As a new biomarker and a member of transforming growth factor super family,growth differentiation factor-15 (GDF-15) is increased in some pathological situations,and plays a positive role.Increasing evidence from animals and clinical trials has indicated that GDF-15 is a promising biomarker to be used for diagnosis,screening,risk stratification and prognosis evaluation in acute coronary syndrome,heart failure and pulmonary vascular diseases.However,there are still numerous challenges and problems need to be resolved in the future,such as appropriate cut-off value in diagnosis and risk stratification in different cardiovascular diseases,improvement in sensitivity and specificity,and combinational application with other biomarkers.

A continuous noninvasive method for blood pressure (BP) estimation by pulse wave transit time (PWTT) is described. A constant linear relation is available between PWTT and BP, but characteristic parameter for the relation is different for different persons. According to hydrostatics, BP in some vessel changes with different body postures. In this paper, the difference, i.e. △BP, between two BP values with different body postures is gained. ECGs and surface pulse waves are also obtained, and then values of PWTT are calculated. Through the A BP and PWTT acquired above, parameter b of BP equation can be determined, and then parameter a is computerized through the measurements and one BP value. Thus a BP equation is got, which can be used to estimate BP values through continuous measurement of PWTT. Compared with the value from invasive BP measurement, the value from this method has an error rate less than 5%. The method is feasible for noninvasive continuous BP monitoring.

Objectives To investigate the expression of TGF-?receptors and signaling protein SMADs mRNA in psoriatic lesional and nonlesional skin,and to analyze their role in the pathogenesis of psoriasis.Methods Expression of TGF-?receptorⅠ,TGF-?receptorⅡmRNA and different SMADs(SMAD2,3,4,6,7)mRNA was investigated by real time PCR method in lesional and nonlesional skin of13psoriatic patients and10normal controls.Results The mRNA expression of TGF-?receptors and all kinds of SMADs was significantly down-regulated in psoriatic lesional skin compared with normal skin con-trols(P0.05).Conclusions There is down-regulated TGF-?pathway in psoriatic lesional skin,which may further indicate that lack of TGF-?mediated growth inhibition might play an important role in the pathogenesis of psoriasis.

Objective To investigate the safe model to prevent and treat complications caused by various artificial liver support system(ALSS).Methods The complications in 191 patients with severe hepatitis during the ALSS(Including plasma exchange、plasma exchange associated with continuous venovenous hemofiltration、plasma exchange associated with hemodiafiltration、plasma exchange associated with plasma absorption、molecular absorbents recycling system) treatment were observed and analyzed. Results During the treatment 287 episodes occurred and the rate of complications was 50.44%(287/569).The clinical manifestation included rash,numbness/tetany,hypotension,blood clotting in the channel,chest distress, disequilibrium syndrome,errhysis on dwell catheter,effusion on dwell catheter.75.61% of these complications was caused by plasma exchange.The rate of complications was the lowest during the treatment of plasma exchange associated with hemodiafiltration.All of these complications got better after prompt sypotomatic therapies were taken.Conclusions Although the rate of complications was high during the treatment of ALSS,all of the complications got better after prompt sypotomatic therapies were taken.This therapeusis must be performed by intensive care.It is more safe than others during the treatment of plasma exchange associated with hemodiafiltration.

Objective To evaluate the efficacy and safety of carvedilol treatment for resistant renal parenchymal hypertension.Methods In this multi-center,open label,self-controlled trial,the enrolled resistant renal parenchymal hypertension patients stopped the use of ?-blocker and ?-blocker and took carvedilol 12.5 mg/d as initial dose and tittered to maximal dose of 50mg/d for 8 weeks.Other treatment was unchanged during the period.Results Among 183 patients enrolled,176 patients were followed up for 8 weeks.The systolic/diastolic BP decreased from(164.0?20.8)/(98.7?12.5)mm Hg to(140.0?14.2)/(84.5?24.7)mm Hg(both P

Objective To investigate the preventive effect of thin foam dressings(Allevyn Thin)combined with ice compress on facial plastic postoperative swelling and to summarize the nursing key points.Methods Sixty patients after facial plastic surgeries in our department were randomly divided into the observation group and the control group with 30 cases in each group.In the control group,ice packs wrapped with sterile gauze were placed on the patients’ wound dressings postoperatively and fixed properly for 30 to 40 minutes with an interval of 30 minutes,6 to 10 times a day for 72 hours postoperatively.In the observation group,thin foam dressing was stick to the wounds,followed by ice compress as in the control group.The facial swelling degrees of both groups were compared on day 3 and day 7 postoperatively.Result The swelling degree in the observation group was significantly smaller than that of the control group(P<0.01).Conclusion Thin foam dressings combined with ice compress can effectively improve the postoperative early swelling of patients receiving facial plastic surgery and therefore it is worthy of clinical popularization and application.

