Objective To evaluate the value of early preventive tracheal intubation in the early first‐aid of serious severe trau‐ma and improve the early first‐aid ability of serious severe trauma .Methods Using retrospective study ,among 258 patients of acute airway obstruction caused by severe trauma ,those who have reached the standard of obstruction and respiratory failure according to observation were as the contrast group (n=84) ,and those who had the tendency of airway obstruction instant treatment of preven‐tive trachea intubation were as early preventive tracheal intubation group (n=174) .The average in hospital days ,the occurrence rate of multiple organ failure and death rate were contrasted .Results In the early preventive tracheal intubation group ,in hospital days were 17 .2 on average ,the occurrence rate of multiple organ failure was 44 .59% and the death rate was 10 .67% .In the con‐trast group ,it was 27 .9 d ,67 .51% and 33 .75% ,the two groups had shown significant difference(P<0 .05) .Conclusion Early tra‐chea intubation have a good trachea management of serious severe traumas ,improve inspiration ,shorten the hospitalization days ,and reduce the occurrence rate of complication .It is important to improving rescuing rate .

Objective To design a vehicle-mounted X-ray diagnosis simulation training system based on the field X-ray diagnostic vehicle to solve the problems during its training and utilization.Methods The field X-ray diagnostic vehicle had its internal and external structure analyzed,and was divided into several functional modules.The technologies of computer programming and database were used for the simulation of the modules.An example was given to simulate the operating process of the vehicle by establishing traumatic condition model,war injury image library and etc.esults The system developed realized the simulation training of the vehicle,and the trainee gained feedback after simulation as references.Conclusion The system implements informatized training of the field X-ray diagnostic vehicle,shortens the training period,decreases the training cost and increases the training efficacy.

OBJECTIVE:To facilitate the modernization of preparation technology for Chinese materia medica preparation.METHODS:The key problems and the strategy for the modernization of preparation technology for Chinese materia medica preparation were analyzed and summarized by reviewing the pertinent literature.RESULTS & CONCLUSION:The development of the modernization of preparation technology for Chinese materia medica preparation lies in the progress in the modernization of extraction technology,quality control and quality standard and the modernization of dosage forms.

Objective Analyzing the regional distribution discrepancy of medical and health resources in China,with the purpose of providing the government with policy making evidences for optimizing medical and health resource allocation.Results Dividing China into three regions based on regional economic development and geographic setting,and selecting 6 indicators for medical and health resources.On the basis of the statistics of 31 provinces released by the state in 2009,analyzing the interprovincial disparities of the distribution of these six resources,by means of the coefficient of variation,Gini coefficient and Theil index.Methods The largest inter-regional allocation disparity is found in the number of biopharmaceutical manufacturing companies per ten thousand population.And the smallest discrepancy is found in the number of hospital beds among these regions.The top two extreme differences of resource possession per ten thousand population between the maximum and the minmum region are the number of biopharmaceutical manufacturing companies and tertiary hospitals.The eastern region is the largest contributor to the discrepancy of allocation for the six resources within and between regions.The less developed regions contribute the most inter-regional discrepancy for the allocation of medical practitioners(their assistants included),hospital beds,tertiary hospitals and pharmaceutical companies.And the developed regions contribute the most inter-regional discrepancy of medical finance support from local governments and the most of the allocation of biopharmaceutical manufacturing companies.In general,regions of higher development enjoy greater possession of the SIX resources per population in such regions. But these two are not always in direct proportion. Condnsion Regional distribution disparity of the six resources is not yetreasonable in China.To better meet the health needs of the population in various regions,the government is expected to increase its financial support for building biopharmaceutical manufacturing companies and tertiary hospitals in the less developed western regions,to better use resources of developed regions,and to keep off investments at low level and repetition.The government is also recommended to pay attention to the proportion of government health finance output and the quality and quantity of medical practitioners.

Objective To explore a medical insurance model for rare diseases and orphan drugs applicable in China.Methods Eleven rare diseases from six disease systems and thirty-five orphan drugs covered were pinpointed for comparative analysis of their present coverage in various medical insurance systems in China.Results The coverage of 35 orphan drugs in the national essential drug list(2009)and the national essential drug list(2012)is 0 and 37.1％ respectively; the coverage in the national essential insurance medicine list is 54.3％ (19 types),and the average coverage in the medicine list for the New Rural Cooperative Medical Insurance Scheme is 33.6％.The study found insufficient rare diseases included in the Basic Medical Insurance Schemes in general.Conclusion The coverage of basic medical insurance for rare disease patients is low in China.In this regard,such measures should be taken to mitigate the economic burden for these patients,namely expanding the coverage of reimbursement list of orphan drugs,building the special reimbursement system of rare diseases and orphan drugs and improving the medical rescue system for rare diseases in China and their medical care level.

Objective To summary the experience in surgical treatment of differentiated thyroid carcinoma (DTC).Methods The clinical data and follow-up results of 110 cases of DTC were retrospectively analyzed.Results 110 patients received operation and TSH suppress therapy.Histologic examination after operation revealed that papillary thyroid carcinoma(PTC) 88 cases(80%) ,follicular thyroid carcinoma 22 cases(20%) ,cervical lymph node metastasis were found in 22 cases(20%).The operation procedure consists of excision of the suffered lobe,isthmus and greater partial of the opposite lobe 59 cases(along with functional cervical dissection 12 cases) ;excision cf the sufferedlobe,isthmus 29 cases(along with functional cervical dissection 7 cases) ;excision of the suffered lobe,isthmus greater partial of the opposite lobe 18 cases(along with functional cervical dissection 5 cases) ;total thyroidectomy and bilateral cervical dissection 2 cases;total thyroidectomy and bilateral cervical dissection with postoperative 131I therapy,1 cases with metastasis to lung.98 cases 10-year survival rate was 91.8%.Conclusion Differentiated thyroid carcinoma has a good prognosis,a proper surgical procedure is the key point to get a good outcome.

