Abstract:The nature and culvert of essential medicines system is educed through analyzing the definition of essential medical service. The existing problems and system design defects of essential medicines are analyzed. The essential rules,essential thinking and mating policies to build the essential medicines of Chinese characteristics are proposed.

Abstract:In this study,we analyzed changes in health resources and utilization of health service in Jiangsu province before and after the implementation of the essential drug system. We studied the balance sheet of 3 districts in a municipality of Jiangsu. We revealed the problems about reducing the ability of medical services,increasing medical losses and inadequate government compensation. We also put forward to some suggestion about increasing the government finance investment to cut loss in health community services.

Abstract:The implementation effect of doctor’s multi-sited license is affected by many factors. We sought to analyze and classify the factors which affect the doctor multi-sites license by applying fishbone diagram. The main impacting factors include policy factors,organizational factors and personal factors. To steadily promot the implementation of doctor’s multi-sited license,it was suggested to promote the policy by improving laws and regulations,establishing a supervision system,modifying physician evaluation system and enhancing physician awareness of the law.

Abstract:Recently,a series of food safety events showed that there were still some urgent problems on our current food safety supervision pattern in actual operation,such as the consultative and coordinating mechanism and the joint participation of the whole society mechanism. Compared to the high security factor of the Hong Kong’s food,the above questions were particularly crucial. The paper draws on the successful experience of safely supervising the food in Hong Kong,and provides the countermeasures of the reform of our food safety supervising model.

Abstract:With the full implementation of the new financial accounting system,the hospital cost accounting will enter a new era. This article will research basic work,accounting processes,accounting reports,analytical applications of the cost accounting,from the hospital management and data basis,trying to construct a new hospital cost accounting system.

Abstract:To analyze a large general hospital in Jiangsu. This study explored the drug use of hospital overall and particular sections,as well as the types,structures and cost control changes of drug use on medicare and private patients after the implementation of the Basic Medical Insurance Drug List of Jiangsu (2010 Edition). Moreover,this study pays attention to the insured patients’ medication,and provides theoretical basis to promote rational clinical drug use,lower operation risk of health insurance funds and control unreasonable increase of medical expenses.

Abstract:Objective:Jiangsu Shengze Hospital is the tertiary hospital located in a town which started operations by the end of 2009. To make better strategies of development,this study surveyed the cognition and objective evaluation of patients and staffs in the hospital. Methods:Literature review was performed to understand the establishment of the hospital and development of social and policy background. The interview and questionnaire survey were used for data collection and statistical analysis. Results:Patients and staffs were satisfied with hospital. However,it needs to focus on the improvement of publicity efforts,medical service level,personnel pay and training,etc. Conclusion:As a typical case of domestic public hospital reforms,it calls for strengthening publicity,ensuring talent team establishment,maintaining the orientation of public welfare. Furthermore,it needs placing emphasis on detailed service and connotation construction. All the conditions mentioned above are fairly important for propelling the stable development of the hospital.

Abstract:As an effective market conduct to choose the best supplier,the tender has become an important managerial approach of public hospitals. The supervision plays a key role in guarantee the tender open,fair,objective,scientific and effective. The important basis of supervision are sound institutions,perfect system,specialized talents and standard operation procedures.

Abstract:Under Tort Law section 60,medical institutions is not responsible for three special statutory exemptions,including patient’s fault,emergency medical treatment and the limit of medical standards;As a tort liability,medical damage liability applies to common exemptions of “Tort Liability Law” Chapter Ⅲ,including intentional fault of patient,the fault of third party and force majeure;However,the prior exceptions signed by medical institutions is invalid.

Abstract:To investigate college students’ sleep health consciousness and habits in Nanjing,the scale of sleep health consciousness and habits was administered to college students. The results are as follows:The students who were surveyed showed positive attitudes toward the arrangement of good sleep environment and no bedtime anxiety,and they showed cautious attitudes toward harmful substance for sleep health. The students who were surveyed showed vague understanding towards the relationship between sports and sleep. When meeting sleep disorders,college students fall back on doctor or classmates and friends,and rarely turn to family or teachers. Universities must take the effective measures to educate students’ sleep health consciousness and habits and improve sleep quality of college students.

Abstract:Objective:To understand the differences in the demand of health education of diabetes with different education degree,and propose ways to enhance manner and promote the effect of health education. Methods:A questionnaire survey was conducted with 502 diabetes in five 3A-grade hospitals of Nanjing. Results:There were statistically significant difference in ten contents,such as technology and note of insulin injections,the effects and adverse reactions of medication. High education level diabetes had higher demand for the effects and adverse reactions of medication,the time and project of regular review. There were also statistically significant differences in diabetes with different education degree. Compared to the low-skilled,diabetes with higher education degree had higher demand in collecting health information and subscribing to newspapers and magazines. Conclusion:Individualized health education is important. We need focus on the use of modern means,such as telephone and internet,and pay attention to the guidance and psychological counseling of families of diabetes.

