Objective:To explore the influencing factors on patients' health seeking behavior in rural China by employing the theory of planned action.Methods:Data from cross-sectional household-based health survey carried out in 2008 were used in the study.Correlations between outcomes and explanatory variables were studied by Logistic regression.Results:The studying population included 19 389 adult patients over the age of 15.Illness awareness,medical experience and structural restriction factors had strong effect on whether the patients chose medical service.Pepople in different socioeconomical status suffered different influences.Conclusion:Responding to the changing trend of health service demand among rural residents,we should recognize the differentiation and allocate the healthcare resources more rationally.

Xanthogranulomatous cholecystitis (XGC) is benign and chronic, which is rarely seen in clinical practice.The clinical and imaging presentation of XGC is similar to that of chronic cholecystitis, cholecystolithiasis and gallbladder cancer.Summarizing the computed tomography (CT) presentations of XGC is helpful in improving the diagnostic accuracy. According to the result of a retrospective analysis based on the clinical data of 17 patients with XGC, we concluded that rim enhancement sign and hypodense band sign in the arterial phase of contrast enhanced CT, and clear in interface between liver and gallbladder and trimness of internal wall in gallbladder are the CT characteristics of XGC.

This study was aimed to evaluate efficacy of acupuncture combined with western medicine in treatment of Alzheimer's disease (AD) with meta-analysis of data came from randomized controlled trials (RCTs). Databases both at home and abroad were comprehensively searched to collect efficacy data of acupuncture combined with western medicine versus western medicine in RCTs. The data was extracted from each study to conduct a meta-analysis with RevMan 5.2. The results showed that 10 studies measured up to standard. Seven studies reported effective cases were carried out by meta-analysis. The total RR was 1.25 [1.14, 1.38]. The funnel plot was approximately symmetry. It was suggested that effect of the therapy group was better than the control group (Z = 4.66,P<0.01). Four studies reported mini-mental state examination (MMSE) scores were carried out by meta-analysis. The total MD was 2.87 [0.64, 5.10]. The funnel plot was approximately symmetry. It was suggested that the therapy group was better than the control group on AD treatment in cognitive function improvement (Z = 2.52,P= 0.01). It was concluded that from current study, acupuncture combined with western medicine in AD treatment was definitely effective. However, it still required further study.

As a potent collagenase activator,ocriplasmin is a recombinant truncated form of serine protease that retains the protease activity of plasmin.Pre-clinical animal experiments,clinical trials and recent clinical studies all indicated a promising outcome of intravitreal injection of ocriplasmin to treat vitreomacular interface diseases,including vitreomacular adhesion (VMA),vitreomacular traction (VMT) and full-thickness macular hole.Ocriplasmin was approved by the Food and Drug Administration of USA in the management of symptomatic VMA,and by the European Medicines Agency in treating VMT-associated macular hole with less than or equal 400 pm.Further randomized controlled clinical trials are needed for further comprehensive observation and evaluation on its efficiency,safety and other noteworthy issues.

Serum adiponectin concentration in diabetic nephropathy (DN) group was significantly higher than that of simple diabetes mellitus (SDM) group.In clinical diabetic nephropathy group with massive albuminuria it was remarkably higher than those of normal control,SDM,and early DN.Furthermore,serum adiponectin concentration was positively correlated with urinary albumin excretion rate and negatively correlated with waist hip ratio.Why it is markedly increased in patients with overt DN merits further investigation.

