To evaluate the reforming effects of health service performance appraisal and distribution motivation system at our center,discuss some questions during the development and application of such an evaluation system and conduct comparative analysis of the policies and data before and after management pilot separation between revenue and expenditure.The performance evaluation system and distribution mechanism were established so as to boost the working efficiency of community health services and ensure their sustained and healthy developments.

Objective To investigate the effects of mifepristone on the expression of fibronectin (FN) in human villus and deciduas after termination of pregnancy. Methods Women with choice of termination of pregnancy(< 49 d) were divided into medical abortion complete group (n=15), medical abortion incomplete group(n=15) and control group (with dilatation and curettage, n=15). The villus and deciduas were collected at the third day of medical abortion or at the day of dilatation and curettage. Immunohistochemical technique was used to examine the expression of FN in villus and deciduas of these three groups. Results The positive expression rates of FN in villus and deciduas of control group were significantly higher than those of two medical abortion groups(P < 0.017), and the positive expression rates of FN of medical abortion incomplete group were significantly higher than those of medical abortion complete group (P < 0. 017). Conclusion Mifepristone can decrease the expression of FN in human villus and deciduas and interfere the condition of embryonic growth, exerting the anti-gestational effect at extracellular matrix level.

Objective To investigate the expression of tumor necrosis factor-alpha (TFN-α) in human villus and deciduas from different abortion. Methods From May 2008 to May 2009, 45 women with early pregnancy( <49days)were divided into three groups, medical abortion completed group ( n = 15),medical abortion uncompleted group( n = 15 )and control group( n = 15, patients with dilatation and curettage ). The villus and deciduas were collected at the third day of medical abortion or at the day of curettage.Immunohistochemical technique was carried out to examine the distribution of TNF-α in villus and deciduas of the three groups. Results The age, gestational age, diameter of gestional sac and levels of serum E2, P and B-HCG before abortion were similar in all three groups. The expression of TNF-o in villus and deciduas of the control group was lowest among three groups[(4. 75 ± 10. 22)% vs (2. 66 ±2. 57)%]. The expression of TNF-α in villus and deciduas of medical abortion completed group was highest among three groups [(26. 67 ± 7.46) % vs ( 18. 44 ± 11. 14) %, P < 0. 05]. Conclusion Appropriate amount of TNF-α exists in the normal pregnancy, mifepristone can increase the expression of TNF-α in human villus and deciduas. and disturb reproductive immunity and effect matenal-fetal interface to induce abortion.

Objective To detect the variation of neuron specific enolase (NSE) and D dimer in blood from neonates with hypoxic ischemic encephalopathy (HIE), and to explore the correlation of NSE and D dimer with brain damage. Methods NSE and D dimer levels in blood from neonates with HIE were measured by ELISA and turbidimetry before and after therapy. Results Blood NSE and D dimer levels in all objective cases were significantly higher than those in the control cases at 1 d after HIE and 5 d after therapy ( t =2.18-15.17, P

OBJECTIVE: Investigate the effect of oxidative stress on the occurrence and development of laryngeal squamous cell carcinoma associated with smoking, and the clinical diagnostic value of catalase on smoking related laryngeal squamous cell carcinoma. METHOD: Collecting 119 smokers(including the smoking related laryngeal cancer group 68 cases, the control group 51 cases), the indexes of catalase (CAT), malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH), nitric oxide (NO) in blood plasma and cancerous tissue in two groups were compared. The association between these oxidative stress indicators and the occurrence and severity of smoking related laryngeal squamous cell carcinoma was analysised by SPSS 17.0. RESULT: (1) Compared with control group, the smoke frequency and amount, CAT, MDA, GSH increased significantly in the smoking related laryngeal cancer group (P = 0.000; 0.000; 0.000; 0.000; 0.000); whereas SOD, NO decreased (P = 0.000; 0.000). (2) The lower the differentiation degree, the higher the serum CAT (P = 0.000) and the higher CAT, MDA, GSH of larynx tissue (P = 0.000; 0.000; 0.000), but the lower the serum NO (P = 0.000) and the lower SOD, NO of larynx tissue (P = 0.000; 0.000); The higher the clinical stage, the higher CAT of serum and larynx tissue and the higher GSH of larynx tissue (P = 0.000; 0.001), the lower NO of larynx tissue (P = 0.009). (3) The serum CAT, MDA were independent risk factors of smoking related laryngeal squamous cell carcinoma (OR = 1.060, 2.475; P < 0.01, P < 0.05). CONCLUSION Oxidative stress is the key factor of the occurrence of smoking related laryngeal squamous cell carcinoma, and the CAT can be used as the indicator of clinical diagnosis of smoking related laryngeal squamous cell carcinoma.
Antioxidants ; metabolism ; Carcinoma, Squamous Cell ; enzymology ; Catalase ; metabolism ; Glutathione ; metabolism ; Head and Neck Neoplasms ; enzymology ; Humans ; Laryngeal Neoplasms ; enzymology ; Malondialdehyde ; metabolism ; Nitric Oxide ; metabolism ; Oxidative Stress ; Risk Factors ; Smoking ; adverse effects ; Squamous Cell Carcinoma of Head and Neck ; Superoxide Dismutase ; metabolism

