The cultural differences in the measure of value, mode ofthinking, code of conduct and consume concept, etc. In the orient and western countries were analyzed. The differences in the cultural back ground, nature, psychology and social effects of the health insurance system in the orient and westem countries and the true meaning of the culture of Medisave Scheme in Singapore and the culture of health insurance system in Germany were investigated. Finally, the authors traced the basic health to its origin.Looking forward to the twenty - first century, the growth rate of the population inthe developed countries will decrease and the population structure will be aged seriously. The social support coefficient will rise. The mode of the health insurance system in Germant - a compulsory social insurance mechanism, as a representative of westerm culture would face a crisis of insurance economics. Singapore mode of the health insurance system, a representative of orient.culture will become a model ofreformed health insurance system in the developing and industrialized countries. Finally it may be the basic mode of the culture of health insurance system in the word.

Objective To evaluate the clinical value of percutaneous renal artery angiography and embolization of the renal artery pseudoaneurysms. Methods A retrospective analysis was made on 15 cases of postoperative urethral bleeding following urinary calculi surgery from January 2012 to February 2014, which were diagnosed of renal artery pseudoaneurysms via the renal artery angiography.Superselective catheter placement was carried out into the proximal of parent artery and the pseudoaneurysm was embolized by using a coil and gelatin sponge. Results Renal artery angiography clearly displayed pseudoaneurysms in the 15 cases, which were located in interlobular artery in 11 cases, arcuate artery in 3 cases, and minor interlobular artery in 1 case.Urethral bleeding was stopped after using gelatin sponge and spring coil embolization.Among them urethral bleeding recurred in 1 case after two days, and a second embolization was conducted.After the embolization, transient renal colic happened in 2 cases and a fever of 37.8-39.3 ℃lasting for 3-8 d was seen in 7 cases.Follow-ups for 3-24 months ( mean, 15 months) showed no renal dysfunction and urinary tract bleeding. Conclusion The transcatheter embolization and angiography can diagnose and treat renal artery pseudoaneurysms, with safe and effective outcomes.

Objective To study the force and pressure transmission through normal wrist,and the effect of transverse carpal ligament release on the biomechanics of carpal tunnel.Methods A 3-D finite element model of the wrist based on CT scan images was established.The load transmission of carpus and the distribution of contact stress on radiocarpal joint under axial compressive force on metacarpals as well as the effect of transverse carpal ligament(TCL)release on the displacement of carpal bones were computed and analyzed.Results The computational results of force and pressure transmission through normal carpus matched well with previous studies.The release of TCL resulted in radial and palmar displacement of the scaphoid,flexion and radial rotation of radiocarpal joint as well as a further radial deviation of the whole carpal tunnel.Conclusion A 3-D finite element model of the wrist that includes the carpal tunnel,distal radius and ulna and proximal metacarpals is developed.This model may simulate the load transmission better and contact stress distribution of carpal tunnel and radiocarpal joint,as well as provide an operational plateform for further deeply studing on biomechanical behavior of carpal structure.The computed and analyzed results of the effect of TCL release on the displacements of carpal bones can be served as related theoratic base on carpal tunnel syndrome,carpal tunnel release surgery and recovery after operation.

Objective: To evaluate the application value and potential faults of Dual-source CT in carotid arterial angiography.Methods: We retrospectively analyzed the images of 477 patients with symptomatic carotid atherosclerosis detected by dual-source CT angiography(CTA) from February 2007 to January 2008,and evaluated the quality of the images,which were classified into 3 quality grades: excellent(with clear display of the lesion and no noticeable motion artifacts,good(with a few motion artifacts but still diagnostically applicable),and poor(with heavy motion artifacts,unclear display and no diagnostic value).Results: Of the 477 images,420(88.1%) were of excellent quality,44(9.2%) of good quality and 13(2.7%) of poor quality.Among the total number of cases,134(28.1%) were shown to be normal and 34(7.1%) abnormal in anatomic structure.Atheromatous plaques were detected in 295 cases(61.8%),carotid artery stenting in 11(2.3%),internal carotid artery occlusion in 1,common carotid artery occlusion in 1,and cervical tumor in 3.Conclusion: Dual-source CT,faster,effective and minimally invasive,is particularly valuable in the diagnosis of carotid arterial lesion and stenosis.

The structure and working principle of dual-source CT(DSCT) and its clinic application are expatiated.Many advantages are proved after the analysis and discussion and also after the validation of clinic application,such as higher temporal resolution for the imaging of cardiac and coronary artery to be finished without the influence of any heart rate,lower X-ray absorbing dose to offer more safe surrounding for the patients,higher special resolution and higher signal to noise of images to offer more reliable diagnostic tool,the technology of dual-energy is special in the examination and research of function and metabolize of human being.

