Lots of problems has exposed in medical system,especially in unreasonable utilization of health resources.This article,from the viewpoint of utilization of health resource,analyzes current problems and countermeasures of the reasonable utilization of health resources.

Objective To investigate the risk factors that affect the perioperative mortality incholangiocarcinoma.Methods The clinical data of sixty two patients with cholangiocarcinoma who underwent operation were reviewed retrospectively.Logistic regression test was used in the perioperative mortality study.Before multivariate analysis,each parameter was evaluated with univariate analysis to define whether it was of statistical significance(P

Objective Study of the feasibility that the former changing trend of tumour after the first BAI can forecast the later curative effect on tumour.Methods Bronchus artery and relational body arteries opacification and BAI have been introduced in 82 primary pulmonary carcinoma cases.In the statistic analysis,SPSS 13.0 for Windows Stat.Software Package has been used.At the meanwhile chi square test,one-sample t-test,GLM-univariate analysis have been adopted as well to study the relationship between the former changing trend of tumour and Later Curative Effect after BAI in mid-advanced stage pulmonary carcinoma.Result There are significance statistical significances between the former changing trend of tumour and the later curative effect after the first BAI in mid-advanced stage pulmonary carcinoma.Conclusion The former changing trend of tumour after the first BAI is the factor influencing the later curative effect.

Objective To study later eurative effects after BAI with single factor analysis.MethodsBronchus artery and relational body arteries opacification and BAI had been introduced in 82 primary pulmonary carcinoma cases.In the statistic analysis,SPSS 13.0 had been used.ResultsThe tumour blood supply types and the times of effective BAI treatment were the factors influencing the later treatment period.Tumour pathologic types,the branches of tumour blood supply,tumour clinic cTNM stages,chems project influenced faintly later curative effect.ConclusionThe blood supply types of primary pulmonary carcinoma and the times of effective BAI treatment are the factors influencing the later treatment period.

Objective To explore the sleep problem and its related factors,and to provide evidence for improving sleep quality of patients with ankylosing spondylitis (AS). Methods Pittsburgh sleeping quality index (PSQI),self-rating depression scale (SDS),self-rating anxiety scale (SAS) and a self-designed questionnaire were applied to survey 318 patients with AS.Data were analyzed by the SPSS 17.0 software.The relationship between the various relevant factors were revealed by t-test,x2 test,Wilcoxon rank-sum test and Pearson correlation analysis.Results The mean total score of PSQI was 6.6±3.6, and 35.4％ of AS outpatients showed poor sleep quality.The difference of PSQI scores and detection rate of poor sleep quality between male and female were not statistically significant.There were significant difference of early morning stiffness(Z=-3.077,P=0.002),BASFI(Z=-4.766,P=0.000),BASDAI(Z=-6.880,P=0.000),nocturnal pain VAS(VAS)(Z=-6.502,P=0.000),total back pain VAS(Z=-6.675,P=0.000),ESR(Z=-2.370,P=0.018),CRP(Z=-2.063,P=0.039) between the poor sleep and the good sleep patients (P＜0.05).The PSQI score was positively correlated with age (r=0.165,P=0.003) but not gender and disease duration (r=0.078,P=0.165; r=0.094,P=0.097).PSQI score difference were also observed between patients with negative mood and patients without negative mood (t=-7.613,P=0.000; t=-7.287,P=0.000).Conclusion High incidence of sleep disorder exists among AS outpatients,and it is closely related with age,anxiety,depression and activity of AS.Attention should be paid to AS patients with sleep problems.

Objective To get the thresholds of single and simultaneously multiple bone conduction auditory steady-state response(BC-ASSR) of young adults with normal hearing,and to compare the thresholds obtained with the two methods.Methods BC-ASSR to single and simultaneously multiple stimuli and PTA were examined in 28(56 ears ) young adults with normal hearing.Results At 0.5,1,2,4 kHz,the thresholds of BC-ASSR to single stimuli were 53,47,53,51 dB SPL respectively;the thresholds of BC-ASSR to simultaneously multiple stimuli were 59,54,63,61 dB SPL respectively.There were significant differences between the two at each frequency. Conclusion There are some difference between the thresholds of ASSR to single and simultaneously multiple bone conduction stimuli,especially at the higher frequencies.

