Community health service is an effective measure to relieve the difficult medical services and expensive medical cost problem,but community inhabitants in Chongqing make little use of community health service.The actual cause is that people s degree of trust in community health service is low.In view of existing situation,this article analyzes the various factors that influence community residents' degree of trust in community health service and puts forward corresponding policy proposal.

Objective To compare the protective effects of midazolam and propofol at equivalent dose on myocardial ischemia reperfusion injury during open heart surgery Methods Thirty six patients,scheduled for elective open heart surgery, were divided into midazolam (M), propofol (P) and no occluding (N) groups Before induction, a bolus of midazolam 0 2mg?kg -1 was given in group M or N , and a bolus of propofol 2 0mg?kg -1 in group P; after induction, midazolam was infused at 0 4mg?kg -1 ?h -1 in group M or N , and propofol at 4 0mg?kg -1 ?h -1 in group P The arterial blood samples were taken to measured the activities of serum enzymes ,at the beginning of CPB, 30min, 4, 12 and 24h after release of the aortic cross clamp Results As compared with those at at the beginning of CPB, the activities of serum enzymes increased significantly in three groups following declamping (P

Metabolic studies were carried out on nine male infants to investigatethe digestibility and utilization of some of the nutrients of the Milk-substitute 5410, there by ascertaining whether those nutrients could satisfy their requirements. From the results of the chemical analyses of the foods and excreta of the infants, statistical treatment of the records on the fre- quency of defecation, the amount and form of the stools, and the growth rate of the infants, it was possible to evaluate the apparent energy utilization of the milk-substitute.The ages of the infants at the beginning of the experiment were 37-77 days, and 6-7 months at the end. The experiment was divided into five periods: in the first and second periods the infants were fed alternately with the milk-substitute and powdered whole milk diet; in the third and fourth periods the diets were the same as the first and second but supplemented with cod liver oil concentrate (sbout 1500 1. U. vitamin A and 500 I. U. vitamin D per day). In the fifth period the protein content of the milk-substitute was raised from 16.6% to 22.6%, supplemented also with cod liver oil. In periods when the infants were fed with the milk substitute alone, the number of defecation was significantly less and loose stools fewer than in the milk diet period. Introduction of cod liver oil tended to reduce the dry weight of the feces. When the milk-substitute with higher protein content was given, the number of defecation increased and occurence of diarrhea was more frequent but not more so than during the cow's milk powder period.From the statistical analyses of the results, it was found that the digestibility of protein and carbohydrate of the milk-substitute was significantly lower than that of cow's milk powder but that of fat was higher. Introduction of cod liver oil increased the digestibility of protein, fat, carbohydrate and crude fibre. There was no significant difference between the availability of energy of the milk-substitute and cow's milk powder, the former being 90.9% while the latter 91.7%.The growth curves of the nine infants showed that the higher the food intake, the higher the growth rate. The caloric intakes of eight infants were 100-120 kcal per kilogram of body weight per day and their growth rates were almost identical. The caloric intake of one infant was consistently below 100 kcal per kilogram of body weight per day and his growth rate was significantly lower. It may be concluded, therefore, that when the Milk-substitute 5410 is given to infants supplying 100-120 kcal per kilogram of body weight per day, would be adequate for normal growth.

Previous feeding experiments on infants have shown that the growth promoting effect of the milk-substitute 5410 was comparable to that of hu- man milk or a milk powder diet. In order to know more about the biochemical and physiological properties of this mixture, nine male infants were put in serial metabolic studies with respect to the digestion, nitrogen, calcium and phosphorus utilization of this soybean product.The age of the infants were 37-77 days at the beginning of the experiment, and 6-7 months at the end. The infants were fed with the milk-substitute and a milk powder diet in alternative periods each of which lasted 2-4 weeks. In the first and second periods the infants were fed milk powder or milk-substitute alone, while in the third and forth periods the same diets were supplemented with concentrated cod liver oil, and in the fifth period the infants were fed with another soybean product similar to mixture 5410 but with higher protein content.The digestibility of protein and the absorption of nitrogen, calcium and phosphorus of mixture 5410 were significantly lower than those of the milk powder diet. However, the nitrogen retention were the same during these two dietary periods (191 and 196 mg per kilo per day). The calcium and phosphorus retention were signigicantly lower during periods without cod liver oil (24 and 24 mg per kilo per day) but improved markedly after supplementation (58 and 36 mg per kilo per day).On the average, each infant received from the milk-substitute 4.3g of protein per kilo per day. The amount of calcium ingested was 850 mg per day; it seems to be that supplementation with cod liver oil is necessary for adequate calcium retention at this level of intake.Raising the protein content of the milk-substitute by further addition of soybean powder may increase the nitrogen retention, but it tends to lower the absorption and retention of calcium and phosphorus due to increased amount of fecal excretion.

