Objective To explore the expression of CD14 and TLR4 ( Toll like receptor - 4) in peripheral blood monocytes during the different stage of cancer patients. Methods The expression of TLR4 and CD14 on peripheral blood monocytes was determined by flow cytometry in 50 healthy control group and 80 patients with malignant tumor who were divided into stable group and advanced group according to the change of the size of tumor measured by image and/or the outcome of tumor makers. Results No significant difference was found in the expression level of CD14 between the different stage of malignant tumor ( stable group and advanced group) and healthy controls [ (6. 1600% ? 2. 32217% ,5. 8629% ? 1. 91896% ) vs (5. 5580% ? 1. 42272% ) ]. The expression of TLR4 in stable group had no significant difference as compared with control group [ ( 10. 4444 ? 3. 16225 ) % vs (8. 8780 ? 5. 24612) % ]. The expression of TLR4 in advanced group was significantly higher than that in controls and stable group [ ( 14. 7286 ? 6. 95213 ) % vs ( (8. 8780 ? 5. 24612) % , ( 10. 4444 ? 3. 16225) % ) (P

Objective To determine the dynamic changes in adenosine monophosphate-activated protein kinase (AMPK) in neurons of neonatal rats suffering from hypoxic ischemic brain injury.Methods Twenty-four-hour old and seven-day old neonatal rats were used in this study.A classic primary cortical neuron oxygen glucose deprivation (OGD) model and neonatal rat hypoxic ischemic encephalopathy (HIE) model were employed.Lactic dehydrogenase (LDH) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) were used to evaluate neuron viability and damage.The expression of phosphorylated adenosine monophosphate-activated protein kinase (P-AMPK),phosphorylated activated protein kinase (P-Akt) and Cleaved Caspase-3 in neurons and brain tissue was measured by Western blot at different time points after OGD or HIE.The Student-t test was used for statistical analysis.Results (1) Compared with the control group,LDH levels at 2,4,8 and 24 h after OGD were higher (all P＜0.05) and optical absorption levels of MTT were lower (all P＜0.05).(2) Levels of P-AMPK in the OGD group were higher than those in the control group,and showed a time-dependent increase at 30 min and 2,4,8 and 24 h (all P＜0.05).The expression levels of P-AMPK in the HIE group were higher than those in the control group (0.345 ± 0.038,0.387 ± 0.112 and 0.618 ± 0.075 at 1,3 and 7 days after HIE,and 0.132±0.032 in the control group,all P＜0.05).(3) The levels of P-Akt increased above the control levels at 30 min (0.991 ±0.134 vs 0.304±0.050),reached a maximum level at 2 h (1.183± 0.107),and then gradually declined,whereas the levels of Cleaved Caspase-3 started to increase at 30 min,and remained elevated at 24 h (all P＜0.05).Conclusion Following hypoxic ischemic brain damage,the expression of P-AMPK is significantly increased in both in vivo and in vitro studies in a time-dependent manner.

Objective To investigate the diagnosis,treatment and prognosis of neonates with severe acute respiratory distress syndrome (ARDS) according to Berlin definition.Methods A retrospective study was carried to analyze the clinical features about diagnosis,treatment,chest X-ray findings,mortality,complications and ventilator parameters in 86 neonates with severe ARDS admitted in the NICU from January 2005 to December 2013.Results (1)Among the 86 cases,55 were cured,and 31 died with 36.0％ mortality.(2) Chest X-ray showed there was decreased lucency of bilateral lungs with ground-glass appearance,lung texture with thick chaos or dot flakes or patchy shadows in 36 neonates; diffuse infiltrates and extensive confluent consolidation shadows in bilateral lungs along with peripheral air brornchograms in 26 cases; heart shadow and diaphragmatic surface disappeared like a white lung change in 24 cases.(3) Persistent pulmonary hypertension of newborn as a complication occurred in 68 cases with 79.1％ incidence.(4) Eighty-six cases were categorized into survival group and death group.The results showed compared with the survival group,the neonates in death group required higher FiO2,and PaO2,and lower PaO2/FiO2 before mechanical ventilation (P ＜ 0.01),but needed higher initial PIP of mechanical ventilation (P ＜ 0.01).Conclusions Neonatal ARDS is still a kind of critical condition with high mortality and lack of evidence-based diagnostic criteria so far.The therapeutic strategy for neonatal ARDS should be a comprehensive measures in addition to appropriate respiratory support.

