Objective To evaluate the clinical safety and efficiency of applying 125I permanent-implant prostate brachytherapy (BRT) in elderly prostate cancer patient treatment.Methods From Jan.2007 to Dec.2011,23 elderly patients (age ≥75 years) with a diagnosis of localized prostate cancer were treated at our institution and then were evaluated retrospectively.The average age was 79.7 (ranged from 75-87) years.The average prostate volume was 52 (ranged from 35-78) ml.PSA level was 6.2±1.5 (ranged from 3.3 to 9.8) μg/L.Seven cases were in T1cN0M0,sixteen cases were in T2aN0M0.Five cases were with Gleason score of 4,two cases were with Gleason score of 5,sixteen cases were with Gleason score of 6.All patients received a single 125I permanent-implant brachytherapy with a total dosage of 145 Gy.Patients were stratified according to biochemical recurrence-free survival (bDFS),overall survival rate (OS) and complications.All the patients had not accepted anti-androgen therapy or external radiotherapy.Results The average followed up were 50 (ranged from 4 to 77) mon.After 3 months,the average serum PSA was 2.4±0.4(ranged from 0.9-3.8) μg/L,there was significant difference compared with that before treatment (P=0.003).After 1 years,the average serum PSA was 0.2-2.7 μg/L and 87％ (20/23) patient's PSA was less than 1 μg/L.2 cases had biochemical recurrence (bNED rate,91％).4 patients died,among them 1 patients died of prostate cancer.The overall survival rate was 83％,and the cancer-specific survival rate was 96％.Of the patients with urethral adverse effects,0-V adverse effect rates were 34.8％,43.5％,17.4％,4.3％,0 and 0.No serious complication such as rectal fistula occurred.Conclusions BRT is an effective and safe monotherapy in elderly prostate cancer patients.

Objective To evaluate the dynamic changes of T lymphocyte subsets in children with hand-foot-and-mouth disease(HFMD)and to provide new evidence for the therapy and prognosis.Methods Peripheral venous blood samples of 346 HFMD cases in acute stage who were hospitalized in Beijing Ditan Hospital from May 1,2008 to August 31,2008 were collected and T lymphocyte subsets were assayed by flow cytometer.Meanwhile,T lymphocyte subsets of 67 HFMD cases in recovery phase were also detected.The pathogens were determined by reverse transcriptionpolymerase chain reaction(RT-PCR)using pharynx swab samples from 99 cases.Different samples were compared by independent-sample t test,paired t test or variance analysis.Results The average levels of T lymphocyte subsets of HFMD children in different agc groups were all lower than reference levels of healthy children in according age groups.In severe cases.T lymphocyte(TL)/lymphocyte (L)ratio in all age groups,helper T cell(Th)/L ratio in children older than 1 year,TL,Th and Th/suppressor T cell(Ts)ratio in children of 1-2 years old were all lower than those in common eases (P＜0.05).The Th/L ratio tended to increase with the disease progression.Ratios of TL/L and Th/L in common cases were increased in recovery phase(TL/L:56.3±8.6 vs 61.1±9.1,t=2.56,P＜0.05;Th/L:30.2±7.2 vs 34.9±7.9,t=2.90,P＜0.05)and all indices of severe cases except Ts/Lratio and Th/Ts ratio increased apparently in recovery phase(P＜0.01).TL[(1.738±0.976)×10~6/Lvs(2.696±1.946)×10~6/L,t=2.17,P＜0.05],Th/L ratio(25.9±7.0 vs 30.2±7.2,t=2.34,P＜0.05),Th[(0.864±0.550)×10~6/L vs(1.459±0.879)×10~6/L,t=2.90,P＜0.01]and L[(3.352±1.458)×10~6/L vs(4.664±2.435)×10~6/L,t=2.32,P＜0.05]of severe cases in acute phase were all lower than those of common cases(P＜0.05),while those were not significantly different in recovery phase between two groups(P＞0.05).The T lymphocyte subsets of enterovirus(EV)71 positive cases were lower than EVT1 negative cases,but there was no significant difference between these two groups(P＞0.05).Conclusion T lymphocyte immune responses may be correlated with HFMD onset and progression.

