Objective To assess willingness to pay(wtp)for typhoid vi vaccine in typhoid epidemic area in Guangxi Zhuang Autonomous Region and to provide evidence for introduction of the vaccine.Methods Applying the method of wtp was investigated in typhoid epidemic area,the curve of "price-accept ratio model"was drawn up with Probit regression.Results The formula of "price-accept ratio model" was described as following:Probit(p)=0.88952-0.46296X.The WTP for typhoid vi vaccine was $10.41,with a 95% confidence interval of $6.67～16.24.Conclusions WTP for typhoid vi vaccine was around $10 in Guangxi typhoid epidemic area.The Contingent Valuation Method was applicable in the investigation of WTP.

Objective To observe the effects of phlorohlucinol on cervical dilatation. Methods Totaling 250 normal parturients were randomized into four study groups (50 in each group) and control group (n=50). Phloroglucinol was given in the study groups(group1,2,3 and 4)at the dose of 40 mg to the cervix and/or 160 mg and 200 mg intravenously during the latent phase. The control group (group1) received only atropine (0.5 mg) intravenously. Results The overall speed of cervical dilatation in the study group was (2.82?1.82) cm/h and (1.78?1.01) cm/h in the control group. The mean time of the first stage of labor was (14.23?1.11) h and (17.71?2.23) h in the study and control group, respectively (P

Objective To evaluate the different effect of 50 g glucose challenge test (GCT) on screening the glucose intolerance at different gestational age. Methods Two thousand pregnant women were divided into 2 groups(1000 in each). Women in group A received 50 g GCT at 14 and 28 gestational weeks respectively and 75 g oral glucose tolerance test (OGTT) were performed in those cases with abnormal 50 g GCT. 50 g GCT was performed after fasting at 14 gestational weeks and repeated one hour after a meal at 28 gestational weeks. Women in group B were screened by 50 g GCT at 28 gestational weeks and followed by 75 g OGTT for those with abnormal 50 g GCT. The diagnostic effect of 50 g GCT for screening at different weeks of gestation with different ways was evaluated. Results (1)The rate of abnormal result of 50 g GCT was higher in fasting cases than that of cases testing after meal (15.6% vs 12.2%, P

Objective To observe the effects of diazepam on the cervix in relieving spasm, eliminating edema and improving dilation during the latent phase of labor. Methods One hundred normal parturients were randomly devided into study group ( n =50) and control group ( n =50). The study group was injected diazepam 10 mg in the cervix during the latent phase. The control group was given 10 mg of diazepam by intravenous injection. Results The dilating speed of cervix in study group was 2.81?1.92 cm/h. The mean time of the first stage of labor was 11.13?1.21 h, while the control group was 1.98?0.92 cm/h and 13.34?0.44 h respectively. The differences between two groups were statistically significant ( P

Objective To investigate the protective effect of ǎn soup of Miao nationality on the intestinal barrier function in rats with acute liver failure ,in order to provide effective diet measures for hepatic failure patients .Methods A total of 50 male SD rats were randomly assigned to five groups :control group(group A) ,acute liver failure model group(group B) ,Bifidobacterium tri‐ple probiotics group(group C) ,high‐doseǎn soup group(group D) and low‐doseǎn soup group(E) ,10 cases in each group .The last four groups were subjected to the acute liver failure model by hypodermic injection with thioacetamide twice .In addition ,the last three groups were respectively intragastrically perfused with Bifidobacterium triple probiotics ,6 mL of ǎn soup and 1 .5 mL of ǎn soup before and during building the acute liver failure model .28 hours after the second injection ,femoral arterial blood to was drew to test serum endotoxin(ETX) ,diamine oxidase(DAO) ,D(‐)‐lactate(D‐lac) ,alanine aminotransferase (ALT) and aspartate amin‐otransferase(AST) .At the same time ,hepatic tissue and ileal tissue within 3 cm away from the ileocecal region were collected to do pathological examination .Results Pathological examination results showed that hepatic cord in hepar arranged mussily ,hepatic lob‐ules structure disordered ,hepatocyte focal necrosis or with large necrotic areas in which a large number of inflammatory cell infiltra‐tion in the acute liver failure model group .The pathology damage of liver in the other groups was almost in the same extent .The ile‐um mucosa in the group A was morphologically intact with clear structure of villi and lined up ,while that of group B was disorder with sparse villi ,epithelial cells in different degree of loss ,missing and necrosis ,lamina propria obviously hyperemia and there were large amount of inflammatory cellular infiltration .Intestinal mucosa injury in the other intervention groups was lighter than that in the group B .In particular ,levels of serum ETX ,D‐Lac ,DAO ,ALT and AST in the group B and other intervention groups were sig‐nificantly higher than that in the group A(P<0 .01) .Compared to the group B ,levels of serum ETX ,D‐lac ,DAO ,ALT and AST in other intervention groups were decreased to various degrees ,and there was significant difference between group B ,group C and group D(P<0 .01) ,and there was no significant difference between group B and group E (P>0 .05) .However ,there was no signif‐icant difference between group C and group D (P>0 .05) ,when obvious difference was observed between group C and group E(P<0 .05) .There was significant difference between group E and roup D (P<0 .05) .Conclusion Results demonstrated that ǎn soup protected intestinal barrier function of acute liver failure rats by reducing the production and release of serum endotoxin content in liver failure rats ,lowering intestinal endotoxemia (IETM ) ,which seems to prevent subsequent liver injury caused by IETM and have certain dietotherapy effect on liver failure .

