The government purchasing of community health service was an important way to change the mode of health service supply,which was also an important way to improve the primary health service supply system.On the basis of government purchasing of community health service development in China,it analyzed the current situation and insufficient coverage of Shenzhen municipal government purchasing community health services,proposed the improvement strategies for improving government guarantee and management capacity,standardizing government purchasing process and enhancing the management of relationship among the main bodies so as to solve the problems of insufficient government guarantee level,nonstandard purchasing process and insufficient cooperative management concept.

Objective To understand the effect of environment variables on anxiety in the soldiers at high altitude.Methods A total of 267 soldiers at high altitude were investigated with the self-rating anxiety scale,the environmental scale and Eysenck personality questionnaire.Results Compared with norm(29.78±0.46),the soldiers at high altitude had higher sore of anxiety(37.22±6.64;t=17.92,P＜0.01).One-way ANOVA and independent.samples t test showed that the anxiety(38.37±5.93,36.65±6.951,36.75±6.88)of military people at high altitude had not evidently difference in different altitude(≥3587.5m,3587.5～2767.9m,≤2767.9m).Parental culture.length of military service(F=3.25,P＜0.05)and neuroticism(R=0.52,P＜0.01)had evidently effect on the depression of soldiers.Conclusion The occurrence of anxiety in the soldiers at high altitude has a higher level.Parental culture.1ength of military service and neuroticism had predictive value for depression.

Objective To investigate the effects of dexamethasone on the airway development and vasculogenesis in cultured human fetal lung exposed to hyperoxia.Methods Human fetal lung at the pseudoglandular stage of development were cultured either in normoxia(21%O2,5%CO2)or hyperoxia(95%O2,5% CO2)for 72 hours.Dexamethasone was added into the culture medium at the concentration of 10-6 mol/L.Whereas ethanol at the same concentration was as control.Harvested tissue wss stained for pancytokeratin to I dentify epithelial cells.CD31 aS a specific antibody of endothelial cell.The effects of lung morphometry were analyzed using computer-assisted image analysis software to ealeuhte the thickness of airways,surface area occupied by airways and the distance of vessels to the nearest airway as well as the surface area of blood vessels.Results The lung architecture remained largely unchanged in normoxia for 72 hours culture,whereas hyperoxic culture of lungs resulted in significant dilation of airways and thinning of epithelium.The surface area occopied by airways increased significantly(P＜0.05).The blood vessels in interstium were more close to the airway epithelium in the hyperoxic lung(50 μm)as compared with normoxia group.Meanwhile,the proportion of the blood wessels in interstium of hyperoxia group(4.0%)Was higher than those of normoxia group (4.2%)and hyperoxia with dexamethasone(5.4%)(P＜0.05).Dexamethasone has the protective effect on lungs exposed tO hyperoxia.Conclusion Our resulta showed that hyperoxia resulted in the simple airways and the decreased bkxxl vessel density in interstitium of cultared human fetal lung.Dexamethasone has protective effect on fetal lungs exposed to hyperoxia and can promote lung mature.

Objective To evaluate the influence and safety of losartan on high sensitive C-reactive protein(hs-CRP) and serum uric acid(UA) of essential high blood pressure(HBP) patients with hyperuricemia (HUA).Methods Eighty HBP patients complicated with HUA were enrolled and divided into the losartan group with losartan 50 mg/d(n =40) and the nifedipine group with nifedipine gastrointestinal therapeutic system (GITS) 30 mg/d (n =40) for 6 months continuously.The serum levels of hs-CRP,UA,hepatic and renal functions,creatine kinase(CK) and blood pressure were measured.Results Compared with before therapy,the systolic blood pressure(SBP),diastolic blood pressure (DBP) were lower in two groups after 6-month treatment and the differences were statistically significant(losartan group:SBP:(158.5 ± 13.2) mmHg vs.(136.7 ± 9.4) mmHg,t =3.50,P ＜ 0.01 ; DBP:(95.6 ± 8.4) mmHg vs.(83.3 ± 6.4) mmHg,t =3.49,P ＜ 0.01 ; nifedipine group:SBP:(157.7 ± 13.9) mmHg vs.(134.6 ± 8.2) mmHg,t =3.53,P ＜ 0.01 ; DBP:(96.1 ± 8.9) mmHg vs.(81.2±6.8) mmHg,t =3.56,P ＜0.01).The differences in terms of systolic and diastolic blood pressure were not significant at post-treatment between losartan and nifedipine group.The serum levels of hs-CRP and UA were significantly lower after 6-month treatment than before treatment in losartan group ((5.68 ± 1.53) mg/L vs.(3.52 ± 0.57) mg/L,t =3.82,P ＜ 0.01 ; (502 ± 45) μmol/L vs.(450 ± 38) μmol /L,t =3.48,P＜ 0.01),but there was no change in nifedipine group(hs-CRP:(5.61 ± 1.64) mg/L vs.(5.33 ± 1.48) mg/L,t =1.34,P ＞ 0.05 ; UA:(499 ± 43) μmol/L vs.(489 ± 42) μmol/L,t =0.68,P ＞ 0.05).There was no significant change regarding of liver and kidney functions and serum CK in losartan group before and after treatment.No adverse reaction occurred in the losartan group.Conclusion Losartan treatment can decrease serum hs-CRP and UA of HBP patients complicated with HUA,and there is no serious adverse reactions and good security during treatment.

