Firstly,this article introduces the background and detailed content about the New health care reform of the United States.Then it describes the basic principles of these reforms and the problems to be solved,putting forward author's own speculative viewpoints to these health care reforms.Finally,it list the reference to New health care reform of our country.

Objective To measure the changes of total factor productivity (TFP)of Zhejiang medical facilities for decision makers to promote their service efficiency.Methods Collecting the panel data of 2005-2010(four input indexes and five output indexes)from medical facilities in Zhejiang province and measuring with Malmquist index of DEA programs of DEAP2.1.Results The average annual TFP growth rate in the period is 2.0％.A further decomposition found that the average annual growth rate of technology progress is 1.8 ％,while that of technical efficiency and pure technical efficiency is only 0.2％respectively.In the meantime,no scale efficiency growth was found.Conclusion The average annual growth of total factor productivity of Zhejiang medical institutions is substantially low in the period,with technology recession found as well.To maximize productivity of the medical sector,the allocation and internal management should be strengthened to stimulate technical efficiency and scale efficiency while encouraging technology innovation.

Objective To describe the CSP genotypic profile in clinical isolates of Aspergillus fumigates from different regions of China,and to investigate if there is a difference in antifungal susceptibility among A.fumigates of different CSP genotypes and from different regions.Methods Totally,112 A.fumigates strains clinically isolated from Fujian,Shanghai,Hebei and Beijing were included in this study,and identified according to macro-and micro-morphological characters,growth temperature and β-tubulin sequence.Classic A.fumigatus strains were typed according to CSP gene sequence.The minimal inhibitory concentrations (MICs) of voriconazole,itraconazole and amphotericin B to A.fumigates were determined in accordance with the National Committee for Clinical Laboratory Standards (NCCLS) M38-A protocol.Results All the strains were identified as classic A.fumigates,and fall into 11 CSP genotypes.The most common genotypes were t04A (n =32),t03 (n =17) and t01 (n =24) in all the strains,tl0,t04A and t01 in Fujian,t04A and t01 in Shanghai,t01,t03 and t04A in Hebei,t02,t04A,t01and t03 in Beijing.One A.fumigatus strain was identified as a new CSP type t25 in Fujian,which showed no obvious difference in morphology,growth rate or appropriate growth temperature from the other CSP genotypes of A.fumigatus strains.No statistical difference was found in the susceptibility to amphotericin B,itraconazole or fluconazole among different genotypes of A.fumigates,whereas the MICs of itraconazole were significantly lower in A.fumigates isolates from Fujian than in those from the other three regions.Conclusions The CSP genotypic profile of A.fumigates varies in clinical isolates from different regions.No significant difference is observed in the susceptibility to amphotericin B,itraconazole or fluconazole among different CSP genotypes of A.fumigates,but the susceptibility to itraconazole is somewhat different between A.fumigates strains from different regions.

Objective To treat scalp lacerations by using the hair apposition technique (HAT) and to compare the HAT with standard suturing in a controlled prospective trial. Method Fifty patients with scalp lacerations were treated either by HAT or by standard suturing. Two groups were evaluated in consumed times for operation, pain sores, and complications. Results There were 30 HAT patients and 20 patients treated with suturing. The took shorter operation time consumed[(3.33 vs. (6.05 t = 4.85.P < 0.01], and HAT produced significantly lower pain score [(1.73vs. (3.20t = 4.01,P < 0.01]. There was a trend that more and more patients were willing to have HAT performed. Conclusions The advantages of HAT include a shorter time consumed for operation, less pain, satisfactory wound healing, and high acceptance by patients. HAT is acceptable for treating scalp lacerations in emergency room.

AIM: To study the action of Shugan Pills (SHGP) (Fructus Toosendan, Rhizoma corydalis, Radix Paloniae Albe, Radix Aucklandiae, Cortex Magnoliae Officinalis, Fructus Aurantii, etc.) on treatment of epigastralgia. METHODS: The analgesic effect was tested by the hot plate test and writhing method. The anti gastric ulcer action of SHGP was observed on the gastric ulcer induced by water immersion stress, reserpine and absolute ethyl alcohol. The effect on gastric secretion in rats was studied with pylorus ligation. The effect on gastrointestinal motility was observed by determination of gastric emptying and small intestinal propulsion ability in mouse. RESULTS: SHGP enhanced hot pain threhshold and decreased the number of twisting body in mouse. SHGP markedly inhibited gastric ulcer induced by water immersion stress, reserpine and absolute ethyl alcohol. SHGP significantly inhibited the secretion of gastric acid and pepsin and promoted the secretion of gastric mucus. SHGP markedly delayed gastric emptying in normal mouse and when gastric emptying and small intestinal propulsion was stimulated by neostigmine. SHGP faintly strengthed the effect of atropine on inhibition of gastrointestinal motility. CONCLUSION: Shugan Pills could have analgesic effect, anti gastric ulcer action, it inhibited the secrection of gastric juice and the activity of gastric smooth muscle. These effects might be the pharmacological mechanisms of SHGP on treatment of epigastralgia.

