This article discusses challenges in the current U .S.healthcare system and their fundamental cau-ses.Such challenges include increasing health expenditure , deficiency and excess in health service utilization , worse health outcomes than other developed countries , and insufficient GP numbers .We suggest that mistakes in early healthcare legislation and an imperfect health management system are the primary causes for these problems .Implica-tions for China ’ s current ongoing healthcare reform are outlined .We draw on the experience in the U .S.and other developed countries but keep China ’ s unique features in mind .Factors that need to be considered in China are ensu-ring the right of healthcare for all , giving full play to the role of government and primary medical institutions , strengthening support for GPs , reforming payment modes , controlling the growth of health expenditure , strengthening legislation, and handling medical accidents and disputes reasonably .

OBJECTIVE:To evaluate the performance of merger and acquisition (M&A) of listed pharmaceutical companies over 3 years from 2000 to 2002. METHODS: Based on the financial data of the listed companies in 26 cases, a data envelopment analysis was performed to compare and evaluate the efficiency of the companies before and after M&A. RESULTS: The efficiency was reduced in the first 3 years after M&A, but increased started from the fourth year. CONCLUSIONS: M&A did not promote the efficiency of listed pharmaceutical companies.

Objective:To investigate the relationship between telomerase activity and DNA ploidy in gastric carcinoma.Methods:Telomerase activity was detected using telomerase repeat amplification protocol(TRAP),and image cytometry(ICM) was used to examine the DNA ploidy.Rusults:The total positive rate of telomerase in gastric carcinoma was 81.25%.The telomerase positive rate in early stage and advanced stage were 55.5% and 87.2% respectively.Aneuploid tumors tend to be telomerase positive.Conclusion:The telomerase activity is correlated with the progression and aneuploid rate in gastric carcinoma.

Objective To investigate the role of hepatic Kupffer cells in acute hemorrhagic necrotizing pancreatitis associated lung injury(AHNP LI) and the therapeutic effects of gadolinium chloride(GdcI_3). Methods Forty-two Wistar rats were randomly divided into four groups:(I) sham operation group;(II) AHNP group;(III) Gdcl_3 (protection) group(Gdcl3 10mg/kg);(IV) Gdcl_3control group(Gdcl_3 10mg/kg).In the sham operation group, the (abdominal) vescera were shifted around for several times and the abdomen was closed.The AHNP model was induced by retrograde intraductal administration of 5% sodium taurcholate(1ml/kg,0.1ml/min).In the Gdcl_3 protection group,Gdcl_3 solution was admmistered by caudal vein injection one day before the AHNP model was made.In these 3 group of animals,specimens were obtained in order at 3h and 6h postoperatively:(1)Blood was withdrawn from the abdominal aorta to determine serum amylase,TNF?,IL-1(in addition,in the sham operation group,blood AST and ALT were determined);(2)A portion of liguefied right lung was obtained to determine MPO;another portion was fixed with 10% formalin for tissue pathological examination;(3)Bronchoalveolar lavage fluid of excised left lung was obtained ,and then alveolar macrophages were isolated,collected and purified.After removal of their nuclear (proteins),the alveolar macrophages were tested to determine NF-?B activation with the use of chemical illumination ELISA method;and (4)pancreatic tissue was reserved for pathological examination.In the Gdcl_3 control group, Gdcl_3 was administered by caudal vein injection,the animals were sacrificed 24h later,and blood was obtained to determine blood AST and ALT. Results In the Gdcl_3 prevention group,the level of MPO in lung tissue,serum (levels) of TNP? and IL-1,and NF-?B activation of alveolar (macrophages) were all significanfly reduced as compared with the AHNP model group(in all,P

Objective To investigate the Th1/Th2 imbalance, defective cell medicated anti tumor response and the relationship between cytokine levels and clinicopathologic findings in colorectal cancer patients.Methods 62 colorectal cancer patients and 15 volunteers were recruited for the study. Peripheral blood samples were collected to detect IL 2, IL 6, IL 10, IL 12, TNF levels and NK activity, proportions of CD3 + , CD4 + ,CD8 + T cells.Results Patients with colorectal cancer had decreased levels of IL 2, IL 12 and elevated levels of IL 6, IL 10 compared to controls( P

Objective To study the clinical and pathological features of rectal carcinoid and factors influencing the prognosis.Methods Data of 33 rectal carcinoid patients were analyzed retrospectively. 29 patients were followed up postoperatively. Primary tumors were classified by size (2*!cm) and muscularis invasion respectively.Results The main symptoms were changes in bowel habits(17/33,52%) and hematochezia (14/33, 42%), or rectal mass (14/33,42%), asymptomatic patients were detected during a survey.Only 4(12%) patients had tumors larger than 2 cm and tumors invading muscularis.The 10 year survival rate was 84% for all patients( n =29), and 94% for those with tumors 2*!cm( n =3) died in 5 years( P = 1 0?10 -9 ) and only one out of the 4 with muscularis invasion lived longer than 5 years( P =1 2?10 -5 ).Conclusions Most rectum carcinoid are at early stage suitable for local excision.

0.05. All arose in the pelvis. 5 year′s survival rate in group Ⅰ was (53.2?1.9)% and (67.3?1.6)% in group Ⅱ, P

To explore the mechanism of Jianpi(splenic tonic) and Shugan(dispersing the stagnated liver-qi) prescription regulating immunity by testing the expression of the differentiation signaling transduction protein,calcineurin.Methods We prepared the Sijunzitang and Chaihushugansan prescription serum,take the Ova as antigen induction and B cell as presenting cell,intervened culturing the CD 4 +T cells for 24 hours, and then examine the expression of calcineurin by RT-PCR,Western-blotting.Results The expression of calcineurin was increased in the stimulated Th cells, and the Sijunzitang and Chaihushugansan prescription serum can reduce it significantly,the Chaihushugansan also improved the expression deficit of calcineurin.Conclusions Jianpi and Shugan prescription can regulate the balance of immunity through affecting the expression of signaling transduction proteins at the Th activation and differentiation stage,The regulating the flow of qi prescription is superiority to supplementing qi one.in treatment of the Th2-mediated autoimmune disease.

Objective To study the effect mechanism of anticancer synergic (KangAiZengXiao,KAZX) decoction on gastric cancer in immunologic deficit rats with implanted tumor. Methods Forty rats were divided into normal control group(n=10), model group(n=15) and KAZX treating group(n=15). Model group and KAZX group were subcutaneously injected axillary the left upper limb with 0 5ml gastri cancer cells,MGC-803 cell(1?10 7/ml) after irradiated by 60 Co(dose:10Gy). Then the three groups were treated with KAZX decoction or distilled water every day, respectively. After three weeks, the rats were sacrificed,and blood WBC, the weight of spleen, activity of NK cell and transformation efficiency of lymphocyte were also detected.Results The rate of loaded tumor in KAZX group was significantly lower than in model group(20% vs 66 7%,P

Objective To investigate change of Th 1/Th 2 Cytokines in the rats with spleen deficiency syndrome and effect of decoction of SiJunZi on it. Methods The contents of IL-4 and IFN-? in the T cells of the rats with spleen deficiency syndrome before and after treatment of decoction of SiJunZi and powder of ChaiHuShuGan were detected by ELISA. Results Compared with normal group, the content of IFN-? decreased (P0 05). After treated with powder of ChaiHuShuGan, the levels of IL-4 and IFN-? did not obviously change compared with normal group (P