Objective To explore the importance of pre hospital emergency care for patients with hypertensive cerebral hemorrhage.Methods A total of 85 patients with hypertensive cerebral hemorrhage transferred by ambulance were considered as the observation group and 51 patients with hypertensive cerebral hemorrhage transferred by family members were considered as the control group.Patients in observation group were given first aid at the scene,transit and hospital,and patients in control group were given first aid after admission in hospital.Effective transit time,complications,and mortality were compared between the two groups.Results Effective transit time was shorter in observation group than in control group [(0.92±0.17) h vs.(1.31±0.39) h,t=8.05,P＜0.001].The complication incidence was lower in observation group than in control group (14.12％ vs.47.06％,x2 =17.77,P＜0.001).The mortality rate was lower in observation group than in control group (15.29 ％ vs.37.25 ％,x2 =8.54,P ＜ 0.01).Conclusions Pre-hospital emergency care could shorten the effective transit time,reduce the complication incidence and improve the survival rate in patients with hypertensive cerebral hemorrhage

BACKGROUND:The distal forearm buckle fracture in children has no secondary displacement risk, and the literatures have reported that the fracture can be treated with external fixators of plaster cast, palm side plate, splint, brace and bandage, and obtain good effect. But different external fixators have different effects on the functional recovery and viability.
OBJECTIVE:To assess the clinical efficacy and safety of splint versus plaster cast for the treatment of distal forearm buckle fracture in Children.
METHODS: The Medline database, Embase database, Cochrane Library, CNKI database and CBM database were searched from the database establishment to April 2011 with the computer;the relative conference papers were hand searched;the Important Clinical Trial Register was searched online without limitation of language. Randomized control ed trials and quasi-randomized control trials were selected for quality evaluation, and the Meta-analysis was performed with Revman 5.1. RESULTS AND CONCLUSION:Two published trials including a total of 314 patients were included, and one randomized control ed trial was evaluated as B scale, another one quasi-randomized control trial was evaluated as C scale. The results demonstrate that no fracture, un-union or re-fracture occurred after treated with splint and plaster case external fixator, and there were no significant differences in pain scores as wel as the daily activities of writing, drawing, self-eating and washing;while the early bathing ability of the patients in the splint group was earlier than that in the plaster cast group, and had no significant difference in the advanced bathing ability. The regular exercise participation in the splint group was better than that in the plaster cast group. There were no significant differences in the incidence of adverse events between two groups. The results indicate that the pain score of the patients with distal forearm buckle fracture in children do not improved after treated with splint and plaster cast, but splint fixation is better than plaster cast fixation in maintaining the batching and regular exercise participation ability with good safety. But the wel-designed and implement large sample and multi-center randomized control ed trials are needed for validation.

The cultural differences in the measure of value, mode ofthinking, code of conduct and consume concept, etc. In the orient and western countries were analyzed. The differences in the cultural back ground, nature, psychology and social effects of the health insurance system in the orient and westem countries and the true meaning of the culture of Medisave Scheme in Singapore and the culture of health insurance system in Germany were investigated. Finally, the authors traced the basic health to its origin.Looking forward to the twenty - first century, the growth rate of the population inthe developed countries will decrease and the population structure will be aged seriously. The social support coefficient will rise. The mode of the health insurance system in Germant - a compulsory social insurance mechanism, as a representative of westerm culture would face a crisis of insurance economics. Singapore mode of the health insurance system, a representative of orient.culture will become a model ofreformed health insurance system in the developing and industrialized countries. Finally it may be the basic mode of the culture of health insurance system in the word.

From the perspective of medical safety management, this paper states that it should foster the con-cept of medical safety, establish the goals of safety management, improve the safety management organization, and implement safety management and control measures. Furthermore, it analyzes several factors of doctors that influ-ence the doctor-patient relationship, which include hospital′s development direction and operation mode, the con-tradiction between the patient′s expectation and the limitation of medical technology, and the uncontrollable factors of medical development. Finally, it puts forward that the implementation of safety management is beneficial to en-hance the basic medical quality, decrease the medical errors, and improve the medical service level.

