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 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.

Objective To investigate the role of platelet-derived growth factor-β receptor (PDGFR-β) in self-renewal of neural stem cells (NSCs).Methods In this study,NSCs of subventricular zone were isolated and cultured from PDGFR-β knockout (PDGFR-β-/-) mice of postnatal day 1 (P1) and P28;the number and diameters of secondary neurospheres were calculated;using 5-bromo-2-deoxyuridine (BrdU) incorporation assay and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay,cell proliferation and survival rates were analyzed;gene expression profiles were determined by PCR-array analyses;the effect of brain-derived neurotrophic factor (BDNF) on secondary neurospheres formation was examined in these cells.Results In PDGFR-β-/-NSCs,stem cell activities,such as number (/well;P1:25.9±1.3vs117.6±3.6,t=4.236,P＜0.01;P28:13.8± 0.7vs 19.8±0.6,t=2.116,P＜0.01)and diameters (μm;P1:67.7±1.9 vs 69.1 ±2.0,t=3.211,P＜0.01;P28:33.4±0.8vs37.8±0.8,t=2.354,P ＜0.01) of secondary neurospheres,cell proliferation (％;P1:73.3 ± 2.7 vs 88.7 ± 3.6,t =2.773,P ＜ 0.05;P28:28.6 ± 9.6 vs 68.2 ± 4.5,t =6.302,P ＜ 0.05) and survival rates (％;P1:14.5 ±2.1 vs 9.3 ± 1.3,t =7.222,P ＜ 0.05),were significantly lower as compared with age-matched controls.In comparison of the same genotypic NSCs,the decrease of secondary neurosphere formation was more striking in P28 NSCs than in P1 NSCs.PCR Array analyses demonstrated that expressions of fibroblast growth factor2 and BDNF were decreased (-2.04 ± 0.25,t =2.653,P ＜ 0.05;-3.24 ± 0.37,t =1.324,P ＜ 0.05),and Noggin (2.31 ± 0.37,t =2.749,P ＜ 0.05) was increased in P1 PDGFR-β-/-NSCs as compared with P1 controls.Addition of BDNF rescued the number and diameter of secondary neurospheres in P1 PDGFR-β-/-NSCs to similar levels as controls.Conclusions PDGFR-β signaling may play a role in the selfrenewal and proliferation of NSCs.BDNF may be involved in the effects of PDGFR-β signaling in these cells.

To retrospectively analyze the clinical data of 305 cases with apoplectic sequela admitted at our general geriatric nursing ward from January 2000 to December 2011.The subjects were divided into 2 groups:hypoalbuminemia and non-hypoalbuminemia.Advanced age (OR =5.624),chronic heart failure (OR =2.298),conscious disturbance (OR =1.575),dysphagia (OR =1.565),complete bedridden (OR=2.874),pneumonia (OR =3.725) and bedsore (OR =5.336) were risk factors for hypoalbuminemia in the patients with apoplectic sequela.And hyperglycemia(OR =0.066)was a protective factor for it.

OBJECTIVE:To explore the clinical efficacy and safety of Leukotriene receptor antagonist combined with Gluco-corticoid nasal spray(called“intranasal steroid”for short)in the treatment of different degree of adenoidal hypertrophy(AH)com-plicated with allergic rhinitis (AR). METHODS:240 AR children with AH were randomly divided into control group,intranasal steroid group and drug combination group,with 80 cases in each group. Control group was given physiological seawater,3 presses each nostrile,in the morning and evening. The intranasal steroid group received Momestasone furoate nasal spray,one press each nostrile,qd. Drug combination group was additionally given leukotriene receptor antagonist Montelukast sodium chewable tablet,4 mg for under 5 year-old and 5 mg for 5-year-old or above,qd,at bedtime. Treatment course of 3 groups lasted for 12 weeks. The change of clinical symptoms and signs(such as nasal obstruction,snore,mouth breathing,etc)and adenoid/pharyngeal ratio(A/N ratio)were compared among 3 groups after treatment as well as the occurrence of ADR. Each group was divided into two sub-groups (medium and severe) according to the severity of AH so as to evaluate therapeutic efficacy. RESULTS:21 children withdrew from the study,including 11 cases in control group,6 in intranasal steroid group and 4 in drug combination group. After treatment,clinical symptom score and A/N in subgroups of drug combination group and intranasal steroid group were all lower than those of control group,with statistical significance(P<0.05). There was no statistical significance in clinical symptom score and A/N between drug combination group and AR complicated with medium AH subgroup from intranasal steroid group(P>0.05). Clini-cal symptom score and A/N of AR complicated with severe AH subgroup from drug combination group were lower than intranasal steroid group,with statistical significance (P<0.05). No obvious ADR occurred in 3 groups. CONCLUSIONS:Intranasal steroid alone and intranasal steroid combined with leukotriene receptor antagonist can improve clinical symptom of AR patients with AH, and reduce adenoid volume. It is suggested to use intranasal steroid firstly for medium AH complicated with AR,and additionally use Leukotriene receptor antagonist for severe AH complicated with AR.

Objective To examire the effects of hydroxyethyl starch (HES 200/0.5 6%) on lung capillary permeability in endotoxemic rats.Methods Forty-two male Wistar rats weighing 250-300 g were randomly divided into 7 groups with 6 animals in each group: group 1 served as control; group 2 received lipopolysaecharide (LPS) 6mg?kg-1 intraperitoneally (i.p.); in group 3-6 1 min after LPS 6 mg?kg-1 i.p. HES 3.75 ml?kg-1 (group 3), 7.5 ml? kg-1 (group4), 15 ml? kg-1 (group 5) or 30 ml?kg-1 (group 6) was infused i. v. at a rate of 0.2 ml ? min-1 ; group 7 received only HES 30 ml ? kg . The animals were anesthetized with urethane. Right external jugular vein was cannulated for continuous intravenous infusion. Animals were sacrificed at 2 h and 4 h after LPS challenge respectively. Lung capillary permeability, lung wet/dry weight ratio and lung PMN accumulation were measured at 4 h after LPS challenge and nuclear factor Kappa B (NF-?B) activation in the lungs at2 h after LPS challenge.Results HES 3.75 ml?kg-1 and 7.5 ml ? kg-1 significantly reduced LPS-induced increase in lung capillary permeability, lung wet/dry weight ratio and lung PMN accumulation ( P

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.

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.