This study was aimed to analyze the formulas and classify the treatment of chronic kidney disease (CKD) by Dr. Huang Chunlin based on the data mining method. A total of 63 CKD outpatients' medical records by Dr. Huang were collected. And 226 formulas prescribed in the medical records were put in the Traditional Chinese Medicine Inheritance Support System (TCMISS). Data mining techniques were applied in the study of as-sociation rule mining algorithm and complex system entropy cluster, the usage frequency and the correlation of each single Chinese medicinal in order to sort out the prescription pattern of CKD. The results showed that to for-tify the spleen and tonify the kidney were found to be the basic method of CKD treatment . Through the applica-tion of TCMISS, the Chinese medicinals used in Dr. Huang's CKD treatment were Astragalus root, Eucommia, Epimedium, Cuscuta, Agastache, Danshen Root, Ligustrum. It was concluded that the TCMISS is of great value in the summarization of clinical experiences of well-known TCM doctors.

Objective To investigate the clinical applicated value of simple transumbilical single-tunnel laparoscopic renal cyst decortication.Methods 7 patients with renal cysts were treated with simple single-tunnel laparoscopic renal cyst decortication.Results The operations of 7 patients were succeed.The mean operative time was 37 (28 ～ 90) min,and the mean time of pulling the drain tube out was 2 (1 ～ 4) d,and the mean int aoperative blood loss was 30 (25 ～ 80) ml,and the mean bed stay was 1.5 (1 ～ 3) d,and the mean hospital stay was 4 (3 ～ 8) d.In 7 patients,no recurrence of the cyst occurred during a follow-up of 1 ～ 6 months by color-ultrasonography,CT after operation.Conclusion The simple transumbilical single-tunnel laparoscopic renal cyst decortication has advantages of economic,minimal trauma,hairdressing,rapid recovery and better effect,therefore it maybe an ideal treatment choice for renal cysts.

Anoikis is a form of apoptosis induced upon cell detachment from extracellular matrix.It has been determined that acquisition of resistance to anoikis is a critical step for tumor cell metastasis.MiR-21,the most prominent oncomiR,plays an important role in tumor progression.In this study,we revealed that up-regulation of miR-21 in human esophageal adenocarcinoma (EA) is associated with lymph node metastasis and poor survival rate.Because of the established anti-apoptosis effect of miR-21,it is tempting to speculate that miR-21 might contribute to tumor metastasis by regulating anoikis,qRT-PCR analysis demonstrated that miR-21 expression in OE33/AR cells (subpopulation of human EA OE33 cells that acquired resistance to anoikis) was significantly increased.Also,transfection of miR-21 mimics provided OE33 cells resisting to anoikis.By luciferase assays,we verified that PDCD4 and PTEN were the functional targets of miR-21.In mouse model,via tail vein injection experiment,we showed that the metastasis formation of OE33 cells in vivo could be mediated by changing the miR-21 expression pattern.Taken together,our findings suggested that miR-21 was involved in the regulation of anoikis in human EA cells.Targeting miR-21 may provide a novel strategy to prevent metastasis.

The paper introduces domestic and overseas current situation of ontology knowledge base,expounds on the buiding method,instrument and specific realization of ontology knowledge base of maternal intelligent interrogation,poins out that the knowledge base is able to provide pregnant women and puerperants with customized diagnosis and treatment service and thus further promotes the application of "Internet + Medical" in the field of maternal and child healthcare.