Community health service is an effective measure to relieve the difficult medical services and expensive medical cost problem,but community inhabitants in Chongqing make little use of community health service.The actual cause is that people s degree of trust in community health service is low.In view of existing situation,this article analyzes the various factors that influence community residents' degree of trust in community health service and puts forward corresponding policy proposal.

Objective To compare the sclerotherapic effects of different concentrations of lauromacrogol on endometrial cyst models in rats in two ways :10 minutes retention with extraction and retention without extraction .Methods Ninety SD rats after modeling were randomly divided into three groups :group A ,10 minutes retention with extraction;group B ,retention without extraction;group C , normal saline .While both A and B group were randomly divided into four subgroups with different concentrations :1% ,0 5.% ,0 2.5% ,and 0 1.25% . Seven days after treatment the cure rates and histopathological changes were observed .Results Cure rates in group A were 86 7.% ,71 4.% ,50% and 20% ;in group B were 100% ,100% ,87 5.% and 37 5.% .In both A and B groups ,the cure rates were not significantly different between 1% ,0 5.% and 0 2.5% concentration subgroups ( P >0 0.5) ,the cure rates of these subgroups in group B had statistical significance with 0 1.25% concentration subgroups and the saline control group( P <0 0.5) ,but there were no significant difference between 0 2.5% and 0 1.25% concentration subgroups in group A .Compared the differences of the cure rates among the same concentration subgroups , it had no statistical significance in groups A and B of 1% and 0 1.25% concentration subgroups( P >0 0.5) , but between 0 5.% and 0 2.5% concentration subgroups ,it had statistical significance( P <0 0.5) .Conclusions It will be conductive to enhancing the sclerotherapic effect if the lauromacrogol concentration remains above 0 2.5% and does not be extracted from the cyst models .

Objective To investigate the clinical effectiveness of fast track surgery ( FTS) nursing during laparoscopic cone-shaped resection of renal tumor. Methods Forty patients who was planned to accept laparoscopic cone-shaped renal tumor resection was divided into either FTS group ( n=20 ) or control group ( n=20 ) according to odd-even number of their admission IDs. The control group was given routine perioperative nursing procedure, and the FTS group was given FTS nursing. Results The operation time, intraoperative blood loss and incidence of complications had no statistical significance between the two groups (P>0. 05). As compared to the control group, patients in the FTS group experienced a shorter anal exhaust time [(30. 3 ± 11. 7) h vs. (43. 0 ± 15. 5) h, t= -2. 924, P=0. 006], shorter post-operative fasting time [(26. 6 ± 12. 1) h vs. (56. 1 ± 18. 1) h, t= -6. 059, P=0. 000], earlier ambulation [(33. 6 ± 16. 8) h vs. (66. 9 ± 28. 6) h, t= -4. 490, P=0. 000], shorter urethral catheterization [(40. 2 ± 18. 5) h vs. (83. 4 ± 39. 6) h, t= -4. 420, P=0. 000], shorter drainage time [(50. 3 ± 22. 5) h vs. (102. 9 ± 46. 0) h, t= -4. 594, P=0. 000], and shorter length of hospitalization [(5. 5 ± 1. 5) d vs. (9. 0 ± 2. 1) d, t= -5. 911, P=0. 000]. Conclusions FTS nursing procedure can reduce the rate of post-operative complications and shorten hospitalization stay. It can not only guarantee the efficacy of surgical treatment but also help the patient to achieve the goal of fast rehabilitation, being worthy of extensive application.

Objective To investigate effects of early administration of high-dose rosuvastatin(40 mg) on coronary microvascular function and short-term outcome in patients treated with primary percutaneous coronary intervention (PCI) for acute myocardial infarction(AMI). Methods Ninety-four consequent AMI patients treated with primary PCI were divided into rosuvastatin group (50 patients) and control group (44 group). The infarct-related artery flow of epicardium was classified in compliance with the TIMI criteria. Myocardial and microvascular perfusion was assessed using the TMPG. The incidence of the MACE and the cytotoxicity and hepatotoxicity of rosuvastatin was respectively recorded in 30 d follow-up period. Results Either patients in the rosuvastatin group or in the control group showed better TMPG immediately after PCI (P<0.05), compared with that before treatment. However, the post-PCI TMPG of the rosuvastatin group was obviously much better than that of control group (P<0.05). Compared with that in control group, the 30-day composite MACE rate was lower in rosuvastatin group and in the TMPG 3 patients of rosuvastatin group:12.0%(6/50) vs. 34.1%(15/44), P<0.05;11.1%(3/27) vs. 42.9%(6/14). There was no cytotoxicity and hepatotoxicity in two groups. Conclusions Early administration of high-dose rosuvastatin (40 mg) can improve coronary microvascular function and short-term outcome in patients treated with primary PCI for AMI, and it is efficient and safety.

