Objective To evaluate the quality of clinical trials about acupuncture and moxibustion treatment of vertebrobasilar insufficiency in China.Methods Literature of clinical trials of acupuncture was collected and analyzed,evaluated by the randomized controlled test criteria and the clinical assessing method in Cochrane handbook of international Cochrane cooperation net.Results Sixteen literatures were brought in.87.5% of the included literature had no clear description of random methods,and no allocation concealment,use of blind methods,sample size calculation,intention-to-treat analysis.Among them,62.5% had explicit diagnosis criteria,12.5% with correct randomizing method,62.5% with explicit evaluation criteria,however,31.22% with no words referring to the comparability among the groups.Conclusions Though acupuncture and moxibustion have been widely applied in prevention and treatment of vertebrobasilar insufficiency,it can not provide evidences of higher reliability for clinical treatment due to less clinical randomized controlled tests and lower quality,which severely hinder testing and verifying of clinical therapeutic effects of acupuncture and moxibustion.It is proposed that multiple central and randomized controlled test should be made,so as to search for feasible acupuncture and moxibustion methods with definite therapeutic effect for vertebrobasilar insufficiency,and provide basis for further systematical evaluation.

Objective:To evaluate the clinical safety and effectiveness of heavy specific gravity levobupivacaine in spinal block.Method:30 selective general surgical patients of ASAⅠ～Ⅱin obstetrics and gynecology were randomly di- vided into levobupivacaine group(L group)and bupivacaine group(B group).After opening the venous channel and transfusing equilibrium liquid 30 mins,the T 4-5 space was selected as the puncture site for the epidural puncture.The 2 medicaments were injected in the rate of 0.1 ml/s respectively.Then the anesthetizing onset time,maintenance time,time of motion blockade and restoration,effect of anesthesia,variations of blood pressure and heart rate and adverse drug reac- tion were observed.Result:The onset time was 82.61?22.10 s in L group and 59.30?21.50s in B group,respectively. The variations of SBP,DBP and HR in L group were less than those in B group.There was no significant difference in the 2 groups in maintenance time,time of motion blockade and restoration and effect of anesthesia.Conclusion:Compared with bupivacaine,heavy specific gravity levobupivacaine can make the same anesthesia effect with a steadier blood circulation. The specific gravity levobupivacaine is a safe and feasible drug for spinal anesthesia.

Objective To investigate the protective effects of ω-3 polyunsaturated fatty acids on severe sepsis patients with myocardial injury.Methods Thirty-one patients with severe sepsis were divided into treatment group (17 cases) and control group (14 cases) by random digits table.All patients received partial enteral nutrition and partial parenteral nutrition with equivalent nitrogen and calorie values for 5 days.The control group was given routine therapy and the treatment group was given routine therapy and ω-3 polyunsaturated fatty acids emulsion.The serum malondialdehyde (MDA),superoxide dismutase (SOD),cardiac troponin Ⅰ(cTnI),N-terminal pro-B urine sodium peptide (NT-proBNP) levels and acute physiology and chronic health evaluation (APACHE) Ⅱ score was compared between two groups before and after treatment.Results There was no difference in indicators before treatment between two groups (P ＞ 0.05).The MDA,cTnI,NT-proBNP and APACHE Ⅱ score in two groups after treatment 5 days was lower than that before treatment 1 day,and the SOD was higher than that before treatment (P ＜ 0.05).The MDA,SOD,cTnI and NT-proBNP after treatment 5 days in treatment group was better than that in control group [(7.50 ±2.06) mmol/L vs.(9.24 ± 1.79) mmol/L,(89.22 ± 16.21) mU/L vs.(76.60 ± 15.13) mU/L,(0.65 ± 0.34)μ g/L vs.(1.03 ± 0.62) μ g/L,(1267.13 ± 279.26) ng/L vs.(1532.47 ± 375.73) ng/L],and there was significant difference between two groups (P ＜ 0.05).The APACHE Ⅱ score was no significant difference between two groups after treatment 5 days.Conclusion ω-3 polyunsaturated fatty acids can reduce the oxidative stress and myocardial injury,decrease cTnI and NT-proBNP levels and improve heart function in the patients with severe sepsis.

Objective To explore the influence of different testing methods on detecting value of to-tal cell volume. Methods 60 reusable dialyzers(low-flux dialyzer and high-flux dialyzer were 30 respec-tively) were enrolled. They were divided into the traditional testing group, the modified testing group and the automatic dialyzer reuse group with 20 dialyzers in each group according to different detecting methods, the results underwent analysis. Results The basic total cell volume of the traditional testing group, the modified testing group and the automatic dialyzer reuse group were (100.10±0.25) ml, (100.13±0.50) ml and (102.00±1.41) ml in 6LR dialyzer, while in 17R dialyzer, they were (113.67±1.30) ml, (118.67±1.30) ml and (119.93±1.77)ml respectively. The total cell volume of the dialyzer reuse in the traditional testing group, the modified testing group and the automatic dialyzer reuse group were (95.20±7.76) ml, (96.20± 7.22) ml and (102.80±4.26) ml in 6LR dialyzer, while in 17R dialyzer, they were (100.00±11.48) ml, (114.35±3.31 ) ml and (117.07±2.96) ml respectively. There was significant difference between the tradi-tional and the modified testing groups in high-flux dialyzers reuse. Conclusions The modified testing method can improve the accuracy of the testing of total cell volume in high-flux dialyzer reuse.

