Objective To study the correlation between economic status and quality of life among patients with chronic ob -structive pulmonary diseases ( COPD) in Xinzhou region of Shanxi province .Methods One hundred forty -eight COPD patients in rural and urban area were randomly selected for the survey , and they filled out a questionnaire and we also accessed to medical records . The survey contains included economic burden on patients , medical expenses and mortality et al .Further to analyze the correlation be-tween economic status and quality of life in patients with COPD .Results For patients with COPD , economic burden in rural area was severe than those in urban area in economically backward areas in Xinzhou region ( P <0.05 ) , the investment on treatment in rural area was lower than in urban area ( P <0.05 ) , the quality of life in rural area was poorer than in urban area ( P <0.05 ) .Conclu-sions Backward economic situation severely restricts the treatment and quality of life in patients with COPD , and it increases the fi-nancial burden on the patient's family.It is necessary to increase the government investment , strengthen social management , and to carry out the supporting work for the patients with COPD in economically backward areas .

Objective To explore the psychometric properties of the Chinese version of the Functional Ability of Visually Impaired Questionnaire (CfaVIQ) by using Rasch Analysis. Methods The faVIQ was translated and adapted into the Chinese-version faVIQ (CfaVIQ). The CfaVIQ was completed by 215 visionlly impaired patients. The data were Rasch-analyzed with the Rating Scale Model of Andrich for calculating item fit statistics, determining the separation index by using Winsteps Rasch measurement program. Results Rasch model analysis indicated individual separation index (3.55) and project separation index (8.01) were both arithmetic greater than 2; the inlier-sensitive fit Mean Square (infitMnSq) and outlier-sensitive fit Mean Square (outfitMnSq) of Items, Persons were both within the range of 0.5-1.5, indicating great coincidence to the model;Wright map analysis showed the distribution of the sample ability and item difficulty was ideally normal. Coefficient of internal consistency was 3.55, separation reliability was 0.93. Pearson correlation coefficient of test-retest reliability was 0.92. Pearson correlation coefficient between CfaVIQ and vision (-0.67), visual acuity (-0.14). The National Eye Institute 25 Item Visual Function Questionnarie (NEI-VFQ25) (0.79) indicated a good construct validity. All the items′outfitMnSq, except outfitMnSq>1.5 of item 10 and item 23,were within the range of 0.5-1.5. Criterion Validity was 0.922 (95%CI:0.858-0.987). Conclusions The CfaVIQ is a culturally specific vision quality of life measure instrument. It can sensitively assess the quality-of-life in the visually impaired group. Rasch measurement model can provide comprehensive and positive information and has good application prospects for analysis of CfaVIQ.

Objective:To investigate in vitro metabolism method and HPLC method for the dextromethorphan.Methods:Total protein of normal liver specimens metabolismed dextromethorphan in vitro.An HPLC method with fluorescence was developed to study the contents of dextromethorphan and metabolites by joining an internal standard(Adriamycin).Methanol-10mmol/l,sodium dihydrogen phosphate solution(50:50,contain 0.01% sodium heptanesulfonate,5% triethylamine,pH 3.5)was used to the mobile phase.Results:Total protein of normal liver specimens metabolismed dextromethorphan in vitro efficiently with coenzyme,Mg~(2+), suitable temperature and pH value.Dextromethorphan and metabolites were analyed by HPLC method with fluorescence.The metabolic rate of dextromethorphan was 16.09%.Conclusion:It is suggested that the metabolism method of dextromethorphan in vitro is simple,convenient and accurate.It can be used for the determination of metabolism dextromethorphan in vitro.

Objectives:To investigate the effects of total parenteral nutrition (TPN) and somatostatin in the treatment of acute pancreatits. Methods: Patients were divided into two groups. Group A was patients treated from 1990 to 1994 with traditional non operative methods. Group B was patients treated from 1995 to 2000 with traditional methods plus both TPN and somatostatin. Results: In group B, morbidity, mortality and hospital stay were improved when compared with group A. The serum albumin concentration was below the normal at the beginning and was not different between the two groups. After the treatment of 15 days,the serum albumin concentration of group B was increased significantly and it remained almost the same in group A. Conclusions: Somatostatin and TPN can significantly improve the treatment effects of acute pancreatitis.

