Objective To compare microsurgery through small skull window hematoma puncture and external drainage in the treatment and clinical effect of basal ganglia hemorrhage.Methods 92 cases of hypertensive basal ganglia hemorrhage were randomly divided into the two groups,46 cases in each group,A group was used microsurgery through small skull window hematoma,group B by puncture drainage.Operation time,complications and serum S100 protein of two groups were compared.Results Two groups were successfully completed operation,operation time, amount of bleeding,the time of hospitalization in A group were (125.3 ±29.1)min,(84.3 ±11.4)mL,(14.2 ± 2.7)d,B group were (70.5 ±5.4)min,(39.6 ±9.6)mL,(8.1 ±1.9)d,A group were significantly higher than that of group B (t =3.724,8.162.2.996,P <0.05,P <0.01 ).A,B two groups had respectively 11 cases,3 cases of respiratory tract infection,A group was significantly higher than that of group B (χ2 =9.12,P <0.05 ).0 case, 3 cases occurred in rebleeding in group A and B,respectively,0 cases,2 cases occurred cerebral hernia in group A and B,respectively,rebleeding,cerebral hernia in group B was significantly higher than that in group A (χ2 =4.76, 4.18,all P <0.05).1 patient because of recurrent cerebral hemorrhage was dead after operation in group B,group A after operation in patients with good treatment in three months according to ADL classification rate was 93.5%,B group after operation in patients with good treatment in three months according to ADL classification rate was 82.6%, the difference was statistically significant (χ2 =5.06,P <0.05).After 1D,7d,14d in serum of S100 beta protein in group A were (3.17 ±0.62)μg/L,(1.52 ±0.41)μg/L,(1.26 ±0.33)μg/L;group B beta protein of serum S100 were (2.38 ±0.52)μg/L,(2.09 ±0.53)μg/L,(1.31 ±0.34)μg/L.1d beta protein of serum S100 in group A was significantly higher than group B (t =2.812,P <0.05);postoperative serum 7d S100 beta protein in group A was lower than that in group B (t =2.620,P <0.05);there was no significant difference between two groups of 14d serum S100 beta protein differences between postoperative (t =1.082,P >0.05).Conclusion Small window craniotomy and puncture drainage micro hematoma surgery treatment of cerebral hemorrhage in basal ganglia and each has advan-tages and disadvantages,we should adopt different treatments according to the patient's condition.

Objective To investigate the clinical effect of vertical incision for breast surgery.Methods According to Lejour method,the first breast shape on the patients who needed operation was designed,and make a mark line corresponding to the breast,and then removal of excess tissue during the operation,operation process should pay attention to the protection of important part of breast of vessels and nerves,to prevent the impact of breast lactation function.Results The operation in 48 patients with breast because of too much too small in patients with 2 cases,1 cases of patients areola was too large,the patients were followed up survey,all the patients were satisfied with the operation of the breast shape,1 cases of operation the scar not satisfied,then the operation scar resection of operation after further results were satisfied,the total satisfaction rate was 98%.Conclusion Breast reconstruction process using vertical incision method for patients with relatively small,less bleeding,almost did not affect the normal function of patients with breast,breast shape is preferred for patients with operation scheme.

With the example analysis method, this paper discussed the feasibility of flipped class to permeate the medical ethics education into medical English teaching. Practice has proved that consciously combining lan-guage teaching with the medical ethics education on various modern networks teaching platform enabled students to foster a correct view of medical ethics and to be qualified medical workers.

