Objective To explore the diagnostic value of serum ischemia‐modified albumin (IMA) ,lipoprotein‐associated phos‐pholipase A2 (Lp‐PLA2) and cardiac troponin I (cTnI) in acute coronary syndrome (ACS) .Methods The levels of serum IMA , Lp‐PLA2 and cTnI were detected in 138 cases of ACS ,including 79 cases of acute myocardial infarction (AMI) ,59 cases of unstable angina pectoris (UAP) ,and the detection results were compared with those in 50 individuals undergoing physical examination(con‐trol group) .The levels of serum IMA ,Lp‐PLA2 and cTnI were compared among various groups .The receiver characteristic curve (ROC) was drawn to evaluate the diagnostic value of IMA ,Lp‐PLA2 and cTnI in ACS .Results The levels of serum IMA ,Lp‐PLA2 and cTnI in patients with UAP and AMI were higher than those in the healthy control group ,and there was statistical differ‐ence between them(t=7 .286 ,8 .589 ,8 .952 ,P<0 .01) .Comparing with the UAP group ,the levels of serum IMA ,Lp‐PLA2 and cTnI in the AMI group were significantly increased(t=4 .063 ,5 .987 ,2 .062 ,P<0 .05) .In the ROC curve analysis ,the area under ROC curve (AUC) of IMA ,Lp‐PLA2 and cTnI were 0 .821 ,0 .843 and 0 .852 respectively .Conclusion The levels of serum IMA , Lp‐PLA2 and cTnI can be used for monitoring and early diagnosis of ACS .

OBJECTIVE:To study the implementation of scoring diseases payment under the control of total budget in some ar-eas of China,and provide reference for the further improvement of the payment. METHODS:Based on the operation process of scoring disease payment in the control of toal budget,the specific practices of Huaian,Nanchang,Zhongshan and Taiwan area, were compared. RESULTS:It showed differences in the control and allocation of total budget,the establishment of scoring diseas-es,the setup of adjustment coefficient,the development of balance methods,the complementary mechanism and the monitor exami-nation setting. CONCLUSIONS:Whether to classify the diseases according to diagnosis and treatment methods,how to setup ad-justment coefficient appropriately,how to reimburse the patients in stages and how to strengthen supervision are worthy of further thinking and exploring.

The microenvironment of lymphoma is an important factor affecting the development of lymphoma, which is involved in regulating the recognition and immune response of lymphoma cells by the immune system. In the era of immunotherapy of lymphoma, the state of microenvironment also affects the effect of monoclonal antibodies, small molecular compounds and other immune targeting drugs on lymphoma cells. Among them, microenvironment-related immune escape is one of the key factors leading to the failure of lymphoma treatment. This article reviews some microenvironment factors such as stromal immune cell subsets, vascular proliferation, hypoxia, immune checkpoint and the recent research progress of immune escape.

Objective To investigate the effect of propofol on the learning and memory function in neonatal rats under hypoxic conditions. Methods Eighty-four 7-day-old SD rats were randomly divided into 6 groups (n = 14 each): propofol + 18% oxygen (propofol-hypoxia, group PH), propofol + air (group PA), propofol +100% oxygen (propofol-oxygen, group PO), 0.9% normal saline (NS) + 18% oxygen (group CH), NS + air (group CA), NS + 100% oxygen (group CO). The rats received injection of intraperitoneal propofol 50 mg/kg or NS 5.0 ml/kg once a day for 7 consecutive days and they were exposed to 18% oxygen, air or 100% oxygen at the end of each injection. SaO2 and respiratory rate (RR) were monitored and recorded after administration. The rats were returned to the cage after recovery of the righting reflex. Six rats in each group were sacrificed 24 h after the 7th injection, and the brain tissues were taken to observe the apoptosis in hippocampal neurons. Morris water maze test was used to test the learning and memory function 2 weeks after administration in the other rats. Results RR was significantly lower and the escape latency at T1.2 longer in group PO than in group CO (P ＜ 0.05). RR and SaO2 were significantly decreased, apoptotic index was increased, the escape latency was prolonged and the frequency of crossing the original platform was reduced in group PA compared with group CA, and in group PH compared with group CH (P ＜ 0.05). Compared with group PO, SaO2 was significantly decreased, apoptotic index was increased, the escape latency was prolonged and the frequency of crosing the original platform was reduced in group PA (P ＜ 0.05). Conclusion Propofol induces apoptosis in hippocampal neurons and decreases the learning and memory function in neonatal rats under hypoxic conditions.

