The author expounds his views on some queries about the integrated management of rural health services. ①The prospective goal of the integrated management is not to solve problems in the internal reform of township public health centers, but to implement management of health services at the village level, a goal that can be attained. ②The structure of property rights of rural health institutions ought not to become the criterion of rural health reform; what should become the criterion ought to be the establishment of safe, effective, comprehensive, and non profitable health services. ③Concrete analyses should be made regarding the increase of charges for medical services after the integrated management. ④The integrated management means management based on integration, the latter being an indispensable means of the former. ⑤Perfection of the integrated management needs to go through a process.

[Objective] To observe the clinical effect of revised Duhuo Jisheng Decoction and combining therapy on scapulohumeral periarthritis. [Method] Select 150 cases for research data, among which, 50 cases were treated with Duhuo Jisheng Decoction and combining therapy as treatment group, other 100 cases with only combining therapy as control group, 15d as a course;compare their effects after 2 courses. [Result] After treatment, the comparison of pain VAS scores between the 2 groups, the difference was of statistical meaning( P<0.05); The cure rate and effective rate were respectively 78.00% and 92.00%,and for other group, they were respectively 60.00%and 85.00%;the treatment group was better than other group, the difference was of statistical meaning.[Conclusion] Revised Duhuo Jisheng Decoction and combining therapy treating scapulohumeral periarthritis pays attention to internal arghralgia treatment, and the superficial as wel , with definite cure effect, worthy emphasizing and promotion for basic hospitals.

The main factor is the number of patients, which predicted by least square method to reduce the deviation. The like equipments located nearby are also considered and the Shared Coefficient is proposed.

Objective To investigate the clinical effects of surgical treatment for varied types of cicatricial blepharon deformities. Methods Eleven patients (16 eyes) suffering from cicatricial blepharon deformities underwent surgical procedures. 4 cases (7 eyes) were treated with free skin flap transfer; 1 case with free skin flap transfer and amniotic membrane grafting, 2 cases with Z plasty; 1 case with pedicled skin flap; 1 case with orbicularis oculi musculocutaneous flap; 1 case (2 eyes) with wedged tarsal excision and blepharoplasty, and 1 case with allografe of keratoconjunctiva and reconstraction of conjunctival sac. Results All of 11 cases (16 eyes) showed satisfactory appearance and eyelid function to certain extent after operations. Conclusion The repair of skin defect and conjunctival sac integrality is the key step in correction of cicatricial blepharon deformities, which may offer good eyelid position and function.

OBJECTIVETo compare the difference in the clinical efficacy on benign prostatic hyperplasia (BPH) between the acupuncture-moxibustion therapy and the medication of Qianliekang tablets.

METHODSOne hundred and twenty-eight patients were randomized into an acupuncture-moxibustion group and a Qianliekang group, 64 cases in each one. In the acupuncture-moxibustion group, acupuncture was applied to Shenshu (BL 23), Pangguangshu (BL 28), Zhongji (CV 3), Guanyuan (CV 4) and Shuidao (ST 28), and the warm moxibustion therapy with moxa stick was used at Shenshu (BL 23), Guanyuan (CV 4) and Shenque (CV 8), once every day. In the Qianliekang group, Qianliekang tablets were prescribed for oral administration, 4 tablets each time, three times a day, for 3 months. The International Prostate Symptom Score (I-PSS) and the changes in residual urine (Ru) and maximal urine flow rate (Qmax) determined with the ultrasonic B test were compared before and after treatment in the two groups.

RESULTSThe results of I-PSS, Qmax and Ru were improved obviously after treatment as compared with those before treatment in the two groups (all P < 0.05). The improvements in the acupuncture-moxibustion group were much more obvious than those in the Qianliekang group [8.62 +/- 2.18 vs 15.26 +/- 2.81, (16.04 +/- 4.33) mL/s vs (12.47 +/- 2.13) mL/s, (10.43 +/- 2.14) mL vs (32.13 +/- 3.24) mL, all P < 0.01]. The total effective rate was 89.1% (57/64) in the acupuncture-moxibustion group, which was better than 68.7% (44/64) in the Qianliekang group.

CONCLUSIONAcupuncture-moxibustion therapy achieves the significant efficacy on BPH, which is better than the oral administration of Qianliekang tablets.

Acupuncture Therapy ; Aged ; Humans ; Male ; Middle Aged ; Moxibustion ; Prostatic Hyperplasia ; physiopathology ; therapy ; Treatment Outcome ; Urination

Cascade in cerebral ischemic injury may cause cholinergic dysfunction,inflammation and oxidative stress. It plays an important role in the pathological processes of vascular dementia. A large amount of basic research has confirmed that cholinesterase inhibitor and N-methyl-d-aspartate receptor inhibitor may improve cognitive function in patients with vascular dementia. However, the efficacy of these drugs has been confirmed in only a part of the patients, and their safety and efficiency have not achieved the expected results. Thus, it needs further study and exploration.

