Objective:To examine the change of serum tumor necrosis-? (TNF-?),nitric oxide (NO) in patients with congestive heart failure(CHF) in vitro and the effect of valsartan on TNF-? production in peripheral blood mononuclear cell(PBMC),and to assess the mechanisms of valsartan in treating CHF.Methods:Venous blood sumples were obtained from both CHF patients (n=12) and healthy volunteers(n=8).Serum TNF-? and NO were measured.PBMC was obtained from both the control and the patient groups.PBMC were cultured with 0,0.01,0.1,1 ?mol/L of valsartan in the presence of lipopolysaccharide.After 24 hours' incubation,TNF-? and NO were measured in the culture supernatants.Results:Serum TNF-? and NO were significantly higher than these of the control group(P

Objective To investigate the effects of levofloxacin on serum interlukin 6(IL-6) and interferon γ(IFN-γ) levels in the treatment of elderly patients with pulmonary tuberculosis.Methods A total of 87 senile pulmonary tuberculosis patients were collected and randomly divided into experiment group and control group.43 patients in the control group were given standardized treatment, 44 patients in the experiment group were treated on the basis of the control group were given levofloxacin, the total treatment was 6 months.By comparing serum IL-6 and IFN-γlevels changes of the patients before and after treatment and negative conversion ratio after treatment and degree of lesions changes of the two groups ,the effects of levofloxacin on pulmonary tuberculosis were explored.Results Compared with before treatment in the two groups, serum IL-6, IFN-gamma levels were significantly lower after treatment, the above indexes in experiment group were higher than those in control group (P<0.05).After 6 months treatment, negative conversion ratio in sputum bacteria in control group was 30 cases (69.77%), and 40 cases (90.91%)in experiment group, with significant difference ( P<0.05).Of the control group, the significant absorption, absorption and deterioration was respectively 22 cases (51.16%), 8 cases (18.60%), 13 cases (27.90%),of the experiment group was 31 cases (70.45%), 9 cases (20.45%), 4 cases (9.09%),respectively.The total lesions absorption rate of the experiment group (90.91%) was significantly higher than control group (69.77%) (P<0.05).Conclusion Levofloxacin in the treatment of senile patients with pulmonary tuberculosis can reduce serum IL-6 and IFN-γlevels, improve the patients'negative conversion ratio of sputum bacteria and total lesions absorption rate, has a good effect for the treatment.

In order to set up sustainable fundraising mechanisms for community health services, it is necessary to calculate the sum of compensation needed for basic public health services and formulate compensation policies on the basis of defining items of basic public health services and in accordance with the economic levels of various regions. At the same time, it is necessary to enforce government purchases after working out strict assessment criteria so as to ensure that funds for community health services are genuinely devoted to basic public health services.

Proceeding from the needs of the reform in the medical and health system and in view of the fact that bringing community health service into line with urhan workers basic medical insurance has become an explicit macro policy of the State, the authors, on the basis of the actual conditions and reform activities in various parts of the country, studied specific and viable policies for the implementation of the macro policy. They explored items of community health service that could be brought into the scope of basic medical insurance, methods of implementation, and control measures, thus offering suggestions to most regions in the country on the adoption of policies for linking community health service with workers basic medical insurance. The paper outlines the background, objective, perspective, methods and conclusion of the studies.

Objective To provide health administrative departments with parameters for formulating community health service policies. Methods An analysis was made by conducting practical surveys and downloading from data banks. Results With the use of district hospitals, community health service centers and family beds, the average expenses per case for cerebral infarction and secondary infection of chronic bronchitis, the first two of 10 diseases analyzed, were respectively 7 074 57 and 8 730 27 yuan, 7 129 20 and 4 790 32 yuan, and 709 45 and 645 27 yuan. Conclusion Treatment of clearly diagnosed chronic noninfectious diseases in medical institutions of different tiers and by different means will incur different medical expenses and the rational use of family beds is a three win policy for the hospital, the insurance company and the patient.

Hilar cholangiocarcinoma is a type of malignant tumor of the extrahepatic ductal system.Due to hepatic artery and portal vein involvement within the liver hilum,the resection rate is low and the prognosis is poor.However,with several advances in imaging technology achieved during the last decades,the accuracy of diagnosing and assessing the resectability of hilar cholangiocarcinoma has been greatly improved.In fact,some new classification and staging systems have been proposed to evaluate the tumor.This review will discuss the recent advances in the classification,staging,and preoperative resectability assessment for hilar cholangiocarcinoma.

