In this study,LDH enzyme-release assay for NK cytotoxicity activity was used to evaluate the natural body defence in gastric cancer patients. The percentage cytotoxicity was 34.12?8.66 in normal adults(92 cases) versus 16.35?7.76 in patients with gastric cancer(37 cases)(P

Objective To explore the effect of bispectral index (BIS) monitoring on hemodynamics patients undergoing laparoscopic cholecystectomy under laryngeal mask anesthesia.Methods 110 patients with laparoscopic cholecystectomy were randomly divided into the control group and the observation group according to digital table method.The control group was administered according to the experience of anesthesiologists,the observation group was administered according to BIS monitoring.The hemodynamic indexes,the dosage of anesthetic drug and recovery time of two groups were analyzed.Results After pulling out the laryngeal mask,the HR (74.13±6.99)beats/min,MAP (78.54±8.01)mmHg and COR (321.23±15.35)nmol/L of the observation group were significantly higher than HR (94.21±9.53)beats/min,MAP(98.67±10.21)mmHg and COR (463.24±20.01)nmol/L of the control group,the differences were statistically significant (t=12.60,11.50,41.76,all P<0.05).The amount of propofol induction (1.65±0.21)mg/kg,dosage of propofol (323.13±15.64)mg and remifentanil (401.21±20.11)μg of the observation group were lower than those of the control group [(2.39±0.34)mg/kg,(414.32±20.34)mg,(469.54±22.39)μg],and the recovery time of the observation group (6.89±1.01)min was significantly better than (10.21±1.42)min of the control group,the differences were statistically significant (t=13.73,26.36,16.84,14.13,all P<0.05).Conclusion The effect of BIS monitoring in laryngeal mask anesthesia for laparoscopic cholecystectomy is significant,which can reduce intraoperative anesthetic dosage,promote hemodynamic stability,reduce the stress response of patients,shorten recovery time,the anesthesia is more safe and reliable.

Objective To evaluate the traditional Chinese medicine(TCM) output efficiency of the coUnty-level TCM hospitals in Jiangsu Province before and after the reimbursement mechanism reform,and to analyze the factors which affect the efficiency of county-level TCM hospitals.Methods Using DEA to analyze the efficiency of county TCM hospitals,and using the Tobit regression to analyze the influence factors.Results The output efficiency of county-level TCM hospitals in Jiangsu Province is low,and the reimbursement mechanism reform in county-level hospitals of TCM efficiency further decreases;payment model,cost model and revenue model of regression analysis indicate that different factors has different influence on output efficiency of county hospitals of TCM.Conclusion The reimbursement strategy of county-level TCM hospitals should be optimized,the balance of revenue and expenditure structure be adjusted,and the intensity of TCM services reimbursement be increased.

Objective To learn the clinical effect and adverse reaction of hydromorphone for continuous epidural analgesia after cesarean section,and to provide effective anesthesia method for clinical.Methods 116 cases of cesarean section were randomly divided into observation group(65 cases) and control group(51 cases),continuous epidural analgesia was used in the two groups after operation.Among them,hydromorphone + ropivacaine was used for the observation group,morphine + ropivacaine was used for the control group.The analgesic effect and sedation degree of the two groups were evaluated.The adverse drug reactions were observed,and satisfaction of the patients after the operation was investigated.Results 6,9,24 hours after operation,the VAS pain scores of the observation group were lower than those of the control group,the differences were statistically significant(t=3.236,4.970,2.547,all P<0.05).3,6,9,24,48 hours after surgery, the differences of Ramsay sedation score between the two groups were not statistically significant(t=0.717,1.502,0.714,1.051,0.589,all P>0.05).The difference of postoperative first exhaust time between the two groups was not statistically significant(t=0.730,P>0.05).The satisfaction degree of the observation group was significantly higher than that of the control group,the difference was statistically significant(t=2.301,P<0.05).The incidence rate of adverse reactions of the observation group was 7.69%,which of the control group was 11.76%,the difference was not statistically significant(x2=0.552,P>0.05).Conclusion For continuous epidural analgesia after cesarean section,hydromorphone can effectively relieve the pain after operation,the safety of the process is high,and it has good clinical application value.

