Humans ; Nose ; anatomy & histology ; surgery ; Petrous Bone ; anatomy & histology ; surgery

Endoscopy ; education ; Humans ; Skull Base ; surgery

Objective To investigate the status of hold vaccination contraindication knowledge by Zhengzhou Municipal vaccination staff for improving the vaccination service.Methods To sample 54 vaccination clinics with Stratified random samping 216 Expanded Program on Immunigation (EPI) staff were suvveyed by questionnaire and analyse the data with descriprive method.Results The knowledge rate on contraindications was 56.9%,knowledge was mainly come from vaccine manual,professional books and tranining.Conclusion The EPI staff's contraindications knowledge was weak,and vaccination contraindication rules should be developed to guide actual work as soon as possible.

Objective To develop a rapid specific method to detect HBV gene mutation by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Methords The patients of YMDD and YIDD mutation were detected by DNA sequencing.Results the DNA sequencing demonstrated that not only YMDD and YIDD/YVDD mutation, but LLLL,LMLL,DLHD,DMHD,LLAQ and LMAQ mutation were also detected in different hepatitis B patients. The results of PCR-RFLP indicated that there were different restricted sites in the distinct mutation.Conclusion The results above indicated that all these mutants exist in the initiator codon of ATG(Met). The mutation of LMLL DMHD LMAQ was associated with Lamivordin treatment. Whether mutation of Met links with the second replicating of HBV needs to be further studied.

Under physiological conditions, many vital functions of the body are controlled by transient release of bioactive substances at a specific time and site. Based on the circadian rhythm character of disease and chronotherapeutic conceptions, pulsatile delivery system has been designed to achieve optimal therapeutic effect and reduce the toxic and side-effect. In recent years, more and more studies are focused on the pulsatile multiparticulate drug delivery system. Pulsatile multiparticulate system possesses many benefits, such as no risk of dose dumping, predictable gastric emptying, flexible release patterns and increased bioavailability. Based on these premises, the aim of this review is to summarize the major design methods of pulsatile multiparticulate and the research progress.

Aim: To investigate the chemical components in Zhizidahuang decoction( ZZDHD) to reveal the possible material therapeutic basis. Methods: High performance liquid chromatography coupled with photodiode array detector and tandem mass spectrometry ( HPLC-PDA-MS/MS) was applied to simultaneously characterize the chemical components and their structures in ZZDHD. The analysis was preformed on a Lichrospher C_(18) column using a binary eluent of 0. 1% acetic acid( A) and methanol( B) mixed under the gradient mode; UV spectra were scaned from 210 nm to 480 nm; negative ESI experiments in data-dependent scan mode were performed. Results: HPLC-PDA-MS/MS chromatogram of ZZDHD was achieved. Based on UV spectral data, information of molecular weight and mass fragmentation behaviors connected with extracted ion current( EIC) chromatogram, twenty kinds of components were detected and identified, including flavonoids, anthraquinones, iridoids and other constituents. Conclusion: The method presented in this study, which combined HPLC with UV and MS, allowes the characterization of compounds in the complex herbal system even without the reference standards.

Objective To learn the clinicians'attitude towards the “Drug and Medical Service Separation” reform in Beijing.Methods A number of pilot hospitals of “Drug and Medical Service Separation” reform in Beijing were pinpointed,for a random questionnaires survey among 800 clinicians,to learn their awareness,evaluation and attitudes to the reform.Results The clinicians were found with good awareness and understanding of the reform,with an awareness rate of 99.5％ ; 72.0％ of them hold that the pricing of “medical service charge” of the reform as reasonable; most of them believe that the reform plays a positive role in relieving the difficulties of seeing doctors and affordability of medical treatment; their approval rate for the reform pilot project is 97.3％; their satisfaction for the reform implementation is 90.8％,and their support for full implementation of the reform is 94.0％.Conclusion The clinicians from those pilot hospitals are sufficiently aware of and understand this policy,and are supportive of the pilot with useful suggestions.The recommended strengthened publicity and training,higher medical service charges,better pay for medical workers,improved incentive mechanism and evaluation mechanism,and better clinicians' satisfaction.

