Objective The research was to achieve Shanghai resident satisfaction of primary health service after new health reform.Methods During self-compiled questionnaire survey,the research adapted stratified random sampling to select 9 community health centers in Shanghai urban,rural and suburb areas.Results Shanghai resident satisfaction rate of new health reform was 85.2％.Satisfaction rate of basic medical security system was 85.0％.Satisfaction rate of basic medical service was 96.5％.Satisfaction rate of basic public health service was 95.1％.Age,region,job,education and income were main factors to satisfaction of primary health service.Conclusion From an overall point of view,Shanghai resident satisfaction of primary health service after new health reform was high.However,the level of basic medical security and convenience of reimbursement were not high.Medical expenses of primary health care institution had not been effectively controlled.Basic medicine could not fully meet the medication needs of primary health care institutions.

Objective To research and develop the model of external reciprocating sports intermittent hypoxia box for rats. Methods Two animal cabins (28 cm?20 cm?15 cm) and one hypoxia chamber (80 cm?80 cm?60 cm) which covered each cabin in turn were developed. 4 male SD rats were placed in each animal cabin. The hypoxia chamber in which low O2 concentration was maintained with filling high-pure Nitrogen continuously, moved to and fro between two animal cabins, and driven by a servomotors. Two animal cabins were covered in turn by the hypoxia chamber and get the same low O2 concentration as in the hypoxia chamber. The goal volume fraction of oxygen in hypoxia chamber was (10?0.5)% and the time of unilateral movement from one animal cabin to another was 4 s, the cycle time of intermittent hypoxia was 180 s, the retention time was 86 s (including the hypoxia and normoxia time was 90 s respectively). The hypoxia chamber runs 8 h per day. The numerical value on artery blood gas of rats in which hypoxia chamber inside and outside was measured Results The reciprocating sports intermittent hypoxia chamber can be operated safely and reliably. The lowest PaO2 is (4.766? 0.536) kPa(or (35.75 ?4.02) mmHg) and the lowest SaO2 is 0.69 ?0.08 when the animal cabin in hypoxia chamber. Conclusion The chronic intermittent hypoxia model for rats is established by self-developed external reciprocating sports intermittent hypoxia chamber.

Objective To evaluate the clinical outcome and the acute toxicity in nasopharyngeal carcinoma (NPC) treated with tomotherapy followed by the anti-EGFR monoclonal antibody.Methods Between March 2008 and November 2009,34 newly diagnosed NPC patients were treated with helical tomotherapy combined with nimotuzumab or cetuximab.All the patients underwent tomotherapy at the dose of 70 Gy/33F for the gross tumor volume (pGTVns) and positive lymphnodes (GTVnd) ,and 60 Gy/33F for the high risk clinical target volume (PTV1),and 56 Gy/33 F for the low risk clinical target volume (PTV2),respectively.17 patients in group N were given weekly injection of 200 mg for 6-7 times and 17 patients in group C were given initial dosage 400 mg/m2 followed by subsequent weekly dosage of 250 mg/m2 for 6-7 times.Acute lesions were evaluated with the RTOG/EORTC criteria.Result The median follow-up time was 22 months.The effective rates (CR + PR) in 3,6 and 12 months were 14/17,12/17,12/17 in group N and 15/17,14/17,14/17 in group C.The 1 year survival rate was 15/17 in group Nand 17/17 in group C.Nimotuzumab had less acute mucositis reaction (u = 2.25,P < 0.05),weight loss(t=2.56,P=0.02) and rash (u=4.36,P＜0.01) compared with cetuximab.Conclusions Helical tomotherapy combined with nimotuzumab or cetuximab was effective and made no difference in the shortterm efficacy and 1 year survival rate for the patients with NPC.Nimotuzumab has less acute reaction than cetuximab.More studies should be done to prove long-term effects.

OBJECTIVE:To demonstrate challenges of pharmacy automation reconstruction so as to set solutions. METHODS:Based on literature review,analysis of pharmacy automation setting and features,this paper gave the suggestions and solutions on construction cost,management model change,equipment maintenance and emergency response,etc. according to the practice of the hospital. RESULTS&CONCLUSIONS:Pharmacy automation construction should be stick to the requirements of new health re-form to lower the cost by using the out resources and interior optimal allocation,to improve efficiency by unified planning and proper design,and to ensure the system running efficiently by sufficient maintenance and contingency plan.

