Objective To investigate the protective effects of G CSF on lungs of rats with acute cholangitis and changes in blood TNF and TXA 2/PGI 2 by treating the rats with G CSF. Methods Seventy two Wistar rats were randomized into the control, infected and treated groups. We established the model of cholangitis in the rats with injection of E. coli 25922 into the bile duct. The animals in the treated group were pretreated with G CSF 500 ng/day bid) for 5 days before the E. coli injection. The levels of blood TNF and TXA 2/PGI 2 were measured at the 3rd, 6th and 12th h after the injection. Meanwhile, the morphological changes in lungs of the rats were observed. Results The morphological changes in lungs were milder and levels of blood TNF and TXA 2/PGI 2 were significantly lower in the treated group than in the infected one (P

Objective: To observe the clinical effects of acupoint injection therapy plus massage on primary dysmenorrhea (PD).
Methods: Ninety patients with PD were randomly divided into a treatment group or a control group, 45 cases in each group. The treatment group was treated by injection of Vitamin K3into Sanyinjiao (SP 6) plus massage on Diji (SP 8). The control group was treated by oral administration of Ibuprofen sustained-release capsule. Before and after the treatment, visual analogue scale (VAS) was adopted to assess pain degree of the patients. The therapeutic effects were observed after continuous treatment of three cycles of menstruation.
Results: After treatment, VAS scores were obviously decreased in both groups and the differences were statistically significant (allP<0.05). The difference in VAS score after treatment was more significantin the treatment group than that in the control group (P<0.01). The total effective rate was significantl higher in the treatment group than that in the control group (P<0.05).
Conclusion: Acupoint injection therapy plus massage for PD is effective and better than simple oral administration of Ibuprofen sustained-release capsule.

Objective To investigate the influence of Chinese medicine ( CM) treatment on life span of middle-late primary hepatic carcinoma (PHC) patients. Results A multicenter retrospective cohort study was carried out in 489 PHC patients at the stages of Ⅱb, Ⅲa and Ⅲb collected from 15 domestic hospitals. With CM treatment as the exposure factor, the enrolled patients were divided into CM group, western medicine (WM) group and the CM-WM combination group. The main outcomes included median survival time (MST) and survival rate, and the effects of CM treatment and minimally invasive therapy on MST were observed. Results Half-a-year survival rate, one-year survival rate and two-year survival rate were 50%, 9%, 1% in CM group, 70%, 30%, 6% in CM-WM combination group, and 50%, 10%, 0% in WM group, respectively. The survival rates in CM-WM combination group differed from those in CM group and WM group (P<0.01), but the differences of survival rates between CM group and WM group were insignificant (P>0.05) . MST at the stages of Ⅱb, Ⅲa, Ⅲb in CM-WM group was obviously prolonged as compared with the other two groups (P<0.01), and MST at the stages of Ⅲa, Ⅲb in CM group was also obviously prolonged as compared with WM group (P<0.05) . The difference of MST at the stage of Ⅱb was insignificant between CM group and WM group ( P>0.05) . CM treatment and minimally invasive therapy were effective on prolonging the survival time of PHC patients ( P<0.01) . The results of COX regressionanalysis showed that Karnofsky scores, CM treatment and minimally invasive therapy were the preventive factors for the prognosis. Conclusion CM-WM combination group has the best long -term therapeutic effect. CM -WM combination treatment is effective on increasing MST and long-term survival rate, in particular for PHC patients at the stages ofⅡb, Ⅲa and Ⅲb. CM treatment and minimally invasive therapy are helpful for the prolongation of the survival time of PHC patients.

Objective To explore the relationship between the expression of EIIIA + fibronectin in incised wound of rat’s skin and injury time. Methods The wounding model was established by cutting the dor-salskin of 48 adult SD rats. The rats were sacrificed atthe pre-setinjury time as immediately, 0. 5h, 1h, 2 h, 3 h, 4 h, 6 h, and 8 h. The skin sam ples were taken at the m argin of wound. The expression of the EIIIA + fibronectin was detected by im m unohistochem istry and W estern blotting and the relationship be-tween its expression and injury time was observed. Results The expression of EIIIA + fibronectin was not observed im m ediately. The basal cell of skin began to showpositive expression 0. 5 h after injury. W ith the extension of injury time, positive staining became stronger. The value of relative optical density was gradually increased with prolonged injury time by the W estern blotting analysis. Conclusion The expres-sion of EIIIA + fibronectin could be used for estimation of injury time in the early stage of skin injury.

