Objective: To analyze the efficiency and differences of China Community Health Service, to analyze the shares of eastern-middle-western regional differences and the difference within each region in the total efficiency difference. Methods: The super efficiency DEA model and decomposition of Gini coefficient by Subgroups are used to analyze the provincial data in China from 2008 to 2011. Results: The eastern-central-western regional difference is the major cause of the efficiency differences in China Community Health Service. In the meantime, the shares of the difference within each region in the total efficiency difference are also non-negligible. Conclusion: To narrow the efficiency differences among eastern, central and western areas; improve the inter-regional flow of community health service resources; improve the support and supervision on the backward regions; make regional policies to coordinate the internal resources of community health services and strengthen the assessment mechanism using efficiency as the indicator.

Transcatheter closure as an alternative to medical surgery has become a preferred therapeutic method to atrial septal defect (ASD).However,thrombopoiesis after occluder implantation has been reported comprehensively and causes a series of serious complications such as cerebral embolism、myocardial infarction,pulmonary embolism and so on.Reasons of device thrombopoiesis are closely associated with atrial fibrillation,persistent atrial septal aneurysm,occluder type,activated coagulation system and occluder endothelialization process.This paper summarizes correlation factors of occluder thrombopoiesis and current related prevention proposal after transcatheter closure of ASD,and provides theoretical and experimental foundation for prevenition of device thrombopoiesis after occluder implantation of ASD.

Nco-adjuvant endocrine therapy has provided opened new alternatives for locally advanced breast cancer, especially for patient groups such as the elderly, those who are not suited for chemotherapy, and those whose response may not be optimal. The latest generation of endocrine therapy for breast cancer,aromatase inhibitors, has proved superior to tamoxifen in terms of toxicity and efficacy in the adjuvant setting.Compared with neo-adjuvant chemotherapy, the appropriate patients to receive nco-adjuvant endocrine therapy can achieve similar short-term benefit. However, because of fewer long-term follow up results, the overall prognosis is not clear.

New technologies and ideas are constantly emerging recently. With the arrival of the era of minimally invasive surgery, most of the colorectal cancer surgeries can be conducted through minimally invasive techniques. In this study, we discuss the status, characteristics, controversy, and consensus of minimally invasive techniques in colorectal cancer surgery.

Triple negative breast cancer (TNBC)is difficult to benefit from endocrine therapy or tras-tuzumab targeted drug therapy.Biological overexpression of breast cancer susceptibility gene 1,p53 gene,vas-cular endothelial growth factor and microRNA suggests that TNBC is easy to metastasis and recurrence and has a poor prognosis.Exploring the molecular subtypes of TNBC,setting out the treatment plan for subtypes and finding the corresponding monoclonal antibody targets are the research direction of TNBC in the future.

Objective To discuss the antitumor mechanism preliminarily by observing effects of Celastrus orbiculatus extracts (COE) on vascular endothelial growth factor (VEGF) mRNA and protein expression in hepatoma (Hepal-6) cells of mice.Methods Hepa1-6 cells were treated with COE at different nontoxic concentration (0, 10, 20, 40, 80, and 160 μg/mL) for 16 h. The mRNA and protein expressions of VEGF were detected by reverse transcription-PCR and Western Blotting,respectively. Results COE significantly inhibited VEGF expression at both mRNA and protein levels in a dose-dependent manner. Conclusion COE can inhibit VEGF expression in Hepa1-6 cells, therefore suggest that VEGF could be chosen as an therapeutic target for COE in the context of cancer chemoprevention and anticancer therapy.

Long-term failure in choice of materials for artificial esophagus (AE) and in treating incidence of postoperative com-plications of esophageal cancer has resulted in lack of ideal AE regeneration. As one of the innate elements forming the human body, carbon possesses high tissue affinity. Artificial esophagus as the induced stent of esophageal regeneration is the best choice for replac-ing esophageal defects and for reintroducing oral feeding after cancer radical resection.

