Objective To explore the relationship between preoperative serum pro-adrenomedullin (pro-ADM) in the patients with closed rupture of small intestine,and postoperative secondary abdominal infection,and to study the value of postoperative serum pro-ADM in assessment of severity of postoperative secondary abdominal infection of this patients.Methods Eighty-five patients with closed rupture of small intestine treated in the emergency surgery from June 2014 to May 2015 were selected.According to the presence of postoperative abdominal infection or not,these patients were divided into infection group and non-infection group.The infection group was further divided into SIRS,sepsis,severe sepsis,septic shock subgroups as per the severity of infection.The levels of serum pro-ADM,interleukin-6 (IL-6),C-reactive protein (CRP) were determined and the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was calculated at admission and the first day、the second day and the third day after operation.Comparisons of these biomarkers were carried out to find out the factors associated with postoperative abdominal infection.In addition,ROC curve was used to verify the factors for predicting the abdominal infection of these patients after operation.The relationship between serum levels of pro-ADM and APACHE Ⅱ score after operation was analyzed.The severity of abdominal infection after operation was assessed with laboratory findings.Results Compared with non-infection group,preoperative and postoperative serum pro-ADM (P =0.03,P ＜ 0.01),IL-6 (P =0.02,P ＜0.01) levels and APACHE Ⅱ scores (P ＜ 0.01,P ＜ 0.01) were significantly higher in infection group (P ＜ 0.05).In the infection groups,the postoperative levels of serum pro-ADM and APACHE Ⅱ scores were increased with the severity of infection increased (r =0.924),and the difference between the groups was statistically significant (P ＜ 0.05),but there were no significant differences in IL-6 and CRP levels between two groups.Conclusion (1) The serum levels of pro-ADM before operation has value in predicting the genesis of abdominal infection in these patients after operation.(2) The serum levels of pro-ADM after operation has value in severity assessment of abdominal infection in these patients after operation.

Objective: To research the effects of Zuogui Pill on the gene expression profile of regenerate hepatic tissue in MSG-liver regeneration-rat.Methods: MSG-liver regeneration-rat models were copied;therapy group were given Zuogui Pill(5g/kg) by intragastric administration.Rats were executed at the 5th day after operation,and the regenerate liver tissues were frozen by liquid nitrogen.1176 gene chips of gene expression profile correlated to cell differentiation and multiplication were adopted to observe the changes of gene expression profile in the regenerate liver tissues.Results: There were 292 differential expression genes in therapy group compared with model group(20 genes were up-regulation expressed and 272 genes were down regulation expressed).Conclusion: Zuogui Pill has significant effects on the gene expression profile of regenerate hepatic tissue in MSG-liver regeneration-rat,and most of the genes are down regulation expressed.The result hints that Zuogui Pill could influence the liver regeneration by regulating the gene expressions of MSG-live regeneration-rat.Down regulation of the gene expressions of regenerate hepatic tissue in MSG-liver regeneration-rat possibly is one of the important molecular mechanisms of Zuogui Pill in nourishing liver and kidney.

Since the current worldwide medical education and clinical practice lay a particular stress on training medical students with scientific knowledge and medical technical skills,enormous medical staffs are shaped into medical technical workers who lack medical morality and emotions,leading to the contradiction between medical morality and technologies.Medical personnel should know that medicine not only observes illness closely,but also attaches importance to the patients themselves who are suffering the pain.Medical students should pay attention to the forming process of medical morality and emotion in their preparative stage,accept the exercise to prepare for medical morality,and recalls their love and concern for life.

