infection.

Objective To study the proliferation and migration of vascular smooth muscle cell (VSMC) after transferred angiotensin Ⅱ (AngⅡ) type 2 receptor (AT2R) gene. 　Methods The recombinant adenoviral vector, AdCMV-AT2R, containing rat AT2 receptor gene was constructed by homologous recombination, and transfered to rat VSMC in vitro. The expression of AT2R mR NA was detected by RT-PCR. The rate of expression and the change of cell cycle in VSMC were analysed by flow cytometry. These assays including cell devision index. Incorporation of bromodeoxyuridine(BrdU) and 3-(4,5-dimethyl-thiazol-2-yl)2,5-diphenyltetrazolium bromide( MTT) were used to determine the proliferation of VSMC. The modified Boyden's chamber method was used to test the migration of VSMC. The r e-organization of F-actin in VSMC was analysed by confocal microscopy. 　Results RT-PCR showed that the expression of AT2R mRNA increased substantially in transferred VSMC, and the peak value of expression rate is about 89.51% at 48 hours. When the expression of AT2R is at peak value, the ratio of S, G2 and M periods was reduced from 31.7% to 13.9%(P<0.05). The OD values of MTT and BrdU incorporation were reduced by 61.4% and 51.6% respectively(P<0.0(1). the number of VSMC migration was reduced by 62.2%(P<0.05) and the expression of F-actin was also decreased signific antly. 　Conclusion AdCMV-AT2R induced high level expression of AT2 receptor in cultured rat VSMC and its expression can significantly inhibit the proliferation and migration of rats VSMC in vitro.

Objective To describe survival of patients with aneurysm subarachnoid hemorrhage (aSAH) and its related factors. Methods Data of 88 patients with aSAH were analyzed retrospectively, including their age, gender, past medical history, therapeutic measures, complications and prognosis, and so on. Their survival and its related factors were identified by Kaplan-Meier method and COX proportional hazard regression model. Results Eighty-eight patients were followed-up for a total of 141. 9 person-year,with an average of (1.6 ?.0) years, and the longest of 5. 6 years. Survival was 78 percent, 73 percentand 68 percent in the first month, first year and 2. 5 - 5. 6 years after onset, respectively. Administration ofnimodipine (RR = 0. 981, 95 % CI = 0. 965 - 0. 997, P = 0. 023) was potential protective factor for deaths caused by aSAH. Compared with conservative medical treatment, both surgical occlusion (RR =0. 147, 95% CI = 0. 041 - 0. 532, P = 0. 003) and intervention embolotherapy (RR = 0. 221, 95% CI = 0. 060-0. 823, P= 0.024) were also protective factors. However, complications such as hyponatremia, pulmonary infection, alimentary tract hemorrhage (RR = 1. 965, 95% CI - 1. 404 - 2. 748, P ＜ 0. 05) and cerebral vasospasm (RR = 2. 951, 95% CI = 1. 473 - 5. 911, P = 0. 002) were independent risk factors for aSAH.Conclusions Prognosis in patients with hyponatremia, pulmonary infection, alimentary tract hemorrhage and cerebral vasospasm is unfavorable, and aneurysm occlusion by surgical operation, embolotherapy andadministration of nimodipine all can decrease fatality caused by aSAH.

Objective To investigate the risk factors related to cerebral vsospasm in patients with aneurysmal subarachnoid hemorrhage (aSAH).Metrods The risk factors related to cerebral vasospasm in 88 patients with aSAH were identified through the multivariate logistic regression analysis and Cox analysis, including demographic factors, healthy habits, past mescal history, acute stress factors, acute complications, acute evaluation indexes, treatment time, therapeutic measures, and hemorrhage involving brain regions. Results Drinking history (OR=1.077,95%CI 1.015-1.142;P=0.014)was an independent risk factor for cerebral vasospasm before admission. Histories of smoking(RR=1.031,95%CI 1.001-1.063:P=0.042),diabetes mellitus(RR=1.333,95%CI 1.100-1.614;P=0.003)and hypertension (RR=1.066,95%CI 1.008-1.127;P=-0.024)were the independent risk factors for cerebral vasospasm during hospitalization. The increased leukocyte count(RR=1.117,95%CI 1.039-1.200;P=0.003)was a predictive factor for cerebral vasospasm; the administration of Nimotop(RR=0.990,95%CI 0.979-1.001;P=0.088)significantly decreased the risk of cerebral vasospasm;the blood glucose lexels in acute stage were not associated with the occurrence of cerebral vasospasm(RR=1.076,95%CI 0.968-1.196;P=0.175);there was no significant difference between endovascular embolization group and surgical clipping group in the risk of cerebral vasospasm(RR=0.792,95%CI 0.322-1.950;P=0.612).Conclusions The risk of cerebral vasospasm increased significantly in patients with aSAH who have the histories of long-term drinking, smoking, diabetes mellitus, hypertension as well as increased leukocyte count. The administration of Nimotop may significantly decrease the risk of cerebral vasospasm