Objective To discuss the clinical characteristics and prognosis of 15 children with hand foot and mouth disease (HFMD) and acute flaccid paralysis (AFP) who were admitted to Beijing Ditan Hospital during the outbreak of HFMD in 2008. Method The epidemiology, clinical manifestations, cerebrospinal fluid (CSF),magnetic resonance imaging and prognosis of 15 children with HFMD and AFP were retrospectively reviewed. The recovery of the patients' affected extremities were monitored for 4 weeks. Results The mean age of these patients was (22.47 ± 20.68) months (range: 5～72 months). Acute paralysis developed (3.47 ± 1.68) days after the onset of fever and progressed to maximum severity within (1～2) days. Poliomyelitis-like syndrome was observed in all cases. Of the 15 cases, 10 had monoplegia of lower limbs, two had paraplegia, one had monoplegia of upper limbs and two had quadriplegia. In these cases, the muscle power varied from level 0 to level 4, and six even showed no muscle power in their affected extremities. Thirteen cases developed neurologic complications (encephalitis, meningitis or ataxia) and three had transient urinary retention. Cerebrospinal MRI examination in eight cases showed hyperintense lesions on T2-weighted images, predominantly in the impaired anterior horn regions of the spinal cord (C2～C7 for cases with upper extremity impairments and T12～L1 for cases with lower extremity impairments), and displayed long T1 signals and long T2 signals. In addition, the midbrain, brain-stem or medulla was also involved in four cases who also contracted encephalitis or meningitis. The muscle strength in 11 patients with single lower extremity impairment showed improvements in the distal limb muscles within 4～8 days, and the other cases showed recovery 2～3 weeks later. Conclusions HFMD in combination with AFP most commonly occurs in children aged less than 2 years old. Acute paralysis develops during the early stage of infection and progresses to a maximum severity within 2 days. In most cases described here, paralysis occurred in a single lower extremity and recovered more rapidly than those with all four limbs affected or with single upper extremity impairment . MRI examination is particularly valuable for the diagnosis and prognosis of AFP because of its high sensitivity and accuracy.

Animals ; Cell Hypoxia ; Cells, Cultured ; Chemokine CXCL12 ; genetics ; metabolism ; Endothelial Cells ; cytology ; metabolism ; Female ; Gene Expression Regulation ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Immunohistochemistry ; Male ; Pulmonary Artery ; cytology ; RNA Interference ; RNA, Messenger ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Swine

OBJECTIVETo investigate the protective effect of progesterone against high intraocular pressure-induced ischemia-reperfusion (IR) injury.

METHODSTwenty-four SD rats were randomly divided into normal control, IR model, dimethyl sulfoxide (DMSO) solvent treatment group, and progesterone treatment group. In the latter 3 groups, retinal IR injury was induced by intraocular injection of saline. In the progesterone group, intraperitoneal injections of 4 mg/kg progesterone were administered 30 min before and 2 h after ischemia, and an equivalent volume of DMSO was used in the DMSO group. The content of malondialdehyde (MDA) and superoxide dismutase (SOD) activity were measured by spectrophotometer after the treatment, and the pathological changes of the retina were observed by transmission electron microscope and light microscope.

RESULTSSix hours after reperfusion, the content of MDA in the model group was significantly higher than that in the normal control group (P<0.01), but lower than that in progesterone treatment group (P<0.01); reverse changes in SOD activity was observed. In the model group, the inner nuclear layer and nerve fiber layer became thinner with obvious cellular pathologies including nuclear condensation, mitochondria vacuolization and endocytoplasmic reticulum swelling. Progesterone treatment markedly alleviated these pathologies in the inner nuclear layer and nerve fiber layer of the retina.

CONCLUSIONProgesterone offers protection of the retina against IR injury in SD rats by increasing SOD activity and decreasing MDA content in the retina.

