The authors first describe the current situation of cooperative medical care in China, pointing out that due to low levels of guarantee, difficulties in fundraising and insufficient government reimbursement, cooperative medical care in rural areas have come across many hardships. It is, therefore, imperative to set up as soon as possible a health security system for people in rural areas. Firstly, it is necessary to break up the dual social security structure of urban and rural areas and set up a model with transitional goals based on the actual situation of the country. Secondly, it is suggested that security taxes begin to be collected, bringing the health security for people in rural areas into line with the social security framework so as to promote the health security for people in rural areas without lowering the level of social security in urban areas.

Objective To evaluate the effeciency and safety of the implantation of phakic iris-fixated intraocular lens for high myopia.Methods 12 cases(18 eyes)with the mean spherieal equivalent refraction was(-15.12?5.23)diopters of myopia,following up 3~6 months after surgery(averaging 5.1 months)were enrolled.Visual acuity,intraocular pressure,contrast sensitivity,glare sensitivity,corneal endothelium and the stable of intraocular lens and the turbid level of lens were observed.Results A postoperation uncorrected visual acuity of(0.73?0.21)was observed in 18 eyes at 6 months.There was significant difference as compared with preoperation corrected visual acuity of(0.52?0.17)(P

Objective To learn about the state of anxiety, related factors and demand of the family members of youngster patients with eye traumas during the operations, to improve the quality of nursing care by effectively relieve the anxiety of family memebers through appropriate intervention. Methods The anxiety and needs of family members of 148 children patients with eye traumas were investigated during the perioperative period with self-rating anxiety scale and self-designed questionnaires, and appropriate nursing was given according to the survey results. Results The anxiety score of family members was (56.93 ± 14.72), which was at higher level when the patients were just admitted. The scores statistically de creased after nursing care. The anxiety was related to factors such as the security and the effect of the operation, the technical level of the surgeon, the anesthesia method (general anesthesia),the age of the children patients and the emergency operation. Conclusions Nursing staff can effectively relieve the anxiety of the family members of children patients during perioperative period by supplying special care according to their different demands.

Objective To demonstrate the result that progression of disease and prognosis of gastrointestinal cancer patients are correlated with the expression of the cluster and the abundance of lost goodwill target (LGT) fingerprint. Methods To research the period of survival and the time of death, 61 patients treated by SELDI (Surface enhanced laser desorption/ionization-time of flight-mass spectrometer)were involved in. According to the fingerprint spectrum obtained by SELDI and the appearance of fingerprints of LGT, these patients were divided into four groups namely non-peak, single-peak, double-peak, tri-peak and multi-peak groups. By means of Multi-factor analysis of variance and Cox regression analysis of risk, we compare four groups each other so as to find out one group in which patients have the greatest risk of death.Results Among the fingerprint spectrums of patients suffered from gastrointestinal cancer, which were obtained by SELDI, the patients with negative expression of LGT had low risk of death, which were lower than those of single-peak and double-peak groups, especially lower than those of tri-peak and multi-peak groups;the risk of death among the tri-peak and multi-peak groups were much higher than single-peak, the difference had statistical significance (P ＜0.05), and the death rate is rather high. Conclusion Among the serums from cancer patients tested by SELDI, the expression of LGT with tri-peak and multi-peak suggested that patient' s state of illness is about to deteriorate. This kind of fingerprint spectrum can be regarded as positive indicators,and the negative expression of LGT suggested that patient will have a good prognosis with a very low risk of death in the near future.

Objective To optimize the extraction process for the effective fraction of Bushen Yizhi ( BSYZ) formula. Methods Yield of the effective fraction and contents of two marker compounds 2,3,5,4 -tetrahydroxystilbene-2-O-β-D-glucoside and osthole assayed by high performance liquid chromatography (HPLC) were used as the optimizing indexes, and weighted coefficient of the indexes was analyzed by analytic hierarchy process ( AHP). Ratio of liquid-to-solid, extraction time, and extraction times were used to screen the optimal conditions by orthogonal test. Results The optimized extraction process of the effective fraction of BSYZ formula was as follows: extracting with 8-fold water for three times, and boiling for 1.5 hours each time. The verification test showed that the comprehensive scores of the optimized extractive process were higher than those obtained in the orthogonal test. Conclusion The optimized extraction process and conditions are practical in the manufacture of the effective fraction of BSYZ formula.

Objective To evaluate the value of united nerve electrophysiological tests in the diagnosis of diabetic peripheral neuropathy (DNP).Methods The quantitative temperature threshold (QTT), including the cold sensation threshold (CST) , thermal sensation threshold (WST), cold pain threshold (CPT) and thermal pain threshold (HPT), sympathetic skin response (SSR) and nerve conduction velocity (NCV) were measured for 85 diabetic patients.Results The abnormal rate of QTT was 84.71％ , significantly higher than that of SSR and NCV (56.47％ and 31.76％ respectively).However, no significant difference was found in the abnormal rate of QTT between the DPN asymptomatic group and DPN symptomatic group (78.85％ and 93.94％ respectively).There was significant difference in the abnormal rate of SSR (48.08％ and 69.70％ respectively) and the abnormal rate of NCV (19.23％ and 51.52％ respectively) between the above two groups(P ＜ 0.05).There was no difference in the abnormal rate of QTT for patients with short or long course of disease (77.77％ and 89.80％ respectively), but significant difference in the abnormal rate of SSR (44.44％ and 65.31％ respectively) and the abnormal rate of NCV (19.44％ and 40.82％ respectively) Conclusion The abnormal rate of QTT was highest in detecting the diabetic patients, and it is not related to clinical symptoms or disease course.However, the abnormal rates of SSR and NCV were related to clinical symptoms and course.It is more sensitive to diagnose DPN using united electrophysiological tests of QTT, SSR and NCV.

