Objective To analyse the health system responsiveness of Huzhou of Zhejiang Province. Methods Performance evaluation method proposed by WHO was employed for the study of responsiveness. The local residents of Huzhou of Zhejiang Province in 2007 were investigated with multilevel cluster stratified sampling. Data were obtained by household survey and involved items such as dignity,independence,privacy,communication,timely attention,equipment,social support and selection of medical staff,and were subjected to empirical analysis. Results Household survey was conducted in 1353 residents,among whom 28.16% lived in town and 71.84% lived in countryside. The index of health system responsiveness of Huzhou was 7.96,slightly higher than that of Zhejiang Province (7.71). The responsiveness was significantly higher for countryside than that for town in independence,communication and timely attention (P

Animals ; Disease Models, Animal ; Endothelin-1 ; metabolism ; Male ; Nitric Oxide ; metabolism ; Paraquat ; poisoning ; Rats ; Rats, Sprague-Dawley

Objective To investigate the causes and mechanism of preterm birth through analysis of the relationship between histological chorioamnionitis (HCA) in placental tissue and preterm birth.Methods Totally,327 preterm birth cases with report of placental pathologic examination were retrospectively collected from those women who delivered from December 1,2009 to December 1,2012 in Peking University First Hospital.According to the etiology of preterm birth,three groups were assigned:iatrogenic group (n=106),spontaneous contraction group (n=56) and premature rupture of membranes (PROM) group (n=165).According to the gestational age at delivery,three subgroups were further divided:early-preterm group (≥ 28-＜ 32 weeks),mid-preterm group(≥ 32-＜ 34 weeks) and late-preterm group (≥ 34-＜ 37 weeks).HCA was confirmed when ≥ 5 neutrophil infiltration identified on the chorionic plate and amniotic membrane under high power light microscope after HE staining.The relationship between HCA and the different types of preterm birth and the different delivery gestational age were analyzed.Besides,the consistency between clinical chorioamnionitis and HCA was also analyzed.Chi-square test was applied for statistics.Results The incidence of HCA in the spontaneous contraction group was significantly higher than in the iatrogenic group and PROM group [66.1％ (37/56) vs 25.5％ (27/106) and 33.3％ (55/165),x2=25.27 and 18.44,both P ＜ 0.01],but no significant difference was found between the latter two groups (P ＞ 0.05).Among the three subgroups,the early-,midand late-preterm subgroup,the incidence of HCA in the iatrogenic group was 24.0％ (6/25),33.3％ (8/24) and 22.8％ (13/57) (P ＞ 0.05),and 13/17,5/7 and 59.4％ (19/32) in the spontaneous contraction group (P ＞ 0.05).However,significantly higher incidence of HCA was shown in the early-preterm subgroup than in the mid-and late-preterm subgroup [70.0％ (20/29) vs 41.2％ (14/34) and 20.6％ (21/102),X2=4.87 and 24.58,both P ＜ 0.05] in the PROM group.Among the subjects in PROM group,those with the latency ≥ 72 h after the rupture of membranes had a higher incidence of HCA than those with the latency less than 72 h [68.6％ (24/35) vs 23.8％ (31/130),x2=24.82,P ＜ 0.01].For all 327 cases in this study,the incidence of clinical chorioamnionitis was 15.9％ (52/327),among which 31 cases [59.6％ (31/52)] were diagnosed as HCA.Conclusions The occurrence of HCA is closely associated with spontaneous contraction preterm.Some iatrogenic preterm birth might cause HCA.The earlier the preterm birth and the longer the latency after PROM,the higher the incidence of HCA.Differential diagnosis is necessary as the inconsistency between clinical chorioamnionitis and HCA.

With the rapid development in cataract operation,characteristics and types of intraocular lens have been improving and altering all along in over fifty years.The correct selection for intraocular lens is significant for cataract patient to get better vision after operation.Description of characteristics and selection of the intraocular lens are summarized.

Objective To investigate the distribution of scopolamine into brain following intranasal .Methods Adult Wistar rats were divided into two groups ,and administrated with scopolamine 0 .3 mg via intraperitoneal or intranasal respectively .Two groups of blood concentration and brain concentration of scopolamine were determined by solid phase extraction (SPE) and LC/MS assay at the time point of 5 ,10 ,20 ,30 ,60 ,120 ,240 ,480 min ,and their kinetic parameters were calculated and compared .Results Scopol-amine bioavailability of intranasal administration was 65% ,and the maximum concentration of scopolamine in brain following in-tranasal administration was much higher than that following intraperitoneal administration .Comparing the ratio of AUC in brain and in plasma ,ratio of intranasal administration is bigger than that of intraperitoneal administration significantly (P<0 .05) .Con-clusion It was concluded that scopolamine′s intranasal administration induced the agent targeting distribution into the brain .