Animals ; Dimethyl Sulfoxide ; Female ; Ischemia ; etiology ; pathology ; Male ; Malondialdehyde ; metabolism ; Ocular Hypertension ; complications ; Progesterone ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; etiology ; prevention & control ; Retina ; metabolism ; Retinal Vessels ; physiopathology ; Superoxide Dismutase ; metabolism

Objective To observe the effect of rosiglitazone on the protein expression of AMPK and GLUT4 in peripheral tissue (liver, skeletal muscle and fat) of type 2 diabetic db/db mice and to prove that rosiglitazone can regulate the glucose metabolism in db/db mice partly through the AMPK pathway. Methods db/db mice were randomly divided into model group and rosiglitazone group according to their blood glucose.The db/m mice were normal control group.After 4 weeks of administration, fasting blood glucose was detected in each group.Western blot was used to detect the contents of AMPK, p-AMPK and GLUT4 in liver, skeletal muscle and adipose tissue. Results (1) Rosiglitazone significantly reduced the fasting blood glucose of db/db mice; (2)Rosiglitazone increased the level of AMPK phosphorylation in the liver, skeletal muscle and adipose tissue of db/db mice, and increased the content of GLUT4 protein in skeletal muscle and adipose tissue. Conclusion Rosiglitazone can increase the phosphorylation of AMPK and the expression of GLUT4 protein in the liver, muscle and fat tissue of db/db mice, and promote the uptake and utilization of glucose in peripheral tissue, suggesting that it can regulate glucose metabolism in db/db mice partly through the AMPK pathway.

Diabetic retinopathy (DR) is an important cause of vision loss and blindness in diabetic patients. Studies have shown that neurodegenerative changes have occurred before diabetic retinal microvascular injury, such as reactive glial increase and ganglion cell apoptosis, and endoplasmic reticulum stress is involved in this process.Studies have shown that neurodegenerative changes have occurred before diabetic retinal microvascular injury, mainly as ganglion cell apoptosis, and endoplasmic reticulum stress is involved in this process.The UPR has three signal paths:the ATF6 signal path, the PERK signal path, and the IRE1 signal path.It is closely related to oxidative stress, inflammation, apoptosis, BRB destruction and angiogenesis in the DR process.Exploring the intrinsic mechanism of ERS and ganglion cell injury is of great significance for finding new effective drugs to prevent or treat diabetic patients.

OBJECTIVETo analyze the characteristics of subjective visual horizontal (SVH) and evaluate its clinical value for vestibular function in peripheral unilateral vestibular hypofunction (UVH).

METHODSEighty-five patients with UVH (study group) and 39 normal persons (control group) accepted vestibular function tests, including SVH, subjective visual vertical (SVV) and caloric test by video-nystagmography. The parameters of the angle of SVH and SVV, directional preponderance (DP) and unilateral weakness (UW) of caloric test were observed. The correlation between SVH/SVV, DP, UW and the course of disease were investigated respectively. SPSS 16.0 software was used to analyze the data.

RESULTSReference range of SVH and SVV was from -2° to 2° in the control group. Among the 85 patients, 46 cases (54.1%) and 43 cases (50.6%) had the abnormal values of SVH and SVV respectively, with no statistical significance (χ(2) = 12.5, P = 0.481) by chi square test. Fifty-five cases (64.7%) with abnormal DP had no statistical significance when compared with SVH and SVV respectively (χ(2) values were 0.19 and 2.86, respectively, P value were 0.164, 0.067, respectively). In UVH, there were positive correlation between SVH, SVV and DP (r value was 0.939, 0.648, 0.658, all P < 0.05) respectively, but no correlation between UW and SVH or SVV (r value was 0.048, 0.085, all P > 0.05). According to the permutation and combination of the four parameters, positive or negative, three main groups could be defined [SVH(+)DP(+)UW(+), SVH(-)DP(+)UW(+), SVH(-)DP(-)UW(+); SVV(+)DP(+)UW(+), SVV(-)DP(+)UW(+), SVV(-)DP(-)UW(+)]. The course of disease in the three main groups was positively skewed distribution, with median of 5.0, 10.0, 15.0 d and 5.0, 9.5, 14.5 d respectively. By Kruskal-Wallis Test, χ(2) value were 8.80 and 6.26, respectively(P value were 0.012, 0.040, respectively), with statistical significance between the above three main groups.

CONCLUSIONSThe SVH value can evaluate the function of the otolithic. The angle of SVH and SVV are changing in the course of disease, SVH and SVV can be used as a guidance of the vestibular compensation evaluation.

Adolescent ; Adult ; Aged ; Caloric Tests ; Case-Control Studies ; Child ; Female ; Humans ; Male ; Middle Aged ; Vestibular Diseases ; physiopathology ; Vestibular Function Tests ; methods ; Visual Perception ; Young Adult