Objective: To analyze the capability to overcome the major outbreak of epidemics in different regions of China, it supports the future public health emergency management stratigies in theory and technology. Methods: Based on the data of 31 regions of China, it evaluates the social vulnerability of two major epidemics (SARS in 2003 and H1N1 influence in 2009) by using factor analysis method. Results: In the middle and eastern regions of China, social vulnerability is relatively low, and comparing to SARS in 2003, it decreases in 2009; while the western and southwesternregions are the opposite. Conclusion: Infrastructure construction of health institution, the cultivation of medical and health personnel and the development of commercial health insurance are the key factors to reduce social vulnerability and enhance the ability of emergency.

Objective:To investigate the effect of Matrine on inhibiting lipopolysaccharide( lipopolysaccharide ,LPS) -induced macrophages to secrete inflammatory cytokines,including tumor necrosis factor-α( TNF-α) ,leukocyte mediated element 1β( IL-1β) on Toll like receptor 4 ( TLR4 ) , c-jun expression. Methods: Cultured macrophage RAW264. 7 of mouse and divided into four groups, including blank control group,matrine group,LPS group,matrine intervention group. Incubated by the concentration was 100 μg/L LPS DMEM for 1 h,then the LPS was discard. Added free serum DMEM or 125. 25 mg/L matrine DMEM to culture. The cells and culture solution of 5,30,60,120 min after the treatment of the above four groups were collected respectively. Detected of mouse RAW264. 7 macrophage TLR4 and c-jun mRNA expression by PCR. Detected of mouse macrophage RAW264. 7 cells c-jun protein expression by immunocytochemical. Measured secretion in cultured solution of TNF-α and IL-1β by ELISA. Results:Expression TLR4 mRNA,c-jun mRNA and c-jun protein and TNF -α and IL-1β secretion quantity indexes of matrine induced and blank group had no statistical significant differences ( P>0. 05 ) . TLR4 mRNA, c-jun mRNA and c-jun protein expression secretion of and TNF-α and IL-1β LPS group at each time point were significantly higher than that of blank group,and the high level to maintain more than 2 h (P<0. 05);matrine intervention group could effectively inhibit LPS induced macrophage TLR4 mRNA,c-jun mRNA and c-jun protein expression and reduce the secretion of inflammatory cytokines TNF-α and IL-1β. Conclusion: Matrine may inhibit LPS induced macrophage mitogen activated protein kinase signal pathway of TLR4 and c-jun expression so that it can effectively reduce the end inflammatory cytokines TNF-α and IL-1β release,effectively inhibit the inflammatory reaction and reduce the degree of endotoxin inflammatory re-sponse.

OBJECTIVE:To analyze the risk factors,pathogens and drug sensitivity test of ventilator-associated pneumonia (VAP) in ICU. METHODS:A case-control study was conducted to analyze the clinical data of 190 patients receiving mechanical ventilatory support in ICU. RESULTS:The incidence of VAP in our hospital was 48.4%;elderly patients(>65 years),duration of mechanical ventilation(>5 d),use of corticosteroids,antacid drugs,indwelling stomach tube,and combined use of antibiotics were the risk factors of VAP;among the 162 pathogens,39 were Gram-positive bacteria(24.07%),102 were Gram-negative bacte-ria (62.96%),21 were fungi (12.96%);multi-drug resistance existed in most pathogens. CONCLUSIONS:A variety of factors are closely associated with the incidence of VAP;the main pathogens of VAP are Gram-negative bacteria;the phenomenon of multi-drug resistance is common. Some measures are adopted to decrease the incidence of VAP,such as strengthen monitoring of el-derly patients,to improve their immunity;use hormonal drugs reasonably;shorten the course of mechanical ventilation as much as possible,and plan ventilator removal;elevate the head of the bed and clean the oral for patients receiving gastric canal implantation and enteral nutrition;clean hands in accordance with asepsis principle strictly,and use antibacterials reasonalbly.

OBJECTIVE:To put forward some suggestion to improve drug bidding system in China.METHODS:The process of drug bidding system reform and its common problems were analyzed.Game theory and information asymmetry theory were adopted to analyze the root of the problems and to put forward suggestions.RESULTS:Governments indiscriminately expanded the goals of bidding policy and strengthen price factor.They neglected important steps such as logistics distribution.Current single evaluation system can not count the medication order exactly.Delayed received payment of medical institution resulted in many problems of drug purchase.CONCLUSION:Centralized drug bidding system should be improved and enhanced.It also should be connected with relevant medical system reform to standardize drug circulation channels,reduce drug price and reduce the burden of patient.

With the development of medical sciences, the concept of prevention and treatment of ischemic stroke is being updated continuously. However, there are still some gaps between the available evidence and clinical practice in its strategies of prevention and treatment. The article performs evidence-based analysis for the available evidence in the prevention and treatment of ischemic stroke in accordance with the scientific levels of evidence classification so as to narrow the gaps between the evidence in this field and clinical practice.

