OBJECTIVE:To observe the effects of dexmedetomidine on hemodynamics of patients underwent cardiac valve re-placement in the anesthesia induction. METHODS:92 patients underwent cardiac valve replacement were randomly divided into ob-servation group and control group,with 46 patients in each group. Both groups received routine anesthesia induction regimen of midazolam 1-2 mg/kg+ fentanyl 0.05 mg/kg+ propofol 1-2 mg/kg+ cis-atracurium 0.15 mg/kg. Observation group was additionally given dexmedetomidine 0.5 μg/kg,within 10 min with pumps,and then maintained with 0.4 μg/(kg·h)till the end of operation;control group was additionally given constant volume of normal saline with pumps. SBP,DBP,MAP,HR,cardiac output(CO), cardiac index(CI),stroke volume(SV),stroke volume variation(SVV)before anesthesia induction(T0),5 min after medication (T1),2 min after anesthesia induction (T2),1 min after intubation (T3),3 min after intubation (T4) and 5 min after intubation (T5)were recorded in 2 groups as well as OAA/S at T0 and 5 min after pumping dexmedetomidine(T1). ADR of 2 groups during anesthesia was also recorded. RESULTS:There was no significantly difference in SVV of 2 groups at T0-T5 (P>0.05);SBP, DBP,MAP,HR,CO,CI and SV of observation group at T0-T5 were all better than those of control group,with statistical signifi-cance(P<0.01);there was no statistically significant difference in OAA/S of 2 groups at T0(P>0.05),and OAA/S of observa-tion group at T1 was decreased significantly and lower than control group,with statistical significance(P<0.01). There was no sta-tistically significant difference in the incidence of ADR as cardiac arrhythmia and hypotension between 2 groups(P>0.05). CON-CLUSIONS:Dexmedetomidine can reduce the influence of anesthesia on the hemodynamics of patients underwent cardiac valve re-placement with good safety.

Objective: To analyze the influences of implementing essential medicine system on primary medical institutions and give suggestions. Methods: Using system dynamics method to construct the compensation mechanism model for primary medical institutions. Compare the growth in revenue and expenditure of primary medical institutions before and after essential medicine system implementation. Results: After the implement of essential medicine system, the growth in total expenditure and total income of primary medical institutions is steadier; when the annual growth rate of government financial subsidies invested more than 13%, the growth in total receipts will keep balance. Conclusion: It’s better to guarantee the government financial subsidies invested in time, raise medical service price properly and establish comprehensive compensation mechanism for implementing compensation mechanism of primary medical institutions.

The Balanced Score card ( BSC) is a new set of performance measurement and strategic management tools. Based on the basic theory of BSC, and on the basis of establishing the basic framework for performance evaluation of four dimensions, namely satisfaction, financial, internal operation, and growth and development, this paper systematically designs specific evaluation indexes from the 4 dimensions in order to construct the performance evaluation index system for catastrophic disease insurance. The objective of this study is to provide a more scientific and reasonable reference for the operational performance evaluation of catastrophic disease insurance offered to urban and rural residents.

OBJECTIVETo investigate the effect of Sijunzi decoction (SJZD) on malondialdehyde (MDA) content and telomerase activity in heart, liver and brain tissues of D-galactose (D-gal) induced aging model mice.

METHODSD-gal aging mice model was established by cervicodorsal region subcutaneous injection with 10% D-gal once a day for six successive months. The model mice in the low-, middle- and high-dose SJZD treated groups were treated with SJZD in a dose of 6 g/kg, 12 g/kg, 24 g/kg per day respectively in the volume of 0.2 ml/10 g for 6 successive weeks. While the mice in the normal control group (NCG, non-modeled) and the model control group (MCG, modeled but untreated) were treated with distilled water instead. The MDA content and telomerase activity in heart, liver and brain tissues of mice was measured with TBA colorimetric method and PCR-ELISA respectively.

RESULTSIn MCG, the MDA content in heart, liver and brain tissues was significantly higher (P < 0.01), and the telomerase activity in liver and heart tissues was significantly lower (P < 0.01) but that in brain tissue was insignificant different to that in NCG (P > 0.05) respectively. As compared with MCG, the MDA content was significantly lower in the three SJZD treated group (P < 0.01). In comparison of telomerase activity between MCG and SJZD treated groups, it was shown that in heart tissue, there was an increased trend of the activity in the low-dose and middle-dose group, but with statistical insignificance (P > 0.05), but it did show a significant increase in the high-dose group (P < 0.05); in liver tissue no significant difference was shown between the three SJZD treated groups and MCG (P > 0.05); as for that in brain tissue, significant increase only shown in the high-dose group (P < 0.01).

CONCLUSIONSJZD can antagonize free radical injury, decrease the MDA content of heart, liver and brain in D-gal aging mice, and increase the telomerase activity in heart and brain tissues but with no effect on that in liver tissue.