Objective: To detect estrogen receptor α and β(ER-α, ER-β)protein expression in different age of mouse thymus.Methods:Protein expression of ER-α and ER-β in thymus was analyzed via immunohistochemistry.Moreover,the relationship between ER-α and cytokeratin 18(epithelial cell marker)was further tested through fluorescence double-staining.Results: Immunohistochemical analysis revealed that both ER-α and β protein was found in nuclei of some thymocytes of 3 month mice.However,expression of ER-β was absence while ER-α was still positive in aged mice, such as 12 months and 16 months old.Double staining further confirmed that lots of ER-α/β positive cells were Foxp3 negative cells.Conclusion: Expression of ER-β is absent while ER-α is still positive in thymus of aged mice, which indicates ER-α is the critical estrogen receptor that involves in thymic involution.Moreover, ER-α/β do not participate in Treg development within thymus.

Objective To investigate the diagnostic value of serum homocysteine in the diagnosis of colon cancer.Methods The performance rate method was used to detect the level of serum homocysteine(Hcy) in colon cancer group(50 cases) who were treated in Beijing Tiantan Hospital Affiliated to Capital Medical University from March 2011 to June 2016 and control group(50 cases).The expression of independent samples t test was used to analysis of the difference of the Hcy levels between the two groups.The ROC curve was used to evaluate the value of Hcy in diagnosis of colon cancer.Results The serum Hcy level in colon cancer group was (18.6±8.9) μmol/L,in healthy control group was (10.7±4.3) μmol/L,colon cancer group serum Hcy levels were significantly higher than those of healthy control group,there was significant difference(t=5.627,P<0.01).AUC of ROC curve was 0.775,cut-off value of 18.5 μmol/L,sensitivity was 0.50,specificity was 0.94,95%CI was 0.682-0.868(P<0.01).Conclusion Serum Hcy can be used as a reference index of the diagnosis of colon cancer.

Objective To investigate the clinical significance of serum pepsinogen (PG) in gastric cancer screening. Methods The clinical data of 930 patients underwent colonoscopy were retrospectively analyzed. Among them, non chronic atrophic gastritis was in 550 cases (chronic atrophic gastritis group), chronic atrophic gastritis in 300 cases (chronic atrophic gastritis group), gastric cancer in 80 cases (gastric cancer group). The patients in chronic atrophic gastritis group were divided into mild chronic atrophic gastritis subgroup (100 cases), moderate chronic atrophic gastritis subgroup (120 cases) and severe chronic atrophic gastritis subgroup (80 cases) according to the severity of the atrophy. The levels of serum PGⅠand PGⅡwere detected by enzyme linked immunosorbent assay (ELISA) method, and the ratio of PGⅠand PGⅡ(PGR) was calculated. Results There was no statistical difference in PGⅡ among the 3 groups (F = 1.226, P>0.05). The PG Ⅰand PGR in gastric cancer group were significantly lower than those in chronic atrophic gastritis and non chronic atrophic gastritis:(70.41 ± 39.42)μg/L vs. (83.10 ± 30.08) and (165.5 ± 41.40)μg/L, 3.76 ± 2.03 vs. 5.08 ± 1.82 and 6.84 ± 1.88, those in chronic atrophic gastritis were significantly lower than those in non chronic atrophic gastritis group, there were statistical differences (P<0.05). The PG Ⅰand PGR in mild and moderate chronic atrophic gastritis subgroup were significantly higher than those in severe chronic atrophic gastritis subgroup and gastric cancer group:(95.50 ± 30.80) and (82.10 ± 31.42)μg/L vs. (70.12 ± 20.12) and (70.41 ± 39.42) μg/L, 5.84 ± 2.88 and 5.08 ± 1.89 vs. 3.90 ± 2.78 and 3.76 ± 2.03, there were statistical differences (P<0.05), but there was no statistical difference between severe chronic atrophic gastritis subgroup and gastric cancer group (P>0.05), and there was no statistical difference between mild chronic atrophic gastritis subgroup and moderate chronic atrophic gastritis subgroup (P>0.05). The receiver operating characteristic (ROC) curve was used, the optimal critical value of PG Ⅰ was 74.8μg/L, the area under curve (AUC) was 0.842, the sensitivity was 90%, specificity was 75%;the optimal critical value of PGR was 4.46, AUC was 0.837, the sensitivity was 75%, specificity was 82%;the AUC of combined detection of PG Ⅰ and PGR was 0.906, the sensitivity was 88%, specificity was 85%. Conclusions Detection of PG Ⅰ combined with PGR can be used as gastric cancer screening, the recommended level of PGⅠ≤74.80μg/L and PGR≤4.46.

Objective:To detect estrogen receptor ? and ?(ER-?,ER-?) protein expression in different age of mouse thymus.Methods:Protein expression of ER-? and ER-? in thymus was analyzed via immunohistochemistry.Moreover,the relationship between ER-? and cytokeratin 18(epithelial cell marker) was further tested through fluorescence double-staining.Results:Immunohistochemical analysis revealed that both ER-? and ? protein was found in nuclei of some thymocytes of 3 month mice.However,expression of ER-? was absence while ER-? was still positive in aged mice,such as 12 months and 16 months old.Double staining further confirmed that lots of ER-?/? positive cells were Foxp3 negative cells.Conclusion:Expression of ER-? is absent while ER-? is still positive in thymus of aged mice,which indicates ER-? is the critical estrogen receptor that involves in thymic involution.Moreover,ER-?/? do not participate in Treg development within thymus.