Abstract:The employment problem of independent college students has become the social focus, and improving the employment competitive ability has become the important content of talent training strategy. SWOT model was used and SWOT matrix was constructed in the article to analyze the internal factors and external factors of employment competitiveness of independent college medical students, then the strategy was explored according to the talent training mode of independent college.

Abstract:For a better understanding of the living conditions of young university teachers after great development of higher education,this study investigated the career planning status of young teachers in five universities in South China by sampling survey. The survey showed that the overall vocational satisfaction of young university teachers is not high. While the teachers recognized the importance of career planning,most of them made short-term planning more than medium-and long-term planning. Through the analysis of the results,some suggestions were proposed for the optimization of young teachers’ career planning in colleges and universities under the new situation. Thereafter,we explored how college unions play the role of a link to the service of school teaching and research and other central tasks,and promoted young teachers’ growth and development.

Abstract:EFL teachers’ self-autonomy is the result of development of society. This article investigated some EFL teachers’ conception about self-autonomy and found many factors,for example,the individuals,universities and society,etc,would influence it. Teachers should be given a much freer surrounding to improve teaching quality.

Abstract:Investigation on 152 international students from undergraduate first grade to graduate third grade of Nanjing Medical University indicated that efficiency of social support system,adaption to the host country culture and the Chinese level were the key points related to the students’ cross-cultural adaption. Compared to girls,undergraduate students,preferring ethnic friends in social activities and who came to China had other reasons,boys,graduate students,preferring Chinese friends and who came to China to pursue the ideal showed relatively higher adaptability in different aspects among the demographic and personalized identity influencing factors.

Abstract:Objective:To investigate the effect of naringenin on TGF-β1/Smad pathway in human bronchial epithelial cells. Methods:HBE cells were divided into the control group,the TGF-β1 group and the naringenin group. The naringenin groups were incubated with different doses of naringenin (25,50 and 100 mol/L) for 2 h. Then the naringenin group and the TGF-β1 group were incubated with TGF-β1. After 2 h,we determined the PAI-1 mRNA level by real time-PCR. After incubated with TGF-β1 for 30 min,we detected Smad2 and Smad2 phosphorylation by Western. Smad2 nuclear translocation was analyzed by indirect immunofluorescent staining. Results:Compared with the control group,the expression of PAI-1 mRNA was significantly increasing in HBE cells stimulated with TGF-β1. Naringenin has inhibitory effects on the expression of PAI-1 mRNA. The totle of Smad2 was similar in different groups. Compared with the control group,phosphorylated-Smad2 was increasing in the TGF-β1 group. Naringenin could significantly inhibit the Smad2 phosphorylation. Immunofluorescent staining showed that the nuclear content of Smad2 in the TGF-β1 group was increased,and in the naringenin group(100 -滋mol/L) was decreased. Conclusion:Naringenin may inhibit TGF-β1/Smad through attenuated Smad2 phosphorylation and suppressed the nuclear content of Smad2 in human bronchial epithelial cells.

Abstract:By introducing and comparing the status quo of the postgraduate education for clinical pharmacy in China and abroad,this study analyzed the problems to be solved in the postgraduate education for clinical pharmacy in China. This study put forward the conception of the establishment of Chinese postgraduate education for professional degree of clinical pharmacy and discusses its necessity. It was concluded that it is hard to meet the demands for high level of clinical pharmacy talents by relying on the model of postgraduate education for clinical pharmacy in China. Based on the analysis,this study provides some strategy and advice for establishment and perfection of the postgraduate education for professional degree of clinical pharmacy from eight aspects in China.

Abstract:Objective:To observe the effect of viral interleukin-6(vIL-6) on the expression of DNA methyltransferase 1(DNMT1). Methods:The eukaryotic expression plasmid carrying vIL-6 gene was transferred into 293T cells. The expression of DNMT1 was examined by quantitative RT-PCR and Western blot. DNMT1 activity was analyzed by colorimetry. Results:Quantitative RT-PCR and Western blot demonstrated that vIL-6 increased the expression of DNMT1. Furthermore,vIL-6 upregulated the activity of DNMT1. Conclusion:vIL-6 can induce the expression of DNMT1. It may be one of the molecular mechanisms of Kaposi＇s sarcoma associated herpesvirus(KSHV)-induced DNA methylation abnormalities and oncogenesis.

