全科医生网英文版

CHINESE GENERAL PRACTICE

(2008)

Volume10,Number21Novermber，2008

Volume10,Number22Novermber，2008

Volume10,Number23December，2008

Volume10,Number24December，2008

Number 1January ，2008

The Practice and Discussion on Graduated Education and Assessment for General Practitioners(GPs) in Zhongshan Hospital SHOU Juan,ZHU Shan-zhu.
Faculty of General Practice,FuDan Medicine Institute,Shanghai 200025，China
? 【Abstract】 Objective To explore a new education and assessment model of GPs′ standard training in comprehensive teaching hospital,which corresponds with biological-psychological-social medical pattern.
Methods Residents,graduated from medical university and willing to become GPs,were selected as training objects.A new series of regulations and precis of GPs′ standard training as well as the methods of examination and assessment were created,based on six aspects involving patient care,medical knowledge,practice-based learning and improvement,interpersonal and communication skills,professional ethics and health-care system-based practice.
Results Established the GPs′ standard training model;designed training outline and scheme;formulated educational administration and assessing means;published several textbooks on GPs′ training;71 students have acquired the qualified certification for GPs′ standard training in the past six years.
Conclusion GPs′ training leading in comprehensive teaching hospital will help to set up and perfect GPs′ educational pattern.
? 【Key word】 General Practice；Education；Evaluation;Comprehensive teaching hospital

The Practice and Analysis of General Medical Mode in Community Teaching HAO Yong－hong，FENG Hai－liang.
Siping Community Health Service of Yangpu Area，Shanghai 200092，China
【Abstract】 By taking advantage of integrating community healthcare resources,this article discusses the framework and evaluation of community teaching,and elucidates on the practice of general medical mode in community teaching.With initial accumulation of some experience and understanding,the author puts forward the shortcomings and countermeasures concerning the practice of general medical mode in community teaching.
【Key word】 General medical practice; Community practice; Medicine practical teaching

A Controlled Trial of Drug Intervention for Preventing the Cirrhotics Esophageal Varices Bleeding ZUO Wen-ge,WANG Chun-ping,XUE Xing-cun,et al.
Department of Gastroenterology,Yan′an Municipal People′s Hospital,Yan′an 716000,China
【Abstract】 Objective To investigate the efficacy of association of propranolol,isosorbide-5-mononitrate (ISMN) and spironolactone in the prevention of first hemorrhage in patients with esophageal varices.
Methods Totally 106 patients with esophageal varices（liver function in Child-Pugh as grade A or B）were randomly divided as trial group treated with propranolol,ISMN and spironolactone （n=54）and control group treated without the above drugs （n=52）.
The prospective survey was conducted for the patients in both groups,51 patients in each group was completed in follow up for 24 months respectively.
Results The rate of first hemorrhage in trial group was significantly lower than that in control group(27.5% vs 52.9%) （P＜0.01）; and so the rate of recurrent hemorrhage was （13.7% vs 37.3%）（P＜0.01）.The total quantity of blood transfused was significantly less in the patients with hemorrhage in trial group than that in the control group (7200 ml vs 28600 ml) (P＜0.05).The inner diameter of splenic vein,the quantity of splenic bloodstream,portal vein bloodstream and Child-Pugh grade were significantly lower in the trial group than those in the control group in the terminal of observation（P＜0.05); while plasma prothrombin activity was higher in the trial group than that in the control group （P＜0.05).
Conclusion The combination of propranolol and ISMN with spironolactone can effectively prevent hemorrhage in cirrhotic esophageal varices.
【Key word】 Propranolol;Isosorbide-5-mononitrate;Spironolactone;Esophageal and gastric varices

Correlation of Pulse Pressure and Patterns of Left Ventricular Hypertrophy and Cardiac Function in Old Patients with Hypertension? WANG Lu-hong,DU Yi-peng,WANG Xiu-hong.
Huguo Temple Chinese Medicine Hospitals Affiliated to Beijing University of Traditional Chinese Medicine,Beijing100035,China
【Abstract】 Objective? To investigate the relationship between pulse pressure (PP) and patterns of left ventricular hypertrophy (LVH) and cardiac function in hypertensive old-aged patients who had been received standard antihypertensive therapy.
Methods The correlation of blood pressure with LVH was analyzed retrospectively in 176 old-aged patients with essential hypertension.
Results （1） There was significant difference in PP between the patients with asymmetric septal hypertrophy,symmetric septal hypertrophy and dilated hypertrophy and shoes with no LVH (P＜0.01).（2） The cardiac systolic and diastolic functions were decreased with rise of PP.（3） Logistic regression analysis showed that PP was strongly correlated with left cardiac insufficiency in old-aged patients with essential hypertensive.Every 10 mmHg increment in PP was associated with 30% increase in left cardiac insufficiency risk 95%CI（1.23～1.37）,P＜0.0001.After adjusting for age and duration of hypertension,every 10 mmHg increment in PP was associated with 19% increase in left cardiac insufficiency risk 95%CI:1.13 to1.25,P＜0.0001.
Conclusion The PP has a positive correlation with patterns of LVH and may be an independent and important risk factor for left cardiac insufficiency in essential hypertensive old-aged patients under standard antihypertensive therapy.The cardiac systolic and diastolic functions were decreased with rise of PP.
【Key word】 Hypertension;Aged;Blood pressure determination；Hyertrophy，left ventricular

Effects of Loratadine and Inhale Corticosteroids on Asthmatic Children with Allergic Rhinitis CHEN Mei,LIU Dan.
The Department of Pediatrics,Fengtian Hospital Affiliated to Shenyang Medical College,Shenyang110024,China
【Abstract】 Objective To evaluate the therapeutic effects of Loratadine in combination with low dose inhaled corticosteroid on allergic asthma.
Methods 67 children with mild to moderate allergic asthma were randomized to receive either Loratadine or placebo on the basis of inhaled Fluticasone propionate for 3 months.Symptom scores of asthma，frequencies of episode of rhinitis、common cold、frequencies of episode of wheeze and doses of inhaled Ventolin as rescue drug were recorded.Serum sICAM-1 were measured before and after treatment.
Results After treatment,there was much better improvement in symptom score,frequencies of episode of rhinitis,common cold,frequencies of episode of wheeze,doses of inhaled Ventolin in Loratadine group as compared with the control group(P＜0.05 ).There was no change in serum sICAmI-1 levels before treatment (P＞0.05 )
However,there was a significant change in serum sICAM-1 levels after treatment in Loratadine group（P＜0.05).
Conclusion On the basis of inhale corticosteroids,orally administered Loratadine significantly improves the therapeutic efficacy of asthma in children with allergic asthma and rhinitis.One of the mechanisms of Loratadine is to reduce the expression of sICAM-1.
【Key word】 Loratadine;Asthma;Rhinitis,allergic;Intercellular adhesion molecule-1

Antitumor Immunity of Dendritic Cells Induced in Vitro and in Vivo in Patients with Carcinoma Cervicis ZHANG Li，WANG Xue-feng.
Department of Histology and Embryology，Liaoning Medical College，Jinzhou121001，China
【Abstract】 Objective To investigate whether dendritic cells (DCs) obtained from patients with carcinoma cervicis can be induced a efficient and specific immune response against carcinoma cervicis in vitro and in vivo.
Methods Cocultured with combination of granulocyte/macrophage colony stimulating factors(GM-CSF) and interleukin 4(IL-4)，DCs can be obtained from peripheral blood of patients with carcinoma cervicis.After activated with Hela-tumor-associated antigen (TAA),DCs were incubated with T lymphocytes to produce cytotoxic T lymphocytes (CTLs) and then the cytotoxic effect of CTLs on cancer cells was detested by MTT assay.The tumor mice were set up by incubation of Hela cells subcutaneously,then the antigen-activated DCs were given; or DCs were first given and then incubation of Hela cells was conducted.The immunotherapeutic effect to tumor was observed in vivo.
Results DCs，induced from peripheral blood of patients with carcinoma cervicis，had a high expression of CD86,CD 40,HLA-DR,CD54 and CD83.The CTLs activated by DCs could specifically kill the cancer cells in vitro.Transfusion of DCs could immunologically protect the mice,reduce the rate of tumor formation,and prolong the latent period.Besides,it also could play an immunotherapeutic effect,and effectively inhibit the growth of tumor.
Conclusion DCs，activated with GM-CSF and IL-4，can efficiently present antigen and induce effective immunoresponse to tumor.It will probably become an effective and special immunotherapy for antitumor.
【Key word】 Dendritic cells (DCs);Granlocyte/macrophage colony-stimulating factor;Interleukin 4;Carcinoma cervicis

Analysis of the Level of Neurotransmitters of Sub-Healthy People with Insomnia LI Shao-dan，YANG Ming-hui，WANG Zhen-fu，et al.
Institute of Traditional Chinese Medicine，General Hospital of PLA，Beijing 100853，China
【Abstract】 Objective To investigate the changes of main neurotransmitters in the brain of sub-healthy people with insomnia and the relationship between the level of neurotransmitters with the degree of insomnia.
Methods Detecting the neuro-transmitters changes and the Pittsburgh Sleep Quality Index (PSQI）values of 46 sub-healthy people with insomnia by Encephalonuctuogram (EFG) technique and PSQI scale respectively.
Results PSQI value of each insomniacs was equal to or exceeded 7，and the value of the most (accounting for 82.6 %) was between 7 and 16.The neuro-transmitter′s levels ofγ-amino-butyric acid (GABA）,Glutamate (Glu),Serotonin (5-HT),Acetylcholine (Ach),Norepinephrine (NE) and Dopamine (DA）were all declined obviously (P＜0.05).The changes of GABA and Glu were significantly correlated with the value of PSQI (r=-0.967，P＜0.01；r=-0.639,P＜0.05 respectively).
Conclusion Main neurotransmitters in the brain of sub-healthy people with insomnia are decreased obviously.GABA and Glu play very important roles in the aggravation of insomnia.
【Key word】 Sleep initiation maintenance disorders；Neurotransmitters；Brain mapping

Correlation between Expression of p21WAF1 Gene and Clinical Pathological Features of Hepatocellular Carcinoma ZHANG Jian－feng，LIU Hai-yan，WU Yin-wei，et al.
Department of Pathology，Affiliated Nanjing Second Hospital，Medical College of Southeast University，Nanjng 210008，China
【Abstract】 Objective To study the correlation of expression of p21WAF1 gene with the clinical pathological features（histological grade，metastasis and tumor size or cover producing）of hepatocellular carcinoma (HCC).
Methods The cancer tissue and peri-cancer tissue samples of the 45 patients with HCC were as random taken.P21WAF1 protein expression in the samples was detected by the immunicytochemical method (SP).The correlation of expression of p21WAF1 gene with the clinical pathological feature（histological grade，metastasis and tumor size or cover producing）of HCC was studied.
Results The positive expression rates of p21WAF1 proteins in the cancer tissue and peri-cancer tissue samples were respectively 68.9% and 15.6%,with a significant difference (P＜0.01).But no correlation was found between expression of p21WAF1 protein expression and clinical pathological features（histological grade，metastasis and tumor size or cover producing）of HCC（P＞0.05）.
Conclusion The positive expression of p21WAF1 gene is not directly correlated with the clinical pathological features（histological grade，metastasis and tumor size or cover producing）of HCC.So p21WAF1 could not serve as an index for malignant differentiation and prognosis of HCC.
【Key word】 p21WAF1；Carcinoma，hepatocellular；Pathological feature

Human Placental Trophoblast Cell Strain Transfected with Hepatitis B Virus Adr Subtype In Vitro ZHANG Lei,SHAO Chen,ZHAO Yan-fang,et al.
Department of Epidemiology,The Fourth Military Medical University,Xi′an 710032,China
【Abstract】 Objective To establish the human placental trophoblast (HPT-8) cells for replicating HBV by transfection of pcDNA3-3HBV adr subtype in vitro.
Methods HPT-8 cells were transfected with eukaryotic expression plasmid pcDNA3-3HBV by using lipofectamine transfection reagent,after being screened with antibiotic G418.HBsAg and HBeAg were identified by enzyme linked immunosorbent assay (ELISA),and HBV DNA was tested by polymerase chain reaction (PCR) in the supernatant of transfected HPT-8 cells.HBcAg and HBsAg were identified by immunocytochemical staining in the transfected HPT-8 cells.
Results After HPT-8 cells were stably transfected with pcDNA3-3HBV,the ELISA showed,.in the supernatant of transfected HPT-8 cells at passage1 and passage2,HBsAg and HBeAg were positive; the immunocytochemistry showed,in the plasma of transfected HPT-8 cells,HBsAg and HBcAg were of positive staining; the PCR revealed positive HBV DNA gene in the supernatant; the real-time quantitative PCR showed copies of HBV genome reach 9×106 copies /L,and RcDNA and cccDNA was found in the HPT-8-HBV cells.
Conclusion Recombinant plasmid pcDNA3-3HBV could be expressed,transcribed and replicated in HPT-8 cells.
【Key word】 Hepatitis B virus;Trophoblast cell;Adr subtype;Transfection

