Based on experience on medical service drilling for many years,this paper analyses the hardship and complexity of medical service support in high & cold mountainous region.It also puts forward some suggestions in such aspects as integral design,focal points insurance,necessaries reinforcement,preach for popularization and mutual cure training.

The study was proceeded on the mRNA expression of the GULT1 and GLUT4 gene in the alloxan diabetic rats by the technique of dot-blot hybridization analysis. The results showed that the levels of the GLUT4 mRNA expression were reduced in diabetic rats while increased in insulin treated diabetic rats. This suggests that the reduced GLUT4 mRNA expression which could affect the quantity of its posttranslational products may be one of the causes of the insulin resistance.

@@

Foreign Bodies ; Foreign-Body Migration ; surgery ; Humans ; Neck ; surgery

Intracranial hypotension syndrome is easily underestimated by doctors and patients,but its occurrence is not infrequent.Primary intracranial hypotension is usually associated with cerebral blood vessel disturbance and infections.Secondary intracranial hypotension is usually secondary to iatrogenic and other diseases or trauma.The main manifestation of intracranial hypotension syndrome is postural headache which may be diagnosed by cerebrospinal fluid pressure measurement during lumber puncture.The headache can disappear by posture adjustment in most children,or by water intake or intravenous administration of hypotonic (0.5％)or saline in serious case.Prognosis is good and precaution is most important for all.

The feasibility to breed gecko, scorpion, centipede,leech and ground beetle together in abreeding shed of our own design with constant temperature was tried for a period of 2 years. Resultsshowed that the animals lead their normal dietetic and living habit satisfactorily, without hibernation andreproduce their offsprings the whole year round. It could be concluded that such breeding scheme is worth-while to advocate for the benefit of those who are engaged in the business of medicinal animal breeding.

Objective To investigate the concentration of procalcitonin,C-reactive protein and WBC count for patients with dif-ferent kind of bacterial infection.Methods 49 blood samples and 81 other samples were collected form different patients for bacteri-al culture.Meanwhile,procalcitonin,C-reactive protein concentration and WBC count of those patients were determined to find whether these indicators exhibited any difference between Gram-positive and Gram-negative bacteria infected patients.Results For bloodstream infection,PCT levels in patients with Gram-nagetive bacterial infection were obviously higher than those with Gram-positive infection(P <0.05 ).For other infection,there was no statistical difference among patients′PCT,CRP concentration and WBC count(P >0.05).Conclusion PCT concentration is valuable in the differential diagnosis of blood stream infection caused by Gram-negative and Gram-positive bacteria,but not in local infection infection.

Objective To study the relationship between red cell distribution width (RDW ) and short-term outcomes in acute coronary syndrome (ACS) patients .Methods A totoal of 1654 ACS patients were divided into RDW ≤12 .1% group(n=419) ,RDW=12 .2% -12 .8% group(n=364) ,RDW=12 .9% -13 .2% group (n= 463) and RDW ≥13 .3% group (n= 408) .Their bio-chemical indicators and incidence of 1-month cardiac death ,heart failure ,recurrent myocardiac in-farction were compared .Relationship between RDW and 1-month adverse cardiac events was as-sessed .Results The incidence of cardiac death ,heart failure ,recurrent myocardiac infarction in-creased with the increasing RDW .Logistic regression analysis showed that RDW ,BNP>100 ng/L and LVEF< 40% were the independent risk factors for 1-month cardiac death in ACS patients (OR=2 .116 ,95% C I:1 .427-3 .137 ,P=0 .000;OR=3 .510 ,95% C I:1 .221 -10 .093 ,P=0 .020 ;OR= 4 .149 ,95% CI:2 .001 -8 .602 ,P= 0 .000 ) ,and that RDW ,age> 65 years ,diabetes and LVEF<40% were the independent risk factors for 1-month heart failure and recurrent myocardi-ac infarction in ACS patients (OR= 2 .134 ,95% CI:1 .602 -2 .844 ,P= 0 .000 ,OR= 2 .010 , 95% C I:1 .135 -3 .560 ,P=0 .017 ;OR=2 .279 ,95% C I:1 .345 -3 .862 ,P= 0 .002 ;OR=5 .009 , 95% CI:2.694-9 .316 ,P=0 .000) .Conclusion RDW is an independent risk factor for the short-term outcomes in ACS patients .