Metabolic studies were carried out on nine male infants to investigatethe digestibility and utilization of some of the nutrients of the Milk-substitute 5410, there by ascertaining whether those nutrients could satisfy their requirements. From the results of the chemical analyses of the foods and excreta of the infants, statistical treatment of the records on the fre- quency of defecation, the amount and form of the stools, and the growth rate of the infants, it was possible to evaluate the apparent energy utilization of the milk-substitute.The ages of the infants at the beginning of the experiment were 37-77 days, and 6-7 months at the end. The experiment was divided into five periods: in the first and second periods the infants were fed alternately with the milk-substitute and powdered whole milk diet; in the third and fourth periods the diets were the same as the first and second but supplemented with cod liver oil concentrate (sbout 1500 1. U. vitamin A and 500 I. U. vitamin D per day). In the fifth period the protein content of the milk-substitute was raised from 16.6% to 22.6%, supplemented also with cod liver oil. In periods when the infants were fed with the milk substitute alone, the number of defecation was significantly less and loose stools fewer than in the milk diet period. Introduction of cod liver oil tended to reduce the dry weight of the feces. When the milk-substitute with higher protein content was given, the number of defecation increased and occurence of diarrhea was more frequent but not more so than during the cow's milk powder period.From the statistical analyses of the results, it was found that the digestibility of protein and carbohydrate of the milk-substitute was significantly lower than that of cow's milk powder but that of fat was higher. Introduction of cod liver oil increased the digestibility of protein, fat, carbohydrate and crude fibre. There was no significant difference between the availability of energy of the milk-substitute and cow's milk powder, the former being 90.9% while the latter 91.7%.The growth curves of the nine infants showed that the higher the food intake, the higher the growth rate. The caloric intakes of eight infants were 100-120 kcal per kilogram of body weight per day and their growth rates were almost identical. The caloric intake of one infant was consistently below 100 kcal per kilogram of body weight per day and his growth rate was significantly lower. It may be concluded, therefore, that when the Milk-substitute 5410 is given to infants supplying 100-120 kcal per kilogram of body weight per day, would be adequate for normal growth.

Previous feeding experiments on infants have shown that the growth promoting effect of the milk-substitute 5410 was comparable to that of hu- man milk or a milk powder diet. In order to know more about the biochemical and physiological properties of this mixture, nine male infants were put in serial metabolic studies with respect to the digestion, nitrogen, calcium and phosphorus utilization of this soybean product.The age of the infants were 37-77 days at the beginning of the experiment, and 6-7 months at the end. The infants were fed with the milk-substitute and a milk powder diet in alternative periods each of which lasted 2-4 weeks. In the first and second periods the infants were fed milk powder or milk-substitute alone, while in the third and forth periods the same diets were supplemented with concentrated cod liver oil, and in the fifth period the infants were fed with another soybean product similar to mixture 5410 but with higher protein content.The digestibility of protein and the absorption of nitrogen, calcium and phosphorus of mixture 5410 were significantly lower than those of the milk powder diet. However, the nitrogen retention were the same during these two dietary periods (191 and 196 mg per kilo per day). The calcium and phosphorus retention were signigicantly lower during periods without cod liver oil (24 and 24 mg per kilo per day) but improved markedly after supplementation (58 and 36 mg per kilo per day).On the average, each infant received from the milk-substitute 4.3g of protein per kilo per day. The amount of calcium ingested was 850 mg per day; it seems to be that supplementation with cod liver oil is necessary for adequate calcium retention at this level of intake.Raising the protein content of the milk-substitute by further addition of soybean powder may increase the nitrogen retention, but it tends to lower the absorption and retention of calcium and phosphorus due to increased amount of fecal excretion.

