Objective To analyze the effect of the new cooperative medical care on the use of outpatient services by rural residents so as to provide scientific basis for its improvement. Methods Using the stratified cluster sampling method, house-to-house surveys on the residents of Dongying via interviews were conducted both before and after the implementation of the new cooperative medical care. Results Although the two-week rate of seeking medical services by the rural residents after the implementation of the new cooperative medical care did not increase, changes did take place in the flow direction of the patients and the rate of seeking medical services at the end of two weeks took a downward turn. Fairness in the use of health services by the residents was enhanced. Conclusion The new cooperative medical care strongly guarantees rural patients' access to medical care.

Medical electrical equipment--modular alarm system to meet YY 0709-2009 requirements and design, through the design of both hardware and software, low/medium/high three priority audible alarm visual alarm information to be verified by testing the same time, now the alarm system has been put into use on a portable infusion device remote microcomputer systems.
Clinical Alarms ; Equipment Design ; Software Design

Purpose:Our experiments are dealing with the affect of docosahexaenic acid(DHA) in doxorubicin to cytoxicity effect of MDA-MB-435s, which is of the anti-human breast cancer and whether it is one of the effect mechanisms that it via the lipid peroxidation of DHA.Methods:Add different match such as anti-cancer drugs?PUFAs?oxidan system of sodium ascorbate and ?-methy-1.4-naphoqui-none?antioxidant of Dl-?-tocopherol and so on to the culture cell line of MDA-MB-435s each 24 hours for 6 days, estimate MDA by TBA with cell extracts and estimate the contents of NO via nitrite salt spectrophotography, then draw out a dosage-effect correlation straight line among contents of MDA,NO and cytoxicity. Mitox is used as contraposition to the peroxidation of ADM which is enhanced by DHA for peroxidation of mitox is low.Results:There have been obvious changes on the contents of MDA of the lipid peroxidation has paralled increased while NO has decreased. There is recitilinear correlation relationship among the contents of MDA and NO from cell extracts and the cytoxicity.Conclusions:It is obvious that DHA can add the cytoxicity of cell line of MDA-MB-435s with ADM, particularly after add non-cytoxicity oxidant. It is lipid peroxidation of oncocyte that one of the mechanisms of DHA can enhance anti-breast cancer effect of ADM.

Objective To investigate the factors and the preventive methods of gastrointestinal leakage.Method 32 cases of gastrointestinal leakage from 1996 to 2001 were analyzed retrospectively.Results In 32 patients,19 cases were benign diseases and 13 cases were malignant diseases.25 cases were selectively operation and 7 were emergency operation, 11 cases treated by re-operation and 21 cases by other methods.24 cases were cured and 8 cases were died.Conclusions Main cause of leakage was operative method unsuitable.Anastomostic skill was deficiency,local condition was bad and ignored postoperative treatment and so on.Preventive methods should be selected to decreasingintestinal leakage.

To investigate the chemical constituents of hemostatic extract of Pyrola calliantha H. Andres, the extract was subjected to chromatographic separation and purification. Along with some known compounds, a new naphthaquinone derivative was isolated and identified as 2-(1, 4-dihydro-2, 6-dimethyl-1, 4-dioxo-3-naphthalenyl)-3, 4, 5-trihydroxylbenzoic acid by physicochemical and spectroscopic analysis.

Objective To investigate the effects of positive end-expiratory pressure (PEEP) on hemodynamics and intra-abdominal pressure in patients with acute respiratory distress syndrome (ARDS) with normal intra-abdominal pressure (IAP) and intra-abdominal hypertension (IAH) during mechanical ventilation under a incremental PEEP.Methods Eighteen ARDS patients with normal IAP or IAH treated in intensive care unit of Anhui Provincial Hospital were enrolled for study.At different PEEP levels (5,10,15,20 cmH2O),hemodynamic parameters including extravascular lung water index (EVLWI),intrathoracic blood volume index (ITBVI),stroke volume variation (SVV) and IAP were measured with PICCO technology.Results Compared with ARDS patients with normal IAP,the ARDS patients with IAH were characterized by:(1) EVLWI was decreasing under the increment of PEEP,but there was no significant difference between 15 cmH2O and 20 cmH2O (t =0.593,P =0.572).As PEEP was gradually escalated,EWLVI had no significant changes in patients with normal IAP.(2) SVV increased as PEEP was being titrated to higher level in both groups but in normal IAP group such effect was observed till PEEP above 10cmH2O (PEEP5 vs.PEEP10,t=0.326,P=0.752; PEEP,10 vs.PEEP 15,t=-20.032,P＜ 0.01).(3) There was no statistical difference in ITBVI between two groups at varied levels of PEEP.(4) PEEP could increase IAP levels and had much more profound effects on patients with IAH.Conclusions PEEP is a contributing factor changing IAP.It is necessary to take the level of PEEP into account as IAP variation is interpreted in patients under mechanical ventilation.Different PEEP levels can significantly affect the EVLWI in patients with IAH but not do not in ones with nomal IAP.

