By mean of reviewing surgery development history,the article narrates how crucial affairs promote surgery,clarifies that interpermeation and intersynthesis among various subjects are the conspicuous features of the contemporary medicine and discusses the development tendency of surgery in 21st based on comprehensive characteristic of medicine.

The article demonstrates three characters of health service system in community and the countryside: equalitarianism,universality and suitability,and puts forward major functions: strengthening propaganda,universalizing life long education,making prevention and health care education and producing psychologic health education.

Objective To investigate the effects of interferon-gamma (IFN-γ) on migration,invasion and vasculogenic mimicry (VM) formation of human melanoma cell line MUM-2B. Methods MUM-2B cells were divided into three groups, control group (10%FBS in DMEM), treatment group1 (10μg/L IFN-γ) and treatment group2 (100μg/L IFN-γ). Different concentrations of IFN-γ were added in the culture medium of MUM-2B cells. Wound-healing assay and matrigel invasion assay were performed to examine the migration and invasion ability of MUM-2B cells. Three-D culture was used to observe the VM formation. The expression of vascular endothelial growth factor (VEGF) of MUM-2B cells was detected by Western blot assay. Results The result of wound-healing assay showed that the migration distance of cells was decreased in treatment groups compared with that of control group. The migration distance of cells was decreased in treatment group 2 compared with that of treatment group 1(P＜0.05). The result of matrigel invasion assay showed that the number of invaded cells was decreased in treatment groups compared with that of control group, and which was significantly decreased in treatment group2 than that of treatment group1 (P＜0.05). The result of 3-D culture showed that cells in control group can form typical VM tube-like structures, whereas cells in treatment groups cannot. Western blot assay showed that the expression of VEGF protein was significantly decreased in treatment groups compared with that of control group, and the expression of VEGF protein was significantly decreased in treatment group2 than that of treatment group 1(P＜0.05). Conclusion These data suggest that IFN-γinhibits migration and invasion of MUM-2B cells, and inhibits VM formation by down regulating VEGF expression in vitro.

Objective: To build a mouse tumor model with a manufactured surgical wound representing acute inflammation, and to evaluate the relationship between acute inflammation or wound healing and the process of tumor growth. Then to observe the impact of IFN-γ/TGF-β on tumor growth. Methods: Male C57BL mice of six weeks were used and divided into the experiment group and the control group. The B16F10 mela-noma cell suspension was injected into the left groin area of each mouse. A wound measured 1 cm in diame-ter was built on the opposite side of bodies in the experiment group when tumor volume was about 0.5 cm~3.The expression of IFN-γ/TGF-β in blood serum and tumor tissues were examined by ELISA. In order to fur-ther confirm the effect of TGF-β on tumor growth, another 16 mice models with melanoma were established and 8 of them received IFN-γ injection (the experiment group). Results: When acute inflammation had influenc-es on tumor, a two-phase development was presented. In the early phase, the growth of tumor in the mice with wound was slower than that in the control group. In the early phase, the release of IFN-γ was higher and the release of TGF-β was lower in the experiment group. In the later phase, the growth of tumor in the mice with wound was similar to that in the controls and the release of TGF-β was higher. In vivo experiment con- firmed the above results. In the early phase, the release of TGF-β was not significantly different between the experiment group and the control group (P>0.05). In the later phase, the release of TGF-β in the experiment group was higher than that in the control group (P<0.05). Conclusion: In the early phase of acute inflamma-tion, inhibitory effects of IFN-y on tumor growth were presented. In the later phase, the inhibited tumor was re-sistant to IFN-γ through the release of TGF-β to balance the effect of inflammatory factors on tumor cells.

Objective To investigate the effect of liver cirrhosis on the potency of propofol for sedation in rats. Methods Fifty-eight male SD rats, aged 10-12 weeks, weighing 180-220 g, were randomly divided into 3 groups: control group (group C, n = 18), mild liver cirrhosis group (group M1, n =20) and severe liver cirrhosis group (group M2, n = 20). The model of liver cirrhosis was established using four factors described by Chen et al. After successful establishment of the model, propofol was injected intravenously. The dose of propofol was determined by up-and-down sequential method for loss of righting reflex. The dose of propofol was 5.912 mg/kg in the first rat and the ratio of the doses between the two consecutive rats was 0.85. ED50 of propofol was calculated using up-and-down sequential method. Results ED50 of propofol was significantly lower in group M1 and M2 than in group C and in group M2 than in group M1 ( P ＜ 0.05 or 0.01 ). Conclusion The liver cirrhosis can enhance the potency of propofol for sedation in rats.

Objective To investigate the early diagnosis value of arterial blood gas analysis , neuron specific enolase and serum glial fibrillary acidic protein in brain injury of premature infant. Methods In the study, 95 premature infants admitted in our hospital were enrolled. 45 premature infants with brain injury were selected as experimental group. 50 premature infants without brain injury were selected as control group. All patients received arterial blood gas analysis , NSE and GFAP on the 1st day and 7th day after birth. Results There is statistically significant difference between the experimental group and the control group on the 1st day after birth in terms of pCO2, pH, BE and lactic acid (P<0.05). In experimental group, there is statistically significant difference between the 1st day and 7th day after birth in terms of pCO2, pH, BE and lactic acid (P < 0.05). The NSE and GFAP levels had statistically significant difference between the experimental group and the control group on the 1st day and 7th day after birth(P < 0.01); the NSE levels of experimental group had statistically significant difference between the 1st day and 7th day after birth (P < 0.05); The GFAP levels of experimental group had statistically significant difference between the 1st day and 7th day after birth (P < 0.01). Conclusion pCO2, NSE and GFAP levels are correlated with brain damage in premature infants in early stage. This could provide evidence of early diagnosis for brain injury in preterm infants.

