After reading and analyzing Shi Re Bing Pian,Xue Shengbai's methods of dampness-eliminating in damp-heat diseases,such as ventilating dampness,resolving dampness,drying dampness and removing dampness,were discovered.The way he establishing therapeutic methods has great instructional meaning in clinical treatment of traditional Chinese medicine.

Objective To probe into the health expenditure and medical expenditure of Chinese people in rural and urban areas as objective references to improve the funding strategy of China's health care system. Methods Statistics annuals from 1999 to 2007 were called into play to analyze the status quo and trends of both expenditures. Results Definite proportion of funds raised for rural and urban health expenditure has grown by 200%;a distinct gap exists between the growth of per-capita medical expenditure in rural and urban residents (152. 86% in urban and 172. 77% in rural areas);medical expenditure maintains a steady growth along with rising per-capita income, yet the health consumption remains at a low level in general, especially among rural residents;since 2003, the income elasticity of the medical expenditure among rural residents keeps rising, narrowing the relative gap with urban residents. Conclusion It is recommended to push up the income of rural residents with greater resources, and to encourage the trend of marginal social medical expenditure. In addition, it is necessary to upgrade medical services, expand medical service coverage, and encourage reasonable consumption of medical services by both rural and urban residents;and to focus the role of cultural factors for greater awareness of the people in health investment and self-healthcare.

HP450 has thecharacteristic of cytochrome P450 and sensitivity to antihistmine drugs.With distinct raiiable regularity in the diverse disease modes of the rat,and some relativity to the development of liver disease,the expression and transcription of the HP450s gene have all changed in the course of the liver cancer. HP450 is possibly regarded as a new index of diagnosing liver cancer and a new target site of preventing and treating liver cancer

Objective To study the influence of BiPAP on lipid level in patients with chronic heart failure of coronary heart disease.Methods 20 patients with chronic heart failure of coronary heart disease were taken BiPAP:Blood samples were taken from forearm vein before and 4 weeks and 12 weeks after treatment,the lipid level was measured and compared.Results The observation group of The coronary heart disease with chronic heart failure in pre-treatment serum level of total cholesterol(TC)(7.47±0.12)mmol/L,triglycerides(TG)(3.52±0.13)mmol/L,low-density lipoprotein cholesterol(LDLc)(3.73 ±0.11)nmmol/L,apolipoprotein-B(Apo-B)(1.37±0.02)g/Lwere significantly lower than 14 weeks after treatment TC(4.5±0.03)mmol/L,TG(2.6±0.02)mmol/L,LDLc(2.8±0.06)mmol/L,Apo-B(1.02±0.02)g/L)(t=2.154,t=2.278,t=2.311,t=2.347,P all<0.05) in coronary heart disease with chronic heart failure;The observation group after treatment 14 weeks of HDL-CH(1.45±0.02)mmol/Land Apo-A(1.21±0.03)g/L lower than before treatment HDLc(1.05±0.01)mmol/L,Apo-A(0.87±0.01)g/L(t=2.234,t=2.318,P all<0.05) in coronary heart disease with chronic heart failure.Conclusion BiPAP therapy could effectively to ameliorate lipid metabolism in patients with chronic heart failure of coronary heartdisease in the long term.

Objective To investigate the causes and influencing factors of dead on arrival (DOA) in children.Methods The clinic data from 66 children with DOA admitted in the emergency department of Hunan Children's Hospital from Jan 2010 to Apr 2012 were analyzed retrospectively.Results All of the 66 cases had cardiac respiratory arrest when admission.Fourteen cases had arrest for 10 minutes,12 cases for 30 minutes to an hour,40 cases had no details.Forty-four (68.2％) cases were carried by parents,22(31.8％)cases were transferred by medical professionals.The main causes of DOA were severe pneumonia with respiratory failure and (or) heart failure,intracranial infection,neonatal diseases.All cases were taken to resuscitation room by triage immediately.Tracheal intubations were completed in 48 cases and intravenous access with injection of epinephrine and other resuscitative drugs were established in all cases,but all cases were dead due to breathing and heartbeat stopped for a long time.Conclusion DOA is one of the important reasons for pediatric high-risk.The key of reduction of DOA incidence and improvement of survival rate is to improve pediatric emergency medical service system,strengthen the health education for the parents,to carry out training and establish homogenization service in emergency ICU.

