Polycentric governance theory of public goods provides a new approach for the goal of Basic medical care and health service for all.From the perspective of the public goods property of basic medical care and health service,the paper analyzed the predicament brought one-center supply mode,and designed the basic medical care and health service polycentric supply mode on the basis on the polycentric governance theory.On the basis,it proposed the polycentric supply synergetic development strategies.

This article described the importance of mechanism refonil in the graduate student training and presented its contents.Also,It summarized the characteristics of the reforill proposals in some universities,and analyzed the problems required to attend and solve ia the refogln.The characteristics of the proposals included to set up innovative fund by university,to perform the student awarded police of tutor leading,to establish the scientific system in recruiting students.By analyzing the problems developed during the reform four measures were lannched,which included to establish evaluating system in assessing students,to create a good relationship between students and tutors,to improve the ability and morality of tutors,and to adjust the management method of research funding.It would be possible to reach the objective of perfecting the reform proposal during the implementation of the measures.

Lung cancer is one of the most frequent malignant tumors. Target therapy is a milestone of non-small cell lung cancer (NSCLC) treatment in the 21st century. Biomarker detections have provided a solid foundation for individualized treatment. This review mainly focused on significance of EGFR mutation detection in EGFR tyrosine kinase inhibitors (EGFR-TKIs) as first line, second line and maintenance therapy in NSCLC. Simultaneously, this review introduced predicting significance of EGFR FISH test for the response of TKI treatment, and analyzed potential predictive biomarkers for antiangiogenic agents and status of antiEGFR monoclonal antibody in NSCLC individual therapy.

Abnormalities of the inferior vena cava occur infrequently.Except a few patients,most with the abnormalities of the inferior vena cava have not symptoms and do not need surgical procedure.However,attentions should be pasd to these anomalies in operation,particularly in the retroperiwneal procedure.only when the anomalies are identified before operation,its pessible to avoid the disaster caused by side-damage.Understanding embryo development of the inferior vena cava is usdful to comprehend the generation mechanism and classification of abnormalities of the inferior vena cava and its main branches.Exact judgment to abnormalities of the inferior vens cava has the important clinical significance.

Objective To study the therapeutic effect of the thrombus suction and direct percutaneous coronary intervention (PCI) for elderly patients with acute ST segment elevation myocardial infarction (STE‐MI) .Methods A total of 124 elderly pa‐tients with acute STE‐MI in our hospital from September 2012 to September 2014 were collected and divided into two groups(under the agreement of patients and family members) ,the experimental group (56 cases) was treated with thrombus suction and direct PCI ,while the control group (68 cases) was only treated with PCI treatment ;the postoperative immediate TIMI flow of coronary artery ,postoperative corrected TIMI frame count (CTFC) ,levels of myoglobin ,cTnT and CK‐MB ,percentage of ST elevation back over 50% ,postoperative 6-month follow‐up situation were observed in the two groups .Results The percentage of postoperative ST segment elevation drop>50% at postoperative 1 h in the experimental group was significantly higher than that in the control group (P<0 .05);the levels of myoglobin ,cTnT and CK‐MB ,postoperative corrected CTFC frames and rate of no reflow in the ex‐perimental group were significantly lower than those in the control group (P<0 .05);during postoperative 6 -month follow up , there were no statistically significant differences in major adverse cardiac events (such as angina pectoris ,myocardial infarction ,re‐vascularization ,etc) between the two groups(P>0 .05);the percentage of LVEF>50% in the experimental group was significantly higher than that in the control group(P<0 .05) ,moreover the percentage of LVEF>50% in the two groups had statistical differ‐ence between before and after operation(P<0 .05) .Conclusion Clinical curative effect of thrombus suction and direct PCI for eld‐erly patients with acute STE‐MI is superior to simple direct PCI treatment .

