Objective To investigate the dynamic changes of ATP content in rat cerebral cortex after transient ischemia followed by reperfusion and the relationship between the change of energy and the recovery of neural function.Methods The rats were subjected to 10 min of middle cerebral artery occlusion (MCAO). At the time point of 0 h, 1 h, 3 h, 6 h, 12 h, 24 h and 72 h after reperfusion, ATP contents of frontal and parietal cortex were measured by capillary zone electrophoresis.Results At the end of 10 min ischemia, ATP content fell dramatically to less than 20% of the control level. After reperfusion, ATP content recovered gradually. After 1 h, 3 h, 6 h and 12 h of reperfusion, ATP content returned to 70.5%, 65.7%, 84.8% and 86.9% of the control level ( P=0.052, 0.030, 0.332 and 0.491). From 24 h on until 72 h after reperfusion, ATP content decreased again, reaching half of the control level ( P=0.003 and P=0.023). After 10 min ischemia, limb function recovered gradually and completely at last. From 24 h on until 72 h after reperfusion, unwillingness of action and eating was found.Conclusions The recovery of cellular energy system function is delayed even though the reperfusion is in time after transient cerebral ischemia. Furthermore, secondary failure of cellular energy system function occurrs with the reperfusion proceeding. These phenomena are probably responsible for the delayed recovery of neural function after cerebral ischemia in spite of reperfusion.

Objective To evaluate the effects of nucleoside/nucleotide analogue treatment on immunoglobulin and complement in patients with chronic hepatitis B (CHB).MethodsA total of 157 CHB patients were recruited and divided into CHB group,liver cirrhosis (LC) group and severe hepatitis B (SHB) group.There were 50 patients who received oral antiviral treatment (lamivudine 100 mg/d,or entecavir 0.5 mg/d,or telbivudine 600 mg/d).Serum levels of complement 3 and 4 (C3,C4),C-reaction protein (CRP),hemolytic complement (CH50),immunoglobulin G,M,A (IgG,IgM,IgA),hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) were detected by enzyme-linked immunosorbent assay (ELISA) or immunoturbidimetry.Hepatitis B virus (HBV) DNA was quantified by real-time polymerase chain reaction (RT-PCR) before and 1,2,3 and 4 weeks after nucleoside antiviral therapy.Comparison of means was done by t test and Mann-Whitney test.The correlation was analyzed by Pearson correlation coefficient test.ResultsSerum IgA and IgM levels of SHB and LC patients were significantly higher than those of CHB patients (P＜0.01).Levels of C3,C4,CH50 and CRP were significantly different among three groups.Levels of C3,IgM,IgG and HBV DNA in HBeAg positive patients were significantly different from those in HBeAg negative patients.There was a statistically significant difference of IgA,IgM,C3 and CH50 levels between patients with high HBV DNA level and low HBV DNA level in HBeAg-positive patients.While in the HBeAg-negative patients,only the IgA level was significantly different with HBV DNA levels.After anti-viral treatment,immunoglobulin and HBV DNA levels were all decreased in three groups,while the serum complement level was increased compared to baseline,and the differences became significant at week 4 of treatment. HBV DNA level was negatively correlated with C3 (r=-0.78,P=0.021) and HBeAg titer was positively correlated with C3 (r=0.87,P=0.015).ConclusionsThe immunoglobulin,CRP,C3,C4,and C H50 could reflect the inflammatory activity in liver.The changes of C3 level can predict the efficacy of antiviral therapy.

Objective:To analyze the mechanism on integration of health care services at the county and town-ship level from the perspective of stakeholder theory. Methods: The stakeholder interest demand was determined by word frequency analysis of interview data from stakeholders in the three regions of Qianjiang, Huangpi, and Zhen-jiang;the degree of attention and gains and losses of stakeholders towards various demands was investigated from the three regions through interest demand questionnaires;the impact of demand benefits on behavioral responses has been evaluated through comprehensive evaluation theory and game theory. Results:Regional integration policies reflect the interest demands of stakeholders in varying degrees; the higher were the scores of demand benefits in interest de-mands questionnaires, the stronger was the willingness of stakeholders to coordinate integration policies. Conclusion:The policies of integration of health care services in rural China should consider all stakeholder interest demands;the better the interest demands of the stakeholders are satisfied, the stronger their motivation for integration reform will be, which may affect the implementation effects of local integration reforms to some extent.

