The authors first describe the current situation of cooperative medical care in China, pointing out that due to low levels of guarantee, difficulties in fundraising and insufficient government reimbursement, cooperative medical care in rural areas have come across many hardships. It is, therefore, imperative to set up as soon as possible a health security system for people in rural areas. Firstly, it is necessary to break up the dual social security structure of urban and rural areas and set up a model with transitional goals based on the actual situation of the country. Secondly, it is suggested that security taxes begin to be collected, bringing the health security for people in rural areas into line with the social security framework so as to promote the health security for people in rural areas without lowering the level of social security in urban areas.

Objective To observe the clinical efficacy of small-dose ranitidine hydrochloride and diphenoxy- late compositae in the combined treatment of diarrhea-predominant irritable bowel syndrome(D-IBS).Methods A prospective,randomized controlled clinical trial was designed.150 D-IBS patients according to RomeⅡcriteria were randomly divided into combined treatment group and control group.The combined treatment group(74 patients)re- ceived ranitidine hydrochloride,0.15g,each evening and diphenoxylate compositae,1 piece,each evening.The control group(76 patients)received diphenoxylate compositae,1 piece,rid.This study consisted of a 2-week baseline period, a 3-week treatment period,followed by a 2-week follow-up period.The main efficacy variable was assessed by per- ception of overall symptom during the previous weeks.Secondary efficacy variables included severity of diarrhea,ab- dominal pain and distention and other symptoms.Results After treatment of 3 weeks,the efficacy of the combined treatment group was better than that of the control group(x~2=5.10,P

BACKGROUND: Absorbable material is a hotspot in orthopedics, which is biodegradable, avoids fixation residues and second surgical trauma compared with the traditional internal fixation.OBJECTIVE: To investigate the clinical efficacy and safety of K-wires, screws and absorbable rods for the internal fixation of Mason II-III radial head fractures.METHODS: Totally 45 patients with Mason Ⅱ-Ⅲ radial head fractures were collected from January 2010 to December 2015 admited in Zhangjiagang First People's Hospital and Zhangjiagang Hospital of Traditional Chinese Medicine, and were then divided into three groups (n=15 per group), followed by implanted with K-wires (group A), screws (group B)and absorbable rods (group C), respectively. The baseline data, operation time, blood loss, healing time, Mayo and Broberg-Morrey scores were compared among groups.RESULTS AND CONCLUSION: (1) There were no significant differences in the baseline data, operation time, blood loss,and healing time among groups (P > 0.05). (2) The Mayo scores in the groups A, B, and C were (88.45±6.22),(92.37±5.60), and (90.82±6.58), respectively; the Broberg-Morrey scores in the groups A, B, and C group were ((90.82±6.83), (93.05±6.54), and (91.68±7.15), respectively; all above scores showed no significant differences among groups (P > 0.05). (4) The total incidence rate of complications in the groups A, B, and C was 20％ (2/15), 13％ (2/15),and 7％ (1/15) respectively, showing no significant difference among groups (P > 0.05). (4) These results indicate that the absorbable rods can obtain satisfactory treatment outcomes for Mason II-III radial head fractures, which is equivalent to the traditional internal fixation. Moreover, it can avoid secondary operation for removing internal fixators and the adverse impact of stress shielding, so it is recommended to be used in clinic.

Objective To investigate effects and safety of dexmedetomidine on the prevention of abnormal mental in patients after liver transplantation.Methods 160 patients after liver transplantation were randomly divided into the two groups using the drawing method:midazolam group(n =80),dexmedetomidine group(n =80),compared the two groups of patients with general,mental abnormality and the occurrence of adverse reactions.Results There were no significant differences in the general situation (gender,age,postoperative ventilator time,ICU stay time,oper-ation time,blood FK506 concentration,APACHEII score 24 hours after operation)of the two groups of patients (P >0.05),the spirit of the abnormal rate of the observation group was lower than that of the control group (P =0.009), incidence of hypotension and hypertension in the observation group was higher than that in the control group (P =0.035,0.029).Conclusion Dexmedetomidine can effectively reduce the postoperative mental disorders in patients in the early stage after liver transplantation.

OBJECTIVETo compare the efficacy of internal fixation (including PFNA and PFN) versus hip replacement (including FHR or THA) in the treatment of trochanteric fractures in adults.

METHODSReports of studies using randomized controlled trials (RCT) to compare internal fixationg with hip replacement in the management of intertrochanteric fractures were retrieved (up to January 1, 2013) from the Cochrane Library, PUBMED Data, CNKI (China National Knowledge infrastructure), Elsevier, the Chinese Biomedical Database, Wanfang Data, and manually. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software RevMan 5.0 was used for data-analysis.

