This paper aims to conduct a literature meta-analysis of the results of existing empirical researches about the relationship between fiscal decentralization and supply of public health service in China.It was found that the different empirical results of the impact of China''s fiscal decentralization on the supply of public health services are subject to different research characteristics.The actual results of the impact, especially the significant effect, are influenced by the characteristics of the starting year, the year of termination, and the number of models, whether the model contains population density, transfer payments, degree of openness, and whether the independent variables include the fiscal expenditure decentralization.Through the funnel plot asymmetry test, it was found that there was publication bias in the sample literature.

Objective To study and evaluate frequency-doubled-double-pulse laser (FREDDY) lithotripsy of ureteral calculi. Methods The experience of 150 cases of ureteral calculi treated with FREDDY from April to December in 2001 was summarized.94 are male patients and 56 female with an average age of 42.There were 48 cases of upper,35 middle and 64 lower ureteral stone. Results Of 150 cases,136(90.6%) were successful on the first lithotripsy.Of which in 131 cases (96.8%) the stone fragment completely expelled in one week.The procedure failed in 9 cases of upper ureteral calculi.Among them,5 cases was due to up drift of calculi or incomplete lithotripsy and was then shifted to ESWL therapy.2 was due to angular twist of the ureter and changed to open operation,and another 2 was due to perforation of ureter during the procedure.Of the 5 failed cases with middle and lower ureteral calculi,1 was due to incomplete lithotripsy,nonfragmentation in 1 case and failure of ureteroscopy in 3(changed to open operation).Different degree of hematuria was seen in every case after operation.High fever or pyonephrosis after operation has not been observed.The average operation time was 32 minutes,and the average time for laser working was 3.3 minutes.The average hospitalization after operation was 2.5 days. Conclusions FREDDY is a kind of laser with the characteristics of single function,simple operation,safe,less damage to the soft tissue and high efficiency of lithotripsy.The procedure is indicated if ESWL failed or not indicated.

Objective To study the effects of acute low temperature and hypoxia on serum SOD and MDA of myocardial ischemia rabbit. Methods 24 rabbits were randomly divided into 3 groups, such as normally low tamperature and hypoxia group, myocardial ischemia normal temporature and normal oxygen group and myocardial ischemia low temporature and hypoxia group. Put myocardial ischemia rabbits into the condition in which low temperature(-10?2) ℃ and hypoxia (oxygen content 8.5% ) existed, superoxide dismutase (SOD) activity and malondialdehyde (MDA) contents were measured after an hour. Results Serum SOD activity were decreased significantly in acute low temperature and hypoxia compared with normal temperature and normal oxygen pressure (P

Objective To observe the effect of environmental factors change on the hemorheology of the rabbit with myocardial ischemia.Methods The rabbits were divided into six groups,the group of myocardial ischemia(myocardial ischemia operation),the group of myocardial ischemia with hypoxia(volume fraction of oxygen of 91.5% nitrogen and 8.5% oxygen) and high temperature [(42?2)℃],the group of myocardial ischemia with hypoxia(volume of fraction of oxygen of 91.5% nitrogen and 8.5% oxygen),the group of myocardial ischemia with hypoxia(volume of fraction of oxygen of 91.5% nitrogen and 8.5% oxygen) and high temperature[(42?2)℃] and hunger(forbid water and fast in 24 h),the group of myocardial ischemia with hunger,control group,10 in each.After 30 minutes of treatment,the indexes of the hemorheology were determined.Results The changed environmental factors,hypoxia,high temperature,hunger,presented an increasing effect on the blood viscosity,plasma viscosity,blood high shear reduced viscosity,blood low shear reduced viscosity and equation K value of ESR(P

Objective To explore the environmental factors change on the plasma endothelin(ET) and nitric oxide(NO) in rabbits exposed to a complex environment:high temperature,hunger,and so on.Methods Ninety China rabbits were randomly divided into myocardial ischemia group,myocardial ischemia and hypoxia and high temperature group,myocardial ischemia and hypoxia group,myocardial ischemia and hunger group,myocardial ischemia and hypoxia and high temperature and hunger group,hunger group,hypoxia group,high temperatures group,control group,ten rabbits in each group.The animal myocardial ischemia was caused by fulgurating the left anterior descending branch artery in the heart.The animal hypoxia was caused by breathing in 8.5% nitrogen oxygen atmosphere(nitrogen content was 91.5%,oxygen content was 8.5%).The animals in the high temperature group were put into a high temperature [(42?2)℃] environment.The animals in the hunger group were treated with fasting and water deprivation for 24 h.Every animal has been taken in above-mentioned experiment environment for 30 min.Blood from jugular veins collected,and the contents of plasma ET and NO were determine.Results Compared with control group,except the hunger group and high temperature group,ET levels in the others six group were significantly increased(P

Objective To investigate the missing rate of polypus with colonoscopy and correlation factors for missed diagnosis.Methods Data with colorectal polyps collected a second colonoscopy within 180 days after polyps were detected and removed on the initial colonoscopy in 186 patients between July 2009 and June 2013.The following factors were statistically analyzed,including lesionrelated factors (the lesion size,location,shape,number,and pathology),and non-lesion-related factors (intestinal cleanliness,colonoscopy post-set time,colonoscopy operator experience,and whether colonoscopy with sedation).Results Polypus missed diagnosis was found in 57 patients out of 186 recruited subjects (30.64％).A total of 76 polypus were missed out of 343 (22.16％) polypus detected by repeated colonoscopy.Flat small polyps were easily missed diagnosis (P ＜ 0.01).Polyps located at sigmoid,cecum and ascending colon,hepatic flexure,and splenic flexure were easily missed diagnosis (P ＜0.05).The rate of missed diagnosis was significantly increased in the condition of the low intestinal cleanliness,short colonoscopy post-set time,non-intravenous anesthesia,and beginner colonoscopy doctors (P ＜ 0.01).Conclusions A markedly missing rate of polyp existed on colonoscopy,and was closely related to the lesion-related factors (the lesion size,location,shape,number,and pathology) and the non-lesion-related factors (the intestinal cleanliness,colonoscopy post-set time,colonoscopy operator experience,and whether colonoscopy with sedation).

