Abstract:Though analyzing the achievements and problems of process of the whole coverage medical insurance in China in detail, the author pointed out that six major issues should be resolved and gave some advices and suggestions to the work of medical insurance under the new situation, including system construction was transformed to system integration and regional co－ordination, insured population growth depended on changes in institutional innovation, stable fair treatment was ensured and innovation of payment mechanism, management and service were harmonious and accurate.

Abstract:Through comparing the health literacy differences between urban areas (samples from Tiexingqiao community) and rural areas (samples from Xishan community) in Yuhua district, 300 residents aged from 15 to 69 respectively, before and after health intervention by questionnaires, the article found that the health literacy status of urban area was much better than rural area. The rate of having basic knowledge and attitudes in rural area was relatively low even after intervention, and the health literacy level of residents between age 65 and age 69 was not significant improved after intervention. As a result, raising the strategy of “two wheels driving mechanism”was a feasible way to shrink the difference of health literacy level between urban and rural areas.

Abstract:Objective: To know the development state of health service in Jiangsu province from 2006 to 2009. Methods: The output of scientific papers of Jiangsu province published in the domestic and foreign academic circles in the four years were analyzed. Results: China Science and Technology Journal Cited Report showed that Jiangsu area had been in a state of the lead and always kept the third place, but the development quality or top innovation point were far behind the areas of Beijing and Shanghai, and the level of development of health service was quite behind other trades of Jiangsu province. Conclusion: During the “Twelfth Five－year Plan”, we should expend money input, foster medical person,maintain stable and sustained development of medical and public health undertakings, at the same time promote high level innovative medical and health service.

Abstract:Objective: To know about medical waste management in primary health care units of Jiangsu province in order to provide evidence for government policy. Methods: Three regions of Sunan,Suzhong and Subei were randomly selected to be investigated. Twenty－two primary health care units were investigated according to present relevant laws and regulations about management of medical waste in our country. Results: Many defects of medical waste management were found in primary health care units. Disposal of sharp medical instruments, construction of temporary storage room, frequency of gathering medical waste, and concentrate disposal needed to be further optimized. Conclusion: Government should consider real situations of primary health care when specific policies are formulated. Practical policies and measures should be carried out and medical waste should be managed reductively, harmlessly and resourcefully.

Abstract:Through observing the level of blood glucose and pregnant outcomes of 120 pregnant women with gestational diabetes mellitus, which were randomly divided into the system health education group and traditional health education group, the article found that there was statistically significant before and after intervention of two groups, and the systematic education group is superior to the traditional education group. There were no significant differences in mode of delivery, birth weight, great children, pregnancy－induced hypertension, polyhydramnios, premature children, fetal distress of two groups, while systematic education group was significantly lower than traditional group in premature rupture of membrane and blood loss. As a result, the systematic health education in the pregnant women with gestational diabetes mellitus was helpful in control of blood glucose and obstetrical disease.

Abstract:Recently,crises of confidence in doctor－patient relationship occur frequently,medical disputes and medical alarm events are ceaseless. Medical practice environment has been seriously affected,while medical staff has burnout and decision－making of quasi－medical career has declined,and medical science brain has been grave drain. As a result,perfecting the relevant legal system and rebuilding the doctor－patient trust are the fundamental policy to optimize the occupation environment.

Abstract:Due to the cognitive autonomy,rich emotion and unique behavioral attribute of the new period college students, the moral education needs a new approach. Empathy,respect,enthusiasm,sincerity of psychological education should be applied to moral education, and only through combination of both, the ideological and political quality should be improved and the effective conduct of moral education should be ensured.

Abstract:Laboratories in colleges and universities are the important position of scientific research. However,there are some problems in the management model. Taking Nanjing Medical University as the example,in consideration of the circumstances,the article explored the construction of laboratories in colleges and universities,which was public scientific research platform,through investigating the advantages and disadvantages of the management model of university lab,analyzing the existing centralized management model,and advancing some strategies for administration and development after the combination of the labs.

Abstract:From the perspective of first－class talent development,the article analyzed the content and requirements of the graduate training model combined with the high level of research,and made recommendations accordingly, such as reformation of a conventional training mode and tutorial system, construction of rewards and punishment institution,and improvement of the research circumstances.

Abstract:The article analyzed the biomedical engineering training model of higher learning institution,and found out advantages and disadvantages,expounded the status quo of the disconnection between theory and practice,the backward of laboratory equipment,the instability of students specialized ideology,then proposed optimization program to deepen the teaching reformation,for example,trying a variety of teaching methods,improving laboratory construction,innovating experiment mode,strengthening the construction of teachers and so on,in order to form the special features and advantages of this teaching model and widen the recognition of the society.

Abstract:Toxicology is the science that studies the adverse effects of chemical,physical or biological agents on living organisms and the ecosystem,including the prevention,treatment of amelioration of such adverse effects. In order to meet the new situation and new demands of the toxicology development,it becomes inevitable to develop innovative toxicological teaching mode and raise high－quality toxicological talents. In this study,the authors proposed to investigate the effects of the innovative teaching mode in toxicology by three aspects,including reforms of classroom teaching,experimental teaching and examination mode. The innovative teaching practice had been proved to be conducive to develop the spirit of innovation which might promote students to be high quality preventive medicine talents with innovative ability.

