Face to impecunious innominate patients,we should keep Humanitarianism principles to heal the wounded and rescue the dying,and also following principles:benefiting both society and patient right,curing first and charging second,well chosen Rx,and respecting life value,Saving innominate patients need energetically support by government and whole society.Govermment should increase investment in hospital,set up special funds for rescuing innominate and critical patients,mobilize people of all walks of life to show their love,encourage civilians to join medicare,so that the inmoinate patients could gain cure in time.

Analyse ethic problem in hospital infection management process through discussing cause and effect of Infection and put forward to resolve approach and countermeasure.

To investigate chemical constituents from Radix Pittospori, chloroform extract of the roots was subjected to column chromatography with various chromatographic techniques. The structures were elucidated on the basis of physico-chemical property and spectral analysis. Two triterpenoids were identified as 22-acetyl-21-(2-acetoxy-2-methylbutanoyl)-R1-barrigenol(1) and 3alpha-hydroxyl-20-demethylisoaleuritolic-14(15)-ene-28, 30-dioic acid (2). Compound 1 is a new triterpene and compound 2 is isolated from this plant for the first time.

Objective Toinvestigatethechangesofcognitiveimpairmentandcerebralhemodynamics inpatientswithacutelacunarcerebralinfarctionwithin2weeksafteronset.Methods Nineteenpatients with lacunar cerebral infarction (a patient group)were consecutive enrolled in the study. Twenty-three sex-and age-matched inpatients without ischemic cerebrovascular disease or healthy volunteers of outpatient department over the same period were used as a control group. The cerebral hemodynamic features were evaluated with transcranial Doppler (TCD)breath-holding test and single photon emission computed tomography (SPECT)resting + adenosine stress imaging. Simultaneously,the neuropsychological tests were performed,the Montreal cognitive assessment (MoCA)was performed including executive capacity, structural capacity,memory (including auditory memory,visual memory,and logic memory ),information processing speed,and visual-spatial ability. Results (1 )There were no significant differences in the years of education,hypertension,diabetes,hyperlipidemia,coronary heart disease,and smoking between the 2 groups (all P>0. 05). Compared with the control group,there were significant differences in the MoCA score,visual memory,executive function,structural capacity,and information processing speed of the patient group (all P<0. 05). (2)19 patients completed the SPECT resting + load test (12 in the control group and 7 in the patient group). There were significant differences in the uptake ratio (UR)in the right basal ganglia (8. 91[-2. 48 - 5. 87]and -6. 21 [-10. 39 - 5. 42 respectively])and left frontal lobe UR (11. 62 [2. 93-16. 87]and 1. 04 [-10. 17- 3. 82]respectively)between the patient group and the control group (P<0. 05). (3)26 patients completed the breath-holding test + head-up tilt table test (n=13 in each group]. The vascular motor reactivities were 13 ± 5 on the left and 21 ± 7 on the right, and the breath-holding indexes were 0. 66 ± 0. 26 on the left and 1. 0 ± 0. 4 on the right in the patient group;the vascular motor reactivities were 24 ± 11 on the left and 30 ± 9 on the right,and the breath-holding indexes were 1. 21 ± 0. 57 on the left and 1. 5 ± 0. 4 on the right in the control group. There were significant differencesbetweenthe2groups(P<0.05).Conclusion Attheearlystageoflacunarinfarction,the patients have presented varying degrees of cognitive impairment and the changes of cerebral hemodynamics.

Aim To investigate the antitumor and antiangiogenic effects of combined low-dose cyclophosphamide(CTX)and recombined VEGF protein vaccine.Methods In this experiment,H22 hepatocellular carcinoma model was established in BALB/c mice.Mice were randomly divided into four groups: control group,CTX group(CTX),VEGF protein vaccine group(V2)and CTX plus V2 group(CTX+V2).The anti-tumor efficacy and antiangiogenic effect were investigated using a subcutaneous tumor model and an intradermal tumor model.Western blot and ELISAwere further adopted to detect the specific anti-VEGF antibody.Results CTX+V2 group displayed a lower tumor volume and tumor weight than either the single therapy group in the subcutaneous tumor model(P<005 vs V2,P<001 vs CTX).Meanwhile,CTX+V2 was more effective for antagonizing tumor-associated angiogenesis compared with either the single therapy(P<005 vs V2,P<001 vs CTX).After CTX+V2 immunization,high titer of anti-VEGF antibody was detected by ELISA and verified by Western blot.Conclusion The therapy of CTX combined with V2 has significant synergistic effect against H22 hepatocellular carcinoma.