Recent years found a series of severe incidents of injuring or killing medical workers in several places in China,deteriorating patient-physician relations,and disturbing medical orders.Beijing Administration of Hospitals,since its founding,has attached great importance to the management of medical disputes,as evidenced in the full-process management covering pre-during-post disputes.The administration guided the hospitals in their dispute resolution,and included resolution rate of disputes as an index of municipal hospital performance evaluation.By means of the guidance of such evaluation, medical disputes and major medical accidents have been resolved satisfactorily,and fine management of service quality of such hospitals in terms of medical service,pharmacy,nursing and medical technology has been intensified all the time.

Objective To observe the biological effects of magnetic fields of different intensities on microvascular endothelial cells in the human brain (HBMECs).Methods HBMECs were cultured in vitro under normal conditions and randomly divided into a control group and several magnetic induction groups——26 mT,62.5 mT,110.7 mT and 215.6 mT at the center pole.Any changes to the cytomembranes were observed 72 h after planking using the lactate dehydrogenase (LDH) method.Superoxide dismutase and malondialdehyde methods were used to detect cellular oxidation due to the magnetic field.An inverted microscope was used to observe any changes in cell morphology,and flow cytometry was employed to detect cell apoptosis.Results Compared with the control group,the LDH value of the 215.6 mT group was significantly higher,but there were no significant differences in oxidative damage,apoptosis or morphology observed.Moreover,there were no significant differences between the controls and the 26 mT,62.5 mT and 110.7 mT groups in any of the above measurements.Conclusion Magnetic fields of different intensity have different biological effects on HBMECs.A 215.6 mT magnetic field influences their cell membranes but causes no oxidative damage,cell apoptosis or morphological changes.These observations and the mechanism need further exploration.

Objective To study the clinical curative effect of syndrome differentiation-based treatment with traditional Chinese medicine on patient with Chronic Kidney Disease (CKD3-4). Method According to prospective multicenter randomized controlled study which was applied to the patients with CKD3-4 , the total of 339 patients were divided into two groups. To one group as standard including 167 patients ,the other including 172 patients. Chinese Traditional Patent Medicine single or combined-prescription oral treatment according to syndrome differentiation-based treatment was employed. To the other group as reference , Chinese Traditional Patent Medicine oral treatment according to experienced rule was applied. The clinical curative effect results were obtained after a 24 weeks-treatment. Result The Scr ,eGFR and UTP with CKD3 in standard group illustrate statistics significance (P<0.05). On the opposite, those of the reference group remain insignificance (P > 0.05). The clinical curative effect result of patient in standard group was better than that of reference group. About the clinical curative effect of CKD4, no statistics significance difference (P > 0.05) could be found between groups or between patients in one group. The TCM score of patient with CKD3-4 in standard group have improved (P < 0.05) according to baseline. However, that of reference group did not show any statistics significance (P > 0.05). Conclusion Syndrome differentiation-based treatment with traditional Chinese medicine illustrated a better result in protection of renal function, reduction in urinary protein and decline in TCM score than the treatment according to experienced rule.