Abstract:The setting of the professional degree of clinical surgical-specialty medicine,which is one of the most significant initiatives in the fields of medical degree management and medical graduate education,takes on an important task to train high quality professionals for society. We explored the training mode in clinical surgery postgraduate,and emphasized on the combination of several aspects in the training of clinical surgery postgraduate,which including the clinical skills training,the scientific innovative ability training,the physician-patient communication skills training,the personal comprehensive quality training,and the English proficiency training.

Abstract:Objective:To investigate the effect of membrane cofactor protein (MCP)on the survival of human cervical ovarian cancer cell. Methods:The expression of MCP mRNA and protein was explored by real-time PCR and Western blot,meanwhile,the effect of MCP on the migration and proliferation of ME180 cell was measured by Transwell and methyl thiazolyl tetrazolium respectively. The augment of human cervical ovarian cancer cells was detected by using MTT method,and the migration of such cells were evaluated by Transwell. Results:The results showed that the expression of MCP significantly increased in human cervical cancer tissue,which contributed to increasing the cells migration and augment the number of ME180 cells. Conclusion:The high expression of MCP in human cervical ovarian cancer cells might be the key machanism of the survival of such cells,and play a vital role in the promotion process.

Abstract:With the development of virtual experimental technology,virtual experiment has gradually become one of the directions of teaching reform of molecular biology. The molecular biology virtual experiment constructed by biochemistry department of Nanjing Medical University shows the interface friendly,realistic,practical and testable characteristics. Highly praise is received by teachers and students in the practice teaching.

Abstract:Objective:To investigate the pro-apoptosis effects of triptolide in human with endometrial cancer cell line (HEC-1B) on proliferation and apoptosis and its underlying mechanisms. Methods:①The Cell Counting Kit-8 (CCK-8)was performed to measure the inhibitive effect of triptolide on the apoptosis on cell proliferation.②The apoptosis and the change of caspase-3/9 in HEC-1B by pretreatment with the z-VAD-fmk(pan-capase inhibitor)were detected by CCK-8 and Western blot. Western blot was used to examine the expression of caspase-3/9,bcl-2. Results:The proliferation of HEC-1B was significantly decreased by triptolide in a dose-and time-dependent manner(P < 0.01),and the effect in 48 h/72 h was obvious. The pan-caspase inhibitor z-VAD-fmk pretreatment reduced triptolide-induced apoptosis in HEC-1B, but the result was still higher than the control group (P < 0.01). Triptolide increased the levels of caspase-3/9 expression while reduced bcl-2 expression in the dose-dependent manner(P < 0.05). Conclusion:Triptolide functions as an effective apoptotic inducer in a caspase-dependent apoptosis via mitochondrial mechanism in human endometrial cancer (HEC-1B).

Abstract:By teaching medical students with the original English textbook of gastroenterology,by implementation of the “standard patients” and PBL teaching mode,by the practice in the international out-patient clinic,by the enlargement of knowledge in pathology,laboratory test,image study as well as gastroendoscopic exercises,and by adding “14 days’ notes”,“simple and straight patient management system” and “good doctor’s card wearing system”,all of which have expanded the international mode of thinking in medical students. Thereafter,these actions enhanced learning initiative,enthusiasm and clinical skills of medical students,and will lay a solid foundation for the development of high-quality medical talents.

Abstract:The main characteristics of KaVo PREPassistant system and its application in clinical lab teaching of stomatology were introduced in this study,as well as its problem and application prospect. We conclude that,in general,the PREPassistant system is more accurate and objective than the supervisor’ s visual assessment in evaluating the dental preparations,which can improve the quality and stability of training.

Abstract:Objective: To explore the effect of melatonin and melatonin receptors on the onset of the puberty by observing the plasma concentration of melatonin and melatonin receptors (MT1,MT2)of hypothalamus and pituitary in precocious puberty female rats. Methods:A total of 40 26-day-old female SD rats were divided into the precocious puberty group(A),the treated group(B)and the control groups including the prepuberty group(C1)and the normal puberty group(C2). N-methyl-DL-aspartic acid(NMA)was used to establish precocious puberty female rat model. GnRH analog(Triptorelin) were used to treat precocious puberty. The nocturnal plasma melatonin and luteinizing hormone(LH) level were assayed by enzyme linked immunosorbent assay(ELISA)and the expressions of melatonin receptors(MT1,MT2) and GnRH mRNA were conducted in hypothalamus and pituitary by real time-PCR. Results:There was no significant difference in the plasma melatonin level in each group. The expression of MT1 mRNA of rat hypothalamus and pituitary in the group A was significantly lower than in the group B and C1,and similar with the group C2. Each group showed no significant differences in the expressions of MT2 of hypothalamus and pituitary. Conclusion:The expressions of MT1 mRNA decreased in precocious puberty female rats. GnRH analog may upregulate the expression of MT1 mRNA in hypothalamus and pituitary. The inhibitory effects of melatonin may decline due to the decreased expression of melatonin receptors in the central nervous system by decrease the expression of melatonin receptor in the hypothalamus. Melatonin and its receptors may participate in normal puberty or precocious puberty.