Objective To explore the risk factors of hyperbilirubinemia in late preterm infants. Methods Clinical data of 211 cases of late preterm infants with hyperbilirubinemia and 246 cases of late preterm infants without hyperbilirubinemia were retro-spectively analyzed between 2011 and 2012. The risk factors of hyperbilirubinemia were filtered. Results Twenty-seven cases of late premature infants with hyperbilirubinemia were severe. Hospital stay less than 3 days, birth asphyxia history, small for gestatio-nal age, head hematoma, delivery injury, hypoalbuminemia, polycythemia, infection, hemolytic disease, feeding intolerance, and fe-tal excretion delay were associated with hyperbilirubinemia (P<0.05). Rural origin, pregnancy-induced hypertension syndrome and premature rupture of membrane were also associated with hyperbilirubinemia (P<0.05). Multivariate logistic regression analysis showed the history of birth asphyxia , fetal excretion delay, hypoalbuminemia, pregnancy-induced hypertension syndrome were risk factors of hyperbilirubinemia in late preterm infants (OR=2.35-4.05). Pregnancy-induced hypertension syndrome and hemolytic dis-ease were risk factors of severe hyperbilirubinemia in late preterm infants (OR=5.74, 73.64). Conclusions Neonatal asphyxia, fetal excretion delay, hypoalbuminemia and pregnancy-induced hypertension syndrome are risk factors of hyperbilirubinemia in late pre-term infants. Strengthening the management of pregnancy-induced hypertension syndrome and the treatment of newborn hemolytic disease can reduce the occurrence of severe hyperbilirubinemia in late preterm infants.

Objective To evaluate the clinical value of three-dimensional power Doppler ultrasound (3D PDUS) in diagnosing cervical cancers.Methods 162 patients with cervical lesions were enrolled.All the cases were confirmed by autopsy or surgery.Vascularization index (VI),flow index (FI) and vascularization flow index(VFI) were all measured and compared.The pathological findings was taken as golden standard.ROC curve was used to find the best cut-off value.Results 3D PDUS indices of benign and malignant lesions were statistically different (P ＜0.0001).The best cut-off value of VI was 4.63 using ROC curves,the area under the curve (AUC) was 0.94,the sensitivity and specificity were 89.10％ and 86.30％,respectively.The best cut-off value of FI was 34.39 using ROC curves,AUC was 0.76,the sensitivity and specificity were 73.40％ and 76.70％,respectively.The best cut-off value of VFI was 1.60 using ROC curves,AUC was 0.93,the sensitivity and specificity were 87.50 ％ and 86.30 ％,respectively.Conclusions 3D PDUS was a new and noninvasive way for the clinical to differentiate benign and malignant cervical lesions.

Objective To establish an appropriate health management model to improve health literacy of army men and promote and maintain physical and mental health of officers and soldiers.Methods A questionnaire survey was conducted among officers and soldiers in South China War Zone before and 2 years after health management.The x2 test was used to calculate the positive rate of officers,high-rank soldiers,soldiers,officers and soldiers in general before and after the intervention.Results After health management,most of items showed significant difference,including easy to get along with others,working under stress,being full of confidence to future life,awareness of harm of anger,anxiety and depression,easy expression of feelings,learning from hero model,being satisfied with social support system,active participation in sports activities,knowing centers that offer psychological services,awareness the necessity of psychological services in primary healthcare units (x2 values were 5.8,12.3,26.9,77.3,15.2,21.5,18.6,16.8,333.8 and 79.4,respectively; all P＜0.05).The most obvious improvement was found in the solders.There was no significant difference in satisfaction with psychological status or communication skills and being proud of military carrier in officers and soldiers (x2 values were 2.3,3.1 and 2.2,respectively; all P＞0.05).The stress from the military management was significantly increased after health management (x2=14.9,P＜0.05).The stress of high-rank soldiers from military management and daily work was also significantly increased after health management (x2 values were 21.6 and 8.3,respectively; both P＜0.05).The stress of solders from daily work was significantly decreased after health management (x2=35.7,P＜0.05).The stress of soldiers from military management and financial difficulties was significantly increased.The stress of soldier from financial difficulties was significantly decreased after health management.After health management,the rate of choosing fiiends and psychological doctors to be listener was significantly increased (x2 values were 10.2 and 32.6,respectively; both P＜0.05).The rate of choosing friends and psychological doctors to be a listener was significantly inclined among high-rank soldiers (x2 values were 9.9and 46.7,respectively; both P＜0.05).The rate of choosing parents and leaders to be listener was significantly increased in soldiers (x2 values were 17.6 and 14.3,respectively; both P＜0.05).Conclusion Health management that includes health education,psychological service,disease consulting and life style intervention may significantly improve psychological status of army men,especially the soldiers.