Objective: To observe the influence of scalp acupuncture plus point injection on intelligence quotient in microcephaly children. Methods: Twenty-five children with microcephaly were treated by scalp acupuncture as main therapy plus point injection. The children's intelligence was tested by China-Wechsler's intelligence scale before and after treatment. Results and Conclusion: Acupuncture can improve intelligence and especially has significant effect on verbal intelligence quotient in microcephaly children.

Objective To observe the clinical curative effect of chronic heart failure (CHF) treated by noninvasive positive pressure ventilation ( NPPV). Methods 48 cases of CHF were randomly assigned to conventional drug treatment under oxygen (control group, n = 24) and non-invasive positive pressure ventilation ( NPPV) under the conventional therapy group (observation group, n =24). The plasma N-brain natriuretic peptide( proN-BNP) and cardiac function changes in two groups before and after treatment were observed. Results The total effective rate 92% in observation group was significantly higher than 66% in control group ( x2 =3. 7851, P ＜ 0. 05 ) ; The plasma proNBNP、respiratory rate and heart rate after treatment in two groups were lower than before treatment(t = 2.787,2.815, 2. 856,2.789,2.804,2.840,all P＜0.01) ;The plasma proN-BNPand heart rate in observation group after treatment were lower than the control group(t =2.123,2.221,all P ＜0.05). Conclusion Noninvasive positive pressure ventilation could significantly improve heart function,reduce plasma proN-BNP and enharce curative effect.

Objective To study a simple, safe and effective way in correction of prominent mandibular angle. Methods Curved osteotomy was employed for prominent mandibular angle through intra and extra oral approach with a small incision in 20 cases.Partial masseter resection was performed simutaneously in 5 cases with masseter hypertrophy, buccal fat pads were resected in 3 cases with broad faces, and genioplasty were performed in 3 cases with micrognathia. Nine cases only suffering from prominent mandibular angle were underwent curved osteotomy reconstruction. Results A series of 20 cases was followed up from six months to six years, in which 95 % was satisfactory.Conclusion The advantages of this method are simple, safe and symmetric with better result. It is easy to dissect under periosteum and perform curved osteotomy with less complication, quick recovery, and better contouring.

Purpose:To analyse the dosimetric parameters measured by the silicon diode, and to describe the features of the dose distributions for small fields.Materials and Methods:P-type silicon diode with small volune and high sensitivity was chosen to measure the PDD,OAR and Sc,p at isocenter for circular fields of 5mm ～50mm in diameter used for stereotactic irradiation .The dosimetric data measured are evaluated by comparising with ones by other methods, such as ionization chamber and films,and ones in literature.Results:The values PDD of 10 and 30 fields at depth from 5cm～20cm are almost the same as those in reference 7 within ?0.6; The effective linear attenuation coefficient extrapolated to zero fiels size is 0.0510cm -1 for 6MV-X rays. The Sc,p value measured by diode and chamber(NE2571) are agread each other within variations of ?0.4% for large field size, but a great difference appears when the field size is 2 times smaller than the diameter of chamber. The Sc,p values by diode for field size of 12.5mm～27.5mm are agreed well with the results by Monte Carlo calculations. The OARs measured by diode are ageed well within 1mm with ones by films developed by ourself. The penumbras(90%～10%) measured by diode are coincidence with the results published.Conclusion:Due to the high dose gradients at the beam edge and the absence of lateral electron equilibrium for the smaller fields, the detector size and positioning are the most impostant factors influenced the measured results. Our practice shows that the silicon diode with diameter of 2mm or smaller is the best choice for the dosimetric date collection for beams used in X-ray stereotactic irradiation.