Abstract:Laboratory animal science is a preceding and comprehensive subject,which has become a major teaching tool in medical and life sciences. Laboratory animal science start lately and education of medical laboratory animal science is still in the stage of exploration. The study analyzed the current situation of medical laboratory animal science and put forward the feasible reform strategy. The study promoted the quality of laboratory animal science teaching,and trained practical and innovation abilities of the medical personnel.

Abstract:Objective:To co-culture the ventral spinal cord explants and major pelvic ganglion explants from rats and investigate the interaction between co-cultured explants. Methods:We had developed a system for long-term co-culturing of ventral spinal cord explants and major pelvic ganglia explants to observe the variance of neuron growth. Results:Explanted tissues of both types survived well in co-culture. Spinal motor neurons(SMNs) emitted numerous outgrowing processes,some of which associated with neurons in explanted major pelvic ganglia. Conclusion:Some contacts of specific motor neuron-major pelvic ganglia neuron were observed apparently,suggesting that a functional interaction may develop between the spinal motor neurons and major pelvic ganglion neurons in vitro.

Abstract:Improving medical students’ humanities quality ability is the important measure to cultivate qualified talents in medical colleges. Aesthetic education of music is an effective way to advance medical students’ humanities quality. The article analyzed the current situation of medical students’ humanities quality and the status of music education in medical students’ humanistic education,explored the promotion function of music education to the contemporary medical students’ humanities quality ability.

Abstract:Objective:By the investigation of the characteristics and factors of vocational interests of the higher vocational nursing students,this study discussed how to build up a stable psychological state of nursing student team. Methods:We conducted a survey and used the Chinese Vocational Interest Inventory of Holland Type to measure 425 higher vocational nursing students. The results were analyzed by SPSS17.0. Results:63.5% of the students were society-type. The ratios of society-type and the strength of interest of no work experience,voluntary enrolment and the second grade students were significantly higher than others(P < 0.05). Conclusion:Professional matching of the higher vocational nursing students in vocational interests and their majors is good. Second-grade is the key period for the students changing vocational interest. Vocational interests of no work experience,voluntary enrolment students tend to be the society-type.

Abstract:Objective:To investigate the effect of bortezomib on multiple myeloma stem cells. Methods:In this study,we cultured human multiple myeloma cell lines KMS-11 and the OCI-MY5 in vitro and set the control group and experimental group of bortezomib treatment. To analyze the proportion of side population cells by using flow cytometry and the mechanism of cancer stem cells efflux Hoechst 33342. Results:After treatment,we found that side population cells were significantly increased. Conclusion:The results indicate that the target of bortezomib is non-side population cells and providing an objective basis for the sequential therapy of bortezomib.

Abstract:Objective:To explore the significance of genetic testing in the etiological diagnosis in deafness patients. Methods:A total of 200 unrelated individuals with nonsyndromic hearing loss of unknown etiology were recruited for the mutational screening,by using the methods of DNA microarray and direct sequencing. The mutations tested were 35delG,176del16bp,235delC and 299delAT in the GJB2 gene,C538T in the GJB3 gene,IVS7-2A>G and A2168G in the SLC26A4 gene,and A1555G and C1494T in the mitochondrial 12S rRNA gene. Results:Deafness-causing mutations were detected in 78 patients(39.0%),of which 59 subjects (29.5%) were diagnosed as hereditary hearing loss. The carrier frequencies of deafness-causing mutations in these patients were 18.5% in GJB2,14.0% in SLC26A4,1.0% in GJB3 and 5.5% in mitochondrial DNA 12S rRNA,respectively. Conclusion:Genetic factors account for almost 30% hearing-impaired subjects of unknown etiology. The results indicate the necessity of genetic screening for mutations of these causative genes in patients with nonsyndromic hearing loss.

Abstract:Vocational guidance is a process of providing advices, guidance and help to job seekers, keeping employment stability and promoting career development. On the basis of the traditional medical students’ vocational guidance, through consulting literature, questionnaire and descriptive research method, the study explores the new ways, new mode and new methods of medical students’ vocational guidance.

Abstract:Objective:To evaluate the correlation of KIR3DS1 alleles,environmental factors with the progression of HIV-1 infection in Chinese population. Methods:In total,86 cases of newly reported HIV/AIDS were recruited from people receiving voluntary counseling and testing(VCT). KIR3DS1 genes was assessed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Meanwhile,questionnaire survey was conducted to collect the environmental information. Results:Cox regression analysis showde that, compared with non-antivirus treatment group, the risk ratio (RR) of antivirus treatment was 0.217(95%CI =0.098~0.480). Conclusion:Antivirus treatment can delay the progression to AIDS,and KIR3DS1 gene may potentially be associated with slower progression to AIDS in Chinese population.