Objective To assess the methodological quality of randomized controlled trials (RCTs) of rheumatoid arthritis (RA) treated with preparations of Tripterygium wilfordii to provide a scientific basis for the improvement of clinical trials and systematic review. Methods CBMdisc (1978-2000) and TCMLRS (1984-2000) were searched for RCTs on rheumatoid arthritis treated with preparations of Tripterygium Wilfordii. Jadad scale and the evaluating scale designed by the EBM methodological research group of Guangzhou University of TCM were used to evaluate the methodological quality of the trials. Results Of the 27 randomized trials included in this study, seven described the methods for randomization and only one had randomized concealment. Blindness was used in six of the trials. Twenty-four of the trials were found to be of low methodological quality with Jadad scores below three. Although all of the trials had their diagnostic standards for subject selection, only 37% described the inclusion and (or) exclusion criteria. Information about drug safety was not reported in 21% of the trials. Conclusions In general, the methodological quality of the studies is disappointing. Many shortcomings exist in the methodology of the included literatures, which calls for future attention to the correct use of the principles of randomization, control and blindness in randomized control trials.

Glucocorticoids(GC) play definite and effective roles in the management of chronic pain,but their toxic and side effects also make them controversial agents.This review discusses various aspects of glucocorticoids including their action mechanism,toxic and side effects,different types of pharmaceuticals and ways of administration.It also ventures some suggestions on rational medication of steroids.

12h interval from injury to operation had significantly higher concentration of plasma D-lactate and endotoxin at above metioned 4 time points. Plasma concentration of D-lactate and endotoxin in the last two groups declined to normal range at 72h after operation, while in the first two groups reduced to normal range before leaving hospital. Conclusion Acute intraperitoneal hemorrhage could damage gut barrier function, and injury degree was related with interval from injury to operation and blood loss amount.

Objective: To explore the effects of early higher protein nutrition support and growth hormone in patients with severe craniocerebral injury. Methods: 60 patients with severe craniocerebral injury were randomized into observation group and control group.The observation group (30 cases) had received on higher protein nutrition support [2-2.5 g/(kg?d)] and growth hormone for one week. The control group(30 cases) had received lower [1.2-1.5 g/(kg?d) protein nutrition support] for one week. The levels of protein index were determined. The clinical effect and complication were compared between the two groups. Results: The serum prealbumin, albumin, transferrin and hemoglobin in the observation group were significantly higher than those in the control group.The staying time in ICU was significantly shorter and the progrosis was better in the observation group. There were no statistical differences about the index of liver function, renal function and the morbility between the two groups. Conclusion: Early higher protein nutrition support and growth hormone can improve the nutrition status and the prognosis of patients with severe craniocerebral injury.

Objective To explore the role of the Hedgehog singaling in the pathogenesis of esophageal cancer.Methods Tissue samples of normal esophageal mucosa,low-grade dysplasia,high-grade dysplasia and esophageal cancer were collected.Immunohistochemical stain,Western-blot and RT-PCR were employed to detect theexpression of Hedgehog protein and gene,methylation special PCR was used to detect the methylation status of Hedgehog gene.Results There was no difference in the expression of SHh protein among nornaml esophageal and low-grade dysplasia,high-grade dysplasia and esophageal cancer(LGD vs.N:t=1.96,P=0.67;HGD vs.EC:t=1.59,P=0.53).However,the expression of SHh protein in high-grade dysplasia and esophageal cancer was higher than that in normal esophageal mucosa and low-grade dysplasia(HGD vs.N:t=0.593,P=0.004;HGD vs.LGD:t=1.308,P=0.325;EC vs.N:t=0.292,P=0.000;EC vs.LGD:t=0.734,P=0.004).The expression of Hedgehog gene in esophageal cancer was higher than that in normal esophageal mucosa,low-grade dysplasia and high-grade dysplasia(EC vs.N:t=0.909,P=0.019,EC vs.LGD:t=0.398,P=0.007;EC vs.HGD:t=0.843,P=0.012).The gene methylation in esophageal cancer was lower than that in normal esophageal mucosa,low-grade dysplasia and high-grade dysplasia(EC vs.N:t=0.0340,P=0.000;EC vs.LGD:t=0.102,P=0.000;EC vs.HGD:t=0.367,P=0.018).Conclusion Hedgehog signaling may play a role in the pathogenesis and development of esophageal cancer,however,demethylation of Hedgehog gene may be one of the mechanism that cause the activity of oncogene in esophageal cancer.