[Objective] This prospective study was conducted to assess the influence of overnight orthokeratology (OK) on low,middle and high myopia in southern Chinese teenagers.[Methods] Fifty-four subjects (107 eyes,age 11.65 ± 2.44 years,mean±SD)who matched the inclusion criteria for OK were enrolled in the study.The subjects were divided into three groups according to the different refraction baseline (low myopia group:0.75 ～ 3.00 D,51 eyes;middle myopia group:3.25 ～ 5.00 D,36 eyes;high myopia group:5.25 ～ 9.00 D,20 eyes).Refraction,central corneal thickness,corneal keratometry,anterior chamber depth and axial length (AL) were measured at baseline and after 1 years using ocular biometry.The changes were evaluated and compared among the groups.Results were analyzed by SPSS 17.0 software.[Results] Fifty-four subjects (total 107 eyes) completed the 1-year follow-up examinations.At baseline,the spherical equivalent refractive error (SER) was-2.15 D ± 0.63 D,-4.20 D ± 0.54 D,and-6.63 D ±1.18 D in three groups.The axial length was (24.50-± 0.66) mm,(25.16-± 0.65) mm,and (26.35 ± 0.87) mm in the three groups,respectively.There were no significant differences among the groups in initial central corneal thickness,anterior chamber depth,central,flat and steep kerotometry.The increase in axial length during the 1-year study period was (0.22 ± 0.27) mm,(0.09-± 0.22)mm and (0.02-± 0.22) mm in three groups,respectively,and the difference was significant between low myopia group and middle myopia group (P =0.04),low myopia group and high myopia group (P =0.008),whereas no significant difference was found between middle myopia group and high myopia group (P =0.35).Spherical equivalence decreased dramatically in three groups after one year (all P ＜ 0.0001).And the difference was significant between low myopia group and middle myopia group (P ＜ 0.0001),low myopia group and high myopia group (P ＜ 0.0001).Central,flat and steep kerotometry after one year became flatten in all group (all P ＜0.0001).There were no significant differences in the change of central corneal thickness,anterior chamber depth and corneal diameter.[Conclusions] OK lens is more effective in middle and high myopia control than in the low myopia control.The change in corneal keratometry may be one of the main factors influencing the OK treatment effect.

Objective:To study the physical activity level and its influence factors among residents in one suburb of Beijing,so as to provide specific interventions for different people in different circum-stances and to provide reference for health relevant policy-making in the future.Methods:In the study, 7 31 9 subjects aged 1 8 years or above were involved.The self-designed questionnaires based on Health Belief Model (HBM)had acceptable validity and reliability.The physical activity levels were calculated to classify sufficient or insufficient amount by a thousand-step equivalent greater than or equal to 6 or 1 0. Multiple variable Logistic regression was used to explore the influence factors of the physical activity among the residents.Results:The residents’median amount of physical activity in the suburb district of Beijing were 9.1 thousand-step equivalent with quartile of (3.8,20.4).The percentages of the thou-sand-step equivalent greater than or equal to 6 or 1 0 were 63.7% and 47.7%,respectively.The median amounts of physical activity from work or household chores,transportation and recreation physical activi-ties were 4.0,1 .0,0.0 and the components of the total amount of physical activity from those were 61 .7%,1 8.3% and 20.1 %,respectively.There were 8.6% residents whose life did notinvolve moder-ate or vigorous intensity activities.By using factor analysis,five factors were extracted from the scale based on the HBM;These factors together contributed to 63.7% of the sum of the squared loadings.The differences of physical activity levels on education level,age,gender,self-efficacy,cues,subjective and objective barriers were statistically significant (P <0.05).Those who were female,with older age,lower education level,higher self-efficacy,fewer cues,fewer subjective and objective barriers preferred to do more physical activities.Conclusion:The physical activity levels among the residents in the suburb dis-trict of Beijing are moderate and high,and most amount of physical activities from work or household chores.Those who are male and whose ages are from 1 8 to 29 years and whose education levels are of university or above should be focused on intervention.Specific interventions should be developed for dif-ferent people in different situations;More attention should be paid to improve the residents’self-efficacy and reduce the subjective and objective barriers of physical activity,and we also should actively advocate people to have more leisure exercise so as to improve the physical activity level among all residents.