Objective To assess the efficacy,compliance and safety of ketogenic diet (KD) for children with infantile spasms,thus to provide an effective basis for the treatment of infantile spasms.Methods Twenty-five patients with infantile spasms were treated with KD.The gas chromatography-mass spectrometry and high performance liquid chromatography-mass spectrometry (HPLC-MS/MS) were used,except for metabolic diseases,to detect the blood routine,urine,stool,blood Iipids,liver function,as well as electrocardiogram (ECG),electroencephalograph (EEG),ultrasound of the urinary system and other related checks of all patients.The KD antiepileptic drug therapy was given after all children were admitted to hospital,and KD started directly in all patients without fasting.The efficacy compliance and safety were followed up in this study.Results KD maintenance therapy for 1 month,3 mouths,6 months were given to 25 cases (100％,25/25 cases),to 22 cases (88％,22/25 cases),and to 10 cases (40％,10/25 cases),respectively.Among them 7 patients (28％,7/25 cases) were in complete control of seizures within 1 month.Up to Class Ⅱ,Ⅲ efficacy level accounted for 32％ (8/25 cases),12％ (3/25 cases),respectively.Thirteen cases of children had varying digestive symptoms,10 cases of them developed asymptomatic hypoglycemia,and 9 cases of children had sleep trouble during KD treatment,but after symptomatic treatment,children's adverse reactions almost subsided.Only 4 cases of children discontinued treatment due to adverse reactions.All children's seizures were fully controlled.Conclusions The effect of KD is sure in the treatment of infantile spasms.Although KD has some adverse reactions,but it can be tolerated;serious body organ dysfunction treated by KD + antiepileptic drugs combination therapy for 1 to 6 months is not found yet,so the therapy is worthy of promotion clinically.

ObjectiveTo investigate the clinical features of intramedullary spinal cord tumors(IMSCT) in children.MethodsThe clinical data including sex,age,pathohistology,clinical manifestations and medical check-up collected from 16 children diagnosed as IMSCT in Shengjing Hospital Affiliated to China Medical University,were retrospectively reviewed and analyzed.ResultsThe study subjects inclu-ded 11 male and 5 female,with an average age of(8.55?4.28) years old,ranged from 15 months to 14 years old.The interval lasted 1 day to 9 years from onset of the syndrome to confirmed diagnosis of IMSCT.The first clinical manifestation was mostly pain.The main clinical mani-festations included limb dyskinesia in 14 cases,pain in 12 cases,urine and stool disturbance in 9 cases,gait irregularity in 8 cases,extremity atrophy in 3 cases.Medical check-up included abnormal tendon reflex in 14 cases,abnormal superficial reflex in 9 cases,sphincter dilatation in 6 cases,positive Babinski's signs in 5 cases,spinal deformity in 4 cases,region masses in 3 cases,paraesthesia in 2 cases,inequality of lower limb in 1 case,dermai sinus in 1 case,pigmentation in 1 case.The cases were evaluated by magnetic resonance imaging,which presented thickened spinal cord and intramedullary abnormal signals in all the cases.Pathological types: teratoma in 5 cases,dermoid cysts in 2 cases,epidermoid cyst in 2 cases.Misdiagnoses included urinary tract infections in 2 cases,rheumatoid arthritis in 1 case,and lumbar disc protrusion in 1 case.ConclusionsThe main pathohistology of pediatric IMSCT is congenital tumor.First clinical manifestation is pain.MRI can show a reliable evidence for the diagnosis.It is important to improve the outcomes of pediatric IMSCT by establishing the diagnosis and administering proper management as early as possible.