全科医生网英文版

CHINESE GENERAL PRACTICE

(2009)

Volume12,Number21Novermber，2009

Volume12,Number22Novermber，2009

Volume12,Number23December，2009

Volume12,Number24December，2009

Number 1January ，2009

Patient Journey vs.Referral Behavior:An Australian Story and Implication to China YANG Hui,Shane Thomas,Colette Browning.
Faculty of Medicine,Nursing and Health Sciences,Monash University,Victoria 3168,Australia
? 【Abstract】 Objective Patient journey in medical services was modeled,internal and external factors of practitioner′s consultation and referral behavior,including self-referral,were explored.The objective is to exam rationale of regulating behaviors of medical resource utilisation through establishing referral system in China.Australian and Chinese cases were used for understanding the process.
Methods literature review and documents analysis.General model of patient journey was established,while variation between countries was specified.
Results Paths of patient journey in reality was results of behaviors and interactions among community doctors,specialists and patients.Parties involved in the process were directed by judgment of their values and benefits.In addition,external factors such as professional anatomy,universal health coverage and tradition of seeking medical service had significant impacts on decision of referral made by both users and providers.
Conclusion It is vital to understand behavior drives internally and environment externally when a policy designed and implemented for regulating or changing behaviors.To ignore behavior analysis,policy could not be implemented in reality.Sole intervention on community doctor′s referral behavior is inefficient for changing style and direction of medical service utilisation.It is urgent to call further studies on behavior analysis focused on community doctor,hospital doctor and patients in process of consultation and referral.Promotions and barriers of effective patient-doctor,and general practice-specialist relationship should be further studied.A practical policy,mutual referral in China as example,is built on good understanding of mechanism of stakeholder′s behavior.
? 【Key word】 Referral;Patient journey;Community doctor;Hospital doctor;Patient;Behavior

Evaluation of Short-term Training of Clinical and Community Teachers in Chongqing HE Ping，LUO Sen-lin，LI Man-xia，et al.
Department of Medicine, Chongqing Pharmaceutical College, Chongqing 400030，China
【Abstract】 Objective To evaluate the effects of short-term training of clinical and community teachers and to put forward constructive suggestions.
Methods One hundred thirty-six teachers were selected by Chongqing Clinical Practice and Community Training Base.After 3-day training they had a written examination and a questionnaire survey, and 12 trainees chosen randomly gave trial lectures and two experts giving scene comments were interviewed.
Results The scores of examination for 83 clinical teachers and 53 community teachers were（66±7） and （62±4） respectively, with a significant difference between the two scores （P＜0.0001）.The trainees who had good comments on teaching method, course design, practical teaching, training contents and? allocation of teaching hours accounted for 67.0%, 54.8%, 58.0% and 34.4% respectively.Some 58.8% of the trainees were satisfied to the training, and 61.0% of the trainees held that the purpose of the training was achieved and they had learnt a lot.
Conclusion The mode of training of general medicine should be classified training of clinical and community teachers, with very qualified trainers, theory teaching, scene teaching, community visits, trainees′ trial lectures and experts′ comments;and the training time should be at least 2 weeks.It is the key for the establishment of a high-quality teaching staff and the fundamental guarantee in training quality of general practitioners to set up a strict condition for selection of trainee and standards of training and assessment, strengthen teacher management, and establish an inspiriting mechanism.

? 【Key word】 General medicine；Teacher training,short-term；Evaluation

Prognostic Factors of Noninvasive BiPAP in Treatment of COPD Patients with Acute Respiratory Failure in Emergency Department ZHANG Yu-mei, ZHENG Ya-an, LIU Gui-hua.
Department of Emergency, Beijing University Third Hospital, Beijing 100191, China
【Abstract】 Objective To determine the prognostic factors associated with failure of noninvasive Bi-level positive airway pressure (BiPAP) ventilation in treatment of patients presenting with acute respiratory failure due to exacerbation of chronic obstructive pulmonary disease (COPD) in emergency department.
Methods? Totally 155 COPD patients complicated by type II respiratory failure selected were given BiPAP based on conventional treatment.The indexes of the patients before and 2 hours after BiPAP treatment were observed, and their correlation with the effect of BiPAP was analyzed.
Results Among all 155 patients, there were 32 successful cases and 32 failed cases in BiPAP treatment.Before treatment, the differences between the patients of successful and failed groups in body weight, body mass index, serum albumin, Acute Physiology and Chronic Health Evaluation (APACHE) II score and consciousness score showed statistically significance （P＜0.05）;and 2 hours after treatment, the differences in consciousness score, heart rate, PaCO2 and pH value were of statistically significance （P＜0.05）.The logistic regression analysis demonstrated that pH change after 2-hour BiPAP treatment, the consciousness score and body mass index before treatment were of independent predictive value for the success of BiPAP treatment.
Conclusion The pH change after 2-hour BiPAP treatment, and the consciousness score and body mass index before treatment are the independent predictive indexes for the effect of BiPAP treatment of COPD patients complicated by acute respiratory failure in the emergency setting.

? 【Key word】 Pulmonary disease,chronic obstructive;Respiratory insufficiency;Noninvasive bi-level positive airway pressure ventilation;Prognostic factors;Emergency

Relationship between Hyperuricemia and Pre-diabetes, Insulin Resistance in Senile Patients JIANG Sheng, LI Su-hua.
The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
【Abstract】 Objective To explore the relations between hyperuricemiaand pre-diabetes (PDM), insulin resistance (IR) in senile patients.
Methods? Totally 74 senile patients with hyperuricemia and PDM (hyperuricemia group) and 56 senile patients with PDM and with normal serum uric acid (control group) were selected, then according to the levels of blood sugar the two groups were again divided as impaired fasting glucose subgroup and impaired glucose tolerance subgroup respectively.The levels of fasting plasma glucose (FPG), fasting insulin (FINS) and 2-hour postprandial blood glucose (2 hPG) were determined and compared between the two groups, and the Homa insulin resistance index (HOMA-IR) and insulin sensitive index (ISI) were calculated.
Results? There were significant differences in serum uric acid, FPG, HOMA-IR and ISI between hyperuricemia group and control group (P＜0.05).There were significant differences in serum uric acid, FINS and HOMA-IR between hyperuricemia-IFG group and control-IFG group (P＜0.05).There were significant differences in serum uric acid and 2hPG between hyperuricemia-IGT group and control-IGT group (P＜0.05).The level of serum uric acid was related positively to FPG, FINS and Homa-IR (P＜0.05), and negatively to ISI (P＜0.05).
Conclusion The hyperuricemia and IR are closely related, being of a causal relationship.The patient with hyperuricemia is likely to be complicated by IGT or/and IFG.
【Key word】 Hyperuricemia;Pre-diabetes;Insulin resistance

Differential Diagnosis of Treadmill Exercise Test Induced Wide QRS Complex Tachycardia? SHEN Yi, ZHENG Ping-yu, LI Hong-wei, et al.
Department of Cardiology, Beijing Friendship Hospital, Capital University of Medical Science, Beijing 100050, China
【Abstract】 Objective To investigate the value of Vereckei′s new approach in differential diagnosis of wide QRS complex tachycardia (WQRST).
Methods A total of 27 patients with WQRST induced by electrocardiogram treadmill exercise test (ETT). WQRST was differentiated according to Vereckei′s new four-stepwise approach.Results The accordance rate of WQRST diagnosed based on the new four-stepwise approach was 92.6% and the rate of misdiagnosis was 7.4%.All WQRSTs induced by ETT stopped by themselves, with no serious result, The 4 patients with ischemic ventricular tachycardia and a patient with ischemic supraventricular tachycardia and bundle branch block were cured by active treatment.
Conclusion Vereckei′s new four-stepwise approach is of important significance to differentiation of WQRST.It is helpful to distinguish VT from SVT timely and accurately, and is beneficial to treatment and prognosis of the disease.

? 【Key word】 Wide QRS tachycardia;Vereckei new approach;Exercise test;Diagnosis

Clinical Study on Endothelial Cell Function in Old Patients Receiving Hemodialysis? ZHENG Jie, HUANG Wen, ZHAI Yan－ling.
Department of Nephrology，Beijing Tongren Hospital，Capital Medical University，Beijing100730, China
【Abstract】 Objective To investigate the change of endothelial cell function induced by maintenance hemodialysis in old patients.
Methods The enzyme-linked immunosorbent assay and chromogenic substrate assay were used to detect the indexes on endothelial cell function before and after hemodialysis in 56 old patients, and the results were compared with those in the normal controls.

Results? The levels of tissue-type plasminogen activator (tPA) antigen, plasminogen activatation inhibitor-1 (PAI-1) antigen and thrombomodulin (TM) in old patients before maintenance hemodialysis were significantly higher than those of normal controls (P=0.000).The levels of tPA antigen and PAI-1 antigen after the first time of hemodialysis showed statistically significant difference from those before hemodialysis (P=0.000).The levels of PAI-1 antigen and TM antigen were positively correlated with the dialysis duration (r=0.522, 0.465 respectively,P＜0.001).
Conclusion The maintenance hemodialysis for old patients may cause injury to endothelial cell function.

? 【Key word】 Maintenance hemodialysis；Endothelial cells

Bedside Monitoring of Sleep Disordered Breathing in Chronic Heart Failure Patients WU Chun, WU Yan, GENG Li-xia, et al.
Department of Cardiology, Shenzhen Hospital, Beijing University, Shenzhen 518036, China
【Abstract】 Objective To investigate the prevalence of sleep disordered breathing （SDB） and its relationship with hypoxemia and bradycardia inpatients with chronic heart failure (CHF) who were in natural sleeping condition at home or in bed.
Methods? Portable diagnostic equipment, Embletta, was used to monitor SDB prevalence in patients with systolic and diastolic heart failure to observe apnea frequencies per hour and total frequency of apnea hypopnea index (AHI).AHI> 10 /h was defined as SDB, and based on it patients were divided into SDB group (AHI＞10/h) and non-SDB group (AHI≤10/h).The relation of AHI with arterial oxyhemoglobin saturation （SO2） and heart rate in both groups were observed.
Results? Among all the enrolled 47 patients the prevalence of SDB was 44.7% （21 cases）.No significant difference was found in gender, age, body mass index (BMI), snoring history, heart functional class, ratios of diastolic heart failure and systolic heart failure, and β-blocker usage between the two groups （P＞0.05）.There were significant differences between the SDB group and non-SDB group in the prevalence of AHI during sleep, average SaO2 , the lowest SaO2, percentage of time length of SO2＜90% in total record time, and prevalence of severe bradycardia (P＜0.05).The lowest heart rate at night was negatively correlated to AHI (r=-0.49,P＜0.05), and so was it to the prevalence of SaO2＜90% （r=-0.52,P＜0.05）.
Conclusion Bedside sleeping apnea monitoring shows that prevalence of SDB in heart failure patients is higher, and it is accompanied by severe hypoxemia and bradycardia.

? 【Key word】 Chronic heart failure;Sleep apnea syndromes;Arterial oxyhemoglobin saturation;Bedside monitoring

Countermeasures and Suggestion for Improving the Life Quality of Old People in Nursing Homes TANG Jun-ke, LI Hui-ying, YOU Jia-kai, et al.
The Department of Information of Minhang District Center for Disease Control and Prevention, Shanghai 201100, China
【Abstract】 Objective To know the current situation of the service in nursing homes and to provide measures and suggestions in order to improve the life quality of the aged.
Methods To investigate the living status of the aged, the condition of daily management and the existing problems in nursing homes in the district by questionnaire and interview.
Results The characteristics of the aged in nursing homes in the district were more of the advanced old people, females, the widowed, illiterates or primarily educated, diseased, and disabled.The main problems existing in these nursing homes were no sufficient beds for demand of the aged, different levels in quality of service and management of the administrators and serve givers and unitary in item and content of service.
Conclusion? The work for population aging should be further enhanced to improve policies regarding old people care by agencies, and gradually develop a complete nursing system for the aged.

? 【Key word】 Nursing home;Quality of life;Countermeasure

Improving Effect of Intervention of Cognitive Behavior on Anxiety and Depression of Patients with Atrial Fibrillation? GE Ke-fa.
People′s Hospital of Pujiang，Pujiang 322200，China
【Abstract】 Objective To investigate the improving effect of intervention of cognitive behavior on anxiety and depression in patients with atrial fibrillation.
Methods Totally 82 patients who meet the standards were randomly divided into two groups, the patients in the control group were only given pharmacotherapy, and those in the trial group based were given additional intervention of cognitive behavior based on the pharmacotherapy.
Results There were statistically significant differences in anxiety and depression between the two groups （P＜0.05）.
Conclusion The intervention of cognitive therapy based on the pharmacotherapy can improve psychological anxiety and depression effectively to the patients with atrial fibrillation.

? 【Key word】 Atrial fibrillation；Anxiety；Depression；Cognitive therapy

Investigation of Children′s Health Status in Three Project Counties of Inner Mongolian Autonomous Region LIU Fen，SHENG Ai-juan，QIAN Hong-juan，et al.
School of Public Health and Family Medicine, Capital Medical University, Beijing 100069, China
【Abstract】 Objective To understand the children′s health status and level of three project counties in Inner Mongolian Autonomous Region, and to explore the possible impacting factors.
Methods? The three-stage stratified cluster sampling was used.The face-to-face interview at the residents′ houses was conducted, and the parameters of children′s growth and development, and hemoglobin (Hb) level were examined.Results Four hundreds and five caretakers for children less that 5-year were investigated and the Hb levels of 278 children form 6 to 36 months were tested.The prevalence of growth retardation? was 15.0%, the prevalence rates of diarrhea and cough (suspected pneumonia) in recent 2 weeks were 30.1% and 29.1% in children under 5-year old.The prevalence of anemia in children from 6 to 36 months was 45.0%.The proportion of added vitamin A was? 3.7%, the proportions of added other vitamins and mineral matter were 7.9% and 29.0% respectively.The percentage of specific vitamin A capsule supplement within half year was 5.0%.
Conclusion? The rate of malnutrition in children under 5 of the three project counties in Inner Mongolian Autonomous Region is higher, the general level of children health remains to be improved.

? 【Key word】 Children；Growth and development；Children health；Inner Mongolian

Current Status of First Aid Ability in Community Health Service Centers in Beijing Chaoyang District CHEN Kai-hong, TAO Li-li, LIU Jun, et al.
Beijing Chaoyang Emergency Medical Center, Beijing 100021, China
【Abstract】 Objective To know the first aid ability of community health services centers so as to give some reference to the construction of first aid stations.
Methods A self-designed questionnaire was taken to conduct investigation on the basic facilities, conditions of personnel for first aid and emergency medical services in 40 community health services centers.
Results The first aid facilities of ambulance in 81.8% of the community health services centers were not complete, and there was a big defect in first aid facilities in the centers.Some 56.7% of first aid personnel were under 35 years old and most of them have primary professional titles and junior college diploma.There were 18 centers with no separate areas of emergency rooms, accounting for 51.4%.
Conclusion It is of an advantage to supply first aid for community health services center.But it should be improved in first aid facilities and technique training of the personnel.

? 【Key word】 Community;First aid;Current status

Nursing Care for Intractable Glossopharyngeal Neuralgia Patients Treated by CT-Guided Radiofrequency Neurolysis? SUN Hai-yan，QI Shu-e，GUO Yu-na，et al.
Pain Medical Center，Xuanwu Hospital，Capital University of Medical Sciences，Beijing 100053，China
【Abstract】 Objective To investigate the nursing method for patients with intractable glossopharyngeal neuralgia（GPN）who experienced CT-guided cervical approach radiofrequency neurolysis.
Methods Totally 25 patients with intractable GPN were treated by CT-guided percutaneous puncture from cervical approach and neurolytic glossopharyngeal block with radiofrequency.And the provided nursing services were (1) proper preoperative preparations, psychological care and dietetic guide;(2) actively cooperating with surgeons to ensure a smooth procedure of operation;(3) carefully observing the possible postoperative complications and giving timely treatment.
Results After operation, pain disappeared in 20 patients and was partly relieved in three patients, and disappeared by additional trigeminal ganglion radiofrequency neurolysis in the rest two patients with trigeminal neuralgia.The following-up showed that there were 22 patients whose pain had not relapsed.The Visual analogue scales of all patients were significantly reduced after operation compared with those before operation （P＜0.05）, and no severe complication was found.
Conclusion A careful, timely and effective perioperative nursing benefits to reduce postoperative complications and to increase the effect of radiofrequency treatment.

? 【Key word】 Glossopharyngeal nerve diseases；Radiofrequency；Neurolytic block；Nursing care

Effect of Parents′ Participation to Post-operative Pain of Congenital Heart Disease Children GU Ying, YU Zhuo-wen, WANG Jun-qiao.
Children′s Hospital of Fudan University, Shanghai 201102, China
【Abstract】 Objective To evaluate the efficacy of parents′ participation in relieving the post-operation pain of children patients with congenital heart disease (CHD).
Methods Non-concurrent controlled trial was used to choose at random 51 patients as trial group and 52 as control group.The patients in the trial group were given Interventions of the parents′ participation in pain assessment, non-pharmacological analgesia and application and management of patient-controlled-analgesia pump.The face, legs, activity, cry, consolability pain scale (FLACC) were adopted to assess the conditions of pain in the patients in both groups 1 to 8 days after the operation.
Results FlACC scores of the patients were not statistically different between the two groups the 1st day after the operation (P＞0.05);the scores of the patients in the trial group was significantly lower than those in the control group from the 2nd to 6th day (P＜0.05);the scores were not statistically different between the two groups from the 7th to 8th day (P＞0.05).
Conclusion Parents′ participation in CHD patient′s post-operation pain management can effectively alleviate the patient′s pain.

? 【Key word】 Heart defects，congenital;Postoperative pain;Parents′ participation；Nursing care

Effect of Prosthetic Replacement for Unstable Intertrochanteric Fractures in the Elderly PAN Su, GAO Zhong-li.
China-Japanese Union Hospital of Jilin University, Changchun 130033, China
【Abstract】 Objective To investigate the clinical effect of prosthetic replacement on the unstable intertrochanteric fractures in the elderly.
Methods 41 patients of unstable intertrochanteric fractures in the eldly were chosen from January 1988 to February 2005,and 15 of them were delt with the prosthetic replacement,while the other 26 patients were delt with the internal fixation.It was compared between the prosthetic replacement group and the internal fixation group that the time length and the volume of blood-transfusion during operation,the ambulatory time,the occurrence of complications,and the activity functional classification decrease after operation.
Results Between the two groups there was a significant difference in ambulatory time (P＜0.01), so was there in blood-transfusion volume (P＜0.05).There was no significant difference in prevalence of complication between the two groups (P＞0.05), however in the trial group there was no case who is sick abed in long-term.
Conclusion The prosthetic replacement could be one of the therapies to the unstable intertrochanteric fractures in the elderly, and it has a certain advantage.
【Key word】 Arthroplasty，replacement;Femoral fractures;Elderly age

A Preliminary Study of Webbed Penes in Different Types of Penile Raphes? JIANG Hai-yang, ZHANG Ding, ZHANG Jian-bao, et al.
Department of Urology, the Fourth Hospital of Shenzhen,Shenzhen 518033,China
【Abstract】 Objective To study the incidence of webbed penes in different types of penils raphes.
Methods Digital photos of penes and scrotums of 136 Chinese males were analyzed to classify penile raphes into following types: straight linear, and curve , arc, twig and insidious.We compared the incidence of webbed connections between penes and scrotums in penile raphes.
Results? The incidence of webbed connection was 0 in straight linear and curve types, 46? 7% in arc, 30? 0% in twig and 23? 5% in insidious, respectively.Chi-square assessment showed a significantly higher incidence of webbed penes in arc and twig types as compared with straight linear and curve (P＜0.05).?
Conclusion This investigation reveals that shapes of penile raphes of Chinese people vary considerably, arc and curve shapes constituting the majority.A branched raphe often portends association with webbed penis.

? 【Key word】 Raphe of penis；Webbed penis

Nosocomial Infection of Newborns: A clinical analysis of 108 cases? YAN Zhi-xin, ZHAO Yu-qi.
Hebei Cangzhou City Centre Hospital, Cangzhou 061001, China
【Abstract】 Objective To investigate constructions of dangerous factors and pathogens of nosocomial infection in newborns so as to facilitate the implementation of preventive measures and effective control of development of nosocomial infection.
Methods Totally108 newborn patients with nosocomial infection in neonatal intensive care unit (NICU) of our hospital from January 2003 to January 2008 were retrospectively analyzed.
Results The nosocomial infection rate was 7.0 percent.The main pathogens of nosocomial infection were Klebsiella pneumoniae and Escherichia coli.The pathogens were sensitive to imipenem and amikacin, and resistant to the third generation of cephalosporin commonly used.
Conclusion Newborn nosocomial infection is related with multiple factors such as invasive operation, lower body mass, basic diseases, iatrogenic transmission.So the management and prevention work should be enhanced to reduce nosocomial infection rate.

? 【Key word】 Infant,newborn;Nosocomial infection;Pathogens

Research Status of the Preventive and Therapeutic Effects of Pelvic Floor Rehabilitation on Postpartum Urinary Incontinence WEI Ya-na, SONG Yan-feng.
Postgraduate Department，Fujian University of Traditional Chinese Medicine，Fuzhou 350025, China
【Abstract】 Pelvic floor rehabilitation (PFR) is of important significance in postpartum urinary incontinence (PPUI), for it is invasive and painless, simple in operation, with no untoward reaction, suitable for family treatment, and of both effects of prevention and treatment.It has gradually become a hot research topic both at home and abroad, and it is a first choice of basic therapeutic method for PPPUT.However, there has been no agreed account about the concrete method of practice of PFR and its actual effect, and thus the relative problems needs to be further studied.
【Key word】 Urinary incontinence；Pelvic muscle exercises；Electric stimulation therapy；Biofeedback

Advance in Research on Vulnerable Plaque YANG Fang-fang, GUO Hang-yuan, CHI Ju-fang.
Shaoxing People′s Hospital, Shaoxing 312000，China
【Abstract】 Thrombosis induced by vulnerable plaque rupture is the main cause of acute coronary events, and the existing examination methods can only be used for the moment or after the occurrence of acute coronary events.While the upstream diagnostic means cannot be clinically used in a large scale so far.The authors here review the progression on the mechanism of development of vulnerable plaque and its detection methods in order to provide a basis for an early diagnosis and active prevention of acute coronary events.
【Key word】 Vulnerable plaque;Coronary disease;Pathology,clinical

Community Public Health Service Package and Financial Investment Accounting in Futian District of Shenzhen City WANG Yue-ping，ZHOU Yong，LUO Le-xuan，et al.
Health Bureau of Futian，Shenzhen 518048，China
【Abstract】

Objective To define the concrete contents, and to set up the financial investment amount of community public health service (CPHS) in Futian District of Shenzhen City so as to lay a basis for set-up and improvement of compensation mechanism of CPHS.
Methods Basing on the cost accounting of CPHS items and combining the population feature of Shenzhen, the contents of CPHS package under deferent criteria of financial investment were defined from different angles of population estimate.And the financial gap of pure CPHS package was quantitatively estimated.
Results In the standard financial investment from the government in 2004, the contents of type A service package included 16 items of CPHS, and type B service package covered all the 39 items of CPHS and the first 6 items of quasi-CPHS.In the actual financial investment from the government in 2004, the contents of type A service package only included the first 10 items of CPHS, and type B service package only included the first 15.5 items of CPHS and the first 6 items of quasi-CPHS.In 2004 the financial defect of type A pure CPHS package in Futian district was RMB 74 887 800 yuan, and that of type B pure CPHS package was RMB 17 853 600 yuan.
Conclusion The governmental investment to the programs of basic CPHS should be enlarged.A special funds for CPHS needs to be set up to guarantee the governmental fanatical subsidy in place.The charge criteria and price system in CPHS should be established and improved so as to get a virtuous compensation mechanism of CPHS.
【Key word】 Community health services；Public health service package；Government financial investment；Accounting

Effect of Practice of Performance Appraisal and Distribution System to Motivation in Desheng Community Health Service Center HAN Cheng-cheng, FENG Yi, LIU Xiang-hong, et al.
Desheng Community Health Service Center,Beijing 100011,China
【Abstract】 Objective Evaluation the reform effect of health services performance appraisal and distribution systems in Desheng community health cervice center.
Methods? Establishment the performance evaluation system and incentive distribution platform in Desheng community health service center, explortion some questions during the development and application to the performance evaluation system, comparative analysis to the policy and datas before and after management pilot Separation between revenue and expenditure.
Results? Initially established the performance evaluation system and distribution machanism in Desheng community health service center.Information technology as a platform to achieve the automated management.The quantity and quality of community health services significantly improved, the same as works initiative and enthusiasm, residents satisfaction have also improved notably and enhance a sense of confidence and sense of identity to the community health institution.
Conclusion? Establishment the performance evaluation system and? distribution system improve community health service centers(stations) internal efficiency,ensure them sustained and healthy development.
【Key word】 Community health services;Performance appraisal;Distribution system

Analysis on Satisfaction to Community Health Service Institutions by Different Holders WANG Zhi-hong，WANG Yun-xia，WANG Fang，et al.
Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology，Wuhan 430071，China
【Abstract】 Objective To learn the patients′ satisfaction to community health service (CHS) institutions run by different holders.
Methods? The descriptive statistic method and Topsis were taken to analyze and assess the patients′ satisfaction to CHS institutions run by different holders.
Results? The overall satisfaction in accessibility to CHS institutions was the highest, up to 90.81%, but the satisfaction in equipment and drug price was lower, being 62.58% and 53.64% respectively.There was a significant difference in satisfaction to the CHS institutions run by different holders （P＜0.0001）.The satisfaction to the institutions held by social groups or individuals was the highest;the satisfaction to the institutions held by the government was similar to that held by enterprises and public institutions;and the satisfaction to the institutions held by some others was lower.
Conclusion? Satisfaction to the institutions held by the government is not high, so it is necessary for us to change thinking, enhance service awareness and improve the service quality.

? 【Key word】 Community health services；Holder；Satisfaction

Development of Software on the Year-checking-up Filling and Examining System for Community Health Services HU Hong-pu，LIANG Wan-nian, LIU Min, et al.
Capital Medical University，Beijing 100069，China
【Abstract】 Objective To set up the filling and examining system of year-checking-up in automatic management system for community health services (CHS).
Methods The filling and examining system of year-checking-up was constructed on the platform of Visual studio 2005, which consisted of seven steps.The first step was to establish a website, the second to add up a web configuration, the third to set up a background database, the fourth to establish a customer log-in module, the fifth to apply session object, the sixth to set up writing-out a filling system of year-checking-up for CHS station, the seventh to establish an examining system of year-checking-up.
Results We finished the development of the filling and examining system of year-checking-up for CHS.By filling model could we could input, increase, revise, delete and inquire the information on year-checking-up for CHS;and by the examining model we could complete the auditing work.
Conclusion Our developed system is speedy for input, simple and easier for practice, fine and clear in interface, highly effective in operation and secure and accurate in data transfer.

? 【Key word】 Community health services；Year-checking-up；Visual studio 2005

Number2January，2009

Pre-hospital Transportation and Admission Delays of Acute Stroke Patients：A Sub-study from Cerebrovascular Events Acute Care Register Database Study ZHOU Yong,WANG Yi-long,WU Di,et al.
Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China
? 【Abstract】 Objective To explore the status of pre-hospital delays of acute stroke patients in 7 cities of China through data of Cerebrovascular Events Acute Care Register Database Study (CARDS).
Methods A total of 31 hospitals eligible were enrolled in CARDS.The register databank,including demographic characteristic,pre-hospital emergency information,key delaying time,stroke subtypes and so on,was set up by expertise group.The doctors having received license filled up the obtained data into the databank in emergency departments.
Results A total of 1 091 patients eligible were registered and included in the final databank.Taking taxi was the first choice of patients going to emergency,accounting for 35.1%,higher than by other means of transportation.The proportion of EMS use was 39.3% in Shanghai,32.3% in Beijing,22.8% in Guangzhou,and 22.0% in other non-provincial-capital cities.Thirty-eight point four per cent of patients using EMS managed to reach emergency departments within 2 hours,accounting for 38.4%,a significantly higher proportion than using other means.
Conclusion Health education of stroke emergency catering to public should be emphasized to improve the long delays of pre-hospital adimission.
? 【Key word】 Registry;Acute cerebrovascular events;Emergency medical service;Cross-sectional study

Expression of Anti-metastasis Gene KAI1 in Epithelial Ovarian Neoplasms and Its Clinical Significance ZHANG Li-juan,WANG Qiu-hong,TANG Chun-sheng.
Obstetric and Gynecological Department,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China
【Abstract】 Objective To detect the relationship of KAI1 expression in epithelial ovarian carcinoma (EOC) to its clinical stages,metastasis and prognosis.
Methods Immunohistochemistry was used to determine the KAI1 expression and its relationship to histological type and grading,clinical stage,metastasis and relapse in 45 EOC patients.
Results There was no relationship of KAI1 expression to patients′ ages,volume and histological types of EOC.The KAI1 expression,which was correlated with clinical staging,lymph node metastasis and recurrence,was higher in stage Ⅰ-Ⅱthan in stage Ⅲ-Ⅳ(P＜0.01).KAI1 positive rate was higher in patients with negative lymph node than in those with positive (P＜0.05),and higher in non-recurrent patients than in recurrent (P＜0.01).There was significant difference in strong positive rate between patients with high histological grading and with low (P＜0.05).
Conclusion Gene KAI1 is probably correlated to clinical staging,lymph node metastasis and relapse of EOC,and thus one of the important markers in determining neoplasm metastasis and prognosis.
【Key word】 Ovarian neoplasms;Gene,KAI1;Immunohistochemistry;Prognosis

Clinical Analysis of Epidemiological Characteristics and Risk Factors of Septic Encephalopathy DAI Xin-gui，AI Yu-hang，CAI Ye-ping，et al.
Department of Intensive Care Unit，the First People′s Hospital of Chenzhou，Chenzhou 423000，China
【Abstract】 Objective To evaluate the epidemiological characteristics and risk factors of septic encephalopathy（SE）.
Methods Two hundred five cases with sepsis,admitted to our Intensive Care Unit（ICU）from Jan.2004 to Jan.2008,were analyzed retrospectively,88 of them were ruled out,and the remaining 117 were divided into SE group （n=52） and no-encephalopathy （NE） group（n=65）.A contrastive analysis was performed on the epidemiological data （age，sexual，time of hospitalization and stay in ICU，morbidity，mortality,etc.）,and the results of related examination（BP，WBC，PLT，K+，Ca2+，iCa2+，ALT，AST，albumin，globulin， TBIL， DBIL， SCr， BUN， CRP， BS， cholesterol， triglycerides，PaCO2，pathogenicbacteria， APACHEⅡscores,etc.）.
Results The morbidity and mortality of SE were 44.44% and 63.46%,respectively.The results of ALT，AST，BUN showed a statistical difference between 2 groups（P＜0.05）.And the brain imaging examination of SE patients showed a specific alterations and the score of APACHEⅡand the mortality had a significant increase when compared with NE（t=5.507，P=0.000）.
Conclusion It is of great significance to determine APACHEⅡ，ALT，AST，BUN，G+ infection in diagnosis and prevention of SE.
【Key word】 Sepsis；Epidemiologic studies

The Effects of Mental Intervention Combined with Postoperative Analgesia on Restlessness During Anesthesia Recovery Period in Patients Undergoing Thoracotomy HAN Guang-yan,ZHAO Yan-li,LI Jian-li,et al.
Department of Anesthesiology,Hebei General Hospital,Shijiazhuang 050051,China
【Abstract】 Objective To investigate the effects of mental intervention combined with postoperative analgesia on restlessness during anesthesia recovery period in patients undergoing thoracotomy in general anesthesia.
Methods One hundred and sixty patients undergoing thoracotomy in general anesthesia were randomly divided into 4 groups:routine interview (group A),mental intervention (group B),postoperative analgesia (group C) and mental intervention combined with postoperative analgesia(group D),40 in each.Mean arterial blood pressure(MAP) and heart rate(HR) were recorded before induction of anesthesia,at the end of operation,and immediately,5,10 min after extubation of endotracheal catheter.The rates of restlessness during anesthesia recovery period were calculated.
Results Group D showed the lowest hemodynamic responses.The rates of restlessness were significantly lowered in group B(17.5%,P＜0.05),group C(30.0%,P＜0.05) and group D (2.5%,P＜0.01)as compared with group A (82.5%).
Conclusion Mental intervention combined with postoperative anlgesia can reduce the rates of restlessness during anesthesia recovery period in patients undergoing thoracotomy.
【Key word】 Psychology，clinical;Analgesia;Anesthesia，general；Postanesthesia nursing

Correlation of Resistin with Hypertension，Lipids，Obesity in Patients with Acute Cerebral Infarction KOU Zhong-ai，ZHAO Ren-liang，WANG Jian-lin，et al.
Department of Neurology，Affiliated Hospital of Medical College，Qingdao University，Qingdao 257024，China
【Abstract】 Objective To investigate the clinical significance of serum resistin levels for atherosclerotic cerebral infarction（ACI）and to analyse its correlation with hypertension，lipids，obesity.
Methods Eighty-two patients with ACI and 15 healthy subjects were selected to determine by ELISA the level of serum resistin.And in the meantime,the levels of triglyceride （TG），total cholesterol（TC），high density lipoprotein cholesterol（HDL-C），low density lipoprotein cholesterol （LDL-C），leptin，insulin，fasting blood glucose （FBG） and hs-CRP were also detected.Quantitative insulin sensitivity check indexes（QUICKI） were calculated.Height，weight，systolic blood pressure（SBP），diastolic blood pressure（DBP），body mass index （BMI） and waist-to-hip ratio （WHR） were measured.
Results （1）There was no significant difference in sex，age and BMI between ACI group and the control （P＞0.05）.WHR，SBP，DBP，serum levels of resistin，leptin，insulin，FBG，LDL-C and hs-CRP were significantly higher （P＜0.05），and HDL-C and QUICKI lower in ACI group than in control （P＜0.05）.Difference in TC，TG between the two groups was not significant （P＞0.05）.（2）The Single factor linear correlation analysis showed that resistin had positive correlation with BMI，SBP，DBP and LDL-C，and negative correlation with HDL-C and QUICKI （P＜0.05）.No relationship was found between resistin and WHR，TC and TG （P＞0.05）.（3）Taking leptin as a dependent variable and other markers as independent variables，multiple stepwise regression analysis showed that resistin was positively correlated with BMI，SBP，LDL-C and hs-CRP （P＜0.05），but negatively correlated with HDL-C and QUICKI（P＜0.05）.
Conclusion The increased resistin may play an important role in the development of atherosclerotic cerebral infarction by influencing lipid metabolism， hypertension and obesity.
【Key word】 Brain infarction；Atherosclerosis；Hypertension

Study on Relationship between Expression of APE1 and Resistance of Human Ovarian Carcinoma to Cisplatin ZHANG Ying,WANG Jian,WANG Dong,et al.
Department of Obstetrics and Gynecology,the Fourth Military Medical University,xi′an 710032,China
【Abstract】 Objective To study the relationship of expression of apurinic/apyrimidinic endonuclease(APE1) protein to human ovarian carcinoma(HOC) resistance to cisplatin,and to detect the mechanism of APE1 in cisplatin-resistant cell subline.
Methods Expression and location of APE1 protein was detected in specimens and HOC cell A2780,cisplatin-resistant cell subline A2780/CP70 in 78 HOC patients.
Results APE1 showed nucleus,hyalomitome expressions or caryoplasm co-expression in HOC tissues.The intensity and location of APE1 protein was significantly correlated with chemotherapy sensitivity.Expression of APE1 gene in A2780 HOC cell line was significantly elevated as compared with those in A2780/CP70 cisplatin-resistant cell subline.
Conclusion There is a correlation of intension and location of APE1 expression with sensitivity of chemotherapeutics based on platinums,which is of suggestive effect in HOC chemotherapy.APE1 location in ovarian cancer cell may be a useful biomarker for platinum resistance.
【Key word】 Ovarian neoplasms;APE1;Cisplatin;Drug resistance

Effects of Extract of Ginkgo Biloba Leaves on Free Radical and Anti-oxidant Level of Testis and Epididymis Tissues in Diabetic Rats XU Qiu-ling,SUN Wei,ZHENG Xue-zhi,et al.
Department of Physiology,Mudanjiang Medical College,Mudanjiang 157011,China?
【Abstract】 Objective To observe the effects of extract of Ginkgo biloba leaves on free radical and anti-oxidant of testis and epididymis tissues in diabetic rats.
Methods Ten of 40 male Wistar rats were randomly chosen as normal control group,the others were given streptozotocin(STZ) and high-fat and -glucose diet to prepare type II diabetic models,and the prepared models selected were randomly divided into diabetes and treatment groups,10 in each.After the treatment group were treated with ginkgo biloba extract for 10 weeks,bilateral testis and epididymis tissues were taken out of all rats to detect MDA an NO levels and activity of SOD,GSH-Px and NOS.
Results? In treatment group there was a sharp drop in SOD and GSH-Px activity (P＜0.01),and an obvious increase in MDA,NO levels and NOS activity (P＜0.01) when compared with the control group.SOD and GSH-Px activity increased obviously(P＜0.01),but MDA,NO levels and NOS activity decreased evidently(P＜0.01) in treatment group as compared with diabetes group.
Conclusion? Extract of ginkgo biloba leaves can provide protection for the testis and epididymis of diabetic rats.
【Key word】 Diabetes mellitus,type 2;Extract of ginkgo biloba leaf;Testis;Epididymis;Free radicals

Acute Disseminated Encephalomyelitis：Clinical Analysis of 7 Cases HAO Dong-lin.
Department of Neurology，Jiangsu University Affiliated Wujin Hospital，Changzhou 213003，China
【Abstract】 Objective To investigate the clinical features of acute disseminated encephalomyelitis(ADEM).
Methods A retrospective analysis and follow-up study were carried out on clinical data of 7 patients with the diagnosis of ADEM to summarize its characteristics in clinical manifestations,imaging,therapy and prognosis.
Results? Before onset,2 patients presented with history of upper respiratory tract infection,1 with diarrhea,and 1 once received diphtheria-tetanus vaccine inoculations.No incentive was found in another 3 patients.Different patients varied in clinical manifestations.Multiple lesions mainly involved in brain alba were found by MRI,probably infecting cerebral cortex,thalamus,brain stem and spinal cord.Glucocorticoid and intravenous immunoglobulin were administered in all patients.No relapse occurred in 6 during a 6-to-12-month follow-up,whereas varying degrees of neurologic sequelae remained in 5.
Conclusion ADEM has multiple clinical manifestations in the central nervous system.Some characteristics can be seen in MRI.Early use of glucocorticoid may be helpful.
【Key word】 Encephalomyelitis,acute disseminated;Glucocorticoid；Magnetic resonance imaging

Diagnosis and Treatment of Islet Cell Tumors ZHAO Xiang-qian,CAI Shou-wang,LIU Rong,et al.
Institute of Hepatobiliary Surgery,General Hospital of People′s Liberation Army,Bejing 100853,China
【Abstract】 Objective To study the Diagnosis and treatment of islet cell tumors.
Methods Clinical data of 58 patients with islet cell tumors admitted to our hospital from January 1995 to December 2007 were retrospectively analyzed.The clinical evidences,diagnosis and surgical treatment were summarized.
Results Of 58 patients,39 had nonfunctional islet cell tumors and 19 had functional (17 insulinomas,2 gastrinomas).Non-functional islet cell tumors were the most commonly characterized by epigastric pain and discomfort,and insulinoma,gastrinoma by Whipple triad and severe peptic ulcer,respectively.The localization diagnosis rates of ultrasonography,CT and MRI were 80.8%,82.6% and 90.0%,respectively.All patients were treated surgically,and 53 of them were followed up.The rates of 1-,3-,5-year survival were 98.1%,96.2%,92.5%,respectively.
Conclusion Nonfunctional islet cell tumors and insulinomas are the most common in islet cell tumors.Diagnosing nonfunctional islet cell tumors is difficult before operation,and therefore,ultrasonography,CT and MRI play an important role in localization diagnoses.Both pathological examination and biological behaviors of the tumors should be considered when judging whether the tumors are benign or malignant.Surgical resection proves helpful in treatment of patients with islet cell tumors.
【Key word】 Adenoma，islet cell;Diagnosis;Therapy

Analysis of Antibiotic Resistance of Metallo-β-lactamase of Pseudomonas Aeruginosa in Clinical Isolates WANG Gui-nian，WANG Jin-ling，WU Juan.
The First Hospital of Zibo City，Zibo 255200，China
【Abstract】 Objective To analyze the detection method and the resistance profile of metallo-β-lactamase Pseudomonas aeruginosa in clinical isolates.
Methods A total of 40 P.aeruginosa isolates in our hospital were analyzed.The phenotype of Metallo-β-lactamase were screened by EDTA-IMP disk diffusion method and E-test method and PCR method.Susceptibility test was performed by determing minimum inhibitory concentrations.
Results Nine of 40 imipenem-resistant Pseudomonas aeruginose isolate by EDTA-IMP disk diffusion method，6 of the strains were screened by E-test method，1 of the strains was found to produce IMP-1 and 3 of the strains were found to produce VIM-2.The strains produced Metallo-β-lactamase were multi-drug resistance，the strains with positive in PCR method highly resistant.The susceptibility to amikacin and ciprofloxacin highly active.
Conclusion Isolates of multi-drug resistance pose a serious situation of Metallo-β-lactamase of Pseudomonas aeruginosa in patients.
【Key word】 Hseudomonas，aeruginosa；Beta-lactamases；Drug resistance

Adverse Reaction to Influenza Vaccine：Analysis of Related Literature WU Wen-yan,WU Hong-ge.
Cadre Sanatorium of Hubei Provincial Military Region，Shi Pai Ling East Road，Wuhan 430070，China
【Abstract】 Objective To discuss the regular pattern and characteristics of adverse drug reactions （ADR） induced by influenza vaccine.
Methods A statistical analysis was performed on data of 26 ADR cases induced by influenza vaccine reported domestically during the period 2000～2008.
Results The most common ADRs were dizziness,headache,fever and anaphylactic response,occurring during the period of 1～72 h,the latest on day 10.
Conclusion Clinicians should pay attention to influenza vaccine adverse events,closely observe patients′ clinical manifestations to ensure the safety of drug use and to decrease incidence of adverse reactions.
【Key word】 Influenza vaccine；Adverse effect

A New Model of Information-and Network-based On-site Rescue with Overall Concept and Seamless Links YUE Mao-xing,HE Dong,QIN Guo-liang,et al.
Center of General Surgery and Center for Special Medical,306th Hospital of PLA,Beijing 100101,China
【Abstract】 Objective To improve the abilities of first aid and on-site rescue for emergency accidents,mass injury of manned space flights and local warfare,and to develop a new concept of consecutive on-site rescue system characterized by information and net-working.
Methods A new on-site rescue model was set up,characterized by information,net work and consecutive management,which included on-site consultation system,mobile intensive care unit and inpatient management.Chi-square test was used to compare,between information- and network-based group and control,the rates of successfully receiving "help" calls,of dispatching ambulances and of successful connection between pre-hospital care and in-hospital within 60 seconds.The achievement ratio of sudden death rescue,the hospital discharge rate of brain trauma patients and rescue effect of severe multiple injury(ISS＞30) were determined.
Results The results showed that this system improved not only the performance of definitive treatment but also the effectiveness of the on-site rescue.In traditional management,the mortality,cure and improvement rates,ineffectiveness of the severe multiple injury were 60%,4%,12% and 24%,respectively,but in the new on-site rescue system were 22.6%,22.6%,50% and 4%,respectively.When compared with traditional management,the mortality of the new system decreased by 43.4%,and the cure rate increased by 18.6%.
Conclusion The model of consecutive rescue has broken the tradition for emergency treatment,which will gain golden time for rescuing patients.Setting up an effective and consecutive on-site rescue chain can decrease the mortality and disability in sudden disasters and local warfares.
【Key word】 Computer communication networks；Emergercy medical service communication systems；Information systems

Assessment of Left Atrium Function by Pulsed Wave Tissue Doppler Imaging ZHU De-cai，LIU Tie-jun，YAO Yu-lian.
Department of Cardiology of Mingzhou Hospitai，Ningbo 315100，China
【Abstract】 Objective This study is designed to assess the left atrium （LA） systolic function in patients with left ventricular diastolic dysfunction(LVDD) using pulsed wave(PW) tissue Doppler imaging(TDI).
Methods Thirty normal subjects and 40 LVDD patients were chosen to detect their LA ejection fraction and force.PW TDI was used to determine the motion velocity of heart muscle around the basis of aortic valve when LA contracted,to compare the difference of left atrial contraction between normal subjects and LVDD patients.
Results? LAF,AEF,the motion velocity of heart muscle around aortic valve basis were higher in LVDD patients than in normal subjects when LA contracted.
Conclusion PW TDI determination of motion velocity of heart muscle around valve basis in systole period is useful in defining left atrial function;there is a significant rise in left atrial contractile function in LVDD patients as compared with normal.
【Key word】 Ultrasonography，doppler，pulsed；Atrial function，left

Latent Risks of Painless Colonoscopy and Its Countermeasures CHEN Xiang-hua.
Endoscopic Department,Hengdian Group Hospital of Zhejiang,Dongyang 322118,China
【Abstract】 Objective To explore the potential safe problems of painless colonoscopy and its countermeasures.
Methods? Adverse reactions were present in 815 of 936 patients chosen,who underwent painless colonoscopy.We analyzed the adverse reactions and the countermeasures we took during and after operations.
Results? During operations,local pains on the injection sites were found in 271 patients,a heart rate drop to 55～45 times/min in 218,limb restlessness in 167,blood oxygen saturation(BOS) decrease to 90%～86% in 134,muscle tension or amyostasia in 27,nausea or vomiting in 13 and respiratory depression in 2;after operations,dizziness in 103 patients,abdominal pain or distention in 67,nausea or vomiting in 26,hypoglycaemic reaction in 3,total body urticaria in1;being sad and starting sobbing or murmuring 2 min after operation in 4;being in manic-state with hallucination and screaming 5 min after in 1.All adverse reactions disappeared after symptomatic therapy.Follow-ups by telephone showed there was no one complaining of any adverse reactions 3 days after operations.
Conclusion Painless colonoscopy may produce adverse reactions in circulation,respiration,enteron and nervous system.Therefore,stringent screening before operation,close care and timely symptomatic trestment during and following are essential in security of application of painless colonoscopy.
【Key word】 Colonoscopy;Security;Countermeasures

Treatment of Puerperal Massive Hemorrhage by Emergency Superselective Uterine Artery Embolization ZHOU Jian-feng.
Department of Interventional Therapy，Xingtai People′s Hospital，Xingtai 054031，China
【Abstract】 Objective To explore the clinical effect of emergency superselect uterine artery emboliaztion on puerperal massive hemorrhage.
Methods Superior soldinger technique was used to carry out femoral artery puncturing to form superselective embolization in uterine arteries.
Results? After superselective embolization,hemorrhage stopped rapidly in 18 cases,decreased obviously but disappeared absolutely after 1-week symptomatic treatment in 2;four cases presented with lower abdominal distention,1 with gluteal pain,11 with low grade fever.No severe complications occurred.
Conclusion? Emergency uterine artery embolization,which can stop bleeding rapidly and completely with exact effect and retain ability to bear children,is superior to surgical procedures in treatment of patients to whom expectant treatment proved ineffective and who were seriously short of blood volume due to postpartum massive hemorrhage.
【Key word】 Postpartum hemorrhage；Radiology，interventional

Stripping Great Saphenous Veins in Lower Limbs by Combined Anterograde and Retrograde Methods：Effect Observation of 300 Cases SUN Wei,JIN Xiao-guo,WANG Xun.
Haining Municipal Hospital of Traditional Chinese Medicine,Zhejiang 314400,China
【Abstract】 Objective To observe the results of operations stripping great saphenous veins in lower limbs,using combined anterograde and retrograde method,in 300 cases,and to compare them with traditional stripping operations.
Methods The control group were given traditional stripping operations,while the therapy group combined anterograde and retrograde stripping operations.The operation time,bleeding volume,numbers of skin incisions and thoroughness of stripping were compared between the two.
Results? There was significant difference between 2 groups in operation time,bleeding volume,numbers of skin incisions and thoroughness of stripping(P＜0.01).
Conclusion When compared with traditional,combined anterograde and retrograde stripping operation takes shorter time,has less bleeding volume and fewer skin incisions,and strips more thoroughly great saphenous veins in lower limbs.
【Key word】 Combined anterograde and retrograde method;Varicose veins;Lower extremity

Combine Traditional Chinese Medicine and Western Medicine in Treatment of Bile Reflux Gastritis：Report of 166 Cases ZHANG Zhi-juan,ZHOU Yu-wen.
Qian′an Epidemic Prevention Station of Hebei Province，Qian′an 064400，China
【Abstract】 Objective To study the therapeutic effects of Traditional Chinese Medicine(TCM) Hezhongxiaopi decoction combined with Western Medicine(WM) on bile reflux gastritis(BRG).
Methods One hundred sixty-six BRG patients were randomly divided into treatment group(n=83) and control group(n=83).The latter were treated with routine WM (hydrotalcite and domperidone),and the former with additional Hezhongxiaopi decoction besides it.After 8 weeks of treatment,we observed the scores of symptoms such as burning epigastric pain,satiety,nausea and vomiting,and analyzed the gastroscopic symptoms of yellow-green bile,gastric mucosal edema,hyperemia,erosion and bleeding points,and then compared both therapeutic effects.
Results The total effective rates of both groups were 89.15%， 67.47%，respectively(u=3.441，P＜0.01).The scores of symptoms and gastroscopic indexes of both groups were significantly increased（P＜0.05）.The curative effect of treatment group was significantly better than that of control.
Conclusion The combine TCM and WM,which is of good effect in treating BRG with fewer adverse reactions,is worthy of further investigation and clinical application.
【Key word】 Gastritis；Bile reflux;Integrated Traditional Chinese Medicine and Western Medicine

Role of Arachidonic Acid and Its Metabolites in Islet β-cell Function and Insulin Resistance YE Xiao-zhen,SHAO Jia-qing,WANG Jian.
Department of Endocrinology,Nanjing General Hospital of Nanjing Military Command,Nanjing Clinical Institute of Southern Medical University,Nanjing 210002,China
【Abstract】 Different levels of arachidonic acid（AA）vary in effect on the islet β-cell function.Physiological concentration of AA promotes insulin biosynthesis or secretion,while the ultra- physiological inhibits it.In addition,AA also prevents the β-cell cytotoxicity and insulin resistance induced by palmitic acid(PA) and stearic acid (SA),and its metabolites also influence significantly the synthesis and secretion of insulin.
【Key word】 Arachidonic acid;Metabolites;Insulin secretion;Insulin resistance,Islet β-cell function

Advance in Study on Invasive Fungal Infection Secondary to Hematological Malignancy LIU Lin-hui，FU Mei-lan.
Department of Hematology，First Affiliated Hospital of Xinjiang Medical University;Urumqi 830054,China
【Abstract】 Invasive Fungal Infection（IFI）secondary to Hematological Malignancy(HM) is a disease with severe nosocomial infection and high mortality， causing aggravation of primary disease or even leading to death.Research of the characterics of IFI in HM,early diagnosis,prevention of its risk factors，prophylactic application of anti-fungus medicines,reasonable choice of effetive anti-fungus medicines should be carried out,thus to decrease the incidence of IFI and to prolong the survival of patients with HM.This review focuses on the progress in research of IFI secondary to HM in recent years.
【Key word】 Hematologic neoplasms；Fungemia；Therapy

Investigation of Quality of Life and Mental State and Social Support Received in Patients with Type 2 Diabetes in Shenzhen Communities ZHANG Wen-han,HU Su-jun,LIU Yi-xin,et al.
Futian District Meilin Hospital，Shenzhen 518049，China
【Abstract】 Objective To investigate quality of life(QOL)，depressive problems and social support received in DM-2 patients in communities,to provide reliable theoretical evidence for pertinent intervention.
Methods? Convenient sampling was used to select elderly DM-2 patients from a community in Shenzhen,and matched DM-free subjects were taken as contro1.There were 107 subjects in each group.A self-designed demographic data questionnaire，WHOQOL-BREF，Self-Rating Depression Scale and Social Support Rating Scale were used.A1l data were processed by SPSS 15.0 and compared by t test，test and multiple regression.
Results There was no significant difference in demographic data between 2 groups（P＞0.05）.Significant difference was found between 2 groups in QOL (P＜0.01),in physiological and mental realms,QOL total scores and health condition.(P＜0.05),in the incidence rate of depression（P＝0.029）,in the depression degree（P＝0.002）,in the total depression score and the depression index（P＜0.05）.In DM group,sufferers from depression were significantly different from non-sufferers in QOL scores（P＜0.01）,in physiological and mental states,society and environment realm,QOL total scores and healthy condition.( P＜0.05).Difference in objective support score was significant between DM group and control (P＝0.037).
Conclusion QOL of DM-2 patients is decreasing,especially in aspects of physiology and psychology.Depression is more liable to occur in DM-2 patients，and with it QOL decreases.The external social support given to DM-2 patients is less than that to healthy control.
【Key word】 Aged；Diabetes mellitus，type 2；Quality of life；Psychology；Social support

Investigation of Health Service Needs and Demand of Residents from Yuetan Community before and after A Decade LIU Jing,DU Xue-ping,DONG Jian-qin.
Fuxing Hospital Affiliated to the Capital Medical University,Beijing 100038，China
【Abstract】 Objective To contribute the knowledge of the changes of residents′ needs and demand for community health service(CHS),to adjust our development plans based on their requirements.
Methods We chose by cluster sampling system 10 423 and 8 343 subjects in years of 1996 and 2005,respectively,to carry out a questionnaire of cross-sectional study,which contained their basic information,and status of economy,living habits,health status and health knowledge,demand and utilization of community health services.
Results The proportion of aged people and the number of people doing regular exercises increased significantly in 2005 as compared with that in 1996.A significant increase was also noted in utilization of different level hospitals.2005′s study showed that 10.2% of elderly lived by themselves,28.9% of residents needed health education and 16% required dietary and physical examinations by general practitioners in Yuetan Community.
Conclusion Based on the changes of residents′ ages,educational levels,payment of medical fees,and their needs and demands for community health services,we should adjust the emphasis on CHS development to improve energetically the benefit-to-the-aged cause,and to develop new service models,to improve ourselves constantly in flexible and various forms of CHS.
【Key word】 Community health services；Health services needs and demand；Aged

Number3February，2009

Challenges for the Development of Health Information Systems for Community Health Services in China LIU Chao-jie.
School of Public Health,Faculty of Health Sciences,La Trobe University,Victoria 3086,Australia
? 【Abstract】 Information systems comprise an important part of the development of community health services.The current infrastructure,however,could not meet the needs of applications of information systems for the community health services.Insufficient managerial skills,lack of clear business objectives,and poor quality of data has seriously jeopardised the achievements of health information systems.The management of health information systems should bring people,data,computers and procedures together.
? 【Key word】 Health Information;Community health services

Referral Patient from Community Doctor to Specialist:What we still don′t know? YANG Hui.
Faculty of Medicine,Nursing and Health Sciences,Monash University,Victora 3168,Australia
【Abstract】 Objective To review studies on referral behaviors and to provide suggestion on further studies on the professional process.
Methods Iterature review.
Results Providing referral service did not always gain positive results,especially patient outcomes.Referral behavior among general practitioners presented significant variation;under-referral and over-referral were both prevalent.The variability could be attributed to doctor psychological determinations,i.e.,perception and tolerance of ambiguity,type and severity of condition,opportunity of doctor professional development and financial benefit.Referral is a process of transferring responsibility of patient management between general practitioner and specialist.Unfortunately,limited research evidence which exploring the behavior in Chinese circumstance was found.
Conclusion It is a vital for policy makers to understand motivation and barriers of doctor referral behavior.Doctors consult and refer patient need to be closely observed and modeled.Further research needs to be conducted on factors impacted on referral decision,cost and patient outcome of referral,and how developed practical and appropriate referral strategies.An implemental strategy should be one of realising expectation and adding values of general practitioner,specialist and patient.Meanwhile,the successful strategy should be one with reasonable and acceptable intervention or governance from government,industry and health insurance.
【Key word】 Referral;Responsibility;Behavior;Stakeholder

Analysis of Respiratory Physiological Factors and Rest Energy Expenditure in Patients with Connective Tissue Disease SU Xin-ming， WU Chun-ling， LIU Gang，et al.
Institute of the Respiratory Disease， the First Hospital of China Medical University， Shenyang 110001， China
【Abstract】 Objective To investigate the effect of some respiratory physiological factors such as pulmonary function and blood-gas analysis on rest energy expenditure (REE) in patients with connective tissue disease (CTD).
Methods Totally 19 patients with CTD and 21 normal subjects were enrolled. REE, rest pulmonary function and arterial blood gas analysis were respectively conducted for all the subjects.
Results The differences in REE, REE/expected value, REE/body surface area REE/body mass between CTD patients and normal subjects showed statistically significant (P＜0.05), and so did in forced vital capacity(FVC), forced expiratory volume in first second (FEV1) and diffusion capacity for carbon monoxide of the lung (DLco) (P＜0.05). There were statistically significant differences in heart rate, arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (SaCO2), arterial blood oxygen saturation (SaO2), and Borg Scale between the two groups (P＜0.05). The REE in CTD patients was positively correlated with hear rate, respiratory quotient, mouth occlusion pressure (P 0.1)/ maximal inspiratory pressure (PIMAX), and Borg Scale (P＜0.01); however it was negatively correlated with PaO2, SaCO2, FVC and DLCO. (P＜0.05).
Conclusion Rest energy expenditure were obviously higher in CTD patients than in normal subjects. Besides PaO2 and SaO2, it is also related with FVC and DLCO.

