In this study,LDH enzyme-release assay for NK cytotoxicity activity was used to evaluate the natural body defence in gastric cancer patients. The percentage cytotoxicity was 34.12?8.66 in normal adults(92 cases) versus 16.35?7.76 in patients with gastric cancer(37 cases)(P

Objective To learn the clinical effect and adverse reaction of hydromorphone for continuous epidural analgesia after cesarean section,and to provide effective anesthesia method for clinical.Methods 116 cases of cesarean section were randomly divided into observation group(65 cases) and control group(51 cases),continuous epidural analgesia was used in the two groups after operation.Among them,hydromorphone + ropivacaine was used for the observation group,morphine + ropivacaine was used for the control group.The analgesic effect and sedation degree of the two groups were evaluated.The adverse drug reactions were observed,and satisfaction of the patients after the operation was investigated.Results 6,9,24 hours after operation,the VAS pain scores of the observation group were lower than those of the control group,the differences were statistically significant(t=3.236,4.970,2.547,all P<0.05).3,6,9,24,48 hours after surgery, the differences of Ramsay sedation score between the two groups were not statistically significant(t=0.717,1.502,0.714,1.051,0.589,all P>0.05).The difference of postoperative first exhaust time between the two groups was not statistically significant(t=0.730,P>0.05).The satisfaction degree of the observation group was significantly higher than that of the control group,the difference was statistically significant(t=2.301,P<0.05).The incidence rate of adverse reactions of the observation group was 7.69%,which of the control group was 11.76%,the difference was not statistically significant(x2=0.552,P>0.05).Conclusion For continuous epidural analgesia after cesarean section,hydromorphone can effectively relieve the pain after operation,the safety of the process is high,and it has good clinical application value.

Objective:To analyze different age group elderly’s financial burden and risk due to non-communicable chronic diseases (NCDs). Methods:Based on CHARLS baseline investigation data, disease economic burden, disease economic risk for family and disease relative risk are used to analyze the economic risk and economic burden of the different age groups of urban and rural NCDs elderly. Results: The diseases financial burdens of urban NCDs elderly are greater than rural; for diseases family risk and relative risk, NCDs elderly are greater than non-NCDs elderly, urban NCDs elderly are greater than rural, high-age group NCDs elderly are greater than low-age group NCDs elderly. Conclusion: It is needed to improve the NCDs elderly’s medical security ability with basic health insurance, especially to improve medical security ability of the high-age group for rural elderly.

Objective To evaluate the traditional Chinese medicine(TCM) output efficiency of the coUnty-level TCM hospitals in Jiangsu Province before and after the reimbursement mechanism reform,and to analyze the factors which affect the efficiency of county-level TCM hospitals.Methods Using DEA to analyze the efficiency of county TCM hospitals,and using the Tobit regression to analyze the influence factors.Results The output efficiency of county-level TCM hospitals in Jiangsu Province is low,and the reimbursement mechanism reform in county-level hospitals of TCM efficiency further decreases;payment model,cost model and revenue model of regression analysis indicate that different factors has different influence on output efficiency of county hospitals of TCM.Conclusion The reimbursement strategy of county-level TCM hospitals should be optimized,the balance of revenue and expenditure structure be adjusted,and the intensity of TCM services reimbursement be increased.

Objective To explore the effect of bispectral index (BIS) monitoring on hemodynamics patients undergoing laparoscopic cholecystectomy under laryngeal mask anesthesia.Methods 110 patients with laparoscopic cholecystectomy were randomly divided into the control group and the observation group according to digital table method.The control group was administered according to the experience of anesthesiologists,the observation group was administered according to BIS monitoring.The hemodynamic indexes,the dosage of anesthetic drug and recovery time of two groups were analyzed.Results After pulling out the laryngeal mask,the HR (74.13±6.99)beats/min,MAP (78.54±8.01)mmHg and COR (321.23±15.35)nmol/L of the observation group were significantly higher than HR (94.21±9.53)beats/min,MAP(98.67±10.21)mmHg and COR (463.24±20.01)nmol/L of the control group,the differences were statistically significant (t=12.60,11.50,41.76,all P<0.05).The amount of propofol induction (1.65±0.21)mg/kg,dosage of propofol (323.13±15.64)mg and remifentanil (401.21±20.11)μg of the observation group were lower than those of the control group [(2.39±0.34)mg/kg,(414.32±20.34)mg,(469.54±22.39)μg],and the recovery time of the observation group (6.89±1.01)min was significantly better than (10.21±1.42)min of the control group,the differences were statistically significant (t=13.73,26.36,16.84,14.13,all P<0.05).Conclusion The effect of BIS monitoring in laryngeal mask anesthesia for laparoscopic cholecystectomy is significant,which can reduce intraoperative anesthetic dosage,promote hemodynamic stability,reduce the stress response of patients,shorten recovery time,the anesthesia is more safe and reliable.

