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 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.

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.

Objective Onto investigate the significance of the pleth variability index (PVI) in predicting hypotension after epidural anesthesia for cesarean delivery. Methods Sixity seven pregnant women, with ASAⅠ~Ⅱ, aged 19 ~ 34 years, were enrolled for elective cesarean delivery. SBP, BDP, MAP, HR, PI and PVI were measured at 5 min after the parturients arrived in the operation room. SBP, BDP, MAP and HR were measured every 3 min after epidural anesthesia. According to the change rate of SDP or MAP was higher than 30% or not, the parturients were divided into two groups (the hypotension group and the non-hypotension group). Results No significant differences were found in parturients'age, body height, weight, BMI, gestational weeks, SDP, DBP, MAP and HR before anesthesia between two groups. The PVI in the hypotension group was significantly higher than that in the non-hypotension group (P<0.05). A receiver operator characteristic curve analysis showed the area under curve was 0.888 when PVI was used for boundary value. When PVI over 17.35 was used as the occurrence of hypotension, the sensitivity of PVI was 0.727, and specificity was 0.895. Conclusion PVI can be used to predict the occurrence of hypotension after epidural anesthesia for cesarean delivery.

Objective To investigate the effects of electroacupunctures at Baihui,Fengfu,and Shenshu on the cognitive function and learning memory of mice exposure with ionizing radiation.Methods C57BL/6J (30-day old) mice were randomly divided into l0 groups consisting of the control group,X-ray exposure groups (4,8 and 16 Gy),electroacupuncture-nonacupiont (E-nonA) groups (4,8 and 16 Gy) and electroacupuncture-acupiont (EA) groups (4,8 Gy and 16 Gy),with 10 mice assigned to each group.The mice were irradiated (IR) on the left cerebral hemisphere with doses of 4,8 and 16 Gy.Some mice were electroacupunctured for 3 courses of treatment.Using weight as a measurable parameter,the open-field test and Morris water maze test were used to evaluate the curative effects.Results Compared with the control group,the weights of mice in the exposure groups (8 and 16 Gy) significantly decreased (t =2.917,9.650,3.043,2.882,P ＜ 0.05) at 7 and 14 d,while the weights of the E-nonA (8 and 16 Gy) and EA groups (8 and 16 Gy) were not significantly altered.Compared to the model groups (8 and 16 Gy),the weights of EA groups (8 and 16 Gy) significantly increased (t =6.602,5.409,19.660,2.975,P ＜ 0.05).In the open-field test,the crossing times and the rearing time of exposure model groups (8 and 16 Gy) significantly decreased compared to the control group (t =2.183,2.119,2.369,2.231,P ＜ 0.05).Compared with model groups (8 and 16 Gy) and E-nonA groups (8 and 16 Gy),the crossing times and rearing time of the EA groups were significantly increased (compared with model:t =8.914,2.727,4.325,4.178,P ＜ 0.05;compared with E-nonA:t =4.030,3.014,2.150,4.771,P ＜0.05).In the Morris water maze,compared with the control,the latent period of model group (4 Gy) was significantly increased and the crossing times significantly decreased (t =4.544,3.422,P ＜ 0.05);compared to model and E-nonA groups (4 Gy),the latent period of EA group significantly increased (compared with model:t =2.877,P ＜ 0.05;compared with E-nonA:t =3.001,P ＜ 0.05).At day 2 and 3,the latent period of model groups (8 and 16 Gy) significantly increased (t =2.544,3.706,3.796,7.934,P ＜ 0.05) and the crossing times (t =2.120,2.393,P ＜ 0.05) significantly decreased,resident time in target area of model group (8 Gy) was significantly decreased (t =2.543,P ＜ 0.05) compared to the control group.Compared with model and E-nonA groups (8 and 16 Gy),the latent period of EA gourps significantly decreased (compared with model:t =5.404,7.869,4.104,15.590,P ＜ 0.05;compared with E-nonA:t =2.938,7.955,6.566,10.350,P ＜ 0.05) while the through times and resident time in target area significantly increased in the EA group (8 Gy) (compared with model:t =2.673,2.613,P ＜ 0.05;compared with E-nonA:t =3.345,2.179,P ＜ 0.05).Conclusions Irradiation with a dose higher than 8 Gy could induce mice brain injury.Electroacupuncture can alleviate the radiation damage of cognitive function as well as learning and memory functions in mice.

Objectives:To investigate the impact of doctor-attacking on medical students’ occupation atti-tude. Methods: We conducted a sample survey towards different major of Wenzhou Medical University by using self - made questionnaire. Reults: The occupation attitude of interviewee is not so bad, the confidence about the occupation is really deep down and the occupational sense of mission worries a lot of people. Doctor-attacking cases damage the honorable sense of occupation, even threatens basic personal security. The spread passive emotion by Network media , as well as the varied choices of occupations, expand the influence of hospital violence. Conclusions: The fre-quent occurrences of doctor-attacking cases weaken the occupational attitude of medical students and became the obstruc-tion to be a doctor,countermeasures should be taken from multiaspect of society,media,schools and teachers through a va-riety of ways.

Objective To explore the effects of different courses of electro-acupuncture at Baihui,Fengfu,and Shenshu of both sides on the behavior of mice exposed to radiation.Methods Fifty C57BL/6Jmice 30 days old were randomly and equally divided into control group,model group (exposure to radiation of 8 Gy),electro-acupuncture group 1 (1 week of treatment),electro-acupuncture group 2 (2 weeks of treatment),and electro-acupuncture group 3 (3 weeks of treatment).The mouse model of radiation-induced brain injury was established by exposure to radiation of 8 Gy and treated with electro-acupuncture.The open field test and Morris water maze test were used to evaluate the cognitive function and spatial learning and memory,respectively.Group t-test difference.Results In the open field test,the model group had significantly fewer vertical or horizontal movements than the control group (P=0.032,0.029,0.028),while the electro-acupuncture groups 2 and 3 had significantly more vertical or horizontal movements than the model group (P=0.001,0.017,0.000).In the Morris water maze test,compared with the control group,the model group had significantly longer latency,a significantly lower frequency of entry into the goal box,and significantly shortened residence time,indicating substantially worse performance of spatial learning and memory (P=0.023,0.001,0.001).Compared with the model group,the electro-acupuncture groups 2 and 3 had significantly shortened latency,a significantly higher frequency of entry into the goal box,and significantly longer residence time (P=0.046,0.017,0.049,0.007,0.031,0.009).Conclusions Different courses of electro-acupuncture treatment at Baihui,Fengfu,and Shenshu of both sides can substantially improve the cognitive function and spatial learning and memory in mice exposed to radiation.Particularly,2 and 3 weeks of electro-acupuncture treatment give the best outcomes.