ObjectiveToinvestigatetheMunicipalHospital(Ezhoucity)theimplementationofruralbasic public health service mode of linkage of areaeffect.Methods The hospital public health division of functions and du-ties,the integration of technology and equipment strength,mobilize theinformation flow,focused team of experts,stand-ardize the informationnetwork,to carry out drive rural area of basic public health work.Results The three level hos-pitals of Ezhou played a leading role,has been associated with lower hospital ( Taihe, Gedian) to establish a long-term cooperative relations,for the scientific management of basic public health items the purpose of the make and model.Conclusion The comprehensive hospital,reflect the public interest in public health work,to achieve the inte-gration of urban and rural public health pattern.

Objective To analyze the diagnostic significance of the expression of perinuclear anti-neutrophil cytoplasmic antibody(pANCA) and anti-Saccharomyces cerevisiae antibody(ASCA) in the patients with inflammatory bowel disease(IBD).Methods Serum samples were collected from 97 patients with IBD,including 86 patients with ulcerative colitis(UC) and 11 with Crohn′s disease(CD).Another group of 36 persons in whom colonoscopic examination was negative served as control.Determinations of ASCA and pANCA were performed using indirect immunofluorescence test(IIFT).Results The positive rate of pANCA in group UC,CD and control was 27.9%,0% and 0%,respectively.Obviously,the rate in group UC was higher than that in the other two groups(P0.05).Four of 11 CD patients(36.4%) were severe cases,among them 3 showed ASCA+;7 were moderate cases(63.6%),and among them 1 case showed ASCA+.The positive ratio of ASCA was significantly different between severe and moderate CD cases(P

ObjectiveTo investigate the feasibility of using the ratio of (Cho + Cr)/Cit derived by MRS to predict the differentiation grades of prostatic cancer and Gleason grading.Methods Five postoperative prostate specimens were spitted and layered according to the region of interest of MRS inspections.The correlation between the CC/C values of each region of interest in each layer and the Gleason scores of the corresponding pathological sections was analyzed.The optimum diagnostic cutoff value was determined by conducting the hypothesis test of the area below the ROC curve of the well and moderately differentiated groups and poorly differentiated ones on the basis of CC/C values with a Spearman test.Results A total of 90 regions with valid pathologic diagnosis were obtained,70 cancer-affected and 20 cancer-free.In MRS,a CC/C value above 0.86 was used as a criterion for defining a cancer-affected region As a result,65 cancer-affected regions and 25 cancer-free regions were identified,among which pathologic diagnosis confirmed 59 and 14,respectively.Spearman′s rank correlation analysis revealed that the CC/C values of the prostatic carcinoma had significant positive correlation with Gleason scores ( r =0.746,P =0.000).For the well and moderately differentiated groups,the hypothesis test about the cutoff value,which was obtained by calculating the area below the ROC curve,was of no statistical significance.For the poorly differentiated groups,the optimum cutoff value was defined as 0.948,and the sensitivity and specificity were 81.4％ and 75.0％,respectively.It was also observed that the Gleason scores of the poorly differentiated endemic regions had positive correlation with the CC/C values ( r =0.605,P =0.000 ),suggesting that CC/C value was associated with the differentiation grade of the poorly differentiated prostatic cancer.When CC/C value was above 0.948,the poorly differentiated prostatic cancer was typically detected and Gleason score was often above 7.Conclusions CC/C values has positive correlation with Gleason scores.MRS may be used to predict the differentiation of prostate cancer.

Triptolide (TP) is a major active component in Tripterygium root, but its therapeutic window was very narrow due to its severe multi-organ toxicity. In this work, the effect of TP combined with glycyrrhetic acid (GA) on mRNA expression and activity of four cytochrome P450 (CYP) enzymes in rat liver was studied after intragastric administration of TP (0.05, 0.3 and 0.6 mg x kg(-1) x day(-1)) and TP (0.6 mg x kg(-1) x day(-1)) combined with GA (30 mg x kg(-1) x day(-1)) for 7 consecutive days. Compared with the control, the high dose of TP significantly up-regulated the mRNA expression levels of CYP2E1, 1A2, 3A1 and 2C11, the co-administration of TP and GA further up-regulated the mRNA expression levels of CYP3A1, 2C11 and 2E1 as compared with the high dose of TP. Meanwhile, TP at high dose and combined with GA significantly increased CYP3A-associated testosterone 6beta-hydroxylation activity (2.2-fold and 4.1-fold, respectively) as compared with the control. Because TP is mainly metabolized by CYP3A2 in male rats, the present work indicated that TP-induced increase of CYP3A activity might be an important reason for the rapidly metabolic clearance of TP in rat liver, and GA can reduce the hepatotoxicity of TP by promoting its hepatic metabolic clearance. Furthermore, the results also suggest that the drug interactions might be occurred when TP and GA were co-administered with other CYP3A substrate drug.

