With the economic development and the deepening of reform in China,more attention has been paid on health.Based on literature from Chinese Journal of Health Statistics in 2008,the number and ranks of practicing doctors,occupancy of hospital beds,the disease spectrums,outpatient per year were analyzed.The results hold it is better for the doctors to practice in more medical institutions.

Objective To evaluate the pulmonary protection of dexmedetomidine in combination with parecoxib in pa?tients undergoing thoracotomy with one-lung ventilation. Methods Eighty patients undergoing elective resection of esopha?geal or lung cancer, including both sex, aged 40-70 yr, ASAⅠ-Ⅲ, were randomly divided into four groups (n=20), dexme?detomidine group (D group), parecoxib group (P group), dexmedetomidine in combination with parecoxib group (DP group) and control group (C group). Dexmedetomidine 1μg/kg was infused in ten minutes and then continued infusion at the rate 0.6μg·kg-1·h-1 until the chest was closed in group D. Parecoxib 40 mg was infused 10 min before the induction of anesthesia in group P. DP group was given parecoxib 40 mg and parecoxib 40 mg 10 min before the induction of anesthesia. The equal volume of normal saline was given in group C. Blood samples were collected for determination of blood gas analysis and the serum concentration of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-8 immediately after the induction of anes?thesia (T1), 30 min (T2) and 60 min(T3) after one-lung ventilation, and at the end of the operation (T4). Oxygenation index (OI) was calculated. The serum levels of TNF-α, IL-6 and IL-8 were detected by ELISA. Results Compared with time T0, the serum concentrations of TNF-α, IL-6 and IL-8 (except IL-8 at the time T2 in DP group) were significantly increased, and OI was decreased in all groups at the time T2-4 (P<0.05). Compared with group C, concentrations of TNF-α, IL-6 and IL-8 decreased and OI increased significantly at the time T2-4 in D group, P group and DP group (P<0.05). There were no obvious differences in concentrations of TNF-α, IL-6, IL-8 and OI value between D group and P group (P > 0.05). Conclusion Combination of dexmedetomidine and parecoxib can further mitigate inflammatory response, improve lung oxygenation dur?ing one-lung ventilation, and provide pulmonary protection in patients undergoing thoracotomy.

Objective To investigate the significance of heat shock protein 60 (HSP60) and heat shock protein 65 (HSP65) on prognosis acute coronary syndrome (ACS) within one year.Methods Eightynine hospitalized patients were collected from department of Cardiovascular disease,the people's hospital of Wuxi city affiliated of Nanjing Medical University and the Second People's Hospital Wuxi City from November 2009 to February 2011,and divided into ACS group (n =50),stable angina pectoris (SAP) group (n =19) and nonCHD group(n =20).HSP60,HSP65 levels in human serum were measured at the time of admission.The followup records of all patients were established to observe the occurrence of coronary events during one year,and analyzed its relationship between with HSP60,HSP65.Results Eighty-four cases were successful followed-up,and lost cases were 5.Eighteen patients occurred cardiovascular events within one year,and their content of serum HSP60 and HSP65 were significantly higher than that of without cardiovascular events (HSP60:(1026.19 ± 253.47) ng/L vs.(845.75 ± 138.52) ng/L,t =2.49,P ＜ 0.05 ; HSP65:(2573.95 ± 768.75) ng/L vs.(2076.38 ± 385.46) ng/L,t =2.58,P ＜ 0.05).In ACS group,the level of serum HSP60 and HSP65 of the patients occurred cardiovascular events was significant higher than that of without cardiovascular events,and there was significant difference(HSP60:(1162.73 ±249.14) ng/L vs.(892.55 ±204.62) ng/L,t =2.19,P ＜ 0.05 ; HSP65:(2714.39 ± 738.44) ng/L vs.(2136.85 ± 472.62) ng/L,t =2.65,P ＜ 0.05).COX regression analysis showed that HSP65 was an independent risk factor for recent cardiovascular events in patients with ACS (RR =1.002,95％CI 1.000-1.004,P =0.035).Conclusion The detection of HSP60,HSP65 in prognostic coronary artery disease prognosis has important value,and HSP65 was an independent risk predictor of ACS in recent cardiovascular events within one year.