? 【Key word】 Connective tissue disease;Energy metabolism;Pulmonary function

Efficacy Analysis of Inhaled Glucocorticoids and β2-Receptor Agonists in Mild Persistent Asthmatics LIU Xiao-feng， KONG Ling-fei.
Department of Respiratory Medicine， The First Affiliated Hospital of China Medical University， Shenyang 110001， China
【Abstract】 Objective To evaluate the clinical effects of Symbicort Turbuhaler inhaler and single Pulmicort Turbuhaler plus single Oxis Turbuhaler inhalers in patients with mild persistent asthma.
Methods The randomized parallel controlling trial was used, forty-six patients were divided into two groups who received Symbicort Turbuhaler inhaler and single Pulmicort Turbuhaler plus single Oxis Turbuhaler inhalers respectively. The clinical symptoms, dosages for remission, lung functions, the scores of Asthma Control Test (ACT), and Asthma Control Questionnaire (ACQ) were investigated.
Results The indicators of efficacy at different times of treatment showed significant differences between the two groups （P＜0.05）. There were significant differences in interactions between the times of indicators of efficacy and groups （P＜0.01）
Conclusion Both Symbicort Turbuhaler and Pulmicort Turbuhaler plus Oxis Turbuhaler can improve symptoms of asthmatic patients, with good efficacy and safety.

? 【Key word】 Asthma；Glucocorticoids；Beta-receptor agonists

Diversity of Allergen Testing in Different Allergic Diseases in Children? MAO Song, LIU Guang-ling, GAO Yuan-fu, et al.
Department of Pediatrics, Nanjing General Hospital of Nanjing Military Command, Nanjing 210003, China
【Abstract】 Objective To investigate the allergen conditions of various allergic disease in children in Nanjing areas in order to give a more effective prevention and treatment.
Methods?
Specific IgE (sIgE) (including those to food allergen and aeroallergen) was tested in 367 Allergic children patients (allergic purpura, allergic rhinitis, asthma, urticaria, dermatitis). The results were analyzed.
Results The detectable rate of food allergen in allergic purpura was obviously higher than that of aeroallergen (P＜0.05), the detectable rate of aeroallergen in asthma and allergic rhtinitis was obviously higher than that of food allergen (P＜0.05), there were no obvious difference between the detectable rates of food allergen and aeroallergen in urticaria and dermatitis （P＞0.05）.
Conclusion? In Nanjing areas, the food allergen is more common in children patients with allergic purpura, and the aeroallergen is more common in children patients with asthma and allergic rhtinitis. The detection of sIgE can be conducive to determine the corresponding allergens so as to provide a basis for prevention, diagnosis and treatment of allergic diseases.

? 【Key word】 Allergic disease;Allergen;IgE;Children

Correlation of Morphologic Change in the Anterior Mediastinum and CT Grade of Emphysema? WANG Xu-rong,PAN A-shan,WANG Jun,et al.
Department of Radiology， Yueqing People′s Hospital，Yueqing 325600, China
【Abstract】 Objective To investigate the diagnosis value of the morphologic change in the anterior mediastinum in patient with emphysema.
Methods Chest CT scanning was performed in 100 emphysema patients whose diagnoses were consistent with the diagnostic standard of chronic obstructive pulmonary disease (COPD) and 50 healthy subjects. The parameters of the anterior mediastinum were measured, including the anteroposterior length, frontal width and retral width. The results were statistically analyzed.
Results Among the 100 patients with emphysema 37 cases were mild, 41 cases were moderate and 22 cases were severe. The anteroposterior length of the patient′s mediastinum had a positive correlation with the score of CT grading of emphysema （r＝0.596，P＜0.01）, but either the frontal or the retral width has no correlation with the score of CT grading of emphysema（r=0.2，P＞0.05）.
Conclusion The morphologic change in the anterior mediastinum could reflect the severity of emphysema, and the change of anteroposterior length of the anterior mediastinum might be a new imaging sign used to assess the severity of emphysema, which provides more evidences for an early diagnosis and management of emphysema.

? 【Key word】 Emphysema;Tomography，X-ray computed

Effect of Auto-CPAP Method on Obstructive Sleep Apneahypopnea Syndrome and Its Pressure Level? YANG Wei-wei， HAN Fang.
Tsinghua University Hospital, Beijing 100084， China
【Abstract】 Objective To evaluate the curative effect of the method of auto-continuous positive airway pressure (Auto-CPAP) in patients with obstructive sleep apneahypopnea syndrome (OSAHS), and to study the change of average pressure level in using Auto-CPAP.
Methods Totally 60 patients with mild or moderate OSAHS were treated by Auto-CPAP and CPAP respectively. The improved grades by the two methods in lowest arterial oxygen saturation (LSaO2), mean SaO2 (MSaO2), the ratio of the time during SaO2＜90% to the total sleep time (SIT90%), the times of more than 4% of oxygen desaturation index per hour (DI4 times/hour) and average pressure level were compared.
Results There were significant differences in LSaO2, MSaO2, SIT90% and DI4 among pre-operation, conventional CPAP and Auto-CPAP treatment (P＜0.05); but there was no significant differences in LSaO2, MSaO2, SIT90% and DI4 between conventional CPAP and Auto-CPAP treatment (P＞0.05). The difference in ratio of the different pressure levels to the total sleep time between the 1st and 7th day of Auto-CPAP treatment was statistically significant (P＜0.05).
Conclusion Auto-CPAP has the same curative effect as the conventional CPAP in OSAHS patients, and as the time is lasting, the time keeping the lower pressure level of Auto-CPAP is gradually prolonged.

? 【Key word】 Sleep apneahypopnea syndrome；Continuous positive airway pressure;Average pressure level

Effect of Implementation of Initial Medical Care at Community in Shenzhen and Thinking? LAI Guang-qiang, WANG Yue-ping, CHEN Jian, et al.
Futian District Public Health Bureau, Shenzhen 518048, China
【Abstract】 Objective To assess the correlativity between the patients′ satisfaction and initial medical care at community through the survey of patients′ satisfaction to community health services in Shenzhen city, in order to evaluate the implementation results of initial medical care at community.
Methods? A localized internationally standardized instrument, EUROPEP-questionnaire, on satisfaction survey was used to investigate 1 765 patients receiving medical services at 30 community health service centers in 6 districts of Shenzhen city.Results? There were significant differences between the patients from labors′ communities and those from non-labors′ communities in general, communication, technique and administration satisfactions (P＜0.01). There were significant differences between the labor population and non-labor population in general and administration satisfactions (P＜0.01). In the two respects of "providing you with the service of prevention of disease" and "letting you know preparation for referral to a hospital of higher level", there were significant differences in satisfaction between the persons without the referral experience and those with the referral experience (P＜0.05).
Conclusion The implementation of initial medical care at community exacerbates the patients′ dissatisfaction to service administration, so the administration of health services by community doctors should improved and the incentive policy for initial medical care at community needs to be adjusted.

? 【Key word】 Community first contact care；Satisfaction；Community health services

Influential Factors of Medical Service Interaction between Community and Hospital and the Countermeasures? LU Yang， ZHANG Lu-lu， MA Yu-qin， et al.
Department of Health Management， Faculty of Medical Services， Second Military Medical University， Shanghai 200433， China
【Abstract】 By definition of the medical service interaction between community and hospital and analysis of the present status of research, we fined that the interaction between community and hospital is lack and an effective mechanism of resource flows and sharing has not been set up through the decisive factors, interaction between community and hospital is not effective. Then we analyze the influential factors based on the behavior characteristics of organizations in health delivery system so as to find the strategy for promotion of the interaction.

? 【Key word】 Interaction between community and hospital；Decisive factor；Countermeasures

Application of Gap Analysis Model of Service Quality to Improve the Community Health Service Management YANG Bo.
Petroleum Hospital, Community Health Service Center of Daqing Village, Jiangbei District, Chongqing 400021, China
【Abstract】 The management of health service quality is the core of community health service (CHS), and improvement of CHS quality is the important guarantee for a sustainable development of it, CHS quality is the difference between expected and actually perceived service qualities. The key to service quality management is the management of service quality gap. The gap analysis model of service quality is a simple but effective tool to analyze 5 kinds of the most probable gaps resulting in failure of offering service, and to help the manager of CHS intuitions to find out the origins of the problems on service quality, so as to strive to close the existing gaps and improve the quality of CHS.

? 【Key word】 Gap analysis model；Community health services;Management quality

Community Health Service from Two Disciplinary Perspectives ZHOU Ye-qin， CAO Ming-qian.
School of Health Administration, Nanjing Medical University， Nanjing 210029， China
【Abstract】 There two basic theory perspectives of constructing community health services. In the medical perspective, the community health service is " health services at community". In sociological perspective, the community health service is "community-based health services". In order to improve the population′s identity with community health service which is the bottleneck of community health service development, we should strengthen the study of sociology in community health service field.

? 【Key word】 Community health services；Perspective of medical；Perspective of sociology

Construction of a Health Management System Suitable for China′s National Conditions? LU Jian-hua， WU Jian-guo， WU Jing-na， et al.
College of Medical Administration， Nanjing Medical University， Jiangsu Province， Nanjing 210029， China
【Abstract】 Now health management at medical institutions are on the position of opening up the medical market, which is a view point to increase medical demand and promote medical consumption belonging to a gentrification management. The ways for an active and effective promotion of health management and a cost control of health maintenance are to plan a scientific and standardized system of health management, to establish a value prerequisite beneficial to all ordinary people and set up a health management standard convenient for everyone to participate, to break up the regulation that relies solely on medical insurance to control the costs of health care, and to combine health management with establishment of a harmonious medical surroundings based on the present status of our health management.
【Key word】 Health management；System；Construction

Asthmatic Children′s Behavior Features and Parental Rearing Patterns? WANG Wei， WANG Xu-mei， HAN Xiao-hua， et al.
Department of Psychology，Shengjing Hospital of China Medical University， Shenyang 110014， China
【Abstract】 Objective To explore the relationship between the behavior problems of bronchial asthmatic children and the rearing patterns by their parents.
Methods A total of 41 asthmatic children in non-acute episode period (asthma group) and 41 healthy children (control group) were enrolled. Achenbach child behavior checklist (CBCL) were filled out by the parents and parental rearing style scales (EMBU) by the children.?
Results The scores of asthmatic children in emotional warmth and sympathy, and overprotection in the father′s scales, as well as emotional warmth and sympathy, over-interference and over-protection in the mother′s scales were significantly different from those? of the health children (P＜0.05). The scores of asthmatic children in activity ability, depression, body complain and social withdrawal were significantly different from those of the health children (P＜0.05). In assessment of parental rearing patterns, the father′s emotional warmth and sympathy were negatively related with the children′s depression (P＜0.05), the father′s interference positively with the children′s hyperactivity and violating discipline (P＜0.05), the father′s overprotection positively with children′s aggression and violating discipline (P＜0.05), the mother′s over-interference and over-protection positively with the children′s body complain (P＜0.05), and the mother′s refusal and denial positively with the children′s social withdrawal (P＜0.05).

Conclusion? Compared with the health children, the asthmatic children have a certain problems of behavior, which correlate to a certain grade with parental rearing patterns.
【Key word】 Asthm;Child behavior；Child care

Effect of Overweight and Obesity on the Self-esteem of Students Aged 12 to 14?? LIU Qing-wu, XIAO Shui-yuan, ZHOU Shao-ping, et al.
School of Public Health, Central South University, Changsha 410078, China
【Abstract】 Objective To study influence of overweight and obesity on the self-esteem of students aged 12 to 14.
Methods The cross-sectional survey and cluster-stratified random sampling were taken. A total of 2 042 students aged 12-14 from 3 schools in urban areas if Chenzhou city were assessed by Self-esteem Scale (SES), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) for their psychological health conditions, Their heights and weights were also measured and the body mass index (BMI) was calculated.
Results The differences in SES score between boys and girls, between the students from only one child family and those from two or more children family showed statistical significance (P＜0.01). While the differences in SES score among students of different ages and from different nations revealed no statistical significance (P＞0.05). There were significant differences in SES score among students with normal BMI, overweight and obesity (P＜0.05), and so did between students of each two groups (P＞0.05). Multiply stepwise regression showed that SES score was negatively correlated to BMI, SAS score, SDS score and students′gender (P＜0.05). Path analysis showed that BMI could directly or through anxiety or anxiety-depression affect self-esteem, with a decreased order in power of BMI, anxiety and depression.
Conclusion Overweight and obesity may affect students′ self-esteem directly or indirectly. Comprehensive measures should be taken to prevent and control overweight and obesity of adolescents, to relieve their anxiety and depression emotion so as to improve their self-esteem.

? 【Key word】 Obesity；Self-esteem；Anxiety；Depression；Adolescent

Nutritional Status and Its Influence on Quality of Life among Digestive Tract Cancer Patients Treated with Chemotherapy ZHAO Ming, LI Yong.
Department of Nutrition and Food Hygiene, School of Public Health, Health Science Center of Peking University, Beijing 100191, China
【Abstract】 Objective To study the nutritional status and investigate its effect on quality of life among digestive tract cancer patients treated with chemotherapy.
Methods The subjective global assessment (SGA), anthropometric measurements and laboratory testing were taken in the nutrition assessment of 77 patients with digestive tract cancer. The patients′ quality of life (QOL) was assessed by using EORTC QLQ-C30, and the QOLs between the patients in good nutrition and the patients in malnutrition were compared.
Results According to SGAT scores, there 65 patients （84.4%）who were in a good nutritional condition and 12 patients （15.6%） who were in a malnutrition condition. The comparison between patients in the two groups showed statistically significant differences in physical function, fatigue, nausea and vomiting, pain, dyspnea, appetite loss, general health status/QOL （P＜0.05）.
Conclusion A lager percentage of the patients with digestive tract cancer are in a malnutrition condition. The QOLs between the patients in good nutrition and in malnutrition are different, so the nutrition assessment of the patients should be paid more attention to, in order to improve the nutritional status and QOL of the patients.

? 【Key word】 Digestive tract cancer;Chemotherapy;Nutritional status;Quality of life

Survey on Long-term Quality of Life of Survivors from Major Earthquake? XIONG Rui-jin， TAO Si-hai， YUE Yuan-ping.
Nursing Department of Tangshan Vocational Technical College， Tangshan 063000， China
【Abstract】 Objective To investigate the condition of long-term quality of life (QOL) of the survivor population after the major earthquake, and to study on whether the family deconstruction by an earthquake would affect the long-term QOL.?
Methods? Cluster stratified random sampling was taken in assessment of the quality of life of the elderly survivors more than 60 years old who experienced the Tangshan earthquake.
Results The total average score of QOL of the elderly people in Tangshan city was (73±23). The scores of the elderly male people in the 7 dimensions of physiological function, physiological role, physical pain, general health, vitality, social function and psychological health showed statistically different significance as compared with those of reference values of Chinese people (P＜0.05); and so did the scores of the female in 6 dimensions of physiological function, physiological role, physical pain, general health, social function and emotional role (P＜0.05). There was a significant difference in general health in comparison of the elderly who lost the spouse with those who did not (P＜0.05); and so there was in comparison of the elderly who lost the child with those who did not (P＜0.05).
Conclusion The earthquake disaster has a certain influence on long-term QOL of the most survivor population, especially of the people who have a incomplete family structure or who are lack of normal family function, which should be paid attention to.

? 【Key word】 Earthquake；People survived；Quality of life

Effect of Aidi Injection on Cellular Immunity in Postoperative Patients with Gastric Cancer HU Ting-hui, LI Jin, XU Zhi-ping.
Department of Tumor, Ningde Municipal Hospital, Ningde 352100， China
【Abstract】 Objective To investigate the effect of Aidi injection on cellular immune function in postoperative patients with gastric cancer.
Methods
Totally 40 gastric cancer patients receiving radical operation were randomly divided as A and B groups, with 20 in each; and 40 healthy physical examinees were enrolled as the controls. After operation, the patients in B group received only conventional anti-inflammatory treatment, and those in A group received additional Aidi injection. The immune functions (Changes of CD3+, CD4+ , CD8+ T cells, and CD4+ T cells /CD8+T cells in peripheral blood) between the patients before operation and the controls, and between the patients in A and B groups before and after operation were compared.
Results In percentages of CD3+, CD4+ , and CD8+ T cells, as well as CD4+ T cells /CD8+T cells, the comparisons between the patients with gastric cancer and the controls all showed a significant difference (P＜0.01), so the comparisons did between the patients in the A and B groups post-operationally (P＜0.01); but the comparisons in patients of B group between pre-operation and post-operation showed no significant difference (P＞0.05).
Conclusion The immune functions of patients with gastric cancer are in a suppressive stage, which can not be improved by operation, but by Aidi injection.

? 【Key word】 Stomach nioplasms；Aidi injection;Immunity,cellular

Value of 16 Multiple-Slice Spiral CT Low Tension Urography in Diagnosis of Renal and Uretal Obstructive Disease? CAO Ya-jie， XIA Hong-bo， WANG He-jun， et al.
Department of X-ray of Tangshan Xiehe Hospital，Tangshan 063000， China
【Abstract】 Objective To explore the application value of 16 multiple-slice spiral CT （MSCT） low tension urography in diagnosis of renal and uretal obstructive disease.
Methods Totally 58 patients with clinically-considered renal and uretal obstructive disease were injected progesterone intramuscularly, 20minutes later contrast-media intravenously, and 30 minutes after that they were treated with low tension urography and MSCT scanning, and three dimensional urography reconstruction as well. The diagnostic result was compared with those of operation and pathology.
Results Among the 58 cases, there were 22 cases of ureter stone, 11 cases of ureterostenosis (3 cases resulting from inflammation, 2 cases from macro-ureter and 6 cases from oppression on the ureter by celiac or pelvic tumor or metastasis), 9 cases of ureter tumor, 7 cases of renal pelvis tumor, 5 cases of ureter tuberculosis, 2 cases of stenosis of ureteropelivic junction, and 2 cases of ureter cyst, all the cases were correct in localization diagnosis. Compared with diagnoses by operational pathology, only one case was by MSCT low tension urography misdiagnosed, one case of ureter tumor was misdiagnosed as inflammatory stenosis, and one case of ureter tuberculosis as ureter tumor. All the rest 55 cases were correctly diagnosed pre-operationally, with an accurate rate of 95 percent in qualitative diagnosis.

Conclusion The 16 multiple-slice spiral CT low tension urography is valuable in diagnosis of renal and uretal obstruction disease, helpful in differential diagnosis of inflammatory disease, and especially valuable in diagnosis of upper urinary obstructive disease caused by serious renal function injure. It is less painful and more effective, may replace conventional intravenous pyelography. So it is worth popularizing.

? 【Key word】 Tomography，spiral comuted；Urography；Urethral obstruction

Effect of Indwelling Anterior Urethral Stent to Anterior Urethral Stricture? LIU Dong-rong, LUO Hou-zhou, WU Ying-jie, et al.
Department of Urology, The 181th Hospital of PLA, Guilin 541002， China
【Abstract】 Objective To investigate the clinical effect of indwelling anterior urethral stent (IAUS) in patients with anterior urethral stricture.
Methods From January 2005 to May 2008, 38 in patients or outpatients with anterior urethral stricture who received IAUS therapy in our hospital were enrolled as the trial group, with 38 patients with the same disease receiving the urethral dilatation as the control group. The therapeutic results in the two groups were observed.

Results The IAUS therapy remarkably reduce the time of urethral dilatation for the patients on the trial group, and their maximum flow rate of urine was obviously increased after the IAUS operation as compared with those of the control group. The IAUS therapy could also improve the patients′ subjective symptoms.
Conclusion The IAUS therapy is of satisfactory effect for patients with anterior urethral stricture, and it is worth spreading clinically.

? 【Key word】 Urethral stricture;Stents;Dilatation

Serum D-Dimer Level in Aged Patients with Pneumonia? YAN Mei， ZHANG Cheng， WANG Rui-ling，et al.
The 2nd Department of Respiratory Diseases， Affiliated Hospital of Jining Medical College，Jining 272029，China
【Abstract】 Objective To investigate the change of serum D-dimer (DD) level in the aged patients with pneumonia.
Methods Totally 30 aged patients with pneumonia were divided as severe pneumonia group (n=12) and non-severe group (n=18) according to Fine′s risk classification, and 20 health persons were concurrently enrolled as the controls. The serum DD level was measured and the results were compared.
Results The serum DD level was (1.06±0.19) mg/L in severe pneumonia group, (0.88±0.16) mg/L in non-severe pneumonia group and (0.35±0.18) mg/L in control group. There were significant differences among the three groups (P＜0.05), there was significant difference between the pneumonia patients and the controls (P＜0.05), and there also significant difference between the severe pneumonia group and non-severe pneumonia group (P＜0.05).

Conclusion The serum DD level may be related to the severity of pneumonia in aged patients.

? 【Key word】 Pneumonia;D-dimer;Aged

Bipolar Prosthetic Replacement for Intertrochanteric Fractures in Elderly Patients: A clinical analysis of 52 cases? LIU Zhong-po，NIE Zhi-hong，HUO Ji，et al.
Department of Orthopeadics, Xingtai People′s Hospital, Xingtai 054001， China
【Abstract】 Objective To evaluated the clinical effect of the bipolar prosthetic replacement for treatment of intertrochanteric fractures in elderly patients.
Methods From 2002 to 2007， fifty-two elderly patients (more than 70) with intertrochanteric fractures were treated with bipolar prosthetic replacement, and follow-up for them was conducted.??
Results A 6-to-20-month follow-up showed the patients could walk 2 to 7 day (3 days in average) after operation, their functions of the lower limbs recovered to the pre-operational level 3 to 6 months after operation, with no post-operational pain, prosthesis dislocation and loosening occurred.
Conclusion For intertrochanteric fracture patients elder than 70 years old, especially those with extensive osteoporosis, the? bipolar prosthetic replacement may be the best choice, with the advantages of earlier functional recovery and lower complications.

? 【Key word】 Bipolar arthroplasty；Aged；Osteoporosis

Effect of Propyl Gallate on Serum Urotensin and Adrenomedullin in Patients with Diabetic Foot? ZHANG Li， CHAI Guo-lu.
Shenzhen Futian Chronic Disease Hospital， Shenzhen 518048， China
【Abstract】 Objective To study the effect of propyl gallate on the serum levels of urotensin Ⅱ (UⅡ) and adrenomedullin (ADM) in patients with diabetic foot.
Methods Totally 92 patients with diabetes mellitus were enrolled and divided into two groups according to weather they had diabetic foot or not, and 30 healthy persons of our hospital were enrolled as the controls. The levels of serum UⅡ and ADM of all subjects were measured and compared, and the changes of serum UⅡ and ADM of in diabetic foot patients were observed before and after treatment with propyl gallate.
Results The serum levels of UⅡ and ADM were significantly higher in diabetic foot patients than in those with no diabetic foot and controls (P＜0.01). After treatment with propyl gallate, the serum levels of UⅡ and ADM were significantly decreased in the diabetic foot patients as compared with those before the treatment (P＜0.01).
Conclusion? Applicati0on of propyl gallate plus an early comprehensive nursing can reduce the serum levels of UⅡ and ADM, and promote the recovery of foot lesion.

? 【Key word】 Diabetic foot；Nursing care;Beibingzhi

Nutritional Support for Critical Patients with Trauma LIU Bao-chi，LI Lei ，LIU Li.
Emergency Department of The First Affiliated Hospital of Zhengzhou University， Zhengzhou 450052， China
【Abstract】 The energy metabolism changes intensively after trauma, which affects the nutritional status of patient directly. Therefore, the nutritional support therapy is of great importance to trauma, being one of the key factors to repair trauma. In this paper we review the features of metabolic changes under the conditions of traumatic distress, and nutritional support channels, time of nutritional support and effect of special nutrient substances. At the same time, we also elaborate the existing problems in the nutrition support therapy.

? 【Key word】 Trauma;Nutritional support

Immobilization for a Primary Traumatic Anterior Shoulder Dislocation WANG Qiao-jie, SHI Hui-peng.
Department of Orthopaedic Surgery, Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233，China
【Abstract】 Traumatic anterior shoulder dislocations are common injuries. For centuries, the conservative management of this injury that most orthopaedic surgeons were familiar with has been to immobilize the affected shoulder in an adducted and internally rotated position for 3 to 8 weeks. However, the validity and efficacy of this method has been questioned by a number of authors. In order to find the appropriate conservative treatment for traumatic anterior shoulder dislocations in an evidence-based approach, we review the literatures concerned, and then discuss whether the shoulder joint after a primary traumatic shoulder dislocation should be immobilized, for how long should it be immobilized and the appropriate position of immobilization, as well as point out the implications for further study.

? 【Key word】 Shoulder joint；Dislocationgs;Conservative treatment

Number4February，2009

Reinforcing Qi Nourishing Yin Promoting Blood Circulation in Intervention of Impaired Blood Vessel Endothelium in Prothrombotic State of Type-2 Diabetes Mellitus
?FANG Zhao-hui,ZHANG Hong,NI Ying-qun.
Department of Endocrinology,the First Hospital of Anhui Traditional Chinese Medicine College，Hefei 230038，China
? 【Abstract】 Objective To observe the intervention effects of reinforcing qi nourishing yin promoting blood circulation on impaired blood vessel endothelium in prothrombotic state of type 2 diabetes mellitus.
Methods Sixty patients with diabetes mellitus in prethrombotic state were selected and divided randomly into treatment group(n=30) and control group(n=30).Both groups were treated with conventional therapeutic methods of western medicine,and treatment group with additional Chinese Medicine method of reinforcing qi nourishing yin promoting blood circulation.The therapy lasted three months.The levels of blood glucose(BG),blood fat,von Wilebrand factor(vWF) and thrombomduline(TM) and the changes of hemorrheology index were detected before and following treatment.
Results Treatment group improved significantly triglyeride(TG),high-density lipoprotein(HDL)，vWF,TM，whole high viscosity,plasma specific viscosity and hematocrit after treatment when compared with control (P＜0.05).
Conclusion Method of reinforcing qi nourishing yin promoting blood circulation can ameliorate prothrombotic state in diabetic patients,reduce efficiently the impairment of blood vessel endothelium,suggesting that its mechanism may be associated with its reduction of BG,regulation of lipid disorders,reduction of vWF,TM levels,and improvement of abnormal hemorheology.
? 【Key word】 Diabetes mellitus,type 2；Reinforcing qi nourishing yin promoting blood circulation；Thrombosis；Endothelium,vascular

Changes of Concentration of Serum Macrophage Inflammatory Protein -1α in Children with Cough Variant Asthma and Its Significance CHEN Miao，LEI Hou-xing，YAN Bi-qing，et al.
Department of Pediatrics，Sixth People′s Hospital Affiliated to Wenzhou Medical College，Lishui 323000，China
【Abstract】 Objective To evaluate the changes of Serum Macrophage Inflammatory Protein -1α(MIP-1α) level and its application in differential diagnosis of cough variant asthma(CVA).
Methods Serum samples were obtained from 49 children with chronic persistent postinfectious cough (group Ⅰ)，37 with CVA(group Ⅱ) and 30 normal (group Ⅲ),to determine the concentration of MIP-1α.
Results There was a positive correlation between the three groups(P＜0.01 ).Group Ⅰwas significantly different from group Ⅲ in MIP-1αlevel(P＞0.05).There was a significantly positive correlation in the level of MIP-1α between group Ⅱ and group Ⅰ(P＜0.05 ),between group Ⅱ and group Ⅲ(P＜0.05 ).
Conclusion The concentration of MIP-1α,which can reflect the types of airway inflammation,is a useful marker to distinguish postinfectious cough from CVA.
【Key word】 Macrophage inflammatory proteins；Cough；Asthma；Child

Expression of TGF-β1 in SiO2-activated Alveolar Macrophage in Silicotic Patients REN Peng，ZHAO Jing，WU Xiu-zhen.
Maternal and Child Health Hospital of Jiaxing，Jiaxing 314000，China
【Abstract】 Objective To study the effect of SiO2 on the expression of Transforming Growth Factor-β1（TGF-β1）in alveolar macrophage(AM) of of silicotic patients.
Methods The experiment was carried out in the Central Laboratory of Medical College of North China Coal Mine from December 2004 to December 2005.Human AM,which were collected from silicotic patients by broncho-alveolar lavage，was cultured in serum-free DMEM (control group) and then given another in vitro exposure to SiO2 (experimental group) for 3h,6h,12h,18h,24h,36h,respectively.The expression of TGF-β1 in AM was detected with immunological method.
Results The expression of TGF-β1 in AM provoked by silica dioxide increased gradually at hours 3,6,12,and reached the peak at hour 18.And then it showed a marked downward trend.
Conclusion SiO2,which may induce high expression of TGF-β1 in AM，participates in the formation of lung fibrosis.
【Key word】 SiO2；Macrophages,Alveolar；Transforming Growth Factor-β1

The Role of CD+4CD+25T Cells in Different Stages of Ulcerative Colitis GUO Min，WANG Jing，WU Di，et al.
Department of Gastroenterology，General Hospital of Coal Industry Ministry of China，Beijing 100028，China
【Abstract】 Objective To investigate the role of CD+4CD+25T cells in the pathogenesis of different stages of ulcerative colitis(UC).
Methods Fourteen healthy subjects(control group) and 27 UC patients,12 in active stage(UC1 group) and 15 in remission(UC2 group),were enrolled to determine in peripheral blood mononuclear cells (PBMC) the proportion of CD+4CD+25T cells and CD+4T cells by using flow cytometry and the level of Foxp3 mRNA in PBMC by using Roche Light Cycler fluorescence quantitative PCR instrument.
Results （1）An increase was observed in the proportion of CD+4CD+25T cells and the level of Foxp3 mRNA，and a significant drop in that of CD+4T cells in UC1 group as compared with control group(P＜0.05).（2）There was no significant difference in the proportion of CD+4CD+25T cells and CD+4T cells and the level of Foxp3 mRNA between group UC1 and normal control(P＞0.05)，but CD+4CD+25T/CD+4T ratio increased markedly in UC2 group when compared with control group(P＜0.05).
Conclusion The changes of CD+4CD+25T cells play an important role in the pathogenesis of different stages of UC.
【Key word】 Colitis，ulcerative; Active phase; Remission; CD+4CD+25T cells

Changes of Blood Sugar and C-reactive Protein Levels in Patients with Acute Cerebral Hemorrhage and Its Clinical Significance LIN Mao-en，LIU Ying-jie，CHEN Jian-sheng，et al.
Department of Emergency，Rui′An Hospital of Traditional Chinese Medicine，Rui′an 325200，China
【Abstract】 Objective To investigate the clinical significance of changes of blood glucose(BG) and c-reactive protein(CRP) levels in patients with acute cerebral hemorrhage(ACH).
Methods? Seventy-eight ACH patients(ACH group) and 28 healthy subjects of matching ages(control group) were enrolled to determine fasting blood glucose(FBG) and CRP at their hospital admission,and to analyze their relationship to pathogenetic condition and prognosis.
Results FBG and CRP were significantly higher in ACH group than in normal controls（P＜0.01）,which showed a positive correlation with the disease extent.There was significant difference in BG and CRP between death group and survival（P＜0.01）.
Conclusion BG and CRP are closely correlated with the genesis,severity and prognosis of ACH.
【Key word】 Cerebral hemorrhage；Blood glucose；C-reactive protein

Effects of EGB761 on Primary Cultures of Embryonic Rat Mesencephalic Cells Injured by MPP+ ZHU Can-hong，XI Shu-fang，WANG Qun-jiang，et al.
The First People′s Hospital of Zhenjiang，Zhenjiang 212002，China
【Abstract】 Objective To explore whether ginkgo biloba extract （EGB761）could partially protect embryonic rat mesencephalic dopaminergic（DAergic）neurons injured by MPP+.
Methods Embryonic rat mesencephalic primary cell culture method was used to isolate and culture the mesencephalic neurons,and the cultured cells were randomized into groups of control(group 1),MPP+(group 2),MPP++EGB761(group 3),MPP++LPS(group 4),and MPP++EGB761+LPS(group 5).The cells were intervened with MPP+,EGB761 and LPS to observe cell growth.Cytoactive was detected by microcolorimetry of 3-(4,5-dimethyl-thiazole-2)-2,5-diphenyl-tetrazolium Bromine-salt(MTT),changes of positive neurons and DA neuron expression by tyrosine hydroxylase(TH) immunofluorescence(FITC),and nitric oxide expression in cultured cells by nitric acid reduction method.
Results Strong growth and significantly extended axons was noted in groups 1 and 3; inhibited cell growth and relatively short axons in group 5; a small number of cells,only a few cells with small cell processes,but most without in 2 and 4.By MTT method,cell absorbance ratio(A value),expressions of immunofluorescence TH positive cells and of cultured cell NO were detected:groups 1,3 differed significantly from groups 5,2,4 in NO level（P＜0.05）,and group 5 from group 2,4（P＜0.05）,group 2 from group 4（P＜0.05）.
Conclusion LPS can increase MMP +-injured DA neuron,microglia activation and the NO which it released may participate in the process of the cell apoptosis.EGB 761 may play a protective role in injured primary cultured brain cells of embryo rats,which may inhibit microglia to activate.
【Key word】 Ginkgo leaf；Dopamine；Lipopolysaccharides；Parkinson disease

A Preliminary Study on Gene Expression Profiling of Endometrial Adenocarcinoma HUANG Shu-fang，LI Xiao-mao，LI Tian.
Department of Gynecology and Obstetrics，Guangdong Provincial People′s Hospital，Guangzhou 510080，China
【Abstract】 Objective To investigate,using gene chip technique,the gene expression profiling of endometrial carcinoma,the tumor-associated genogroups in its initiation and progression,and function.
Methods? Total RNA was extracted,using a standard TRIZOL protocol,from 11 endometrial adenocarcinoma samples and matched normal tissues,and DNA was labeled fluorescence during reverse transcription.Experiment group(carcinoma samples) were labeled Cy-5-dCTP and control group(normal tissues) Cy-3-dCTP.Microarray with 8 064 genes was supported by Chipscreen Bioscience; equal quantitative probes of both groups were mixed and hybridized on the microarray; the Cy5:Cy3 ratio was obtained by computer analysis.
Results Preliminary analysis of gene expression profiling showed that 274 genes expressed differentially between 11 carcinoma samples and normal tissues were chosen from 8 064 genes in which 92 genes were up-regulated and 182 genes down-regulated.
Conclusion cDNA microarray technique is effective in screening the genes differentially expressed between human endometrial adenocarcinoma and normal endometrium,and the genes are involved in extracellular matrix proteins，cytokine，apoptosis，signaling，cell cycle，oncogene and so on,whcih suggests that these genes are associated with the occurrence，development and metastasis of endometrial adenocarcinoma.
【Key word】 Oligonucleotide array sequence analysis; Endometrial neoplasms; Gene expression profiling

Protective Effect of Eleutheroside Preconditioning to Myocardial Ischemic Reperfusion Injury in Isolated Rats KONG Yu，XU Feng，YU Zhen-qiu.
Anzhen Hospital，Beijing 100029，China?
【Abstract】 Objective To investigate the protective effect of eleutherosid preconditioning to myocardial ischemic-reperfusion injury(IRI) in isolated rats and the dose-effect relationship between eleutheroside preconditioning and the myocardial protection.
Methods Male rat hearts,which were isolated and perfused with Langendorff apparatus,were randomly divided into 5 groups,6 in each.The isolated hearts were subjected to 25 min ischemia and then followed by 30 min reperfusion after 15min stabilization in control group（C）.In the eleutheroside preconditioned groups（P1,P2,P3,P4），the hearts were perfused with eleutheroside (30 mg/kg，40 mg/kg，60 mg/kg and 80mg/kg,respectively) for 10 min before ischemia-reperfusion.Left ventricular developed pressure (LVDP)，left ventricular end diastolic pressure (LVEDP)，maximal rate of increase /decrease of left ventricular pressure (±dp/d tMax)，and coronary blood flow (CF) were monitored continuously.And an arrhythmias score was used to quantify the arrhythmias during reperfusion.
Results After reperfusing 30 min reperfusion，as compared with group C，① P2 and P3 groups might increase LVDP、+dp/dtMax and-dp/dtMax more significantly（P＜0.05）;②P2 and P3 groups might raise CF more significantly (P＜0.01);③P2 and P3 groups had lower arrhythmia scores （P＜0.05）.
Conclusion Eleutheroside preconditioning has a dose-effect on IRI of isolated rat hearts.
【Key word】 Eleutheroside；Reperfusion injury；Myocardial ischemia

Investigation of Perioperative Antibacterial Drug Utilization in Hospitalized Parturients Undergoing Cesarean Section CHANG Hong-xia，REN Hao-yang，LI xue-mei.
The Second Clinical Pharmacy of PLA General Hospital，Beijing 100853，China?
【Abstract】 Objective To investigate antibacterial agent utilization during perioperative period in cesarean section cases hospitalized in Fuxing Hospital affiliated to Capital University of Medical Sciences，to provide basis for rational use of drugs in clinical work.
Methods The perioperative antibacterial drug utilization in 731 patients undergoing cesarean section in 2006.6～12 was analyzed.
Results One hundred percent of 731 patients were treated with antibacterial drugs,32 42% of whom with two kinds,and cefuroxime was used the most frequently.63 77% were given medicine after operation.
Conclusion Unreasonable use of perioperative prophylactic antibiotics are mainly inappropriate timing of medication,too big doses and prolonged use of drugs.So some necessary adjustment should be made according to relevant principles of antibacterial application.
【Key word】 Cesarean section；Intraoperative period；Anti-bacterial

A Review of Adverse Drug Reaction of Traditional Chinese Patent Medicines in Beijng Hospital from 2004 to 2007 ZHANG Bi-hua，GAO Su-qiang，FU De-xing.
Pharmacy Department，Beijing Hospital，Beijing 100730，China
【Abstract】 Objective To analyze reports on adverse drug reaction（ADR）of traditional Chinese patent medicines(CPM) in Beijing hospital from 2004 to 2007,to promote the rational clinical use of CPM.
Methods One hundred eighty-three ADR reports of traditional CPM were analyzed，and clinical manifestation of 23 cases were compared with description of drug instruction manuals.
Results From 183 available ADR reports in which 66 kinds in 10 genus CPM were invoved，101 cases were induced by Removing-Stasis drugs.ADR was implicated in some of organs and systems，the most common damage due to ADR was in skin and appendix（53.01%），the next came nervous system and digestive system.The prognoses were good.One hundred fourteen（62.30%）of 183 cases were cured，68 （37.16%）were improved，and sequelae was found in only 1.ADR was labeled definitely in 16 of 23 kinds of directions，"not definite yet in 6（26.09%）"，no ADR label in 1（4.35%）.
Conclusion The ADR of CPM shouldn′t be ignored.It is very important to monitor ADR and to manage standardizedly pharmaceutical production and drug application in control of drug abuse,reduction of ADR and promotion of CPM safe and reasonable use.
【Key word】 Chinese patent medicines；Adverse effects

Efficacy of Sublingually-Administered Phloroglucinol on Acute Spastic Abdominal Pain from Stomach and Intestines FU Yong-yong，HE Xian-sheng.
Department of Internal Medicine，Traditional Chinese Medicine of Sanmen Hospital，Taizhou 317100，China
【Abstract】 Objective To evaluate the efficacy and security of sublingually-administered phloroglucinol in treating acute spastic abdominal pain from stomach and intestines.
Methods Two hundred fifty patients were randomly divided into 2 groups.The control group(n=125) were given an intramuscular injection of anisodamine (10 mg)，and therapy group(n=125) given sublingually phloroglucinol oral lyophilisates 80 mg.The analgesia efficacy,the starting time of abdominal pain release and the side effects were analyzed 10 minutes after administration.
Results There was no significant difference in analgesia efficacy（P＞0.05）,and in starting time of abdominal pain release（P＞0.05）,but there was in the side effects between two groups（P＜0.01).
Conclusion Sublingually-administered phloroglucinol is effective and safe in treating acute spastic abdominal pain from stomach and intestines.
【Key word】 Phloroglucinol；Administration，sublingually；Anisodamine；Abdominal pain；Efficacy

Emergency Treatment of Femoral Artery False Aneurysm due to Addictive Drug Injection by Artificial Vascular Transplantation ZHENG Quan，ZHANG Gang-qing，JIANG Yi-heng，et al.
Department of General Surgery，The Second People′s Hospital of Guangdong Province，Guangzhou 510317，China.
【Abstract】 Objective To assess the feasibility and clinical effectiveness of emergency treatment of femoral artery false aneurysm due to addictive drug injection by artificial vascular transplantation.
Methods Under emergency condition,5 patients with femoral artery false aneurysm and massive hemorrhage due to addictive drugs injection were treated by artificial vascular transplantation after pseudoaneurysm resection and debridement of inflammatory tissues.Its feasibility and clinical effectiveness and complications were observed.
Results All surgeries were successful，5 patients saved their limbs successfully.During 3～24-month follow-up，the grafted vessels were unobstructed and no complication was found in all patients.
Conclusion Femoral artery false aneurysm with massive hemorrhage due to addictive drug injection can be treated by artificial vascular transplantation after pseudoaneurysm resection under emergency condition.
【Key word】 Aneurysm，false；Blood vessel prosthesis；Femoral artery；Infection

Therapeutic Effects of Ibuprofen Suspension on Renal Colic ZHAN Jian-fei，WANG Pei-le，YU Wang-hai，et al.
Department of Urology，Zhuji People′s Hospital，Zhejiang Province，Zhuji 311800，China
【Abstract】 Objective To compare the analgesic effects between ibuprofen suspension,Indometacin Suppositories and a combination of dolantin and atropine in patients with renal colic.
Methods Using randomized controlled method,327 patients with renal colic were randomly divided into 3 groups.Group A(n=144) received ibuprofen suspension; group B(n=80) Indometacin Suppositories and group C(n=103) a combination of dolantin and atropine.The total effective rate of analgesia,onset time and side effects were analyzed.
Results The efficacy rates was higher in Group A than in Group B (94.5%,82.5%,respectively,P＜0.01)，and the onset time was significantly shorter in Group A than in Group B(P＜0.01).No significant difference was found in efficacy rates and onset time between Group A and Group C (P＞0.05).Group B had fewer side effects than group C (P＜0.01).
Conclusion Ibuprofen Suspension can be used as a choice drug instead of pethidine with spasmolytics and other non-steroidal analgesics in treatment of renal colic.
【Key word】 Renal colic；Ibuprofen；Indometacin

Clinical Effects of Radiofrequency Catheter Ablation on Ventricular Arrhythmia ZHANG Ye，WANG Yu-tang，SHAN Zhao-liang，et al.
Department of Cardiology，General Hospital of PLA，Beijing 100853，China
【Abstract】 Objective To evaluate the efficacy and safety of radiofrequency catheter ablation (RFCA) in patients with idiopathic ventricular tachycardia (IVT) and frequent ventricular premature (FVP).
Methods RFCA with activation sequence mapping and/or pace mapping was performed in 141 patients with IVT and FVP (80 males and 61 females).
Results RFCA was successful in 128 patients (90.8%).The successful rate in IVT or FVP patients with the ectopic focus localized on the right ventricular outflow tract was 92%.The 24-hour ambulatory electrocardiography was conduced in 20 patients before and after the operation,the difference in average beats/24h before the operation (21 824±12 769) and after the operation (1 548±2 926) was statistically significant (P＜0.001).During the period of 3 to 36 months follow-up,10 patients relapsed and were all successfully re-ablated.No complication was found.
Conclusion Radiofrequency catheter ablation (RFCA) is an effective safe and feasible treatment for patients IVT and FVP with severe symptoms and drug-resistant.
【Key word】 Radiofrequency catheter ablation；Ventricular tachycardia；Ventricular premature

A Clinico-pathological Study of Gastric Neuroendocrine Tumor and Gastric Carcinoma with Neuroendocrine Cell Differentiation YANG Han-jin，WANG Jian-fei，ZHANG Ding-fang，et al.
Department of Pathology，People′s Hospital of Xianju County，Xianju 317300，China
【Abstract】 Objective To investigate the clinico-pathological characteristics of gastric neuroendocrine tumor(NET) and gastric carcinoma with neuroendocrine cell differentiation.
Methods We reviewed the clinical and pathological data of 10 patients with gastric NET and 4 with gastric carcinoma with neuroendocrine cell differentiation.Histochemical and immunohistochemical stain were performed.
Results The symptoms of the patients were similar，presenting mainly at advanced stage.Most tumors were ulcer type，their favourite sites were in the cardia or antrum.Two of 10 NET patients were diagnosed as typical tumour,3 as atypical,5 as small cell carcinoma.Every cancer cell showed a neuroendocrine marker,such as chromogranin A(CgA),positive synaptophysin(Syn) and neuron-specific enolase(NSE).In 4 patients with gastric carcinoma with neuroendocrine cell differentiation.,a small number of positive tumor cells of neuroendocrine tumor markers were noted to scatter in gastric cancer tissues,and their components were tubular adenocarcinoma,expression of carcinoembryonic antigen(CEA),epithelial membrane antigen(EMA) and positive mucus staining(AB/PAS).
Conclusion? Gastric neuroendocrine tumors are mainly atypical and small cell carcinoma,most with high malignancy; gastric cancer with neuroendocrine differentiation does not affect the gastric cancer malignancy.They are in different histological types,and typing is of instructive significance in their treatment.
【Key word】 Stomach；Neuroendocrine tumors；Carcinoma，neuroendocrine

Treatment of Chronic Anal Fissure with Botulinum Toxin A HUANG Shi-feng，LIU Bin，TANG Jian-rong，et al.
The First Department of General Surgey，The Fourth Hospital Affiliated to Guangxi Medical University，Liuzhou 545005，China
【Abstract】 Objective To evaluate the effectiveness and safety of botulinum toxin A injection in treatment of chronic anal fissure.
Methods Forty patients with chronic anal fissure were treated with botulinum toxin A(30units) injected into internal anal sphincter.Cure rates and side effects were recorded during treatment.
Results Four weeks after treatment，26 patients(65%) were cured，7 patients had symptomatic improvement，two patients had mild incontinence to flatus which remitted spontaneously within 3 weeks after treatment.Eight weeks after treatment，31 patients(77.5%) were cured of fissures，2 patients had symptomatic improvement。Three patients relapsed during 12 months of follow-up，but all healed when re-treated with botulinum toxin A.
Conclusion Botulinum toxin A injection is a safe and effective nonsurgical method in treatment of chromic anal fissure.
【Key word】 Fissure in ano;Toxins；Anus

Effect of Yanshen Instant Herbal Granules No.1 on Renal Anemia in Patients Undergoing Chronic Hemodialysis TAN Jin-chuan，YANG Feng-wen.
Department of Nephrology，Hebei Provincial TCM Hospital，Shijiazhuang 050011，China
【Abstract】 Objective To observe the effects of Yanshen Instant Herbal Granules No.1 on renal anemia in patients undergoing chroninic hemodialysis.
Methods Sixty-four chronic renal failure patients undergoing hemodialysis in our hospital were divided randomly into therapy group (n=32) and control group (n=32).Control group were treated with only erythropoiesis stimulating factor，therapy group with additional Yanshen Instant Herbal Granules No.1 besides.Changes of residual renal function(RRF) hemoglobin (Hb),hematocrit(HCT),albumin(ALB) were determined before and following treatment.
Results? There was no significant difference in urine volume,RRF,Hb,HCT and ALB between 2 groups before treatment (P＞0.05),but there was after treatment(P＜0.05).
Conclusion Yanshen Instant Herbal Granules No.1 can not only protect and improve RRF,but correct obviously anemia status in patients undergoing chronic hemodialysis.
【Key word】 Yanshen instant herbal granules No.1；Hemodialysis；Renal anemia

The Non-operational Treatments of Degenerative Spondylolisthesis YU Hong-chao，YANG Xiao-li.
Hospital of Institute of CHGC，Xi′an 710065，China
【Abstract】 Degenerative spondylolisthesis is one of the commonest reasons for back and legs pain in elderlies.Non-operational treatments have showed better effects on most cases of degenerative spondylolisthesis.These non-operational treatments for degenerative spondylolisthesis were summarized in this article.
【Key word】 Degenerative spondylolisthesis;Lumbar vertebrae;Non-operational treatments

ICH Score for Predicting of Outcome of Spontaneous Intracerebral Hemorrhage ZHANG Shuo，GUO Yang.
Department of Neurology，Shengjing Hospital of China Medical University，Shenyang 110004，China
【Abstract】 The ICH score is a simple and validated clinical grading scale which is composed of several factors related to outcome of spontaneous intracerebral hemorrhage（ICH）： clinical features，vital sign，CT scan presentations.The ICH score reliably stratifies patients with regard to risk of mortality and functional outcome after ICH which plays an important role in the evaluation and management of patients after ICH.With the proposal and external validation of ICH score，several grading scales derived by the ICH score took as clinical outcomes the mortality and functional status within 30 days or 6 months，which developed and modified ICH score with components and scores.It′s still controversial which scale is more reliable in prediction of ICH with different clinical outcomes.
【Key word】 ICH score；Cerebral hemorrhage；Prognosis

Analysis of Income and Expense of Shanghai Suburban Community Health Service Centers from 2003 to 2005 XIE Qing-wen，ZHU Chang，ZHU Jing-fen，et al.
School of Public Heath，Shanghai Jiaotong University，Shanghai 200025，China
【Abstract】 Objective The aim of this study was to have a view of the income and expenses of community health service centers (CHSC) in Shanghai suburb from 2003 to 2005.
Methods A cluster sampling survey was conducted to investigate the data of Shanghai Suburban CHSC.
Results In 2003~2005，the average annual gross income，the average annual gross expense，the average annual medicament income and the average financial subsidies income showed a tendency to increase.The average annual progressive increases were 23.42％,20.84％,29.41％,39.22％,respectively.
Conclusion The overall financial condition of Shanghai Suburban CHSCs is good,but they still need the government to support strongly when carrying out CHSC functions and continues to develop soundly.
【Key word】 Shanghai；Community health services；Income；Health expenditures

Number5March，2009

　　Referral Documents-A Key Indicator of General Practice Quality YANG Hui，Shane Thomas.
　　Faculty of Medicine,Nursing and Health Sciences，Monash University，Victori 3168，Australia

　　【Abstract】 Objective To explore potential opportunity of developing and using standardised referral document between community health services and hospital care in China,for improving effectiveness and efficiency of referral service and ensuring quality of care and patient safety.