Abstract:Team－based learning (TBL) in education of medical ethics course is not only accordant with teaching rules,but also according to the trend of moral development. There is an argument in teaching practice,and the positive effect is higher than the negative effect. In order to enhance and improve team－based learning in education of medical ethics course,the article gave some suggestions that limited the object and area of TBL,made possible methods to remedy the defect of TBL,and let medical students think over the modern characters,localization and culture features of medical ethics

Abstract:The article introduced the reform of examination methods of health economics course. The reform emphasized the assessment of the process and the result of the teaching,the former included class attending,group discussion in class,extra work out of class. The reform got the recognition of teachers and students and achieved the expectation aim,such as improving students’ participation enthusiasm of subject teaching,enhancing students’ autonomous learning ability. Courses examination reforms should be constantly improved which need school,teacher,student and others active participation from all sides.

Abstract:Medical examination mode should be a mode that includes not only the theory of knowledge but also practical skills, and consists of formative evaluation and end evaluation. We did our best to study and reform in many aspects: problem－based learning combined with lecture－based learning, objective structured clinical examination, separation of teaching from examination, network database construction and so on. Early results showed that it was worthy of popularization and application.

Abstract:Surgery is the subject of practice. The clinical practice of surgery undergraduate students is a critical component of higher medical education in our country. It is a very important period for medical students to combine the basic knowledge and clinical practice after they complete their basic and clinical theory learning,and they will also finish the role transition that from a student to a doctor at this very time. We face the chief problem is how to culture the practical type medical professional. The problems of clinical practice in surgery were analyzed in this article,at the same time countermeasures were raised.

Abstract:Objective:To investigate the possible role of microRNA-125b(miR-125b) in the development of multidrug resistance (MDR) in human gastric cancer cell line SGC7901/VCR. Methods:Using quantitative real-time PCR analysis and Western blot to detect the expression difference of miR-125b and anti-apoptotic protein BCL2 and MCL1 between multidrug-resistant human gastric cancer cell line SGC7901/vincristine(VCR) and its parental SGC7901 cell line, respectively. BCL2 and MCL1 3’-untranslated region-based luciferase reporter plasmids were constructed to testify the target genes of miR-125b. Transient transfection of miR-125b mimic was used to up-regulate the expression level of miR-125b in SGC7901/VCR cells and the effect of miR-125b on the expression of BCL2, MCL1 and the MDR phenotype was observed. Flow cytometry was used to detect VCR-induced apoptosis of the SGC7901/VCR cells after transfection. Results:miR-125b was low expressed in multidrug-resistant human gastric cancer cell line SGC7901/VCR, and the downregulation of miR-125b was concurrent with the overexpression of antiapoptotic genes BCL2, MCL1 in SGC7901/VCR cells compared with the parental SGC7901 cell line. The luciferase activity of BCL2 and MCL1 3’-untranslated region-based reporters constructed in SGC7901/VCR cells suggested that BCL2 and MCL1 were the common target genes of the miR-125b. Overexpression of miR-125b sensitized SGC7901/VCR cells to anticancer drugs of VCR, CDDP, ADR and VP-16. Overexpression of miR-125b also inhibited the expression of BCL2, MCL1 and sensitized SGC7901/VCR cells to VCR-induced apoptosis. Conclusion:miR-125b plays a role in the development of MDR in human gastric cancer cell line, at least in part, by modulation of apoptosis via targeting BCL2 and MCL1.

Abstract:Objective: To investigate the role and the correlation of HIF-1α and EphA2 in the process of vasculogenic mimicry in esophageal squamous cell carcinoma. Methods: Two esophageal cancer cell lines Eca109 and TE13 were transfected by plasmid harboring interfering RNA targeting HIF-1α and EphA2. The relationship of the expression of HIF-1α and EphA2 was measured by RT-PCR and Western blot. The formation of tubular networks of Eca109 and TE13 cells was analyzed by three-dimension culture in vitro.Results: ①The expression of EphA2 in Eca109 and TE13 was inhibited with silencing HIF-1α. On the contrary, the expression of HIF-1α in Eca109 and TE13 was not obviously inhibited with silencing EphA2. ②The mRNA expression of HIF-1α and EphA2 were markedly inhibited in Eca109 and TE13 lines with silencing HIF-1α and EphA2 gene. ③The numbers of tubular networks were both remarkably decreased in Eca109 and TE13 with silencing HIF-1α and EphA2 gene, but the number of the former was more than the latter. Conclusion: HIF-1α and EphA2 may both participate the formation of vasculogenic mimicry of esophageal squamous cell carcinoma. EphA2 may be one of the important factors regulated by HIF-1αin the process.