BACKGROUND:Intracranial aneurysms have a high mortality, and finite element analysis to predict fracture risk has become a hot topic at present. Finite element analysis requires reliable fluid-structure interaction model, blood model of aneurysm is very easy to obtain, but the vascular wal model can not be obtained directly, only by artificial settings, which may have an impact on calculation results.
OBJECTIVE:To investigate the effects of vascular wal thickness on fluid-structure interaction analysis in finite element modeling of complex intracranial aneurysms, and provide a more reliable method of finite element modeling for the numerical simulation study of intracranial aneurysms.
METHODS:A three-dimensional numerical model of tandem left intracranial internal carotid artery aneurysms of a 67-year-old man was obtained by three-dimensional angiography. Four fluid-structure models were got postoperatively by thickening vascular wal , which were artificial y set for 0.3 mm, 0.4 mm, 0.5 mm, 0.6 mm. According to intraoperative measured data, dynamic characteristics of fluid-structure interaction of tandem internal carotid artery aneurysms were simulated by the finite element method, comparing four models to calculate the difference between the results.
RESULTS AND CONCLUSION:Among the four models, there were no difference in blood flow chart, blood pressure drop chart and wal shear stress chart (P>0.05). The deformation of the vascular wal was the most obvious in C 2 segment of the internal carotid artery, and the thicker vessel wal was accompanied by the more apparent deformation (P<0.01). Von Mises stress in the vessel wal of the four models reached a local maximum in the I and J points, the thinner vessel wal was accompanied by the larger local maximum (P<0.01). The settings of vascular wel may affect the fluid-structure interaction analysis of complex intracranial aneurysms and appropriate thickness settings wil obtain accurate calculation.

Objective To know the quality of life-related factors in patients with asthma, and then carry out certain effective counter nursing measures. Methods Investigated 137 patients with severe asthma, to know their nursing requirement and factors which can influence their quality of life, and then counert nursing measures were carried out for patients according to the results of investigation. Compared the quality of life of patients with asthma before and after the research. Results There was a negative correlation between the quality of life for patients with asthma and their smoking habit, sleeping station, disease course and complica-tions respectively, while a positive correlation between the quality of life for patients with asthma and their edu-caiton background, asthma-related knowledge and incomes. The nursing requirement about health education, psychological interview, treatment services were the main requirements. After the nursing intervention, the quali-ty of life for patients with asthma was significant better than before. Conchlsions There were several factors which can influence the quality of life for patients with asthma, analysis,carry out certain strategy and eval-uation a kind of proper mode for adult patients with asthma.

[ABSTRACT]AIM:Toinvestigatetheeffectofintracerebroventricular(icv)injectionofacidulatedartificialce-rebrospinal fluid ( aCSF ) on the respiratory reactions and the functions of acid sensing ion channels ( ASICs ) in this process.METHODS:Healthy adult SD rats (n=30) were divided into aCSF with pH 7.4 control group, aCSF with pH 6.5 group, amiloride control group, amiloride plus aCSF with pH 6.5 group, psalmotoxin 1 (PcTx1) control group and PcTx1 plus aCSF with pH 6.5 group.The electromyogram (EMG) of the diaphragm was monitored to observe the respirato-ry responses induced by icv injection of acidulated aCSF .The ASICs blockers were also injected into the lateral cerebral ventricle firstly and acidulated aCSF was injected following the ASICs blockers to observe the effect of ASICs on the respira -tory regulation by the central chemoreceptor .RESULTS:After icv injection of acidulated aCSF , the respiratory responses of the rats were excited (P<0.05).The respiratory excitation responses disappeared after icv injection of ASICs blocker amiloride.The degree of respiratory excitation was weakened after icv injection of ASIC 1a blockers-PcTx1.CONCLU-SION:ASICs play a key role in the respiratory regulation by the central chemoreceptor and ASIC 1a partly operates in this process.

Objective To explore the mechanisms of coronary artery lesions in patients with Kawasaki disease by detecting thrombomodulin level in both acute and convalescence stages. Methods Fifty-eight patients were recruited in which 34 were male and 24 were female. This group was further divided into coronary artery lesion group(25 cases) and non-coronary artery lesion group(33 cases). Normal control group was consisted of 30 healthy children in which 17 were male and 13 were female. Thrombomodulin was measured by enzyme linked immunosorbent assay. Results Compared with the control group, TM level was increased in the Kawasaki disease group. TM level in the acute stage group and convalescence group was higher than that of the control group, TM level in acute stage group was higher than that of the convalescence group (P<0.05). Compared with non-coronary artery lesion group, TM level of the coronary artery lesion group was increased and the difference was significant (P<0.01). Correlation analysis showed that the TM level was positively related with coronary complications of the Kawasaki disease (r=0.855, P<0.01 ). Conclusion TM increases significantly in Kawasaki disease. It is correlated with the development of coronary artery lesions. In addition, it is also associated with apparent hypereoagulation and thrombocytophilia. TM can predict the development of coronary artery lesions.

Ceramics ; Esthetics, Dental ; Humans

The annual Live Interventional Neuroradiology & Neurosurgery Course(LINNC) is one of the most important congresses in the neurosurgery and neuroradiology field.LINNC 2009 was held on May 25th this year and lasted for 3 days.In this article, the authors introduced the main points of the congress.The congress mainly discussed some hot topics at present time, including both the clinical and fundamental studies of cerebral arteriovenous malformation, ischemic cerebral disease and intracranial aneurysm, etc.Both neurological and neuroradiological case demonstrations related to the topics, and the main course of the congress were alternately performed.Recent advances in imaging technique and clinical application, such as Dyna-CT and Xper-CT, were also presented on the congress.