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.

Tumor markers for early diagnosis of cancer is an important auxiliary mean,which for early tumor detection,monitoring and for judging curative effect of treatment regimens play important role.Clinical method for early diagnosis on ovarian cancer is the detection of serum CA125,however,its precision and specificity for early diagnosis are not enough.It has been found that in the development period of the patients with ovarian cancer,SMRP and CA125 is co-expression.This article reviews the value of serum mesothelin on diagnosis of epithelial ovarian cancer to provide reference on early diagnosis and treatment.

NOK is a newly identified receptor protein-tyrosine kinase (PRTK) molecule that can promote tumorigenesis and metastasis. Previous data showed that NOK could activate the phosphatidylinositol 3'-kinase (PI3K) pathway in stable BaF3 cells. But how does NOK activate PI3K in cells remains unknown. It was showed that NOK physically interacted with the PI3K downstream effector Akt and enhanced its activation in human embryo kidney 293T (HEK293T) cells. Deletion mapping indicated that protein kinase B (Akt) was able to directly contact with the kinase domain of NOK. Inactivating the Akt kinase domain significantly reduced the intermolecular interaction between NOK and Akt, while constitutively active mutant of Akt apparently had a stronger interaction with NOK. NOK did not have an additive effect on insulin-mediated Akt activation. Overall, the results indicate that NOK might complex with Akt and directly activate PI3K/Akt signaling pathway.

Objective To study the diagnostic value of spiral CT pulmonary angiography(SCTPA) for pulmonary embolism(PE).Methods SCTPA scans were performed in 25 patients with PE,the contrast-enhanced SCT scans of the pulmonary arteries were performed,MPR,MIP and SSD were performed simultaneously.Results The 29 SCTPA scans were performed in 25 patients, including the central type in 23 cases(92%) and the peripheral type in 2 cases(8%).The rates of the main,the sinistral and dextral,the middle lobular,the lobular and the lingular pulmonary artery displayed were 100%,the rates of the segmental pulmonary artery displayed were 97.77% and the rates of the subsegmental pulmonary artery displayed were 68.00%.The lobular and segmental pulmonary artery were mainly embolized,the rates of PE were between 46.58% and 75.00%.Conclusion SCTPA has great value in earlier and clear and definite diagnosis of PE.

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

Esophageal and Gastric Varices ; complications ; prevention & control ; surgery ; Gastrointestinal Hemorrhage ; complications ; prevention & control ; surgery ; Humans

Objective The difference of the equivalent IOL powers before and after LASIK was calculated by using the Haigis-L formula and Sirius ray-tracing respectively.And study the correlation be-tween the intraocular lens power and the myopic before laser in situ keratomileusis.Methods Ninety-one patients undergoing myopic laser in situ keratomileusis were enrolled, they were divided into 3 groups ac-cording to myopic diopter, group I (-1.00D~-3.00D) 13cases, group II( -3.25D and -6.00D)60 cases, group III(-6.25D~-10.0D)18 cases.The equivalent IOL power before and after LASIK will be calculated using Haigis-L formula and Sirius ray-tracing.The data were analyzed using SPSS20.0.Results 80.2%of the cases calculated using Haigis-L formula were within ±0.50D of the predicted refraction , 94.5%were within ±1.00D, and 100%within ±1.50D.also, within ±0.50D of the predicted refrac-tion 13cases(100%),51cases(85%),9cases(50%) in group I, II, III respectively.74.7% of the eyes calculated using Sirius ray-tracing were within ±0.50D of the predicted refraction , 89.0%were within ± 1.00D, and 100%within ±1.50D.within ±0.50D of the predicted refraction 12cases(92.3%),48cases (80%),8cases(44.4%) in group I, II, III respectively.Conclusions Sirius ray-tracing and Haigis-L formula can calculate IOL power accurately in eyes with prior myopic LASIK, with no need for preoperative data.and there is positive correlation between the intraocular lens power aberration and the myopic diopter before LASIK.

Ventilator associated pneumonia (VAP) is a challenging complication of critical illness.Aerosolized antibiotic is an option for the management of VAP currently,as it is reported that it could increase levels of drug in alveolar without increasing systemic toxicity.The articles that focused on the aerosolized antibiotics in the treatment of VAP and its influence factors were reviewed,and it was found that to achieve maximum drug delivery efficiency and reduce the influence of nebulization method,some factors,such as ventilation modes,tidal volume,nebulizer type,should be adjusted and monitored during the treatment.

Objective To understand the effects of "total quantity control" indexes on community health services and the residents' use of them so as to provide scientific basis for furthering reform in the medical insurance system.Methods A survey was made on the operation of the 3 community health centers of Jiangbin Xincun,Huashanwan and Hejianong in Jingkou District of Zhenjiang by means of direct inquiry and literature review.Results The average annual quantity of medical insurance plans allocated to the centers in the last 4 years involved 810 thousand yuan,the quantity actually fulfilled involved(953.5) thousand yuan,and the estimated annual quantity the centers were capable of fulfilling was valued at(1.45) million yuan,nearly 500 thousand yuan more than the quantity actually fulfilled. Conclusion Total quantity control on community health centers not only hinders the healthy development of community health services and the enthusiasm of the medical workers but also adversely affects the residents'use of health services and their health maintenance.

Objective To investigate the role of insulin-like growth factor (IGF)-Ⅰ , ⅠⅠ , platelet-derived growth factors (PDGF)-AA,-BB and keratinocyte growth factor (KGF) in various stages of the pulmonary development in rats. Methods All lung tissues of fetal and neonatal rats were collected at the gestational age 18, 20, 21 d, and 1, 4, 7, 10 and 21 d after birth. The expression of IGF-Ⅰ , IGF- ⅠⅠ , PDGF-AA and PDGF-BB was detected by immunohistochemistry and Western blot, respectively. The levels of IGF- Ⅰ , IGF-ⅠⅠ , PDGF-A, PDGF-B and KGF mRNA were measured by reverse transcription polymerase chain reaction (RT-PCR). Results The peak expression of IGF-Ⅰ was at 4, 7 and 10 d after birth. IGF-ⅠⅠ was detectable early in fetal lung development and decreased gradually until 21 d after birth. The changes of IGF- Ⅰ , ⅠⅠ mRNA were similar to IGF- Ⅰ , ⅠⅠ polypeptides. The PDGF-A,PDGF-B mRNA were abundant early in fetal lung development. The steady state of PDGF-A chain mRNA was significantly different only at 7 d (0. 97?0. 23,P0. 05). The PDGF-AA polypeptide was abundant early in fetal lung development, and the expression peak was found in 1, 4 and 7 d after birth. KGF mRNA was higher in the fetal samples than that of rats after birth, but no difference in postnatal rats at all time points. Conclusions Peptide growth factors may play a critical role in the development of lung in rats.