Objective: To understand the economic operation status of primary health services institutions from 2007 to 2012 in Hunan. Methods: Collecting relevant data from health statistics yearbook and health financial annual report. Descriptive statistics was used to analyze the data. Results: ⑴The quantity of medical services increased steadily within a narrow range , per capita daily burden of doctors were remarkably increased, bed utilization ratio got a significant growth but still lower than hospital level; ⑵the total revenue rose by year, the growth rate of drug revenue had a descending trend, financial aid revenue was growing strongly with 84% growth rate in 2010 and 72%in 2011; ⑶the total expenses rose by year, the drug expenses was almost steady, while the medical expenses had a remarkable rise, as a result, the proportion of drug expenses was descending from 35.4% in 2007 to 27.02% in 2012; ⑷the balance rate stayed at lower level, and negative balance had been existed since 2011 and the medical revenue and expenditure’ loss was most serious. Conclusion: Since the implement of new medical reform, especially the implement of essential medicine institutions, the balance of financial revenue and expenditure of primary health services institutions have been serious. Self compensation ability are poor, the institutions were facing development difficulty, it needed supports from comprehensive reform measures.

Two hundred and forty patients with primary hypertension in Weifang Community were randomly sampled as contract group and another 240 hypertensive patients were sampled as control group.Patients in contract group signed service contract with general practitioners (GPs),who provided individualized service for hypertension management.Patients in control group receive conventional outpatient service for hypertension management.The clinical data of patients before and one year after contracted services were documented and compared with those in control group.The results showed that in contract group the average systolic pressure decreased from 134.60 mm Hg (1 mm Hg =0.133 kPa) to 130.62 mm Hg (P =0.000),reaching-the-target-BP rate increased from 56.3％ to 85.5％ (P =0.000),serum total cholesterol and triglyceride decreased significantly one year after receiving contracted services (P =0.000) ; while these indicators were not significantly changed in control group (all P ＞ 0.05).The results indicate that the contracted services of GPs can improve the effectiveness of hypertension management in community.

Objective To explore the effective countermeasures for the Scientific research funds auditing in medical schools.Methods Political-Economic-Social Technological (PEST) method was used to analyze the macro environment changes for research funding audit,including policy,economics,social,technology..We described the situation in the research funds auditing,based on the model of Strengths-Weaknesses Opportunities-Threats (SWOT).Results Some counter-measures in the research funds auditing are recommeded for solution.Conclusions The PEST-SWOT model could provide effective countermeasures for the research funds auditing in medical schools.

Objective To systematically evaluate the efficacy of traditional Chinese medicine/herbal decoction combined with ursodeoxy-cholic acid (UDCA)in the treatment of primary biliary cirrhosis (PBC),and to provide a reference for clinical medication.Methods Lit-erature published before July 31,2014 was searched in databases as follows:Cochrane Library,PubMed,China National Knowledge Infra-structure (CNKI),Chinese Scientific Journals Full-text Database (VIP),Chinese Biomedical Literature Database (CBM),and Wanfang Data.The randomized controlled trials (RCTs)comparing the efficacy of traditional Chinese medicine/herbal decoction combined with UD-CA versus UDCA alone in PBC patients were included in the analysis.The methodological quality of included trials was assessed and the data were extracted,followed by meta-analysis using RevMan 5.0 software.Results A total of 12 RCTs were included,involving 681 patients with 346 in the test group and 335 in the control group.The results of meta-analysis showed that,after 6 months of treatment,the overall response rate,improvement rate,and biochemical indices of liver function (ALT,ALP,GGT,and TBil)and hepatic fibrosis in the test group were significantly improved compared with those in the control group (all P<0.05).There were no significant differences between the two groups in the immunological indices such as IgA,IgG,anti-mitochondrial antibody (AMA),and AMA M2 subtype (all P>0.05 ). Conclusion Traditional Chinese medicine/herbal decoction combined with UDCA markedly improves the indices of hepatocellular necrosis and cholestasis,degree of hepatic fibrosis,and clinical symptoms in PBC patients after 6 months of treatment,but leads to no significant im-provement in immunological indices.Due to the limited number of included RCTs and patients through systematic evaluation,and the pres-ence of selection bias and publication bias,more double-blind randomized controlled trials with large sample size,multicenter involvement, and high quality are required to provide convincing evidence.

Objective:To investigate the clinicopathologic features and diagnostic methods of intraductal papillary(IP)lesions of the breast.Methods:The clinical data of 1 679 patients who had been pathologically diagnosed as having IP were analyzed retrospectively.Results:Nipple discharge is the most common clinical symptom of IP. According to the postoperative pathological results, IP patients were divided into solitary IP group and multiple IP group . Nipple discharge was more common in solitary IP group ( P<0.05). Bloody discharge and duct nipple discharge and discharge in unilateral breast were the most common clinical symptom of IP, though the difference was not significant ( P>0.05). The accuracy of diagnosing IP by fiberoptic ductoscopy(FDS) was 88.66% which was significantly higher than that of breast ultrasound and mammography. Solitary IP patients with nipple discharge undergoing FDS before surgery and lesions were more often detected located in general or level Ⅰ-Ⅱ duct system ( P<0.05). Postoperative follow-up did not show malignant transformation in solitary IP group, while there were 4 cases in the multiple IP group of malignant transformation and higher recurrence rate of IP ( P<0.05). Conclusions:Bloody discharge, single duct nipple discharge and unilateral breast involving 1esion and 1esions located in the general or level Ⅰ-Ⅱ duct system are common clinical features of IP. FDS has advantages in the diagnosis of IP with nipple discharge. For fear of recurrence , and malignant transformation in multiple IP, active postoperative follow-up should be carried out.