Objective To investigate the relationship between single nucleotide polymorphism (SNP) at position + 10225 in adiponectin receptor 1 gene and type 2 diabetes.Methods The genotypes of + 10225C/G of adiponectin receptor 1 were detected by polymerase chain reaction with sequence specific primers (PCR-SSP) in 200 type 2 diabetes and 100 health controls.Fasting blood samples of all cases were obtained to extract DNA and detect genotype.Statistical software spss 13.0 was used to analyzed.Results Frequency of G-type allele in type 2 diabetes was 40.5％,that in normal controls was 23.5％,there was significant diffierences in the genotype frequencies of SNP+10225 between type 2 diabetes and health controls (x2 =128.0,P＜0.01).Conclusion AdipoR1 + 10225C/G polymorphism was probably associated with type 2 diabetes,G-type allele might be a genetic risk factor of type 2 diabetes.

Objective To evaluate efficacy and safety of porcine small intestine submucosa (SIS) for the repair of severe vaginal relaxation (stage Ⅳ) in women.Methods Biological repair meshes were fixed in 18 patients with stage Ⅵ vaginal relaxation,among which anterior walls were fixed in 12 cases,posterior walls in 5 cases,and both walls in 1 patient.Patients with POP underwent vaginal vault suspension first,then patient with SUI underwent transvaginal urinary incontinence surgery.Extravesicle fascia was transversely folded and sutured with 2-0 Mousse.The pelvic arch ligament together with vesicle fascia,SIS mesh and vaginal submucosa were sutured 3 stitches per side with 1-0 Mousse.Scar tissue at posterior vaginal wall was rhombically excised followed by transverse folding constriction of the rectovaginal fascia with 2-0 Mousse.A 1-0 Mousse was then used for colpoperineoplasty by suturing ruptured superficial anal sphincter,superficial transverse perineal muscle,and bulbocavernosus muscle.Patients were followed at 2,6,and 12 months post-operatively.Unsuccessful outcome was defined as diameter of outer 1/3 of vagina greater than 3.5 cm,or vagina prolapsed beyond hymen.Results The median follow-up was 13 months.Pelvic Organ Prolapse/Urinary Incontinence/Sexual Function Short Form Questionnaire (PISQ-12) was obtained in 13 patients and the score increased was noted (P＜0.01).Pelvic floor distress inventory-short form for scoring the quality of life (PFIQ) was collected from 18 patients and the score decreased was noted (P＜0.01).Pelvic floor impact questionnaire (PFIQ-7) was gathered in 18 patients and the score decreased was noted (P＜ 0.01).One unsuccessful case with stage Ⅱ anterior vaginal wall prolapse who underwent posterior vaginal wall fixed with patch ended with a diameter of outer 1/3 of vagina greater than 4.0 cm post-operation.Severe complications like infection,rosion,rejection or SUI were not noticed in any case.Conclusions The anatomical repair of pelvic floor is the most effective modality for vaginal rejuvenation.Adjunct SIS can enhance vaginal elasticity,reduce scar formation and recurrence,particularly.

Objective:To study the mechanism on extracellular signal-regulate kinases ( ERK) signal transduction by calcium influx initiated by combination of estrogen with calcium channels or estrogen re-ceptor in endometrial cancer cell Ishikawa. Methods: Confocal test was used to determine the relative calcium mobilization by stimulation of estrodiol together with and without the inhibition of ICI182780 and nifedipine. Western-blotting was used to detect the protein expression of phosphorylated ERK1/2 (P-ERK1/2) in the same condition. Results:The transient calcium flux initiated by 17β-estrodiol (E2) and a membrane-impermeable conjugate of estrogen and bovine serum albumin ( E2-BSA ) , and the calcium mobilization could be inhibited by ICI182780 and nifedipine in 1 min. In Ishikawa cells, phosphorylation of ERK1/2 was stimulated by E2 , and the phosphorylation could not be inhibited by E2 after the combination with ICI182780 in 5 min and in 30 min. The phosphorylation also could not be in-hibited by E2-BSA after the combination with nifedipine in 5 min, but in 30 min the phosphorylation was decreased. The phosphorylation of ERK by E2-BSA was decreased by the combination with nifedipine in 30 min. Conclusion:The transient calcium flux initiated by estrogen has an effect on the activation of ERK signal pathway in endometrial carcinoma cells.

