Objective:To find out the relationship between mental factors and outpatient service utility. Method: Stratum-based random sampling method was used to select samples. The sample was interviewed with both self-made questionnaire and Kessler 10 rating scale.Results:The survey covered 11652 persons aged 15 and above. The incidence within two weeks was 10.38% (10.87% in rural areas and 7.73% in urban areas), the average rate of outpatient service seeking within two weeks was 4.83% (4.97% in rural areas and 4.11% in urban areas), 63.59% of the patients selected mainly the basic health service institution when they sought outpatient service; the primary mental factor affecting utility of outpatients was the mental state (K10 score), and the OR value of the high K10 group (scored 30-50) was 2.258 (95% CI: 1.265-4.032).Conclusions:Poor mental health is associated with higher utility of out-clinic service.

Objective To discuss the importance of saving the life of patients and the severity assessment in early emergency for the trauma and hemorrhagic shock patients in the first-aid of pre-hospital and emergency department.Methods Retrospective anal-ysis of the 182 patients data.Results With early and aggressive treatment,177 cases of survival,5 cases of death,and the survival rate 97.3%.Conclusion The disease of traumatic shock patients is complex,high mortality.the early detection,taking timely and effective rescue measures are the key to increase the survival rate.

Abstract: To report the diagnosis, treatment and outcome of 4 patients with hematological diseases complicated with Aeromonas hydrophila bloodstream infection in the Second Affiliated Hospital of Kunming Medical University, further clarify the importance of blood culture and deepen the clinical understanding of the disease. Four patients with hematological diseases complicated with Aeromonas hydrophila bloodstream infection treated in the Second Affiliated Hospital of Kunming Medical University from 2017 to 2021 were recruited as the study objects. The clinical manifestations, blood culture collection, detection time of Aeromonas hydrophila, laboratory examination, treatment and prognosis of the patients were retrospectively analyzed. In this study, 4 cases were male patients with hematological diseases, who were in myelosuppression after chemotherapy. After fever, blood culture was collected and Aeromonas hydrophila was detected. The positive time of blood culture in 4 cases ranged from 4 to 11 hours. The results of antibiotic sensitivity showed that it was highly sensitive to the second, third and fourth generation cephalosporins, quinolones and carbapenems. Four patients were treated with imipenem cilastatin sodium in the early stage, and one patient recovered after active anti infection and leukocyte raising treatment. One patient did not complete chemotherapy due to a request for discharged, and the follow-up was unknown. Two patients developed rapidly into necrotizing fasciitis and died later. Hematological diseases complicated with Aeromonas hydrophila bloodstream infection are rare, but the mortality rate is high. For patients with repeated fever and considering infection, blood culture should be carried out as soon as possible to confirm the pathogen and drug sensitivity test. During clinical treatment, the treatment should be adjusted in time in combination with the patient's situation. In addition to anti-infection treatment, the patient's immunity should be improved and the development of necrotizing fasciitis should be vigilant. Keywords: Aeromonas hydrophila; hematologic diseases; leukemia; bloodstream infection; blood culture; necrotizing fasciitis

Objective To establish the reference range of serum human serum insulin levels in our laboratory and investigate measurement stability, Methods The automated Architect i2000 chemiluminescence immunoassay, calibrator and quality control materials were used to measure concentration of serum insulin. Totally 413 cases of healthy adults were enrolled. The physiologic characteristics and the influence of laboratory markers on insulin levels were analyzed. Then the reference range in our laboratory was established. The thermal stability of insulin at different temperatures was investigated. Results Within-run imprecision and between-day imprecision of the automated Architect i2000 insulin assay were 1.67% and 2. 6%, which indicated that this system had good analytical performance. The subjects were classified into 4 groups according to age range ( 10 years). There was no significant difference among four age groups (the median is 5. 6, 5.2, 5.3 and 5. 7 mU/L) (X<'2> = 1. 929,P >0.05). However, the insulin levels were higher in female ( median = 5.7 mU/L) than male ( median = 5.0 mU/L) ( Z = 3.696, P < 0.01 ). The reference range was established based on the 2. 5 and 97.5 percentile values. The reference range of insulin for female was 2. 6-11.8 mU/L and 2. 3-11.6 mU/L for men, which differed from that of other insulin assay. Insulin had a positive correlation with BMI (r =0. 115 ,P =0. 019) and triglyeeride (r =0.143 ,P = 0. 004), and a negative correlation with high density lipoprotein (r = -0.179, P = 0.000). Insulin was stable at 25 ℃ for at least 4 hours or 4 ℃ for 24 hours or could be extended to at least 7 days when stored at -20 ℃. Conclusion Gender is an important physiologic characteristic which has an impact on human serum insuhn level. Insulin reference range should be established according to gender. Insulin immunoreactivity was not very stable at different temperatures.

