The social reputation-based incentive mechanisms in preventing the free riding behaviors were put for-ward according to the analysis of personal digital library and P2P technology. Since the reputation value of personal digital library was calculated according to the maximum flow algorithm, personal digital library must increase its reputation value by sharing the resources when it is going to obtain the necessary resources it wants.

Part-time practice of medical practitioners(PPMP)is one of the important issues involved in reformation of health care system in China.On the basis of literatures review,some aspects such as concept,reason,advantage and disadvantage of PPMP are systemically analyzed in order to provide some suggestions for regular management of PPMP in the reformation of health care system.

ObjectiveTo study the association between cardio-ankle vascular index (CAVI) and carotid atherosclerosis as well as the risk factors in patients with type 2 diabetes mellitus.MethodsSixty type2 diabetic patients and 60 non-diabetic patients at the same hospitalization period were selected.The clinical features,laboratory test results such as free blood glucose ( FBG),blood lipids and other biochemical markers were recorded.Carotid intima-media thickness (IMT) and CAVI were measured.The relationship between CAVI and carotid atherosclerosis were analyzed; a multivariate linear regression analysis was performed between CAVI and risk factors of type 2 diabetes mellitus.ResultsThe body mass index,triglycerides,FBG,HbA1 c,IMT,the incidence of carotid artery plaque and CAVI values of diabetic group were significantly higher than that of nondiabetic group.Difference between the two groups was statistically significant ( all P ＜ 0.05 ) ; CAVI and carotid IMT was significantly correlated to each other( r =0.435,P ＜ 0.01 ) ; Multiple linear regression analysis showed that CAVI was significantly correlated to age (β =0.458,P ＜0.01 ),triglycerides (β =0.058,P =0.012),FBG (β =0.168,P =0.002) and HbAlc (β =0.228,P =0.003).ConclusionCAVI inpatients with diabetes was positively correlated with carotid IMT.Age,diabetes,triglycerides,FBG and HbAlc are independent risk factors for arterial stiffness.

OBJECTIVE:To evaluate the research of antidepressive agents from the literatures perspectively in order to develop antidepressive agents in China.METHODS:The literatures about antidepressive agents recorded in PubMed database from Jan.1st,1998 to Oct.31th,2008 were analyzed with bibliometric methods.RESULTS:A total of 17784 literatures on antidepressive agents were recorded and the total number increased slowly.A total of 96 literatures were collected from Chinese literatures which increased rapidly in recent years.34 literatures among 74 literatures during 1998～2007 are in English and 40 in Chinese involved 56 institutes and 51 magazines.Literatures collected from Beijing took up the greatest proportion.CONCLUSION:It is needed to enlarge investment and scale of scientific research on antidepressive agents continuously.

BACKGROUND:Tol-like receptor (TLR) and its signaling pathway play an important role in autoimmune diseases, hypersensitivity, inflammation, apoptosis and transplant rejection; however, its effects on immune pathogenesis of Henoeh-Schonlein purpura in children have not been fuly elucidated. OBJECTIVE:To investigate the TLR2 expression in peripheral blood mononuclear cels in children with Henoeh-Schonlein purpura and its correlation with immune response. METHODS: Sixty-four children with Henoeh-Schonlein purpura were divided into two groups: non-renal damage group (n=36) and renal damage group (n=28). Meanwhile, another 30 healthy children subjected to health examination acted as control group. Flow cytometry and florescent quantitative PCR were employed to detect TLR2 protein and mRNA expression in peripheral blood mononuclear cels, respectively. ELISA was used to detect plasma interferon-γ and interleukin-4 levels and transforming growth factor β and interleukin-10 levels secreted from Treg cels. RESULTS AND CONCLUSION:Levels of interferon-γ and interferon-γ/interleukin-4 in the children with Henoeh-Schonlein purpura were significantly lower than those in the control group (P < 0.05), while the level of interleukin-4 was higher than the control group (P < 0.05). The expression of TLR2 protein and mRNA was significantly higher in the Henoeh-Schonlein purpura children than the healthy children (P < 0.05) and significantly higher in the renal damage group than the non-renal damage group (P < 0.05). Compared with the control group, the levels of interleukin-10 and transforming growth factor β were significantly higher in the children with Henoeh- Schonlein purpura (P < 0.05). These findings indicate that Henoeh-Schonlein purpura children have increased levels of TLR2 protein and mRNA in the peripheral blood mononuclear cels, and exhibit immune imbalance. TLR2 is involved in the pathogenesis of Henoeh-Schonlein purpura, and transforming growth factor β can be used to evaluate Treg immune response and provide reference for diagnosis, treatment of prognosis of Henoeh-Schonlein purpura children.

