Drawing on recently published foreign literature, this paper comprehensively analyses the research status of medical tourism from the concept of decision-making factors and risks for tourists, as well as the impacts of medical tourism. For future research, it proposes a greater focus on medical tourists, caregiver-companions and medi-cal tourism facilitators. To promote the development of Chinese medical tourism, a development model must be con-structed, international medical services, consummate policies, and regulations must be in place, and medical tourism personnel must be trained and welcomed.

Vascular endothelial growth factor is a vascular endothelial cell-specific mitogen.It is the most important angiogenic factor.VEGF expresses highly after cerebral infarction.It plays importmt roles in angiogenesis and neuroprotection.At the same time,its overexpression will also increase vascular permeability;thereby it may aggravate brain edema.This article reviews the advances in research on VEGF and its receptors and cerebral infarction.

Aim To observe the effect of recombinant human interferon and verazole used alone or in combination in resisting respiratory synthesis virus (RSV) in vitro. Methods RSV strains were proliferated with Hela cells in Eagles solution on a 96 hole plate. The recombinant human interferon and virazole were diluted to different concentrations and were separately added in the dose of 100 ?l to each hole of the plate. After 48 hours cultured, the concentrations of the drugs for inhibiting cytopathogenic effect(CPE)of RSV were determined. Results When the concentration of interferon was ≥5 U?ml -1 and virazlole ≥24 ?g?ml -1 ,respectively,the effect of the two drugs on inhibiting the CPE of RSV was remarkable and was improved with their concentration increasing .When the concentrations of the two drugs were lower than that of their effect respectively , their united use also had obvious effect in resisting the virus. In addition, the different using methods of interferon have also different results. Conclusion Both recombinant human interferon and virazole are effective in inhibiting RSV in vitro and will bring about better effect when used in combination.

ObjectiveTo evaluate the effect and complication of whole γ-knife stereotactic radiotherapy on the non-small cell lung cancer and explore the value of γ-knife stereotactic radiotherapy in treatment of non - small cell lung cancer. Methods42 patients with non -small cell lung cancer:γ-knife radiotherapy patients ,4 ～ 8Gy once a day,five times a week,4 ～ 10times and 40 ～50Gy in total. ResultsThe overall response rate (CR + PR) in γ-knife was 71.4％. The1-,2-and 3-year survival rates were 95.5％, 59.5％, 33.3％. ConclusionCompared with conventional radiation,γ-knife stereotactic radiotherapy could achieve tumor dose escalation,and give the normal tissue better protection at the same time. It could improve the tumor control rate of non-small cell lung cancer,improve long survival rate,and so could reduce the radiation reaction.

Objective To evaluate the application of small dural window exposure strategy for removal of subdu-ral hematomas and decompressive craniectomy in patients with severe brain injury. Methods Eighty patients with an ad-mission Glasgow Coma Scale score of 8 or less were randomly divided into two groups:Routine craniectomy group (42 pa-tients) and small dural window exposure strategy group (38 patients). The clinical outcomes were compared between these two groups. Results The average quantity of blood transfusion (erythrocyte suspension)at 24 h was 2.85 ± 1.98 and 1.43±1.40 unit in the routine craniectomy group and small dural window exposure strategy group, respectively. The num-bers of the delayed intracranial hematomas, traumatic epileptic seizure as well as acute encephalomyelocele were 10, 12 as well as 9 in the routine craniectomy group and 2, 3 as well as 1 in the small dural window exposure strategy group. However, the time of operate duration and the incidence of cerebral infaction were not significantly different between two groups (P>0.05). After 6-month follow-up, there were 16 cases with favorable outcomes including 10 with good recov-ery and 6 with mild disability and 26 cases with unfavorable outcomes, including 7 with severe deficits, 6 with persistent vegetative status and 13 dead in the routine craniectomy group. In contrast, there were 23 cases with favorable outcomes including 12 good recovery and 11 mild disability and 15 cases with unfavorable outcome including 6 with severe deficits, 4 with persistent vegetative status and 5 dead in the small dural window exposure strategy (P﹤0.05). Conclusion small dural window exposure strategy is an excellent technique for the complete evacuation of the traumatic intracranial hemato-ma, especially those with massive intraoperative swelling .

Objective To explore and evaluate the application value of damage control theory in bilateral craniotomy operation of severe craniocerebral trauma.Methods Seventy patients with Glasgow coma scale score ≤ 5 scores were divided into 2 groups by random digits table method with 35 cases each:standard trauma craniotomy group (normal group),non-standard craniotomy and small dural window exposure strategy group (improved group).The clinical data were compared.Results There was no significant difference in postoperative cerebral tissue bone window embedded meal,large area cerebral infarction incidence rate between two groups (P ＞ 0.05).There was significant difference in the duration of surgery,blood transfusion amount within 24 hours,traumatic epileptic seizure within 1 month,the acute intraoperative encephalocele between normal group and improved group [(2.80 ± 0.63) h vs.(4.21 ± 1.04) h,(3.90 ± 1.02) U vs.(5.55 ± 1.32)U,14.3％(5/35) vs.48.6％(17/35),5.7％(2/35) vs.25.7％(9/35)] (P ＜0.05).Followed up for 6 months,good prognosis,moderate disability,severe disability,vegetative state,death was 4,4,8,6,13 cases in normal group and 8,9,5,4,9 cases in improved group,and there was significant difference (x2 =5.040,P =0.025).Conclusion Severe craniocerebral trauma bilateral craniotomy damage is bigger,damage control theory to guide the improved operation method,can improve the rescue efficiency.