Objective To assess global and regional cardiac twist function in hypertrophic cardiomyopathy(HCM) patients by velocity vector imaging(VVl).Methods Thirty HCM patients and 33 normal subjects were enrolled into this study.Two dimensional echocardiographic images of parasternal left ventricular basal level,middle and apical level short axis plane,apical four-and two-chamber plane were obtained.Maximal rotation degree,peak rotation rate,circumferential strain (CS) and strain rate (CSR),radial strain(RS) and strain rate(RSR) in systole were measured using VVI offline software.In addition,diastolic peak un-rotation rate,untwisting rate(unTwR) were measured.Each parameters was analyzed both in subendocardial and subepicardial layer.Results There was no significant difference in left ventricular ejection fraction between two groups.EDV,ESV,SV were significantly decreased (P＜0.01) in HCM group.Left ventricular twist(LVtw),CS of subendocardial layer were higher in HCM group than control group(P＜0.05),while the peak rotation rate,un-rotation rate,CS,CSR were lower of subepicardial layer (P＜0.05).The RSR of each short axis level were significantly decreased in HCM group (P＜0.01).The diastolic unTwR was decreased in HCM group (P＜0.05).For further analysis of the two subgroups in HCM,more regional torsion deterioration occurred in patients with left ventricular outflow tract obstruction than those without obstruction.Conclusions The global cardiac twist angle of HCM was higher than normal person,but the circumferential deformation ability of regional myocardium was impaired,left ventricular outflow tract obstruction may aggravate the regional myocardial dysfunction.

Objective To discuss the surgical techniques and efficacy of a new method of breast treatment of hypermastia. Methods From January 2009 to February 2011, a series of 15 patients underwent a new technique for reduction mammaplasty. This technique involved a superomedial pedicle nipple-areolar complex (NAC). Results In our series, the resection weight per breast was (522. 9±218.3) g and the new nipple-to-sternal-notch distance was (21.7± 1.74) cm postoperatively. Mean nipple elevation was 8. 5cm (range, 4-16 cm). There were no hematoma and partial or complete NAC necroses occurred in our series. Minimal wound dehiscence occurred in one case ( 6.7 % ). Thirteen patients were followed up for 6 to 18 months. NAC sensibilities were comparable before and after operation, and good breast shapes were produced in all cases. Conclusion The superomedial pedicle technique provides good results with respect to NAC viability and sensibility, breast contour and last superomedial fullness.

OBJECTIVE:To provide reference for rational use of cancer pain narcotic drugs in our hospital. METHODS:The amount of narcotic drugs in our hospital was analyzed statistically during second quarter of 2012 to second quarter of 2015. RE-SULTS:12 specifications and 4 dosage forms of narcotic drugs were involved in our hospital during second quarter of 2012 to sec-ond quarter of 2015. Total amount of narcotic drugs was in an increasing tendency. Oxycodone hydrochloride sustained-release tablet was the largest quantity of narcotic drug used and grew fastest. The amount of surgical drugs kept stable,while total amount of oral preparation increased significantly,in particular,a significant increase in Morphine tablets. CONCLUSIONS:The application of narcotic drugs in our hospital is basically reasonable. The preferred oral principle has been implemented,and treatment of cancer pain is more standardized.

Objective:To study the health equity and explore the influencing factors of health inequities among those insured in New Rural Cooperative Medical System and to provide theoretical and factual basis for improvement of medical insurance system through .Method:Using concentration index decomposition to explore the sources of inequity in health outcomes and the degree of horizontal inequity in health outcomes .Results:Economical level leads that the concentration indexes of two week prevalence favor the poor , i.e.the worse the health outcome of the rich is.Economical level leads that the concentration indexes of chronic disease prevalence and self -reported health defective rate favor the rich , i.e.the worse the health outcome of the poor is .Conclusion:Economic level is the primary factors affecting two weeks prevalence , age, culture level, the employment situation is the factors al-leviate health outcomes unfair .Increase people′s economic level and cultural level , improve the situation of em-ployment is important to the health equity .

