Objective To find out about the utilization of health resources by rural pulic health centers in Hubei Province in the Ninth Five-Year Plan period so as to provide primary information for the better use of rural health resources. Methods The issues of Hubei Health Statistics and Hubei Almanac in 1990 and from 1996 to 2000 were collected and statistial analyses were conducted by means of the spss software. Results In the Ninth Five-Year Plan period, the human resources and fixed assets of rural public health centers in Hubei Province kept increasing whereas the volume of services dropped year by year. The reduction in the average number of outpatient visits and discharged patients per annum was respectively 4. 42% and 4. 09%. The efficiency of the health personnel in delivering medical services has been decreasing, with the average number of patients treated by each person per annum, the annual number of beds utilized, and the annual number of discharged patients in 2000 dropping respectively by 27.54% , 30.22% and 26.36% , as compared with 1996. The annual ratio of bed utilization was around 30% and the number of bed turnovers was about 20 times, evidencing, moreover, a tendency of going down. Conclusion The input of health resources in the rural public health centers in Hubei Province in the Ninth Five-Year Plan period increased while the rate of utilization dropped. It is suggested that integrated management in the rural areas be adopted, better utilization of health resources made, reform of the public health centers deepened, and internal management improved; greater stress be laid on improving the quality of rural health personnel; and the rural cooperative medical and health system be perfected.

Objective To explore the application and effect of scene imitation method in the education of patients before fiberoptic bronchoscopy.Methods 264 elective bronchoscopy patients between March 2007 and Decembet 2007 were randomly divided into control group(120 patients)and the experiment group(144 patients)Traditional health education was applied in the control group before bronehoscopy.Scene imitation method in health education was applied in the experiment group before bronchoscopy.Results The examination succes rate in the experiment group was significantly improved(P＜0.05).The medical order obeying behavior(MOOB)of the patients was significantly different between the two group(P＜0.01).Conclusion Before the use of fiberoptic bronchoscopy,the new scene simulation method Can help patients on the list obtain more cognitive ability about the testing.Comparing the traditional education,it establishes a sound relationship between doctors and patients,reduces complication and leads to more accurency of testing,thus helping patients to recover soon.

Objective to observe the efficacy and application value of PFNA and Gamma in the treatment of intertrochanteric fractures in elderly. Methods 100 patients with intertrochanteric fractures were divided into PFNA group and Gamma group, who received PFNA treatment and Gamma treatment respectively. And the operation status of patients at different ages,postoperative recovery,and complications were observed. Results The operation time,intraoperatve blood soss of PFNA group were lower than those of Gamma group(P<0. 05). There was no significant difference in fracture healing time. The Harris score of the over 75s in PFNA group was higher than that in Gamma group(P<0. 05),and the complications were less than Gamma group(P<0. 05). Conclusion PFNA was suitable for the patients at differ-ent ages with the advantages of more rigid fixation,good anti-rotation,fewer trauma and fewer complications.

This article has shown the experiences to achieve more effective teaching results by integration of multiple teaching patterns,including case-based,problem-based learning,in the teaching of water-electrolyte metabolism and acid-base balance disorders.

Objective To summarize the experience of ultrasound-guided percutaneous nephrostomy during percutaneous nephrolithotomy(PCNL) under B-ultrasound guidance. Methods A ultrasound-guided percutaneous nephrostomy was performed in 43 cases by using a 18-gauge needle.Then the percutaneous puncture was expanded for establishing a working tunnel. Under nephroscope,stone fragmentation was completed in the renal pelvis and the upper segment of the ureter.Results The success rate of percutaneous puncture was 100%.Of the 43 cases,the percutaneous working tunnel was successfully established in 42 cases(97.7%),while a conversion to open surgery was needed in 1 case because of uncontrolled hemorrhage after puncture.The overall stone clearance rate was 100%(42/42),including 38 cases of stone removal on one session and 4 cases of two-staged clearance.No serious complications,such as massive hemorrhage or neighboring organ injuries,were encountered.Re-examinations with B-ultrasonography or KUB at 1 month after operation showed no residual stones.Conclusions Ultrasound-guided percutaneous nephrostomy is minimally invasive,safe,and reliable.Proper use of this technique is crucial for a successful performance of percutaneous nephrolithotomy in the treatment of upper urinary tract calculus.

Objective To investigate the correlation between atherosclerotic renal artery stenosis and hypertension.Methods One hundred and seventy-nine patients underwent renal artery angiography after coronary artery angiography. Results Among the 179 patients, 56.4% patients were detected as renal artery normal, 24% as renal artery disease, and 19.6% as renal artery stenosis. Compared with hypertensive patients with normal renal artery, ARAS patients had higher systolic blood pressure (148?23 mm?Hg vs 136?18 mm?Hg, P

Objective To investigate the correlation between atherosclerotic renal artery stenosis and the severity of coronary lesions in patients with confirmed coronary artery disease and the impact of renal artery stenosis on serum inflammation related factors.Methods 163 patients from Peking University First Hospital with confirmed coronary heart disease by coronary angiography underwent selective renal artery angiography from Dec 2002 to Sep 2003.Serum hypersensitive C reactive protein(hs-CRP)and Interleukin-6(IL-6)were measured.Results Patients combined with coronary disease and renal artery stenosis were presented with more acute coronary syndrome(ACS)and triple-vessel CAD.Serum hs-CRP and IL-6 levels were also higher in this group.Conclusion Renal artery stenosis is correlated with severe coronary disease.Inflammation state could be one of the reasons for this connection.