Expression of B7-H3 in Non-Small-Cell Lung Cancer ZHAO Jian-qiang，SUN Yu-ping，WANG Wei,et al.
Shandong University,Jinan Central Hospital,Jinan 250013,China
【Abstract】 Objective To study the expression of B7-H3 in non-small-lung cancer and its relation with cancer clinicopathological variables.
Methods The expression of B7-H3 in 70 surgically resected specimens of non-small-lung cancer was evaluated immunohistochemically; Furthermore,the correlation between B7-H3 expression and clinicopathological variables was analyzed.
Results In these tumor specimens,expression of B7-H3 was observed in the cell membrane and/or cytoplasm.There was no significant difference between the patients with squamous cell carcinoma and those with adenocarcinoma in positive expression of B7-H3（P＞0.05）.And there was a significant association between the high expression for B7-H3 and lymph node metastasis (P=0.046).
Conclusion The expression of B7-H3 is probably related to the metastasis and development of non-small-cell lung cancer.
【Key word】 B7-H3;Carcinoma,non-small－cell lung cancer;Immunohistochemistry

Exploration of Rural Community Health Care and New-type Rural Cooperative Medical System WANG Yong-dong，LI Fang-jian.
The Center of Community Health Care of Dongfeng，Zhongshan 528425，China
【Abstract】? Recently，in some developed rural areas community health care(CHS) has been first explored and practiced.As the basic model of health service，rural CHS has improved the new-type rural cooperative medical system.It improves the rural health service system and so as meet the demands of rural residents for their basic medicine and public health service.This new model is good for other regions at home to reference in practice.
【Key word】 Community health services；Rural；New-type rural cooperative medical system

Primary Study about Expenditure Controlling of New Cooperation Medical System ZHOU Shang-cheng，KUANG Cheng-yun，CHAI Yun.
Yunyang Medical College，Shiyan 442000，China
【Abstract】 On the base of expenditure controlling methods acdepted by urban employees′medical insurance system and traditional cooperation medical system，the author studies the causes of rising expenditure of New Cooperation Medical System and puts some countermeasures forward.
【Key word】 New cooperation medical system；Health care cost；Cost control

Technology and Strategy on Prevention and Treatment of Chronic and Non-infectious Disease WANG Ya-dong，KONG Ling-zhi.
Capital Medical University，Beijing 100036，China
【Abstract】 Now the prevention and treatment of chronic diseases have been paid more attention worldwide.In this article，we study the principle for prevention and treatment of the chronic diseases，the technical measures as well as the condition and the strategy of their implementation，explore the experience and problems in the prevention and treatment at home and abroad，and then put forward some proposals.
【Key word】 Chronic and non-infectious disease；Universal precautions

Health Management and Its Application in Chronic Non-infectious Disease ZHOU Fen，SUN Yu-mei.
Nursing School，Health Medical College，Peking University，Beijing 100083，China
【Abstract】 To undertaking health management on chronic non-infectious diseases could not only raise the patients′ life quality but also cut down the expense of medical service effectively.At present,lots of relative researches have been done at home and abroad.The overviewed are as follows: the origin and definition of health management,its practice and effect evaluation in chronic disease.
【Key word】 Chronic non-infectious disease；Health management；Disease management

Investigation of Community Nursing Services and the Influential Factors WANG Sheng-feng，QI Yu-mei，MAO Zong-fu，et al.
Medical School of Jingmen Technical College,Jingmen 448000，China
【Abstract】 Objective To find out what the community nursing services are and to explore the related influential factors.
Methods The questionnaires was used to survey the community nursing services in 3 medium-sized cities of Hubei province from the aspects of disease nursing,health education,prevention and healthcare,family nursing,rehabilitation,nutrition guidance,family planning,psychological health,community medical diagnosis and hospice care.And the related influential factors were analyzed.
Results The first two services offered by community nurses were diseases nursing (94.1%) and health education (88.6%),the last two were medical diagnosis (15.4%) and hospice care (14.6%).The offered service mainly influenced by age was rehabilitation; the services influenced by education background were health education,prevention,psychological health and community medical diagnosis; the services influenced by professional titles were family planning,psychological health and nutrition guidance; the services influenced by working years were health education,prevention,family planning and family nursing.
Conclusion Community nurses offer more disease nursing and health education but less medical diagnosis and hospice care.The community nurses should be assigned more appropriately,nursing procedures be more standardized,professional qualities be enhanced,and a better condition be built up to develop community nursing services.
【Key word】 Community nursing;Nursing services;Influential factors

Investigation of the Current Status of Health Promotion Hospitals in Beijing: An Clinical Analysis of 805 Inpatients GUO Xiu-hua，TIAN Xiang-yang，PAN Yue-song,et al.
Department of Epidemiology and Statistics，The School of Public Health and Family Medicine，Capital Medical University，Beijing 100069，China
【Abstract】 Objective To investigate the current status of health promotion for patients in hospitals of Beijing，in order to provide measures for the improvement of health promotion work in hospitals of Beijing.
Methods The multi-staged and stratified random sampling was taken in investigating 805 inpatients form both pilot an non -pilot hospital through questionnaires.
Results The degree of satisfaction of the patients in the pilot hospital to the hospital green environment,ward conditions,conditions of bathroom,food quality,service attitude of the food deliver was higher than that in the non-pilot hospitals,with a significant difference（P＜0.05）.The synthetic score of the pilot hospitals was higher than that of the non-pilot hospital.
Conclusion The pilot project in health promotion hospitals of Beijing is successful.However there are some respects which remain to be improved，including the natural and hygiene environments in hospital,paying close attention to psychological stress of patients and health education.
【Key word】 Inpatients；Patient satisfaction；Health promotionl

Status of Health Care Behaviors of Urban Residents in Shenyang XU Shou-qi，XIA Xiao-ming.
Shenyang Health Education Institute，Shenyang 110031，China
【Abstract】 Objective To understand the status of health care behaviors of urban residents in Shenyang City.
Methods A questionnaire survey was conducted among 5703 residents selected by stratified randomly sampling in Shenyang,including socio-demographic information and health care behaviors.
Results There were 15.01% of residents who had have more than four kinds of health agents; there were 16.03% of residents who had grasped more than three skills; there were 14.80% of residents who had joined physical checkup.There was a significant difference in health care behavior among people with different incomes,and educational levels（P＜0.05）.
Conclusion Health education should be done with a definite object,paying attention to the different needs of people with to different incomes and educational levels.And efforts should be made to enhance the health education for population with low-income，low literacy to help improve their health behavior.
【Key word】 Patient acceptance of health care；Cities；Shenyang

Negative Sign of Straight-leg Raising Test in Lumbar Disc Herniation DENG Zhong-cun,MA Rui-fang,LOU Hong-min.
Department of Neurosurg,the Second Hospital of Heze City,Heze 274000,China
【Abstract】 Objective To investigate the clinical significance of negative sign of straight--leg raising test in lumbar disc herniation.
Methods The physical examination,imaging findings and observation in operation were taken for analysis of the conditions of the lumbar disc herniation patients with negative sign of straight--leg raising test.
Results The main reasons for negative sign of straight-leg raising test in patients with lumbar disc herniation were denaturalization of spinal nerve root,un-sensitivity of ache，prominence position，pathological balance of the spinal nerve root,enlargement of the spinal cannel，protective action by lumbar muscles and professional factor.
Conclusion The analysis of the clinic symptom carefully and consultation of imaging findings objectively so as to exclude the reasons of negative straight-leg raising test Are an important way to avoid misdiagnosis.
【Key word】 Intervertebral disk displacement ；Physical examination

Installation of Intrauterine Device and Bacterial Vaginitis in Women YUAN Hong-ying,HE Tao,WANG Yan，et al.
Medical College of Henan University of Science and Technology,Luoyang 471003,China
【Abstract】 Objective To discuss the relationship between intrauterine device (IUD) and bacterial vaginitis (BV),and to provide a basis for the safe use of IUD.
Methods BV was detected for 328 women with IUD (trial group) and 74 women without IUD (control group) by means of sialidase activity.Then comparison was made between the two groups in such aspects as types of IUD,whether there is bleeding after IUD,and whether there is complication of infection by some pathogens.
Results? The positive rate of BV was 29.6% in the trial group,and was 13.5% in the control group,with a significant difference (P＜0.01).In BV positive rate there was no significant difference among the three types of IUD (P＞0.05); there was a significant difference in BV positive rate among the bleeding group,non-bleeding group and the control group (P＜0.01); and there was no significant difference between the non-bleeding group and the control group(P＞0.05).The rate of complicated infection in BV group was 82.7%,and in non BV group was 34.5%.with a significant difference (P＜0.01).
Conclusion The installation of IUD is associated with occurrence of BV.Bleeding after IUD could increase the incidence of BV.The rate of complicated infection by other pathogens for IUD women with positive BV increases.
【Key word】 Intrauterine device;Vaginitis，bacterial;Infection

Delayed Sking Grafting in Treatment of Patients with Deeply Burned Hands PANG Shu-guang,YE Sheng-jie,CHEN Ru-jun,et al.
Wenzhou Medical College，Wenzhou 325000,China
【Abstract】 Objective To discuss the method of tangential excision and delayed skin grafting on deeply burned hands in order to improve the effects of operation.
Methods Early escharectomy was taken for deeply burned hands,then the wound was covered with pig skin treated with glutaraldehyde,and autografting of skin was conducted 2 to 3 days later.
Results Survival rate of grafted autoskin was 96.2%,no subcutaneous hematoma formed and no patient was given additional skin grafting.No vesicle occurred during the growth of skin slice,no superficial sclerosis appeared after healing,and no obvious scar was left.
Conclusion The delayed skin grafting is an ideal operation method to repair the wound of deeply burned hands.
【Key word】 Burns;Hand;Escharectomy;Delayed skingrafting

Relationship between ROCKⅡ and Preeclampsia DONG Xiao,SHANG Tao.
Department of Urology,The First Affiliated Hospital,China Medical University,Shenyang 110001,China
【Abstract】 In order to find out the relationship between Rho associated coiled coil forming protein kinase-Ⅱ (ROCKⅡ) and preeclampsia,we had consulted And summarized the relative medical literatures at home and abroad,finding out ROCKⅡplays a role in attack of preeclampsia.Here we review the relation of Rho/ROCKⅡ signal transduction with preeclampsia.
【Key word】 Rho(ras homologus oncogenes)；ROCK(Rho associated coiled coil forming protein kinase)；Preeclampsia

Advance in Research on Prognosis Factor of Idiopathic Pulmonary Fibrosis TAIN Hui，YU Jian－hua，PENG Shou-chun,et al.
The Second Internal Medicine Department of the Second Fuxin Municipal People′s Hospital,Fuxin 123000,China
【Abstract】 The patients idiopathic pulmonary fibrosis (IPF) have a poor prognosis.The median length of survival from the time of diagnosis is usually of approximately 2 to 3 years.The study of prognostic factors for IPE patients provides important indexes for clinical therapies and development of new drugs.The parameters of clinical,pulmonary physiology,imaging and bronchoalveolar lavage fluid provide considerable information for prognosis; however,they need to be further confirmed.
【Key word】 Pulmonary fibrosis;Prognosis；Related factors

Research on Reliability and Validity of Indicator System for Community Health Services Performance WANG Fang，ZHANG Quan-hong，JIN Jian-qiang，et al.
Faculty of Social Medicine，School of Public Health，Tongji Medical College，Huazhong University of Science and Technology，Wuhan 430030，China
【Abstract】 Objective To investigate the reliability，validity and differentiation of evaluation indicator system for community health services in order to provide some methodological advice for setting a scientific evaluation system of community health services.
Methods On the basis of performance assessment of community health services of 12 administrative districts in Hubei Province,the internal continuity reliability，construction validity and differentiation were tested by using mathematical statistical methods.
Results Cronbach′s alpha coefficients of the second class indicators and the third class were 0.919 and 0.959 respectively； the factor analysis of the second class indicators showed that three factors were extracted，the accumulative variance reached 78.556%.The 12 districts were classified into three grades by using cluster analysis.
Conclusion Testing the reliability，validity and differentiation of evaluation indicator system is the precondition for practical assessment，and the assessing methods should be chosen correctly； the indicator system in this study is good in terms of construction validity，internal continuity reliability and differentiation.
【Key word】 Community health services；Evaluation indicator；Reliability；Validity

The Traits and Betterments of Community Health Family Service CAO Gui-li.
Dongcheng District Administration for Community Health Care Service，Beijing 100010，China
【Abstract】 Family service is important content of Community Health Service.On function,Family service is not only effective means for Community health care and instruction,but also an measure for people hospitalizing easily.It extends and deepens the Community Health service.On practice,Family service accords with the needs of Urban Community Health.However,there are some deficiency that can not be ignored.The criterion and procedure that certificated by law and authority must be founded so as to develop family service normally.
【Key word】 Community health services；Family services

