This paper gave a dynamic analysis on the health resource allocation and utilization of Chongqing since it became a municipality,found out the extrusive problems existing in the health resource allocation and put forward some corresponding proposals,hoping to benefit the health administration on constituting regional health development planning.

Objective To investigate the risk factors of wound complications following the abdominal aorta balloon occlusion in order to provide the basis for the preoperative management and reduce postoperative complications.Methods Two hundred and sixty-one patients with the sacral tumor aged over 18 were selected as subjects who hospitalized at Peking University People's Hospital from January 2006 to December 2012.All subjects were underwent sacral tumor posterior resection operation after occlusion of the distal abdominal aorta.Patients were divided into two groups according to the existence of postoperative wound disorder.The general information of the patients was collected including intra-operative data and post-operative data.SPSS19.0 software was applied for statistic analysis Results Among 261 cases,89 cases were with incision complications,and the incidence of complications was 34.1％ (89/261).There was no significant difference regarding of age,weight,preoperative complications (P ＜ 0.05).Compared with that of no complications group,operation time of wound complications group was longer ((218.27 ± 72.08) min vs.(197.40 ± 53.92) min,P =0.046),and intra-operative bleeding was more ((2368.0 ± 1984.7) ml vs.(1701.6 ±958.8) ml,P =0.000),as well as a longer balloon occlusion time ((78.0 ± 23.8) rain vs.(65.2 ± 17.8) min,P =0.005).Moreover long hospitalized periods was in wound complications group ((47.6 ± 26.3) d,vs.(26.7 ± 9.0) d,P ＜ 0.05).Single factor analysis showed that the factors including operation time,intra-operative bleeding volume,time and times of balloon occlusion balloon occlusion were related to postoperative wound complications.Non conditional logistic regression analysis shows that factors of the balloon occlusion time(OR 1.028,95％ CI 1.012-1.045,P =0.001) and block number(OR 6.266,95％ CI 1.186-33.119,P =0.031) were related to the wound healing following balloon occlusion the abdominal aorta.Conclusion The risk factors of wound complications following the abdominal aorta balloon occlusion included occurrence balloon occlusion time and blocking times.That single balloon occlusion with 60 min reduced wound complication rate.

Objective To investigate the significance of anti-SmD1 antibody and other auto-antibod- ies in systemic lupus erythematosus(SLE).Methods Forty-four SLE patients and 136 other rheumatic dis- eases patients were studied.The later group included Sj(?)gren's syndrome,undifferentiated connective tissue disease,ankylosing spondylitis,and rheumatoid arthritis.Immunoblotting was used to measure,the anti-SmD1 antibody,ANuA and anti-SSA60 000 antibody.ANA and anti-dsDNA were detected by indirect immunofluo- rescence,immunodotting was used to measure the anti-Sin antibody.Results The seropositive rate of anti- StuD1 was 47.7% in SLE patients.It was much higher than that of anti-Sm(P

Objective To analyze the antiangiogenic effect of stereotatic radiosurgery (SRS) in rat C6 gliomas using MR perfusion imaging(PWI) technique. Methods Twenty rats implanted with C6 glioma cells in the brain were randomly assigned into group A (without any therapy) and group B which underwent SRS therapy 4 weeks after implantation. PWI was performed to measure the regional cerebral blood volume (rCBV) and regional cerebral blood flow (rCBF) in tumor's region before therapy in all rats and 1 week later in group B. PWI sequence was applied pre-and post--inhalation of a mixture of 10% CO_2 and 90% air. rCBV and rCBF were analyzed. PaCO_2 and blood PH values were monitored before and aftermixed gas inhalation. All the MRI examination were car-ried out at a 3.0T magnet. The rats were sacrificed after MRI examination. Microvessel density (MVD) and number of mature ves-sels (with muscle layer) were measured histologically using immunohistochemical staining for factorⅧ and smooth muscle actin (SMA). PWI data, and pathological results were analyzed statistically. Results The size of tumors in group B remarkably de-creased with obvious necrotic area in the center 1 week after SRS therapy. PH value decreased and PaCO_2 increased significantly af-ter mixed gas inhalation. Blood gas data changes in group B were not significantly different from that in group A. The rCBV and rCBF of tumor's core in group B declined greatly after SRS treatment. The necrotic area was dark in rCBV and rCBF maps, that suggested no blood supply in this region. After therapy, the changing rate of rCBV and rCBF pre-and post-inhalation of gas in group B was greater than those in group A. The MVD of tumors in group B after treatment was sta-tistically less than that in group A. The number of SMA positively stained vessels in group B was nearly equal to that in group A. The percentage of SMA(+)/MVD in group B was significantly higher than that in group A. Conclusion SRS can inhibit the angiogenesis of rat C6 glioma, however vessels with smooth muscle cells are insensitive to SRS.