OBJECTIVE: To investigate the dynamic trends of activities of matrix metalloproteinase (MMP)-2/9 and protein expressions of their inhibitors-tissue inhibitor of matrix metalloproteinase (TIMP)-1/2 during the progression of pulmonary fibrosis in rats so as to get insight of the roles played by MMP-2/9 in lung injury and fibrogenesis. METHODS: Forty-eight SD rats were randomly divided into normal control group (n=18) and bleomycin (BLM)-treated group (n=30). The pulmonary fibrosis was induced by intratracheal injection of BLM once. At the consecutive time of 1 day, 3 days, 1 week, 2, 3, and 4 weeks after intoxication, the lung-to-body weight ratio was calculated and the inflammation and collagen deposition in lung tissue were checked by HE and Masson stainings respectively. Meanwhile, the content of hypdroxyproline (Hyp) in lung tissue was assayed with Jamall's method, the protein expressions of MMP-2/9, TIMP-1/2 were examined by Western blotting, and the activities of MMP-2/9 were detected by gelatin zymography. RESULTS: The histopathological changes in lung tissue in the BLM-treated group from 1 day to 2 weeks after intoxication presented local lesions, broadened alveolar wall and septum, infiltration with lots of inflammatory cells and few of fibroblasts inside alveolar space and septum. At this early stage in the BLM-treated group, the lung-to-body weight ratio was increased significantly, the protein expressions and activities of MMP-2/9 were obviously increased especially for activity of active MMP-2, and the protein expressions of TIMP-1/2 were also increased gradually, as compared with those in the normal control group. From 3 to 4 weeks after intoxication in the BLM-treated group, the alveolar structure was damaged, parts of the alveolar space collapsed and replaced by collagens and fibroblasts, and the alveolar wall and septum obviously widened with remarkable fibrotic characteristics, as compared with those in the normal control group. Meanwhile, the lung-to-body weight ratio and the activities of MMP-2/9 were decreased in the BLM-treated group as compared with those in the same group at 2 weeks after intoxication, but the content of Hyp and the protein expressions of TIMP-1/2 were both increased dramatically, especially at 4 weeks after intoxication. CONCLUSIONS: During the lung fibrogenesis induced by BLM in rats, the alveolar inflammation is the most important alteration with enhanced MMP-2/9 activities in the early stage. While in the late stage, the main change is displayed as pulmonary fibrosis, characterized by increased TIMP-1/2 and declined MMP-2/9 activities.

This study was aimed to investigate the effects of high-dose strictosamide injection on cardiovascular sys-tem of anesthetized beagle dogs and to examine the inhibition of strictosamide on ion channels in vitro. Indexes such as changes of systolic blood pressure (Sys), diastolic blood pressure (Dia), mean blood pressure (MBP), heart rate (HR), PR, QRS, QT, QTcb and QTcv at different time points before and after strictosamide injection in dogs were monitored by the polygraph system. The inhibition of strictosamide at different concentrations on hERG potassium channel in CHO-hERG cells and Nav1.5 sodium channel in HEK-293-Nav1.5 cells were measured by whole-cell patch-clamp method. The results showed that compared with the blank control group, Sys, Dia, MBP and HR were obviously declined 15 min after medication in the strictosamide (60, 18 mg·kg-1) group and the vehicle-control group (containing tween-80) (P < 0.05). After medication, all indexes were recovered. Compared to the vehicle-control group, there were no significant differences at different time points in each medication groups. Compared with the blank control group and before medication, the QT interval, QTcb and QTcv were significantly prolonged 15 min af-ter medication in the strictosamide (60, 18, 6 mg·kg-1) group and the vehicle-control group (P< 0.05). When medi-cation stopped, indexes were recovered at certain level. Compared with the vehicle-control group, there were no sig-nificant differences of QT interval, QTcb and QTcv of each medication group at different time points (P> 0.05). The inhibition of strictosamide on hERG potassium channel and Nav1.5 sodium channel were weak with IC50 values of 560.8 μM and > 900 μM, respectively, which were far greater than the positive controls. It was concluded that sin-gle, high-dose intravenous injection of strictosamide may lead to a lower blood pressure, a slower heart rate and a prolongation on the QT interval in beagle dogs, which returned to basal levels when medication stopped. It was spec-ulated that the reduction of blood pressure and the slowing of heart rate were related to tween-80 contained in the vehicle control group. No significant inhibitory effects were detected on hERG potassium channel and Nav1.5 sodium channel in vitro, which suggested that other mechanisms may be involved in strictosamide-induced QT interval pro-longation in animals.

ObjectiveTo investigate the prevalence and associated risk factors of chronic kidney disease (CKD) in adult population receiving body check from urban area of Hefei, Anhni. MethodsA total of 33 451 subjects who were older than 20 years and received healthy examination in Health Center of Anhui Provincial Hospital from January 2005 to December 2007 were enrolled in this study. CKD was defined as proteinuria, and/or hematuria, and/or using the simplified MDRD equation. ResultsThe prevalence of proteinuria was 2.74% (95%CI: 2.57%-2.92%), hematuria 7.67% (95% CI:7.39%-7.96%), and reduced eGFR 0.80%(95% CI:0.71%-0.90%). 9.92% (95% CI:9.60%-10.25%) subjects had at least one indicator of kidney damage. Age, female, diabetes mellitus, hypertension, and hyperuricemia were independently associated with CKD. ConclusionsThe prevalence of chronic kidney disease is 9.92% in adult population receiving body check from urban area of Hefei, Anhui. Independent risk factors associated with CKD are age, female, diabetes mellitus, hypertension, and hyperoricemia.