Feasibility in Practice of AIDS/STD Prevention Service in Community Health Service Centers ?MENG Sha,LIU Min.
The School of Public Health,Peking University,Beijing 100083,China
【Abstract】 In this article we study the feasibility in practice of integration of acquired immunodeficiency syndrome and sexually transmitted disease (AIDS/STD) prevention services into the daily work at community health centers (CHC).We mainly review the important function of community health service in AIDS/STD prevention,the advantage of general practitioner in AIDS/STD prevention service,and the requirement of AIDS/STD prevention service in urban communities.At the same time,we summarize the effect of practice of AIDS/STD prevention services so as to provide basis for the further development of AIDS/STD prevention services based on CHC.
【Key word】 Community health service center；Acquired immunodeficiency syndrome；Sexually transmitted disease；Universal precautions

Training of General Physicians on Cardiovascular Diseases LI Hong,WANG Ning-fu,LIU Qiang,et al.
Department of Cardiology,The Affiliated Hangzhou Hospital,Nanjing Medical University,Hangzhou 310006,China
【Abstract】 General practice prevails in the community health services for cardiovascular diseases.General physicians carry out the primary and secondary prevention,long term management and emergency management of cardiovascular diseases.In this study,we briefly discuss the main points and control measures of cardiovascular diseases for general physicians,in order to provide the basis for training of general physicians on techniques in diagnosis and treatment of cardiovascular diseases.
【Key word】 General practice;Cardiovascular diseases;Community health services

Study on the Prediction Method of Communicable Disease XIE Zhao-hui,HUANG Jian-shi.
Chinese Academy of Medical Sciences ＆ Peking Union Medical College,Beijing100005,China
【Abstract】 To understand the application of prediction method of communicable disease in public health researches and work through reviewing literatures published during 1994～2006,and provide suggestions for future work.
【Key word】 Communicable diseases;Forecasting;Methods

Information Sharing and Standardization of the Abstract of Inpatient Records YANG Peng，LIU Dan-hong，PAN Feng，et al.
Department of Health Statistics，Fourth Military Medical University，Xi′an 710032，China
【Abstract】 Objective To explore a method of information sharing and standardization by an example of the abstract of inpatient records.Methods According to the Chinese National Health Information Framework and Health Data Dictionary，the general structure and entries of the abstract of inpatient records were defined by XML Schema.
Results The XML Schema of the abstract of inpatient records were defined by dividing the information of the abstract of inpatient records into three parts and mapping every entry to the corresponding data element of Health Data Dictionary.According to the Schema,the Schema figures and the exchange format of XML file were created.Conclusion The paper proposed a feasible standard-driven solution to exchange patient encounter information among different parties and information systems.
【Key word】 Medical records；Standardization；Metadata；eXtensible markup language

Number2January，2008

Meta-analysis of the Effect of Screening Tool SCORE on Women Osteoporosis WU Xiu-yun，LIU Dian-en,Angela M Cheung.
School of Health Management,Weifang Medical College,Weifang 261042,China
? 【Abstract】 Objective To evaluate the effectiveness of the screening tool SCORE in identifying women osteoporosis.
Methods A systematic literature search was performed by conducting computerized searches for English-language literatures using MEDLINE,EMBASE and PubMed (1966-2006),and the hand searches for the relative literatures in references.Eligibility assessment was applied in study selection by using the inclusion and exclusion criteria formulated before hand.The random effect model （DerSimonian and Laird） was taken in Meta-analysis.
Results? The sensitivity of included studies was between 83.6% and 98%,while the range of specificity was 12.5%~53.9%.The effect of fit was better on the conditions that the cut-off value is 6 and T≤-2.0,and the summery of the area under the curve (SAUC) was 0.802,by which means the SCORE has effectiveness of screening for low bone density.
Conclusion? The SCORE has a certain screening effect,but its specificity is lower.Further validation studies of the instruments and Meta-analysis are required.
? 【Key word】 Osteoporosis;Meta-analysis;SCORE

Disorder of Small Cervical Vertebra Articulations Playing an Important Role in Pathologic Mechanism of Migraine? Geng Li-ming.
Department of Neurology,No.404 Hospital of Chinese PLA,Weihai 264200,China
【Abstract】 Objective To investigate the effect of disorder of small cervical vertebra anticulations on migraine.
Methods 228 cases with migraine were divided into two groups:Group A ( n=150 cases) and Group B (n= 78 cases).All were treated with drugs of calcium antagonists (with a dose of 5~10mg/d) and propranolol (30~60mg/d) for 1 month,and Group A were given an additional treatment of manual reposition (MR).After treatment,we evaluated the clinical symptoms and the results of transcranial Doppler (TCD) at the spot,on the 3rd day,and in the 3rd week and 3rd month.Results? In evaluation of clinical symptom,the rate of Grade I was 91 3%,Grade II 88%,Grade III 83 3% and Grade IV 98 7% in Group A;and in Group B,Grade I was 0,Grade II 19 2%,Grade III 28 2% and Grade IV 17 9%.There was significant difference in them between the two groups(P＜0.01);Significant difference was found in TCD index between pre-treatment and post-treatment(P＜0.01).
Conclusion Manual reposition of cervical vertebra articulations can be done by releasing compression of cervical vertebra articulations and/or inducing disorder of musculi colli structure to stimulate cervical sympathetic plexus,and it can play an important initiation role in pathologic mechanism of migraine.
【Key word】 Migraine;Cerbvical vertebra,；Manipulation，orthopedic

The Value of Computed Tomography in Fracture and Ligament Damage of Knee MA Zhan-zhong,WANG Hao-ran.
Orthopedic Center of Beijing XiYuan Hospital,Beijing100091，China
【Abstract】 Objective We sought to evaluate the value of CT in trauma of knee and to find the proper examining ways to improve the diagnosis.
Methods We analyzed retrospectively the records of 45 patients with knee trauma,and compare all the findings by CT with the clinical data and X-ray findings.
Results There were totally 83 fracture sites in the 45 cases,and 82 fracture sites and 1 case of false negative fracture site and 69 ligaments damages were found by CT,while only 58 fracture sites and 17 ligaments damages were found by X-ray.Conclusion CT is more accurate in finding knee fractures and more sensitive in diagnosing ligaments damages than X-ray.But CT needs to be applied with clinical data and X-ray when assessing laceration of ligaments.
【Key word】 Knee;Fracture;Patellar ligaments；Tomography;Spiral computedr

Effects of Magnesium Sulfate on Levels of Plasma Urotensin Ⅱin Patients with Severe Preeclampsia WU Wen-ying,XU Chun-lin,LI Hai-xia,et al.
Department of Obstetrics and Gynecology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China
【Abstract】 Objective To study the effects of magnesium sulfate (MgSO4) by intervenous(IV) drop on levels of plasma urotensin (U-II) in patients with severe preeclampsia.
Methods 68 cases with severe preeclampsia were given IV drops of MgSO4 for 3 days.We compared plasma U-Ⅱlevels、mean arterial pressure(MAP)、umbilical artery systolic/diastolic ratio(S/D) and resistant index(RI)、24h urine protein levels before and after treatment,and recorded subjective symptoms.
Results (1)There was significant difference in the levels of plasma U-Ⅱ,MAP,S/D,RI and 24h urine protein between pre-treatment and post-treatment (P＜0.05).(2) The levels of U-Ⅱwere positively correlated with the levels of MAP、S/D and RI、24h urine protein before and after the treatment（P＜0.05）.(3).There was significant difference in descending rate of U-II between patients in whom subjective symptoms had not disappeared and those in whom subjective symptoms had disappeared (P＜0.05).
Conclusion MgSO4 can decrease the levels of U-Ⅱin patients with severe preeclampsia,U-Ⅱmay be correlated with pregnancy induced-hypertension syndrome.
【Key word】 Preeclampsia;Magnesium sulfate;UrotensinⅡ;Mean arterial pressure

Dual Blockage of Renin-Angiotensin System in Patients with Early Diabetic Nephropathy:A Study of Randomized Control Trial YANG Fu-yan，SHAO Feng-jie.
Department of Nephropathy,the First People′s Hospital of Xinxiang,Xinxiang 453000,China
【Abstract】 Objective To observe the effect of angiotensin-converting enzyme inhibitor (ACEI) combined with angiotensin receptor blocker (ARB) on early diabetic nephropathy(DN).
Methods A randomized controlled trial was carried out in seventy-six patients with early diabetic nephropathy,who were divided into ACEI group,ARB group and a combined group.The ACEI group were given enalapril,and the ARB group losartan;The combined group received therapy of both enalapril and losartan.Clinical data was collected at baseline and after 12 weeks of treatment..
Results There were no significant differences in hemoglobin 1c(HbA 1c),blood pressure,urinary microalbumin excretion rate(UAER),glomerular filtration rate(GFR),and blood K+ among the three groups before treatment(P＞0.05);After 12-week therapy,the combined group were significantly different from ACEI group and ARB group in SBP and UAER(P＜0.01）.
Conclusion Treatment of ACEI combined with ARB can dually block Renin-Angiotensin System,and strongly lower UAER and contractive pressure.
【Key word】 Renin-angiotensin system；Angiotensin-converting enzyme inhibitors；Angiotensin Ⅱ Receptor blockers；Diabetic nephropathy

Clinical Significance of T Lymphocyte Subsets of Peripheral Blood in Patients with Acute Leukemia GAO Ran，LI Yan.
Department of Hematology，the First Affiliated Hospital，China Medical University，Shenyang 110001，China
【Abstract】 Objective To evaluate the clinical significance of the changes in T lymphocyte subsets of peripheral blood in patients with acute leukemia.
Methods Sixty cases with acute leukemia were divided into two groups:Group A (n=30)who were confirmedly diagnosed but not yet treated;Group B(n=30) who were confirmedly diagnosed and treated systematically with chemo-therapy ;And 30 normal subjects were enrolled as control group.We examined T lymphocyte subsets by APAAP,including the ratios of CD+3T cells，CD+4T cells，CD+8T cells and CD+4/CD+8.
Results Group A was significantly different from Group B and the control group in ratios of CD+3T cells，CD+4T cells，CD+8T cells and CD+4/CD+8（P＜0.05）;There was no significant difference in them between Group B and the control group(P＞0.05）.
Conclusion T lymphocyte subsets were markedly changed in Group A,but recovered essentially to normal after treatment.It shows that cell immunity has close correlation with genesis,development and turnover of leukemia.
【Key word】 Acute leukemia；T lymphocyte subsets； Immune function

Relation of Histological Grade with Expressions of Estrogen Receptor, Progesterone Receptor, CerBb-2 and p53 and Lympha Node Metastasis of Breast Cancer RAN She-wei, WANG Xiao-yi, TAN Jin-xiang, et al.
Department of Surgery of No.7 Hospital of Chongqing, the First Affiliated Hospital of Chongqing University of Medical Sciences, Chongqing 630000, China
【Abstract】 Objective To investigate the correlation between histological grade and expressions of estrogen receptor (ER), progesterone receptor (PR) ,CerBb-2 and p53, and lympha node metastasis of breast cancer.
Methods The expressions of ER,PR,CerBb-2 and p53 in 187 cases breast cancer were detected by immunohistochemical method; Histological grade were detected by modified Nottingham of Bloom-Richardson system.
Results There was no significant difference in positive expression rates of ER, PR and p53 among grade Ⅰ, Ⅱand Ⅲ (P＞0.05), but the ezpression of CerBb-2 increased with the rise of histological grade（P＜0.05）. The expressions of CerBb-2 (-) and p53 (-) were higher than those of CerBb-2(+) and p53(+) in ER(+) in breast cancer tissue of ER(+) and PR(+) （P＜0.05）. There was no obvious correlation between lympha node metastasis and histological grade of breast cancer tissue.
Conclusion The expressions of ER, PR and p53 do not obviously change with increase of histological grade in breast cancer; but the expression of CerBb-2 does. The expressions of CerBb-2 and p53 are negatively correlated with ER expression; The lympha node metastasis is of no obvious correlation with histological grade of breast cancer.
【Key word】 Breast cancer; Histological grade; Estrogen receptor; Progesterone receptor; CerBb-2; p53; Lympha node metastasis