Abstract:Objective:To investigate the effects of phosphoinositide 3-kinase(PI3K) inhibitor LY294002 on growth, apoptosis and cell invasion of anaplastic thyroid carcinoma cell line HTH-15. Methods:To perform the experiments, cells were divided into two groups: DMSO control group and LY294002(0~100 μmol/L) treated group. The proliferation inhibitory rate of HTH-15 cells treated by different doses of LY294002 was evaluated by MTT assay; the distribution of cell cycle was calculated by flow cytometry; the protein expression level of phosphorylated-Akt (p-Akt) and matrix metalloproteinases (MMP)-2 in HTH-15 cells were detected by Western blot; Transwell chamber was applied to investigate cell invasion. Results:The growth of HTH-15 cell line was inhibited by LY294002, and this inhibition was in a time and dose-dependent manner. Treated with different concentration of LY294002, the percentage of cells in G1 phase was remarkably higher than that of DMSO control group(P < 0.05); And the protein expression level of p-Akt and MMP-2 in LY294002 group was significantly down-regulated compared to that of DMSO control group (P < 0.05). The cell invasion capacity was also inhibited when treated with LY294002. Conclusion:PI3K-AKT pathway does exist in anaplastic thyroid carcinoma HTH-15 cells, and LY294002 can inhibit the growth of HTT-15 cells through PI3K-Akt pathway,induce apoptosis, and reduce cell invasion ability. PI3K-Akt pathway presents an appealing therapeutic target on Anaplastic.

Abstract:Objective:To investigate the effect of TGF-β1 on the proliferation of human Tenon’s capsule fibroblasts(HTFs) and the effect of Paclitaxel on the proliferation of HTFs stimulated by TGF-β1. Methods: ① HTFs cultured by tissue block adhering wall method were observed by optical microscope and identified by immunocytochemistry methods. ② The 4th and 6th generation of HTFs were incubated with various concentrations of TGF-β1(0,2.5,5,10,25,50 ng/ml)for 24 hours. The proliferation of HTFs was evaluated by CCK-8. ③HTFs were treated with 10 ng/ml TGF-β1 and various concentration of Paclitaxel (0,10,100,1 000,10 000 nmol/L) for 24 h in order observe proliferation. ④ The cell apoptosis was measured by Hochest33342 staining. Results:① The Tenon’s fibroblasts were successfully cultured. The results of vimentin immunocytochemisty staining was positive. ② Treatment of the cells with 2.5~25.0 ng/ml TGF-β1 increased the proliferation of the HTFs. ③ 100~10 000 nmol/L Paclitaxel suppressed the proliferation of the HTFs stimulated by TGF-β1. ④ Hochest staining shows a clear apoptotic features. Paclitaxel treatment resulted in increased number of apoptotic cells in a dose-dependent manner. Conclusion: TGF-β1 may increase the proliferation of HTFs, which could be reduced by Paclitaxel. Paclitaxel could bind to TGF-β1 receptor and interfere in signal transmission and inhibit the scarring after glaucoma filtering surgery.

Abstract:Objective:To establish fibroblasts stably expressing human cementum protein 1 (hrCEMP1). Methods: Eukaryotic expression vector pcDNA3.1-hrCEMP1 was transduced into NIH3T3 cells using SofastTM,and stably transfecting cell line was selected by G418. The transcription of hrCEMP1 in the transfecting cells was determined by RT-PCR and enzyme-linked immunosorbent assay(ELISA). Results: hrCEMP1 mRNA was transcripted and expressed in the transfected NIH3T3 cells. Conclusion:With positive compound transfection, outside hrCEMP1 gene can be successfully transducted and expressed in NIH3T3 cells, which is the foundation of researching the induction of hrCEMP-1 on fibroblast cells.

Abstract:Objective:To investigate the effect of sunitinib on platelet-derived growth factor(PDGF)induced human airway smooth muscle cells(HASMCs) proliferation, migration and phosphorylation of ERK(p-ERK). Methods: HASMCs derived from human bronchus were divided into six groups: normal group, PDGF-BB group, PDGF-BB and sunitinib intervention group, sunitinib intervention group, U0126 intervention group, PDGF-BB and U0126 intervention group. Cell cycle progression was analyzed by flow cytometry. Migration was examined by Transwell test. The protein expressions of p-ERK were determined by Western blot analysis. Results: PDGF-BB (20 ng/ml) increased the proliferation and migration of HASMCs significantly (P < 0.01); sunitinib(3 nmol/L) decreased the proliferation and migration of HASMCs stimulated by PDGF-BB significantly(P < 0.05), which was no difference compared with U0126. The expression of p-ERK in PDGF-BB group was higher than that of the normal group(P < 0.01), which can be decreased by sunitinib. There is no difference between the effect of sunitinib and U0126 on p-ERK expression induced by PDGF-BB. Conclusion: Sunitinib can directly inhibit HASMCs proliferation and migration induced by PDGF-BB through the modulation of the ERK pathway.

Abstract:Objective:To investigate the effects of visfatin on the proliferation and invasion of human cholangiocarcinoma QBC939 cells, and explore the possible mechanisms. Methods: QBC939 cells were cultured and treated with visfatin at different concentrations of 25,50,100 and 200 ng/ml for 6,12, and 24 h. QBC939 cells without visfatin treatment were used as control group. The proliferation rate of the QBC939 cells was measured by MTT assay. Transwell chamber assay was performed to determine the effect of visfatin 200 ng/ml on the invasion capability of QBC939 cells for 24 h later, and Western blot was used to observe MMP-2 protein expression. Results: The results showed that visfatin could significantly improve growth and proliferation of QBC939 cells. The effect is in a dose and time-depended by MTT method(P < 0.01). The invasion capability of QBC939 cell was significantly increased after visfatin 200 ng/ml treatment for 24 h(P < 0.01). The expression of MMP-2 was increased in QBC939 cells treated with visfatin. Conclusion: Visfatin significantly increases the proliferation and invasion capabilities of QBC939 cells in vitro. The possible mechanism may be related with up regulation of MMP-2 level.

