Objective To investigate the status and capacity of eye care services in Yunnan Province in 2007. Design Cross-sectional questionnaire survey. Participants 165 medical institutions in Yunnan Province. Methods Using a standardized questionnaire designed by Ministry of Health,the all hospitals of county or above and eye hospitals in Yunnan Province were investigated during October to December 2007. Main Outcome Measures Number of ophthalmologists and ophthalmic nurses,surgical volume per year,out-patient volume per year and number of ophthalmologists who can operate cataract independently. Results Totally 165 hospitals covered Yunnan Province participated in this study (response rate was 100%). In all these institutions,there were 735 ophthalmologists and 771 nurses. 392 ophthalmologists could perform cataract surgery independently. Within 16 prefectures of Yunnan,Zhaotong prefecture had the least resources of ophthalmology (7 ophthalmologists per million population) while Kunming had 32 ophthalmologists per million populations. In 2006,58346 eye surgeries were performed in all these institutions,including 23833 cases of cataract surgeries. 27 hospitals were not able to provide cataract surgical services. Out 165 institutions,only 29 hospitals (17.6%) had advanced ophthalmic equipments and 6 hospitals (3.6%) did not have any ophthalmic equipment. Conclusion There are big differences of eye care services among different level and different location of medical institutions in Yunnan Province of China. Inappropriate distribution of human resources and low productivity are main issues. Further resources allocation and optimized use of resources in eye care services are needed to meet the needs of patients.

Objective To explore the clinical significance of heart rate turbulence (HRT) in patients with chronic heart failure(CHF).Methods Thirty CHF patients(CHF group) and 28 non-organic heart disease persons (control group) were examined by 24 hours dynamic electrocardiogram (DCG).According to the NYHA grading of the cardiac function,CHF group were divided into low-degree heart failure (LdHF) sub-group (NYHA Ⅰ -Ⅱ,16 cases) and high-degree heart failure (HdHF) sub-group (NYHA Ⅲ-Ⅳ,14 cases).In CHF group,ischemic heart disease (IHD) patients were 18 cases and non-ischemic heart disease (NIHD) patients were 12 cases.Two indexes of HRT including turbulence onset (TO) and turbulence slope (TS) were measured and analyzed.Results The TO value in CHF group [(0.43 ±0.83)%] was significantly higher than that in control group [( - 1.49 ± 1.00)%] (P ＜0.05),and the TS value in CHF group[( 2.67 ± 0.66) ms/RRI] was significantly lower than that in control group [( 8.52 ± 2.09)ms/RRI] (P ＜0.05).The TO value in the HdHF sub-group [(0.79 ± 0.67)%] was significantly higher than that in LdHF sub-group[(0.12 ± 0.86)%] (P = 0.026),and the TS value in the HdHF sub-group [(2.88 ±0.79) ms/RRI] was significantly higher than that in LdHF sub-group [(2.40 ± 0.35) ms/RRI] (P= 0.045).The TO and TS values had no significant difference between the IHD and the NIHD patients (P＞0.05).In CHF group,53.3%(16/30) patients' TO and TS values were both abnormal (TO ≥ 0,TS ≤ 2.5 ms/RRI),and 40.0% (12/30) patients had only TO or TS value abnormal,93.3% (28/30) patients had abnormal HRT.Conclusion The phenomenon of HRT in the patients with CHF obviously decrease,and the HRT can be used to evaluate the severity of heart failure and predict the prognosis of the heart failure.

