Objective To investigate the characteristic of lipoprotein(a)[Lp(a)]in different phases of chronic kidney disease (CKD ),to provide the basis for clinical prevention and treatment of CKD.Methods 200 patients with CKD in the Republic Hospital of Shifang were collected as study group,including 5 phases (every phase had 40 cases),and 100 healthy people were selected as control group.Measured the serum Lp(a)of both study and control group,analyzed the correlations between Lp(a)and different phase of CKD.All data were analyzed by SPSS version 17.0.The significant level was established at 0.05.Results CKD1 [(146.0 ±95.5)mg/L]and all CKD group [(231.5 ±133.2)mg/L]had higher level of serum Lp(a)than the control group [(115.5 ±70.2)mg/L] (Z=-2.800,P<0.05 and Z=-7.922,P<0.05).CKD3 had higher Lp(a)level than CKD2(Z=-2.069,P<0.05 ),while there were no significant differences between each of the other two groups.CKD4 -5 [(325 .0 ± 194.7)mg/L]also had higher Lp(a)level than CKD1 -3 [(182.0 ±110.5)mg/L](Z=-4.439,P<0.05). Conclusion Patients with CKD always have high level of serum Lp(a),which have been slowly increased since CKD1 ,meanwhile the level of Lp(a)may have a certain correlation with the stage of CKD development,since Lp(a) is an important promoting factor in the progress of CKD.

Objective To study the role ofTAK-242,a Toll-like receptor 4 (TLR4) specific inhibitor,in β-amyloid peptide (Aβ)25-35 inducing PC12 cytotoxicity and its potential mechanism.Methods PC12 cells were cultured with different concentrations of Aβ25-35 (0,10,20 and 30 μmol/L) for 24 h,and then,the cell survival rate was detected by CCK-8 kit to choose the specific concentration of Aβ25-35 to establish cell AD models.The survival rate of Aβ25-35 inducing PC12 cells was further detected one h after TAK-242 intervention.The PC12 cells were divided into four groups:control group,Aβ treatment group,Aβ+TAK-242 pretreatment group and TAK-242 group.The apoptosis of cells was observed with Hoechst 33258 kit.The secretions of interleukin (IL)-1β and tumor necrosis factor-α (TNF-α) were detected with ELISA.The protein expression levels of TLR4,myeloid differentiation factor 88 (MyD88),IκB kinase complexus α/β (IKKα/β) and nuclear factor (NF)-κB were detected by Western blotting.Results The cell survival rate decreased gradually with the increase of Aβ25-35 concentrations after PC12 cells cultured with Aβ25-35 for 1 h.Twentyμmol/L Aβ25-35 was used to establish the AD models,with which the cell survival rate was closely half of the control group.As compared with Aβ treatment group,Aβ+TAK-242 pretreatment group had significantly increased cell survival rate and significantly decreased apoptosis (P＜0.05).The secretions of IL-1β and TNF-α in Aβ treatment group were significantly increased than those in the control group (P＜0.05),and Aβ+TAK-242 pretreatment group had significantly decreased secretions of IL-1β and TNF-α (P＜0.05).As compared with those in the control group,the protein expressions of TLR4,MyD88,IKKα/β and NF-κB in the Aβ treatment group were significantly increased (P＜0.05);as compared with Aβ treatment group,the protein expressions of TLR4,MyD88,IKKα/β and NF-κB in the Aβ+TAK-242 pretreatment group were degraded obviously,with significant differences (P＜0.05).Conclusions Aβ25-35 could reduce the cell survival rate and apoptosis in PC12 cells by up-regulating the expressions of TLR4/MyD88 signal pathway related proteins and increasing the secretions of IL-1β and TNF-α,and the phenomenon is concentration-dependent.TAK-242 could resist Aβ25-35-induced PC12 cytotoxicity through down-regulating the TLR4/MyD88 signal pathway related proteins levels and decreasing the secretions of TNF-α and IL-1β.

Objective:To construct a hierarchical management model of performance objectives,and to explore its application value in the management of medical equipment procurement process.Methods:The procurement performance evaluation indicators were screened from the medical equipment procurement declaration level,process level,use level and disposal level,and the comprehensive evaluation model was developed by entropy weight method and data envelopment analysis(DEA)method to form the process management plan at the level of personnel,system,data and equipment.A total of 717 sets of medical equipment purchased by Beijing Youan Hospital from 2019 to 2022 were selected,and the conventional management mode(348 units)and hierarchical management mode(369 units)were used for management according to different performance objectives evaluation methods.The performance objectives achievement,the quality of procurement process management and the satisfaction of clinical allocation management of medical equipment procurement under different management modes were compared.Results:The 369 units of equipment under the hierarchical management model included operating room equipment,laboratory equipment,inpatient treatment equipment,disinfection supply equipment and other medical equipment,and the performance objectives achievement of the procurement were(96.10±3.46)%,(96.76±2.65)%,(95.59±2.52)%,(96.06±2.34)%and(96.88±1.75)%,respectively,which were higher than those of the management model,the difference was statistically significant(t=2.663,2.801,2.858,4.111,3.548,P＜0.05)The effective ratio of DEA in the comprehensive evaluation of the medical equipment procurement declaration level,process level,use level and disposal level under the hierarchical management model were 96.7%,98.6%,94.6%and 99.7%,respectively,which were higher than those of the conventional management model,the difference was statistically significant(x2=10.983,9.327,7.270,12.309,P＜0.05).The satisfaction of clinical departments with the procurement and use of medical equipment under the hierarchical management model were(95.82±2.83)%and(97.25±1.96)%,respectively,which were higher than those of the conventional management model,the difference was statistically significant(t=5.575,5.248,P＜0.05).Conclusion:The hierarchical management model can effectively implement the performance objectives of medical equipment procurement,improve the management quality of medical equipment procurement process,improve satisfaction of clinical departments and management personnel after procurement,and ensure the quality of equipment operation.