To explore the clinical manifestations, diagnosis and treatment of pulmonary thromboembolism associated with protein C (PC)/protein S (PS) deifciency. Two male patients 29 and 26 years old diagnosed with PC deifciency and/or PS deifciency were retrospectively analyzed and related literatures were reviewed. The most common symptoms were pain in the lower limbs with chest pain or decreased vision. Color dopper lfow imaging (CDFI) showed lower deep venous phlebothrombosis. Multislice CT angiography (CTA) revealed pulmonary embolism. The level of serum homocysteine (HCY) increased and the level of plasma PC/PS content decreased to PC 57.4%, and PS 28.9%in patient 1, while PS 33.4%in patient 2. Poor routine anticoagulant response was observed. After the diagnosis of PC/PS deficiency, vitiamin B6 and B12 anticoagulant therapy was added, and the symptoms in the patients improved significantly. Congenital thrombophilia should be taken into consideration for young patients with lower deep venous thrombosis and pulmonary embolism which occur recurrently without obvious predisposing causes before 40. Plasma PC/PS concentrations or activity help a lot in the diagnosis and treatment.

ObjectiveTo explore the effects of different health management on adults with prediabetes.MethodsA total of 1182 pre-diabetics were enrolled in this prospective observation study and assigned to one-by-one interview group,in situ education group,communicative interview group and control group.Three intervention groups received life style intervention ( including health education and risk factor control) for 2 years.Analysis ofvariance,x2 test or q test were used for data analysis.ResultsAfteryear intervention,fasting plasma glucose (FPG)and 2 h plasma glucose of the intervention groups were significantly decreased ( P ＜ 0.05 ).FPG of the one-by-one interview group and the in situ education group was significantly lower than that of the communicative interview group at 6 months ( P ＜ 0.05 ). At 24months,FPG of the one-by-one interview group was lower than that of the in situ education group (P ＜0.05).The percentage of participants who showed appropriate blood glucose control was increased in the intervention groups. In addition,blood pressure,triglyceride,cholesterol,creatinine and body weight of those in the intervened groups were significantly improved compared with the control group ( all P ＜ 0.05 ),although electrocardiogram results and arteriosclerosisshowed nosignificant changes(P ＞ 0.05 ).Conclusion Health management may contribute to life style change and hypertension control of prediabetics.Furthermore,in situ education may be the most effective life style interventions.

Objective To make a survey on common cosmetic allergens, and to provide epidemiological data and clinical evidence for cosmetic allergy. Methods Patch test was performed by using 49cosmetic allergens from a European cosmetic series and 5 Chinese standard screening allergens on 89patients with suspected cosmetic allergic contact dermatitis. Test results were determined according to the International Contact Dermatitis Research Group (ICDRG) recommendation. Results Of the 89 patients, 61(68.5%) showed positive reactions to one or more cosmetic allergens. The most common allergens were fragrances (33.7%), followed by preservatives (30.3%), para-phenylenediamine (25.8%) and amerchol L 101(10.1%). Conclusion Fragrances, preservatives, para-phenylenediamine and amerchol L 101 are dominant causative allergens in patients with cosmetic allergic contact dermatitis.

Objective To compare the therapeutic effect of combined fascia sheath suspension and frontal muscle flap suspension in the treatment of congenital severe congenital ptosis.Methods 46 cases (58 eyes) with congenital severe upper eyelid prolapse who were treated from March 2015 to March 2016 in Eye Hospital of Hebei Province were selected.The patients were divided into two groups:combined fascial sheath suspension group and frontalis muscle flap suspension.Comparisons of postoperative patients with eyelid height,eyelid radian,corneal exposure with eyes closed,eyelid activity,complication of the situation were carried out.And patient satisfaction survey was conducted.Results The effective rate of combined fascial sheath suspension group was 93.10％,the complication rate was 6.9％,and the patient satisfaction rate was 91.22±0.37,significantly better than the frontal muscle flap suspension group of patients (75.86 ％,24.14 ％ and 75.05 ± 0.28,respectively).The time of closure of the eyelid was shortened,the complications were less,and the eyelid had better activity.The difference between the two groups was statistically significant (P＜0.05).Conclusions Combined fascia sheath for congenital severe upper eyelid droop is significant,with fewer complications and a higher rate of satisfaction,which is worth clinical promotion.

Small intestinal neuroendocrine carcinoma is poorly differentiated,highly malignant,and originated from the diffuse neuroendocrine system.It diffusely expresses the general neuroendocrine differentiation markers.The disease can be manifested as carcinoid syndrome,but most of the patients were with occult onset and absence of specific clinical symptoms,which led to difficult diagnosis before operation.On June 18,2012,a patient with manifestation of recurrent vague abdominal pain received capsule endoscopy at the Northern Jiangsu People's Hospital.The capsule endoscope was retained in the distal small intestine,and malignant ileum lesion was revealed during the surgical exploration.Finally,poorly differentiated neuroendocrine carcinoma with abdominal wall metastases was identified by pathological examination.