Abstract:Objective:To investigate the distribution and resistance of positive pathogens isolated from blood culture in the First Affiliated Hospital of Nanjing Medical University in 2011. Methods:Automatic blood culture instrument of BACTEC 9240 was used for blood samples; bacteria and fungus were identified by API system and automatic detection machine of VITEK2;bacterial drug sensitivity was determined by disk diffusion method;drug sensitivity of fungi was determined by Rosco method;and Whonet 5.4 software was used for data analysis. Results:Among the 4 051 blood culture samples,602 cases showed positive.Gram-negative bacteria accounted for 47.5%,gram-positive bacteria for 45.0%,fungi for 7.0% and anaerobes for 0.5%. Of the Gram-positive bacteria,61.8% were Staphylococcus,18.0% were Enterococcus and 14.3% were Streptococcus. There was no resistance to linezolid,vancomycin and teicoplanin in Staphylococcus,while nine stains were intermediary sensitive to teicoplanin. The sensitive rate of Enterococcus to linezolid was 100.0%,but two stains of E. faecium were resistant to vancomycin or teicoplanin. The Gram-negative bacteria were composed mainly of Escherichia coli,Klbesiella pneumoniae,Acinetobacter bauamnnii and Pseudomonas aeruginosa. The sensitive rates of Enterobacteriaceae to imipenem and meropenem were 86.8% and 85.8%. Acinetobacter bauamnnii had a relatively high resistance to many antimicrobial drugs,which was above 50.0%. Conclusion:There is a variety of pathogens isolated from the blood culture,which show an increasing trend of the resistance to many antimicrobial agents. Strengthening surveillance allows of no delay.

Abstract:Objective:To identify small supernumerary marker chromosome by application of multiplex ligation-dependent probe amplification (MLPA)and array comparative genomic hybridization (aCGH). Methods:One case with abnormal mentality was indentified with de novo small supernumerary marker chromosome. G-banding analysis indicated that the patient has a karyotype of 47,XY,+Mar. MLPA was applied to investigate the origin of small supernumerary marker chromosome. Moreover,aCGH was used to define the precise location and size of de novo chromosome. Results:The result of MLPA showed the patient had duplication in 18p11.21 and 18p11.32;aCGH revealed that there was 15 Mb duplication from 18 p11.21-p11.32 in the patient. MLPA and aCGH revealed the presence of small supernumerary marker chromosome,which was derivative from the short arm of chromosome 18. Conclusion:The technologies of MLPA and aCGH can be used for identifying the origin of small supernumerary marker chromosome and defining the loci of the chromosome and can be applied to genetics analysis.

Abstract:Objective:To analyze the prevalence and genotype distribution of cervical human papillomavirus (HPV) infection among women in Nanjing,China. Methods:Fast nucleic acid hybridization chip was performed to detect cervical HPV DNA and genotype of 7 531 women and the prevalence and genotype distribution were analyzed. Results:The overall prevalence of cervical HPV infection was 33.0% among women in Nanjing(age-standardized prevalence was 37.3%). Among 2 485 HPV-positive women,the overall prevalence of HPV infection was highest in the group aged ≤24 years(43.3%)and there was significant difference between the prevalence of different age-stratified group;the overall prevalence of multiple genotypes HPV infection was highest in the group aged ≤24 years(40.0%)and there was significant difference between the prevalence of different age-stratified group;among the detected 21 HPV genotypes,the most common high-risk HPV genotypes were HPV16(8.6%),HPV58(7.6%),HPV52(5.2%). Conclusion:The prevalence of cervical human papillomavirus among women aged ≤24 years in Nanjing was relatively high,cervical disease prevention program should give priority to this population;HPV 16,HPV 58 and HPV 52 were the most prevalent cervical HPV genotypes among women in Nanjing.

