Objective To understand the implementation of New Rural Cooperative Medicine(NRCM)in Hunan Province carried out in Miluo City.Methods Qualitative study was combined with secondary data collection.Results Government in Miluo took initatives to organize NRCM and financed it with the NRCM Funds;each peasant could enjoy NRCM by paying only 10 yuan,and the NRCM participation rate reached 73.6%;currently reimbursement mainly focused on hospitalization,lowest-payment for seeking care,and reimbursement proportion varied in health facilities at different levels;the health facilities and peasants benefited a lot from NRCM.Conclusions The NRCM participation is increasing,funds allocated properly,peasants welcoming it.Further measures for NRCM improvement may include allocating more funds,perfecting reimbursement procedures.Besides,the NRCM for some population like persons without children or suffering severe disease awaits solution.

Objective To determine the effect of video-assisted retroperitoneal debridement in treatment of infected necrotizing pancreatitis.Methods The clinical data of patients with infected necrotizing pancreatitis was retrospectively analyzed.Heart rate,mean arterial pressure,body temperature and indicators for inflammatory response including level of WBC,CRP and procalcitonin before and after VARD treatment were compared.Results After VARD treatment,the heart rate (preoperative vs.postoperative 8 h,108 ± 22/min vs.95 ± 17/min),mean arterial pressure (preoperative vs.postoperative 12 h,66 ± 18 mmHg vs.79 ± 19 mmHg) and body temperature(preoperative vs.postoperative 24 h,38.3 ± 1.7 ℃ vs.37.3 ± 1.3 ℃) improved significantly (all P ＜ 0.05).Level of WBC [preoperative vs.postoperative 48 h,(13.8 ±6.6) × 109/L vs.(10.1 ±5.2) × 109/L],CRP(preoperative vs.postoperative 48 h,145 ± 88 mg/L vs.95 ± 4 mg/L) and procalcitonin (preoperative vs.postoperative 48 h,1.4 ± 0.7 μg/L vs.0.9 ± 0.4 μg/L) also decreased significantly(all P ＜ 0.05).Conclusions VARD therapy can significantly reduce systemic inflammation and improve the general condition of infected necrotizing pancreatitis patients.

Objective To determine the effects of cyclooxygenase-2 (COX-2) on risk stratification and prognosis of patients with gastrointestinal stromal tumor (GIST).Methods Literatures in the Cochrane libraries of clinical comparative trials,PubMed,EMBASE,Cancer Lit and Chinese BioMedical Literature from 1966 to 2012 were retrieved using the Cochrane systematic evaluation method.The original data were extracted and crosschecked by 2 reviewers.The indicator for assessment including positive rates of COX-2 in GIST patients with different tumor diameters (＜5 cm versus ≥5 cm),mitosis of cancer cells (＜5/50 HPF versus ≥5/50 HPF) and National Institute of Health (NIH) risk stratifications (very low + low versus intermediate + high).The relationship between COX-2 expression and recurrence and metastasis of GIST was evaluated.All the data were analyzed using the RevMan 5.1 software with Meta analysis.The heterogeneity between studies was analyzed using the I2.The binary data were presented by odds ration (OR) and 95％ confidence interval (95 ％ CI).Results Seven articles with a total of 415 patients were included in the analysis.The COX-2 expression did not correlate with the tumor diameters,NIH risk stratifications and tumor metastasis and recurrence (OR =0.60,0.72,2.46,P ＞ 0.05),but with the mitosis of cancer cells (OR =0.46,P ＜ 0.05).Conclusion COX-2 expression is partly correlated with risk stratification of GIST,but has no effect on the prognosis.

Objective To evaluate the correlation of the ion selectivity electrode assay and arsenazo Ⅲ assay for serum calcium determination and compare the differences between two methods.Methods 142 serum samples were collected from patients and detected by ion selectivity electrode assay and arsenazo Ⅲ assay,the differences of two methods were compared,person correlation and Bland -Altman was used to discuss the correlation.Results The serum calcium concentration detected by ion selectivity electrode assay was (2.23 ±0.10)mmol/L and detected by arsenazo Ⅲ assay was (2.24 ±0.12)mmol/L,the difference between the two methods was not statistically significant (t =-1.09,P >0.05).The person correlation analysis demonstrated that the two methods had a positive correlation (r =0.393,P <0.01).The Bland -Altman consistency analysis showed that ion selectivity electrode assay was agreed with arsenazo Ⅲ assay.Conclusion The two methods for serum calcium concentration determination,the ion selectivity electrode assay was coincidence with the arsenazo Ⅲ assay.