Objective To investigate the experience of microinvasive surgical occlusion of ventricular septal defect (VSD).Methods A total of 142 children with VSD was given microinvasive surgical occlusion from March 2009 to December 2013 at our hospital.There were 90 males and 52 females,the age ranged from 8 months to 11 years,and body weight from 7 kg to 35 kg,and ventricular septal defects were divided into membranous type,film cycle headquarter type,pulmonary valve type,and muscle type.The diameter of VSD was 2 ～ 10 mm.Under general anesthesia,an incision was made in the lower part of sternum or intercostals space,and a special occluder was inserted to close the ostium via right ventricle puncture under the guidance of transesophageal echocardiography.Results A total of 139 cases had successful occluded with a 97.8％ of successful rate,using blocking umbrella 4 ～ 12#,including 25 eccentric umbrella.Two cases were operated under extracorporeal circulation because of aggravated aortic valve insufficiency.One case without handled muscular ventricular septal defect combined atrial septal defect for guide wire pass muscular defect failed.Full set did not have death and third degree A-V block.Conclusions Microinvasive surgical occlusion is easy to handle,operation-time short,and relative broad for the closure of ventricular septal defect.It has a fast recovery and good effectiveness with a beautiful outlook and safety.

Objective To investigate health equity status of urban dwellers with different social stratification and provide evidence for health promotion.Methods 1,007 urban dwellers were surveyed in Zhejiang province in a stratified sampling based on their income,occupation and education,with their health equity analyzed.Results The proportion of urban dwellers to participate in social health insurance reached 97.5％,a proportion of statistical significance (P＜0.05).The two-week prevalence rate and two-week attendance rate of urban dwellers of different social stratification has no significant difference,but the rate of sickness without attending was significantly negatively correlated to social stratification.The proportion of no visiting because of poverty was 23.1％ in the lower social class,3.2％ in middle and lower class,and 0％ in the middle and upper class,a difference being statistically significant (P＜0.001).The outpatient clinic of first choice and ranking of the hospital was positively correlated to social stratification.Conclusion There is health inequity for urban dwellers with different social stratification,for which the government should pay more attention to lower social class.

Objective To investigate the efficacy of ultrashort and short-acting insulin after subcutaneous insulin infusion pump under glucose monitoring in treatment of diabetes.Methods 110 cases with type 2 diabetes were selected,they were randomly divided into two groups with a random number table:the study group and the control group,55 cases in each group.The study group was treated with short -acting insulin after subcutaneous injection of insulin pump,the control group was treated with short -acting subcutaneous insulin infusion by insulin pump therapy, glucose monitoring system was used to monitor glucose during treatment of the two groups.The clinical efficacy after a month of treatment was observed.Results Before treatment,fasting blood glucose(FPG),postprandial 2 h blood glucose(2h PG),bedtime blood glucose of the two groups had no statistically significant differences.After treatment, FPG and 2hPG,bedtime blood glucose in the study group were (6.01 ±1.06)mmol/L,(7.90 ±0.50)mmol/L, (7.13 ±0.95)mmol/L respectively,which of the control group were (5.98 ±1.04)mmol/L,(7.91 ±0.48)mmol/L, (7.14 ±0.94)mmol/L,which were significantly lower than before treatment (t =9.843,23.669,13.569,9.683, 22.881,13.710,P <0.05),the two groups after treatment showed no significant differences(P >0.05).The blood glucose time and insulin dosage in the study group were (5.59 ±1.30)d,(39.98 ±11.01)u/d,which of the control group were (6.98 ±1.40)d,(51.89 ±11.97)u/d,and there were significant differences between the two groups(t =1.825,5.431,P <0.05).The mean blood glucose,blood glucose standard deviation,time percentage of blood glucose≥10 mmol/L,time percentage of blood glucose≤3.9 mmol/L in the study group were (5.95 ±0.61 )mmol/L, (1.28 ±0.25)mmol/L,(14.16 ±2.13)%,(6.35 ±1.45)%,which in the control group were (6.59 ±0.94)mmol/L, (1.54 ±0.29)mmol/L,(15.15 ±2.14)%,(7.96 ±1.42)% respectively,and the differences were statistically significant between the two groups(t =4.236,503.6,2.432,5.883,P <0.05).Conclusion Glucose monitoring system in monitoring blood glucose is accurate and reliable,ultra -short -acting insulin after subcutaneous insulin pump infusion in treatment of diabetes is better than short -acting insulin.

This study was aimed to define the scope of traditional Chinese medicine (TCM) informatics standards. The basic construction of three-dimensional profiling framework includes TCM business domain, elements of TCM informationization and specificity level. The clinical informatics standards development was stated as an example to demonstrate the application method of this three-dimensional profiling framework.