OBJECTIVE:To observe clinical efficacy and safety of butylphthalide in the treatment of Alzheimer’s disease (AD). METHODS:94 AD patients selected from our hospital during Jan. 2013-Jun. 2014 were divided into control group(45 cas-es)and observation group(49 cases). Control group was given routine treatment as nourishing nerve,lowering blood lipid,taking Memantine hydrochloride tablet orally 5 mg,bid. Observation group was additionally given Butylphthalide soft capsule orally 0.2 g,tid,on the basis of control group. Both groups were treated for consecutive 1 year. Clinical efficacy of 2 groups were observed, and MMSE,ADL,the levels of TNF-α,IL-1,CRP and BDNF were observed before and after treatment;the incidence of ADR was compared. RESULTS:The total effective rate of observation group was 85.71%,which was significantly higher than that of control group(66.67%),with statistical significance(P<0.05). There was no statistical significance in MMSE and ADL between 2 groups before treatment (P>0.05);those of 2 groups increased significantly after treatment,the observation group was higher than the control group,with statistical significance (P<0.05). There was no statistical significance in the levels of TNF-α,IL-1, CRP and BDNF between 2 groups before treatment(P>0.05). Above indexes of 2 groups were improved significantly after treat-ment,the observation group was better than the control group,with statistical significance(P<0.05). There was no statistical dif-ference in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Butylphthalide is effective in the treatment of AD,can improve cognitive and life skills and reduce inflammatory level with good safety.

OBJECTIVE:To investigate the clinical efficacy and safety of Shugan granule in the adjunctive treatment of melas-ma with irregular menstruation. METHODS:140 cases of melasma with irregular menstruation were divided into observation group and control group according to random number table method,with 70 cases in each group. Control group was given vitamin C,vi-tamin E and compound retinoic acid and other routine medicines;observation group was additionally given Shugan granule 10 g, bid. A treatment course lasted for 21 d,and both groups received 2 courses of treatment. The area of melasma,irregular menstrua-tion integral,clinical efficacy of melasma and irregular menstruation were observed in 2 groups,and the occurrence of ADR was re-corded. RESULTS:There was no statistical significance in the area of melasma and irregular menstruation integral between 2 groups before treatment (P>0.05);after treatment,the area of melasma decreased significantly in 2 groups,and the observation group was significantly lower than the control group;irregular menstruation integral decreased significantly,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). Total effective rates of melasma and ir-regular menstruation were 61.86% and 61.43%, which were significantly higher than those of control group (45.71%and 44.29%),with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Shugan granule shows significant therapeutic efficacy in adjunctive treatment of melasma with irregu-lar menstruation,and can decrease the area of melasma and improve irregular menstruation significantly.

OBJECTIVE: To select specific DNA aptamer for determining ketamine by FluMag-SELEX. METHODS: Based on magnetic beads with tosyl surface modification as solid carrier and ketamine as target, a random ssDNA library with total length of 78 bp in vitro was compounded. After 13 rounds screening, DNA cloning and sequencing were done. Primary and secondary, structures were analyzed. The affinity, specificity and Kd values of selected aptamer were measured by monitoring the fluorescence intensity. RESULTS: Two ssDNA aptamers (Apt#4 and Apt#8) were successfully selected with high and specific abilities to bind ketamine as target with Kd value of 0.59 and 0.66 μmol/L. The prediction of secondary structure was main stem-loop and G-tetramer. The stem was the basis of stability of aptamer's structure. And loop and G-tetramer was the key of specific binding of ketamine. CONCLUSION FluMag-SELEX can greatly improve the selection efficiency of the aptamer, obtain the ketamine-binding DNA aptamer, and develop a new method for rapid detection of ketamine.
Aptamers, Nucleotide/metabolism* ; DNA ; DNA, Single-Stranded/genetics* ; In Vitro Techniques ; Ketamine/metabolism* ; Oligonucleotides ; SELEX Aptamer Technique/methods*

Objective Toinvestigatethetechnicalfeasibilityandefficacyofvertebralarteryorigin and adjacent subclavian artery stenosis treated with a single self-expandable stent implantation simultaneously. Methods Twenty-onepatientswithposteriorcirculationischemicsymptomsweretreatedwithasingle stent implantation for vertebral artery origin (stenosis rate≥70%)and adjacent subclavian artery stenosis (stenosis rate ≥50%)simultaneously. The head end of a single self-expandable open-cell stent was implanted into the middle or distal V1 segment of vertebral artery,and the caudal end was implanted at the proximal subclavian artery during procedure. At 6 -12 months after procedure they received followed-up with CTA and/or DSA. The clinical and image data of the patients were analyzed retrospectively. Results Allstentswereimplantedsuccessfully.Thevertebralarterystenosisratewasdecreasedfrom 87. 1 ± 5. 7% before procedure to 7. 4 ± 6. 4% and the subclavian artery stenosis rate was decreased from 61.9±8.4% to4.5±5.7% aftertheprocedure.Therewassignificantdifference(allP<0.05).No perioperative complications occurred. The in-stent restenosis (about 50%) was found in one patient (4.8%)during the follow-up and he did not have any relevant clinical symptoms. One patient (4. 8%) had recurrent vertigo at 6 months after procedure. CTA and DSA examinations revealed stent compression and vertebralarteryocclusion.Conclusion Asingleself-expandablestentimplantationforthetreatmentof vertebral artery origin and adjacent subclavian artery stenosis simultaneously is feasible and safe. The incidences of in-stent stenosis and stent compression are low.