Different preparations of Hydroxyethyl starch (HES) each have unique molecular weight, degree of substitution and manner of substitution, which are responsible for their intravascular volume expansion and half-life. HES solutions have notable effects on ameliorating hemodynamic and hemorrheological parameters, as well as unique capacity to prevent and reduce capillary leak. Compared with other colloid solutions, HES is more effective, safe and economical. It is an ideal volume expander.

In order to study the physiological action of glucocorticoid receptor (GR) in intact animal, an animal model of GR depletion was developed in the rat by mifepristone (RU486), an antagonist of GR. Mifepristone 50 mg/kg body weight mixed in polyvinyl alcohol (PVA) was injected intramuscularly every 12 h in order to maintain the plasma mifepristone at the concentration of about 10-6mol/L for 72 h. In the meanwhile, the plasma corticosterone (B) was stabilized at about 15 ?g/dl by unilateral adrenalectomy 3 d before. In this model mifepristone occupied 88.1 ?10.7% of the total GR in hepatic, brain cytosol and thymocytes as measured by the exchange assay with [3H]dexamethasone (Dex) as ligand. Some indexes of glucocorticoid response were measured in the control, model and bilateral adrenalectomized (AdxT) rats. The polymorphonuclear eosinophil leukocyte (PME) count in blood and phospholipase A2(PLA2) activity in serum were decreased and tyrosine aminotransferase (TAT) activity of the liver was elevated in the control rats after stress provoked by epinephrine, but these changes were reversed in the model rats as well as in the AdxT rats. Thus it may be concluded that decrease of GR to about 12% may result in adrenoglucocorticoid insufficiency in spite of the normal functioning adrenal gland and high plasma level of B. So far as we know this is the first success to produce experimental endocrine insufficiency in a receptor depletion animal model and to quantitate the occupational threshold of about 12% of the total GR in rats.

Objective To discuss the effects of Danshen Chuanxiongqin injection on oxidative stress and cardiac function in patients with acute myocardial infarction after PCI. Methods A total of 84 patients with acute myocardial infarction underwent PCI treatment, patients were randomly divided into control group and observation group. The two groups received oral clopidogrel and aspirin before operation, and two prevention and treatment of myocardial infarction were given after operation. The treatment group was treated with Danshen Chuanxiongqin injection on the basis of the control group.The two groups were detected with superoxide dismutase (SOD), malondialdehyde (MDA), nitric oxide (NO), cardiac troponin I (TnT), creatine kinase isoenzyme (CK-MB), plasma brain natriuretic peptide (brain natriuretic, peptide, BNP) level in PCI after surgery before and after PIC 12 and PIC after 7 days.The left ventricular end diastolic diameter (LVEDD) and ejection fraction (LVEF) were compared between the two groups before and after treatment. Results Postoperative 12h, two groups of indicators were elevated. After the treatment of 7D, the treatment group MDA, TnT, CK-MB, BNP, significantly lower than the control group, SOD, NO, higher than the control group, the difference was statistically significant (P<0.05). Heart color index, LVEDD and LVEF were improved in the two groups, but there was no significant difference between the two groups. Conclusion Danshen Chuanxiongqin injection can effectively scavenge free radicals, inhibit oxidative stress, alleviate inflammation and improve ischemia-reperfusion injury and cardiac function in patients with acute myocardial infarction after PCI.

[Objective] To review the treatment of metabolic syndrome from phlegm and stasis, so as to provide effective ideas for the treatment of metabol-ic syndrome.[Method] Through searching for literatures related to Chinese medicine treatment of metabolic syndrome in the last decade, we can summarize the role of phlegm and blood stasis in the metabolic syndrome and its relationship with various components of metabolic syndrome. We can also research the application of the resolving the phlegm and removing blood stasis in the metabolic syndrome. [Results] Phlegm, blood stasis consistently run through the metabolic syndrome, and have a close relationship with each component of metabolic syndrome. The prescription of resolving the phlegm and remov-ing blood stasis can not only improve the clinical symptoms, but also can improve obesity-related indicators, reduce blood glucose, increase insulin sensitiv-ity, improve endothelial function and so on. [Conclusion] Treating metabolic syndrome from phlegm and stasis is safe and effective, which can reverse dia-betes, insulin resistance and prevent cardiovascular events through multi-channel, multi-level, multi-target. It has a broad application prospect and is worth further in-depth study.