Abstract:Objective:To investigate the characteristics of the allele distribution of HLA-B*15 gene family in Jiangsu population, then to study its influence on the selection of clinical transplantation donor and HLA related diseases. Methods:A total of 3 238 cord blood samples from Jiangsu Cord Blood Bank were analyzed by sequence-based typing. Then the sequences encompassing exon 2,3, and 4 for HLA-B gene were typed by direct sequencing of PCR products. The gene frequencies distribution of HLA-B in this population was compared with that in other populations. Results:A total of 21 different HLA-B*15 alleles were detected: B*1501(B62),B*1502(B75),B*1503(B72),B*1505(B62),B*1507(B62),B*1508(B75),B*1510(B71),B*1511(B75),B*1512(B76),B*1513(B77),B*1517(B63),B*1518(B71),B*1521(B75),B*1525(B62),B*1527(B62),B*1529(B15),B*1532(B62),B*1535(B62),B*1546(B72),B*1558(B62) and B*1568(B35). A total of 21 different HLA-B*15 alleles were identified. B*1501(4.69%) was the most frequent allele, followed by B*1511(2.55%),B*1502(2.10%),B*1518(1.34%),B*1527(1.27%). Conclusion:Our study demonstrates the high diversity of HLA-B*15 in the Jiangsu population, which shows direct significance for the selection of transplantation donor, the diagnosis and treatment the HLA related diseases.

Abstract:Objective:To investigate the effect of in vivo shRNA plasmid vector gene transfer to silence OPN expression upon epithelial to mesenchymal transition of the tubular epithelial cells (TECs) in rat chronic allograft nephropathy (CAN) models, and to explore the possible role of OPN in CAN. Methods: Orthotopic renal-transplantation using F344 rats as donors and Lewis rats as recipients was operated to establish Allo group, while transplantation from Lewis to Lewis rats as Syn group. Hydromechanics based gene transfer method was used to establish RNAi and EV groups, for which OPN-shRNA or empty vector was injected into the renal vein. Rats in each group were sacrificed 12 weeks after the surgery. Allograft samples were collected and sectioned for HE staining, masson’s trichrome staining, immunohistochemical study and Western blot assay. Results: The morphological changes of allograft in Allo/EV group consist with CAN. Compared with the Syn group,Western blot showed a significant rise of OPN expression. In the RNAi group, the OPN expression was significantly reduced(P < 0.05) compared with Allo/EV group. The RNA interference inhibited EMT of TECs and the pathogenesis of CAN, which were confirmed by immunohistochemistry and HE/Masson’s trichrome lightscopy. Conclusion:The OPN expression in rat CAN model was significantly up-regulated. The in vivo RNA interference inhibited the OPN expression. Inhibition of OPN can protect the allograft from pathogenesis of EMT and IF/TA in CAN.

Abstract:Objective:To assess the association of monocyte chemotactic protein-1(MCP-1)gene G2518A and CC chemokine receptor 2(CCR2) gene G190A polymorphisms with coronary artery disease(CAD). Methods:Databases, including PubMed, EMbase, CNKI and CBM, were searched to get the association studies on MCP-1/CCR2,RANTES/CCR5 genes polymorphisms and CAD. Results:A total of 21 case-control studies were identified. The Meta-analysis included 6 835(MCP-1-G2518A) CAD case and 11 142 controls,2 801 CAD cases and 5 789 controls(CCR2-G190A),respectively. MCP-1 gene G2518A polymorphism was significantly associated with CAD(P = 0.04). The CCR2 gene G190A polymorphism was also significantly associated with the presence of CAD(P = 0.005). In stratified analysis by race, the MCP-1 gene G2518A polymorphism was significantly associated with the presence of CAD in non-Asian(P = 0.04), while not in Asian(P > 0.05). Conclusion:Our results showed that the MCP-1 gene G2518A and CCR2 gene G190A polymorphisms were associated with an increased risk of CAD.

Abstract:Objective:To explore the association between diabetes mellitus(DM) and risks of extrahepatic cholangiocarcinoma (ECC) by meta-analysis. Methods:Databases of Chinese CNKI, Wanfang, Medline, EMBASE were searched for the articles on the relationships of DM and ECC risk from databases establishment to September 2010;Adjusted relative risks(RRs) and their corresponding 95% confidence intervals(95%CI) were calculated using a random-effect model;Potential sources of heterogeneity between studies were explored and publication bias was evaluated. Results: DM was associated with an increased risk of ECC,with pooled OR=1.62(95%C1=1.05~2.49) for case-control studies and pooled RR=1.54(95%C1=1.06~2.23)for cohort studies. The significant heterogeneity was mitigated in some of the subgroup analyses and publication bias was not significantly in the studies(Egger’s test,P = 0.798;Begg’s test,P = 0.548). Conclusion: The present study suggests that DM may be a high risk factor for ECC.