Clinics are a main institutional form for doctors to open personal business in China .The develop-ment process of clinic reflects the situation of medical staff free practice .This study summarized the supervision poli-cies on clinic in China since the founding of China and got three conclusions .The first one was the attitude of the practice of the clinic has changed significantly .The change include four stages which were authorization ( 1949—1957 ) , limitations ( 1958—1977 ) , re-authorization ( 1978—1996 ) , promotion and encourage ( 1997—) along with macroeconomic system reform and the changes of government's governance ideas on health sector .The second conclu-sion was that the government gradually raised awareness of the status and role of the clinic institutions in the health system over the past several decades .The third conclusion was the supervision policies became more meticulous .In the future , clinical institutions can be a useful supplement to public medical institutions in China for its development process and characteristics .

Objective:To understand the current situation and problems of the supervision of individual clinics in China , and put forward some reform suggestions .Methods:Two cities were selected from typical provinces in east-ern, central and western regions by typical sampling .The investigation was conducted by semi-structured interviews and typical clinic participant observation method .Results:There were serious problems in the regulation of the pri-vate clinics and it was necessary to build efficient regulation mechanism .Conclusions:We should strengthen the su-pervision of private clinics .In the future , we should improve the access threshold for the private clinic; strengthen inter-sector cooperation and joint law enforcement; promote information exchange and information network construc-tion;use economic incentives and punitive measures at the same time and make the association itself and social su -pervision work .

Objective: To evaluate the health risk of drinking water in Ningbo City, Zhejiang Province from 2021 to 2022, so as to provide insights into ensuring the safety of drinking water. Methods: The monitoring data of drinking water from 2021 to 2022 in Ningbo City were collected from the Chinese Disease Prevention and Control Information System. The routine indicators and disinfectant indicators (radioactivity indicators were excluded) of drinking water were evaluated according to the reference limits issued by Standards for Drinking Water Quality (GB 5749-2006), and the qualification rates were calculated. The indicators with detection rate higher than 50% were selected, and assessed the carcinogenic and non-carcinogenic risks via drinking water using the risk assessment model recommended by the United States Environmental Protection Agency. Results: A total of 1 678 samples were monitored in Ningbo City from 2021 to 2022. Sodium hypochlorite was the main disinfectant among 1 558 samples from centralized water supply (1 079 samples, 64.30%), and none of the 120 samples from decentralized water supply underwent disinfection treatment. The qualification rate of 88.38%, and the pollutants with a detection rate higher than 50% were nitrate, fluoride, trichloromethane and aluminum. The median carcinogenic risk value of trichloromethane was 2.964×10-6 (interquartile range, 3.909×10-6), and the median hazard quotient values of nitrate, fluoride, trichloromethane and aluminum were 1.631×10-2 (interquartile range, 1.361×10-2), 3.955×10-2 (3.164×10-2), 2.231×10-2 (2.942×10-2) and 2.136×10-4 (6.573×10-4), respectively. Conclusion The carcinogenic and non-carcinogenic risks through drinking water for 17 pollutants in drinking water of Ningbo City from 2021 to 2022 were at low levels.

n positive blood culture, and they are resistant to a variety of antimicrobial agents, which should be called attention.

OBJECTIVE:To investigate the effects of Compound changpu yizhi decoction combined with nimodipine on clini-cal symptoms,cognitive function and cerebral blood flow velocity of patients with mild cognitive impairment(MCI)after stroke, and its medication safety. METHODS:84 MCI patients after stroke in our hospital from Feb. 2012 to Oct. 2014 were selected as re-search objects and randomly divided into observation group and control group,42 cases in each group. All patients received basic preventive treatment;control group was additionally given Nimodipine tablet 30 mg,tid,po;based on it,observation group was given Compound changpu yizhi decoction,one dose a day,taking with warm water every morning and evening. They were treated for 3 months. Clinical symptoms of patients were compared by vascular dementia TCM syndrome table before and after treatment, mini-mental state examination(MMSE)was used to compare the cognitive function of patients before and after treatment,cerebral blood flow velocity before and after treatment and incidence of adverse reactions in 2 groups were compared. RESULTS:Before treatment,there was no statistical significance in clinical symptom scores,cognitive function score and blood flow velocity of main artery between 2 groups(P>0.05). Clinical symptom scores of 2 groups were decreased significantly,while cognitive function and cerebral blood flow velocity were increased significantly;there was statistical significance,compared to before treatment (P<0.05). Memory scores,pain scores,complexion scores,tongue scores,pulse scores,additional scores and total scores in observa-tion group were obviously lower than control group;orientation ability scores,recall ability scores,language skills scores and com-prehensive cognitive function scores in observation group were obviously higher than control group;blood flow velocities of anteri-or cerebral artery,middle cerebral artery,posterior cerebral artery,vertebral artery and basilar artery in observation group were obvi-ously faster than control group,with statistical significances(P<0.05). The incidence of ADR in observation group and contral group were 11.90%and 9.52%,there was no statistical significance between 2 groups(P>0.05). CONCLUSIONS:Compound changpu yi-zhi decoction combined with nimodipine helps to relieve clinical symptoms of MCI patients after stroke,improve cerebral blood circulation and cognitive function,with good safety.