Adult ; Antibodies, Monoclonal, Murine-Derived ; administration & dosage ; therapeutic use ; Female ; Hemophilia A ; drug therapy ; Humans ; Rituximab

Objective:To evaluate the changes of different parts of upper airway after alternating rapid palatal expansion and constriction via three dimensional measurement, compared with the protocol of ra-pid palatal expansion alone.Methods: In the study, 36 patients with retrognathic maxilla were selected and randomized to either group A or group B.The patients in group A were treated with rapid palatal expansion alone.The patients in group B were treated with alternating rapid palatal expansion and constriction.Three dimensional analyses were performed on all pre-and post-treatment cone-beam computed tomography (CBCT) images with the software Dolphin.Results: Two subjects in group B were lost to follow up during the treatment.The gender distributions, ages and all measuring items before treatment had no significant difference between group A and group B (P>0.05).Nasal floor width, nasal lateral width, nasal volume, and nasopharynx volume increased significantly in each group after rapid palatal expansion alone or rapid palatal expansion and constriction (P<0.05).The variations of oropharyngeal volume and hypopharyngeal volume had no significant difference (P>0.05).No significant difference was observed in the nasal floor width and nasal lateral width increment among the anterior, median and posterior parts in each group either (P>0.05).No significant difference in all the measuring items was observed between the two groups (P>0.05).Conclusion:Alternating rapid palatal expansion and constriction could increase the volume of nasal and naopharynx cavities by the similar way of rapid palatal expansion alone, and had no obvious effect on oropharynx and hypopharynx cavities.

Objective:To investigate the stiffness characteristic of triple-negative human breast cancer at different size in a implantation nude female mice model using shear wave elastography(SWE) and to compare the clinical pathologic features of tumors with elasticity variables.Methods:Human breast cancer MDA-MB-231 cells were injected into 30 nude female mice and 27 transplanted tumors were successfully found in nude female mice. Ultrasound and SWE were longitudinally performed on maximum diameter plane of 21 tumours in 21 nude mice. The elastic parameters of maximal elasticity(Emax), mean elasticity (Emean) and standard deviation of elasticity(Esd) were recorded. The mice were divided into 3 groups according to the tumor size. They were group A with tumor size less than or equal to 5 mm, group B with tumor size greater than 5 mm and less than or equal to 10 mm, group C with tumor size larger than 10 mm and smaller than or equal to 15 mm. Compared with pathology, the relationships between Ki67 of transplanted tumor and elastic parameters were analyzed.Results:As the transplanted tumors increased, the values of Emax, Esd, Ki67 all increased. The lesions maximal size, Emax, Esd, Ki67 were significant higher in group B ( P<0.001, P=0.006, P=0.002, P=0.026) and group C ( P<0.001, P<0.001, P<0.001, P=0.028) than group A. The other parameters were not significantly different among the groups(all P>0.05). The size of transplanted tumors was significantly and positively correlated with Emax ( rs=0.673, P=0.001), Esd ( rs=0.661, P=0.001), and Ki67 ( rs=0.509, P=0.018). Conclusions:SWE Emax and Esd can reflect the tumor tissue stiffness change and biological activity during the tumor growth.

Objective To evaluate the regulatory role of mTOR signaling in activation of renal interstitial fibroblasts and the potential effect on interstitial fibrosis. Methods 8-week old female C57BL/6 mice (n=30) underwent unilateral ureteral obstruction (UUO) to induce renal interstitial fibrosis. Animals were randomly divided into rapamycin (2 mg·kg-1· d-1) group and UUO group (vehicle-treated) (n=15 each group). Daily intraperitoneal injection of rapamycin or saline was applied to animals from day 1 before operation to the end of experiment.Three mice were sacrificed at day 1,3,7,14 respectively and kidneys were harvested for further analysis.NIH3T3 cells were stimulated by TGF-β for 12 hours with the presence or bsence of rapamycin (100 nmol/L). Results Immunofluorescent co-staining revealed that active fibroblasts highly expressed pS6K and α-SMA in kidney interstitium.Administation of rapamycin significantly inhibited activation of mTOR signaling in fibroblasts and ameliorated interstitial fibrosis of obstructed kidneys.Real-time PCR confirmed that rapamycin decreased the mRNA expression of FSP1,TGF-β,CTGF and Col4A1 in fibrotic kidneys. In vitro experiment revealed that TGF-β induced highly expression of pS6K and αSMA in cultured NIH3T3 cells,which could be markedly inhibited by rapamycin. Conclusions mTOR signaling highly activates in interstitial fibroblasts during kidney fibrosis.Inhibition of mTOR signaling by rapamycin decreases the activation of fibroblasts and ameliorates interstitial fibrosis.