Objective To explore measures for the reform of the cooperative business operation system of township public health centers and evaluate in a comprehensive way the results of the reform. Methods A study was made by means of typical investigation of the specific measures taken by 16 township public health centers in Xianju County of Zhejiang Province in the reform of the cooperative business operation system and changes in health resources and service efficiency brought about by the reform were analyzed. Results In the reform, mixed type cooperation was adopted, with public ownership dominating; current assets were assigned in the form of stocks, with all the staff having a share; and a distribution system was established, clarifying the proportions of state, collective and personal interests. As a result, the infrastructures of the centers were enhanced, the service capabilities improved, the financial situation bettered, the value of national assets increased, the potentialities of the staff brought into full play, and social benefits maximized. Conclusion The measures taken by the centers in the reform, which were basically sound and resulted in significant first fruits, could be popularized as an effective model for deepening the reform of health care institutions in the rural areas.

Objective To explore the relationship between oxidative stress inducing neuronal apoptosis and the protein expressions of c-Myc, Fas-FasL and nuclear factor ?B (NF-?B) in neurons. Methods The primarily cultured neurons of SD rat in vitro were divided into 5 groups: Group A (control), Group B (treated with hypoxia), Group C (treated with small dose of H 2O 2), Group D (treated with hypoxia and SOD) and Group E (treated with H 2O 2 and SOD). Then, the neuronal apoptosis was elevated with TUNEL,Gel electrophoresis and flow cytometry. The protein expressions of c-Myc, Fas-FasL and NF-?B were detected with immunohistochemistry. Results Apoptosis rates of the Groups B and C were 6 and 8 times than that of the Group A respectively ( P

The development of medical technology draws the doctor-patient relationship ever closer.However,the abundance and complexity of medical knowledge and technology make it a difficult task for medical personnel to grasp medical knowledge and skills,setting up a higher request for handling physician-patient relationship.Besides,medical disputes between doctors and patients caused by the abuse of medical technology in clinical practice also contribute to the contradiction between the advancement of medical technology and the latency of medical morality.Therefore,it is one important part in the study on medical morality from the perspective of medical technology ethics to take a rational view on the development of medical technology and construct a harmonious physician-patient relationship.

Animals ; Cycadopsida ; chemistry ; Down-Regulation ; drug effects ; Female ; Flavones ; isolation & purification ; pharmacology ; Isoproterenol ; Male ; Myocardial Ischemia ; chemically induced ; metabolism ; prevention & control ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; metabolism ; p38 Mitogen-Activated Protein Kinases ; metabolism

AIM: To explored the treatment effects of retinal laser photocoagulation and the applications of color Doppler flow imaging(CDFI) in the diabetic retinopathy.METHODS: We collected 60 patients(120 eyes) with diabetic retinopathy(Ⅲ~Ⅳstage) from February 2013 to February 2014 in Anyang Eye Hospital admitted in fundus disease department.The health control (HC) group of 55 normal people was established simultaneously.Ocular blood flow velocity of the 55 normal people (110 eyes) and the 60 patients (120 eyes) was examined by CDFI of central retinal artery (CRA) and posterior ciliary artery (PCAs) using the PHILIPS HD6.Peak systolic velocity(PSV) was recorded.The examinations of CDFI, electroretinogram(ERG) and the vision were performed in pre-operation, 1,7d, 1, 3 and 6mo postoperatively.RESULTS: Compared the PSV of CRA of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the PSV of CRA of the DR group after photocoagulation with the data before, there was a significant difference(P<0.05).Compared the PSV of PCAs of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the PSV of PCAs of the DR group after photocoagulation with the data before, there was a significant difference at 1d postoperatively(P<0.05), there was no significant difference at 7d, 1, 3 and 6mo(P>0.05).Compared the aA and bA of ERG of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05).Compared the aA and bA of ERG of the DR group after photocoagulation with the data before, there was a significant difference(P<0.05).Compared the aT and bT of ERG of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the aT and bT of ERG of the group DR after photocoagulation with the data before, there was no significant difference(P>0.05).The vision of 49 cases(98 eyes) was improved 1 to 3 rows, the effective rate was 82%.The vision of 11 cases(22 eyes) remained constant.CONCLUSION: Retinal laser photocoagulation is an effective treatment to diabetic retinopathy patients, which can significantly reduce the peak systolic velocity of the central retinal artery, improve and stabilize the condition, protect visual function in long-term clinical effect.Color doppler flow imaging can observe the changes of ocular vessel flow velocity in diabetic` eyes noninvasively, repeatedly and in real time, providing a basis for clinical treatments.