Objective To investigate the electrophysiology mechanism of the P wave dispersion (Pd) and the maximum P wave duration (Pmax) in patients with paroxysmal atrial fibrillation (PAF),and evaluate the effect of the Pd and Pmax in the prediction of PAF. Methods Forty-eight patients with PAF (group PAF) were slected and divided into 2 sub-groups according to the organic heart disease,group PAF1 (20 cases, without organic heart disease) and group PAF2 ( 28 cases, with organic heart disease). Forty-six patients without PAF were selected as control group. The Pd and Pmax were measured from the 12-lead surface electrocardiogram (ECG). Results The Pd and Pmax in group PAF was higher than that in control group [(41.11 ± 4.97 ) ms vs. (27.77 ± 4.72) ms, ( 111.43 ± 8.01 ) ms vs. (95.57 ± 9.01 ) ms] (P ＜ 0.05 ). The Pmaxin group PAF2 was significantly higher than that in group PAF1 (P ＜ 0.05),and there was no significant difference in the Pd between group PAF2 and group PAF1 (P＞ 0.05 ). The specificity, sensitivity and positive predictive value of Pd ≥40 ms combined with Pmax ≥ 110 ms was 95.65%, 81.25% and 95.12%. Conclusion The Pd and Pmax in the patients with PAF are significantly higher than those in the patients without PAF, and Pd≥40 ms combined with Pmax≥ 110 ms can be used to predict the PAF more reliably and accurately.

Objective To observe the effect of maxillary sinus floor augmentation with transalveolar tech-nique and simultaneous implant.Methods 50 cases of patients with missing tooth in maxillary posterior region with insufficient vertical bone treated by author were selected.Maxillary sinus floor augmentation with transalveolar tech-nique and simultaneous implantation were given after local anesthesia.X -ray was given on the right day,2 weeks, 3 months and 9 months after operation.And the situation of osseointegration was observed.Results There were 2 cases of injuries of maxillary sinus mucoperiosteum in the 50 cases (4%),and no obvious complication was found for timely treatment.There were 5 cases of gingiva with obviously swollen around implant and BOP(+),and the symptoms were obliterated one week after paradental basic therapy and oral health guidance were given.All the situations of the osseointegration of implants were good,and no loosening or dropping case was found in follow up.One year after operation,the mean obsorbation of bone around the neck of implant was (0.9 ±0.3)mm.There was no obvious absorption of bone around implant,and obvious continuous image of maxillary sinus floor could be observed by imaging examination.The satisfaction of chew,pronounce,aesthetics,maintenance and comfort was all 100%,and 49 cases were satisfied with operation tolerance,and satisfaction rate was 98%.Conclusion Ther effect is desired to apply maxillary sinus floor augmentation with transalveolar technique and simultaneous implant under strict indication.And the satisfaction degree is high.

Leukocytes from peripheral blood of 70 normal Chinese,40 males and 30 females, were cultured in vitro according to a modification of Moorhead's method.Chromosome studies were carried out.Table I lists the results obtained including age group,metaphase plates counted and analysed and the chromosome number of each cell.92.4 per cent of 8031 counted cells had the diploid number(2n=46).Chromosome measurements were made from camera lucida drawings.Measurements were estimated to the nearest 0.1 mm on a fine metric scale.The relative length,arm ratio and centromere index of each chromosome were calculated from measurements of 18 haploid chromosome sets of 11 metaphase plates in 6 males and 4 females.The averages,range of variation and 99% confidence limits are listed in Table Ⅲ.Systematic studies of individual chromosomes under the light microscope revealed the following morphological characteristics.The short arms of all 10 acrocentric chromosomes from groups 13—15 and 21—22 could be shown to possess satellites,but in general only 2—8 of these chromosomes at a time carried satellites.In many cells the satellite-carrying chromosomes tended to associate with each other through their satellites.The number of chromosomes involved in each association varied between 2 to 5,occasionally 6.It was not rare to find secondary constrictions to occur regularly in certain regions of chromosomes 1,4,9,13,and 16.Attachments of satellites to such regions of chromosomes 1,4,9,and 13 were also observed.Karyotypic analysis of 357 metaphase plates led us to conclude that in most cases the unequivocal identification of chromosome pairs 4—5,6—12+X,13—15,19—20,and 21—22 was im- possible.Accurate characterisation of these chromosome pairs will have to await further technical advances. The length of the Y chromosomes was systematically measured in order to deter- mine its variability and heritability.Among our sample of 40 male subjects 29 had a Y chromosome slightly larger than chromosome 21,8 slightly smaller or larger than chromo- some 18(long Y chromosome),and 3 smaller than chromosome 21(short Y chromo- some).The heritability of the size of the Y chromosome was established(Fig.Ⅳ). “Spontaneous”aberrations were discovered in 34 of 70 cases.Aberration rates varied from 0.88 to 13 per cent.The relation between aberrations and radiation injuries was briefly discussed.