Objective To investigate the efficacy and safety of aminophylline,caffeine citrate and aminophylline combined with naloxone in prevention of apnea of prematurity(AOP).Methods Ninety-four infants with a birth weight ＜ 1 500 g and gestational age ＜ 34 weeks admitted to Department of Pediatrics,Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology between Jan.2010 and Jan.2012 were randomly divided into 3 groups.(1) Aminophylline group (n =30):30 infants received a loading dose of 4-5 mg/kg of aminophylline and then maintained by a dose of 2 mg/kg,with intravenous drip q12 h.(2) Caffeine citrate group(n =32):a loading dose of 20 mg/kg of caffeine citrate was followed by a daily maintained dose of 5 mg/kg,with intravenous drip per day.(3) Aminophylline combined naloxone group (observation group,n =32):32 infants were treated with Aminophylline combined with naloxone.After 6 hours of the first dose of aminophylline,a dose of 0.1 mg/kg naloxone was injected,q12 h.Then the two drugs were used alternately.The mortality and incidence of AOP,bronchopulmonary dysplasia(BPD),retinopathy of prematurity (ROP) and brain injury were evaluated,and drug-related side effects were recorded.Results 1.There was no significant difference in gender,gestational age,birth weight,maternal antenatal glucocorticoid application,pregnancy (including multiple pregnancy) and delivery,5 min Apgar score,oxygen therapy,and the application of positive airway pressure as well as pulmonary surfactant among the 3 groups(all P ＞0.05).2.Compared with aminophylline group,the incidence of apnea of caffeine group and observation group were significantly lower (F =6.704,P ＜ 0.05),but there was no significant difference between caffeine group and observation group (P ＞0.05).3.There was no statistically significant difference in mortality,duration of oxygen therapy,the incidence of ROP,brain injury and hearing loss,postmenstrual age,body weight at discharge,the duration and cost of hospitalization among the 3 groups(all P ＞0.05).4.The BPD incidence in caffeine group[9.4％ (3/32 cases)] and observation group [12.5％ (4/32 cases)] were lower than that in Aminophylline group [20.0％ (6/30 cases)],but there was no statistical significance among the 3 groups(P ＞ 0.05).5.No drug-related side effects were recorded in the 3 groups.Conclusions It is safe and effective to use aminophylline combined with naloxone in prevention of AOP,and its efficiency is similar to caffeine citrate.

Objective To investigate the neuroprotective effects and mechanisms of 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/ IMP cyclohydrolase(AICAR) supplement (AMPK activator) in different stages of neonatal rats sufferring from hypoxia-ischemia encephalopathy ( HIE). Methods Neonatal rat hypoxia-ischemia brain injury model was employed in this study. A total of 160 neonatal rats were distributed into five groups: sham, model control,AICAR30 min, AICAR24 h and AICAR72 h. The neuroprotective effects of AICAR supplement (30 min, 24 h, 72 h post operation) were compared by cresyl violet staining; Expressions of P-AMPK,AMPK in the brain tissue were measured by Western blotting.Foot-faults method was used to evaluate the long-term prognosis of the rats. Results Compared with the sham group, the survival of rats brain in model control group was significantly decreased [(100.0± 0.1)% and (45.3± 6.3)%, P< 0.05]. AICAR had neuroprotective effects when treated at 30 min and 24 h post operation,while the protective effects disappeared when treated later (72 h post operation) (P>0.05). Compared with the sham group, the expression of P-AMPK significantly increased about three times, while ATP level decreased close to the same. Conclusion Early AICAR treatment can protect hypoxia-ischemia brain injury by increasing AMPK-ATP level.

