Objective To detect the atherosclerotic progression in low density lipoprotein receptor (LDL-R) gene knock-out mouse by ultrasound biomicroscopy(UBM) technique,and to monitor the intima media thickness (IMT) and changes in plague of aortic wall.Methods 10 male LDL-R gene knock-out mice of 16 weeks age and 10 LDL-R gene knock-out mice of 24 weeks age were in the experimental group,and 10 male C57BL/6 mice of 16 and 24 weeks age were in the control group.The shapes of their aortic roots,ascending aorta,aortic arch and CCA were detected by UBM,and the IMT at aortic root view and carotid artery bifurcation were measured,then the data were compared with histopathology of the corresponding vascular segments.Results The difference between the IMT of aortic root and carotid artery bifurcation of the 16 week old LDL-R mice and the control group of the same age had no statistical significance.The difference between the IMT of carotid artery bifurcation of the 24-week-old LDL R mice and the control group of the same age had no statistical significance.The IMT of aortic root thickened compared with control group of the same age(P ＜0.01).Conclusions The UBM technique can be used to detect the atherosclerotic progression in LDL-R gene knock-out mouse.

Objective:To optimize the water extraction technology of Xiaokeantangfang. Methods: The extraction technology of Xiaokeantangfang was optimized by orthogonal design with the content of astragaloside A and the extract yield as the indices and the a-mount of added water,extraction time and extraction times as the influencing factors,and the results were verified. Results:The amount of added water had significant effect on the content of astragaloside A(P<0. 05). The optimal extraction technology was as follows:12-fold amount of added water,extracting for 3 times with 0. 5 hour per time. The average extract yield was 38. 33%(RSD=1. 22%,n=3), and the average content of astragaloside A was 0. 0828 mg·g-1 for 3 batches of samples in the validation tests(RSD=3. 37%, n=3). Conclusion:The optimal water extraction technology of Xiaokeantangfang is stable and feasible, which can provide experimen-tal basis for the oral preparation of Xiaokeantangfang.

Objective To estimate and optimize the dosage regimen of vancomycin and linezolid for treatment in different Gram-positive cocci infections. Methods The pharmacokinetic data of vancomycin and linezolid were collected, and the pharmacodynamics in vitro of these drugs for staphylococcus epidermidis, staphylococcus aureus, enterococcus faecalis and enterococcus faecium were analysed. The cumulative response fraction (CFR) was evaluated in different dosage regimens of two drugs against four types of bacteria. Results The regimen of 3 500 mg/d vancomycin was recommended for patients with staphylococcus epidermidis infection. The regimen of 2 500 mg/d vancomycin was recommended for patients with staphylococcus aureus infection. The regimens of 3 000 mg/d vancomycin and 400 mg linezolid given 2 times/day were recommended for patients with enterococcus faecalis infection. The regimens of 2 500 mg/d vancomycin and 400 mg linezolid given 2 times/day were recommended for patients with enterococcus faecium infection. Conclusion In application of vancomycin and linezolid for treatment of Gram-positive cocci infections, different dosage regimens should be used in different types of infections.