The instance reality of medial equipment combined with the center problem of standardization management on medical equipment stock to discuss the questions of how to manage and what about manage.According to correlated management demand and the fact of medical procurement,from the point of view on frame construction flow to the problem of elementary demand on medical equipment procurement,the stock process of medical instrument,the stock process of medical consumable and the management of purchase invoice etc were analyzed.The beneficial research reference can be provided by the daily management jobs of stock and maintenance,the management question of more refinement and general standardization.

The general principles on maintenance and management of technical specification are discussed. Through summarizing many years maintenance experiences of the hospital or medical institutions technical support department, the beneficial mentalities and referential experiences are provided by standardized and effective management on maintenance of medical equipment, according to the medical technology level of medical equipment management department, the economic efficiency, the size of medical equipment, the quality of maintenance technicians, and service ability as well as the management methods of medical equipment material.

OBJECTIVE:To investigate the utilization of antibiotics in urinary surgery patients in our hospital.METHODS:The problems lie in the perioperative use of antibiotics in a total of 600 patients with ureter stones,kidney stones,bladder stones and(or)benign prostatic hyperplasia(BPH)undergoing urinary surgery from Jan.to June in 2006 and from Jan.to June in 2007 were analyzed in accordance with the Guiding Principles of Clinical Application of Antibacterials and the related regulations of antibiotics in our hospital.RESULTS:The rate of rational use of antibiotics rose from 12.5% before intervention to 88.2% after intervention.The problems of improper selection of antibiotics,irrational timing and too long duration of drug use were improved to a great extent.CONCLUSION:The intervention on the rational perioperative use of antibiotics is effective and it greatly enhanced the rationality in the perioperative use of antibiotics in urinary surgery patients.

Objective To investigate the effect of T149-C and A163-G polymorphism of osteoprotegerin promoter region combined with low-body weight on bone mineral density (BMD) of postmenopausal osteoporosis women and postmenopausal healthy women. Methods Seventy-three postmenopausal osteoporosis women and 61 postmenopausal healthy women were enrolled. The shifted patterns were searched from randomly selected 25 samples by SSCP-PCR and their sequences were determined by cycle sequencing. The T149-C and A163-G polymorphisms were determined by PCR-RFLP. BMD of lumbar spines and femoral neck, Ward and trochanteric areas were measured by dual energy X-ray absorptiometry. Results T149-C and A163-G polymorphisms in the postmenopausal osteoporosis women and the postmenopausal healthy women were through Hardy Weinberg equilibrium. Both single and combined genotype frequencies of the T149-C and A163-G polymorphism did not show any difference between postmenopausal osteoporosis women and postmenopausal healthy women. The BMD levels of the postmenopausal osteoporosis women were significantly lower than those of the postmenopausal healthy women in lumbar spines and femoral neck, and BMI levels of the postmenopausal osteoporosis women was significantly lower than those of the postmenopausal healthy women. Conclusions The T149-C and A163-G polymorphism has no synergistic effect on bone mass in both the postmenopausal osteoporosis women and the postmenopausal healthy women. The single and combined genotypes of the T149-C and A163-G polymorphism may not be used as genetic markers in predicting their risk of developing osteoporosis in Chinese women of the Han nationality, but may be susceptible gene of osteoporosis.

AIM Interleukin 1?(IL-1?), which is a pivotal cytokine in inflammatory response, can inhibit human polymorphonuclear leukocyte (PMN) apoptosis,which can enhance PMN-mediated cytoxicity. Therefore we research the effect of IL-1? on the change of PMN functions was studied. METHODS Functional capacity of PMN was assessed by spreading, polarization (shape change), superoxide anion production and phagocytosis. RESULTS IL-1? can prolong PMN function by the inhibition of PMN apoptosis. CONCLUSION IL-1? inhibits PMN apoptosis, resulting in a larger population of surviving PMN with a greater capacity for phagocytosis and superoxide production. The later potentially facilitates PMN mediated tissue injury and may be one of mechanisms by which IL-1? contributes to organ dysfunction.