Community health service is an effective measure to relieve the difficult medical services and expensive medical cost problem,but community inhabitants in Chongqing make little use of community health service.The actual cause is that people s degree of trust in community health service is low.In view of existing situation,this article analyzes the various factors that influence community residents' degree of trust in community health service and puts forward corresponding policy proposal.

Adult ; Antibodies, Monoclonal, Murine-Derived ; administration & dosage ; therapeutic use ; Female ; Hemophilia A ; drug therapy ; Humans ; Rituximab

BACKGROUND: The method of culture purified sinoatrial node cell is important in investigating its ultrastructural characteristics and autorhythmic mechanisms.However,the corresponding method has not been standardized.OBJECTIVE: To summarize the localization,cultivation and purification of sinoatrial nodes isolated from newborn rabbits,and to study the morphological characters of primary cultured pacemaker cells.METHODS: Hearts of the newborn rabbits(within 24 hours)were embedded in paraffin for hematoxylin-eosin staining,The location of sinoatrial nodes was observed under an optical microscope,the morphology of sinoatrial nodes cells were observed by light microscope and electron microscope.RESULTS AND CONCLUSION: Sinoatrial nodes localized in the anterior wall of the superior vena cava and the posterior laterial wall of right atrium.There was about 0.32 mm between its lowest point and sulcus terminalis.Three distinct types of cells were observed among the cultured cells of sinoatrial nodes: spindle,spider and polygon.The spindle cells occupied the greatest proportion of the cultured cells(59.6±7.3)%.The spontaneous contraction frequency of spindle cells was the highest among the constracting cells(145±9)times per minute.The ultrastructure observation showed that myofibrils and other organelles in spindle cells were sparse and significantly decreased in number compared with triangle cells.There was no significant difference between triangle cells isolated from sinoatrial nodes and from atrial muscle.Sinoatrial nodes could be harvested along the anterior root of the superior vena cava down to the posterolateral sulcus.Among the cultured cells from neonatal rabbit sinoatrial nodes,the spindle cells with small body and fast pulse frequency are pacemaker cells.

Objective To compare the short-term effect of Docetaxe and Irinotecan combined with Xeloda in treatment of end stage gastric cancer.Methods 65 patients with advanced gastric cancer were randomly divided into two groups.33 patients in group A received Docetaxe plus Xeloda and 32 patients in group B received Irinotecan plus Xeloda.At least two treatment cycles were completed.Results The overall response rate is 54.54%(A) and 53.13%(B),and the median progression-free survival was 6.1 months and 6.2 months.Patients in group A experienced more anemia,and patients in group B,diarrhoea.Conclusion The effects of Docetaxe or Irinotecan combined with Xeloda in the treatment of advanced gastric cancer are comparable and well tolerated.

OBJECTIVE To understand epidemiologic situation of pathogens causing nosocomial infection,their resistance and changing pattern.METHODS A retrospective analysis was made upon the pathogens data from 2002 to 2006.The identification of bacteria was evaluated by VITEK32 and susceptibility test by K-B method.RESULTS The prevalence rate was 6.4%,and main infection sites were lower respiratory tract and urinary tract.Gram-negative bacteria(38.11%) stood first,followed by Gram-positive bacteria(25.25%) and fungi(22.54%).The mean resistance of Gram-negative bacteria was very high,from them Stenotrophomonas maltophilia(72.71%) and Chryseobacterium meningosepticum(68.13%) stood the highest.Besides Enterococcus faecalis,the mean resistance of Gram-positive bacteria exceeded 55.00%.Candida albicans stood first on the list of fungi.CONCLUSIONS The composition of pathogens is changing and showing serious resistances.It is important to strengthen nosocomial infection management and utilize drug rationally.

BACKGROUND:Bone marrow mesenchymal stem cells have beneficial effects on the treatment of various diseases. Mitochondria transfer is newly proposed and its specific mechanisms of action and control factors remain unclear.
OBJECTIVE:To review the studies about stem cells and mitochondrial transfer, then to discuss its value on clinical.
METHODS:The PubMed, VIP and Wanfang databases were searched for related articles concerning stem cells and mitochondrial transfer. Key words were“stem cell, embryonic stem cell, progenitor cell, mitochondria”in Chinese and“Stem cell[s], Mother cell[s], Progenitor cell[s], Colony-Forming Unit[s], Colony Forming Unit[s], Mitochondria[l] transfer”in English. Thirteen articles were found initial y, and using the citation tracking method, final y 42 articles were determined. RESULTS AND CONCLUSION:Studies have shown that mitochondrial transfer from bone marrow mesenchymal stem cells is associated with rescue of aerobic respiration and restoration of mitochondrial function in the injured somatic cells. Bone marrow mesenchymal stem cells and recipient cells form tunneling nanotubes for mitochondrial transfer. Movement of mitochondria between cells is regulated and directed by Miro1. The successful transfer of mitochondria may be accompanied with the clearance of damaged mitochondria. The rescue of mitochondrial function in early stages may provide a valuable therapeutic strategy for various diseases include acute lung injury.