　　Methods Literature review and document analysis.

　　Results Referral letter is a tradition of western medicine and has changed it format referral form.Standardised general practice referral form has been found in Australia and its quality is assessed in practice accreditation.The standardised document contents contact details of general practitioner,specialist and patient;reason for patient referral;clinical information,including warnings,allergies,current medication,social history,past medical history,progress,and investigation results;as well as consent to referral and sharing relevant information.The benefits of standardised referral includes improving patient information flow,enabling improved triage,prioritization and management of patient,increasing efficiency of electronic referral process and improving use of computerized community health software applications.Standardised referral form has not been found.Traditional referral document is used and presented as San Lian Dan,triplicate form,which actually function as account keeping,instead of communicating between doctors.

　　Conclusion China needs further studies on referral documents which practically and appropriately exchange patient information among medical service providers.Standardised referral document which supporting quality and continuous of patient care is especially required in context of healthcare development through strengthening community health services.

　　【Key word】 Referral document；General practice；Quality

Risk Factors of Complicated Acute Kidney Injury in Elderly Patients with Chronic Nephropathy YU Min, HAN Bing, SHI Yao-xun.
Department of Nephrosis，Affiliated Hospital， Academy of Military Medical Sciences， Beijing 100071， China

　　【Abstract】 Objective To investigate the risk factors of the acute kidney injury secondary to chronic nephropathy in the elderly patients.

　　Methods Retrospective analysis was conducted for the clinical data of 92 patients with chronic nephropathy complicated by acute kidney injury in our hospital from January 2001 to December 2007. They were divided as group A in which 48 elderly patients whose ages were above 60, and group B in which 44 middle-aged and young patients whose ages were under 60. The clinical data, treatments and outcomes in the two groups were analyzed.

　　Results Among the risk factors to cause acute kidney injury the elderly patients with chronic nephropathy, the main ones were severe infection (29.17 %), nephrotoxic drugs (22.92%), hypovolemia (16.67 %), with significant differences as compared with group B (P＜0.05). There was significant difference in total effective rate between the two groups (P＜0.05).

　　Conclusion The risk factors of the acute kidney injury in the elderly patients with chronic nephropathy are multiple. It is of very important significance to pay attention to the high risk factors and to detect them, to control all kinds of infection timely, to avoid the use of nephrotoxic drugs, and to strengthen the holistic treatment for prevention of the acute kidney injury. 

　　【Key word】 Chronic kidney disease；Acute kidney injury；Elderly patients；Risk factors

Plasma Levels of Adrenomedullin and Urotensin II in Atopic Children with Bronchiolitis CHEN Xiao-hong, ZHOU Guo-zhong, XIA Yun, et al.
Department of Pediatrics, the People′s Hospital of Shaoxing, Shaoxing 312000, China

　　【Abstract】 Objective To investigate the changes of plasma levels of adrenomedullin (ADM) and Urotensin II (U-II) in atopic children with bronchiolitis so as to evaluate their clinical significances. Methods Totally 153 pediatric patients with bronchiolitis were recruited and divided as atopic group (n=60) and non-atopic group (n=93), with 30 health children enrolled as the controls. The symptom scores at the acute stage and remission stage, and hospitalization days between the two-patient groups, as well as plasma levels of ADM and U-II among the three groups were compared.

　　Results? Compared with the non-atopic group, the symptom scores at acute and remission stages in the atopic group were higher（P＜0.01）, and the hospitalization duration was longer （P＜0.01）, with significant differences. There were statistically different significances in plasma ADM and U-II among the three groups （P＜0.01）.

　　Conclusion Atopic children with bronchiolitis have higher plasma levels of ADM and U-II than non-atopic children with bronchiolitis, their condition is severer and clinical course is longer, and they are more likely to have recurrent wheezing episodes.

　　【Key word】 Bronchitis；Adrenomedullin;Urotensin Ⅱ

Correlation between Post-infarction Depression and Focal Location and Area of Cerebral Infarction? MA Yu-mei， LI Fei.
General Department of Yinhang Community Health Service Centers of Yangpu District in Shanghai， Shanghai 200438， China

　　【Abstract】 Objective To study the relation between depression at acute stage and focal location and area in patients with cerebral infarction.

　　Methods One hundreds and eighty patients with a diagnosis of first ever cerebral infarct were included in the study and were divided into depression group and non-depression group according to Hamilton depression rating scale (HAMD）. The conditions of infarction location and area between the two groups were compared.

　　Results? Between the two groups, there were significant differences in the infarction rates of left and right cerebral hemispheres （P＜0.05）, but there was no significant difference in the infarction rate of left cerebellar hemisphere and multi-infarction rate of dual cerebral hemispheres (P＞0.05). There were 39 cases (43.3%) with maximum radius of infarction focus ＞3.6 cm in patients with complicated depression, and 26 cases (28.9%) in those with no depression. In patients with moderate or serious depression, there were 26 cases (66.7%) with radius of infarction focus ≥3.6cm, and 9 cases (17.6%) in those with radius of infarction focus ＜3.6 cm, the comparison revealed a significant difference （P＜0.01）.

　　Conclusion Depression status of patients with cerebral infarction is related with left cerebral infarction and correlated with infarction area.

　　【Key word】 Brain infarction；Depression

Role of Insulin Resistance and Serum Uric Acid in Coronary Heart Disease LI Xiao-ying, YANG Rui-ying, WU Hai-liang, et al.
The Affiliated Hospital of Ningxia Medical University, Yinchuan 750004, China

　　【Abstract】 Objective To investigate the effect of insulin resistance (IR) and serum uric acid (UA) on the occurrence of coronary heart disease (CHD).

　　Methods Totally 88 patients were divided into three groups of controlled group(CO), stable angina (SA) group and acute coronary syndrome (ACS) group. The levels of fasting plasma glucose (FPG) and fasting insulin (FINS) were detected, and insulin sensitivity index was calculated. The levels of UA, alpha-granule membrane protein 140 (GMP-140), von Willebrand factor (vWF), plasminogen activator inhibitor type-1 (PAI-1)，thromboxane B2 (TXB2) and C-reacting protein (CRP) were measured. The results were compared among the groups.

　　Results Logistic stepwise regression analysis indicated that the correlative factors with CHD were UA, CRP, ISI, PAI-1 and PT (P＜0.05). The correlative factors with ISI were UA, vWF, GMP-140, TXB2, PAI-1, FPG and LDL (P＜0.05).

　　Conclusion Insulin resistance and serum uric acid may cause the occurrence and development of CHD by the mechanisms of damaging blood vessel endothelium function, activating platelet, changing coagulation and fibrinolysis, and causing inflammatory reaction.

　　【Key word】 Coronary disease;Uric acid;Insulin resistance

Application of Preoperative Endoscopic India Ink Tattooing in Laparoscopic Colorectal Cancer Surgery　WANG Wei， LIU Bin，YANG Zhi-ming.
The First Department of General Surgey, the Fourth Hospital Affiliated to Guangxi Medical University, Liuzhou 545005， China

　　【Abstract】 Objective To evaluate the effectiveness of endoscopic India ink marking technique in laparoscopic colorectal cancer surgery.

　　Methods From March 2006 to June 2008, 61 patients with colorectal carcinomas were recruited and were at random divided as trial group (TG, n=30) and control group (CG, n=31). The patients′ lesions in the TG were localized preoperatively by endoscopic India ink tattooing, while those in the CG were localized preoperatively by the conventional method.

　　Results There were significant differences in visualization rate of the tumors, operative time and hemorrhage amount of the patients during the operation between TG and CG (P＜0.05).

　　Conclusion Preoperative endoscopic India ink tattooing is an effective technique for intraoperative localization of colorectal cancer lesions. It can markedly shorten the operative time, reduce operative hemorrhage and make the range of resection more correct. It is simple and with a good application future. 

　　【Key word】 Laparoscopy;India ink;Colorectal neoplasms

Low-Frequency Ultrasonic Therapy with Minimally Invasive Surgery for Cerebral Hemorrhage ZHAO Hai-bin， ZHAO Cheng-bo， LU Shi-ping， et al.
Neurosurgery Department of Jiyang People′s Hospital，Jiyang 251400， China

　　【Abstract】 Objective To observe the efficiency and safety of low-frequency ultrasonic therapy in combination with minimally invasive surgery in patients with hypertensive cerebral hemorrhage.

　　Methods The inpatients with hypertensive cerebral hemorrhage were divided randomly into two groups. The patients in the trial group were first given minimally invasive surgery crashing and aspirating hematoma, and then treated with low-frequency ultrasound; while the patients in the control group were treated only with minimally invasive surgery crashing and aspirating hematoma.

　　Results Ten days after treatment the scale of European Stroke Scale (ESS), mass of hematoma, elimination rate of hematoma and content of D-dimer (D-D) and fibrinogen of the patients in the trial group were all significant different from those in the control group (P＜0.05).

　　Conclusion The low-frequency ultrasonic therapy in combination with minimally invasive surgery is reliable and safe for cerebral hemorrhage.

　　【Key word】 Ultrasonic therapy；Surgical procedures，minimally invasive；Cerebral hemorrhage

Impact of Seasons and Holidays on Emergency Visit in Patients with Cardio-cerebro-vascular Diseases ZHANG Yu-mei,ZHENG Ya-an,LIU Gui-hua.
Beijing University Third Hospital,Department of Emergency,Beijing 100191,China

　　【Abstract】 Objective To examine impact of seasons and holidays on emergency visit in patients with cardio-cerebro vascular diseases.

　　Methods Patients with cardiovascular and/or neurological diseases were retrospective examined and analyzed.Data were collected from consecutive patients from the Department of Emergency of a large-scale general hospital,Beijing University Third Hospital,Beijing,from August,2003 to July,2008.Diseases were classified by the 10th version of International Classification of Diseases.

　　Results 16 856 patients were enrolled in the study with an average cases per day of 9.1±3.9.Emergency visits of patients with cardiovascular and/or neurological diseases were lest frequent in June to September (7.7±3.4 visits / day) and most frequent in March and in October (10.6±3.7 visits / day).Hypertensives had a similar rhythm.Patients with coronary heart disease peaked in coldest December and January.Patients with acute stroke focused at spring.Weekly,patients visited with a madir on Wednesday (8.2±3.9 visits / day) and a peak on Sunday (9.5±4.3 visits / day).In the 3 Chinese annul 7-day long vacations,patients visited more frequently (11.2±4.7 visits / day) and demonstrated a nadir at second day (7.8±1.9 visits / day) and a peak at sixth day (14.9±7.6 visits / day).

　　Conclusion A rule was observed in emergency visit in patients with cardio- and cerebro- vascular diseases,which is important to facilities and work force arrangement.

　　【Key word】 Cardiovascular diseases;Cerebrovascular diseases;Emergency treatment;Seasons rhythm

The Family Physician Integrated Care in Taiwan and the Enlightenment Our Community Health Care TONG Jing-jing，XIA Wei，ZHANG Xiao.
School of Public Health，Southeast University，Nanjing 210009，China

　　【Abstract】 Based on the description of the construction and the mode of operation of The family physician integrated care in Taiwan.The article analysises of it′s characteristics and advantages comparing to community health service in our country.Then,the paper tries to make same recommendations to improve for the future development:reconstruct the service model by cooperating between communities and hospitals,changes the direction of service providers in community,strengthen the self-construction of community′s institutions,and create an interactive network platform to achieve information sharing.

　　【Key word】 Physicians，family；Integrated care；Community health services

How to Develop Community Nursing Workforce System Suitable for China? PAN Jun-hua， LIU Chao-jie， PEI Li-kun， et al.
Beijing Fengtai Vocational Health Worker′s Training Centre， Beijing 100072， China

　　【Abstract】 Community health cause has been a priority and developed in China. However, the community nursing lagged behind the development of community health cause and has not played its potential function and role. How to construct a workforce system of community nursing suitable for Chinese actual conditions is an important subject for community nursing development in future. In this article we review the status of development in community nursing workforce in China, analyze the identified problems and their causes, and investigate how to establish a new workforce system of community nursing suitable in China.

　　【Key word】 Community health services；Community nursing；Human resources

Operating Pattern of Community Nursing Based on Service Oriented Architecture in China? HE Guo-ping， GUO Jia， WANG Jing.
School of Nursing， Central South University， Changsha 410013， China

　　【Abstract】 The origination, definition, idea and structural mode of service oriental architecture (SOA) were first described, then the operating pattern of community nursing in China was put forward based on the idea and structural mode of SOA. Taking the current status of community nursing in China into consideration, it is necessary for us to set up the community nursing center and change operating mode, to run community nursing professional education and enforce the study of community nursing education, to organize special nursing skills trainings.

　　【Key word】 Community healthcare；Operating pattern；Service oriental architecture

Patient Satisfaction on Community Health Services in Beijing - qualify of Care as Patient Perspective YUAN Qi，YAN Hong-mei，ZHU Qing，et al.
Beijing Hepingli Hospital，Beijing 100013，China

　　【Abstract】 Objective To explore associated factors which determinate patient satisfaction on community health services and to inform policy development and quality improvement of community health services.

　　Methods Patient questionnaire survey was conducted in four community health centres and 12 stations in four urban districts of Beijing.The questionnaire was localized RACGP tool of Australia and pre tested in a Beijing community.Training session was organized by investigator for ensuring quality of data collection process.Totally 4.500 questionnaires were delivered to patients who aged 15 and over， while 4，223 of them returned and validated for data analysis.SPSS 13.0 was occupied for data analysis.

　　Results Overall patient satisfaction rate on community health services was 96.6%.The satisfaction rate for doctor′s respect was 95.9%， while the lowest rate was about facility for sick children in community health venues， i.e.only 37.7%.

　　Conclusion Medical technical competency and attitude toward patients could be key determinants of patient satisfaction.

　　【Key word】 Community health service；Patient satisfaction；Associated factor；Beijing

The Important Role of General Medical Wards in General Hospitals CHEN Wen-ji, TANG Shi-zhong.
Southeast University, Zhongshan University Hospital Subsidiary of General Medicine,Nanjing 210009,China

　　【Abstract】 Objective Objective Head to explore general medical wards in general hospitals in the role. Methods In our hospital general medical ward of the 548 cases of hospitalized patients with the source, type of illness, prognosis and outcome, such as for analysis. Results General medical ward patients with multiple sources, age span, and the combined number of diseases, health care heavy workload. Conclusion General medical wards are general practitioners training base are of general application of the concept of medical establishments, specialist medical services are a supplement to the platform are two-way referral.

　　【Key word】 General medical wards；General hospital；Medical model

Establish the Performance Evaluation Index System for Community Health Service Center ZHANG Li，PAN Xiao-hong，ZHANG Hui.
Health Service Center for Community of Lingyin，Hangzhou 310013，China

　　【Abstract】 Along with the high speed development of community health service，scientific evaluation system of community health service must be made.Based on huge investigation research，the essay established fourteen indexes by performing Delphi method.If this essay arouses professional researchers′ attention to establish a scientific theory for selecting indexes which evaluate the performance of community health service accurately，the objective，every person has the right to receive health service，would be achieved earlier.

　　【Key word】 Community health service center；Performance evaluation；Index system；Weight

A Survey of Domestic Management Consciousness of Hypertensive and/or Diabetic Patients in Beijing Area LIU Ya, YAN Shan, LIU Jie-lin, et al.
Department of Hypertension Research, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China

　　【Abstract】 Objective To investigate the status of domestic management consciousness of hypertensive and/or diabetic patients in Beijing area.

　　Methods A questionnaire was designed by ourselves and published on Beijing evening newspaper. Hypertensive and/or diabetic patients in Beijing area returned the questionnaires by mail or fax. 871 valid questionnaires were collected.

　　Results? Among the 871 patients, there were 257 （29.5%）who had hypertension alone, 164（18.8%）who had diabetes mellitus, and 450（51.7%）who had hypertension complicated by diabetes mellitus. There were significant differences among the 3 groups of patients in incidences of coronary heart disease, fundus disease, foot lesion, angiosclerosis of lower limb and peripheral neuropathy (P＜0.01). In patients with hypertension complicated by diabetes mellitus there were significant differences among incidences of coronary heart disease, fundus disease, angiosclerosis of lower limb and peripheral neuropathy (P＜0.05). There were 98 hypertension patients and 20 diabetic patients who self-monitored their blood pressure or sugar 1 to 3 times a day. More than 80% patients had consciousness of healthy diet and right treatment.

　　Conclusion The possession rate of self monitoring equipment was very low among hypertensive and/or diabetic patients in Beijing area, so did the rate of self monitoring frequency. Their domestic management consciousness should be strengthened.? 

　　【Key word】 Hypertension；Diabetes；Epidemiology；Beijing

Application Status of Female Condom among Female Commercial Sex Workers in Gejiu City? XU Yan， LUO Jia-hong， LI Xiao-mei， et al.
Department of Health Statistics， Public Health College of Kunming Medical University， Kunming 650031， China

　　【Abstract】 Objective To investigate the acceptability of female condom (FC) among female commercial sex workers (CSWs) and to search the existing shortcoming of female condom, so as to provide scientific basis for application and popularization of female condom.

　　Methods The epidemiological field research was applied. The baseline questionnaire, coital log and follow-up questionnaire were taken to investigate the use of female condoms by 113 f CSWs for 24 weeks.

　　Results The numbers of sexual intercourse among 113 CSWs in 24 weeks amounted to 17 696, of which application of male condom accounted for 69.3% and application of female condom for 29.9%. Female condom price that 113 CSWs are willing to offer was RMB (1.5±0.6) yuan. There was a significant difference in female condom utilization rate among three workplaces of the ballroom, beauty parlors and street-based sites (P＜0.001). As time goes the number of CSWs who applied the female condom was gradually decreased because of client′s pleasure (P＜0.001), and the number of CSWs who did not apply the female condom was gradually increased because of noisy sound in utilization (P＜0.001), and the number of CSWs who did not apply the female condom was gradually decreased because of client′s non-pleasure, discomfort utilization or malformation of the condom (P＜0.05).

　　Conclusion Female condom is generally acceptable by CSWs, it may be complementary to male condom. Nevertheless, to spread the utilization, multiple factors such as its price and improvement, difference in social humanity context and clients should be taken into consideration. 

　　【Key word】 AIDS；Condom；Female condom；Commercial sexy workers

Effects of Compound Liquor of Coptis Chinensis on Chronic Osteomyelitis and Nursing Care of Closed Lavage? LU Hua-lin, JIANG Shun-wan, TANG Ji-ping.
Department of Chinese Medicine Hospital, Luohu District, Shenzhen 518001, China

　　【Abstract】 Objective To evaluate the effectiveness of external application with self-produced compound liquor of Coptis Chinensis in treatment of chronic osteomylitis, and to approach on nursing of closed lavation.

　　Methods Totally 87 patients with chronic osteomylitis were randomly divided into trial group (n=45) and control group (n=42). The patients in the trial group were treated by externally applying self-produced compound liquor of Coptis Chinensis and those in the control group treated by liquor of gentamycin. The closed continuous irrigation and drainage, wet packing and soaking were adopted according to local conditions of each case. The effects and relapse rates between the two groups were observed and compared.

　　Results? There was significant difference in clinical effect between the tow group (P＜0.05). The average treatment course in the trial group was （21±8）days, and in the control group was （29±20）days, with a significant difference （P＜0.05）. There was 1 relapsed case (2.20% of relapse rate) in the trial group, but 8 rasped cases (21.05% of relapse rate) in the control group, with a significant difference （P＜0.05）.

　　Conclusion The self-produced compound liquor of Coptis Chinensis is of better effect than liquor of gentamycin in external application for chronic osteomylitis. The important nursing measurements in treating chronic osteomylitis are unobstructed drainage, and timely and reasonable functional exercise of the patients. 

　　【Key word】 Closed lavation;Chronic osteomylitis;Compound liquor of coptis chinensis;Nursing care

The Survey of Application of Phosphate Binder in Hemodialysis Patients and Intervention LIU Qun，WANG Ying，LIU Hui-lan，et al.
Fuxing Hospital Affiliated to Capital University of Medical Sciences，Beijing 100038,China

　　【Abstract】 Objective Hyperphospheremia is common in maintenance hemodialysis(MHD) patients.this study was to investigate the use of phosphate binding and the recognition and compliance in MHD patients.

　　Methods This trial was conducted in 58 patients on hemodialysis,to know their use of phosphate binding and to give them healthy education.

　　Results All patients received phosphate binding,most of them can take these drugs with meal(49/58),10 of all patients omit to take these drugs usually.Most phosphate bindings are calcium carbonate(20mg calcium/pill),17 patients take calcium over 1500mg everyday.The average blood phosphate level decreased after 3 months through propaganda instruction(P＜0.05).

　　Conclusion Calcium carbonate is the common phosphate binding,it can decrease blood phosphate effectively.The most important things in healthy education on patients are as following:the harm of hyperphosphatemia,how to control the intake of phosphate in diet and how to receive phosphate binding properly.

　　【Key word】 Maintenance hemodialysis;Phosphate binder;Questionaire;Intervention

Efficacy of Trimebutine Combined with Compound Digestive Enzyme Capsules in Functional Dyspepsia WANG Yun-fa.
Zhoushan People′s Hospital， Zhoushan 316000， China

　　【Abstract】 Objective To investigate the clinical efficacy of Trimebutine combined compound digestive enzyme capsules in treatment of functional dyspepsia.

　　Methods Totally 110 patients were at random divided into 3 groups：group A of 32 cases treated with Trimebutine, group B of 36 cases treated with compound digestive enzyme capsules, and group C of 42 cases treated with Trimebutine combined compound digestive enzyme capsules. All were treated for 4 weeks, and then the clinical efficacy and total effective rates were compared.

　　Results The total effective rates of group A, B and C group were 71.9%, 72.2% and 92.9% respectively. The effective rate in group C was statistically different from those in group A and B （P＜0.05）.

　　Conclusion The effect of Trimebutine combined compound digestive enzyme capsules is markedly higher than those of either Trimebutine or compound digestive enzyme capsules alone. 

　　【Key word】 Functional dyspepsia；Trimebutine；Compound digestive enzyme

Cause and Clinical Manifestation of Vertigo?? JING Gai-ping， TANG Jian-liang.
Department of Neurology， Kangci Hospital, Jiaxing City, Zhejiang Province， Jiaxing 314500， China 

　　【Abstract】 Objective To analyze the common vertigo clinically.

　　Methods? A retrospective analysis was conducted for clinical data of 243 patients with vertigo in department of neurology of our hospital from June 2001 to June 2007, in order to study the clinical presentations and causes.

　　Results Vertigo secondary to vestibular system diseases was most common, being accounted for 92.59% in this report; among them central vertigo stood first, accounted for 83.54 %, followed by around vertigo, 9.05 %. Non-vestibular system vertigo accounted for 7.41%. Cerebrovascular disease vertigo accounted for most of the central vestibular vertigo, being 80.66%; among them, posterior circulation cerebrovascular disease vertigo counted for 79.84%, and transient ischemic attack for 66.67%.

　　Conclusion Vertigo is of a variety of causes that involve multi-disciplinary subjects and systems, especially nervous system. For vertigo with unknown reasons some auxiliary examinations such as CT and MRI should be chosen and follow-up observation be given so as to avoid misdiagnosis and mistreatment. 

　　【Key word】 Vertigo;Clinical analysis

Clinical Features of Renal Tuberculosis: An analysis of 180 cases? LONG Yong-qi, YANG Luo-yan, TANG Yu-xin, et al.
Xiangya 2nd Hospital Affiliated to Xiangya Medical School, Changsha 410008， China

　　【Abstract】 Objective To discuss the clinical features and effective treatment of renal tuberculosis.

　　Methods Retrospective analysis was conducted on the clinical data of 180 patients with renal tuberculosis.

　　Results Among the 180 patients there were 132 （73.3%）whose ages were from 21 to 40, 164 （91.1%） whose routine uronoscopy was abnormal, 166 （92.2%） whose uronography or retrograde pyelography was abnormal, 168 （93.3%） whose B-ultrosonography was abnormal, 104 （74.3%） who were given cystoscopy; 40 （22.2%） who were given single pharmacotherapy, and 140 （77.8%） who were given surgical therapy.

　　Conclusion The incidence of renal tuberculosis is still higher. The main diagnostic methods are routine uronoscopy, B- ultrosonography and intravenous pyelography; CT is the most valuable diagnostic method for advanced renal tuberculosis. Diagnostic treatment is an important basis for confirmed diagnosis.

　　【Key word】 Tuberculosis,renal；Early diagnosis；Diagnostictreatment

The Clinical Study of the 32 Radiation Enterocolitis WANG Shao-xin，SUN Tao，LIU Chao-qun，et al.
Department of Gastroenterology，Navy General Hospital，Beijing 100037，China

　　【Abstract】 Objective By the clinical observation of the radiation enterocolitis，acute and chronical radiation enterocolitis′ case features and therapeutic efficiency are analyzed.

　　Methods Respectively analyzing the 32 radiation enterocolitis is to observe their case feature and compare their therapeutic efficiency and prognosis.

　　Results For the 23 acute radiation enterocolitis，the course of treatment is short，therapeutic efficiency is good，the efficiency rate is 95.6 percent and its prognosis is very good.However，for the 9 chronical radiation enterocolitis，the course of treatment and the time of taking effect isn′t as short as that acute cases，the efficiency rate is 33.3 percent and its prognosis isn′t content.

　　Conclusion Radiation enterocolitis is precaution crucial.The prognosis of that acute is very good，but that chronical is very troublesome to treat and its prognosis is not excellent.

　　【Key word】 Enteritis；Radioactivity;Treatment ontcome

Correlation of Cardiac Outputs Measured with Ultrasonic Cardiac Output Monitor at Aortic Valve Area and Pulmonic Valve Area? CHU Ming-yi, LI Chun-xiang, LIU Ni-ni, et al.
Department of Emergency, the First Hospital of Qinghua University, Beijing 100016, China

　　【Abstract】 Objective To verify the correlations of cardiac outputs (COs) and cardiac indexes (CIs) at aortic valve (AV) area and pulmonic valve (PV) area of the healthy adults measured with ultrasonic cardiac output monitor (USCOM).

　　Methods The CO and the CI at AV area and PV area of 46 healthy adults during rest were measured respectively with USCOM and the correlations between the COs and CIs were studied.

　　Results There was no statistically significance in differences of COs and the CIs measured with USCOM at healthy adults′ AV area and PV area （P＞0.05）. The results showed the left and right heard were correlated both in CO （P＝0.000） and the CI （P＝0.000）.

　　Conclusion? COs and the CIs of the left and right heart are of correlativity. So if one side of CO is unavailable, it can be replaced by the other side as measured with USCOM. 

　　【Key word】 Cadiac output；Ultrasonography,doppler

Management for Frequent Ventricular Extrasystole in Patients with Non-organic Heart Diseases LUO Xiao-lan, ZHAO Shui-ping, ZHAO Yan-shu.
Department of Cardiology, the Second Xiangya Hospital of Central South University, Changsha 410011， China

　　【Abstract】 Objective To explore the treatment strategy for frequent ventricular extrasystole in patients with non-organic heart diseases.

　　Methods Totally 50 patients with frequent ventricular extrasystole of non-organic heart diseases were recruited. The treatment schemes for them were respectively set up and conducted, and a 5-year follow-up was conducted to observe the conditions.

　　Results The 5-year follow-up showed that the number of 24-hour ventricular extrasystole is of no significant difference from that 5 years ago （P＞0.05）. However the majority of the patients were symptomless, they lived and worked normally, and no dead case was found.

　　Conclusion The management for ventricular extrasystole in patients with non-organic heart diseases should be based on explanation and psychological alleviating rather than the anti-arrthymia drugs. However the organic heart diseases should be excluded. 

　　【Key word】 Premature ventricular beats;Treatment

Surgical Treatment for Carpal Tunnel Syndrome MA Jian-ping, YANG Jian-zhen, WU Yu-qing.
The Hospital of Shenzhen Nanshan Chronic Disease, Shenzhen 518054, China

　　【Abstract】 Objective To investigate the result of surgical treatment forcarpal tunnel syndrome.

　　Methods Clinical symptoms, examination method, operation type and the prognosis were retrospectively analyzed in 16 patients with carpal tunnel syndrome.

　　Results Most of the patients had pain or numbness at the radial sides of three and half fingers. There were 14 cases (87.5%) whose wrist flexion test was positive, 14 cases (87.5%) whose tourniquet test was positive, and 13 cases (81.3%) whose wrist percussion test was positive. All patients were operated and injected with prednisolone acetate. No postoperative complication was found. The follow-up of 1 to 5 years (average 2 years) in 15 cases showed an excellent and good rate of 93.8%.

　　Conclusion Severance of transverse carpal ligament, median nerve interfascicular neurolysis and local injection of prednisolone acetate is a simple and effective therapy for carpal tunnel syndrome.

　　【Key word】 Carpal tunnel syndrome;Diagrosis；Therapy

Effect of Jinghua Weikang Capsules on Gastric Ulcers? FAN Zhe， WEN Quan.
Changchun University of Traditional Chinese Medicine Hospital， Six Medical Consultation， Changchun 130021， China

　　【Abstract】 Objective To observe the effects of Jinghua Weikang capsules in treatment of gastric ulcers.

　　Methods Totally 65 patients with gastric ulcer diagnosed by gastroscopy were randomly divided into two groups, with 100 in each. The patients in the trial group were given Jinghua Weikang, 2 capsules orally, a.c., 3 times a day; while those in the control group were given famotidine, 20 mg orally, twice a day, with additional 20 mg, h.s., and sucralfate 1g orally, 4 times a day a.c. and h.s.. The course of treatment was 30 days. The effects and untoward reactions in both the groups were observed.

　　Results There was a statistically significant difference in clinical effects between the two groups was (P＜0.05). No adverse reaction was found, the patients were all well tolerated to the drugs.

　　Conclusion Jinghua Weikang capsules is of good effect to gastric ulcer, with no untoward reaction.? 

　　【Key word】 Stomach ulcer；Jing Hua Wei Kang capsules；Drug therapy

Effects of Qishenyiqi Dripping Pills on Idiopathic Pulmonary Fibrosis LONG Tao, LI Ying.
Intensive Care Unit, Tianjin First Central Hospital (East Division), Tianjin 300011, China

　　【Abstract】 Objective To observe the effects of Qishenyiqi Dripping Pills in the treatment of idiopathic pulmonary fibrosis.

　　Methods Sixty-two patients with idiopathic pulmonary fibrosis were divided randomly into two groups: control group in which 30 cases received oral prednisone of 0.25～0.50 mg·kg-1·d-1, and trial group in which 32 cases were treated with Qishenyiqi Dripping Pills on the basis of above conventional therapy, with a course of 3 months. The clinical effects of the patients in both the two groups, as well as forced vital capacity predicted percent (FVC%), volume in 1 second predicted percent (FEV1%), diffusing capacity of the lung for carbon monoxide predicted percent (DLCO%), and arterial oxygenation (PaO2) before and after therapy were observed.

　　Results After treatment, between the two groups there was significant difference in clinical effect (P＜0.05), and there were significant differences in FVC%, FEV1%, DLCO% and PaO2 between the two groups (P＞0.05).

　　Conclusion Qishenyiqi Dripping Pills is a significant effect for idiopathic pulmonary fibrosis.
【Key word】 Pulmonary fibrosis；Qishenyiqi dripping pills；Therapy

Chylous Ascites Secondary to Radical Gastrectomy: A clinical report of 3 cases? CHEN Jian-zhong.
Department of Surgery, The Second People′s Hospital of Fuyang, Fuyang 311404, China

　　【Abstract】 Objective To investigate the treatment principle and method for chylous ascites secondary to radical operation of gastric cancer.

　　Methods Three patients with chylous ascites secondary to the radical operation of gastric cancer were treated by draining, with fasting and total parenteral nutrition (TPN). One of them was treated with additional somatostatin.

　　Results All the three patients were successfully treated with non-operative methods for 9 to 24 days.

　　Conclusion Chylous ascites? secondary to radical operation of gastric cancer may be treated by raining, fasting and TPN, but some need additional somatostatin.

　　【Key word】 Stomach neoplasms；Surgical procedures，operative；Chylous ascites

Individual Identification of Health Record and Its Standardization LI Hong-lei，LIU Dan-hong，YANG Peng，et al.
Department of Health Statistics，Forth Military Medical University，Xi′an 710032，China

　　【Abstract】 Objective To explore individual identification of health record and its standardization.

　　Methods Based on HL7 RIM，used UML modeling tools for data modeling.According to the Chinese National Information Framework and Hospital Information Basic Data Set Standard，defined the metadata.

　　Results The individual identification was given attribute division and definition，and information data model was constructed.

　　Conclusion The paper proposed data item and data standards about individual identification information，which met the need of current healthcare information system，and offered the premise for establishing health record index data base and the minimum data set.

　　【Key word】 Health record；Individual identification；Standardization；Metadata；Data standard

Number6March，2009

Effect of Perioperative Mild Hypothermia on Platelet Functions in Neurosurgery Patients CHEN Shu-bin，XU Shu-sheng，LI Shao-chen，et al.
Department of Anesthesiology，Longnan Hospital，Daqing 163453，China

　　【Abstract】 Objective To investigate the effect of perioperative mild hypothermia on platelet aggregation and adhesion function in patients undergoing brain surgery.

　　Methods Sixty cerebral surgery patients were divided into hypothermia group and incubation group,30 in each.Venous blood was collected before induction,and 60 min and 120 min after,respectively.Turbidimetry and glass ball methods were used to determine platelet aggregation and adhesion function.

　　Results We found that platelet aggregation and adhesion were significantly decreased 60 minutes and 120 minutes after induction，as compare with pre-induction（P＜0.05）,and decreased significantly in hypothermia group compared with incubation group（P＜0.05）.

　　Conclusion? Platelet aggregation and adhesion are inhibited when patients develop perioperative mild hypothermia.

　　【Key word】 Intraoperative period；Hypothermia；Blood platelets

Effect of Mirtazapine on Irritable Bowel Syndrome and Changes of Neuropeptide-Y Level　　LI Qian，LI Xin-hua，WU Juan.
Derpartment of Digestive System,Xiangya Hospital of Central South University,Changsha 410008,China

　　【Abstract】 Objective To evaluate the curative effect of mirtazapine with pinaverium bromide in treating irritable bowel syndrome(IBS) and its influence on the changes of neuropeptide-Y level.

　　Methods Fifty-five IBS patients,who were chosen in this study based on Rome Ⅲ criteria and evaluated with self-rating anxiety scale(SAS) and self-rating depression scale(SDS),were divided randomly into two groups.Combination group(n=28) were treated with mirtazapine and pinaverium bromide,and control group(n=27) only with pinaverium bromide,for 4 weeks.The improvement of abdominal pain,bloating and abnormal bowel traits and movements were evaluated in both groups after treatment,and meanwhile the neuropeptide-Y level in blood samples drawn before and after treatment was radioimmunodetected.

　　Results The average SAS score of 55 patients was 47.4±9.3,SDS was 57.6±8.8.The improvement in individual symptoms such as abdominal pain and abnormal stool traits and in overall symptom were significantly higher in combination group than in control group（P＜0.05）.There was significant difference in neuropeptide-Y level between post-treatment and pre-treatment in combination group after 4 weeks（P＜0.01）.

　　Conclusion IBS patients present with varying degrees of depression.The curative effect of mirtazapine combined with pinaverium bromide is superior to single-used pinaverium bromide in IBS treatment.The mechanism of mertazapine in treating IBS may be related to its increase of neuropiptide-Y level.

　　【Key word】 Mirtazapine;Pinaverium bromide;Irritable bowel syndrome;Neuropeptide-Y
The Comparison of Three Surgical Procedures for Perinephritis due to Calculi Obstruction YUAN Yin-tian,WANG Xing-shan,WANG Xiao-qiang,et al.
The People′ s Hospital of Shouguang City,Shouguang 262700,China

　　【Abstract】 Objective To compare the efficacies of obstruction removal and double J tube drainage by ureteroscopy,ureterolithotomy and double J tube placing,and double J tube placing and extracorporeal shock wave lithotripsy(ESWL) in treating obstructive perinephritis.

　　Methods 116 cases of obstructive perinephritis treated in this hospital from January 2006 to June 2007 were divided into three groups:group A(n=40,given obstruction removal and double J tube drainage by ureteroscopy),group B (n=37,given ureterolithotomy and double J tube placing),and group C (n=39,given double J tube placing and ESWL).

　　Results The operations of 39 patients were successful in group A,with a succesful rate of 97.5%； 37 in group B,with a 100.0% succesful rate； in group C,double J tube placing was successful in 37 patients,ESWL was successful in 18,with a succesful rate of 46.2%.There was not significant difference in operation successful rate between groups A and B（P＞0.05）,but there was between groups A and C（P＜0.05）；Significant difference was found in mean time of postoperative hospital stay between groups A and B,and between groups B and C（P＜0.05）； There was significant difference in treatment costs between 3 groups（P＜0.05）.Conclusion? Ureteroscopy operation with double J tube placing,which is safe with small traumas and quick recovery,is the best method in treatment of prinephritis due to calculi obstruction.

　　【Key word】 Ureteroscopes；Perinephritis；Drainage

Diagnostic Value of Carcinoembryonic Antigen,Adenosine Deaminase and Mesothelial Cell Counting in Differentiating between Malignant Pleural Effusion and Tuberculous YIN Zong-bao,TAN Yuan,CHEN Yan-fan,et al.
Department Respiratory Medicine，the First Affiliated Hospital of Wenzhou Medical College，Wenzhou 325000，China

　　【Abstract】 Objective To evaluate the value of carcinoembryonic antigen(CEA),adenosine deaminase(ADA) and mesothelial cell counting in differentiating between malignant pleural effusion(MPE) and tuberculous.

　　Methods We chose 91 pleural effusion patients for unknown reasons from July 2007 to July 2008,among whom 43 were diagnosed as tuberculous pleurisy(group A) and 48 as MPE(group B) by thoracoscope pathological biopsy.The levels of CEA,ADA and mesothelial counting were determined in both groups.Results The levels of CEA,mesothelial cell counting and the ratio of CEA in pleural effusion and blood serum were significantly higher in group B than in group A.The sensitivity,specificity and correct rate of ADA level in tuberculous pleural effusion were 88.4%,95.0%,84.4%,respectively.The sensitivity and specificity of CEA+ADA and the CEA ratio in pleural fluid and blood serum were better in group B.Conclusion Combined detection of CEA,ADA,mesothelial cell counting,CEA ratio in pleural effusion or in blood serum is of relatively high clinical value in differentiating between MPE and tuberculous.The correct rate of CEA plus ADA is the highest in all indexes.

　　【Key word】 Combined detection；Malignancy pleural effusion；Carcinoembryonic antigen;Adenosine deaminase;Mesothelial cells 

Effects of Oral Rehydration on Ischemic Injury in Gastric Tissue in Rats with 40% Blood Volume Loss HOU Jing-yuan,ZHANG Li-jian,ZHOU Guo-yong,et al.
Laboratory of Shock and Organ Dysfunction,Burn Institute,the First Hospital Affiliated to the PLA General Hospital,Beijing 100037,China

　　【Abstract】 Objective To investigate the effects of oral rehydration(OR) with glucose electrolyte solution (GES) on ischemia injury in gastric tissue in rats with 40% blood volume loss.

　　Methods SD rats were randomly divided into 3 groups:group S(without hemorrhage，OR,n=24),group H(with hemorrhagic shock，no OR,n=24) and group H+GES(with hemorrhagic shock,OR,n=24).And each group were randomized into 3 subgroups:2-hour group,4-hour and 24-hour (n=8,respectively) according bleeding time.Group S were not bloodletted,only cannulated in the right carotid and extubated after 25 min,and given OR following operation.About 40% of total blood volume was bloodletted from the right common carotid artery of rats,2 times,at an interval of 15 min.,to establish HS models in groups H and H+GES.Group H+GES were given lavage,3 times (at hours 0 5,1,6,respectively),with glucose-electrolyte solution 3 times as much as lost blood after hemorrhage.After gastric blood flow (GBF）was measured by laser Doppler at hours 2，4 and 24 following hemorrhage,animals were sacrificed to take specimens of gastric tissues to evaluate Na+-K+-ATPase and the rate of tissue water content(WC)，and to determine the gastric pathological changes.

　　Results GBF and the activity of Na+-K+-ATPase were significantly higher in group H+GES than in group H(P＜0.05),and lower than in group S(P＜0.05);The water content of gastric tissue of group H was significantly higher than that of group S(P＜0.05),and lower than that of 2-hour sub-group and 4-hour,higher than that of 24-hour sub-group in group H+GES.Less edema and hyperemia were found in H+GES group than in H group 24 h after hemorrhage.

　　Conclusion OR can alleviate edema and ischemic injury in gastric tissue by increasing GBF and gastric Na+-K+-ATPase in rats with early hemorrhagic shock.

　　【Key word】 Blood loss；Fluid therapy；Gastric mucosa；Na+-K+-ATPase

Influence of Ginkgo Biloba Extract on Expression of Protein Kinase B in Insulin Resistant Rat Skeletal Muscle SONG Guang-yao，WANG Jing，QU Dong-ming，et al.
Department of Endocrinology，Heibei Provincial Hospital，Shijiazhuang 050051，China

　　【Abstract】 Objective To study the influence of ginkgo biloba extract(EGB) on protein kinase B(PKB)expression in insulin resistant(IR) rat skeletal muscle,and to investigate its partial molecular mechanism in improving insulin sensitivity.

　　Methods? IR rat models were established by high-fat diet,and given intervention with different dosages of EGB intraperitoneal injection for 4 weeks,with rosiglitazone as positive control.After intervention,serum total cholesterol(TC),triglyeride(TG),fasting blood glucose(FBG),fasting insulin(FINS) were determined,and hyperinsulinemic euglycemic clamp was performed to evaluate glucose infusion rate(GIR);The level of skeletal muscle PKB protein was assayed by Western Blot;expression of PKB mRNA by real-time RT-PCR.

　　Results? IR models were successfully duplicated by high-fat diet,GIR was significantly decreased,and FBG,FINS,TC,TG increased when compared with normal control group (P＜0.01).A decreasing tendency was seen in PKB protein level in skeletal muscle,and the intervention of middle or high dosage of EGB,which was similar to rosiglitazone in effect,improved these parameters more effectively than low dosage.

　　Conclusion EGB can improve the IR state induced by high-fat diet.The up-regulation of PKB expression in skeletal muscle was associated with its insulin sensitization.

　　【Key word】 Ginkgo biloba extract;Insulin resistance;Protein kinase B

Expression of TLR-4，TNF-α and NF-κB in Rat′s Cardial Muscles during Ischemia-reperfusion LIU Dong-yun,LIU Kun-shen.
Graduate Academy of Hebei Medical Univrersity,Shijiazhuang 050082,China

　　【Abstract】 Objective To investigate the expression of TLR-4 、TNF-α and NF-κB in rat cardial muscles during ischemia reperfusion.

　　Methods Twenty-five female SD rats were randomly divided into sham operation group (n=5),ischemia group(n=5),ischemia reperfusion 30min group(n=5),ischemia reperfusion 60 min group(n=5),ischemia reperfusion 90min group(n=5),Expression mRNA of TLR4 、TNF-α、NF- κB were measured by RT-PCR.

　　Results The expression level of TLR4 、TNF-α and NF- κB significantly increased after ischemia- reperfusion.there are positive correlation among them.

　　Conclusion These data suggest that myocardial ischemia- reperfusion can result in intensive activation of TLR-4 、TNF-α and NF- κB Treatment with inhibitors to TLR4 may be benefit for attenuation of myocardial injury induced by ischemia- reperfusion and subsequent acute inflammatory response.

　　【Key word】 Reperfusion injure;TLR4;Tumor necrosis factor-alpha;NF-kappa B

Aβ-induced Inflammatory Response in Hippocampus of Rat and the Suppressing Effect of Puerarin on It WANG Wen-sheng，CHAI Xi-qing，WANG Ying-jie，et al.
Key Laboratory of Neurobiology and Vascular Biology，Ministry of Education;Department of Biochemistry and Molecular Biology，Hebei Medical University，Shijiazhuang 050017，China

　　【Abstract】 Objective To observe the inflammatory response under light microscope and electron microscope after beta-Amyliod（Aβ） was injected into bilateral hippocampus of rat，and to detect the changes of the expression of cyclooxygenase-2（COX-2） and inducible nitric oxide synthase（iNOS），synthases involved in inflammatory response，in hippocampus，and to investigate the effects of Puerarin on these.

　　Methods 24 male Wistar rats were randomly divided into Puerarin group，Aβ group and Control group.Every group contained 8 rats.Aβ25～35 was injected into bilateral hippocampus of rats in Puerarin group and Aβ group.Instead，the sham operation was performed in Control group： normal sodium was injected into bilateral hippocampus.The rats in Puerarin group were treated intraperitoneally（ip） with Puerarin of 150 mg·kg-1·d-1 for 14 days，while the ones in Aβ and Control groups were treated shamly with normal sodium of 3.75 ml·kg-1·d-1 for same period.Morris water maze was used to examine learning and memory performance，and rats were executed sequently，and hippocampus were taken out and observed under light microscope and electron microscope.COX-2 and iNOS proteins in hippocampus were detected by immunohistochemistry and Western blot analysis.

　　Results The rats in Aβ group displayed longer the average escape latency（P＜0.05）and less frequency of trying to find the platform than the ones in Control group（P＜0.05）.Puerarin treatment shortened the average escape latency(P＜0.05）and increased frequency of trying to find the platform than those in Aβ group（P＜0.05）.Under light microscope and electron microscope，there was more intensive inflammatory response in hippocampus in Aβ group than those in Control group，while less intensive inflammatory response in Puerarin group than those in Aβ group.The levels of COX-2 and iNOS in hippocampus of rats increased in Aβ group than those in Control group（P＜0.01）.The expression of COX-2 and iNOS decreased after Puerarin treatment（P＜0.05）.

　　Conclusion Aβ may arouse to inflammatory response by activation of COX-2 and iNOS,that lead to neuron lesion and develop learning and memory impairment in rat.Puerarin may improve learning and memory impairment by suppressing Aβ-induced inflammatory response.

　　【Key word】 Amyloid beta-protein；Prostaglandin-endoperoxide；Puerarin

Effect of Atorvastatin on Ischemia-reperfusion Myocardial Cell Apoptosis in Rats MENG Hong,ZHANG Ying-jie.
Department of Cardiology,the First Hospital Affiliated to Liaoning Medical College,Jinzhou 121001,China

　　【Abstract】 Objective To observe the effect of short-term pretreatment with atorvastatin on ischemia-reperfusion myocardial cell apoptosis in rats,to investigate its possible mechanism.

　　Methods A total of 48 male SD rats weighting 250～300 g were randomly divided into sham-operated group(group A，0.9% normal saline，2 ml/d),ischemia-reperfusion group (group B，0.9% normal saline，2 ml/d),atorvastatin group (group C,atorvastatin 20 mg·kg-1·d-1) and atorvastatin+N-nitro-L-arginine methyl ester(L-NAME)group (group D,atorvastatin 20 mg·kg-1·d-1,L-NAME 15 mg/kg).L-NAME was injected from tail vena 15 min before ischemia.After 3 days of pretreatment,rats were subjected to 30 min　left-anterior-descending coronary artery occlusion and 120 min reperfusion.After reperfusion,serum nitric oxide(NO) levels,total superoxide dismutase (TSOD) vitality and malondialdehyde (MDA)of myocardial tissue were measured.The apoptotic morphological changes were observed by hoechst fluorescence staining,and the fas protein expression by immunohistochemistry and cardiomyocyte apoptosis index(AI) by llow cytometry.

　　Results? When compared with group B,atorvastatin increased NO content and TSOD vitality,decreased MDA content,depressed fas expression,and inhibited cardiomyocyte apoptosis（P＜0.01).In group D,NO decreased,MDA increased（P＜0.01),similar to group B(P＞0.05),decreased TSOD vitality decreased,fas expression and cardiomyocyte apoptosis increased as compared with group C（P＜0.01).

　　Conclusion Atorvastatin can reduce ischemia reperfusion injury by inhibiting apoptosis of cardiacmyocyte.Its mechanism may be related to reduction of the production of oxygen derived free radicals and decrease of fas protein expression.NOS-NO may be one of the pathways to inhibit cardiacmyocyte apoptosis.

　　【Key word】 Atorvastatin;Reperfusion injury;Apoptosis

Progress in Clinical Research of Itraconazole in the Treatment of Vulvovaginal Candidiasis GAO Shu-hong,FAN Shang-rong.
Shantou Medical University,Shantou 515041,China

　　【Abstract】 Itraconazole,a triazole,is an oral antifungal agent with a wide spectrum of antifungal activity.Itraconazole is used in treating vulvovaginal candidiasis.The mechanism,drug resistance，clinical effect and side effect of Itraconazole in the treatment of vulvovaginal candidiasis were reviewed.

　　【Key word】 Itraconazole;Administration,oral;Vulvovaginal candidiasis;Drug resistance;Treatment outcome

Zolpidem Application in Neurology YU Dong-shan.
Institute of Nanjing Brain Hospital Affiliated to Nanjing Medical University，Nanjing 210029，China

　　【Abstract】 The paper will review zolpidem application in neurology.Zolpidem can specific stimulate benzodiazepine receptor on α1 subnuit，which result in calm/hypnotic effects，that may be used to hypnotic.Otherwise，case reports and case series indicated that zolpidem can still treat sleepwalking，keep silent syndrome，extremely sleepy，eyelid spasm，muscle rigidity，post-operating pain.

　　【Key word】 Zolpidem；Sleep initiation and maintenance disorders；Mutism

Application of Wireless Digital Transmission Mobile Electrocardiogram Monitoring System in Pre-hospital First Aid AN Tie-feng,JIANG Xiao-yan,ZHANG Jin-jun，et al.
Emergency Medical Center,Beijing 100031,China

　　【Abstract】 Objective To research the application of the wireless digital transmission mobile electrocardiogram monitoring in pre-hospital first-aid.

　　Methods Wireless digital transmission mobile electrocardiogram was used to monitor 200 patients in prehospital first-aid.The ECG of each patient was transmtted to the hospital at the same time.ECG heart rate,QRS wave,T wave,P-R segment,and Q-T segment,blood pressure,SpO2,respiratory rate,general time and pre-transmitting time were measured in the first-aid of prehospital and inhospital.All patients were divided into 6 groups according to ambulance dispatching time,and into 2 groups according to transmitting places.The successful rates of first transmission were compared.

　　Results? Some difference but not significant was noted in a few ECG factors and respiratory rate between scene examinations and transmissions on the spots(P＞0.05).No significant difference was found in blood pressure and SpO2 between the two,but there was significant difference in general time and pre-transmission time(P＜0.01).The successful rate of transmission at 0:00-4:00 and 12:00-16:00 was 100%,there was not significant difference between 6 groups(P＞0.05).The difference in successful rate of transmission was not significant between on-the-spot and on-the-way.