Abstract:Objective:To investigate the influence of different antiplatelet therapies on the platelet activation and aggregation in patients with acute cerebral infarction. Methods:CD62P was measured by flow cytometry,arachidonic acid-induced platelet maximal aggregation rate(MARAA),adenosine diphosphate-induced platelet maximal aggregation rate(MARADP)were performed by turbidimetry. A total of 97 cerebral infarction patients were randomly divided into different antiplatelet therapy groups(the aspirin group,the clopidogrel group and the aspirin plus clopidogrel group). CD62P,MARAA and MARADP were measured on the 1st day (before treatment)and 10th day after admission. Results:On the first day,comparisons of CD62P,MARAA and MARADP among the three treatment groups were not significant. The levels of CD62P,MARAA and MARADP in each group were significantly decreased from 1 day to 10 day after admission. Comparison of MARADP decrease extent among the three treatment groups was significant,MARADP of the aspirin plus clopidogrel group decreased more distinctly than the clopidogrel group and even more than the aspirin group. Comparisons of CD62P and MARAA decrease extent among three treatment groups was not significant. Conclusion:Three antiplatelet therapies(aspirin,clopidogrel,aspirin plus clopidogrel) all reduced platelet activation and maximum aggregation rate,which indicated that each antiplatelet therapy was effective. Aspirin plus clopidogrel therapy could most significantly reduce platelet aggregation,which indicated that the curative effect was better among three antiplatelet therapys.

Abstract:Objective:To observe the indexes of syndromes of traditional Chinese medicine (TCM) in patients during the perioperative period of cardiopulmonary bypass (CPB)operations,and evaluate the effect of FuXinJian on TCM syndromes in patients with resistance mechanism disorders after CPB operations. In addition,to investigate the etiology and pathogenesis of resistance mechanism disorders after CPB operations,as well as the clinical application of FuXinJian in CPB operations. Methods:A total of 90 patients were divided into 3 groups according to completely randomized design,who needed CPB in open heart valve replacement surgery,as well as qi-deficiency and blood-stasis type or heart-blood stasis type. The 3 groups were the FuXinJian preoperative intervention group(n = 30),the FuXinJian postoperative intervention group(n = 30)and the control group(n = 30). The scores of indexes and the rates of score reduction of TCM symptoms(clinical symptoms)in patients were observed and recorded in 7 days before operations(T1),one day before operations(T2),one day after operations(T3),eight days after operations(T4). Results:The scores of the indexes of TCM symptoms(clinical symptoms) in patients of all of the 3 groups had no significant difference in T1,and the clinical data of the 3 groups had comparability (P > 0.05). Compared with the control group,the scores of the indexes of TCM symptoms decreased significantly in the first group in T2,T3 and T4,as well as the rates of score reduction increased significantly. No significant difference was detected in the scores of the indexes of TCM symptoms and the rates of score reduction between the second group and the control group in T2,T3. The scores of the indexes of TCM symptoms decreased and the rates of score reduction increased significantly in the second group in T4(P < 0.05). Conclusion:FuXinJian can effectively improve TCM syndromes of resistance mechanism disorders in patients after CPB operations.

Abstract:Objective:To evaluate the role of embolism in lacunar infarction(LI). Methods:Consecutive patients admitted to our hospital with acute cerebral infarction from Oct. 2008 to Jun. 2011 were reviewed. Patients with cardioembolism or other determined etiologies were excluded while other patients were divided into two groups,including the LI group and the non-LI group according to the diameter of infraction. Risk factors and arteries plaques and stenosis of two groups were analyzed. Results:There was no statistical difference of every risk factor between two groups(P > 0.05);the plaques and stenosis in the territory arteries were significantly more frequent than that in the contralateral side in both groups(P < 0.05);the plaques and stenosis in the territory arteries and the progressive and multiple infraction were significantly less frequent in the LI group than in the non-LI group (P < 0.05);the differences of plaques and stenosis in the territory arteries of progressive infraction and plaques of multiple infraction between two groups were of no significance(P > 0.05),but stenosis in the territory arteries of multiple infraction was significantly less frequent in the LI group than in the non-LI group (P < 0.05). Conclusion:Embolism is an important but not dominant mechanism in lacunar infarction.

Abstract:Objective:To observe the early effects of dopamine on patients undergoing mitral valve replacement after cardiac pulmonary bypass on left ventricular contraction,hemodynamics and urine volume,so as to revaluate the clinical effects of dopamine on patients undergoing open heart operation. Methods:Eighteen patients with American Society of Anesthesiologists Status(ASA)Ⅱ~Ⅲ,age≤70 years,male or female,preoperatively NYHAⅡ~Ⅲ,EF≥45% and without using cardiotonic agents,scheduled for mitral valve replacement were studied. Complete intravenous general anesthesia was used in anesthesia induction and during intraoperative anesthesia. The patients were divided into two groups,including the D group(n = 8) and the F group(n = 10). The D group:after cardiac pulmonary bypass with continuous infusion dopamine intravenously; thr F group:without receiving dopamine intravenously. With controlling the coincidence of ventricular rate by pacemaker,cardiac index(CI),left ventricular ejection fraction(LVEF),central venous pressure(CVP),mean arterial pressure(MAP),systemic vascular resistance index(SVRI),the value of lactic acid,urine volume and phenylephrine dosage were compared between two groups after cardiac pulmonary bypass. Results:Within the group D and F,the values of the examinations had no statistical significance (P > 0.05). Except that the LVEF at the points 30 min and 60 min of the group F were more than the group D,there were no differences in the levels of CI,LVEF,CVP,MAP,SVRI,urine volume and phenylephrine dosage between the two groups at the same points(P > 0.05). However,the urine volume of the groups D and F had statistical significance(P < 0.05),and lactic acid value at the same points between both of the groups were significantly different (P < 0.01). Conclusion:In this study,the result suggested that it isn’t necessary for the normal heart function of the patients undergoing mitral valve replacement after cardiac pulmonary bypass to receive prophylactic dopamine,but obviously increasing urine output and the clearance of lactic acid.