Objective To investigate the C1q expression in the patients with pulmonary tuberculosis (TB) and its mechanism on the anti-TB role of macrophages .Methods Each 30 cases of active pulmonary TB ,tuberculous pleurisy ,latent Mycobacterium tu-berculosis infection and healthy controls were selected .Peripheral venous blood 10-20 mL was collected on the next day of admis-sion or on the time for physical examination .Pleural fluid 50 mL was extracted in the patients with hydrothorax and the lung tissue specimens 1 cm × 1 cm × 1 cm was taken in the operative patients .The real-time quantitative PCR(RT-PCR) was adopted to detect the express C1q in peripheral macrophages and the C1q expressing in macrophages of the lung tissue was detected by immunohisto-chemical staining .Results The peripheral blood C1qA expression level in the active pulmonary TB group and the tuberculous pleu-risy group was significantly higher than that in the healthy control group and the latent TB infection group (P<0 .05) .The C1qA expression level in hydrothorax in the tuberculous pleurisy group was higher than that in the active pulmonary TB group (P<0 .05) ,and the C1q expression in hydrothorax in these two groups was higher than that in peripheral blood (P<0 .05) .C1q was strongly expressed in macrophage cytoplasma in the active pulmonary TB group and the TB pleurisy group ,but weakly expressed in the multinuclear macrophages .Conclusion The peripheral blood C1qA expression level in the active pulmonary TB group and the tuberculous pleurisy group was significantly higher than that in the healthy control group and the latent TB infection group (P<0 .05) .The C1qA expression level in hydrothorax in the tuberculous pleurisy group was higher than that in the active pulmonary TB group (P<0 .05) ,and the C1q expression in hydrothorax in these two groups was higher than that in peripheral blood (P<0 .05) . C1q was strongly expressed in macrophage cytoplasma in the active pulmonary TB group and the TB pleurisy group ,but weakly ex-pressed in the multinuclear macrophages .

3T3-L1 adipocytes transfected with TSH receptor (TSHR) shRNA were incubated with bovine TSH.The concentration of tumor necrosis factor (TNF)-α in culture medium was measured by enzyme linked immunosorbent asssy.Protein level of insulin receptor substrate 1 (IRS-1) was quantified by Western blotting.Tyrosine phosphorylation of IRS-1 was measured by immunoprecipitation.The results showed that 1 mIU/ml TSH significantly sitmulated TNF-α release in 3T3-L1 adipocytes [(341.85 ± 12.00 vs 522.67 ± 36.22) ng/L,P＜0.01],along with the decreases in IRS-1 protein expression and its tyrosine phosphorylation (P＜ 0.01).These effects disappeared when TSHR expression was down-regulated with RNA interference in 3T3-L1 adipocytes.In addition,WP9QY,a TNF-α antagonist,blocked TSH-decreased IRS-1 expresssion.These results suggest that TSH downregulates IRS-1 protein expression and its tyrosine phosphorylation through stimulating production of TNF-α,and thus contributes to the development of insulin resistance.

Objective: To observe clinical efficacy of oral folic acid (FA) intervene in hyper-homocysteinemia (HHcy) patients combining coronary artery disease (CAD) and heart failure (HF), to study the effect of blood level of Hcy on cardiac function. Methods: A total of 126 relevant patients with blood level of Hcy>15 μmol/L were randomly divided into 2 groups:Routine group, the patients received anti-platelet therapy, statins, beta-blockers, diuretics, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonist and FA group, in addition to above mentioned therapies, the patients also received FA 5 mg/day. n=63 in each group and all patients were treated for 3 months. Fasting blood levels of Hcy, BNP and left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), 6-minute walk test (6MWT) were compared between 2 groups at pre- and 3 months post-treatment. Results: ① Based on NYHA classification, the patients with cardiac function at II, III, IV had accordingly increased blood levels of Hcy, BNP and LVEDD, while decreased LVEF and 6MWT, all P<0.05. ② Blood levels of Hcy were positively related to BNP (r=0.733, P<0.001) and LVEDD (r=0.511, P<0.001), negatively related to LVEF (r=-0.382, P<0.001) and 6MWT (r=-0.410, P<0.001). ③ With 3 months treatment, FA group and Routine group showed decreased Hcy level as (8.43 ± 1.87) μmol/L vs (3.29 ±1.68) μmol/L and BNP (891.84 ± 456.10) pg/ml vs (682.24 ± 463.79) pg/ml, reduced LVEDD (4.33 ± 1.231) mm vs (2.06 ± 1.73) mm, while elevated LVEF (6.59 ± 2.28) % vs (2.52 ± 2.37) % and 6MWT (142.97 ± 55.15) m vs (86.35 ± 59.06) m, all P<0.05. Conclusion: Increased blood level of Hcy is risky for HF occurrence, FA may treat HHcy and further improve the cardiac structure and function in HF patients.