　　Conclusion This system is suitable for pre-hospital first-aid.Application of wireless digital transmission mobile electrocardiogram monitoring system can enhance the effect and the quality of pre-hospital first aid,shorten therapeutic time and make possible the seamless junction between hospital and pre-hospital.

　　【Key word】 Wireless digital transmission and mobile electrocardiogram monitoring;Emergency medicalservices;Join between hospital and pre-hospital 

Analysis of Misdiagnosis of Intranasal Contact Point Headaches LOU Zheng-cai,LOU Fang-yi.
Department of Otorhinolaryngology,Yiwu Central Hospital,Yiwu 322000,China

　　【Abstract】 Objective To analyze the cause of misdiagnosis of intranasal contact point headaches,and to improve the diagnostic level and therapentic effect of it.

　　Methods Aretrospective review was performed on 51 cases that met the criteria of having contact points between the septum and the lateral nasal wall,as demonstrated by CT scans of the sinuses and endoscopic examinations.These patients underwent surgical intervention in order to correct the contact points.They were re-evaluatedfor clinical parameters 8～12 months after the surgical correction of their anatomic abnormalities.

　　Results 51 cases were misdiagnosed above three times,33 sides were due to the hypertrophy of ethmoidal bulla,39 sides were due to the hypertrophy and ingression of processus uncinatus,81 sides were due to abnormal,32 sides were due to upper nasal septal deviation.After follow-up periods of 8-12 mouths,39（76.47%）patients were cured,8（15.69%）were relieved to an extent,and 4（7.84%）did not benefit.The total effective rate was 92.16%.

　　Conclusion The main reason for misdiagnosis is the lack knowledge of intranasal contact point headaches.Headache without reasons complicated with nasal structure abnormal and the nasal mucosa extrusion should be consider intranasal contact point headaches.Clinically significant pain may improve after surgical correction of intranasal anatomic abnormalities by endoscope.

　　【Key word】 Nasal;Headache;Endscope

Effect of Spleen Aminopeptide on Th1/Th2 Cytokine in Children with Recurrent Respiratory Tract Infection WANG Li-ying,ZHOU Qi-gang,ZHANG Lei-lei.
Jianggan District Jiubao Community Health Center of Hangzhou City,Hangzhou 310019,China

　　【Abstract】 Objective To observe the effect of spleen aminopeptide on peripheral blood Th1/Th2 cytokine in children with recurrent respiratory tract infection（RRTI）.

　　Methods 66 RRTI children were randomized into two groups,33 in each.The control group were given conventional anti-infection and symptomatic treatment,while the treatment group given,besides it,additional freeze-dried powder spleen aminopeptide,2 mg,oral bedtime,one time each day during acute infection period,or one time every other day after acute infection,a 3-month course.The treatment efficacy and the levels of interleukin-4(IL-4) and γ-interferon (IFN-γ) in cultured supernatant peripheral blood mononuclear cells(PBMC) were detected by double antibody sandwich ELISA before and after treatment.

　　Results In the treatment group,IL-4 in supernatant PBMC decreased significantly (P＜0.01),while IFN-γ increased significantly (P＜0.01).In control group,there was no significant difference in IL-4 and IFN-γ levels in supernatant PBMC between pre- and post-treatments.

　　Conclusion Spleen aminopeptide,which can enhance cell-mediated immunity induced by Th1 in RRTI children,suppress humoral immunity induced by Th2 and modulate the balance of Th1/Th2 cytokine,is an ideal drug for RRTI children with exact clinical effectiveness and good safety.

　　【Key word】 Respiratory tract infections；Child；Interleukin-4； γ-interferon；Spleen aminopeptide

Relationship between Therapeutic Methods and Prognosis of 71 Patients with Severe Acute Pancreatitis SU Yan-ming，ZHANG Zong-ming，JIANG Yi，et al.
Departement of General Surgery，the First Affiliated Hospital of Qinghua University，Beijing 100016，China

　　【Abstract】 Objective To summarize the therapeutic schedules for severe acute pancreatitis(SAP).

　　Methods The medical records of 71 SAP patients were reviewed.Among them，45 cases were treated surgically，26 nonsurgically.

　　Results In this series，10 patients died with a mortality of 14.1%.The surgical cure rate was 63.4%(45/71) and the mortality was 15.6%(7/45).The nonsurgical cure rate was 36.6%(26/71) and the mortality was 11.5% (3/26).25 cases were given early surgery，and 4 died with a mortality of 16.0%,and 20 received postponed operation，3 died with a mortality of 15.0%.

　　Conclusion A comprehensive treatment program and a timely choice of appropriate surgical treatment according to every patients′ specific conditions is an important measure to improve clinical cure rate and reduce complications and mortality of SAP.

　　【Key word】 Pancreatitis；Treatment；Surgical procedures，operative

Therapy of Intravenous Gamma Globulin with Baspirin in Kawasaki Disease:A Clinical Study of 93 Cases CHEN Xi,XU Er-di,XIAO Yan-feng.
Department of Pediatrics,the Second Affiliated Hospital of Medical School of XI′an Jiaotong University,XI′an 710004,China

　　【Abstract】 Objective To compare the effects of different dosages of intravenous gamma globulin(IVGG) in treating Kawasaki disease（KD）.

　　Methods A retrospective review was carried out on the medical records of KD patients at our institution from February 2002 to February 2008.The patients were divided into two group.Group A were given IVGG,400 mg·kg-1·d-1,5 days,Group B given 1 000 mg·kg-1·d-1,2 days,and both given additional oral aspirin,30～50 mg·kg-1·d-1.After 2～3-week observation,ultrasound cardiogram was performed to compare the symptomatic relieves and the incidences of coronary artery lesions(CAL) between the 2 groups.

　　Results The average pyrogenetic stage was（2.6±1.6）days in Group A,and （1.2±1.4）days in Group B,the difference was significant(P＜0.05).The CAL incidence was 18.9% in Group A,and 7 1% in Group B,the difference was significant(P＜0.05).

　　Conclusion Both of the therapies can prevent KD children from CAL.However,as to alleviating symptoms,shortening defervescent time,2-day big dosage of IVGG does better than 5-day small dosage.

　　【Key word】 Mucocutaneous lymph node syndrome;Gamma-globulins；Different dosages；Coronary disease

Comparative Study on Sertraline(Made in China） and Zoloft in the Treatment of Depression JIN Ya-jun，CHEN Zhi-yu.
The Fourth Ward，Psychiatric Department，the Seventh People′s Hospital of Hangzhou City，Hangzhou 310013，China

　　【Abstract】 Objective To explore the efficacy and safety between Sertraline(made in China） and Zoloft in the treatment of depression.

　　Methods 57 patients were randomly divided into sertraline（made in China）group（n= 29）and zoloft group（n =28）for 8 weeks.The clinical efficacies were assessed with the Hamilton depressive scale（HAMD）and adverse effects with the treatment emergant symptom scale（TESS）before treatment and at the ends of the 8th week treatment.

　　Results There was no significant difference in the curative effect between two groups after 8-week(P＞0.05).Adverse effects of both groups were mild.

　　Conclusion Sertraline(made in China） has an equivalent efficacy to zoloft,but sertraline(made in China） has less prices and has good choose.

　　【Key word】 Sertraline；Deprressive disorder

Electroacupuncture Combined with Splint Fixation in the Treatment of Closed Tibial Fractures WU Fang.
Xindeng TCM Bone Injury Hospital of Fuyang，Fuyang 311404，China

　　【Abstract】 Objective To observe the effect of electroacupuncture combined with splint fixation for closed tibial fractures.

　　Methods The clinical datas of 41 patients suffering from closed tibial fracture in our division were collected.Treatment group(n=21) were given splintage in line with electroacupuncture therapy following diaplasis,and control group(n=20) given diaplasis and traditional Chinese medicine.

　　Results After 10-month observation,in treatment group,19 cases were completely healed,with a mean healing time (82±11) days,and 2 delayed union but completely healed after another 2～3-month treatment.While in control group,11 was completely healed，with a mean healing time of (101±10) days.There was significant difference in clinical effect and healing time between two groups（P＜0.05）.

　　Conclusion Electroacupuncture combined with splintage has a satisfactory effect on closed tibial fractures.

　　【Key word】 Tibial fractures;Electroacupuncture;Splints

Clavicular Fixation Belts in Prevention and Cure of Axillary Subcutaneous Effusion Following Radical Mastectomy ZHOU Lan-lan.
Tumor Hospital of Haining，Jiaxing 314400，China

　　【Abstract】 Objective To explore the the clinical effect of clavicular fixation belts in prevention and cure of axillary subcutaneous effusion after radical mastectomy.

　　Methods We chose 41 patients as observation group,who underwent breast cancer operations from July 2007 to July 2008,and chose retrospectively another 45 cases as control group who underwent operations from June 2006 to June 2007.Observation group were treated with pressure dressing with clavicular fixation belts,while control group with conventional gauze bandage and cotton padding with adduction site in the upper extremity of affected side.Axillary incision healing and wound pain were compared between two groups.Results There was significant difference in axillary incision healing(P＜0.05),but there was no in incision pain(P＞0.05) between two groups.Conclusion Clavicular fixation belts after radical mastectomy,which can improve incision healing and prevent axillary subcutaneous effusion,is easily accepted by patients and is worthy of generalizing.

　　【Key word】 Braest neoplasms；External fixators；Infraskin-flap hydrops

Clinical Study on the Hapoglycemic Side Jiawei in the Treatment of Diabetic Nephropathy YU Hong.
Liuyang Hospital of Traditional Chinese Medicine，Liuyang 410300，China

　　【Abstract】 Objective To observe the therapertic effect of the hapoglycemic side Jiawei on diabetic nephropathy(DN).

　　Methods The treatment group(34 cases of DN) was treated with routine treatment plus the hapoglycemic side jiawei,and the control group(32 cases of DN) was treated with routine treatment of western medicine.

　　Results The total effective rate of 81.54% in the treatment group was significantly higher than 59.38% in the conteol group.After treatment,urine albumin excretion rate and 24-hour urinary protein significantly decreased(P＜0.05),low-density lipoprotein-cholesterol significantly decreased(P＜0.05).

　　Conclusion The hapoglycemic side jiawei has functions of regulating lipid metabolism,reducing urinary protein,improving renal function and main clinical symptoms,delaying hypofunction of renal function,in treatment of DN.

　　【Key word】 Diabetic nephropathies;TCM therapy;Hapoglycemic side jiawei

The Pathogenesis and Related Factors of Primary Bile Reflux Gastritis GUO Wei-qiang,YAO Ping.
Department of Gastroenterology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China

　　【Abstract】 Whether primary bile reflux gastritis have their special pathological changes has always been the focus of the peoples concern;the coordinated movements disorders of the stomach-pylori-duodenum is related to this disease,but its exact mechanism remains unclear;there is more controversial about the relationship between the helicobacter pylori infection and duodenogastric reflux.This review will refer to the research advancement about the pathogenesis and related factors of primary bile reflux gastritis.

　　【Key word】 Bile reflux;Gastritis；Duodenogastric reflux；Etiology

Progress in Experiments and Clinical Research of Ozone by Percutaneous Puncture in Dorsal Disc Prolapse? TAN Hua-bing,WU Xi.
People′s Hospital of Yunyang Medical College,Shiyan 442000,China

　　【Abstract】? Ozone can reduce nucleus pulposus osmotic pressure and inflammatory reaction and relieve pains by oxidating proteoglycans,thus to achieve the goal of treating dorsal disc prolapse.Ozone therapy is found more safe and effective in treatment of dorsal disc prolapse when comparing it with percutaneous diskectomy,nerve root injection of steroids and so on.Ozone injection with collagenase or with ion radio frequency can improve therapeutic effect.It is the key of improving treatment to assess correctly the status of slipped disc and spinal stenosis and to control its indications and contraindications.

　　【Key word】 Intervertebral disk displacement；Ozone；Punctures

Recent Progress in Research of Ischemic Biliary Tract Lesions Following Liver Transplantation? LI Qian-guo,REN Rui,DU Cheng-you.
Department of Hepatobiliary Surgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China

　　【Abstract】 Biliary tract complications after liver transplantation impact the long-term survival of implanted liver grafts.Ischemic biliary lesions of liver grafts become increasingly the main type of biliary tract complications,and affect severely 5-year survival rate of patients having received liver transplantation.This paper reviews relevant reports on ischemic biliary lesions after liver transplantation to improve awareness of this disease.

　　【Key word】 Liver transplantation;Postoperative complications;Bile duct diseases;Graft survival

Effect of Community-based Rehabilitation Upon Motor Functions and Activities of Daily Living of Cerebral Apoplexy Patients ZHANG Jin-sheng,HUANG Yong-xi,LI He-xing,et al.
Medical Service Central of Desheng Community,Beijing 100011,China

　　【Abstract】 Objective To observe and analyze the effects of community-based rehabilitation on motor function and activities of daily living(ADL) in cerebral apoplexy patients.

　　Methods? 46 cases of cerebral apoplexy patients were enrolled according to relevant standards,who were given standard rehabilitation care in Desheng Community Health Service Center(treatment group),while another 37 similar cases from subordinate health service stations(control group) given only rehabilitation guidance once a week.Fugl-Meyer assessment(FMA) and Bathel index rating scale were used to observe the therapeutic effects of both groups.

　　Results? The motor function of treatment group was improved more significantly after treatment than before,and more than that of control group（P＜0.05）.

　　Conclusion The professional community-based rehabilitation for cerebral apoplexy patients is an indispensable means.

　　【Key word】 Cerebrovascular accident；Hemiplegia；Community health services；Rehabilitation nursing

Diet Therapy for 258 Pregnant Patients with Impaired Glucose Tolerance LU Su-fei.
Department of Nutrition,Jinhua Hospital of Traditional Chinese Medicine,Jinhua 321017,China

　　【Abstract】 Objective To observe the effect of diet therapy on impaired glucose tolerance(IGT).Methods Two hundred fifty-eight abnormal pregnant women were given diet guide and health education.Results Blood glucose was controlled in normal range in 243 cases,the effective rate was 94.2%.Conclusion Diet guide can effectively control blood glucose level of IGT pregnant patients.

　　【Key word】 Diabetes,gastational;Nutrition policy;Health education

Number7April，2009

Necessity and Feasibility of Promoting Combination of Individual Account Utilization with Community Health Service by Setting up Pooling Funds of Outpatient Service ZHANG Kai-jin,WANG Min,JIANG Li,et al.
Department of Medical Insurance in School of Public Health,Southeast University,Nanjing 210009,China

　　【Abstract】 In order to improve efficiency of the medical insurance fund for urban workers and expand the utilization of individual account,in this paper we first review the relative literatures.Then,through investigation and comparative analysis of the medical insurance for urban workers in some parts of Jiangsu province,we explore the necessity and feasibility of setting up a model of pooling funds of outpatient service that corresponds to community health service n the basis of the empirical operation of domestic individual account.

　　【Key word】 Pooling funds of outpatient service;Individual account;Community health services

Improving the Efficiency of Individual Account Utilization and Promoting the Combination of Individual Account with Community Health Services JIANG Li,ZHANG Kai-jin,WANG Min,et al.
Department of Medical Insurance in School of Public Health,Southeast University,Nanjing 210009,China

　　【Abstract】 In order to improve the efficiency of the use of individual account,reduce health insurance costs,and promote the sustainable development of medical insurance system,on the basis of empirical research of the raising managing,using of individual account,and the medical expenditure of outpatient services in the primary medical institutions in some cities of Jiangsu Province,in this paper we discuss some problems in practical utilization of individual account in China.In order to promote the rational allocation of medical resources,speed up the development of community health service institutions,reduce the risk of medical insurance funds,we also put forth combination of the individual account with community health service establishment of community outpatient pooling funds.

　　【Key word】 Medical insurance；Individual account；Community health services

Establishment and Consideration of Pooling Funds of Outpatient Service WANG Min,ZHANG Kai-jin,JIANG Li,et al.
Department of Medical Insurance in School of Public Health,Southeast University,Nanjing 210009,China

　　【Abstract】 In order to explore the issues existing in the development and construction of pooling funds of outpatient service model,in this pare,we bring forward a model using individual account to build the combining pooling funds of outpatient service with community health service on the basis of the literature research and empirical analysis of medical insurance of some cities in Jiangsu province.We discuss it from five points of capital source,coverage,treatment and expense sharing mechanism,the method of payment and fund management.By using SWOT analysis,we make a comprehensive analysis on the superiority,inferiority,opportunity and threat of the internal and external environment of the pooling funds of outpatient service,and prove the feasibility of the model in actual operation.We also put forth some problems needing attention in the process of building the pooling funds of outpatient service: how to control and manage the risk of the unified planning fund of outpatient service,how to combine the pooling funds of outpatient service with community health service efficiently,and the supporting policies,system and technique.

　　【Key word】 Pooling funds of outpatient service;Model;SWOT analysis;Individual account;Community health services

Clinical Significance of Serum MMP-9 Level in Acute Aortic Dissection Presenting with Abdominal Pain WEN Tie,XIONG Guang-zhong,LIU Ling.
Department of Emergency Surgery,the Second Xiangya Hospital,Central South University,Changsha 410011,China

　　【Abstract】 Objective To investigate the clinical significance of matrix metalloproteinases-9 (MMP-9) for differentiation of acute aortic dissection (AAD) with abdominal pain in emergency.

　　Methods? Healthy subjects (control group),AAD patients with abdominal pain (AAD group),patients with acute pancreatitis (pancreatitis group) and patients with other acute abdominal diseases (acute abdomen group),with 20 in each group were enrooled.Serum levels of MMP-9,lipoprotein(a) ［LP(a)］ and high-sensitivity C-reactive protein (hs-CRP) were assayed by enzyme-linked immunosorbent assay and immunoturbidimetric assay respectively,and the results were compared.

　　Results The level of serum MMP-9 was （1 352±415）μg/L in AAD group,which was higher than（127±87）μg/L in control group,（768±239）μg/L in pancreatitis group,and （244±90）μg/L in acute abdomen group （P＜0.01）.The level of hs-CRP was 1.7（3.6）mg/L in control group,which was lower than 22.5（33.3）mg/L in AAD group,20.9（26.1）mg/L in pancreatitis group,and 21.3（29.7）mg/L in acute abdomen group （P＜0.01）;while among AAD,pancreatitis and acute abdomen groups there was no significant difference in hs-CRP level （P＞0.05）.The level of LP(a) was （50±23）mg/L in control group,which was lower than （395±49） mg/L in AAD group,（383±68）mg/L in pancreatitis group,and （360±46） mg/L in acute abdomen group （P＜0.01）;while among AAD,pancreatitis and acute abdomen groups there was no significant difference in LP(a) level （P＞0.05）.Conclusion AAD patients with abdominal pain had significantly higher serum MMP-9 level than patients with pancreatitis and other acute abdominal diseases.

　　【Key word】 Matrix metalloproteinase-9;Lipoprotein（a）;High-sensitivity C-reactive protein;Aortic dissection;Abdomen,acute

Impact of Non-Standardized Dosage of Aspirin on High Risk Patients with Cardiocerebrovascular Diseases? LIU Jun-hui,LIU Wen-xian,CHEN Li-ying,et al.
Beijing Anzhen Hospital,Capital University of Medical Sciences,Beijing 100029,China

　　【Abstract】 Objective To investigate the impact of non-standardized dosage of aspirin on high risk patients with cardiocerebrovascular diseases.

　　Methods? Totally 456 outpatients,who regularly receive asprin 40-150 mg/d,from Beijing Anzhen Hospital and community health service centers from June to December of 2007 were enrolled.Of which 275 patients who received asprin ≥75 mg/d were taken as standard group and 181 patients who received asprin ＜75 mg/d were taken as non-standard group.The platelet aggregation rate and its influential factors were analyzed.

　　Results? The platelet aggregation rates induced by arachidonic acid (AA) and adenosine diphosphate (ADP) were （11±3）%,（70±11）% respectively in standard group;and （22±6）%,（73±9）% respectively in nonstandard group （P＜0.01）.The abnormal rates of platelet aggregation induced by AA and AD were 12.73%,52.00% respectively in standard group;and 25.41%,64.64% respectively in nonstandard group （P＜0.01）.Logistic regression analysis showed that,for abnormal platelet aggregation,female,overweight and smoking were independent risk factors in non-standard group,and smoking was independent risk factor in standard group.

　　Conclusion The high risk patients with cardiocerebrovascular diseases should taken aspirin of standardized dosage to inhibit platelet aggregation properly,and thus to reduce death induced by cardiocerebrovascular accidents.

　　【Key word】 Aspirin;Cardiovascular and cerebrovascular diseases;Dose-response relationship,drug

Expression of Hypoxia Induced Factor 1α in Lung Cancer Tissue and Its Relation with Drug Resistance ZHAO Xiang.
Department of Thoracic Surgery,Liaoning Provincial Tumor Hospital,Shenyang 110000,China
【Abstract】 Objective To investigate the expressions of hypoxia induced factor 1α (HIF-1α),multidrug resistance related protein1(MRP1) and glutathione S-transferase pi (GST-π) in lung cancer tissue,and the correlation among them.

　　Methods The expressions of HIF-1α,MRP1 and GST-π were tested by immunohistochemical method in lung cancer specimens of 53 patients.The relationships of their positive expressions to invasion degree and lymphatic metastasis of lung cancer were analyzed.

　　Results? In specimens of 53 lung cancer patients there were 44（83.0％）with HIF-1α positive expression and 28 （52.8％） with GST-π positive expression,with a positive correlation between the two (P＜0.05);but there was no correlation between HIF-1α expression and MRP1 expression for which there were 31 (58.5％) with positive expression (P＞0.05).The expression rates of HIF-1α,MRP1 and GST-π in lung tissues of T3 and T4 groups (60.0％,80.0％ and 73.3％ respectively) were significantly higher than those (26.3％,44.7.％ and 42.1％ respectively) of T1 and T2 groups (P＜0.05).The expression rates of HIF-1α,MRP1 and GST-π(84.0％,72.0％ and 68.0％ respectively) in lung tissues of the patients with lymphatic metastasis were significantly higher than those (25.0％,42.9.％ and 39.3％ respectively) of the patients with no lymphatic metastasis (P＜0.05).

　　Conclusion HIF-1α may up-regulate the expression of GST-π.High-level expressions of HIF-1α,MRP1 and GST-π are associated with invasion degree and lymphatic metastasis of lung cancer.

　　【Key word】? Lung neoplasms；Hypoxia induced factor 1α；Multidrug resistance associated proteins；Glutathione transferase

Relevant Factors for No Reflow after Coronary Reperfusion in Patients with Acute Myocardial Infarction? SUN Jing,SHEN Hong.
Department of Emergency,Chinese PLA General Hospital,Beijing 100853,China

　　【Abstract】 Objective To investigate the no reflow phenomenon after coronary reperfusion in patients with acute myocardial infarction (AMI),and to analyze its relevant factors according to clinical and laboratory indexes.

　　Methods? The clinical data of 60 patients with AMI who underwent reperfusion therapies in emergency department of our hospital were investigated,and no reflow phenomenon in the patients with AMI was analyzed by using multiple logistic regression.

　　Results? Reperfusion was successful in 39 patients (reflow group),and no reflow occurred in 21 patients (no reflow group).The time from attack to visit was （10.9±2.1） h and the time from visit to performance of reperfusion was （21.8±1.6） h for the patients in reflow group;while the time from attack to visit was （8.0±2.1）h and the time from visit to performance of reperfusion was（34.4±2.5） h for the patients in the no reflow group（t =1.104 and t = 1.621 respectively,bothP＜0.05）.After pharmacotherapy for no reflow,there were 10 patients (16.7%) with thrombolysis in myocardial infarction (TIMI) flow≤grade 2 and 6 patients (10.0%) with complications.The related factors for no reflow phenomenon were age,hyperlipemia,diabetes mellitus,and triglyceride (P＜0.05).

　　Conclusion? The risk factors for no reflow phenomenon and complications after coronary reperfusion in patients with AMI are age,hyperlipemia,diabetes mellitus and triglyceride.

　　【Key word】 Myocardial infarction；Myocardial reperfusion；No reflow

Operative Therapy Versus Conservative Treatment for Intra-Articular Calcaneal Fracture: A systematic analysis　YANG Mao-wei，CHU Li-wei，WANG Xu-dong,et al.
Department of Orthopaedics,The First Affiliated Hospital of China Medical University，Shenyang 110001，China

　　【Abstract】 Objective To compare the therapeutic efficacy of open reduction and internal fixation and conservative treatment for displaced intra-articular calcaneal fractures.

　　Methods All randomized controlled trials (RCT) of operative versus conservative treatment for displaced intra-articular calcaneal fractures were collected.According to Cochrane cooperation network standard,the quality appraisal of the studies and meta-analysis of the results were conducted.

　　Results Totally 7 published trials involving 650 patients were included.The result showed that the open reduction and internal fixation was superior to conservative treatment in terms of helping patients back to work and improving the recovery of Bohler′s angle.As for Subtalar joint ROM，two article didnot gave the standardized deviate,So meta-analysis did not do in these study.As for foot pain,there was no significant difference between the two methods 〔RR=0.92,95％ CI （0.76,1.14）〕.On account of the outcome measures varied in the trials,the meta-analysis could not be performed.

　　Conclusion? The open reduction and internal fixation was superior to conservative treatment in terms of helping patients back to work and improving the recovery of Bohler′s angle for displaced intra-articular calcaneal fractures. 

　　【Key word】 Calcaneus；Fracture；Surgical procedures operative；Randomized controlled trials;Meta-analysis

Demonstration Implementation of Dual Referral between General Hospital and the Community Health Service Centers under New Regional Community Mode? ZHANG Yue-hong，LIU Li-hong，LIU Fan，et al.
Desheng Community Health Service Center，Beijing 100011，China

　　【Abstract】 Objective To explore the establishment of dual referral system between community health service centers and general hospital under new regional community mode of medical health service so as to improve the time effectiveness of dual referral and satisfaction of patients.

　　Methods? The people′s hospital of Beijing University and a general hospital of grade 3,and two community health service centers were chosen as pilot to establish dual referral system between community health service centers and general hospital under new regional community mode of medical health service.

　　Results? The effective rate of upward referral was 95.89%,and the effective rate of downward referral was 100.00%.The consultation rate through long-distance video was 100.00%,the passed rate of performance evaluation was 94.34%,and the rate of community doctors receiving long-distance video training on continuing education was 100.00%.

　　Conclusion? Demonstration implementation of dual referral between general hospital and the community health service centers under new regional community mode of medical health service provides a supporting evidence that is standardized and with strong feasibility for further improvement of the dual referral.

　　【Key word】 Regional medical health services；General hospital；Community health services；Two-way referral

Current Situation of Community Public Health Service in Sichuan Province　LI Yu-qiang，YANG Yi，JING Lin，et al.
Sichuan Provincial Bureau of Health，Chengdu 610041，China

　　【Abstract】 Objective? To know the conditions of community public health service in 2006 in Sichuan province so as to analyze the problems and find out their corresponding solutions.

　　Methods A total of 12 community health centers from 6 cities were chosen to conduct questionnaire survey and focus group discussion on developing conditions and some problems that needed urgently to be resolved.

　　Results More that half of the service centers provided 37 items of all the 44 items of the community public health services.The existing problems were that the policies had not been implemented fully,part of the public health functions had not carried out completely,specific health care providers had difficulties,and quality of the community public health service needed to be improved.

　　Conclusion Efforts should be made to set up the basis of systematic construction of community health centers and carry out all the policies,to increase the service items of community health centers and provide overall service,to definite the individual professional identity and fulfill the duties.

　　【Key word】 Community health services；Public health service；Current situation

Assessment on Reliability and Validity of Primary Care Assessment Tool_Provider Survey（Short Version） DU Juan,WANG Hui-li,LU Xiao-qin,et al.
School of Public Health and Family Medicine，Capital Medical University，Beijing 100069，China

　　【Abstract】 Objective To analyze the reliability and validity of Primary Care Assessment Tool_Provider Survey（Short Version）(PCAT_PS).

　　Methods Totally 202 general practitioners who were trained in Beijing Municipal Training Center of General Practice from 2002 to 2008 were surveyed in order to assess the reliability and validity of PCAT_PS with consistency reliability and construction validity.

　　Results? The Cronbach′α coefficients of all factors of PCAT_PS were over 0.6 with an exception of cultural competence.Factor analysis of construction validity of PCAT_PS showed that factor loadings were significantly greater (P＜0.05) except COIS1 (P＞0.05).Goodness of fit index (GFI) and comparative fit index(CFI) were lower than 0.9,which is possibly because of irrationality of some item setup.

　　Conclusion? Some items of PCAT_PS are not completely suitable for Chinese situation because of difference in culture background and economy level,therefore they need to be continuously revised.

　　【Key word】 Primary care；Reliability；Validity；Confirmatory factor analysis

Difficulties and Suggestions on Buying Public Service by the Government for Community Health Services　ZHANG Cheng-mian,SUN Yong-fa,WU Hua-zhang.
Chinese Medical University,Shenyang 100011,China

　　【Abstract】 By introducing the foreign reformation experience of buying health care service by the government and combining the real conditions of it in China,in this paper we analyze the existing problems on buying the service for community public health service by the government and put forth the strategy and suggestions,in order to provide some reference for implementation of this reform in China.

　　【Key word】 Public health services;Purchase,medical practice;Community health services

Establishment of Electronic Medical Record Quality Control System in Community Health Care and Its Applying Efficiency? SHEN Qiang,CAO Gui-li,DAI Gui-zhi,et al.
Dongcheng District Administration for Community Health Care Service,Beijng 100010,China
【Abstract】 Objective? To explore a quality control system of electronic medical record (EMR) suitable for community health service (CHS),and to examine its effect in improving and standardizing EMR through practical application.

　　Methods? An EMR quality control system was set up based on the existing CHS net system,by which general practitioner management in CHS institutions of Dongcheng District of Beijing were conducted.The changes of EMR quality from the second half year of 2006 to the first half year of 2008 were compared.

　　Results? The qualified rate of the EMR went up from 25.55% to 32.48% (χ2=10.677,P=0.001),and passed rate of the EMR went up from 86.19% to 96.62% (χ2=50.050,P=0.000).

　　Conclusion? The application of EMR quality control system can improve CHS quality and standardize CHS behavior of diagnosis and treatment.

　　【Key word】 Community health services;Electronic medical records;Quality control

Empirical Study on Influencing Factors of Satisfaction in New Cooperative Medical Scheme? WANG Hong-man，CHEN Jiang，FU Qiang，et al.
Center for Global Health and Social Development Peking University Health Science Center，Beijing 100191，China

　　【Abstract】 Objective? To analyze the major influencing factors of satisfaction degree in new cooperative medical scheme (NCMS).

　　Methods? Logistic regression analysis and other statistical methods were taken for analysis of social economy conditions of farmers in Beijing rural area in 2007.

　　Results? More that 90% of the farmers had a desire to join NCMS.The farmers′ satisfaction degree to NCMS was correlated with the satisfaction of the government propaganda,family income,knowing degree of reimbursement,transparency of the policy and way to pay the fee (P＜0.05).

　　Conclusion The influencing factors of farmers′ satisfaction to NCMS are their satisfaction degree to government propaganda,family income,knowing degree of reimbursement,transparency of the policy and way to pay the fee.The propaganda on NCMS should be enhanced and the guaranteeing plane of completion and optimization should be open,thus to meet demands of medical service in different levels.

　　【Key word】 NCMS；Satisfaction degree；Influence factors

Life Quality in Patients with Somatization Disorder Its Relative Factors? DONG Li-ping,HU Bo,SUN Sheng-gang.
Department of Neurology,Union Hospital,Wuhan 430030，China

　　【Abstract】 Objective To evaluate the quality of life of the patients with somatization disorder (SD) and analyze its relative factors.

　　Methods Cross-sectional survey of 90 SD patients was conducted by using self-edited investigating scale for general information,screening for somatoform symptoms-7 for somatic symptoms,self-rating depression scale (SDS) and self-rating anxiety scale (SAS) for emotional condition,and short-form-36 healthy survey (SF-36) physical component summary,(PCS) and mental component summary (MCS) for quality of life.The results were compared with those of 1 688 normal citizens in Hangzhou (controls).

　　Results? The scores of SD patients in SF-36,or in 8 dimensions of physiological function （76±14）,physiological role （10±17）,body pain （45±16）,total health （22±12）,vigor （37±13）,social function （57±19）,emotional role （20±29） and mental health （48±14）;and the scores of（42±12） in PCS and （33±21） in MCS were significant different from the corresponding scores of (82±20）,（81±34）,（82±20）,（57±20）,（52±21）,（83±18）,（84±32）,（60±23）,（50±10）,（50±10）（t=-3.58,-31.80,-17.95,-22.06,-8.82,-10.71,-17.25,-6.62,-5.27 and -6.51,P<0.01）.Single factor analysis demonstrated that there were significant differences in MCS among the SD patients with different genders,educational levels,average family incomes per month,numbers of somatic symptom and degrees of depression and anxiety (P＜0.05).Multiple linear stepwise regression showed that PCS was negatively related with numbers of somatic symptom,so was MCS with numbers of somatic symptom and anxiety.

　　Conclusion The quality of life of SD patients is significantly lower than that of normal population.The number of somatic symptom,depression and anxiety are closely related with quality of life of SD patients.

　　【Key word】 Somatoform disorders；Depression；Anxiety；Quality of life

Correlative Factors for Hypertension in College Candidates WANG Su-yan,A Zi-ya,CUI Guang-shu,et al.
Zhongguancun Hospital,Beijing 100190,China

　　【Abstract】 Objective To analyze the correlative factors involved in hypertension of the students who participate in college entrance examination.

　　Methods Totally 163 students with hypertension due to participating in college entrance examination and 165 students with normal blood pressure as controls were surveyed by using questionnaire.

　　Results In the group of hypertension the ratio of male over female was 152/11,the percentages of ones who had previous history of hypertension,who had previous history of trauma;who studied for more than 2 h per time,who had accompanying headache and lassitude,who had accompanying sour neck and shoulders,who were overweight or obesity,and who exercised less than 4 times each week were 33.1%,13.5%,48.5%,24.5%,13.5%,81.0%,and 58.3% respectively,which were significantly different from those in the control group,or 125/40,1.2%,22.4%,35.2%,35.8%,26.7%,33.3% and 69.1% respectively (P＜0.05).Male and traumatic history were positively correlated with hypertension,but the history of previous hypertension,exercise time each week and body mass index were negatively correlated with hypertension (P＜0.05).

　　Conclusion The hypertension in students who take college entrance examination are of correlativity to gender,traumatic history,history of previous hypertension,exercise time and body mass index.

　　【Key word】 Hypertension；Student；Risk factors；Questionnaire

Investigation of Critical Thinking Disposition among Community Nurses? MA Xin-cui，JIN Rui-hua，WANG Cui-ling.
Nursing Department，Shanxi Medical University，Taiyuan 030001，China 

　　【Abstract】 Objective To know the present status of critical thinking disposition among community nurses so as to provide reference to establishment of definite goal of critical thinking desposition for community nursing speciality,and training of community nurses as well.

　　Methods? Stratified randomized sampling was taken in enrolling 322 community nurses from 51 community health service institutions of six urban districts in Taiyuan city.Questionnaire was used to investigate their critical thinking disposition and general data.

　　Results? The average score of Critical Thinking Disposition-Chinee Version (CTDI-CV) for all the 322 community nurses was (276.32±26.84),among them 145 nurses had positive trait,6 had negative trait,and 171 were of no definite disposition.The scores of truth-seeking,open-mindedness and systematizing ability,and the total score in nurses with secondary education background were （35.21±6.71）,(37.30±5.33),(38.70±5.44),(270.03±26.88) respectively,while those in nurses with junior college education background were (38.02±5.71),(39.00±5.20),(40.61±5.89),(279.47±26.41)respectively,there were significant differences （P＜0.05）.The scores of systematizing ability and inquisitiveness in nurses with different levels of professional title ［(38.86±5.57),(39.96±6.60) vs (40.49±5.56),(41.68±6.37) vs (40.56±5.84),(42.74±6.38) vs (44.80±6.26),(38.20±7.19)］ showed significant differences（P＜0.05）.

　　Conclusion The total scores of critical thinking disposition of community nurses are lower than positive standard score.The community nurses′ critical thinking disposition need to be instructed enhanced purposely.A definite critical thinking objective should be made in community nursing specialty and nurses′training.

　　【Key word】 Critical thinking；Community nurse;Taiyuan city

Situation of Application and Related Knowledge Mastery of Insulin Pen in Diabetic Patiens before Discharge in Different Grade Hospitals? ZHOU Qiu-hong,LI Ying-lan,LI Qiang-xiang.
Endocrine Department,Xiangya Hospital Affliated to Central South University,Changsha 410008,China

　　【Abstract】 Objective To understand the situation of application of insulin pen and mastery condition of its related knowledge by patients with diabetes mellitus (DM) before discharge in hospitals of three levels of province,city and county.

　　Methods? Totally 146 patients with DM,who come from three hospitals of province,city and county in Hunan and need continuous insulin injection after discharge,were investigated by using self-made survey questionnaire on "application of insulin pen and its related knowledge".

　　Results? Generally the patients in provincial hospital were better than those in municipal and county hospitals in all respects such as in examining the property and time of efficiency of the medicine before injection,exsufflation and alcohol desiccation followed by injection,depth of injection based on the fatty thickness,alternative sites of injection,no depression on the injection site by cotton ball after withdrawal of needle,disposable needle,efficacy time and side-effects of the insulin,presentation of hypoglycemia and its self aid measures,correct storage and carrying of the pen (P＜0.05). Conclusion? The situation of application of insulin pen and mastery condition of its related knowledge by patients with DM before discharge are not satisfactory.Nurses in the municipal and county hospitals should enhance the health education of the DM patients who need insulin pen so that the patients can control their blood sugar better and improve their life quality.

　　【Key word】 Diabetes mellitus;Insulin therapy;Insulin pen;Health education

Comprehensive Therapy for Ⅲ and Ⅳ Stage Decubital Ulcers in Old Patients with Diabetes Mellitus? CHEN Su-wen,LU Xiao-wei,HUANG Xiu-ling,et al.
The Seventh People′s Hospital of Shenzhen，Shenzhen 518081,China

　　【Abstract】 Objective? To investigate the clinical effects of comprehensive therapy for decubital ulcers at Ⅲ and Ⅳ stage in old patients with diabetes mellitus.

　　Methods? The methods of treatment and care were debriding necrosis tissue and pus;medicine application;lamp radiation;povidone iodine solution dressing;administration of insulin,antibiotics,hydrogen dioxide solution and 0.5% povidone iodine solution;basic nursing and nutritional supports.

　　Results? There were 30 patients with 45 decubital ulcers.The effects evaluated 4 weeks after treatment were cured for 18 ulcers,remarkable effect for 15 ulcers,and improved for 12 ulcers,with no case of non-response.The effects evaluated 6 weeks after treatment were cured for 39 ulcers and remarkable effect for 6 ulcers,with remarkably effective rate of 100% and curative rate of 86%.The effects evaluated 8 weeks after treatment were with curative rate of 100%.

　　Conclusion? The comprehensive therapy is of remarkable effect for decubital ulcers at Ⅲ and Ⅳ stage of old patients with diabetes mellitus;it could improve the environment of ulcers,inhibit the growth of pathogens,and promote the formation of granulous tissue,with features of less pain and strong feasibility of operation,so that it is worth to popularize.

　　【Key word】 Aged；Decubitus ulcer；Diabetes mellitus

Assay of Serum Uric Acid in Parkinson′s Disease Patients and Its Clinical Significance? GONG Shou-hui，CHEN Quan-feng，ZHU Gui-zhong，et al.
Department of Neurology，The First People′s Hospital of Xiangfan City，Xiangfan 441000，China

　　【Abstract】 Objective To investigate the changes of serum uric acid content in patients with Parkinson′s disease.

　　Methods Totally 93 patients with Parkinson′s disease receiving medical service in the First People′s Hospital of Xiangfan City from Junuary 2007 to March 2008 were chosen as trial group,and 91 healthy persons whose age,sex and nationality matched the patients were erolled as the controls.The serum uric acid contents in the two groups were examined and compared.

　　Results The serum uric acid was （270±75） μmol/L in the trial group and（342±62） μmol/L in the controls（t=7.09,P＜0.01）.There were 43 cases in the trial group and 14 cases in the control group who had a low level of serum uric acid （χ2=20.48,P＜0.01）.

　　Conclusion The level of serum uric acid is lower in patients with Parkinson′s disease than in normal person.The uric acid as an important antioxidant in nervous system may be of a certain significance in occurrence and development of Parkinson′s disease.

　　【Key word】 Parkinson disease；Uric acid；Reactive oxygen species

Diagnosis and Treatment of Liver Metastasis in Colorectal Carcinoma: A clinic report of 31 cases? FAN Bo,FAN Yan-xia,BIAN Yong-sheng,et al.
Department of General Surgery,The First Hospital of Baoding,Baoding 071000,China

　　【Abstract】 Objective To evaluate the effect of operation and prognostic factors of liver metastasis of colorectal carcinoma.

　　Methods? The data of 31 colorectal carcinoma patients complicated by liver metastasis who received operation were retrospectively analyzed.

　　Results No patient died from operation.Ten patients had simultaneous liver metastasis and received homochronous operation on the primer and metastatic carcinomas,among them there were 1 patient complicated by disruption of wound and 1 case by subphrenic abscess,however they were cured.There 27 cases who survived for 1 year,14 cases for 3 years,and 9 case for 5 years.In all the patients,the 5-year survival rate was 8/18 in 18 patients with single liver metastatis,and 1/13 in 13 patients with 2 or 3 metastases,with a significant difference (P＜0.05).The 5-year survival rate was zero in the 10 cases with synchronous liver metastasis,and 9/21 in 21 cases with metachronous liver metastasis,the difference was significant (P＜0.05).

　　Conclusion? The effect of operation in liver metastasis of colorectal carcinoma is good.The results of single and metachronous liver metastases are better in prognosis.

　　【Key word】 Colorectal neoplasms；Neoplasm metastasis ；Liver

Exercise Rhabdomyolysis: A literature review of 84 cases? MA Li-na,FENG Ming.
Xuanwu Hospital,Capital University of Medical Science,Beijing 100053,China

　　【Abstract】 Objective To explore the characteristics of exercise rhabdomyolysis so as to raise the rate of early diagnosis and prevent the complications.

　　Methods? The reports of exercise rhabdomyolysis in domestic medical journals from 2000 to 2008 were retrieved and the data including general symptoms,clinical features,treatments and prognosis were reviewed retrospectively.

　　Results A total of 20 documents with 84 patients were found,myosalgia was often seen in patients of exercise rhabdomyolysis,and the main features were increased creatin kinase,myoglobulinuria,and mostly accompaning acute renal failure.

　　Conclusion More attentions should be paid to the prevention and the early diagnosis of exercise rhabdomyolysis in order to improve the prognosis.

　　【Key word】 Rhabdomyolysis；Exercise

Expression of COX-2 in Cystitis Glandularis and Its Implication to Relapse? JIANG Peng,LIU Ben,ZHENG Xiang-yi,et al.
Department of Urology,the First Affiliated Hospital of Medical School,Zhejiang University,Hangzhou 310003,China

　　【Abstract】 Objective To explore the expression of cyclooxygenase-2 (COX-2) protein and its clinical implication to relapse of disease in cystitis glandularis.

　　Methods? The immunohistochemistry- streptavdin-peroxidase (SP) method was taken to detect the expression of COX-2 protein in focal tissues of 40 cystitis glandularis patients without relapse and 25 cystitis glandularis patients with relapse,and with normal bladder mucosa tissues of 10 subjects as the controls.

　　Results? The expression of COX-2 protein in normal bladder mucosa tissues of 10 subjects was negative,the positive expression rate of 40 cystitis glandularis patients without relapse was 35.0%,and the positive expression rate of 25 cystitis glandularis patients with relapse was 64.0%,there was a significant difference among the 3 groups (P＜0.05).

　　Conclusion? The COX-2 protein expression is higher in cystitis glandularis tissue than in normal tissue,and COX-2 protein expression rate and intensity were significantly higher in cases with relapse,which indicates that the clinical detection of COX-2 is of a guiding significance to judge the prognosis of patients with cystitis glandularis.

　　【Key word】 Cystitis；Recurrence；Epoxy compounds

Effect of Daflon on Pelvic Vein Congestion Syndrome? WU Wen-ying,ZHANG Rui-min,XU Chun-lin.
Department of Obstetrics and Gynecology,the People′s Hospital of Fengrun District,Tangshan 064000,China

　　【Abstract】 Objective To investigate the therapeutic effect of Daflon on pelvic vein congestion syndrome (PVS).

　　Methods? Totally 32 PVS patients were randomly divided as trial group (n=18) control group (n=14).Patients in the triall group were administered with Daflon,whole those in the control group were administered with composite Salvia Miltiorrhiza injection plus penicillin sodium intravenously,The effects and untoward reaction between the two groups were compared.

　　Results? There were in the trial group 10 case with remarkable effect,5 cases with effect,and 3 cases with no response;while there were in the control group 1 case with remarkable effect,5 cases with effect,and 8 cases with no response.There was a significant difference between the two groups (P＜0.01).After treatment the maximum inner diameter of pelvic vein was （3.7±1.3）mm in the trial group and （5.2±1.5）mm in the control group, with a significant difference betwenthe two groups (P＜0.05).There was no significant difference in untoward reaction between the two groups (P＞0.05).

　　Conclusion? Daflon has a bettere effect to PVS,however it needs a further long-term observation through a large clinical sample. 

　　【Key word】 Daflon;Pelvic vein congestion syndrome;Treatment outcome

Diagnosis and Treatment of Lupus Nephritis XU Xiao-yan,SANG Xiao-hong.
Xinjiang Medical University,Urumqi 830054,China

　　【Abstract】 Most of systemic lupus erythematosus involves the kidneys,and an early intervention can significantly improve the prognosis.This paper reviews the current lupus nephritis progress in diagnosis and treatment.The judgment and classification of the condition is of a greater guiding significance to treatment.The treatment includes traditional glucocorticoids,cyclophosphamide,azathioprine,and cyclosporin A;as well as some other drugs that are recently studies more and selective such as mycophenolate mofetil,leflunomide,tacrolimus.

　　【Key word】 Lupus nephritis;Systemic lupus erythematosus;Diagnosis；Therapy

Roles of Brain Natriuretic Peptide in Neuroendocrine and Myocardial Remodeling SONG Kang-xing,LU Cai-yi.
Institute of Geriatric Cardiovascular Diseases,PLA General Hospital,Beijing 100853,China

　　【Abstract】 Brain natriuretic peptide (BNP),a peptide hormone with extensive physiological effects,plays an important regulating role locally and generally.In this paper we review the roles of BNP in neuroendocrine system and its influence on myocardial remodeling.

　　【Key word】 Natriuretic peptide,brain;Renin-angiotensin system;Myocardial remodeling

Number8April，2009

Effect of Emulsified Isoflurane on Cardiomyocytes and Caspase-3 Expression in Hypoxia-reoxygenation Neonatal Rats YANG Meng-chang，CHEN Yu-pei,XU Qian，et al.
Anesthesia Department,the Second Affiliated Hospital,Chongqing Medical University,Chongqing 400010,China

　　【Abstract】 Objective To discuss whether caspase-3 expression participates in the protective effect of emulsified isoflurane (EI) on myocardial cells.

　　Methods Neonate rat in vitro cardiomyocytes were cultured primarily to establish Hypoxia-reoxygenation(H/R) models and divided into 4 groups: normal control(N group),H/R,H/R+fat emulsion (F group),H/R+0.28 mmol·L-1 EI(EI group),8 in each.Supernatant was cultured from suckling mice,to determine LDH activity and cTnI levels,and SOD activity and MDA content were detected.Inverted microscope was used to observe the changes of characteristics and morphology of myocardial cell growth.And caspase-3 expression was measured by Western blot.

　　Results? Groups H/R,F,EI were significantly different from N group in LDH,MDA and cTnI(P＜0.05).There was significant difference in SOD(P＜0.05),but there was not in LDH,MDA and cTnI(P＞0.05) between H/R group and F; significant difference was noted in LDH,MDA,cTnI and SOD between groups H/R and EI(P＜0.05).EI group differed significantly from F group in LDH,MDA,cTnI and SOD(P＜0.05).There was significant difference in caspase-3 expression between 4 groups.

　　Conclusion The protective effect of emulsified isoflurane (EI) on primarily cultivated cardiomyocytes H/R injury may be associated with its inhibiting caspase-3 expression.

　　【Key word】 Emulsified Isoflurane；Primary Culture； Myocardial Cells； Hypoxia; Reoxygenation

Effect of RHuEPO on Hippocampal Neurons Apoptosis and Expression of p-Akt in Statural Epilepticus rats? SHI Zhi-qin，LI Wei，LIU Rui-chun，et al.
Department of Neurology，the Second Hospital of Hebei Medical University，Shijiazhuang 050000，China

　　【Abstract】 Objective To observe the effect of recombinant Human erythropoietin（rHuEPO） on the hippocampal apoptotic neurons and the expression of p-Akt in rats with statural epilepticus（SE）kindled by the Pentylenetetrazol,and to make further investigation of the possible mechanisms of rHuEPO by using phosphatidylinositol kinase (pI3k) inhibitor LY 294002.

　　Methods SD rats were divided into group A(normal control,given saline),group B(PTZ),group C(PTZ+rHuEPO),group D(PTZ+LY294002+rHuEPO),group E(DMSO control,PTZ+DMSO+rHuEPO),15 in each.The changes of ethology and electroencephalogram(EEG) were detected.The hippocampal pathological changes were observed by HE staining,the hippocampal neuron apoptosis by TUNEL method,and the expression of phosphorylated protein kinase B(P-PKB/p-AKt) by immunohistochemical method.

　　Results There were a small quantity of apoptotic neurons and p-Akt positive neurons showed in group A.The p-Akt positive cells decreased，and the apoptotic neurons increased in group B,as compared with groups C,D and E（P＜0.05）.The p-Akt positive cells increased and the apoptotic neurons decreased in groups C,E,when compared with group D （P＜0.05）.

　　Conclusion RHuEPO has anti-apoptosis neuroprotection and survival promotion.P13K/Akt signaling pathway may play a important role in which rHuEPO educe neuroprotection.Its mechanism may be rHuEPO activation of important survival pathway(P13K/Akt) to exert neuroprotective effect,related to Akt activity.

　　【Key word】 Status epilepticus；Erythropoietin，recombinant；PI3K/Akt

Effect of Telmisartan on Adipokines Expression and Insulin Resistance in SD Rats with High-fat Diet HUANG Ying-rui，LIU Chang.
Department of Endocrinology,the First Affiliated Hospital of Liaoning Medical College,Jinzhou 121001,China

　　【Abstract】 Objective To evaluate the efficacy of telmisartan on adipokines expression (adiponectin and TNF-α) and insulin sensitivity in diet-induced insulin resistance rats.

　　Methods Six-week-old male Sprague-Dawley(SD) rats were fed with high-fat diet for 8 weeks to induce insulin resistance and then treated with telmisartan dissolved in drinking water in a dose of 5 mg/kg per day for 6 weeks.Serum parameters and the expressions of adiponectin and TNF-α in white adipose tissues (WAT) were detected and the insulin sensitivity index was measured.

　　Results The levels of serum parameters and TNF-α expression decreased significantly(P＜0.05),and adiponectin expression and insulin sensitivity index escalated in telmisartan group.

　　Conclusion Telmisartan treatment might improve insulin sensitivity by altering levels of adiponectin and TNF-α protein in diet-induced obese rats.These results indicate that telmisartan could be used as a therapeutic tool for metabolic syndrome,including visceral obesity.

　　【Key word】 Telmisartan; Insulin resistance; Adiponectin; Tumor necrosis factor-alpha

Influence of Autologous Bone Marrow Mesenchymal Stem Cells Transplantation by Intracoronary Infusion on Angiogenesis and Cardiac Function in Myocardial Infarction Rabbits ZHU Hong,LI Xue-qi,JIN Li-juan,et al.
General Department,Xuanwu Hospital,Capital University of Medical Sciences,Beijing 100053,China

　　【Abstract】 Objective To observe the influence of autologous bone marrow mesenchymal stem cells(BM-MSCs) transplantation by intracoronary infusion on angiogenesis and cardiac function in myocardial infarction rabbits.

　　Methods Forty-five white Japanese big-ear rabbits were divided randomly into 3 groups,BM-MSCs,control and sham operation,15 in each.In BM-MSCs group,bone marrow was extracted to establish AMI　models by separating,purifying and in vitro amplifying BM-MSCs,and ligating left anterior descending(LAD) of coronary artery,and 5-bromodeoxyuridine(BrdU,5×106) labeled BM-MSCs was infused into LAD after reperfusion.In control,AMI models were established in the same way,infusing equivalent serum-free medium.And in sham operation group the same things were done except that LAD was not ligated.24 h or 4 weeks after operation,left ventricle ejection fraction(LVEF) and fractional shortening (FS) of the ventricular minor-semi axis were measured by echocardiography.after 4 weeks,the survival of transplanted BM-MSCs was evaluated by BrdU antibody immunohistochemical staining,and the expression of vascular endothelial growth factor(VEGF) protein and the changes of capillary density were detected in all groups.

