This paper introduces the background, implication and construction of the county health services community (County medical alliance) model in Anhui Province under the background of new medical reform,and briefly introduces the relationship between medical insurance, enhancing the ability to upgrade and standardize services and medical treatment integration of the typical experience.It also analyses the challenges faced in the construction of medical syndicate, such as the mechanism of regional environmental restriction, compensation and assessment mechanisms which have not been established yet, and the sustainable development of information technology that has lagged behind, and put forward the policy suggestion to improve the construction of medical community, with a view to providing reference for the next work.

To introduce the development of myelodysplastic syndrome network course.

Technological improvement for microorgnism isolation is important since isolation provides substantial materials for the exploitation of new microbial resources. In this study, a new approach, dispersion and differential cetrifugation (DDC), was applied in the isolation of acidophilic and acidoduric streptomycetes from 12 acid soil samples. Contrast with traditional method, the new approach yielded satisfying results with 2 - 20 times isolation efficiency and good selectivity. 45 representatives out of 249 streptomycetes isolates, which belonged to 12 color groups, showed morphology and cell wall type consistent with streptomycetes. The optimum pH range for their growth were between pH 4.5 - 5.5. It is proved that we succeeded in the rare-streptomycetes isolation using DDC approach.

OBJECTIVETo provide the basic knowledge of wrist joint for diagnosing of these morphological change in pathological condition by measuring the posteroanterior X-ray films of different types of distal radius fracture by AO classification.

METHODSEleven radiographic indexes were measured including following 7 new parameters of 83 cases of distal radius fracture: ulnar styloid length (USL), ulnar head length (UHL), ulnar head diameter (UHD), maximal distal radius width (MDRW), proximal distal radius width (PDRW), sigmoid notch length (SNL) and sigmoid notch width (SNW) by Pacs system in standard X-ray films. The indexes were defined by the ratio of these parameters to the length of the third metacarpal. Statistical significance of indexes and correlations of parameters were analyzed by SPSS 16.0.

RESULTSIt was found that indexes of 11 parameters and 27 pairs of indexes had significantly different. Compared the indexes of 14 groups with normal group existed statistical significance, 62 pairs value of 11 parameters had correlations.

CONCLUSIONThe study provides additional radiographic index that will be helpful to more careful diagnosis and treatment of the distal radius fractures and their associated injuries such as ulnar wrist injuries or carpal instability.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Radiography ; Radius ; diagnostic imaging ; Radius Fractures ; diagnostic imaging ; Wrist Joint ; diagnostic imaging ; Young Adult

OBJECTIVETo investigate the expression and activity of silent information regulator 1 (SIRT1) in the temporal lobe of epileptic patients and rat models and explore its role in the occurrence and progression of epilepsy.

METHODSThe temporal lobe tissue of epileptic patients and rat models (induced by lithium-pilocarpine) were examined for SIRT1 expression using immunohistochemistry and Western blotting and also for SIRT1 activity using SIRT1 Deacetylase Assay Kit.

RESULTSImmunohistochemistry detected positive SIRT1 expression mainly in the cytoplasm of the neurons in both human and rat brains, and the epileptic groups showed stronger SIRT1 immunoreactivity than the control group. Western blotting and activity assay showed that the expression and activity of SIRT1 were significantly increased in the temporal lobe of patients with refractory epilepsy as compared with the tissues samples from non-epileptic patients (P<0.05). In the rat models of epilepsy, SIRT1 expression was up-regulated at 6, 24, and 72 h and at 7, 14, 30, and 60 days after kindling (P<0.05) and SIRT1 activity was significantly increased at 6, 24, and 72 h and at 7 and 14 days (P<0.05), with the peak level of SIRT1 expression and activity occurring at 72 h.

CONCLUSIONUp-regulation of SIRT1 expression and activity in the temporal lobe of epileptic patients and rat models may play an important role in the pathogenesis of epilepsy.