Objective To discuss the classification and treatment of the degloving hand.Methods All 68 degloving hand treated between January, 2005 and December, 2014 in our department were reviewed.The cases were divided into three types according to the extent of the injury.Type Ⅰ the degloving tissue had enough blood supply which was debrided and stitched.Type Ⅱ the degloving tissue had less or no blood supply which was revascularized with replantation or vein anastomosis, some degloving palm or dorsum resurfaced the wound by the degloving skin graft.Type Ⅲ the degloving tissue had no blood supply or severely damaged,the tissue defect should be resurfaced with other tissue reconstruction.Type Ⅱ and Ⅲ were further divided into subtype A, B and C depending on the degloving scope and location, each subtype has its own surgical procedure.Results The total survival rate was 83.8％.The survival rate decreased with the increasing extent of the injury and the increasing degloving scope.Conclusion Classification of the hand degloving injuries depending on the extent of the injury, the degloving scope and location is useful for the assessment of injury and the selection of proper operation procedures.

Objective To investigate the correlation between different blood pressure levels and carotid atherosclerotic plaque formation.Methods The population participated in stroke screening were selected from September 2012 to January 2013 in Dongying,Shandong province.The subjects met the diagnostic criteria of ideal blood pressure (systolic blood pressure [SBP] ＜ 120 mm Hg and diastolic blood pressure [DBP] ＜80 mm Hg,1 mm Hg =0.133 kPa),normotensive (SBP 120-129 mm Hg and/or DBP 80-84 mm Hg),and high-normal blood pressure (SBP 130-139 mm Hgand/or DBP 85-89 mm Hg)were selected.The questionnaires,physical examinations,blood biochemical tests,and neck vascular ultrasound examination were performed.The detection rates of carotid plaque among the normotensive,high-normal blood pressure and ideal blood pressure groups were compared.Multivariatelogistic regression analysis was used to identify the independent risk factors for carotid plaque.Results The proportions of men and diabetes,as well as the levels of body mass index (BMI) and fasting blood glucose (FBG) of the normotensive and high-normal blood pressure groups were significantly higher than those of the ideal blood pressure group (all P ＜0.05).The detection rates of carotid plaque of the normotensive,high-normal blood pressure and ideal blood pressure groups were 12.41％,38.14％ and 49.45％,respectively.The proportions of men and age,as well as the levels of SBP,FBG,and homocysteine (Hcy) of the carotid plaque formation group were significant higher than those of the non-carotid plaque formation group (all P ＜0.05).Multivariable logistic regression showed that age,SBP,FBG,and Hcy were the independent risk factors for carotid atherosclerotic plaque formation,while female gender was an independent protective factor.After adjusting the risk factors such as age,FBG,and Hcy,etc,the risk of plaque formation of the high-normal blood pressure group was significantly higher than that of the ideal blood pressure group (odds ratio 1.354,95％ confidence interval 1.028-1.783; P =0.031),while there was no significant difference between the normotensive group and the ideal blood pressure group.Conclusions High-normal blood pressure was significantly associated with the increased risk of carotid plaque formation,which was an independent risk factor for carotid plaque formation.

Objective To observe the influence of storage time and condition on the chemical components in the volatile oil of Fructus Evodia by GC-MS.Methods The volatile oil was extracted from Fructus Evodia by steam distillation and the amount of each components in the volatile oil was determined by area normalization method and the components were identified by GC-MS.Results One hundred and sixteen components were separated and identified,which accounted for more than 90% in the total constitutes of the volatile oil.The content of volatile oil in Fructus Evodia was influenced by the storage time and condition.Conclusions The method is reliable and has a good repeatability,and can be applied to analyze volatile components in Fructus Evodia.This will provide a certain scientific basis for the storage and clinical application of Fructus Evodia.

Objective To study the effects of physical training on baroreflex sensitivity (BRS) by monitoring finger arterial pressure among volunteers who had experienced three-months′ aerobic or anaerobic exercises.Methods A total of 16 healthy men were divided into the aerobic exercise+anaerobic exercise group (group A,n=7) and aerobic exercise group (group B,n=9).Each subject was trained for 12 weeks.Head-up tilt (HUT) table test was performed before and 4,8,and 12 weeks after training.Blood pressure,finger arterial pressure and electrocardiogram (ECG) were compared between the two groups.Results The BRS was significantly increased after training in group A,although no changes were found in group B.Conclusion Three-months′ aerobic exercise+anaerobic exercise seems to enhance the BRS; however,three-months′ aerobic exercise may decrease the BRS.