　　Results Twenty-four hours after transplantation,LVEF and FS of sham operation group were better than those of groups BM-MSCs and control (P＜0.01).Four weeks after,LVEF and FS of groups BM-MSCs and sham operation were better than those of control group (P＜0.01),and anti-BrdU antibody immunohistochemistry showed positive in BM-MSCs group.The expression of VEGF and capillary density were more abundant in BM-MSCs group than in control and sham operation (P＜0.01).

　　Conclusion Autologus BM-MSCs transplanted by intracoronary infusion can survive in AMI region,augment expression of VEGF protein and induce angiogenesis,thus to improve cadiac function.

　　【Key word】 Myocardial infarction; Bone marrow mesenchymal stem cells; Cell transplantation; Coronary vessels; Vascular endothelial growth factor; Capillaries

Changes of Hippocampal Nuclear Factor КB Expression in Rats with Epilepsy Kindled by Pentylenetetrazol? ZANG Ying-zhuo，WANG Wei-ping，LI Hong,et al.
Department of Neurology，the Second Hospital of Hebei Medical University，Shijiazhuang 050000，China

　　【Abstract】 Objective To investigate the changes of hippocampal nuclear factor-kappaB (NF-KB) expression in rats with pentylenetetrazol(PTZ)-kindked epilepsy to find its pathogenesis.

　　Methods Status epilepticus(SE) was induced by PTZ intraperitoneal injection to observe rat ethological changes,and immunohistochemistry and reverse transcription-polymerase chain reaction(RT-PCR) were used to determine hippocampal NC-KB expression of SE rats and control group at hours 1,6,24,72,respectively.

　　Results In SE group,the hippocampal NF-KB expression began to increase after 6 hours， reaching the highest at hour 24（P＜0.05），and began to decrease at hour 72，but higher than normal control group.

　　Conclusion NF-KB nuclear translocation,namely hippocampal neuron activation,is the major mechanism of the formation of PTZ-kindled epileptic rats， involving in epilepsy.

　　【Key word】 PTZ；Epilepsy；Hippocampus；NF-κB

Effect of Simulated Ischemia on Na+/K+ Pump Current of Guinea Pig Ventricular Myocytes ZHANG Zhe,CUI Jing-Xia,WANG Yong-li.
Department of Pharmacology,Hebei Medical University,Shijiazhuang 050017,China

　　【Abstract】 Objective To investigate the effect of simulated ischemia on Na+/K+ pump current(IP) of ventricular myocytes.

　　Methods Ventricular myocytes were isolated from guinea pig by collagenase solution,and IP of ventricular myocytes was recorded using whole-cell patch clamp technique.Dihydroouabain(DHO) was used to simulate ischemia perfusion,thus to make simulated ischemia of the cells.We observed the effect of simulated ischemia on IP of the ventricular myocytes and on the IP of high- and low-DHO affinities.

　　Results In simulated ischemia,Ip was significantly reduced in a time-dependent manner.In addition,simulated ischemia inhibited the low-DHO affinity Na+-K+ pump current (Il) but did not effect on the high-DHO affinity Na+-K+ pump current(Ih).

　　Conclusion The specific inhibition of simulated ischemia on the low-DHO affinity Na+-K+ pump current may be one of the mechanisms responsible for the ischemia-induced elevation of Na+ in ventricular myocytes.

　　【Key word】 Na(+)-K(+)-exchanging ATPase；Myocardial ischemia；Patch-clamp techniques

Rapamycin Used in Kidney Transplantation Patients in China：A Meta-analysis of Clinical Curative Effects ZHAN Sheng-li,CAI Ming,SHI Bing-yi,et al.
Department of Urology，the Second Affiliated Hospital， Chinese People′s Liberation Army General Hospital,Beijing 100091,China

　　【Abstract】 Objective To study the efficacy and safety of Rapamycin in immunosuppressive therapy in renal allograft recipients.

　　Methods We retrieved randomly and comparatively published studies on Rapamycin in renal allograft recipient,to perform a Meta analysis on the results.Odds ratio (OR) and its 95% confidence interval (CI) were used as the measurement parameter of efficacy comparison.The statistical analyses were performed using Stata software.

　　Results A total of 4 control studies were enrolled,4 Chinese literatures and 0 foreign.The results indicated that Rapamycin prevented effectively kidney transplantation recipients from acute rejection (OR 0.20,95%CI 0.05~0.86，P=0.03) ， no significant difference was found in delayed graft function between Rapamycin group and control (OR 2.06,95%CI 0.37~11.59,P=0.41),but there was in hyperlipoidemia (OR 3.38,95%CI 1.39~8.22,P＜0.007).

　　Conclusion Application of Rapamycin in kidney transplantation recipients can reduce effectively the incidence of acute rejection,without any adverse effects on delayed graft function.Its side effects are mainly manifested as elevated blood lipids.

　　【Key word】 Kidney transplantation; Rapamycin; Meta-analysis

Effect of Ischemic Preconditioning on Myocardial Ischemic/Reperfusion Injury in Diabetic Rats PAN Wei,JIA Jun-hai.
Department of Laboratory Medicine,School of Medical Science and Laboratory Medicine,Jiangsu University,Zhenjiang 212013,China

　　【Abstract】 Objective To study the effect of ischemic preconditioning(IP) on myocardial ischemic/reperfusion(IR) injury in diabetic rats.

　　Methods Streptozotocin injection was used to establish diabetic rats,which were divided into three groups: IR,IP and sham.NO content in serum and myocardial tissues were determinated by nitrate reductase method.The expression of MMP-2 in myocardial tissues was measured by immunohistochemistry.

　　Results NO content and MMP-2 expression decreased significantly in IP group,as compared with IR group.

　　Conclusion? IP can decrease myocardial IR injury by reducing NO production and MMP-2 expression.

　　【Key word】 Diabetes mellitus; Reperfusion injury; Ischemic preconditioning

Therapeutic Effect of Ultra Earlier Thrombolysis of Recombinant Tissue Plasminogen Activator in Acute Cerebral Infarction TAN An-xiong，LI Jin-cheng，WANG Yu-yin，et al.
Shaoyang Medical College，Hu′nan，Shaoyang 422000，China

　　【Abstract】 Objective To evaluate the efficacy and safety of recombinant tissue plasminogen activator(rTPA) in acute cerebral infarction(ACI).

　　Methods One hundred twenty-eight ACI patients (stroke onset within 6 h) were randomized into treatment and control groups.The control were treated with conventional therapy,and the treatment group with additional rt-PA besides conventional.The results were comparatively evaluated by CSS and Barthel index(BI),before treatment or day 90 after.

　　Results There was no significant different in CSS scores and BI between treatment group and control before treatment（P＜0.05）,but there was after treatment（P＜0.01).Significant difference was noted in therapeutic effect between 2 groups.Urethremorrhage with gingival bleeding(GB) was found in 1 patient,GB in 1 in treatment group,and urethremorrhage with GB in 1,GB in 2 in control group.Conclusion Application of rt-PA within 6 h of stroke onset is efficient and safe in ACI patients.

　　【Key word】 Recombinant tissue plasminogen activator；Cerebral infarction； Thrombolytic therapy

Correlation Between Relapse of Cerebral Infarction and Supersensitivity C-Reactive Protein WANG Qiu.
Department of Neurology，the Central Hospital of Liaoning Electric Power Company，Shenyang 110003，China

　　【Abstract】 Objective To investigate the correlation between supersensitivity C-reactive protein （hs-CRP） and repalse of cerebral infarction(CI).

　　Methods This study included 61 CI patients in stable stage and 55 healthy subjects.Levels of Serum hs-CRP,TG,TC,LDL-C,HDL-C and UA were compared between two groups.

　　Results Content of hs-CRP was (4.6±2.3） mg/L in CI patients and（2.1±1.4）mg/L in control.The difference was significant（P＜0.01）.But there was not significant difference in contents of TG，TC，LDL-C，HDL-C and UA,which weren′t correlated with hs-CRP.

　　Conclusion CI patients after acute stage are still hyperresponsive to inflammation.Perhaps hs-CRP is a sensitive predictor of CI repalse.

　　【Key word】 High Sensitivity C-reactive protein；Brain infarction；Recurrence

A Study on Monosialotetra Hexosyl Ganglioside in the Treatment of Acute Cerebral Infarction CHEN Song-chun，XU Jun，WEI Wen-shi.
Department of Neurology，Huadong Hospital，Fudan University，Shanghai 200040，China

　　【Abstract】 Objective To evaluate the curative efficacy of monosialotetra hexosyl ganglioside sodium（GM1）in the treatment of acute cerebral infarction.

　　Methods 59 cases of the acute cerebral infarction were randomly divided into a treatment group and a control group，the control group were treated with shuxue tong injection，the treatment group were treated with GM1 injection combines with shuxue tong injection.To give marks to patients nerves function and activities of daily living with NIHSS and BI before and after the therapy respectively.

　　Results As compared with the control group，there appeared significant differences in the marks of NIHSS and BI in the therapy group with GM1（P＜0.05）and（P＜0.01）respectively.

　　Conclusion There are significant therapeutic effect in the treatment of acute cerebral infarction with monosialotetra hexosyl ganglioside sodium，it can improve the early rehabilitation of nerves function.

　　【Key word】 G（M1）Gangiloside；Cerbrovasular accident；Treatment outcome

Clinical Analysis of Pregnant Women with Lupus Nephritis CHEN Shan-ying,WU Bi-de,LIAN Xue-jian,et al.
Zhangzhou Municipal Hospital ，Zhangzhou 363000，China

　　【Abstract】 Objective To study the diagnosis and treatment of pregnant women with lupus nephritis.

　　Methods The clinical data of 19 cases of pregnant women with lupus nephritis were analyzed retrospectively.

　　Results after glucocorticoid treatment,17 patients were improved and discharged,1 refused termination of pregnancy,1 left hospital without permission.Nineteen patients had 22 pregnancies altogether,including 8 live births,12 therapeutic abortions or induced labors,2 stillbirths,1 non-medical abortion and 1 lost follow-up.

　　Conclusion Lupus nephritis is not a contraindication of pregnancy,but lupus activity and deteriorated conditions may occur,and the proportion of abortion,prematurity and intrauterine growth retardation is relatively high during pregnancy.Pregnancy should be terminated at the right time.

　　【Key word】 Pregnancy；Lupus nephritis；Diagnosis；Therapy

Drug Adverse Reactions in Hospitalized Elderly：Analysis of 128 Cases? YANG Wei.
Comprehensive Department，Xuanwu Hospital of Capital Medical University，Beijing 100053，China

　　【Abstract】 Objective To contribute the knowledge of the adverse drug reactions(ADR) in elderly,to provide important information on drug use.

　　Methods? Classification statistic and analyses were performed on case histories of 128 ADR old patients who were hospitalzed in our hospital.

　　Results There were a total of 10 varieties of drugs causing adverse reactions,mainly in intravenous medication,among which antibiotics ranked first,followed by drugs for nervous system and circulation.The most common ADR was lesions of skin and annexa,and lesions of digestive and nervous systems was secondary.

　　Conclusion Rational drug use should be attached importance to decrease the occurrence of adverse reactions.

　　【Key word】 Adverse drug reactions;The aged

Progress in Pharmacotherapy of Obsessive Compulsive Disorder YU Dong-shan.
Nanjing Brain Hospital Affiliated to Nanjing Medical University，Nanjing 210029，China

　　【Abstract】 Obsessove compulsive disorder is relatively easy to identify,but difficult to treat.This paper reviews new progress in its pharmacotherapy to guide clinical medication.

　　【Key word】 Compulsive personality disorder； 5-Hydroxytryptamine reuptake inhibitors；Drug therapy

Clinical Application of Blood Purification in Treatment of Acute Poisoning LI Yi,PENG Peng.
The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054，China

　　【Abstract】 In recent years,a variety of blood purification methods has been used increasingly for treatment of acute poisoning,and have achieved some effects,there are commonly 7 different purification methods including dialysis,blood perfusion,hemofiltration,etc.This paper discusses the application of main blood Purification methods in acute poisoning.

　　【Key word】 Hemofiltration；Hemoperfusion；Plasma exchange; Poisoning

Clinical Values of Percutaneous Dilational Tracheostomy by Bronchoscopy LI Wen-xiong,CHEN Hui-de,WANG Xiao-wen,et al.
Department of Surgical Intensive Care Unit,Chaoyang Hospital,Capital Medical University,Beijing 100020,China

　　【Abstract】 Objective To compare the intraoperative complications of percutaneous dilational tracheostomy (PDT) guided by bronchoscopy or not,and to evaluate the clinical values of PDT by bronchoscopy in surgical critical patients.

　　Methods A prospective randomized study was undertaken to compare the procedural difficulty and intraoperative bleeding level of PDT between group A (n=42,PDT without bronchoscopy guide) and group B (n=45,PDT with bronchoscopy guide).

　　Results? No death related to procedure occurred in both groups.There were 28,10 and 4 cases compatible to procedural difficulty levels I,II and III,respectively,in group A,while 40,4 and 1,respectively,in the group B.And there were 34,5 and 3 cases compatible to intraoperative bleeding volume levels of A,B and C,respectively,in group A,while 42,2 and 1,respectively,in group B.The procedural difficulty was significantly lower in group B than in group A(P＜0.05),but there was not significant difference in bleeding level between groups A and B（P＞0.05).

　　Conclusion PDT technique performed by bronchoscopy guidance reduced significantly its intraoperative procedural difficulty and should be widely applied in clinics.

　　【Key word】 Tracheostomy;Bronchoscopy；Intraoperative complications

Analysis of Common Misdiagnoses of Pulmonary Carcinoma and its Analysis DING Ke-lan.
Pingliang Medicine School,Pingliang 744000,China

　　【Abstract】 Objective To discuss the common causes of misdiagnoses of pulmonary carcinoma and its precautions.

　　Methods Clinical manifestations and misdiagnosis causes were analyzed retrospectively.

　　Results? Misdiagnosis rate of pulmonary carcinoma was found to be very high,caused mainly by non-typical early clinical manifestations,doctors′ poor knowledge of extra-pulmonary manifestations of lung cancers and its genesis trend in younger patients,and incomplete imaging examinations.

　　Conclusion The main measures reducing lung cancer misdiagnoses are sufficient understanding of the diversity of its clinical manifestations,and regular chest X-ray examinations for high-risk patients combined with varied imaging and clinic.

　　【Key word】 Lurg neoplasms; Misdiagnosis

Effect of Puncture Catheterization in Different Lateral Positions on Puerpera Epidural Cavity Vascular Injury? ZHOU Rong-cang.
Department of Anesthesiology,Branch of Tangshan Workers′ Hospital,Tangshan 063000,China

　　【Abstract】 Objective? To compare the effects of puncture catheterization(ASA) in different positions on puerperal epidural cavity vascular injury.

　　Methods One hundred forty full-term pregnant women undergoing cesarean section without complications were divided into left lateral decubitus group and right,70 in each.Vascular injuries in puerperal epidural catheterization were compared between 2 groups.

　　Results Vessel injuries occurred in 5 patents in left group,with an 8% bleeding rate,and 13 in right,with a 22% bleeding rate,and there was significant difference between 2 groups（P＜0.05）.

　　Conclusion The occurrence of vascular injury of left lateral decubitus is lower than that of right,and the left epidural puncture catheterization can reduce complications induced by obstetric epidural anesthesia.

　　【Key word】 Hematoma，subdural；Pregnant women；Spinal puncture

Analysis on Clinical Features of Depression of Patients with Parkinson Disease YANG Kai-ren,JIANG Xiao-qin,MAO Fu-rong,et al.
The Third Hospital of Quzhou,Quzhou 324000,China

　　【Abstract】 Objective To study the clinical features of the depression in patients with Parkinson disease.

　　Methods Clinical features were evaluated by the Hamilton Rating Scale for Depression(HAMD24),Hamilton Anxiety Scale(HAMA),Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS) in 35 Parkinson patients with depression (research group) and 35 depression patients(control group).

　　Results There was no significant difference in total scores of SDS，HAMD24，HAMA between 2 groups.Total scores of SAS was higher in research group than in control (P＜0.05).The scores of cognitive function,diurnal variation were lower in research group than in control(P＜0.01).

　　Conclusion Depression of Parkinson patients shows special clinical features,with relative more anxiety symptom but without obvious biological.

　　【Key word】 Parkinson disease;Depression;Anxiety

Clinical Application of Magnetic Resonance Angiography in Morphological Evaluation of Esophageal and Gastric Varices LI Nan,AO Guo-kun,WANG Xin，et al.
Digestive Department,the Second Affiliated Hospital of PLA General Hospital,Beijing 100091,China

　　【Abstract】 Objective To evaluate the role of magnetic resonance angiography(MRA) in the hemodynamic study of esophageal and gastric varices.

　　Methods Twenty one patients with cirrhotic esophageal and gastric varices were given MRA before and following combine interventional therapy,to determine the anatomical morphological changes of portal vein system and compare the results with those of indirect portal venography(IPVG) and of gastroscopy.

　　Results The anatomical imaging of esophageal and gastric varices was clearly displayed in MRA and its imaging quality was better than that of IPVG.Conclusion MRA,a very useful noninvasive technique,can be used as the first choice in the management of patients with esophageal and gastric varices.

　　【Key word】 Esophageal and gastric varices; Magnetic resonance angiography;Indirect portal venography

Antibiotic-associated Diarrhea in Old Patients ZHANG Ning，KONG JIAN-hua，YU Xiao-jiu，et al.
Fuxin Hospital of the Captal University of Medical Sciences，Beijing 100038，China

　　【Abstract】 Objective To evaluate the characteristics，prevention and treatment of antibiotics associated diarrhea （AAD） in old men.

　　Methods Retrospictive analysis was performed in 75 patients with AAD.

　　Results The kinds of anti-biotis and the age of patients were related to the occurrence of AAD.

　　Conclusion Rational use of antibiotics，timely diagnoses and intervention were important measures for managing AAD patients.

　　【Key word】 Anti-bacterial agents；Colitis；The aged

Malignant Lymphoma First Presenting with Fever of Unknown Origin：A Clinical and Pathological Analysis of 48 Cases WANG Zhi，FENG Jin-ping，WANG Chen，et al.
The 2nd People′s Hospital of Wuxi,Wuxi 214000，China

　　【Abstract】 Objective To investigate the clinicopathologic characteristics and diagnostic procedures of malignant lymphoma(ML) by analyzing the presentations of 48 cases with fever of unknown origin(FUO).

　　Methods The clinical data of 48 ML patients with FUO admitted to our hospital from January 2001 to June 2008 were analyzed.

　　Results （1）Among them were 28 males and 20 females with an average age of 58 years,ranging from 19 and 83.The pattern of fever varied.（2）Other clinical characteristics were complicated，but without specificity.（3）Biopsy can be taken from different spots，includes bone marrow aspiration and bone marrow core biopsy in ML patients.（4）Some cases needed surgical operations to support the diagnoses.

　　Conclusion ML clinical manifestations with FUO varied,and its final diagnoses depends on pathology,and it is important to find histological bases by lesion puncture biopsy guided by imaging techniques.And exploratory laparotomy or splenectomy can be performed when necessary.ML is the most common cause of FUO.Most FUO patients can be given definite diagnoses through thorough examinations and careful analyses.

　　【Key word】 Fever of unknown origin；Lymphoma

Clinical Applications of ZHITING-EASY STASIS Vascular Closure Device after Carotid Artery Stenting LI Jun-rong,LI Sheng-hua,SHEN Xin,et al.
Department of Neurology,Jiangning Hospital,Nanjing 211100,China

　　【Abstract】 Objective To evaluate the safety and effect of ZHITING-EASY STASIS vascular closure device after carotid artery stenting(CAS).

　　Methods A total of 60 patients receiving CAS were divided into group A (using ZHITING-EASY STASIS) and groups B (using manual compression),30 in each.The success rate of hemostasis,time of hemostasis,braking time and occurrence of complications were assessed.

　　Results （1）When compared with group B,the time of lying in bed significantly decreased in group A〔(22.4±3.4) h VS (4.8±0.8)h,P＜0.001〕.（2）The hemostasis time of group A was significantly shorter than that of group B 〔（2.5±0.9）min VS (27.1±6.4) min,P＜0.001〕.

　　Conclusion ZHITING-EASY STASIS vascular closure device is safe and effective in rapid hemostasis after Carotid Artery Stenting.

　　【Key word】 Hemostasis，surgical；ZHITING-EASY STASIS vascular closure device；Carotid artery stenting

Improved Sleeve-type Circumcision: Clinical Analyses of 560 Patients with Redundant Prepuce and Phimosis ZHANG Ye,BAI An-sheng,GUO Wei,et al.
Department of Urology,Affiliated Hospital of Yan′an University,Yan′an 716000,China

　　【Abstract】 Objective To evaluate the effect of improved sleeve-type circumcision procedure in treatment of patients with phimosis and redundant prepuce.

　　Methods We reviewed the data of 560 patients with phimosis and redundant prepuce who underwent improved sleeve-type circumcision.

　　Results Improved sleeve-type circumcision procedure had such advantages as less blood lose,minor incisional scars，neat incisions，one-stage healing and good outlook of penis,without postoperative edema,secondary bleeding or infection.

　　Conclusion? Improved sleeve-type circumcision does not impair penis lamina superficialis blood vessels and lymphatic,and complete frenulum of prepuce can be left,achieving satisfactory treatment effects with fewer complications

　　【Key word】 Circumcision; Phimosis

Effect of Bushenwenyanghuyu Method on Menalgia in Patients with Endometriosis? BIAN Wen-hui,DU Hui-lan,CHEN Hui-juan,et al.
Hebei Medical University,Shijiazhuang 050017，China

　　【Abstract】 Objective To investigate the effect of the Bushenwenyanghuyu Method on Endometriosis.

　　Methods Total 46 patients with endometriosis and menalgia were randomly divided into two groups: treatment group and control group,23 in each.The treatment group were given Bushenwenyang medicine,and the control given Gestrinone,3 months.We observed the Quality Of Life (QOF) and the changes of menalgia of the two groups.

　　Results The scores of the treatment group were higher than those of the control group; Menalgia was decreased significantly in both groups.Treatment group was superior to the control in QOF and hemorrheologic improvement,whithout amenorrhea.

　　Conclusion Bushenwenyanghuyu,which is effective in the treatment of Endometriosis,can obviously improve the Quality Of Life of the patients with Endometriosis.

　　【Key word】 Endometriosis; Bushenwenyanghuayu method; Dysmenorrhea;Quality of life

Parkinson′s Disease and Rapid Eye Movement Sleep Behavior Disorder DONG Li，ZHANG Wei，LUO Xiao-guang.
Department Neurology，the First Hospital of China Medical University，Liaoning Province，Shenyang 110001，China

　　【Abstract】 Parkinson′s disease(PD) is a neurodegenerative disease，which frequently occurs in aged.In the past，people always think highly of the symptoms of motion.But in these years，more and more people have become to pay attention to sleep disorder of PD,which also seriously affects patients′ quality of llife.The incidence of rapid eye movement sleep behavior disorder is relatively high,it should be given more attention.

　　【Key word】 Parkinson disease；Dyssomnias

Present Situation of Treatment of Feminine Pressure Urinary Incontinence LI Yan，Guli′na.
Ababaikeli.Department of Gynecology,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054

　　【Abstract】 Stress urinary incontinence(SUI) is a non-fatal disease.However,most women with SUI are shamed to consult doctors due to the lack of correct understanding,thus to delay diagnosis and treatment to seriously affect the patients′ quality of life and mental and physical health.And so,positive treatment is the most important thing for SUI women.This paper reviews the status quo of SUI treatment.

　　【Key word】 Urinary incontinence，stress；Therapy;Female

Knowledge and Identification of Inpatients on Two-way Referral System　SUN Yu-wen，XU Liang-wen.
Health Management School，Hangzhou Normal University， Hangzhou 310018，China

　　【Abstract】 Objective To understand the knowledge and identification of inpatients on two-way referral system,to find out the existing problems from the patients′ point of view.

　　Methods We investigated,by site questionnaire survey,100 patients′ knowledge of two-way referral system and health insurance policies,points of view on referral paths and decision power,and their satisfaction to the system.

　　Results Only 45 of 100 patients knew two-way referral system,mainly through such medias as newspapers,network etc.Four experienced referral from community heath services to big hospitals,3 from big hospitals to community health services.After doctors′ explanation,9 patients were satisfied with two-way referral system,51 relatively,36 normally,4 dissatisfied.The main cause of dissatisfaction was mistrust of treatment level of community health services.

　　Conclusion Patients were lack of the knowledge of two-way referral system.Medical Administrative departments should enhance its publicity,improve its management and supervision.

　　【Key word】 Two-way referral；Community health services；Cognition；Identity

Number9May，2009

Application of QOL Scale-FAMILY in Evaluation of Quality of Life for Caregivers of Patients with Laryngocarcinoma? LIU Yi -qun,GAN Xiu-ni， TANG Wei，et al.
Department of Nursing,the Second Affiliated Hospital,Chongqing Medical University， Chongqing 400010， China

　　【Abstract】 Objective To study the possibility of measuring quality of life for caregivers of Chinese patients with laryngocarcinoma with the Quality of Life Family Version (QOL Scale-FAMILY) made by National Medical Center and Beckman Research Institute of USA so as to provide a scale for caregivers of Chinese patients with laryngocarcinoma.

　　Methods A Chinese version of QOL Scale-FAMILY was completed through translation,back-translation and cultural adaptation of the American scale,and then its feasibility,validity and reliability were assessed via letter inquiry,telephone inquiry and face-to-face questionnaire survey about the quality of life of 100 caregivers (most of them were the spouse or children) laryngocarcinoma patients.

　　Results The internal consistency Chinese version of QOL Scale-FAMILY was good,the Cronbach′ s αcoefficient was 0.794,the three dimensions were satisfactory for group comparison,except for the mental health dimensionα= 0.649; and the test-retest reliabilityγ was 0.841.The four common factors from factorial analysis were in accordance with their theoretical structures,and the cumulative contribution rate was 60.2%.

　　Conclusion The reliability and validity of QOL Scale-FAMILY Chinese version are acceptable.After adjustment of certain items,it can be used in measurement of quality of life for laryngocarcinoma patients′ family members.

　　【Key word】 QOL Scale - FAMILY;Laryngocarcinoma patients′ family members;Quality of life

Interventional Effect of Improving Insulin Resistance with Rosiglitazone plus Small Doses of Metform and Nateglinide on Pre-diabetic Patients with Simple Nonalcoholic Fatty Liver? WANG Shao-zhen,XU Yan-guang,SHI Ya-nan.
Department of Gastroenterology,Metabolic Disease Hospital,Tianjin Medical University,Tianjin 300070,China

　　【Abstract】 Objective? To investigate the interventional effect of improving insulin resistance by Rosiglitazone combined with small doses of Metform and Nateglinide on pre-diabetic patients with simple nonalcoholic fatty liver.

　　Methods Totally 42 IGR patients with simple nonalcoholic fatty liver were selected and given Rosiglitazone combined with small doses of Metform and Nateglinide for six months.The index changes relevant to insulin resistant before and after the therapy were compared.The changes of fatty liver after the therapy were assessed through abdominal B-ultrasonography and CT scanning.

　　Results? Before and after the therapy,the patients′ body weight were （84±13）kg vs （78±12）kg; body mass index,（29±4）kg/m2 vs （27±3）kg/m2; fasting blood glucose,（5.9±0.6）mmol/L vs （5.7±0.4）mmol/L; 2-hour postprandial blood glucose,（8.3±2.6）mmol/L vs （6.3±0.8）mmol/L; glycosylated hemoglobin,（5.9±0.6）% vs （5.2±0.6）%; triglyceride,（3.0±1.5）mmol/L vs （2.7±1.3）mmol/L; lower density lipoprotein-cholesterol,（4.1±1.5）mmol/L vs （3.7±1.2）mmol/L; fasting insulin,（28±13）mIU/ml vs （14±7）mIU/ml; Homa insulin resistance index,（7.2±3.6）vs （3.6±1.7）; and adiponcetin,（7±3）mg/L vs （9±3）mg/L,all the differences were significant （P＜0.05）.CT value was increased from （0.73±0.13） to （0.83±0.14） after the therapy （P＜0.05）.

　　Conclusion Rosiglitazone with small doses of Metform and Nateglinide can improve not only the insulin resistance,but also the adipose accumulation in liver cells,and thus has an interventional effect to pre-diabetes with simple nonalcoholic fatty liver.

　　【Key word】 Fatty liver;Prediabetic state;Rosiglitazone;Metformin;Nateglinide;Insulin resistance

Influence of Arterial Chemoembolization on Expression of Proliferating Cell Nuclear Antigen in Bladder Cancer? SHAO Si-hai,WANG Rong-jiang,SHI Qi-lin,et al.
Department of Urology， Pathology and Imaging,The First Affiliated Hospital of Huzhou Teachers College,Huzhou 313000， China

　　【Abstract】 Objective To investigate the influence of preoperative arterial chemoembolization on the expression of proliferating cell nuclear antigen (PCNA) and clinical significance in bladder cancer.

　　Methods Before and after chemoembolization,the expression of PCNA of cancer tissue in 50 patients with bladder cancer were examined by immunohistochemistry.The relation of its expression to the pathological grade and clinical stage was evaluated clinically.

　　Results Before chemoembolization in expression of PCNA in cancer tissue,there was no significant difference among different pathological grades （P＞0.05）,but there was a significant difference among different clinical stages （P＜0.05）.After chemoembolization there was significant difference among different pathological grades （P＞0.05）.All the patients were followed up for 6 to 44 months,with an average of 22.5 months.There were 8 patients (16%) who got postoperative relapse; the time of relapse was 6 months after chemoembolization in 2 cases,6 to 12 months in 3 cases,and 24 to 36 months in 3 cases.There were 4 cases that died; the time was respectively 5 months,11 months,11 months,and 21 months in each case.In 46 survival patients there was a significant difference in level of PCNA expression between the patients with no relapse and those with relapse after chemoembolization （P＜0.05）.

　　Conclusion Preoperative arterial chemoembolization can reduce the expression of PCNA,regulate the differentiating degree of bladder cancer,decrease the grade and stage of the tumor.The expression PCNA can serve as a predictive factor for prognosis of bladder cancer.

　　【Key word】 Bladder neoplasms；Antineoplastic combined chemotherapy；Proliferating cell nuclear antigen

Influencing Factors of Malignant Pregnancy Outcome of Perinatal Infants in Preeclampsia? WANG Juan-juan,QIN Jiang-xia,WANG Dong-mei.
Department of Obstetric and Gynaecology,The First Teaching Hospital of Xinjiang Medical University,Urumqi 830054,China

　　【Abstract】 Objective To explore the influencing factors for malignant pregnancy outcome of perinatal infants in preeclampsia.

　　Methods Totally 297 patients with preeclampsia enrolled were divided as groups of early onset severe preeclampsia (EOSP) (n=84),early onset mild preeclampsia (EOMP) (n=28),late onset severe preeclampsia (LOSP) (n=76),and late onset mild preeclampsia (EOMP) (n=109).Logistic regression was used to analyze the relative factors that may affect the malignant outcome for perinatal infants.

　　Results The prevalence rates of newborn asphyxia,stillbirth,newborn death,fetal distress and premature infant were 26.19%,22.62%,2.38%,13.10%,and 82.14% respectively in EOSP group,3.57%,3.57%,0,14.29%,10.71% respectively in EOMP group,13.16%,6.58%,1.32%,19.74%,18.42% respectively in LOSP group,and 2.75%,0.0,11.93％,4.59％respectively in EOMP group.There were significant differences in prevalence rates of newborn asphyxia,stillbirth and premature infant between LOSP and LOMP groups （P＜0.05）,and there were significant differences in prevalence rates of stillbirth and premature infant between EOSP and LOSP groups（P＜0.05）.Partial thromboplastin time and level of albumin of the patients with preeclampsia and the body mass of newborns were influencing factors for malignant pregnancy outcome of perinatal infants in preeclampsia.

　　Conclusion Partial thromboplastin time and level of albumin of the patients with preeclampsia and the body mass of newborns may influence the pregnancy outcome of perinatal infants.

　　【Key word】 Eclampsia;Perinatal infant;Pregnancy outcome;Influence factors

Comparative Study on Treatment of Generalized Anxiety with Sertraline and Buspirone? LIN min， SHEN Xin-hua.
The Third Municipal Hospital of Huzhou， Huzhou 313000， China

　　【Abstract】 Objective To investigate the clinical efficacy and compliance of Sertraline and Buspirone in treatment of generalized anxiety.

　　Methods A total of 104 generalized anxiety patients compatible with Chinese Classification and Diagnostic Criteria for Mental Disorders,3th Edition (CCMD-3) were randomly divided as trial group treated with Sertraline,and control group with Buspirone.Before treatment and at the end of 1st,2nd,4th,8th week after treatment,Hamilton Rating Scale for Depression (HAMD)，Hamilton Anxiety Scale (HAMA) and Clinical Global Impression Scale (CGI-GI) were used to evaluate the efficacy,and Treatment Emergent Symptom Scale (TESS) to evaluate the safety.

　　Results Sertraline group：The scores of HAMA and HAMD at the end of 4th and 8th week were （16±3） and （10±5）; （15±4） and （7±5）; Buspirone group：The scores of HAMA and HAMD at the end of 4th and 8th week were （17±3） and （10±5）; （15±4） and （7±5）.Two groups of patients before and after? treatment had a significant difference （P＜0.01）.Few or slight side effects were found in both groups.

　　Conclusion Both Sertraline and Buspirone are safe and effective in treatment of generalized anxiety.

　　【Key word】 Sertraline；Buspirone；anxiety

Effective Comparison between Glucomannan and Acarbose in Type 2 Diabetic Patients?? WANG Wei,CHEN Yu-lan,HUANG Bin-xiong.
Ouyang Hospital,Shanghai 200081,China

　　【Abstract】 Objective To observe the effects of Glucomannan and Acarbose on blood sugar,blood fat and blood pressure in patients with type 2 diabetes mellitus.

　　Methods? Totally 248 type 2 diabetic patients were randomly divided into two groups,with 124 in each.Based on the original treatment,the patients in one group received Glucomannan and in the other group received Acarbose for 12 weeks respectively,and then the lchanges in blood suger,fat and pressure of the patients in both groups were evaluated.

　　Results? After treatment,in Glucomannan group and Acarbose group,the levels of

　　glycosylated hemoglobin (HbA1c) 〔(6.4±1.1)%,（6.3±1.0）%〕,fasting blood glucose (FBG) 〔（7.0±1.7）mmol/L,（6.9±1.8）mmol/L〕,2-hour postprandial blood glucose (2hPG) 〔（10.0±3.7）mmol/L,（10.0±4.2）mmol/L〕,systolic pressure 〔（124±15）mm Hg,（124±15）mm Hg〕,diastolic pressure 〔（78±9）mm Hg,（79±9）mm Hg〕,triglyceride （TG）〔（1.8±0.8）mmol/L,（1.8±0.9）mmol/L〕,lower density lipoprotein-cholesterol (LDL-C) 〔（3.1±0.8）mmol/L,（3.0±0.8）mmol/L〕 were significant different respectively from those before treatment,or 〔（7.9±0.7）%,（7.8±0.6）%〕,〔（8.2±1.6）mmol/L,（8.2±1.6）mmol/L〕,〔（14.0±3.2）mmol/L,（14.0±3.3）mmol/L〕,〔（130±15）mm Hg,（130±15）mm Hg〕,〔（84±8）mm Hg,（82±6）mm Hg〕,〔（2.1±1.0）mmol/L,（2.0±1.0）mmol/L〕,〔（3.4±0.9）mmol/L,（3.2±0.7）mmol/L〕（P <0.05）.However,after treatment,there were no significant differences between the two groups in HbA1c,2hPG,blood pressure,TG,and high density lipoprotein-cholesterol (HDL-C) 〔（1.27±0.24）mmol/L vs （1.28±0.29）mmol/L〕（P＞0.05）.

　　Conclusion? Both Glucomannan and Acarbose can decrease the levels of blood sugar,blood fat and blood pressure of patients with type 2 diabetes,and they are about equal in effect.However,viewing from health economic angle,Glucomannan is cheaper in price and thus more suitable for community health services.

　　【Key word】 Glucomannan；Acarbose；Diabetes mellitus,type 2；Blood glucose

Clinic Effect of Rhubarb by Different Administration Route in Critical Patients with Gastrointestinal Dysfunction? CAI Xiao-ni,MENG Zhang-ge.
Zhuji People′s Hospital,Zhuji 311800,China

　　【Abstract】 Objective To observe the therapeutic effect of rhubarb by different administration route on the critical patients with gastrointestinal dysfunction.

　　Methods Totally 138 critical patients with complication of gastrointestinal dysfunction were divided into 3 groups: gastric tube group,high enema group and combination group.All the patients were treated with conventional treatment of acid inhibition,hemostasis and stomach drainage.Besides,the patients were treated with rhubarb through gastric tube in the gastric tube group,through enema high in the high enema group and through both ways in the combination group.The effects on gastric hemorrhage,stomach drainage and intestinal paralysis among the three groups were compared after the treatment.

　　Results The effective rates of gastric hemorrhage,stomach drainage and intestinal paralysis were respectively 84.2％,80.7％ and 82.4％ in combination group,60.4％,52.1％ and 58.3％ in the gastric tube group,and 58.1％,55.8％ and 55.8％ in the high enema group,with significant differences among the three groups （P＜0.05）.The time for patients to begin to be tolerant of enteric nutrition was （3.6±2.4） days in the combination group,which was significantly different from that of （5.5±2.2） days in the gastric tube group and that of （5.8±3.7） days in the high enema group （P＜0.01）.

　　Conclusion The result of Rhubarb by way of gastric tube combined with high enema is better for critical patients with gastrointestinal dysfunction.

　　【Key word】 Rheum officinale；Gastrointestinal dysfunction;Critical illness；Multiple organ failure；Drug administration routes

Selection of Data Sets in Community Electronic Health Records? DU Zhao-hui， PENG Hui-zhen， SHEN Jia-ni， et al.
Weifang Community Health Care Center， Pudong New District，Shanghai 200122，China

　　【Abstract】 Objective To study classifying selection of data sets in community electronic health records (EHR).

　　Methods Delphi measure and expert consulting were adopted to select data sets in HER.

　　Results The data sets of 601 original indexes were sorted out,and 435 indexes were finally screened out through two rounds of Delphi measure.

　　Conclusion The data sets in HER should be reasonably classified,and thus to stimulate the data sets in HER that meets the demand for local health.Delphi measure is a better measure.

　　【Key word】 Electronic health records(EHR)；Data indexes；Selection

Utilization Situation of Electronic Health Records in Community Health Services? PENG Hui-zhen， GUO Zhi-jie， BAO Yong.
School of Medicine，Shanghai Jiao Tong University，Shanghai 200025，China

　　【Abstract】 Objective To summarize the practice process of informatization of health records in community health service (CHS) center A in Shanghai so as to supply reference for the establishment and implementation of policy by the relative health administration departments.

　　Methods? The literature review and expert consulting were taken to collect the data,740 health records were at roadman drawn from the CHS center A so as to analyze know the renew conditions.

　　Results On the base of computerized and networking management health records,the establishment,up-to-data and utilization of electronic health records had realized in the CHS center A.The inter-communication of information and data in the whole center and the target of all-in-one management of community residents′ health records were also realized.

　　Conclusion Good effects have been achieved in practice of informatization of health records in the CHS center A,which set up a good foundation for realization of health records networking among multi-health institutions.

　　【Key word】 Health records；Informationization；Community health services

Data Processing for Investigation of Community Health Services? ZHANG Pu-hong,ZHAO Jing.
Beijing Management Center for Community Health Service,Beijing 100053,China

　　【Abstract】 In order to improve the level of data processing and utility in health management,society diagnosis and investigation studies in the context of community health service,we here analyze and expound the problems commonly encountered in data processing and their causes and impacting degrees,as well as how to find the problem and the resolving methods for them respectively from four respects of data collection,data entering,data cleaning,and preparation before analysis that are concerned in every day work of community health services.

　　【Key word】 Data collection;Data entering;Data cleaning;Epidemiological survey;Community health services

Functional Implementation of Urban Community Health Service in China? LI Yan,JIN Sheng-guo,LIU Li-qun,et al.
Department of Health Development,Capital Institute of Pediatrics,Beijing 100020,China

　　【Abstract】 Objective To estimate the functional implementation of urban community health service (CHS) in China,analyze the existing problems and causes,and thus provide recommendations for future development.

　　Methods A self-designed questionnaire and mode of report to the next higher level were used to investigate the functional implementation of urban CHS centers and stations in cities of China,including the quantity of institutions,basic medical cares,and public health services.

　　Results By the end of October 2007,there were 26 472 CHS organizations in China totally,including the 6 340 CHS centers and 20132 CHS stations.By the end of December 2006 the carrying out rate of basic medical casers got 100.0%.The average amount of patients in clinic and emergency for each center was 34 498; and that for each station was 6 740.The carrying out rates of planned immunization service,child care,maternity health care and health education service at the health service centers were 77.0%,77.6%,79.3%,and 86.7% respectively; and the average amount of people served were 5 763,2 075,714,and 2 356 respectively.The conditions of functional implementation were varied among different regions,in different levels of the cities and in different types of CHS organizations.

　　Conclusion The network of CHS in China is gradually improved.The function of basic health services has been further implemented.The carrying out rate of basic medical services is high,but the quantity of service is smaller.The condition of implementation for basic medical service is poorer in the middle and western regions of China.The function of public health services is gradually enhanced,and the implementation conditions in the eastern region and provincial level cities of China are good.

　　【Key word】 Community health services;Service function;Carrying out rate;Service quantity;Cities

Feasibility of Implementation System of First-treatment by Family Doctors in Yuetan District of Beijing? DONG Yu-ming， DU Xue-ping， DONG Jian-qin.
Fuxing Hospital Affiliated to Capital Medicine University， Beijing 100038， China

　　【Abstract】 Objective To investigate the feasibility of implementation of system of first-treatment by family doctors.

　　Methods Questionnaire survey was taken to investigate 536 persons from 200 families in Yuetan district on the status of implementation of system of first-treatment by family doctors.

　　Results The average age of the surveyed persons was (56.20 ± 18.352) years.Among them the ones whose age≥61 years accounted for 52.9%,the ones who had hypertension for 39.55%,the ones who had diabetes mellitus for 24.07%,the ones who had heart disease for 15.49%,and the ones who had chronic joint disease for 14.55 %.Over the past year 89.0% of the residents chose the Community Health Clinics as their first choice to seek medical care.Some 87.0 % and 84.0 % of the residents were satisfied respectively to their family doctor′s diagnosis and treatment of diseases.Some 86.0 % believed that the current "one-stop reimbursement" policy is convenient.For the patients who participated in the "one-stop reimbursement",the average proportion of medical cost to the total was 42.62 % in 2007.Some 68.5% of the residents expressed their willingness to accept the system of first-treatment by family doctors under the present circumstances.

　　Conclusion? The residents in Yuetan district are willing to receive community health services,the technological skill in community health services is higher,and the government preferential policies supports the development of community health services.It is feasible to implement the system of first-treatment by family doctors in Yuetan district.

　　【Key word】 The first-treatment system of family doctors；Community health services；Feasibility

Single Expenditure by Residents on Chronic Diseases in Demonstration Sections of Community Health Service in Henan Province? LIU Xin-kui， WU Hong，? ZHENG Qi， et al.
The First Affiliated Hospital of Zhengzhou University， Zhengzhou 450052， China

　　【Abstract】 Objective To investigate the single expenditure by the residents on common cold,upper respiratory tract infection,hypertension,diabetes mellitus,coronary heart diseases in community health service (CHS) in Henan province.

　　Methods The community residents from demonstration sections (2 287 persons) and non-demonstration sections (1 169 persons) of CHS in 3 cities were selected as the subjects.The investigation was conducted by investigators with household survey and with the same questionnaire.

　　Results The single expenditures by the residents from demonstration sections on common cold,upper respiratory tract infection,hypertension,diabetes mellitus,coronary heart diseases in CHS were respectively RMB（22±9）,（16±5）,（17±6）,（29±4） and （36±5） yuan,as were lower than RMB （79±16）,（157±26）,（53±18）,（397±11） and （122±12） yuan respectively in other hospitals （P＜0.01）.The single expenditures by the residents from non-demonstration sections on common cold,upper respiratory tract infection,hypertension,diabetes mellitus,coronary heart diseases in CHS were respectively RMB（26±8）,（14±4）,（8±5）,（39±3） and （57±4）yuan,as were lower than RMB（105±19）,（81±17）,（102±16）,（112±24） and （135±22）yuan respectively in other hospitals（P＜0.01）.There was a significant difference in single expenditure between the residents from demonstration sections and those from non-demonstration sections（P＜0.01）.

　　Conclusion The single expenditure by the residents on common cold,upper respiratory tract infection,hypertension,diabetes mellitus,coronary heart diseases in CHS were lower than that in other hospitals.CHS can remarkably reduce the expenditure of medical service and restrain its increasing too quickly.

　　【Key word】 Community health services；Chronic diseases；Medical expenditure

Present Situation of Community Rehabilitation Contingent for Disabled Persons and the Strategies in Zhabei District of Shanghai? WEI Bu-liang， DAI Jia-hui， CHEN Gang， et al.
Zhabei Disabled Person′s Federation，Shanghai 200070， China

　　【Abstract】 Objective To know the present situation and existing problems of community rehabilitation contingent in Zhabei district of Shanghai,in order to provide objective bases and suggestions for establishment of a community rehabilitation contingent in Zhabei district that meets real demand,optimizes resource allocation,is beneficial to effective development of work and with higher quality.

　　Methods The questionnaire survey was conducted to investigate the education backgrounds,majors,job category,knowledge and skills commanded,etc.of four kinds of community rehabilitation staff including officials,doctors,guiders and attendant to the disabled.

　　Results The majority of community rehabilitation staff had a high and middle school record,part-time job,a certain difference in knowledge-and-skill level from job requirement.The structure of community rehabilitation doctors was less reasonable.

　　Conclusion The target-oriented training for each kind of community rehabilitation staff needs to be enhanced,especially the training on knowledge-and-skill for home service doctors.

　　【Key word】 Community rehabilitation；Health manpower；Strategies

The Clinical Study of Transtelephonic Electrocardographic Monitoring System (TEM) in Social Commune Medical Unit CHENG Shuo-tao,ZHANG Hui-jie,GUO Yue-ping.
ECG department of Shenzhen Sun Yixian Cardiology Hospital,Shenzhen 518001，China

　　【Abstract】 Objective To study the acutance and efficiency of TEM system by social commune medical unit.We hope the result could be a foundation that supported the width application of TEM.

　　Methods Established the social commune TEM system by Shenyang Lingwei Medical Electric Equipment TEP system.We were reviewed more than 2 thousands cases of TEM system from 2003 to 2008.And collecting,summarizing,and analyzing data of the cardiac events in those cases.

　　Results TEM monitoring has high generally positive rate (36.94%);TEM has extra sensible and accurate capability to diagnosis arrthymia,ratio of sensibility and specificity is 33.84% and100% respectively.Especially,there is a appearance advantage of TEM system about the timeliness and efficiency-cost ratio of monitoring.There has been a series advantage about efficiency-cost ratio and on times in myocardial ischemia with symptoms.In those patients,the ratio of sensibility and specificity is 100% and 92% respectively.

　　Conclusion The TEM system can monitor all arrhythmia effective and accurate,while it has high ratio of cost and effective.

　　【Key word】 Electrocardiography；Custodial care;Transtelephonic electrocardographic monitoring system

Depression and Anxiety in Patients with Chronic Pain? ZHANG Wen-xiang,NI Jia-xiang.
Department of Pain,Xuanwu Hospital,Capital Medical University,Beijing 100053,China

　　【Abstract】 Objective To investigate the correlation of pain with depression and anxiety of inpatients with chronic pain.

　　Methods Totally 131 inpatients with chronic pain at the pain department of Xuanwu hospital，Capital Medical University from July 2007 to March 2008 were enrolled.They were divided into 3 groups according to their different diseases: trigeminal neuralgia in group I (n=45); cervical or lumbar spine disease in groupⅡ (n=39); and complex neuralgia in group Ⅲ (n=47).They were all given mini-invasive neural intervention for the pain after hospitalization.The conditions of depression and anxiety of the patients were assessed by visual analogue pain scale (VAS),Hamilton Rating Scale for Depression (HASD) and Hamilton Rating Scale for Anxiety (HAMA) before and after treatment and 3-month follow-up after treatment.

　　Results (1) There were significant differences in painful degree as compared group I with group Ⅱ before treatment,group I with group Ⅲ after treatment,and group I with group Ⅱ and Ⅲ three months after treatment (P＜0.05).The painful degrees after treatment and 3 months after treatment in the 3 groups all showed a significant difference from those before treatment.(2) The prevalence rates of depression and anxiety were 49.62% and 57.25% respectively.Before treatment,the prevalence rate of depression in group Ⅲ （72.3%） showed significant difference from those in group I （37.8%） and Ⅱ（35.9%）（P＜0.01）.The prevalence rates of depression in group Ⅰ,Ⅱ,and Ⅲ were respectively 4.4%,10.3% and 25.5% after treatment,and 0,15.2% and 17.6% three months after treatment,which were significantly different from before treatment（P＜0.05）.(3) The prevalence rate of anxiety before treatment was 68.1% in group Ⅲ,which was significant from 43.6% in group Ⅱ （P＜0.05）.Before treatment,the prevalence t=rates of anxiety in group Ⅰ,Ⅱ,and Ⅲ were respectively 57.8%,43.6% and 68.1%,which showed significant differences from 13.3%,15.4% and 27.7%） after treatment,and 0,24.2% and 20.6% three months after treatment （P＜0.05）.The prevalence rate of anxiety in group Ⅰ after treatment also showed a significant difference from that 3 months after treatment （P＜0.01）.

　　Conclusion The prevalence rates of depression and anxiety of inpatients with chronic pain are higher.The painful degree of patients with trigeminal neuralgia is highest.The prevalence rates of depression and anxiety in patients with complex neuralgia are highest.The mini-invasive neural intervention can reduce the painful degree,and prevalence rates of depression and anxiety.

　　【Key word】 Pain；Depression；Anxiety

Effect of Social Support on Mental Health of Middle School Students with Parents′ Divorce? LIU Heng,ZHANG Jian-xin.
Department of Philosophy,Xiamen University， Xiamen 361005， China

　　【Abstract】 Objective To investigate the influence of parents′ devoice on mental health of middle school students in China,and analyze the effects of sex,rural or urban background and social support.

　　Methods The mental health conditions and social support of 1 882 high school students,from 13 schools in cities of Guangdong,Sichuan and Henan provinces,were tested by using the checklist of SCL-90 and the scales of objective and subjective social support.

　　Results There were 292 students who were influenced by the divorce of their parents.Their SCL-90 factors in somatization,compulsive symptom,interpersonal relationship,depression,hostility,affright,paranoid,and psychopathy were (0.63±0.04),(1.15±0.04),(0.91±0.04),(0.84±0.04),(0.89±0.04),(0.56±0.03),(0.77±0.04),and (0.73±0.04) respectively,which showed statistically significant differences as compared with those (0.53±0.02),(1.01±0.02),(0.77±0.02),(0.72±0.02),(0.73±0.02),(0.49±0.02),(0.68±0.02),(0.60±0.02) of 1 590 students from normal families (P＜0.05).However,there was no significant influence of rural or urban background and sex on the most of SCL-90 factors.Multiple regression analysis showed subjectively social support impacted the SCL-90 factors significantly.

　　Conclusion The parent′s divorce is of significantly negative influence on the mental health of the students mental health.However,the rural or urban background and sex give no significant influence.The subjectively social support is more effective than grade of the students and parents′ divorce on student′s mental health.

　　【Key word】 Student；Divorce；Mental heath；Social support；SCL-90

Path Analysis on the Factors Influencing Hospitalization Expense of Delivery Women? MENG Bing， ZHU Hai-jing， WANG Rui.
South Building Clinical Department， PLA General Hospital， Beijing 100853， China

　　【Abstract】 Objective To analyze the main influencing factors on the hospitalization expense of delivery women so as to control the medical expense and improve medical quality by taking the policy and measures.

　　Methods The path analysis was taken to deal with the data and hospitalization expense of 1 678 delivery women during 2007 in a hospital.

　　Results The number of hospitalization days and delivery manner were the most influencing factor of hospitalization expense of delivery women.The other influencing factors were in order of pregnancy complication,delivery complication,disease before pregnancy and expense category.

　　Conclusion The major influencing factors are the number of hospitalization days and delivery manner.The reasonably measures must be taken to control the increase of delivery expense effectively.In preservation health education on pregnant women should be enhanced and complications should be prevented.In treatment cesarean section rate should be the primary measure.