BACKGROUND:Left ventricle volume or volume index and left ventricle mass or mass index are commonly used to evaluate left ventricle remodeling. Recently,real-time three dimensional echocardiography (RT3DE) has been attempted to evaluate left ventricle remodeling index (LVRI),and it is believed that LVRI can serve as new index to evaluate left ventricle reconstruction clinically. OBJECTIVE:To assess application of RT-3DE in evaluating left ventricular remodeling in patients with hypertension. DESIGN,TIME AND SETTING:Case-control observation was performed at the Department of Ultrasonography,First Hospital of Liaoning Medical University from September 2008 to September 2009. PARTICIPANTS:A total of 90 hypertension patients and 30 normal people were selected. The hypertension patients were divided into 3 subgroups according to interventricular septum,left ventricle myocardial thickness and end-diastolic diameter:normal configuration,concentric hypertrophy and eccentric hypertrophy groups with 30 cases in each group. METHODS:Three dimensional echocardiography of 90 patients and 30 controls was performed. Left ventricular end-diastolic volume (EDV),left ventricular end-diastolic epicardial volume (EDVepi) were measured by RT-3DE; left ventricular mass (LVM),left ventricular mass index (LVMI),left ventricular end-diastolic epicardial volume index (EDVI),LVRI were calculated and compared with two-dimensional echocardiography (2DE) Simpson biplane method. MAIN OUTCOME MEASURES:LVRI,LVMI,and EDVI detected by RT-3DE and 2DE Simpson biplane. RESULTS:LVRI,EDVI,LVMI measured by RT-3DE and 2DE were significantly different in hypertension patients (P 0.05). The LVRI measured by RT-3DE,2DE and EDVI,LVMI measured by 2DE were significantly correlated in normal control,normal configuration and concentric hypertrophy group (P 0.05). CONCLUSION:Real-time three-echocardiographic LVRI can serve as a new approach for evaluating left ventricular remodeling in clinic.

Objective To explore the effect of Laparoscopy-assisted radical pull-out operation for Hirschsprung disease.Methods The clinical data of 12 patients with Hirschsprung disease admitted to our hospital in the last 2 years were retrospectively reviewed.Results The surgical procedures of 12 cases were successfully performed by laparoscopy,including 6 cases of common segment,4 cases of short segment,and 2 cases of long segment type.All the operations were completed with laparoscopy in 80-130 min(mean 100 min).There was very little bleeding during the procedure and no obvious scar.There were no complications.Conclusions Laparoscopy-assisted radical pull-out operation for Hirschsprung disease is feasible and effective.

