Objective To explore the effect of laparoscopy and laparotomy surgery on immune function related indicators in ovarian benign tumor patients. Methods From January 2015 to January 2016, 86 cases of ovarian benign tumor patients were set as study objects. All the patients were randomly divided into control group and observation group, 43 cases in each. Patients in control group were given traditional laparotomy surgery, while patients in observation group were given laparoscopic surgery. The changes of immune function related indexes before and after operation were recorded, before operation, day 1 and day 3 postoperative, number of peripheral white blood cells (WBC), neutrophil ratio (NGR), immunoglobulin (IgA, IgG, IgM) levels, C reactive protein (CRP) content and the distribution of T lymphocyte subsets (CD3+, CD4+ and CD3+/CD4+ ratio) distribution were respectively determined, and the incidence of postoperative complications was recorded, and were further statistical analyzed. Results There was no significant difference in immunoglobulin IgA, IgG and IgM between the twogroups before operation (P > 0.05). Postoperative, only the IgG content of the two groups was significantly lower than that before the operation (P < 0.05 ); The levels of WBC, NGR and CRP in the control group patients in the昀rst day and the third day after surgery were significantly increased compared with preoperative period, while CRP in the observation group was higher than that before the operation, there was significant difference between the two groups (P < 0.05). There was no significant difference in CD3+, CD4+ and CD3+/CD4+ ratios between the two groups before operation (P > 0.05), the difference between the two groups was significant (P < 0.05). The complication rate of the observation group after operation was 6.98%, the control group was 16.28%. Conclusion Clinical use of laparoscopic treatment of benign ovarian tumors relative to the traditional laparotomy can effectively reduce the immune system of patients with immune function, with high safety, contribute to the recovery of patients, it is worthy of clinical promoting.

Objective:Discussing the audit idea of equipment and material procurement in health system under the latest requirements of the administrative institutions internal control specification and Chinese internal auditing standards.Methods: According to the specific requirements of the new specification and the new standard, combined with the practical work experience and the review of the literature, to discuss the audit idea of equipment and material procurement in health system, based on the perspective of internal control audit of procurement and payment cycle.Results: Systematic reviewing and standardized summarizing the procedure, content and method of the equipment and material procurement audit in health system were used.Conclusion: It has been found that audit of fine design under the new specification and the new standard could well improve the work quality and work effectiveness of the internal audit in health system.

Objective]To investigate the application value of four-dimensional ultrasound with high definition flow(HD flow) in the observation of fetal pulmonary vein.[Methods]From June 2015 to June 2016,130 fetuses in our hospital underwent prenatal fetal echocardiography were included in this study. Color Doppler and high definition flow imaging were used to observe and count the number of pulmonary veins in the fetal four chamber view. In the condition of opening HD flow ,the 3D volume data was collected from the heart of the fetal four chamber view,and the 3D images of the fetal pulmonary vein were obtained by using the post processing software. Comparisons were made between the three methods for visualization numbers of the normal fetal pulmonary veins. For 5 cases of abnormal pulmonary venous drainage,STIC combined with HD flow technique was used to carry out three-dimensional reconstruction of pulmonary veins,to observe the abnormal drainage.[Results]The display rate of HD flow on fetal pulmonary veins was higher than that of color Doppler. For the 17~32 weeks fetal,four-dimensional ultrasound combined with HD flow could better observe the spatial location of pulmonary veins.[Conclusions]STIC combined with HD flow technology can display fetal pulmonary veins better in the second and early-third trimester of pregnancy ,and three-dimensional reconstruction of the image is more intuitive ,helpful to understand the spatial relationship.

Lysophosphatidic acid is a intermediary metabolite in lipid metabolism, mainly produced from activated platelets. It may cause the apoptosis of hippocampal neurons, abnormal phosphorylation of tau protein and increased permeability of the tight junction of endothelial cells, which is closely correlated with pathological changes of ischemic cerebrovascular diseases, Alzheimer's disease and vascular dementia. It is shown that lysophosphatidic acid may induce the opening of the blood-brain barrier under pathological conditions, and enters central nervous system through the blood-brain barrier, and causes different effects of pathological changes by acting on various cells.

Objective To optimize the formulation of sinomenine hydrochloride pulsatile drug delivery tablets by central composite design-response surface method.Methods The tablets containing sinomenine hydrochloride were prepared by dry-compression coating technique.The influence factors included the amount of sodium carboxymethyl starch in core tablets, the ratio of HPMC/carrrageenan,and the amount of matrix materials in coating film.The evaluation parameter was lag time.Experiments were done on the central composite design,and the data were simulated using multi-linear equation and second-order polynomial equation.The possibly optimal formulation was predicted by response surface method.The lag time of the tablets prepared under the optimum condition was compared with the predicted.Results The lag time was simulated using second-order polynomial equation and the regression coefficient was 0.993 7.The lag time in vitro of the tablets prepared under the optimum conditions was about 6 h,then drug released in pulsatilerelease character.Bias between the observed and predicted values of the lag time was within ?4.43%.Conclusion The sinomenine hydrochloride pulsatile tablets could release drug quickly in vitro at the predetermined time.Central composite design-response surface method can be used to optimize the formulation and the model developed in this study proves to be highly predictable.

By using the diagnosis related groups(DRGs) method, we analyze and compare the rationality and feasibility of outcomes and human resources distribution of clinical specialties and health care professionals.It may increase the hospital management levels and feasibility.The introduction of DRGs for the majority of hospital management may enhance the performance evaluation and human resource levels in the hospitals.

China ; Curriculum ; Education, Dental ; Oral Medicine ; education

Adolescent ; Adult ; Aged ; Calcaneus ; injuries ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; Fractures, Bone ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; pathology ; physiopathology ; Recovery of Function ; Retrospective Studies ; Young Adult

Objective: To study the expression of calcium-sensing receptor (CaR) in human macrophages and the effect of CaR on macrophages converting to foam cells with its mechanism. Methods: Human macrophages were treated with ox-LDL (100 mg/L) for 48 h to induce foam cell formation, the experimental foam cells were cultured in 3 groups for 48 h respectively. Blank control group, Foam cell + CaR agonists (Agonists) group and Foam cell + CaR inhibitor (Inhibitor) group. The CaR expression in macrophages was measured by immuno-fluorescence and Western blot analysis. The positive foam cell formation was detected by oil red O staining, the intracellular cholesterol metabolism in foam cell was observed by HPLC, the inlfammatory cytokine secretion in foam cell culture supernatant was examined by ELISA, the protein expressions of CD36 and acyl-coA: cholesterol acyl-transferase (ACAT-1) in foam cells was measured by Western blot analysis. Results: Immuno-lfuorescence and Western blot indicated CaR is expressed in human macrophages. Compared with Control group, Oil Red O staining and HPLC showed that Agonists group had less positive foam cell formation, decreased CE, FC , TC, and Inhibitor group had more positive foam cell formation, increased CE, FC, TC, allP<0.05; ELISA presented that Agonists group had decreased TNF-α, MIF, increased anti-inflammatory cytokine IL-10, and Inhibitor group had increased TNF-α, MIF, decreased IL-10, allP<0.05; Western blot analysis indicated that Agonists group had decreased protein expressions of CD36, ACAT-1 in foam cells, and Inhibitor group had increased protein expressions of CD36 and ACAT-1. Conclusion: CaR is expressed in human macrophages, the higher CaR expression may inhibit macrophages converting to foam cells.