Abstract:Objective: To study the efficacy of different use of oxytocin during elective cesarean section. Methods:A total of 160 samples of Anaesthesiologists Ⅰ and Ⅱ subjects undergoing cesarean delivery were randomly divided into four groups. Following fetal extraction,the uterus was injected 20 U oxytocin. Women in the A group received 20 U of oxytocin intravenously within 30 seconds. The B group received 10 U of oxytocin within 30 seconds. The C group received 5 U of oxytocin within 30 seconds followed by an infusion of 5 U/h for 2 hours. The D group received 2 U of oxytocin within 30 seconds followed by an infusion of 10 U/h for 2 hours. We detected ECG,NBP,SpO2, hemodynamics and postoperative vaginal bleeding with 24 hours,uterine contractility, and adverse effects after administration of oxytocin,the serum oxytocin concentration at the beginning of injection,10,30,60 min. Results:After the administration of oxytocin,the MAP in the A and B groups decreased,but the heart rate increased. The incidence of vomiting and nausea was higher in the group A. The serum oxytocin concentration was significantly increased in the group A,B and C,and then decreased. Compared among groups,the serum oxytocin concentration of the group A,B,C and D were decreased by turns. There was no difference among the groups in the vaginal bleeding volume and the uterine contractility. Conclusion:Low dose of oxytocin followed by an infusion could stable the hemodynamics of women during the elective cesarean section and decreased the adverse effects.

Abstract:Objective:To explore the relationship between endogenous hydrogen sulfide(H2S)of the blood plasma and the contraction of myometrium. Methods:The sixty cord plasma samples were collected and divided into two groups according to the delivery has not launched the contractions. The concentration of H2S was assayed by sensitive sulphur electrode. The expressions of cystathionine beta-synthase (CBS) and cystathionine gamma-lyase (CSE) in placenta were measured by using immunohistochemistry. Results:H2S contents in the group which mothers did not start uterine contraction were higher than that mother started uterine contraction(P=0.01); The expressions of CSE were detected in cytoplasm of placental villi trophoblast cells and at higher levels in the group with mothers did not start uterine contraction. The expressions of CBS had not seen in both two groups. Conclusion:Cytoplasm of placental villi tropho- blast cells are included CSE and no CBS. The production of H2S in cord plasma is regulated by trophoblast cells. H2S content in cord placenta is related to initiation of parturition.

Abstract:Objective:To analyze the CT findings of Castleman’s diseases in order to improve diagnostic level. Methods:CT imaging features of 13 patients with Castleman’s disease proved by surgery pathology were retrospectively reviewed. Results:Pathological changes were found in 7 cases in the retroperitoneal zone,3 cases in right cervical part,1 case in right pharyngeal portion,1 in mediastinum and 1 in pelvic cavity. Eight cases were the lesions with local and disseminated distribution and 5 cases were multicentric. Eleven cases were hyaline vascular subtype, 1 case was plasma cell subtype and 1 case was Castleman’s disease with plasmocytoma. Localized Castleman’s disease often showed large homogeneous soft tissue with calcification and cyst formation,and tumor had significant enhancement which was similar to the enhance model of aorta. Multicentric Castleman’s disease showed multiple soft tissue nodules and moderate to significant enhancement. Conclusion:Localized Castleman’s disease of hyaline vascular subtype has some performance characteristics of CT,while multicentric Castleman’s disease has no imaging feature,so the diagnosis of Castleman’s disease depends on pathology.