Abstract:Objective:To investigate the expression of serotonin transporter(5-HTT) in right atrial appendages(RAAs) of patients with valvular atrial fibrillation(AF) and study its clinical significance. Methods:RAAs were obtained from 28 patients undergoing heart valve replacement. Among them, 13 patients were in sinus rhythm(SR), 15 patients had AF. We compared the differential mRNA and protein expression of 5-HTT in the RAA tissues between the two groups by real-time quantitative PCR, Western blot and immunohistochemisty. Results:The mRNA expression of 5-HTT in the AF group was 2.2 times higher than that of the SR group(P﹤0.01).The result of Western blot showed that the 5-HTT protein expression in AF was 2.13 times higher than that in SR(P﹤0.05), which was confirmed by immunohistochemistry. Conclusion:These data suggested that the abnormal levels of 5-HTT in RAAs may be involved in the occurrence and maintenance of valvular AF.

Abstract:Objective:To explore the protective effects of comprehensive measures,including pulmonary artery perfusion with 4℃ oxygenated blood and intermittent ventilation on lung during CPB. Methods:Thirty patients with rheumatic heart disease(RHD) or congenital heart defect(CHD) were divided into two groups with random number table: protective group (n =15), given simultaneously intermittent ventilation and pulmonary artery perfusion with 4℃ oxygenated blood on lung during CPB; control group (n =15) , performed using routine approaches. Mechanical ventilation time was recorded, the lung oxygenate index(OI), respiratory index (RI), airway resistance(Raw) and lung static compliance (Cstat) were detected at the beginning, ending,1 h and 6 h after CPB termination, respectively. Results:The time of mechanical ventilation was significantly shorter in protective group than in the control group. The OI and Cstat of protective group at 1 h and 6 h after CPB termination was significantly better than that of the control group (P < 0.05, P < 0.01, respectively); the Raw and RI of protective group was significantly lower than that of control group at 1 h and 6 h (P < 0.05, P < 0.01, respectively). Conclusion:Comprehensive measures, pulmonary artery perfusion with 4℃ oxygenated blood and intermittent ventilation, has protective effects on lung injury during CPB.

Abstract:Objective:To investigate the effects of right ventricular apex pacing(RVAP) or right ventricular outflow tract septal pacing(RVSP) on left ventricular systolic synchronicity and cardiac function in VVI mode after 1-year of implantation. Methods:Sixty patients who were dependent on pacemaker and can only received VVI single-chamber pacemaker implantation were devided into two groups: the right ventricular apex pacing group(RVAP group, n=30) and the right ventricular outflow tract septal pacing group(RVSP group, n=30). The left ventricular ejection fraction(LVEF) was measured before and one year after operation. The time-volume curves were also recorded by real time three dimensional echocardiography (RT-3DE) to evaluate left ventricular systolic synchronicity. Results: There were no differences on left ventricular systolic synchronicity and LVEF between the two groups before operation. After one year’ follow-up, LVEF in RVSP group increased, but no difference compared with that in RVAP group(P > 0.05). However, the parameters of left ventricular systolic synchronieity(Tmsv 16-SD%and Tmsv 12-SD%) significantly decreased in RVSP group(P < 0.05). Conclusion: The RVSP pacemaker keeps better left ventricular synchronous contraction and has less negative effects on the cardiac function than RVAP pacemaker. Therefore RVSP pacemaker is in accordance with physiological pacing.

Abstract:Objective:To evaluate the impact of left or right bundle branch block(LBBB or RBBB) on LV dyssynchrony and function using phase analysis of gated myocardial perfusion SPECT. Methods: Thirty patients with LBBB, thirty with RBBB and thirty normal subjects with normal cardiac function were enrolled in this study. They all underwent gated myocardial perfusion SPECT imaging. End diastolic volume (EDV), end systolic volume (ESV) and LV ejection fraction (LVEF) were calculated from Philips Cardio MD QGS; The reconstructed data were then submitted to SyncTool to measure phase standard deviation(PSD), phase histogram bandwidth(PHB). Results: All parameters studied showed statistically significant differences between the LBBB and RBBB or control groups. There are no statistically differences between RBBB and control groups. Normal values were calculated based on control group. If PSD > 12.4° is considered dyssynchrony, the rate of LV dyssynchrony in LBBB, RBBB and NL groups is 70%, 16.7%, 0.0%, respectively. If PHB > 43.7° is considered dyssynchrony, the rate of LV dyssynchrony in LBBB, RBBB and NL groups is 63.3%, 13.3%, 3.3%, respectively. Conclusion: Phase analysis of G-MPS can effectively evaluate the LV dyssynchrony caused by LBBB accurately. LBBB can lead to obvious LV dyssynchrony and dysfunction.

Abstract:Objective:To compare image quality of patients with different heart rate(HR) by 256-silce computed tomography coronary angiography(CTCA) using prospective electrocardiogram(ECG)-gating. Methods:Two hundred patients with suspected coronary artery disease underwent 256-slice CTCA using prospective ECG-gating. Patients were divided into two groups according to their HR: the first group(50 b.p.m≤HR < 70 b.p.m,n = 99) and the second group(70 b.p.m≤HR < 90 b.p.m,n = 111). Image quality was evaluated between those two groups. Results:Total 1410(94.95%)segments of the first group were evaluated,among which 1 123(79.65%) segments were classified as excellent,253(17.94%)were good and 34(2.48%) were bad. Total 1 571(94.35%) segments of the second group could be evaluated,1 208(76.89%) segments were classified as excellent,309(19.67%)were good and 54(3.44%) were bad. Conclusion:The patients with HR < 90 b.p.m can undergo CTCA using prospective ECG-gating. Image quality can satisfy the diagnostic requirement.

