Objective:To analyze the efficiency and influencing factors of Chinese medical and health resources. Methods:Based on the panel data of 31 mainland provinces from 2003 to 2011 in China, use the two-stage Malmquist-Tobit model to analyze. Results:The efficiency of Chinese medical and health resources shows an increasing trend, which is dual driven by improvement of technical efficiency and technological progress. The efficiency varies among different areas, and the descending order of efficiency value is east, west and center. The level of economic development, population density, the proportion of profitable hospitals, the levels of urbanization and education can promote Chinese medical and health efficiency with different extent. Conclusion:To improve the efficiency of Chinese medical and health resources, it needs to promote economic development level, allocating health resources reasonably, and advancing urbanization and education levels orderly.

Objective To observe the clinical effect of psychological intervention combined with alendronate and low molecular heparin calcium on the treatment of senile osteoporotic fracture. Methods From February 2014 to March 2017, clinical data of 82 elderly patients with osteoporotic fracture in the first people's hospital in Jiande were retrospectively analyzed. All the patients were randomly divided into the control group and the experimental group with 41 cases in each group. The control group patients were given alendronate sodium and low molecular heparin calcium; At this basis, the experimental group were received psychological nursing intervention. The effect in the two groups was compared. Results After treatment, bone mineral density (BMD) index and pain scores in the two groups were significantly improved. BMD and pain scores in the experimental group were significantly better than those in the control group (P<0.05). The total effective rate was 95.12% (39/41) and the complication rate was 17.07% (7/41) in the experimental group, while in the control group were respectively 70.73% (29/41), 36.59% (15/41), the differences were statistically significant (P<0.05). Conclusion Psychological intervention combined with alendronate sodium and low molecular heparin on the treatment of senile osteoporotic fracture has significant effect, can effectively improve the clinical symptoms of patients, reduce the incidence of complications, with clinical application value.

Objective To explore the feasibility and safety of right ventricular septal pacing with active fixation electrodes.Methods This was a randomized and control clinical trial.Patients implanted with pacemaker were randomly divided into two groups.One group underwent the right ventrieular high septal pacing with the active fixation electrodes(RVS group),and the other group underwent the right ventricular apical pacing with the passive fixation electrodes(control group).The parameter was recorded in two groups in and after operation and compared accordingly.Results (1)There were no significant differences in the procedure time between two groups[averaged(59.6±3.2)and(60.2±3.7)minutes respectively].But the time of exposing X-ray was significant longer in RVS group.(2)There was no significant difference in acute implanting measurement,except perioperative and postoperative threshold 1 month in RVS group was higher than that in control group(P＜0.05 or＜0.01).After 3 months,there was no significant difference.(3)Impedance decreased significantly in 1 month and 3 months in RVS group[P＜0.01 or＜0.05).(4)There was no difference in R-wave sensing between two groups.(5)After 100%pacing,the mean QRS duration Was shorter in RVS group,but the difference was not significant.(6)Operations in two groups came off smoothly and there were no complications.Conclusion It is feasible and secure to pace from RVS with active fixation electrodes.

Objective To demonstrate simultaneously on transcription and translate levels the tyrosine-hydroxylase(and somatostatin)gene expression and peptide storage in same intrinsic cardiac ganglionic neuron of bufo bufo gargarizans. Methods Using immunohistochemical method,in situ hybrodization method and in situ hybrodization/immunohistochemical double labeling method on freeze-sections of sinus venanum cavanum of bufo bufo gargarizans atrial posterior wall (30*!?m)to observe THmRNA and /or TH-IR and SSmRNA and /or SS-IR dyeing neurons of intrinsic cardiac ganglia. Results There are kinds of positive neurons:1.TH-IR positive neurons;2.THmRNA positive neurons;3.TH mRNA/TH-IR double positive neurons and 1.SS-IR positive neurons;2.SSmRNA positive neurons;3.SSmRNA/SS-IR double positive neurons.Conclusion 1.TH mRNA and TH appearing in same intrinsic cardiac ganglionic neuron demonstrate that a part of intrinsic cardiac ganglionic neurons are possibly adrenergic sympathetic neurons;2.SSmRNA positive neurons and SSmRNA/SS-IR double positive neurons indicat that SS could be a neurotransmitter of intrincic cardiac ganglinic neurons.It provides neuroanatomy evidence of regulating cardiac function(excitatory conduct、cardiac muscle secrete and contract)by intrinsic cardiac SS-nergic neuron.

