Objective:To analyze the efficiency and influencing factors of Chinese medical and health resources. Methods:Based on the panel data of 31 mainland provinces from 2003 to 2011 in China, use the two-stage Malmquist-Tobit model to analyze. Results:The efficiency of Chinese medical and health resources shows an increasing trend, which is dual driven by improvement of technical efficiency and technological progress. The efficiency varies among different areas, and the descending order of efficiency value is east, west and center. The level of economic development, population density, the proportion of profitable hospitals, the levels of urbanization and education can promote Chinese medical and health efficiency with different extent. Conclusion:To improve the efficiency of Chinese medical and health resources, it needs to promote economic development level, allocating health resources reasonably, and advancing urbanization and education levels orderly.

Objective To observe the clinical effect of psychological intervention combined with alendronate and low molecular heparin calcium on the treatment of senile osteoporotic fracture. Methods From February 2014 to March 2017, clinical data of 82 elderly patients with osteoporotic fracture in the first people's hospital in Jiande were retrospectively analyzed. All the patients were randomly divided into the control group and the experimental group with 41 cases in each group. The control group patients were given alendronate sodium and low molecular heparin calcium; At this basis, the experimental group were received psychological nursing intervention. The effect in the two groups was compared. Results After treatment, bone mineral density (BMD) index and pain scores in the two groups were significantly improved. BMD and pain scores in the experimental group were significantly better than those in the control group (P<0.05). The total effective rate was 95.12% (39/41) and the complication rate was 17.07% (7/41) in the experimental group, while in the control group were respectively 70.73% (29/41), 36.59% (15/41), the differences were statistically significant (P<0.05). Conclusion Psychological intervention combined with alendronate sodium and low molecular heparin on the treatment of senile osteoporotic fracture has significant effect, can effectively improve the clinical symptoms of patients, reduce the incidence of complications, with clinical application value.

Objective To explore the feasibility and safety of right ventricular septal pacing with active fixation electrodes.Methods This was a randomized and control clinical trial.Patients implanted with pacemaker were randomly divided into two groups.One group underwent the right ventrieular high septal pacing with the active fixation electrodes(RVS group),and the other group underwent the right ventricular apical pacing with the passive fixation electrodes(control group).The parameter was recorded in two groups in and after operation and compared accordingly.Results (1)There were no significant differences in the procedure time between two groups[averaged(59.6±3.2)and(60.2±3.7)minutes respectively].But the time of exposing X-ray was significant longer in RVS group.(2)There was no significant difference in acute implanting measurement,except perioperative and postoperative threshold 1 month in RVS group was higher than that in control group(P＜0.05 or＜0.01).After 3 months,there was no significant difference.(3)Impedance decreased significantly in 1 month and 3 months in RVS group[P＜0.01 or＜0.05).(4)There was no difference in R-wave sensing between two groups.(5)After 100%pacing,the mean QRS duration Was shorter in RVS group,but the difference was not significant.(6)Operations in two groups came off smoothly and there were no complications.Conclusion It is feasible and secure to pace from RVS with active fixation electrodes.

Objective To demonstrate simultaneously on transcription and translate levels the tyrosine-hydroxylase(and somatostatin)gene expression and peptide storage in same intrinsic cardiac ganglionic neuron of bufo bufo gargarizans. Methods Using immunohistochemical method,in situ hybrodization method and in situ hybrodization/immunohistochemical double labeling method on freeze-sections of sinus venanum cavanum of bufo bufo gargarizans atrial posterior wall (30*!?m)to observe THmRNA and /or TH-IR and SSmRNA and /or SS-IR dyeing neurons of intrinsic cardiac ganglia. Results There are kinds of positive neurons:1.TH-IR positive neurons;2.THmRNA positive neurons;3.TH mRNA/TH-IR double positive neurons and 1.SS-IR positive neurons;2.SSmRNA positive neurons;3.SSmRNA/SS-IR double positive neurons.Conclusion 1.TH mRNA and TH appearing in same intrinsic cardiac ganglionic neuron demonstrate that a part of intrinsic cardiac ganglionic neurons are possibly adrenergic sympathetic neurons;2.SSmRNA positive neurons and SSmRNA/SS-IR double positive neurons indicat that SS could be a neurotransmitter of intrincic cardiac ganglinic neurons.It provides neuroanatomy evidence of regulating cardiac function(excitatory conduct、cardiac muscle secrete and contract)by intrinsic cardiac SS-nergic neuron.

Objective:This study aimed to analyze the prognostic factor of bilateral hydronephrosis caused by advanced cervical cancer and evaluate its value of treatment. Methods:A total of 40 patients with bilateral ureteral obstruction secondary to cervical cancer were diagnosed through computerized tomography, radioactive nephrogram, and blood tests for renal function. The placement of retrograde internal double-J ureteral stents was performed under a cystoscope in 13 patients. The placement of antegrade internal double-J ureteral stents via percutaneous nephrostomy was performed in 25 patients. Two cases had external ureteral stents via percutaneous nephrostomy. Twenty-nine patients underwent radiotherapy after normalization of their blood urine nitrogen and creatinine levels. The prognostic value of the treatment and renal function before placement of ureteral stents and radiotherapy after placement of ureteral stents were analyzed. Results:The normalization rate of renal function after ureteral stenting was 91.3%(21/23). The median survival time was longer in patients with untreated cervical cancer than that in patients with recurrent cervical cancer (χ2=9.379, P=0.009). After ureteral stenting, the median survival time was longer in patients who underwent radiation therapy than that in patients untreated with radiation (χ2=17.329, P=0.000). The median survival time was not significantly influenced by renal function before placement of ureteral stents (χ2=1.37, P=0.242). Conclusion:The patient with bilateral ureteral obstruction from untreated cervical cancer or from recurrent pelvic disease after surgical therapy should be considered for ureteral stenting followed by appropriate radiation.