Abstract:Objective: To explore the expression of blood serum free fatty acid (FFA) and cytokeratin 18 (CK18) and their impact on patients with type 2 diabetes mellitus with non alcoholic fatty liver disease (NAFLD). Methods: Forty patients with type 2 diabetes, 40 cases with type 2 diabetes with alcoholic fatty liver disease, 20 cases of healthy controls were enrolled. Fasting blood glucose (FPG), cholesterol (TC), triglyceride (TG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl (GGT), glycated hemoglobin (HbA1c), insulin (FINS), FFAa and CK18 were detected, and liver B-ultrasound was performed. Results: ① BMI, FPG, FINS, A1C levels and HOMA-IR were significantly higher in group of type 2 diabetes than that of the normal control group; CH, TG, ALT, AST, GGT levels were not significantly different. BMI, FPG, FINS, CH, TG, ALT, AST, GGT levels and HOMA-IR were significantly higher in group of type 2 diabetes with NAFLD than that of type 2 diabetes group (P <0.001); ② Compared with normal control group, FFA levels were significantly increased in group of type 2 diabetes, but CK18 levels were not significantly different. In group of type 2 diabetes with NAFLD, CK18 and FFA levels were higher than normal control group as well as type 2 diabetes group(P < 0.001). Conclusion: Compared with type 2 diabetes patients, insulin resistance, metabolic disorders were more significant and apoptosis of liver cells increased in patients with type 2 diabetes with NAFLD. Further study on pathogenesis of type 2 diabetes with NAFLD should be performed.

Abstract:Objective:To evaluate the therapy effects of glargine on glucolipid metabolism and B-cell function,insulin detection in newly diagnosed type 2 diabetes mellitus(T2DM) patients. Methods:Thirty-two cases of newly diagonosed T2DM,were treated with subcutaneous injection of glargine at fixed time everyday. Fasting serum glucose,blood lipid,blood pressure,the HOMA-IR were detected and compared after three months treatment. Results:After three months treatment,blood lipid,blood pressure,blood glucose,glycohemoglobin A1c(HbA1c) were significantly lower,the bodyweight had no signifancanct difference compare with the un-treatment group;the level of the HOMA-B were significantly higher after treatment;the HOMA-IR were significantly lower(P < 0.01). Conclusion: Glargine can effectively improve,control serum glucose,blood lipid,blood pressure,and the glaginetreatment did not influence the detection of insulin.

Abstract:Objective:To investigate the potential role of Class Ⅲ β-tubulin,Microtubule-associated protein tau(MAPT) and inhibitor-of-apoptosis protein survivin serving as biomarkers for paclitaxel sensitivity in primary gastric cancer. Methods: Viable tumor cells obtained from the samples of fifty-four patients with gastric carcinoma were tested for their sensitivity to paclitaxel using ATP-based tumor chemosensitivity assay(ATP-TCA). Reverse transcription-PCR was used to analysis the mRNA level of related genes expression. Results:Class Ⅲ β-tubulin mRNA level was negatively correlated with the sensitivity to paclitaxel (r = -0.372,P = 0.006), but related to histological differentiation(P = 0.029). MAPT mRNA level is negatively correlated with the sensitivity to paclitaxel(r = -0.292,P = 0.032). Survivin mRNA level was also negatively correlated with the sensitivity to paclitaxel(r = -0.340,P = 0.012),but related to histological differentiation(P = 0.009). Significant relationship was found between Class IIIβ-tubulin and MAPT or survivin expression, respectively(P = 0.037 or P = 0.000). Conclusion: Our results demonstrate that the mRNA expression levels of Class Ⅲ β-tubulin, MAPT and survivin in gastric cancer might be of good value in predicting the sensitivity to paclitaxel.

Abstract:Objective:To investigate the expression and clinical significance of CD24 in human esophageal squamous cell carcinoma(ESCC). Methods:CD24 expression of 63 esophageal squamous cell carcinomas was analyzed by SP immunohistochemistry,and the expression level of CD24 was calculated by the positive cells ratio. Results:CD24 expression was observed in cytomembrane,cytoblast and cytoplasm in esophageal squamous cell carcinoma tissues. The positive rates were 80.95%(51/63),88.88%(56/63)and 85.71%(54/63),respectively,which were obviously higher than 55.56%(35/63),50.79%(32/63) and 0 in the normal esophageal tissues. The expression of CD24 was increasing with the deep of invasion, the increasing number of regional lymph nodes, the distant metastasis and the clinical stage of tumor. The differences among each groups were statistically significant(all P < 0.05). Conclusion:The expression of CD24 has a positive correlation with the depth of invasion, the regional lymph nodes, the distant metastasis and the TNM stage of esophageal squamous cell carcinoma (P < 0.05). The expression of CD24 may play a significant role in the development of the esophageal squamous cell carcinoma and be a new independent prognostic marker in tumor progression of this disease.