Objective To evaluate the effect of amniotic products after transcervical resection of uterine adhesions (TCRA). Methods This study was carried out in 57 patients with intensive degree of intrauterine adhesions (IUA) who had been treated by TCRA between Jun. 2013 to Jun. 2014. These patients were devided into two groups randomly. In group amnion, 29 patients were placed amniontic scaffold balloon after TCRA;in group balloon, 28 patients were placed Foley′s balloon after TCRA. The two groups′balloons were taken out after TCRA 7 days. All patients were taken artificial cycle treatment. The uterine cavity form and the menstruation of 2 groups were observed in 3 months after TCRA. Results In group amnion, IUA score dropped from 10.1±0.5 preoperatively to 3.2±1.5 postoperative (P<0.01), in group balloon, IUA score dropped from 10.1 ± 0.5 preoperatively to 6.3 ± 2.5 postoperative (P<0.01). In group amnion, the menstrual score increased from 13.3 ± 4.4 preoperatively to 32.6 ± 5.5 postoperative (P<0.01), in group balloon, the menstrual score increased from 11.1±5.8 to 26.5±5.6 (P<0.01). The menstrual improvement of group amnion was better than that of group balloon significantly (P=0.002). In group amnion, the recurrence rate of adhesion was 21%(6/29), in group balloon, the recurrence rate of adhesion was 36%(10/28). There was no significant difference (P=0.248). The pregnancy rate of group amnion was 28%(8/29), the pregnancy rate of group balloon was 21%(6/28). The difference of pregnancy rate in two groups was not significant (P=0.760). Conclusion This small sample observation indicate that amniotic products used in the treatment of intensive IUA could improve menstrual, reduce the recurrence of adhesion, but the impovement of the pregnancy rate should be confirmed by large sample observation.

[Summary] There are a variety of treatment methods for stress urinary incontinence ( SUI) .Surgery is effective but has high risks, only to adapt to the limited population .Conservative treatment has a high recurrence rate and poor long-term results.Local injection of stem cell has been proposed as a new minimally invasive therapy of SUI .Stem cells, with the ability to transform into muscle cell , secrete various growth factors , promote local nerve and muscle tissue regeneration , and repair sphincter dysfunction .This article reviewed on therapy of skeletal muscle-derived stem cells and the associated risks of treatment .

Objective To investigate the relationship between homocysteine(Hcy)and blood uric acid(UA)in the patients with type 2 diabetes mellitus(T2DM)complicating hypertension.Methods 85 patients with T2DM complicating hypertension were se-lected as the groupⅠ,78 patients with simple T2DM as the group Ⅱ and 74 individuals with healthy physical examination as the group Ⅲ.Hcy,UA,TC,TG and HDL-C were measured in all the subjects.Results Compared with group Ⅲ(control),the levels of Hcy,UA,TC and TG in the group Ⅰand groupⅡwere significantly increased(P <0.05),but the level of HDL-C was significantly decreased(P <0.05).Compared with the group Ⅱ(T2DM),the levels of Hcy,UA,TC and TG in the group Ⅰwere significantly in-creased(P <0.05 ),but the level of HDL-C was obviously decreased,the difference had statistical significance (P <0.05 ).There was good positive correlation between the Hcy level and the UA level in the patients with T2DM complicating hypertension (r =0.658,P <0.05).Conclusion The levels of Hcy and UA are significantly increased in the patients with T2DM especially complica-ting hypertension.High Hcy and high UA are the important risk factors of T2DM complicating cardiocerebrovascular diseases.

Aim To investigate the effects of homocysteine on monocyte chemoattractant protein-1(MCP-1),intercellular cell adhesive molecule type-1(ICAM-1),vascular cell adhesive molecule1-1(VCAM-1)mRNA expression and the protective effects of arecoline,PPVP,DMHPPP and simvastatin in cultured bovine aorta endothelial cells,thereby to explore possible mechanisms by which the compounds affect the formation of atherosclerosis(AS).Methods Bovine aorta endothelial cells were cultured in vitro with indicated concentration of HCY for indicated time.After the cells were harvested at the specified situation,the MCP-1,ICAM-1 and VCAM-1 mRNA expression was detected by reverse transcription-polymerase chain reaction(RT-PCR) and normalized to the mRNA level of ?-microglobulin in the absence or in the presence of homocysteine or land arecoline,PPVP,DMHPPP and simvastatin,respectively.Results The expression of MCP-1,ICAM-1 and VCAM-1 mRNA all increased dose-and time-dependently after treatments with 0.1,0.5,5.0 mmol?L~(-1) HCY for 6 h and 0.1 mmol?L~(-1) HCY for 3,6,12,24 h,respectively.Compared with control group,after the bovine aorta endothelial cells were incubated with 10 ?mol?L~(-1) arecoline,PPVP,DMHPPP,simvastatin for 20 h in advance,respectively,the injury effects which were subsequently induced by 0.1 mmol?L~(-1) HCY for 6 h could be prevented.Conclusions Cultured bovine aorta endothelial cells could express MCP-1,ICAM-1,VCAM-1 mRNA at a low level,and HCY could induce a higher expression.The over expression could be blocked by arecoline,PPVP,DMHPPP and simvastatin.