Objective To analyse the health system responsiveness of Huzhou of Zhejiang Province. Methods Performance evaluation method proposed by WHO was employed for the study of responsiveness. The local residents of Huzhou of Zhejiang Province in 2007 were investigated with multilevel cluster stratified sampling. Data were obtained by household survey and involved items such as dignity,independence,privacy,communication,timely attention,equipment,social support and selection of medical staff,and were subjected to empirical analysis. Results Household survey was conducted in 1353 residents,among whom 28.16% lived in town and 71.84% lived in countryside. The index of health system responsiveness of Huzhou was 7.96,slightly higher than that of Zhejiang Province (7.71). The responsiveness was significantly higher for countryside than that for town in independence,communication and timely attention (P

Animals ; Disease Models, Animal ; Endothelin-1 ; metabolism ; Male ; Nitric Oxide ; metabolism ; Paraquat ; poisoning ; Rats ; Rats, Sprague-Dawley

With the rapid development in cataract operation,characteristics and types of intraocular lens have been improving and altering all along in over fifty years.The correct selection for intraocular lens is significant for cataract patient to get better vision after operation.Description of characteristics and selection of the intraocular lens are summarized.

Objective To investigate the causes and mechanism of preterm birth through analysis of the relationship between histological chorioamnionitis (HCA) in placental tissue and preterm birth.Methods Totally,327 preterm birth cases with report of placental pathologic examination were retrospectively collected from those women who delivered from December 1,2009 to December 1,2012 in Peking University First Hospital.According to the etiology of preterm birth,three groups were assigned:iatrogenic group (n=106),spontaneous contraction group (n=56) and premature rupture of membranes (PROM) group (n=165).According to the gestational age at delivery,three subgroups were further divided:early-preterm group (≥ 28-＜ 32 weeks),mid-preterm group(≥ 32-＜ 34 weeks) and late-preterm group (≥ 34-＜ 37 weeks).HCA was confirmed when ≥ 5 neutrophil infiltration identified on the chorionic plate and amniotic membrane under high power light microscope after HE staining.The relationship between HCA and the different types of preterm birth and the different delivery gestational age were analyzed.Besides,the consistency between clinical chorioamnionitis and HCA was also analyzed.Chi-square test was applied for statistics.Results The incidence of HCA in the spontaneous contraction group was significantly higher than in the iatrogenic group and PROM group [66.1％ (37/56) vs 25.5％ (27/106) and 33.3％ (55/165),x2=25.27 and 18.44,both P ＜ 0.01],but no significant difference was found between the latter two groups (P ＞ 0.05).Among the three subgroups,the early-,midand late-preterm subgroup,the incidence of HCA in the iatrogenic group was 24.0％ (6/25),33.3％ (8/24) and 22.8％ (13/57) (P ＞ 0.05),and 13/17,5/7 and 59.4％ (19/32) in the spontaneous contraction group (P ＞ 0.05).However,significantly higher incidence of HCA was shown in the early-preterm subgroup than in the mid-and late-preterm subgroup [70.0％ (20/29) vs 41.2％ (14/34) and 20.6％ (21/102),X2=4.87 and 24.58,both P ＜ 0.05] in the PROM group.Among the subjects in PROM group,those with the latency ≥ 72 h after the rupture of membranes had a higher incidence of HCA than those with the latency less than 72 h [68.6％ (24/35) vs 23.8％ (31/130),x2=24.82,P ＜ 0.01].For all 327 cases in this study,the incidence of clinical chorioamnionitis was 15.9％ (52/327),among which 31 cases [59.6％ (31/52)] were diagnosed as HCA.Conclusions The occurrence of HCA is closely associated with spontaneous contraction preterm.Some iatrogenic preterm birth might cause HCA.The earlier the preterm birth and the longer the latency after PROM,the higher the incidence of HCA.Differential diagnosis is necessary as the inconsistency between clinical chorioamnionitis and HCA.

Objective To investigate the distribution of scopolamine into brain following intranasal .Methods Adult Wistar rats were divided into two groups ,and administrated with scopolamine 0 .3 mg via intraperitoneal or intranasal respectively .Two groups of blood concentration and brain concentration of scopolamine were determined by solid phase extraction (SPE) and LC/MS assay at the time point of 5 ,10 ,20 ,30 ,60 ,120 ,240 ,480 min ,and their kinetic parameters were calculated and compared .Results Scopol-amine bioavailability of intranasal administration was 65% ,and the maximum concentration of scopolamine in brain following in-tranasal administration was much higher than that following intraperitoneal administration .Comparing the ratio of AUC in brain and in plasma ,ratio of intranasal administration is bigger than that of intraperitoneal administration significantly (P<0 .05) .Con-clusion It was concluded that scopolamine′s intranasal administration induced the agent targeting distribution into the brain .

To explore the clinical manifestations, diagnosis and treatment of pulmonary thromboembolism associated with protein C (PC)/protein S (PS) deifciency. Two male patients 29 and 26 years old diagnosed with PC deifciency and/or PS deifciency were retrospectively analyzed and related literatures were reviewed. The most common symptoms were pain in the lower limbs with chest pain or decreased vision. Color dopper lfow imaging (CDFI) showed lower deep venous phlebothrombosis. Multislice CT angiography (CTA) revealed pulmonary embolism. The level of serum homocysteine (HCY) increased and the level of plasma PC/PS content decreased to PC 57.4%, and PS 28.9%in patient 1, while PS 33.4%in patient 2. Poor routine anticoagulant response was observed. After the diagnosis of PC/PS deficiency, vitiamin B6 and B12 anticoagulant therapy was added, and the symptoms in the patients improved significantly. Congenital thrombophilia should be taken into consideration for young patients with lower deep venous thrombosis and pulmonary embolism which occur recurrently without obvious predisposing causes before 40. Plasma PC/PS concentrations or activity help a lot in the diagnosis and treatment.

