Objective To determine whether plasma Leptin level is associated with atherosclerosis in maintenance hemodialysis(MHD)patients.Methods During 1997-01~2003-06,plasma Leptin levels in MHD patients and healthy volunteers were measured and intima-media thickness(IMT)and prevalence of atherosclerotic plaques of the extracranial common carotid artery were also measured.Results Plasma Leptin levels in the MHD patients were higher than those in the healthy volunteers(P

AIM:To put forward the suggestions for standardizing the pharmacoeconomic research.METHODS:The background of formulation and main points of Canadian Guidelines for the Pharmacoeconomic Evaluation were introduced and its recent development was described.At the same time,we put forward our tentative plan about establishing Chinese guidelines for the pharmacoeconomic evaluation.RESULTS ＆ CONCLUSION:A series of guidelines for the pharmacoeconomic evaluation should be established,which is approved by departments of social safeguard,drug supervision and public health administration,to standardize the pharmacoeconomic research.The goverment should make corresponding policy publicized and make pharmacoeconomic evaluation connect with drug price,clinically rational drug use,catalog of classified management of drugs and catalog of drugs in medical insurance.A pharmacoeconomic framework,which conforms China's national conditions and is controlled by goverment,will established.

Objective To investigate the changes of intestinal floras in elderly patients with first-episode untreated schizophrenia and to analyze the role of intestinal floras in schizophrenia .Methods Thirty elderly patients(≥60 years old) with first-episode un-treated schizophrenia treated in our hospital from July to October 2016 were selected as the observation group ,while 30 healthy peo-ple undergoing physical examination in the same period were selected as the control group .The bifidobacterium ,lactobacillus and bacteroides of stool samples in the two groups were tested by 16SrRNA real-time fluorescence quantitative PCR (qPCR) .Results The bifidobacterium content of stool samples in the observation group was significantly lower than that in the control group ,while the bacteroides content was significantly higher than that in the control group ,moreover the ratios of bacteroides/lactobacillus and bacteroides/bifidobacterium in the observation group were significantly increased ,the difference was statistically significant (P<0 .05);the lactobacillus content had no obvious difference between the two groups .Conclusion The phenomena of intestinal flora disorder and intestinal flora disproportion exist in elderly patients with first-episode untreated schizophrenia .Intestinal flora may be involved in the pathogenesis of schizophrenia .

Objective To compare using the transabdominal route versus the transoral route in establishing naso-biliary drainage in laparoscopic surgery.Methods The combined use of laparoscopy with choledochoscopy and duodenoscopy to establish naso-biliary drainage was carried out in 204 patients with gallbladder and common bile duct calculi.In 162 patients,the naso-biliary drainage was established transabdominally and in 42 patients it was established transorally.The success and the complication rates in the two groups were compared.Results Of 162 patients using the transabdominal route,4 patients failed.There were 6 patients (3.7％) who had no output from the nasobiliary drain.There were 3 patients (1.8％) who had only intestinal juice outflow from the nasobiliary drain.Primary closure failed in 3 patients (1.8％),all resulting in bile leak.Pancreatitis occurred in 2 patients (1.2％) after the operation.There was 1 patient (0.6％) whose nasobiliary drain was wrongly ligated.Of 42 patients with nasobiliary drainage using the transoral route,6 patients failed.There was 1 patient (2.4％) who had no output from the nasobiliary drain.There was 1 patient (2.4％) who had intestinal juice output from the nasobiliary drain.Primary closure failed in 1 patient (2.4％) with resultant bile leakage.Pancreatitis occurred in 4 patients (9.5％) after the operation.The success rate of establishing a nasobiliary drainage in the transabdominal group was significantly higher than that in the transoral group,but the complications were less.Conclusions Nasobiliary drainage established through the transabdominal route in laparoscopy surgery for patients with gallbladder and common bile duct calculi was technically easier and had a high success rate.It had less complications.

Objective To observe the migration and distribution of OECs in injured spinal cord and discuss their relation with the recovery of spinal cord function. Methods The rats were contused by a force of 10 g · 25 mm with NYU-impactor at T10 level. The OECs acutely isolated from green fluorescence protein (GFP) rats were purified, identified and then transplanted into the injured site and the rostral and caudal parts of the spinal cord one week after injury, with total volume of the transplanted OECs for 90 000/μl. Within 13 weeks after transplantation, the migration and distribution of OECs were qualitatively observed on the cryo-sections under fluorescence light microscope. The area and the length of OECs distribution were semi-quantitatively determined. The locomotor function of the spinal cord was appraised by BBB score. Results OECs were located collectively in the transplanted site at early stage after transplantation and then spread gradually mainly along the long axis of the cord. OECs could be found in the cavity of the contused spinal cord. The area and the length of OECs distribution were increased from 1.33 mm2 and 4.23 mm respectively at one week to 3.30 mm2 and 7.68 mm respectively at 13 weeks after transplantation. In the meantime, the locomotor function was gradually improved. Conclusion OECs can migrate within the contused spinal cord, as may contribute to the recovery of locomotor function.