BACKGROUND: Transplantation of neural stem cells into inner ear brings hope for treatment of sensorineural deafness, while guinea pig is the preferred animal in developing animal models of aminoglycosides poisoning-induced deafness. Successful animal models have been established after study for several scores of years. How to isolate neural stem cells and label them from hippocampi of guinea pigs is one of the problems to be solved in transplantation of stem cells into inner ear.OBJECTIVE: To isolate and culture neural stem cells from hippocampi of newborn guinea pigs so as to lay basis for transplantation of neural stem cell in the treatment of sensorineural deafness.DESIGN: Single sample observation SETTING: Staff Room of Microbiology and Immunology, Zhengzhou University MATERIALS: This experiment was carried out at the Staff Room of Microbiology and Immunology, Zhengzhou University from March to June 2005. Newbornguinea pigs born within 24 hours of either gender, weighing 50 to 80 g, provided by Experimental Animal Center of Zhengzhou University were used in this experiment.METHODS: Neural stem cells from the hippocampal tissue of newborn guinea pigs were isolated and cultured by serum-free medium containing basic fibroblast growth factor (bFGF) and epidermal growth factor (EGF).Expression of nidogen was detected with immunocytochemical staining.Neural stem cells were labeled by DAPI.MAIN OUTCOME MEASURES: ① In vitro growth of neural stem cells; ② neural stem cells nidogen expression was identified by immunofluorescent staining; ③ labeled stem cells by fluorescence and detected the labeling rate.RESULTS: ①Clone-like cluster of neural stem cells were obtained from hippocampal tissue ② Neural stem cells could express nidogen. ③Labeling rate of DAPI was 93.4% and no attenuation of fluorescence brightness as observed after 8 generations in culture.CONCLUSION: The cells obtained from hippocampal tissues of newborn guinea pigs can be used as donor cells in the treatment of neurosensory deafness by transplanting neural stem cells, for their obvious proliferation ability and high-labeled efficiency with fluorescent dye.

Child ; Humans ; Practice Guidelines as Topic ; Syncope ; diagnosis

Podcast,a versatile web-based technology,has been widely employed in international nursing education.In China,however,it is only applied based on its video-related function.The other functions,such as subscribing,participating,mobile,and sharing learning option have not been fully exploited.The studies on application of podcast demonstrate that it can excite the learning interest,alleviate stress and anxiety,and enhance the preclinical educational experience.Moreover,it facilitates the self-study ability.Therefore the podcast is expected to be applied more widely in the domestic nursing education.

Objective To observe the inhibitory role of valproic acid (VPA) in hypertrophic cardiomycytes induced by angiotensin Ⅱ (Ang Ⅱ)in rats. Methods The cultured rat cardiomyocytes were divided randomly into control group, hypertrophic group and VPA group. They were treated with Ang Ⅱ to induce hypertrophy and then given with VPA. The morphologic changes of cardiomyocytes were observed under the contrast phase microscope and electron microscope. The mRNA levels ofβ-MHC were exmained by reverse transcriptase polymerase chain reaction (RT-PCR) method. The protein expression of C-FOS was exmanined by immunohistochemistry method. Results Stimulated by Ang Ⅱ, the cardiomyocytes were enlarged under the contrast phase microscope and the ultrastructure also changed. After stimulated by Ang Ⅱ, the mRNA level of β-MHC and the protein expression of C-FOS increased in the hypertrophic cardiocytes. Given by VPA, these data decreased accordingly. Conclusion VPA may inhibit the cardiomyocyte hypertrophy induced by angiotensin Ⅱ in some degree.

BACKGROUND: If it is feasible to realize the controllable urination by establishing artificial abdomen-bladder reflex arc basing on remained somatic-reflection below the paralyzed level.OBJECTIVE:To establish an artificial abdomen-bladder reflex arc in canines abdomen to resume the bladder dysfunction due to spinal cord injury.DESIGN:Bilateral comparative observing study with experimental animal as subjects.SETTING:At the Research Institute of Surgery,Third Military Medical University of Chinese PLA.MATERIALS:This study was carried out at the Research Institute of Surgery of Daping Hospital,Third Military Medical University of Chinese PLA from April 2002 to December 2004.Six adult male canines were adopted with body mass of 10-12 Kg.INTERVENTIONS:This is achieved by intradural microanastomosis of the proximal end of right T12 ventral root and the distal end of right S2 ventral root,as well as the distal end of right S2 dorsal root and Ti2 dosal root by end-to-side microanastomosis. After axonal regeneration,the abdomenspinal cord center-bladder new artificial bladder reflex pathway was established,hereby inducing urinating by right abdominal stimulation. The bladder func-tion was assessed with electrophysiological examination and detrusor elec-tromyograms at postoperative 9 months,which was compared with the left controls.MIAN OUTCOME MEASURES: l①Electrophysiological examination.②Bladder contracting function.RESULTS:Data from six canines were analyzed statistically without loss.①Evoked potentials from the anastomosized distal site could be detected by the stimulation (115 mV,1.0 ms)at the right T12 dorsal root in all six canines before and after the spinal cord transaction at the T12 segment level,which was similar to the left side in shape and amplitude.② After paraplegia for 48 hours ,bladder contraction was very quickly initiated by a series of stimuli(1 000 mV, 10 Hz, 2 s) at the right T12 dorsal root with the new reflex arc and the evoked bladder pressure increased to 61% of control side,and to 51% of control side by stimulation at the right abdomen.CONCLUSION:The new bladder artificial autonomic reflex arc is established basing on the somatic reflex at the level higher than the injured con-secutive spinal cord and provides afferent passages for the transduction of bladder sensory,showing satisfactory function of conducting motor excitation. Reconstruction of the bladder autonomic reflex arc by intradural microanastomosis results in bladder contraction,and contributes to controllable urination of canines.