Objective:To investigate clinical efficacy of conformal sphincter preservation operation (CSPO) versus intersphincteric resection (ISR) in the treatment of low rectal cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 183 patients with low rectal cancer who were admitted to two medical centers (117 in the Changhai Hospital of Naval Medical University and 66 in the Huashan Hospital of Fudan University) from August 2011 to April 2020 were collected. There were 110 males and 73 females, aged (57±11)years. Of 183 patients, 117 cases undergoing CSPO were allocated into CSPO group, and 66 cases undergoing ISR were allocated into ISR group, respectively. Observation indicators: (1) surgical situations of patients with low rectal cancer in the two groups; (2) postoperative complications of patients with low rectal cancer in the two groups; (3) follow-up; (4) influencing factors for prognosis of patients with low rectal cancer; (5) influencing factors for satisfaction with the anal function of patients with low rectal cancer. Follow-up was conducted using outpatient examination, questionnaire and telephone interview to determine local recurrence, distal metastasis, survival, stomal closure, satisfaction with the anal function of patients. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was analyzed using the rank sum test.The Kaplan-Meier method was used to draw survival curves, and life table method was used to calculate survival rates. Log-rank test was used for survival analysis. Univariate analysis was performed using the linear regression. Variables with P<0.10 in the univariate linear regression analysis were included for multivariate analysis. Multivariate analysis was performed using the COX stepwise regression model and linear regression analysis. Results:(1) Surgical situations of patients with low rectal cancer in the two groups: cases with laparoscopic surgery, operation time, volume of intraoperative blood loss, distance from tumor to distal margin, cases with postoperative chemotherapy, duration of postoperative hospital stay were 44, (165±54)minutes, (142±101)mL, (0.6±0.4)cm, 76, (6.6±2.5)days for the CSPO group, respectively, versus 55, (268±101)minutes, (91±85)mL, (1.9±0.6)cm, 9, (7.9±4.7)days for the ISR group, showing significant differences between the two groups ( χ2=35.531, t=8.995, -3.437, -3.088, χ2=44.681, t=2.267, P<0.05). (2) Postoperative complications of patients with low rectal cancer in the two groups: 19 patients in the CSPO group had complications. There were 6 cases with grade Ⅰ complications, 12 cases with grade Ⅱ complications, 1 case with grade Ⅲb complication. Fourteen patients in the ISR group had complications. There were 4 cases with grade Ⅰ complications, 7 cases with grade Ⅱ complications, 1 case with grade Ⅲa complication, 2 cases with grade Ⅲb complications. There was no significant difference in the postoperative complications between the two groups ( χ2=0.706, P>0.05). Patients with complications in the two groups were improved after symptomatic and supportive treatment. There was no perioperative death in the postoperative 30 days of the two groups. (3) Follow-up: 183 patients received follow-up. Patients of the CSPO group and ISR group were followed up for (41±27)months and (37±19)months, respectively, showing no significant difference between the two groups ( t=-1.104, P>0.05). There were 2 cases with local recurrence and 9 cases with distal metastasis of the CSPO group, respectively, versus 3 cases and 4 cases of the ISR group, showing no significant difference between the two groups ( χ2=1.277, 0.170, P>0.05). The 3-year disease-free survival rate and 3-year total survival rate were 84.0% and 99.0% for the CSPO group, versus 88.6% and 92.8% for the ISR group, showing no significant difference between the two groups ( χ2=0.218, 0.002, P>0.05). The stomal closure rate was 92.16%(94/102) and 96.97%(64/66) for 102 patients of CSPO group and 66 patients of ISR group up to postoperative 12 months,respectively, showing no significant difference between the two groups ( χ2=1.658, P>0.05). Of the 8 cases without stomal closure in the CSPO group, 2 cases refused due to advanced age, 4 cases subjectively refused, and 2 cases were irreducible due to scar caused by radiotherapy. Two cases in the ISR group had no stomal closure including 1 case of postoperative liver metastasis and 1 case of subjective refusal. There were 92 and 61 patients followed up to 12 months after stomal closure, of which 75 cases and 38 cases completed questionnaires of satisfaction with the anal function. The satisfaction score with the anal function was 6.8±2.8 and 5.4±3.0 for CSPO group and ISR group, respectively, showing a significant difference between the two groups ( t=-2.542, P<0.05). Fifty-four cases in the CSPO group and 21 cases in the ISR group had satisfaction score with the anal function >5, showing no significant difference between the two groups ( χ2=3.165, P>0.05). (4) Influencing factors for prognosis of patients with low rectal cancer: results of COX stepwise regression analysis showed that gender and pT staging were independent influencing factors for disease-free survival rate of patients with low rectal cancer ( hazard ratio=2.883, 1.963, 95% confidence interval as 1.090 to 7.622, 1.129 to 3.413, P<0.05). Gender and pT staging were independent influencing factors for total survival rate of patients with low rectal cancer ( hazard ratio=10.963,3.187, 95% confidence interval as 1.292 to 93.063, 1.240 to 8.188, P<0.05). (5) Influencing factors for satisfaction with the anal function of patients with low rectal cancer: results of univariate analysis showed that surgical method and tumor differentiation degree were related factors for satisfaction with the anal function of patients with low rectal cancer (partial regression coefficient=1.464, -1.580, 95% confidence interval as 0.323 to 2.605, -2.950 to -0.209, P<0.05). Results of multivariate analysis showed that surgical method, tumor differentiation degree and preoperative radiotherapy were independent influencing factors for satisfaction with the anal function of patients with low rectal cancer (partial regression coefficient=1.637, -1.456, -1.668, 95% confidence interval as 0.485 to 2.788, -2.796 to -0.116, -2.888 to -0.447, P<0.05). Conclusion:Compared with ISR, CSPO can safely preserve the anus in the treatment of low rectal cancer, without increasing the incidence of postoperative complications, which can also guarantee the oncological safety and improve the postoperative anal function.