Objective To investigate the role of mylin basic protein,S100B and arterial blood gas analysis's levels in early diagnosis of brain injury in premature infant.Methods A total of 95 premature infants treated in our hospital were enrolled in the study.Experimental group was 45 premature infants with brain injury.Control group was 50 premature infants without brain injury were the.All patients were detected with arterial blood gas analysis,MBP and S100B on the 1st day and 7th day after birth.Results The pH,PCO2,BE,lactic acid,MBP and S100B's levels in experimental group were significantly different between the 1st day and 7th day after birth.In the 1st day after birth,compared with the control group,the pH,PCO2,BE,lactic acid,MBP and S100B in the experimental group were obviously high than that of control group.Conclusion On the 1st day after birth,monitoring arterial blood gas analysis,S100B protein and MBP's levels could be useful in early diagnosis of brain injury in preterm infants.

Objective To determine the content of total flavonoids and luteolin from Pteris multifida Poir. Methods The content of total flavonoids was determined by gradient elution of macroporous resin D101 and ultraviolet spectrophotometry. The content of luteolin was determined by HPLC. The analysis was performed on a RP-C18 column(4.6 mm×250 mm, 5 μm) with aceconitrile-0.2% phosphoric acid (35:65) as the mobile phase at a flow rate of 1.0 ml/min, and 30 ℃ temperature. Results The detection of wave length was set at 349 nm. The content of luteolin was 0.015%, 0.019%, 0.016%, and the content of total flavonoids was 0.015%, 0.019%, 0.016%, respectively. Conclusions The method is suitable for the determination of flavonoids componets from Pteris multifida Poir.

Objective:To conduct a meta-analysis for the effects of ultra-early postoperative rehabilitation on hospital stay, complications and vasospasm in patients with aneurysmal subarachnoid hemorrhage (aSAH).Methods:PubMed, Embase, Cochrane Library, WOS, CNKI, CBM and Wanfang databases were searched by computers to collect control studies on ultra-early rehabilitation of aSAH. The retrieval time limit was from the establishment of the databases to August 2021. The methodological quality of the included literature was evaluated according to Cochrane Handbook Systematic Reviews Interventions, and the Revman 5.2 software was used for meta-analysis.Results:A total of 5 articles were obtained, with a total of 413 patients. The methodological quality of the 5 studies was lower (grade C). The results of the meta-analysis showed that the average length of stay in the intervention group (mean difference –4.14, 95% confidence interval [ CI] –10.69-2.42; P=0.22] and the incidence of complications (odds ratio 0.86, 95% CI 0.40-1.83; P=0.70) were lower than those in the control group, but there was no significant difference. The incidence of cerebral vasospasm in the intervention group was lower than that in the control group, and there was significant difference (odds ratio 0.31, 95% CI 0.18-0.53; P<0.001). Conclusions:Postoperative ultra-early rehabilitation in patients with aSAH can reduce the incidence of cerebral vasospasm without increasing the incidence of complications. Therefore, the ultra-early rehabilitation can be considered. The methodological quality of the literature included in this study is lower, and high-quality randomized controlled trials are needed to further verify the effects of ultra-early rehabilitation on hospital stay, complications, and cerebral vasospasm.

Objective:To investigate the prevalence of mild cognitive impairment(MCI)in elderly inpatients in high altitude areas, analyze the influencing factors, and then construct a risk factor model.Methods:A cross-sectional random sampling method was used to conduct a questionnaire survey among elderly patients over 65 years old hospitalized at Qinghai Provincial People's Hospital from October 2018 to February 2019.The survey contents included demographic data, lifestyles, physical activities and cognitive function.The occurrence of MCI was analyzed with descriptive epidemiological measures, a predictive model of influencing factors was established using Logistic regression analysis, and influencing factors were ranked.Results:There were a total of 1412 elderly people aged 65 and above, with 760 males, accounting for 53.8%.The ages of respondents ranged between 65-82 years, with an average age of(72.8±5.8)years.Of the subjects, 600 had MCI, with a prevalence of 42.4%.Male( OR=1.318, P=0.02), junior high school education or above( OR=0.521, P<0.001), bedriddenness( OR=2.658, P=0.002), lifestyle( OR=0.702, P=0.011), abnormal defecation( OR=1.625, P=0.005)and frailty( OR=1.536, P=0.002)were included into the predictive model of influencing factors.The area under the ROC curve in this study was 0.676(95% CI: 0.648-0.704), with sensitivity=0.553, specificity=0.741, and Youden index=0.274.When ordered by importance, the independent risk factors were frailty, male, abnormal defecation, bedriddenness, lifestyle, and education level. Conclusions:Male, frailty, abnormal defecation and long-term bedriddenness are risk factors for cognitive impairment in elderly people, whereas living with a partner and education above junior high school are protective factors.