Objective To study the effects E.coli purine nucleoside phosphorylase suicide gene on human gastric cancer MKN-45 cells as well as the bystander effect.Methods The ePNP gene was subcloned to pcDNA3.1 to construct recombinant eukaryotic expression vector pcDNA3.1-ePNP.The recombinant plasmid was transfected into MKN-45 cells by lipofectamin method and positive cell clones were screened with G418.Then MePdR was added to these gene-modified cells and the sensitivity of the cells to MePdR was studied as well as the bystander effect.Results MePdR treatment of MKN-45/ePNP cells induced cytotoxic and antiproliferative effects in a concentration-dependent manner with 100% cell death since 1 mg?L-1.Bystander effect was strong in vitro as 100% of tumor cells were killed by MePdR with only 10% MKN-45/ePNP cells.The gene-modified gastric cancer cells MKN-45/ePNP were sensitive to the treatment of MePdR compared with unmodified tumor cells,and also a remarkable bystander effect was observed.Conclusion The efficiency of ePNP/MePdR system and the potential feasibility of suicide gene strategy for clinical therapy of human gastric cancer are demonstrated.

Chromosomes, Human, Pair 14 ; Humans ; Ring Chromosomes ; Syndrome

Objective To observe the effects of aging on liver and heat shock protein (HSP)70 expression in rats,and explore the role of HSP 70 in the changes of aging liver. Methods 24 healthy Sprague Dawley rats were divided into 4 groups according to age:21-day-old group,3-monthold group,12-month-old group and 18-month-old group (n=6 per group).Routine blood tests and biochemical tests were tested. Liver tissues were observed under light microscopy. The mRNA expression of HSP70 was detected by real-time PCR. Results The ratios of liver weight to body weight were decreased gradually with aging in 4 groups (0.073,0.050,0.025,0.019,respectively,t=78.016,P =0.000).Compared with those of young rats (21-day-old and 3-month-old),serum albumin levels of aged rats (12-months and 18-months) were declined [(35.0±2.7) g/L and (39.8±3.5) g/L vs.(27.3±9.3) g/L and (20.6± 1.7) g/L,t=12.233,P=0.000].Nevertheless serum alkaline phosphatase (ALP) levels were increased with aging [(68.8± 23.3) U/L,(71.6 ± 19.2)U/L,( 185.9 ± 41.5) U/L,(418.6 ± 140.6) U/L,respectively,t =35.454,P=0.000].The differences in other routine biochemical indexes were not found among the age groups (P＞0.05).Liver histological changes including hepatocytes disordered and vacuolization or fatty changes were detected with aging,especially in 18 month-old rats. Real-time PCR results indicated that the expression level of HSP70 mRNA was much lower in 18-month-old rats than in 12-month-old and 3-month-old rats (0.218 vs.0.220 and 0.230,P=0.000). Conclusions HSP70,as a stress protein,may play an important role in the procedure of injury and senescence of liver cell,and then can serve liver aging as one of the influential markers.

Objective To study the clinical, histopathologic and ultrastructural characteristics of achromic naevus (AN). Methods Clinical data, including sex, age, age of onset, pattern of lesions, involved sites, shape and number of lesions and associated systemic diseases, were collected from 85 patients with AN. Skin melanin index was detected in 34 lesions of 19 patients with AN, 30 lesions of 12 patients with vitiligo and 64 contralateral normal skin islands of the 31 patients. Reflectance confocal microscopy (RCM) was performed to analyze the lesion, normal skin and junctional area between lesional and normal skin of 62 patients with AN. Tissue samples were obtained from lesions and perilesional normal skin of 17 patients with AN and subjected to pathological examination as well as ultrastructural study with transmission electron microscopy; also, skin biopsy specimens were immunostained for tyrosinase, HMB45, tyrosinase-related protein-1 (TRP-1), TRP-2 and CD117. Results Of the 85 patients with AN, 23 (27.1%) developed lesions at birth, and 21 (24.7%) after 3 years of age; 72 (84.7%) had irregularly shaped lesions, 54 (63.5%) had only a single lesion. The mean melanin index and relative melanin index of AN lesions were 186.56 ± 52.86 and 80 ± 11, respectively, significantly lower than those in normal skin islands (223.88 ± 63.19 and 100, both P < 0.01), but higher than those in depigmented lesions from 12 patients with vitiligo (128.57 ± 64.31 and 60 ± 20, both P < 0.01). RCM revealed a decline in the number of melanocytes and brightness of melanin caps, even distribution of melanin in lesions, as well as obscure demarcation between lesions and normal skin from patients with AN. Fontana-Masson stain showed that the melanin content was lower in lesions than in perilesional skin (1810.12 ± 327.96 vs 2064.24 ± 260.41) from patients with AN. Microscopic examination demonstrated a decrease in melanocyte and melanosome number, presence of immature melanocytes at stage Ⅱ and Ⅲ in cytoplasm and dendrites of melanocytes and keratinocytes, aggregated melanosomes in affected keratinocytes in lesions of AN. In 17 patients with AN, the relative expression levels of tyrosinase and TRP-1 were 1827.35 ± 307.09 and 6102.54 ± 1642.64, respectively, in normal skin specimens, significantly higher than those in lesional skin (1477.35 ± 224.05, 5322.33 ± 1565.26, both P< 0.01); no statistical difference was observed in the expression levels of HMB45, TRP-2 or CD117 between lesional and normal skin. Conclusions AN is an early-onset, nonfamilial aggregated, stable leukoderma with irregular margins, and in lesions of AN, the number of both melanocytes and melanosomes is decreased with the presence of immature melanosomes. The measurement of relative melanin index and reflectance confocal microscopy may offer a non-invasive approach to the diagnosis of AN.