Objective To explore the clinical features of hypertrophic cardiomyopathy (HCM) in aged patients in China. Methods The 711 patients with HCM in our hospital from Sep 2002 to Sep 2008 were retrospectively reviewed. Clinical data were compared between patients older and younger than 65 years. Results The 103 patients(14.5%) were older than 65 years. Compared with those patients younger than 65 years, the aged patients had a higher prevalence in female (52. 5 vs 29. 0%, P<0. 01), in comorbidity (64. 1% vs 25.0%, P<0, 01)and in atrial fibrillation (21.4% vs 14.0%, P<0. 05). Cardiac insufficiency was the most common symptom in aged patients with HCM. The age(r=0. 213, P<0. 05), size of left atrium (r=0. 308, P<0. 01) and atrial fibrillation (r= 0. 362, P<0. 01) had significant correlation with heart function. The 24 % of patients had one or more major risks for HCM-related sudden cardiac death (SCD), among which syncope was most common. Conclusions A higher prevalence of comorbidity, a higher incidence of atrial fibrillation and worse heart function existed in aged patients with HCM. The major risks for HCM-related SCD should not be neglected in evaluation for aged patients.

Objective To analyse the prognostic factors of ST-elevation acute myocardial infarction men and women. Methods The data of 904 in-hospital patients with ST-elevation myocardial infarction were collected from the database of our hospital during 2003-2004 and 728 of them were followod-up. The patients were divided into groups of male and female. Results Women had more accompanying diseases such as diabetes mellitus (DM) and hypertension than men; left ventricular ejection fraction(LVEF) was lower in female. The rate of successful reperfusion was lower in women than men (P < 0.05). Mortality rate was higher in women. 728(202 female) patients were followed up. The use of β-blockers were statistically different between two groups during follow-up. In the female group, LVEF was lower significantly and the rate of reodmission for heart failure and myocardial infarction as well as that of mortality was higher (P< 0.05). Multivariate analysis showed that sex difference was an independent risk factor for in-hospital mortality (OR = 2. 130,95% CI 0. 954-4.754, P = 0. 045) , but not for mortality in the followed-up period and readrnission. Conclusion There are many factors leading to the poor prognosis of ST-elevation acute myocardial infarction in women. It is essential to pay more attention to its clinical characteristics and begin intervention of the risk factors earlier so as to improve the prognosis.

The etiological agent of severe acute respiratory syndrome (SARS) was identified as a new coronavirus, termed SARS-CoV. Establishment of an efficient and sensitive diagnostic system of SARS-CoV genetic materials is crucial for SARS control. In this study, we quantified SARS-CoV mRNAs in both infected cell culture lysate and in supernatant by using Real-time quantitative revere transcription-PCR based on EvaGreen鈩?dye and Taqman-MGB probes. For extensive evaluation of sensitivities and specificities, 13 pairs of primers and 4 probes were designed based on different genes of SARS-CoV. Glyceraldehydes-3-phosphate dehydrogenase (GAPDH) was selected as the internal control gene. Results showed that S-gene-specific PCR was the most sensitive for detection, but because of its sequence variability in the different viral strains, primers and a probe based on the N gene were suitable substitutions. Meanwhile, we found the mRNA concentrations in cell culture lysates were much higher than in cell supernatant and facilited more sensitive detection of the SARS-CoV.

BACKGROUND: It is necessary to keep a good cervical curvature for improving nerve symptom in patients with cervical spondylotic myelopathy (CSM). It is verified that cervical anterior plate internal fixation implant is effective to restore the physiological curvature of cervical vertebra.OBJECTIVE: To assess the physiological lordosis of cervical vertebra in CSM patients after cervical anterior plate internal fixation implantation.DESIGN: Observational study.SETTING: First Affiliated Hospital of Nanchang University.PARTICIpANTS: Totally 72 CSM patients were enrolled at Department of Orthopaedics, First Affiliated Hospital,Nanchang University from February 2003 to January 2006, including 46 males and 26 females, aged 45-70 years,averagely 54 years, with the history of 2-6 years. Inclusive criteria included ①cervical spinal cord compression shown in MRI, and ②using autogenous iliac bone. The experiment was approved by Hospital Ethics Committee, and all patients signed the informed consent. Cervical anterior plate was Orion locking plate offered by Shufamo Company. There were single segmental discectomy group (n =32) and two-level segmental discectomy group (n =40) according to experimental requirement.METHODS: ①Anterior decompression plus autogenous iliac bone implant plus titanium plate internal fixation were utilized.The patients were in supine position; shoulder and back were blocked up; neck backward, and endotracheal tube was done under general anesthesia. Transverse or oblique incision was made at right anterior neck. Discectomy decompression was performed with Caspar vertebra ecarteur. Three-dimensional autogenous iliac bone was implanted in decompressed intervertebral space. Immediate stability was obtained after Orion locking titanium plate was fixed, with placement drainage, and then the incision was sutured. ②Postoperative daily activities were conducted with cervical gear, which was removed 8 weeks later. ③Lateral cervical vertebrae X-rays were taken before operation, immediately after operation, 6 and 12 months after operation. Lordosis of the fusion segment was measured with Cobb's angle, and lordosis of cervical vertebra was assessed with D value. These data were analysed by statistic software. ④Bone fusion of the patients was followed up for 12 months after operation. Vertebral fusion standards included no abnormity between two spinous processes of the fusion segment, no lucency between implant and vertebra, as well as bone trabecula across the interface between implant bone and vertebra. ⑤Biocompatibility between material and host was observed during follow-up.MAIN OUTCOME MEASURES: ①Changes of Cobb's angle and D value at different time points before and after operation,and ②Bone fusion and rejection were followed up.RESULTS: Totally 72 patients were involved in the result analysis. ①Cobb's angle was larger and D value was higher immediately after operation, 6 and 12 months after operation than those before operation in the single segmental discectomy group and the two-level segmental discectomy group (P＜0.05). ②Findings of 12-month follow-up showed that bone fusion appeared in all patients of the two groups. ③No significant rejection was found after titanium plate internal fixation implantation. It was found that material and host had a good biocompatibility.CONCLUSION: It is satisfactory to restore physiological lordosis of cervical spine by using cervical anterior plate internal fixation plus autogenous iliac bone for CSM.