Objective To investigate the effect of fatty acid synthase (FASN)on apoptosis in pancreatic cancer cell PANC-1 and the possible molecular mechanism.Methods Annexin V/FITC and flow cytometry were performed to detect the expression of FASN in pancreatic cancer PANC-1 after C75 treatment and the change of apoptosis in pancreatic cancer cell PANC-1 treated with C75.Quantity reverse transcriptase polymerase chain reaction (RT-PCR)and Western blot were used to measure the protein and RNA expressions of Caspase-3,bcl-2 and FASN.Results Inhibited by C75,the activity of FASN in pancreatic cancer cell PANC-1 was significantly decreased.Meanwhile,PANC-1 showed an increased apoptosis level in a dose-dependent manner (P < 0.05 ). Furthermore,after C75 inhibited FASN in pancreatic cancer cells,the protein and RNA expressions of Caspase-3 significantly increased (P <0.05)whereas the level of Bcl-2 reduced (P <0.05).Conclusion FASN is involved in the process of apoptosis in PANC-1 via Bcl-2 and Caspase-3.Therefore,FASN will provide a new target for the treatment of pancreatic cancer and generate better treatment efficacy.

Objective To study the very early diagnosis of acute myocardial infarction (AMI) by harmonic imaging integrated backscatter(IBS).Methods Thirty normal persons,12 cases at the very early stage of AMI (in 2 hours),36 cases with AMI (in 2-12 hours) were examined by IBS and the cyclic variation of integrated backscatter (CVIB) with HP Sonos 5500 ultrasonic system in different areas (the areas of myocardial infarction and no myocardial infarction).Results In the areas of AMI of the very early stage (in 2 hours),IBS was much higher than that of the areas of normal (14.7 vs 8.3,P

Objective To study the general shape of anterior cruciate ligament (ACL) insertion in rabbits and establish an animal model of ACL reconstruction using oval tunnels.Methods Eighteen mature white New Zealand rabbits were used in this study.Eight of them were used for anatomy study and the other 10 were for building an animal model.After removal of the medial femoral condyle and other soft tissues around ACL,the morphology of the ACL insertion was examined and the diameter of ACL insertions was measured using a caliper.An oval-tunnel dilator (1.6 mm×2.5 mm) was designed to make an oval-tunnel in the right knee of the rabbits while a round tunnel was drilled using a 2 mm diameter Kirschner wire in the left knee of the rabbits.Their hamstring tendon grafts were harvested as grafts for both sides and the compatibility between the bone tunnel and graft was examined for both groups.Right after the surgery,the knees of both sides were given the three-dimensional CT scan.Results The shape of ACL insertion of rabbits was oval.In the femur side,the average major and minor diameter of the ACL insertion was 5.28 ± 0.83 mm and 2.61 ± 0.33 mm respectively.In the tibial side,the major and the minor diameter of the ACL insertion was 5.33 ± 0.40 mm and 2.68 ±0.11 mm.The bone tunnel was compatible with the graft in both groups.In the oval tunnel ACL reconstruction group,the cross sectional area of the femoral bone tunnel was 3.18 ± 0.09 mm2 and the cross sectional area of the tibial bone tunnel was 3.26 ± 0.15 mm2.In the round tunnel ACL reconstruction group,the corresponding measurements were 3.13 ± 0.10 mm2 and 3.11 ± 0.11 mm2 respectively.There was no significant difference between the two groups.Conclusion The shape of ACL insertion in rabbits is oval.Using the self-made oval tunnel dilator we have successfully built an oval tunnel ACL reconstruction animal model with a good compatibility between the bone tunnel and graft.This lays the foundation for further research in the future.