Objective Jizhipingchuan soft capsula is mainly used to treat acute bronchitis and acute attack of chronic bron-chitis.This paper investigate the antitussive, antiasthmatic and expectorant effects of Jizhipingchuan soft capsula according to its func-tions. Methods The antitussive effect of Jizhipingchuan soft capsula was observed in cough mouse model induced by ammonia and in guinea cough pig model induced by citric acid, and the latent period of asthma was observed in guinea pig induced by acetylcholine chloride and histamine phosphate.Its expectorant effect was evaluated by the excretion of phenol red in mice and the exudation phlegm in rats. Results Jizhipingchuan soft capsula could decrease the frequence of cough induced by ammonia in mice and induced by cit-ric acid in guinea pig.It could prolong the latent period of cough in guine pig and also prolong the latent period of asthma in guine pig induced by acetylcholine chloride and histamine phosphate.Jizhipingchuan soft capsula could significantly increase the amount of phe-nol red secreted in mice and the phlegm exudation of rats. Conclusion Jizhipingchuan soft capsula showed definite antitussive, an-tiasthmatic and expectorant effects.

Relations between doctors and patients are the most basic and important human relations in medical practice.Some reports indicate that non-technical medical factors result in most cases of physician-patient conflicts.In this paper we analyzed non-technical medical factors from the fields of society,ethics and mentality,and concluded main reasons for physician-patient conflicts are the lack of "being discreet when alone",the absence of "patients-oriented service concept",the ignorance of responsibility of "life-saving",and the missing of humanity care.

OBJECTIVE To compare the effect and safety of coblation plasma surgery and beclomethasone dipropionate nasal spray in the treatment of perennial allergic rhinitis. METHODS A stratified,randomized,controlled trial of surgery and medicament was performed in the treatment of perennial allergic rhinitis. A total number of 102 patients were involved in the trial,including 56 cases with swelling of inferior turbinate,28 cases in surgery group,28 cases in medicament group; and 46 cases without swelling of inferior turbinate,23 cases in surgery group,23 cases in medicament group. Coblation plasma surgery was performed in all surgery groups. Each patient was given 50?4?2 ?g/d of beclomethasone dipropionate nasal spray in all medicament groups,Treatment time was 3 months. The symptom scores (SS)and visual analogue scale(VAS)were recorded. RESULTS Effect assessment showed that both methods had significant repressive effect on allergic symptoms,the effect of surgery group was better than that of medicament group at the 14th day,28th day and 3th month in cases with swelling of inferior turbinate. Difference between the surgery group and medicament group in cases without swelling of inferior turbinate had no statistic significance. CONCLUSION Both coblation plasma surgery and beclomethasone dipropionate nasal spray are effective to treat perennial allergic rhinitis. But coblation plasma surgery is better than medicament in cases with swelling of inferior turbinate.