Objective To investigate the clinical value of combined detection of H‐FABP with cTnI in the diagnosis of myo‐cardial damage caused by hypoglycemia .Methods Levels of blood H‐FABP and cTnI were examined at 0 to 3 h ,24 h ,48 h after hy‐poglycemia diagnosed ,and were compared with the control group .The levels of H‐FABP and cTnI at 24 h after hypoglycemia diag‐nosed were compared among different groups separated according to the decreasing extent of blood sugar (1 .0 to 2 .1 mmol/L ,<1 .0 mmol/L group) ,the duration of hypoglycemia (< 24 h ,≥ 24 h group) and clinical feature of hypoglycemia (symptom and no symptom group) .The sensitivity and specificity of H‐FABP and cTnI in myocardial damage was also statistical analyzed in this study . Results The statistic difference of the increasing H‐FABP levels was found for 0 to 3 h(P<0 .01) and 24 h (P<0 .01) ,but not found for 48 h(P>0 .05) .The statistic difference of the increasing cTnI levels existed for 24 h (P<0 .01) and 48 h (P<0 .01) ,but not for 0 to 3 h (P>0 .05) .The increasing extent of H‐FABP and cTnI levels was obvious for group with blood sugar <1 .0 mmol/L ,duration of hypoglycemia ≥24 h and have hypoglycemia symptom ,these data have obvious statistic difference compared with other groups(P<0 .05 ,P<0 .01 ,P<0 .01) .The sensitivity and specificity of H‐FABP methods were higher than those of cTnI ac‐cording to the 0 to 3 h and 24 h detection data ,while the opposite result was found for 48 h .Conclusion Combined detection of H‐FABP with cTnI could be well applied in the diagnosis of myocardial damage caused by hypoglycemia .

Objective To evaluate the lung protective effect of sustained inflation(SI)and its mechanism for exogenous acute lung injury(ALI) animal models. Methods Exogenous acute lung injury animal models were replicated using intravenous injection of oleic acid. Immunohistochemis?try and double antibody sandwich ELISA were carried out to detect IL?10 and IL?6 protein levels in lung tissues and serum. Western blot was used to detect the expression level of SP?A in lung tissue and bronchoalveolar lavage fluid(BALF). The expression of ICAM?1 and SP?A mRNA in lung tis?sue was measured by reverse transcription PCR. The apoptosis of lung tissue cells was detected by flow cytometry. Results The maintenance of 20 s lung recruitment method of 35 cmH2O pressure could improve PaO2 and PaO2/FiO2,reduce PaCO2,and improve oxygenation and pulmonary com?pliance. The re?expansion effect of sustained inflation for exogenous acute lung injury was good. The IL?10 and IL?6 levels in lung tissue and serum for SI group were significantly higher than those of the control group(P<0.05). The SP?A expression level of lung tissue and BALF in SI group was significantly reduced compared with the control group(P<0.05). Flow cytometry analysis showed that the apoptosis rate of SI group was significant?ly higher than that of the control group(P<0.05). Conclusion Sustained inflation played an important role in lung protection against exogenous ALI through inhibition of apoptosis,lightening of inflammatory response,reduction of pulmonary edema and SP?A degradation in lung tissue,as well as promotion of SP?A synthesis and secretion in pulmonary alveolus.

Objective To identify the threshold of percentage of body fat (BF％) associated with diabetes mellitus,hypertension and dyslipidemia in an elderly Chinese population.Methods An individual was considered as a subject if they exhibited any one of the three cardiovascular disease risk factors:diabetes mellitus,hypertension or dyslipidemia.A total of 1 140 subjects were recruited from the Physical Examination Center of Tianjin Hospital,China (male 511,female 629,aged ≥60 years).Questionnaire interview,physical examination,body composition measurement,blood biochemistry measurement,muscle strength measurement and other measurements were performed for each subject.Receiver operating curves (ROC) were created to determine the optimal percentage of body fat cutoff points,with the presence of diabetes mellitus,hypertension or dyslipidemia as outcome variable.Results The percentage of subjects with at least one of the following conditions (diabetes mellitus,hypertension or dyslipidemia) was 62.8％ for men and 73.9％ for women.Increased percentage of body fat was associated with an increased occurrence of diabetes mellitus,hypertension or dyslipidemia in the elderly,particularly among women.The ROC curve shows that the threshold of fat percentage in men and women was 28.2％ and 36.6％,respectively.Conclusion The risks of diabetes,hypertension and dyslipidemia is closely related to elevated body fat mass in the elderly.The percentage of body fat mass is an important indicator of obesity,threshold of BF ％ can provide reference for clinical obesity intervention in elderly patients.It also can provide reference for the treatment and prevention of cardiovascular disease.