This paper gave a dynamic analysis on the health resource allocation and utilization of Chongqing since it became a municipality,found out the extrusive problems existing in the health resource allocation and put forward some corresponding proposals,hoping to benefit the health administration on constituting regional health development planning.

Objective To investigate the cause of vertical root fracture in pulpless teeth, and advance the measures of prevention. Methods The clinical data of 20 vertical root fracture in pulpless teeth (17 patients) were collected. The status of the teeth and periodontium before therapy were reviewed, the position and direction of the root fracture were observed, the type and position of the restoration and the occludent station of the teeth were analyzed. Results It was revealed that vertical root fracture frequently occurred in the molars (16/20). Vertical root fracture were frequently found in front teeth(4/20) and premolars (5/20)among those with coronal integrity. Decrease of alveolar level of various degrees was found in 19 cases, among which 8 were mild, 7 moderate and 4 severe. Vertical root fracture mainly took place in molars after coronal restoration (6/7). Vertical root fracture would likely to occur no matter whether they would be worked as the abutment teeth of the removable partial denture or fixed prostheses. Early contact occurred in lateral bite (6 cases) was more susceptible to vertical root fracture than that occurred in centric bite (1 case). Conclusion The causes of vertical root fracture in pulpless teeth are complicated. Due to unfavorable outcomes, it is important to take precautions for vertical root fracture.

Objective To construct a mono-specific bivalent diabody (scFv dimer) gene derived from an anti-anti-idiotypic monoclonal antibody NP48 of Schistosoma japonicum and to express and characterize the protein.MethodsThe mono-specific diabody gene (D) was constructed by SOE (splicing by overlap extension) and using Gly_4Ser as a linker to join the C-terminus of the V_H to the N-terminus of the V_L.D was linked with prokaryotic expression vector pBAD/g. The target protein expression in E.coli TOP10 was induced by arabinose. Then a purification procedure for the target protein was carried out. The antigen binding activity of expressed product was detected with Dot-ELISA. ResultsThe V_H-G_4S-V_L (D) gene was confirmed by sequencing. The pBAD/g-D recombinant were determined by digesting with endonucleases and expected bands were identified. There were less soluble target proteins in the supernantes and higher target proteins in the pellets as inclusion body when separating the D expression proteins. And the insoluble fraction was recovered as a soluble, correctly processed protein by solubilising with 8 mol/L Urea. The molecular weight of the target protein was about 27 kD. The binding activity of the target protein to anti-idiotypic monoclonal antibody NP30 of Schistosoma japonicum was verified by Dot-ELISA. ConclusionThe purified protein from the constructed recombinant pBAD/g-D could interact specifically with antigen NP30. So the constructed mono-specific diabody has the part characteristics of anti-anti-idiotypic monoclonal antibody NP48 of Schistosoma japonicum.

After operations such as organ transplantation or cardiopulmonary bypass complicated with is-chemia/reperfusion injury,activated inflammatory cells can express and secret HMGB1,and cooperate with other inflammation factor to induce tissue damage.The mechanism is HMGB1 actives such receptors as TLRs,RAGE,TM,and NF-κB transcription factor,P38MAPK pathway,induce releasing of HMGB1 itself and other inflammation factors.Different with sepsis,HMGB1 emerges much earlier,lasting longer.Inter-ference therapy of HMGB1 could effectively decrease secretion of HMGB1 after ischemia/reperfusion injury.

Objective To study the expression of P57kip2 and its clinical significance in hilar bile duct adenocarcinoma.Methods The expressions of P57kip2 in hilar bile duct adenocarcinoma tissues (37 cases) and normal bile duct tissues (32 cases) were determined by immunohistochemical SP methods.The relations between the expression levels of P57kip2 with clinicopathologic parameters were analyzed.Results The positive rate of P57kip2 was 43.2％ (16/37) in bile duct adenocarcinoma,while it was 87.5％ (28/32) in normal duct tissues (P ＜0.01).The expression level of P57kip2 in adenocarcinoma showed no significant association with gender,age or CA19-9 level (P ＞0.05),but they were significantly related with lymph node metastasis,invasion and degree of differentiation (P ＜ 0.05).Conclusions P57kip2 is associated with the occurrence and development of hilar bile duct adenocarcinoma.It may play an important role in invasion and metastasis of hilar bile duct adenocarcinoma.The P57 protein can be used as an index to diagnose hilar bile duct adenocarcinoma.

