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In order to further promote hierarchical medical system and enhance the capacity of primary healthcare services, China began to build compact county medical community. At present, the development of China′s compact county community still exists such problems as the construction of service system, the basic institutional mechanism, the quality of supply capacity and the core guarantee mechanism. In order to solve the existing problems, the authors took Shaxian District of Sanming City, Fujian Province, Dancheng County of Zhoukou City, Henan Province, and Yangqu County, Taiyuan City, Shanxi Province as examples to summarize the experience of the advanced pilot areas of the policy. In the future, the construction of compact county community in China should be based on the construction of " single-core multi-layer" system, starting from the five levels of collaborative management, practical operation, system construction, basic guarantee and multi-party supervision, to comprehensively enhance the healthcare services, and finally achieve the goal of the strategy of hierarchical medical and Healthy China.
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<p><b>OBJECTIVE</b>To observe the effects of micro-invasive embedding combined with montelukast sodium and simple montelukast sodium for children cough variant asthma (CVA).</p><p><b>METHODS</b>A total of 240 patients were randomly assigned into an observation group and a control group, 120 cases in each one. Considering of cases dropping, 101 patients in the observation group and 105 cases in the control group were included. Montelukast sodium chewable tablets were applied before sleep for 3 months in the control group, 5 mg a time, once a day. Based on the treatment as the control group, micro-invasive embedding was used for 3 months in the observation group, twice in the first month and once in the other two months. The acupoints were Feishu (BL 13), Danzhong (CV 17), Dingchuan (EX-B 1), and Zusanli (ST 36). Follow-up was conducted 9 months after treatment in the two groups. The cough score, serum immunoglobulin (IgE, IgG, IgA), platelet activating factor (PAF) were observed before and after treatment. The indices were compared before and after treatment and at follow-up, including pulmonary function indices[peak expiratory flow rate (PEF), forced expiratory volume at the 1st second (FEV1)], and small airway function indices[forced expiratory flow rate with remaining 25% vital capacity (MEF25%), forced expiratory flow rate with remaining 50% vital capacity (MEF50%), forced expiratory flow rate with remaining 75% vital capacity (MEF75%) and mid expiratory flow rate (MEF25%-75%)]. Also, the total effects were evaluated.</p><p><b>RESULTS</b>①The total effective rate in the observation group was 93.1% (94/101), which was better than 87.6% (92/105) in the control group (<0.05). The cough disappearance time of the cured children in the observation group was (10.38±2.64) d, and it was shorter than (10.72 ±2.60) d of those in the control group (<0.05). After treatment, the cough score apparently decreased compared with those before treatment in the two groups (both<0.05), with better result in the observation group (<0.05). At follow-up, the recurrence frequency of the observation group was (1.43±1.20), and it was less than (1.91±1.71) in the control group (<0.05). ②The levels of serum IgA and IgG after treatment in the two groups increased, and those of serum IgE and PAF decreased, compared with those before treatment. There was statistically significance except IgG in the control group before and after treatment (all<0.05), with better Results in the observation group after treatment (all<0.05). ③ Compared with those before treatment, all the pulmonary function indices were improved obviously after treatment and at follow-up in the two groups (all<0.05), without statistically significance between the two groups (both>0.05). ④ There was no statistically significance before and after treatment on small airway function indices in the two groups (all>0.05). The indices at follow-up increased compared with those before treatment in the two groups (all<0.05), with better Results in the observation group (all<0.05).</p><p><b>CONCLUSIONS</b>Micro-invasive embedding combined with montelukast sodium achieved de-finite effect for children CVA, which can improve the body's immune and microcirculation. The effect is better than that of simple montelukast sodium on improving small airway function, etc.</p>
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Objective:To explore the expression of Bcl related anti-apoptotic protein 3 (BAG3 protein)in colon cancer and its clinical significance,and to clarify the relationship between its expression and the occurrence and development of colon cancer.Methods:A total of 90 cases of colon cancer tissue and paracancerous tissue were selected, the expressions of BAG3 protein in different tissues were detected by tissue microarray and immunohistochemical SP method;Kaplan-Meier method,univariate analysis and multivariate analysis were used to investigate the relationship between the clinicopathological parameters and the prognosis of the patients with colon cancer.Results:The expression of BAG3 protein in the colon cancer tissue was high,and the positive expression rates of BAG3 protein in the colon cancer tissue and paracancerous tissue were 37.8% and 0.01%,respectively, and the difference was significant (P < 0.05).The expression of BAG3 protein was associated with gender and tumor size (P <0.05),but there was no correlation between the expression of BAG3 protein in the colon cancer tissue and age,pathologic grade,TNM stage,and lymph node metastasis (P >0.05).The Kaplan-Meier results showed that the expression of BAG3 protein in the colon cancer tissue was not related with the prognosis of the patients and the survival rates of the younger patients and the higher TNM staging patients were high. Conclusion:The expression of BAG3 protein in the colon cancer tissue is high,and its expression is associated with the tumor size;BAG3 protein may act as a tumor marker and therapeutic target for colon cancer.