Objective To evaluate the therapeutic efficacy of intratympanic dexamethasone injections combined with prednisone in patients with idiopathic sudden sensorineural hearing loss. Methods A total of 71 patients diagnosed with sudden hearing loss were treated with intratympanic dexamethasone injections plus prednisone (B group) or prednisone alone (A group). Hearing was evaluated by pure tone audiogram performed before initial treatment and at 4 weeks following the final treatment. Results The total recovery rate after the treatment was 81.8% in the B group and 55.3% in the A group. The diflference between two groups was statistically significant (P < 0.05). Conclusion The present study suggests that sudden sensorineural hearing loss patients treated with intratympanic dexamethasone combined with prednisone have a higher likelihood of hearing recovery than those treated with prednisone alone.

Objective To analyze the curative effect of traditional Chinese medicine(TCM)combined with early enteral nutrition(EN)for treatment of patients with severe acute pancreatitis(SAP). Methods 70 SAP patients were randomly divided into TCM plus EN group(36 cases)and conventional therapy group(34 cases). Both groups received routine treatment. Additionally,TCM+EN group received early EN and TCM decoction treatment〔the ingredients of decoction including radix bupleuri,radix paeoniae alba,radix scutellariae,fructus aurantii immaturus, magnolia bark,raw rhubarb(rhubarb was added at last during cooking the decoction)and natrii sulfas exsiccatus (dissolved in water to be administered)each 10 g,the decoction was concentrated to 150 mL and then administered via a stomach tube to the patient,afterwards the tube was clipped for 2.5-3 hours,twice a day,4-7 days constituting a therapeutic course〕. After treatment,the time for patients' symptoms improvement,the situation of intestinal recovery, the length of stay in hospital,the total medical cost,serum C-reactive protein(CRP),aspartate aminotransferase (AST), lactate dehydrogenase (LDH), amylase (AMY), acute physiology and chronic health evaluationⅡ(APACHEⅡ)score and complications,intensive care unit(ICU)transfer rate and case fatality rate in two groups were observed. Results The time for symptoms improvement of abdominal tenderness(day:1.68±1.01 vs. 3.89±1.07), abdominal distension(day:2.17±1.48 vs. 4.24±3.23),abdominal pain(day:3.12±1.14 vs. 4.94±3.21)and the intestinal recovery of exhaust defecation time(day:3.48±0.92 vs. 5.32±3.30)of SAP patients after treatment in the TCM+EN group were faster significantly than those in the conventional therapy group(all P<0.05). The length of stay in hospital(day:15.50±1.75 vs. 19.35±1.69)and total cost(wan yuan:1.812±0.424 vs. 3.292±1.081) of TCM+EN group were less than those of conventional therapy group(P<0.05 or P<0.01). After treatment,the levels of serum CRP,AST,LDH,AMY,APACHEⅡscore in TCM+EN group and conventional therapy group were all lower than those before treatment,and on day 10,the degree of descent was more prominent in TCM+EN group〔CRP(mg/L):98.972±43.384 vs. 122.392±71.621,AST(U/L):75.952±55.668 vs. 126.391±47.431, LDH (μmol?s-1?L-1):1.48±0.21 vs. 2.61±1.46,AMY(U/L):146.362±58.792 vs. 226.392±37.692,APACHE Ⅱscores:6.978±3.352 vs. 13.652±7.621,P<0.05 or P<0.01〕. There was no death in TCM+EN group,while in the conventional therapy group,there was 1 case dead. ICU transfer rate in TCM+EN group was less than that in the conventional therapy group(2.78% vs. 11.76%),but there was no statistical significant difference between the two groups(χ2=0.99,P>0.05). Among the 70 patients with SAP,the cause of the disease due to gallstone accounted for 55.72%,hyperlipidemia for 37.14%,alcoholic for 4.28%and other 2.86%. Conclusion The use of TCM combined with early EN for treatment of patients with SAP can enhance the curative effect of SAP,reduce the hospitalization time and the total cost of patients,and decrease complications and mortality,that is conducive to the faster recovery of patients.

Objective To evaluate the efficacy and safety of itraconazole injection in treatment of invasive fungal infection in the patients with multiple organ dysfunction syndrome.Methods Invasive fungal infection in 15 patients with multiple organ dysfunction syndrome was treated with 200 mg itraconazole injection,twice a day on the first two days,then once a day,for 8 to 14 days.During the treatment,the symptoms and signs,the results of chemical detection were recorded.Everyday fungus,sputum,stool smear or culture were performed.Results The recovery rate,effective rate,and fungal clearance in this trial with itraconazole injection were 80%(12/15),86.7%(13/15),and 86.7%(13/15) respectively.The side effect was not found.Conclusion Itraconazole injection is an effective and safe drug against invasive fungal infection in patients with multiple organ dysfunction syndrome.