Abstract:Objective:To investigate the correlation between histone deacetylase 1(HDAC-1) expression and clinical pathological significance. Methods:HDAC-1 protein expression in 120 cases of breast cancers and a control group of 20 cases of breast hyperplasia in breast tissue were examined by immunohistochemical, and the relationships between HDAC-1 protein and clinical features and conventional detection index of ER, PR, HER-2 were analyzed. Results:Among 120 patients with breast cancer, HDAC-1 was high expressed in 43 cases(35.83%), but HDAC-1 was low expressed or not in control group, the difference was significant. HDAC-1 in breast cancers with high expression was significantly correlated with age, clinical stage, HER-2, expression(all P < 0.05): patients who were older than 50 years(49.50%), in clinical period of stage Ⅲ ~ Ⅳ(64.28%), or HER-2(55.26%) was positive correlation with HDAC-1 high expression, but HDAC-1 expression was negatively correlated with tumor size, histological grade, with or without lymph node metastasis, and cancer tissues and adjacent tissues without infiltration of lymphocytes, and ER(33.89%) or PR(39.28%) expression(P > 0.05). Conclusion: HDAC1 protein plays an important role in the development of breast cancer, and HDAC-1 inhibitor is expected to become a new targeting drug for breast cancer treatment.

Abstract:Objective:To evaluate the effects of antiviral therapy in prevention of tumor recurrence after curative treatment for patients with hepatocellular carcinoma (HCC). Methods: Between Aug 2003 and Aug 2008, 93 patients undergoing radical liver resection for HCC were enrolled in the retrospective analysis. Patients were assigned to two groups: 43 cases of patients(serum HBV-DNA ≥1.0×105 copies/ml) without lamivudine antiviral therapy after operation and 50 cases of patients(serum HBV-DNA ≥1.0×105 copies/ml) received lamivudine(100 mg/d) antiviral therapy after operation. The Kaplan-Meier method was used to calculate the tumor-free survival rates, Log-rank test was performed to evaluate the difference between two groups. Results: All patients were followed-up, the overall recurrence rate and mortality were 78.49%(73 cases ) and 69.89%(65 cases). The 1,3,5-year recurrence rate was 76.74%, 44.19%, 13.95% in radical liver resection group without antiviral therapy and 88.25%, 69.78%, 28.73% in radical liver resection group received lamividine antiviral therapy(P = 0.014 3). Conclusion: The study suggested that antiviral therapy after radical liver resection in patients with HCC can reduce the tumor recurrence and those patients with HBV-DNA ≥1.0×105 copies/ml should received an antiviral therapy as early as possible after extirpation of the primary tumor.

Abstract:Objective: To evaluate the efficacy and toxicity of the combination chemotherapy of docetaxel, oxaliplatin and fluorouracil (DOF regimen) on advanced gastric cancer. Methods: Sixty-five patients with advanced gastric cancer were randomized into DOF regimen group(n = 33) and FOLFOX4 regimen group (n = 32). Clinical efficacy and adverse reactions were observed in the two groups. Results: The objective response rate was 51.5% in DOF regimen group. The median TTP in DOF regimen group was 8.6 months and the one year survival rate was 57.3%. In FOLFOX4 regimen group, the objective response rate was 46.9%%. The median TTP was 5.8 months and the one year survival rate was 41.2%. Statistical analysis indicated that the two groups had similar objective response rate (P > 0.05); TTP and one year survival rate in DOF regimen group were better than FOLFOX4 regimen group(P <0.05); The incidences of neutropenia, thrombocytopenia and hair loss were higher in DOF regimen group than in the FOLFOX4 regimen group(P < 0.05). Conclusion: DOF regimen is effective in treating advanced gastric cancer and the toxicities can be tolerated. It is worth clinical application and extension.

Abstract:Objective:To investigate the refraction accuracy of three different measurements and their influencing factors after excimer laser corneal refractive surgery. Methods: Seventy-eight cases(154 eyes) performed with Excimer laser corneal refractive surgery from optometry clinic, the Eye Ear Nose and Throat Hospital, FuDan University were selected randomly from Dec 2008 to Jan 2009. Sphere,cylinder and cylinder axial of all the patients were measured three months(mean 14.2 weeks)before and after surgery by auto-refractomer wavefront analyzer and phoropter inspection(without cycloplegic). Higher-order aberration, corneal curvature and corneal thickness of every patient were also measured at the same time before and after surgery. Results: The cylinder of auto-refractor and phoropter were significantly different respectively(P < 0.05). Sphere, cylinder and cylinder axial of auto-refratomer and phoropter were significantly different (all P < 0.01) respectively. Sphere of wavefront analyzer and phoropter were statistician different (P < 0.01).The differences of sphere between auto-refratomer and phoropter were found to be related to the corneal curvature,(the regression coefficient is -0.07, P=0.009, P < 0.01). The differences of sphere between waverfront analyzer and phoropter were found to be respectively related to high order wave aberration (C7, C12 )and corneal curvature (The regression coefficient is -0.475, 0.489,-0.004,respectively, and P was 0.001, 0.001, 0.024, respectively). Conclusion: The accuracy of low order wave aberration is better than that of auto-refractomer in measuring refraction especially after surgery. The differences of which the accuracy of preoperative and postoperative measurement of the same eye with three instruments mainly relates to the changes of curvature of the cornea and higher-order aberrations after the excimer laser corneal refractive surgery.

