The concept of the health promoting hospital, a modern mode of medical service that has turned from the formerly unitary pattern of medical treatment to the health promoting and life quality improving pattern of medical treatment, prevention and health care, was proposed by modern medical institutions so as to keep up with the change in medical modes and medical socialization. In recent years, many countries in the world have adopted the advanced service ideas of the health promoting hospital and conducted active research on various specific subjects. The paper gives an account of the concept, basic theories, development history, and latest progress both at home and abroad of the health promoting hospital so as to give an impetus to health education and health promotion in China.

OBJECTIVE To evaluate the effectiveness of applying neuronal stem cells to bridging a 10mm long facial nerve defect in rabbits using a tissue engineered artificial nerve. METHODS Thirty-six Japanese white rabbits were randomly divided into three groups of 12. Group A: chitosan guidance channels with collagen protein sponge were filled with neuronal stem cells and NGF; Group B: chitosan guidance channels with collagen protein sponge were filled with NGF; Group C: autograft nerve. A series of examinations were performed, including electrophsiological methods, histological staining of nerve, Brdu and S100 immunohistochemical staining, at 12 weeks after operation. RESULTS At 12 weeks after operation, all examination results from Group A were better than from Group B(P0.05). CONCLUSION Neuronal stem cells can be used as seeding cells in peripheral nerve tissue engineering for repairing 10mm facial nerve defects.

Objective To compare the diagnosis value of three-dimensional power Doppler imaging(3D-PDI)and color Doppler flow imaging(CDFI)on carotid artery stenosis.Methods Forty-nine patients with carotid artery atherosclerosis plaque or stenosis diagnosed by CDFl were enrolled in the study.The degree and ratio of carotid artery stenosis were measured by 3D-PDI in free-hand mode,and measured by DSA in one week,the results were compared with CDFI.Results 3D-PDI of normal carotid artery with atheromatous plaque showed the stereo image,quantity character and exact position of plaque,volume of vessel lumen and spatial distribution of blood flow directly.There was no statistical difference in diameter stenosis rate between 3D-PDI and CDFI[(52.0±0.9)% vs(51.7±0.8)%,P＞0.05],and the area stenosis rate measured by CDFI was significantly lower than that by 3D-PDI[(58.0±0.2)% vs(52.0±0.5)%,P＜0.01].In the diagnosis of stenosis classification,the rates of light,mild and severe stenosis were significantly different between CDFI and 3D-PDI(P＜0.05)and not significantly between 3D-PDI and DSA methods(X2=0.0538,P＞0.05).The detection rates of atherosclerotic plaques numbers in carotid crotch were significantly different between 313-PDI and CDFI(P＜0.05).Conclusions 3D-PDI can offer more valuable information for the diagnosis and trentment of carotid artery stenosis,it is more accurate than CDFI and similar to DSA.

Objective To evaluate the correlation between hyperlipidemia and lower limb arterial disease in eldedy diabetic patients with color Doppler uhrasonography.Methods Two hundred and sixty elderly diabetic patients and 206 normal subjects were enrolled in the study.Doppler uhrasonographic manifestations of lower limb arterial disease,blood pressure and blood biochemistry parameters including fasting plasma glucose(FPG),postprandial plasma glucose(PPG),TC,TG,HLD-C,LDL-C,apoprotein B (apoB),very low density lipoprotein cholesterol(VLDL-C),apoprotein Al(apoA1)and fibrinogen(Fb)were compared between the 2 groups.Results (1)The blood biochemistry parameters,including the levels of FPG,PPG,TC,TG,VLDL-C,LDL-C,apoB and Fb were higher in diabetic patients t11an in normal subiects.while HDL-C was lower(all P＜0.05).(2)The thickness of intima-media(IMT)in the lower limb arterial disease group was significantly increased and the presence of arterial stenosis and wall plaques more in diabetic patients[IMT in 205 cases(78.85%),atherosclerotic plaque in 241 cases(92.69%),muhivessel disease(more than 2 vessels)in 60 cases(23.08%)and arterial stenosis in 89 cases (34.23%)]than in normal subjects[IMT in 37 cases(17.96%),atherosclerotic plaque in 51 cases (24.76%),muhivessel disease in 27 cases(13.11%)and arterial stenosis in 3 cases(0.01%)],all P＜0.01.(3)Regression analysis showed that lower limb arterial disease was correlated with high level of LDLC and low level of HDL-C.Conclusions Arteriosclerotic plaque is one of the early manifestations in elderly diabetic patients and hyperlipidemia may provide the basis of its formation.Doppler uhrasonographic examination of lower limbarterial discloses the early arteriosclerotic changes of lower limb arterial disease in elderly patients and offers the basic data of indication for clinical treatment.

Objective To evaluate the color Doppler flow imaging (CDFI) findings in predicting possible difficulties of laparoscopic cholecystectomy (LC). Methods A total of 99 patients with acute cholecystitis received CDFI examination, and were divided into easy LC group (n=67) and difficult LC group (n=32) according to the indexes including the volume of gallbladder, the thickness of gallbladder wall, the condition of arterial flow in the gallbladder wall, the condition of gallbladder cavity and fossa, and of the intra-and extra-hepatic bile duct. After LC, all the patients were redivided into easy LC group and difficult LC group according to a difficulty scoring system of LC. The relationship among imaging results, operation difficulties and operation findings was investigated. Results According to the final score of difficulty scoring system of LC, the number of patients in easy LC group and difficult group was 61 and 38, respectively. Compared with easy LC group, patients in difficult LC group had bigger gallbladder volume [(39.5±13.2)am3 vs(32.6±10.4)cm3], thicker gallbladder wall [(10.1±4.0)mm vs(3.8±0.9)mm], more stone incarceration in the neck of gallbladder, abundant color blood flow signal of the gallbladder wall and more severe adhesion of gallbladder to the adjacent tissues, with statistical difference between the 2 groups (t=-2.820,-12.318,-3.952,x2=33.548,19.461,P<0.05). Using gallbladder volume, the thickness of gallbladder wall, infarction of stones in the neck of gallbladder and adhesion of gallbladder to the adjacent tissues as prediction indexes, the accuracy of CDFI in predicting the possible difficulties of LC was 94% (93/99). Conclusion Preoperative CDFI is helpful in predicting difficulties of LC for acute cholecystitis.

