China ; Curriculum ; Education, Dental ; Oral Medicine ; education

OBJECTIVE:To evaluate the subsequent performance after the merger & acquisition (M&A) in the form of cash in medical industry during 3 years from 2000 to 2002.METHODS:Base on the financial data of the merging party and by means of principal component analysis and factor analysis,a scoring system was built for the evaluation of the performance of M&A so that the comparison of effect scores before and after M&A could be realized.RESULTS:The effect scores fluctuate dramatically after M&A,but finally reverted to the initial level before M&A.CONCLUSION:M&A in the form of cash failed to bring long-term profits to the entire medical industry.

Objective To observe the earlier changes of left heart structure and function in patients with Grade 1 hypertension.Methods 65 patients with Grade 1 hypertension were measured on the left atrial diameter(LAD),left ventricular diameter,thickness of ventricular,mass index and evaluate the left ventricular systolic and diastolic function by UCG.Results Compaired to 50 normal controls,the LAD and left ventricular diastolic function of the patients(38.06?3.68 mm,0.72?0.11) was significantly different with those of 50 normal controls(29.86?3.08 mm,1.18?0.08)(P

Adult ; Esophagus ; surgery ; Female ; Foreign Bodies ; surgery ; Humans ; Male ; Middle Aged ; Neck ; surgery

Objective To evaluate the effect of sevoflurane on hippocampal calcium/calmodulindependent protein kinase Ⅱ (CaMK Ⅱ)/cyclic adenosine monophosphate response element-binding protein (CREB) signaling pathway in aged rats.Methods Sixty pathogen-free healthy male Sprague-Dawley rats,aged 18 months,weighing 600-750 g,were divided into 2 groups (n=30 each) using a random number table:control group (group C) and sevoflurane group (group Sev).Group Sev inhaled 2％ sevoflurane in the mixture of 50％ air and oxygen (2 L/min) for 4 h.Group C inhaled the mixture of 50％ air and oxygen (2 L/min) for 4 h.Morris water maze test was performed on 6 days before anesthesia and 1 day after anesthesia.The escape latency,swimming distance,frequency of crossing the original platform and time of staying at the platform quadrant Ⅱ were recorded.On 1,3 and 7 days after anesthesia,the rats were sacrificed,and the hippocampus was obtained for determination of the expression of CaMK Ⅱ,phosphorylated CaMK Ⅱ,CREB and phosphorylated CREB by Western blot.Results Compared with group C,the escape latency and swimming distance were significantly prolonged,the frequency of crossing the original platform was decreased,and the time of staying at the platform quadrant Ⅱ was reduced on 5th day of training and 1 day after anesthesia,and the expression of CaMK Ⅱ,phosphorylated CaMK Ⅱ,CREB and phosphorylated CREB was down-regulated after anesthesia in group Sev (P＜ 0.05).Conclusion Sevoflurane leads to cognitive decline through inhibiting hippocampal CaMK Ⅱ/CREB signaling pathway in aged rats.

Humans ; Organometallic Compounds ; chemistry ; metabolism ; toxicity

Objective To investigate the clinical efficacy of laparoscopic radical gastrectomy in elderly patients with advanced gastric cancer.Methods The clinical data of 85 elderly patients with advanced gastric cancer who were admitted to the Ningbo First Hospital from January 2012 to June 2014 were retrospectively analyzed.Laparoscopic radical gastrectomy was performed on 46 patients (LRG group) and open radical gastrectomy on 39 patients (ORG group).All the patients underwent primary tumor resection for gastric cancer + D2 lymph node dissection,and the postoperative recovery plans were done according to enhanced recovery program.The volume of blood loss,number of lymph node dissected,operation time,intraoperative arterial partial pressure of carbon dioxid (PaCO2),time to anal exsufflation,indwelling time of gastric tube,time for out-off-bed activity,time for fluid diet intake,postoperative hemoglobin,duration of hospital stay and occurrence of complications in the 2 groups were analyzed.The follow-up by outpatient examination and telephone interview was carried out on patients up to August 2014.The count data were analyzed by the chi-square test and Fisher exact probability.The measurement data with normal distribution were presented as x ± s and analyzed using the t test.The t' test was used if the data were deficient.Results Surgical procedures in the 2 groups were successfully carried out and no perioperative death occurred.There was no conversion to open surgery in the LRG group.The resection margins in all the patients were negative.The operation time and number of lymph node dissection in the LRG group were (239 ±68)minutes and 27 ± 10,compared with (227 ±50)minutes and 26 ± 10 in the ORG group,with significant differences (t =0.919,0.179,P ＞ O.05).PaCO2 in the LRG group was (41 ± 5) mmHg (1 mmHg =0.133 kPa),which was significantly higher than(36 ± 5) mmHg in the ORG group (t =4.745,P ＜ 0.05).The volume of blood loss was (102 ± 44)mL in the LRG group,which was significantly less than (200 ± 120) mL in the OPG group (t' =-4.807,P ＜ 0.05).The postoperative level of hemoglobin in the LRG was (110 ± 15) g/L,which was significantly higher than (98 ± 27)g/L in the ORG group (t' =2.471,P ＜ 0.05).The time to anal exsufflation,indwelling time of gastric tube,time for out-off-bed activity,time for fluid diet intake,duration of hospital stay in the LRG group were (2.6 ± 0.7) days,(2.1 ± 0.7) days,(1.1 ± 0.3) days,(4.1 ± 0.7) days and (11 ± 4) days,which were significantly different from (4.8 ± 1.5) days,(4.0 ± 1.8) days,(4.5 ± 0.6) days,(5.9 ± 1.8) days and (18 ± 3) days in the OR G group (t' =-8.415,-6.206,-33.831,-5.879,t =9.632,P＜0.05).Eight patients in the LRG group and 15 patients in the ORG group had complications,with the incidence of complications of 17.4％ (8/46) and 38.5％ (15/39),respectively,showing a significant difference (x2 =4.748,P ＜ 0.05).Forty-four patients in the LRG group and 36 patients in the ORG gorup were followed up for 2-25 months,1 patient in the LRG group and 2 patients in the ORG group died and others had full recovery.Conclusions Laparoscopic radical gastrectomy could provide a safe and complete tumor resection for elderly patients with advanced gastric cancer compared with open radical gastrectomy,meanwhile,it can improve postoperative recovery and reduce postoperative complications in elderly patients with advanced gastric cancer.

