Bruton tyrosine kinase (Btk) is a member of the non-receptor protein tyrosine kinases of Tec family.It plays an important role in growth,proliferation,differentiation and signal transduction of B lymphocyte.After activation of B-cell receptor (BCR) by diverse stimuli,Btk is activated through tyrosine phosphorylation.Activated Btk can stimulate several downstream signaling proteins.Btk and BCR signaling pathways play important roles in initiation and maintenance of B cell malignancies.This review focuses on the recent findings in association of Btk and B cell malignancies.

Objective To investigate the immune disorder in elderly patients with severe ischemic stroke and to explore whether a new type of diabetes-specific enteral nutrition formula can regulate the immune function of these patients.Methods In the randomized controlled prospective study,90 patients aged 60-80 years with acute ischemic stroke and NIHSS score more than 10 and dysphagia were randomized to two groups:receiving a new type(Group A) of,versus traditional(Group B) diabetes-specific enteral nutrition.30 Patients aged 60-80 years with acute ischemic stroke and NIHSS score ≥10 without dysphagia were enrolled as control(Group C).The immune function was observed,and the nutritional status and immunological function were compared between two different enteral nutrition groups at 7 days of treatment.Results After 7 day follow-up,the serum lipid stats significantly ameliorated in group A.An obvious suppression of immune state was observed in severe acute ischemic patients at onset of 7 days.At day 7 of treatment,the percentage of CD3+ T cells in group A was(69.25±9.93)％ after treatment vs.(63.36±7.79)％ at baseline(P＜0.001),and CD3 +CD4+T cells was(45.79±9.47)％ after treatment vs.(36.12±9.15)％ at baseline(P＜0.001),as well as CD4+/CD8+ cells were(2.27±1.40)％ after treatment vs.(1.70±0.82)％ at baseline(P=0.001).At 7 days of treatment,the percentage of CD3+ T cells was higher in group A (69.25 ±9.93) ％ than in group B(63.07± 9.47) ％ (P＜0.001),and the percentage of CD3 + CD4 cells was higher in group A(45.79 ± 9.47) ％ than in group B(41.32 ± 8.89) ％ (P=0.024).Conclusions Enteral nutrition preparations can provide sufficient energy support in the acute ischemic stroke.Immunosuppressive state exists in patients with acute phase of severe ischemic stroke.The new type of diabetic enteral nutrition formula can significantly improve immunosuppressive state in patients with acute severe stroke.

Objective To assess the public health service quality objectively in Shenzhen,and promote the equity of basic public health services.Methods The criterion and method of the assessment were established by municipal health administrative department,the assessment of institutions and regions were conducted by experts selected by municipal professional institutions.Regional assessment was the comprehensive evaluation of public health service qualities of professional public health institutions,medical institutions and the community health centers.The assessment of the degree of public health service quality satisfaction was accomplished by a third-party institution.Results The accomplishment ratio of indicators for public health service quality was 93.2％.This ratio has witnessed a high increase with mental health institutions,occupational disease prevention and control institutions and health education institutions on one hand.On the other,it has dropped with institutions of disease control,chronic disease control and medical institutions within the region.On the whole,this ratio has increased with all the districts to different extents.Despite the overall improvement of public health capabilities citywide,imbalances are found among districts and institutions as well.Conclusion It is imperative to further improve the public health service system and equity while carrying out specific tasks in this respect.

ABSTRACT:Objective To investigate whether medial cerebellar nucleus may be involved in the pathogenesis of post-stroke depression (PSD)and explore the pathway that mediates this effect.Methods Healthy SD rats were randomly divided into five groups:control group,stroke group,PSD group,medial cerebellar nucleus (Med)lesion group,and superior cerebellar peduncle (xscp)lesion group.The ethological score of depression was evaluated.The neurotransmitters of Glu and GABA in the lateral hypothalamic area were detected by high performance liquid chromatography.Results Compared with those in control group,the levels of GABA and Glu expressions did not significantly differ in the lateral hypothalamic area in stroke group (P > 0.05 ).In contrast,the levels in PSD group,Med lesion group and xscp lesion group were lower than those in stroke group to different extent (P <0.01). Conclusion These results preliminarily show that medial cerebellar nucleus may participate in the pathogenesis of post-stroke depression,which may be mediated by the cerebellum-hypothalamic pathway.

Objective To investigate the clinical efficacy of heat-sensitive point thunder-fire moxibustion in treating knee osteoarthritis (KOA). Methods One hundred and forty-eight KOA patients were randomly allocated to treatment and control groups, 74 cases each. The treatment group received heat-sensitive point thunder-fire moxibustion and the control group took diclofenac sodium enteric-coated tablets. The Visual Analogue Scale (VAS) score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and 50 yards fastest walking time were observed in the two groups before and after 30 days of treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant pre-/post-treatment differences in the VAS score and WOMAC subscores in the two groups (P<0.01). There was a statistically significant pre-/post-treatment difference in 50 yards fastest walking time in the treatment group (P<0.05). There were statistically significant post-treatment differences in the VAS score, the WOMAC score and the WOMAC pain and stiffness scores between the treatment and control groups (P<0.01). There were statistically significant differences in the VAS and WOMAC scores at three months after treatment between the treatment and control groups (P<0.01). The total efficacy rate was 95.9%at the end of treatment and 95.6%at three months after treatment in the treatment group, and 86.1%at the end of treatment and 86.8%at three months after treatment in the control group; there were statistically significant differences between the two groups (P<0.05). Conclusion Heat-sensitive point thunder-fire moxibustion is an effective way to treat knee osteoarthritis.