To analyze and discuss ethics of treatment in Heinophilic arhtropathy. Treatment of those patients not only could relieve their distress in thought, but also could improve their quality of life. And we raise operational contraindications are relative,not absolute.

Objective To observe the effect of antihypertension treatment at different time after acute onset of stroke on patients' prognosis.Methods Ninety-six patients with ischemic stroke were randomly divided into three groups who received antihypertension treatment separately at the 4th,7th and 10th day after onset.Patients' neurologic deficit and ischemic events were observed at 1 month and 3 months in follow-up.Results Patients who received antihypertension at the 4th day after onset had severer neurologic deficit and more ischemic events than those who received antihypertension at the 7th or 10th day.The patients who received antihypertension treatment at the 7th and 10th day did not show significant difference in prognosis and occurrence rate of ischemic event.Conclusion It is preferable to start antihypertension treatment at the 7th day after onset for patients with ischemic stroke.

ObjectiveTo investigate the effects of autophagy on exocrine function of pancreas in rats with acute sepsis, and to determine whether the mitochondrial coenzyme Q (Mito Q) can prevent exocrine dysfunction of pancreas mediated by autophagy.Methods ExperimentⅠ: 30 Sprague-Dawley (SD) rats were randomly divided into three groups, with 10 rats in each group. All the rats were given lipopolysaccharide (LPS, 10 mg/kg) intraperitoneally, and Wortmannin (2 mg/kg), the specific inhibitor of autophagy (LPS+ Wortmannin group), Mito Q (6.5μmol/kg, LPS+Mito Q group), or the same volume of normal saline (LPS group) was respectively injected via the tail vein 1 hour later. Survival rate was assessed within 12 hours after LPS injection. ExperimentⅡ: another 100 male SD rats were randomly divided into ten groups with 10 rats in each group: namely control 4, 6 and 12 hours groups, LPS 4, 6 and 12 hours groups, and LPS+ Wortmannin 4 hours group, Wortmannin 4 hours group, LPS+ Mito Q 6 hours group, and Mito Q 6 hours group. The protocols of model reproduction and drug administration were the same as in the experimentⅠ. Blood samples were collected at each time point, and the amylase content was determined with the velocity method. The levels of reactive oxygen species (ROS) in the pancreases were measured with enzyme-linked immunosorbent assay (ELISA). The expression of the autophagy-related protein LC3 was determined with Western Blot. The pathological changes in the pancreas were observed with microscopy.Results① The survival time in the LPS+ Wortmannin group was significantly shorter than that in the LPS group (hours: 7.50±0.64 vs. 11.90±0.13,χ2= 19.847,P= 0.001). There was no significant difference in the survival time between LPS+ Mito Q and LPS groups (hours: 11.60±0.24 vs. 11.90±0.13,χ2= 1.055,P= 0.137).② The serum amylase in the LPS 6 hours, LPS+ Wortmannin 4 hours, and LPS+ Mito Q 6 hours groups were significantly higher than those in the control group at the same time points (U/L:2 881.00±550.12 vs. 2 099.20±249.57, 3 672.00±779.24 vs. 2 081.36±245.18, 2 975.20±687.03 vs. 2 099.20± 249.57, allP< 0.05), and were significantly lowered in LPS 12 hours group (U/L: 794.00±218.71 vs. 2 086.80±261.75, P< 0.01). The pancreatic ROS in the LPS 6 hours and 12 hours groups, LPS+ Wortmannin 4 hours group, and LPS+Mito Q 6 hours group were significantly higher than those of the control group at the same time points (kU/L: 3.18±1.06 vs. 1.78±0.37, 3.63±1.08 vs. 1.85±0.41, 3.14±0.98 vs. 1.65±0.34, 3.17±1.03 vs. 1.78±0.37, allP< 0.05). The serum amylase and pancreatic ROS in LPS+ Wortmannin 4 hours group were significantly higher than those of the LPS group at the same time points (U/L: 3 672.00±779.24 vs. 2 432.20±442.85, kU/L: 3.14±0.98 vs. 1.87±0.42, both P< 0.05), but there were no differences in above two parameters between LPS+ Mito Q 6 hours group and LPS group (U/L: 2 975.20±687.03 vs. 2 881.00±550.12, kU/L: 3.17±1.03 vs. 3.18±1.06, bothP> 0.05). Light microscopy showed that obvious pathological changes were found in the pancreas in the LPS 6 hours and 12 hours groups, LPS+Wortmannin 4 hours group, and LPS+ Mito Q 6 hours group. Electron microscopy showed that the number of autophagic vacuoles increased 6 hours after LPS administration. There was no difference at any time point in the number of autophagic vacuoles between LPS+ Mito Q 6 hours group and LPS 6 hours group, and the autophagic vacuoles were not found after Wortmannin intervention. It was demonstrated by Western Blot that the levels of LC3 protein in the LPS 6 hours and 12 hours groups, and LPS+ Mito Q 6 hours group were significantly higher than those of the control group at the same time points (A value: 0.34±0.02 vs. 0.17±0.02, 0.37±0.03 vs. 0.18±0.04, 0.36±0.02 vs. 0.17±0.02, allP< 0.05), but there were no differences between LPS 12 hours group or LPS+ Mito Q 6 hours group and LPS 6 hours group (bothP> 0.05).Conclusions Autophagy prevents exocrine dysfunction of pancreas in septic rats, and the autophagic capacity or autophagosome-formation rate may determine the development of exocrine pancreatic dysfunction. The mitochondria-targeted antioxidant Mito Q does not prevent exocrine dysfunction of pancreas.

