Objective To study the supportive personnel system reform for implementing the essential medicine system in Guangxi,as well as its impacts on the township hospitals and problems so incurred.Methods Deans (and/or vice deans)and financial staff of 24 townships hospitals were interviewed,while 80％ of medical staff of health centers in 8 counties were subject to a questionnaire survey,to evaluate impacts of the essential medicine system on township hospitals.Results As shown in the outcomes,44.02％of those surveyed were less enthusiastic after the new system was put in place,township health center doctors found their average salary decreased(P=0.027),and the rewarding salary failed to distinguish differences among posts,which all worsened the brain drain of these doctors.Conclusion The new personnel system is found with setbacks of poor incentive mechanism and poor operability.Thus further improvement should be made in scientific measurement of the gaps found in the performance-based pay,and the implementation of thetwo-way flow of medical personnel policy.

Objective To evaluate the serum level of antimicrobial peptide human cationic antimicrobial protein 18 ( hCAP18 ) in non-small cell lung cancer ( NSCLC ) patients and its auxiliary diagnosis and prognosis value.Methods Case-control study was used.The serum level of hCAP18 was measured by enzyme linked immunosorbent assay ( ELISA) in 50 cases with NSCLC patients of department of thoracic surgery and 50 cases healthy people of department of physical examination from January 2011 to January 2012 in Tongji Hospital of Tongji University.The concentrations of hCAP18 in serum of NSCLC patients before and after surgery were analyzed.The sensitivity and specificity of serum hCAP18 for the diagnosis of NSCLC were evaluated using the receiver operating characteristic ( ROC ) curves.Data was analyzed by using the t-test and Log-rank test.Results Serum hCAP18 concentration in NSCLC patients (6 733 ±771.8) μg/L was significantly higher than in healthy controls (253 ±6.9) μg/L (t=8.396, P<0.05) .However, the concentration of hCAP18 showed no significant difference between squamous cell carcinoma and adenocarcinoma[(6 300.0 ±1 221.0) μg/L and (7 074.0 ±1 005.0) μg/L, respectively;t=0.494 2, P <0.05 ] .hCAP18 levels had significantly decreased in serum of NSCLC patients after 30 d surgery compared to preoperative results[from (6 733.0 ±771.8) μg/L to (433.6 ±38.2)μg/L;t=8.512, P<0.05].ROC analysis of serum hCAP18 yielded an AUC (Area under the ROC curve) of 0.931 ( 95% CI =0.884 -0.978 ) with 95% sensitivity and 96.3% specificity, which was higher than the CYFRA21-1[0.873 (95%CI=0.758-0.917)].The relapse rate of NSCLC patients with serum hCAP18≤390.0 μg/L was 12.5%(4/32), while 44.4%(8/18) in NSCLC patients with serum hCAP18>390.0μg/L (χ2 =22.64,P<0.05).Conclusions Detection of serum hCAP18 shows a good sensitivity and specificity for the auxiliary diagnosis of NSCLC. It is possible to be a potential detection index for noninvasive diagnosis and monitoring progression of lung cancer.