Objective:This study aimed to analyze the prognostic factor of bilateral hydronephrosis caused by advanced cervical cancer and evaluate its value of treatment. Methods:A total of 40 patients with bilateral ureteral obstruction secondary to cervical cancer were diagnosed through computerized tomography, radioactive nephrogram, and blood tests for renal function. The placement of retrograde internal double-J ureteral stents was performed under a cystoscope in 13 patients. The placement of antegrade internal double-J ureteral stents via percutaneous nephrostomy was performed in 25 patients. Two cases had external ureteral stents via percutaneous nephrostomy. Twenty-nine patients underwent radiotherapy after normalization of their blood urine nitrogen and creatinine levels. The prognostic value of the treatment and renal function before placement of ureteral stents and radiotherapy after placement of ureteral stents were analyzed. Results:The normalization rate of renal function after ureteral stenting was 91.3%(21/23). The median survival time was longer in patients with untreated cervical cancer than that in patients with recurrent cervical cancer (χ2=9.379, P=0.009). After ureteral stenting, the median survival time was longer in patients who underwent radiation therapy than that in patients untreated with radiation (χ2=17.329, P=0.000). The median survival time was not significantly influenced by renal function before placement of ureteral stents (χ2=1.37, P=0.242). Conclusion:The patient with bilateral ureteral obstruction from untreated cervical cancer or from recurrent pelvic disease after surgical therapy should be considered for ureteral stenting followed by appropriate radiation.

1. Microsurgical relationships of the arteries at the base of the brain and the trigeminal nerve were studied bilaterally on 30 brains. Twenty seven trigeminal nerves made contact with the arteries 33 times which represents 55 percent of the cases. Six of 27 trigeminal nerves had double contact.2. Of 33 arteries in contact with 27 nerves, seventeen involved the superior cerebellar arteries (SCA) (28.33?5.82%), seven the anterior inferior cerebellar arteries (AICA) (11.67?4.15%) and nine the middle inferior cerebellar arteries (MICA) (15.0?4.61%).3. The outer diameter of the superior cerebellar artery is the largest averaging 1.41?0.20 mm; the anterior inferior cerebellar artery comes next averaging 1.06?0.36 mm and the middle inferior cerebellar artery the smallest, averaging 0.62?0.14 mm.4. 27 trigeminal arteries arising from the upper or middle segement of the basal artery were found on the ventral surface of the trigeminal nerves in 17 brains, and 16 trigeminal branches arising from the AICA. MICA. and PICA were also found at the roots of 16 trigeminal nerves. Anastomoses were noted between the trigeminal arteries and the trigeminal branches in four cases of 16 trigeminal nerves.5. The association between the neurovascular contact and the trigeminal neuralgia are discussed. It is suggested that the neurovascular contact either from dorsal or ventral aspects may be the anatomical cause of the trigeminal neuralgia.6. The neurovascular contact of the trigeminal nerve with the SCA was usually on the dorsal or dorsalmedial aspect of the nerve, but the point of contact with AICA or MICA was mainly on the ventral aspect of the nerve. Besides, there are trigeminal arteries and trigeminal branches at the ventral surface of the nerve. All these topographic observations provide microsurgical information for neurosugeons.

Objective To investigate the expression of fragile histidine triad (FHIT) gene in cervical carci-noma and relationship with its clinical-pathological implication. Methods The expression of FHIT was detected by immunohistochemistry SP method in 42 cases of cervical carcinoma and 13 cases of adjacent tissue. Results 47.6% (20 of 42) of cases expressed FttIT in the tumor cells,and 92.3% (12 of 13) of cases of the adjacent tissue were present. There was a significant positive correlation between cervical carcinoma and adjacent tissue(P <0.01). The positive rates of FHIT in high and middle desrees of differentiation were significantly higher than that in low degree of differentiation(54.2% vs 38.9%). Tumors with lymph node metastases(45.9%) had loss FHIT protein expression than those without metastasis(60.0%) (P <0.05). The FHIT expression between Ⅰ and Ⅱ stage,the difference was significant(55.0% vs 45.5%) (P < 0.05). Conclusion FHIT gene plays an improtant role in the occurrence and development of cervical carcinoma. It is suggested that FHIT can be a useful marker for predicting invasion and metas-tasis ability of cervical carcinoma.