Objective To investigate the clinical significance and safety of liquid-based cytology (thinprep cytologic test, TCT ) in pregnant women and cytological characteristics of the smears during pregnancy. Methods TCT were performed in 1951 pregnant women (group A), 3752 gynecological out-patients(group B)and 5069 routine screening women (group C ). The age of the women was ranged from 20 to 39 years. The cytological preparations were analyzed using TCT method following the Bathesda system (TBS) standard. Results (1) The incidence of abnormal epithelial patterns in groups A, B and C was 23.58%(460/1951), 19.22%(721/3752) and 13.40%(679/5069) respectively (P0.05). Conclusions TCT smear screening is necessary, safe and acceptable for routine prenatal tests. There is no difference in the cervical squamous intraepithelial lesions between pregnant and non-pregnant women.

Objective To investigate the correlation between acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) scores and delirium probability of senile severe pneumonia patients undergoing invasive mechanical ventilation (MV).Methods A retrospective study was conducted. Eighty-nine senile severe pneumonia patients undergoing invasive MV admitted to intensive care unit (ICU) of Hunan Provincial People's Hospital from January 2015 to March 2017 were enrolled. APACHE Ⅱ scores were collected 24 hours before invasive MV. Consciousness assessment method-ICU (CAM-ICU) was used to diagnose delirium, and the patients were divided into delirium group and non-delirium group. The first delirium occurrence time, duration of MV and the length of ICU stay were recorded. The patients were divided into ≤15, 16-20, 21-25, 26-30, 31-35, 36-40 groups according to APACHEⅡ score, and the incidence of delirium in all groups were observed. The linear regression and Pearson correlation were used to analyze the correlation between APACHE Ⅱ scores and delirium probability. Receiver operating characteristic (ROC) curve was plotted to analyze the predictive effect of APACHEⅡ score on delirium.Results Eighty-nine patients were enrolled in the final analysis, of which 35 had delirium, and 54 had no delirium, with delirium incidence of 39.33%, and the first delirium occurrence time of (1.85±1.30) days. The duration of MV and the length of ICU stay of delirium group were significantly higher than those of non-delirium group [duration of MV (days): 9.43±4.77 vs. 6.08±3.30, length of ICU stay (days): 14.60±6.59 vs. 9.69±4.61, bothP < 0.01]. The APACHE Ⅱ score in delirium group was significantly higher than that in non-delirium group (29.89±5.45 vs. 21.48±4.76,P < 0.01). With the increase in APACHE Ⅱ scores, the delirium incidence was gradually increased. Correlation analysis showed that there was a negative correlation between APACHE Ⅱ scores and first delirium occurrence time (r = -0.411,P = 0.014), and a significant linear positive correlation between APACHE Ⅱ scores and delirium incidence in all patients was found (r = 0.982, P = 0.000), which indicated the higher APACHE Ⅱ scores, the higher delirium incidences and the earlier first delirium occurrence time was. ROC curve analysis showed that the area under ROC curve (AUC) of APACHE Ⅱ scores on predicting delirium occurrence was 0.877, when the cut-off value of APACHE Ⅱ score was over 27, the sensitivity was 92.59%, the specificity was 71.43%, the positive predictive value was 83.33%, and the negative predictive value was 86.21%.Conclusions With the increase in APACHE Ⅱ score, the incidence of delirium was increased gradually in senile severe pneumonia patients receiving invasive MV. APACHE Ⅱ score played an important clinical value in evaluating the delirium probability of these patients

