Objective To probe into a doctor-seeking medical management model for China's urban hypertension patients under medical insurance, and enhance the level and quality of medical insurance management. Methods Hypertension patients were surveyed with a structured questionnaire, and the staff at community health centers and medical insurance management centers received qualitative interview. Results The hypertension patients are found to see doctors mostly at community health centers and tertiary hospitals; complaints among hypertension patients for existing medical insurance vary with their areas, mostly targeting on complicated reimbursement procedure, high threshold of medical insurance payment and low level of reimbursement. Recommendation Experiment with the single-disease payment for hypertension, with the total prepayment in per capita and per disease; greater efforts in hypertension control in communities, with more favorable medical insurance policies for communities;elevated collaboration with medical institutions at all levels, and building and standardizing the management information network for hypertension patients.

Objective To proceed deep data mining in large database obtained by Cancer Genome Anatomy Project and to distinguish the difference expression genes of gastric carcinoma.Methods The 300,783 serial analysis of gene expression records from 4 libraries of gastric cancer and 2 libraries of normal gastric tissue in database of the Cancer Genome Anatomy Project were analyzed by digital gene expression displayer.Results The 201 difference expression tags represented 136 genes(54 up-regulated and 82 down-regulated) and 65 ESTs(24 up-regulated and 41 down-regulated) were distinguished,and these genes were involved in biological process and signal transduction pathways,such as cell cycle regulation,cell proliferation and apoptosis.The gene expression profile in whole body normal and cancer tissues of PTMA were constructed by digital Northern based on serial analysis of gene expression database and by virtual Northern based on cDNA database,respectively.Conclusion The difference expression genes of gastric cancer can be distinguished effectively with bioinformatics,and the results will guide our further molecular biology research.If validated by molecular biology experiment,the difference expression genes will be used as molecular targets of gastric carcinoma.

BACKGROUND: The free border of meniscus is avascular portion, for which, it is not susceptible for the meniscus to be cured naturally after injury. Therefore, it is necessary to induce fibrous tissue healing probably under certain situation.OBJECTIVE: To adopt tissue engineered cartilage and fibrin adhesive to treat meniscus injury in avascular portion and compare the results.DESIGN: Randomized group division and blank control experiment was designed.SETTING: Animal Laboratory of a Shenzhen Second People's Hospital.green-purplish-blue adult rabbits were selected, randomized into 3 groups,12 rabbits in each, named blank control, fibrin adhesive group(FA group)and tissue engineered cartilage group(TE-C group).METHODS: The experiment was performed in Animal Laboratory of Shenzhen Second People's Hospital from September 2003 to March 2004.Ten baby rabbits borne in 3 to 5 days were sacrificed to collect fibrochondrocytes for culture so as to prepare tissue engineered cartilage containing 12 × 108 L-1chondrocytes. Thirty-six adult rabbits were prepared into the injured model in avascular portion of meniscus (0. 7 × 0. 3) cm with full-thickness laceration. In blank control, no any filler was applied for management; in FA group, fibrin adhesive was infused in laceration; and in TE-C group, tissue engineered cartilage was infused in laceration. Four animals of each of 3 groups were sacrificed in the 2nd, 6th and 12th weeks after operation. Eight menisci were collected in each group each time for gross morphological observation and histological examination.MAIN OUTCOME MEASURES: Gross morphological observation and histological examination in injured meniscus model of rabbit.logical observation in injured meniscus model of rabbit: In blank control, the splits in meniscus were not been healed and tissue filler was not apparent. In FA and TE-C groups, the splits had been filled up with tissue fillers comblank control, 2 to 12 weeks after operation, there was chondrocyte proliferation presented on the border of splits. In FA group, 12 weeks after operation, on the defect border, there were many fibroblastic cells that closely adhered to adjacent tissue, resulting in scar tissue healing. In TE-C group,12 weeks after operation, cartilage cavities and capsule were apparent in the defect and chondrocftes were in cell condensation.CONCLUSION: Tissue engineered cartilage is survived in the acceptors, resulting in fibrocartilaginous healing and specific biological label of chondrocytes. But the remarkable difference presents in collagen arrangement among the repaired tissue, adjacent normal meniscus tissue and normal cartilage.

Objective To investigate the incidence and influence factors of stress ulcer SU) in traffic injury patients. Methods Clinical data of 362 traffic injury patients were studied retrospectively.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score was carried out for all the patients.All the patients had gastroscopy and a comparative analysis was done on the SU patients with or without bleeding and the patients without SU. Results The patients with extensive burn in traffic injury were more susceptible to SU as compared with other trauma patients,with statistical difference ( X2 =7.028,P ＜ 0.05 ).The incidence of SU or hemorrhage was increased with higher APACHE Ⅱ score.The incidence of SU hemorrhage in patients with diabetes or cardiopulmonary disease was significantly higher than that in patients without diabetes or cardiopulmonary disease ( P ＜ O.05 ). Conclusions Traffic injury patients should receive routine gastroscopy.APACHE Ⅱ score has some predictive value for SU or hemorrhage.The incidence of SU hemorrhage is also determined by combined factors of underlying diseases and treatment methods.

The effects of mifepristone (RU486) on the productions of plasminogen activator and progesterone in rat granulosa cells and luteal cells were studied by fibrin overlay method and radioimmunoassay method. The results showed that RU486 could significantly antagonize tPA activity and progesterone production enhanced by human chorionic gonadotropin (hCG). Secretion of tPA from luteal cells was significantly promoted by RU486 with or without prostaglandin F2a (PGF2α), but progesterone production in luteal cells was markedly inhibited with the same treatment. With method of tissue culture, the results showed that RU486 was capable of stimulating tPA and urokinase (uPA) activity in endometrium of pregnant rats. These findings indicated that antifertility of RU486 might be partly mediated through plasminogen activator-plasminogen activator inhibitor system.

