BACKGROUND: Blood-letting puncture on 12-well points of hand is a kind of effective emergent approaches on cerebral apoplexy. It is testified in animal experiment that bleeding on 12-well points of hand can dilate cerebral vessels, enhance blood flow in brain, improve acute anoxic state in ischemic brain tissue and relieve acid toxin due to accumulation of lactate.OBJECTIVE: To explore the effects and mechanism of blood-letting puncture of 12-well points of hand nitric oxide (NO) contents and nitricoxide synthase (NOS) activity after cerebral ischemia in rats.DESIGN: Randomized controlled animal experiment was designed.SETTING: Department of Physiology of Medical Institute of Xianning College.MATERIALS: The experiment was performed in Department of Physiology of Medical Institute of Xianning College from March 2003 to February 2004. Totally 84 Wistar rats were employed in the experiment, aged of 2 or 3 months, of either sex, body weighted (230±20) g and provided from Experimental Animal Center of Medical Institute of Xianning College.METHODS: Totally 84 rats were randomized into sham operation group,ischemia group and ischemia + bleeding group, 28 rats in each one. Modified Longa method [3] was applied to prepare the model of embolism of cerebral middle artery in rat. In ischemia + bleeding group, after cerebral ischemia, blood-letting puncture was applied with three-edged needle on Shaoshang (LU11), Shangyang (LI1), Zhongchong (PC9), Guanchong (TE1),Shoochong (HT9) and Shaoze (SI1) in sequence firstly on the left foreleg,and then on the right one, corresponding to the analogy of 12-well points of hand of human. One blood drop was just required. NO content and NOS activity were assayed in 30 minutes, 1 hour, 2 hours and 4 hours of ischemia in brain tissue successively in each group.MAIN OUTCOME MEASURES: NO content and NOS activity in brain tissue in each group.RESULTS: ① NO content in 30 minutes, 1 hour, 2 hours and 4 hours of ischemia in ischemia group was (116.16±26.63), (118.94±24.47),(115.65±25.29) and (108.87±26.52) μmol/L successively and NOS ac tivity was (507.22±92.52), (502.08±92.52), (510.71±96.63) and (495.29-±88.41) μkat/L, which was higher significantly than the sham operation group (t=2.474-4.731, P ＜ 0.05 or 0.001). ② In ischemia + bleeding group,, NO content was (91.8±11.51), (93.55±13.88), (92.52±11.62) and (84.3±11.51) μmol/L successively and NOS activity was (337.6±88.41),(340.99±96.63), (344.48±84.3) and (337.6±90.46) μkat/L, indicating significant difference in comparison with ischemia group (t=2.199-3.507,P ＜ 0.05-0.01).CONCLUSION: Blood-letting puncture on 12-well points of hand inhibits the increased NO content and NOS activity in ischemic brain tissue and alleviates the injury of free radical to brain tissue so that the focal brain ischemia of rats is protected.

Objective To explore the use of integrated two methods in vitro in prediction of eye irritation caused by cosmetics.Method Chorioallantoic membrane vascular assay ( CAMVA), bovine corneal opacity and permeability (BCOP) and Draize rabbit eye irritation test were used to determine the predictive potential of eye irritation of 60 kinds of cosmetics.Results CAMVA method was able to distinguish 41 non-irritant samples and 18 irritant samples.BCOP method was able to predict 35 non-irritant samples , 21 mild-moderate irritant samples and 4 severe irritant samples . Combination of CAMVA and BCOP methods could obviously improve the identification ability of irritation , and the classification consistency with Draize rabbit eye irritation testing reached 98.3%.Conclusions The integrated test strategy combined BCOP with CAMVA can be used to appropriately predict ocular irritation of cosmetics , with a prediction range covering non-irritant to severe irritant samples .

Objective To research the most commonly used five method to evaluated the difficulty airway , and compare which methods were more suited for the pregnant woman in general anesthesia. Methods 214 patients with full-term pregnancy who requested emergency or elective caesarean-section were assigned. During the pre-anesthetic visit,we evaluated patients from Mallampati score, thyromental distance, body mass index (BMI), inter-incisor gap, and upper lip bite test. After endotracheal intubation ,patients were divided into 2 groups based on Cormack classification. Results Five ways sensitivity descending order were upper lip bite test (79.5%)、Mallampati score (76.9%)、BMI (56.4%)、inter-incisor gap (51.3%)、thyromental distance (35.9%); specificity descending order were upper lip bite test (93.1%)、Mallampati scores (86.3%)、inter-incisor gap (85.1%)、thyromental distance (76.6%)、BMI (62.3%). Conclusions In pregnant women ,Mallampati score and the upper lip bite test are the better indicators to predict difficult airway.

This article elaborated the connotation of public hospital medical insurance payment system and the importance of reform,summarizing and analyzing the practical exploration of promoting medical insurance payment system reform in the localities.Then it moved on to introduce new progress of medical insurance payment system reform abroad and the emerging mode of medical insurance payment, such as pay for performance,payment by results,and bundled payment.In the end,the authors put forward policy suggestions to improve medical insurance payment system at public hospitals in China, namely to build a modern healthcare payment system in line with the needs of medical service system.Such a system should be guided by comprehensive performance,restrained by cost budgeting, based on a diversified payment mode,and supported by information technology.In addition,it should have scientific payment standard and modern governance mechanism,and keep interactive development with commercial health insurance.

