To study the newly-developed drug of Chinese materia medica (CMM) for clinic use is an intricate systematical engineering with multi factors between subject and object, such as the theoretical system of disciplines, the objects of study, and the consumers of the drug. The characters, advantages, and deficiency in the simple systematic theory of traditional Chinese medicine (TCM), the reductionism of the western medicine in the latter days, and the modern systematology of the neoteric TCM. Base on the view point of systematical thinking mode for study on new drug of CMM used for clinic, the forming process of CMM is divided into three stages, they are the formation of raw medicinal materials, the preparation of the drug, and the in vivo metabolism of the drug, among every stages each factor is analyzed. The thinking mode and the research method explored for the newly-developed drug of CMM are put forward by the above-mentioned rational knowledge. The focuses and key problems in the study are approached in scientific practice. Finally an argument on this topic is set fourth. That is, applying the thinking mode to observing the interference rule of CMM on diseases in clinic from various sides of life movement in an integrity, common relation, and varied way by means of the verified experimental measure and systematic analysis method. Acting on the principle of combining the inheritance with the innovation, keeping on developing what is useful and healthy, and discarding what is not in TCM, the modern CMM will be degenerated and obtained in a completely new sense.

In China, the implementation of community health service shows that the prevention is an essential and important part of our national health system and is helpful to decrease the medical expenditure gradually. According to the data from Health Statistic Information Center of Ministry of Health in China, we calculated that the total health expenditure of China would be decreased 8000.0 million yuan only in 2001, among which, 1188.3 million, 1953.9 million and 4833.0 million yuan were respectively saved for the government budget, the society and resident if implementing the policy of community health service powerfully. And every outpatient can save 15.46 yuan per time. By the quantitative analysis on the economic contribution of community health service, it can be proved that a great economic benefit could be gotten from the implementation of community health service.
China ; Community Health Services/*economics ; Financing, Government ; Health Care Costs ; *Health Expenditures ; Health Plan Implementation/economics

Objective Radical surgery is extensively used in the treatment of lung cancer in elderly patients .This study aimed to investigate the effects of acute hypervolemic hemodilution (AHVHD) on the cognitive function and plasma S100βof elderly people following radical surgery for lung cancer . Methods A total of 112 lung cancer patients treated by radical surgery were equally randomized to an AHVHD and a non-AHVHD control group .Using the Mini-Mental State Examination scale ( MMSE) , we evaluated the cognitive function of the patients .We made comparisons between the two groups in the cerebral oxygen metabolism indexes and plasma S100βlevels at T0(immediately after anesthesia induction), T1(15 min after hemodilution), T2(60 min after hemodilution), T3(60 min before the end of surgery ) and T4 ( at the end of surgery ) as well as MMSE scores before and after operation . Results At T1 , T2, T3, and T4, the values of jugular venous oxygen saturation in the AHVHD group were (75.1 ±4.3), (78.5 ±3.1), (79.1 ± 4.4), and (79.6 ±2.8) %, respectively, with time-dependent decreases in Da-jvO2 and cerebral oxygen extraction , and significantly higher than that at T0 (P<0.05) and those in the control group ([63.4 ±2.0], [63.9 ±1.8], [64.2 ±3.0], and [64.7 ±3.2]%) (P<0.05).The levels of plasma S100βat T1, T2, T3, and T4 were remarkably lower in the AHVHD group ([0.53 ±0.04], [0.52 ±0.07], [0.51 ±0.06], and [0.50 ±0.08] μg/L) than in the control ([0.64 ±0.06], [0.64 ±0.04], [0.65 ±0.05], and [0.67 ±0.06] μg/L), with statistically significant differences between the two groups at the same time point (P<0.05).At 1, 3, 5, and 7 days after surgery, the MMSE scores were markedly higher in the AHVHD group (24.3 ±1.7, 26.5 ±1.9, 27.8 ±1.3, and 28.1 ±1.0) than in the control (21.1 ±1.6, 24.0 ±2.1, 25.9 ±1.8, and 26.4 ±1.7) (P<0.05). Conclusion AHVHD can significantly improve cognitive function and reduce plasma S 100βin elderly patients following radical surgery for lung cancer , which may be related to cerebral oxygen metabolism .