Objective To investigate the effects of tetrahydroxystilbene glucoside (TSG) on cytochrome P450(CYP) in mouse livers .Methods Kunming male mice were divided into the blank ,low dose and the high dose of TSG groups .3 ,5 and 7 after intra-gastrical administration of TSG ,mice were sacrificed and the mRNA expressions of CYP isoenzymes in mouse livers were measured by real time reverse transcription-polymerase chain reaction(RT-PCR) ,respectively .Results TSG significantly inhibited CYP1A2 and CYP 3A4 mRNA expressions at 3th ,5th and 7th day after treatment .TSG time-dependently increased CYP2E1 mRNA expres-sion .TSG inhibited CYP4A14 mRNA expression at 7th day after treatment .Moreover ,TSG had no significant effects on CYP2B10 , CYP3A11 and CYP3A25 mRNA expressions .Conclusion TSG has significant effects on CYP1A2 ,CYP2E1 ,CYP3A4 and CYP4A14 mRNA expressions but no significant effects on CYP2B10 ,CYP3A11 and CYP3A25 mRNA expressions .

Objective To observe the effects of puhnonary rehabilitation on the symptoms and quality of life of persons with chronic obstructive pulmonary disease (COPD).Methods COPD patients were recruited from a hospital and community health centers and given pulmonary rehabilitation in the community.The rehabilitation program included health education and nutrition guidance,medication,breathing exercises,and physical exercise.Each patient was followed up every 4 weeks by telephone.The outcome measures included pulmonary function (FEV1％,FEV1/FVC％),St George's questionnaire (SGRQ),the Medical Research Council scale (MRC),Borg scoring,evaluation of anxiety and depression,the six-minute walk test (6MWT),and an evaluation of nutritional status.All of the patients were observed for one year.Results A total of 85 patients completed the program and were included in the final statistical analysis.There was no difference in FEV1 ％ before and after rehabilitation.Six-minute walking distance improved significantly in statistical terms but the average increase was only from (416.1 ±99.84)m to (437.51 ±116.17)m.The SGRQ scores decreased by an average of 4.8 points after a year of rehabilitation,with significant improvements among the moderately and severely impaired.Incidents of COPD exacerbation also decreased significantly.Patients with a low body mass index had the greatest SGRQ score improvments.Few patients showed depression or anxiety in this research population.Conclusions Pulmonary rehabilitation in the community can improve exercise tolerance and the quality of life for persons with COPD,reducing incidents of acute exacerbation.Patients may benefit from such pulmonary rehabilitation regardless of disease severity.The compliance was good despite the infrequent monitoring.Pulmonary rehabilitation in the community is worthy of more widespread use.

Objective To compare different dose of remifentanil combined with propofol for painless abortion and approach to an appropriate dose of remifentanil.Methods Ninety pregnant women with ASA 1 were randomly divided into three groups(n=30)before administrating remifetanil,a bolus midazolam 1 mg was injected inminutes later.These two drugs did not stop administration until three minutes before the end of negative suction.MAP,HR,SpO2,BIS,RR,VT,PET CO2 were monitored.The onset,operation and recovery time,sedation score and adverse reaction were recorded.Results Sedation scores were significantly different between group A and C [(3.90±0.97)and(4.90±0.85),t=4.24,P＜0.01].Three cases in group A were found moving.MAP,HR,BIS decreased as compared witll baseline.HR reduced significantly in group C(P＜0.05,P＜0.01).Respiratory movement was lower and shallower.RR,VT decreased compared to preoperative one.PET C02 increased gradually (P＜0.05,P＜0.01).There were two cases of respiratory depressing in group A,four cases in group B and ten cases in group C(five cases apnea more than three minutes).All patients used oxygen mask to maintain SpO2＞95%.Incidence of adverse reactions such as chest titanic,nausea and vomiting,itching were of no difference among three groups(P＞0.05).All patients were satisfied with anesthesia.Conclusion The appropriate infusing dose of remifetory devices such as oxygen mask and monitoring life signs are very important to prevent respiratory depress and bradycardia during operation.