Diazepam in Treatment of Late Status Epilepticus Induced by Lithium and Pilocarpine in Rat Model? LIU Yang，LIU Xian-zeng，GAO Xu-guang.
Department of Neurology，People′s Hospital of Peking University，Beijing，China 100044
【Abstract】 Objective The aim of the present study was to investigate the efficacy of diazepam (DZP) treatment given at two different phases of status epilepticus (SE) in a lithium-pilocarpine rat model：during continuous ictal discharges (CIDs，phase 3)，and during late periodic epileptiform discharges (late PEDs，phase 5).
Methods SD rats were randomly divided into three groups:Group A (given DZP during CIDs,phrase 3,1h),Group B (given DZP during late PEDs,phrase 5,4h),and a control group.Changes in cortical and hippocampal electroencephalographs (EEGs) were observed continuously during the phases of SE，as well as at 24th，36th，48th，and 72nd hours after SE onset.We compared the rats (treated with DZP during CIDs and late PEDs) with the control rats who were not treated with DZP.
Results In all three groups，hippocampal and cortical EEGs displayed five distinct phases of SE.There was no significant difference in the duration of phases 1 and 2 among the three groups.Although DZP administration during CIDs did not terminate CIDs in most rats，it did significantly shorten the duration of phases 3 and 4 of SE.Importantly，DZP given during phase 5 successfully ended behavioral and electrographic seizures in most rats.
Conclusion Hippocampal and cortical EEGs displayed five distinct phases of SE that were similarly responsive to DZP treatment.Termination of electrographic seizures with DZP treatment was more effective in the last phase of SE (late PEDs) than in phase 3 (CIDs).These findings suggest that the conclusion may refer to early phrase of SE but may not to late phrase that the longer epileptic seizure lasts,the more difficult termination can be.
【Key word】 Status epilepticus； diazepam； Lithium Chloride；continuous ictal discharges； late periodic epileptiform discharges

Discogenic Low Back Pain CHU Wan-Zhong,LI Xiao-guang,QIU Si-Qiang.
Taishan Medical College,Tai An 271016,China
【Abstract】 Chronic Low Back Pain(lbp) is a common health problem and one of the most difficult problem to deal in modern medicine.Among all lbp patients,40% are with discogenic lbp which most doctor don′t know much about and easily misdiagnose.This article overviews the desease from disease history、epidemiology、etiopathogenisis、nosogeny and clinical manifestation to improve our knowledge about it.
【Key word】 Low Back Pain,Intervertebral disc

Mechanism of Oxaliplatin Neurotoxicity :Progress in Treatment and Prevention? QU Zhuo-hui,MENG Chun,WANG Yao-hui.
Department of Oncology,Siping Central Hospital,Siping136000,China
【Abstract】 Peripheral neurotoxicity is the clinic-dose limited effect of oxaliplatin.Several chemoprotectant compounds have been tried to prevent and treat its side effect.Some drugs,including calcium magnesium solutions,carbamazepine,amifostine and glutathione,etc,are reported to have some effects of treatment and prevention on it.This article reviews the progress in prevention and treatment of oxaliplatin-induced peripheral neurotoxicity.
【Key word】 Oxaliplatin;Neurotoxicity;Prevention;Drug therapy

Distribution and Drug Resistance of Pathogenic Bacteria in Patients with Diabetic Foot JIN Hua-wei，ZHU Qi-qian，WU Dong-dong，et al.
Department of Endocrinology,People′s Hospital of Shaoxin,Shaoxing 312000,China
【Abstract】 Objective To study the distribution and drug resistance of pathogenic bacteria in patients with diabetic foot to provide a basis for reasonable application of antibiocs in our district.
Methods Excretion specimens from raw surface of diabetic-foot-infected patients was cultured to do susceptibility test by K-B or dilution method.
Results Among the 95 excretion specimens from diabetic-foot-infected patients,69 (72 6%) were cultured out bacteria and disjuncted out 106 strains of pathogenic bacteria(PB),of which 51 (48 1%) were gram-positive bacteria(GPB),50 (47 2%) gram-negative bacteria(GNB),5(4 7%) eumycete;and of which 15 strains of extended spectrumβlactamases(ESBL) were found( 34 1% of enterobacteriaceae).Diabetic foot infection was mainly from coagulase negative staphylococcus(CN-S),staphylococcus aureus(SA),bacillus proteus(BP) and Escherichia coli(E coli) ;and fungous infection(FI) was also detected.According to susceptibility test,multi-cross drug resistance was found,GNB was sensitive to imipenem and antibiotic filled with βlactamases inhibitor,and GPB to vancocin,amphemycin,and cephalosporin ;E coli was drug-fast to commonly-used antibiotic,and CN-S and enterococcus was drug-fast to other clinical commomly-used antibiotic except vancocin.
Conclusion The pathogenic bacteria in diabetic foot infection distribute extensively and some of them are multi-cross drug resistant.Bacteria producing ESBLs assume an spreading tendency.Broad-spectrum antibiotics should be used in patients with diabetic foot infection at the initial stage.
【Key word】 Diabetic foot;Bacterial infections and mycoses;Antibacterial agents;Drug resistance

Medical Succor and Security in Chaoyang District of Beijing During 2008 Olympic Games:Assessment of Risk CHE Kai-hong,TAO Li-li,WANG Rui.
Emergenay aid center of Chaoyang area,beijing 100021,China
【Abstract】 Objective To identify and evaluate risks of medical security in Chaoyang district of Beijing during Beijing Olympic Games to give the government technical supports for management and decision-making.
Methods Matrix Analysis was used to analyze risks of public emergencies and ability for response to emergency.
Results The emphasized public emergencies we must keep away included terror affairs,introduced-infectious disease,trouble caused by special population,food origin disease and water origin disease.The main risks of ability for response to emergency were deficient ability of comprehensive succor,lack of communication equipment,disunity of information channel and some unsmooth succor path.
Conclusion Related departments should take pertinent measures to prevent and control risks of medical security during Olympic Games.
【Key word】 Rescue work；Safety management ；Accident prevention

Role of Community Health Stations in Remedy of Acute Myocardial Infarction ZHOU Shu-na,ZHU Yu-kun,WU Guo-li.
Zhanlanlu hospital,xicheng district of Beijing,Beijing100044,China
【Abstract】 Objective To study remedy rates of acute myocardial infarction(AMI) in both community health stations(CHS) and community health centers(CHC),and to summarize the role of CHS in remedy of AMI.
Methods Retrospective analysis was carried out on 55 patients with AMI accepted in Zhanlanlu Hospital from 2000-2006,of whom 20 were from CHS and 35 from CHC.We analyzed the clinical data and remedy effects of the two groups.
Results Both groups came to visit themselves or accompanied by their family members.18 out of 20 patients from CHS came to visit within 0 3～2 0 hours,2 within 6 0～12 0 hours.Remedy was carried out at once and AMI patients were referred to hospital by green channel for transportation as soon as possible.Less complication occurred and case fatality rate was lower.6 out of 35 patients from CHC came to visit within 1～4 hours and 29 within 4～436 hours with more complication and higher case fatality rate.
Conclusion The patients with AMI visiting community stations receive timely,accurate and effective treatment and rapid reference to hospitals for further treatment.CHS plays an important part in remedy of patients with AMI.
【Key word】 Emergency medical services； Community health center;Myocardial infarction

?Clinical Observation on the Treatment of Burned Wound with Various Techniques YI Xian-feng，SONG Chun-hong，SU Mei-zhen，et al.
Department of Burn Surgery，the Second Affiliated Hospital，Shantou Medical College，Shantou University，Shantou 515041，China
【Abstract】 Objective To investigate the clinical effects of the consociation application of millimeter wave,infrared ray and ultraviolet ray to treatment of burns.
Methods Eighty cases with the deep Ⅱdegree of burn wound were randomly divided into 4 groups：millimeter wave treatment group(A group)，infrared ray treatment group(B group),ultraviolet ray treatment group(C group),combined treatment group (C group)and then the clinical effects of millimeter wave treatment,infrared ray treatment,ultraviolet ray treatment and combined treatment of burn wound were observed,respectively.
Results The symptoms and healing condition of the burn wound were observed from the beginning to the fourth day.The D group was significantly different form A,B and C groups in curative effects（P＜0.05）,and there was no difference among A,B and C groups in curative effects（P＞0.05）.
Conclusion The curative effect of combined application of the three techniques is better than the single application of millimeter wave，infrared ray and ultraviolet ray in treating deep Ⅱdegree of burn wound.
【Key word】 A millimeter of wave；Infrared ray；Ultraviolet ray；Consociation application burn treatment；Clinical observation

?Clinical Studiy on Miao People Suffering from Bronchial Asthma in Western Hunan TIAN Xiao-ping,SHI Cheng-li,LI Hong-mei,et al.
Internal Medicine,Jishou Medical University,Jishou 416000，China
【Abstract】 Objective To comprehend the cause of bronchial asthma and its diagnosis and treatment condition in Western Hunan.
Methods A retrospective analysis was carried out on the basis of the clinical data from 138 Miao people suffering from bronchial asthma who were hospitalized in Respiratory Internal Medicine Department of the First Hospital Affiliated to Jishou University from January 2002 to October 2005.
Results There were 125 cases of miao people with bronchial asthma in Western Hunan,accounting for 90.58%.The main causes of bronchial asthma are hereditary traits,weather changes,allergen contact and smoking.All of them got better and came out of hospital after the treatment.
Conclusion? Rapid climate changes and poor medical facilities in western Hunan are the main causes for the complicated condition of patient with asthma and its complications.
【Key word】 Miao nationality in Western Hunan；Bronchial asthma；Clinical characto

Clinical Observation on External Dissection and Internal Ligation,Situ Skin Bridge Plastic Operation Plus Sphincterotomy in Treatment of Circumferential Mixed Hemorrhoids GAN Xin-biao,YU Li-min，QIU Hong-gen.
Surgical Department,Qingshan Shipyards Hospital,China Changjiang Shipping Group,Hubei 430082,China
【Abstract】 Objective To compare the clinical effects of single application of external dissection and internal ligation and combined application of external dissection and internal ligation,situ skin bridge plastic operation plus sphincterotomy in the treatment of circumferential mixed hemorrhoids.
Methods 128 patients with circumferential mixed hemorrhoids were randomly divided into the situ skin bridge plastic operation plus sphincterotomy group(observation group,65 cases) and single application of external dissection and internal ligation(control group,63 cases),and then the healing time of post-operative wound and the condition of complications were observed.
Results There was no significant difference between the two groups in wound healing time (P＞0.05).Postoperative complications of the two groups:in the observation group,there were 7 cases of post-operative pain,2 cases of edema around the wound,3 cases of urinary retention,1 cases of anal stenosis;in the group,there were 17 cases of post-operative pain,13 cases of edema around the wound,310cases of urinary retention,13 cases of anal stenosis and 13 cases of post-operative fluid,gas leakage.There were significant differences between the two groups (P＜0.05).
Conclusion? Combined application of external dissection and internal ligation,situ skin bridge plastic operation plus sphincterotomy in the treatment of circumferential mixed hemorrhoids can relieve post-operative pain and edema around the wound,prevent post-operative anal stenosis,fluid and gas leakage,and beatify the appearance of anus,and thus bearing comparatively higher clinical application values.
【Key word】 Hemorrhoids;Surgical procedures，operative;Anus

Experience of Diagnosis and Treatment on Abdominal Compartment Syndrome in 21 Cases SUN Wen-Yu,ZHANG Hong-Bin,LIANG Jian.
Department of Surgery,the Fourth Affiliated Hospital of China Medical University,Liaoning 110032,China
【Abstract】 Objective To investigate the clinical manifestations as well as diagnosis and treatment methods of abdominal compartment syndrome.
Methods? Twenty-two cases were treated in our hospital from January 2000 to May 2006,and a retrospective study was used to analyze the clinical data of them.
Results Abdominal trauma in 8 cases,severe acute pancreatitis in 6 cases,lower intestinal obstruction in 5 cases and severe abdominal infection in 3 cases.All the patients manifested marked abdominal distension and increased abdominal wall intensity.Eleven cases underwent surgery within 24 hours,5 cases underwent surgery over 24 hours and 5 cases received non-operative therapy.There were significant differences before and after the operation in 16 cases in vesical pressure values.The cure rate of patients received early treatment was 9/11 and that of patients received delayed treatment was 3/5,the mortality rate of those received non-operative therapy was 4/5.Conclusion ACS is mostly seen in severe surgical patients,and generally covered by the primary disorder,so the timely diagnosis of it and early decompressive laparotomy are the key to improve the cure rate.
【Key word】 Abdominal injuries;Decompression

Analysis of the Curative Effect of Cervix Edema during Labor Treated by Cervix Blockade GAO Shan,LIU Jie,LIU Ying.
Department of Gynaecology and obstetrics,China-Japan Friendship Hospital,Beijing100029,China
【Abstract】 Objective To observe the curative effect and security of using complex lidocaine and atropine to treat cervix edema during labor by cervix blockage.
Methods 68 cases with cervix edema during labor were randomly divided into the research group (38 cases ) and the control group(30 cases).Multipoint injection was applied to the location of edema in the research group,while in the control group,the laboring process was observed with the normal method.The regression time of cervix edema,stretching condition of the cervix mouth,deliver mode,cervical laceration,postpartum hemorrhage,and neonatal asphyxia in each group were observed and analyzed.
Results There were significant differences between the two groups in cervix edema regression efficiency,cervical mouth dilation speed and vaginal delivery rate（P＜0.05）；and there was no significant differences between the two groups in cervical laceration rate,poster-operative hemorrhage rate and neonatal asphyxia rate（P＞0.05）.
Conclusion It is an effective method for treating cervix edema to block cervix with complex lidocaine and atropine during labor.This method is very simply and without any obvious adverse reaction,so it is worth spreading.
【Key word】 Blocking therapy;Cervix diseases;Labor,obstetric