Objective To compare the protective effects of midazolam and propofol at equivalent dose on myocardial ischemia reperfusion injury during open heart surgery Methods Thirty six patients,scheduled for elective open heart surgery, were divided into midazolam (M), propofol (P) and no occluding (N) groups Before induction, a bolus of midazolam 0 2mg?kg -1 was given in group M or N , and a bolus of propofol 2 0mg?kg -1 in group P; after induction, midazolam was infused at 0 4mg?kg -1 ?h -1 in group M or N , and propofol at 4 0mg?kg -1 ?h -1 in group P The arterial blood samples were taken to measured the activities of serum enzymes ,at the beginning of CPB, 30min, 4, 12 and 24h after release of the aortic cross clamp Results As compared with those at at the beginning of CPB, the activities of serum enzymes increased significantly in three groups following declamping (P

Objective To investigate the effects of ulinastatin on cerebral injury during cardiac valve replacement and the possible mechanisms involved. Methods Twenty-four NYHA Ⅱ or Ⅲ patients of both sexes (13 male, 11 female) aged 23-45 yr undergoing cardiac valve replacement with hypothermic cardiopulmonary bypass (CPB) were randomly divided into two groups: control group (group C, n = 12) and ulinastatin group (group U, n = 12) . In group U ulinastatin 12 000 U?kg-1 was given i.v. after induction of anesthesia, 6 000 U? kg-1 was added to the priming solution and another 6 000 U?kg-1 was given at 5 min before aortic unclamping. In group C normal saline was given instead of ulinastatin. Internal jugular vein was cannulated and the catheter was advanced in a cephalad direction till jugular bulb. Blood samples were taken from jugular bulb after induction of anesthesia(T1) , when rewarming to 36℃(T2), 30 min (T3 ) and 6 h (T4 ) after discontinuation of CPB for determination of plasma S100? protein, neuron specific evolase (NSE) , MDA concentrations and SOD activity. Plasma TNF-?, IL-6, IL-8 and IL-10 levels were also determined at T1, T3 and T4.Results Plasma levels of S100? protein, NSE and MDA were significantly increased during and after CPB (T2-4) compared to the baseline values before CPB (T1), but were significantly lower in group U than in group C (P

Objective To analyze the change of disease spectrum and the direct cause of death in Xi'an Children's Hospital emergency patients in the past 2 years.Methods The cases of death in 130 emergency cases from 2009 to 2010 were retrospectively analyzed.Results The main causes of death in 2009 were pneumonia,congenital heart disease,asphyxia,neonatal pulmonary hemorrhage and intracranial hemorrhage.Meanwhile,The main cause of death in 2010 were pneumonia,asphyxia,viral encephalitis,congenital heart disease and neonatal pulmonary hemorrhage,which significantly changed compared with 2009.Major direct causes of death were found:respiratory failure in 25 cases (27.5％),heart failure in 17 patients ( 18.7％ ),shock in 17patients ( 18.7％ ),asphyxia in 16 cases ( 17.5％ ),and hernia in 16 cases ( 17.5％ ),Conclusion In order to reduce the mortality rate of emergency patients,we should strengthen health care,actively manage pulmonary infection,systemic infection,and shock,control heart failure,and prevent aspiration.

Three encoding sequence genes (Lab, 3C, 3D) from 19 isolates of O-serotype of foot and mouth disease virus(FMDV) were down-loaded from GenBank. And the coding and amino acid sequences of 3 FMDV proteases (Lpro, 3Cpro, 3Dpol) were compared with the FMDV OA/58 serotype Lab, 3C, 3D sequences abstracted in our laboratory and qualified by variance analysis and multiple analysis(Duncan method). The experimental results revealed that the Lab, 3C and 3D genes had similar nucleotide mutation rates(P>0.05). However, overall analysis of the amino acid substitutions revealed that the Lpro- coding region was more prone to amino acid alterations than 3Cpro and 3Dpol- coding regions(P<0.01), but via multiple comparison, at the amino acid mutation, both 3Cpro and 3Dpol showed no significant difference. Depending on Swiss--pdb-Viewer sofe to simulate amino acid alterations at mutation hotspots, the findings showed that these alterations at hotspots failed to ruin the spatial structures of these 3 proteases. This result presents that the nucleotide mutation just acts on dynamics related to FMDV mutation, but the real evolutionary power must depend on the infected host cells to select functions with each viral proteases.