OBJECTIVE:To investigate the characteristics and future trend of drugs for cardiovascular diseases in our hospital METHODS:By using the 《China pharmaceutical information net》 adopted in the Second Hospital of Xi'an Jiaotong University,the drug consumption was statistically analysed RESULTS:Sum and daily cost of drug-consumption for cardiovascular diseases assumed an increasing tendency CONCLUSION:The drugs for cardiovascular diseases are complicated in classification and numerous in kind,therefore we should rationally use them

Objective To discuss the 3D reconstruction dual-source CT angiography (DSCT) in diagnosing nutcracker syn-drome,Methods 24 cases with known or suspected "nutcracker" syndrome were underwent with DSCTA and 3D recon-struction, left renal vein (LRV) were demonstrated and measured. Results Among 24 cases, 16 cases were diagnosed with "nutcracker" syndrome; the imaging demonstrated LRV were compressed. The angle between SMA and AO of 24 cases with "nutcracker" syndrome was abnormally acute(<45°). The angle A was 14°～38°, the average angle was 28.12°±7.92°. The angle A' was 11°～21°, the average angle was 16.46°±3.42°. Conclusion The 3D reconstruction DSCTA may be the most useful tool in diagnosing nutcracker phenomenon.

Objective To discuss the 3D reconstruction dual-source CT angiography (DSCT) in diagnosing nutcracker syn- drome. Methods 24 cases with known or suspected "nutcracker" syndrome were underwent with DSCTA and 3D recon- struction, left renal vein (LRV) were demonstrated and measured. Results Among 24 cases, 16 cases were diagnosed with " nutcracker" syndrome; the imaging demonstrated LRV were compressed. The angle between SMA and AO of 24 cases with "nutcracker" syndrome was abnormally acute(

Objective To evaluate the effects of different doses of dexmedetomidine on propofol-induced inhibition of responses to laryngeal mask airway (LMA) insertion when combined with fentanyl in patients undergoing gynecological operation.Methods One hundred and twenty-five ASA Ⅰ-Ⅱ female patients,aged 20-60 yr,scheduled for elective short-time surgery,were randomly divided into 5 groups (n =25 each):normal saline group (group NS) and different doses of dexmedetomidne groups (groups D1-4).Normal saline 40 ml and dexmedetomidne 0.4,0.6,0.8,1.0 μg/kg (in 40 ml of normal saline) were infused over 10 min in groups NS and D1-4,respectively.1％ propofol was then given by target-controlled infusion.The concentration of propofol was determined by using modified Dixon's up-and-down method.The initial plasma concentration of propofol was 3.0 μg/ml and the ratio between the 2 successive concentrations was 1.1.Fentanyl 1.5 μg/kg was injected intravenously when the effect-site concentration of propofol reached the preset plasma concentration.LMA was inserted 4 min later.When LMA insertion was successful,the concentration of propofol was decreased in the next patient and when LMA insertion failed,the concentration of propofol was increased in the next patient.Failure of LMA insertion was defined as difficulty in inserting LMA or body movement,corner of mouth movement,biting LMA,swallowing and/or lacrimation during insertion.The median effective target effect-site concentration and 95％ confidence interval of propofol blunting responses to LMA insertion when combined with fentanyl were calculated.Results The median effective target effect-site concentration (95％ confidence interval) of propofol blunting responses to LMA insertion when combined with fentanyl were 3.09 (2.83-3.36),2.48 (2.26-2.73),2.29 (2.18-2.41),2.04 (1.95-2.12) and 1.67 (1.55-1.81) μg/ml in groups NS and D1 4,respectively.Conclusion Dexmedetomidine can enhance propofol-induced inhibition of responses to LMA insertion when combined with fentanyl in dose-dependent manner in patients undergoing gynecological operation.

Objective To assess the value of selective renal arterial embolization in treating mononephrous renal angiomyolipoma. Methods 1 6 patients with mononephrous renal angiomyolipoma were retrospectively analyzed.To observe and analyze the changes in renal function,lesions reduction and its complications.Results Symptoms have been improved significantly after treatment,no se-rious complications were observed during operation and postoperation.The creatinine level in postoperation was lower than the pre-operative level,followed-up after 1year.Conclusion Selective renal artery embolization is a safe and effective method for the treat-ment of mononephrous renal angiomyolipoma.