AIM: To investigate the effect of Changankang Capsule (Radix Astragali, Rhizoma Coptidis, Flos Lonicerae, etc.) on acute inflammation and immune function in mice. METHODS:Swelling ears induced dimethylbenzene and capillary vessel increase permeability induced by acetic acid, 2,4 diniitrofluorobenzene (DNFB) induced delayed type hypersensitivity (DTH) was adoptedas mouse model. extent of swelling ears, lymphocyte proliferation and the Tumor necrosis factor ? and interleukin 1 ? in serum were observed. RESULTS:Changankang had significantly anti inflammation in mouse's acute inflammatory model and could inhibit swelling ears and lymphocyte proliferation, decreased the level of TNF ?, but made little iufluence on IL 1? change. CONCLUSION:Changankang Capsule has the effect on anti inflammation and inhibitory effect on the DTH. Its action mechanism may be related to the inhibition of the production of TNF ?.

Objective: To explore the effect of low-level laser irradiation (LLLI) preconditioning on milieu of infarcted myocardium in experimental rats.
Methods: The myocardial infarction (MI) model was established by left anterior descending (LAD) artery ligation in female rats. 3 weeks later, the qualified MI rats were randomly divided for 3 groups: ① LLLI preconditioning group, the rats received thoracotomy for LLLI by a 635nm, 5mW diode laser with the energy density of 0.96 J/cm2 for 150 seconds, n=26. ② Control group, the rats received thoracotomy for daylight irradiation, n=27. ③ Sham operation group, the rats received thoracotomy without LAD ligation, n=24. The Expressions of myocardial vascular endothelial growth factor (VEGF), glucose-regulated protein 78 (GRP78), superoxide dismutase (SOD) and malondialdehyde (MDA) were evaluate by real time-PCR, Western blot analysis and other relevant laboratory test at 1 hour, 1 day and 1 week after treatment. The myocardial cell apoptosis was examined by TUNEL staining, and left ventricular function was detected by echocardiography.
Results: LLLI preconditioning obviously increased the myocardial VEGF, GRP78 expression and SOD activity, decreased MDA production; while it could not really improve the myocardial cell apoptosis at peri-infarcted area and left ventricular function in experimental rats.
Conclusion: LLLI preconditioning may improve the milieu of infarcted myocardium via decreasing the oxidative stress in experimental rats.

Objective: To explore the effect of omentopexy combining autologous atrial tissue patch cardiomyoplasty for treating the chronic myocardial infarction (MI) in experimental rats.
Methods:The MI model of SD rats was established by left coronary artery ligation. 3 weeks later, the qualiifed animals were randomized into 4 groups for the 2nd operation. ① Control group, the rats only received re-thoracotomy, ② Atrial appendage group, the autologous atrial tissue patch was harvested from left atrial appendage of rats and transplanted to infarcted zone, ③ Omentum group, the omentum of rats was transplanted to infarcted zone through diaphragm and ④ Combination group, the left atrial appendage tissue and omentum were transplanted to infarcted zone together. 4 weeks after the 2nd operation, the cardiac function was evaluated by echocardiography, the size and scar thickness of the infarction were examined by Masson staining, the survival of transplanted atrial tissue and angiogenesis were measured by immunohistochemistry, the protein expressions of VEGF, MMPs and TIMP-3 were examined by Western blot analysis, and the activities of MMPs were
identiifed by gelatin zymography.
Results:4 week after the 2nd operation, transplanted left atrial appendage tissue only survived in Combination group. The areas of infarction were similar among different groups, P>0.05. Compared with Control group, Combination group had the increased scar thickness (329 ± 33)μm vs (391±31)μm, improved LVEF (47.5 ± 4.5)%vs (57.9 ± 5.8)%, improved LVFS (20.7 ± 2.0)%vs (25.2 ± 3.6)%, all P<0.05. Compared with Control group, both Omentum group and Combination group demonstrated higher density of angiogenesis at infracted area (33/0.2) mm2 vs (49/0.2) mm2 and (33/0.2) mm2 vs (48/0.2) mm2, all P<0.01. Combination group had decreased protein expressions of MMPs, while the expressions of TIMP-3 were similar among different groups, the activities of MMP-2 and MMP-9 were decreased by 68%, P=0.002 and 64%, P=0.016 respectively.
Conclusion:Omentopexy could improve the angiogenesis and support the survival of transplanted autologous atrial tissue patch, therefore improve the cardiac function in experimental rats with chronic MI.