Objective: As the breakthrough for public hospital reform in China, County public hospital comprehensive reform has become the main part of the reform, the reasonable use of New Rural Cooperative Medical System(NCMS) would strongly push the process of new medical reform. Methods: The method of mathematical modeling was applied in policy imitate of hospital operation historical data, to estimate the increasing of decreasing status of NCMS hospital compensation expenditure after the implementation of county-level public hospital comprehensive reform measurement in 10 county-level public hospital. Results: Through analyzing the operation data of applying county-level public hospital comprehensive reform measurement in 10 county-level public hospital from 2010 to 2012, there was 66.67% annual time, the NCMS compensation expenditure for public hospitals increased to 23.075 6 million yuan, which increased by 1.691 7 yuan averagely. Conclusion: After the implementation of comprehensive reform policies, the influencing factors of NCMS funds on the decreasing degree of county-level public hospital expenditure were mainly the proportion of pre drug addition ratio and basic drug sales in the total drug sales.

The paper covered key progress of the management system reform for China's public hospitals and analyzed main roadblocks in the reform.It proposed such policy recommendations as clearly separating the regulation and management affairs,concentrating management authorities to build an integrated management system,establishing a clear-cut appraisal criteria for accountability,and completing supportive reforms for effective management.

Objective: To understand the gambling relations between the stakeholders of catastrophic medical insurance policy under New Rural Cooperative Medical System ( NCMS) , and provide theoretical references for the smooth operation of catastrophic medical insurance policy of NCMS. Methods:Analyzing the game relationships among the four sides:the government, business insurance agencies, designated medical institutions and participating farmers suffering from catastrophic diseases through game theory. Results: The government and business insurance agency, and the government and designated medical institution belong to cooperative games. The farmers participated in catastrophic medical insurance tend to choose cooperative strategy. Non-cooperative games exist in business insurance agency, designated medical institution and participating farmers. Conclusion: Strategic relationship of close cooperation should be established between the business insurance agencies and designated medical institutions. The government should strengthen the regulatory constraints between the business insurance agencies and designated medical institutionsi, at the same time, it needs to establish the incentive mechanism soon.

Based on the analysis on protections of civil rights in public health crises, this paper reviewed some related issues about the right of life, personal liberty, etc. It was found that the system of emergency laws was not perfect, and the articles about basic civil rights protections among different laws was inconsistent, we are also lack of a comprehensive management department to coordinate crisis response. The government should perfect laws and adjust management functions to protect citizens’ legitimate rights.

The active components from Centipeda minima were extracted by water or ethanol, and identified by FTIR spectroscopy and UV-visible spectrophotometer. The molluscicidal effect of aqueous extract and ethanol extract from Centipeda minima against Oncomelania hupensis was determined as referring to the WHO guidelines for laboratory molluscicidal test. Treated with over 2.0 g/L aqueous extract and ethanol extract for five days, the mortality of O. hupensis was up to 100%, and their LC50 for snails was 0.50 g/L and 0.62 g/L, respectively. The molluscicidal activity of aqueous extract was higher than that of ethanol extract. The main components of aqueous extract and ethanol extract were sesquiterpens lactones and sterols.

Aim To explore the effect of miRNA-143 ( miR-1 4 3 ) on homocysteine ( Hcy ) induced-vascular smooth muscle cells ( VSMCs ) proliferation and the mechanism .Methods VSMCs were cultured and in-cubated with Hcy by using primary cultured method . Then, cells were treated with different concentrations of Hcy and folate .VSMCs proliferation was determined with MTT assay , miR-143 was measured by qRT-PCR, and methylation of miR-143 was determined with meth-ylated PCR.Results After cells were treated with dif-ferent concentrations of Hcy , the proliferation of VSMCs was significantly increased , mRNA expression of miR-143 was decreased and methylation of miR-143 was increased .The proliferation of VSMCs was signifi-cantly decreased when transfected VSMCs with miR-143 precursor , and cell proliferation was increased by using miR-143 inhibitor transfection .Conclusion Hy-pomethylation of miR-143 may inhibit VSMCs prolifera-tion.

