Objective To investigate the clinical diagnosis and treatment of children's relapsesable intussusception by Peutz-Jeghers syndrome.Methods 5 cases of relapsesable intussusception result from Peutz-Jeghers syndrome which confirmed by operation and pathological diagnosis in children were analyzed retrospectively.Results All patients were diagnosed definitely by operation and pathological diagnosis and recovered well postoperatively.Conclusions Treated with the intussusception and resected polypus is effect to Peutz-Jeghers syndrome because it caused intussusception recurred easily,and patients should be followed up and examined regularly.

This article elaborated the connotation of public hospital medical insurance payment system and the importance of reform,summarizing and analyzing the practical exploration of promoting medical insurance payment system reform in the localities.Then it moved on to introduce new progress of medical insurance payment system reform abroad and the emerging mode of medical insurance payment, such as pay for performance,payment by results,and bundled payment.In the end,the authors put forward policy suggestions to improve medical insurance payment system at public hospitals in China, namely to build a modern healthcare payment system in line with the needs of medical service system.Such a system should be guided by comprehensive performance,restrained by cost budgeting, based on a diversified payment mode,and supported by information technology.In addition,it should have scientific payment standard and modern governance mechanism,and keep interactive development with commercial health insurance.

Objective To investigate the changes of lipopolysaccharide binding protein(LBP) in serum and ascites in patients with liver cirrhosis and its clinical significance. Methods Ninety?six cases of liver cir?rhosis patients who were treated in the NO. 202 Hospital of People's Liberation Army from January 2013 to De?cember 2015 were selected as research subjects,and were divided into liver cirrhosis with spontaneous bacterial peritonitis(SBP) of 27 patients as SBP group,69 cases of patients with liver cirrhosis as non?SBP group accord?ing to the clinical diagnosis. The level of LBP in serum and ascites,routine blood test and liver function indica?tors of two groups were detected and comparative analyzed. Receiver operating curve( ROC) was drawn to select LBP diagnosis best critical value of SBP. Results The level of LBP in serum and ascites of SBP group were significantly higher than that of non?SBP group((43. 2±10. 6) μg/L vs. (19. 5±7. 5) μg/L,(280. 6±73. 9)μg/L vs. (127. 4±42. 0) μg/L),and the difference was statistically significant(t=12. 324,7. 892;P<0. 05) . ROC curve showed that the diagnosis of SBP sensitivity was 82. 30%,the specificity was 78. 36%,the area un?der ROC curve AUC value was 0. 821 when Cut?off value of LBP in ascites was 23. 5 g/L;the diagnosis of SBP sensitivity was 85. 59%,the specificity was 81. 24%,the area under ROC curve AUC value was 0. 856 when Cut?off value of LBP in serum was 152. 1μg/L. Conclusion LBP levels in serum and ascites in cirrhotic patients for the differential diagnosis of SBP has some clinical value.

Objective To review the treatment of repair gastroschisis with autogenous umbilical cord and evaluate its effect. Methods Thirty newborns who underwent the repair gastroschisis with autogenous umbilical cord between August 1992 to October 2007, 26 cases survived under observed and followed-up, observing physical growth, intelligence measuring and whether the area of operated in abdomen need staged repair or not. Compared with 15 cases who underwent traditional operation method at the same time. Results Two cases died, 2 cases abandoned, and 26 ease received survive (survive rate 86.7%)and their growth was well in 26 cases. But in those 15 cases who underwent traditional operation method, 5 cases survived (survive rate 33.3%). There were significant difference in the survive rate, the mean operative time and postoperative hospital stay time between the two operation methods (P <0.05).Conclusion The material is adopted easily in the operation, autogenous umbilical cord is elastic tissue and no toxicity, it can relax the abdominal press effectively after the operation, the survive rate is high.

Objective: To observe the influence of transcutaneous CO2emission (TCE) at points on the meridian or beside the meridian after different stimulations like acupuncture De-qi, sham acupuncture, study the correlation between acupuncture De-qi and local energy metabolism through TCE. Methods: Twenty healthy volunteers (male 8, female 12, average age 29 years old) were selected. Before, during and after five different acupuncture Neignan (PC 6), the TCE was measured at Quze (PC 3), point A [at the lower one fourth of line between Tianquan (PC 2) and Quze (PC 3)], point B [at the middle of line between Ximen (PC 4) and Quze (PC 3)], point C (2 cm ulnar side point A) and point D (2 cm ulnar side point B) with a high sensitive C02 instrument (Frewil-Q.F., made in China). The measure results were compared. Results: The comparison on value of TCE before and after the acupuncture, in Sham acupuncture and shallow acupuncture groups, it increased in all five points; in De-qi acupuncture group, there are significant increase on point A, point B, and Quze (PC 3), it has statistic significance, but there are no significant increase on point C and D. After Ximen (PC 4) or Daling (PC 7) were pressed to block Neiguan (PC 6), the value of TCE on Quze (PC 3), point A and point B were decreased during acupuncture Neiguan (PC 6), and increased after the block was removed, but there was no significant difference. Conclusion: Sham acupuncture has also some effects on body, it can increase energy metabolism of local skin, it may be the reason that shallow acupuncture without qi amving can obtain clinical efficacy. The operation method of traditional qi arriving acupuncture can increase energy metabolism of relevant meridian skin, mechanical press can reduce this effect.