Aging ; drug effects ; metabolism ; Animals ; Brain ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Female ; Free Radical Scavengers ; pharmacology ; Galactose ; Liver ; metabolism ; Male ; Malondialdehyde ; metabolism ; Mice ; Myocardium ; metabolism ; Telomerase ; metabolism

OBJECTIVE： To establish the method for the content determination of gentiopicrin and loganic acid in Gentiana scabra， and to investigate the correlation of their contents with appearance traits and quality gradation criterion. METHODS： HPLC method was adopted. The determination was performed on Ascentis Express C18 column with mobile phase consisted of 0.1％ phosphoric acid-acetonitrile （gradient elution） at the flow rate of 0.4 mL/min. The column temperature was 30 ℃， and detection wavelength was set at 240 nm. The sample size was 1 μL. Taking the length， number and diameter of fibrous roots as indexes， the appearance and morphological characteristics of G. scabra were studied. The relationship of gentiopicrin and loganic acid content with the appearance property of medicinal material was analyzed by SPSS 21.0 software. k-mean clustering analysis was carried out by using SPSS 21.0 software， and gradation standard for G. scabra was established preliminarily. RESULTS： The linear range of gentiopicrin and loganic acid were 0.5-3.0 μg/mL （r＝0.999 9） and 0.05-0.50 μg/mL （r＝0.999 9）. The limit of quantification of gentiopicrin and loganic acid were 0.295， 0.289 μg/mL； the detection limit were 0.082， 0.081 μg/mL； RSDs of precision， stability， repeatability tests were all lower than 2％； the recovery rates were 97.56％- 102.23％ （RSD＝1.56％， n＝6） and 97.58％-102.67％ （RSD＝1.86％， n＝6）. Correlation results showed that there was a significant positive correlation of the length of G. scabra， the number of roots， root diameter， with the contents of gentiopicrin and loganic acid. The order of affecting content was the number of roots ＞length ＞root diameter. k-means clustering analysis showed that 54 batches of G. scabra was divided into two categories； S4-S6，S13，S17-S23，S25，S28，S31-S34 were clustered into a category； S1-S3， S7-S12， S14-S16， S24， S26，S27，S29， S30，S35-S54 were clustered into the other category. The results of gradation showed that 54 batches of G. scabra could be divided into two grades， and the results were consistent with the cluster analysis. CONCLUSIONS： Established method is simple and stable， and can be used for simultaneous determination of gentiopicrin and loganic acid in G. scabra. The more fibrous roots， the longer the length， the thicker the root， the higher the content of gentiopicroside and loganic acid， the better the quality of G. scabra.

OBJECTIVE：To simultaneo usly determine the contents of atractylenolide Ⅱ ，β-eudesmol，atractyloxin and atractylone in Atractylodes chinensis ，and to evaluate the quality of A. chinensis with different growth years combined with color difference principle. METHODS ：HPLC method was adopted. The determination performed on Agilent Eclipse XDB-C 18 column with mobile phase consisted of acetonitrile- 0.2％ phosphoric acid （gradient elution ）at the flow rate of 1.0 mL/min；the detection wavelengths were set as 208 nm（atractylenolide Ⅱ，β-eudesmol），340 nm（atractyloxin）and 220 nm（atractylone）；the sample size was 15 μ L. Using atractyloxin as reference，QAMS was adopted to establish relative correction factors （RCFs） of atractylenolideⅡ，β-eudesmol and atractylone ；the content of each component in A. chinensis with different growth years were calculated. The contents of above 4 components were determined by external standard method and then compared with the results of QAMS. The color difference values of A. chinensis powder were measured based on color difference principle. The correlation analysis of above 4 components content with color was carried out by Pearson correlation analysis. RESULTS ：The separation degree of atractylenolide Ⅱ，β-eudesmol，atractyloxin and atractylone in A. chinensis was higher than 1.5. The linear range were 1.01-10.10，3.30-33.00，4.40-44.00，5.34-53.40 μg/mL，respectively. RSDs of precision ，reproducibility and stability tests were all lower than 2％，while the average recovery rates were 101.34％-104.67％（RSD＜1.5％，n＝6）. Using atractyloxin as reference ， RCFs of atractylenolide Ⅱ，β-eudesmol and atractylone were 3.896 7，5.928 2，9.727 9，with RSD of 0.35％，2.89％，0.36％ （n＝6），respectively. Relative deviation of 3 components （except for atractyloxin ） in 24 batches of A. chinensis ranged 0.03％-1.45％ between QAMS and external standard method ，which indicated that the results of two methods were consistent ，and the content of each component increased with the increase of growth years. Atractylenolide Ⅱ，β-eudesmol，atractyloxin and atractylone in A. chinensis had significant negative correlation with its color shade （L*），total color difference （E*ab）（P＜0.01）， and significant positive correlation with color red-green direction （a*）， color yellow-blue direction （b*）（P＜0.01）. CONCLUSIONS：The established HPLC-QAMS method can be used for the determination of atractylenolide Ⅱ，β-eudesmol， atractyloxin and atractylone in A. chinensis . The longer the growth period is ，the higher each component content is. The color of A. chinensis is closely related to the content of each component ，and the content of effective components is higher in A. chinensis with dark yellowish brown color.