?The Feasibility and Skills of Laparoscopic Surgery in 92 Patients with Histories of Abdominal Surgery XIAO Ying-li,WANG Jing-bo.
PLA 251 Hospital,Zhangjiakou 075000,China
【Abstract】 Objective To investigate the practicability and significance of Laparoscopy examination and treatment in patients with histories of abdomen surgery.
Methods The intraoperative situation of abdominal adhesion and treatment by laparoscopy were summarized retrospectively in 92 cases.
Results The operations of dissecting adhesion by laparoscopy succeeded in 90 cases and without any complication.
Conclusion Operations by laparoscopy can be performed in patients with histories of abdomen surgery，and it is safe and practicable.
【Key words】 Abdominal postoperative;Gynecology;Laparoscopy

?The Impact of Aspirin on Blood Coagulation of Patients with Pregnancy Induced Hypertension Syndrome LIAO wen-ping,QIU ming.
Changsha township Hospital of Kaixian,Chongqing 405402，China
【Abstract】 Objective To study the impact of low dose Aspirin on incidence,bleeding amount after parturition and blood coagulation of patients with pregnancy induced hypertension syndrome(PIH).
Methods 109 high risk patients were randomly divided into 55 cases of Aspirin treated group and 54 cases of control group,The incidence of PIH and the bleeding amount after parturition was observed;And the prothrombin time (PT),partia1 thrombop1astin time (APTT) and fibrinogen (Fg) were compared before and after treatment by Aspirin.
Results There were significant differences in the incidence of PIH between treatment and control group（P＜0.05);The bleeding amount after parturition had no significant difference between the two groups（P＞0.05）;Moreover,there were obvious differences of the PT,APTT and Fg before and after treatement by Aspirin.
Conclusion Low dose Aspirin can significantly improve the blood coagulation of PIH,and reduce it incidence.
【Key word】 Aspirin;pregnancy induced hypertension syndrome;PIH;blood coagulation

?Effect of Compound Diandao Pulvis Drug Facial Mask on Acne Model of Rabbit′s Ears YANG Liu,YANG Wen-zhi,YU Lin.
Institute of traditional Chinese medicine,Southern Medical University,Guangzhou 510515,China
【Abstract】 Objective To observe the Effect of Compound Diandao Pulvis Drug Facial Mask (CDPDFM) on acne model of rabbit′s ears.
Methods Sixteen New Zealand white rabbits were randomly devided into the experimental group and control group.Oleic acid was applied on experimental rabbit′s ears to establish the acne model of rabbit′s ears.The rabbits in treatment group were smeared with CDPDFM 2ml once per day for 2 successive weeks.And the CDPDFM was washing-out in 30 minutes.The rabbits in control group were smeared with tretinoin cream 1ml once per day.The ears of the rabbits in both groups were observed macroscopically and histologically.
Results? In experimental group,macroscopic observation indicated that the ear skin became thinner and softer,corneous plug in local hair follicle was decreased,pitting hair follicle remained after partial falling of corneous plug,mild peeling,and papules were relived or become flat.Histological observation manifested that thickness of cuticle was relieved,mild follicular orifice was expanded lightly and a few keratinized materials was filled in.In the treatment group,macroscopic observation indicated that the ear skin became thinner and softer,corneous plug in the hair follicle was decreased,papules were relived or became flat.Histological observation manifested that mild hyperkeratesis in the epidermis,a few inflammatory cell infiltrations in the dermis and a few keratinized materials were filled in the follicular orifice.There were significant differences in the experimental group before and after treatment（P=0.01）,there were significant differences in the control group before and after treatment（P=0.01）,and there was no significant difference in the experimental and control group before and after treatment（P= 1）.
Conclusion CDPDFM can improve abnormal cornification of hair follicle of in acne model of rabbit′s ears.
【Key word】 Acne;Compound diandao pulvis drug facial mask;Models;animal;Traditional chinese pharmacy

Influential Factors about Decline of Cognition Ability in the Elderly LI Zhi-wu,HUANG Yue-qin,LIU Yu-zhi.
The Sixth Hospital of Beijing University,Beijing 100083,China
【Abstract】 With the increase in the number of aged people,the incidence of senile dementia raises correspondingly.Decline of cognition ability is a key factor leading to dementia in the elderly.This article reviews on the influential factors concerning the decline of cognition ability such as age,gender,education level,affective disturbance,life style,eating habit,body situation,etc.
【Key word】 Cognition disorders;Aged;Risk factors

The Role and Molecular Mechanism of Neural Reparation after Cerebral Ischemia with Constraint-Induced Movement Therapy ZHAI Zhi-yong,NIE Ying-xue,ZHAO Chuan-sheng.
Department of Neurology,the First Clinical Hospital of China Medical University,Shenyang 110001,China
【Abstract】 At present,constraint-induced movement therapy(CIMT) is extensively applied to the area of rehabilitation,and is confirmed to be able to efficiently promote motor recovery after cerebral ischemia.The functional remodeling of cerebral cortex and neuranagenesis after cerebral ischemia by CIMT can complement the function of injured tissues,which has been confirmed by functional neuroimaging techniques.CIMT can activate endogenous nerve stem cells by upregulating strornal cell-derived factor-1(SDF-1),and SDF-1 facilitates axon anagenesis by inhibiting the activity of Rho kinase.Inhibiting the activity of Rho kinase can also eliminate depressant effect mediated by Nogo receptor.Therefore,SDF-1,Nogo and Rho kinase are probably significant molecules that facilitate neuranagenesis after cerebral ischemia with CIMT.
【Key word】 Exercise therapy;Brain ischemia;Nerve regeneration;Strornal cell-derived factor-1;Nogo;Rho kinase

Progress in Research of Survivin Gene in Bladder Cancer CHENG Rui-xiang,MA Zhi-qiang,YANG Shu-wen,et al.
Urology Department，The Second Hospital of Hebei Medical University，Shijiazhuang 050000，China
【Abstract】 Survivin gene is a new member of the apoptosis inhibitory protein family,with a high specificity of tissue distribution and a powerful anti-apoptotic function.Bladder cancer is the most common cancer of genitourinary system of men with a high recurrence rate.This study is to review the inner correlation between the survivin gene and bladder cancer so as to determine tumor markers with the values to early diagnosis and prognosis,and to take prompt and proper treatment for raising overall survival rate of the patients with bladder cancer.
【Key word】 Survivin； Bladder neoplasms； Gene，tumor suppressor

Number3February，2008

Present Developing Situation of the Community Health Service Institutions in Hefei City DING Hong,PENG Song,CHEN Shou-chun，et al.
Health Administrative College of Anhui Medical University,Hefei 230032,China
? 【Abstract】 Objective To know the present developing situation and the defects of the community health service (CHS) institutions in Hefei city.
Methods Questionnaires were conducted on the establishing time,running mode,origin and areas of business rooms,professional department construction,numbers of drug sorts and the number of the staff in selected 115 CHS institutions in Hefei city.
Results The average serving radius by the CHS center and station were 3.8 kilometer and 1.8 kilometers respectively.The average number of health technical personnel of CHS centers and stations were 29.4 and 6.0 people.The majority of the CHS institutions were in the fixed-unit for the medicine guarantee.The average numbers of drugs were 471 sorts and 411 sorts provided by the CHS centers and stations respectively.There are averagely 30 beds in the CHS centers and 3.7 observing beds in stations.
Conclusion? The Staff number,bed number and sorts and quantity of drugs in CHS institutions are already up to the standard.However the construction of CHS network should be strengthened; and an integration of six respects" service function should be improved.And the supervision and management for the CHS institutions operated individually or privately should be enhanced too.
? 【Key word】 Community health services；Resources allocation；Hefei

Situation of Resources Disposition and Service Ability of Hefei Community Health Service Institutions CHEN Shou-chun,WANG Yuan-yuan,FANG Jian-dong，et al.
Hefei Health Bureau,Hefei 230022,China
【Abstract】 Objective To know the present situation of the resources disposition and service ability of the community health service (CHS) institutions in Hefei city.
Methods Questionnaires were conducted,through inquiry and file material review,on the numbers and construction of health technique personnel,basic equipment disposition,service ability and mode and relationship between the high and low sets of the CHS institutions in selected 115 CHS institutions in Hefei city.
Results There were altogether 1 538 health technical personnel,41% of the personnel were engaged in general medicine work; 53% had educational background of junior college or above.There were statistically significant differences in disposition,education background and age of the personnel between the CHS centers and CHS stations （P＜0.01）.The facilities for diagnosing and treating and the assistance tester of the CHS institutions were better; more than 90 % of the CHS institutions could provide diagnosis and treatment and first aids of common and frequently-seen diseases.However,the service ability of prevention and mother and child health care was in short.
Conclusion The distribution of health technical personnel should be further consummated.The dispositions of respirator,gastrolavage machine,anesthetic machine and infant high and weight measuring gauge in CHS centers should be focused on; and the dispositions in CHS centers on B-ultrascope,electrocardiograph and gynecological and obstetrical instruments in CHS stations should be focused,so that to enrich and develop the service of CHS institution.
【Key word】 Community health service institution；Resources allocation；Deliver of health care；Hefei

Working Situation and Satisfaction Degree of the Community Health Administrative Personnel in Hefei City? PENG Song,WANG Yuan-yuan,LI Kang-lan,et al.
Health Administrative College of Anhui Medical University，Hefei 230032,China
【Abstract】 Objective To know the working situation and the degree of satisfaction of the community health administrative personnel in Hefei city.
Methods Totally 158 administrative personnel in the Hefei 115 community health service institutions were enrolled as the investigation subjects,and 155 questionnaires in effect were obtained on the social feature,satisfactory degree of income,working condition assessment and satisfactory degree of working situation.
Results The average working time of CHS administrative personnel was 2.0 years.The average working time daily was (10.3±2.6) hours; Some 74.2% of the personnel were graduates from junior college or above,and 79.4% of them were from clinic medicine or nursing specialities.About 31.0% were unsatisfied with the present income,and 71.6% held that the human resource of their institutions is short; 43.9% believed that the fundamental equipments of their institutions cannot meet the routine work; 60.0% held that the financial deficits exists in their institutions,and 33.5% were unsatisfied with "an integration of the six respects" service function provided by their institutions and 57.4% were unsatisfied with their present working situation.
Conclusion The constructions of the speciality and age of the administrative personnel are unreasonable; the concerned departments should pay more attention to improving the working condition; and it is a feasible way to raise the raise satisfactory degree of the present working situation by raising administrative personnel' income satisfaction degree,improving the running situation of financial organizations and increasing the comprehensive function of the institution.

? 【Key word】 Community health services；Administrative personnel；Satisfaction；Hefei

Working Situation and Satisfaction Degree of the Community Health Technical Personnel in Hefei City FANG Jian-dong,WANG Yuan-yuan,LI Kang-lan，et al.
HeFei Health Bureau,Hefei 230022,China
【Abstract】 Objective To find out the present working situation and the degree of satisfaction of community health technical personnel in Hefei city.
Methods? Totally 302 technical personnel in the Hefei 115 community health service institutions were enrolled as the investigation subjects,and 155 questionnaires in effect were obtained on the social feature,satisfactory degree of income,working condition assessment and satisfactory degree of working situation.
Results The male and female percentages of the community health technical personnel were 38.2% and 61.8% respectively,the average age was (38.4±12.8) years,the average working time was 2.0 year,and the average working time daily was （9.1±2.1） hours.Some 39.4% had educational background of junior college; and 18.1% had educational background of college or above; About 78.8% health technical personnel originated from the clinical and nursing specialities,and only 0.3% from the public health speciality.Some 41.0% of the health technical personnel were employed temporarily.About 49.3% health technical personnel are pleased to the present working situation.
Conclusion The structure of health technical personnel needs to be improved further.It is a feasible way to raise the satisfaction degree of the health technical personnel on the present working by providing a good diagnosing and treating condition and meet the demand of routine working.
【Key word】 Community health services；Health technical personnel；Satisfaction；Hefei

Demand of Community Health Personnel for Training in Hefei City WANG Yuan-yuan，PENG Song，CHEN Shou-chun，et al.
Health Administrative College of Anhui Medical University，Hefei 230032，China
【Abstract】 Objective To find out the demand of community health service (CHS) personnel on-the-job training in Hefei city.
Methods Totally 158 community health administrators and 243 community doctors and nurses were enrolled by random sampling from 115 community health service institutions,their conditions of receiving on-the-job training on CHS or general practice and their hope of training during the recent 3 years were investigated.
Results? In recent 3 years 67.6% of the CHS personal had received training of community health sanitation or general practice,the average time for training in one year was 15 days.About 94.2% of them hoped to get more training,with the special topic training being the most hoped.There were significant differences in training receiving rate,training content,mode and duration among community administrators,doctors and nurses（P＜0.05）.
Conclusion On-the-job training needs to be further enhanced.And the desire of CHS personnel for training is strong; the training materials should be designed with special purpose.