Objective: To construct an evaluation index system of public health emergency preparedness capacity in county-level centers for disease control and prevention (CDC), so as to provide the evidence for improving the public health emergency preparedness capacity in county-level CDC. Methods: An index system framework was created based on review of health emergency policies, laws and regulations released in China from 2003 to 2023. The importance, sensitivity and accessibility of indicators were scored and screened through two rounds of Delphi expert consultations, and the weights of indicators were calculated using precedence charts. The efficiency of Delphi expert consultations was evaluated using the active coefficient, authority coefficient and coordination coefficient. Results: Eighteen experts participated in consultations, including 9 men, 15 with educational levels of master degree and higher, 12 with preventive medicine or public health as the specialty, and 12 with deputy senior professional titles and higher. The active coefficients of two rounds of consultations were 100.00% and 94.44%, and the authority coefficients were 0.83 and 0.84, respectively. The coordination coefficients of secondary and tertiary indicators during the second round consultation were 0.341 and 0.241, which were both higher than those during the first round (both P<0.05). The final evaluation index system included 8 primary indicators, 21 secondary indicators and 58 tertiary indicators. Among primary indicators, health emergency organization and management (0.203 1), health emergency team building (0.203 1) and financial support for health emergency (0.203 1) had the highest weights, and of secondary indicators, completion degree of health emergency administration regulations (initial weight/global weight: 0.750 0/0.152 3), health emergency team building (0.750 0/0.152 3) and financial support for emergency (0.750 0/0.152 3) had the highest weights, while among tertiary indicators, defining the duty of health emergency administration sectors had the highest weight (0.750 0/0.114 2). Conclusion The created evaluation index system is feasible for evaluation of the public health emergency preparedness capacity in county-level CDC.

Objective:To identify the key convergence points in the medical-nursing combined care among literature, and establish a mechanism for medical-nursing combined care integration from the perspective of the synergy theory, for the purpose of promoting the integrated development of such care in China.Methods:Relevant literature on the medical-nursing combined care were retrieved from the CNKI database from September 2013 to September 2021. The search formula used was TI= "the medical-nursing care integration" AND SU=(convergence+ transformation+ coordination+ mechanism), while supplementary searches were made using " pkulaw.com database" and Baidu Scholar database. The method of literature content analysis was used to screen key points of the medical-nursing combined care, and the convergence mechanism was built based on the perspective of the synergy theory.Results:A total of 42 literatures were included in this study, 8 key convergence points of medica-nursing combined care integration were identified. Namely the 4 key horizontal convergence points of medical care, aging care, rehabilitation and nursing, the 3 key vertical convergence points of home care, institution care and community care, and the one key convergence point of institutional medical care. Based on the synergy theory and the 8 key convergence points, the " 431" convergence mechanism of medical-nursing combined care was constructed. This mechanism refered to the horizontal linkage of healthcare, nursing, rehabilitation and aging care, the vertical redirection among home care, institution care and community care modes, and the development mode focusing on institutional aging care.Conclusions:At present, the poor convergence between aging care and nursing care in China is a key roadblock hindering the integrated development of aging and nursing care. Medical-nursing combined care should be conducive to the " 431" convergence development, achieving horizontal linkage, vertical redirection, and resource sharing, for the purpose of high-quality development of China′s aging care system.

Objective To explore the present human resources and problems at community health centers in Shandong province .Methods PPS sampling method was used to extract data of 333 community health centers in 17 cities in Shandong province in 2015 .Then the human resource status was analyzed and evaluated by descriptive research indexes .Results Data showed that 333 community health centers had 19809 employees ,and 12271 of them having staffing quota. These employees include 6355 physicians ,5169 nurses ,and 3064 medical and pharmaceutical technicians .For the physicians ,4841 of them are medical practitioners ,1313 were assistant medical practitioners ,while the numbers of obstetricians and gynecologists ,general practitioners ,and TCM practitioners were 756 , 2124 and 432 respectively .Conclusions These community health service centers are faced with such problems as lack of human resources ,irrational personnel makeup ,and obvious shortage of public health ,general practitioners and medical/pharmaceutical professionals. It is recommended to increase and optimize manpower by means of motivating existing personnel ,introducing new manpower and training opportunities for the retention.Medical alliances are expected to encourage more high-end professionals to the primary institutions .

OBJECTIVE: To design a series of geometric indexes, which can improve the correlation between geometric parameters and dosimetric parameters. METHODS: 48 cases of upper abdomen were selected. Manual and automatic segmentation were performed for two organs at risk, which were stomach and duodenum. Three overlapping structures, which were the overlaps with target expanded by 5 mm, 10 mm and 20 mm, were generated for each organ at risk. The geometric parameters of overlapping structures were calculated. The relationship between these geometric parameters and the dosimetric parameters of organs was investigated. RESULTS: When the geometric parameters of overlapping structures related to the target expand 5 mm, 10 mm and 20 mm were larger than 0.4, 0.6 and 0.8 respectively, the maximum dose differences of manual and automatic segmentation were less than 3 Gy. For the case with no overlaps between the organs and the target expansions, the overlap structure corresponding to target expanding 20 mm were recommended for safety considerations. CONCLUSIONS For organs at risk in the upper abdomen, the overlapping geometric parameters were closely related to the maximum dose of organs. Overlapping geometric parameters could predict whether the difference of maximum dose caused by automaticsegmentation was clinically acceptable or not.
Organs at Risk ; Radiometry ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated