Coordinated care delivery is faced with various challenges to carry out in China,which are major decisions to make for decision makers,including how to push forward,how to deliver resources, services and patients to primary institutions,and how to ease the difficulties and affordability of seeing doctors.Based on analysis of roadblocks in coordinated care delivery in China,the authors provided near-term and long-term policy recommendations on the system,including how to build a scientific and reasonable healthcare delivery system,coordinated care delivery by stages,building incentives and constraint mechanisms,and enhancing public awareness and patient-doctor education.

Concept of coordinated care delivery is clearly defined,before a comparative analysis is made between such a concept and the integrated care delivery concept which is popular overseas and similar.On such basis,a theory framework is established for building and implementing such care delivery in line with the integrated theory of care delivery systems.Coordinated care delivery system now in place in China aims at rationally delivering medical resources,services and patients to primary institutions,by means of efficiently distributing resources and service systems and integrating care delivery flows,thus offering patients with cost effective and appropriate services and optimizing the care delivery system.

Systemic Sclerosis(SSc) is a fibrotic disease characterized by immunological abnormalities,vascular injury and increased accumulation of extracellular matrix.The etiology has not been fully elucidated yet,so we need to establish a suitable animal model for research.This review is to introduce murine model of bleomycin-induced SSc,and summarize research works on the pathogenesis and treatment of SSc based on this model.

Objectives To investigate the effect of rhEPO on newborn rats with necrotizing enterocolitis (NEC). Meth-ods Sixty newborn Sprague-Dewley (SD) rats at the age of 48 hours were randomly divided into 5 groups:control group, NEC group, and intervention groups 1, 2 and 3 treated with rhEPO. The rats were fed rat breast milk substitutes and stressed under hypoxia and cold exposure to establish NEC model. The rats with NEC were treated with different doses of rhEPO (0.1U/ml, 1U/ml and 10U/ml) in intervention groups. The expression of Bcl-2 and caspase-3 were measured by immunohistochemistry, and intestinal pathological changes were observed using HE staining. The value of positive expression was analyzed by IOD (integral optical density) image analysis system. Results Abdominal distention, decreased activity and unresponsiveness occurred in NEC rats 24 hours after stress exposure, and pale skin, decreased skin temperature and respiratory rhythm change were observed in severe cases. The symptoms appeared later and milder in three intervention groups. The NEC incidence of newborn rats was as followings:control group(0%), model group(60%), intervention group 1( 30%), intervention group 2(18.2%), intervention group 3(9.1%) and the difference was signiifcant between each group (P=0.008). The grades of intestinal injury, the expression of active caspase-3 and Bcl-2 were signiifcantly different among groups (P<0.01). Intestinal injury was the most severe and the expression level of active caspase-3 was the highest in NEC group. After rhEPO treatment, the intestinal injury and the production of active caspase-3 protein were decreased, and the expression of Bcl-2 was increased. Conclusions Oral rhEPO could decrease the ex-pression of intestinal active caspase 3, and increase the expression of Bcl-2. The protective effect of rhEPO on NEC is dosede-pendent.

Humans ; Lymphocytes ; cytology ; drug effects ; Micronucleus Tests ; Occupational Exposure ; prevention & control ; Polycyclic Aromatic Hydrocarbons ; toxicity ; Population Surveillance ; methods

The endophytic bacterum 01-144 was marked by using the method of antib iotic-resistance. Colonization of 01-144 in tomato root and stem was investig ate d. Result showed that 01-144 colonized in the root and stem and the colonizing a bility in the root was stronger than in the stem after dipping seed or watering root treatmeat, It was also found that this bacterium could more easly colonized in the low stem than in the upper stem. The population fluctuation of 01-144 ha d the same trend in both root and stem i.e.first increased then decreasing, an d the fluctuation in the root was more even than in the stem.

Objective To detect the relationship between XPD Lys751Gln polymorphism and the risk of adult acute leukemia (AL). Methods 100 adult AL patients and 100 controls were chose as case and Lys751Gln were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) analysis in peripheral blood. Results The genotype frequency of Lys/Lys, Lys/Gln, Gln/Gln were 83 %, 16 %, 1% in case group and 90 %, 10 %, 0 in control group, respectively. The difference the two groups was no signficant difference (x2=1.44, P =0.49). No significantly increased risk for adult AL was observed for those carrying variant genotype with OR analysis (x2 = 2.10, P =0.15, OR =1.84; 95 % CI 0.80-4.25). Individuals with the variant genotype of XPD Lys751Gln might enhance the risk of adult AL (OR =2.77, 95 % CI 0.99-7.73). Conclusion XPD Lys751Gln polymorphism is found to have relationship with adult acute lymphocytic leukemia.

Analyzed in the paper is the present development of medical rehabilitation service system in Beijing,Changsha,and Urumqi,in an effort to identify key measures,and discover problems found with the policy environment and system building.Based on such findings,the authors proposed such measures as developing policies and regulations, optimizing resource allocation, strengthening training of rehabilitation personnel and greater publicity.

Objective To investigate the intermediary effect of depression between housebound and cognition in community-dwelling older adults and to provide intervention for the improvement of the life quality.Methods A total of 720 senior adults were selected to fill out demographic questionnaire,including Rasch-Derived Center for Epidemiological Studies Depression Scale (CES-D-R),housebound scale and the minimental state examination (MMES).Results The depression score of the elderly in community was (3.95±4.12),housebound score was (4.26±1.23),cognition score was (21.52±4.04) and the incidence rate of the cognitive disorder was 37.1%.Cognition was significantly negatively related to housebound and depression (r=-0.409,P<0.01;r=-0.485,P<0.01).Housebound was significantly positively related to depression (r=0.555,P<0.01).The community elderly age,sex,marital status,degree of education,self-assessment of health,living space,depression and the housebound could be used to predict the cognitive function,and all of them could explain the variance of cognitive function of 50.8%(P<0.05).Housebound had a direct effect of-0.02 on cognitive function(P>0.05).The indirect effect of housebound on cognitive function through depressive mood was-0.45(P<0.05).Conclusions The elderly housebound has an intermediary effect on the cognitive function through the depression.

0.05). While the significant differences existed between postoperative hypoxemia group and non-hypoxemia group (P