　　【Key word】 Parturition；Fees，medical；Influence factors；Path analysis

Community Quality of Life (QOL) and Relevant Influential Factors in the Elderly?? XIONG Rui-jin， YUE Yuan-ping， KANG Wen-yan.
Nursing Department of Tanghan Vocational Technical College， Tangshan 063000， China

　　【Abstract】 Objective To understand the status of the elderly of Tangshan city in QOL and its main influential factors.

　　Methods? The stratified cluster random sampling was taken to investigate the citizens aged 60 and above in Tangshan urban regions about their QOL and its influential factors.

　　Results? There were significant differences in QOL scores of 4 dimensions of physiological function,physiological role,general health and social function among the elderly of different age groups (P＜0.05).In the older patients with diabetes mellitus,coronary heart disease,osteoarthrosis,chronic bronchitis and prostatic disease the scores of physiological function were respectively 69±24),(68±25),(68±24),(54±29),and (57±23); the scores of physical pain were respectively(72±24),(75±22),(75±22),(67±19),(and 64±17); the scores of vitality were respectively(63±18),(64±17),(64±16),(59±17),and(48±20); the scores of social function were respectively(75±23),(77±25),(77±25),and (70±24),with significant differences as compared with those in the elderly with no the diseases above-mentioned (P＜0.05).The scores of mental health in the elderly with spouse died and without were respectively (69±14) and (70±15) (P＜0.05).The scores of mental health in the elderly with children′s life frustrated and without were respectively (51±8) and (54±11),and the scores of social function were respectively (73±27) and (82±23) (P＜0.05).The scores of physiological function in the elderly with harmonious family and without were respectively (74±23) and (61±30),and the scores of mental health were respectively (71±15) and(62±16) (P＜0.05).The scores of vitality in the elderly with economic difficulty and without were respectively (63±18) and (67±15),the scores of mental health were respectively (72±15) and (67±15) (P＜0.05).The scores of mental health in the elderly with difficulty in seeking medical care and without were respectively (64±17) and (69±14),and the scores of social function were respectively (79±22) and (84±24) (P＜0.01).Multiple regression analysis revealed aging,some chronic diseases,experience of negative life events and negative psychological feelings could influence the physiological and mental health of the elderly? (P＜0.05).

　　Conclusion? Aging,some chronic diseases,experience of negative life events and negative psychological feelings could make decline of quality of life for the elderly.The society and family should concern it and set up a happy life environment for improving their quality of life.

　　【Key word】 Communities；Elderly；Quality of life；Influencing factors

Diagnosis and Treatment of Extra-adrenal Pheochromocytoma LI Zhen-hua,ZHAO Wei,KONG Chui-ze,et al.
Deptment of Urology,The First Affiliated Hospital of China Medical University,Shenyang 110001,China

　　【Abstract】 Objective To study the diagnosis and treatment of extra-adrenal pheochromocytoma.

　　Methods The clinical data of 37 patients of extra-adrenal pheochromocytoma were retrospectively analyzed.

　　Results? There were 86% of the patients who had hypertension,86.7% whose 24 h urine catecholamine increased and? 80% whose vanillylmandelic acid increased,88.9% whose plasma epinephrine increased and? 71.4% whose norepinephrine increased.The foci were localized mainly by abdominal ultrasonography,CT and MRI.The patients with extra-adrenal pheochromocytoma accounted for 14.0% of all the concurrent patients with pheochromocytoma.Tumor resection was successfully performed in 89.2% patients,and 16.2% of the foci were malignant.

　　Conclusion Urine catecholamine and vanillylmandelic acid,plasma epinephrine and norepinephrine are of important significance for the diagnosis of extra-adrenal pheochromocytoma.Three dimensional enhanced CT scanning can be the first choice of localization.Relapse is rather common in this disease; the recurrent case should be managed with surgical operation.

　　【Key word】 Pheochromocytoma，extra-adrenal;Diagnosis;Therapy

Cesarean Section Pregnancy: A clinical analysis of 35 cases LI Yan,WANG Dan-bo.
Department of Gynecology and Obstetrics,Shengjing Hospital of China Medical University,Shenyang 110004,China

　　【Abstract】 Objective To explore the pathogenesis,early diagnosis and pertinent treatment of cesarean scar pregnancy (CSP).

　　Methods The clinical presentations,diagnoses,treatments and outcomes of thirty-five patients with CSP in Shengjing Hospital of China Medical University from January 2003 to August 2008 were retrospectively analyzed.

　　Results The average age of the patients was 33.4 years.The interval from the last cesarean delivery to diagnosis ranged from 8 months to 9 years,with an average interval of 2 years.The most common symptoms of CSP were amenorrhea and vaginal bleeding,with heavy vaginal bleeding in 20 patients.There were 16 patients who were misdiagnosed as early intrauterine pregnancy.The diagnosis was made through comprehensive analysis of data on cesarean delivery history,gynecologic examination,ultrasonogram and magnetic resonance imaging.The therapies were mainly hysteroscopic therapy,surgical removal and repair of the part of cesarean scar,hysterectomy and conservative treatment.All of the 35 patients got good recovery.

　　Conclusion CSP is rare and usually misdiagnosed.The early diagnosis should be made for the patients with cesarean delivery history by combination of gynecologic examination with laboratory detections.The hysteroscopic therapy is new and effective for CSP.

　　【Key word】 Cesarean section pregnancy;Cesarean section;Hysteroscopy;Early diagnosis;Therapy

Influence of Nursing Intervention on Mental Health of Patients with Hyperplasia of Mammary Glands? ZHANG Yu-jun.
The Second People′s Hospital of Fuyang， Zhejiang Province， Fuyang 311404， China

　　【Abstract】 Objective To explore the influence of nursing intervention on negative mood,uncertainty and coping styles of patients with hyperplasia of mammary glands.

　　Methods Ninety-two patients with hyperplasia of mammary glands were randomly divided as intervention group and control group.The comprehensive nursing intervention was additionally performed on patients in the intervention group,just routine nursing care was carried out on patients in the control group,and the course of nursing was 3 months for both groups.The mental conditions of the patients were surveyed at the 3rd day (before intervention) and at the end of half year (after intervention).The self-rating anxiety scale (SAS),the self-rating depression scale (SDS),the Medical Uncertainty Inventory Scale (MUIS) and Medical Coping Modes Questionnaire (MCMQ) were used to assess the effect of nursing intervention on the patients with hyperplasia of mammary glands.

　　Results After nursing intervention,the scores of anxiety,depression,uncertainty,and facing,avoidance and yielding in coping style in the trial group were respectively （40.5±6.6）,（42.4±7.1）,（51.3±8.4）,（21.5±4.5）,（13.3±2.6） and（9.4±2.2）,which showed significant differences from （48.3±7.3）,（50.0±8.2）,（82.1±9.6）,（18.2±4.3）,（16.7±3.4） and （12.1±2.7） in the control group respectively (P＜0.05).

　　Conclusion Nursing intervention can decrease negative mood and uncertainty of patients with hyperplasia of mammary glands,enhance their actively coping styles,and promote the prognosis and rehabilitation of disease.

　　【Key word】 Hyperplasia of mammary glands;Nursing intervention;Anxiety;Depression;Uncertainty;Coping styles

Gastrointestinal Function and Life Quality of Patients after Laparoscopic Common Bile Duct Exploration and Open Common Bile Duct Exploration? ZHANG Wei-gen.
Department of Surgery,the Second People′s Hospital of Fuyang,Fuyang 311404,China

　　【Abstract】 Objective To evaluate the gastrointestinal function and life quality of patients who underwent laparoscopic common bile duct exploration (LCBDE) and open common bile duct exploration (OCBDE) for choledocholithiasis.

　　Methods The average postoperative anal exhaust time,the incidence of untoward gastrointestinal reaction and gastrointestinal quality of life index (GIQLI) of the patients,who underwent LCBDE and OCBDE,2,5,10 and 16 weeks after the operation were compared.

　　Results Postoperative anal exhaust time (49±20)h in group LCBDE was less than(70±24)h in group OCBDE (P＜0.05).The incidences of untoward gastrointestinal reaction of the two groups were respectively 30.0％ and 35.0％（P＞0.05）.There was no significant difference in the GIQLI scores between the two groups before the operation 16 weeks after the operation (P＞0.05).However 2,5,10 weeks after the operation the GIQLI scores were （108.2±4.7） vs （97.3±4.8）,（119.1±3.5） vs （107.8±3.0）,and （121.3±4.0）vs（112.0±3.2）（P＜0.05）.

　　Conclusion The LCBDE and OCBDE have similar influence to remote GIQLI of the choledocholithiasis patients.However,the postoperative recovery of gastrointestinal function after LCBDE is quicker and thus more beneficial to the short term improvement fro the patients postoperatively.

　　【Key word】 Cholecystectomy，laparoscopic;Common bile duct exploration;Cholelithiasis;Quality of life;Gastrointestinal tract function

Ultrasonic Characteristics of Color Doppler Ultrasonography in Left Renal Vein Compression Syndrome? TAO Shan， WU Qiang， XIANG Lun-xiang， et al.
Department of Ultrasound， Three-gorge Central Hospital， Chongqing 404000， China? 【Abstract】 Objective To investigate the ultrasonic characteristics of color Doppler ultrasonography (CDU) in diagnosis of left renal vein compression syndrome.

　　Methods CDU data of 35 patients with left renal vein compression syndrome were retrospectively analyzed to sum up its ultrasonic characteristics and changes of blood flow signal.

　　Results Compressed narrowing of left renal vein in varying degrees was noted,the distal end of compressed part expanded,and the ratio of anteroposterior diameter at the widest point of expanded part (D1) to that at the narrowest (D2) was ≥2 when in supine position,and D1/D2 was ≥3 at 15th minute in spinal back extension position.CDU showed that the blood flow in the narrowest part became thin or even missing,blood flow signals were colorful and flow rate became rapid; and that the blood flow in the expanded part became wide,blood flow signals were gloomy,and flow rate was slow.

　　Conclusion CDU can show directly the compressed signs,stenosis in the left renal vein,and the blood flow changes of both narrow and expanded parts.So a definite diagnosis can be made by using CDU combined with clinical data.

　　【Key word】 Ultrasonography，doppler，color；Renal veins

Application Value of Improved Hypotonic Intravenous Pyelography in Diagnosis of Pelviureteric Hydrocele? CAO Ya-jie， FAN Bao-he， WANG He-jun， et al.
X-ray Department of Tangshan Xiehe Hospital,Tangshan 063000， China

　　【Abstract】 Objective To explore the application and value of improved technique for low tension intravenous pyelography in diagnosis of pelviureteric hydrocele.Methods Totally 27 patients with unilateral or bilateral hydronephrosis and ureter expansion diagnosed clinically and by B-Ultrasonography,20 min after intramuscular progesterone,were given intravenous injection of contrast agent at the elbow vein and then improved hypotonic intravenous pyelography.

　　Results In 27 patients there were 5 with mild hydronephrosis,15 with moderate hydronephrosis and 7 with severe hydronephrosis.All the mild,moderate hydronephrosis patients and the majority of severe hydronephrosis patients had a good pelviureteric developing and a clear diagnosis; only a small number of patients with severe hydronephrosis were not developing.

　　Conclusion The improved hypotonic intravenous pyelography,based on hypotonic medication with low-line position,has a good pelviureteric developing and a clear diagnosis.This is a valuable method.

　　【Key word】 Urography；Hydronephrosis;Posture

Nephropathia Pancreatica: A clinical analysis of 82 cases CHEN Fa-dong,MAO Hong,HU Su-jie,et al.
The Third Affiliated Hospital of Wenzhou Medical Collage， Rui′an 325200,China

　　【Abstract】 Objective? To find out the clinical characteristic of nephropathia pancreatica (NP).

　　Methods The clinical presentations,laboratory examinations,therapies and outcomes of 82 NP patients in our hospital retrospectively analyzed.

　　Results All the 82 NP patients had lumbago and percussion pain at renal region.There were 53 patients (64.63%) with laboratorial albuminuria,37 (45.12%) with microscopic hemoturia,12 (14.63%) cellular cast,3 (3.66%) with granular cast; 3 (3.66%) with Liguria,5 (6.98%) with anuria,10 (12.20%) with fixed urine specific gravity; 10 (12.20%) with diffuse renal swelling in B-Ultrasonography,15 (18.30%) with increased blood urea nitrogen,and 5 (6.98%) with serum creatine.All patients were given continuous gastrointestinal decompression,acid suppression,inhibition of pancreatic secretion and prevention and treatment of infection,as well as avoidance of nephrotoxic drugs.There were 3 patients with server acute pancreatitis (AP) complicated by renal failure that died,and all the rest patients were gradually cured.In 159 patients with mild AP there were 48 (30.19％) with NP complication,and in 45 server AP patients there were 34 （75.56％） with NP complication,the difference in NP prevalence between the two was significant (χ2=30.03,P＜0.01).The average hospitalization time for 82 NP patients was （20±10） days,which was significantly different from 15±8）days in 122 patients without NP (P＜0.01).

　　Conclusion Acute pancreatitis may be complicated by renal failure.The patients should be examined completely to avoid miss-diagnosis,the nephrotoxic drugs be avoided,and the complications be actively treated.

　　【Key word】 Pancreatitis；Complication；Nephrosis

New Progress in Laparoscopic Myomectomy? FENG Yi-chen,MA Cai-ling.
Department of Gynecology,The First Affiliated Hospital of Xinjiang Medical College,Urumqi 830054,China

　　【Abstract】 In recent years,the treatment of hyteromyoma by laparoscopic myomectomy (LM) has become a trend.In this article we review its indication,contraindication,the problems existing during the operation and postoperatively; we also make a comparisons among the 4 kinds of newest auxiliary technique and other 3 kinds of therapies.

　　【Key word】 Laparoscopes;Myomectomy

Progress in Research of the Relationship between Chronic Renal Disease and Cardiovascular Disease? WANG Gui-hua.
61623 Military Hospital,Beijing 100039,China

　　【Abstract】 The relationship between renal and cardiac diseases has been extensively concerned in recent years.In this paper the progress in clinical research of the relationship between chronic renal disease and cardiovascular disease is reviewed.The common pathogenic factors for the two diseases are emphasized and they are risk factors to each other.From a view of medical integration,the research of the correlation among diseases of different systems should be enhanced in order to seek effective methods of prevention and treatment.

　　【Key word】 Kidney diseases;Cardiovascular diseases;Cardio-renal syndrome

Number10May，2009

Relationship of Hypoalbuminemia to Clinical Prognoses of Elderly Chronic Obstructive Pulmonary Disease YU Rong-xiu，ZHANG Hong-xuan，LIAO Huo-sheng.
Pingzhou Branch of Guangdong Provincial People′s Hospital，Foshan 528251,China

　　【Abstracts】 Objectives? To investigate the relationship between hypoproteinemia and clinical prognoses of elderly chronic obstructive pulmonary disease(COPD).

　　Methods Fifty-nine elderly COPD patients (above the year of 60) hospitalized in our hospital from Jan 2005 to June 2008 were divided into group A(with low seralbumin) and group B(with normal ) according to plasma-albumin concentrations in hospitalized period.

　　Results There was siginificant difference in the incidence of respiratory failure,heart failure,electrolyte disturbances and acid-base imbalance between group A(55.6%,48.1%,62.9%,36.3%,respectively) and group B(21.9%,12.5%,25.0%,9.4%,respectively)(P＜0.05 );the fatality rate of group A(14.8%) was significantly higher than that of group B(0)(P＜0.05).

　　Conclusions Hypoalbuminemia can effect on the prognoses of acute exacerbation period of COPD,and cause the rates of complications and fatality to rise,suggesting that the degree of albumin is correlated to pathogenetic conditions and prognoses in elderly COPD patients.

　　【Key words】 Pulmonary disease，chronic obstructive；Hypoproteinemia；Prognosis

Application and Care Monitoring of Sequential Mechanical Ventilation in COPD with Respiratory Failure QU Yun-zhong,TANG Xiang-lin,CHEN Ping.
Department of Respiratory Medicine,Second Xiangya Hospital of Central South University,Changsha 410011,China

　　【Abstracts】 Objective To explore the treatment effectiveness of sequential mechanical ventilation in chronic obstructive pulmonary disease(COPD) with type Ⅱ respiratory failure and its nursing care monitoring.

　　Methods Ninety-six severe COPD patients with type Ⅱ respiratory failure were given tracheal cannula and mechanical ventilation,and then divided randomly into treatment group (n=48) and control (n=48).The control group were given conventional mechanical ventilation treatment,and the treatment given sequential noninvasive-invasive-noninvasive mechanical ventilation.Custody was performed in the same time.We observed the time of invasive ventilation,total time of mechanical ventilation,length of stay in respiratory intensive care unit(RICU),incidence of ventilator-associated pneumonia(VAP),rate of re-intubation and cases of hospital mortality.

　　Results The durations of invasive mechanical ventilation of treatment group and control were 74.12±31.06 h,168.38±56.60 h,respectively(P＜0.05);the re-intubation incidences were 6.25%,31.25%,respectively(P＜0.05) ;the incidence of VAP were 2.08%,27.08%,respectively(P＜0.05).

　　Conclusions Sequential noninvasive-invasive-noninvasive mechanical ventilation under the guidance of pulmonary infection control windows can shorten obviously mechanical ventilation,reduce reintubation and VAP incidence,and it can improve treatment effectiveness if combined with effective care measures.It is of certain clinical value.

　　【Key words】 Pulmonary diseases,chronic obstructive；Respiratory insufficiency；Respiration，artificial；Nursing care

Effects of Losartan on Remodeling of Airway Extracellular Matrix in Rat Models with Chronic Obstructive Pulmonary Disease LIU Hong-ling，SUN Hai-qiang，LI Hai-feng，et al.
Department of Respiratory Medicine,Affiliated Hospital of Liaoning Medical College,Liaoning 121001,China

　　【Abstracts】 Objectives To investigate the intervention effect of Losartan on remodeling of extracellular matrix in rat models with chronic obstructive pulmonary disease(COPD).

　　Methods Thirty SD rats were randomized into groups of control,model and Losartan,10 in each.COPD models were established by tobacco fumigating in combination of intratracheal instillation of lipopolysaccharide.The changes of morphous and function of COPD models were evaluated by HE slices and arterial blood gas analysis,the levels of matrix metalloproteinases-9(MMP-9) in bronchoalveolar lavage fluid(BALF) and tissue-inhibitor of metalloproteinase-1(TIMP-1) by enzyme-linked immunosorbent assay(ELISA),and the expressions of MMP-9 and TIMP-1 by immunohistochemistry.

　　Results The expressions of MMP-9 and TIMP-1were higher in model group(27.2±1.6,24.7±1.8,respectively) than in control(12.0±1.3,12.0±1.3,respectively)(P＜0.01),and lower in Losartan group(17.0±1.5,15.0±1.7,respectively) than in model group.The ratio of MMP-9 and TIMP-1 reached a new balance.

　　Conclusions Losartan can prevent and cure the remodeling of COPD extracellular matrix which is correlated with MMP-9,TIMP-1.This effect is associated with its recovery of the balance between MMP-9 and TIMP-1.

　　【Key words】 Pulmonary disease,Chronic obstructive;Matrix metalloproteinase-9;Tissue inhibitor of metalloprotinease-1;Losartan

Effect of Walking on Quality of Life and Cost-effectiveness in Impaired Glucose Tolerance Patients ZHANG Jing-hui,TANG Si-yuan,CHEN Bei-fang,et al.
27th Ward of Department of Geriatrics,Xiangya Hospital of Central South University,Changsha 410008,China 

　　【Abstract】 Objective To explore the effects of walking on quality of life（ QOL）and direct cost-effectiveness of lowering blood sugar in impaired glucose tolerance patients.

　　Methods One hundred four patients with impaired glucose tolerance were divided randomly into experimental group and control.The control group were given a standard treatment of lowering blood sugar,and the experimental took a strengthening walk twice a day besides it.We compared between 2 groups the scores of pre- and post-intervention QOL and the cost-effectiveness of lowering blood sugar after 6 months.

　　Results? After 6 months of intervention,the physical dimensions scores (59±5 ),psychological(59±4),social(59±4),satisfaction(60±6),general adaptation(238±14) and total(298±18) were significantly higher in experiment group than in control (47±10,47±9,48±9,47±9,189±28,237±33,respectively) (P＜0.01) ;the direct dost-effectiveness of lowering blood sugar of experiment group(9.42) was significantly lower than that of control(11.50)

　　Conclusion? Walking helps improve QOL of patients with impaired glucose tolerance and reduce direct cost-effectiveness of lowering blood sugar.

　　【Key word】 Walking;Impaired glucose tolerance;Quality of life;Cost-effectiveness

Metformin with Lifestyle Intervention in Treatment of Clozapine-induced Metabolic Disorders WANG Xiang-li.
Linyi Mental Health Center，Linyi 276005，China

　　【Abstract】 Objective To explore the clinical effects of metformin combined with lifestyle intervention on body weight(BW),glucose or lipid metabolic disorders induced by clozapine.

　　Methods One hundred thirty-six schizophrenic patients with clozapine-induced obesity (body mass index ＞25) were randomized into metformin with lifestyle intervention group(Met group,n=69) and lifestyle intervention group(TLC group,n=67).Both were given lifestyle intervention,but Met group were treated with additional clozapine,0.5 g,3 times/d.Treatment and observation lasted 6 months.We measured and compared blood pressure(BP),body mass and waist circumference(WC),alamine aminotransferase(ALT),aspartate-transferase(AST),γ-glutamyl transferase(GGT),total cholesterol(T-CHO),triglycerol(TG),high density lipoprotein cholesterol(HDL-C) ,low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),postprandial 2 h blood glucose,fasting insulin(INS) ,BMI and insulin resistance index(IRI).

　　Results Only T-CHO decreased significantly in Met group after treatement(P＜0.05),but at the end of month 6 the rest indexes decreased.No significant changes were noted in diastolic blood press（DBP）and HDL-C.BMI,WC,FBG,INS,postprandial 2 h BG and insulin,IRI,TG,ALT were decreased in Met group,significantly different from TLC group（P＜0.05）.All indexes were decreased significantly except DBP,TCHO,HDL-C in group TLC at the end of month 6.

　　Conclusion Metformin only or combined with Lifestyle intervention is of relatively good effects in treatment of BW increase and glucose or lipid metabolic diaorders induced by clozapine,but the combined has better results,and earlier effects,suggesting that metformin has good independent treatment effectiveness in treating clozapine-induced metabolic disorders.

　　【Key word】 Clozapine；Metformin；Life style；Metabolism dysfunction

Effects of Ligustrazin on High-glucose-induced Transdifferentiation of Human Renal Proximal Tubular Epithelial Cells WU Xiao-nan，WU Yi-lan，CHEN Jie，et al.
School of Public Health,Fujian Medical University,Fuzhou 350004,China

　　【Abstract】 Objective To investigate the effects of ligustrazin on high-glucose-induced HK-2 transdifferentiation in human renal proximal tubular epithelial cells.

　　Methods HK-2 cells were cultured in vitro with high glucose(25 mmol/L of D-glucose),recombinant high glucose and ligustrazin for 48 h.Ligustrazin was added 30min prior to high glucose and subsequently co-treated for 48 h in concentrations of 40,80,160 μg/ml,respectively.Morphological changes were assessed by phase contrast microscopy,transdiferentiation of tubular cells into myofibroblasts by immunofluorescence with monoclonal antibodies to α-SMA,and the expression of α-SMA and E-cadherin mRNA by RT-PCR.

　　Results High glucose induced striking morphological changes in epithelial cells.With the co-intervention of 80 μg/ml ligustrazine,no significant changes were noted in cell morphology.Immunofluorescence showed that α-SMA expression enhanced significantly after stimulation by high glucose,but reduced after addition of 80 μg/ml ligustrazine.By RT-PCR,high glucose up-regulated α-SMA mRNA significantly,but decreased E-cadherin mRNA（P＜0.01）.Recombinant high glucose with ligustrazine up-regulated E-cadherin mRNA（P＜0.01）but reduced α-SMA mRNA in a dose-dependent manner.

　　Conclusion Ligustrazin can attenuate high glucose-induced EMT,thereby to prevent tubulointerstitial fibrosis in diabetic nephropathy.

　　【Key word】 Tetramethylpyrazine；Kedney tubules；Cell differentiation；Hyperglycemia

Smokers with Type 2 Diabetes LI Juan,SHEN Xing-ping,ZOU Sen-biao,et al.
Intensive Care Unit,Department of Emergency,Xiamen University Affiliated Zhongshan Hospital,Xiamen 361004,China

　　【Abstract】 Objective To investigate the relationship between cell adhesion molecules(CAM) levels and oxidative stress(OS) in male smokers with type 2 diabetes mellitus(T2DM).

　　Methods This study included 112 male T2DM patients,63 of whom were smokers,49 nonsmokers;another 30 healthy male nonsmokers were chosen as control group.We detected the levels of soluble intercellular adhesion molecule-1 (sICAM-1),soluble vascular cell adhesion molecule-1(sVCAM-1),E-selectin and malondialdehyde(MDA),and activity of superoxide dismutase(SOD).

　　Results In MDA,sICAM-1,sVCAM-1 and SOD,T2DM smokers(8.2±3.6μmol/L,1.033±201μg/L,2.2±1.5μg/L,71±10U/ml,respectively) were significantly different from control group (4.2±2.4μmol/L,579±112μg/L,1.4±0.9μg/L,105±16U/ml,respectively) and T2DM nonsmokers (6.5±4.9μmol/L,899±121μg/L,1.4±0.8μg/L,82±11U/ml,respectively) (P＜0.05).The levels of E-selectin was significantly higher in T2DM smokers (62±28μg/L) and nonsmokers(59±19μg/L) than in control group (41±15μg/L) (P＜0.05).In sICAM-1,SOD and MDA ,heavy smokers (1.119±188μg/L,9.5±3.4μmol/L,61±10 U/ml,respectively) was significantly different from T2DM nonsmoker(899±121μg/L,6.5±4.9μmol/L,82±11U/ml,respectively),light smokers(938±137μg/L,7.6±2.4μmol/L,77±9U/ml,respectively) and moderate (986±151μg/L,8.3±2.5μmol/L,67±12U/ml,respectively),and moderate T2DM smokers different from T2DM nonsmokers and light T2DM smokers (P＜0.05).The difference was significant in sICAM-1,SOD and MDA between light T2DM smokers,moderate and T2DM nonsmokers(P＜0.05）.The level of sICAM-1 was positively correlated with systolic pressure,homeostasis model of assessment for insulin resistance index(HOMA-IR),MDA and E-selectin（r=0.36,0.29,0.38,0.28,respectively,P＜0.05）,and negatively with SOD（r=-0.25,P＜0.05）,positively with systolic pressure,HOMA-IR and MDA（r=0.25,0.28,0.32,respectively,P＜0.05）;E-selectin positively with HOMA-IR,sICAM-1 and MDA（r=0.31,0.28,0.30,respectively,P＜0.05）,and negatively with SOD（r=-0.22,P＜0.05）.

　　Conclusion? Smoking may increase serum CAM level and OS,and smoking quantity is correlated with sICAM-1 and OS.

　　【Key word】 Smoking;Diabetes mellitus;Cell adhesion molecules;Oxidative stress

Effects of Hypoxia on Synthesis and Secretion of Intermedin in Rats with Pulmonary Arterial Hypertension HUO Xiu-qing，YU Zhong-he，WANG Ping.
Beijing Military Command General Hospital，Beijing 100700，China

　　【Abstracts】 Objectives To study the effects of hypoxia on the synthesis and secretion of Intermedin and its mechanism and significance in the pathophysiological process of hypoxic pulmonary arterial hypertension(PAH).

　　Methods PAH animal models were reproduced，68 male Wistar rats were divided randomly into control group and 1-，2-,3-week hypoxia groups,14 in each.Pulmonary arterial pressure(PAP) and RVdp/dt(max) were measured by right cardiac catheterization,the dynamic changes of intermedin content by radioimmunoassay.

　　Results Control group was significantly different from hypoxia groups 1-,2-,3-,4-week in PAP（16.0±1.2， 17.9±2.5， 19.8±1.6， 21.6±1.2 mm Hg,respectively）and RVdp/dt max(1482±134,1569±227,1657±168,1815±185 m/s,respectively)(P＜0.05);significant difference was noted in PAP between hypoxia groups and control(P＜0.05);there was significant difference in RVdp/dt max between 1-week hypoxia group and control(P＜0.05).Control group differed significantly from 1-,2- 3-,4-week hypoxia groups in Intermedin (138.6±5.3,154.6±20.2,158.8±21.3,166.3±12.2 pg/ml,respectively ),arterial pO2(97.3±1.6,89.0±6.5,81.5±6.2,80.5±7.3 mm Hg respectively ) (P＜0.05 ) .2- and 3-week hypoxia groups were significantly different from control in Intermedin content(P＜0.05).There was significant difference in PaO2 level between hypoxia groups and control(P＜0.05).

　　Conclusions Hypoxia may result in elevation of serum intermedin contents in rats,and intermedin plays an important role in pathophysiological mechanism of hypoxic PAH.

　　【Key words】 Pulmonary hypertension；Intermedin；Hypoxia

Relationship between Congenital Heart Diease and Toxoplasma,Rubella Virus,Cytomegalovirus and Herpes Virus WU Chun-tao,CHEN Li-hua,LIU Su,et al.
Department of ICU,Third Hospital of Hebei Medical University,Shijiazhuang 050051,China

　　【Abstracts】 Objectives To investigate the relationship of congenital heart disease(CHD) to the infections of toxoplasma(TOX),rubella virus(RV),cytomegalovirus (CMV)and herpes simplex virus(HSV) .

　　Methods? Eighty patients with CHD were chosen as CHD group,and 32 without as control.Myocardial tissues,blood serum,and 4 kinds of pathogenic genes(TOX,RV,CMV,HSV) in leukocytes were detected by polymerase chain reaction(PCR) fluorescence quantitation.

　　Results? In CHD group,the positive detection rats of TOX,RV,CMV,HSV in myocardial tissues were 16.2%,18.8%,28.8%,7.5%,respectively,and in control,0,0,18.8%,6.2%,respectively;there was significant difference in TOX and RV gene positive detection rate between 2 groups(P＜0.05),but no difference in CMV and HSV(P＞0.05).TOX,RV,HSV pathogenic genes were not detected in CHD group,neither in control,namely there was no acute infection.The positive ratio of CMV was 44% in leucocyte in CHD group,and 41% in control.Conclusions? The occurrence of CHD is related to the infections of TOX,RV,CMV,HSV,but not to the quantity of pathogenic infection.

　【Key words】 Heart defects,congenital;Toxoplasma;Rubella virus;Cytomegalovirus;Simplexvirus;Genes;Polymerase chain reaction

　　Effects of Mosapride on Gastric Emptying and Plasma Motilin in Oral Rehydration of Rats with 40% Blood Volume Loss HU Sen,ZHOU Guo-yong,LI Lin,et al.Laboratory of Shock and Organ Dysfunction,Burns Institute,First Hospital Affiliated to the PLA General Hospital,Beijing 100037,China

　　【Abstract】 Objective To investigate the effects of mosapride on gastric emptying and plasma motilin in oral medication of glucose electrolyte solution (GES) in hemorrhagic rats.

　　Methods SD rats were randomly divided into GES group(oral GES after sham operations),H+GES (oral GES after hemorrhage)，and GES/MOS (oral GES and mosapride).About 40% of total blood volume was let from rat carotid arteries to establish models of hemorrhagic shock in all groups.GES were given GES lavage by doubling the blood loss at min 30,60,respectively.Mosapride(0.5 mg·kg-1·w·-1）was dissolved and given in the first intragastric administration.The gastric emptying rate was determined by phenol red method and plasma motilin by radioimmunity at hour 4 after hemorrhage.

　　Results The gastric emptying rates of groups GES,H+GES and H+GES/MOS were(92.4.3±12.5)%,(62.4±11.4)% and (79.6±10.7)%,respectively,at hour 4 after hemorrhage.There was significant difference between 3 groups（P＜0.05）.The plasma motilin of H+GES/MOS group was dramatically higher than that of H+GES（103.8±11.4 vs.72.5±14.3，P＜0.05）,and lower than that of GES（132.3.8±24.1，P＜0.01）at hour 4 after hemorrhage.The plasma NO content was significantly lower in H+GES/MOS group than in H+ GES（83.2±12.6 vs.105.7±13.2，P＜0.01),but still higher than in GES（53.6±6.9，P＜0.05).

　　Conclusion Mosapride can increase significantly plasma motilin levels,reduce NO,promote the stomach to evacuate oral solution and enhance the effects of oral rehydration in rats with hemorrhagic shock.

　　【Key word】 Shock，hemorrhagic；Fluid replacement therapy;Motilin；Gastric emptying

Intervention of Xuebijing Injection in Dynamic Changes of Mesentery Microcirculation in Rats with Sepsis LI Bing,ZHU Zhi-hong,TIAN Wan-guan,et al.
Department of Emergency,PLA General Hospital ,Beijing 100853,China

　　【Abstracts】 Objectives To study the dynamic changes of mesentery microcirculation blood flow in rats with sepsis and the mechanism of action of Xuebijing injectio.

　　Methods One hundred fifty Wistar rats were divided by random digits table into groups of sepsis,Xuebijing and sham operation.Cecal ligation and perforation(CLP) were used to establish sepsis rat models.Real-time observation was performed by microscope on the dynamic changes of capillary blood flow,vascular diameter and episporium number of polymorphonuclear neutrophils(PMN) in mesentery microcirculation instantly,at hours 12,24,48,72,respectively,after model establishment.

　　Results In sepsis group,mesentery microcirculation blood flow speeded up in 12 h after CLP,and began to slow down at hour 24,and the number of PMN adhering to the wall of the blood vessels increased significantly;stasis of blood stream appeared at hours 48,72 and microthromboses came into being gradually,and its blood flow was significantly slower than that of Xuebijing group.

　　Conclusions Mesenteric blood flow slows down continuiously,causing microthrombosis and mesenteric microcirculation disturbance in septic rats;Xuebijing injection can improve septic mesenteric microcirculation function to reduce microthrombosis.

　　【Key words】 Sepsis;Xuebijing;Microcirculation;Mesentery;Neutrophils

Early Diagnosis and Treatment of Acute Mesenteric Vascular Occlusion XU Yi,MA Jun-xun，CHEN Xiao-xiong,et al.
Department of Emergency,Tongren Hospital,Affiliated to Capital Medical University,Beijing 100730,China

　　【Abstract】 Objective? To analyze the clinical features of acute mesenteric vascular occlusion to put forward principles of early emergency diagnosis and treatment.

　　Methods We analyzed the data of 25 patients with acute mesemteric vascular occlusion in No.1 Affiliated Hospital of PLA General Hospital from 2004 to 2008.

　　Results In all 25 patients diagnosed as acute mesenteric vascular occlusion,16 as acute mesenteric arterial occlusion,9 as venous;5 were confirmed on first diagnosis,the other 20 confirmed after being first diagnosed as other diseases and treated symptomatically without any improvement.The 5 patients confirmed on first diagnosis were cured following early conservative therapy,18 were treated with routine surgeries,including 10 with emboli removal,necrotic intestinal canal resection with end-to-end anastomosis,and 8 only with necrotic intestinal canal resection with anastomosis;2 died due to general deterioration and nonperformance of surgeries.A total of 9 cases died.

　　Conclusion Precautions should be given to acute mesenteric vascular occlusion at early stage.Early diagnoses and surgical treatments can lower effectively its mortality rates.

　　【Key word】 Acute mesenteric vascular occlusion;Diagnosis;Therapy;Emergency treatment

Distribution of 567 Pathogenic Bacteria Isolated from Emergency Intensive Care Unit and Their Drug Resistance WANG Yue，ZHANG Lu-tao，SHI Li-ke，et al.
Department of Infection Management，the Second Hospital of Hebei Medical University，Shijiazhuang 050000，China

　　【Abstracts】 Objectives To investigate the distribution of infection sites and resistance of common pathogenic bacteria isolated from emergency intensive care unit(EICU) patients,to provide the reference for empiric treatment and infection control in hospital.

　　Methods Pathogenic bacteria,isolated from specimens of EICU patients from Nov.1 2006 to May 31 2008,were collected to perform drug sensitive test by Kirby-Bauer and statistical analysis by WHONET5 3 software according to CLSI standards(2005 edition).

　　Results Of the 567 isolates，gram-negative bacilli， gram-positive cocci and fungi accounted for 82.19% （n=466），10.41% （n=59） and 7.4% （n=42）,respectively.The most common pathogenic bacteria were Pseudomonas aeruginosa（PA,25.93%），Acinetobacter baumannii （AB,19.4%），Klebsiella pneumoniae （KP,14.29%），Escherichia coli（EC,10.93%），Staphylococcus aureus（SA,4.23%）， Candida albicans（CA,3.35%）.Relatively lower percentage of PA was resistant to isepamicin and amikacin.AB were relatively sensitive to imipenem and meropenem;KP,EC and Proteus mirabilis(PM) were highly sensitive to imipenem,with ESBLs detection rates of 55.56%，75.81%， 50%,respectively.Methicillin resistant strains in SA coagulase negative staphylococcus(CNS) accounted for 91.67% and 83.33%,respectively.No vancomycin-resistant strains were detected.

　　Conclusions The most common site of infection is lower respiratory tract，Gram-negative bacteria are the majority of the pathogenic bacteria seperated from EICU.The results of drug sensitive test show that most of bacteria are highly and multiple resistant to common antibacterials.Strengthened monitoring of etiology and drug resistance is of great significance in guiding rational clinical use of antibacterials and prevention of hospital infection.

　　【Key words】 Intensive care units；Bacteria；Fungi；Drug resistance

Identification of Bacteria and Drug Sensitive Tests of Fungal Infections:Report of 398 Cases WANG Xiao-hong.
Clinical Laboratory of First Affiliated Hospital of Jiamusi University， Jiamusi 154002，China

　　【Abstracts】 Objectives? To contribute the knowledge of hospital fungal infections to guide rational use of antifungal agents,prevention and control of the occurrence of fungal infections.

　　Methods Micro-biological assay and drug sensitive test were performed on 398 strains of clinical separated fungus.

　　Results? Most fungal infections were in respiratory tracts (216 strains in sputum,41 in throat swab),and then in urine specimens of urinary tracts(85 strains).Candida albicans were the most in fungal infection(234 strains),accounting for 58.8%.

　　Conclusions Etiological test,rational use of antifungal agents and effective prevention and control are the keys to reduce fungal infections.

　　【Key word】 Fungi；Antifungal agents；Microbial sensitivity tests

Integrated Remedy for Agonal Injury LIU Bao-chi,LI Lei,PEI Hui,et al.
Emergency Department of First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China 

　　【Abstract】 Objective To investigate the effect of remedy on agonal injury and its mode.

　　Methods Integrated remedies such as pre- and in-hospital care,emergency operations and ICU were performed on 116 agonal injured patients.

　　Results Of 116 patients(79 male,37 female,aged ranging from the year of 16 to 69),21 died due to resuscitation failures in emergency departments;63 received operations and ICU treatments,7 died;32 were transferred into special wards following initial treatments,16 died.The others recovered successfully.

　　Conclusions Integrated remedies of agonal injured patients can improve survival rate.

　　【Key words】 Multiple trauma;Critical illness;First aid

Effect of Emergency Medical Service on Pre-hospital Delay in Patients with Acute Stroke in Beijing WANG Ya-bing，JIAO Li-qun，LING Feng.
Department of Neurosurgery,Xuanwu Hospital,Capital Medical University，Beijing 100053，China

　　【Abstracts】 Objectives To investigate the effect of emergency service system on prehospital delay and related factors in patients with acute stroke in Beijing.

　　Methods We evaluated the medical records of 1029 consecutive acute stroke patients admitted to 15 major hospitals in Beijing within 24 hours after symptom onset.

　　Results A total of 1029 cases were enrolled.The median pre-hospital delay was 6.61h.The patients who chose EMS took shorter delayed time than those who did not;Logistic Regression Analysis showed that the main factors related to pre-hospital delay were disease time,delay in primary hospitals,post-onset disease severity and so on.

　　Conclusions Beijing first-aid system can shorten,to some extent,pre-hospital delay of acute stroke patients;education of cerebrovascular disease knowledge should be further strengthened and the role of EMS publicized,and close co-operation enhanced between hospitals and first-aid systems so that EMS can play a greater role in pre-hospital emergency system.

　　【Key words】 Emergency medical service;Cerebrovascular accident；Transportation of patients

Clinical Significance of Revised Trauma Index in Emergency Remedy ZHANG Guo-hui，CAO Ya-jie，ZHANG Hai-bo.
The Third People′s Hospital of Tangshan,Tangshan 063100，China

　　【Abstract】 Objective To study guidance role of Revised trauma index(RTI) in emergency remedy and its value grading method.

　　Methods RTI were used to score prospective group(723 cases≦9,1302 between 10 and 16,695 ≧17) ,and to treat correspondingly based on the scores.Retrospective analysis was performed on retrospective group(571cases ≦9,1122 between 10 and 16,622 ≧17).We analyzed comparatively the diagnosis and treatment results of both groups.

　　Results In retrospective group,not too serious actual traumatic conditions but simple contusions and lacerations were found in 67 of the patients with ≦9 RTI scores,without any complications,only simple suture and symptomatic treatment were needed;the pathogenetic conditions were worsened in varying degrees and hospitalized for further therapy in 120 of those with 10～16 scores after out-patient treatment.The above cases were classified as treatment failures.There was significant difference in failures of diagnosis and treatment between patients with varying scores in 2 groups（P＜0.01）.The patients with ≦9 of both groups had not complications,there was significant difference between patients with different scores（P＜0.05）.

　　Conclusion RTI,which can be used as one of methods in assessing traumatic severity in pre-hospital care,is of guidance effect in first-aid.It can reduce diagnostic error rate and complications.

　　【Key word】 Revised trauma index;Injury severity score；Triage；Wounds and injuries 

Establishment of Venous Accesses in Pre-hospital Emergency and Its Influencing Factors and Coping Strategies CHEN Jian-hui,ZHANG Xiao-fan,ZHANG Zhen-xin,et al.
Wuxi Emergency Center,Wuxi 214023，China

　　【Abstract】 Objective To probe into the influencing factors and coping strategies of establishment of venous accesses,to raise the achievement ratio of venipuncture(VP).

　　Methods We analyzed the results of questionnaires and data from electronic medical record management system,to discuss the influencing factors and coping strategies of venous access establishment in pre-hospital emergencies.

　　Results The main factors influencing emergency VP were emergency whenness,stability of first-aid vehicles,light inside vehicles,seasons,conditions of patients′ own veins,co-ordination of patients and their dependants,etc.The rate of patients receiving VP was 59.83% in summer,and 53.41% in winter,the difference was significant (P＜0.05).The rate of low past-service doctors′ performing VP was 51.22%,and that of high past-service was 58.39%,the difference was significant(P＜0.05).

　　Conclusion VP achievement ratios in pre-hospital emergencies are influenced by such factors as time,environment,pathogenetic conditions,doctors′ psychological state,etc.Difficult VP problems in pre-hospital emergencies can be resolved by acquisition of good-capacity vehicles,rational allocation and cooperation of staff,training and psychological intervention.

　　【Key word】 Emergency medical services；Infusions，intravenous；Punctures

Rapid Assessment of Emergency ECG for Hyperkalemia ZHOU Jun-rong.
Department of Cardiology,Clinical Division of Medical Department,PLA General Hospital,Beijing 100853,China

　　【Abstracts】 Objectives To evaluate the value of emergency ECG for the forecast of hyperkalemia.

　　Methods Synchronous 12-lead electrocardiograph was used to perform ECG examinations on 106 suspected hyperkalemia patients.Serum potassium concentration was detected by blood collection,and ECG characteristics were analyzed.

　　Results Serum potassium concentration in ECG elevated in 101 patients;the sensitivity of emergency ECG was 95.3% in diagnoses of hyperkalemia.

　　Conclusions Emergency ECG can be used as one of effective methods in rapid screening of hyperkalemia.The ECG features of hyperkalemia are of relatively high value in prediction of hyperkalemia.

　　【Key words】 Hyperkalemia;Electrocardiography;Emergency

Imaging Diagnosis of Congenital Cholangiectasis:Report of 40 Cases ZHAO Liang，YAO Lan-hui.
Department of Abdominal Ultrasound，the First Affiliated Hospital of Xinjiang Medical University，Urumqi 830054，China

　　【Abstract】 Objective To investigate the imaging manifestations of congenital cholangiectasis to probe into the value of imaging examinations.

　　Methods A retrospective analysis was carried out to compare the results of ultrasonic wave(US),CT and magnetic resonance cholangiopancreatography(MRCP) of 40 congenital cholangiectasis patients.

　　Results The imaging manifestations of congenital cholangiectasis varied with different methods.The correct rates of preoperative US,CT and MRCP were 83.8%，86.7%，93.9%,respectively.

　　Conclusion In imaging examinations of congenital cholangiectasis,US should be the first choice,and MRCP contribute the options of its clinical typing and surgeries.

　　【Key word】 Congenital cholangiectasis；Imageology；Diagnosis

Clinical Treatment of Low-flow Priapism LI Cheng-fu，ZHAN Sheng-li，CAI Ming，et al.
Andrology Center，Fuyang Second People′s Hospital，Fuyang 236015，China

　　【Abstracts】 Objectives? To investigate the clinical efficacy of glandular cavernosum shunting and corpus cavernosum tunnel surgery in patients with low-flow priapism.

　　Methods Eleven patients,who were diagnosed finally as low-flow priapism through medical histories,physical examinations,cavernosum aspiration blood gas analyses and Doppler ultrasonography,were given conservative treatment,intracavernous lavage and drug injection,glandular cavernosum shunting and corpus cavernosum tunnel surgery.

　　Results Priapism extincted completely in 10 patients,partly in 1.

　　Conclusions Patients in whom priapism occurs within 24 h should be treated with intracavernous injection,at h 24 or over with glandular cavernosum shunting and corpus cavernosum tunnel surgery.Both are of good clinical effect in treatment of low-flow priapism.

　　【Key words】 Priapism;Thearpy

Recognition of Spontaneous Intracranial Hypotension Syndrome GE Yong-chun，ZHAO He-qing.
Department of Neurology，The Second Affiliated Hospital of Soochow University，Suzhou 215004，China

　　【Abstract】 Objective To investigate the clinical，neuroimaging(NI) and Cerebrospinal fluid（CSF） features of spontaneous intracranial hypotension syndrome（SIH） and its prognosis.

　　Methods Nineteen SIH patients (from 2004 to 2008) were enrolled.We observed the clinical manifestations,the features of CSF and NI,and its prognosis.

　　Results Eighteen patients suffered orthostatic headache in preliminary diagnoses;the symptom became illegible with disease progression in 1 of them,another one had illegible orthostatic headache on visit.Patients had different associated symptoms.CSF pressure were below 60 mm H2O,cells and proteins increased slightly in 18 patients.In brain CT examination,normality was noted in 14 patients,subdural effusion in 2,subdural hematoma in 3(relatively large and more severe progressive condition in 2).Six patients were given MRI examinations,and 5 of them presented with diffuse thickening of dura mater.

　　Conclusion? SIH clinical features,CSF changes and MRI are of certain characteristic.SIH is not always a benign prognosis,a small number of patients may be complicated by major subdural hematoma to cause more severe progressive conditions,which requires emergency brain surgery.

　　【Key word】 Intracranial hypotension；Tomography，spiral computed；Magnetic resonance imaging

Low-flow Sevoflurane Inhalation Anaesthesia in Radical Mastoidectomy JIN Xiu-ling,YUE Jun,WU Hui.
Departement of Anesthesiology,the First Affiliated Hospital of Wenzhou Medical College,Wenzhou 325000,China

　　【Abstracts】 Objectives To investigate the clinical application of low-flow sevoflurane inhalation anaesthesia in radical mastoidectomy.

　　Methods Forty patients with chronic suppurative otitis media were divided into isoflurane group(n=20,given isoflurane maintenance anesthesia) and sevoflurane group(n=20,given sevoflurane).We recorded perioperative heart rates(HR) and blood pressure(BP),post-operative recovery time,and occurrence of nausea and vomiting 24 h after operations.

　　Results? There was no significant difference in perioperative HR and BP between 2 groups(P＞0 05).In isoflurane group,post-operative nausea and vomiting scores were 0(9 cases),1(3 cases),2(5 cases),3(3 cases),respectively,and in sevoflurane group 0(16 cases),1(1 case),2(2 cases),3(1 case),respectively,the difference was significant(P＜0 05).In isoflurane group,the recovery time of automatic respiration,time of initial eyes open,time of intial intercom,recovery time of orientation were 10.3±3.3,11.4±3.5,14.5±6.1,24±6 min,respectively,and in sevoflurane group 5.4±2.1,6.7±1.9,8.5±2.4,17±6 min,respectively,the difference was significant(P＜0.05).

　　Conclusions? The recovery time of sevoflurane inhalation anesthesia is shorter and has fewer side effects than that of isoflurane.Low-flow sevoflurane anesthesia can be applied safely and effectively in mastoidectomy.

　　【Key words】 Sevoflurane ；Isoflurane;Anaesthetics，inhalation；Blood pressure;Mastoidectomy

Effect of Surgery Combined with Rupisanjie Capsules for Mammary Gland Hyperplastic Nodules HONG Zhong-wu，FU Jian-fei， XU Xi-shan.
Oncology Service of Zhejiang Jinhua Central Hospital，Jinhua 321000，China

　　【Abstracts】 Objectives? To study the effectiveness and feasibility of Rupisanjie capsules on the mammary gland hyperplastic nodules after mammary partial mastectomy.

　　Methods Three hundred fourteen mammary gland hyperplastic nodule patients were divided into treatment group(n=157,receiving oral Rupisanjie capsules besides surgeries )and control(n=157,receiving surgeries only).

　　Results? When compared with control,the reoperative rate of treatment group decreased significantly(21 7%,8 9%,respectively,χ2=9.837，P=0.002);the overall effective rate was significantly higher in treatment group than control(90.8% vs 43.3%， u=12.047，P=0.000),and the rate of side effect was low(5 7%).

　　Conclusions? In patients with hyperplasia of mammary glands with suspected canceration nodules,partial mastectomy with Rupisanjie capsules can reduce reoperative rate.

　　【Key words】 Fibrocystic disease of breast；Surgical procedures；Rupisanjie capsules；Treatment outcome

Insulin Combined with Traditional Chinese Medicine in Newly-diagnosed Type 2 Diabetes with Extreme Heat due to Yin Deficiency YU Hong.
Liuyang TCM Hospital，Liuyang 410300,China

　　【Abstracts】 Objectives To explore the effects of short-term insulin intensive treatment with Chinese traditional medicine(CTM) on newly-diagnosed type 2 diabetes mellitus (T2DM)with extreme heat due to yin deficiency.

　　Methods Forty-eight newly-diagnosed T2DM patients with extreme heat due to yin deficiency were randomized into insulin group(receiving insulin treatment only) and combination group(receiving treatment of insulin combined with CTM).

　　Results In combination group,significant difference was noted in FBG,AUCG,Homa-B,Homa-IR,AUCI,AUCCP30,total symptom scores and main symptom scores between post-treatment(5.6±1.3 mmol/L,39±7,138±40,59±20,16±5,1.9±0.9,15.6±2.1,5.4±1.5,respectively ) and pre-treatment(13.9±3.1 mmol/L,61±18,14±4,35±11,8±4,5.2±1.2,32.8±8.3,21.6±4.6,respectively)(P＜0.05 ) .There was significant difference in Homa-B,main symptom scores between combination group(138±40,5.4±1.5,respectively) and insulin (112±46,8.4±2.4)(P＜0.05 ).

　　Conclusions? Short-term insulin treatment combined with TCM can greatly improve insulin resistance and clinical symptoms in newly-diagnosed T2DM patients with extreme heat due to yin deficiency.

　　【Key words】 Diabetes mellitus,Type 2；Insulint resistance；Insulin；Drugs，chinese herbal

Clinical Analysis of Tracheal Neurilemmoma：Description of One Case and Review of the Literature ZHANG Yun-jian,LIU Fa-yong,XIA Guo-guang,et al.
Department of Respiratory,Jishuitan Hospital,Beijing 100035,China

　　【Abstract】 Objective To analyze the clinical manifestations of tracheal neurilemmoma in order to improve the diagnosis of this rare disease.

　　Methods One case of tracheal neurilemmoma was reported.The clinical features of other thirty-one cases from the literature were reviewed.

　　Results The most common presentation of tracheal neurilemmoma is progressive dyspnea.cough,hemoptysis,and obstructive atelectasis were also reported.Some of the reported neurilemmomas were misdiagnosed as asthma.chest CT,and fiberoptic bronchoscopy are helpful in the diagnosis of intratracheal tumors.A definitive diagnosis can be made only by histological analysis.As for appropriate therapies,surgery,bronchofiberoptic resection can be chosen depending on the patient′s status，the location and size of the tumor.