Air ; analysis ; Alkenes ; analysis ; Butadienes ; analysis ; Chromatography, Gas ; methods ; Environmental Monitoring ; methods ; Workplace

Objective To observe the effects of salmeterol/fluticasone on the bone metabolism and bone density of the patients with moderate COPD and whether the effects is relate with inhaled corticosteroid course. Methods Sixty pa-tients with COPD were divided into 2 groups by random digit table. Patients in experimental group (n=30) were given conven-tional therapy with salmeterol/fluticasone one inhale(bid) for continuously 12 months while patients in control group (N=30) were given conventional therapy without any glucocorticoid.The bone mineral density (BMD) of the femoral triangle in all patients were measured by DXA before therapy, 3 months and 12 months after therapy. At the same time, biochemical indi-cators that are correlated with bone metabolism include bone gla protein (BGP) and alkaline phosphatase (ALP) were mea-sured by radioimmunoassay. Results The BMD, BGP and ALP of patients in experimental group and in control group be-fore therapy, 3 month and 12 month after therapy were compared. There is no significant difference (P>0.05) between these two groups before therapy and after 3 month but significant difference was shown after 9 months (P<0.05). Conclusion Short period inhaling salmeterol/fluticasone in patients with COPD is safe. But long-term inhaling salmeterol/fluticason may lead to decline of the bone density in patients with COPD.

Objective To investigate the effects of Qili-Qiangxin capsule on cardiac and pulmonary functions in heart failure patients with chronic pulmonary heart disease. Methods A total of 64 heart failure patients with chronic pulmonary heart disease were divided into two groups with the method of random sampling: a treatment group (33 patients) and a control group (31 patients). The patients in the control group received conventional treatment, those in the control group received Qili-Qiangxin capsule on this basis the treatment group for 7 days. The changes of the cardiac and pulmonary functions, and plasma N-terminal pro B-type natriuretic peptide (NT-proBNP) were compared between two groups. Results The total effective rate in the treatment group was significantly higher than that of the control group (90.90% vs. 77.42%; χ2=3.908, P<0.05). There were significant difference between two groups in left ventricular ejection fraction (50.73% ± 7.23%vs. 45.22%± 6.36%;t=3.229, P=0.002), stroke volume (63.64 ± 8.38 ml vs. 56.73 ± 8.15 ml;t=3.341, P=0.001), right ventricular end-diastolic diameter (48.39 ±5.56 mm vs. 52.61 ± 6.95 mm; t=2.690, P=0.009), mean pulmonary arterial pressure (21.73 ± 5.78 mmHg vs. 27.26 ± 6.16 mmHg; t=3.705, P=0.001), plasma NT-proBNP level (535.73 ± 175.78 pg/ml vs. 831.26 ± 228.26 pg/ml; t=5.824, P=0.000), forced expiratory volume in first second (60.32% ± 5.56% vs. 48.61% ± 4.67%; t=9.093, P=0.000), percentage of forced expiratory volume in first second to forced vital capacity (66.73%± 5.78%vs. 58.26%± 5.34%;t=6.078, P=0.000), arterial oxygen saturation (96.73%± 5.78%vs. 93.26%± 5.26%;t=2.507, P=0.015), arterial partial pressure of oxygen (82.73 ± 16.78 mmHg vs. 67.26 ± 13.26 mmHg;t=4.075, P=0.000) arterial partial pressure of carbon dioxide (46.73 ± 8.78 mmHg vs. 54.26 ± 9.26 mmHg; t=3.339, P=0.00). Conclusion Qili-Qiangxin capsule can improve cardiac and pulmonary functions in heart failure patients with chronic pulmonary heart disease.

Objective To study the effect of dendritic cells(DC) stimulated with C5b-9 on allogenic lymphocytes. Methods DC was stimulated with C5b-9.CD4+ T and CD8+ T cells were isolated by magnetic-activated cell sorting (MACS),and were cocultivated with DC.The maturation markers and cytokine secretion of T cells were analyzed by flow cytometry and ELISA.Results The high pure CD4+ T and CD8+ T cells were separated successfully.After cocultivated with DC,the muturation markers CD25 and CD69 of CD4+ T were up-regulated by 26.31% and 52.73%,and IL-2 and IFN-? of CD4+ T cells were promoted from 126.3 ng?L-1 and 156.7 ng?L-1 to 409.2 ng?L-1 and 471.5 ng?L-1;the levels of IL-10 before and after coculture were 104.3 ng?L-1 and 107.1 ng?L-1.However these markers and cytokine secretion of CD8+ T were not influenced.Conclusion C5b-9 can adjust the function of DC and regulate the immuological response of T cells.

Objective To define a suitable and adequate sample volume for the detection of bacterial contamination in cord blood (CB) via BacT/ALERT system. Methods A total of 1 376 cord blood units were routinely screened for aerobic and anaerobic microorganisms by culturing the erythrocyte fraction(EF) or plasma fraction(PF) with 20 ml and 10 ml sample volume. The microbial contamination was detected by BacT/ALERT 3D system, and the results of this method were compared with the improved Martin/thiogly collate broth(22 ℃) and thioglycollate broth(35 ℃).Results The rates of positive BacT/ALERT results were 1.16%(10 ml) and 1.24%(20 ml) for PF, and 3.20%(20 ml) for EF. The positive rate of Martin/thiogly collate broth(22 ℃/35 ℃) was 1.00% for EF. Conclusion Using BacT/ALERT system for microbial detection in cord blood bank can enhance the security of umbilical cord blood transplantation.