Objective To compare the long-term effectiveness of anti-interleukin-2 receptor antibodies vs.rabbit antithymocyte globulin as induction therapy in kidney transplantation.Methods Between 2006 and 2010,371 recipients of kidney transplants were treated with calcineurin inhibitors (CNI),mycophenolate mofetil and prednisone.261 patients of them received induction therapy with anti-interleukin-2 receptor antibodies (IL2Ra group),and 88 patients received rabbit antithymocyte globulin (rATG group).All the patients received ganciclovir against cytomegalovirus and SMZ against pneumocystis carinii.The data of delayed graft function (DGF),the rate of acute rejectin (AR) and infection in the first year and patient/allograft long survival rate in two groups were retrospectively analyzed during a follow-up period of 1 to 5 years postoperatively.Results There was no significant difference in the sex,age and causes of end-stage renal disease between the two groups.The rATG group had more kidney transplants from deceased donors (P＜0.01 ) and the cold ischemia time was longer than that of the IL2Ra group (P＜0.01 ).The IL2Ra group and the rATG group had similar incidence of DGF (3.1％ vs.1.8％,P＞0.05).One year after operation,the incidence of AR in IL2Ra group and rATG group was 10.7％ and 2.7％ respectively (P＜0.05),and the incidence of infection in IL2Ra group and rATG group was 14.9％ and 21.8％ respectively (P＞0.05).One-,two- and three-year patient survival rate in IL2Ra group was 98.9％,98.9％ and 98.5％ respectively,and that in rATG group was all 98.2％ (P＞0.05).The one-,two- and three-year allograft survival rate in IL2Ra group was 98.5％,98.1％ and 97.7％ respectively,and that in rATG group was all 97.3％ (P＞0.05).Conclusion rATG is more effective than IL2Ra preventing from acute rejection and does not increase the risk of infection for induction in kidney transplant recipients.

Objective To evaluate the application of Sigma stent in treatment for esophagn-tracheal fistula. Methods Clinical data of 22 cases of esophago-tracheal fistula treated with Sigma stent were retrospectively analyzed, including 17 cases of esophageal cancer and 5 cases of benign esophageal diseases, with length of 4 days to 2 months. One single stent was placed in 5 cases, two stents ( both in trachea and esophagus each) in 15 cases, and three stents in 2 cases, and 18 eases with tube-type trachea stent, 3 with obtuse angle L-type and 1 with Y-type. Placement of stent was by interventional method or/and endoscopy. Results Forty-one stents were successfully placed in 22 patients with no death in the procedure. And, all patients with fistula were healed successfully and could have normal eating 2 to 4 days after operation, except 1 patient who received a tracheal stent inserted first, but an esophageal stent inserted again due to incomplete seal of the fistula and another benign case who received surgical operation 1 year after stent placement due to protracted unsealed fistula, with an overall cure rate of 91% (20/22). Conclusions Placement of Sigma stent in the esophagus or/and trachea could effectively heal esophago-tracheal fistula. All the patients can eat normally after the procedure. Stent can be recycled and formation of secondary esophago-traeheal fistula can be prevented effectively with such procedure.

Objective To investigate the role of calpain in the spinal dorsal horn in development of paw inflammatory pain in rats.Methods Forty-eight male SD rats,aged 6 weeks,weighing 160-200 g,were randomly divided into three groups:normal control group(group C,n =8),PBS group( n =16),zymosan-induced paw inflammatory pain group (group Z,n =24).Inflammatory pain was induced by injection of zymosan 1.25 mg into the plantar surface of left hindpaw.Group PBS received the equal volume of PBS 100 μl.The mechanical paw withdrawal threshold (MWT),paw withdrawal thermal latency (PWTL) and maximum thickness of the plantar surface of left hindpaw were measured before (T0 ) and at 30 min,1,2,4,8,24 and 48 h(T1-7 ) after zymosan or PBS injection.Eight rats were sacrificed at T4 in group PBS and at T4.6,7 in group Z respectively.The left lumbar segment (L4-6) was removed to determination of spectrin α Ⅱ breakdown products,IκBα,cyclooxygenase-2 (COX-2)expression and NF-κB activity in the spinal dorsal horn by Western blot.Results Compared with group C,MWT and PWTL were significantly decreased,maximum thickness of paw and NF-κB activity in the spinal dorsal horn were significantly increased,spectrin α Ⅱ breakdown products and COX-2 expression in the spinal dorsal horn were upregulated,while IκBα expression was down-regulated in group Z( P ＜ 0.05 or 0.01 ),but no significant change was found in group PBS( P ＞ 0.05).Conclusion The activation of calpain in the spinal dorsal horn is involved in the development of paw inflammatory pain in rats through activating NF-κB and up-regulating the expression of COX-2.