Objective To evaluate intra-arterial catheter directed thrombolysis in combination with artery angioplasty for chronic long superficial femoral artery occlusion.Methods Clinical data were reviewed on patients of chronic long superficial femoral artery occlusion treated by endovascular therapy from September 2010 to September 2012.In 19 patients,catheter-directed thrombolysis was initially carried out,which was followed by endovascular angioplasty balloon dilatation or stent placement.The other 37 patients were treated by upfront endovascular angioplasty balloon dilatation or stent placement.Results In the thrombolysis group,the occluded length of the artery before and after thrombolysis was (16 ± 5) mm and (10 ± 6) mm(t =3.598,P ＜ 0.05).The length and the number of stents used in thrombolysis group was lower than stent group [(10±5) cm、(1.6±0.8) vs.(12±4) cm、(2.1 ±0.7),t=2.102,P＜0.05].There were no significant difference in primary patency rate assisted,primary patency rate and secondary patency rate between thrombolysis group and stent group.Conclusions For patients of chronic long superficial femoral artery occlusion,a successful catheter directed thrombolysis with artery angioplasty reduces the number of stents for angioplasty.

Objective To evaluate the prevention and treatment of rectal complications following 125I brachytherapy for prostate cancer. Methods A total of 90 patients with locally advanced prostate cancer was treated by transrectal ultrasound guided prostate 125I brachytherapy combined with maximal androgen blockage from November 2001 to June 2006. The patients were followed every 1～3 months postoperatively, and rectal complications was analyzed and treated. Results Eighty-nine patients were followed for 1～55 months (mean, 22 months). The incidences of rectal complications at grade Ⅰ, Ⅱ, Ⅲ, and Ⅳ were 11.2% (10/89), 6.7% (6/89), 0%, and 2.2% (2/89), respectively. Symptomatic therapy was conducted in 16 patients with grade Ⅰ or Ⅱ complications, which were symptomatically relieved 6 months later. The grade Ⅳ complications occurred in 2 patients, one of whom underwent repeated examinations and treatment for proctitis, and the other of whom was complicated with severe diabetes and received a laparocolostomy with cystostomy. Conclusions The optimal medical treatment for radiation proctitis is follow-up checkups and observations. To reduce the incidence of urethrorectal fistula, excessive examinations and treatment should be avoided. Accompanying diabetes should be treated promptly and actively.

Objective To explore the effect of combined use of antiplatelet drugs on late-onset bleeding in elderly patients after high frequency electric resection of the colon polyps on colonoscopy.Methods Data with late-onset bleeding after high frequency electric resection of the colon polyps on colonoscopy were collected from 64 elderly patients using antiplatelet drugs from January 2010 to December 2013.Those 64 elderly patiets using antiplatelet drugs were divided into aspirin,clopidogrel,and aspirin + clopidogrel groups.The clinical situation,blood-coagulation time,bleeding-occurrence time,emergency colonoscopy hemostatic rate of demand,and hemostatic time in hospital were analyzed.Results No statistically significant differences were found in the blood-coagulation time,bleeding-occurrence time,and hemostatic time in hospital among aspirin,clopidogrel,and aspirin + clopidogrel groups.However,the clinical situation,and emergency colonoscopy hemostatic rate of demand in aspirin + clopidogrel group were significantly more serious and higher than those of the aspirin or clopidogrel groups (P ＜ 0.01).Conclusions There are more serious clinical situation and higher emergency colonoscopy hemostatic demand in patients with combined use of antiplatelet drugs relative to the use of single antiplatelet drug.The clinicians should pay attention to the combined use of antiplatelet drugs for late-onset bleeding in elderly patients after high frequency electric resection of the colon polyps on colonoscopy.

Objective To investigate interventions of vitamin E( VE) on indomethacin-induced gastric mucosal injury. Methods Fifty mice were randomly divided into 5 groups. Normal control group was administrated with saline, others were intragastrically administrated with indomethacin ( 20 mg · kg-1 ) . After 4 hours, mice were intragastrically treated with saline, cimetidine(200 mg·kg-1),VE(25,50 mg·kg-1) once a day for 5 consecutive days. By the end of the treatment,gastric mucosa injury index,serum superoxide dismutase(SOD) activity,and malondialdehyde(MDA) content were determined. ResultsGastric mucosal injury indexs of mice treated with cimetidine,VE at low and high doses were significantly lower than that of the model control and higher than that of the normal control(P<0. 01). VE at high doses showed significantly less mucosal injury than that of the cimetidine group(P<0. 05). Healing-rate of gastric mucosal injury in cimetidine group,VE low-dose and high-dose groups were significantly higher than that of model control group(P<0. 01). SOD activity of VE at low and high doses was significantly lower than that of the model control and cimetidine groups(P<0. 05). The results also revealed that cimetidine and two doses of VE significantly elevated SOD activity and lowered the level of MDA(P<0. 05, 0. 01). Conclusion VE can obviously promote the healing of gastric mucosal injury,especially at high dose,which is better than cimetidine,while,the low dose is comparable with cimetidine.