OBJECTIVETo study the value of Pentraxin 3 (PTX3) in diagnosing the severity and cardiovascular function of the critically ill children. Method A total of 178 patients who were older than 28 days, with acute infection of respiratory or neurological system, excluding chronic or special disease, and admitted to the pediatric intensive care unit (PICU) of Hunan Children's Hospital from October 1, 2013 to April 30, 2014 were enrolled, including 102 male cases and 76 female cases. The ages ranged from 1 month to 13 years and 1 month, 78 of them were less than 1 year old ; 58 cases were between 1 to 3 years old; 42 cases were above 3 years old; 101 cases were diagnosed as respiratory system diseases, 77 cases had nervous system diseases. PTX3 was detected with enzyme-linked immunosorbent assay (ELISA) within 1 d after enrollment, at 3 days and 7 days, meanwhile, troponin, myocardial enzyme, brain-type natriuretic peptide (BNP), C-reactive protein (CRP), plasma calcitonin (PCT) and WBC etc. Were measured. According to the plasma PTX3 value which were measured within 24 h after enrollment the patients were divided into three groups: mildly elevated group (< 44 µg/L) 41 cases; moderately elevated group (44 - < 132 µg/L) in 66 cases; severely elevated group 71 cases (132 µg/L or higher). Those 178 patients were divided into 3 groups according to the degree of infection: non-sepsis group (78 cases), sepsis group (70 cases), severe sepsis group (30 cases), and in each group, those with heart failure were respectively 19 cases, 28 cases, 17 cases. Analysis of the plasma PTX3 expression changes in different clinical manifestations, different condition, different degrees of organ damages and prognosis for the patient. The continuous variables were analyzed with t-test, F-test, H-test, the categorical variables were analyzed with Chi-square test, and the correlation analysis was performed to calculate Pearson coefficients.

RESULTThe PTX3 value measured within 24 h after enrollment increased with the degree of infection (50. 4(35. 2,70. 4) µg/L; 175. 8 (99. 6, 309. 9) µg/L;419. 9 (168. 3, 468. 6) µg/L; H = 88. 345, P = 0. 000). PTX3 level gradually declined, while in severe sepsis group decreased slowly (P <0. 05); the area under the ROC curve of Plasma PTX3 was larger than that of other inflammatory markers such as CRP and PCT, white blood cells and neutrophils in the diagnosis of sepsis; while the former three are PTX3, PCT and CRP (the sensitivity and specificity respectively were 0. 77, 0. 68; 0. 66, 0. 6; 0. 47, 0. 55); the PTX3 value of the severely elevated group was significantly higher than those of the mildly and moderately elevated groups (P <0. 05). The proportion of having 3 or more organs failure increased as the PTX3 rising among the groups of mildly elevated group, moderately elevated group and severely elevated group (1(2. 4%), 4(6. 1%), 14(19. 7%) χ2 =16. 16,P = 0. 000); and in each group, the proportion of having good and poor prognosis for these three groups were different (33 (80.5%) and 8 (19. 5%), 35 (53%) and 31 (47%), 28 (39.4%) and 43 (60.6%), χ = 17. 663, P = 0. 000). The K-M curve for these three groups had statistically significant difference (χ2 = 7. 086, P = 0. 029). Those with heart failure had higher PTX3 value than those in non-heart failure at the same degree of infection. PTX3 value increased with myocardial enzyme (troponin, creatine kinase isoenzyme, BNP) levels. In the diagnosis of heart failure, the area under the ROC curve were respectively PTX3 0. 824; BNP 0. 772; CM-KB 0. 643; CNTIO. 671, the sensitivity and specificity were PTX3 0. 8, 0. 58; CK-MB 0. 56,0. 79; CTNI 0. 60,0. 69; BNP 0. 73, 0. 58. In terms of predicting the prognosis of sepsis with heart failure complications, the PTX3 value's area under ROC curve was larger than that of BNP (respectively 0. 844, 0. 472).

CONCLUSIONThe PTX3 is an objective biochemical marker in diagnosis of sepsis; it is helpful in assessment of severity and prognosis of sepsis; it also has a certain clinical value in the assessment of sepsis cardiovascular function damage.

Adolescent ; Biomarkers ; blood ; C-Reactive Protein ; analysis ; Calcitonin ; blood ; Cardiovascular System ; physiopathology ; Child ; Child, Preschool ; Creatine Kinase ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Infant ; Intensive Care Units, Pediatric ; Leukocyte Count ; Male ; Natriuretic Peptide, Brain ; blood ; Prognosis ; Protein Precursors ; blood ; ROC Curve ; Sensitivity and Specificity ; Sepsis ; diagnosis ; physiopathology ; Serum Amyloid P-Component ; analysis ; Troponin ; blood