Abstract:Objective:To evaluate the diagnosis of melanoma of uvea with color doppler ultrasound and differential diagnosis with other intraocular mass. Methods:Sonogram of 33 patients with melanoma of uvea and 56 patients with other intraocular mass were retrospective analyzed. All diagnosis were confirmed by pathology or following up. Results:Thirty-two patients of uveal melanoma included 32 cases of choroidal melanoma and 1 case of ciliary body melanoma. From them,lesions of 28 patients were hemicycle in shape. The other masses were in mushroom shape. All 32 melanomas of uvea appeared isoechoic or hypoechoic,well-defined boundary lesions in ultrasound. In those,18 tumors were of anterior hyper-echogenicity and posterior attenuation which called scooping phenomenon and 15 tumors had choroidal excavation. Vigorous flow in 25 lesions and manipulus flow in the other 6 lesions from short posterior ciliary arteries could be detected with color doppler flow imaging. All patients had retinal detachment in different level. Other intraocular masses included 6 cases of ciliary body tumors,8 cases were uveal metastatic carcinoma,16 cases were choroidal hematoma,8 cases were choroidal hemangioma and 18 cases were retinoblastoma. Conclusion:High frequency color doppler ultrasonography has great value in the diagnosis and differential diagnosis of uveal melanoma.

Abstract:Objective: To investigate the clinical value of serum IL-6,CA724 and VEGF in gastric cancer patients. Methods:The serum levels of IL-6,CA724 and VEGF were detected with ELISA in 40 healthy subjects and 80 patients with gastric cancer. Results:The levels of three kinds of tumor markers in gastric cancer patients were obviously higher than those in the control group (IL:149.62 ± 43.00 vs 48.12 ± 28.02 ng/ml,CA724:15.29 ± 3.64 vs 4.53 ± 3.47 U/ml,VEGF:212.78 ± 125.61 vs 64.8 6±17.67 pg/ml,respectively,P < 0.01). Sensitivity of detection was improved when they were combined. The positive rate of IL-6,CA724 and VEGF in combination was 76.3%,which was significantly higher than that of single marker (33.8%,43.8% and 52.5%,respectively). The values of IL-6,CA724 and VEGF were also higher in gastric cancer patients with liver metastasis than those without such metastasis(168.43 ± 54.03 vs 130.81 ± 10.00 ng/ml,16.20 ± 4.57 vs 14.39 ± 2.05 U/ml,289.47 ± 140.61 vs 136.09 ± 11.22 pg/ml,P < 0.05). The positive rates of IL-6,CA724 and VEGF in gastric cancer patients with liver metastasis were remarkably higher than those in gastric cancer patients without liver metastasis(50.0% vs 17.5%,P < 0.05;55.0% vs 32.5%,P > 0.05;65.0% vs 40.0%,P > 0.05). Conclusion:The results suggested that the determination of serum IL-6,CA724 and VEGF is valuable for the diagnosis of gastric cancer and liver metastasis. The diagnostic value can be enhanced by detection of IL-6,CA724 and VEGF in combination.

Abstract:Objective:To describe the baseline data and epidemiological characteristics of Mycobacterium tuberculosis (MTB) strains circulating in Jiangsu Province,and to provide policy makers with recommendations for prevention and control of tuberculosis. Methods:Sputum smear-positive tuberculosis patients reported in June and July 2010 were continuously recruited. Diagnosis was further confirmed by sputum culture. Proportional method which was recommended by WHO/IUATLD was used to determine the sensitivity to the four first-line anti- tuberculosis drugs,and we further analyzed the drug resistant spectrum and possible risk factors. Results:Of all the 260 patients,there were 216(83.1%) new cases and 44(16.9%)previously treated ones,with the male-to-female ratio of 2.25∶1. Drug resistant test indicated that 186 (71.5%)strains were sensitive to all the four anti-tuberculosis drugs, including rifampin,isoniazid,ethambutol,streptomycin,while 74 strains were resistant to at least one drug. The total resistance proportion was 28.5% and the MDR (at least resistant to INH and RFP at the same time)proportion was 34(13.1%). Multivariate Logistic regression showed that treatment history was significantly associated with MDR. Compared with the new cases,previously treated ones had 3.40 times risk of MDR,with the adjusted OR of 3.40 (95% CI:1.42-8.13). Conclusion:The high prevalence of drug resistance has been a major challenge for TB control. Prevention and control of drug-resistant tuberculosis should emphasize on the implementation of the DOTS (direct observed therapy) to increase the treatment compliance and treatment success rate and reduce the occurrence of drug resistance tuberculosis.

Abstract:Objective:To detect the features of the teeth image effectively,SIFT algorithm was preformed to use in the image of teeth model. Methods:This approach identified potential interest points by searching over all scales and image locations with the difference-of-Gaussian function. Keypoints were selected based on their stability and a detailed model was obtained to determine location and scale of the candidate location. Assign one or more orientations to each keypoint location based on local image gradient directions. The gradients of local image in region around each keypoint were measured,and the features were matched by KNN algorithm. Results:This method can detect the features effectively and offer some available parameters for 3D reconstruction of the teeth model through lots of experiments and comparing with other feature extraction algorithms. Conclusion:SIFT algorithm performed in the image of teeth model may contribute to 3D reconstruction of the teeth.