OBJECTIVE:To observe clinical efficacy and safety of thymosin in adjunctive treatment of chronic eczema,and to investigate its mechanism from the change of peripheral T lymphocyte subsets. METHODS:160 patients with chronic eczema were randomly divided into observation group and control group,with 80 cases in each group. Both group received conventional therapy as mizolastine,Desonide cream. Observation group additionally received Thymosin enteric-coated tablet 20 mg,po,tid;control group was given placebo the appearance of which was same with Thymosin enteric-coated tablet. Treatment course lasted for 4 weeks. The change of T lymphocyte subsets,clinical efficacy and the occurrence of ADR were compared between 2 groups. Re-currence rate of both groups were followed up for 1 year. RESULTS:The effective rate of observation group(91.25%)was signifi-cantly higher than that of control group(77.50%),with statistical significance(P<0.05). After treatment,CD4+ and CD4+/ CD8+ of 2 groups were significantly increased,while CD8+ was decreased significantly;CD4+ and CD4+/ CD8+ of observation group were significantly higher than those of control group,with statistical significance(P<0.05),but there was no statistical significance in CD8+ between 2 groups(P>0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). Re-currence rate of observation group(31.51%)was significantly lower than that of control group(64.52%)during follow-up period, with statistical significance (P<0.05). CONCLUSIONS:In summary,thymosin can improve clinical efficacy and reduce recur-rence rate by regulating T lymphocyte subsets with good safety.

Budd-Chiari syndrome (BCS) is a rare disease. Because of lack of clear characteristic symptoms in the early stage, many patients are misdiagnosed or never diagnosed. Early diagnosis and prompt treatment play a key role in improving survival rates and quality of life for BCS patients. With the progress in imaging techniques, the radiological examination is playing more and more important role in the diagnosis and assessment of BCS. Ultrasound, computed tomography, magnetic resonance imaging and digital subtraction angiography are all helpful in evaluating the obstruction of hepatic vein and inferior vena cava. Thus, these imaging tests should be used rationally according to their features. On the other hand, the interventional therapy is the preferred method for the treatment of BCS. This paper intends to get a deeper understanding of BCS for clinicians, which is essential for patients to be diagnosed in time.

Acute respiratory distress syndrome (ARDS) is a serious state threaten human health with a high mortality about 30%-40%. At present, there is no effective treatment for ARDS. Microvesicles derived from mesenchymal stem cells (MSC-MVs) have a heterogeneous subcellular structure secreted by MSCs. It plays an important role in the repair of tissue and organ damage.Recent studies have shown that MSC-MVs, played an important role in repairing lung injury, may replace MSC for cell therapy. Therefore MSC-MVs may bring new hope for ARDS treatment.

Objective To investigate the clinical experiment of arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator for treatment of total ankle joints tuberculosis. Methods From January 2001 to April 2005, 6 patients (4 males and 2 females), with a mean age of 33 years old (range, 28 to 44 years old) and mean duration of 13 months, received arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator. All patients had received at least 3 weeks standard drug treatment for tuberculosis before the operation. After thoroughly debridement under arthroscopy using anterolateral and anteromedial approaches, a half-ring sulcated external fixator was used to fix the ankle joint at the neutral position. 4 days (2-7 days) after the operation, patients could walk with partially weight bearing. All patients replied to our questionnaire and the average follow-up was 21.3 months, with a range of 6-42 months. Patients returned for a clinical and radiolographic evaluation every week before the tibiotalar joints union. The external fixator apparatus were removed after the joint fused. Results Fusion occurred in all patients, the average time to clinical and radiographic union was 12.5 weeks (9-17 weeks). 3 patients were graded as excellent: no pain with a stable fusion. The others were graded as good: mild pain, occasional limp with a stable fusion. There were no sinus or other complications occurred. Conclusion There are considerable advantages using arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator for treatment of total ankle joints tuberculosis without serious bone defect, include: limited invasion, quickly recovery, thoroughly debriding the tuberculose focus. And the half-ring sulcated external compression fixator could achieve stable and elastic fixation with adjustable rigidity. And patients can walk earlier to promote ankle fusion and decrease related complications.