? 【Key word】 Community health services；Health manpower；Inservice training；Hefei

Development and Exploration of the Clinical Internship Teaching for Shanghai General Practitioners in Standardized Training Community Practice Base ZHAO Jie，SHAN Jiong.
Shanghai Siping Community Health Center，Shanghai 200092，China
【Abstract】 Objective To explore a series of effective teaching measures according to the status and characteristics of the community by carrying on the clinical internship teaching work for Shanghai general practitioners standardized training community practice base.
Methods The teaching work was divided into two parts of the theoretical study and the community practice.Batches of the implementation of small class teaching and teaching of problem-based learning (PBL) were carried out; various forms of teaching were introduced including role-playing,simulation scenarios,group discussion and case discussion.During the practice in the community,the method of one teacher taking the responsibility to teach one student was adopted and implementation of the mutual assessment between teaching and learning was carried out.
Results Through the theoretical study and community practice,nine students quickly adapted to and were familiar with the community health service.They were willing to accept the vocational study and one-for-one teaching mode.
Conclusion? The standardized training for general practitioners has obtained a certain achievement.However,there are some problems.It is suggested that the investment from the government should be increased,evidence-based medicine teaching techniques and methods introduced,taking the study of methods as a key point and carrying out one-for-one teaching mode,emphasizing the cultivation of "human-oriented" humanities,and strengthening the communication and exchanges.

? 【Key word】 General practitioners；Residency training；Community education；Shanghai

Quantitative Assessment of Regional Myocardial Function by Strain Rate Imaging in Patients with Acute Myocardial Infarction after Percutaneous Coronary Intervention YANG Jing-wen,HU Da-yi,ZHU Tian-gang,et al.
Department of Cardiology,Beijing Haidian Hospital,Beijing 100080,China
【Abstract】 Objective To evaluate the effect of strain rate imaging in quantitative detection of regional myocardial function in patients with acute myocardial infarction after primary or delayed percutaneous coronary intervention (PCI).
Methods Totally 30 patients with acute myocardial infarction with ST-segment elevation were divided as the primary and delayed treatment groups.The peak strain rates (SR) at systolic,early and late diastolic phases were detected before PCI operation and one week,1 month and 3 months after PCI.
Results In the primary PCI group the systolic SR,early diastolic SR and late diastolic SR at 1 month and 3 months after the PCI operation increased significantly as compared with those before PCI (P＜0.01).In the delayed PCI group,only early diastolic SR at 3 months after PCI increased significantly as compared with that before PCI (P＜0.05).
Conclusion Strain rate imaging can quantitatively evaluate the regional myocardial function in acute myocardial infarction with ST-segment elevation after primary or delayed PCI.

? 【Key word】 Acute myocardial infarction with ST elevation;Ercutaneous coronary intervention;Tissue doppler imaging;Strain rate imaging

Assessment of the Patients with Idiopathic Pulmonary Fibrosis by Saint George′s Respiratory Questionnaire PENG Shou-chun,LI Zhen-hua，YANG Xing-yu.
Institute of Respiratory Disease,The First Affiliated Hospital,China Medical University,Shenyang 110001,China
【Abstract】 Objective To investigate correlation between Saint George′s Respiratory Questionnaire(SGRQ) scores and impairment of functional and anatomic lung parameters in patients with idiopathic pulmonary fibrosis (IPF).
Methods Totally 34 patients with IPF according to the ATS/ERS criteria underwent SGRQ scores and pulmonary function tests (PFTs),dyspnea score,arterial blood gas analysis,the 6 minute walk test (6MWT) and HRCT scores.
Results There was a deterioration in various SGRQ scores.The SGRQ scores were significantly correlated with PFTs,PaO2 during the rest,dyspnea score,6MWD and HRCT scores （P＜0.05）.Specially,the total lung capacity (TLC) was in inverse correlation with the symptoms score,activity score,impacts score and total score of SGRQ scores （P＜0.01）; and stepwise multiple regression analysis revealed that TLC was an important contributory parameter for the SGRQ scores.
Conclusion The SGRQ is a validated instrument for evaluating health status of patients with IPF.
【Key word】? St.George′s Respiratory Questionnaire；Idiopathic pulmonary fibrosis；Six-minute walk test；Tomography,spiral computed

Sequence Polymorphism and Plasma Activity of the Promotor of Plasminogen Activator Inhibitor-1 Gene in Cerebral Infarction CHEN Yi-jian，ZHANG Li-qun，CHEN Fang-ping.
Department of Hematology，Affiliated Xiang-Ya Hospital of Central South University，Changsha 410008，China
【Abstract】 Objective To evaluate the role of 4G/5G polymorphism of plasminogen activator inhibitor-1 promotor (PAI-1) in the development of cerebral infarction (CI) and the correlations between PAI-1 genotype and plasma PAI-1 activity in Chinese.
Methods One hundred and thirty patients with CI were randomly recruited,with one hundred healthy subjects were enrolled as controls.PAI-1 genotypes (4G/4G，4G/5G and 5G/5G) were analyzed by sequence specific primers-polymerase chain reaction （PCR-SSP） technique.PAI-1 activity was determined by substrate chemoluminescent enzyme immunoassay.Triglyceride，total cholesterol，glucose were determined by biochemical analyzer.
Results? There were no significant differences in distribution frequency of PAI-1 genotypes and 4G and 5G allele genes between CI patients and controls （P＞0.05）； PAI-1 activity of CI group was significantly higher than that of controls （P＜0.01）.PAI-1 4G/5G polymorphism was associated with PAI-1 activity.There was significant difference in PAI-1 activity among 4G/4G，4G/5G and 5G/5G （P＜0.01）.
Conclusion PAI-1 genotypes are related with PAI-1 plasma activity levels.Subjects with 4G allele gene have higher PAI-1 activity than that with 5G allele gene,which leads decrease of fibrinolysis activity and thus raise the risk for the attack of CI.PAI-1 activity levels play an important role in the development of CI.
【Key word】 Cerebral infarction；Plasminogen activator inhibitor-1；Gene polymorphism

Activity of Creatine Kinase in Manic Patients ?JIANG Rong-quan，LING Ying-chun，HUANG Lei.
Department of Neurology，Seventh Hospital of Shaoxing City，Shaoxing 312000，China
【Abstract】 Objective To study the relationship between the manic patients and creatine kinase (CK).
Methods Totally 154 patients with manic episode were enrolled as trial group.They were valued with Bech-Rafaelsen manic rating scale (BRMS) respectively at the admission and 2,4,8 weeks after treatment; meanwhile,the fasting venous blood samples were collected for assay of CK activity.And 60 normal persons were enrolled as control group.
Results The activity of CK of the trial group was higher than that of the control group at the admission,with a significant difference （P＜0.01） and a good correlation with BRMS score.Four for 4 weeks after treatment,there was no obvious difference in CK activity between the trial group and the control group （P＜0.05）.
Conclusion The increase of the CK activity is likely related to the severity of the patients′manic episode and the attack of the disease.
【Key word】 Bipolar disorder；Creatine kinase；Psychiatric status rating scales

Effect of Pentylenetetrazol-kindled Epilepsy on Learning and Memory and Expression of Postsynaptic Density 95 in Rats WANG Pei，WANG Bing，LIU Rui-chun，et al.
Department of Neurology，the Second Hospital of Hebei Medical University，Shijiazhuang 050000，China
【Abstract】 Objective To explore the effect of epilepsy kindled by pentylenetetrazol(PTZ) on learning and memory and expression of postsynaptic density 95 （PSD-95）in rats.
Methods Rats were given PTZ till being kindled successfully.Their behaviors were afterwards determined by Morris water maze and the expression of PSD-95 in hippocampus dentate gyrus（DG）by immunohistochemical method.
Results The ability of learning and memory was impaired and the immunoreactivity of PSD-95 decreased simultaneously in rats with pentylenetetrazol-kindled epilepsy（P＜0.01）.
Conclusion The impairment of the ability of learning and memory might be related with the change of PSD-95 in hippocampal neurons in rats with pentylenetetrazol-kindled epilepsy.
【Key word】 Pentetrazole； Epilepsy；Neurobehavioral manifestations；Postsynaptic density 95

Co-measurements of PICP with Col III,LN and AFP in the Diagnosis of Liver Disease HAO Jian-hua,ZHANG Jian-hua,LV Bin-bin,et al.
The Sixth People's Hospital of Shenzhen,Shenzhen 518052,China
【Abstract】 Objective To investigate the significance of measuring C‐terminal propeptide of type I.procollagen (PICP）in diagnosing liver disease and its relationship with type III collagen (Col III),laminin (LN) and Alpha-fetoproteins (AFP).
Methods The enzyme linked immunosorbent assay (ELISA) and Chemiluminescence were taken to assay the concentration of PICP,Col III,LN and AFP in serum of the patients with hepatitis,hepatocirrhosis and liver cancer with the health persons as the controls.
Results In the liver disease patients,the values of serum PICP,Col III,LN were more high then normal controls (P＜0.01）.The levels of PICP,Col III,LN and AFP were also significantly different among various liver disease groups (P＜0.05).The level of serum PICP was positively correlated with LN (r=0.997， P＜0.01).
Conclusion? The level of serum PICP is highly increased in patients with liver disease,especially in those with liver cancer.There is a positive correlation between the levels of PICP and LN.
【Key word】 Collagen type Ⅰ; Collagen type Ⅲ; Laminin; Alpha-fetoproteins; Hepatitis; Liver cirrhosis; Liver neoplasms

Clinical Significance of Vertebral Artery Blood Flow Detected by Color Doppler Ultrasonography in Patients with Cervical Instability YU Ming,QIN Ru-jie,SU Qing-lun,et al.
The First People's Hospital of Lianyungang City,Jiangsu 222002,China
【Abstract】 Objective To investigate the clinical significance of continuous measurement of vertebral artery blood flow by color Doppler ultrasonography in patients with cervical instability and the treatment effect.
Methods Totally 100 patients with cervical instability were divided into five groups according to the age and sex.Each group received different conservative treatments.The vertebral artery blood flow was detected by color Doppler ultrasonography before treatment,at the end of treatment and two weeks after treatment to observe the changes of shape,the internal diameter,route,blood flow at the positions of anteflexion,neutral and retroversion respectively.Another 30 patients with cervical spondylopathy (no instability) were enrolled as concurrent controls.
Results Before treatment,88.0% of the patients in the trial group were found to have abnormal vertebral artery in morphology or various indexes,the difference was significant as compared with the control group (P＜0.05).There were significant differences before treatment in peak systolic velocity,(PSV),end diastolic velocity (EDV) and resistive index (RI) of both left and right sides between the two groups (P＜0.05).And there were also significant differences in.PSV,EDV and RI in the same group before and after treatment (P＜0.05).In the comprehensive treatment subgroup in the trial group significantly higher rate of improvement of abnormal vertebral artery was achieved at the end of treatment and two weeks after treatment as compared with others(P＜0.01).
Conclusion Measurement of vertebral artery blood flow by color Doppler ultrasonography is helpful to about the condition for patients with cervical instability,it can offer valuable references to clinical treatment.The result of comprehensive therapy for patients with cervical instability is good.
【Key word】 Cervical instability;Ultrasonography，doppler，color;Vertebral artery

Intervention of Irbesartan to Myocardial Hypertrophy in Experimental Model Rats WANG Xiao-ping,NING Xiao-ran,WANG Jing-lian,et al.
Hebei Provincial People's Hospital,Shijiazhuang 050051,China
【Abstract】 Objective To investigate the inventive effects of Irbesartan to left ventricular hypertrophy and chronic heart failure in rat models with myocardial hypertrophy and heart failure induced by isoproterenol (ISO).
Methods Thirty Wistar rats were divided into normal control group,model group and therapy group randomly,with ten rats in each group.The rat models with myocardial hypertrophy and heart failure were established by subcutaneous injection of a larger dosage of ISO for 7 days.Rats in therapy group were given Irbesartan for intervention.All the rats in every group were monitored by echocardiograph via the thorax on the 10th day,6th week and 12th week respectively.Myocardial and plasma angiotensin Ⅱ levels were measured in of rats in all groups.
Results Compared with control group,the end-diastolic interventricular septal thickness (IVSTd) and left ventricular posterior wall thickness (LVPWd) in the model group were increased and the left ventricular cavity enlarged (P＜0.01); the ejection fraction (EF) and fractional shortening (FS) were decreased (P＜0.01).Compared with model group,the IVSTd and LVPWd in the therapy group were reduced and the EF and FS were increased,(P＜0.01).The myocardial and plasma angiotensin Ⅱlevels in both the model and therapy groups were obviously higher than those of the control group (P＜0.05),but no significant difference was found between those of the therapy group and those of the model control group (P＞0.05).
Conclusion? The ventricular hypertrophy and heart failure of the model rats are related with over activity of Renin-Angiotensin-Aldosterone System in local myocardia and circulatory system.Irbesartan could improve cardiac function and reduce the left ventricular hypertrophy by antagonizing the actions of angiotensin Ⅱin cordial tissue and plasma through angiotensin Ⅱ receptors.
【Key word】 Echocardiography；Cardiomyopathy,hypertrophic；Ventricular function;Angiotensin Ⅱ；Irbesartan;Rats