Objective To census the preoperative prevalence rate of deep venous thrombosis (DVT) and to evaluate the risk factors of DVT in senile osteoporotic hip fractured patients.Methods The object of study were patients aged 60 and above, and osteoporotic hip fracture by low energy injury in 2013.Based on medical records, all the patients with osteoporotic hip fracture were evaluated the signs and symptoms of DVT in 24 h, D-dimer test and underwent Doppler ultrasound screening of bilateral venous system in lower extremity after admission, and all the patients received preoperative prophylactic anticoagulation.Patients with popliteal and proximal level thrombus or floating thrombus underwent inferior vena cava (IVC) filter insertion.Outcome measures: age, gender, fracture type, D-dimer value in 24 h preoperatively, occurrence time of DVT and region, grade of preoperative American Society of Anesthesiologists, preoperative medical diseases.Results 702 of 946 hip fracture inpatients were comprised in this retrospective study.All were not founded any symptom or signs of DVT.All patients were took preoperative Doppler ultrasound screening and the results as follows: 36 of 302 patients (11.9％) with femoral neck fracture were proved preoperative thrombosis(13 male, 23 female), the average age was 72.7 year-old(range from 62-90 year-old), on the same side as the fractured hip in 31 patients, bilateral thrombosis in 5 patients.74 of 400 patients (18.5％) with intertrochanteric fracture were proved preoperative thrombosis(38 male, 36 female), the average age was 76 year-old (range from 60-95 year-old), on the same side as the fractured hip in 68 patients, bilateral thrombosis in 6 patients.The most prevalence rate of DVT were in the first day after osteoporotic hip fracture, 15 patients (41.7％) with femoral neck fracture and 38 patients (51.40％) with intertrochanteric fracture.There were more proximal level and multiple level involment thrombosis over 5 days after injury.The most thrombosis were proven at calf and popliteal vein.Conclusion The prophylaxis of DVT should be started even in the emergency department in senile patient with osteoporotic hip fracture.To avoid the risk factors, early surgery and early postoperative mobilization will be effective.

Objective To investigate the effects of different doses of propofor on ATP-sensitive K~+currents(I_KATP)in human atrial myocytes and the underlying mechsnism.Methods A small piece of myocardiumwas obtained from right atrium in patients undergoing atrial septal defect or ventricular septal defect surgery.Themyocardium specimen was placed in cold Ca~(2+)-free cardioplegic solution aerated with 100% oxygen.Themyocardium specimen was cut into small chunks(1 mm~3).Atrial myocytes were isolated by enzymatic dissociationtechnique.The effects of propofol on I_KATP in atrial myocytes were studied using the whole-cell configuration ofpatch-clamp technique.Results The outward currents were recorded with a pipitte solution containing 0.3mmol?L~(-1) ATP.The currents were inhibited by glibendamide 10 ?mol?L~(-1),a specific K_ATP channel inhibitor,suggesting that the outward currents were I_KATP.I_KATP aws activited by propofol in a dose-dependent manner.Conclusion Propefol can activate the I_KATP in human myocytes in a concentration-dependent manner and themechanism of its myocardial depressant action may be partly explained.