Objective To evaluate the risk factors for the postoperative acute renal failure requiring dialysis (ARF-D)after heart valve surgery. Methods Adult patients (age≤18 years) underwent valve surgery with preoperative serum creatinine ＜300 μmol/L were included between January 2005 and December 2008. Fifty patients developed ARF-D within 30 days postoperatively (ARF-D group). While random 220 patients had the same operation without ARF-D served as the control group. Univariate analysis and multivariable logistic regression were used to identify risk factors of ARF-D after valve surgery.Results The incidence of ARF-D was 1.78%, and the early mortality rate was 65.5%. Multivariate analysis identified the following independent risk factors of ARF-D: age, previous cardiac surgery, preoperative serum creatinine, NYHA class Ⅳ,and low cardiac output syndrome. ARF-D group had a longer hospital stay and ICU stay than that of the control group ( P ＜0.001 ). Conclusion Conclusion ARF-D had a higher mortality rate and longer hospital stay following heart valve surgery.Age, previous cardiac surgery, preoperative serum creatinine, NYHA class Ⅳ, and low cardiac output syndrome were the independent risk factors of ARF-D after heart valve surgery.

Objective　To study the feature of immunoglobulin complementarity determining region 3 (CDR3) gene in neonates of different gestational age (GA), and the effect of neonatal maturity on the diversity of CDR3 nucleotide sequence. Methods　DNA were extracted from cord blood of 10 neonates of very immature (25-30 weeks), 12 immature (31-36 weeks), and 11 mature (37-41 weeks). CDR3 sequence was amplified suing nested PCR technique then cloned and sequenced. Results　1. There was a CDR3 length of 29.4±7.8, 32.4±9.2 and 40.8±10.7bp, including NDN length of 13.5±5.6, 16.1±7.8 and 22.0±8.5bp respectively in very immature, immature and mature neonates. 2. DP73 and DP75 were preferentially used in very immature and immature neonates, VH5, DP73 and DP75 were used in mature neonates. The usage rate of DP73 and DP75 reduced, whereas VH5 was raised with GA increasing. 3. For D gene segment, there was a frequent use of DN, DQ52 and DXP in very immature neonates, whereas DXP, DLR and DN in immature and mature neonates. 4. JH4 usage was preferential, followed by JH6 in all neonates, and their usage rate was decreased with GA increasing. 5. 63.3%, 68.8% and 92.0% of CDR3 sequence respectively in very immature, immature and mature neonates have an open reading frame with 303bp long encoding 101 residues. Conclusion　During the early life of neonates, VH-D-JH rearrangement of IgH gene is in an active condition, but the diversity is limited. Humoral immunity is a gradual development with increasing GA. Both heterogeneity and similarity of CDR3 sequence exists in neonates with different GA.

OBJECTIVE:To develop a method for quality control of Chenxiang huazhi pills.METHODS:Auklandia lappa,Cyperus rotundus,Crataegus pinnati fida,Rheum palmatum,Magnoliae officinalis and Pharbitis nil were identified by TLC.HPLC was used for determination of hesperidin.RESULTS: The chromatographic spots were identified without interference of negative control.Hesperidin had a good linearity within the range of 0.024 2～0.483 2 mg?mL-1 (r=0.999 4)with average recovery of 102.5%(RSD=2.0%,n=6).CONCLUSION: This standard is used for quality control of Chenxiang huazhi pills.

Objective To evaluate patient-controlled epidural analgesia (PCEA) with morphine on breastfeeding neonatal neurological arid adaptive capacity after cesarean section.Methods Thirty healthy parturients after cesarean section under epidural block were randomly selected as test group, and thirty healthy parturients with natural childbirth served as control group without any opioids administration. In test group the patients received PCEA after cesarean section. The regimen included a loading dose of morphine 2mg, bupivacaine 12.5mg and droperidol 0.5mg in 10ml of normal saline, followed by background infusion at 2 ml?h~(-1) with an 2ml bolus dose and a 20min lockout interval. The PCEA solution contained morphine 20mg, bupivacaine 125mg and dreporidol 5 mg in 100ml of normal saline. The samples of intravenous blood and colostrums were taken 2, 4, 8,12 and 24 h after the loading dose administration for measurement of plasma and colostrums concentrations of morphine. The neonatal neurological and adaptive capacity scores(NACS) of both groups were recorded at corresponding time points, Results Concentrations of morphine in colostrum and plasma kept decreasing following the loading dose administration. There was a significant positive correlation between concentrations of morphine in colostrum and plasma (r=0.998, P

Objective To report the clinic experience of tr eatment of severe pelvic fracture in order to improve the early diagnosis and operation of the injury.Methods We retrospectively studied the clin ic data of106patients admitted to our hospita l for severe pelvic fracture from Apr il 1994to May 2002.Results The main causes for pelvic fracture were traffic accident injury(69cases,65.1%)and falling accident injury(31cases,29.3%).87cases were in the survival group,and 19cases in the death group,with t he mortality of about 17.9%.In the death group,10di ed from hemorrhagic shock,4of severe cerebral injury,3from MOF,and 2from ARDS.32cases with pelvic f ractures were treated by opening red uction and internal fixation,91.7%of which achieved good results.Conclusion In the treatment of severe pelvic fra ctures,prehospital emergency care is very important.Complicated severe injuries should be treated pr omptly and pelvic fractures be fixed with internal fixation as soon as possibl e.