Objective:To compare the osteogenic differentiation of dental pulp stem cells(DPSCs)induced by osteopontin(OPN)and mineralizing culture medium(MCM).Methods:DPSCs were cultured with OPN(OPN group)and MCM(MCM group)respectively. The morphology of the DPSCs were observed under inverted microscope.The mineralize nodules were observed by alizarin red staining. RT-RCR was used to detect the mRNA expression of bone sialoprotein (BSP),Runt-related transcription factor 2(Runx-2),osteocal-cin(OCN)and collagen-1(Col-1).Results:Similar number of mineralized nodules was found in the 2 groups(P >0.05)after 28 day culture.The mRNA expression level of BSP gene in OPN group was higher than that in MCMgroup(0.864 ±0.112 and 0.514 ±0.068, P <0.05),while the expression level of Runx-2 gene in OPN group is lower than that in MCMgroup(0.186 ±0.017 and 0.324 ±0. 058,P <0.05).The expression level of Col-1 and OCN genes in both groups were similar(P >0.05).Conclusion:The capabilities of OPN and MCMin inducing osteogenic differentiation of DPSCs are similar.

Objective: To explore the effect of low-level laser irradiation (LLLI) preconditioning on milieu of infarcted myocardium in experimental rats.
Methods: The myocardial infarction (MI) model was established by left anterior descending (LAD) artery ligation in female rats. 3 weeks later, the qualified MI rats were randomly divided for 3 groups: ① LLLI preconditioning group, the rats received thoracotomy for LLLI by a 635nm, 5mW diode laser with the energy density of 0.96 J/cm2 for 150 seconds, n=26. ② Control group, the rats received thoracotomy for daylight irradiation, n=27. ③ Sham operation group, the rats received thoracotomy without LAD ligation, n=24. The Expressions of myocardial vascular endothelial growth factor (VEGF), glucose-regulated protein 78 (GRP78), superoxide dismutase (SOD) and malondialdehyde (MDA) were evaluate by real time-PCR, Western blot analysis and other relevant laboratory test at 1 hour, 1 day and 1 week after treatment. The myocardial cell apoptosis was examined by TUNEL staining, and left ventricular function was detected by echocardiography.
Results: LLLI preconditioning obviously increased the myocardial VEGF, GRP78 expression and SOD activity, decreased MDA production; while it could not really improve the myocardial cell apoptosis at peri-infarcted area and left ventricular function in experimental rats.
Conclusion: LLLI preconditioning may improve the milieu of infarcted myocardium via decreasing the oxidative stress in experimental rats.

Covered in the paper are concepts and contents of medical risk and emergency response technology.Based on a description of medical risk information management experiences in Japan,Sweden and the United States and the current studies of medical risk response information management,the paper proposed measures for China in medical risk information emergency technology.Recommendations made include establishing a comprehensive emergency medical risk information management system,scientific medical risk information collection,monitoring,assessment,early warning systems,as well as building an intelligent risk emergency information decision system and establishing medical risk communication channels,thereby preventing effectively the occurrence of medical risks.

Objective To investigate the accuracy of predicting middle cerebral artery infaction with contin -ue electroencephalograph .Methods 40 cases with middle cerebral artery infaction were divided into malignant groups(14) and binigan groups(26).They were all with continued beside electroencephalograph within 24 hours after admission.Results Abnormal CEEG rate in malignant groups [85.71%(12/14)]was significantly higher than that in binigan groups[65.38%(17/26)](χ2 =10.405,P=0.001).In malignant groups,severe abnormal CEEG was seen in 4 cases developed coma at the second day of admission ,moderate abnormal CEEG was found in 6 cases,slight abnormal CEEG was detected in 2 cases,normal CEEG was detected in 2 cases.Conclusion Early CEEG has a cer-tain value for predicting middle cerebral artery infaction .

Objectives To investigate the causes of short stature in Turner syndrome (TS). Methods 86 patients were di-agnosed with TS by karyotypes from 2004 to 2013. According to the deletion types of the X chromosome short arm, growth hor-mone (GH), insulin-like growth factor-1 (IGF-1) and thyroid function, the TS patients were divided into different groups and com-parison was made among groups. Results Ht SDS in three groups with different extent of the deletion of the X chromosome short arm were (-4.39±1.08), (-3.26±1.25) and (-2.84±0.15) (P<0.05). The proportion of growth hormone deifciency (GHD) in the three groups were 62.5%, 38.9%and 0%(P<0.05). Ht SDS in groups with different degree of IGF-1 level were (-4.37±1.10), (-3.82±1.07) and (-3.25±0.91) (P<0.05). There was no signiifcant difference of Ht SDS between hypothyroidism patients with and without GHD (P>0.05). Conclusions The deletion of X chromosome short arm may cause the short stature in TS. The GH-IGF-1 axis in TS is impaired, but GHD is not related to short stature in TS.