Objective To investigate the efficacy of ultrasound?guided iliohypogastric∕ilioinguinal nerve block and transversus abdominis plane block for analgesia after cesarean section. Methods Ninety parturients, aged 20-40 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective cesarean section, were divided into 3 groups ( n=30 each) using a random number table:con?trol group (group C), ultrasound?guided iliohypogastric∕ilioinguinal nerve block group (group IH∕II) and ultrasound?guided transversus abdominis plane block group (group TAP). In IH∕II and TAP groups, bilat?eral ultrasound?guided iliohypogastric∕ilioinguinal nerve block and transversus abdominis plane block were performed after surgery, respectively, with 0.5% ropivacaine 1.5 mg∕kg ( the maximal dose 100 mg) plus dexamethasone 5 mg for each side. All the patients received patient?controlled intravenous analgesia with morphine after surgery, and numeric rating scales scores at rest and during movement were maintained<4 within the 48 h after surgery. The cumulative consumption of morphine was recorded at 6, 12, 24, 36 and 48 h after surgery. The occurrence of adverse reactions such as nausea, vomiting, pruritus, over?sedation and respiratory depression was observed and recorded in the analgesic period. Results Compared with group C, the cumulative consumption of morphine was significantly decreased at each time point in IH∕II and TAP groups ( P<0.01) . Compared with group IH∕II, no significant change was found in the cumulative consumption of morphine at 6 and 12 h after surgery, and the cumulative consumption of morphine was sig?nificantly increased at 24, 36 and 48 h after surgery in group TAP ( P<0.05) . No nausea, vomiting, pru?
ritus, over?sedation and respiratory depression was found in IH∕II and TAP groups. Conclusion For par?turients, ultrasound?guided iliohypogastric∕ilioinguinal nerve block and transversus abdominis plane block both can provide analgesic efficacy after cesarean section, and the efficacy of the former one is better.

Objective To examine the distribution of flurbiprofen axetil in cerebral-spinal fluid (CSF) by determining the CSF concentration of flurbiprofen after iv administration. Methods Seventy-two ASA Ⅰ or Ⅱ patients of both sexes aged 18-75 yr weighing 54-82 kg undergoing spinal or combined spinal-epidural anesthesia for lower extremity or lower abdominal surgery were studied. Flurbiprofen axetil 1 mg/kg was injected intravenously.CSF 2 ml and venous blood 3 ml were obtained simultaneously every 5 min after iv injection for 45 min (T1-9 ) for determination of flurbiprofen concentration using high performance liquid chromatography, and the CSF/blood flurbiprofen concentration ratio was caculated. Results Flurbiprofen was not detected in CSF at T1,2 after iv injection in 3 and 4 patients. The CSF flurbiprofen concentration was significantly higher at T4-9, and CSF/blood flubiprofen concentration ratio higher at T5-9 than at T3 ( P ＜ 0.05). There was no significant difference in CSF flurbiprofen concentrations among T4-9 ( P ＞ 0.05 ) Conclusion Flurbiprofen is detected in CSF after iv injection, the CSF flurbiprofen concentration peaks at 20 min after iv injection and it lasts until 45 min after iv injection.

