Based on experience on medical service drilling for many years,this paper analyses the hardship and complexity of medical service support in high & cold mountainous region.It also puts forward some suggestions in such aspects as integral design,focal points insurance,necessaries reinforcement,preach for popularization and mutual cure training.

The study was proceeded on the mRNA expression of the GULT1 and GLUT4 gene in the alloxan diabetic rats by the technique of dot-blot hybridization analysis. The results showed that the levels of the GLUT4 mRNA expression were reduced in diabetic rats while increased in insulin treated diabetic rats. This suggests that the reduced GLUT4 mRNA expression which could affect the quantity of its posttranslational products may be one of the causes of the insulin resistance.

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Transient receptor potential(TRP)channels as an important non-selective cation channels family mainly permeate Ca2 + ,Na + and other cations. TRPC channel is a subtribe of TRP family which regu-lates the second messenger of Ca2 + concentration and variety of protease activity,and which can directly or in-directly affect the biological behavior of cells. Recently,more and more evidences have certificated the TRPC channels affect the tumorigenesis and development,such as regulation of proliferation,differentiation,migra-tion,apoptosis and resistance of chemotherapeutic agents during cancer progression.

Objective To investigate effects of mouse nerve growth factor on serum brain-derived neurotrophic factor, Fibulin-5 and intracranial blood flow in patients with acute cerebral infarction.Methods 98 patients with acute cerebral infarction in our hospital from September 2015 to September 2016 were selected as the research object, divided into observation group and control group, 49 cases in each group.The control group was treated with conventional treatment of acute cerebral infarction, patients in the observation group on the basis of conventional treatment combined with mouse nerve growth factor, Enzyme-linked immunosorbent assay was used to detect serum brain-derived neurotrophic factor, Fibulin-5, Intracranial ultrasonography was used to detect intracranial blood flow, the brain-derived neurotrophic factor, Fibulin-5, cerebral blood flow were compared between the two groups before and after treatment.Results Before treatment, two groups of patients with brain-derived neurotrophic factor (BDNF), Fibulin-5 and hemodynamics, the difference was not statistically significant.After treatment, the levels of BDNF and Fibulin-5 in the observation group were (5.63 ±1.34), (156.63 ±12.79), significantly higher than the control group (4.26 ±1.54), (115.52 ±15.66), the difference was statistically significant ( P<0.05 ) , the observation group of patients with cerebral hemodynamics index , average blood flow ( Qmean ) , the average blood flow velocity (Vmean), dynamic impedance (DR), cerebral vascular characteristic impedance (ZCV), cerebral vascular peripheral resistance (R) were significantly better than the control group, the difference was statistically significant (P<0.05), the prognosis of the observation group was better than that of the control group, the difference was statistically significant ( P<0.05 ) .Conclusion Clinical effect of mouse nerve growth factor on acute cerebral infarction is helpful to promote the growth of nerve function inhibition, improve cerebral blood flow, better prognosis.

Objective To observe the effect of Danshen injection combined with ulinastatin on the brain protection and inflammatory reaction in patients with Severe traumatic brain injury.Methods 83 cases of patient with Severe traumatic brain injury were randomly divided into the observation group(43 cases)and the control group(40 cases).The control group was given ulinastatin based on conventional treatment,and the observation group was given Danshen injection and ulinastatin based on the control group.For 10 days,the differences of hemodynamic parameters(Qmean、Zc、DR)and serum nerve function indexes(β-EP、DynAl-13、NSE),inflammatory factors(IL-1,IL-6,TNF-α,CRP)between the two groups were be compared.Results ①Comparison of hemodynamic parameters There was significantly difference of Qmean、Zc、DR in these two groups(Fgroup=6.126,5.024,5.621,P<0.05),Qmean was showed a rising trend over time and Zc、DR were showed a declining trend over time(Ftime=10.146,9.247,9.381,P<0.05),the changed amplitude in observation group was higher than the control group(Finteraction=5.357,4.257,4.813,P<0.05); Comparison of nerve function indexes There was significantly difference of β-EP、DynAl-13、NSE in these two groups(Fgroup=5.827,6.294,6.731,P<0.05),they was all showed a reducing trend over time(Ftime=12.613,11.746,9.842,P<0.05),the declined amplitude in observation group was higher than the control group(Finteraction=6.353,7.251,4.284,P<0.05);Comparison of inflammatory factors There was significantly difference of IL-1,IL-6,TNF-α,CRP in these two groups(Fgroup=4.284,5.162,6.174,4.291,P<0.05),they was all showed a rising then reducing trend over time(Ftime=9.163,10.357,13.457,12.434,P<0.05),the changed amplitude in observation group was higher than the control group(Finteraction=4.255,5.242,8.530,7.847,P<0.05).Conclusion Danshen injection combined with ulinastatin has more obviously function of protecting the cerebralfunction and suppressing inflammation in the treatment of Severe traumatic brain injury compared with ulinastatin alone.