Objective Tostudy the effects ofRheu compositus (Dachengqi Decoction, DD) on the NF-κBactivity of alveolar macrophages in ARDS rats and its inflammatory cytokine expression, and hence to explore the molecular mechanism of the anti-inflammatory effects of DD. Method The 65 male Wistar rats were randomly di-vided into the control group (n = 12), the ARDS model group (n = 21), the DD treatment group (n = 16) and the dexamethasone treatment group (n = 16). The rots of model group received 1 mg/(kg·0.5 mL) LPS injected intra-poritoneally and LPS in dose of 5 mg/(kg·0. 5 mL) was administrated by slow dropping endotracbeally 16 hours later. Modeling was successfully established 6 hours later evidenced by arterial gas analysis. The rats of con-trol group received 0.5 mL normal saline injected intravenously through tail vein instead of LPS. Three days after establishment of modeling, DD was given to rats of DD treatment group by intragastric instillation for 3 days in dose of 2.31 g/(kg·d),in which the weight of drug was calculated on the basis of dried herbal medicine. In dexam-ethasone treatment group, rats had intra-peritoneal injection of 2 mg/kg dexamethasone for 3 days after modeling was established. Seventy-two hours later, the arterial blood gas analysis and pathological study were carried out, in rats of all groups, and the findings were graded. The levels of TNF-α, IL-1 and IL-10 both in the plasma and in the brenchoalveolar lavage fluid were determined by using the enzyme linked immunosorbent assay (ELISA). Besides the nucleopretein concentration of pulmonary alveolar macrophage (PAM) was maeasuredwith the BAC method, and the NF-κB activity was determined with the Western Blotting, and with the evaluation of the DD' s effect on the transcription activity of PAM inflammatory cytokines. All the experimental data were processed by the SPSS 13.0 for statistical analysis. The analysis of variance was used for the comparison between groups, and P < 0. 05 showed the statistical significance of the difference. Results DD didn' t significantly reduce the TNF-α level [(510.97±76.20) pg/mL,(476.16±98.03) pg/mL, P >0.05], but significantly deceased the plasma IL-1 level [(381.99±34.30) pg/mL, (300.69 ± 50.99) pg/mL, P <0.05]. At the same time, there was no signif-icant changes in the plasma IL-10 level [(345.96 ± 67.72) pg/mL, (345.30 ± 78.52) pg/mL, P > 0.05]. Whereas TNF-α level in BALF was significantly decreased [(130.94 ± 33.51) pg/mL, (106.59 ± 26.64) pg/ mL, P < 0. 05, so was the IL-1 level in BALF (82.5 ± 25.36) pg/mL, (63.89 ± 22.96) pg/mL, P < 0. 05], but IL-10 level in the BALF was significantly increased[(77.09 ± 26.05) pg/mL, (148.05 ± 53.50) pg/mL, P <0.01]. DD significantly reduced the nueleoprotein level of PAM[(5.35 ± 2.44) μg/μL, (3.54 ± 2.01) μg/ μL, P < 0.05]and significantly inhibited the NF-κB activity [electrophoretic band optical density × area/consult mtio:(1.45±0.71),(1.11±0.28), P <0.05]aswell. Conclusions DD regulated systemic pro-inflammato-ry media/anti-inflammatory media balance in rats with ARDS by mainly reducing the level of IL-1. The regulatory effects of DD on the local lung injury not only inhibit the producing of TNF-α and IL-1 level,but also increase the IL-10 level to reestablish the local pro-inflammatory factors/anti-inflammatory factors balance so as to inhibit the lo-cal excessive irranune response. DD inhibits the NF-κB activity in the PAM of ARDS rats so as to restrain the pro-duction of pro-inflammatory cytokines (TNF-α and IL-1). This kind of multi-target bidirectional regulation plays an active role in regulating the immune balance and protecting the target organ from the excessive injury.

Objective To study the effective method of improving the diagnosis and treatment of blunt liver injury.Methods The clinical data of 135 cases with blunt liver injury hospitalized in Daxing District People' s Hospital from January 2000 to October 2010 were reviewed retrospectively.Results By standard grading of American Society of Trauma Surgery (AAST) in 1994,36 cases were grade Ⅰ,42 cases gradeⅡ,33 cases gradeⅢ,14 cases grade Ⅳ,10 cases gradeⅤ.Fifty-one cases were treated by non-operative therapy,among which 42 cases were crued,9 cases underwent operative surgery.Ninety-three cases were treated by operative therapy,seven cases died.The morbidity related to blunt liver injury was 5.19％.Conclusions Non-operative therapy may be used firstly in patients with stable hemodynamics,but close monitoring should be done for changes of the life signs.Timely and reasonable choice of time and the way of surgery is important to avoid complications and reduce the mortality rate.