Objective To know the epidemiological characteristics of hand-foot-mouth disease in Yangpu District and provide evidence for specific strategies and measures of hand-foot-mouth disease activity prevention and control. Methods Descriptive analysis of the data from hand-foot-mouth disease epidemic situation in Yangpu District from 2005 to 2008 was made. Results 1 348 cases were reported in the whole Yangpu District from 2005 to 2008, and no severe cases, no death. The average morbidity in Yangpu District was 27.48/100 000. The male to female ratio was 1.46∶1. The infection occurred to infants aged from 1 year to 5 years (85.39%). The incidence of the native population children aged 2 to 3 exceeded 10/100 000. The season peak appeared from May to July (70.18%), and outbreaks used to occur at nurseries and kindergartens. The typical clinical presentations mainly included fever and rash. The rash mainly occurred to hands, feet, mouth, buttocks and so on. Conclusions Incidence varied significantly between different sexes, seasons and ages. It can cause large-scale epidemic in a short period of time, the epidemic was very difficult to control, but the leaders attach importance to take the early warning and monitoring, accuratey deal with emergencies, health education promotion and training of comprehensive measures, the epidemic can be effectively controlled.

Objective To investigate the brain activation map during substraction and multiplication tasks in health adults.Methods 13 volunteers were undergone two tests of substraction and multiplication in the form of block-design.The fMRI data were analyzed by SPM99 software with statistic t-test to generate the activation map.Results In substraction ,the left middle frontal gyre(MFG),inferior frontal gyre(IFG),superior parietal lobule(SPL),inferior parietal lobule(IPL),angular gyre(AG),superior temporal gyre(STG),the right MFG,SPL,IPL , bilateral visual association cortex and cerebellum were activated.In multiplication , the left superior frontal gyre(SFG),MFG,IFG,SPL,AG,the right SPL,precentral gyre(PCG) and bilateral visual association cortex were activated.Conclusion (1)The bilateral prefrontal areas,parietal cortex and occipito-temporal areas are involved in calculation and have the function of working memory ,numerial manipulation and visua-space attention;(2)The cerebellum is involved in cognitive arithmetic.

Objective:To transfect genes using ultrasound targeted microbubble destruction (UTMD) techniques and observe the effects of RNA interference on cervical cancer (HeLa) cell line in silencing survivin gene and inducing apoptosis. Methods: Recombinant expression plasmid of short hairpin RNA (shRNA) targeting survivin gene was constructed. It was co-treated with microbubbles and transfected to cultured HeLa cells followed by exposure to ultrasound (P+UTMD group). Moreover, blank control group (C), plasmid group (P), ultrasound exposure group (US), plasmid and ultrasound exposure group (P+US), plasmid+ Lipofectamine group (P+L) were used as controls, respectively. Transfection efficacy was evaluated by observing the red fluorescence in the cells by fluorescent microscopy and flow cytometry(FCM). Ultrasound intensity and exposure time were optimized. Cell apoptosis was investigated using flow cytometry analysis, Hoechst staining, and DNA ladder method. Expression of survivin mRNA was assessed by RT-PCR. Results: Restrictive enzyme digestion and sequencing analysis verified that the recombinant plasmid was successfully constructed. UTMD significantly increased gene transfection efficacy in cultured HeLa cells (P<0.01). Gene transfer was the most prominent at ultrasound intensity of 1.0 W/cm2 and exposure time of 3 min (P<0.01). RT-PCR showed that the expression of survivin mRNA in P+UTMD group was inhibited by (83.33±2.73)%. The differences were significant compared with any other groups (P<0.01). FCM analysis showed that the apoptosis ratio in P+UTMD group was significantly increased as compared with other groups (P<0.01). Hoechst staining and DNA ladder showed that apparent apoptosis and DNA ladder were detected only in P+UTMD and P+L groups. Conclusions:UTMD effectively enhances the transfection efficacy of expression plasmid. It is a novel and effective non-viral gene transfer system and has promising foreground. UTMD mediates RNA interference silenced survivin gene and induces significant cell apoptosis, which provides a new method for tumor research and gene therapy.

An analysis of the fundamental concepts for public hospital reform further defined public hospitals and other hospitals,business and non-business in nature,public benefits and welfare,as well as public benefits and profit-oriented hospitals.These distinctions can help reformers of public hospitals clarify their concepts,make clear the purpose and direction of the public hospitals reform,so as to speed up the reform with theory support.