Objective To explore the relationship between preoperative serum pro-adrenomedullin (pro-ADM) in the patients with closed rupture of small intestine,and postoperative secondary abdominal infection,and to study the value of postoperative serum pro-ADM in assessment of severity of postoperative secondary abdominal infection of this patients.Methods Eighty-five patients with closed rupture of small intestine treated in the emergency surgery from June 2014 to May 2015 were selected.According to the presence of postoperative abdominal infection or not,these patients were divided into infection group and non-infection group.The infection group was further divided into SIRS,sepsis,severe sepsis,septic shock subgroups as per the severity of infection.The levels of serum pro-ADM,interleukin-6 (IL-6),C-reactive protein (CRP) were determined and the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was calculated at admission and the first day、the second day and the third day after operation.Comparisons of these biomarkers were carried out to find out the factors associated with postoperative abdominal infection.In addition,ROC curve was used to verify the factors for predicting the abdominal infection of these patients after operation.The relationship between serum levels of pro-ADM and APACHE Ⅱ score after operation was analyzed.The severity of abdominal infection after operation was assessed with laboratory findings.Results Compared with non-infection group,preoperative and postoperative serum pro-ADM (P =0.03,P ＜ 0.01),IL-6 (P =0.02,P ＜0.01) levels and APACHE Ⅱ scores (P ＜ 0.01,P ＜ 0.01) were significantly higher in infection group (P ＜ 0.05).In the infection groups,the postoperative levels of serum pro-ADM and APACHE Ⅱ scores were increased with the severity of infection increased (r =0.924),and the difference between the groups was statistically significant (P ＜ 0.05),but there were no significant differences in IL-6 and CRP levels between two groups.Conclusion (1) The serum levels of pro-ADM before operation has value in predicting the genesis of abdominal infection in these patients after operation.(2) The serum levels of pro-ADM after operation has value in severity assessment of abdominal infection in these patients after operation.

Objective To explore the relationship between oxidative stress inducing neuronal apoptosis and the protein expressions of c-Myc, Fas-FasL and nuclear factor ?B (NF-?B) in neurons. Methods The primarily cultured neurons of SD rat in vitro were divided into 5 groups: Group A (control), Group B (treated with hypoxia), Group C (treated with small dose of H 2O 2), Group D (treated with hypoxia and SOD) and Group E (treated with H 2O 2 and SOD). Then, the neuronal apoptosis was elevated with TUNEL,Gel electrophoresis and flow cytometry. The protein expressions of c-Myc, Fas-FasL and NF-?B were detected with immunohistochemistry. Results Apoptosis rates of the Groups B and C were 6 and 8 times than that of the Group A respectively ( P

Since the current worldwide medical education and clinical practice lay a particular stress on training medical students with scientific knowledge and medical technical skills,enormous medical staffs are shaped into medical technical workers who lack medical morality and emotions,leading to the contradiction between medical morality and technologies.Medical personnel should know that medicine not only observes illness closely,but also attaches importance to the patients themselves who are suffering the pain.Medical students should pay attention to the forming process of medical morality and emotion in their preparative stage,accept the exercise to prepare for medical morality,and recalls their love and concern for life.

Objective To explore measures for the reform of the cooperative business operation system of township public health centers and evaluate in a comprehensive way the results of the reform. Methods A study was made by means of typical investigation of the specific measures taken by 16 township public health centers in Xianju County of Zhejiang Province in the reform of the cooperative business operation system and changes in health resources and service efficiency brought about by the reform were analyzed. Results In the reform, mixed type cooperation was adopted, with public ownership dominating; current assets were assigned in the form of stocks, with all the staff having a share; and a distribution system was established, clarifying the proportions of state, collective and personal interests. As a result, the infrastructures of the centers were enhanced, the service capabilities improved, the financial situation bettered, the value of national assets increased, the potentialities of the staff brought into full play, and social benefits maximized. Conclusion The measures taken by the centers in the reform, which were basically sound and resulted in significant first fruits, could be popularized as an effective model for deepening the reform of health care institutions in the rural areas.

Objective: To research the effects of Zuogui Pill on the gene expression profile of regenerate hepatic tissue in MSG-liver regeneration-rat.Methods: MSG-liver regeneration-rat models were copied;therapy group were given Zuogui Pill(5g/kg) by intragastric administration.Rats were executed at the 5th day after operation,and the regenerate liver tissues were frozen by liquid nitrogen.1176 gene chips of gene expression profile correlated to cell differentiation and multiplication were adopted to observe the changes of gene expression profile in the regenerate liver tissues.Results: There were 292 differential expression genes in therapy group compared with model group(20 genes were up-regulation expressed and 272 genes were down regulation expressed).Conclusion: Zuogui Pill has significant effects on the gene expression profile of regenerate hepatic tissue in MSG-liver regeneration-rat,and most of the genes are down regulation expressed.The result hints that Zuogui Pill could influence the liver regeneration by regulating the gene expressions of MSG-live regeneration-rat.Down regulation of the gene expressions of regenerate hepatic tissue in MSG-liver regeneration-rat possibly is one of the important molecular mechanisms of Zuogui Pill in nourishing liver and kidney.