Adolescent ; Adult ; Animals ; Disease Models, Animal ; Epilepsy ; metabolism ; Female ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Sirtuin 1 ; metabolism ; Temporal Lobe ; metabolism ; Young Adult

BACKGROUNDPulmonary hypertension (PH) is a set of pathophysiological syndromes characterized by increased pulmonary artery pressure and pulmonary vascular resistance, resulting in increased right ventricular afterload. The left and right ventricles interact through hemodynamics. What impact will PH have on synchronization and function of the left ventricle (LV)? The aim of this study was to evaluate the synchronization of the left ventricular wall motion and left ventricular function in patients with varying degrees of PH using velocity vector imaging (VVI) technology.

METHODSSixty patients with chronic PH served as the experimental group, and 20 healthy volunteers served as the control group. According to the different degrees of pulmonary artery systolic pressure, the experimental group was divided into three groups: mild, moderate, and severe PH groups. The time to peak systolic longitudinal velocity (Tvl), the peak systolic longitudinal velocity (Vsl), the peak diastolic longitudinal velocity (Vel), the peak systolic longitudinal strain (Sl), and strain rate (SRl) in 18 segments were measured in each group.

RESULTSTvl in the control group and each group with PH was reduced from basal to apical segment, and in control group Tvl in various segments of the same wall and in different walls showed no significant difference (P > 0.05). With increase in pulmonary artery pressure, Tvl values measured showed an increasing trend in groups with PH. In groups with PH, Vsl and Vel of each wall were reduced sequentially from basal to apical segments, showing gradient change; Vsl and Vel values measured showed a decreasing trend with increase in pulmonary artery pressure, in which the differences of Vel values measured in the control group and the mild PH group were statistically significant (P < 0.01), and the differences between other groups were statistically significant (P < 0.01). In groups with PH, Sl and SRl in basal segment and the middle segment of each wall were decreased; the difference between groups was statistically significant (P < 0.01).

CONCLUSIONSAsynchronization of the LV and decreased left ventricular function were present in patients with chronic PH; VVI technology can accurately evaluate left ventricular function in patients with PH, and indicators such as Tvl, Vsl, and Vel are valuable.

Adult ; Aged ; Echocardiography ; Elasticity Imaging Techniques ; Female ; Heart Ventricles ; diagnostic imaging ; physiopathology ; Humans ; Hypertension, Pulmonary ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ventricular Function, Left ; physiology

Cryptosporidium andersoni ATP-binding cassette (CaABC) is an important membrane protein involved in substrate transport across the membrane. In this research, the nucleotide binding domain (NBD) of CaABC gene was amplified by PCR, and the eukaryotic expression vector of pEGFP-C1-CaNBD was reconstructed. Then, the recombinant plasmid of pEGFP-C1-CaNBD was transformed into the mouse intestinal epithelial cells (IECs) to study the iron transportation function of CaABC. The results indicated that NBD region of CaABC gene can significantly elevate the transport efficiency of Ca2+, Mg2+, K+, and HCO3 - in IECs (P<0.05). The significance of this study is to find the ATPase inhibitors for NBD region of CaABC gene and to inhibit ATP binding and nutrient transport of CaABC transporter. Thus, C. andersoni will be killed by inhibition of nutrient uptake. This will open up a new way for treatment of cryptosporidiosis.
ATP-Binding Cassette Transporters/*chemistry/*genetics/metabolism ; Adenosine Triphosphate/metabolism ; Amino Acid Sequence ; Animals ; Calcium/metabolism ; *Cloning, Molecular ; Cryptosporidiosis/parasitology ; Cryptosporidium/chemistry/genetics/*metabolism ; Humans ; Iron/metabolism ; Mice ; Molecular Sequence Data ; Protein Structure, Tertiary ; Protozoan Proteins/*chemistry/*genetics/metabolism ; Sequence Alignment