BACKGROUND:The anesthesia process is required strict in establishing rabbit models of ileal neobladder. It is required for cleaning operation field, quick postoperative recovery, and the choice of anesthetics and anesthesia does not influence smooth muscle peristalsis. OBJECTIVE:To compare the anesthetic effects between urethane and chloral hydrate in rabbits with ileal neobladder. METHODS:Eighteen rabbits were randomly assigned to urethane and chloral hydrate groups, and were respectively anesthetized with 20% urethane 5 mL/kg and 10% chloral hydrate 2 mL/kg through the ear vein. Double ureter was dissociated at 1 cm outside original bladder, and 15 cm-intestine obtained from 10 cm of ileocecal junction was implanted so as to establish models of ileal neobladder. RESULTS AND CONCLUSION:Heart rates were significantly lower compared with these before anesthesia in al cases (P≤ 0.05), but no differences were detected between two groups (P > 0.05). Compared with the chloral hydrate group, the maintain time and recovery time were longer and the mortality rate was higher in the urethane group. Above data indicated that chloral hydrate is a safe long-acting anesthetic in establishing rabbit models of ileal neobladder.

Objective To identify and compare melanin distribution in iris and skin tissues of rabbits from four breeds including WHBE rabbit.Methods Ferrous sulphate staining was performed for iris and skin tissue of rabbits from different breeds.Results It showed dark green staining in both iris stroma and iris pigment epithelium of WHBE rabbit, while light green staining was observed in its follicles.Conclusion The results of histologic evaluations provide some clues to the future research on mechanism of WHBE rabbit phenotype mutation.

At present,the doctor-patient relationship in China is a little tense,communication between doctors and patients is not smooth,and the doctor-patient communication skills of the young doctor is obviously insufficient and need to be improved.In this paper,we analyze the factors that affect the communication between doctors and patients in the Department of Neurology through the complexity of professional knowledge,the current background and so on.In addition,we discuss multiple methods of improving communication capability among this group doctors,hoping to strengthen young physicians' clinical basic skills training,and impart doctor-patient communication skills from the linguistic modifiers,oral expression,words and deeds,use of metaphor,simulation training and other aspects,and establish dynamic assessment system of doctor-patient communication ability.

Objective:To evaluate the efficacy of Epstein-Barr nuclear antigen 1/immunoglobulin A (EBNA1/IgA), BamH1 Z transactivator/IgA (Zta/IgA), capsid antigen/IgA (VCA/IgA), and Epstein-Barr virus deoxyribonucleic acid (EBV-DNA) in detecting different stages of na-sopharyngeal carcinoma (NPC). The relationship between the EBV markers and stages of NPC was also analyzed. Methods:Blood sam-ples of 152 untreated patients with NPC and 675 healthy subjects were collected.ELISA was used to detect the serum levels of EBNA1/IgA, Zta/IgA, and VCA/IgA. Fluorescence quantitative PCR (FQ-PCR) was used to detect the plasma levels of EBV-DNA. ROC and correla-tion analyses were employed to assess the detection assays for NPC diagnosis. The positive rates of EBV markers in NPC patients in dif-ferent stages were analyzed statistically. Results: The positive rates of EBNA1/IgA, Zta/IgA, VCA/IgA, and EBV-DNA in NPC patients were higher than those in the healthy individuals. The expression of EBNA1/IgA was relatively high in early NPC. The sensitivity of EB-NA1/IgA was 77.8%. In advanced NPC, the level of EBV-DNA was high, and the sensitivity of EBV-DNA was 88.8%. The specificity of EBV-DNA and EBNA1/IgA could reach more than 96%. The combination of EBV-DNA and EBNA1/IgA showed the best diagnostic value, with a sensitivity of 92.1%(early stage 82.5%, advanced stage 98.9%) and a specificity of 96.9%. The positive rates of EBV-DNA were positively associated with the NPC clinic stage and N stage. The positives rates of Zta/IgA were positively associated with the NPC N stage. Conclusion:The best single index for NPC screening in an asymptomatic population is EBNA1/IgA. EBV–DNA is an ideal index for auxiliary diagnostics of advanced NPC. The combination of EBV-DNA and EBNA1/IgA shows the best diagnostic value. EBV-DNA is an important index in the stage and illness monitoring of NPC. Zta/IgA can indirectly reflect the character of lymph node metastasis, and it may be useful in assessment of NPC surveillance.

orrect knowledge about the benign biological behavior of the ovarian GTS and reasonable therapeutic regimen can have the disease ends with good prognosis.

Objective To evaluate the value of reducing radiation dose with decreased size of ECG-pulsing windows and influence on image quality in dual-source CT coronary angiography. Methods 120 patients with stable heart rate(HR) were divided into four groups according to HR and the rang of ECG-pulsing windows in dual-source CT coronary angiography: HR ＜ 70 bpm and 61% ～ 77% R-R interval of ECG-pulsing windows, HR ＜ 70 bpm and 25% ～ 80% R-R interval of ECG-pulsing windows,HR ＞ 80 bpm and 31% ～47% R-R interval of ECG-pulsing windows, and HR ＞ 80 bpm and 25% ～ 80%R-R interval of ECG-pulsing windows was employed, respectively. The radiation dose parameters were recorded and image quality scores were performed. The image quality and radiation dose between two slow HR groups and between two fast HR groups were compared respectively. Result The effective doses were (7.06 ± 2. 13 ), ( 11.34 ± 3.65 ), ( 6. 67 ± 1.97 ) and ( 9. 92 ± 3. 15 ) mSy for four groups, respectively.The effective dose was decreased by 37.74% for slow HR and by 32. 76% for fast HR using narrow ECG-pulsing windows. There was no difference on image quality between two slow HR groups and two fast HR grouvs. Concluslons The proper application of narrow ECG-pulsing windows can reduce radiation exposure significantly to stable slow or fast HR patients in dual-source CT coronary angiography withont sacrificing the image quality.