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.

Objective To elucidate the relationship between mandibular lateral displacement and mandible asymmetry by observing the morphological changes of condylar head and mandible during mandibular lateral displacement in growing rats.Methods Forty-eight male Wistar rats at the age of four weeks were divided at random into experimental and control groups,with 24 rats in each group.A super-hard resin plate was cemented to upper incisors to displace rat mandibles 2 mm to the left during closure(Ipsilateral side).A metal crown was fitted to lower incisors.The rats were killed 2,4,8 or 12 weeks after appliance attachment.The mandible was dissected out and halved.The length and width of condylar head were measured with a caliper.Radiographic films of the mandibles were exposed,and selected measurements were made.Results The length of condylar cartilage on the ipsilateral side was significantly larger than contralateral side in experimental group(P

Objective To investigate the feasibility of laparoscopic radical gastrectomy for gastric cancer.Methods Laparoscopic radical gastrectomy was performed in 8 cases from Febrary 2005 to April 2005,including radical distal gastrectomy in 6 cases,radical total gastrectomy in 1 case,and radical proximal gastrectomy in 1 case.Results All the 8 patients underwent laparoscopic radical gastrectomy smoothly and no conversion to open surgery was required.The operation time was 340?62 minutes in radical distal gastrectomy,was 362 minutes in radical proximal gastrectomy,and 423 minutes in radical total gastrectomy.The intraoperative blood loss was 100～250 ml(mean,140 ml) in radical distal gastrectomy,300 ml in radical total gastrectomy,and 170 ml in radical proximal gastrectomy.No blood transfusion was needed.The number of havested lymph nodes was 18～37(mean,23).No surgical-related complications occurred.The time to first flatus was 38～56 hours(mean,42.4 hours),and the time to liquid diet was 2～5 days(mean,2.5 days).All the 8 cases were followed for 12～14 months postoperatively and no recurrence or metastasis was observed.Conclusions Laparoscopic radical gastrectomy is a feasible technique for patients with gastric cancer at early stage or early progressive stage.

Objective Color-coded digital substraction angiography (CC-DSA) was based on DSA and takes image postprocessing via corresponding software (iFlow or Angioviz).It can observe the change of datas,which will be used to analysis the hemodynamics.CC-DSA has advantages of high temporal and spatal resolution.Meanwhile it spends less time and dose not increase the quantity of contrast-medium and X-ray.The application of CC-DSA in recent years were reviewed in this paper.

Component separation technique in recent years both at home and abroad is mainly used in the repair of abdominal wall defects and abdominal wall reconstruction,especially for the great defect of the abdominal wall repair.Combined with laparoscopic minimadly invasive techniques,synthetic patch reflects the technology advantage in the abdominal wall reconstruction.This paper focuses on the surgical principle of component separation technique,indications,advantages,methods of operation,complications and related progress

Objective To study the effect of PPARγ ligand troglitazone (TGZ) on invasion and metastasis of gastric cancer cells, and investigate the relationship of PPARγ ligand with gastric cancer.Methods The expression of PPARγ in gastric cancer cell line MGC803 were detected by immunofluorescence cytochemistry method. The effect of different density TGZ on proliferation activity and adhesion of gastric cancer cell were detected by MTT chromatometry. The effect of different ligands on invasion and metastasis of gastric cancer cell MGC803 were detected by invasion system in vitro. Results The expression of PPARγ mainly located in cell nucleus. TGZ inhibited the proliferation of gastric cancer cell, decreased cell adhesion, locomotory capacity and invasion to matrigel, which had time and dose-dependent relationship.When treatment with 0. 1,1.0 and 10μ mol/ L TGZ, inhibition ratio of invasion and metastasis of cell was 8.79% ,31.31% ,51.42% and 28.29% ,4. 27% ,59. 27% respectively, which had statistical significance compared with control group( P <0. 05). When treatment was 10μ mol/L TGZ, cell adhesion was 0. 32 ±0. 03, it was statistically significant higher than that in control group (0. 52 ± 0. 04, P < 0. 05 ). Conclusion Human gastric cancer cell line MGC803 expressed functional PPARγ protein. TGZ inhibited adhesion and invasion of MGC803 cell on ECM at different degree, the effect of combination of two ligands was evident, which mechanism of action needed to be further investigated.

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.