Objective To investigate the clinical value of ultrasound examination of carpal canal structure in patients with mild hand-arm vibration disease.Methods A total of 29 patients (58 wrists) with mild hand-arm vibration disease who were treated in Shenzhen Prevention and Treatment Center for Occupational Diseases from May to December,2015 were enrolled as observation group,and 20 healthy volunteers (40 wrists) were enrolled as the control group.Color Doppler ultrasound was used to observe the morphology and echo of the median nerve in the carpal canal and 9 muscle tendons and transverse carpal ligament.The thickness of transverse carpal ligament and diameter of the median nerve at the level of the hamulus of hamate bone were measured,as well as the cross-sectional area of the median nerve at the level of pisiform bone.Results In the 29 patients with hand-arm vibration disease patients in the observation group,8 experienced entrapment of the median nerve in the carpal canal,among whom 5 had entrapment in both wrists;there were 13 wrists (23％) with nerve entrapment and 45 wrists (77％) without nerve entrapment.Compared with the control group,the patients with hand-arm vibration disease and nerve entrapment in the observation group showed significant thickening of the transverse carpal ligament at the level of the hamulus of hamate bone and a significant increase in the crosssectional area of the median nerve at the level of pisiform bone (P＜0.05),while there were no significant differences in the thickness of transverse carpal ligament at the level of the hamulus of hamate bone and the crosssectional area of the median nerve at the level of pisiform bone (t=-9.397 and-4.385,both P＞0.05).Conclusion Ultrasound examination can clearly show the radiological changes of carpal canal contents in patients with mild hand-arm vibration disease and has a certain diagnostic value in nerve damage in patients with hand-arm vibration disease.

Objective To investigate the clinical value of ultrasound examination of carpal canal structure in patients with mild hand-arm vibration disease.Methods A total of 29 patients (58 wrists) with mild hand-arm vibration disease who were treated in Shenzhen Prevention and Treatment Center for Occupational Diseases from May to December,2015 were enrolled as observation group,and 20 healthy volunteers (40 wrists) were enrolled as the control group.Color Doppler ultrasound was used to observe the morphology and echo of the median nerve in the carpal canal and 9 muscle tendons and transverse carpal ligament.The thickness of transverse carpal ligament and diameter of the median nerve at the level of the hamulus of hamate bone were measured,as well as the cross-sectional area of the median nerve at the level of pisiform bone.Results In the 29 patients with hand-arm vibration disease patients in the observation group,8 experienced entrapment of the median nerve in the carpal canal,among whom 5 had entrapment in both wrists;there were 13 wrists (23％) with nerve entrapment and 45 wrists (77％) without nerve entrapment.Compared with the control group,the patients with hand-arm vibration disease and nerve entrapment in the observation group showed significant thickening of the transverse carpal ligament at the level of the hamulus of hamate bone and a significant increase in the crosssectional area of the median nerve at the level of pisiform bone (P＜0.05),while there were no significant differences in the thickness of transverse carpal ligament at the level of the hamulus of hamate bone and the crosssectional area of the median nerve at the level of pisiform bone (t=-9.397 and-4.385,both P＞0.05).Conclusion Ultrasound examination can clearly show the radiological changes of carpal canal contents in patients with mild hand-arm vibration disease and has a certain diagnostic value in nerve damage in patients with hand-arm vibration disease.

Objective To explore the value of controlled decompression under intracranial pressure monitoring in craniotomy of patients with severe cerebral hemorrhage.Methods One hundred and six patients with severe cerebral hemorrhage,admitted to our hospital from January 2015 to July 2018,were prospectively enrolled.These patients were divided into control group (n=5 l) and treatment group (n=55) according to their families' wishes.The patients in the control group were treated with traditional craniotomy and hematoma removal;the patients in the treatment group were treated with controlled decompression combined with craniotomy and hematoma clearance under intracranial pressure monitoring,and intracranial pressure monitoring and management were carried out after operation.The rate of bone flap acceptance during operation,incidences of complications such as re-bleeding,scalp exudation,intracranial infection and cerebral infarction after operation,rate of re-operation and Glasgow outcome scale scores 6 months after injury were compared and analyzed between the two groups.Results Five patients had midway withdrawal (2 from the control group and 3 from the treatment group),and 101 patients (49 from the control group and 52 from the treatment group) were included in the statistical analysis.The rate of bone flap acceptance in the treatment group (69.2％) was significantly higher than that in the control group (24.5％,P＜0.05).The incidences of complications such as bleeding,scalp exudation,intracranial infection and cerebral infarction (11.5％,7.7％,3.8％,and 13.5％) were significantly lower than those in the control group (30.6％,22.4％,16.3％,and 34.7％,P＜0.05).The re-operation rate (3.8％) was significantly lower than that in the control group (16.3％,P＜0.05).Good recovery rate in the treatment group (76.9％) was significantly higher than that in the control group (55.1％,P＜0.05).The mortality rate (7.7％) was significantly lower than that of the control group (22.4％,P＜0.05).Conclusion For patients with severe cerebral hemorrhage,controlled decompression under intracranial pressure monitoring combined with craniotomy and hematoma removal can significantly improve the rate of bone flap acceptance,reduce the rate of second-stage cranioplasty,reduce the incidence of complications and re-operation rate,and more effectively improve the quality of life and prognosis of patients.