Objective To evaluate the diagnosis value of urodynamics in patients with benign prostate hypertrophy(BPH).Method With urodynamic device,the full set of urodynamic exam was administrated in 427 patients with BPH,and the externalsphincter urethral myogram was monitored simultaneously in pressure-flow studies(PFS).The umdynamic finding such as Q_(max),P_(det)-Q_(max),DS(descending slope)and post-voiding residual(PVR)were recorded,as well as the situation of bladder detrusor constraction and bladder compliance and urethral sphincter coodination.The bladder outflow obstruction was diagnosed by A-G nomogram,P-Q plot and DS.The IPSS score and prostate volume were also acquired.Results The diagnostic rate of BOO is 81.5%,among them concomitantly detrusor muscle impair in 117 cases (27.4%),decreased bladder compliance in 162 case(37.9%),urethral sphincter dyssynergia in 148 cases(34.7%),and unstable bladder in 164 cases(38.4%).The increase degree of BOO show an increasing tendency with urodynamic finding such as Q_(max),P_(det)-Q_(max),P_(open),DS,IPSS score and prostatic volume respectively,but a decreasing tendency with Q_(max) and bladder compliance.Conclusions The urodynamic exam plays an important role in diagnosis of BOO.There is a positive relation among degree of BOO with urodynamic findings such as P_(det)-Q_(max),P_(open),DS and IPSS score and prostatic volume,however,a negative relation with Qmax and bladder compliance respectively.

Objective To better promote the health education and health promotion among patients with chronic disease, general practitioners (GPs) in the community should master the knowledge of non-communicable diseases (NCDs). This paper aimed to describe the current situation of GPs' knowledge about prevention and treatment of NCDs. Methods Self-designed questionnaires were issued to 1 077 GPs in community health service centers, and all GPs finished the questionnaire without assistance. The content of questionnaire includes the general information of GPs and six questions focusing on NCDs. Results Overall, 1 076 GPs completed the questionnaire, and the response rate was 99.9% (1 076/1 077). With regard to the six questions about NCDs, 90.4% (973/1 076) of GPs were well aware of the diagnosis of hypertension. Apart from that, the knowledge of diabetes mellitus (60.9%, 655/1 076), factors related to NCDs (70.2%, 755/1 076), the concepts of mental illness (52.0%, 560/1 076) and the clinical significance of tumor markers (87.9%, 946/1 076) among GPs were adequate, while more than half of the GPs did not know a lot about home oxygen therapy. Conclusion The mastering level of knowledge about prevention and treatment of NCDs among GPs varies that they need further improvement.

OBJECTIVE To study the drug-resistant diversity of Gram-negative bacilli isolated from inpatients during recent five years.METHODS A total of 1 464 Gram-negative bacilli isolated were detected and retrospectively analyzed from 1999 to 2003.Antimicrobial susceptibility testing was performed using Kirby-Bauer method.RESULTS The resistance of Pseudomonas aeruginosa to piperacillin rised from 17.6% of 1999 to 79.2% of 2003,and that to ciprofloxacin rised from 4.3% of 1999 to 36.0% of 2003.The resistance of Escherichia coli to quinolones was above 50%,while to third-generation cephalosporins was 30-40%;the resistance of E.coli to piperacillin rised from 42.9% of 1999 to 68.9% of 2003,and that to ciprofloxacin rised from 40.0% of 1999 to 73.5% of 2003.The resistance of Acinetobacter to piperacillin rised from 31.2% of 1999 to 67.5% of 2003,and that to ceftriaxone rised from 36.0% of 1999 to 74.1% of 2003.The resistance of Serratia to ceftazidime,ceftriaxone,gentamicin,amikacin and piperacillin rised sharply.Imipenem was the most active antibiotic tested against Gram-negative bacilli.Cefoperazone/sulbactam and piperacillin/tazobactam also showed excellent activity against Gram-negative bacilli.CONCLUSIONS During recent five years,the resistance of the most common Gram-negative bacilli has increased rapidly.How to delay the resistance development of common strains become a global problem.