Primary seminal vesicle adenocarcinoma (PSVA) is an extremely rare disease without any unified diagnostic criterion. Differential diagnosis of PSVA from prostate cancer, colon cancer, and bladder cancer is necessary but difficult because of the lack of standard management. Radical resection is considered the mainstay of primary treatment that offers satisfactory prognosis. Most cases with PSVA are diagnosed at advanced stages because its early manifestation is nonspecific and it is rarely diagnosed in clinic. In this study, we described the case of a 52 year-old PSVA patient who was treated at the Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, in July 2012. The patient underwent local excision, with tumor residuals visible under the naked eye. The patient benefits from a six-cycle paclitaxel (175 mg/m2) therapeutic regimen combined with cisplatin (60 mg/m2), as well as pelvic modulated radiotherapy with a radiation dose of 60 Gy/30 F. At present, the patient is disease-free and undergoes regu-lar follow-up.

Objective To evaluate the effects of two fluid therapy methods guided by SVV and CVP re-spectively on intestinal barrier of colon cancer surgery with elderly patients. Methods 50 elderly patients with ASA Ⅱ~Ⅲ level were randomly divided into Group S (fluid therapy guided by SVV) and Group C (convention-al fluid therapy). Each group has 25 cases. Patients in group S were treated under goal-directed fluid infusion strategy with target of 10%≤SVV≤12%. Group C received conventional infusion characterized by monitoring central venous pressure (CVP) and mean arterial pressure (MAP). Fluid volume, surgery time, urine volume, blood loss, exhausting time, post-operative hospitalization days in Group S and Group C were recorded. MAP, HR, CVP, SVV, HCO3- of patients were recorded at the same time before anesthesia (T0), beginning of surgery (T1), one hour after surgery (T2) and ending of surgery (T3) respectively. Venous blood samples were collected at the time points of T0, T1, T2 and T3 to detect DAO and D-lactic acid levels. Results MAP and CVP at time points of T2 and T3 in Group S were obviously lower than that in Group C; total intraoperative fluid volume in Group S was obviously less than that in Group C (P < 0. 05); postoperative exhausting time and hospitalization days in Group S decreased significantly (P < 0.05) and the content of DAO and D-lactic acid in Group S were lower than that in Group C (P < 0.05). Conclusion For elderly patients with colon cancer surgery, fluid thera-py guided by SVV is better than conventional fluid therapy guided by CVP in protecting intestinal barrier.

AIM: There is a controversial argument about the choice of total hip replacement (THR) and bipolar artificial femoral head replacement (FHR) for elderly patients with femoral neck fracture. This study was designed to explore the long-term biocompatibility and functional recovery of joints in patients over 70 years with femoral neck fracture by THR and bipolar artificial FHR. METHODS: Sixty patients with femoral neck fracture over 70 years were enrolled from the First Department of Bone and Joint Surgery in the First Hospital of Jilin University from January 2002 to December 2006. There were 21 cases (8 males and 13 females) receiving THR, with a mean age of (72.1?3.5) years, and 18 of them were complicated with internal diseases. While 39 cases (16 males and 23 females) received bipolar artificial FHR, their average ages was (75.1?6.4) years, and 35 of them were complicated with internal disease. ①Choice of artificial prosthesis: Sixteen prosthesis were produced by Germany Link Company and American Zimmer Company, 44 artificial joints were offered by Beijing Mengtaiyin Medical Instrument Co., Ltd. ②All the patients were operated by senior doctors who were qualified for post technique owing to more than 10-years working experience about artificial joints. ③The mean time of follow-ups for all patients was 37 months. The difference was compared in biocompatibility between materials and host, joint function, Harris scoring, time of operation, blood loss, time of hospitalization, cost of hospitalization and adverse effect. RESULTS: ①Comparison of biocompatibility: Two revisions for abrasion of acetabular wall were carried out 5 years after bipolar artificial FHR, and there was no infection of incision, dislocation of hip joint or loose of artificial joint in other patients of these two groups. ②Comparison of adverse effect: There was one patient with complications of pain and red swelling of hip in each group. No infection occurred around the prosthesis, and these two patients recovered after symptomatic treatment. ③Comparison of follow-ups for joint function: The average Harris scores was 89.8?8.6 in THR group and 72.7?9.5 in bipolar artificial FHR group, and there were significant differences in these two groups (P 0.05). ⑤Comparison of operation time and blood loss: The average operation time were (150.2?24.3) minutes in THR group and (105.8?22.1) minutes in bipolar artificial FHR group, with significant differences (P