Objective To evaluate the value of automatic bacteria identification systems including Phoenix and Vitek2 Compact, as well as blaOXA-51-like gene amplification in the identification of Acinetobacter species compared with amplified ribosomal DNA restriction analysis(ARDRA). Methods A total of 50 non-repeated clinical isolates of Acinetobacter species were collected in PUMCH from 2006 to 2007 and identified by ARDRA, blaOXA-51-like gene amplification, Phoenix and Vitek2 Compact,respectively. Results Compared with ARDRA, the sensitivity and specificity of blaOXA-51-like gene amplification were both 100%. The accuracy rates of Phoenix and Vitek2 Compact were 44% and 56%, respectively. Conclusions The accuracy of phenotypic identification of Acinetobacter species is not ideal, however, blOXA-51-like gene amplification could be used as a fast and reliable method for identification of A. baumannii. ARDRA is recommended in the study of drug resistant mechanisms and homological analysis of Acinetobacter species.

0.05). Cross-reactivity was seen in 1 case of clonorchiasis sinensis by both the methods. Conclusion Microwave ELISA has the advantages of high sensitivity, specificity and rapidity.

From the Chinese medicine point of view on the physiological functions of healthy atmosphere and vitality, healthy atmosphere and vitality of the relationship, we can know that healthy atmosphere and vitality has important role in the life activities of the body. They complement each other. In the pathogenesis of AIDS, AIDS epidemic poi-son has the characteristics of wounding healthy atmosphere. When it attacks the body upright, vitality will be injured firstly. Because of that it is inextricably linked with the characteristics of the AIDS epidemic poison and vitality physiological functions. Therefore, AIDS epidemic poison attacks healthy atmosphere and vitality co-exist, the injury of healthy atmosphere and vitality is throughout the whole process of AIDS .

Objective: To investigate the effects of dexmedetomidine (DEX) on oxidative stress and systemic inflammatory response syndrome(SIRS) during cardiopulmonary bypass (CPB).Methods: Totally 62 patients scheduled for mitral valve replacement surgery were enrolled in this study and randomly assigned to DEX group with constant infusion of DEX (0.5 μg·kg-1 ·h-1 , n =31) and the control group with the same amount of 0.9% sodium chloride injection(n =31).A volume of 4 ml of jugular vein blood was respectively withdrawn before the induction of anesthesia (T0), at 10 min after aortic-off clamping(T1), the end of bypass(T2), 4h after bypass(T3),12h after bypass(T4) and 24h after bypass(T5).The serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6(IL-6), interleukin-8(IL-8) and interleukin-10(IL-10) were determined.Results: The serum CRP in both groups increased remarkably at T1-T5 , while the serum CRP in DEX group was significantly lower than those in the control group at T3-T5.The serum TNF-α increased remarkably in control group at T2-T4, while the serum TNF-α increased remarkably in DEX group at T2-T3;the serum TNF-α in DEX group was significantly lower than those in the control group at T3-T4.The serum IL-6, IL-8, IL-10 in both groups were increased remarkably at T2-T5, T1-T5,T1-T3, respectively.The serum IL-6 and IL-8 in the DEX group were significantly lower than those in the control group at T2-T4 while the serum IL-10 in the DEX group was significantly higher than that in the control group at T1-T3.The serum WBC in both groups at T3-T5 were higher than those at T0, while the serum WBC in the control group was significantly higher than that in the DEX group at T3-T5.However, the differences between the two groups at mechanical ventilation time, ICU observation time, the incidence of postoperative SIRS after 24h, hospitalization days, and the adverse reactions were not statistically significant.Conclusion: DEX has notable protective effects on systemic inflammatory response syndrome during extracorporeal circulation.

Based on status and trends of international medical education,the authors probe the teaching theory,training objectives and curriculum system in military medical university. The purpose is to research and practice creative training model to train creative medical professionals for the army.

Actins ; metabolism ; Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; pathology ; Lymphatic Vessels ; metabolism ; pathology ; Male ; Middle Aged ; Vascular Endothelial Growth Factor C ; metabolism