Regulation of Psychological Factors to Pain Cognition YUE Jian-ning.
Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China
【Abstract】 Pain is not only a body reaction,but also a psychologic reaction.Pain reaction is always related to unhappy emotion(such as aversion and horror),then create behaviors such as retraction,escape and opposition,meanwhile,cause complicated physiologic function changes.The review are mainly about anatomy and physiological foundation that how can pain cognition been regulated with psychologic factor and this theory have been used in clinical therapy.
【Key word】 Pain; Cognition; Psychological theory

Mode of Sort Management of Pulmonary Tuberculosis for Community Population and Assessment on Its Effectiveness in Futian District of Shenzhen ZHAO Rong.
Futian District Hospital for Control and Treatment of Chronic Diseases,Shenzhen 518048，China
【Abstract】 Objective To explore the effective mode of detection,treatment and management of pulmonary tuberculosis (PTB) for community population and its influential factors.
Methods The cases of PTB patients and their outcome before and after the sort management of PTB for community population was implemented were statistically analyzed.Health education on the knowledge of PTB was conducted for 246 newly diagnosed patients with PTB who received treatment of the whole superintended course for two months.Before and after the health education,the questionnaire survey was made on the health knowledge of PTB.
Results There was a significant difference in the rate of regular treatment of both the resident and temporarily living patients with PTB and the cure rate of the smear-positive patients before and after the sort management of PTB for community population （P＜0.01）.And there was also a significant difference in the awareness rate of the relative knowledge on the PTB before and after health education （P＜0.01）.
Conclusion? The sort management mode of pulmonary tuberculosis for community population is of high efficiency,it can effectively control the regional epidemicity of tuberculosis.
【Key word】 Tuberculosis，pulmonary；Community health services；Mode of management；Effectiveness assessment

Relationship between Body Mass Index and Dyslipidemia among Hypertension Patients in Fuxin Rural Areas of Liaoning Province ZHANG Xin-gang，SUN Zhao-qing，ZHANG Xin-zhong，et al.
Department of Cardiology，Shengjing Hospital of China Medical University，Shenyang 110004，China
【Abstract】 Objective To study the relationship between different body mass index (BMI) and the prevalence of dyslipidemia in rural areas of Fuxin City of Liaoning Province.
Methods The cluster stratified sampling taken in epidemic investigation and laboratory examination for resident (≥35 years old) group with hypertension.BMI levels were divided into different groups and SPSS 11.5 statistical software was used for analysis of relationship between the BMP level and dyslipidemia.
Results Totally 6 411 hypertension patients (2 805 were male and 3606 were female) aged (56.8±11.1) years were enrolled in the study.In men，the prevalence of total cholesterol (TC)，triglyceride (TG) and low-density-lipoprotein (LDL-C),and in women the prevalence of TG，LDL-C and high-density-lipoprotein (HDL-C) had a significantly increase with increase of BMI levels（P＜0.05）.After the factors of age，smoke，drink，blood pressure and fasting plasma glucose were adjusted,the risk of dyslipidemia in TC，TG and LDL-C was increased significantly with increase of BMI levels.
Conclusion The BMI is closely related with dyslipidemia among the rural hypertensive individuals,and the obesity is an important risk factor for dyslipidemia.
【Key word】 Body mass index；Hyperlipidemia；Hypertension；Rural population；Liaoning

Prevalence of the Chronic Kidney Disease among Adults in Nanning City of Guangxi HUANG Li，LIAO Yun-hua.
Department of Nephrology，The First Affiliated Hospital，Guangxi Medical University，Nanning 530021，China
【Abstract】 Objective To investigate the prevalence of chronic kidney disease in adults in Nanning city.
Methods The computer system was made up to investigate the prevalent condition of chronic kidney disease in 122 adult patients whose first visit in our hospital in Nanning city.
Results The average age of attack in male was mostly from 41 to 50 years,and in female was mostly more than 60 years.There was a significant difference in the age of attack,etiological construction and rate of occurrence of hypertensive complication in first visit （P＜0.05）.
Conclusion The chronic kidney disease in Nanning city has its own feature in prevalence，and more efforts should be made in monitoring for resolve it.
【Key word】 Nephrosis；Epidemiology；Adult；Guangxi

Comparison on Effects of Different Minimally Invasive Surgeries for Seriously Cerebral Hemorrhage of Hypertension WANG Bao-hua，YU Guo-ping.
Neurology department，Haiyang Branch of the Affiliated Hospital of Qingdao University，Haiyang 265100，China
【Abstract】 Objective To explore the effective therapy for seriously cerebral hemorrhage of hypertension.
Methods Totally 112 patients with seriously cerebral hemorrhage of hypertension were randomly divided into three groups.The 35 patients in group A were treated with the hematoma-breaking and suction through the skull-drilling,the 37 patients in group B with puncture drainage liquefaction through the skull-drilling,the 40 patients in group C with pinhole multi-locations hematoma suction.The postoperative residual volume of hematoma,mid-line deviation,re-hemorrhage rate and mortality among the patients after the treatment were compared and analyzed.
Results? There was no significant difference in mortality,residual volume of hematoma and mid-line deviation between group A and B （P＞0.05）.There was an obvious difference in re-hemorrhage rate between group C,B and A （P＜0.05）.There were obvious differences in mortality, mid-line deviation and residual volume of hematoma,between group C and B, A （P＜0.05）.
Conclusion The chief influencing factors for deterioration of seriously cerebral hemorrhage are volume of hematoma,high intracranial pressure and mid-line deviation.The pinhole multi-locations intracranial hematoma suction may effectively reduce intracranial pressure and clean hematoma,which can obtain better results for acute and serious cerebral hemorrhage of hypertension.
【Key word】 Intracranial hemorrhage，hypertensive；Surgical procedures，minimally invasive；Hematoma，sudural，intracranial

Diagnosis and Treatment of Cystitis Glandularis: A analysis of 211 Cases LIU Ben,HUANG Xiao，ZHENG Xiang-yi，et al.
Department of Urology,The First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,China
【Abstract】 Objective To approach the method of diagnosis and treatment of cystitis glandularis.
Methods A retrospective analysis of clinical data of 211 cases（124 males and 87 females）of cystitis glandularis was made.
Results The lesions were located at the trigone and bladder neck in 185 cases,at lateral wall of bladder in 13 cases,at anterior wall in 2 cases,at posterior wall in 7cases,at apex of bladder in 4 cases.Of the 211 cases,7 were treated conservatively,3 cases were followed up for 3 to 24 months,and their symptoms were remitted by anti-infectious therapy.And 204 were treated by transurethral resection,partial cystectomy,or total cystectomy,of which 168 cases were followed up for 8 months to 9 years.There were 143 cases with no recurrence,and 25 cases with recurrence.
Conclusion Cystitis glandularis is a proliferative disorder of the bladder mucosa,with many and variant types.It should be treated according to different etiological factors and types.
【Key word】 Cystitis;Cystoscopy；Pathology，clinical

Partial Excision of the Inferior Turbinate with Mini-electrical Cutter plus Fractured-bone Removing in Treatment of Chronic Hypertrophic Rhinitis ZOU Bing.
Department of Otolaryngology,Nanxishan Hospital of Guang Xi Zhuang Autonomus Region,Guilin 541002,China
【Abstract】 Objective To investigate the effect of submucosal partial excision of the inferior turbinate with mini-electrical cutter plus fractured-bone removing technique in treatment of chronic hypertrophic rhinitis.
Methods Totally 130 patients with chronic hypertrophic rhinitis patient were randomly enrolled,of which 65 cases were given submucosal partial excision of inferior turbinate with mini-electrical cutter combined with fractured-bone removing technique (group A),45 cases given partial excision of inferior turbinate under nose endoscope (group B),and 20 cases given radio frequency therapy of inferior turbinate (group C),The postoperative follow-up was made for 6 months to 1 year.
Results? In group A there were 46 cases who were cured and 19 cases who got improved; in group B there were 30 cases who were cured and 15 cases who got improved; and in group C there were 15 cases who were cured,15 cases who got improved and 1 case who was no responded.There was no significant difference in effect among the three groups (P=0.892).
Conclusion? S partial excision of the inferior turbinate with mini-electrical cutter plus fractured-bone removing is of good therapeutic effect for inferior turbinate hypertrophy of chronic rhinitis,with the merits such as complete reservation of submucosal ciliary structure of the inferior turbinate.
【Key word】 Turbrinates；Rhinitis，allergic，perennial

Role of Endotoxin in Attack of Preeclampsia DONG Xiao,LI Si-yang,SHANG Tao.
Department of Urology,First Affiliated Hospital,China MedicalUniversity,Shenyang 110001，China
【Abstract】 To find out the actions of lipopolysaccharide(LPS) in the arising,developing and natural course of preeclampsia and eclampsia.Internal or external medical literature consulted by various means were summarized.Results:Lipopolysaccharide has certain relationships with preeclampsia.Lipopolysaccharide plays an very important role in the arising,developing and natural course of preeclampsia and eclampsia.
【Key word】 Lipopolysaccharide;Preeclampsia；Eclampsia

Angiotensinogen Gene Polymorphism and Essential Hypertension and Cerebral Stroke in China YANG Yue-ming，HE Ji-ling.
Inner Mongolia，Department of Neurology，Baogang Hospital，Baotou 014010，China
【Abstract】 Essential hypertension and cerebral stroke are common diseases in clinical works.Many factors such as heredity and environment play an important role in their occurrence and progression.Studying related genes and their polymorphisms helps to prevent and treat the diseases.This paper reviews the condition of the studies of the relationship of the angiotensinogen gene polymorphism to essential hypertension and cerebral stroke.
【Key word】 Angiotensinogen ；Gene polymorphism；Essential hypertension；Cerebral stroke

Stress Management of General Practice based on JDCS Model WANG Guang-rong，ZONG Wen-hong，PANG Lian-zhi.
Health Bureau of Zhabei District of Shanghai，Shanghai 200072，China
【Abstract】 The article aim to discuss how to release work stress of the general practice and how to promote their service performance.Some strategies are supposed to maintain effective mananagement based on working requirements,control and social supporting system from JDCS model,including:1)Multi-step training combined with systematic general practice education,2)Establishing supportive platform of general practice team,3) Setting up the service of Career development and psychology consulting.By doing so,we can improve the efficiancy,team work enviroment,promote the social commisional duty of all team menbers,fullfill the servie functions,and redundent the community public health servise system.
【Key word】 Community health services；Stress management；JDCS model

Application of Project Management Mode in Management of Community Health Services YE Wei-jun,SHUI Li-ming,DU Li-jun,et al.
Jiangdong District Health Bureau of Ningbo，Ningbo 315040，China
【Abstract】? From January of 2005,community health project management has been widely conducted in Jiangdong District of Ningbo city.Since then the project management system has been improved through such measurements as establishment of project management objectives,construction of project management platform,standardization of project management technique,completeness of project incentive mechanism and implementation of quality control.It is proved in practice that the project management is of important significance to raise efficiency of community health service,enhance the efficiency in use of government funds,go on the orientation of health and integrate the public health resources.
【Key word】 Community health services；Project management

Problems of Child Health Care in China and the Countermeasures CHEN Xiao-hui，HAO Xiao-ning，LI Shi-xue，et al.
The Gongming People's Hospital of Bao'an District，Shenzhen 515106，China
【Abstract】 The health status of children in China has been improved greatly in recent years.However some problems still exist such as low awareness of child health care.Imbalanced levels of growth and development of children between the rural and the urban areas,lower level of health care for children of floating population and non-enough attention paid to the problems of child mental health and psychological behavior.So the government should enhance the child health care management，increase the investment to the grass roots especially in rural areas，and develop a comprehensive service and management of child health care that is in multi-levels and all round ways,with a high quality during the whole course.
【Key word】 Child；Delivery of health care