Objective:To investigate the expression of CD55 in triple-negative breast cancer (TNBC) and its correlations with prognosis.Methods: The expressions of CD55 was detected by immunohistochemistry Streptavidin-Peroxidase method in 100 cases of triple-negative breast cancer and 50 cases of adjacent-carcinoma tissues, with clinical and pathological features and follow-up data, the Cox model analysis was established and to analyze the prognostic factors. Results: The positive expression of CD55 was 56.0% in the tissues from triple-negative breast cancer, whereas its positive rate was 8.0% in the corresponding adjacent breast tissues, with statistical significance (x2=32.0,P<0.05). The expression of CD55 was significantly related with tumor size, clinical stage and axillary lymph node metastases (x2=7.404,x2=8.688,x2=4.802;P<0.05); the expression of CD55 did not show correlation to age, and histologic grade. Multivariate analysis showed that the age, clinical stage, CD55 protein expression and axillary lymph node metastasis were the independent risk factors affecting the 5-year disease-free rate of patients and that clinical stage and axillary lymph node metastasis were the independent risk factors affecting the 5-year overall rate of patients.Conclusion: The expression of CD55 might be related to the development and prognosis of triple-negative breast cancer. The expression of CD55 may be used as one of the indicators in determining the progress and prognosis of TNBC.

Objective:To study the comparison of advantages of 3D and 2D laparoscope applied in clinical surgery.Methods: 42 cases were received retrospective analysis using 3D and 2D laparoscopic technology to complete abdominal surgery and were divided into 3D group and 2D group according to the methods of surgery. We observed the indexes for operation time, intraoperative blood loss, postoperative exhaust, catheter indwelling time, placement time of abdominal cavity drainage tube and postoperative hospitalization days, etc.Results: The two groups of patients completed smoothly laparoscopic surgery. There was no significant difference between 3D and 2D laparoscopic monitoring on indexes in the postoperative exhaust, catheter indwelling time, placement time of abdominal cavity drainage tube and postoperative hospitalization days. But the difference was statistically more significant in the operation time and intraoperative blood loss in 3D than that in 2D group (t=0.358,t=2.455;P<0.05).Conclusion:3D high definition amplification of three-dimensional surgical field similar with the traditional laparotomy is the future trend in the development of minimally invasive surgery. Compared with 2D, 3D technology can improve the overall level of the operation, with the features of easier and faster operation, smaller wound, quicker recovery, less postoperative complications, etc.

Objective:To study the effect of learning plan guidance based on clinical nursing pathway applied in the teaching of surgical nursing.Methods: The nursing specialty students from two classes of grade 2010 were divided into experiment group and control group for the research randomly. Learning plan guidance based on clinical nursing pathway was performed in experiment group, while traditional teaching method was performed in control group. Students were evaluated by teacher during the course; Theoretical examination was carried out after the course. The students in the experiment group were required to fill in questionnaire.Results: Attitude of students in the experiment group is positive. Experimental group was excelled control group obviously in theoretical examination, and the difference was statistically significant (P<0.01).Students in the experiment group made a positive evaluation for teaching effect.Conclusion: Learning plan guidance based on clinical nursing pathway is suit for the reform in teaching of surgical nursing. It can improve the student nurses' comprehensive abilities.