The article introduces the properties of public health enterprise in current China and concomitant conflicts.The manifestations,causes and solutions to the conflicts are discussed so as to provide some proposals to solve relative problems for improving the physician-patient relationship and health service.

In order to study the effect of chronic noise exposure on auditory center, seven guinea pigs were .exposured to 105 dB A noise 8h daily for 45 d. Then the animals were killed by decapitation. The superior olive and inferior colliculus were taken immediately to make the samples of electron microscope. The mitochondria swelling, membrane rupture, cristae breaking, ballooning degeneration were found. The rough surfaced endoplasmic reticulum was swollen and expanded. The lysosome and secondary lysosome were increased. The cell interstitial edema and synaptic besicle decrease were observed. The nuclear chromatid was decreased and nucleolus was kept to the side. The laminae of neurilemma of nerve fibers were dissociated, swollen and broken. The results indicate that the ultrastructure, neural cells and fibers in the auditory center are damaged by chronic noise exposure and most of these damages are irreversible.

Objective To compare the genetic difference of Pogostemon cablin from different habitats.Methods Forty-six primers were used to analyze the fingerprint of Pogostemon cablin by Random Amplified Polymorphic DNA,and 6 of them were identifiable.Primer S358 could reflect the tiny polymorphic differences of Pogostemon cablin from different habitats which had 3 same amplified strips.Primers S358,S359,S443 could be used for the identification of Shipai sample from its other species.Results The results of cluster analysis showed that the two samples from Gaoyao were classified as one type,the four samples from Zhanjiang,Hainan,Shipai as another type,one sample from Caizhilin and one from the pharmacy of the First Affiliated Hospital of Guangzhou University of TCM as the the third type,and the sample from the Qingping Traditional Chinese Herbal Market as the fourth type.Conclusion The RAPD analysis can be used for the identification of Pogostemon cablin from different habitats.

Objective To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) in detecting small liver metastasis (SLM) from breast cancer. Methods A total of 92 cases diagnosed as breast cancer by surgical pathology and suspected SLM by conventional ultrasonography were included in this study. CEUS was used to check liver lesion in patients. The biopsy operation was used as the gold standard. The coincidence rate of benign and malignant pathology was used to compare the consistency between CEUS and biopsy pathology. Results In 92 cases suspected liver metastases of breast cancer by routine ultrasound, there were 54 cases were diagnosed as benign by pathology, and all 92 cases were diagnosed as benign by CEUS. Thirty-eight cases were diagnosed as metastasis by pathology, in which 36 cases were correctly diagnosed by CEUS. The sensitivity of CEUS for the diagnosis of liver metastases of breast cancer was 94.74%(36/38), specificity was 100%(54/54), positive predictive value (PPV) was 100%(36/36) and negative predictive value (NPV) was 96.43%(54/56). Conclusion CEUS has a higher diagnostic value in SLM of breast cancer, and has clinical practical value.

Objectives: To evaluate the clinical significance of nuclear matrix protein 22 (NMP 22) in the detection of bladder transitional cell carcinoma (BTCC) and compare with voided urine cytology(VUC). Methods: A total of 69 cases with voided urine samples for NMP 22 and VUC test were included in this study. Thirty of them were BTCC patients(BTCC group) and twenty nine suffered from other urological diseases (nonbladder cancer group, NBC group). Ten were healthy volunteers (control group). Results: The NMP 22 values for BTCC group (67.3 U/ml) were significantly higher than that of NBC group(7.4 U/ml) and control group (4.3 U/ml)( P 0.05). NMP 22 was more sensitive than VUC in low grade BTCC(Ⅰ,Ⅱ)(62.50% vs 12.50%,P 0.05). Conclusions:Urinary NMP 22 is a useful marker for the early diagnosis of BTCC. It is more sensitive than VUC in low stage and grade BTCC.

OBJECTIVE To study the electrophysiological character of the Auditory Brainstem Response to Speech Sounds (s-ABR) in healthy adults. METHODS We assessed the auditory brainstem response to a synthesized stop-consonant speech syllable /da/ in 40 native-Chinese speech adults (20 female). Timing components of the response were compared between males and females to determine the relationship between inducing rate ,latency of waves and sex and age of participants. RESULTS The latency of wave V and A was shorter in females was that of males (Vt(38)=-3.601, P =0.001, At(38)=-2.829, P=0.007).The other peaks latency except V、A can see difference between gender but do not have statistics differences (P>0.05); The latency has no statistical difference in different age (P>0.05); The amplitude has no statistical difference in different gender and age (P>0.05). CONCLUSION The waves of s-ABR has good stability for studying mechanism of auditory speech processing tools.