Objective To investigate the effects of autophagy on cardiac function and to determine whether the mitochondrial coenzyme Q (MitoQ) prevents cardiac dysfunction,mediated by autophagy,in rats with acute sepsis.Methods Forty-five Sprague Dawley (SD) rats were randomly divided into 9 groups (n =5,each group):control group,4 h lipopolysaccharide(LPS) group,6 h LPS group,12 h LPS group,4 h LPS + Wortmannin group,4 h LPS + MitoQ group,6 h LPS + MitoQ group,MitoQ group and Wortmannin group.Rats in LPS + Wortmannin group and LPS + MitoQ group were intraperitoneally given LPS(10 mg/kg) and followed by an injection of Wortmannin(2 mg/kg) and MitoQ (6.5 μmol/kg) via tail vein 1 hour later,respectively.Rats in each group were given the same amount of normal sodium in addition to different intervention drugs.The cardiac function parameters were measured by a BL-420E + biosignal collection system.Blood samples from abdominal aorta were taken at each time point,and creatine kinase MB isoenzyme (CK-MB) content was detected by using the velocity method.The content of reactive oxygen species (ROS) in isolated myocardial tissues in rats was measured by enzyme-linked immunoadsorbent assay(ELISA).The protein expression of microtubule-associated protein 1 light chain 3 (LC3) was detected by Western blot method.The pathological changes of myocardial tissue were observed by light and electronic microscopy.Results Compared with the control group,the left ventricular systolic pressure(LVSP),the rate of the rise in left ventricular pressure (± dp/dt max) were significantly decreased in 6 h LPS group,6 h LPS + MitoQ group and 4 h LPS + Wortmannin group(P ＜0.05),left ventricular end-diastolic pressure(LVEDP) was significantly increased in these 3 groups(P ＜0.05).The contents of CKMB and ROS in 6 h LPS group,6 h LPS =MitoQ group and 4 h LPS + Wortmannin group were higher than those in the control group(P ＜ 0.05).Electron microscopy showed that the number of autophagic vacuoles increased 6 h after LPS was administered,but did not increase significantly thereafter to 12 h.There was no difference at any time point in the number of autophagic vacuoles in the group given MitoQ and LPS.Immunoblotting demonstrated that the levels of LC3Ⅱ protein in the LPS 6 h group and LPS + MitoQ 6 h group were higher than those in the control group(P ＜0.05),but there was no difference between the LPS 12 h and LPS 6 h groups (P ＞ 0.05).Conclusions The mitochondria-targeted antioxidant MitoQ does not prevent cardiac dysfunction.However,autophagy prevents cardiac dysfunction,and the autophagic capacity or autophagosome-formation rate may determine whether cardiac dysfunction develops.