthy individuals and in patients with cinhosis (HLC), in order to help guide development of an effective interventional treatment program.

METHODSConsecutive patients (n=248) were divided into the following three groups: group A (control; n=94), group B (MOVC patients; n=68), group C (HLC patients; n=86). The angle between the hepatic vein and inferior vena cava was measured and defined as the T value. The morphology of the RHV was classified as N, U, or I. The difference of the constituent ratio was compared among the three groups for the T value and the angle type.Measurement data was calculated as x ± s,and groups were compared using one-way ANOVA; count data was calculated as relative number, and groups were compared using the chi-square test.

RESULTSThe average T value of group B was significantly higher than that of group A (56.1 ± 13.7 vs. 49.3 ± 7.8, P=0.010) and of group C (vs. 51.5 ± 10.0, P < 0.001); the difference was statistically significant (F=8.750, P < 0.001), but there was no significant difference between the groups A and C.N-type proportion of B group was 48.5% (33/68), greater than that of group A(16.0%,15/94) and C (16.3%, 14/86), x² = 20.1, x² =18.6.U-type proportion of B group was 11.8% (8/68), smaller than that of groups A (28.7%,27/94) and C (37.2%, 32/86), 2 2 = 6.70, x² =12.8, and the differences were statistically significant (P < 0.01). For groups A and C, the N and U types were not significantly different.

CONCLUSIONThe angle between the RHV and the inferior vena cava in MOVC patients is morphologically different from that in healthy humans, with the angle value in MOVC patients being slightly larger. However, this difference is irrelevant to cirrhosis.

Hepatic Veins ; Humans ; Vena Cava, Inferior

OBJECTIVETo investigate the dynamic changes of type I collagen, and the activity of metalloproteinases-1 (MMP-1) and tissue inhibitor of metalloproteinases-1 (TIMP-1) after angioplasty.

METHODSThe restenotic model of iliac arteries of domestic microswine was established with hypercholesterol feed plus two angioplasties. Angioplastied vessels were harvested at the end of 1, 2, 3 and 6 months after the second angioplasty. Immunohistochemistry, transmission electronic microscopy and image quantitative analysis techniques were employed to study neointimal proliferation, the phenotype of vascular smooth muscle cells (VSMC) and the expression of type I collagen, MMP-1 and TIMP-1.

RESULTSThe peak of vascular neointimal proliferation was at 3 months after angioplasty. The expression of type I collagen gradually increased from 1 to 6 months after angioplasty. For MMP-1, expression was lower in the early stage after angioplasty but increase to normal levels of control vessels at 6 months after angioplasty. Expression of TIMP-1 rapidly increased in the early phase after angioplasty, reached peak at 3 months and maintained the high level till 6 months after angioplasty. Meanwhile, the VSMC was predominantly the synthetic phenotype at the early stage and was transformed to the contractive phenotype at the late stage after angioplasty. The ratio of TIMP-1 and MMP-1 was positively related to the area of the neointima and the expression of type I collagen respectively (P < 0.01).

CONCLUSIONType I collagen increased gradually after angioplasty, which might be determined by the ratio of TIMP-1/MMP-1 and also related to the phenotype of VSMC.

Angioplasty ; Animals ; Arterial Occlusive Diseases ; metabolism ; surgery ; Collagen Type I ; metabolism ; Iliac Artery ; surgery ; Matrix Metalloproteinase 1 ; metabolism ; Muscle, Smooth, Vascular ; cytology ; metabolism ; Swine, Miniature ; Tissue Inhibitor of Metalloproteinase-1 ; metabolism

Background: Bone metastases are common in patients with advanced cancer. Bisphosphonates (BPs) could prevent or delay the development of skeleton-related events (SREs). The present study aimed to identify the clinical features of and treatment strategies for Chinese patients with bone metastases. Methods: Consecutive cancer patients who had bone metastases and received BP treatment were enrolled. A ques-tionnaire was developed to collect the patients’clinical data, as well as information on the diagnosis and manage-ment of bone metastases. Physicians’awareness of the guidelines and knowledge of the application of BP were also assessed. Results: A total of 3223 patients with lung cancer (36.5%), breast cancer (30.9%), prostate cancer (8.5%), and gas-trointestinal cancer (5.7%) were included in this study. The sites of bone metastases were the thoracic spine (56.0 %), lumbar spine (47.1%), ribs (32.6%), and pelvis (23.2%). The SRE frequency was the highest in patients with multiple myeloma (36.6%), followed by those with lung cancer (25.9%), breast cancer (20.2%), prostate cancer (18.2%), and gas-trointestinal cancer (17.3%). Irradiation to the bone was the most frequent SRE (58% in lung cancer patients, 45% in breast cancer patients, and 48% in prostate cancer patients). Our survey also showed that 45.5% of patients received BP within 3 months after their diagnosis of bone metastases, whereas the remaining 54.5% of patients did not receive BP treatment until at least 3 months after their diagnosis of bone metastases. The SRE frequency in the former group was significantly lower than that in the latter group (4.0% vs. 42.3%, P < 0.05). In patients with more than 6 months of continuous BP treatment, the mean time to the first SRE was significantly longer than that in patients with less than 6 months of continuous BP treatment (7.2 vs. 3.4 months, P < 0.05). In addition, 12.2% of the physicians were not aware of the efcacy of BP in preventing and delaying SRE. Only half (52.3%) of the physicians agreed that the BP treatment should persist for at least 6 months unless it was intolerable. Conclusions: Our study suggested that prompt and persistent BP treatment was associated with a reduced risk of SREs. However, our survey also revealed that the proper application of BP was not as common as expected in China.

T cell recognition of foreign peptide antigen and tolerance to self peptides is key to the proper function of the immune system. Usually, in the thymus T cells that recognize self MHC + self peptides are deleted and those with the potential to recognize self MHC + foreign peptides are selected to mature. However there are exceptions to these rules. Autoimmunity and allergy are two of the most common immune diseases that can be related to recognition of self. Many genes work together to lead to autoimmunity. Of those, particular MHC alleles are the most strongly associated, reflecting the key importance of MHC presentation of self peptides in autoimmunity. T cells specific for combinations of self MHC and self peptides may escape thymus deletion, and thus be able to drive autoimmunity, for several reasons: the relevant self peptide may be presented at low abundance in the thymus but at high level in particular peripheral tissues; the relevant self peptide may bind to MHC in an unusual register, not present in the thymus but apparent elsewhere; finally the relevant self peptide may be post translationally modified in a tissue specific fashion. In some types of allergy, the peptide + MHC combination may also be fully derived from self. However the combination in question may be modified by the presence of other ligands, such as small drug molecules or metal ions. Thus these types of allergies may act like the post translationally modified peptides involved some types of autoimmunity.
Animals ; Autoantigens ; immunology ; Autoimmunity ; HLA Antigens ; immunology ; Humans ; Hypersensitivity ; immunology ; Receptors, Antigen, T-Cell ; metabolism ; T-Lymphocytes ; immunology ; metabolism