Objective To analysis the changes of heart function in early stage after lung transplantation,and to explore its relationship with decreased pulmonary artery pressure.MethodsFrom 2002 to 2010,echocardiography results of 90 patients before and after lung transplantation in Wuxi People's Hospital were collected, 20caseshadcompletedateofpreoperativeandpostoperative echocardiography.Echocardiographic changes had been analyzed.Pearson linear correlation analysis was applied to determine the relationship between the early postoperative changes in cardiac structure and function and decreased pulmonary artery systolic pressure.ResultsPostoperative pulmonary artery systolic pressure ([38.30 ± 8.92]mm Hg) compared with preoperative([60.05 ± 29.10]mm Hg) was significantly lower(t =3.120, P = 0.006) , Postoperative right ventricular diameter was significantly reduced compared with the preoperative(t = 36.000, P = 0.008) , tricuspid and pulmonary valve regurgitation significantly reduced (t =57.000 and 66, Ps ＜ 0.05) .Postoperative left atrial diameter and left ventricular end diastolic diameter ([35.15± 5.73]mm and [43.25 ± 5.56]mm) compared with preoperative([32.40 ± 7.29]mm and [40.15 ± 6.20]mm)were significantly expanded (t =-2.384 and t =-2.153, Ps ＜ 0.05) .Although postoperative stroke volume ([59.54 ± 14.97]ml)compared with preoperative ([44.18 ± 15.85]ml)significantly increased (t =-3.918, P = 0.004) , but the postoperative left ventricular ejection fraction ([63.10 ± 8.48]％)compared with preoperative ([71.75 ± 8.10]％)was significantly decreased (t =3.742, P = 0.001) .Pearson linear correlation analysis showed the greater degree of decreased systolic pulmonary artery pressure after lung transplantation, the larger rate of increased postoperative left atrial diameter and left ventricular end diastolic diameter, and the bigger range of decreased postoperative LVEF (r = 0.642,0.737 and 0.448, P ＜ 0.05) .ConclusionIn early stage after lung transplant, right heart structure was normalization, right heart function improved,left heart enlarged, stroke volume increased, but left ventricular function reduced.There were a linear correlation between those changes and reduced systolic pulmonary artery pressure.

AIM: To investigate the effects of low-dose paclitaxel on the morphology of bladder after partial bladder outlet obstruction ( BOO) in rats.METHODS:Healthy female Sprague-Dawley rats ( n=30) were randomly di-vided into sham operation group, BOO group and low-dose paclitaxel group.The rats in BOO group and low-dose paclitaxel group received operation to establish an obstruction model, while the rats in sham group underwent sham operation.After operation, the rats in low-dose paclitaxel group received intraperitoneal injection of paclitaxel at a dose of 0.3 mg/kg twice a week for 4 weeks.At the same time, the animals in sham group and BOO group received the same volume of saline by in-traperitoneal injection.Four weeks after operation, each rat was sedated and the bladder was weighted.Histological chan-ges of the bladder were observed by HE staining.Collagen deposition in the bladder tissue was observed by Masson stai-ning, and the fibrosis area was measured.The ultrastructure of the detrusor was studied by transmission electron microsco-py.RESULTS:Compared with sham operation group, a significant increase in bladder weight (0.376 g ±0.052 g vs 0.112 g ±0.014 g, P<0.05), the muscle hypertrophy, and a decrease in the percentage of collagen area [collagen/(col-lagen+muscle), 29.66%±2.69%vs 38.94%±3.67%, P<0.05] was observed in BOO group.Under electron micro-scope, intracellular connection had more gap junction and desmosomes than intermediate junction.The cell gap widened with a large amount of collagen fiber.Compared with BOO group, low-dose paclitaxel group decreased bladder weight (0.215 g ±0.025 g vs 0.376 g ±0.052 g, P<0.05) and improved the muscle hypertrophy.The percentage of the colla-gen area was also decreased (19.94%±1.90% vs 29.66%±2.69%, P<0.05).The detrusor microstructure showed that the intermediate junction was characterized by a predominance among the intracellular connections, and the intercellu-lar space contained less collagen fibers in low-dose paclitaxel group.CONCLUSION:Low-dose paclitaxel may ameliorate the morphological damage of the bladder and recover bladder function in the rats with BOO by slowing down the process of bladder fibrosis.