Objective:To analyze different age group elderly’s financial burden and risk due to non-communicable chronic diseases (NCDs). Methods:Based on CHARLS baseline investigation data, disease economic burden, disease economic risk for family and disease relative risk are used to analyze the economic risk and economic burden of the different age groups of urban and rural NCDs elderly. Results: The diseases financial burdens of urban NCDs elderly are greater than rural; for diseases family risk and relative risk, NCDs elderly are greater than non-NCDs elderly, urban NCDs elderly are greater than rural, high-age group NCDs elderly are greater than low-age group NCDs elderly. Conclusion: It is needed to improve the NCDs elderly’s medical security ability with basic health insurance, especially to improve medical security ability of the high-age group for rural elderly.

Objective Jizhipingchuan soft capsula is mainly used to treat acute bronchitis and acute attack of chronic bron-chitis.This paper investigate the antitussive, antiasthmatic and expectorant effects of Jizhipingchuan soft capsula according to its func-tions. Methods The antitussive effect of Jizhipingchuan soft capsula was observed in cough mouse model induced by ammonia and in guinea cough pig model induced by citric acid, and the latent period of asthma was observed in guinea pig induced by acetylcholine chloride and histamine phosphate.Its expectorant effect was evaluated by the excretion of phenol red in mice and the exudation phlegm in rats. Results Jizhipingchuan soft capsula could decrease the frequence of cough induced by ammonia in mice and induced by cit-ric acid in guinea pig.It could prolong the latent period of cough in guine pig and also prolong the latent period of asthma in guine pig induced by acetylcholine chloride and histamine phosphate.Jizhipingchuan soft capsula could significantly increase the amount of phe-nol red secreted in mice and the phlegm exudation of rats. Conclusion Jizhipingchuan soft capsula showed definite antitussive, an-tiasthmatic and expectorant effects.

Objective To study the effective method of improving the diagnosis and treatment of blunt liver injury.Methods The clinical data of 135 cases with blunt liver injury hospitalized in Daxing District People' s Hospital from January 2000 to October 2010 were reviewed retrospectively.Results By standard grading of American Society of Trauma Surgery (AAST) in 1994,36 cases were grade Ⅰ,42 cases gradeⅡ,33 cases gradeⅢ,14 cases grade Ⅳ,10 cases gradeⅤ.Fifty-one cases were treated by non-operative therapy,among which 42 cases were crued,9 cases underwent operative surgery.Ninety-three cases were treated by operative therapy,seven cases died.The morbidity related to blunt liver injury was 5.19％.Conclusions Non-operative therapy may be used firstly in patients with stable hemodynamics,but close monitoring should be done for changes of the life signs.Timely and reasonable choice of time and the way of surgery is important to avoid complications and reduce the mortality rate.

Multislice Cr angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease.Rapid improvements in multislice CT scanners over the last decade have allowed this technique to become a potentially effective alternative to invasive coronary angiography in patients with suspected coronary artery disease.High diagnostic value has been achieved with multisfice CT angiography with use of 64-and more slice CT scanners.In addition,multislice CT angiography shows accurate detection and analysis of coronary calcium,characterization of coronary plaques,as well as prediction of the disease progression and major cardiac events.Thus,patients can benefit from multislice CT angiography that provides a rapid and accurate diagnosis while avoiding unnecessary invasive coronary angiography procedures.The aim of this article is present an overview of the clinical applications of multislice CT angiography in coronary artery disease with a focus on the diagnostic accuracy of coronary artery disease;prognostic value of coronary artery disease with regard to the prediction of major cardiac events; detection and quantification of coronary calcium and characterization of coronary plaques.Limitations of multislice Cr angiography in coronary artery disease are also briefly discussed,and future directions are highlighted.