Objective To learn the recent development and regional distribution of clinics in China.Methods Based on statistics and a nationwide survey of clinics in the country,a simple linear regression was made to find factors determining clinics regional distribution.Results Clinics in China were found to have grown sizably from 134 000 in 2008 to 155 000 in 2014;medical technology workers to 2.31 per clinic in 2014;and the total revenue of these clinics accounted for only 0.724% of all medical institutions,while there are more clinics in the east than the west regions in China.Conclusions The role of clinics in attracting high quality medical resources to primary care should be further enhanced for development of the hierarchical medical system in China.

Objective To observe the efficacy and prognosis of recombinant human brain natriuretic peptide ( rhBNP) and conventional treatment in acute myocardial infarction patients undergoing percutaneous coronary intervention therapy complicated by acute of left heart failure. Methods Retrospective analysis of 229 cases of hospitalized patients with acute myocardial infarction undergoing percutaneous coronary intervention therapy in 24 hours after admission, complicating with acute left ventricular failure in Shenyang Military General Hospital from June 2012 to January 2014 were enrolled and devided into: the conventional heart failure therapy group (the control group, n=122) and the rhBNP plus conventional treatment group ( the treatment group, n =107 ) , according to the patient's economic conditions and wishes. Observed improvement in heart failure symptoms before and after treatment during hospitalization and follow-up and also the 30 days and 12 months mortality. Results After 72 hrs of treatment of heart failure, both groups had decrease in heart rates, systolic blood pressure and NT-proBNP levels as compared to pre-treatment levels ( all P ﹤ 0. 05 ) . The NT-proBNP levels and heart rate of the treatment group decreased more significantly compared to the control group (both P﹤0. 05). Compared with the control group, rhBNP which to be used 72 hrs, can improve the cardiac function of AMI patients with the ratio of KillipⅡ-Ⅲ(72. 9%vs. 54. 9%, P=0. 005). There was no significant differences between two groups in in-hospital mortality and early follow-up period ( 30 days ) ( P ﹥0. 05 ) . After 12 months of follow-up, the mortality of the treatment group was lower than the control group ( 6. 5% vs. 13. 9%, P = 0. 068 ) . Through logistic regression analysis, the value of NT-proBNP and whether patients were treated with rhBNP on the basis of the routine drug were independent influencing factors for mortality of 12 months. Conclusions Additional to standard conventional therapy for acute left heart failure in patients with acute myocardial infarction undergoing PCI, rhBNP can lower the 12 months mortality and improve prognosis.

Purpose:To discuss the function of Gd-BOPTA on the deferment of manifestation of MRI,which bring influence to the immune mensuration of antigen PCNA,PTEN.Materials and Methods:Scanning with MRI on the 35 patients with pathologically verified HCC the image were analyzed concretely.Pathologic diagnose was made with Edmondson pathologic classification standard,and it was expressed with index of PCNA and PTEN of immune quantitative analysis.Results: HCC was negatively related to the index of PCNA,and most patients with high index were lightly or not deferred enhanced(13/16),Patients with low index were evidently enhanced ( 10/19).The degree of HCC deferred enhancing was positively related to the expression of PTEN.Most HCCs( 15/17) with negative PTEN were lightly or not deferred enhanced,while positive patients of PTEN were mostly enhanced obviously(11/18).Conclusion: Deferment of Gd-BOPTA can be used to basically estimate the tincture of tumor biology,therefore,the enhanced degree of which,the PCNA,PTEN,can offer great help in choosing the therapuetic method and estimating the outcome of the the therapy.