Objective To probe into a doctor-seeking medical management model for China's urban hypertension patients under medical insurance, and enhance the level and quality of medical insurance management. Methods Hypertension patients were surveyed with a structured questionnaire, and the staff at community health centers and medical insurance management centers received qualitative interview. Results The hypertension patients are found to see doctors mostly at community health centers and tertiary hospitals; complaints among hypertension patients for existing medical insurance vary with their areas, mostly targeting on complicated reimbursement procedure, high threshold of medical insurance payment and low level of reimbursement. Recommendation Experiment with the single-disease payment for hypertension, with the total prepayment in per capita and per disease; greater efforts in hypertension control in communities, with more favorable medical insurance policies for communities;elevated collaboration with medical institutions at all levels, and building and standardizing the management information network for hypertension patients.

Objective To proceed deep data mining in large database obtained by Cancer Genome Anatomy Project and to distinguish the difference expression genes of gastric carcinoma.Methods The 300,783 serial analysis of gene expression records from 4 libraries of gastric cancer and 2 libraries of normal gastric tissue in database of the Cancer Genome Anatomy Project were analyzed by digital gene expression displayer.Results The 201 difference expression tags represented 136 genes(54 up-regulated and 82 down-regulated) and 65 ESTs(24 up-regulated and 41 down-regulated) were distinguished,and these genes were involved in biological process and signal transduction pathways,such as cell cycle regulation,cell proliferation and apoptosis.The gene expression profile in whole body normal and cancer tissues of PTMA were constructed by digital Northern based on serial analysis of gene expression database and by virtual Northern based on cDNA database,respectively.Conclusion The difference expression genes of gastric cancer can be distinguished effectively with bioinformatics,and the results will guide our further molecular biology research.If validated by molecular biology experiment,the difference expression genes will be used as molecular targets of gastric carcinoma.

Objective To study the changes of cytokine activation in patients with chronic congestive haert failure(CHF) as indicated by plasma levels of C-reactive protein(CRP)and its relation to adrenomedullin(ADM) and endthelin-1(ET-1).Methods The plasma levels of CRP,ADM and ET-1 of 60 decompensated haert failure(DHF) patients group and 30 essential hypertension patients with compensated cardiac function(CCF) group were tested. CRP was determined by immunoturbidometry,ET-1 and ADM were determined by radioimmunoassay.Results The plasma levels of ET-1 ,ADM and CRP of decompensated heart failure group were significantly higher than the compensated cardiac function group;In the decompensated heart failure group,the plasma levels of CRP and ADM were elevated according to worsening of heart failure(NYHA classification) ;In the decompensated heart failure group,the plasma levels of CRP were positively correlated with ADM(r=0.57).Conclusion There is extensive activation of cytokines,ADM and ET-1 in patients with chronic congestive heart failure.Cytokine activation might play a role in the synthesis of ADM,thus contribute to the hum oral regulation of heart failure,but may not be re- sponsible for the activation of ET-1.

Objective To explore the effect of low dose of dexamethasone and mannitol on the early swelling of oral and maxillofacial injuries.Methods A total of 100 patients with oral and maxillofacial injuries who were treated in Huanggang City Center Hospital from February 2015 to January 2016 were divided into two groups by means of an envelope randomized group.Group 50 patients, group A patients received low doses of dexamethasone treatment, B group of patients on the basis of increased mannitol for treatment, compared the efficacy of both groups of patients with maxillofacial swelling improved.Results The clinical general improvement probability of group B was significantly higher than that of group A, and the distance between the horizontal direction and the vertical direction of group B was significantly higher than that of group A (P<0.05).Conclusion The combination of low dose dexamethasone and mannitol has a great effect on the early swelling of oral and maxillofacial injury, and it is worthy to be further implemented in the future clinical practice.

The current problems of pharmacology teaching in nursing in 3-year program colleges lie in that the teaching ideas drop behind;course orientation is vague;the development of text books lags;the contents lack characteristics;and there is no clear aims in the practice teaching.So,it is essential to make the teaching evolution.First,according to the post needs,the orientation of the courses should be definite,and new ideas about the curriculum should be set up.Meanwhile,the development of text books should be speeded up and the teaching contents should be optimized.Then,practice teaching needs to be improved,and cultivation of their comprehensive competence should be enhanced.To improve the students’professional qualities,emphasis on the penetration of humanities should be paid attention to.

Carcinoid Tumor ; metabolism ; pathology ; surgery ; Chromogranin A ; metabolism ; Humans ; Male ; Middle Aged ; Orchiectomy ; Teratoma ; metabolism ; pathology ; surgery ; Testicular Neoplasms ; metabolism ; pathology ; surgery

Child ; Fructose ; administration & dosage ; analogs & derivatives ; therapeutic use ; Humans ; Male ; Status Epilepticus ; drug therapy

Objective To investigate the incidence and influence factors of stress ulcer SU) in traffic injury patients. Methods Clinical data of 362 traffic injury patients were studied retrospectively.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score was carried out for all the patients.All the patients had gastroscopy and a comparative analysis was done on the SU patients with or without bleeding and the patients without SU. Results The patients with extensive burn in traffic injury were more susceptible to SU as compared with other trauma patients,with statistical difference ( X2 =7.028,P ＜ 0.05 ).The incidence of SU or hemorrhage was increased with higher APACHE Ⅱ score.The incidence of SU hemorrhage in patients with diabetes or cardiopulmonary disease was significantly higher than that in patients without diabetes or cardiopulmonary disease ( P ＜ O.05 ). Conclusions Traffic injury patients should receive routine gastroscopy.APACHE Ⅱ score has some predictive value for SU or hemorrhage.The incidence of SU hemorrhage is also determined by combined factors of underlying diseases and treatment methods.

Objective To evaluate the risk factors for the postoperative acute renal failure requiring dialysis (ARF-D)after heart valve surgery. Methods Adult patients (age≤18 years) underwent valve surgery with preoperative serum creatinine ＜300 μmol/L were included between January 2005 and December 2008. Fifty patients developed ARF-D within 30 days postoperatively (ARF-D group). While random 220 patients had the same operation without ARF-D served as the control group. Univariate analysis and multivariable logistic regression were used to identify risk factors of ARF-D after valve surgery.Results The incidence of ARF-D was 1.78%, and the early mortality rate was 65.5%. Multivariate analysis identified the following independent risk factors of ARF-D: age, previous cardiac surgery, preoperative serum creatinine, NYHA class Ⅳ,and low cardiac output syndrome. ARF-D group had a longer hospital stay and ICU stay than that of the control group ( P ＜0.001 ). Conclusion Conclusion ARF-D had a higher mortality rate and longer hospital stay following heart valve surgery.Age, previous cardiac surgery, preoperative serum creatinine, NYHA class Ⅳ, and low cardiac output syndrome were the independent risk factors of ARF-D after heart valve surgery.