Objectve To evaluate the serum level of antimicrobial peptide human cationic antimicrobial protein 18 (hCAP18) in colorectal patients and it auxiliary diagnosis and prognosis value.Methods Case-control study was used.The serum level of hCAP18 was measured by enzyme linked immunosorbent assay(ELISA) in 68 cases with colorectal patients of department of gastrointestinal surgery and 40 cases healthy people of department of physical examination from January 2014 to Junc 2015 in Tongji Hosptial of Tongji University.The concentrations of hCAP18 in serum of colorectal patients before and surgery were analyzed.Immunohistochemistry was used to detect hCAP18 expression in colorectal carcinoma.The effect of hCAP18 on colon carcinoma cell proliferation was detected by BrdU-ELISA and soft agar colony formation assay.The sensitivity and specificity of serum hCAP18 for the diagnosis of eolorectal were evaluated using the receiver operating characteristic curves(ROC).Date was analyzed by using the ttest and one-way analysis of variance.Results hCAP18 serum levels in colon cancer of stage Ⅰ,Ⅱ,llⅢ and Ⅳ patients were (0.46 ± 0.18) mg/L,(0.65 ± 0.45) mg/L,(1.26 ± 0.68) mg/L and (2.35 ± 1.06)mg/L.Mean value was(1.16 ±0.88) mg/L,which was significantly higher than in normal people (0.19 ±0.07) mg/L (t =5.290,P ＜ 0.05).hCAP18 levels had significantly decreased in serum of colorectal patients after 30 d surgery compared to preoperative results [from (1.16 ± 0.88) mg/L to (0.26 ± 0.06) mg/L;t =3.971,P ＜ 0.05].Immunohistochemistry results showed hCAP18 was high expression in colon cancer tissue compared with adjacent tissues;BrdU-ELISA assay results showed HCTll6 and SW480 cell proliferation increased significantly after 0.05-1 mg/L of hCAP18 treatment;Soft agar clone formation experiment proved hCAP18 could significant enhance clone formation of HCT116 and SW480 colon cancer cell lines.The size of clonal cluster of HCT116 was increased from (145.40 ± 35.20) μm to (370.80 ± 32.65) μm (t =10.50,P ＜ 0.05) and SW480 was increased from (101.00 ± 27.10) μm to (369.00 ± 27.29) μm (t =15.58,P ＜0.05);The numbers of clonal cluster of HCT116 was increased from 8.50 ± 2.30 to 42.80 ± 6.60 (t =3.945,P ＜ 0.05) and SW480 was increased from 6.20 ± 1.70 to 46.00 ± 7.20 (t =4.775,P ＜ 0.05).ROC analysis of serum hCAP18 yielded an AUC (area under the ROC curve) of 0.93 (95％ CI =0.859-0.999)with 91.17％ sensitivity and 80.00％ specificity,which was higher than the CEA[0.78 (95％ CI =0.699-0.933)].Conclousions Detection of serum hCAP18 shows a good sensitivity and specificity for the auxiliary diagnosis of colon cancer.It is possible to be potential detection index for noninvasive diagnosis and monitoring progression of colon cancer.hCAP18 could promote the proliferation of colon cancer cells,it played an important role in the progression of colon cancer.

Objective To investigate the effects of obesity on blood pressure variation and plasma levels of nitric oxide (NO) and endothelin (ET) in elderly hypertensive patients.Methods A total of 175 elderly patients with hypertension were screened for this study.Based on body mass index,they were categorized into three groups with normal weight (n =69),overweight (n=56) and obesity (n=50).24 hour dynamic blood pressure,NO and ET levels were monitored.Results No significant differences in 24 h systolic blood pressure,daytime systolic blood pressure,nighttime systolic blood pressure,24 hours diastolic blood pressure (24 h-DBP) and night time diastolic blood pressure were found among the groups (all P＞0.05).Morning systolic and diastolic blood pressure were higher in obese group than in normal weight and overweight groups(both P＜0.05).The daytime diastolic blood pressure was higher in obese group than in overweight group.24 h systolic blood pressure variation,daytime systolic blood pressure variation,and blood pressure pattern were higher in obese group than in overweight and normal weight group [(12.6 ± 2.7)％ vs.(10.4 ±2.2)％ and (9.4±1.9)％,(12.2±2.9)％ vs.(10.2±2.2)％ and (9.2±2.1)％,(5.2±10.5)％vs.(1.4± 6.9) ％ and (1.8 ± 8.2) ％ group,all P＜ 0.05].The nighttime systolic blood pressure variation,24 h diastolic blood pressure variation,daytime diastolic blood pressure variation were increased in obese group as compared with normal weight group [(9.8 ± 3.7)％ vs.(8.2 ± 3.1)％,(15.3±3.3)％ vs.(13.2±4.2)％,(14.7±3.7)％ vs.(12.9±3.8)％,all P＜0.05].No differences were found in nighttime diastolic blood pressure variation among the groups.Plasma NO level was lower in obese group than in overweight and normal weight group [(29.8± 14.2)μmol/L vs.(47.9± 18.6) μmol/L and (94.6 ± 42.9) μmol/L,P＜0.01].Plasma ET level was significantly higher in obese group than in overweight group and normal weight group [(46.5± 9.8)ng/L vs.(37.3±4.8) ng/L and (31.1± 5.5) ng/L,P＜0.01].24 h systolic blood pressure variation was significantly correlated with plasma NO level (r =0.340,P =0.004) in normal weight group.Conclusions Obesity can effectively increase blood pressure variation and ET level,and reduce plasma NO level in elderly hypertensive patients.Obesity is one of the most important influencing factors for blood pressure variation,plasma NO and ET levels.