Mobile internet terminals were connected to the pharmacy of the hospital to improve the outpatient pharmacy process, building an internet-based pharmacy service model for general tertiary hospitals. This model covered the entire outpatient service, ranging from registration, payment and dispensary at the hospital. It significantly enhanced the efficiency, namely 80. 8% less time for payment, not to mention the free delivery and no waiting time for dispensary.

OBJECTIVE:To observe the efficacy and safety of mesalazine combined with bifidobacterium tetravaccine(live)in the treatment of ulcerative colitis(UC). METHODS:83 UC patients were tandomly divided into control group(42 cases)and test group (41 cases). Control group was orally given 1.0 g Mesalazine enteric-coated tablet,4 times a day;test group was additionally given 1.5 g Bifidobacterium tetravaccine tablet(live),3 times a day. The treatment course fr both group was 6 weeks. The clinical efficacy,and serum high sensitivity C-reactive protein(hs-CRP),interleukin(IL)-4,IL-8 levels before and after treatment and the incidence of ad-verse reactions in 2 groups were observed. RESULTS:After treatment,serum hs-CRP and IL-8 in 2 groups were significantly lower than before,and test group was lower than control group;serum IL-4 level was significantly higher than before,and test group was higher than control group,the differences were statistically significant(P<0.05 or P<0.01). Total effective rate in test group was sig-nificantly higher than control group,the difference was statistically significant(P<0.05). And there was no significant difference in the incidence of adverse reactions (P>0.05). CONCLUSIONS:Mesalazine combined with bifidobacterium tetravaccine (live) is more effective than mesalazine alone UC,with similar safety.

Objective To investigate if apoptosis induced by arsenic trioxide(As_2O_3)on bladder cancer T24 cell line is related to the alteration of protein kinase C and cyclic adenosine monophosphate (PKC-cAMP)and its possible mechanism.Methods Apoptosis was studied by TUNEL method.Radio- immunoassay and enzyme immunoassay methods were used to detect the PKC-cAMP alteration in apoptotic process.The expressions and activation of caspase3 were observed by immunocytochemical method and Western blot.Results Atter 24-h drug treatment,the cell apoptosis induced by different concentrations of As_2O_3 was detected by TUNEL method.In control group,the apoptosis rate was 0.86%;PKC level was 2.55 pmol?min~(-1)??g~(-1);cAMP concentration was 22.56 pmol/ml;the expression rate of caspase3 was 8.01%.Compared with control group,the apoptosis rates of 5?mol/L and 10?mol/L As_2O_3 groups increased 8.51-fold and 13.33-fold,respectively;PKC Level decreased 59.22% and 64.71%,respectively;cAMP in- creased 5.34-fold and 4.23-fold,respectively;expression rates of caspase3 increased 3.96-fold and 6.76- fold,respectively.The differences were significant(P＜0.05).Compared with As_2O_3 groups,apoptosis rates of 5?mol/L and 10?mol/L As_2O_3+100nmol/L phorbol 12-myristate 13-aectate(PMA)groups decreased 40.22% and 45.58%,respectively;PKC increased 1.00-fold and 0.76-told,respectively;cAMP decreased 8.37% and 31.46%,respectively;expression rates of caspase3 decreased 51.09% and 65.03%,respective- ly.Activation of caspase3 was detected in As_2O_3-treated groups and As_2O_3+100 nmol/L PMA-treated groups;and activations of caspase3 in PMA-treated groups were weaker than those in As_2O_3-treated groups. Conclusions The antitumor mechanism of As_2O_3 may be the induction of bladder cancer T24 cell apopto- sis by decreasing PKC and increasing cAMP level.

Different routes of surgical nutrition have different influences on physical immunity.Total parenteral nutrition (TPN) for a long time may inhibit immune function. Enteral nutrition (EN) may maintain integrity of structure and function of intestinal mucosa, prevent bacterial translocation, lighten systematic inflammatory response and improve immune function. This article reviewed the regulation of parenteral nutrition (PN) and EN to immunity and the application of immune enhanced nutrition.