Objective To observe the clinical therapeutic effect of hyperbaric oxygen (HBO) therapy and swallowing training combined with Fengchi acupoint acupuncture on dysphagia caused by pseudobulbar paralysis after stroke. Methods Seventy-five patients were randomly divided into control group, HBO therapy group, swallow training group, acupuncture group and combined treatment group (n = 15). Patients in all groups were given cerebro-vascular disease routine treatment. In addition, the patients in HBO therapy group, swallowing training group and ac-upuncture group were given HBO therapy, swallowing training and Fengehi (GB20) acupoint acupuncture simultane-ously, respectively. The patients in combined treatment group were given HBO therapy combined with swallowing training and Fengchi acupoint acupuncture. Modified Kubota-Chiari's swallowing functional classification was used to assess swallowing function before and on the 3rd d,6th d,9th d, 12th d, 15th d, 18th d and 21st d after treatment. Results It was shown that the patients in all groups but the control group got significant improvement in swallowing after treatment, as demonstrated by the swallowing function scores (P < 0.05). Moreover, the priority order in im-provement of swallowing function and recovering rate were: combined treatment group > acupuncture group > swal-low training group > HBO therapy group > control group(P < 0.05). Conclusion The combination of HBO ther-apy, swallowing training and Fengchi acupoint acupuncture could act synergically to ameliorate dysphagia caused by pseudobulbar paralysis after stroke.

Objective To analyze the equity of the allocation of the health human resources in Chongqing from 1997 to 2012 , and to provide the basic information for regional health planning .Methods The statistical description ,Gini Coefficient and Theil in-dex are used to analyze the previous allocation and trends of the health human resources and the equity in Chongqing during the 16 years based on the distribution of demography and geography .Results The number of the health human resources grew rapidly from 1997 to 2012 .The Gini coefficients of health professionals and medical practitioners (and assistants) are under 0 .3 based on the distribution of demography ,while registered nurses′are fluctuation in 0 .4 .However ,from the distribution of geography ,the Gi-ni coefficient of health professionals ,medical practitioners (and assistants) and registered nurses are above 0 .5 .The Gini coefficient of the one hour economic circle is higher than two wings areas .The trends about the totle Theil index are consistent with the Gini coefficient .Based on the distribution of demography ,the Theil index between regions is higher than the one within the region .On the contrary ,the Theil index between regions is below the one within the region by the geographic distribution .Conclusion Com-pared to the national ,less total health human resources are reserved in Chongqing .Distribution by demographics about health human resources are more equitably than the one by geographic distribution .The variances between the economic circles contribute more to the total Theil index than those within the economic circles .The government′s leading role should be strengthen ,and enhancing the regional health planning .

Objective To constructed the cell model transferred angiotensin Ⅱ (AngⅡ ) type 2 receptor (AT2R) in vascular smooth muscle cells(VSMC) Method The VSMCs, isolated from the aorta of rat, were cultured by routine method. Recombinant adenoviral vector, AdCMV-AT2R, containing rat AT2 receptor gene was constructed by homologous recombination, and then it was used to transfer AT2 receptor gene to VSMC in vitro. The rate of AT2R expression in VSMC was analysed by flow cytometry. The expression of mRNA, protein were detected by RT-PCR, Western blot and immunohistochemistry respectively. The angiotensin Ⅱ (AngⅡ) type 1 receptor (A T1R) was determined as well. Result The expression rate of AT2R in VSMC was increased signific antly after transferred by AdCMV-AT2R with time, and the peak value detected by flow cytometry was about 89.51% at 48 hours. RT-PCR, Western blot and immunohistochemistry showed that the expression of AT2R mRNA and protein were increased obviously in transferred VSMC. There were no significantly change of AT1R expression during AT2R expression. Conclusion Our study indicates that AdCMV-AT2R did generate high level expression of AT2 receptor and its expression did not affect AT1R exp ression in cultured VSMC. The VSMCs transferred AT2R gene may be used as a good model to study the effect of AT2R on their biological action such as proliferation, migration and apoptosis.