BACKGROUND: Plasminogen activator inhibitor 1 is the main regulator of the fibrinolytic system in vivo. The increase of plasminogen activator inhibitor 1 is closely related to thrombotic disease and it is also an independent risk factor for development of thrombotic disease.OBJECTIVE: To investigate the effect of huangqi(Astragalus), danggui (Angelica) and ligustrazine as medicines activating blood and eliminating stasis on the expression of plasminogen activator inhibitor 1 in HepG2 hepatocarcinoma cell strain.DESIGN: A randomized controlled study.SETTING: First Cadre Department of General Hospital of Chinese People' s Armed Police Force.MATERIALS: The experiment was completed in Academy of Military Medical Sciences of PLA from August to December 2004. HepG2 hepatocarcinoma cell strain was cultured. According to different drugs in culture medium, they were divided into six groups: control group, huangqi group,danggui group, huangqi + danggui group, compound danshen group and ligustrazine group.METHODS: Huangqi, danggui, huangqi + danggui, compound danshen and ligustrazine were added in HepG2 culture medium respectively. MTS assay was used to detect the effect of medicines activating blood and eliminating stasis on proliferation of HepG2 cells, plasminogen activator inhibitor 1 was assayed by specific enzyme-linked immunosorbent assays(ELISA),plasminogen activator inhibitor 1 activity was measured by amidolytical assay. 0.5 μg/mL of transforming growth factor β1 cells was added in HepG2 culture medium to stimulated production of plasminogen activator inhibitor 1. Control group was treated under the same conditions but without Chinese herbs.RESULTS: The inhibitory rates of cellular proliferation in huangqi and danggui groups werc(6.51 ±2. 66)% and (4.42 ±2. 19)%, but those in huangqi + danggui, compound danshen and ligustrazine groups were (12. 06 ±4. 98)%, (16. 38 ±4.06)% and(32. 83 ±9.8)% respectively,t = 2. 447 - 3. 707, P ＜ 0.05. Compared with the control group, huangqi,danggui, compound danshen and ligustrazine significantly inhibited plasminogen activator inhibitor 1 expression(22.68 ± 2.20, 11.11 ± 1.23,19.66±1.53, 15.45±1.27, 16.90±0.33, 14.01±0.74, t=2.447-3.707, P ＜ 0.05) and activity(2.16±0.014, 2.01 ±0.006, 1.95±0.014, 1.79±0. 104, 1.53±0.045, 1.48±0.012, t =2.447-3. 707,P ＜ 0.05) in HepG2 cells. The evident inhibitory effects were observed in the group of huangqi + danggui, especially in compound danshen and ligustrazine.CONCLUSION: The plasminogen activator inhibitor 1 expression and activity were inhibited effectively by huangqi, danggui, compound danshen and ligustrazine.

Objective To compare postoperative complications between endoscopic thyroidectomy via breast areola approach and open thyroidectomy.Methods From June 2011 to June 2014,475 patients underwent thyroidectomy.Patients were divided into traditional open group (251 cases) and endoscopic thyroidcctomy group (224 cases).Postoperative complications were recorded and compared.Results All operations were successfully completed.There was no case in endoscopic thyroidectomy group converted to traditional open surgery.There was no serious postoperative complication occurred,including injury to trachea,mediastinal emphysema,intraoperative massive hemorrhage and cardiopulmonary accidents.The difference of postoperative complication between two groups had no statistical significance (all P ＞0.05) as to permanent recurrent laryngeal nerve injury,Homer syndrome,permanent hypoparathyroidism,chyle leakage,postoperative hemorrhage and infection of incision.However,postoperative ecchymosis was more often in endo group (P ＜0.05).Conclusions Compared to traditional open thyroidectomy,endoscopic thyroidectomy via breast areola approach has significant cosmetic advantages without increasing the incidence of major postoperative complications.