BACKGROUND: According to up-to-date development, the best timing to repair cleft palateis at 9-12 months old after birth when the articulation does not begin to develop.However, there are many over-eight-year-old children who still suffer from unrepaired cleft palate. Therefore, it is veryimportant to adopt proper surgery for these patients to improve palate form and articulatory function. OBJECTIVE: To study the characteristics of the cleft palate in patients of over 8 years old and the effects of palate repair and posterior pharyngeal flap transplantation (PPFT) on articulation. DESIGN:A controlled study with children patients as subjects. SETTING: Department of Maxillofacial Surgery, Medical College of Stomatology, Fourth Military Medical University of Chinese PLA PARTICIPANTS: Twenty-four children patients of cleft palate who were treated in the Department of Maxillofacial Surgery ,Medical College of Stomatology, Fourth Military Medical University of Chinese PLA from January 2000 through December 2003 were enrolled in the study. Fourteen were male and ten female. Their ages varied from 8 to 20 years old (mean 13.8 years). Three cases were bilateral complete cleft palate and twelve cases were unilateral complete cleft palate. Nine were incomplete cleft palate. METHODS :Two flap palatoplasty and upper pedicle PPFT were conducted in all the patients. In thirty days after surgical treatment, the patients were asked to repeat the words of a doctor in the phonetic lab with his or her lips 10 cm away from microphone. The words of the patients were recorded and evaluated subjectively by 5 doctors specialized in pathologic phones. MAIN OUTCOME MEASURES :The palatopharynx was observed with nasopharyngoscope before and after operation. And the improvement of nasal gas leakage and enhanced rhinophonia were also evaluated. RESULTS: The repaired cleft palate was healed in the first intention in all the patients. The soft palate retreated satisfactorily and the palatopharynx was apparently closed, which created good preconditions for articulation. The patients' articulation was also improved in different degrees. All the 24 patients had the fourth grade of enhanced rhinophonia and nasal gas leakage before repairing. After palate repair and PPFT, the enhanced rhinophonia and nasal gas leakage of grade 1 was in 3 patients, grade 2 in seven, grade 3 in six and grade 4 in eight patients. CONCLUSION: The combination of palate repair and pharyngoplasty is able to improve the form of soft palate and the articulation of over-eightyear-old patients with cleft palate.

Objective To evaluate the value of intraduetal ultrasonography (IDUS) in diagnosing biliary and pancreatic disorders. Methods The findings by endoscopic retrograde cholangiopancreatography (ERCP) and IDUS from 19 patients with suspected biliary and pancreatic disorders from July 2006 to August 2007 in our hospital were analyzed retrospectively. Results Of the 19 patients, 17 had obstructive jaundice (including 6 eases of cholangiocarcinoma, 2 pancreatic adenocareinoma, 2 gallbladder carcinoma, 2 chole-docholithiasis with bile duct stricture, 2 autoimmune pancreatitis, 1 papillary adenocarcinoma, 1 papillary adenoma, and 1 sclerosing cholangitis) and 2 intraduetal papillary mueinous tumor (IPMT). The diagnosis was confirmed by surgery and pathological findings in 11 patients. The diagnostic accuracy of ERCP and IDUS was 73. 7% (14/19) and 84. 2% (16/19), respectively, and that of ERCP combined with IDUS was 89. 5% (17/19). The sensitivity and specificity of ERCP to differentiate benign bile duct strictures from ma-lignant ones were 100. 0% (11/11) and 83.3% (5/6), respectively; and those of IDUS were 100. 0%(11/11) and 100. 0% (6/6), respectively. The sensitivity and specificity of ERCP in diagnosing cholan-gioeareinoma were 83.3% (5/6) and 60% (3/5), respectively; and those of IDUS were 100. 0% (6/6) and 40. 0% (2/5), respectively. Conclusion Combination of ERCP with IDUS can improve the diagnostic accuracy of pancreaticobiliary disorders. Additionally, IDUS shows higher sensitivity and specificity in differ-entiation between benign and malignant bile duct strictures, but it is still difficult to identify the etiologic factors of malignant bile duet strictures by IDUS.

Objective:To establish a new method of designing and fabricating a facial simulation model of infant cleft lip for lip repair simulation and surgery teaching. Methods: Using latest three-dimensional scanning, reversed engineering and rapid prototyping techniques to fulfill the individual design and rapid auto-manufacture for the facial model of the cleft lip infants. With the new chromatosis technique and special silicone material of Maxillofacial Prosthetics the simulative face of infant cleft lip were fabricated. The new simulation model was used for lip repair surgery teaching. Results: The vivid faical data was successfully acquired by scanner and then designed by software. The solid plastic partern of patient's face was fabricated by machine, which was eventually replaced by maxillofaical silicon. The surgeon applied it for pre-surgery simulation and surgery teaching. Conclusion: This study successfully designed and fabricated the new simulation model of cleft lip infant's face, which can be a ideal training model for lip repair surgery teaching.