Objective To evaluate the of the decision process to perform staged or synchronous bilateral percutaneous nephrolithotripsy (PCNL) in the treatment of bilateral upper urinary tract calculi. Methods Patients with an indication for bilateral PCNL were enrolled in the study from Jan. 2008 to Dec. 2008. The decision to perform staged or synchronous bilateral PCNL was based on the initial side operative time, the changes of hemoglobin level and systolic arterial pressure, the results of blood gas analysis and the patient′s tolerance at the end of initial side operation. The patients were divided into two groups, patients who underwent synchronous bilateral PCNL were in group one. Patients where the PCNL procedure was stopped after the initial side and subsequently underwent staged bilateral PCNL three to six weeks later were placed in group two. The success and complication rates of two groups were compared and analyzed. Results Of 60 planned simultaneous bilateral PCNLs, nine were stopped after the initial side, due to prolonged operative time in four cases, a hemoglobin level ＜100 g/L or the decrease of more than 30 g/L in three cases, a systolic arterial pressure lower than 90 mm Hg or the decrease more than 30 mm Hg in two cases, an arterial blood pH lower than 7.35 or the arterial oxygen saturation lower than 95% in two cases or the patients were intolerant to the surgery in three cases. Between the two groups, the differences of patient gender, age, BMI, preoperative hemoglobin level, the total hemoglobin decrease, the side initiated operation, stone number and second side stone burden were insignificant. However, there were significant differences in the first operative side stone burden, total stone burden, the first operative side operative time and total operative time. The stone-clearance rate was 87.3% in group one and 88.9% in group two. There was no difference in complication rate of two groups. Conclusions Prolonged operative time, large blood loss during the first operation side and patient intolerance are the main causes of staged bilateral PCNL.

Objective To evaluate the immediate and short term therapeutic efficacy of percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) and to investigate the prevention of the related complications. Methods PTSMA was conducted in 3 patients with HOCM refractory to medication. The immediate effect was evaluated by pressure monitor, but the follow up effect by observation of the clinical symptoms and ultrasonic cardiogram. Results The left ventricular outflow tract gradients triggered by ventricular premature beats decreased from 143 mmHg (ranging from 70 to 180 mmHg) to 53 mmHg (ranging from 30 to 80 mmHg). Complete atrioventricular block (Ⅲ?AVB) with atrioventricular node rhythm was found in 1 case, and complete right branch bundle block (CRBBB) in another one. Follow up of the 3 cases at 6 months after operation revealed remarkable improvement of the patients' cardiac function (NYHA), disappearance of angina pectoris, and obvious attenuation of ventricular septal hypertrophy and SAM (systolic anterior motion of mitral) phenomenon. Conclusion PTSMA is an effective method with satisfactory short term effect for the patients with HOCM refractory to medication.

Objective To observe the effect of hyperbaric oxygen,rehabilitation training or acupuncture at Fengchi acupoint on pseudobulbar paralysis after stroke.Methods 90 patients were divided into group Ⅰ(A,B,C) or Ⅱ(A,B,C) randomly.Patients in all groups were given conventional therapy,while those in groups ⅠB and ⅡB were given hyperbaric oxygen,ⅠC and ⅡC were given swallowing training and group Ⅱ was given acupuncture at Fengchi acupoint additionally.They were assessed with Modified Kubota-Chiari's swallowing functional classification before and after treatment.Results In all groups except ⅠA,swallowing function scores improved after treatment significantly(P<0.05).The scores were different significantly between group Ⅰ and group Ⅱ after treatment(P<0.05).Except 3 d after treatment,the scores were different significantly between sub-group of group Ⅰ or group Ⅱon other time points(P<0.05).Conclusion The hyperbaric oxygen is more effective than conventional therapy on pseudobulbar paralysis,but less than swallowing training.Acupuncture at Fengchi acupoint can improve their efficacy.