During the mission of Peace friendship-2015, between September 2015 and January 2016,the Chinese Navy hospital ship respectively participated in the Harmony-2015joint military exercise in Malaysia and with the local military of Polynesia and Barbados .The article summarized the relevant background of the joint military exercise and the main practices in various stages .This article also suggests that the emergency platform be moved forward , the function of the triage area be expanded, basic life support(BLS),advanced cardiovascular life support (ACLS),and advanced trauma life support(ATLS) training programs be introduced, the training model and the test system be innovated , and realistic traumatic conditions be designed in order to guarantee the success of the joint exercise .

Objective To investigate serum DJ-1 expression and its significance in ovarian cancer. Methods The expression levels of DJ-1 protein were detected by double antibody sandwich method in 52 cases of ovarian tumors (9 cases of benign ovarian tumors, 5 cases of borderline ovarian tumors and 38 cases of ovarian cancer,ovarian tumor group and 20 non-ovarian tumors (control group). Results The expression of DJ-1 protein was lower in the control group than that in ovarian tumor group (P<0.05). The expression of serum DJ-1 protein was higher in ovarian cancer than that in borderline ovarian tumors and in benign ovarian tumors. The expression of serum DJ-1 protein was higher in borderline ovarian tumors than that in benign ovarian tumors (P<0.05).The expression of serum DJ-1 protein was higher in poorly differentiated and moderately differentiated ovarian cancer than that in high-grade differentiated ovarian cancer (P<0.05). No significant dif-ference was found in the expression serum of DJ-1 protein between different pathological and different histological types of ovarian cancer (P>0.05). Conclusion DJ-1 might be used as a serum marker in the diagnosis of ovarian cancer. It might be involved in the pathogenesis of ovarian cancer,and could predit the development and prognosis of ovarian cancer.

Objective To analyze the factors for willingness to pay(WTP)in different quantiles and to provide evidence for formulating premium of minors covered by Urban Residents'Basic Medical Insurance.Methods In a field survey,the study adopted the contingent valuation method and quantile regression to measure and analyze the WTP.Results The influencing factors and degree of influence varied in different quantiles.Annual household income was significant in 10 of 11 quantiles with the maximum marginal effect of 350 yuan.Whether the insured comes from a village in a city affects 8 of the 11 quantiles whereas gender,age and health conditions of minors have minor effect on willingness to pay.Conclusion The premium standard should be raised from 40 yuan per person per year to 100 yuan.Minors can be categorized into subgroups and be set with distinct premiums in terms of the significant influencing factors and its influence degree.

Objective To investigate of the effect and mechanisman of SERCA2 on the phenotype modulation of HASMCs. Methods HASMCs were starved for 5 days and divided into different groups ,then we observed morphology change of the cells from the microscope and detected a-actin、SERCA2 and p-ERK by Western Blot,cells proliferation was observed by CCK-8 method. Results Compared with the control group,PDGF could reduce a-actin of HASMCs and increased the cells proliferation ability ,TSG could significantly inhibit the effect (P<0.01), PDGF could also significantly inhibit SERCA2 protein and increased the expression p-ERK (P<0.01), while U0126 significantly inhibited the effect (P < 0.01). Conclusion PDGF may induce HASMCs phenotype modulation through the regulation of SERCA2 and p-ERK.

Objective To explore the diagnostic value of detecting serum DJ-1 protein combined with CA125 for epi?thelial ovarian tumors. Methods Double antibody sandwich method and electrochemiluminescence immunoassay were used to determine the serum levels of DJ-1 protein and CA125 in 82 cases of epithelial ovarian tumors and 80 non-ovarian tumor cases (control group). The clinical significance of detecting serum DJ-1 protein combined with CA125 was analyzed. Results The expression levels of DJ-1 and CA125 were significantly higher in ovarian tumor group than those in the con?trol group (P<0.05). The critical value of serum DJ-1 was 6.800μg/L and 6.965μg/L in ovarian cancer group compared with the control group and non-ovarian tumor group. The sensitivity of combined detection of DJ-1 and CA125 was higher than that of any marker alone. Conclusion The detecting serum levels of DJ-1 combined with CA125 are helpful to the diagnosis of ovarian cancer, which can be a good marker of ovarian cancer and may improve the early diagnosis rate of ovarian cancer.