Objective　To explore the relationship of defense style and mental health in student of middle school. Method 203 middle student were investigated with Defense Style Questionnaire (DSQ) and Symptom Check List-90 (SCL-90). Results There were no significant difference for 4 factors of DSQ in man／female and advance middle school or not(P>0.05); there were significant difference for immature defense mechanism and middle type factor ,and conceal factor in high-symptom score team with that of low-symptom sore team(P<0.01) and it is positive-correlation with each factor-score and total score of SCL-90. Conclusion School and family need to pay attention to the higher correlation in the total score of SCL-90 with immature defense mechanism and middle type factor and conceal factor.

Objective To evaluate four tumor markers of insulin-like growth factor 1((IGF-1), CEA, cytokeratin fragment antigen 21-1 (CYFRA21-1), neuron-specific enolase (NSE) for the diagnosis and prediction of treatment response in human lung cancer. Methods Serum samples were taken from three groups: 91 patients with lung cancer, 30 healthy adults and 15 patients with benign pulmonary diseases. Serum IGF-1 was assayed by radioimmunoassay and CEA, CYFRA21-1, and NSE by electrochemiluminescence immunoassay. The differences among the three groups were determined by Kruskal-Wallis one-way analysis of variance (ANOVA) and with Mann-Whitney rank-sum test. Diagnostic efficacy was evaluated by ROC curves. Results The four serum tumor marker levels were significantly higher in lung cancer group, as compared with the benign and the healthy (IGF-1:χ2=26.95,P<0.001, CEA:χ2=49.11,P<0.001; CYFRA21-1:χ2=40.63,P<0.001; NSE:χ2=14.76;P<0.001). The diagnostic sensitivities of IGF-1, CEA, CYFRA21-1 and NSE was 75.6% (34/45), 53.3% (24/45), 66.7% (30/45) and 42.2% (19/45) respectively for lung cancer. The diagnostic sensitivity of IGF-1 combined with CYFRA21-1 was 95.5 %( 43/45) and that of IGF-1 combined with CEA and CYFRA21-1was 97.8%(44/45). Only IGF-1 and CYFRA21-1 showed significant changes before and after treatment (IGF-1: χ2=5.99,P=0.014; CYFRA21-1:χ2=4.99, P=0.025) in cancer group. Conclusions Serum IGF-1, CEA, CYFRA21-1 and NSE are all valuable for lung cancer diagnosis and the combination of those parameters can enhance the diagnostic efficiency. Serum IGF-1 and CYFRA21-1 may also be useful for evaluating the treatment response in lung cancer.

Objective To explore effects of monitored anesthesia care (MAC) on gastrointestinal endoscopy.Methods All patients who underwent gastrointestinal endoscopy in Peking University People's Hospital from September 2010 to September 2015 were analyzed retrospectively and divided into two groups:the MAC group and control group by usage of MAC.Success rates of removal of foreign bodies by upper gastrointestinal endoscopy were compared between two groups during this period.Detection rates of ectopia of gastric mucosa in upper esophagus were compared between two groups from September 2014 to September 2015 when esophagogastroduodenoscopy was performed.The monthly cases of gastrointestinal endoscopies were compared between the two groups,which were separately collected from one MAC operating table and one routine operating table from September 2014 to September 2015.Results The success rate of removal of foreign bodies in the MAC group was higher than that in the control group (100.0％ VS 89.7％,x2 =11.737,P=0.001).The detection rate of ectopia of gastric mucosa in upper esophagus in the MAC group was higher than that in the control group(4.3％ VS 1.7％,x2 =58.751,P＜0.001).The monthly cases of gastrointestinal endoscopies in the MAC group was higher than that in the control group(350.2±36.2 cases VS 213.2±27.9 cases,t =17.591,P＜0.001).Conclusion The use of MAC for gastrointestinal endoscopy improves operating success rate,accuracy and operating time.MAC in gastrointestinal endoscopy can be recommended.

OBJECTIVE:To reduce errors in drug dispensing so as to improve the accuracy of drug use.METHODS:The application of bar code technology in both domestic and foreign counties was overviewed,the flow-sheet and the chief function of the “bar code checking program”for the drug dispensing developed in our hospital were introduced.RESULTS &CONCLUSION:Connecting “bar code checking program”to hospital information system in the drug dispensing and adding machine judgment procedures can reduce the occurrence of error while improving quality of drugs dispensing.