Female ; Humans ; Leiomyomatosis ; diagnosis ; surgery ; Uterine Neoplasms ; diagnosis ; surgery ; Vascular Neoplasms ; diagnosis ; surgery ; Vascular Surgical Procedures ; methods ; Veins

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 evaluate the value of endometrial volume measurement and 3-dimensional power Doppler imaging(3D-PDI) in the differentiation between endometrial polyps and endometrial hyperplasia.Methods One hundred and fifty-six women who diagnosed as thick and inhomogeneous endometrium or hyperechogenic focal intrauterine structures by 2D ultrasound were enrolled,including 50 patients with endometrial polyps in the proliferative phase,51 cases with hyperplasia and 55 cases with normal histology or others.All were scheduled for hysteroscopy,dilatation and curettage,and the ultrasound was performed within 24 hours before the procedure. Endometrial volume, vascularity index (VI), flow index (FI) and vascularity flow index (VFI) were measured. These parameters were compared between endometrial polyps group and endometrial hyperplasia group.Results These parameters (endometrial volume,VI,FI and VFI) were all considered statistically significant between two groups.Conclusions Endometrial volume and 3D-PDI are good diagnostic tools in the differentiation between endometrial polyps and endometrial hyperplasia.

Objective To investigate the multiple factors correlated to femoral head necrosis in patients over 45 years old with femoral neck fractures after closed reduction and cannulated screws fixation.Methods Three hundred patients with femoral neck fracture were admitted from May 1999 to May 2004 and treated by closed reduction and internal fixation with cannulated screws.We analyzed the multiple factors:age,gender,Garden classification,follow-up time,procedure delay,quality of reduction,time of full-weight-loading,fixation removal, and preoperative traction.Multiple correlation factors were analyzed by SPSS10.0 statistic system.Results Complete case records were documented in 99 cases who were followed up for an average of 24.5 months(range,8 to 60 months).Femoral head necrosis occurred in 15 cases(15.2%).Time of femoral head necrosis was 8 to 50 months after operation.The combination of quality of reduction,preoperative traction,age,and age?fixation re- moval was found to have the most significant influence on femoral head necrosis after internal fixation for femoral neck fractures.Conclusions Good reduction is the most important factor correlated to the outcome of a femoral neck fracture.Age is linked to the risk of necrosis but it is relatively insignificant.Preoperative traction in wrong positions can increase the incidence of necrosis.Garden classification is important in predicting femoral head necrosis and is associated with quality of reduction,but it is not a risk one in the combination of multiple correlation factors that lead to the necrosis.

Objective To discuss teaching methods of TCM lectures for students of Western medicine in colleges and universities.Methods Totally 36 studens majoring in Western medicine from Capital Medical University were involved in the study. The first questionnaire survey showed the interest of those students. According to the students' response, the topics for the lectures were determined. The purpose for the second questionnaire was to investigate the teaching outcomes. Results The recovery rate for the first questionnaire was 100%, and the effective rate was also 100%. Students showed interest in the course of Introduction of TCM Health Maintenance, with few different ideas. The recovery rate for the second questionnaire was 88.89%, and the effective rate was also 88.89%. Students were relatively satisfied with lecture teaching, with few different ideas.Conclusion Lecture teaching can promote students' interest and teaching quality.

Humans ; Pulmonary Embolism ; diagnosis ; therapy ; Venous Thromboembolism ; diagnosis ; therapy

Objective To estimate and optimize the dosage regimen of vancomycin and linezolid for treatment in different Gram-positive cocci infections. Methods The pharmacokinetic data of vancomycin and linezolid were collected, and the pharmacodynamics in vitro of these drugs for staphylococcus epidermidis, staphylococcus aureus, enterococcus faecalis and enterococcus faecium were analysed. The cumulative response fraction (CFR) was evaluated in different dosage regimens of two drugs against four types of bacteria. Results The regimen of 3 500 mg/d vancomycin was recommended for patients with staphylococcus epidermidis infection. The regimen of 2 500 mg/d vancomycin was recommended for patients with staphylococcus aureus infection. The regimens of 3 000 mg/d vancomycin and 400 mg linezolid given 2 times/day were recommended for patients with enterococcus faecalis infection. The regimens of 2 500 mg/d vancomycin and 400 mg linezolid given 2 times/day were recommended for patients with enterococcus faecium infection. Conclusion In application of vancomycin and linezolid for treatment of Gram-positive cocci infections, different dosage regimens should be used in different types of infections.

Adult ; Elbow Joint ; injuries ; Female ; Humans ; Joint Dislocations ; therapy ; Musculoskeletal Manipulations ; Radius ; abnormalities ; Radius Fractures ; therapy ; Synostosis ; therapy ; Ulna ; abnormalities

ObjectiveTo assess the value of the Beijing version of Montreal Cognitive Assessment ( MoCA) in community dwelling older adults residing in Shenyang,China.MethodsThe stratified random sampling method was used to investigate the population over 60 years old in 4 communities of Shenyang in the year 2011.Mini-Mental State Examination (MMSE) and the Beijing version of MoCA were administered to all participants.258 old people finished the assessment.ResultsThe internal consistency of the MoCA Beijing version was good,yielding a Cronbach alpha of 0.836.The correlation between the MoCA Beijing version and the MMSE was good(r=0.623,P＜0.001 ).Only 15.1％ participants had an education of over 12 years,but 26.3％ participants had an education of 6 years or less.Only 3 items of MoCA Beijing version ( naming lion,forward digit span,recall daisy)showednosignificantdifferencebetweenpersonswithandwithoutover 6yearsofeducation.ConclusionsThe results indicates that the Beijing version of MoCA have good reliability and validity.This study shows that an education of 6 years or less might be the proper population to add the one point in China,and the cutoff-point of 26 for normal is too high for Chinese population.

Objective To study the association between serum interleukin-33 (IL-33) level and human stromelysin-2 (ST2) level in patients with rheumatoid arthritis (RA) associated with interstitial lung disease (RA-ILD) and its correlation with lung function and other laboratory parameters.Methods Two hundred and forty-five newly diagnosed RA patients during March 2012 to March 2013 in the in-patient and out-patient clinic of the First Affiliated Hospital of Liaoning Medical College were enrolled into this study.Patients were further divided into RA group (n=187) and RA-ILD group (n=58).Sixty subjects who came to the hospital for routine health check-up was composed of the normal control group.The clinical data of the two groups and controls were collected and their serum IL-33 and ST2 concentrations were measured.The t test was used to compare the difference between the two groups.Multiple variance analysis was used to com-pare the difference between groups.Pearson's correlation analysis was applied to explore the relationship between IL-33 concentrations and related variables.Results ① This study showed that the prevalence of RA associated interstitial lung disease was 23.7％(58/245).② The concentration of IL-33 [(746±43) pg/ml] and ST2 [(3413±169)pg/ml] of the RA-ILD group was significantly higher than that of the RA group [(433±42) pg/ml,(1500±147) pg/ml] (P＜0.01).③The vital capacity (VC％),forced vital capac-ity (FVC％),maximal midexpiratary flow curve (MMF％) and carbon monoxide diffusing capacity (DLCO) of the RA-ILD group were significantly lower than those of the RA group.④ The serum level of IL-33 was negatively correlated with that of RF and ACPA (IL-33 and RF,r=0.82,P＜0.01; IL-33 and ACPA,r=0.55,P＜0.01).Serum level of IL-33 was negaitively correlated with DLCO (r=-0.80,P＜0.01).Conclusion IL-33 participates in the pathogenesis of RA; and may be involved in the pathogenesis of RA-ILD.