Since 2004,provinces and cities began to implement the national policy that gave the poverty advanced schistosomiasis patients some temporary assistance.The central and local government arranged special funds to provide medical assistance.This paper reviewed the policy of the assistance,the necessity of performance evaluation and research status of advanced schistosomiasis.Finally,it put forward some suggestions on the implementation of performance evaluation of advanced schistosomiasis,so as to provide reference for the government to allocate limited health resources reasonably and optimally and perfect relevant policies.

In order to check the neck response and injury during motor vehicle accidents, we developed a detailed finite element model for human cervical spine C4-C6. This model consisted of cortical bone, cancellous bone, annulus, nucleus, ligaments and articular facet, and it also set up contact in the contacting parts for simulating the movement perfectly under frontal impact. This model could be used for stress and strain distribution after the frontal impact load was applied on this model. During the process of frontal impact, the most displacement simulated data were in the interval range of experimental data. The experimental results showed that this model for the human cervical spine C4-C6 simulated the movement under the frontal impact with fidelity, and reflected the impact dynamics response on the whole.
Accidents, Traffic ; Biomechanical Phenomena ; Cervical Vertebrae ; physiology ; Finite Element Analysis ; Humans ; Models, Anatomic ; Movement

Objective To study the changes of sex hormone levels and the intervention of Chinese medicine female depression patients of kidney deficiency and liver depression type.Methods According to CCMD-3 and ICD-10 depressive episodes diagnostic criteria and the Chinese medicine dialectical criteria,120 patients from March 2007 to March 2011 were selccted and randomly recruited into a treatment group (n=60) and a control group (n=60),respectively.The treatment group was treated with traditional Chinese medicine with the functions of tonifying kidney and soothing liver,while the control group was treated with paroxetine.Both groups were treated for 12 weeks.Another healthy group of 60 cases was also setup.HAMD score and symptom score were used to observe the curative effects,the changes of E2,P,and PRL were observed in the patients and healthy persons.Results In the treatment group:E2 levels increased,PRL decreased,compared with the same group before treatment,the difference was statistically significant,[before treatment,E2=(103.6±28.24)pmol/L,after treatment,E2=(167.7± 30.46)pmol/L,P＜0.01; before treatment,PRL=(32.5 ±7.61)μg/L,after treatment,PRL=(15.3±5.92)μg/L,P＜0.01],Compared with the healthy group,the difference was not statistically significant,[healthy group E2=(176.3±33.63) pmol/L,PRL=(12.7±5.23) μg/L,P＞0.05) ].Although the E2 level of the control group after treatment was significantly elevated than the same group before the treatment [before treatment E2=(101.3±27.18)pmol/L,after treatment E2=(142.1 ±30.11)pmol/L,P＜0.01 ],but compared with healthy controls,the differences were statistically significant [healthy group E2=(176.3±33.63)pmol/L,P＜0.01].Conclusion The method of tonifying kidney and soothing liver has effective interventions on sex hormone secretion in depression patients and improvement in patients with depressive mood.

Objective To investigate the value of dynamic transperineal ultrasound in women with chronic proctalgia.Methods A prospective study was described.Women met the diagnostic criteria of chronic proctalgia were included.Patients were submitted to dynamic transperineal ultrasound.Bladder neck descent(BND),retrovesical angle(RVA),anorectal angle,rectocele and other indicators were observed at rest and during maximal Valsalva.Results A total of 33 patients with chronic proctalgia were included.BND was 1.1-27.5 (13.21 ± 7.77)mm,4 of which were more than 25 mm.The RVA were greater than 140 ° in 8 patients during Valsalva maneuver.Six cases were diagnosed with cystourethrocele and 5 cases were diagnosed with isolated cystocele.Anorectal angles were 82.6-134.0 (113.12 ± 10.95) ° at rest and 77.6-123.0 (110.10 ± 13.28) ° during Valsalva respectively,there was no statistical significance (P ＞ 0.05).Fourteen cases were found rectocele with the depth 1.2-1.7 (1.38 ±-0.17)cm;14 cases were found rectal intussusceptions,7 of which were associated with rectocele,2 of which were associated with rectocele and enterocele.Conclusions Dynamic transperineal ultrasound can show the whole pelvic floor anatomy in female patients with chronic proctalgia to evaluate the pelvic floor function and detect other functional disorders.