Background:The goals for treatment of achalasia are reducing lower esophageal sphincter pressure (LESP)and alleviating esophageal obstruction and its related symptoms.Peroral endoscopic myotomy (POEM)is a promising option for treating achalasia.Aims:To assess the short-term efficacy of POEM for treating achalasia by analyzing the dynamic changes in esophageal manometry.Methods:A retrospective study was conducted in 39 achalasia patients receiving POEM in Nanjing Drum Tower Hospital from Dec.2011 to Oct.2012.Data of water-perfusion esophageal manometry and one-month follow up were collected and analyzed.Results:Thirty-eight patients accomplished the POEM procedure and esophageal manometry three days after treatment.The post-POEM LESP was significantly reduced as compared with the pre-POEMones (P <0.01),while no significant difference was seen in LES relaxation rate before and after POEM.With regard to the motility of esophageal body,absence of peristalsis and increased synchronous contraction were observed both pre-and post-operatively.One month after POEM,LESP was still significantly lower than that before treatment (P <0.05).Thirty-seven patients had their dysphagia alleviated with an efficacy rate of 94.9%.Conclusions:POEM can reduce LESP and alleviate clinical symptoms of achalasia patients but has no effect on esophageal peristalsis during the short-term follow up.Esophageal manometry is useful for evaluating the short-term outcome postoperatively.

The infectivity of asymptomatic HBsAg carriers' blood was studied in 36 recipients.Their positive rate of anti-HBs was 56.2% before transfusion. After transfusion hepatitis B developed in 2 recipients and SGPT became abnormal in 4(11.1%) of the 36 recipients. The anti-HBs became positive in 83.3% (10/12). The incidence of hepatitis B among blood recipients was lower than that of Western Europe and North America, but similar to that in Southeast Asia. The overall infection rate of HBV was higher than that of the other localities. The infectivity of asymptomatic HBsAg carriers' blood correlated well with the titer of HBsAg. There was no apparent changes in the titer of HBsAg in all the 3 recipients with positive HBsAg before transfusion.No new HBsAg carriers developed in 36 recipients.

Limonin existed in citrus fruits has been shown to have anti-bacterial, anti-viral, anti-feedant, anti-nociceptive, anti-inflammatory activities and anti-carcinogenic activities. But the clinical use is limited by its low bioavailability. The aim of this study is to observe the absorption and secretion transport mechanisms of limonin in intestine which can pave the way for the further study and clinical use. The transport characteristics and mechanisms of limonin in rat were studied by in situ intestine perfusion and in vitro Caco-2 cells method. The intestinal absorption of limonin was probably via a facilitated diffusion pathway which was poor and without segment-selection. Verapamil and ketoconazole improved the absorption remarkably according to the result of in vitro Caco-2 cells study; however, probenecid had no significant effect on the absorption. The P-gp efflux and CYP3A4 metabolism were involved in the poor intestinal absorption and low bioavailability of limonin. The exploration of the intestinal absorption mechanism is crucial to the design of dosage form and clinical use of limonin.

AIM: To investigate the effect of mydriasis optometry combined with amblyopia treatment on refraction and amblyopia changes in children with mixed astigmatism and amblyopia.METHODS: Totally 163 children (289 eyes) of mixed astigmatism and amblyopia from January 2010 to May 2011 were treated.All of the patients received mydriatic optometry and spectaculars with amblyopia therapy and were followed up for 5a to observe amblyopia efficacy and refractive status changes.RESULTS: With 5a, main diameter diopter at distant vision decreased year by year, average decline in the first year was 0.55DS, 0.56DS in the second year, 0.72DS in the third year, 0.95DS in the fourth year, 1.89DS in the fifth year.The spherical equivalent changed from 1.12DS at distant to 0.78DS at near.The corrected visual acuity of all the patients at first visit was 0.2-0.8 with varying degrees amblyopia.After a 5-year treatment, it was effective in 268 eyes (92.7%), in which 165 eyes (57.1%) improved, 103 eyes (35.6%) cured, the results was better as the period of spectaculars wearing was longer.There was 36 eyes (37.5%) improved and 60 eyes (62.5%) cured in 1.50-2.50DC group;118 eyes (74.2%) improved, 41 eyes (25.8%) cured in 2.50-3.50DC group;11 eyes (32.3%) improved, 2 eyes (5.9%) cured, 21 eyes (61.8%) useless in >3.50DC Group.The differences of efficacy among the groups were significant (all P<0.05).CONCLUSION: Appropriate spectaculars is the basic for amblyopia treatment.It is effective for most children with mixed astigmatism and amblyopia to take mydriasis optometry and amblyopia treatment.