Pre-hospital care is an important part of the health care system. Nowadays , there are many defects in the pre-hospital emergency charging method in China. It analyzes the effectiveness and impact of adjustment the charging method. There will be a preliminary study of hospital first aid fees adjustment of changing the current method from front-line staff receiving cash to entrusting the local hospital, charge with real-time settlement of health insurance for the convenience of the patient and reduce the workload of health insurance agencies, make financial emergency center management more standardized and efficient.

Objective To compare the results of clinical treatment of shoulder and neck pain in patients with and without upper cervical degeneration. Methods Fifty two patients with diagnosed shoulder and neck muscular fasciitis(with high tension and tenderness on the trapezius) were divided into 3 groups: group A,with upper cervical degeneration(16 cases);group B,with upper cervical degeneration(15 cases),and group C,without cervical degeneration(21 cases).There were no significant difference in gender,age and course of disease among the 3 groups.Patients in 3 groups were regularly treated by naprapathy and electric therapy(intermediate frequency).Cervical traction and manipulation was added to the patients in group A.Treatment for 3 groups lasted for 2 weeks.The Visual Analog Scale(VAS) scores and Odom criteria before and after treatment were used for determining the results of clinical treatment. Results The VAS scores after treatment were significantly improved in group A and group C as compared with that in group B(P=0.000).Odom criteria of group A(93.8%) and group C(95.2%) were excellent and good without significant difference(P=0.692),but they were significantly higher than that of group C(P=0.001). Conclusions Patients with shoulder and neck pain accompanied by upper cervical degeneration(narrowing of intervertebral foramen) should be treated with cervical traction and manipulation beside the routine therapy.

Objective To investigate the diagnosis value of the cytological examination of the cerebrospinal fluid of central nervous system leukemia.Methods Adopting cell smear centrifugal machine to collect the cerebrospinal fluid cells,the cells were stained and examinated under the microscope.Results Fifty-nine children with different type of leukemia had been examinated by 438 times by cerebrospinal fluid.The positive rates of the cases and samples were 15.3% and 8.7%,respectively.Conclusion The cytological examination of cerebrospinal fluid is especially valuable for the early diagnosis ,therapy and relapse of central nervous system leukemia of monitoring.

Objective To explore main influencing factors of postgraduate entrance examination of medical students in medical universities and to provide guidance for postgraduate entrance examination and employment.Methods Totally 300 2008 and 2009 grade undergraduates of Kunming Medical University were enrolled and divided into postgraduate entrance examination group (n =181)and non postgraduate entrance examination group (n =97).Self-designed questionnaire was used.Intentions of postgraduate entrance examination of two groups and main factors of not taking postgraduate entrance examination were analyzed.Softwares of Excel 2003 and SPSS 17.0 were applied to do constituent ratio analysis and x2 test of gender and residence.Results Among all enrolled students,71.2％ paid attention to the entrance exam and 65.1％ said that they would take part in the entrance exam.There was no significant differences in taking entrance exam between males and females (x2 =3.213,P=0.073).Age (74.1％),family economic situation (71.1％) and current employment status (68.1％) were the main influencing factor of graduate entrance exam.There were significant differences between factors of age and family economic situation and factors of gender and census register (x2 =4.810,P =0.028 and x2 =9.612,P =0.002).There was no significant difference between factors of age and family economic situation and factor of current employment status (x2 =0.279,P =0.597).Conclusions Age,family economical situation and current employment situation are major influencing factors of postgraduate entrance examination for medical students.Postgraduate entrance examination for medical students needs positive guidance and more care from schools,society and family.Medical students should form correct view for employment and postgraduate entrance examination according to their own condition.

Objective To evaluate plasma natriuretic peptide brain (BNP) levels in elderly male patients with type 2 diabetes and primary osteoporosis.Methods A total of 122 elderly male patients with type 2 diabetes were divided into 3 groups according to bone mineral density(BMD):normal group (41 cases),osteopenia group (40 cases) and osteoporosis group (41 cases),and another 33 age matched healthy subjects as control group.Plasma BNP levels were determined by ELISA.Results Plasma BNP levels in osteoporosis group [(1.95 ± 0.49) pmol/L] and osteopenia group [(1.64±0.48) pmol/L] were significantly elevated compared with that in normal group [(1.32±0.38) pmol/L] and control group [(1.26±0.39) pmol/L] (all P＜0.01).There was a statistical difference between osteoporosis group and osteopenia group (t=3.539,P＜0.05),and also between normal group and control group (t=2.726,P＜0.05).Plasma BNP levels had negative correlation with BMD of 2na-4th lumbar vertebra (r=-0.366) and femoral neck (r=-0.375),body mass index (r=-0.288) and estrodiol (E2) (r=-0.352) (all P＜0.05); while had a positive correlation with parathyroid hormone (PTH) (r=0.353,P＜0.05).Conclusions With BMD declining,plasma BNP levels are elevated in elderly male type 2 diabetes,which may be related to the compensatory increase in PTH and the decrease in estradiol.