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Objective To establish the diagnosis of am niotic fluid em bolismwith blood sam ples by liq-uid-based cytology technique and to study the validity of m ethod. Methods The blood sam ples were collected from patients who suffered from am niotic fluid em bolism. The com ponents of am niotic fluid in blood samples were examined with blood smear by two direct smear methods(supernatant smear, sedi-ment smear) and two liquid-based cytology methods(autom atic smear, manual smear). The positive de-tection rate of each m ethod was calculated. Results The positive detection rates of two liquid-based cy-tology methods(84.6% and 92.3%, respectively) were m uch higher than those of two direct methods(53.8% and 61.5%, respectively). Conclusion The liquid-based cytology technique could im prove the positive detection rate of am niotic fluid em bolism.
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This paper summarize the perioperative nursing of 11 patients with vaginal reconstruction using autologous buccal micro-mucosa. The preoperatively psychological nursing,meticulous specialist care and oral care,as well as postoperatively diet instruction,oral care,vaginal care,and serf-care instruction before discharge are the key points to reduce postoperative compli-cations and increase the success rate of surgery.
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Objective To investigate the relationship between intrauterine growth retardation (IUGR) and en docrine parameters so as to assess the effects of the main endocrine factors on IUGR. The concentrations of growth hormone (GH), insulin, T3, T4 and TSH were measured in umbilical cord blood, amniotic fluid and maternal serum. Methods The samples were collected from 23 pregnant women who were diagnosed as the full term IUGR, 42 normal full term pregnant women with normal infants' weight were taken as control. Growth hormone and insulin were mea sured by radioimmunoassay. T3, T4 and TSH were investigated by micro-radioimmunoassay. Results The concentra tions of growth hormone, insulin and T4 in umbilical cord blood were lower in IUGR than that in control group(GH 4. 63μg/L vs 7.01μg/L, insulin 10. 68μIU/ml vs 31.44μIU/ml, T4 87. 39nmol/L vs 138. 10nmol/L. P ＜0. 05, 0. 05 and 0. 05, respectively). The TSH concentration in umbilical cord blood was higher in IUGR than in control group (10. 84μmIU/L vs 5. 75μmIU/L, P ＜0. 01). The concentration of growth hormone in maternal serum and the concen tration of insulin in amniotic fluid were also lower in IUGR group than in control group(GH 1.77μg/L vs 2.74μg/L, P ＜0. 01, insulin 5. 84μIU/mi vs 15. 64μIU/ml, P ＜0. 01). Conclusion This study confirms that full term neonates with IUGR are abnormal in endocrine factors. The inadequacy of growth hormone may be one of the causes of IUGR. The relative scarcity of growth hormone and insulin seems to be a factor to compromise the fetus' metabolism. Be sides, the early hypothyrosis of infants with IUGR might protect them from unfavorable environment in the uterine.