Objective To carry out the urban community residents satisfaction investigation and analyze the present situation of public service of medical institutions,to discuss under the new situation,the development of medi-cal and health innovation mechanism,thus to meet the multi -level and diverse people health services demand. Methods Random stratified sampling of Qingdao city community residents,1 430 people,adopted the method of the questionnaire about the present situation of public hospital and community health service center and the satisfaction was investigated.Results Of Qingdao city community residents,1 430 people chose to large public hospital patients (65.8%),community health service centers (37.3%).In a large public hospital from visits to the end,took at least half a day to account for 69.5%,more than a day (18.7%);Unreasonable process part (45.2%),such as hospital formalities complex,paper take inconvenient,medical guide was too little,expert outpatient service limit number,to see the doctor for a long time,adjust time was shorter,the doctor for the patient and the lack of patience,etc.The process was reasonable and convenient accounted for 40.0%.Think of large public hospital service attitude,subject to further improvement accounted for 58.2%;Think good service attitude,the very satisfied accounted for 30.7%.Think that community health service center service attitude good,very satisfied accounted for 43.2%;Think the service attitude in general,efficiency was 37.9%.96.1% of the respondents believed that society should form a public -private joint diversified do medical pattern,provided residents with various preferential policies.98.4% of the respondents expected countries to optimize the medical service resources allocation,promoted resources with high quality and the countryside in poor areas.Conclusion At present,most of the patients choose to large public hospital,process and service attitude is the key of the need to improve.Large public hospitals and community health service center should strengthen the cooperation and formation mechanism of innovation and development,and make the patients more options,so as to get better medical service quality.

Objective To investigate the value of glycated hemoglobin(HbA1c)and urine trace albumin (u -ALB)content in early diagnosis of type 2 diabetic nephropathy.Methods 200 patients with type 2 diabetes were selected as diabetes group,and 30 cases of healthy people as control group.According to the content of HbA1c, the diabetes patients were re -divided into low group (HbA1c <7%),the median group(7.1%≤HbA1c≤10%) and high value group (HbA1c >10.1%).The levels of HbA1c and u -ALB were detected and the correlation between them was calculated.Results The values of HbA1c (8.85 ±1.22)% and u -ALB (88.3 ±12.4)mg/L in the diabetes group were significantly higher than those of the control group (t =10.88,54.25,all P <0.05);The level of HbA1c in the high,medium and low group[(11.02 ±1.37)%,(8.45 ±2.01)%,(6.88 ±1.23)%]were consistent with the levels of the respective levels of fasting glucose[(13.22 ±2.05)mmol/L,(9.25 ±1.28)mmol/L, (6.27 ±0.63)mmol/L].HbA1c and constituting the u -ALB levels were positively correlated in the high,medium and low group(r =0.452,0.512,0.452,all P <0.05).Conclusion The combined detection of HbA1c and u -ALB levels has important value for early diagnosis of type 2 diabetic nephropathy.

