Objective To observe the symptoms,short and long term effects of body gama-knife in treatment of obstructive jaundice caused by cholangiocarcinoma.Methods 76 patients with obstructive jaundice caused by cholangiocarcinoma were treated with OUR-QGD body gamma-knife.The single therapeutic dose was 3.0-4.0 Gy,isodose curves was 50.0 ％-65.0 ％,the total treatment time was 10-12 times.The liver function,blood routine and adverse effects were monitored.Results Among 76 patients,the jaundice symptoms of 69 cases were significantly reduced,the TBIL and ALT levels were significantly lower than that before treatment (P ＜ 0.05),the ORR was 88.16 ％ (67/76),DCR was 90.79 ％ (69/76).The median TTP was 8.8 months and the median OS was 13.4 months.Conclusions Body gamma-knife treatment for obstructive jaundice caused by cholangiocarcinoma can significantly improve symptoms of patients,and improve their life quality.This treatment has less adverse effects and satisfaction short-time and long-term effects.

Objective: To establish a white noise-induced stress ulcer model in rats and to assess the changes of gastric parietal cell configuration and acid secretion under noise stress. Methods: Rats were randomly divided into 3 groups: NS 4 h,8 h and control groups. The rat NS model was induced by white noise. The pH values of gastric juice were measured by the pH/mV pH meter and the gastric ulcer index (UI) was evaluated. The stomach tissue was processed for immunofluorescence detection and the β subunit of H+, K+-ATPase was immunostained. The gastric parietal cell configuration was observed with conventional microscopy and confocal laser scanning microscope. Results: (1)The pH value of NS 4 h group (2.22±0.05) was significantly lower than that of control group (2.59±0.21, P<0.05), but higher than that of NS 8 h group (1.31±0.06, P<0.01). (2) The UI of NS 4 h group (10.5±1.29) was significantly higher than that of the control group (P<0.05), but significantly lower than that of NS 8 h group (34.36 ± 2.22, P < 0.01). (3) The reticular pattern parietal cells in NS 4 h group (55.5±3.42)/100 was significantly higher than that in control group (42.5±3.70/100, P<0.01), but lower than that in NS 8 h groups (62.0±3.46/100, P<0.05). (4) The pH was negatively related with both UI (r=-0.85, P<0.05) and the number of reticular parietal cells (r=-0.89, P<0.05). Conclusion: A white noise-induced stress ulcer model has been successfully established in rats. NS rats develop gastric mucosal lesions with increased acid secretion, which is closely related with the oxyntic function of parietal cells.

3D printing technology has become the focus of the study on rapid proyotyping technology in recent years. This paper introduced the principle, material and equipments of 3D printing, as well as the foot orthosis. This paper also summarized the application of 3D printing in custom-made foot orthosis, and the differences between 3D printing and traditional technology from the aspect of structure design, material, and clinical application, etc., and discussed the problems and future development of 3D printing.

Humans ; Sleep Initiation and Maintenance Disorders ; classification ; diagnosis ; therapy

Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Methylprednisolone ; therapeutic use ; Mucocutaneous Lymph Node Syndrome ; diagnosis ; drug therapy ; gamma-Globulins ; therapeutic use

