Objective To explore the correlation between global end diastolic volume index(GEDI)and central venous pressure(CVP)of severe sepsis patients during fluid resuscitation by pulse induced continuous cardiac output(PiCCO )test. Methods Sixty-four severe sepsis patients had been treated by fluid resuscitation strictly in accordance with the guidelines for treatment of sepsis in 2008. During the treatment,GEDI and corresponding CVP data were measured and recorded to observe the correctness of volume reaction under different CVP ranges,and the relativity between GEDI and CVP was analyzed. Results In the whole process of monitoring circulatory blood volume,no significant correlation between CVP and GEDI(r=-0.012,P>0.05)was found in severe patients with severe sepsis. When the CVP was in 0-8 mm Hg(1 mm Hg=0.133 kPa)or greater than 12 mm Hg,there was no correlation with the GEDI(r=-0.009,-0.020,respectively,both P>0.05). When the CVP was in 8-12 mm Hg at the 6 hours resuscitation target required by the guidelines,there was an obvious positive correlation between CVP and GEDI(r=0.653,P<0.01). Conclusion CVP is not suitable to be an exclusive target indicator for fluid resuscitation volume.

Objective To investigate the role and implication of Engrailed-2 (EN2) in human hepatocellular carcinoma (HCC) and the effect of silencing EN2 genes on the proliferation and invasion of HepG2 cells by RNA interference.Methods Immunohistochemistry was used to detect the expression of EN2 in the HCC tissues and corresponding non-cancerous adjacent liver tissues in 126 patients with HCC.The expressions of EN2 and the relationship between EN2 expression and clinicopathological features and prognosis were analyzed using the Chi-square test.The survival curve was drawn using the Kaplan-Meier method and the survival was analyzed using the log-rank test.EN2-small interfering RNA (siRNA) was transfected into HepG2 cell lines mediated by LipofectamineTM 2000,and the expression of EN2 were detected by Western blotting assay.The cell proliferation and invasion were measured by methyl thiazol tetrazolium (MTT) and Transwell assays.Results EN2 positive expression rate was high (62.7％) in HCC tissue but low in the corresponding peritumoral tissue (23.5％,P ＜ 0.01).The high expression of EN2 was strongly correlated with tumor size,metastasis and AJCC TNM stage.The cumulative 5-year survival rate was 33.9％ in the low EN2 expression group,whereas it was 5.1％ in the high EN2 expression group (P ＜ 0.01).Expression of EN2 in EN2 siRNA group was significantly lower than that in control siRNA group and control group (P ＜ 0.05),respectively.The cell proliferation and invasion ability were significantly reduced in the EN2 siRNA group.Conclusion The expression of EN2 is highly up-regulated in HCC tissues and down-regulation of EN2 could inhibit proliferation and invasion of HepG2 cells,which indicating that EN2 is involved in the process of HCC carcinogenesis and progression and may serve as a biomarker for predicting prognosis of HCC patients.

OBJECTIVE: To improve the quality, efficiency and management of hospital pharmacy dispensing work. METHODS: Following the principle of logistics, the drug dispensing path was planned as a whole to reduce the ineffective drug handling, and the dispensing process was designed and machines were reasonable utilized. RESULT & CONCLUSION: Improving pharmacy dispensing work in line with the principle of logistics is conducive to the improving of both quality and efficiency of dispensing work, strengthening of management and lowering of labor intensity.

Objective To investigate the expression of indu ci ble initric oxide synthase(iNOS) in gastric carcinoma and its relationship with angiogenesis and the prognosis. Methods Immunohistochemical staining method was used to det ect the expression of iNOS, VEGF CD34 in gastric carcinoma. Results The positive expression of iNOS in gastric carcinom a was 58.70% and iNOS was not detected in normal gastric tissue. The rate of the positive expression of iNOS in stage Ⅳ was higher than that in stageⅠ～Ⅲ. Th e positive expression of iNOS in gastric carcinoma with lymph node metastasis wa s higher than those with no metastasis. The MVD was 59.88? 18.02/HP and 55.5 9+ 19.39/HP in gastric carcinoma positive for iNOS and VEGF, repectively, obviou sly higher than those with negative expression of iNOS and VEGF, repectively ( P

Objective To evaluate the relationship between the expression of cyclooxygenase-2(Cox-2) and inducible nitric oxide synthase (iNOS) and the angiogenesis in gastric carcinoma. Methods Immunohistochemical stain was used to detect the expression of Cox-2, iNOS and MVD in 45 resected specimens of gastric carcinoma. The monoclonal antibody against CD34 was used for displaying vascular endothelial cells, and MVD was detected by counting the CD34-positive vascular endothelia cells. Paracancerous tissues were examined as the control. Results The expression rates of Cox-2, iNOS and MVD in gastric cancer were significantly increased, compared with those in the paracancerous tissues (77.78% vs. 33.33%, 68.89% vs. 17.78%, 58.13?19.99 vs. 24.02?10.28, P