Abstract:Objective:To investigate the effect of acute hypervolemic hemodilution on deep vein thrombosis(DVT) of elderly patients performed operation on huckle. Methods: Forty ASA Ⅰ or Ⅱ patients aged 65-85 yr weighing 52-83 kg undergoing operation on huckle were randomly allocated into 2 groups (n = 20 each): control group (group C); group AHH(group H). Fluid infusion was performed with 6% HES at 15~20 ml/(kg·h) or normal saline at 0.7~0.8 ml/(kg·h) for 1 h through right internal jugular vein before epidural anesthesia. Venous blood samples were obtained before AHH(T0), the end of operation(T2)and the first day of post-operation(T3)for measurement of hematocrit (HCT), prothrombin time(PT), activated partial thromboplastin time(APTT), fibrinogen(FIB), D dimer, whole blood viscocity at low or high shear rates, plasma viscosity, RBC aggregation and RBC deformation. Another venous blood sample was obtained after AHH (T1) for measurement of hematocrit(HCT). CVP at T0 and T1 were monitored. Two group of patients were survey the deep veins of lower limb by color Doppler ultrasound at the day preoperative and the seventh day post-operation. Results: CVP were stable in all patients. Low or high shear rates,plasma viscosity and RBC aggregation index was significantly decreased in group H at T1 and T3 than at T0. But RBC deformation index was significantly advanced at T2 and T3 than at T0 in group H. Plasma viscosity was significantly decreased at T2 and T3 than at T0 and DD was advanced at T3 than at T0 and T2 in group C. Low or high shear rates and RBC aggregation index was significantly decreased, but RBC deformation index was significantly advanced at T2 and T3 in group H than in group C. DD was decreased at T3 in group H than in group C. The incidence rate of DVT in group H was lower than in group C in the seventh day afteroperation. Conclusion: AHH with HES preoperative improves intraoperative hypercoagulability and sluggish blood flow and decreases the incidence rate of DVT.

Abstract:Objective:To study the application of forward optimization technique in the intensity-modulated radiation therapy for nasopharyngeal carcinoma. Methods:From March 2003 to August 2010, 92 patients with nasopharyngeal carcinoma underwent intensity-modulated radiation therapy and were considered in this retrospective study. All treatment plans were designed according to contour-based optimization technique based on the patient’s anatomy, i.e., on the outlined structures like planning target volume and organs at risk, or the apertures can be defined according to certain isodose-lines achieved with an open field. Results:The dose distributions and dose-volume histograms met the demand of treatment in all patients. The doses of 95 percent(D95)of planning gross tumor volume of nasopharyn (PGTVnx) were greater than or equal to 70 Gy for all patients(92/92). The D95s of planning target volume of high risk region (PTV1) were greater than or equal to 60 Gy for 85 patients(85/92), and the D95s of planning target volume of low risk region (PTV2) were greater than or equal to 54 Gy for 82 patients(82/92). The maximum doses of cord were 45 Gy for all patients(92/92). The mean number of segments was 39(range,29~65) and the median was 41. The mean total monitor units (MU) were 720.5(range, 586.9~1 050.7) and the median was 758.6. The mean treatment time was 15.7 min (range, 11.6~23.5 min) and the median was 16.5 min for 65 patients underwent after October 2006. Conclusion:This study suggests that intensity-modulated radiation therapy appears to be a new effective option for nasopharyngeal carcinoma. The satisfactory dose distributions can be obtained using reasonable contour-based optimization technique. The superiorities of contour-based optimization such as deep decreased segments can reduce total MU and shorten treatment, get more efficient treatment outcomes.

Abstract:Objective:To establish a determination method of palonosetron level in plasma. Methods:LC conditions were as follows: Hypersil GOLD(150 mm × 4.6 mm, 5 μm)was used with the mobile phase consisting of acetateamine buffer (0.1% formic acid )-method(50∶50). Equipped with an atmospheric pressure chemical ionization(APCI) source was used as detector. The plasma samples added with internal standard were extracted with Acetic Ether, then concentrated and determined by LC-MS/MS. Results:The linear range of palonosetron was 0.04~20.00 ng/ml . The lower limit of quantification(LLOQ) was 0.04 ng/ml. The recoveries of palonosetron at low, middle and high concentration and the intra-day and inter-day RSDs all met the standards. Conclusion:The established method is sensitive, specific, reproducible and suitable for studies of pharmacokinetics and detection of plasma drug concentration of palonosetron.

Abstract:Objective: To investigate the main inhalant allergens in children with respiratory allergic disease in Nanjing urban districts and provide evidence for prevention and treatment of patients with respiratory allergic diseases. Methods: All cases were collected from out-patient and in-patient department of the Nanjing Children’s Hospital Affiliated to Nanjing Medical University from June 1 st,2009 to July 31 th,2010. Four thousand three hundred and fifty-five children lived in Nanjing urban districts, aged from 1 to 12 years old with diagnoses of asthma and(or)allergic rhinitis were enrolled. All the patients underwent skin prick tests(SPT) with 13 standardized common inhalant allergens. The positive rates, grades and categories of allergens were analyzed. Results:①Of the 4 355 patients,2 618(60.1%)were atopic. Dermatophagoides pteronyssinus(D.p,52.0%) and Dermatophagus farinae(D.f,50.9%) were the most prevalent inhalant allergens.② As age growing, the positive rates, grades and categories of skin prick tests increased, and the preponderance of atopy in boys was more significant. Conclusion: D.p and D.f were the most prevalent inhalant allergens in respiratory allergic disease in Nanjing urban districts. With age growing, children, especially boys, with respiratory allergic disease are more sensitive to inhalant allergens.