Objective To explore the risk factors of breast cancer recurrence for the cause exploration and prevention of the disease.Methods With matched case-control method,a survey was conducted among survival cases of histologically diagnosed breast cancer patients in Southern hospital from January 2004 to December 2007 in Guangzhou city.The survival cases were divided into case group and control group according to the inclusion criteria.Unconditional logistic model was used to analyze the data.Results Multiple factors logistic regression analysis showed mental stimulations [OR =10.926,95％CI (5.041-23.682)],oral contraceptive pills history [OR=2.634,95％CI(1.548-4.482)],benign breast disease history [OR=5.183,95％CI(2.100-12.790)],human epiderma growth factor receptor-2 (HER2) positive [OR=2.257,95％CI (1.326-3.843)],lymph node metastasis [OR=2.021,95％CI (1.272-3.212)],distant metastasis [OR=3.718,95％CI (2.125-6.503)] might be associated with the increasing breast cancer recurrence risk.Regular exercise [OR=0.460,95％CI(0.234-0.905)],low stage of disease [OR=0.106,95％CI(0.022-0.498)],breast nursing time [OR=0.053,95％CI(0.009-0.316)],dietary intake of soy isflavones[OR=0.154,95％CI (0.032-0.745)] might be associated with the decreasing breast cancer recurrence risk.Conclusions Clinical medical staff should take attention to the breast cancer who had benign breast disease history to ensure timely check-ups,early detection,early diagnosis and early treatment.Improving physical and psychological quality,reducing oral contraceptive pills,prolonging breast nursing time,and increasing dietary intake of soy isflavones were important to the prevention of breast cancer recurrence.

[Objective]To study the injury mechanism of sacral plexus resulting from sacral zone-Ⅱ fractures of lateral compression.[Method]Six short-term(in a year) embalmed pelves were obtained from anatomic department of Hebei Medical University with preserving sacral plexus and resecting pubic symphysis,the models of sacral zone-Ⅱ fractures of lateral compression were produced.Quantitative analysis for fracture displacement was carried out to observe the characteristic and the mechanism of sacral plexus injury.Sacral plexus were replaced by proportional diameter silica gel pips fulled with contrast medium,experimental procedure was repeated under X-ray.The experimental data were analyzed by SPSS10.0 statistic software and the result was obtained.[Result]In lateral compression type sacral canal was closed and its volume reduced and small free fracture segment resulted in sacral plexus nerves oppressed,especially of L_5,Sland S_2.At the same time,the more overlapping of pubic symphsis,the more serious of compression.[Conclusion]Sacral plexus is conncted with the wall of pelvic cavity and fixed.Zone-Ⅱ sacral fracture is likely to damage sacral plexus.In lateral compression type of sacral fracture nerve injury is mainly compression injury which position is in nerve canal,especially of S_1,S_2.And L_5 can be crushed in fracture interspace to be damaged seriously.

Objective:Dual-track teaching mode in higher colleges and universities of Chinese medicine in clinical pathology teaching reform and practice, so as to change the phenomenon of university students of traditional Chinese medicine western medicine foundation weak, and improve the teaching quality of clinical pathology.Methods: We use the traditional teaching method (LBL) and teaching method of the problem-based learning (PBL) to make double-track recess internship teaching model in clinical pathology, and in practice use the access type, interactive type and potential mining methods to motivate the students’ learning.Results: The dual-track teaching model realizes complementary teaching effect of a variety of teaching methods, makes the teaching quality enhance unceasingly. It not only exercises the students’ ability of autonomous learning, cultivate the students’ clinical thinking, but also stimulates students’ imagination and improves the students’ ability to analyze and solve practical problems.Conclusion: The dual-track teaching mode is worth popularizing in the higher colleges and universities of traditional Chinese medicine, and it can improve the students’ comprehensive quality and innovation and make it better from students to the role of the doctor.