　　Conclusion An tracheal tumor should be considered in the differential diagnosis of dyspnea,especially with no effect of bronchodilator therapy.Fiberoptic bronchoscopic cryotherapy can be attempted in the management of intratracheal tumor.

　　【Key word】 Trachea;Neurilemmoma;Bronchoscopes;Diagnosis;Cryotherapy

Research Progress in Correlation between Nasal Structural Abnormalities and Chronic Headache LOU Zheng-cai，LOU Fang-yi,LOU li-ming,et al.
Departmentof Otolaryngology;Yiwu Municipal Central Hospital,Yiwu 322000，China

　　【Abstract】? Etiological diagnoses of chronic headache have been tough problems.In recent years tunica mucosa nasi contact headache has been paid more and more extensive attention to.International Headache Society has classified it as one of the causes of headache in 2004.This article reviews the research of correlation between nasal structural abnormalities and chronic headache.

　　【Key word】 Nose；Dissection；Paranasal sinuses；Headache

Negative Pressure Drainage and Wound Healing ZHOU Jian-da,LIU Jin-yan,HU Yuan,et al.
Department of Burn and Plastic Surgery,the Third Xiangya Hospital of Central South University,Changsha 410013,China

　　【Abstract】 To investigate the possible mechanism of negative pressure drainage(VSD) promoting wound healing and the best VSD condition.This article analyzes retrospectively the research results of a number of scholars and sums up the best condition of VSD techniques for promotion of wound healing.

　　【Key word】 Drainage；Wounds and injuries

Effectiveness of Community Intervention on Elderly Depressive Disorders in Beijing Yuetan Community WANG Hui-lan，DU Xue-ping.
Fuxing Hospital，Affiliated to the Capital Medical University， Beijing 100038，China

　　【Abstracts】 Objectives To explore the community intervention of the elderly depressive disorders，to provide more evidences for community intervention policy.

　　Methods Geriatric Depression Scale was used to screen 84 patients with elderly depressive disorders and to perform 6-month community intervention(conventional and psychological),and then the effects were analyzed.

　　Results? The post-intervention scores of Geriatric Depression Scale,Hamilton Depression Scale,Quality of Life Summary Scale,Family Functional Assessment Scale,Social Support Rating Scale were 15.0±4.0,8.7±6.4,17.9±3.3,4.8±2.6,27.1±7.0,respectively;the pre-intervention scores were 13.0±5.0,10.6±6.7,18.7±4.0,4.1±2.0,25.1±5.1,respectively.The difference was significant(P＜0.05).

　　Conclusions Community intervention can relieve depressive symptoms and improve quality of life in patients with elderly depressive disorders.

　　【Key words】 Depression；Aged；Community health services

Investigation of Compliance of Hand-washing Behaviors in Out-patient Medical Staff MA Ai-zhu,ZHOU Yan,ZHANG Fan,et al.
Information Technology Department ,2nd Affiliated Hospital of Wenzhou Medical College,,Wenzhou 325027,China

　　【Abstracts】 Objectives To find out the compliance of hand-washing behaviors in medical staff and their execution rate.

　　Methods Using self-designed questionnaires in combination with field observation,we investigated randomly the hand-washing knowledge of medical staff from different out-patient departments(departments of Traditional Chinese Medicine(TCM),ophthalmology,internal medicine,surgery,dermatology,ophthalmology & otorhinolaryngology,gynecology ) and their execution rates of hand-washing.

　　Results Ninety percent of medical staff had received training of hand-washing knowledge;30% did not grasp six-step method of hand-washing,thinking that the longer hand-washing lasted,the better it would be.The reasons that medical staff failed to wash hands in accordance with norms were busy work,health care priority,hands remaining clean without contact with patients′ secretions and excreta,the thought that the pollution of medical supplies or other factors were the main reasons for infection.The rate of hand-washing execution was high in departments of gynecology and dermatology,and low in TCM and surgery.

　　Conclusions The rate of hand-washing is not high in medical staff.Knowledge of hand-washing should be enhanced and behaviors normalized to reduce effectively the occurrence of hospital infections.

　　【Key words】 Medical staff，hospital；Hand washing；Compliance

Enlightenment on Electronic Medical Record Metadata by Comparing Traditional Paper Record Metadata Between China and America XU Wei,WANG Zhi-yong,CHEN Wei-wei,et al.
Department of Medical Information，Second Military Medical University,Shanghai 200433,China

　　【Abstract】 Objective Analyze differences of paper medical records between China and U.S.,and propose ideas on EMR metadata research.

　　Methods We extracted metadata using paper medical records in Changhai Hospital as a sample of Chinese paper medical record;Then,we chose paper medical record metadata in ASTM_E1384-07 as comparator.

　　Results Contents of Paper medical record metadata between China and U.S.are almost the same,but the classification and format are different.

　　Conclusion It is inevitable to build up EMR metadata standard in China,and ASTM_E1384-07 standard as well as other international standard can provide useful references.

　　【Key word】 Electronic medical record；Metadata；ASTM_E1384-07；Problem list

Number11June，2009

Effect of Implementation of Separated Management of Income and Expenditure on the Service Quality in Beijing Community Health Service Institutions? WANG Jun-li， YIN Na, CHEN Qi, et al.
?Beijing Ditan Hospital, Beijing 100015, China
【Abstract】 Objective To find out whether the service quality of community health service (CHS) institutions had been improved following the implementation of separated management of income and expenditure.
Methods The questionnaire survey was conducted in 489 CHS institutions and a part of the outpatients in Beijing, and the data was statistically analyzed by using SPSS 13.0 software.
Results In 2007, the original levels of community management quality of chronic diseases (including hypertension, diabetes mellitus, coronary diseases and brain stroke) had been kept. The health education, residents′ evaluation and visiting intention had been obviously improved, and better in the intervention group than in the control group.
Conclusion The service quality in CHS institutions has been improved following implementation of separated management of income and expenditure. Nevertheless, it is still not ideal, especially in public health services, which need to be further strengthened so as to get an early return of commonweal in CHS as soon as possible.
【Key word】 Community health services；Separated management of income and expenditure;Service quality;Evaluation;Beijing

Changes of Service Quantity Following Implementation of Separated Management of Income and Expenditure in Beijing Community Health Services Institutions WANG Na, WANG Jun-li， YIN Na, et al.
Health Management and Education College of Capital Medical University, Beijing 100069, China
【Abstract】 Objective To find out the changes of service quantity of Beijing community health service (CHS) institutions after the implementation of separated management of income and expenditure.
Methods The questionnaire survey was conducted in 489 CHS institutions in Beijing, and the data was statistically analyzed by using SPSS 13.0 software.
Results The total person-time visiting at outpatient and emergency departments, the service quantity of house call and family bed, and public health service (excluding immunization) quantity in CHS institutions were larger in 2007 than those in 2006. Compared to the control group, the increasing ranges of outpatient and emergency quantity and the most of public health service quantity in the intervention group were higher than those in the control group, but lower of the service quantity of house call and family bed.
Conclusion The service quantity of CHS institutions has been improved to some extent as compared with that of the corresponding period of last year. The separated management of income and expenditure promotes evidently the outpatient and emergency quantity and public health service, however, the service of house call and family bed needs to be enhanced.
【Key word】 Community health services; Separated management of income and expenditure;Volume of service;Beijing

Investigation on the Training General Practitioners for Senior Title Test in Zhejiang Province? MI Xu-feng, LI Jun-wei.
Zhejiang University, Hangzhou 310006, China
【Abstract】 Objective To explore the mode of training program suitable for senior title test of community general practitioners through investigation of the relative contents of training program for senior title test of community general practitioners in Zhejiang province.
Methods A questionnaire was made based on reviewing the relative literatures at home and abroad, and on-the-spot investigation was taken to survey the trainees taking part in the training of general practitioners for senior title test and the experts in the general practice field in Zhejiang province.
Results Totally 52 trainees (96%) and 35 experts (100%) believed it was very necessary to carry out this training work; 47 trainees (87%) and 35 experts (100%) held that one week length of training period was the most reasonable; 37 trainees (69%) and 35 experts (100%) chose the theoretical lecture combining with case analysis in class as training method, and they all believed the key contents should be fundamental theory and method of general practice, the relative policies on general practice and community health services, and the common problems of health in community.
Conclusion It is very necessary to carry out the training for senior title test of community general practitioners,? in Zhejiang province. A preliminary training program for senior title test of general practitioner can be drawn up on the basis of the results of this investigation.
【Key word】 General practitioner;Title assessment;Training;Zhejiang province.

Practice and Thinking of General Practitioners′ Residency Training in Shanghai? ZHAO Jie， ZHANG Yuan， HUANG Yan.
Shanghai Siping Community Health Center， Shanghai 200092， China
【Abstract】 In this article we expound our experience in the general practitioners′ residency training in Shanghai municipality, summarize the strong points and shortcomings in carrying out the general practitioners′ residency training, and put forward the countermeasures as well. 
【Key word】 Physicans，family；Residency training；Shanghai
Impact of Extremely High Temperature and Drought on Outpatients′ Disease Spectrum in Internal Medicine? YU Lan-ying， TAN Jing， ZHONG Zhao-hui， et al. School of Public Health， Chongqing Medical University， Chongqing 400016， China
【Abstract】 Objective To investigate the disease spectrum features and variations of Internal Medicine Outpatients during the period of extremely high temperature and drought.
Methods The history conventional data analysis in descriptive method was adopted in analyzing the disease spectrum features of internal medicine outpatients in July and August 2006 in Chongqing, and compared them with those in the same periods of 2005 and 2007.
Results The average temperatures during the same periods of July and August were respectively 29.5 ℃ and 26.1 ℃in 2005, 31.2 ℃ and 32.7 ℃ in 2006, and 27.5 ℃ and 29.4 ℃ in 2007; the highest temperatures were respectively 35.6 ℃ and 30.8 ℃ in 2005, 37.4 ℃ and 39.5 ℃ in 2006, and 31.9 ℃ and 36 in 2007; the precipitations were respectively 3.0 mm and 6.3 mm in 2005, 2.1 mm and 0.3 mm in 2006, and 11.8 mm and 2.6 mm ?in 2007; the evaporations evaporation 6.5 mm and 3.8 mm? in 2005, 8.4 mm and 9.6 mm in 2006, and 4.1 mm and 8.2 mm in 2007; the relative humidities were respectively 67.9% and 76.7% in 2005, 67.3% and 50.9% in 2006, and 84.3% and 69.0% in 2007 （P＜0.05）. The constituent ratios of male to female were respectively 48.91% and 51.09% in 2005, 46.03% and 53.97% in 2006, and 47.17% and 52.83% in 2007; and the constituent ratios aged 14 and below, 39 and below, 64 and below, and 65 and above were respectively 1.14%, 41.34%, 41.88% and 15.64% in 2005, 0.70%, 40.57%, 41.69% and 17.04% in 2006, and 0.62%, 39.72%, 41.95% and 17.71% in 2007（P＜0.05）. The diseases of respiratory system, digestive system and circulatory system had been in the first three places during the three years. And the constituent ratio of upper respiratory infection was in the first place in individual disease classification in 2006.
Conclusion The impact of weather of extremely high temperature and drought on people′s health is different in age and gender. The main diseases affected by such weather are respiratory system diseases, with upper respiratory infection being more evident. 
【Key word】 High temperature and drought；Outpatients；Internal medicine；Disease spectrum
Effect of Rosiglitazone on Patients with Nonalcoholic Steatohepatitis? ZHANG Xue-ling， LI Jian-xu.
Qingdao Municipal Hospital, Qingdao 266011, China
【Abstract】 Objective To observe the effect of Rosiglitazone in treatment of patients with non-alcoholic steatohepatitis (NASH).
Methods Totally 78 NASH patients were randomly divided as trial group (n=39) and control group (n=39). All the patients were given conventional treatment, and the patients in the trial group were treated with oral Rosiglitazone, 4 mg twice a day, while those in the control group with intravenous drop of energy mixture, once a day, for 12 weeks. Then the effects, liver functions and leptin between the two groups were compared.
Results In the trial group there were 32 cases with a remarkable effect, 5 case with effect and 2 cases with no effect, as compared with those of 24, 7 and 8 respectively in the control group, the differences were significant (u=2.14,P＜0.05). After treatment, the differences in levels of serum ALT ［（48±19）U/L and （67±19）U/L］, AST ［(37±8)U/L and (46±17)U/L］ and GGT ［(61±10)U/L and (72±14) U/L］ were statistically significant （P＜0.01）. The levels of leptin for man and woman in the trial group were （11±9） ng/ml and （26±15）ng/ml after treatment, which showed a significant difference from those ［（16±7）ng/ml and （33±17）ng/ml］ before treatment （t=1.73, 1.37; P＞0.05）. No untoward effect was found in the patients of both groups.
Conclusion? Rosiglitazone is safety and effective in treating NASH, and it can remarkably improve liver function.
【Key word】 Fatty liver，non-alcoholic;Rosiglitazone；Treatment outcome.

Impact of Social, Behavioral and Psychological Factors on Sleep Disorder in Working Population
SHANG Li, LI Jian, ZHOU Mei, et al.
School of Public Health, Kunming Medical University, Kunming 650031, China
【Abstract】 Objective To analyze the impact of social, behavioral and psychological factors on the sleep disorder by investigation of the sleep conditions of urban working population.
Methods A cross-sectional survey was conducted in a sample of 2 178 subjects aged 30-65 years, who were chosen randomly from the central areas in Kunming city, to analyze the conditions of sleep disorder under the various social, behavioral and psychological factors by multiple Logistic regression.
Results The significant differences were found in the prevalence of sleep disorder between men and women; among people with different education backgrounds, occupations, extents of job stress and family stress; among people working with different types of companies and under different types of contracts; between people taking physical exercises or not. Smoking or not, drinking alcohol or not, taking shift work or not （P＜0.05）. The Logistic regression showed that sleep disorder was correlated with male, alcohol drinking, no physical exercise, higher job stress and family stress（P＜0.05）.
Conclusion As a sensitive and early predictor of general health in working population, the sleep quality is affected by many social, behavioral, and psychological factors.
【Key word】 Sleep disorders；Psychology，social；Behavioral medicine；Occupational groups

Pathogenic Bacterium Culture of Bronchoalveolar Lavage and Endotracheal Suction Fluids in Delayed Ventilator-associated Pneumonia DUAN Xian-wu, GUO Wei, XIE Bao-yuan.
Respiratory Department of Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
【Abstract】 Objective To comparatively evaluate the significances of routine qualitative cultures of endotracheal suction fluids (ESF) and bronchoalveolar lavage fluids (BALF) to antibiotic therapy for delayed ventilator-associated pneumonia (VAP).
Methods? The culture of ESF was performed twice weekly for the patients mechanically ventilated. A diagnosis of VAP was made according to the results of BALF. The result of the last culture of ESF performed just before the suspicion of VAP was record, and compared with the results of BALF to see whether they were consistent.
Results VAP was diagnosed (by BALF culture) in 33 of the 42 patients who were suspected. Among the 33 patients with positive culture of BALF for VAP, the last culture of ESF of 28 (84.8%) cases had the same microorganisms and the same antibiotic sensitivity. There was no significant difference in detectable rate of VAP between the two methods （χ2﹦0.08，P＞0.01）.
Conclusion The routine qualitative culture of ESF performed twice weekly is of good guidance for an early treatment of delayed VAP.
【Key word】 Bronchoalveolar lavage fluid;Endotracheal aspirate;Mechanical ventilation;Pneumonia.

Lipid and Glucose Metabolism and Their Relationship in Patients with Gestational Impaired Glucose Metabolism? YANG Yong-bin， SHAO Jia-shen，XU Wei， et al.
Shanghai Jiaotong University Affiliated Shanghai First People′s Hospital，Shanghai 200080， China
【Abstract】 Objective To investigate the serum lipid levels, and glucose metabolism and lipid metabolism in pregnant women with glucose metabolism disorders.
Methods? Totally 406 pregnant women at 24-28 gestational week, who received antenatal care in the clinic of our hospital from 2003 to 2005 and whose 50g glucose challenge test ≥7.8mmol／L, were given 75g glucose oral glucose tolerance test (OGTT). And at the same time they were given determinations of serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c), apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB). They were divided according to the results of OGTT as gestational diabetes group (GDM, n=115), gestational impaired glucose tolerance group (GIGT, n=60) and positive glucose challenge test group 〔GCT(+), n=231〕. The age of the pregnant women, number of gravidity and parity, and delivery pregnancy week were all recorded.
Results The TG level in GDM group was higher than those in GIGT and GCT(+) groups, but the levels of HDL-c and ApoB were lower than those in GIGT group and GCT(+) group （P＜0.05）. There was no significant difference in levels of TC and HDL-c among the three groups （P＞0.05）. The TG level was positively correlated with the levels of fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c) and Homa insulin resistance index (HOMA-IR); and it was negatively correlated with the levels of insulin sensitivity index (IAI), index of beta-cell function (HBCI). The level of HDL-c was negatively correlated with the levels of FPG and HbA1c, but positively with the level of HBCI.
Conclusion The patient with gestational impaired glucose metabolism has abnormal lipid metabolism. The serum lipid disorder is closely associated with pancreatic islets secretion function and insulin resistance. 
【Key word】 Diabetes,gestational ；Glucose metabolism；Lipid metabolism.

Detection of Peripheral Blood Interleukin-16 and Its Gene Polymorphism in Asthma Patients? ZHOU Ying, ZHU Hong, PENG Jiang-long, et al.
Yancheng Health Vocational & Technical College， Yancheng 224006，China
【Abstract】 Objective To investigate the association of change of interleukin-16 (IL-16) of peripheral blood and its gene polymorphisms with asthma.
Methods Totally 42 diagnosed asthmatic patients were enrolled as the subjective, concurrently with 37 health persons as the controls. The serum level of IL-16 was measured by double antibody sandwich method of ELISA. The plasma IL-16 genotypes were determined by PCR-RFLP.
Results The level of serum IL-16 in asthmatics 〔（89.4±8.2）pg/ml〕 was higher than that of the controls〔（30.8±5.2）pg/ml〕 (P＜0.05). The genotype distribution and allele mutation frequencies of IL-16 of 259-gene locus in asthmatics showed no difference from those in the controls (P＞0.05). Conclusion IL-l 6 takes part in path physiological process of asthmatic pathogenesis. However IL-16 gene mutation is not related with asthma. 
【Key word】 Asthma；IL-16；Gene polymorphism.

Features of Magnetic Resonance Imaging and Angiography of Brain in Type 2 Diabetes Patients with Cerebral Infarction? YANG Chao-ping， ZHANG Xiang-jian， ZHANG Zhen-hua， et al.
Cadre Wards，Cangzhou Central Hospital， Cangzhou Hebei Province 061001， China
【Abstract】 Objective To investigate cerebral vascular change of patients with diabetic cerebral vascular disease and its relation with the course, clinic feature and prognosis of disease through the examinations of magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA).
Methods Totally 119 patients with acute cerebral infarction were enrolled, including 55 in group A whose condition was type 2 diabetes complicated by cerebrla infarction and 64 in group B whose condition was cerebral infarction with no diabetes mellitus. All the patients were examined by MRI and MRA of brain.
Results? The incidence rates of relapsed, massive and multiple cerebral infarction in the group A were higher than those in the B group（P＜0.05）. Compared with the group B, the prevalence rates of lesions of middle cerebral artery and vertebral artery in the group A was higher （P＜0.01）; and the prevalence rates of serious stenotic lesions was also higher （P＜0.05）.
Conclusion? MAR examination is helpful to assess the extent of the cerebral vascular lesion for diabetic patients, it is of important value to prevention of apoplexy.
【Key word】 Cerebral infarction； Diabetic angiopathy；Magnetic resonance imaging； Magnetic resonance angiography.

Clinical and Pathological Analysis of Henoch-schonlein Purpura Nephritis in Children FAN Zhong-min,LIU Guang-ling,XIA Zheng-kun,et al.
Department of Pediatrics,Nanjing Genaral Hospital of PLA,Nanjing 210002,China
【Abstract】 Objective To investigate the correlation between clinical presentation and pathological changes in children with Henoch-Schonlein purpura nephritis(HSPN).
Methods According to the clinical feature,pathological changes,152 HSPN children have been devided into 5 clinical types and 3 histological degrees respectively.The linkages between those two classifications were analyzed.
Results Uab type was the largest group among all the clinical types,and HT type was the smallest group.Patients of R-GH type and NS type had higher histological degrees than that of Uab type and I-GH type.More than half of the patients had co-deposition of immunoglobulin A,G and M.The percentage of co-deposition of immunoglobulin A,G and M in I-GH,R-GH and NS types were higher than that in Uab type.The amount of proteinuria was higher in the group which poorly responded to corticosteroid therapy.
Conclusion HSPN children with clinical types of NS,R-GH as well as those with co-deposition of immunoglobulin A,G and M had more severe histological damages.Steroid therapy was an effective treatment to most of HSPN children except for those who had massive protinuria or accompanied by high persentage of cresents and sclerosis in glomeruli.
【Key word】 Nephritis;Child;Pathology;Symptoms and signs.

Latest Efficacy and Safety of YH-16 Combined with GP for Advanced Non-small Cell Lung Cancer? ZHANG Te, LIU Da-hai, WANG Bin, et al.
The Central Hospital, Huzhou 313000, China
【Abstract】 Objective To evaluate the short term efficacy and safety of rh-endostatin (YH-16) combined with gemcitabine+cisplatin (DDP) (GP regimen) in the treatment of advanced non-small cell lung cancer.
Methods A total of 104 patients, pathologically confirmed with advanced non-small cell lung cancer (NSCLC), were randomly divided as trial group (YH-16 combined with GP, n=48) and the control group (Docetaxel, n=56). The latest efficacy was evaluated strictly after 2 cycles of the treatment according to RECIST criteria, the quality of life (QOL) was assessed by Karnofsky（KPS）scores, the toxicity was evaluated according to NCI CTC 3.0 version criteria.
Results? There were no case with complete response (CR), 16 (33.3%) with partial response (PR), 20 (41.7%) being stable (SD) and 12 (25.0%) being in progress (PD) in the trial group; the total effective rate (CR+PR) was 33.3% (16/48), and clinically beneficial rate (CR+PR+SD) was 75.0% (36/48). And in the control group there also no case with CR, 8 (14.3%) with PR, 8 (14.3%) being SD and 40 (71.4%) being PD in the trial group; the total effective rate (CR+PR) was 14.3% (8/56), and clinically beneficial rate (CR+PR+SD) was 28.6% (16/56). There were significant differences between the two groups in effect, total effective rate and clinically beneficial rate （P＜0.05）. There was no significant difference between the two groups in untoward effects including leucopenia, thrombocytopenia, nausea and vomiting （P＞0.05）.
Conclusion The therapy of YH-16 combined with GP, as a second-line regimen is more effective than Docetaxel monotherapy for NSCLC. It can evidently raise the effective rate and clinically beneficial rate in patients with NSCLC, and with a good safety. 
【Key word】 Non-small cell lung cancer;Endostar;GP regimen;Docetaxel.

Investigation of the Expression of MMP-7 and MVD in Breast Cancer CAO Gao-jian.
General Surgery of Ruian People Hospital，Zhejiang，Ruian 325200，China
【Abstract】 Objective To investigate the relationship between the biological characteristics and the expression of MMP-7 and MVD in breast cancer.
Methods 60 fresh samples were obtained from patients who underwent breast cancer operation in the department of surgery，and then the expression of MMP-7 and MVD were studied by means of immunohistochemical assay.Eventually，contrasting the clinicopathological prognostic index in each different group， the relationship between the biological characteristics and the expression of MMP-7 and MVD in breast cancer were evaluated.
Results The positive expression rate of MMP-7 in the d≤2cm group、with lymph node metastasis group were all higher than that in the d≤2cm group without lymph node metastasis group （P＜0.05）.MVD of MMP-7 positive group was higher than that of MMP-7 negative group.
Conclusion MMP-7 and MVD were associated with the invasion and metastasis of mammary cancer.MMP-7 could promote the microvessel development in mammary cancer.
【Key word】 Prreast neoplasms；Matrilysin；MVD.

Current Status of Management of Hypertension in A Community of Fuzhou and the Countermeasure?? CAO Jian-ping， LIN Dong-jie， ZHOU Wei-min， et al.
Institute of Public Health， Fujian Medical University， Fuzhou 350004， China
【Abstract】 Objective To investigate the integrated management of hypertension in community health services organizations of Fuzhou.
Methods Totally 950 hypertension patients from Fuzhou Shanghai Community Health Center and were enrolled, and site observation and in-depth interviews were taken.
Results A special management mode of hypertension including computer management and follow-up management was adopted since the establishment of Fuzhou Shanghai Community Health Center.
Conclusion The community has got a certain of achievement in hypertension management. However there exist in comprehensive prevention and treatment still some problems such as imperfect management mechanism and unfixed direction of two-way referral. We propose primarily a program of hypertension management suitable to the community.
【Key word】 Community health services；Hypertension；Comprehensive management.

Peer Education on Tuberculosis Control for Middle School Students in Chongqing Reservoir Areas: Formative evaluation? HUANG Rui-rui， WANG Hong， WANG Yang.
Department of Maternal， Children and Adolescent Health， Chongqing Medical University， Chongqing 400016， China
【Abstract】 Objective To know middle school students′ demands for tuberculosis control education in Chongqing reservoir areas, then to analyze whether peer education can meet the demands and what would be the suitable ways.
Methods The qualitative interview combined with quantitative questionnaire survey was used. Totally 48 students, from a middle school in Chongqing reservoir area, were interviewed as focus group and 14 relative health educators were in-depth interviewed. And 1 639 students were surveyed through questionnaires about their levels of awareness, belief of knowledge on prevention and treatment of tuberculosis and their behaviors, and their demands for health education.
Results The average scores of the students in their awareness, belief and behavior of tuberculosis were respectively（5.95±3.47）,（5.60±2.21） and （3.27±1.65）. The students, who hoped to get the knowledge on prevention and treatment of tuberculosis through lectures by or consultation to doctors, accounted for 64.5%; through TV and radio, accounted for 56.4%, and through health education courses at school, accounted for 53.6%. Most of the students were willing to take part in peer education practice to serve others and to improve their own capability themselves. The relative officials believed that peer education was beneficial to comprehensive quality of the students, and thus a feasible way to development of health education on tuberculosis prevention and control.
Conclusion The middle school students of Chongqing reservoir areas are lack of knowledge on tuberculosis prevention and control, with weak consciousness of protection, no good hygiene habit and lower level of knowledge on tuberculosis prevention and control. There is condition suitable for peer education, which can be applied in middle schools of Chongqing reservoir areas for students to improve their tuberculosis control levels.
【Key word】 Thberculosis；Peer education；Students；Formative evaluation.

Preventive Role of New Nursing Posture to Deep Venous Thrombosis after the Cesarean Section Operation? LIU Xiu-juan, ZHANG Xiao-ying, QIU Zhong-jun.
Tangshan Women and Children Health, Tangshan 063000, China
【Abstract】 Objective To investigate the effect of new posture of nursing care in prevention of deep venous thrombosis in women who underwent the cesarean section operation.
Methods A total of 192 women who underwent the cesarean section operation were randomly divided as trial group (receiving new nursing posture after the operation, n=96) and control group (received conventional nursing posture after the operation, n=96). The Likert scale was taken to compare the patients′ satisfaction. And the postoperative prevalence rate of deep venous thrombosis, good comfortableness rate, normal lactation rate, secretion of lochia, and uterine contraction were observed between the two groups.
Results The satisfaction degree in the trial group was higher than that in the controls (P＜0.01). There between the two groups were significant differences in prevalence rate of deep venous thrombosis （0 vs 6.2%）, good comfortableness rate （87.5%vs33.3%）, secretion amount of lochia〔（84±16）ml vs（98±19）ml〕and uterine contraction degree 〔（2.0±0.5）cm vs（1.0±0.5）cm〕 (P＜0.05).
Conclusion The new nursing posture can effectively prevent the occurrence of deep vein thrombosis, and it is safe and feasible, being worth popularizing clinically.
【Key word】 Deep venous thrombosis;Cesarean section operation;Prevention；Posture;Nursing care.

Causes and Management of Hepatolithiasis Complicate by Hemobilia:A clinical report of 51 cases QU Shun-xi,FU Qing-jiang,LI Ying-jun,et al.
Kailuan Hospital Affiliated to North China Coal Medical College,Tangshan 063000,China
【Abstract】 Objective To investigate the cause of the hemobilia? in patients with hepatolithiasis and its treatment.
Methods? The data of 51 patients with hemobilia were retrospectively analyzed to find the causes and to summarize the treatment.
Results In all the 56 patients, 16 had pre-operative hemobilia, of which 6 got choledocholithiasis or cholelithiasis (among them 5 patients received basket extraction with endoscopic sphincterotomy), 6 patients had severe cholangititis or pancreatitis, and 4 patients had bacillary liver abscess. 35 patients had post-operative hemobilia, of which 32 patients had got choledocholithotomy, 2 patients got biliary intestinal anastomosis, and one got hepatectomy. Among 10 patients treated by conservative therapy 9 cases were cured and one case died. Among 32 patients treated by hepatic artery angiography and interventional embolization 29 cases were successful in hemostasis, 2 cases had hemobilia again and cured by operation, and one case died. All 11 patients (including 2 cases who did not respond to intervention) who received surgical therapy recovered.
Conclusion? Most of the patients with hemobilia have a complication of intrahepatic or extrahepatic biliary calculi. The therapy should be chosen based on promptly analyzing the causes and location of hemabilia and combining with amount of hemorrhage. If the condition allowed, the first choice for post-operative hemobilia should be hepatic artery angiography and interventional embolization, and the key to raise the effect is reasonably choosing operative opportunity. 
【Key word】 Hemobilia；Calculi；Combined modality therap.

Pathological Features and Surgical Effect of Invasive Thymoma? HUANG Ri-mao， LUO Wan-jun，JIANG Hai-he， et al.
Department of Cardiothoracic Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
【Abstract】 Objective To summarize the pathological features of invasive thymoma and to investigate the clinical effect of surgical treatment.
Methods? The data of 69 patients with invasive thymoma were analyzed about the pathological features, operative modes and results of disease.
Results Among the 69 patients with invasive thymoma, according to Masaoka clinical stages, 23 were at stage Ⅱ, 37 at stage Ⅲ, and 9 at stage Ⅳ. Totally 51 patients were given complete tumor resection, of which 36 were performed enlarged tumor resection, including 27 of mediastinal pleural resection, 7 lung of wedge resection, 9 of superior vena cava or innominate vein partial resection and of vascularplasty, and 4 of replacement of superior vena cava. The rest 18 patients received palliative resection or only tumor biopsy. All patient received radiotherapy and/or chemotherapy after operation. No operative death occurred and no serious complication was found.? Conclusion Surgical therapy is an important means of treatment for invasive thymoma, and the tumour and the involved tissue and organ should be removed as complete as possible. Postoperative radiotherapy and chemotherapy can effectively improve the therapeutic results

【Key word】 Thymoma;Symptoma and signs；Procedures operative.

Perioperative Management of Preschoolers with 4th Ventricle Glioma: A report of 84 cases
DENG Zhi-hong, YANG Wei-zhong, YANG Fang-yu, et al.
Department of Neurosurgery, Xiehe Hospital, Fujian Medical University， Fuzhou 350004， China
【Abstract】 Objective To investigate the treatment of 4th ventricle glioma in preschooler patients during the perioperative period.
Methods? Among the 84 preschooler patients with 4th ventricle glioma, 5 were given an emergency ventricular drainage by ventriculopuncture via occipital lobe, and craniotomy and resection of the tumor; 68 were given an emergency ventricular drainage by ventriculopuncture via frontal lobe, and 3 to 7 days later, craniotomy and resection of the tumor followed; 11 were given a time-limited ventricular drainage by ventriculopuncture via occipital lobe, and craniotomy and resection of the tumor. The results of all the patients were observed.
Results Postoperative complications at early stage of the patients were meningitis in 7 cases, swallow dysfunction in 6 cases, peripheral facial palsy in 4 cases, subcutaneous dropsy in 4 cases, mutism in 3 cases, and stress ulcer in 2 cases. Most of the complications were cured after treatment, but there were 5 cases died.
Conclusion Characteristics of the management of perioperative period such as enhancing nourishment in preschoolers with 4th ventricle glioma should be emphasized. The better strategy is to do ventriculopuncture via frontal lobe first, and then 3 to 7 days later craniotomy and resection of the tumor. Protection of brain stem function during operation is the most important link of perioperative period. 
【Key word】 Perioperative;Glioma;Fourth ventricle;Microsurgery；Child，preschool.

Epidemiological Analysis and Treatment of Clustering Onset of Mycoplasma Pneumoniae Infection WANG Bao-he, GAO Yan.
Internal Medicine Department, Central Hospital of Beijing Prison Administration Bureau, Beijing 100054， China
【Abstract】 Objective To analyze the epidemic pattern and clinical features of Mycoplasma pneumoniae infection, and to evaluate the effectiveness of control measures so as to provide evidence for quick and effective control of epidemic situation henceforth.
Methods The epidemiological cross-sectional survey was taken in investigating all the subjects, then the upper respiratory tract multi-pathogenic nucleic acid was detected to 26 throat swab specimens obtained from mycoplasmal pneumonia patients and their close contacts.
Results The density of registered inhabitants here was? 2.2㎡/person, with bad ventilation. There were 136 incidences from June 20th to September 9th of 2007, aged 16 to 24, all male, and 34 of them hospitalized because of pneumonia. Their clinical features were fever, dry cough, pharygodynia, chest distress, fatigue and normal or low leukocyte number; Chest X-ray showed fuzzy uniform shadows in lung lobe or segment; Multi-pathogenic nucleic acid detection showed the positive rate of throat swab specimens was 33.3% for mycoplasmal pneumonia patients, and 20% for their close contacts. Early diagnosis, implementations of isolation, ventilation, sterilization, and preventive use of azithromycin all had good effects for the rapid control of the epidemic situation.
Conclusion In with the conditions of bad ventilation and high residence density, mycoplasma pneumoniae infection can cause clustering prevalence.
【Key word】 Pneumonia，mycoplasma;Infection;Cluster；Epidemiology.

Clinical Analysis on Multi-organ Damage in Asphyxial Newborn WU Yi-qi.
Department of Pediatric, the Central Hospital of Fengxian District, Shanghai 201400， China
【Abstract】 Objective To discuss the functional damages of the heart, liver and kidney in asphyxia newborn.
Methods Totally 62 asphyxial newborns were chosen, of which 51 were with mild asphyxia and 11 with serious asphyxia. And 20 normal newborns were chosen as controls. The functions of the heart, liver and kidney in the three groups were measured and compared.
Results The levels of serum aspartate aminotransferase (AST), creatine phosphokinase (CPK), creatine kinase-M (CK-MB), lactate dehydrogenase (LDH), and creatinine (CREA) in the control group were respectively (39±21)U/L, (199±49)U/L, (32±17)U/L, (214±104)U/L, and (51±20)μmol/L; while those indexes in the mold asphyxia group were (99±42)U/L, (1162±321)U/L, (78±46)U/L, (732±329)U/L, (91±26)μmol/L; and in the serious asphyxia group were (140±115)U/L, (2 989±855)U/L, (1 157±988)U/L, (1 157±988)U/L, (125±63)μmol/L. There were significant differences in the level of serum AST, CPK, CK-MB, LDH, and CREA between each two groups (P<0.01). The level of total bilirubin (TBIL) 〔(125±53)μmol/L〕in the control group was significantly different from those in the asphyxia groups〔(89±40)μmol/L and (69±31)μmol/L〕 (P<0.01).
Conclusion? The detection of serum AST, CPK, CK-MB, LDH, TBIL, and CREA is of important significance to evaluate multi-organ damages of asphyxial newborns. 
【Key word】 Asphyxia，neonatorum；Heart injuries；Hepatic insufficiency；Kidney failure.

Reduction under Arthroscopy plus Posteromedial Approach Limited Incision for Splitting Medial Condyle Fracture of Posterior Tibial Plateau? YUAN Chong， YANG Guang， LIU Tie-min， et al.
People′s Hospital of Zhuji， Zhuji 311800， China
【Abstract】 Objective To investigate the clinical effect of posteromedial approach limited incision following reduction under arthroscopic surveillance on the splitting medial condyle fracture of the posterior tibial plateau.
Methods? Totally 11 patients with splitting medial condyle fracture of the posterior tibial plateau were given reduction under arthroscopy, posteromedial approach limited incision, and screw fixation of tibial plateau, then the clinical effects were observed.
Results The follow-up was conducted for 6-24 months, the scores for knee joint evaluation of Hospital for Special Surgery of America (HSS) was 89-90. No obvious articular surface collapse, no varus and valgus deformity and traumatic arthritis, and other complications were found.
Conclusion? Reduction under arthroscopy plus posteromedial approach limited incision in treatment of splitting medial condyle fracture of posterior tibial plateau can
Arthroscopic reduction under surveillance, posterior the medial approach, the limited incision tibial plateau after condylar fractures, facial fractures and fully reveal the fractured surface, block and articular surface so that an accurate anatomic reduction, and firm fixation can be conducted, and thus it has a small injure, a short operative time, and a good restoration of joint function. 
【Key word】 Arthroscopy;Tibial fracture;Ligaments.

Characteristics of Internal Carotid Ultrasonography and Blood Tests in Cerebral Infarction Patients? DONG Rui-qing.
Department of Internal Medicine， Wuxi Wangzhuang Hospital，Wuxi 214028，China
【Abstract】 Objective To investigate the differences in intima-media thickness (IMT) of the carotid artery, plasma fibrinogen (Fg), low-density lipoprotein (LDL) and triglyceride (TG) between cerebral infarction patients at acute stage and patients with no cerebral infarction.
Methods Totally 164 patients with cerebral infarction and with no cerebral infarction received color power angiography of the carotid artery, blood biochemistrical and hemostatic tests.
Results There was a significant difference in IMT between the two group （P＜0.05）, however, there was no significant difference in levels of plasma Fg, LDL, and TG （P＞0.05）.
Conclusion The carotid IMT is closely associated with cerebral infarctions, which should be paid more attention by the clinical doctor. There may be regional difference in plasma lipid level. However, the relation of plasma Fg with cerebral infarctions is uncertain, which needs to be further studied.
【Key word】 Cerebral infarction；Carotid artery；Ultrasonography，doppler，color.

Role of Orbital Fibroblast in the Pathogenesis of Graves Ophthalmopathy and Its Immunotherapy? YE Xiao-zhen, WANG Jian.
Department of Endocrinology, Najing General Hospital of Nanjing Command, the Najing Clinical Institute of Southern Medical University, Nanjing 210002， China
【Abstract】 The orbital fibroblast expresses receptors of thyrotropin (TSHR), insulin-like growth factor-1 (IGF-1 R), and immunoregulatory molecules. Under the conditions of appropriate stimulation part of the cells can produce hyaluronic acid, inflammatory mediators and auto-antibodies; and another part of the cells can differentiate into mature adipocytes. All these cells are the major target cells of autoimmune process in Graves ophthalmopathy. Therefore, it may be the new targets to inhibit the activity of cytokines, to reduce B-cell to inhibit the production of antibodies, and to check the adipocyte differentiation of orbital fibroblasts. Here we review the role of orbital fibroblasts in the pathogenesis of Graves ophthalmopathy and its relative immunotherapy.
【Key word】 Graves′ disease；Fibroblasts；Immunotherapy；Pathogenesis.

Progress in Medical Therapy for Diabetic Foot Ulcer? GU Ping， WANG Jian.
Department of Endocrinology， Nanjing General Hospital of Nanjing Military Command， Nanjing 210002， China
【Abstract】 Diabetic foot is one of chronic complications of diabetic mellitus. The foot ulcer is a high risk factor to infection, gangrene, amputation and even death. Diabetic foot ulcer needs timely and accurate assessment, diagnosis, treatment and long-term follow-up. Now the treatment of diabetic foot ulcer is not perfect. In this article, we review the medical therapy for diabetic foot ulcer such as the application of growth factor, skin substitute, hyperbaric oxygenation and autologous bone marrow cell implantation. 
【Key word】 Diabetic foot；Foot ulcer；Hyperbaric oxygenation；Biocompatible materials；Stem cell transplantation；Therapy.

Premature Ovarian Failure and Its Relevant Factors in Genetics? HAN Ning-ning, DUAN Ling, ZHANG Zhao-xia.
The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
【Abstract】 Premature ovarian failure (POF) that is common among women under the age of 40 is a functional failure of the ovarian caused by a variety of factors. Idiopathic POF is the most common type. However, these patients usually have no definite cause. A small part of POF has special cause, involving genetics, immunology, gonadotropin receptor defects, enzyme deficiencies and iatrogenic factors. Understanding the cause of it will be helpful to prevent its occurrence and improve its clinical therapy.
【Key word】 Ovarian failure,premature；Genetics；Immunology.

Investigation of Categories of Common Diseases and Medicines Used among Patients in Community Health Service Institutions in Beijing LIU Yan， LIU Min， HAN Cheng-cheng， et al.
School of Public Health， Peking University， Beijing 100191， China
【Abstract】 Objective To study categories of common diseases and medicines used among Patients in community health service institutions in Beijing.
Methods Typical investigation was conducted to analyze the categories of common diseases and medicines used among patients with electronic medical records in a community health service institution (CHS). The first twenty common diseases were ranked by visiting person-times of diseases, and the proportion of drugs used for the first twenty common diseases was analyzed according to person-times of drugs used.
Results Among the patients seeking medical care at the CHS 57.45% were more than 60 years. The percentage of person-times of the first twenty common diseases was 87.88%, and the first three diseases were hypertension accounting for 19.24%, cute upper respiratory infection accounting for 16.96% and cardiovascular diseases accounting for 9.37%. The percentage of drugs used for the first twenty disease at the CHS was 87.28%, and the highest percentage was 95.87% for acute upper respiratory infection and the lowest one was 27.59% a for insomnia.
Conclusion? The most common diseases at community health service institution are chronic diseases and respiratory illness. The categories of drugs in medicinal list of CHS institutions in Beijing can meet the demands for common diseases to a certain extent; however some kinds of drugs may be added appropriately.? 
【Key word】 Community health service institutions；Common diseases；Medicine list.

Approach and Empirical Research on the Path of Two-way Referral between Urban and Rural Hospitals WANG Bao-yu，ZHANG Qi-yu，PAN Jing-ye,et al.
The First Affiliated Hospital of Wenzhou Medical College，Wenzhou 325000，China
【Abstract】 The deficiency of the two-way referral mechanism or other reasons brings difficulties to the operation of the referral network. Through approach on the path of the two-way referral, in this paper we explore the operation procedure and safeguard mechanism, put forward countermeasures and suggestions, and thus develop gradually a reasonable model of medical care that inducts the patients with ailment to community health institution, those with serious disease to hospital, and those seeking for rehabilitation to community health institution, so that the patients can be diverted properly and the urban and rural medical resources be revitalized.
【Key word】 Two-way referral；Mechanism path；Counterpart support between urban and rural hospitals.

Effect of Continuous Health Education on Diabetic Patients in Two-way Referral between Hospital and Community Health Services Center?? CHEN Xian-hui, CAI Jun-ming.
Pingshan People′s Hospital of Shenzhen City，Shenzhen 518118,China
【Abstract】 Objective To evaluate the result of continuous health education on diabetic patients in two-way referral between hospital and community health service center.
Methods Totally 126 patients with diabetes mellitus were randomly divided as intervention group and control group, with 63 in each. The patients in the control group were given knowledge on diabetes mellitus only at hospitalization; while those in the intervention group were given two-way referral management, they were given health interventions according to the specific conditions of the patients so that they could master the correct medication, reasonable control of diet, timely monitoring of blood glucose, adequate exercise, and prevention of complications.
Results? There were significant differences in behaviors compatible with medical orders and level of fasting blood glucose between the two groups （P＜0.05）. There were in the control group 12 patients who were hospitalized once, 2 patients twice; 4 patients who had complications, with average expense of 1 280 RMB yuan per outpatient. And in the prevention group the average expense per outpatients was 760 RMB yuan, no one was hospitalized with primary diabetes mellitus, and no complication was found.
Conclusion The self-management capability of the patients in the intervention group is improved, their compatible behavior with the medical orders is obviously enhanced, their clinic expense is less, and their complications are also less. The continuous health education in two-way referral management is conducive to raise the patients′ diabetic awareness. 
【Key word】 Communinty health services；Diabetes；Community hospitals；Referral.

Research of the Economic Compensation of Urban Community Health Service in a Certain Provincially Administered Municipality RONG Chao， HUANG Xiao-guang， WEI Guang-feng， et al.
School of Health Policy and Management， Nanjing Medical University， Nanjing 210029， China
【Abstract】 Objective To describe and analyze the 4 years economical compensation situation for urban community health service in a certain provincially administered municipality，and find existent major problems.
Methods The data of urban community health service in this provincially administered municipality was collected and analyzed so as to fine the existent major problems.
Results The compensation situation for urban community health service in the municipality was not good, the major problems were an inadequate government investment, undertaking numerous free service、nonstandard item charge, and supplementing medical service through drugs.
Conclusion The compensation mechanism of urban community health service in a certain provincially administered municipality is unreasonable. It needs an urgent regulation and improvement, and the corresponding strategy should be actively taken aiming at the problem.
【Key word】 Community health services；Economic compensation；Health economic policy.

Community Health Services in Fangzhuang Community Health Center? LEI Ying, GE Cai-ying, GAO Rong-huan.
Fangzhuang Community Health Center, Beijing 100078, China
【Abstract】 We have actively explored new modes of service delivery, enriched "regional medical care". Taking management of chronic diseases as starting point, and the residents′ demand as guidance, we raise the community health service levels and improve the service function through scientific research and teaching activities. We carry out health education, pairing-assistance and two-line management of income and expenditure so as to make the development of the community heath services fast.
【Key word】 Community health services；Health education；Pairing-assistance;Two-line management of income and expenditure.