Objective To evaluate the value of color Doppler flow imaging (CDFI) in the diagnosis of elderly femoral arterial pseudo aneurysm and treating with ultrasound-guided compression after percutaneous transluminal coronary angioplasty (PTCA). Methods Twenty-six elderly patients who were found a mass and/or vascular murmur in the puncture region were examined by CDFI, and the results of CDFI were proven by clinic and MRI. All pseudo aneurysms were repaired by CDFI guidance to compress simply and/or injecting directly batroxobin into the pseudo aneurysm lumen combined with compression.Results Pseudo aneurysms were diagnosed definitely by CDFI in 26 cases,and the accuracy rate was 100%. Twenty-two cases were repaired with CDFI guidance to compress simply and percutaneously injection of batroxobin into the pseudo aneurysm lumen combined with compression occurred in 3 cases. One case was cured by surgery after failing to be repaired with CDFI guidance. Conclusions CDFI has an important diagnosis value of pseudo aneurysm after PTCA. The method of CDFI guidance compression and batroxobin injection for repairing pseudo aneurysm is simple, safe and effective.

Objective To evaluate the values of clinical application of color Doppler ultrasound in the diagnosis and treatment of iatrogenic femoral artery pseudoaneurysm (IFAP) in the elderly following percutaneous transluminal coronary angioplasty(PTCA). Methods A tota.of 35 patients aged(73.8±1.3) years with IFAP after PTCA were examined by color Doppler ultrasound.All cases were treated by compression simply for blocking blood flow with probe guided by ultrasound,and the failed cases were injected Reptilase into the lumen of pesudoaneurysm. Results 35 patients were diagnosed as IFAP by color Doppler ultrasound and the coincidence rate with clinical diagnosis was 100％ (35/35).Among all patients,31 cases were cured by simply compression guided by ultrasound and 3 cases were cured hy the injected reptilase into lumen,the cure rate was 97.15％(34/35).One cases was cured by surgery after failure to treat by the two above methods.34 cases (97.2％)were verified into occlusio by ultrasound after 24-48 h of treatment. Recurrence and other serious complications were not found during follow-up of 3-6 months. Conclusions Color Doppler ultrasound can be used for the preferred method in accurate diagnosis and effective cure of IFAP following PTCA in the elderly.

AIM:To investigate ischemia reperfusion (I/R)-induced proteomic changes in rat skeletal muscle. METHODS: Healthy male Wistar rats were randomly divided into two groups as follows (n=6): sham group and I/R group. I/R of right hind limb was induced by 4 h ischemia followed by 24 h reperfusion. The 2-DE was applied to separate the proteins extracted from skeletal muscle tissue at the end of experiment, followed by Coomassie Brillant blue R-250 staining. Computer image analysis was used to determine the differential expression of proteins between the two groups, and 7 protein spots expressed differentially were picked out and subjected to in-gel digest and MALDI-TOP for identification. RESULTS: 354?13 proteins were detected and the match rate was (78.7?1.4)%. 10 proteins displayed significant changes after I/R, of which, 6 proteins increased and 3 proteins decreased in expression. Moreover, 2 spots in I/R group were observed, only 1 spots of which in control. 5 proteins were identified after mass spectrometry. Mitochondrial aldehyde dehydrogenase (ALDH) precursor, heat shock 27 kD protein (HSP27), an unnamed protein product (increased in I/R group), ?-actin (decreased in I/R group), and nuclear transport factor 2 (NTF-2) W7a mutant were found in I/R group. CONCLUSION: I/R injury induced differential proteomic changes in rat skeletal muscle. ALDH, ?-actin and HSP27 expression, and NTF-2 mutation are involved in I/R injury.

Objective To observe the clinical efficacy ofXing Nao Kai Qiao (brain-awakening and orifice-opening) needling plus thunder-fire moxibustion in treating vertebrobasilar ischemia.Method Fifty-five patients with vertebrobasilar ischemia were randomized into a treatment group of 26 cases and a control group of 29 cases. The treatment group was intervened byXing Nao Kai Qiao needling plus thunder-fire moxibustion, while the control group was by oral administration ofYangxue Qingnao granules. The blood flow of vertebrobasilar arteries were observed by using ultrasonic Doppler blood-flow detector before and after intervention, and the clinical efficacies were compared between the two groups.Result The recovery and markedly-effective rate and total effective rate were respectively 61.5% and 96.2% in the treatment group, versus 34.5% and 89.7% in the control group, and the differences were statistically significant (P<0.01,P<0.05). The VS and VD of vertebral arteries and VS of basilar arteries were significantly changed after intervention in the treatment group (P<0.05). The VS of basilar arteries was significantly changed after intervention in the control group (P<0.05). After treatment, The VS of vertebral and basilar arteries in the treatment group was significantly different from that in the control group (P<0.05).ConclusionXing Nao Kai Qiao needling plus thunder-fire moxibustion is an effective approach in treating vertebrobasilar ischemia.

In order to improve bilingual teaching in clinical epidemiology,a multidimensional teaching mode with flexible method was constructed.And it was proposed that based on the student-centered learning,the content of teaching should be adjusted,English should be used logically and clinical courses and practice should be closely connected.The new teaching method was proved successful.