Objective To investigate the effects of minute quantity of endogenous endotoxin originating from the lung on ventilator-induced lung injury in rats. Methods Thirty-two pathogen-free male adult SD rats weighing 370-390 g were randomly divided into 4 groups ( n = 8 each): group I spontaneous breathing (group C) ; group Ⅱ spontaneous breathing + IPS (group CL) ; group IE mechanical ventilation (group M) and group IV mechanical ventilation + LPS (group ML). The animals were anesthetized with intraperitoneal 20% urethane 0.8 ml/100 g. Right common carotid artery and left femoral vein were cannulated for BP monitoring and fluid and drug administration. The animals were tracheostomized. In group CL and ML LPS 100μg /kg was instilled into trachea. In group M and ML the animals were mechanically ventilated (V_T 20 ml/kg, PEEP=0, I = E = 1:1). P_(ET) CO_2 was maintained at 35-45 nun Hg by adjusting respiratory rate. The animals were breathing or ventilated with room air,and ECG, BP, HR and P_(ET)CO_2 were continuously monitored. Blood gases were analyzed at the beginning and 1, 2 and 3 h of experiment. The animals were sacrificed at 3 h of experiment. The lungs were removed for microscopic examination. The pathological changes of the lung were scored (0 = normal,3 = severe change) . Wet/dry lung weight ratio was determined. The left lung was lavaged. The broncho-alveolar lavage fluid (BALF) was collected. WBCs in BALF were counted. Pulmonary albumin permeability (PAP) (BALF protein concentration/plasma protein concentration) was determined. Plasma TNF-a and macrophage inflammatory protein 2 (MIP-2) concentrations were detected with ELISA. The endotoxin receptor CD14 mRNA expression in lung tissue was determined by RT-PCR and the macrophage CD14 expression in BALF was determined by immuno histochemistry in group C and M. Results Wet/dry lung weight ratio and PAP were significantly higher in group ML than in group M and C. WBC count in BALF, the pathological score and plasma MIP-2 concentration were significantly higher in group M and ML than in group C and were significantly higher in group ML than in group M. TNF-a concentration was significantly higher in group CL and ML and was not detected in group C and M. CD14mRNA expression in the lung tissue and CD14 expression in BALF macrophage were significantly higher in group M than in group C. Conclusion Minute amount of endogenous endotoxin from the lung can aggravate ventilator-induced lung injury in rats. Mechanical ventilation with large tidal volume sensitizes the lung to LPS stimulation through up-regulation of CD14 exexpression.

Objective:To study the inhibitive effect of SQ on HcaF 16 A 3 cells in vivo.Methods:SQ was given to BALB/C mice after bearng tumors for 10 consecutive days.The therapeutic effect was determined by measurement to tumor weight?immunological function and morphological changes.Flowcytometry and electronic microscope were used to evaluate the distribution of cell cycle.Results:The inhibition rate was 65.68%,NK/M? activities and cytokine production were enhanced by SQ,cell cycle was stopped at the S phase.Necrosis could be seen nuder microscope and characteristic apoptotic body could be seen under electronic microscope.Conclusion:SQ had a significant anti tumor effect by regulate immune system and inhibit tumor cell proliferation.

ObjectiveTo investigate the role of apoptosis played in myocardial hypertrophy and the effect of L-arginine (L-Arg) on the pathogenesis.Methods36 rats were randomly divided into the control group, model group and L-Arg treating group. The animal model of over-loading myocardial hypertrophy was made, and systolic blood pressure (SBP)and the cardiac indexes were measured, spectrophotography and flow cytometry were used to detect the content of nitric oxide (NO), activity of superoxide dismutase (SOD) and apoptosis rate.ResultsIn the model group, SBP, cardiac indexes and myocardial apoptosis rate increased, the content of NO and activity of SOD decreased compared with the control group. While, in the L-Arg treating group, SBP, cardiac indexes and apoptosis rate decreased, the content of NO and the activity of SOD increased compared with the model group.ConclusionMyocardial apoptosis may play an important role in the pathogenesis of myocardial hypertrophy and cause the losing of myocardial cells. L-Arg induces the increasing production of NO and inhibits myocardial apoptosis through increasing the activity of SOD.

Objective To investigate and analyze the requirement for health education during and after hospitalizadon of patients with cerebral apoplexy.Methods 150 sober patients with cerebral apoplexy from department of neurology were investigated by questionnaires and the results were analyzed. Results The education content that most patients wanted to understand during hospitalization was treatment method and limbs activity(83.6%and 82.2%);The health education style that they prefered was to communicate directly with doctors and nurses(74.0%);The education content after hospitalization that most patients required was self-nursing knowledge.clinical manifestation and first aid when relapse(90.4%,87.7%and 87.7%).The health education style that they most needed after hospitalization Was that Some reference books would he recommended to them (56.2%).The time choice for health education was consultation whenever they had problems.Conclusion Medical workers should supply selective education and instruction according to the health education requirement and style at different stages of patients with cerebral apoplexy.