Small intestinal neuroendocrine carcinoma is poorly differentiated,highly malignant,and originated from the diffuse neuroendocrine system.It diffusely expresses the general neuroendocrine differentiation markers.The disease can be manifested as carcinoid syndrome,but most of the patients were with occult onset and absence of specific clinical symptoms,which led to difficult diagnosis before operation.On June 18,2012,a patient with manifestation of recurrent vague abdominal pain received capsule endoscopy at the Northern Jiangsu People's Hospital.The capsule endoscope was retained in the distal small intestine,and malignant ileum lesion was revealed during the surgical exploration.Finally,poorly differentiated neuroendocrine carcinoma with abdominal wall metastases was identified by pathological examination.

Objective To observe the effect of auricular-plaster therapy on non-incisional pain from post-laparoscopic surgery.Methods Sixty patients with non-incisional pains from laparoscopic surgery were divided into experimental group (n=30) and control group (n=30).The patients of control group after laparoscopic surgery were routinely given the oxygen inhalation for 6 hours and encouraged to do off-bed activity earlier.Besides the above-mentioned treatment,the patients of experimental group were additionally given auricular-plaster therapy.The patients of two groups were compared in terms of pain intensity and duration.Result The pain duration in the experimental group was significantly shorter and the pain density was significantly lower than that of the control group (bothP<0.05).Conclusion Auricular-plaster therapy can significantly reduce the duration and intensity of non-incisional pain from gynecological laparoscopy.

BACKGROUND:Autologous hard palate mucosa has been validated to be a substitute of the tarsal conjunctival. OBJECTIVE:To investigate the treatment outcomes of autologous hard palate mucosa applied in the eyelid reconstruction. METHODS:180 patients (180 eyes) with eyelid defects aged 10-63 years old were recruited, including 122 males and 58 females, and subjected to the transplantation of autologous hard palate mucosa. In the same time, flaps were designed and transferred into the defected eyelid soft tissues. All patients were followed up for over 3 months to observe the treatment outcomes. RESULTS AND CONCLUSION:Three months after surgery, viscous secretions were found in the implanted region and conjunctival sac, which were relieved and eliminated by usage of antibiotic drops. All implanted hard palate mucosa survived within 1 year, neither infections nor falling off occurred, and blood vessels growth into the implant-tissue conjugation that inosculated with the host vessels presenting no rejection. The implants revealed different degrees of shrink in 132 patients, but the eye function was normal. During the hospitalization, some uncomfortable feeling such as eye pain had been relieved, and the wound showed no infections and healed well. During the follow-up, there were eight patients with slight lower eyelid ectropion and three with hypophasis. The length or height difference of both eyelids was within 2 mm, except those who lost eye bal s. These results suggest that autologous hard palate mucosa achieve satisfactory outcomes in the eyelid reconstruction and possesses good histocompatibility.

Objective To study the theraputic effect of cyclophosphamide,glucocorticoid combined with sildenafil on pulmonary hypertension in systemic lupus erythematosus(SLE?PAH) patients,and to analyze the prognosis adverse factors. Methods Forty?six cases patients with SLE?PAH from Tangshan Gongren Hospital from January 2009 to January 2015 were selected as research subjects. All patients were treated with prednisone, cyclophosphamide and sildenafil,and the course of treatment was 24 weeks. The treatment effect was observed, the systemic lupus erythematosus disease activity score(SLEDAI),6 minutes walk distance and heart function before and after the treatment were compared. The effective and uneffective patients'clinical and test information were compared,and the prognosis adverse factors were analyzed. Results After 24 weeks treatment,the total ef?fective rate was 78. 3%(36/46). Pulmonary artery systolic pressure(PASP) dropped from (59±16) mmHg be?fore treatment to (45±15) mmHg after treatment,there was significant statistical difference(t=-4. 539,P<0. 01). SLEDAI dropped from (6. 6±2. 3) points to (2. 4±0. 8) points,,there was significant statistical differ?ence(t =11. 680,P<0. 01). The 6 minutes walk distance rose form (402±96) minutes to (465±97) minutes, there was significant statistical difference( t=-3. 137,P<0. 01) . Cardiac function improved significantly,there was significant statistical difference( P<0. 01) . There were 10 cases uneffective and deterirated patients,with the age of (42±6) years,36 cases effective patients with the age of (33±4) years,the difference was statistically significant( t=-5. 423, P<0. 01 ) . Uneffective and deterirated patients' anti?RNP antibody positive rate was 90. 9%( 9/10 ) , significantly higher than the effective patients ( 52. 8%( 19/36 ) ,χ2 = 4. 552, P<0. 01 ) . Conclusion Cyclophosphamide, glucocorticoid combined with sildenafil has obvious effect on patients with SLE?PAH. PASP,heart function and 6 minutes walk distance are the important indicators of prognosis. Anti?RNP antibody and age are the adverse prognostic factors.