Objective: To explore the brain damage effects of lysophasphatidyl choline(LPC) in rats with pancreatitis and explore the pathogenesis of pancreatic encephalopathy(PE).Methods: SD rats were divided into test group,control group one and control group two at random.Acute edematous pancreatits rat model was induced following Aho HJ method for test group and control group one,then test group rats were venously applied with LPC and control group one was injected saline through tail vein.Control group two was treated with venous injection LPC through the rat tails without operation.Horseradish peroxidase(HRP) was used as a tracer to detemine if the blood-brain barrier(BBB)was open 7～10 days after successive application of LPC.The extravasated tracer was showed by diaminobenzidine(DAB).Rat brain tissue sections were examined by ponceau stain and Luxol Fast Blue stain to determine whether the rat brains were demyelination at the same time.Results: The BBB permeability of the test groupLTU rats increased greatly and obvious demyelination was observed in test group rat brains while both control groups had basically intact BBB and scarce demyelination was observed in both control groups.A statistical difference existed between the test group and control groups.Conclusion:LPC definitely open the BBB of the rat pancreatitis and demyelinates the brain of pancreatitis rats thus LPC plays an important role in the pathogenesis of PE.

Objective To study the association of apolipoprotein ( Apo) E gene polymorphism with difference in biochemical metabolism of diabetic nephropathy of Hui and Han populations. Methods ApoE genotype was determined by PCR-RFLP in diabetic patients with or without diabetic nephropathy (DN) and normal peoples in Hui and Han peoples, the related biochemical parameters were simultaneously detected. Results (1) Huis had 3 genotypes, i. e. E2/E3, E3/E3 and E3/E4, and their frequencies were 0. 043, 0. 894 and 0. 064, respectively. Hans had 5 genetypes, i. e. E2/E2, E2/E3 , E2/E4, E3/E3 and E3/E4, and their frequencies were 0.075,0.060, 0.164, 0.642 and 0.060, respectively. The frequencies of 3 alleles, E2, E3 and E4, in Huis and Hans were 0.021, 0.947, 0.032 and 0.187, 0. 702, 0.112, respectively. The results showed that difference in frequencies of genotypes and alleles of Huis and Hans was very significant (both P

Objective To evaluate the role of extracelluar signal-regulated kinase (ERK)-cyclic AMP response element binding protein (CREB) signaling pathway in the spinal cord in naloxone-induced withdrawal response in morphine-dependent rats.Methods Fifty male adult SD rats,aged 2 months,weighing 200-250 g,in which intrathecal catheters were successfully implanted without complications,were randomly divided into 5 groups (n =10 each):group control (group C); group morphine dependence (group MD); group morphine withdrawal (group MW); group U0126 (ERK signaling pathway blocker); group dimethyl sulfoxide (DMSO,solvent for U0126).Morphine dependence was induced by increasing doses of subcutaneous morphine for 6 days.The initial dose of morphine was 10 mg/kg twice a day and was increased by 10 mg/kg twice every other day until 50 mg/kg on 6th day in groups MD,MW,U0126 and DMSO.Morphine withdrawal response was induced by intraperitoneal naloxone 4 mg/kg at 4 h after last morphine administration in groups MW,U0126 and DMSO.U0126 150μg (in DMSO 10 μl) and DMSO 10 μl were administered intrathecally at 30 min before naloxone administration in groups U0126 and DMSO respectively.Morphine withdrawal response (0=no withdrawal response,3 =severe response)and touch evoked agitation (0 =no agitation,2 =severe agitation) were observed and scored during 1 h after naloxone administration.The animals were then sacrificed and the spinal cord was removed for determination of the expression of phosphorylated ERK (p-ERK) and phosphorylated CREB (p-CREB) by immuno-histochemistry and Western blot.Results Morphine withdrawal significantly up-regulated the p-ERK and p-CREB expression in group MW compared with group C ( P ＜ 0.05).Withdrawal response score and touch evoked agitation score were significantly increased in groups MW,U0126 and DMSO as compared with group MD ( P ＜ 0.05).U0126 pretreatment significantly attenuated naloxone-induced increase in withdrawal response score and touch evoked agitation score and down-regulated p-ERK and p-CREB expression in group U0126 as compared with group MW ( P ＜ 0.05).Conclusion ERK-CREB signaling pathway in the spinal cord is involved in morphine withdrawal response in morphine-dependent rats.