Objective:To investigate the effect of recombinant lipoproteins of Brucella outer membrane protein 16, 19 (L16 and L19) on the expression of immune regulatory factors in human monocytic leukemia cell line (THP-1 cells). Methods:THP-1 cells activated with phorbol ester (PMA) were used as an in vitro experimental cell model, and a group design was used to co-culture L16, L19 and THP-1 cells (L16 stimulated group, L19 stimulated group), respectively. THP-1 cells activated with PMA were used as the control group. When co-cultured for 4 hours, immunofluorescence staining (IFS) and Western blotting were used to detect whether L16 and L19 entered the cells, respectively; when co-cultured for 12, 24 hours, real-time fluorescent quantitative PCR was used to measure the mRNA expression levels of interferon regulatory factor 1 (IRF-1) and trans activator protein of major histocompatibility complex class Ⅱ (CⅡTA); Western blotting was used to detect the protein expression levels of T cell immunoglobulin mucin-3 (Tim-3) and γ interferon receptor 1 (IFNGR1). Results:When co-cultured for 4 hours, L16 and L19 were observed entering THP-1 cells in the L16 stimulated group and L19 stimulated group, respectively. When co-cultured for 12 hours, the expression level of IRF-1 mRNA in the L16 stimulated group (0.16 ± 0.15) was significantly lower than that in the control group (1.00 ± 0.00, P < 0.05). When co-cultured for 24 hours, the expression level of CⅡTA mRNA in the L16 stimulated group (0.17 ± 0.10) was significantly lower than that in the control group (1.00 ± 0.00, P < 0.05). When co-cultured for 12 and 24 hours, there were no statistically significant differences in the expression levels of IRF-1 and CⅡTA mRNA between the L19 stimulated group and the control group ( P > 0.05). Western blotting results showed that there were statistically significant differences in the expression levels of INFGR1 and Tim-3 protein among the control group, L16 stimulated group, and L19 stimulated group after co-cultured for 12 and 24 hours ( F = 50.92, 6.80, 148.73, 156.57, P < 0.05). Among them, when co-cultured for 12 hours, the expression level of INFGR1 protein in the L16 and L19 stimulated groups were significantly lower than that in the control group, and the L19 stimulated group was higher than the L16 stimulated group ( P < 0.05), and the expression level of Tim-3 protein in the L19 stimulation group was higher than that in the control group ( P < 0.05). When co-cultured for 24 hours, the expression level of INFGR1 protein in the L16 and L19 stimulated groups were lower than that in the control group, and the L19 stimulated group was higher than that in the L16 stimulated group ( P < 0.05); and the expression level of Tim-3 protein in the L16 stimulated group was higher than that in the control group and L19 stimulated group ( P < 0.05). Conclusions:Brucella L16 can downregulate the expression levels of IRF-1 and CⅡTA mRNA in THP-1 cells. Both L16 and L19 can downregulate IFNGR1 and upregulate Tim-3 protein expression levels.

Objective To find out factors related to avascular necrosis (AVN) of femoral head through a retrospective study of patients with femoral neck fractures treated with cannulated screws.Methods Two hundred and thirty cases of femoral neck fracture whn had been treated with cannulated screws in our department from August 1994 to October 2003 were analyzed statistically.Six factors of patient,age,gender,fracture type (Garden clas- sification),reduction method (close or open),the quality of reduction (Garden Index) and time interval from injury to surgery were analyzed statistically with rank sum test and logistic multiple regression.Results Factors that might have an impact on avascular necrosis of femoral head were ranked in the following likelihood sequence: fracture type,quality of reduction,reduction method,time interval from injury to surgery and age.Gender was found to have little impact on the prognosis of femoral neck fracture (P＞0.05).Conclusions Fracture displacement is the most critical factor that influences the prognosis.Anatomical reduction (close or open) must be achieved to re- duce the risk of AVN.Timing of surgery shows its importance.High age will not lead to an increased incidence of AVN.