Objective To investigate the value of the three-dimensional endorectal ultrasonography (3D-ERUS) in the tumor staging before transanal endoscopic microsurgery (TEM).Methods The clinical data of 30 patients with rectal cancer who underwent 3D-ERUS before TEM at the Nanjing Hospital of Traditional Chinese Medicine from April 2012 to December 2013 were retrospectively analyzed.The accuracy,sensitivity and specificity of the 3D-ERUS were evaluated according to the results of the postoperative pathological examination.The consistency of the results of the 3D-ERUS and postoperative pathological examination were compared by Kappa consistency test.Results Of 30 patients,25 patients in stage T0,3 in stage T1 and 2 in stage T2 were diagnosed by preoperative 3D-ERUS.There were 2 patients (stage pT0) with inflammatory polyp by postoperative pathological diagnosis,6 patients (stage pT0) with tubular adenoma,16 patients (stage pT0) with villioustublar adenoma,2 patients (stage pTis) with carcinoma in situ,2 patients (stage pT1) with tectal adenoma and 2 patients (stage pT2) with rectal adenoma.There were 2 patients with excessive tumor staging by 3D-ERUS,1 patient in stage pT0 was misdiagnosed in stage T1,1 in stage pT1 was misdiagnosed in stage T2 and 1 in stage pT2 was misdiagnosed in stage T1 with insufficient tumor staging.The accuracy of 3D-ERUS in the preoperative tumors staging of TEM was 90.0％ compared with the resuls of postoperative pathological examination.The accuracy,sensitivity and specificity of 3D-ERUS in stage pT0,pTl,and pT2 of TEM were 96.7％,90.0％,93.3％ and 96.2％,50.0％,50.0％ and 100.0％,92.8％,96.4％,respectively.There was a significant difference in the consistency between preoperative 3D-ERUS and postoperative pathological examination (κ =0.685,P ＜ 0.05).Conclusion 3D-ERUS is an accurate clinical method in the preoperative tumors staging of TEM,and can be used as the preoperative assessment for TEM.

Objective To evaluate the agreement between dynamic transperineal ultrasound (DTP-US)and dynamic magnetic resonance imaging defecography (DMRD) in the diagnosis of rectocele,and to compare the correlation and difference between the depth of rectocele measured by DTP-US and DMRD.Methods The clinical data of 18 female patients with rectocele who were admitted to the Third Affiliated Hospital of Nanjing University of Chinese Medicine from September 2011 to May 2012 were retrospectively analyzed.All patients received examination via DTP-US and DMRD,and the agreement of the 2 diagnosing methods was analysed.The accurate rates of the detection of other pelvic floor abnormalities by the 2 methods were calculated.The agreement of DTP-US and DMRD in diagnosing rectocele was analysed by Cohen's kappa test.The difference of the depth of rectocele measured by DTP-US and DMRD was compared by paired samplet test,and the correlation of the depth of rectocele measured by DTP-US and DMRD was analyzed by using the Pearson correlation coefficient.Results Of the 14 patients diagnosed by DTP-US,there were 7 patients with bladder prolapse,5 with unrelaxed pelvic floor,2 with uterine prolapse,2 with rectal internal mucous intussusception and 1 with enterocele; of the 18 patients diagnosed by DMRD,there were 12 patients with bladder prolapse,8 with unrelaxed pelvic floor,8 with uterine prolapse,6 with rectal internal mucous intussusception and 1 with enterocele.The agreement coefficient between DTP-US and DMRD in diagnosing rectocele was obvious (κ =0.737,P ＜ 0.05).The depth of the rectocele detected by DTP-US and DMRD were (15 ±6)mm (range,7-24 mm) and (27 ±7)mm (range,20-41 mm),with significant difference between the 2 groups (t =-16.124,P ＜0.05).There was a high coefficient between DTP-US and DMRD in detecting the depth of rectocele (| r | =0.874,P ＜ 0.05).The depth of rectocele detected by DMRD increased as the increase of depth of rectocele detected by DTP-US (| r | =1.000,P ＜ 0.05).Conclusions The agreement between DTP-US and DMRD in diagnosing rectocele is high.The depth of rectocele measured by the 2 methods not only has statistically significance,but also exists a high degree of correlation.While DTP-US is superior to DMRD in terms of quick diagnosis and better telerance of patients.