Objective To assess the effect of continuous renal-replacement therapy (CRRT) dose on the outcome of acute renal failure (ARF) patients with meta-analysis of randomized controlled trials (RCTs). Methods Studies were identified by systematic search of peer-reviewed publications in Medline, EMBASE and Cochrane library database through June 2010. All the RCTs that compared the incidence of clinical outcome such as mortality, need for chronic dialysis between standard and low dose CRRT were eligible. The pooled relative risk (RR) for clinical outcome was compiled using a random-effects model. Heterogeneity was evaluated by means of subgroup and sensitivity analysis. Results Six eligible studies were identified. By meta-analysis, standard dose CRRT was associated with non-significant 13% mortality risk reduction (RR 0.87, 95%CI 0.70-1.07, P=0.19)and 13% composite outcome risk reduction of chronic dialysis dependence and mortality (RR 0.87, 95%CI 0.69-1.09, P=0.21), but the trend toward increased chronic dialysis dependence risk among survivors (RR 1.43, 95%CI 0.94-2.18, P=0.09). The overall test for heterogeneity among cohort studies was significant (P=0.001, I2=76.2%). The risk of mortality was modality was significantly lower in some studies of which delivered dose was moer than 35 ml·kg-1·min-1,modality was continuous venous-venous hemofiltration (CVVH) and major cause was non-sepsis treated with standard dose CRRT. Conclusions Standard dose CRRT in patients with ARF does not improve survival, renal recovery and composite outcome, but decreases mortality in important subgroups including those with higher delivered dose, CVVH and non-sepsis.

Objective:To conduct a survey on the difference in medical staff remuneration level and satisfaction within the eastern, central and western township health centers, explore the influencing factors on remuneration satis-faction, and put forward some suggestions. Methods:909 medical staff and 104 township health centers from 9 coun-ties in the eastern, central and western regions were investigated. The Descriptive, ANOVA and Hierarchical Linear Model ( HLM) methods were used to analyze the survey results. Results:Average annual medical staff remuneration was 28 324 Yuan in 2011 and the remuneration satisfaction was 2. 77 in five-point scale. The difference between the remuneration level (F=140. 16,P<0. 001) and remuneration satisfaction (F=240. 84,P<0. 001) among three re-gions was statistically significant. The HLM analysis indicated that the working time, workload per day in individual level and whether by practicing the policy of separation between revenue and expenditure, the number of average monthly discharged patients and the fiscal appropriation income in the township health centers level affected the remu-neration satisfaction. Conclusions:The medical staff remuneration level and satisfaction in the township health centers were low, both having a great regional difference. Therefore, the improvement of the medical personnel remuneration satisfaction is obtained through improving the revenue and expenditure, and the performance-based pay system.

Objective To investigate the expression of metastin and its significance in benign breast disease,normal breast tissue and breast carcinoma.Methods SP immunohistochemistry was used to determine the expression of metastin in 16 benign breast disease,12 normal breast tissue and 56 breast carcinoma.Results The positive rates of metastin in benign breast disease,normal breast tissue and breast carcinoma were 68.8%,75% and 30.4%,respectively.The expression of metastin in breast carcinoma was much lower than that in benign breast disease and normal breast tissue(P

Objective To evaluate the accuracy of ultrasonographic measurement of the subglottic airway diameter in selecting the cuffed endotracheal tube (ETT) size for the pediatric patients with congenital heart disease.Methods Sixty pediatric patients of both sexes with congenital heart disease,of American Society of Anesthesiologists physical status Ⅱ-Ⅳ,aged 1 month-7 yr,undergoing elective open heart surgery,were included in this study.The subglottic airway diameter was measured by bedside ultrasonography after induction of anesthesia.The outer diameter of the cuffed ETT was determined according to the subglottic airway diameter.The air leak test was performed after intubation to determine whether or not the ETT size selected based on ultrasonography was appropriate.When the difference between the inner diameter of the finally selected ETT and the result calculated by the Motoyama formula was less than 0.2 mm,the ETT size selected based on the Motoyama formula was considered appropriate.The agreement and correlation between the subglottic airway diameter measured by age-based formula and ultrasonography and the outer diameter of the actually selected ETT were analyzed using Bland-Altman plot and Passing-Bablok regression analysis.Results The accurate rate of the ETT selected based on the ultrasonic measurement and Motoyama formula were 80％ and 55％,respectively,and there was significant difference (P＜0.05).Conclusion Ultrasonographic measurement of the subglottic airway diameter produces higher accuracy than the classical Motoyama formula in selecting the cuffed ETT size for the pediatric patients with congenital heart disease.

Objective To explore the treatment characteristics and effect of hip fracture in aged patients. Methods A retrospective analysis was performed in 143 elderly patients with hip fracture, aged 75 years and over. 28 cases received non-surgery treatment and 115 cases received surgery treatment. Much of them had at least one chronic disease. The complications, preoperative preparation, operative indications, internal fixation devices, postoperative management, mortality rate and recovery rate were reviewed. Results The mortality rate of nonoperative management patients was 39.3% (11/28) in one year, and that of operative management patient was 8.7% (10/115). The recovery rate of nonoperative management patients was 28.5% (8/28) in one year, and that of operative management patients was 75.3% (79/115). Conclusions If full attention is paid to preoperative treatments, hip fracture of aged patients treated by operation is safe and effective.