OBJECTIVE:To provide reference for improving related policy and list about medical insurance medicines in China. METHODS:The descriptive analysis method was used to compare 2017 and 2009 edition of Medicine List for National Basic Medical Insurance,Employment Injury Insurance and Maternity Insurance in respects of item,medicine classification (including classification code,grading and name),medicine types(including new type,removed type),dosage(including new dosage classification,adjusted dosage form),the limit of payment and use.The trend of its development and the existing problems were discussed. RESULTS:Compared with 2009 edition,2017 edition of medicine list added the item of"drug classification code"and removed the item of"English name". The grading of drug classification code was reduced from six grades to four grades. The code and name of four grades classification were in accordance with the first four grades classification rules of the anatomical-therapeutic-chemistry(ATC). A total of 2 535 types were included in 2017 edition,increasing by 362 types compared to 2009 edition(151 chemical medicines,211 Chinese patent medicines). 15 types of chemical medicines were removed,and 4 types were transferred to Chinese patent medicine list;11 types of Chinese patent medicines were removed,and one type was transferred to chemical medicine list. 2017 edition was actually 20 more dosage forms than 2009 edition,involving 31 types;dosage forms of 231 types were adjusted(143 chemical medicines,88 Chinese patent medicines). Chemical medicines of usage and payment restriction increased from 239 to 302,and Chinese patent medicines increased from 72 to 115,respectively. CONCLUSIONS:2017 edition of list increases the number of medicine,expands the scope of clinical medication and improves the classification structure of the list.The number of medical insurance cost control type shows a growing trend.

Objective To study the correlation between multiple comet tail sign and the early abdominal visceral injury and explore the clinical application of the multiple comet tail sign in prompting the early abdominal visceral injury in an oleic acid animal model.Methods The experimental animals were divided into an experimental group and a control group.The sonograms of the lungs,livers and kidneys of control group were collected,and then the rabbits were executed.The animals of experimental group were made into multiple comet tail sign models.The thorax sonogram of successful model showed at least one lung area with varying degrees of multiple comet tail sign.Collect the sonograms of lungs,livers and kidneys were collected,and then the rabbits were executed.The two groups of rabbits were dissected,and the lungs,livers,kidneys,and spleens were removed to make the tissue sections.The gross pathologic findings and microscopic histological changes of the two groups were observed and noted.The ultrasound scores of chest sonograms were recorded:short comet tail sign for 1 point,isolated comet tail sign for 2 points,mild multiple comet tail sign for 3 points,moderate multiple comet tail sign for 4 points,and falls sign (severe multiple comet tail sign) for 5 points.The degree of organ injury was assessed by the percentage of pathologic injury area under microscope,and the correlation between the multiple comet tail sign and abdominal organ injary was analyzed.Results The successful rate of multiple comet tail sign model in experimental group was 100％.The sonograms of liver and kidney have no significant change after the experiment.The incidence of positive pathologic changes in experimental group was 100％ (11/11).The gross pathologic findings of lung were complete shape with dark red hemorrhagic area at surface;the microscopic pathologic findings were pulmonary edema (11/11,100％) and pulmonary hemorrhage (9/11,81.8％).The incidence of positive pathologic changes in the liver of experimental group was 45.5％ (5/11).The gross pathologic findings of liver were complete shape with reddish brown surface and flexible texture;the microscopic pathologic findings were cellular swelling of hepatocytes (5/11,45.5％).The incidence of positive pathologic changes in the kidneys of experimental group was 18.2％ (2/11).The gross pathology had no obvious changes,and the microscopic pathologic findings were cellular swelling of renal tubular epithelial cells (2/11,18.2％).Results showed that the lung ultrasound scores of rabbits with liver injury were obviously higher than those of rabbits with no liver injury,and there was significant differences (Z=-2.529,P=0.011).There was a statistically significant positive correlation between the lung ultrasound scores of rabbits with liver injury and the microscopic pathologic area of liver lesion (r=0.893,P=0.041),and the higher the lung ultrasound score,the more severity of the liver injury.Conclusions The appearance of multiple comet tail sign is earlier than the sonogram changes of liver and kidney.The most sensitive pathologic changes of abdominal organ appear in liver,followed by kidney.The scope and extent of the multiple comet tail sign can prompt the early injury in liver and kidney.