Objective To carry out a systematic evaluation for the diagnostic accuracy of Des-γ-carboxy-prothrombin(DCP) in primary hepatocellular cancer(PHC) by Meta-analysis.Methods The published international and domestic studies on DCP in the diagnosis of PHC were searched in multiple databases from its inception until December 2016.A total of seventeen studies were finally selected,among which 1 970 cases of PHC group and 2 588 cases of control group were included.The control group was composed of chronic hepatitis,cirrhosis,tumors in other systems and healthy subjects with physical examination.A meta-analysis was performed using Stata 12.0.Results The overall pooled results of the analysis and the 95％ confidence intervals were as follows:the sensitivity(SEN) was 0.79 (0.74 to 0.83),the specificity (SPE) was 0.90 (0.87 to 0.93),the positive likelihood ratio(PLR) was 8.1 (5.8 to 11.1),the negative likelihood ratio(NLR) was 0.24(0.19 to 0.29),the diagnostic odds ratio(DOR) was 34(21 to 55) and the area under the summary receiver operator characteristic curve (SROC) was 0.91 (0.89 to 0.93).The sensitivity combined the detections of AFP and DCP in the diagnosis of PHC was 0.90 with 0.94 of AUCROC and 56 of DOR.Conclusion The serum DCP may exhibit a relatively higher diagnostic specificity for PHC.The combined detections of AFP and DCP could improve the sensitivity and diagnostic accuracy.

Objective To investigate clinical first selected method on the differential diagnosis at early stage between amyotrophic lateral sclerosis(ALS) and cervical spondylosis.Methods The clinical features and EMG in 53 patients with ALS,14 patients with cervical spondylotic myelopathy(CSM) and 23 patients with cervical spondylotic radiculopathy(CSR) were analysed.And then the value of ratio of every probability was calculated.According to the value of ratio, the clinical features and EMG were compared in differential dia gnosis.Results A multiprogram that consisted of high multiple clinical features was used in differential diagnosis, true positive rate is 98%, and true negative rate is 86.5%,EMG still couldn't be used in the differential diagnosis.Conclusion The program is the first selected method, which can be used in the differential diagnosis between ALS and CSM/CSR.

Objective:To compare the clinical efficacy of Du's heat-reinforcing method and Western medication in treating diarrhea-predominant irritable bowel syndrome (IBS-D).Methods:Sixty-five IBS-D patients were randomized into two groups by the random number table.Thirty-three cases in the treatment group were intervened by acupuncture with Du's heat-reinforcing method,while thirty-two cases in the control group were given oral administration of pinaverium bromide tablets.The intervention lasted 4 weeks for both groups.The IBS symptom severity score (IBS-SSS),IBS-quality of life (IBS-QOL) and hospital anxiety and depression scale (HAD) were adopted to evaluate the therapeutic efficacy.Results:The two groups each had two dropout cases.The clinical recovery rate was 38.7％ and the total effective rate was 90.3％ in the treatment group versus 13.3％ and 66.7％ in the control group.The treatment group was superior to the control group in both clinical recovery rate and total effective rate (both P＜0.05).After 1-week and 4-week treatment,respectively,the IBS-SSS scores were lower compared with the baseline in both groups,and the intra-group differences were statistically significant (both P＜0.05);the score in the treatment group was lower than that in the control group,and the between-group difference was statistically significant (both P＜0.05).After 4-week treatment,the component scores of IBS-QOL showed improvements in both groups,and the treatment group was superior to the control group in the improvements of dysphoria,interference with activity,health worry and food avoidance (all P＜0.05).The anxiety and depression scales of HAD (HAD-a,HAD-d) in the treatment group and the HAD-a in the control group obtained significant improvements (all P＜0.05);the scores of HAD-a and HAD-d in the treatment group were significantly better than those in the control group (both P＜0.05).Conclusion:Acupuncture with Du's heat-reinforcing method can effectively ease the symptoms of IBS-D,improve the quality of life and the state of anxiety and depression.It can produce a more significant efficacy than oral administration of pinaverium bromide tablets.

Objective To discuss the way of treating accelerated rejection. Methods Seven patients of accelerated rejection were treated by efficient anti-rejection treatment. ResultsSix patients of accelerated rejection were reversed by efficient treatment of anti-rejection. One allograft was removed because treatment was invalid. And six patients were still alive, the longest survival one has reached to 3 years. ConclusionThe treatment emphasis of accelerated rejection should be focused on 3 aspects, including early diagnosis, efficient treatment in time, and paying more attention to any possible complications during the process of treatment.