Objective:To select suitable chemotherapy for cervical cancer patients by ATP-tumor chemosensitivity assay.
Methods:Seventy-two hospitalized patients with cervical cancer between July 2007 and October 2009 were enrolled. The patients were randomly divided into a trial group (n=35) and a control group(n=37). ATP-TCA was used to detect the sensitivity of 35 samples of cervical cancer in the trial group to 6 combined chemotherapy regimens. The chemotherapy regimen in the trial group was confirmed by the results of susceptibility testing and that in the control group was confirmed by clinical experience. One-year recurrence rate and 3-year survival rate of two groups were compared after 3 year follow-up.
Results:ATP-TCA was measured in 32 of the 35 patients in the trial group. The sensitive patients for paclitaxel+carboplatin, paclitaxel+oxaliplatin, bleomycin+ifosfamide+cisplatin, bleomycin+vincristine+cisplatin, fluorouracil+cisplatin, and gemcitabine+cisplatin were 20, 18, 17, 18, 17, and 21, respectively. There was no significant difference in the 1-year recurrence between the two groups (P>0.05), while the 3-year survivors in the trial group were more than those in the control group (P<0.05).
Conclusion:ATP-TCA method is good for patients with cervical cancer because it is sensitive, effective, and individualized.

The incidence of systemic fungal infections have increased dramatically, moreover, drug resistance including either primary (intrinsic) or secondary (acquired) resistance, becomes one of the main reasons accounting for the failure of treating invasive fungal infections in the past decades. Nowadays, clinically available antifungal drugs are limited and their combination in antifungal therapy was not effective. It is expected to be a new strategy to synergistically sensitize antifungal drugs against drug-resistant fungi by using new small molecules. Based on the study in our research group and the reported work of others, we reviewed the research of the natural products which have synergistic effect with the antifungal agents against drug-resistant fungi. This review focused on the resource, structure, pharmacological activity, and action mechanism of the compounds, as well as somewhat in common, and would provide theoretical base for seeking new drug against drug-resistance fungi.
Antifungal Agents ; chemistry ; pharmacology ; Biological Products ; chemistry ; pharmacology ; Drug Synergism ; Fungi ; drug effects

Cell Adhesion Molecules ; metabolism ; Cells, Cultured ; Endothelial Cells ; cytology ; metabolism ; physiology ; Humans ; Integrins ; metabolism ; Membrane Proteins ; metabolism ; Neoplasms ; metabolism ; pathology ; Organ Specificity ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Saphenous Vein ; cytology ; Tumor Cells, Cultured ; Umbilical Veins ; cytology

OBJECTIVE: To establish the stable and efficient hearing damage model by using low dosage of cispla tin, and investigate the mechanism. METHOD: C57 mice were divided into 7 groups (every group, n = 8), the first group was the control group, the others were separately intraperitoneally injected with different dosages of cispla tin for different time. We measured the auditory brainstem response (ABR) of the mice, and obtained the basal coil of organ Corti. We observed the shape of inner hair cells (IHC) by staining AgNO3 and marked otoferlin in the IHC by immunofluorescence,successively sliced by laser confocal microscopy. The RNA fragments were amplified by RT-PCR. RESULT: After cisplatin administration for four days, the thresholds of the ABR improved in 1.5 mg/kg and 3.0 mg/kg group, and compared with the control group, the ABR thresholds improved in each group with ciplatin administration for seven days. With the same dosage, the ABR threshold of the 0.75 mg/kg x 7 d group was higher than 0.75 mg/kg x 4 d group, and there was no time-effect relationship existing in other groups with different dosage. The otoferlin was less expressed 3.0 mg/kg groups than the control group. However, the oto ferlin expressed in the 1.5 mg/kg groups were almost the same as the control group. The alteration of the IHC was observed most remarkablely in 3.0 mg/kg x 7 d group. CONCLUSION Low dosage of cisplatin can impair the hearing, and the expression of otoferlin may involve in the underlying mechanism.
Animals ; Cisplatin ; toxicity ; Cochlea ; drug effects ; metabolism ; pathology ; Hair Cells, Auditory, Inner ; drug effects ; pathology ; Membrane Proteins ; metabolism ; Mice ; Mice, Inbred C57BL

OBJECTIVETo investigate the pathogenesis of globozoospermia, fertilization ability of round-headed sperm, and the application value of assisted oocyte activation in intracytoplasmic sperm injection (ICSI) for the wives of glohozoospermia men.

METHODSWe collected oocytes from the wives of 2 globozoospermia patients and randomly divided them into two groups after ICSI to receive calcium ionophore A23187-activation and conventional treatment, respectively. We reviewed the relevant literature published at home and abroad, and discussed the etiology of globozoospermia, fertilization ability of round-headed sperm, and treatment options for this disease.

RESULTSQuality embryos were obtained in the A23187-activation group while no fertilized oocytes, oocyte cleavage, quality embryos, or blastular formation were found in the conventional treatment group. Both women achieved pregnancy and gave birth to healthy neonates after transfer of the quality embryos from the A23187-activation group.

CONCLUSIONCalcium ionophore A23187 can be applied to ICSI for the wives of globozoospermia men and bring about desirable clinical outcomes. Meanwhile, attention should be paid to its safety.

Calcimycin ; therapeutic use ; Calcium Ionophores ; therapeutic use ; Female ; Humans ; Infertility, Male ; drug therapy ; Male ; Oocytes ; Pregnancy ; Sperm Injections, Intracytoplasmic ; Spermatozoa ; abnormalities