Objective To investigate the effect of methylene blue(MB)on liver ischemia-reperfusion (I/R) injury in rabbits.Methods Twenty-four healthy New Zealand white rabbits of both sexes welshins 2.0-2.3 kg were randomly divided into 3 groups (n=8 each):group Ⅰ sham operation(group s);group Ⅱ I/R and group Ⅲ methylene blue (group MB).The animals were anesthetized with intravenous 2% pentobarbital 30 mg/kg.Liver I/R was produced by occlusion of hepatic blood flow for 40 min followed by 60 min repeffusion.In group MB methylene blue 5 mg/kg was injected iv at 20 min before liver ischemia.Femoral artery was carmulated for MAP monitoring and blood sampling.MAP and HR were recorded immediately before(T1,baseline)and at 20 and 40 min of ischemia (T2,3) and 1,5,30,60 min(T4-7)of repedusion.Blood samples were collected at T1,T5,T6 and T7 for measurement of seruln TNF-α and IL-6 concentrations.Plasma AST and ALT activities were measured at T1,T6 and T7.Liver specimens were obtained at the end of experiment for determination of SOD activity and MDA content.Results In group I/R MAP was significantly decreased at T4-7 during reperfusion and HR at T7 as compared with the baseline at T1;while in group MB no significant change in MAP and HR Was observed during ischemia and reperfusion as compared with the baseline.The gerum TNF-α and IL-6 concentrations and the plasma ALT and AST activities were significantly increased during reperfusion as compared with the baseline immediately before ischemia in group I/R and MB and were significantly lower in group MB than in group. I/R. The SOD activity was significantly higher while MDA content was significantly lower in group MB than in group I/R. Microscopic examination showed that liver damage was less severe in group MB than in group I/R. Conclusion The administration of MB can maintain hemodynamic stability and attenuate liver I/R injury in rabbits.

Objective To explore the influence of automatic and semi-automatic hemodialyzer reuse method on hemodialyzer reuse effect. Methods 1728 dialyzers were randomly divided into automatichemodialyzer reuse group and semi- automatic hemodialyzer reuse group with 864 dialyzers in each group. Thetime of douching and testing, the cost of sterilization,the frequency of the pyrphgen reaction,the broken dialyzer membrane and re-examined dialyzer between the two groups were measured. Results The time of douching dialyzer, testing of total cell volume and pressure in the semi- automatic hemodialyzer reuse group was (26.443±3.237), (2.172±0.128) and (2.157±0.090) minutes respectively,while the automatic hemodialyzer reuse group was (5.793±0.193), (1.257±0.118) and (1.110±0.076) minutes respectively. The frequency of re-examined dialyzer in testing total cell volume and pressure was 499(57.755%), 243(28.125%) respectively. At the same time, all dialyzer in semi-automatic hemodialyzer reuse group could be examined successfully at a time. The cost of sterilization in automatic henmdialyzer reuse group was (9.330±0.138)yuan. No pyrogen reaction and broken dialyzer membrane happened. Conclusions The semi-automatic bemodialyzer reuse group can retrench cost during perfusion,but consumes long douching time, lacks matching detection equipment, difficult to detect, and is not easy to read data and has high re- examination rate. while in the automatic hemodialyzer group, it is convenient of douching and detection, but the cost of sterilization and equipment is high, and clinical demand can be fulfilled only when the dialysis center can allocate reasonable number of the machines.

Objective To explore the mechanism and regulative function of betulin on anti-aging genes related of normol human dermal fibroblasts (ESF-1), and to reveal the repairing mechanism of betulin on wrinkles. Methods The cultured cell in vitro were divided into the control group, the estradiol group and the betulin high, medium and low dose groups. Competence of ESF-1 cells was detected by MTT. Expression of mRNA of collagen type I and Ⅲ (ColⅠand Col Ⅲ), tissue inhibitors of matrix metalloproteinase 1 and 2 (TIMP-1 and TIMP-2), matrix metalloproteinase 1 (MMP-1) was detected by RT-PCR. Results Compared with the control group, the proliferation of ESF-1 cells (0.455 ± 0.037, 0.445 ± 0.040 vs. 0.385 ± 0.601) in the estradiol group and the medial-dose betulin group were increased (P<0.05). Compared with the control group, the expression of mRNA of ColⅠ (0.960 ± 0.012, 0.929 ± 0.015 vs. 0.842 ± 0.014), Col Ⅲ (0.892 ± 0.009, 0.824 ± 0.022 vs. 0.768 ± 0.025), TIMP-1 (0.938 ± 0.026, 0.878 ± 0.035 vs. 0.796 ± 0.022), TIMP-2 (0.557 ± 0.025, 0.506 ± 0.036 vs. 0.436 ± 0.063) in the estradiol group and the medial-dose betulin group were increased (all P<0.01). Conclusion Betulin based on increasing the competence of ESF-1 cells, promoting collagen synthesis and the expression level of related-proteinase is to suspend the development of wrinkles.

The paper presented the implementation of the healthcare reform policy and initial success of Xinyu TCM Hospital in its reform pilot work of public hospital reform in Xinyu city ,Jiangxi province. The authors also analyzed problems and causes of the hospital in business development and cost control during the reform ,proposing to carry out TCM development policy ,enhance government investment ,streamline TCM service pricing ,and innovate TCM supporting model. In addition ,they also proposed TCM hospitals to enhance management ,and reform their mechanism to resolve such problems as high operating costs ,and poor talent development and lack of feature disciplines .

Experience-oriented teaching approach was introduced into the bilingual course of medical imaging in order to improve the teaching effect.This approach was performed through English literature translation activities and scene-teaching.Meanwhile it points out that this approach has particular advantages in stimulating students' interest and initiative in study.