BACKGROUND: Eggembryosin is characterized by tonifying kidney and vital essence, invigorating qi and spleen, replenishing and activating blood, beautifying and nourishing face, and improving constitution of whole organism.OBJECTIVE: To observe the influence of eggembryosin on aging index,quantity of hemocytes and quality of immune organs of animal models, and analyze its effect on cosmetology, anti-senility and immunoloregulation.DESIGN: Randomized controlled observation.SETTING: Department of Pharmacology, Xinxiang Medical College.MATERIALS: The experiment was carried out in the Department of Pharmacology of Xinxiang Medical College between April 1998 and September 2002. A total of 80 Kunming mice of both sexes were selected in this study.METHODS: ① Effect of eggembryosin on activity of superoxide dismutase (SOD) in serum, content of malondialdehyde (MDA), lipofuscin and hydroxyproline respectively in serum, liver and tendon of tail of aging mice: Thirty mice were divided into 3 groups according to randomly lined table, including eggembryosin group, D-galactose model group and normal control group with 10 in each group. The former two groups were injected with D-galactose to copy aging models, and eggembryosin group were perfused with eggembryosin to measure activity of SOD in serum, content of MDA, lipofuscin (aging index) and hydroxyproline (elasric index of skin) respectively in serum, liver and tendon of tail. ② Effect of eggembryosin on mass of immune organs of mice with low immunological function: Thirty mice were selected and divided as the same way mentioned above. Mice in eggembryosin group were perfused with eggembryosin. In addition, those in eggembryosin group and cyclophosphamide (CAP) group were peritoneally injected with CAP to copy immunosuppression models and calculate index of thymus (spleen) (mg/g) = weight of thymus (spleen)/body. ③ Effect of eggembryosin on quantities of erythrocytes and hemoglobin of mice with blood deficiency: Twenty mice were divided into 2 groups according to randomly lined table, including eggembryosin group and normal control group with 10 in each group. Values of erythrocytes and hemoglobins of mice were measured before administration. Models in types of blood-deficiency blood-loss were copied with tail xsanguinations, and then, mice were perfused with eggembryosin and saline, respectively. Blood of mice were collected from their tails to measure values of erythrocytes and hemoglobin.MAIN OUTCOME MEASURES: Activity of superoxide dismutase (SOD) in serum, content of malondialdehyde (MDA), lipofuscin and hydroxyproline respectively in serum, liver and tendon of tail of aging mice, index of thymus, and spleen, contents of blood erythrocytes and hemoglobins.RESULTS: A total of 80 mice were involved in the final analysis without any loss. ① Activity of SOD in serum and contents of hydroxyproline in tendon of tail of mice in eggembryosin group were significantly higher than those of mice in D-galactose model group (P ＜ 0.01); content of MDA in serum and content of lipofuscin in liver of mice in eggembryosin group were significantly lower than those of mice in D-galactose model group (P＜ 0.01). ② Indexes of thymus and spleen of mice in eggembryosin group were higher than those of mice in CAP group (P ＜ 0.05-0.01). ③ Increasing values of blood erythrocytes and hemoglobin of mice in eggembryosin group were significantly higher than those of mice in normal control group (P ＜ 0.01).CONCLUSION: Eggembryosin taken orally can improveanti-oxidation of organism and elasticity of skin, increase quality of immune organs damaged by CAP and immunological function, and nourish the blood.

Objective: In the authors' previous study, acupuncture had an effect along meridians. The effect ofacupuncture can be represented by local energy metabolism which can be expressed by transcutaneous CO2 emission (TCE). To study the transportation of the effect of acupuncture and the influence to the transportation when blocking the meridians, the following experiment was carried out. Methods: Twenty healthy volunteers (male 8, female 12, average age 29) were examined on pericardium meridian at points between Quze (PC 3) and Tianquan (PC 2) (Point a), between Ximen (PC 4) and Quze (PC 3) (Point b), two control points (c and d) beside a and b and Quze (PC 3). TCE was measured on these five points before, during and after acupuncturing Neiguan (PC 6) by a high sensitive CO2 instrument (Frewil-Q.F., made in China). Mechanical pressure of 1 kg (2 cm～ 1 cm area) was given on Ximen (PC 4) or Daling (PC 7) during the acupuncture and TCE were measured before acupuncture, during acupuncture and mechanical pressing, withdrawing acupuncture but keeping pressing and after withdrawing the pressure. Results: TCE increased significantly on point a, b and Quze (PC 3) during and after acupuncture without mechanical press. When mechanical press was given at Ximen (PC 4), no significantly increase was found on above three points during and after acupuncture. When pressing Daling (PC 7), there was still significant (P<0.05) increase at Quz～ (PC 3) and point during acupuncture and significant increase (P<0.05) at point b after acupuncuture while pressing was kept. Conclusion: Acupuncture can enhance the energy metabolism expressed by TCE along meridians and this effect can be eliminated by mechanical pressing along meridians on the way between acupuncture point and measured point.