Serum insulin immunoassay plays an important role in the investigation of glucose metabolic disorders. Insulin assay has undergone method innovations for 50 years. Diverse insulin molecular immunogenicity and multiform biological activities, in addition to the immunoassay complexity, make serum insulin assays practically interfered by the factors such as blood sample qualities, serum anti-insulin antibodies and immunological cross-reactivity. Meanwhile, lack of standardization has imposed obstacles in the comparative studies among different reference laboratories.

Covered in the paper is the practice of an information platform of a medical alliance centering on Wuxi People′s Hospital,and its application in 1 6 member hospitals.Thanks to the overall standardization,planning, construction, regulation and synergy of the members in tiered medical services,such a platform contributes positively in sharing management,technology and medical resources among the members.

Objective To investigate the clinical curative effect and the influence on knee joint function of knee osteoarthritis treating with sodium hyaluronate combined with compound salvia injection.Methods 78 patients with osteoarthritis treated in our hospital from June 2015 to August 2016 were randomly divided into three groups: sodium hyaluronate group, compound salvia injection group and sodium hyaluronate plus compound salvia injection combination therapy group, 26 cases each group.The levels of serum inflammatory cytokines (IL-6,TNF-αand IL-1β) were measured by ELISA before and after treatment in the three groups, and the improvement of knee joint function and the change of pain score before and after treatment were analyzed as well.Results The total effective rate of sodium hyaluronate combined with compound salvia injection was significantly higher than that of sodium hyaluronate and compound salvia injection alone ( P <0.05 ); after treatment, patients VAS pain score was significantly decreased ( P <0.05), and the VAS pain scores in the combination group were significantly lower than those of the group treated with sodium hyaluronate and the compound salvia injection (P<0.05).The levels of IL-6, TNF-αand IL-1βin the three groups were significantly lower than those before treatment (P<0.05),and the inflammatory factors in the combination group were significantly lower than those in the alone treatment group (P <0.05). Conclusion Sodium hyaluronate combined with compound salvia injection has good clinical curative effect on knee osteoarthritis,improving the function of knee joint, reducing pain and so on.

Objective Cathepsin K (CTSK) played an important role in adipocyte differentiation.The activation of CTSK needs to convey by mannose-6-phosphate receptors (M6PR) in osteoclasts. The aim of the present study was to identify the effects of mannose-6-phosphate (M6P) in adipocyte differentiation and its underlying molecular mechanism. Methods Oil red O staining, accumulation of cytoplasmic triglycerides and glycerine release were used to assess its effects on adipocyte differentiation in the 3T3-L1cell line. The enzyme activity of CTSK was observed by laser confocal microscopy. The proliferation of 3T3-L1 preadipocytes was detected by MTT methods. mRNA expression of M6PR was determined by RTPCR. Results M6P could prevent adipocyte differentiation in a dose-dependent manner as evidenced by absence of triglyceride accumulation and glycerol content. Statistical significance was showed when the concentrations of M6P were 5.0 mmol/L and 8. 0 mmol/L respectively(P ＜0. 05). The mRNA expression of M6PR was detected during the whole process of adipocyte differentiation. With the increase of M6Pconcentration, enzyme activity of CTSK was inhibited in a concentration-dependent manner. MTT method showed that the absorbance at 570 nm of 3T3-L1 preadipocytes was 0. 057 ±0. 091, increased about 62. 9%at 10. 0 mmoL/L compared with the control group (P ＜ 0. 05 ). Conclusion M6P inhibits the terminal differentiation of adipocyte, which may be associated with its effect of blocking CTSK activity by competitive binding with M6PR.

The mechanism of sudden cardiac death caused by variation in SCN5A is still unclear. Recently, the converging evidences suggest that the dysfunction of regulation mediated by transforming growth factor-β1 in cardiac fibration and reconstruction of cardiac iron channel could be main reason of SUNDS caused by variation of SCN5A. The resent progress of the mechanism of transforming growth factor-β1 in sudden cardiac death caused by variation of SCN5A gene is reviewed in this paper, hoping to provide reference for the research and practice of sudden cardiac death in forensic medicine.

Day care is described in the paper in terms of its meaning and management.As to areas deserving attention given the initial success,the authors proposed to priortize medical insurance compensation policy,medical resource deployment,patient safety and follow-up for discharged patients.These efforts may further quality of care and patient satisfaction.