Objective To evaluate the role of intercellular gap junction in lung injury induced by hemorrhagic shock and resuscitation in rabbits. Methods Twenty-four healthy rabbits of both sexes weighing 1.5-2.2 kg were used in this study. The animals were anesthetized with iv 3% pentobarbital 30 mg/kg,tracheostomized and mechanically ventilated. Femoral artery was cannulated for MAP monitoring, blood-letting.Right external jugular vein was cannulated for fluid infusion. Hemorrhagic shock was induced according to the method described by Wiggers. MAP was maintained at 35-40 mm Hg for 60 min. The animals were then randomly divided into 2 groups (n = 12 each):traditional treatment group (group A) and octanol group (group B). Both groups received rapid iv infusion of lactated Ringer's solution (LR solution) 1.5 ml·kg-1 ·min-1 for 30 min (T3 ).In group B 99.5% octanol (a specific gap junction inhibitor) 5 mmol/kg was injected intraperitoneally (IP) in addition to iv LR solution infusion. Thirty minutes later the animals were resuscitated with infusion of the blood withdrawn and LR solution (the volume was equal to the volume of blood loss). Then LR solution was infused iv at 2.5 ml· kg-1 · h-1 for 150 min ( T4 ). Left ventricular systolic pressure (LVSP) and HR were recorded before blood letting (T1), immediately after successful establishment of the model (T2), and at T3 and T4. The mortality during resuscitation was calculated. The animals were killed at T4. Blood samples were taken from femoral artery for determination of the serum protein concentration. The lungs were removed. The left lower lobe was lavnged. The protein concentration in broncho-alveolar lavage fluid (BALF) was measured. Lung permeability index (LPI) was calculated (LPI = protein concentration in BALF protein concentration in serum). Na+-K+-ATPase and Ca2+-ATPase activities and W/D lung weight ratio were determined and microscopic examination was performed. Results HR was significantly lower at T3 and T4 and LVSP higher at T4 in group B than in group A. The pulmonary permeability index, W/D lung weight ratio and mortality were significantly lower and the activities of Ns+-K+-ATPase and Ca2+ -ATPase were significantly higher in group B than in group A. The lung tissue danage was significantly ameliorated in group B. Conclusion Intercellular gap junction is involved in the development of lung injury induced by hemorrhagic shock and resuscitation in rabbits.

Objective To analyze the effect of different medical insurance payments on medical expenses so as to provide some suggestions for Guangdong Provincial Department of Offsite Medical Insurance Administration in its future policy-making.Methods An statistic analysis was conducted of medical expenses among patients who chose different medical insurance payments and their average length of stay.Results Medical expenses and average length of stay were statistically different among patients who chose different payments.Conclusion The medicare reimbursement′s inclusion of prevention and diagnosis should be recommended to establish a flexible referral system, reinforce the payments reform and increase the efficiency of social security funds.

Objective:To calculate the health efficiency of government health expenditures in 1990 , 2000 and 2010 and analyze its determinants. Methods:To calculate the health efficiency of government health expenditures and analyze its determinants by using the DEA-Tobit model. Results:Health efficiency of government health expenditures has been increasing gradually;the same provinces are found to be on the productive frontier, but the provinces off the frontier are different;eastern provinces have a higher efficiency than those in the middle and western regions. Fiscal decentralization has a significant negative impact on health efficiency. Conclusion:The current Chinese fiscal decen-tralization system reform is important to improve the health efficiency of government health expenditures.

Objective To study the correlation between normal level of thyroid hormone and gensini coronary scor-ing system. Methods Coronary heart disease patient who were treated with Cardio-angiography (CAG) (n=231) were divid-ed into 4 groups based on gensini coronary score. All the patients were examined with indexes include total triiodothyronine (TT3), total thyronine(TT4), free thyronine(FT4), free triiodothyronine (FT3), thyroid stimulating hormone (TSH). And correla-tion between thyroid hormone level and gensini coronary scoring system was studied by Spearman correlation analysis and Multiple regression analysis. Results No significant difference was found in the levels of TT3, TT4, FT4, Cholesterol(CHO) and Triglyceride(TG) between the all 4 groups (P>0.05). FT3 and HDL-C decreased with the increase of extent of coronary artery lesions(P<0.01), and AGE and LDL-C raised with the coronary artery lesions extent (P<0.05). Gensini coronary scoring system was linearly negatively correlated with FT3, HDL-C and positively correlated with age and LDL-C. Age, FT3,HDL-C,LDL-C was independently correlated to Gensini score. Conclusion The lower level of FT3 is an indepen-dent risk factor for CHD.