Objective:To give the test in cases of changing the conditions of measurement and reference value, compare the test results, and detect the capacity of QuickCheck, so as to offer reference for the daily morning check of accelerator and the evaluation of test results. Methods:Change the output dose, field size, SSD, angle of collimator and gantry angle of the accelerator, and then evaluate QuickCheck’s capacity of monitoring accelerator accordingly. Compare the field parameters measured by QuickCheck with the data from the 3D water tank. Results:When the output dose was 1 cGy higher than the reference value or 6 cGy lower than it, the field size expanded or contracted more than 2 cm simutaneouly, SSD was 2 cm higher or 1 cm lower than reference value, the collimator rotated more than 2 °, the gantry angle rotated more than 6 °, and then the test results of QuickCheck surpassed threshold. Comparing the measuring results of QuickCheck with 3D water tank, the difference between the flatness of the two was 3.84%, symmetry (G/T) 0.67%, symmetry (L/R) 0.47%and dose rate 1.2 MU/min. Conclusion:QuickCheck is rather accurate in testing the output dose, field size, angle of collimator, flatness, symmetry and dose rate, so it could meet the requirement of accelerator’s daily QA. However, its capability is relatively poor on examining SSD and the deviation of gantry angle.

Objective To investigate the effects of splenctomy on the idiopathic thrombocytopenic purpura (ITP) patients. Methods 9 patients with ITP were involved in the present study,who were performed with splenecto-my because of refractoriness, contraindicatiun and intolerance during corticosteroids therapy. Results The average platelet count of the patients before operation was 35×109/L,while the first,4th and 7th day after operation,the aver-age platelet count was 98×109/L, 179×109/L and 235×109/L. After follow-up for 6 months,there were 7 cases having marked improvement, and the total effective rate was 88.9%. Conclusion Splenectomy is a recommendable method for ITP, expecially for those are inefficient,incompatible and intolerated to continually pharmacotherapy.

Objective To investigate the expression of fragile histidine triad (FHIT) gene in cervical carci-noma and relationship with its clinical-pathological implication. Methods The expression of FHIT was detected by immunohistochemistry SP method in 42 cases of cervical carcinoma and 13 cases of adjacent tissue. Results 47.6% (20 of 42) of cases expressed FttIT in the tumor cells,and 92.3% (12 of 13) of cases of the adjacent tissue were present. There was a significant positive correlation between cervical carcinoma and adjacent tissue(P <0.01). The positive rates of FHIT in high and middle desrees of differentiation were significantly higher than that in low degree of differentiation(54.2% vs 38.9%). Tumors with lymph node metastases(45.9%) had loss FHIT protein expression than those without metastasis(60.0%) (P <0.05). The FHIT expression between Ⅰ and Ⅱ stage,the difference was significant(55.0% vs 45.5%) (P < 0.05). Conclusion FHIT gene plays an improtant role in the occurrence and development of cervical carcinoma. It is suggested that FHIT can be a useful marker for predicting invasion and metas-tasis ability of cervical carcinoma.

Purpose　To study the proteins expression of genes related to apoptosis of retinal cells in development of human fetus．　Methods　Fifty cases of retinas of human fetus aged from 12 to 38 weeks were collected and paraffin embedded sections were made． Immunohistochemical method was used．　Results　Fas protein was expressed by cells of ganglion cell layer, inner and outer nuclear later, which were just formed on 16th week． It was not expressed until 38th week, Fas(+) staining appeared in layers of retina． Fas-L(+) staining was detected in cells of layers of retina on 26th week and the positive staining located in ganglion cell layer on 32th week． Neuronal fiber layer was Fas-L positive． Bax positive staining was detected on 8th week． Bax positive nucleus were observed mainly in GCL and ONL on 16th week． It was in INL on 24th week and in Müller cells inner terminates on 26th week． After this time, all cells of retina were bax immune negative staining． Bcl-2(+) staining appeared in differentiating neuroblastic layer on 16th week． Beginning on 24th week, bcl-2 (+) staining was observed in glial cells of GCL and inner terminates of Müller cell．　Conclusion　Apoptosis of developing retinal cell may be Fas/Fas-L independent and bax may be involved in apoptosis of the cells．

Objective To observe the diagnostic value of telomerase,VEGF,CD44_ V6 ,MMP_2,MMP_9and their combined examination in distinguishing malignant pleural effusion from benign one.Methods Sixty patients with pleural effusions were observed,thirty of them sufferring from malignant pleural effusion and thirty of them sufferring from benign one.The expression of telomerase,CD44_ V6 ,VEGF,MMP_2,MMP_9were tested in the pleural effusion by RT-PCR and ELISA technique.The sensitivity and the specificity of each examination method were calculated,in order to find out appropriate combination.Results As single-item detection,the diagnosetic value of VEGF was the best,the cutoff of VEGF was 181.1pg/ml,the sensitivity of VEGF examination was 90.0%,and the specificity was 86.7%.The sensitivity and the specificity of combined examination VEGF+CD44_ V6 and VEGF+MMP_2 were the best,the sensitivity of VEGF+CD44_ V6 was 83.3%,and the specificity was 90.0%.The sensitivity of VEGF+MMP_2 was 80.0% and the specificity was 93.3%.Conclusion The level of telomerase,VEGF,CD44_ V6 ,MMP_2,MMP_9in malignant pleural effusion is clearly higher than that in benign pleural one,the difference having significant statistic meaning.VEGF has higher sensitivity and specificity .Of combined examination,VEGF+CD44_ V6 and VEGF+MMP_2 have higher sensitivity and specificity.