Objective Tostudy the effects ofRheu compositus (Dachengqi Decoction, DD) on the NF-κBactivity of alveolar macrophages in ARDS rats and its inflammatory cytokine expression, and hence to explore the molecular mechanism of the anti-inflammatory effects of DD. Method The 65 male Wistar rats were randomly di-vided into the control group (n = 12), the ARDS model group (n = 21), the DD treatment group (n = 16) and the dexamethasone treatment group (n = 16). The rots of model group received 1 mg/(kg·0.5 mL) LPS injected intra-poritoneally and LPS in dose of 5 mg/(kg·0. 5 mL) was administrated by slow dropping endotracbeally 16 hours later. Modeling was successfully established 6 hours later evidenced by arterial gas analysis. The rats of con-trol group received 0.5 mL normal saline injected intravenously through tail vein instead of LPS. Three days after establishment of modeling, DD was given to rats of DD treatment group by intragastric instillation for 3 days in dose of 2.31 g/(kg·d),in which the weight of drug was calculated on the basis of dried herbal medicine. In dexam-ethasone treatment group, rats had intra-peritoneal injection of 2 mg/kg dexamethasone for 3 days after modeling was established. Seventy-two hours later, the arterial blood gas analysis and pathological study were carried out, in rats of all groups, and the findings were graded. The levels of TNF-α, IL-1 and IL-10 both in the plasma and in the brenchoalveolar lavage fluid were determined by using the enzyme linked immunosorbent assay (ELISA). Besides the nucleopretein concentration of pulmonary alveolar macrophage (PAM) was maeasuredwith the BAC method, and the NF-κB activity was determined with the Western Blotting, and with the evaluation of the DD' s effect on the transcription activity of PAM inflammatory cytokines. All the experimental data were processed by the SPSS 13.0 for statistical analysis. The analysis of variance was used for the comparison between groups, and P < 0. 05 showed the statistical significance of the difference. Results DD didn' t significantly reduce the TNF-α level [(510.97±76.20) pg/mL,(476.16±98.03) pg/mL, P >0.05], but significantly deceased the plasma IL-1 level [(381.99±34.30) pg/mL, (300.69 ± 50.99) pg/mL, P <0.05]. At the same time, there was no signif-icant changes in the plasma IL-10 level [(345.96 ± 67.72) pg/mL, (345.30 ± 78.52) pg/mL, P > 0.05]. Whereas TNF-α level in BALF was significantly decreased [(130.94 ± 33.51) pg/mL, (106.59 ± 26.64) pg/ mL, P < 0. 05, so was the IL-1 level in BALF (82.5 ± 25.36) pg/mL, (63.89 ± 22.96) pg/mL, P < 0. 05], but IL-10 level in the BALF was significantly increased[(77.09 ± 26.05) pg/mL, (148.05 ± 53.50) pg/mL, P <0.01]. DD significantly reduced the nueleoprotein level of PAM[(5.35 ± 2.44) μg/μL, (3.54 ± 2.01) μg/ μL, P < 0.05]and significantly inhibited the NF-κB activity [electrophoretic band optical density × area/consult mtio:(1.45±0.71),(1.11±0.28), P <0.05]aswell. Conclusions DD regulated systemic pro-inflammato-ry media/anti-inflammatory media balance in rats with ARDS by mainly reducing the level of IL-1. The regulatory effects of DD on the local lung injury not only inhibit the producing of TNF-α and IL-1 level,but also increase the IL-10 level to reestablish the local pro-inflammatory factors/anti-inflammatory factors balance so as to inhibit the lo-cal excessive irranune response. DD inhibits the NF-κB activity in the PAM of ARDS rats so as to restrain the pro-duction of pro-inflammatory cytokines (TNF-α and IL-1). This kind of multi-target bidirectional regulation plays an active role in regulating the immune balance and protecting the target organ from the excessive injury.

Objective To explore whether Cl2MDP-loaded gelatin particles can induce the depletion of macrophage or can depress the immunity of macrophage in SD rat models of immune thrombocytopenic purpura(ITP) to treat the ITP rats.Methods SD rats were intravenously injected with 150 ?L of anti-platelet serum once per 24 hr to induce the ITP model.The platelet count was persistently less than 50?109L-1 in these models.After intravenous injection of a group dose of Cl2 MDP-gelatin particles,the platelet counts of these models were examined at the time of 4 hr,24 hr,48 hr,72 hr and 96 hr,respectively.The pathological change of macrophages in spleen was observed by electron microscopy.Results Cl2MDP-loaded gelatin particles can significantly increase the platelet counts of ITP models from less than 50?109L-1 to mean 180?109L-1 in 24 hr after injection.The pathological changes of macrophages were seen under electron microscope,such as degeneration, necrosis and so on.Furthermore,rats pre-treated with Cl2 MDP-loaded gelatin particles can evade the decrease of platelet counts when they were injected anti-platelet serum.Conclusion Cl2 MDP-loaded gelatin particles can promptly,effectively restoreplatelet counts of ITP models to physiological level with a dose dependent manner.So,the targeting therapy of drug-loaded gelatin particles offers a new approach to treat ITP.