Animals ; Cycadopsida ; chemistry ; Down-Regulation ; drug effects ; Female ; Flavones ; isolation & purification ; pharmacology ; Isoproterenol ; Male ; Myocardial Ischemia ; chemically induced ; metabolism ; prevention & control ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; metabolism ; p38 Mitogen-Activated Protein Kinases ; metabolism

The development of medical technology draws the doctor-patient relationship ever closer.However,the abundance and complexity of medical knowledge and technology make it a difficult task for medical personnel to grasp medical knowledge and skills,setting up a higher request for handling physician-patient relationship.Besides,medical disputes between doctors and patients caused by the abuse of medical technology in clinical practice also contribute to the contradiction between the advancement of medical technology and the latency of medical morality.Therefore,it is one important part in the study on medical morality from the perspective of medical technology ethics to take a rational view on the development of medical technology and construct a harmonious physician-patient relationship.

Objective To discuss the efficacy of the modified subinguinal approach for the treatment of acetabular anterior column and wall fractures.Methods A clinical retrospective study was performed of the 5 patients who had been treated at our department from January 2011 to April 2015 for acetabular anterior column and wall fractures and conformed to follow-ups.They were 3 males and 2 females,aged from 19 to 45 years (mean,35.6 years).The duration from injury to surgery averaged 7.6 days (range,from 4 to 10 days).The subinguinal ligament approach was adopted in the 5 cases,through which the inguinal ligament was preserved intact after sharp dissection of its insertion at the anterior superior iliac spine and medial-upper advancement,the advantage of expanded exposure of the first window by the Farid sub-ilioinguinal approach was retained,and additional lesions due to iliac osteotomy were avoided.The operation time,intraoperative bleeding,postoperative reduction and time for fracture union were documented.Merle d' Aubigne and Postel scoring system was used to assess the hip joint function of the affected limb at the final follow-ups.Results The operation time ranged from 110 to 150 minutes (mean,125 minutes);the intraoperative bleeding ranged from 415 to 550 mL (mean,450.2 mL).By the Matta's criteria,the postoperative reduction was rated as excellent in 4 cases and good in one.The 5 patients were followed up for an average of 32.4 months (range,from 6 to 43 months).Their fractures united clinically after an average of 4.6 months (range,from 3 to 6 months).The hip joint function was rated as excellent in 2 and good in 3 by the Merle d' Aubigne and Postel scoring system at the final follow-ups.Follow-ups observed no serious complications like inguinal hernia,internal fixation failure,myositis ossificans,or avascular necrosis of the femoral head.Conclusions As the modified subinguinal approach can provide a broad surgical exposure,lead to minimal injury to the inguinal ligament,avoid lesions caused by iliac osteotomy,and decrease operation time and bleeding,it may be a better approach for acetabular anterior column and wall fractures.

Objective To understand the mental health status of residents aged 15 years old or above in Hainan Province,and and to analyze its influencing factors to provide a scientific basis for improving the psychological health level of populations.Methods A multistage randomsampling method was used to extract 3 295 residents in Hainan Province and perform the investigate on the mental health status.Results Among 3 295 surveyed residents,410 respondents had mental disease,accounting for 12.44％ of respondents total number.The total score of SCL-90 in the residents of Hainan Province was lower than that of the national norm(t=14.65,P=0.00).(2)The morbidity of mental disease had no statistical difference between different genders(wald x2 =0.27,P=0.60);which had statistical difference among marital status,environmental satisfaction and family harmony (wald x2 =46.53,P =0.00;wald x2 =51.98,P =0.00;wald x2 =89.47,P =0.00).(3) The non-conditional Logistic regression analysis results showed that the influencing factors entering the regression equation were marital status(OR=0.52),family type(OR =0.57;0.53),environment satisfaction(OR=1.26),family harmony(OR=1.31),health self-examination(OR=0.72),borrowing 5 000 yuan within 2 d when urgent need(OR=1.31) and general well-being(OR=0.86).Conclusion The factors influencing mental illness in residents are multiple,so synthetic measures should be taken for its prevention.

A total of 906 subjects with no history of diabetes who had undergone coronary angiography were included in this study and categorized into four groups according to the level of fasting plasma glucose (FPG):≤5.5 mmoL/L,5.6-6.0 mmol/L,6.1-6.9 mmoL/L,and ≥ 7.0 mmol/L.Significant coronary artery disease (CAD) was defined as ≥ 50％ reduction of lumen diameter at least in one major coronary artery.The severity of coronary atherosclerosis was defined by the Gensini score.The clinical data,laboratory indexes,and coronary angiography results were compared among various groups.The risk factors for the prevalence and severity of angiographic CAD were analyzed.The results showed that the prevalence of angiographic CAD,the number of diseased vessels,and the Gensini score were increasing with increasing FPG levels among four groups (P＜0.05 or P＜0.01).The FPG level was significantly correlated with angiographic CAD (P =0.004) and the Gensini score (P =0.010),suggesting that FPG was an independent risk factor for the prevalence and severity of angiographic CAD.