Objective:To analyze the progress of the contracting service model in community health centers in the typical areas in China, and provide empirical evidence for the hierarchical system targeted to make first contact and orderly dual transfer. Methods: Purposive sampling was adopted. Twelve community health centers in Beijing, Shanghai , Zhengzhou and Chengdu areas where the general practitioner model was conducted earlier and set to be the representative one, were selected as the field survey sites. A thematic framework analysis was used to describe the key factors around the contacting service model. Results:This model was developed around the following key factors:using the general practice team as the main service provider, taking the patients with chronic diseases as the main contracting groups and extending to their family members with the number of contracted ranging around 1500~2000 , freely providing both essential public health and medical services, fully using the family physician room as the con-tracting service platform and highlighting the actively serving concept, building the financial and non-financial incen-tives, health insurance benefits and green transfer mechanisms in order to efficiently guarantee the contracting service development. Conclusions: Based on the information platform, the contracting service model in the sample sites played a great role in the appointment and referral services development as well as the self-health management among residents, improving the relationship between physicians and patients, and promoting the formation of orderly health service pursuing pattern.

Objective: To explore the utilization and effects of informatization in perfecting the community health service mode. Method:Through purposive sampling, 12 community health service centers in Beijing, Shang-hai, Chengdu, and Zhengzhou were selected for site investigation. The heads of the health administrative department and community health service centers were interviewed, with a focus on the construction and utilization of the local community health informatization and a discussion of the role of informatization in perfecting the community health service mode. Results:The information systems can be divided into core systems, core auxiliary systems, and periph-eral support systems. Informatization provides strong support to perfecting the community health service mode in opti-mizing the service process, improving work efficiency, strengthening institutional cooperation, promoting quality regu-lation, optimizing performance appraisal, and strengthening doctor-patient interaction. Conclusion: Informatization plays a key role in perfecting the community health service mode. Recommendations were proposed to strengthen community health informatization construction and utilization:optimizing service processes, promoting the efficient co-ordination of safe health services, optimizing performance appraisals, and strengthening doctor-patient interaction.

Objective:To analyze the concerning guarantee mechanisms during the transformation of the com-munity health service mode. Method:Purposive sampling was adopted. Twelve community health service centers in Beijing, Shanghai, Zhengzhou, and Chengdu, where the transformation of the community health service mode was pi-loted earlier and representative, were selected as the field survey sites. The qualitative method was used to collect da-ta accompanied by the quantitative method. Results: The guarantee mechanisms related to the transformation of the community health service mode could be concluded into four main types:collaboration mechanism, health profession-al training mechanism, incentive mechanism, and policy guarantee mechanism. All of the four mechanisms contribu-ted to the improvement of general teamwork, dual referral systems, and the development of contract and appointment services. Conclusion:During the transformation of the community health service mode, priority strategies include top-down design, health professional training mechanisms, and performance-based incentive mechanism, all of which should be implemented in the future.

Objective:To analyze the structure modes of general practice teams in community health care cen-ters in order to provide empirical evidence for the transformation of the community health service mode. Method:Pur-posive sampling was adopted. Twelve community health service centers in Beijing, Shanghai, Zhengzhou and Cheng-du, where the transformation of the community health service mode was piloted earlier and representative, were se-lected as the field survey sites. The qualitative method was used to collect the data accompanied by the quantitative method. Results:The structure models of general practice teams could be divided into four types:1) general practi-tioner+nurse+nurse assistant+pharmacist, 2) physician (general practitioner, herbalist physician) +nurse+com-munity volunteers, 3 ) physician ( general practitioner/herbalist physician ) +nurse +assistant +community volun-teers, and 4) general practitioner+nurse+assisting team (professionals of public health and maternal care, etc) +supportive team ( pharmacists, health technician, etc) . Conclusion:The paper verified the common sense conclusion that general practitioners should play an essential role in general practice teamwork. The four general practice team models analyzed above positively contributed to the improvement of efficiency and quality, the relationship between health professionals and patients, the promotion of community participation, and the combination between preventive care and clinical care.