Objective To analyze the effect of exogenous recombinant spherical adiponectin on the autophagy and endoplasmic reticulum stress in testis of diabetic mice induced by streptozotocin, and explore the mechanism of such protective effect to the testis of diabetic mice. Methods Forty-eight male C57BL/6 mice were randomly divided into normal control group (NC, n=8) and diabetes group (n=40). Diabetic mouse model was established by intraperitoneal injection of streptozotocin, and 24 mice were successfully established. Diabetic mice were randomly divided into diabetic group (DM, n=8), diabetic adiponectin low dose group (DLA, n=8), and diabetic adiponectin high dose group (DHA, n=8). Mice in DLA group and DHA group were given intraperitoneal injection of recombinant spherical adiponectin at dose of 5 μg/(kg·d) and 15 μg/(kg·d) respectively. Mice in NC group and DM group were given intraperitoneal injection of the same amount of normal saline. After 8 weeks of adiponectin treatment, blood samples were taken to measure fasting blood glucose with glucose oxidase method. Enzyme-linked immunosorbent assay (ELISA) was performed to determine serum testosterone, insulin, follicular stimulating hormone (FSH) and luteinizing hormone (LH). Testicular weight was measured, and the testicular index (proportion by weight of testis/body) was calculated. Sperm count and mobility were measured. Morphological changes of testicular tissues were observed by HE staining. The mRNA expressions of endoplasmic reticulum stress (GRP78, CHOP, Caspase-12) and autophagy (LC3, Beclin1 and p62) were determined by real-time PCR. Results Compared with NC group, it was found in DM group that seminiferous tubules were deformed, the number of spermatogenic cells and Sertoli's cells reduced, the number of sperm in the tubular lumen reduced, and spermatogenic cells sloughed in some tubular lumens. The body weight, testicular weight, sperm motility, sperm count, and the levels of serum insulin, testosterone, LH and FSH significantly decreased in DM group than those in NC group (P<0.05). The mRNA expression of Beclin1 and LC3 were significantly decreased (P<0.05), and of p62, GRP78, CHOP and Caspase-12 were significantly increased in the testis of DM group compared with NC group (P<0.05). Recombinant spherical adiponectin significantly reversed the changes mentioned above in the testis of diabetic mice, and the effect was better in DHA group than in DLA group. Conclusions The level of autophagy is decreased and the level of endoplasmic reticulum stress is increased in the testis of diabetic mice. Recombinant spherical adiponectin may have the protective effect on the testis of diabetic mice by regulating autophagy and endoplasmic reticulum stress, and the protective effect of adiponectin may be dose-dependent.

AIM: To observe the changes in subfoveal choroidal thickness ( SFCT ) after intravitreal injections of ranibizumab ( IVR ) for macular edema secondary to retinal vein occlusion ( RVO) .
METHODS:Thirty-six eyes of 36 patients with macular edema secondary to RVO) were treated with 0. 5mg IVR monthly for 3mo and received additional IVR as needed over the following 1a period. SFCT of the all eyes ( the affected eyes with RVO and unaffected fellow eyes ) was measured by enhanced depth imaging optical coherence tomography images before and after the IVR.
RESULTS: The mean SFCT of the affected eyes with RVO decreased from 246. 7±115. 0μm at baseline to 220. 5±102.0μm at 1mo (P<0.05), 198.3± 114.0μm at 6mo (P<0.01), 212. 6± 96. 0μm at 12mo (P<0. 01). Whereas the fellow eyes changed from 229. 4±108. 0μm at baseline to 226. 3±107. 0μm at 1mo (P>0. 05), 228. 6±127. 0μm at 6mo (P>0.05), 223.6±101.0μm at 12mo(P>0.05). There were statistically significant difference between affected eyes with RVO and unaffected fellow eyes.
CONCLUSION: The SFCT is decreased after IVR for macular edema secondary to RVO. IVR seems to affect the hemorheology of the choroid.

Objective To perform a biomechanical study on and compare the stability of internal fixation with closed Kirschner wire in different spots from the epicondylus medialis to sulcus nervi ulnaris and epicondylus lateralis of humerus in the treatment of GartlandⅢsupracondylar fractures of humerus in children in order to provide basis for avoiding cubitus varus in clinic.Methods Twenty models of su- pracondylar fractures were made from ten humerus samples,then divided into two groups(group A and group B).They were fixed with closed Kirschner'wires.Ulnar Kirschner wire varied.In group A five spots were selected averagely from the epicondylus medialis to the sulcus nervi ulnaris.Kirschner wires entered from one of the five spots into another spot of humerus.In group B Kirschner wires entered defferent spots of humerus from the central spot of sulcus nervi ulnaris.Biomechanical tests were carried out,such as axial load,axial displacement,stress intensity,axial rigidity and anti-twisty ability.Forty-six children with Gart- landⅢsupracondylar fracture of humerus were treated and followed up for more than one year.Results In beth groups,with the angle of Kirschner wires and fracture side increasing,the strain and the vertical displacement decreased,the stress intensity and the axial rigidity increased,and the anti-twists ability was enhanced.There was statistic difference(P＜0.05).The follow-up of the 46 patients showed the elbow joint function recovered well with no cubitus varus malformation.Conclusion Internal fixation with closed Kirschner wires in sulcus nervi ulnaris from the epicondylus medialis and the epicondylns lateralis of humerus for GartlandⅢsupracondylar fracture of humerus in children has the advantages of enhancing bio- mechanical stability,effective prevention of secondary replacement of outlying black of the fracture and a- voidance of cubitus varus.It can be widely used clinically.