Number12June，2009

A Comparative Research of Insulin Pump Therapy and Multiple Subcutaneous Insulin Injection in Treatment of Type 2 Diabetic Elderly Patients with Community-acquired Pneumonia BAI Xiao-ning，HOU Min-quan，WANG Hui-fang.
Department of Geriatrics，the First Affiliated Hospital，Medical School of Xi′an Jiaotong University，Xi′an 710061，China
? 【Abstract】 Objective To study the efficacy and safety of continuous subcutaneous insulin injection(CSII) and multiple insulin(MSII) in treatment of type 2 diabetic elderly patients with community-acquired pneumonia（CAP）.
Methods During the period from January 2004 to January 2008，78 type 2 diabetic elderly patients with CAP in our hospital were divided into group CSII(39 cases) and group MSII(39 cases) at randomly，these patients has never used insulin before，to observe the days of controling all symptoms of pneumonia，blood glucose up to scratch and cure of pneumonia，the requirement of insulin，rates of hypoglycaemia between the two groups after insulin and antibiotics therapy.
Results Blood glucose levels of all patients in two groups were up to standards.After the treatment,the levels of glycated hemoglobin〔（7.0±2.1）%〕 and C-reactive protein〔（14.3±6.1）mg/L〕 reduced significantly，and the level of fasting C-peptide〔（6.2±0.5）μg/L〕 increased remarkably in group CSII,compared with group MSII〔（8.9±1.8）%,（22.0±8.0）mg/L,（4.0±0.7）μg/L,respectively〕（P＜0.01）. The days of controling all symptoms of pneumonia，blood glucose up to scratch and cure of pneumonia were significantly shorter in group CSII（P＜0.05），while the requirement of insulin and rates of hypoglycaemia were lower in group CSII（P＜0.01）,there were statistical differences between group CSII and group MSII.
Conclusion CSII in conjugation with antibiotics is able to control blood glucose，all symptoms of pneumonia and days of cure of pneumonia in time and effectually. The method has low expenditure of insulin and rates of hypoglycaemia,which is a better method for type 2 diabetic elderly patients with CAP.
? 【Key word】 Diabetes mellitus，type 2；Community acquired pneumonia；Insulin pump；Aged

Effect of Fluvastatin on Expression of Megsin in Renal Tissues of Diabetic Rats LIU Mao-dong,LI Ying,ZHANG Yan-ling,et al.
Department of Nephrology,the 3rd Hospital of Hebei Medical University，Shijiazhuang 050051,China
【Abstract】 Objective To estimate fluvastatin,a hydroxy-methyl-glutaryl coenzyme A（HMG-CoA）reducase inhibitor,which can protect kidney from damage by repressing the expression of megsin in renal tissue.
Methods Eighteen male Spragur-Dawley rats,in whom diabetes was induced with intraperitoneal injection of streptozotocin,were divided into normal control (NC) group,diabetic control(DC),and diabetic with oral fluvastatin (DF),6 in each.At the end of 6th week after establishment,we measured serum total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),hypertrophy index(kidney weight/body weight),serum creatinine clearance rate(Ccr),urine albumin excretory rate (UAER) corrected by body weight(BW).Immunohistochemical technique was used to estimate the expression of megsin,type IV collagen and laminin in renal cortex,and the results were analyzed semi-quantitatively with the pathological image analysis system.The renal tissues of diabetic rats were observed with light microscope after periodic acid-Schiff（PAS）staining.
Results In NC group,blood glucose(BG),TC,TG,hypertrophy index,Ccr,UAER,and the levels of kidney megsin,IV collagen and laminin were significantly lower in NC group〔(5.7±0.8)mmol/L,（1.78±0.30）mmol/L,（1.0±0.7）mmol/L,（3.4±0.5）mg/g,（1.63±0.51）ml·min-1·kg-1,（2.1±0.6）μg/24 h,（4.6±1.2）,（4.7±0.9）,（8.5±1.3）,respectively〕 than in DC〔(19.7±2.5)mmol/L,（8.61±0.85）mmol/L,（4.5±0.7）mmol/L,（7.7±1.3）mg/g,（5.31±0.38）ml·min-1·kg-1,（9.7±1.2）μg/24 h,（19.5±0.9）,（19.6±0.6）,（25.3±1.5）,respectively〕 ,and than in FC〔（19.8±1.3） mmol/L,（3.80±0.79）mmol/L,（2.4±0.5）mmol/L,（5.2±0.5）mg/g,（2.97±0.18）ml·min-1·kg-1,（5.9±1.0）μg/24 h,（14.2±1.0）,（14.8±1.1）,（17.8±1.0）,respectively〕,the difference was significant(P＜0.05).PAS staining showed that mesangial proliferation was obvious in DC group,and it reduced in DF group as compared with DC.
Conclusion Fluvastatin can play the role of renal protection by inhibiting the expression of megsin which increased in renal tissue of diabetic rats.
【Key word】 Fluvastatin；Diabetic nephropathies；Megsin；Immunohistochemistry

Influence of Benazepril on Vascular Endothelial Growth Factor in Patients with Early Diabetic Nephropathy LI Yuan-mei.
Department of Endocrinology,Yiwu Central Hospital，Zhejiang Province,Yiwu 322000,China
【Abstract】 Objective To investigate the expression of vascular endothelial growth factor (VEGF) in early diabetic nephropathy(DN) and the impact of benazepril on VEGF.
Methods Eighty early DN patients were divided into DN group and benazepril intervention group.Using chemiluminescence method,hexokinase endpoint law,as well as immunohistochemical detection to detect the urine protein,FBG and plasma VEGF expression and analysis of data related to each other.
Results Before the treatment,there were no significant differences in the level of FBG，VEGF and UAER（P＞0.05）;while after the treatmetn,the level of FBG,VEGF,and UAER in DN group were （7.0±1.4）mmol/L,（201±29）pg/ml and （138±42）mg/24 h respectively，those in benazepril intervention group were （6.5±1.8）mmol/L,（143±19）pg/ml and（112±33）mg/24 h respectively，there were significant differences in the level of VEGF and UAER between two groups（P＜0.05）.
Conclusion VEGF in the pathogenesis of DN plays an important role,over-expression leads to kidney damage,angiotensin-converting enzyme inhibitor benazepril may has abnormal expression of VEGF by inhibiting the non-renal hemodynamics protection.
【Key word】 Benazepril；Diabetic nephropathies;Vascular endothelial growth factor;Angiotensin-converting enzyme inhibitors

Assessing Clinical Features of the Fasting Urine Calcium,Urine Creatinine and Their Ratio in the Postmenopausal Osteoporosis with Alendronate Management YANG Hong-bin,ZHU Qing-wen,YU Zhan-jun,et al.
Department of Endocrinology and Metabolism,People′s Hospital of Quzhou City,Quzhou 324000,China
【Abstract】 Objective To study the clinical features of the fasting urine calcium(U-Ca),urine creatinine(U-Cr) and their ratio(U-Ca/Cr) in the postmenopausal osteoporosis (PMOP) with alendronate management.
Methods 102 PMOP patients aged 45～69 years were identified using dual-energy X-ray absorptiometry (DXA) measurements of the spine and hip bone mineral density.All PMOP cases took alendronate 70 mg once a week for 6 months.The U-Ca and the U-Cr of the spot urine samples were measured at the baseline,3 and 6 months after taking alendronate by Azo arsine III assay and Sarcosine oxidase assay.U-Ca and U-Cr of the fasting urine samples in 103 normal menstrual cycle health women were tested simultaneously with the PMOP,and calculated their U-Ca/Cr.
Results The values of U-Ca and U-Ca/Cr at the baseline,3 months,and 6 months after taking alendronate in the PMOP group were statistical significance （P＜0.01）,but the U-Cr were statistically similar （P＞0.05）.The U-Ca and U-Ca/Cr at 3 months,and 6 months after taking alendronate in the PMOP group were significantly lower than those at the baseline （P＜0.01）,and the U-Ca at 6 month spot returned higher than it at 3 month spot （P＜0.01）.The values of U-Ca and U-Ca/Cr at the baseline in the PMOP group were signicantly higher than the health control（P＜0.05）,but the both values at 6 month spot restored the health women levels（P＞0.05）.
Conclusion The fasting U-Ca index and U-Ca/Cr ratio may be the best biochemical markers of bone resorption to assess the PMOP bone turnover status,and monitor the effect of treatment with alendronate in the PMOP.The fasting U-Ca/Cr ratio shows more stable than the fasting U-Ca index in the PMOP patients with alendronate thrapy,but the fasting U-Cr index was no clinical significance.
【Key word】 Osteoporosis postmenopausal;Alendronate;Urine calcium/creatinine ratios

Efficacy of Modified Electroconvulsive Therapy in Acute Depression YANG Kai-ren,JIANG Xiao-qin,MAO Fu-rong,et al.
The Third Hospital of Quzhou,Quzhou 324000，China
【Abstract】 Objective To evaluate the efficacy and safety of modified electroconvulsive therapy(MECT) in acute depression.
Methods Sixty-nine patients with acute depression were divided into 2 groups.The study group(n=35 ) were given MECT in combination of selective 5-serotonin reuptake inhibitor(SSRI),4 weeks,and the control(n=34) given SSRI,4 weeks.The effects and adverse reactions were evaluated by Hamilton Depression Rating Scale,17 version(HAMD17) and Treatment Emergent Symptom Scale(TESS) before treatment and at ends of weeks 1,2,3,4 of treatment,respectively,and the memory function by Wechsler Memory Scale(WMS) before treatment and day 1,at ends of weeks 1,2 of treatment,respectively.
Results There was significant difference in clinical effect between 2 groups after 4 weeks of treatment（u=3.35，P＜0.01）.In study group,the total scores of HAMD17 at ends of weeks 1,2,3,4 of treatment were （17.4±4.5）,（12.6±4.9）,（9.1±4.8）,（8.3±5.1）,respectively,significantly different from pre-treatment(22.8±5.0)（P＜0.01）,while in control,at ends of weeks 2,3,4 were （19.4±4.7）,（17.0±4.2）,（14.7±5.1）,respectively,differing significantly from pre-treatment(22.0±4.9)(P＜0.05 ).There was significant difference in total score of HAMD17 at ends of weeks 1,2,3,4 of treatment between 2 groups(P＜0.05),but there was not in TESS between study group〔(2.61±0.51),（2.72±0.46）,（2.58±0.54）,（2.42±0.49）,respectively〕 and control〔(2.45±0.49),（2.51±0.43）,（2.41±0.47）,（2.29±0.45）,respectively〕( P＞0.05 ).In study group,WMS pictures and recognition scores on day 1 of treatment were （10.2±2.8）,（9.6±2.9）,respectively,and WMS pictures,scores of recognition and association at end of week 2 were （13.8±3.5）,（12.7±3.5）,（14.7±4.1）,respectively,significantly different from those of control〔(11.7±3.0),（11.1±3.0）,（12.4±3.7） ,respectively〕(P＜0.05).
Conclusion MECT in combination of SSRI is superior to SSRI,with faster onset,and without obvious increased adverse reaction.
【Key word】 Electroshock;Serotonin uptake inhibitors；Depressive disorder

Correlation between Mannan-binding Lectin and Ischemic Cerebrovascular Disease HU Jin，JIA Tian-jun，ZOU Yu-an.
Department of Neurology，the First Hospital of Hebei North College， Zhangjiakou 075000，China
【Abstract】 Objective To explore the point mutation of Exon I 54 of mannose-binding lectin(MBL) gene in patients with ischemic cerebrovascular disease and healthy controls,and to determine MBL level in serum.
Methods Point mutation of MBL Exon I 54 was detected by polymerase chain reaction-restriction fragment length(PCR-RFLP),and MBL level by enzyme-linked immuneadsorption assay(ELISA).
Results The serum MBL levels of ICVD group and control were （3 372±661）μg/L,（2 065±196）μg/L,respectively,the difference was significant（P＜0.01）.Allele frequencies of ICVD group were GGC 84.0% ,GAC 16.0%,while those of control were GGC 84.0%,GAC 16.0%,the difference was not significant in genotype distribution and allele frequency between 2 groups（P＞0.05）.
Conclusion The relationship between ICVD and MBL is of great significance in research and treatment of cerebrovascular diseases.
【Key word】 Mannose-binding lecting；Cerebrovascular disorders；Polymerase chain reaction

Changes of Serum N-terminal B-type Natriuretic Peptide Level in Patients with Graves after Surgery RAO Hui-min,SUN Yu,YANG Chang-li,et al.
Department of Surgery,the Second People′s Hospital of Hainan Province,Wuzhishan 572200,China
【Abstract】 Objective To evaluate the clinical significance of changes of serum N-terminal B-type natriuretic peptide (NT-proBNP) levels in patients with Graves after surgery.
Methods Thirty Graves patients who received bilateral subtotal thyroidectomy were chosen as Graves group,and 31 healthy subjects as control.Serum free triiodothyronine(FT3),free thyroxine(FT4) and serum NT-proBNP were determined before or after surgeries.
Results In Graves group,the levels of FT3,FT4 and NT-proBNP were（23.0±15.1）pmol/L,（55.3±31.0）pmol/L,89.41 pg/ml,respectively,before surgeries,and （3.8±1.0）pmol/L,（15.3±1.6）pmol/L,36.31 pg/ml,respectively,after surgeries,the difference was significant（P＜0.01）.In control,the levels of FT3,FT4 and NT-proBNP were （3.7±0.9）pmol/L,（15.6±2.3）pmol/L,34.43 pg/ml,respectively,significantly different from those of Graves group before surgeries（P＜0.01）,but not from those of Graves group after(P＞0.05).Multiple regression analysis showed that NT-proBNP was independently correlated with FT4 in Graves group before surgeries（r=0.589，P＜0.01).
Conclusion Serum NT-proBNP level decreases significantly in Graves group after surgeries,probably affected by thyroid hormone,which may be a direct affection.
【Key word】 Graves′ disease；Natriuretic peptide，brain；Thyroid hormones

Effects of Beijing Hypotensive No.0 and Indapamide on Essential Hypertension in Northwestern Rural Areas XUE Xiao-lin，ZHAO Ling-long，WANG Xin-lan，et al.
Department of Cardiology,the First Affiliated Hospital of Medical College,Xi′an Jiaotong University,Xi′an 710061,China
【Abstract】 Objective To evaluate the efficacy of Beijing Hypotensive No.0 and indapamide on essential hypertension in Northwestern rural areas.
Methods Nine hundred eighty high-risk or very-high-rsik patients with essential hypertension were enrolled from 16 rural health service centers in 4 provinces(Shaan′xi,Gansu,Qinghai and Ningxia),to observe the therapeutic effects of antihypertensive drugs(group A,n=481,receiving indapamide;group B,n=499,receiving Beijing Hypotensive No.0),and to detect serological biochemical indicators.
Results When compared with pretreatment,the systolic blood pressures of group B after 1,3,7,12 months of treatment decreased by 6.62,20.87,27.04,27.38 mm Hg,respectively,in group B,and by 6.31,20.14,24.71,24.94 mm Hg,respectively,in group A;the diastolic fell 3.47,10.78,14.41,14.84 mm Hg,respectively,in group B,and 3.68,9.74,12.43,13.58 mm Hg,respectively,in group A(P＜0.01 compared with the baseline).No severe side effects were observed.
Conclusion Long-term use of Beijing Hypotensive No.0 or indapamide,which has an excellent cost performance,can result in good effects in blood pressure control.
【Key word】 Hypertension;Rural areas;Beijing hypotensive No.0;Indapamide

Expressions of SDF-1 and Its Receptor CXCR4 in Colorectal Carcinoma and Their Clinical Significance ZHAN Xiao-hong,ZHOU Rong-rong,ZHENG Shu-fang,et al.
Department of Pathology,Qingdao University Medical College,Qingdao 266033,China
【Abstract】 Objective To evaluate the role and clinical significance of SDF-1 and its receptor CXCR4 in development,infiltration and metastasis of colorectal carcinoma.
Methods The levels of SDF-1 and CXCR4 protein expression were detected by SP immunohistochemical method in 60 patients with colorectal carcinoma(CC group),23 with colorectal adenoma(CA group) and 22 with normal colorectal mucosa(NCM group).
Results CC group was significantly different from groups CA and NCM in positive expressions of SDF-1 and CXCR4(P＜0.05),which was the highest in CC group among the three(P＜0.05).Stronger expressions of SDF-1 and CXCR4 proteins were observed in CD group,as compared with NCM group (P＜0.05).The positive expressions of SDF-1 and CXCR4 were closely correlated with the depth of tumor infiltration and metastasis of lymph node(P＜0.05),but not with genders and ages of patients and differentiation of cancer.The positive expression of SDF-1 was positively correlated with that of CXCR4 in colorectal carcinoma(r=0.436,P＜0.01).
Conclusion SDF-1 and CXCR4 are important factors in development,infiltration and metastasis of colorectal carcinoma.
【Key word】 SDF-1；CXCR4；Intestinal neoplasms；Metastasis；Infiltration

Expression of FGFR1OP and PTEN in Glioma and Their Clinical Significance TAN Yong-gang,WANG Hao.
Ward of Oncology,Shengjing Hospital,China Medical University,Shenyang 110004,China
【Abstract】 Objective To investigate the effect of FGFR1OP and PTEN proteins in gliomas and their clinical significance.
Methods The expressions of FGFR1OP and PTEN were detected in 54 glioma specimens by SP method.The relationship between the expression of 2 proteins and various clinicopathologic factors was evaluated.
Results The positive expressions of FGFR1OP and PTEN in gliomas were 66.7%,48.1%,respectively.The OD value of FGFR1OP in high malignant gliomas(grades Ⅲ～Ⅳ) was （0.131±0.010）,and in low (grades Ⅰ～Ⅱ) was （0.118±0.010）,the difference was significant(t=-5 497,P=0.000).The OD value of PTEN in high malignant gliomas was （0.113±0.008）,and in low was（0.135±0.016）,the difference was significant(t=0.239,P=0.026).No significant correlation was noted between FGFR1OP and PTEN in expression intensity.
Conclusion Our findings suggest that increased FGFR1OP expression and/or decreased PTEN expression are/is related to increased activity of cell proliferation and progression of glioma.
【Key word】 Glioma；FGFR1OP；PTEN

Biochemical Changes in Substantia Putamen of Patients with Parkinson Disease:Observation by Proton Magnetic Resonance Spectroscopy Tuerxunjiang·Aili，Tuerxun·Shabiti，YANG Xin-ling，et al.
Department of Neurology,the First Affiliated Hospital of Xinjiang Medical University，Urumuqi 830054，China
【Abstract】 Objective To evalutate the metabolism of the putamen by proton magnetic resonance spectroscopy（1H-MRS） in patients with Parkinson disease（PD）.
Methods Fifteen PD patients were divided into 2 groups according to Hoehn-Yahr stage.Thirteen healthy volunteers were enrolled as control in this study.MRS was used to determine N-acetylaspartate/chline(NAA/Cho)，N-acetylaspartate/creatine (NAA/Cr) and the ratio of Cho/Cr in putamen.
Results In PD patients,the ratios of NAA/Cr and NAA/Cho in putamen reduced significantly and the ratio of Cho/Cr increased〔(1.3±0.3),（1.16±0.30）,（1.13±0.27）,respectively,in early stage,and （1.2±0.5）,（1.14±0.44）,（1.16±0.25）,respectively,in late stage〕 as compared with control〔(2.3±0.4),（1.64±0.28）,（1.43±0.32）,respectively〕,and there was not significant difference in ratio of Cho/Cr between control group and PD patients（P＜0.05）.
Conclusion 1H-MRS is a noninvasive technique providing useful informations on metabolic changes in the bilateral putamen of PD patiennts.?
【Key word】 Parkinson disease；Magnetic resonance spectroscopy；Creatine；Choline

One-way Endobronchial Valve System in Chronic Obstructive Pulmonary Disease MENG Ai-hong,ZHNAG Xiao-peng,LIU Li-jun，et al.
Respiratory Division,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China
【Abstract】 Objective To study the application of one-way endobronchial valve system with bronchoscope in therapy of chronic obstructive pulmonary disease(COPD).
Methods? Seventeen healthy male sheep〔weighing（25±5）kg〕 were enrolled to establish emphysema(EMPH) models by papain.In basal anesthesia,one-way endobronchial valves were embedded in the segmental brochus of EMPH regions with bronchoscope.Sixteen established EMPH sheep were divided into stent group(n=10) and control(n=6).Computerized tomography(CT) scanning was performed before operations and on days 10,30,60 after ,to observe clinical symptoms and to detect lung function.
Results Preoperative EMPH images were visible in all 16 sheep.In stent group,when compared with preoperative CT scannings,obvious wedge-shaped atelectasis images were noted on day 10 after operation,reduced on day 30.CT images showed a further narrowing,consolidation on day 60.No images of pneumonia or lung abscess was found in all examinations.The 60 d functional residual capacity(frc) of stent group was lower after operation 〔(65.7±13.2)ml〕 than before〔(105.0±15.3)ml〕,the difference was significant(P＜0.05),and lower than that of control〔(135.0±20.3)ml〕,the difference was significant(P＜0.05).
Conclusion One-way endobronchial valve system is safe and effective in COPD therapy.
【Key word】 Bronchoscopic lung volume reduction；One-way endobronchial valve system;Pulmonary emphysema;Pulmonary disease,chronic obstructive;Pulmonary fibrosis

Diagnoses and Treatments of Intrahepatic Bile Duct Cystadenoma DAI Bing-hua，YANG Mei-hua,LIU Chen，et al.
Biliary Tract SurgeryⅠ,the Eastern Hepatobiliary Hospital,Shanghai 200438，China
【Abstract】 Objective To explore the clinical features,treatment and prognosis of intrahepatic bile duct cystadenoma.
Methods A retrospective analysis was carried out on clinical data and follow-up results of 19 patients with intrahepatic bile duct cystadenoma,and Cox regression analysis was used to analyze the factors influencing its prognosis.
Results? The majority of 19 patients(4 males,15 females,with a mean age of 49.9 years) presented as abdominal discomfort,4 with jaundice.Five patients were confirmed by imaging(26.3%).Abnormal carbohydrate antigen 19-9(CA19-9) was noted in 7 patients,and alpha-fetoprotein(AFP) and carcinoembryonic antigen(CEA) were normal in all.Fifteen received radical surgeries(11 lobectomy of liver,4 tumor radical excision combined with common bile duct embolectomy),4 palliative surgeries.Pathological results suggested that 15 patients presented with bile duct cystadenoma,4 with local atypical hyperplasia and 2 with moderate/severe;3 with intrahepatic bile duct papillary cystadenoma;1 with bile duct serous cystadenoma.There was correlation between surgical methods and tumor-free live time(β=4.174，P=0.014）.
Conclusion Intrahepatic biliary cystadenoma occurs mainly in adult females,presenting mainly as abdominal discomfort;Imaging has a low rate of definite diagnoses;a radical surgery will give a relatively good prognosis.
【Key word】 Adema，bile duct；Pathological conditious，signs and symptoms；Therapy；Prognosis

Thought Patterns of Clinical Diagnoses of Cryptococcal Meningitis CAI Jian-ying,ZHU Chun-mei,LUO Shou-qi.
The Fourth People′ Hospital of Panzhihua City,Panzhihua 617061，China
? 【Abstract】 Cryptococcal meningitis(CM) is not a rare disease,but with a high rate of misdiagnoses.This paper analyzes the thought patterns of CM diagnoses in clinic through the diagnosis and treatment of 1 case.Giving priority to commonly encountered diseases is the first diagnosis thinking principle that we should follow,and then comes the unified or individual principle;we should combine the individual principle with clinic and related basis,abandon the habit of inclination thinking,and maintain the activeness of diagnosis thought.
? 【Key word】 Meningitis,cryptococcal;Diagnosis;Therapy

Analysis of Bacterial Culture and Drug Sensitivity Test in Patients with Acute Cholecystitis TAO Xing-he.
The First People′s Hospital of Wuyi County，Jinhua 321200，China
【Abstract】 Objective To contribute the knowledge of bile aerobe infection in acute cholecystitis(AC) and its sensitivity to antibiotics,to provide basis for clinical anti-infective therapy.
Methods Bile was collected from 122 AC patients to do aerobe culture and drug sensitivity test(DST).
Results In 122 cases of bile samples,positive aerobes were detected out in 83（68.03%）;a total of 92 strains were isolated,among which Escherichia coli accounted for 51.08%,Klebsiella pneumoniae 10.87%,Enterococcus faecalis 11.95%.DST results showed that in all bacteria there were varying degrees of drug resistances,relatively higher resistant to penicillin,cephalosporins;Gram-positive bacteria were the most sensitive to vancomycin,but Gram-negative bacilli to imipenem.
Conclusion Use of bile is necessary in bacterial culture and DST.Clinical antibiotics choice should be made reasonably based on results of laboratory DST,to prevent the abuse of antibiotics to reduce bacterial resistance.
【Key word】 Bile；Anti-bacterial agents；Microbial sensitivity tests

Detection of Extended Spectrum β-lactamase Klebsiella Pneumoniae Isolated from Patients in Urumqi and Their Drug Resistance ZHANG Jie，ZHANG Li，JI Ping，et al.
Xinjiang Medical University，Urumqi 830054，China?
【Abstract】 Objective To analyze the detection rates and antimicrobial resistance of extended spectrumβ-lactamases（ESBLs）klebsiella pneumoniae(KP) isolated from patients in Urumqi district，to provide references for rational use of antimicrobial agents in clinic.
Methods The strains were identified by VITEK TWO automatic microorganism analyzing system，drug sensitive test by K-B disk diffusion procedure，ESBLs by double-disk synergy test,and a retrospective investigation was performed on the resistance spectrum of clinical KP isolates in the First Affilied Hospital of XinJiang Medical University.
Results Three hundred ninety-one KP strains were detected with a positive rate of 42.71%.KP producing ESBLs was the most resistant to Penicillins (to Ampicillin as high as 100.00%),the lowest to imipenem,and showed relatively high sensitivity to Meropenem,Piperacillin/Tazobactam,cefoperazone/sulbactam;KP had a high multidrug resistance(MDR) to aminoglycosides,fluoroquinolones,sulfonamides.
Conclusion KP,which has a high rate of positive ESBLs,is resistant or multi-resistant to most antimicrobial agents.Imipenem and β-lactamase inhibitor compounds can be used to control infection caused by KP.
【Key word】 Klebsiella pneumoniae；Extended spectrum beta-lactamases；Drug resistance
Remedy Effect of Multidisciplinary Integration Treatment for Multiple Organ Dysfunction Syndrome in Elderly TAN Qing-wu,LI Qing-hua.
Bethune International Peace Hospital,Shijiazhuang 050082,China
【Abstract】 Objective To assess the effectiveness of multidisciplinary integration treatment for multiple organ dysfunction syndrome in elderly(MODSE).
Methods The multidisciplinary integration treatment mode was established to rescue 45 patients with MODSE.
Results Thirty-nine patients were successfully treated.All of 29 patients with 2 or 3 failed organs,and 8 of 12 patients with 4 ,1 of 2 with 5,1 of 2 with 6 was successfully treated.
Conclusion MODSE multidisciplinary integration treatment model can mobilize effectively multidisciplinary active participation,emphasizing chronergy and continuity of consultation,embodying the common responsibility of multi-disciplines,making full use of the advanced treatment technology of multi-disciplines in time,giving MODSE patients intime optimal treatment and improving the rescue rate of MODSE.
【Key word】 Multiple organ failure； Aged；Multidisciplinary integration treatment mode
Therapeutic Effect of Cardio-pulmonary Resuscitation on Sudden Cardiac Arrest:Report of 12 Inpatients JIANG Dan-yu.
Department of Internal Medicine,the People′s Hospital of Shenhe District，Shenyang 110016,China
【Abstract】 Objective To summarize the rescue effects of cardio-pulmonary resuscitation on cardiac arrest(CA).
Methods Twelve CA patients were admitted to our hospital and received salvage as early as possible.Artificial airways were established effectively,closed cardiac massage was performed correctly,and medicine for rescue was applied rationally.
Results Among 12 patients with CA，three patients survived.
Conclusion Improvement of rescue measures and intime performance of cardio pulmonary resuscitation can improve the achievement ratio of inhospital rescue.
【Key word】 Heart arrest;Cardiopulmonary resuscitation;Institutional practice

Effects of Tropisetron on Postoperative Nausea and Vomiting Related to Patient-controlled Intravenous Analgesia with Tramadol LIU Jie-ming,WU Hai-su.
ICU，Zhejiang Cancer Hospital，Hangzhou 310022,China
【Abstract】 Objective To investigate the effects of tropisetron on postoperative nausea and vomiting (PONV) related to patient-controlled intravenous analgesia (PCIA) with tramadol.
Methods Three hundred patients experienced abdominal surgery were divided randomly into 3 groups,100 in each.Group A received 5 mg tropisetron to prevent PONV,Group B 10 mg tropisetron,Group C normal sodium (control group).PONV was observed within 24 h after operation.
Results Groups A,B,C confronted with postoperative nausea(8,5,79 cases,respectively),and with vomiting(8,6,63,respectively).In Group A the number of patients gaining 0,1,2,3 scores of postoperative nausea degree were 92,3,3,2 respectively,in Group B 95,3,1,1,respectively,and in Group C 21,22,20,37,respectively.In Group A,the numbers of patients scored 0,1,2,3 of postoperative vomiting degree were 92,3,2,3,respectively;in Group B 94,2,2,6,respectively,and in Group C 37,28,22,13,respectively.There was not significant difference in incident and degree of nausea and vomiting between Groups A and B（P＞0.05）,but Group C different from Groups A,B（P＜0.05）.
Conclusion Use of 5 mg or 10 mg tropisetron,which is superior to single use of tramadol in control of PONV caused by PCIA,is one of antiemetic approschs,economic,effective and worthy of popularization.
【Key word】 Tropisetron;Tramadol;Postoperative nausea and vomiting；Analgesia，patient-controlled

Effect of Semiconductors Laser Orientator on Assistance of CT-guided Puncture for the Treatment of Trigeminal Neuralgia QU Pi-sheng,TAO Fan,ZHENG Han-guang,et al.
Integrated Chinese and Western Medicine Hospital of Zhejiang Province,Hangzhou 310003，China
【Abstract】 Objective To investigate the effects of semiconductors laser orientator on assistance of CT-guided puncture for the treatment of trigeminal neuralgia.
Methods 67 patients who underwent radiofrequency thermocoagulation,were divided into two groups randomly:observation group (group Ⅱ) with semiconductors laser orientator and contral group (group Ⅰ) without the device for assisting after CT scan at first for scout view.The mean times of puncture,the successful puncture rate at the first time,the effect and complication were compared between group Ⅱ and Ⅰ.
Results The first time successful puncture rate of the group Ⅰ was 54%(19/35） and group Ⅱ was 78%(25/32),that was significantly lower than group Ⅰ(P＜0.05).The effect and complication rate of group Ⅱ and Ⅰ were same.
Conclusion The orientator has an excellent assistant role for CT-guided puncture and it is safe,reliable,and effective.
【Key word】 Trigeminal neuralgia;Catheter ablation；Semiconductors laser orientator

Effect of Improved Circumcision with V-Y Frenoplasty in Combination of Psychotherapy in Treatment of Premature Ejaculation DAI Fan-rong.
Department of Urology,Xiangshan Hospital of Traditional Chinese Medicine,Zhejiang Province,Xiangshan 315700,China
【Abstract】 Objective To discuss the curative effect of improved circumcision with V-Y frenoplasty in combination of psychotherapy in treatment of premature ejaculation(PE).
Methods Twenty-senven PE patients were given psychotherapy following circumcision and V-Y frenoplasty.
Results All patients were given 3-month follow-up.Effects were noted in 24 patients（88.9%）,but no effects in 3.
Conclusion Improved circumcision with V-Y frenoplasty combined with psychotherapy in PE treatment is easy to do with obvious effects and quicker recovery,and with less complications or mild postoperative pains.
【Key word】 Circumcision；Premature ejaculation

Family Bromadiolone Poisoning with Hematuria as Primary Symptom LIU Ming-juan，SHI Bing，YE Li-ping，et al.
Department of Hematology,the Second Hospital Affiliated to General Hospital of Chinese People′s Liberation Army，Beijing 100091，China
【Abstract】 Objective To analyze the mechanism，clinical characteristics，diagnoses and treatments of bromadiolone poisoning.
Methods? Integrating with past literatures,we analyzed retrospectively data of 5 bromadiolone poisoning patients(in 2 families) with hematuria as the primary symptom.
Results Poisoning was characterized by skin and mucosa bleeding in 5 patients,4 patients presented with hematuria as primary clinical manifestation,3 were accompanied by oral mucosal bleeding,3 by skin petechiae or ecchymoses,1 by limb pains due to deep muscle bleeding,1 without bleeding symptom.The white blood cell count(wbc) elevated mildly in 5 patients,hemoglobin level decreased in 1;prothrombin time,activated partial prothrombin time and thrombin time were prolonged and activity of thrombinogen reduced in 5;fibrinogen level increased in 2.Coagulation factor Ⅶ,Ⅸ,Ⅹ decreased.Hemorrhage was effective after supplementary Vitamin K1 or fresh frozen plasma(or prothrombin complex).
Conclusion Primary manifestation being hematuria should be taken into account the possibility of bromadiolone poisoning,which is mainly treated by supplementary Vitamin K1 with a long course.
【Key word】 Bromadiolone；Hematuria；Poisoning

Clinical Effects of Light Concentration of Cyclosporine A in Patients with Renal Transplantation ZHANG Guo-qing,XIAO Jin-zhu,CHE Xian-ping,et al.
Department of Urinary Surgery,Nongken Chief Board Hospital of Hainan Province,Haikou 570311,China
【Abstract】 Objective To observe the clinical effects of light concentration of cyclosporine A(CsA) in patients with renal transplantation(RT).
Methods One hundred forty RT patients were divided into experimental group(receiving light CsA concentration,n=66) and control (receiving conventional CsA concentration,n=74).We observed the concentration of whole blood CsA,renal function,triglyceride and other complications.
Results CsA concentrations of week 2 and month 1 after medication were lower in experimental group〔(211.6±43.5)ng/ml,（248.2±46.4)ng/ml,respectively〕 than in control 〔(304.3±58.4)ng/ml,（346.1±56.9）ng/ml,respectively〕（P＜0.05）.The levels of BUN and Cr of month 12 were lower in experimental group〔(7.2±1.1)mmol/L,（62.7±15.3）μmmol/L〕than in control（P＜0.05）.There was not significant difference in triglyceride levels of week 2,month 1 between 2 groups,but those of months 6 or 12 in experimental group 〔(1.85±0.21)mmol/L,（1.26±0.19)mmol/L〕was lower than in control(P＜0.05).No irreversible rejection reactions were noted in all patients,but light ones in 1 of experimental group and in 2 of control,the difference was not significant(P＞0.05).The incidence of pulmonary infection rate was 10.6% in experimental group,and 24.3% in control,the difference was not significant（χ2=4.491,P＜0.05）.
Conclusion Light CsA concentration in renal transplantation can prevent rejection reaction and reduce the incidence of adverse reactions.
【Key word】 Renal transplantation;Cyclosporine A;Immunosuppression

Chronic Nodular Gastritis in Adults:Clinical Study of 36 Cases YAN Jun,CHEN Xiao-yan,PEI Ji-hua,et al.
Department of Digestion,the Second Affiliated Hospital of Wenzhou Medical College,Wenzhou 325000,China
【Abstract】 Objective To observe the clinical features of chronic nodular gastritis and its histopathological changes in adults.
Methods Clinical manifestations,Helicobacter pylori(H.pylori) infection and its histopathology were analyzed retrospectively in 36 patients with chronic nodular gastritis.
Results All patients presented mainly as upper abdomen pain(52.8%) and dyspepsia symptoms such as abdominal distention,sour regurgitation,belch,etc (36.1%).Thirty-two were infected with H.pylori.
Conclusion Nodular gastritis in adults,the presentation of which is not of specificity,is closely related to H.pylori infection.
【Key word】 Gastritis;Helicobacter pylori;Signs and symptoms

Pericardial Effusion and Cardiac Enzyme Changes Caused by Hypothyroidism PANG Jian-wei，YANG Guang-yuan，Pan Jia-qiu，et al.
Department of Endocrine,the First Affiliated Hospital of Jiamusi University,Jiamusi 154002,China
【Abstract】 Objective To study the clinical characteristics of pericardial effusion(PCE) and myocardial enzyme changes caused by hypothyroidism (HT),to improve the cure rate and to reduce missed diagnosis in treatment.
Methods The clinical manifestations and results of laboratory examinations were analyzed in 26 patients with PCE and myocardial enzyme changes to explore the relationship between PCE and myocardial enzyme changes.
Results HT performances such as chills and fatigue were noted in 26 cases,body mass gains,appetite loss,turmeric skin and non-pitting edema in both lower extremities in 20,menstrual disorders in 18,rough skin,sparse hair lack of luster and blunt actions in 16;in the performance of heart damage,there were low and blunt tones(18 cases),palpitation and short breath(6 cases) and arrhythmias(3 cases).PCE was found in 22 cases,myocardial enzyme changes in 24,and no correlation was proved between PCE and myocardial enzyme changes（rs=-0.0778，P=0.7055）.After 8 weeks of treatment,HT symptom was obviously improved,ECG,X-ray and cardiac echocardiography returned to normal,and thyroid function and myocardial enzyme levels to normal,too.
Conclusion HT can cause PCE and myocardial enzyme changes.A large amount of unexplained pericardial effusion and and severe myocardial enzyme changes without obvious cardiac tamponade symptom should be taken into account the possibility of HT.?
【Key word】 Hypothyroidism；Pericardial effusion；Creatine kinase

The Effect of Compound Xianzhen Decoction on Balance Ability for the Postmenopausal Patients Suffered with the Osteoporosis WANG Shu-li,ZHOU Li-zhen,WANG Chang-hai.
Beiing Royal Integrative Medicine Hospital，Beijing 102209，China
【Abstract】 Objective To research the effect of Compound Xianzhen Decoction on balance ability for the postmenopausal patients suffered with the osteoporosis.
Methods Randomized controlled trail was designed.A total of 148 postmenopausal women suffered with osteoporosis,aged 50～80 years old and lived in Beijing,were randomly divided into four groups:treatment group,western medicine control group,Chinese medication control group,and sport group.All groups participated in taking a walk with gait speed of 120 steps per minute,3 days per week.Walking lasted 30 minutes every time.In addition,treatment group received Compound Xianzhen Decoction one dose daily,western medicine control group received salmon calcitonin nasal spray 20 μg and Caltrate 600 mg daily，Chinese medicine control group received Xianling Gubao Capsule 6 grains/24 hours.All participants were prohibited to receive estrogen or diphosphonate during trails.The course of treatment was 6 months.Balance ability (including walking test on balance beam,timed up and go test,one-leg balance test with eyes closed,strengthening Romberg test) were measured and symptoms were observed before and after treatment.
Results In Compound Xianzhen Decoction group,time decreased significantly in timed up and go test〔（6.3±1.9）s vs (6.8±1.8)s，P＜0.05〕and lengthened significantly in strengthening Romberg test 〔（23.9±39.6）s vs （11.1±15.7）s，P＜0.05〕comparing after treatment to before.After analysing between groups，there is significant in timed up and go test and strengthening Romberg test（P=0.03 and P=0.008 respectively）.Furthermore,the group of Compound Xianzhen Decoction had lowest rank in timed up and go test but hightest rank in Romberg test.In addition，Compound Xianzhen Decoction had best effect to modify symptoms and was significant difference with other groups.
Conclusion Compound Xianzhen Decoction could partly improve dynamic and static equilibrium and modify general symptoms in postmenopausal women suffered with osteoporosis.The result was deduced initially to correlate with the improvement of proprioceptive sensibility and muscle power in lower extremity.
【Key word】 Compound xianzhen decoction；Osteoporosis，postmenopausal；Balance ability；Muscle power

Ca2+ Apoptosis and Drug Regulation XUE Quan-fu,WANG Zhen-gang.
Institute of Basic Sciences，Chinese Academy of Medical Sciences，Department of Physiology and Pathology，Peking Union Medical College，School of Basic Medicine，Beijing 100005，China
【Abstract】 Diseases can be induced by overage or insufficiency of apoptosis.The increase of cytosolic Ca2+ overload plays a critical role in apoptosis.Base on pathogenesis of apoptosis induced by Ca2+ overload,the rational targets are suggested for investigation and development of new therapeutics.
【Key word】 Calcium metabolism disorders；Apoptosis；Mitochondria

Research Progress in Risk Factors of Endometrial Cancer LIU Xia，ZHANG Wei-yuan，DAI Yin-mei.
Beijing Obstetrics and Gynecology Hospital，Capital Medical University，Beijing 100026，China
【Abstract】 Endometrial cancer(EC) is one of 3 common malignant tumors of female reproductive tracts.The causes and pathogeneses of this disease have not been illuminated clearly so far.Epidemiological researches have shown that endometrial cancer is associated with endo- or exo-genous estrogens，obesity，hypertension，diabetes mellitus and life styles，etc.Restricting these risk factors will be a reliable theoretical basis for EC prevention.
【Key word】 Endometrial neoplasms；Risk factors；Estrogens

Analysis on Etiology of Acute Pancreatitis in Past 15 Years in Quanzhou District FANG Tai-yong,XIE Yuan-zhi,LIANG Yi-zhi.
Department of Gastroenterology,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China
【Abstract】 Objective To investigate the changes in constituent ratio and etiologies of acute pancreatitis (AP) in different time periods in Quanzhou District.
Methods Analyses were performed on clinical data of 450 AP patients hospitalized in 2nd Affiliated Hospital of Fujian Medical University from 1991 to 2005.Data were divided into group A (1991-1995),group B(1996-2000),group C(2001-2005),to perform statistical analyses.　Results The absolute number of AP patients increased year by year.The ratio of male to female was 1.15:1.Groups A,B,C accounted for 0.15%,0.33% and 0.46%,respectively,out of the total cases hospitalized in departments of surgery and medicine during the corresponding time periods,the difference was significant(P＜0.05).The incidences of biliary tract diseases of groups A,B,C were 40.00%,42.75%,39.77%,respectively (P＞0.05);those of idiopathic pancreatitis were 38.33%,27.48%,17.37%,respectively (P＞0.05);those of hyperlipidemia were 3.33%,9.22%,21.62%,respectively (P＞0.05).
Conclusion The number of AP patients is increasing year by year.There are more females than males in biliagenic or idiopathic AP patients,and more males in hyperlipidemia or alcohol-induced AP.Biliary tract diseases remain the major causes of AP.
【Key word】 Pancreatitis;Epidemiology

Investigation of Prevention and Treatment Capabilities of Stroke Recurrence in General Practitioners and Nurses in Beijing Communities JIANG Bin，FANG Xiang-hua，WU Yong-hao，et al.
Department of Neuro-epidemiology，Beijing Neurosurgical Institute，Capital Medical University， Beijing 100050，China
【Abstract】 Objective To investigate prevention and treatment capabilities of stroke recurrence in general practitioners（GPs）and nurses（GNs）in Beijing communities.
Methods Self-designed questionnaire was carried out in 119 GPs and GNs working in centers（or stations）of community health service in Beijing.
Results 61.40% of GPs and 35.71% of GNs reported that they had the capability of managing patient with stroke.Based on hundred-mark system,41 was the average total score of knowledge related prevention and treatment of stroke reccurrence in community medical staff,and scores of doctors(42) was higher than that nurses(38).
Conclusion Not all of GPs and GNs working in centers（or stations）of community health service in Beijing have the capability of system management of stroke patients.Their knowledge of prevention and treatment of stroke recurrence should be further improved.
【Key word】 Cerebrovascular accident；Community health service；General practitioner；General nurse

Number13July，2009

Evaluation on Teaching Effect of Health Education by College Students and the Impacting Factors LIU Ming-liang，WU Xiu-yun，ZHUANG Li-hui.
Center for Disease Control and Prevention，Shandong Shouguang 262700，China
【Abstract】 Objective To understand how students in Weifang Medical University evaluate the teaching contents and effect of health education and to analyze the influence of sex and schooling system on the evaluation.
Methods A random sampling and an anonymous questionnaire were conducted in 575 students (one third of the total) who selected the course of health education.
Results The reason for the students to choosing the health education course were their believing of the usage of the course to future career 47.3% and their interest to the health education 42.1%.There was no significant difference in view point of the usage of the health education to the future career among the students with different sexes and under different schooling systems （P＞0.05）.But there was significant difference in evaluation of teaching effect and teaching mode among the students with different sexes （P＜0.05）,and so was in evaluation of bilingual teaching among the students under different schooling systems （P＜0.05）.The suggestions from the students to future teaching reform mainly included increasing the teaching hours,taking a mode of heuristic and discussing teaching,increasing relevantly the video teaching,and expecting more expressive and varied multimedia courseware.
Conclusion The teaching effect and teaching mode of the course are good based on the students′ views.The quantity of existing teaching hours for the course meets the demands of the majority of the students,however some contents still need to be enhanced and enriched.The improving suggestions include mainly enriching teaching contents,reforming teaching mode,adding case discussions,increasing teaching hours enhancing bilingual teaching.
【Key word】 University student;Health education;Teaching effect;Influencing factor

Tracking Study and Analysis of Effect of General Practitioners′ On-the-job Training in Shanghai Pudong New District SONG Hui-jiang,REN Guang-wei,SHI Rong.
Sanlin Community Health Service Center,Pudong New District,Shanghai 200124，China
【Abstract】 Objective To make tracking study and analyze the effect of on-the-job training for general practitioners in Pudong New District of Shanghai.
Methods The questionnaire survey was conducted on leaders and colleagues of trainees who attended the on-the-job training for general practitioners from 2004 to 2007.
Results The leaders and colleagues held the general practitioners taken part in the training had greatly improved in clinical experiences,medical knowledge,health education and guidance foe family panning techniques （P＜0.05）;and had a little improvement in the patients′ satisfaction （P＜0.05）.The evaluation on trainees′ working quality and working amount and scientific research capabilities from the leaders of urban community health service centers was significantly different from that from the leaders of rural areas（P＜0.05）.
Conclusion The current mode of general practitioners′ training is scientific and feasible.After the training,the trainees can obtain the basic professional knowledge and general practice skills.However the training on scientific research means should also be included,internship period and service contents in community health service should also be increased;man-oriented and active development of general practice needs to be performed so as to meet the demand of community residents.
【Key word】 General practitioners；On-the-job training；Effect evaluation

Multiple Correspondence Analysis of Relationship between Duration and Complications in Hypertension Patients in Beijing GUO Xiu-hua,ZHANG Pu-hong,LUO Yan-xia,et al.
Department of Epidemiology and Health Statistics,School of Public Health and Family Medicine,Capital Medical University，Beijing 100069，China
【Abstract】 Objective To explore the relationship between gradual increase of duration of hypertension and its complications.
Methods From August to October 2005,a total of 16 711 residents aged≥18 years,from 18 Districts or counties of Beijing,were enrolled by equal proportion in stratified cluster random sampling,and questionnaire survey,blood pressure measures,physical and laboratory examinations were conducted.Totally 6 176 hypertension patients were screened.Multiple correspondence analysis was performed to explore the relationship between the durations (based on four stages of ＜5,5～,10～,and≥15years) and complications of hypertension.
Results Female young and middle-aged residents with a short course living in rural areas had less complications.Elderly patients with a long course living in urban areas had varies complications.
Conclusion The interventions should be applied as early as possible to slow the development of disease.And intensive monitoring needs to be conducted for patients with a long course of hypertension to improve their quantity of life.
【Key word】 Hypertension；Duration；Complications；Multiple correspondence analysis

Determinants of Self-Rated Health among the Elderly and Their Extents LIU Heng,CHAO Jian-qian,YANG Ying-chun,et al.
Public Health School,Southeast University，Nanjing 210009，China
【Abstract】 Objective To realize the determinants of self-rated health (SRH) among the elderly and their influencing extents.
Methods China Health and Nutrition Survey (2006) was used to analyze the determinants and compare the extent of each factor through ordinal logistic regress model.
Results Age,education,martial status,objective body and psychologic health had great effects on SRH of the elderly (P＜0.05),thereinto,the memory and living feeling were the maximal influence factors,their OR value reached to 5.44 and 4.85.In addition,the elderly could or could not deal with ADL and IADL by themselves,whether suffering from serious illness recently also affected the SRH.
Conclusion ①The social-demographic variables have affections on SRH of the elderly,people who are older,received more education and living with spouse have more positive SRH.②The SRH of elderly is effected by body and psychological health,especially the latter.③The daily behaviors of old person also have a certain impact to their SRH.Appropriate smoking,drinking and doing some exercise have promotion to the health of the elderly.
【Key word】 Aged;Self-rated health;Factor analysis,statistical

Metabolic Features and Relevant Risk Factors of Nonalcoholic Fatty Liver in Uygur and Han Nationality Patients with Type 2 Diabetes Mellitus ZHU Hong-xia,ZHU Jun,ZHANG Ming-chen,et al.
Department of Endocrinology,the First Affiliated Hospital,Xinjiang Medical University,Urumqi 830011,China
【Abstract】 Objective To compare the metabolic feature of? risk factors of disease in patients with type 2 diabetes (T2DM) complicate by nonalcoholic fatty liver (NAFL) between Uygur and Han Nationalities.Meanwhile,to investigate the relative factors of T2DM complicate by NAFL.
Methods Totally 2 664 staff members and retirees form Shenxin Enterprise receiving health examination by Liudaowan Hospital in Urumqi as the subjects.The results of their physical examination and laboratory tests were analyzed.
Results Among the subjects there were 1 696 of Han nationality,886 of Uygur nationality,and 82 of other nationalities.There were 265 cases of T2DM,117 cases of T2DM complicated by NAFL (DFL group),148 cases of simple T2DM (NDFL group).prevalence rates of NAFL in the Han and Uygur were 37.0%（60/162） and 55.1%（54/98） respectively.The levels of waistline,body mass index,diastolic blood pressure, serum triglyceride,fasting serum insulin,alanine aminotransferase,aspartate aminotransferase and insulin resistance index (HOMA-RI) of patients in the DEL group were significantly different from those in NDFL group (P＜0.05).In DFL group the levels of waistline,body mass index and fasting in the Uygur were significantly different from those in the Han (P＜0.05).In the NDFL group the levels of insulin waistline and systolic blood pressure in the Uygur were significantly different from those in the Han (P＜0.05).Multiple analysis of Logistic regression showed that waistline and HOMA-RI were the risk factors for NAFL development ［P＜0.01;OR=1.190,5.389;95%CI （1.079,1.312) and （1.580,18.387）］.
Conclusion The patients with T2DM complicated by NAFL have remarkable over weight,central obesity,dyslipidemia and insulin resistance.Waistline and HOMA-RI were risk factors of NAFL,the Uygur patients had more obvious central obesity and insulin resistance than the Han patients.
【Key word】 Diabetes mellitus,type 2;Fatty liver,nonalcoholic;Insulin resistance;Hyperlipidemia;Uygur nationality

Reliability,Validity and Response of Patient-Reported-Outcome Scale in Stroke Patients with Spastic Paralysis WANG Yang,ZHAO Hong,LIU Zhi-shun,et al.
Department of Acupuncture,Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China
【Abstract】 Objective To evaluate the reliability,validity and response of the Patient-Reported-Outcome Scale (PRO) for stroke patients with spastic paralysis.
Methods Totally 109 patients from Guang′anmen Hospital,Xuanwu Hospital and Huguosi Hospital were investigated before and after (4±1) weeks so as to evaluate the reliability and validity of the PRO.
Results The Cronbach′s Alpha coefficients before and after filling out the PRO were more that 0.65,the split-half reliability of the scales were 0.786 and 0.775 respectively.The correlation coefficients of the two PRO scales with Barthel Scales were-0.253 and -0.182 respectively,and those with SS-QOL were -0.377 and -0.403 respectively.
Conclusion Patient-Reported-Outcome Scale is of good reliability and validity in evaluation of stroke patients with spastic paralysis.
【Key word】 Spastic paralysis;Scale;Reliability;Validity

Characteristics of Thyroid Function in Senile People and the Effects of Age and Nutrient Condition GUO Hong,HAO Rui-rui,CHEN Ying,et al.
Comprehensive Department of Beijing Friendship Hospital,Affiliated to Capital Medical University,Beijing 100050,China
【Abstract】 Objective To investigate the characteristics of thyroid function in senile people and the effects of age and nutrient condition on the function.
Methods Totally 79 senile inpatient with no thyroid disease were enrolled.The levels of T3,FT3,T4,FT4,and TSH among different age groups and different serum albumin levels groups were compared.
Results Among the patients in four groups of aged 60-74,75-79,80-84,and 85-95 there was no significant difference in levels of T3,T4,FT4,and TSH （P＞0.05）;but there was as significant difference in level of FT3 （P＜0.05）.Among the patients in four groups of level of serum albumin＜30 g/L,30～35 g/L,and ＞35 g/L there was no significant difference in levels of T4,FT4,and TSH （P＞0.05）;but there was a significant difference in levels of T3 and FT3 （P＜0.05）.
Conclusion The level of FT3 is different among senile people of different ages,and the levels of T3 and FT3 are also different among senile people with different levels of serum albumin.
【Key word】 Thyroid Function;Aged;Thyroid hormones;Albumin

Effect of G894T Mutation in the Endothelial Nitric Oxide Synthase Gene and Abnormality of Waist-to-Hip Ratio on Essential Hypertension LI Dong-jie,WU Wei-feng,XU Yi-lin,et al.
Department of Epidemiology and Statistics,Qingdao University Medical College,Qingdao 266021,China
【Abstract】 Objective To analyze the effect of G894T mutation at exon 7 in the endothelial nitric oxide synthase (eNOS) gene (Glu298Asp),abnormality of waist-to-hip ratio (WHR) and the interaction between the two factors on essential hypertension.
Methods Two hundred and thirty-five patients without taking anti-hypertension medication and two hundred and forty normotension controls were randomly recruited from four communities in Qingdao.G894T mutation was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).Additive model was used to analyze the interaction between G894T mutation and abnormality of WHR.
Results T allele frequency (18.94%) and abnormality of WHR(69.79%) in patients were significantly higher than those in controls (12.71%,47.92%),（χ2=6.927,23.433,P＜0.01）.After adjusting age，gender,drinking,smoking，body mass index and blood fats by logistic regression，synergy index between G894T mutation in eNOS gene and Abnormality of WHR was 1.542,attributable interaction was 0.909,attributable interaction percentage was 25.34%,pure attributable interaction percentage was 35.14%.
Conclusion G894T mutation in the endothelial nitric oxide synthase gene is associated with essential hypertension.G894T mutation of eNOS gene and abnormality of WHR show a positive interaction.Control of abnormality of WHR can reduce the risk of essential hypertension in general population.
【Key word】 Hypertension;Nitric-oxide synthase;Genes;Waist-hip ratio;Interaction analysis

Effects of the Combined Therapy of Reduced Glutathione and Prostaglandin E1 on Chronic Hepatitis B FU Jun-lu,CHEN Zhi-qiang.
Department of Biochemistry,Hanzhong Professional and Technical Institution of Medical College，Hanzhong 723000，China
【Abstract】 Objective To investigate the effects of the combined therapy of reduced glutathione (GSH) and prostaglandin E1 in patients with chronic viral hepatitis B (CHB) and on the oxidative impairment in the body.
Methods From January 2007 to January 2009 62 CHB patients were enrolled and randomly divided as trial group (n=31) and control group (n=31).The patients in the control group were treated with GSH (1 200 mg in 0.9% sodium chloride solution 100 ml) based on the supporting therapy;while those in the trial group with additional prostaglandin E1 (20 μg in 0.9% sodium chloride solution 100 ml) for four weeks.The clinical effects,and serum levels of superoxide dismutase（SOD）,glutathione peroxidase (GSH-Px) andmalondialdehyde (MDA) were observed,and the results between the two groups were compared.
Results After treatment,there were in the trial group 22 case with a remarkable effect,7 cases with an effect,and 2 cases with no response;while in the control group 17 cases,5 cases,and 9 cases respectively,with a significant difference （u=1.99,P＜0.05）.Before treatment,the levels of serum SOD,GSH-Px and MDA in the trial group were （106±18）μU/L,（57.8±23.4）U/L and （9.4±1.3）μmol/L? respectively;and those in the control group were（103±13）μU /L,（57.4±21.4）U/L and （9.4±1.3）μmol/L respectively,with no significant difference（P＞0.05）.After treatment,the levels of serum SOD,GSH-Px and MDA in the trial group were （173±13）μU/L,（89.4±15.8）U/L and （7.9±3.5）μmol/L respectively;and those in the control group were（199±11）μU/L,（103.2±14.3）U/L and （5.6±2.4）μmol/L respectively,with significant differences （P＜0.05）.
Conclusion The combined therapy of GSH and prostaglandin E1 for CHB patients is of higher effect than GSH only,it can correct oxidants-antioxidants imbalance in the body of CHB patient.
【Key word】 Hepatitis type B，chronic；Reduced glutathione；Prostaglandin E1；Superoxide dismutase；Glutathione peroxidase；Malondialdehyde

Renal Function after Using Three Different Types of Left Ventricular Assist Devices MA Ling,LI Wan-dong,TANG Zhi-yin,et al.
Department of Anesthesiology,Shengjing Hospital of China Medical University,Shenyang 110004,China
【Abstract】 Objective To investigate the impact on renal function after implantation of three different types of left ventricular assist device (LVAD).Methods Twenty-three patients undergoing LVAD implantation were retrospectively analyzed and categorized into 3 groups based on the different LVAD pump implanted: Group A (n=12) Toyobo,Group B (n=8) Novacor and Group C (n=3) HeartMate.The levels of blood urea nitrogen (BUN),creatinine and creatinine clearance (CrCl) in the duration of ICU and on postoperative day 1,3 and 7 among the patients in the 3 groups were compared.
Results The ICU staying time of the patient in the three group were（17 ± 15）d,（12 ± 9）d,and （11 ± 8）d respectively,with a significant difference among the three groups （P=0.546）.The levels of BUN,creatinine and CrCl on postoperative day 1,3 and 7 among the patients in the 3 groups showed no significant difference （P＞0.05）.There were 2 patients in group A,because of renal insufficiency,received hemofiltration after LVAD implantation;while no patient in group B and C needed hemofiltration.
Conclusion No significant difference was found in levels of BUN,creatinine and CrCl on postoperative day 1,3 and 7 among the patients in the 3 groups.However,patients using Toyobo LVAD tend to have renal dysfunction.
【Key word】 Left ventricular assist device;Renal function;End-stage heart failure

Effect of Atorvastatin 20 mg on Patients with Chronic Heart Failure ZHANG Guo-yang,YU Yi-bo,ZHU Yun-yun.
Ningbo No.1 Hospital,Ningbo 315000,China
【Abstract】 Objective To investigate the effect of Atorvastatin 20 mg in patients with chronic failure.Methods Totally 86 inpatients with chronic heart failure were randomly divided as trial and control groups.The patients in the control group (n=43) were given conventional medication of anti-heart failure;while those in the trial group (n=43) were given additional Atorvastatin 20mg each day.Before treatment and after 6,12 months treatment,6-minute walk test (6-MWT) was conducted for all the patients,and the levels of Nt-proBNP,serum lipoprotein,and liver function were detected.At the same time the vascular accidents were recorded.
Results After 6,12 months treatment,there were significant differences in total cholesterol (TC) and low density lipoprotein (LDL) between the two groups (P<0.05).The results of 6-MWT in the trial group before treatment,after 6,12 months treatment were respectively （356±75）m,（374±63）m,and （424±53）m,while those in the control group were respectively（343±56）m,（363±59）m,and （403±68）m,compared between the two groups there was no significant difference at the first two time points (P＞0.05),but after 12 months treatment there was (P<0.05).The levels of Nt-proBNP in the trial group before treatment,after 6,12 months treatment were respectively ［454（167-3 027）］ pg/ml,［357（143-2 102）］ pg/ml,and ［296(103-1 256)］ pg/ml,while those in the control group were respecti