Objective To investigate the effects of splenctomy on the idiopathic thrombocytopenic purpura (ITP) patients. Methods 9 patients with ITP were involved in the present study,who were performed with splenecto-my because of refractoriness, contraindicatiun and intolerance during corticosteroids therapy. Results The average platelet count of the patients before operation was 35×109/L,while the first,4th and 7th day after operation,the aver-age platelet count was 98×109/L, 179×109/L and 235×109/L. After follow-up for 6 months,there were 7 cases having marked improvement, and the total effective rate was 88.9%. Conclusion Splenectomy is a recommendable method for ITP, expecially for those are inefficient,incompatible and intolerated to continually pharmacotherapy.

Objective To evaluate the diagnosis and treatment procedures for malignant pheochromocytoma. Methods 12 cases of malignant pheochromocytoma surgically treated were reviewed.This series comprised of 4 male and 8 female patients.All the tumors were confirmed on surgery and pathological studies. Results All the cases were operated.One died of hypotension after surgery.11 cases have been followed up for 2.5～13.0 years.4 died of recurrence and complication of hypertension.3 died of extensive metastases more then one year after operation.One died of pulmonary infection 4 years after operation and the others have been surviving. Conclusions Imaging procedures are important for the diagnosis of malignant pheochromocytoma.Recurrent tumors greater than 5 cm in diameter and uneven density in the tumor denote malignancy.Prompt radical extirpation of the tumor is the only means to achieve a long survival.

BACKGROUND: Wound healing is a complex biological process regulated temporally and spatially by many repair factors. Studies have showed the predominant expression of cytokines in wound healing process, which is a kind of molecular vital reaction, and may be a new reference index in wound age estimation. But the precise relation of the expressions of cytokines and distribution to wound age is not clear.OBJECTIVE: To probe into the relation of the expressions of cytokines and distribution to wound age in the healing process of the mouse skin wounds.DESIGN: A randomized controlled confirmation study based on the experimental animalsSETTING: Department of Pathology of the First Military University of Chinese PLA, which is a key laboratory of molecule oncology of Chinese PLA.MATERIALS: The study was completed in the Key Laboratory of Molecule Oncdogy of Chinese PLA from July to September in 2003. Sixty-five Kunming mice of either gender, weighing 25 - 28 g, were involved.INTERVENTIONS: The mice were randomly divided into the experimental and the control group. The mice in the experimental group were divided into 12 subgroups according to the different times of trauma. The mice were killed at the following time intervals: 15 minutes, 30 minutes, 1 hour, 3 hours, 6hours, 12 hours, 24 hours, 48 hours, 72 hours, 96 hours, 1 week or 2 weeks after wound and the wounded skin was excised( n = 5 each). As a control, 5mice without wounding were examined.MAIN OUTCOME MEASURES: The amount and distribution of staining positive inflammation and repair cells in skin wound tissues.RESULTS: Persistent positive expression of vascular endothelial growth factor(VEGF) was seen in the epidermal cells and sebaceous gland cells. The expressions of transforming growth factor β1(TGF-β1) and basic fibroblast growth factor (bFGF) in the epidermal cells were increased at 3 hours after incision and lasted till 12 hours and 48 hours respectively. There was a similar distribution in the positive amount of inflammation and repair cells among VEGF, TGF-β1 and bFGF. Six hours after injury, some of neutrophils showed positive reactions. After 12 hours, macrophages and fibroblasts were mainly positive cells. The number of the positive cells was increased with wound age,and the peak occurred at 96 hours. There were still some positive macrophages and fibroblasts at week 1 and week 2 after the incision.CONCLUSION: There was a time-related expression of TGF-β1 and bFGF in the epidermal cells in mouse skin wounds. The amount and distribution of inflammation and repair cells that express VEGF, TGF-β1 and bFGF were changed in a time-related manner in the healing process of mouse skin wounds.