Objectives To investigate the role of angiogenic T cells (Tang) and endothelial progenitor cells (EPC) in the pathogenesis of preeclampsia. To explore the relationship between Tang and EPC. Methods From Mar 2013 to Aug 2014, 40 patients diagnosed preeclampsia (PE) and delivered in Hunan Provincial People′s Hospital. A total of 20 of them were defined as the mild preeclampsia group and the other 20 cases were recruited as the severe preeclampsia group. And 24 healthy pregnant women wererecruited as the control group. The percentage of Tang and EPC in peripheral blood mononuclear cells (PBMC) were determinated by flow cytometry between 28 and 40 gestational weeks. Results (1) There was no significant difference in the age, pre-pregnancy body mass index(Pre-BMI) or gestational age among the three groups (P>0.05). The differences of blood pressure among the three groups were statistically significant (P<0.05). The gestational week at delivery, the birthweight of the neonates and the 1 minute Apgar score in the severe preeclampsia group were lower than those in the mild preeclampsia group and the control group, with statistically significant differences (P<0.05). The morbidity of neonatal asphyxia in the severe preeclampsia group was 35%(7/20);and in the mild preeclampsia group it was 5%(1/20), with statistically significant difference( P<0.05). (2) The percentage of Tang in maternal peripheral blood was(52.7 ± 8.0)%, (47.5 ± 8.8)% and (45.5 ± 8.7)% in the control group, the mild preeclampsia group and the severe preeclampsia group, respectively. The difference among the three groups was significant (F=4.248,P<0.05), and SNK q analysis showed there was significant difference between the control group and the severe preeclampsia group(P<0.05).While there was no statistically significant difference between the mild and the severe preeclampsia group, nor between the control group and the mild preeclampsia group(P>0.05). (3) The percentage of EPC in maternal peripheral blood was (0.16±0.07)%, (0.09±0.07)%and (0.08±0.05)%in the control group, the mild and the severe preeclampsia group, respectively. Analysis of variance showed that difference among the three groups was significant (F=9.351, P<0.05). The percentage of EPC in the mild or the severe preeclampsia group was significantly higher than that of the control group(P<0.05). (4) There was no statistically significant correlation between the Tang level and the EPC level in the control group ( r=-0.325, P>0.05). In the preeclampsia group (including mild and severe cases), there was positive correlation between the Tang level and EPC level (r=0.667, P<0.01). The positive correlation between Tang level and EPC level were proved respectively in the mild preeclampsia group (r=0.803, P<0.01) and the severe preeclampsia group (r= 0.520, P<0.05). Conclusions The number of Tang had some correlation with the pathogenesis of preeclampsia. The percentage of Tang had positive correlation with the level of EPC in women with preeclampsia. Tang might have some influence on the change of EPC′ level. Tang together with EPC were likely to contribute to the angiogenesis in preeclampsia.

Objective To explore the effect and the possible mechanisms of silent homo sapiens eukaryotic translation elongation factor 1 alpha 2(EEF1A2)gene on the growth of pancreatic cancer cell in vivo.Methods The pancreatic cancer xenograft models in mice were established.The mice were equally divided into control group,negative control group and EEF1A2 group,which were injected with PBS,negative control siRNA and EEF1A2 siRNA into xenograft tumors respectively.The size and weight of tumors in each group were measured.The expression of EEF1A2 and PCNA in tumor tissue of each group was detected by immunohistochemistry.The cell apoptosis rate in tumor tissue of each group was determined by TUNEL.Results In xenograft nude mice models,since the 17th day of injection,the growth of tumor size in EEF1A2 group was obviously slower than that of negative control group and control group(all P＜0.05).By the end of the treatment,the tumors were cut off and weighted.The weight of tumors in EEF1A2 group(0.27g± 0.06g)were significantly lower than those of control group and negative control group(0.39g± 0.08g and 0.43g± 0.07g,P＜0.05).EEF1A2 mostly expressed in cytoplasm of pancreatic cancer cell.In negative control group and control group,the positive cells distributed densely and the positive rate was(72.58 ± 25.47)％ and (76.75±23.19)％ respectively.The distribution of positive cells in EEF1A2 group was scattered and the positive rate was(34.78±21.36)％,the difference was statisically significant(P＜0.01).The expression of PCNA at protein level in EEF1A2 group was significantly lower those that of control group and negative control group(P＜ 0.01).The result of TUNEL test indicated that the cell apoptosis rate in EEF1A2 group was higher than those of control group and negative control group (P＜0.01).Conclusions The EEF1A2 gene can be effectively silented in vivo,which significantly inhibits the growth of pancreatic cancer cell.It may be related with inhibition of cell proliferation and promotion cell apoptosis.