Objective　To investigate the preventive measurement of vagal reflex occurrence on patients with percutaneous transluminal coronary angioplasty (PTCA).Methods　On the reason of vagal reflex occurrence,to 75 patients with PTCA adopt the measurement to prevent hypovolemia,control the excessive rebound of cavity viscera,adjust the patients mental state,and so on.Then to observe the level of patients with vagal reflex occurrence,and compare with the control group of 75 patients under common care.Results　The prevent group level of patients with vagal reflex occurrence is 2.61%;the control group is 28%.Conclusion　To patients with PTCA adopt the measurement to prevent hypovolemia,control the excessive rebound of cavity viscera,adjust the patients mental state,and so on.The effect to decrease the level of vagal reflex occurrence is great.

Objective To detect CYP2J3 gene expression and contents of 11,12-EET in heart,liver,lung,kidney and aorta thoracalis after CYP2J3 gene transfection.Methods The rat transgenic model was developed by injecting plasmid through vena dorsalis penis.The animals were divided into control group、 pcDNA3.1 transgenic group and pcDNA3.1-CYP2J3 transgenic group.The expression of CYP2J3 mRNA was detected by RT-PCR and content of 11,12-EET was examined by the HPLC at 14 days and 28 days after injection.Results Twenty eight days after injection,both expression of CYP2J3 mRNA and the content of 11,12-EET were significantly increased as compared with that of control and pcDNA3.1 transgenic group(P

Objective To evaluate the outcomes of the payment reform at public hospitals in Sanming city.Methods Interrupted time series analysis was used to compare changes of the average days of stay,per capita hospitalization expense,outpatient expense per visit,proportion of medical expense and that of drugs during hospitalization at 21 public hospitals at or above county level before and after the DRGs reform.Results Comparisons before and after the reform found the average days of stay at the original momentum,poor control in curbing the proportion of medical expense and that of drugs during hospitalization,adropping followed by rising trend in the outpatient expense per visit,and minimal drop of the abovementioned proportions.Conclusions The rapid growth of outpatient and hospitalization costs at tertiary hospitals may be incurred by unreasonable cost transfer,structural trend of hospitalization expense makeup,and rationality pending scrutiny.

Tripartite-sector reform (a synergistic reform in public health services,medical insurance and medicine production-circulation) in Sanming city was described in the paper which centers on medical insurance.Tapping full potentials of the medical insurance,the city achieved efficient synergy among healthcare,medical insurance and medication systems.This reform has trimmed out inflated drug pricing to some extent for rooms of maneuver of medical service pricing changes,thus curbing excessive growth of medical costs successfully.The authors proposed areas of further improvements including the relationship between achieving such objective as curbing medical expenditure,and advancement of technical/medical service capacity;that between integrative control of medical insurance expenditure and protection of people's health;the equilibrium of interests between medical insurance,healthcare and medication.All these will contribute to the goal of healthy patients flow and a hierarchical medical system.

Purpose To investigate the diagnostic utility of the immunohistochemical markers SALL4, D2-40 and Glypican-3 in prima-ry testicular germ cell tumors (TGCTs). Methods The expression of SALL4, D2-40 and Glypican-3 protein was detected by EnVi-sion immunohistochemical method in 56 cases of primary testicular germ cell tumors, including 5 intratubular germ cell neoplasms ( IT-GCNs) , 10 seminomas, 14 embryonal carcinomas ( ECs) , 14 yolk sac tumors ( YSTs) , 1 choriocarcinoma, 5 immature teratomas and 12 mature teratomas. 10 normal testicular tissues and 5 lymphomas were selected as control. Results All of ITGCNs, seminomas, YSTs and ECs were diffusely strongly positive for SALL4. Focal SALL4 staining was seen in choriocarcinoma, 3 of 5 immature terato-mas and 3 of 12 mature teratomas. All of ITGCNs, seminomas showed diffusely strong D2-40 staining. ECs (4/14) were focally posi-tive for D2-40, while choriocarcinoma, YSTs and teratomas were negative for D2-40. Glypican-3 was diffusely positive in YSTs (13/14), and focally weakly positive in ECs (2/14), respectively. ITGCNs, seminomas, choriocarcinoma and teratoma were negative for Glypican-3. In contrast, 10 normal testicular tissues and 5 lymphomas showed no SALL4, D2-40 and Glypican-3 staining. Conclu-sions SALL4 is a useful diagnostic marker with high sensitivity and specificity for TGCTs. Combination of SALL4, D2-40 and Glypi-can-3 is helpful to the diagnosis and differential diagnosis for TGCTs.