Objective:To investigate the characteristics and significance of insulin-like growth factor 1(IGF- 1) and insulin-like growth factor binding protein 2 (IGFBP2) expressions in ankle cartilage of patients with Kashin-Beck disease (KBD).Methods:In this case-control study, 10 KBD patients who were hospitalized in the Department of Orthopedics of Shaanxi Provincial People's Hospital from January 2010 to December 2016 were selected as KBD group, and 10 patients with ankle fracture caused by trauma but without talus injury during the same period were selected as control group, the cartilage tissues of the two groups were collected. IGF-1, IGFBP2 positive cells, the mRNA and protein expressions of IGF-1, IGFBP2 in the cartilage tissues were detected by immunohistochemistry, real-time fluorescent quantitative PCR and Western blotting, respectively. According to the expressions of IGF-1 and IGFBP2 in ankle cartilage of KBD patients, a patient with amputation caused by trauma was selected in Shaanxi Provincial People's Hospital, and ankle joint cartilage was taken to prepare chondrocytes for in vitro cell verification experiments. The chondrocyte were divided into control group (0 ng/ml T-2 toxin), T-2 treatment group (20 ng/ml T-2 toxin) and T-2+ IGFBP2 silenced group (20 ng/ml T-2 toxin+ 50 nmol/L IGFBP2 siRNA), the MTT method and dimethyl methylene blue staining were used to detect the activity of chondrocyte and the secretion of sulfated glycosaminoglycan (sGAG). Results:In the control group and the KBD group, the number of IGF-1[(47.26 ± 8.97), (68.15 ± 7.42) cells] and IGFBP2 positive cells [(27.56 ± 5.40), (71.85 ± 7.62) cells] in the cartilage tissues were significantly different ( t = 4.487, 9.402, P < 0.01). Compared with the control group, the IGF-1, IGFBP2 mRNA and protein expression levels in KBD group were significantly higher, the differences were significantly different ( t = 3.340, 20.700, 4.684, 8.699, P < 0.05 or < 0.01). In cell experiment, the chondrocyte activitives and sGAG contents of the control group, T-2 treatment group, and T-2+ IGFBP2 silenced group were significantly different ( F = 226.70, 80.66, P < 0.01); among them, the cell activitives and sGAG contents of the T-2 treatment group and T-2+ IGFBP2 silenced group were lower than those of control group ( P < 0.05), and the T-2+ IGFBP2 silenced group were higher than those of the T-2 treatment group ( P < 0.05). Conclusions:The expressions of IGF-1 and IGFBP2 in the ankle cartilage of KBD patients are significantly higher. Silencing IGFBP2 gene can reduce the inhibitory effect of T-2 toxin on chondrocyte activity and the secretion of sGAG.

Objective To investigate the specific vessels signs in lung cancer by 64-slice spiral CT in first phase perfusion ima-ging so as to get more reasonable time about CT angiography .Methods Among the 47 cases ,there were 38 cases of central and 9 cases of peripheral primary lung cancer underwent 64-slice spiral CT in first phase perfusion imaging :one scan was obtained every 1 seconds during 8-38 seconds with 8 section × I without scanning interval after injection .Precontrast and postcontrast attenuation on every leisions was recorded ,to calculate the peak height(PH) and peak height time by time density curves TDC of pulmonary le-sions to aorta ,those reflect the the tumor feeding artery Imaging about lesions of lung cancer and inflammation .observed and calcu-lated the display rate and display time of lesions of lung cancer and inflammation .means of t test was used for statistics .Results a-bout the peak heights of in pulmonary artery and aorta phese ,statistically significant differences were found between inflammation and lung cancer(P<0 .05) .no statistically significant differences were found between central and peripheral lung cancer (P>0 .05) . about the peak heights time in aorta phase ,no statistically significant differences were found among three groups (P>0 .05) .The tumor vascularity were discoved in lesions in patients with lung cancer (44/47 cases ,93 .62% );The erosion narrow pulmonary ar-tery were discoved in central lung cancer (37/38 cases ,97 .37% ) ,in peripheral lung cancer(6/9 cases 66 .67% );no abnormal pulmo-nary artery were discoved only in 4 patients with lung cancer .Both tumor vascularity and abnormal pulmonary artery were most dis-plaied in 18-31s in CT angiography .Conclusion 64-slice spiral CT in first phase dynamic perfusion imaging can order completely show the specific vessels signs in lung cancer and reflect the tumor feeding artery Imaging of lung cancer .Analysising those benefi-ted to select reasonably the time of CT angiography and Improve the rate of lung cancer diagnosis .