RESULTSSeven articles were included in the meta-analysis. The results showed that,compared internal fixation with hip replacement,there were statistical significance in the duration of surgery time [WMD = -2.66, 95% CI (-5.25,-0.06), P = 0.05], intra-operative blood loss [WMD = -24.20, 95% CI (-30.38, -18.02), P < 0.000 01], hospital stays time [WMD = -4.72, 95% CI (-5.18, -4.25), P < 0.000 01], bearing load time [WMD = -29.54, 95% CI (-30.77, -28.31), P < 0.000 01], total complications rate [WMD = 0.15, 95% CI (0.11, 0.22), P < 0.000 01], the good rate of Harris scores [WMD = 1.09, 95% CI (0.54,1.32), P < 0.05]. However, there were no statistical significance in the rate of deep venous thrombosis [WMD = 1.09, 95% CI (0.47, 2.55), P > 0.05]. CON- CLUSION: Hip replacement (containing FHR or THA) for the treatment of intertrochanteric fractures is superior to internal fixa- tion in regards to the duration of surgery time, the mean duration of hosipital stays, mean post-operative down time, intra-opera- tive blood loss, the rate of post-operative good Harris scores. But there is not enough evidence to show any difference between hip replacement (containing THA or FHR) and internal fixation in regards to the rate of deep venous thrombosis. However, internal fixation for the treatment of intertrochanteric fractures is superior to hip replacement (containing FHR or THA) in regards to total complications rate.

To observe the expressions of matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in rats with pulmonary fibrosis (PF) induced by bleomycin, and to explore the mechanisms of Shenlong Decoction in preventing and treating PF.

Objective To discuss the prognostic impact of atrial fibrillation (AF) in patients with chronic heart failure(CHF).Methods From January,2005 through December,2006 we studied 461 patients with a discharge diagnosis of CHF.Patients were divided by baseline rhythm in sinus rhythm(SR) or AF groups.The main endpoints were all cause death within 3 years and readmission to the hospital for heart failure.Results AF group were more likely to be older and female and to have a history of valvular disease and have a higher left ventricular ejection fraction (LVEF).However,SR group were more likely to have a history of ischemic heart disease.During 3 year follow-up,the main endpoints was higher in AF group than in those with SR group (P ＜0.01).After adjusting for other covariables,AF and age were related to increased the risk of main endpoints during 3 years follow-up (RR =1.311,95％ CI:1.002-1.715,P ＜0.05 ; RR =1.014,95％ CI:1.004-1.024,P ＜ 0.01).Conclusion AF and age were the main risk factors of increased adverse forward prognosis in patients with CHF.

ObjectiveTo investigate the changes in the expression of transforming growth factor beta-1 (TGF-β1) during differentiation of pulmonary microvascular endothelial ceils (PMVECs) into smooth muscle cells in rats with hepato-pulmonary syndrome (HPS).MethodsPrimary PMVECs were harvested from healthy adult SD rats of both sexes aged 3-4 months and inoculated in low-glucose DMEM culture medium (1(6/cm2 ) and randomly divided into 2 groups ( n =24 dishes each):control group ( group C) and HPS group.HPS was produced by chronic ligation of common bile duct.In group C serum obtained from normal rats was added to PMVECs,while in HPS group serum obtained from rats with HPS was added.The final concentration of serum was 10％.After being incubated for 24,48 and 72 h,the expression of SM-MHC,SM-α-actin and calponin protein and TGF-β1 mRNA and protein in PMVECs was determined by RT-PCR and Western blot analysis.ResultsThe expression of SMMHC,SM-α-actin and calponin protein.was positive in HPS group whereas the expression of SM-α-actin and calponin protein was negative and the expression of SM-MHC protein was barely detectable in group C.The expression of SM-MHC,TGF-β1 mRNA and protein was significantly higher in HPS group than in group C.The expression of SM-MHC,SM-α-actin and calponin protein and TGF-β1 mRNA and protein was increasing with duration of incubation from T1 to T3 in group HPS.ConclusionTGF-β1 plays an important role in the myogenic differentiation of PMVECs in rats with HPS.

Aconitum ; poisoning ; Animals ; Disease Models, Animal ; Female ; Hemoperfusion ; methods ; Male ; Plant Poisoning ; therapy ; Rabbits

Biomarkers ; metabolism ; Cholesterol ; metabolism ; Coronary Disease ; Humans