ObjectiveTo identify exon 20,24,25 mutations of ELN in patients with PFD.MethodsThe study was designed as case-control analysis.The PFD patients were from the second hospital of the Hebei medical university.30 PFD patients were examined and scored according to the Pelvic Organ Prolapse (POP-Q) classification,and the patients were divided into two groups,the low-grade ( A1 ) group and the high-grade (A2) group.20 non-PFD women were selected as the control group (B).Venous blood had been collected and DNA sequences were determined and compared with the standard sequence in NCBI GENEBANK.ResultsExon 20 114 G ｜ A mutation was found in PFD patients,which can induce protein structure change.There were seven cases in the A2 group and one in the B group; it had statistically different between two groups ( P ＜0.05).Exon 24 81C | G mutation was found in the trial group,it had no statistically difference between two groups ( P ＞ 0.05 ).None mutation of Exon 25 was found in all the groups.IVS20 17T｜ C mutation was found in the A2 group,which had statistically difference compared with control group and the low-grade group ( P ＜ 0.05 ).IVS24 69A | T mutation was found in the trial group,it had no statistical difference with control group ( P ＞ 0.05 ).ConclusionsMutations of elastingene exon 20,exon 24 were found in the PFD patients,which can induce the change of the primary protein structure.IVS20 17T | C mutation also existed in the trial group; the elastin gene mutation may be the reason that people are easy to suffer from PFD.

OBJECTIVETo observe the efficacy of Xingnaojing Injection (XI) in treatment of sepsis-associated encephalopathy (SAE).

METHODSTotally 65 SAE patients were retrospectively analyzed at EICU from September 2010 to September 2013. They were assigned to the control group (32 cases) and the treatment group (33 cases) according to whether they received XI. Patients in the control group received anti-infection and symptomatic support, while those in the treatment group were intravenously injected with XI at 20 mL per day for additional 7-10 days. The fever clearance time, Glasgow coma scale (GCS), C-reactive protein (CRP), neuron-specific enolase (NSE), and improvement of electroen-cephalogram (EEG) were observed in the two groups.

RESULTSCompared with the control group, the fever clearance time was shortened, CRP levels decreased, GCS score and efficacy of EEG was alleviated in the treatment group after treatment with statistical difference (P < 0.05). No adverse reaction occurred during medication.

CONCLUSIONX1 was safe and effective in treatment of SAE.

C-Reactive Protein ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Humans ; Injections ; Phosphopyruvate Hydratase ; metabolism ; Sepsis-Associated Encephalopathy ; drug therapy ; Treatment Outcome

Objective To investigate the effectiveness of endoscopy and enteral nutrition (EN) in the treatment of acute biliary pancreatitis (ABP) in elderly patients and its impact on prognosis.Methods Eighty-four elderly patients with ABP were randomly divided into two groups,including 42 cases of combination treatment group,42 cases of routine treatment group.The routine treatment group was managed with normal comprehensive treatment,and in combination treatment group,patients were treated with additional endoscopic retrograde cholangiopancreatography (ERCP),endoscopic sphincterotomy (EST) and endoscopic naso-biliary (ENBD) drainage and EN.The clinical symptoms,serum inflammatory cytokines,complications and prognosis were compared.Results The CRP,TNF-α,IL-2,and serum amylase,glucose,AST after treatment were significantly lowered than those before treatment (P ＜ 0.05).In addition,the levels of CRP,TNF-α,IL-2,and serum amylase,glucose,AST,ALB in combination treatment group were significantly lower than those in routine treatment group (P ＜ 0.05).The time to abdominal pain cessation,time to fever cessation,hospital stay in combination treatment group were (4.6± 1.3),(3.7± 1.3),(13.5± 2.7) d,which were significantly lower than those in routine treatment group [(6.1 ± 1.3),(5.5 ± 2.1),(18.1 ± 3.8) d,P ＜ 0.05].The APACHE Ⅱ score of combination group after treatment was (7.l ± 1.8) point,which was significantly lower than that in routine treatment group [(9.2 ± 2.6) point,t =3.41,P ＜ 0.05)].The incidence rates of ARF,ARDS,peri-pancreatic infection and abdominal hemorrhage,in combination group were 7.1％,4.8％,4.8％,4.8％,respectively,which were significantly lower than those in routine treatment group (23.8％,19.1％,21.4 ％,19.1％,P＜0.05).The mortality in combiration group was 4.8％,which was lower than 16.7％ in routine treatment group with no statistical significant.Conclusions It is a safe and effective to treat elderly ABP patients with endoscopy combined with EN,which can significantly reduce complications and mortality.

Adenocarcinoma ; therapy ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carboplatin ; administration & dosage ; Carcinoma, Squamous Cell ; therapy ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Doxorubicin ; administration & dosage ; analogs & derivatives ; Female ; Humans ; Hysterectomy ; Lymph Node Excision ; methods ; Middle Aged ; Uterine Cervical Neoplasms ; therapy