Objective To understand the basic situation of hospital infection ,relevant problems were collected so as to pro‐vide reference for making infection control program .Methods Infection data in 2013 was reviewed and input into database which was built by EpiData3 .0 ;the descriptive statistical method was used for the characters of clinical distribution of hospital infection and χ2 test was used for the rate comparison by the SPSS17 .0 software .Results Four hundred and thirteen hospital infection cases were found in 2013 and infection rate was 1 .2% ,which was higher in patients with malignant tumor .The main parts of hosipital in‐fection were respiratory and urinary system .Escherichia coli ,Pseudomonas aeruginosa ,Acinetobacter bacteria Bauman ,Staphylococ‐cus aureus and Klebsiella pneumoniae were the main pathogen in nosocomial infection .Conclusion The focus for future prevention and control work are to strengthen hospital infection training ,susceptible sites management ,and formulate relevant rules of opera‐tion .

Objective To investigate the effect of erythropoietin on hemorrhage in hip replacement surgery .Methods 48 cases undergoing elective hip replacement surgery in our hospital From June 2014 to October 2016 were selected and devided into control group and experimental group according to the conditional similarity, 24 cases in each group, then the application of erythropoietin in hip replacement surgery was explored.For the experimental group, erythropoietin was injected subcutaneously at three, five and seven days before operation, the dose was 250 U/(kg· times).The control group received 0.9%sodium chloride injection of the same volume of saline, and the other treatments were the same as in the experimental group.Preoperative situation, hemoglobin (Hb) levels, blood pressure (diastolic pressure and systolic blood pressure) at one day before surgey and three, seven and 14 days after surgey were compared and analyzed.Results There were no significant difference in body weight, hemoglobin (Hb), and age between the two groups before operation.The levels of Hb in the experimental group and the control group at 3 and 7 days after operation were compared, the difference was statistically significant (P<0.05), 14 days after the surgey, Hb returned to normal in the experimental group, while the Hb level in the control group was still significantly lower than that in the control group before surgey, the difference was statistically significant (P<0.05).There was no significant difference in diastolic blood pressure and systolic blood pressure between the two groups.Conclusion Preoperative erythropoietin mobilization in patients with hip replacement surgery can reduce the amount of bleeding during and after operation , and the adverse reactions are not obvious.

Objective To investigate the application of delayed sternal closure (DSC) following neonatal cardiac surgery.Methods We retrospectively analyzed clinical data of 360 neonatal patients underwent cardiac surgery through median sternotomy in Guangdong General Hospital between June 2009 and June 2014.These neonates were divided into 2 groups:DSC group (190 cases) and non-DSC group(170 cases).Comparing the differences between 2 groups,we analysed the application of DSC following neonatal cardiac surgery and the effect of DSC on surgical site infection.Results The cardiopulmonary bypass time,cross clamp time and mechanical ventilation time were longer in DSC group than in non-DSC group.The mortality rate in the DSC group(20.53％) was markedly higher than that in the non-DSC group(5.29％).However,there was no statistical difference in the incidence of sternal wound infection between 2 groups.Conclusion As an effective treatment for neonates with severe cardiac surgery,DSC doesn' t increase the incidence of surgical site infection.

Objective To explore the role of Kv channel interacting protein 1(KChIP1)in the process of epileptic seizure and the relationship between KChIP1 and gamma-aminobutyric acid-(GABA)ergic neurons.Methods Normal female Sprague-Dawley rats were treated with pentylenetetrazole to make acute pentylenetetrazole models of epilepsy.Laser Scanning Confocal Microscope(LSCM)combined with double-labeled immunohistochemical technique was applied to observe the expression of the KChIP1 and the GABAergic neurons in the hippocampus of rats.Results The number of KChIP1-postive neurons in the hippocampus was significantly increased in the acute pentylenetetrazole model rats(P<0.05).There was no significant difference in the number of double-labled neurons(P>0.05),nor of the GABA-postive neurons between the model rats and the controls.The ratio of double-labeled neurons/total positive neurons was 63.9% in the hippocampus.Conclusion The KChIP1 might be involved in epileptogenesis of pentylenetetrazole induced seizure.The KChIP1 was associated with GABAergic neurons,whereas it may be functionally different from GABA.