Objective To investigate the characteristics of auditory nerves and brainstem pathways,patho-physiological and nerve damages and the correlation between oxygen indexes,and the values of high stimulation ABR in patients with OSAHS.Methods Auditory brain stem responses (ABR)at rates of 11.1 times/s,31.1 times/s,51.1 times/s were performed in both the moderate-to-severe OSAHS group(5 cases of moderate and 34 cases of severe,in total of 39 cases ,78 ears)and the control group (34 cases,68 ears).According to the character-istics of ABR,the correlation with parameters of blood oxygen was studied.Results At the rate of 11.1 times/s, wave V latencies (5.79±0.22 ms)in OSAHS patients were longer than that in the control group.At the rate of 31.1 times/s,wave V latencies (5.98±0.19 ms)and waveⅠ(1.85±0.18 ms)in OSAHS patients were prolonged more than those in the control group.At the rate of 51.1 times/s,wave V latencies (6.09±0.25 ms)and waveⅠ(1.94±0.26 ms)in OSAHS patients were longer than those in the control group.Increasing stimulation rates from 11.1 times/s to 31.1 times/s showedΔⅠwas longer in OSAHS group(0.12±0.17 ms)than in the control group (0.07±0.11 ms).Increasing stimulation rates from 11.1 times/s to 51.1 times/s showedΔⅠwas longer in OS-AHS group(0.21±0.25 ms)than in the control group(0.15±0.10 ms).All above had correlations with hypoxia. Conclusion High stimulation rates in ABR by amplifying the waveⅠ latency confirm cochlear and auditory nerve damages near the cochlear segment in patients with moderate to severe OSAHS.Therefore the study of nerve injury in OSAHS patients should take blood oxygen saturation and hypoxia percentage rather than AHI.

Amisulpride,a kind of the second generation antipsychotics,was marketed in China in 2010.A series of clinical research and experience before and after listed,especially the data based on Chinese population,provided evidence for the generalization and application of amisulpride.In order to optimize the clinical application of amisulpride,and improve the prognosis of patients,Expert Advice on the Practical Use of Amisulpride in the Treatment of Schizophrenia is presented here.This advice is based on the recent evidence and clinical experience,for guiding the clinical medication of amisulpride.

Regenerative endodontic therapy aiming at restoring dentin-pulp complex has been a hot research topic in recent years. Currently, only pulp revascularization has been applied clinically, while stem cell transplantation and cell homing have not been applied in clinical practice. After many years of basic research and clinical practice, regenerative endodontic therapy has made progress. However, it also exposed some problems including confusion of concepts, improper selection of indications, incomplete evaluation criteria. This article summarizes and discusses the current situation, problems and future clinical practice of regenerative endodontic therapy.

Objective To evaluate the left ventricular diastolic function of patients with normal left ventricular ejection fraction ( LVEF) by echocardiography and real‐time cardiac catheter measurement ,and improve the accuracy and reliability of echocardiographic diagnosis . Methods One hundred and twenty patients with know n or suspected coronary artery disease w ho underwent coronary angiography and left ventricular catheterization were prospectively selected from July 2017 to January 2018 in the Affiliated Hospital of Jiangsu University . According to the left ventricular end diastolic pressure ( LVEDP) real‐time measurement ,the patients were divided into groups of LVEDP ≤15 mm Hg ( 43 cases ) and LVEDP ＞ 15 mm Hg ( 77 cases) . General data were compared and the difference of echocardiographic parameters between the two groups were analyzed ,and the ROC curve of each echocardiographic parameter for diagnosing LVEDP was draw n . Results T he parameters including flow propagation velocity ( VP) ,the ratio of filling fraction of E and A ( E/A) ,early diastolic filling deceleration time ( DT ) ,the duration of mitral A ( A‐dur ,) mitral annulus velocity at the septal side ( e′sep) ,systolic pulmonary venous flow velocity ( PVs) ,diastolic pulmonary venous flow velocity ( PVd ) and PVs/PVd were used to the diagnosis of the increasing of LVEDP ,however their accuracies were low ( AUC between 0 .5～0 .7) . T he parameters including left atrial volume index ( LAVI ) , tricuspid regurgitation ( T Rmax ) ,mitral annulus velocity in lateral wall of left ventricle ( e′lat ) ,average e′,E/e′sep ,E/e′lat ,average E/e′,velocity of pulmonary vein atrial reversal ( PVa) ,pulmonary vein atrial reversal duration ( Pva‐dur) ,the difference between the duration of pulmonary venous A wave and mitral A wave( PvaD‐AD) were also used to the diagnosis of the increasing of LVEDP , but their accuracies were still poor ( AUC between 0 .7～0 .9 ) . According to the real‐time left ventricular pressure measurement and different parameters of echocardiography ,the multivariate regression equation :LVEDP＝ 0 .292 LAVI + 0 .35 PVa + 0 .04 T Rmax + 0 .075 ( PvaD‐AD ) －0 .109 PVs －6 .773 was put forward as a correction standard ,the accuracy of the diagnosis of LVEDP was significantly improved ( AUC ＝0 .922) . Conclusions T he assessment of left ventricular diastolic function needs to be performed comprehensively with multiple parameters . T he multiple regression equation can accurately evaluate left ventricular diastolic function in patients with normal LVEF .