AIM: To study the changes in anterior chamber angle after phacoemulsification and foldable IOL implantation with ultrasound biomicroscopy.METHODS: Small-incision phacoemulsification and foldable IOL implantation were performed in 50 eyes of 46 senior patients, and the changes of anterior chamber angle were determined quantitatively by using ultrasound biomicroscopy before and one month after the surgery.RESULTS: In all patients, the angle was widened significantly one month after the surgery (P＜0.01). The measurements of TIA500 ( trabecular-iris angle at 500μm from the scleral spur) , AOD250 (angle-opening distance at 250μm from the scleral spur) and AOD500 (angle-opening distance at 500μm from the scleral spur) increased significantly after the operation ( P＜ 0.01). The mean post/pre-operative TIA500ratio, AOD250 ratio and AOD500 ratio were 1.65 (1.12-4.91),1.81 (1.06-2.67) and 1.65 (1.01-2.76), respectively. A significant negative correlation existed between preoperative and postoperative data.CONCLUSION: Small-incision cataract surgery deepens the anterior chamber and widens anterior chamber angle significantly in senior patients. The narrower the preoperative angle, the higher ratio of post/preoperative ratio found.

Objective To compar the cerebrospinal fluid (CSF) flow between empty sella syndrome (ESS) and normal volunteer in the cerebral aqueduct with MRI in phase contrast cine mode. Methods Thirty-eight ESS patients (ESS group) and 38 normal volunteers (control group ) were involved in this study.The aqueduct CSF flow image was positioned perpendicularly to the midbrain aqueduct at the middle sagittal T1WI or T2WI image. The waveforms were analyzed for the flow direction, flow rate, flow volume rate and cardiac cycle. Results The CSF flow of the aqueduct in control group and ESS group had two directions which was downward flow during the systolic period and upward flow during the diastolic period of the cardiac cycle. The.systolic period downward peak flow rate, diastolic period upward peak flow rate, mean downward flow rate, mean upward flow rate and mean flow rate were (5.231 ± 0.262), (4.902 ± 0.281 ),(3.083 ± 0.191 ), (3.032 ± 0.151 ), (3.151 ± 0.162) cm/s in control group, and (6.244 ± 0.356), (6.091 ±0.430), (3.916 ± 0.196), (3.812 ± 0.273 ), (3.690 ± 0.291 ) cm/s in ESS group respectively,and there was no significant difference between the two groups ( P ＞ 0.05 ). The systolic period downward peak flow volume rate, diastolic period upward peak flow volume rate, mean downward flow volume rate,mean upward flow volume rate and mean flow volume rate were (0.050 ± 0.003 ), (0.050 ± 0.004), (0.030± 0.002), (0.031 ±0.002), (0.030 ± 0.003 ), ( 0.004 ± 0.001 )ml/s in control group, and (0.058 ± 0.003 ), (0.063 ± 0.005),(0.039 ±0.002), (0.038 ±0.003), (0.038 ±0.003), (0.004 ±0.001) ml/s in ESS group respectively,and there was no significant difference between the two groups(P ＞ 0.05 ). The correspond cardiac cycle of systolic period downward peak flow rate, correspond cardiac cycle of diastolic period upward peak flow rate, mean cardiac cycle were (40.890 ± 37.096), (501.026 ± 19.374), (719.511 ± 14.946) ms in control group,and (35.921 ±6.218), (531.553 ± 16.764), (770.700 ±21.579) ms in ESS group,and there was no significant difference between the two groups (P ＞ 0.05 ). Conclusion Part of CSF flows into the area of saddle in ESS patients, but it has no effect on CSF indexes in area of cerebral aqueduct.