Shengmai San was first recorded in Medical Origin and Insights, a medical book written by ZHANG Yuan\|su. Shengmai San composed of Ginseng Radix et Rhizoma, Ophiopogonis Radix and Schiandrae Chinensisin Fructus. Ginseng Radix et Rhizoma as the monarch drug in the prescription has effects in invigorating vigour potently, and promoting production of body fluid to quench thirst. Ophiopogonis Radix as a sweet-cold minister drug has effects in nourishing yin, clearing heat and generating fluid and moistening lung to stop cough in the prescription. Both medicines are combined to have a good effect in replenishing Qi. Schiandrae Chinensisin Fructus is an adjuvant medicine, with effects in acid astringency, retaining Yin with astringent and hidroschesis. Ginseng Radix et Rhizoma has effects in strengthening the healthy energy, and Ophiopogonis Radix has a effect in retaining yin with astringent. It is a classic prescription for treating deficiency of Qi and Yin. With the in-depth research of modern medical experts, it is found that Shengmai San not only has a significant therapeutic effect on cardiovascular diseases, central nervous system diseases and endocrine system diseases, but also a good effect on digestive system diseases, immune system and hematopoietic system diseases and shock. As China's aging population, irregular diet and other problems become increasingly serious, the incidences of cardiovascular diseases, senile dementia, cerebral infarction, diabetes, liver dysfunction and other diseases have become higher and younger, which is a serious threat to human health. Therefore, by consulting a large number of domestic literatures, the authors respectively elaborated the therapeutic effect and mechanism of Shengmai San and its modified prescriptions on the above diseases, with the aim to reveal the target and mechanism of this prescription on the above diseases, provide theoretical basis for better treatment of the above diseases and promote the clinical application of this prescription. In addition, it provides reference ideas for the research of other classical famous formula.

Rats ; Animals ; Okadaic Acid/toxicity* ; PC12 Cells ; Triterpenes ; tau Proteins/metabolism* ; Phosphorylation

OBJECTIVETo investigate surgical treatment approach of transclavicular and transsternal tumor.

METHODSTwelve cases of neck-root and mediastinum thoracis tumor subjected to cervicothoracic-combined surgical treatment were retrospectively analyzed and summarized.

RESULTSSeven cases of benign tumor survived 1-8 years after surgery. The other 5 patients were malignant tumor. Among 4 cases of metastatic squamous cell carcinoma without definite origin at neck-root site who underwent operation and routine radiotherapy, one case died of orthotopic relapse and armpit metastasis at the 16th months postoperatively; one case was lost of follow-up after surgery; another two cases showed no relapse after follow-up of 50 months and 27 months, respectively. In addition, one case of thyroid papillary carcinoma located at neck-root and mediastinum remained alive for 40 months after operation combined with radiotherapy and chemotherapy.

CONCLUSIONSThe evaluation of twelve cases of transclavicular and transsternal tumor with adoption of cervicothoracic-combined surgical approach improves and develops traditional knowledge of surgical therapy of neck-root tumors.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Clavicle ; pathology ; Female ; Head and Neck Neoplasms ; pathology ; surgery ; Humans ; Male ; Mediastinal Neoplasms ; pathology ; Middle Aged ; Neck ; surgery ; Retrospective Studies ; Sternum ; pathology ; Thoracic Cavity ; surgery ; Young Adult

OBJECTIVETo study the cranial-cervical lymph return and pathway in rabbit in order to provide the experimental and theoretical basis for the study of intracranial metastasis of cervical tumor and extracranial metastasis of intracranial tumor.

METHODThe distribution and clearance of tracers were observed after microinjection of lymph developer labeled by 99mTc into cerebral cortex and deep cervical lymph nodes of rabbit.

RESULTSIn the cerebral cortex microinjection with 99=Tc-labeled lymph developer group, the radioactivity were detected in Willis artery, deep cervical lymph nodes and venous blood. The radioactivity curve was the same in Willis artery and deep cervical lymph nodes. The peak in the artery blood was higher than that in venous blood. In the lymph nodes microinjection with 99mTc-labeled lymph developer cervical group, the radioactivity were detected in skull base dura mater, brain, cerebrospinal fluid and venous blood. The peak in skull base dura mater showed earlier than that in cerebrospinal fluid and brain. The peak in venous blood was the last, but the radioactivity in it was the highest.

CONCLUSIONThe cranial-cervical lymph return in rabbit is existent. Their pathway perhaps is Willis artery, skull base dura mater and cerebrospinal fluid circulation.

Animals ; Lymph ; diagnostic imaging ; metabolism ; Lymph Nodes ; diagnostic imaging ; metabolism ; Lymphatic System ; metabolism ; Lymphatic Vessels ; diagnostic imaging ; metabolism ; Lymphoscintigraphy ; Male ; Organotechnetium Compounds ; Rabbits