Number4February5，2008

Diagnosis and Treatment of Pneumocystis Carinii Pneumonia in aged Patients ZHANG Jin-chuan,DAI Jian-ye,Fan Jin.
Department of Respiratory Medicine(in the South Building),General Hospital of PLA,Beijing 100853，China
? 【Abstract】 Objective To deepen our understanding of diagnoses and treatment of pneumocystis carinii pneumonia(PCP) in aged patients.
Methods We reviewed the diagnosis and treatment of two aged patients with PCP.
Results The two aged patients were given final diagnosis when pneumocystis carinii(PC) or PCR(+) was discovered by clinical features,radiographic abnormalities and sputum specimen smear Giemsa stain(or grocott).One case was treated with SMZco,the other with caspofungin due to side reaction of SMZco.
Conclusion PCP is a kind of opportunistic infection which has vulnerability for aged patients with lung cancer and MV patients with long-term hospitalization.It can be given a final diagnosis by positive PCR in sputum specimen or PC discovered in sputum smear staining.Differential diagnosis should be done between PCP and other kinds of pneumonia.SMZco is the first choice in the treatment of PCP,but caspofungin can be used when SMZco fails or produces side reaction.
? 【Key word】 Pneumonia,pneumocystis carinii；Elderly

The Expressions and Correlation of NF-кBp65 and HPA in Colorectal Carcinoma HOU Feng,ZHANG Lu-ping,ZHENG Shu-fang，et al.
Deprartment of Pathology,Qingdao University Medical College,Qingdao 266033,China
【Abstract】 Objective To evaluate the effect and correlation of NF-кBp65 and HPA in infiltration/metastasis of colorectal carcinoma.
Methods The expressions of NF-кBp65 and HPA were detected by SP immunohistochemical method in 60 cases of colorectal carcinoma、23 cases of colorectal adenoma and 26 cases of normal colorectal mucosa.
Results The difference of the positive expressions of NF-кBp65 and HPA among the colorectal carcinoma、colorectal adenoma and normal colorectal mucosa is significant（P＜0.05）,and the difference between any tow groups is significant（P＜0.05）;the positive expression of NF-кBp65 and HPA were closely correlated with depth of tumor infiltration and metastasis of lymph node（P＜0.05）,and there was no correlation with the age,gender and differential degree（P＞0.05）；The positive expressions of NF-кBp65 and HPA is correlated in the colorectal carcinoma (r=0.49，P＜0.05）.
Conclusion NF-кBp65 and HPA are important factors in infiltration and metastasis of colorectal carcinoma,NF-кBp65 may promote the infiltration and metastasis by up-regulating the expression of HPA.
【Key word】 NF-kappa B;Heparanase;Intestinal neoplasms;Neplasm metastasis;Infiltration

Significance on IgG-antiendothelial Cell Antibody in Determining the Activity of Systemic Lupus Erythematosus ZHANG Shuang-xin,SHAO Fu-ling,SU Li-na,et al.
The First Hospital of Shijiazhuang,Shijiazhuang 050011,China
【Abstract】 Objective To investigate the significance of IgG-antiendothelial cell antibody (IgG-AECA) in determining the activity of systemic lupus erythematosus (SLE).
Methods? The serum IgG-AECA and its titer were determined by indirect immunofluorescence (IIF) technique in 39 active SLE patients,25 remissive SLE patients and 25 healthy controls.
Results There was a significant difference in positive rate of IgG-AECA among the patients in the three groups (P＜0.001),and there were also significant differences between the patients of each two groups (P＜0.017).The titer level of IgG-AECA in patients of active group is higher than that in patients of remissive group (P＜0.05).
Conclusion? The levels of serum IgG-AECA and its titer in patients with active SLE are higher than those in patients with remissive SLE;so the levels of serum IgG-AECA and its titer could be served as one of indexes to evaluate the activity of SLE
【Key word】 Lupus erythematosus,systemic;Antibodies,endothelial cells;Vasculitis

Expression of COX-2 and P-gp and Its Prognosis in Gastric Carcinoma YE Shu-cheng,WANG Jun-ye,YUAN Guo-zhen,et al.
Department of Oncology,Affiliated Hospital of Jining Medical College,Jining 272029，China
【Abstract】 Objective To investigate the clinical significance of Cyclooxygenase-2 (COX-2) and P-glycoprotein (P-gp) expressions in Gastric Carcinoma.
Methods The expressions of COX-2 and P-gp of gastric carcinoma tissue were detected by SP immunohistochemical in 60 cases.
Results The positive rates of COX-2 and P-gp were respectively 63.3% (38/60) and 68.3% (41/60) in the whole group.Some significant correlations were observed between the expression of COX-2 and the clinical factors including degree of differentiation（Uc=3 .582,P=0.000）,depth of invasion（Uc=3.084,P=0.002）,lymphatic metastasis (Uc=2.570 P=0.010) and TNM staging （χ2=7.552,P=0.006）；And there was significant correction between the expression of P-gp and the clinical factors including depth of invasion（Uc=2.448,P=0.014）,lymphatic metastasis (Uc =2.547,P=0.011) and TNM staging（χ2=5.396,P=0.020）.Significant difference was found in degree of differentiation,depth of invasion,lymphatic metastasis and TNM staging when COX-2 and P-gp repectively in simultaneous expressions,individual expressions and no expressions（P＜0.05).The expression of COX-2 was in significant correlation with that of P-gp in gastric carcinoma (r=0.374,P=0.004).The overall survival rates of 1,3,5 years were respectively 83.3%,40.0% and 30.0% in the whole group;.And in COX-2 positive group they were respectively 79.0%,28.9%,15.8% and in COX-2 negative group were 90.9%,59.1%,54.6%,and there was significant difference in survival rates between the two groups (χ2=7.885,P=0.005).
Conclusion COX-2 is involved in adjustment of P-gp expression in gastric carcinoma..COX-2 expression may be used as an important survival predictor in gastric carcinoma.
【Key word】 Gastric carcinoma；Cyclooxygenase-2；P-glycoprotein；Multidrug- resistance；Prognosis

Application of CT Measurement in Septoplasty WANG Pei-hua,WANG Tao,WANG Zhong-ying,et al.
Department of Otorhinolaryngolgy,The Ninth People′s Hospital,School of Medicine,Shanghai Jiaotong University，Shanghai,200011，China
【Abstract】 Objective To research the malformation degree of deviation of Nasal Septum using way of CT measurement.It is objectively benefit to quantificative analysis in Septoplasty.
Methods We use the software of CT measured range (Radworks Cd-viewer software package) to measure the parameters of 19 DNS cases.The parameters include the deviation degree and the deviation data of the nasal septum on the benchmark plane of horizontal position of infraorbital foramen,the malformation plane of horizontal position and the malformation plane of coronal position on the preoperative and postoperative in 2D CT scan image.We can evaluate preoperation and postoperation objectively and quantificationally.
Results The parameters of 19 cases can be evaluated the malformation degree of Nasal Septum in the preopertion.The measured parameters showed significant different respectively by paired-test between preoperation and postoperation.
Conclusion It is benefit to evaluate the malformation degree in the preoperation correctively and the effect in the postoperation.
【Key word】 Radiographic image enhancement；Nasal septum

Preventive Effect of Reduced Glutathione on the Reinjury of Multi-injured Liver Function GAO Yong-he,LI De-yong.
Jurong City People′s Hospital in Jiangsu Province,Jurong 212400，China
【Abstract】 Objective To research clinical preventive effect of reduced glutathione(GSH) on the reinjury of multi-injured liver function.
Methods 69 cases,who needed reoperation after multi-injury of liver,were randomly divided into a preventive group (n=33) and a control group(n=36).The preventive group were given IV drops of GSH(1.8 g/d) for 3 days before the operation and for 4 days after it.We examined the total bilirubin (TBIL),direct bilirubin (DBIL),alanine aminotransferase (ALT),aspartate aminotransferase (AST),glutamyltransferase (GGT),alkaline phosphatase (ALP),cholinesterase (CHE) before using GSH and on the 5th day after surgery,and compared the liver functional parameters and total effective rates before operation with those after it.
Results There was significant difference in TBIL、DBIL、ALT and AST between the two groups after the re-operation (P＜0.05),while no significant difference was found in CHE、GGT and ALP between them (P＞0.05).The total efficacy ratios were respectively 84.85 %（28/33）and 44.4 %（16/36）.There was significant difference in curative effect between the two groups (P＜0.05).
Conclusion? GSH plays a role in prevention of re-injury of liver function.
【Key word】 Reduced glutathione;Multiple traume;Re-injury of liver function;Prevention

Effect of Atorvastatin on the Levels of Blood Fat and Serum Inflammatory Factor in Patients with Coronary Artery Disease JIANG Rong-jian,QIN Shu,KONG Hong,et al.
Sichuan Academy of Medical Science,Chengdu 610072,China
【Abstract】 Objective To observe the effect of atorvastatin on the levels of blood fat and serum inflammatory factor in patients with coronary artery disease.
Methods From 2006/3 to 2006/12,forty patients with coronary artery disease were randomized into two groups:Group A (n=20)given conventional therapy and Group B (n=20)given an additional treatment of atorvastatin besides conventional one.We determined,by enzyme linked immunosorbent assay and routine enzymic method,the serum tumor necrosisαfactor (TNF-α),9-matrix metalloproteinase(MMP-9),C reactive protein(CRP),malondialdehyde(MDA) and the level of blood fat including total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C) and triglyeride (TG）before the treatment and 8 weeks after treatment.
Results There was significant difference in the levels of TNF-α,MMP-9,CRP,MDA and blood fat (TC,LDL-C and TG) between the two groups.
Conclusion? Atorvastatin can decrease remarkably the levels of TC,LDL-C and TG,and lessen the level of inflammatory reaction in patients with coronary artery disease.
【Key word】 Antilipemic； Coronary disease； Inflammation;Tumor necrosis factor-alpha;Malondialdehyde

Circular Statistical Analysis in Investigation on Peak Phase of Incidence and Death Solar Term in Patients with Acute Hemorrhagic Apoplexy:A Study of 353 cases LIANG Zhang-rong，HE Ming-feng， ZHANG Ji-ping，et al.
Department of Emergency，Foshan Municipal hospital of Traditional Chinese Medicine，Foshan 528000，China
【Abstract】 Objective To investigate the relationship of solar term with incidence，death in patients with acute hemorrhagic apoplexy.
Methods The incidence solar term of 353 cases and the death solar term of 90 cases among them,who were with acute hemorrhagic apoplexy,were recorded and analyzed by circular statistical analysis.We calculated the peak phase of incidence and death and observed the characteristics of the solar terms of incidence and death.
Results There was no definite concentration of solar term of incidence and death in all the 353 patients and 90 of them（P＞0.05）.The incidence rate of acute hemorrhagic apoplexy was relatively lower in the solar term between Spring Equinox and Beginning of Summer and the death rate was relatively lower in the solar term between Spring Equinox and Summer Solstice.
Conclusion There is no specific peak solar term concerning incidence and death of acute hemorrhagic apoplexy，which indicates that it is necessary to prevent positively incidence and death of acute hemorrhagic apoplexy in all of the four seasons，and that treatment and nursing should be strengthened in the solar term of relatively high incidence and death rate to decrease morbidity and mortality of acute hemorrhagic apoplexy.
【Key word】 Stroke；Solar terms，medicine；Death

Changes of Very Long-chain Free Fatty Acids in Serum and Liver Tissues of Rats with Diabetes Induced by High Fat Food WANG Xiao-ling,JIANG Ling-ling,MA Jing,et al.
Department of Biochemistry and Molecular Biology,Hebei Medical University,Shijiazhuang 050017,China
【Abstract】 Objective To explore the changes of very long-chain free fatty acids (VLCFFAs) in serum and liver tissues of rats with diabetes induced by high fat food.
Methods 30 male Sprague-Dawley(SD) rats were divided randomly into a control group (n=15) and a high fat group (HF group,n=15).The control group were fed with common rodent diet and the HF group with high fat diet，and indicators of insulin resistance and biochemistry were measured afterwards.When insulin resistance was confirmed,the HF group were injected a low-dose of streptozotocin (STZ) to induce type 2 diabetes.The changes of serum and liver fatty acids were measured.
Results Insulin resistance was found in the HF group by euglycemic clamp,oral glucose tolerance test（OGTT）and insulin sensitivity index (ISI).Type 2 diabetes was successfully induced by STZ in the HF group.Analysis of gas chromatography showed that the levels of C22:0,C22:6,C26:0 of serum were higher in the HF group than in the control group (P＜0.01);and the levels of C22:0 and C24:0 of liver were lower in the HF group than in the control group (P＜0.01)， but the levels of C22:6 and C26:0 of liver were higher in the HF group than in the control group (P＜0.01).
Conclusion The profiles of VLCFFAs of serum and liver changed in HF group.
【Key word】 Fatty acids；Diabetes mellitus；Insulin insistance

Clinical Evidences and Possible Mechanisms of Statins in Treatment of Heart Failure due to Dilated Cardiomyopathy:Progress in Research XU Fu-kang,GUO Hang-yuan,