Objective To retrospectively analyze the clinical characteristics,prognosis and risk factors of novel bunyavirus infection.Methods The clinical data of 68 patients with novel bunyavirus infection confirmed by laboratory diagnosis at Wendeng Central Hospital of Weihai were retrospectively collected.Epidemiological characteristics,clinical manifestations,physical signs and laboratory results were analyzed.Results Twenty two patients (32.4 ％) had intimate contact with ermine (breeding ermine or ermine biting) ; 4 patients (5.9％) had been bitten by tick within 2 weeks,6 patients (7.4％) had intimate contact with patients with severe fever with thrombocytopenia syndrome (SFTS) ; and 25 patients (36.8 ％) had a history of fieldwork before the onset of the disease.Thirty-four patients (50.0 ％) were over 60 years old and 27 cases (39.7％) had underlying diseases.Initial symptoms in all patients were fever accompanied by loss of appetite,fatigue and other toxemic symptoms,followed by multi organ damage.Other clinical manifestations included nervous system damage (27 cases,39.7％),hemorrhage (4 cases,5.9％),rapid atrial fibrillation (10 cases,14.7％) and pneumonia (18 cases,26.5％).White blood cell count of 55 cases (80.9％) was less than or equal to 2.0 × 109/L,platelet count of 18 cases (26.5％) was less than or equal to 30 × 109/L.Abnormal hepatic function was found in 62 cases (91.2％); elevated myocardial enzymes was found in 68 cases (100.0％),prolonged activated partial thromboplastin time in 44 cases (64.7％),hyponatremia in 23 cases (33.8％),hypokalemia in 29 cases (42.6％),hypocalcemia in 36 cases (82.4％),hyperglycemia in 49 cases (72.1％).Serum nucleic acid quantitation of novel bunyavirus varied from 1.10 × 102 to 5.78 × 107 tissue culture infective dose (TCID)/ mL.Fifty five cases were cured,accounting for 80.9 ％,while 13 (19.1％) died eventually.Conclusions High risk factors of novel bunyavirus infection included intimate contact with ermine and infected patients,tick biting and fieldwork.Patients with elder age,underlying diseases,nervous system symptoms,hemorrhage,pneumonia,low platelet,high viral load and elevated myocardial enzymes may have poor progonsis.

Objective To evaluate the effect of prefilling blood reservoir with mannitol-adeninephosphate MAP) solution on the damage to erythrocytes in intraoperative salvaged blood in patients.Methods One hundred and fifty blood samples were collected from 150 patients who were scheduled for elective spinal surgery requiring blood salvage,and were equally and randomly divided into 5 groups (n =30 each) using a random number table:group N,group N1,group N2,group M1 and group M2.The blood reservoir was not prefilled before surgery in group N,while the blood reservoirs in N1,N2,M1 and M2 groups were prefilled with normal saline (NS) 100 ml,NS 200 ml,MAP solution 100 ml and MAP solution 200 ml,respectively.Blood sauples were obtained for erythrocyte osmotic fragility test after the salvaged blood was washed,and hemolysis rates in different concentrations of hypotonic NaCl solution were calculated.The concentration of free hemoglobin in the clear supernatant liquid (FHb) of washed blood placed for 0 h (T0),1 h (T1) and 2 h (T2) were detected.Results Compared with N and N1 groups,the hemolysis rate of washed erythrocytes under 0.48％ 0.68％ NaCl solutions was significantly decreased,the concentration of FHb at T1 was decreased,and no significant change was found in FHb at T2 in group M1.Compared with N and N2 groups,the haemolysis rates of washed erythrocytes under 0.48％-0.68％ NaCl solutions were significantly decreased,and the concentrations of FHb at T1,2 were decreased in group M2.The concentration of FHb was significantly lower at T2 in group M2 than in group M1.Conclusion Prefilling blood reservoir with MAP solution can mitigate the damage to erythrocytes in the intraoperative salvaged blood in patients,and the efficacy of prefilling of 200 ml is superior to that of prefilling of 100 ml.