Objective: To explore and discuss the clinical curative effect on intermittent positive pressure breathing therapy of non - invasive ventilator in the treatment for chronic obstructive pulmonary disease (COPD) of elderly patients with complication of acute respiratory failure. Methods: 112 elderly patients who were COPD (all of patients were acute exacerbation period) with complication of acute respiratory failure were divided into control group (60 cases) and observation group (52 cases) as the random number table. A series of basic therapy including routine anti-inflammatory, relieving asthma and expectorant therapy were implemented for all of patient. And the non-invasive ventilator was used to implement non-invasive mechanical breathing therapy. In this therapy, patients of control group were implemented sustaining positive pressure breathing therapy, while patients of observation group were implement intermittent non-invasive positive pressure breathing therapy (1:1). The curative effect, pH value (at 6,24 and 72h), PaO2 (at 6,24 and 72h), PaCO2 (at 6,24 and 72h) and complications between the two methods were compared. Results: There was no significant difference in the general demographic characteristics between the two groups. For patients at 6, 24 and 72 h, the differences of the pH value, PaO2and PaCO2 between pre and post-treatment were significant in observation group (F=5.669, F=6.985, F=7.628, P<0.05) and control group (F=5.311, F=6.892, F=7.958, P<0.05) , respectively. The differences of the pH value, PaO2 and PaCO2 at 6h, 24h and 72h were significant (at 24h, F=6.776, F=7.098, F=7.673. at 72 h, F=7.883, F=6.983, F=7.335, P<0.05),respectively. For two groups, the differences of pH value, PaO2 and PaCO2 at pre-weaning, post-weaning 6h and post-weaning 12h were not significant. While the mechanical ventilation time and mechanical ventilation rate of observation group were significant lower than that of control group (t=3.591, x2=3.052, P<0.05). Besides, the incidences of complications including flatulence, trachea intubation, respiratory and relative pneumonia of observation group were significant lower than that of control group (x2=4.997, P<0.05). Conclusion: The new method can significantly shorten duration of breathing and duration of hospital stays. And its incidence of complication is lower while safety of treatment is relatively higher than that of traditional method.

Objective To analyze the change of disease spectrum and the direct cause of death in Xi'an Children's Hospital emergency patients in the past 2 years.Methods The cases of death in 130 emergency cases from 2009 to 2010 were retrospectively analyzed.Results The main causes of death in 2009 were pneumonia,congenital heart disease,asphyxia,neonatal pulmonary hemorrhage and intracranial hemorrhage.Meanwhile,The main cause of death in 2010 were pneumonia,asphyxia,viral encephalitis,congenital heart disease and neonatal pulmonary hemorrhage,which significantly changed compared with 2009.Major direct causes of death were found:respiratory failure in 25 cases (27.5％),heart failure in 17 patients ( 18.7％ ),shock in 17patients ( 18.7％ ),asphyxia in 16 cases ( 17.5％ ),and hernia in 16 cases ( 17.5％ ),Conclusion In order to reduce the mortality rate of emergency patients,we should strengthen health care,actively manage pulmonary infection,systemic infection,and shock,control heart failure,and prevent aspiration.

As to a nitrite-oxidizing bacterium screened in our laborator y, the effect of pH, nitrogen sources, carbon sources and sodium chloride on its g rowth was studied in order to obtain high cell density. It showed that the cult ure conditions of nitrite- oxidizing bacterium were 4500mg/L sodium nitrite, 1 .5g/L sodium carbonate, 0~0.5% sodium chloride and 0~0.1% glucose at 28℃~30 ℃, 110 r/min and pH 8.0~8.5. After cultivation for 9 days, the bacteria conc entration reached 4.6?109 MPN/mL and all NO-_2-N in the medium w as converted to NO-_3-N. But the transformation of nitrogen sources was inhibited while the sodium chloride concentration exceeded 0.5% or glucose con centration exceeded 0.1%. According to the test of NO-_2-N conversion with nitrite-oxidizing bacteria in a freshwater aquaculture pond, NO-_2 -N began to decrease on the third day of the moculation of this bacterium and t he concentration dropped from 1.47mol/L to 0.49mol/L after 18 days at 25℃ and pH 8.6.

Objectives To investigate the etiological factors,clinical features and treatment of pediatric primary spontaneous pneumothorax (PSP). Methods The clinical data of 84 PSP patients under the age of 18 from Departments of Emergency,Respiratory Diseases and Thoracic Surgery of our hospital from June 1999 to June 2009 were collected. There were 72 males (85.7%) and 12 females (15.3%) with a ratio of 6 to 1. Their age ranged from 14 to 18 (mean 17.06). Patients with pneumothorax following trauma,pneumonia,iatrogenic and other underlying causes were excluded. Therapeutic methods included oxygen therapy for 4.8% patients,closed drainage of pleural cavity for 57.1% patients,and surgery for 38.1% patients,But there were 31 patients receiving surgical treatment after closed drainage was failed. The period of follow-up ranged from 1 to 123 months (mean 25.73 months) through telephone or outpatient. Results Eighty-four patients were included,of whom 96.4% had chest pain,7.1% had chest tightness,66.7% had dyspnea,8.3% had shortness of breath and 14.3% had cough. There were 96.4% patients having decreased breathing sound and 3.6% having absent breathing sound. Bullae or blebs occurred mostly in apex and upper lobe. Twenty-one patients suffered from recurrent pneumothorax. Smokers (66.7%,n=9) had higher recurrent rate than non-smokers (22.0%,n=75). Conclusion PSP should be considered when symptoms such as chest pain and dyspnea appear in teenagers. Closed drainage of pleural cavity combined with surgical procedure is recommended for treatment. PSP patient with a history of smoking has higher recurrent rate of PSP.