Objective To explore the effect of predictively nursing care for children with congenital large-sized nevus.Methods 142 cases of children with congenital large-sized nevus were treated by surgical resection,based on the principle of voluntary and informed patients,and order of children admitted to hospital were randomly divided into control group and observation group,and the two groups of children were 71 cases.Children in the control group received routine care;children in the observation group received nursing care support.Comparison of the two groups of children with treatment compliance and the satisfaction of paediatric patients' family,postoperative recovery and complicatians were observed.Results Observation group of patients treatment compliance was significantly higher;the difference was significant (P＜0.05).Observation group of children family satisfaction was significantly higher [97.2 ％ (63/71) vs 88.7 ％ (63/71)],the difference was significant (P ＜ 0.05).1,3,6,and 9-month postoperative follow-up was observed in children with recovery of the observation group were better than the control group;the difference was significant (P＜0.05).After nine months the two groups of children were cured.Group of children were observed without serious complications;redness developed in 1 patient in the control group and skin graft necrosis developed in 2 patients.Conclusions Pediatric patients with congenital large-sized nevus with predictively nursing care measures have better clinical efficacy,worthy of promoting.

AIM: To compare the difference of A-scan and lOL Master in intraocular lens power measurement.
●METHODS:Two hundred and twenty-six patients (230 eyes) with age-related cataract were included in the study. Before surgery, axial length was measured by A-scan and lOL Master respectively and corneal curvature was measured by auto refractometer. lntraocular lens power was calculated according to the SRK-T formula. Corneal curvature was measured by auto refractometer and the refractive outcome was performed by phoropter three months after cataract surgery.
●RESULTS:The mean axial length was (23. 48 ± 1. 94) mm measured by A-scan and (23. 75±1. 96) mm measured by lOL Master. There was significant difference between them ( P < 0. 05 ). After random grouping, the preoperative and postoperative mean corneal curvature in A-scan group was (43. 94±1. 81) D and (43. 98±1. 87) D respectively. There was no statistically significant difference between them (P>0. 05). And the results were (44. 10 ± 1. 57 ) D and ( 44. 11 ± 1. 58 ) D in lOL Master group. There was no significant difference between them (P>0. 05); The mean absolute refractive error (MAE) in A-scan group was ( 0. 47 ± 0. 27 ) D and in lOL Master group (0. 41±0. 19) D. The difference was significant (P<0. 05).
●CONCLUSION: lOL Master is proved to be slightly more accurate than A-scan for lOL power calculation.

Objective To investigate the levels of serum chemerin in the acute myocardial infarction (AMI) patients and explore the clinical significance.Methods A total of 76 AMI patients from January 2013 to December 2013 were inrolled and 30 healthy patients were included as normal control(NC) group.Chemerin, tumor necrosis factor α(TNF-α), adiponectin were asessed by enzyme linked immunosorbent assay(ELlSA).The clinical data of high sensitivity C reactive protein (hs-CRP), body mass index (BMI), blood lipids, underlying diseases et al were collected.Results Serum levels of chemerin in AMI patients was higher than the NC group significantly((12.97±4.17) μg/L vs.(30.96± 17.16) μg/L, t =5.642, P＜0.001).The Serum levels of Chemerin in single vessel disease group, two vessel disease group and triple vessel disease group were (22.25 ± ±6.93) μg/L, (28.57 ± 15.92) μg/L, (37.95 ± 16.52) μg/L respectively and was linearly increasing relationship with increasing AMI severity (P＜0.001, F =22.84, r2 =0.397).Serum levels of Chemerin positively correlated with TNF-α, hs-CRP level(r2=0.347,0.455 ,P＜0.001) and negative correlated with adiponectin(r2 =0.396,P＜0.001).Logistic regression analysis showed that chemerin was an independent risk factor for AMI (OR =4.822,95％ CI 4.422-7.141, P =0.032).Conclusion The results showed that serum chemerin levels were significantly elevated in AMI patients,and chemerin may be involved in the development process of AMI.

This paper describes the administrative structure of the health system and its basic characters in Tai-wan province, and focus on the analysis of the main approaches and characteristics of the health system planning and management:“Taiwan’s health care network plan” was used to allocate the health resources reasonably; the health insurance system and “The Hospital Accreditation” were combined to regulate the behavior of the medical institu-tions;the form of public/government hosted and private running” was used to improve the efficiency of the public hospitals;the public and private hospitals were treated equally by the government to promote the private to invest in the hospital;and the public hospitals were managed strictly. Then we proposed several implications from the practices of Taiwan for our country in strengthening health care system planning and management.