Objective To explore the safety and efficacy of hepatic resection with selective hepatic vascular exclusion(SHVE). Methods SHVE was used in 246 consecutive patients undergoing major or complex liver resection in our center. Preoperative demographic and clinical data,details of the surgical procedure, pathologic diagnosis, postoperative course and complications were collected and analy zed. Results From January 2000 to July 2007, liver resections were performed IJnder SHVE in 246 patients; total SHVE, right partial SHVE and left partial SHVE in 145, 54 and 47 patients, respectively. SHVE was converted to total hepatic vascular exclusion(THVE)in 3 patients to repair the wall of inferior vena cava(IVC). Hemodynamic tolerance to SHVE was excellent, only with a slight increase in systemic and pulmonary vascular resistance during clamping.There were no deaths. and the morbidity was 24.8%.The mean leyth of hospital stay was 9.6 days(range 8-18) .Conclusion Our study showed that SHVE is a safe and effective procedurei and it is applicable to liver tumors near but not invade the inferior vena cava.

Objective To observe the expressions of two inhibitors of apoptosis proteins (LAPs), survivin and livin, as well as their related factors, Bci-xl and Caspase-3 in mycosis fungoides (MF), along with the effects of NB-UVB irradiation on them. Methods Totally, 30 patients with MF (5 at erythema stage, 16 at plaque stage and 9 at tumor stage) collected from 1995 to 2007 were included into this study. Of the patients, 11 received the treatment with NB-UVB irradiation. Tissue samples were resected from 30 untreated patients, 11 irradiated patients and 10 normal human controls. SABC immunohistochemistry (IHC) stain was used to evaluate the protein expression of survivin, livin, Bel-xi and caspase-3 in these samples. Also, the mRNA expression of these four factors and cell apoptosis were detected by hybridization in situ (ISH) and terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-fluorescence nick end labeling (TUNEL stain) respectively in the samples from 11 patients before and after NB-UVB irradiation. Results In samples of erythema-stage MF, plaque-stage MF and tumor-stage MF, the positivity rate was 40.00%, 75.00%, 77.78% for survivin respectively, 60.00%, 68.75%, 88.89% for Bcl-xl respectively, 40%, 25%, 44.44% for livin respectively, and 60.00%, 68.75%, 88.89% for caspase-3 respectively. No expression of survivin or Bcl-xl was observed in normal controls, while the expression of livin and caspase-3 was similar between MF and control samples. After NB-UVB irradiation, an increase was noticed in the count of apoptosis cells (t=6.49, P<0.001) and mRNA expression of caspase-3 (P<0.10), while a decrease in the mRNA expression of survivin and Bcl-xl in MF tissues, and no changes occurred to the mRNA expression of livin (P>0.10). Conehsions Survivin, Bcl-xl and caspase-3 may be associated with the pathogenesis of MF by regulating the cell apoptosis of T lymphocytes. NB-UVB could suppress the mRNA expression of survivin and Bcl-xl, lower the levels of LAP, enhance the transcription of caspase-3, and accelerate the apoptosis of tumor cells, which may partly explain the mechanism of therapeutic effect of NB-UVB in MF.

By means of literature review,the authors initiated the behavior expression system of hospitals' social responsibilities,which is further refined and revised with questionnaires and Delphi method.13 expressions of such behavior expressions were determined,namely “providing quality of care to patients”,“undertaking rescue assignment for emergencies”,and “fulfilling government-assigned tasks”.All of the 13 expressions were supported by 75％ of the experts during the second round of experts consultation.

Objective To investigate the pathogenesis,high risk factors,clinical characteristics,methods of diagnosis and treatment,and prognosis of vaginal intraepithelial neoplasia (VAIN).Methods The clinical data of thirteen cases of VAIN treated in Zhejiang Provincial Cancer Hospital dated Mar.2002 through Dec.2008 were reviewed and analyzed retrospectively.Results Twelve of 13 VAIN cases were performed the human papillomavirus(HPV) detection with 92% (11/12) HPV positive rate.None of the cases shown specific clinical manifestation.Among the 13 cases,6 of them accompanied with cervical cancer,4 cases with cervical intraepithelial neoplasia (CIN ),and 3 cases with vulvar intraepithelial neoplasma (VIN).Five cases synchronously diagnosed with cervical lesion and 3 with vulva lesion were underwent surgery,while the other 5 cases were diagnosed metachronously.Among 8 cases underwent surgery,1 case with CIN underwent argon plasma coagulation (APC) after surgery,1 case with the positive edge of VIN underwent APC.During follow up,1 case with locally advanced cervical cancer underwent radiotherapy again,3 cases with VAIN received APC,while 1 cervical cancer cases with VAIN received no treatment.The average follow-up time was 25.6 months (range 6-87 months).Two cases died of cervical cancer metastasis.The other 11 cases were normal and still alive.None of them progressed to invasive carcinoma.Conclusions The main reason of VAIN is HPV infection.There are not specific clinical manifestations,usually diagnosed when reviewing cervical or vulva lesions and rarely progressed to invasive carcinoma.The main treatment of VAIN is surgery with the adjuvant treatment of APC.