Objective To study the clinical efficacy of unstable angina patients with the treatment of Yixin Kangtai capsule combine with diltiazem .Methods A total of 98 patients with unstable angina were randomly divided into control group and treat-ment group ,49 in each group .The control group was given conventional anti-anginal drug therapy ;while combination group was given Yixin Kangtai capsule combine with diltiazem on the basis of conventional anti-anginal medication .The course was 30 days . After the treatment ,the symptoms of angina ,ECG ST-T ,blood viscosity and markers of endothelial function NO and ET levels were observed .Results After treatment ,the total effective rate of the combination therapy group was higher than that of the con-trol group (P< 0 .05) ;the angina attacks and its duration in combination therapy group were lower than that of control group(P<0 .05) ;the total efficiency of electrocardiogram in combination therapy group was better than that of the control group (P< 0 .05) ;blood viscosity values and ET levels of combination therapy group were reduced compared with before treatment (P < 0 .05) ,but NO levels were increased(P< 0 .05) .Conclusion Yixin Kangtai capsule combine with diltiazem have significant efficacy for unsta-ble angina pectoris ,and have protective effect on endothelial function in patients with unstable angina .

Objective To investigate the effect of microRNA-101 (miRNA-101) on atrial fibrosis in human chronic atrial fibrillation (AF). Methods Right atrial appendages were obtained from 59 patients (30 with AF) undergoing cardiac surgery, including 47 patients with valve heart disease and 12 patients with congenital heart disease. The expression of miRNA-101 was determined by quantitative real-time PCR in the right atrial appendages of patients with and without AF. The cell-specific localization of miRNA-101 was detected by in situ hybridization assay. The mRNA and protein expression levels of transforming growth factor β typeⅠreceptor (TGFβRⅠ) and collagen type I (COL1) were determined by quantitative real-time PCR and Western-blot assay, respectively. Collagen in the right atrial appendages was observed by Masson staining assay. Results The expression of miRNA-101 was found to be significantly down-regulated in AF patients compared with patients with sinus rhythm (SR) (P < 0.05). The result of miRNA-ISH showed that miRNA-101, which was highly distributed within the connective tissues of heart, was down-regulated at about 24.9% in patients with AF compared with patients with SR. No significant differences at the mRNA expression level of TGFβRI was found between patients with AF and patients with SR (P > 0.05). But the protein expression of TGFβRI in patients with AF was significantly higher than that of patients with SR (P < 0.05). The mRNA and protein expressionsl of COL1 were significantly higher in patients with AF than thoset of patients with SR (P < 0.05). The collagen was significantly increased in patients with AF than that of patients with SR (P < 0.05). Conclusions Downregulation of miRNA-101 may contribute to atrial fibrosis in human atrial fibrillation by targeting TGFβRⅠ.

Objective To analyze the expression of glial fibrillary acidic protein(GFAP) in hippocampal of rats with hypoxic-ischemic brain damage(HIBD) after injection of bone marrow stromal cells(BMSCs) supernatant into the lateral ventricle of the neonate rats,assess the ability of learning and memory,and explore the mechanism.Methods 7-day-old SD rats were randomly divided into sham operation group,model group,cells and supernatant group,with 20 rats in each group.The HIBD model was established via the ligation of left carotid arteries followed by 2-hour hypoxia.One week later,rats in control group were injected with 0.01 mol/L PBS 2 μl via the left ventricle.Meanwhile,the cell and the supernatant groups were injected with BMSCs and supernatant harvested from BMSC culture,respectively,via the same route.In the sham operation group,the left carotid arteries were separated but not ligated,and no hypoxia treatment was imposed on this group.They also received 0.01 mol/L PBS injection 2 μl per weak post surgery.8 weeks later,Morris water maze test was performed to assess the learning and memory,and the expression of GFAP in the dentate gyrus of rats was measured by immunohistochemistry.Results Morris water maze showed that the searching time of the probe trail(T1:(15.40±2.80) s) and reversal probe trail (T2:(16.45± 1.16) s) of the model group was shorter than that of the sham operation group (T1:(19.96±2.57) s,T2:(2:25.32±2.54)s,P＜0.05),while the searching time of the cell group(T1:(17.54± 1.80)s,T2:(18.99± 1.47) s) and supernatant group (T1:(17.40±2.37) s,T2:(17.96± 1.09) s) was prolonged compared with that of the model group (P＜0.05).No significant difference between the cell group and the supernatant group (P＞0.05).The integral optical density (IOD) value of GFAP positive cells was higher in the model group than that in the sham operation group(15.26±1.49 vs 12.82±2.56,P＜0.05),while the IOD of cell group(18.13±1.97) and that of the supernatant group(17.38± 1.64) were higher than that of the model group (P＜0.05).However,there was no significant difference between the cell group and the supernatant group (9＞0.05).Conclusion BMSC supernatant injected through lateral ventricle can improve the HIBD rats' abilities of learning and memory.The mechanism might be that MSCs secrete some cytokines to promote central nervous system repair.