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 evaluate the compliance effect of secondary prevention on high risk patients of gastric cancer and to investigate their knowledge,attitudes,and practice about gastric cancer.Methods 206 high risk patients of gastric carcinoma cancer were investigated with questionnaires.Results of all cases,54 patients were compliant,69 patients semi-compliant,and 83 patients were not compliant in monitoring cohort.The results showed distribution of the compliant patients was significantly different with their gender,occupation and family income per person,and not significant with their education background.Conclusion The compliance and KAP of the patients on high risk for gastric cancer aren't satisfied,which needed to be enhanced in the future.

Objective To study the relationship between the expression of human Stanniocalcin-1(hSTC-1) mRNA in the peripheral blood from patients with colorectal cancer and its malignant behavior. Methods RT-PCR was used to detect hSTC-1 mRNA in the peripheral blood from 57 patients with colorectal cancer. The peripheral blood from 14 patients with gastrointestinal inflammatory diseases, 15 healthy volunteers and 5 pregnant women were served as controls. Results The positive rate of hSTC-1 mRNA in 57 patients with colorectal cancer was 49.12% (28/57), and the mRNA expression of hSTC-1 was significantly related with the clinical stage of colon cancer (P

Objective To investigate the effect of structured preoperative instruction on anxiety and self-care compliance in elder patients with cataract surgery.Methods Eighty patients over the age of 60 years undergoing cataract surgery were randomly assigned into experiment group and control group with 40 cases in each group. The experiment group received structured guidance preoperative intervention and the control group wtih routine care.SA(Self-Rating Anxiety Scale)and self-designed self-care compliance scale were used before and after interuention,postoperative patients’anxiety and self-care compliance were assessed 1d before and after surgery.Result There were significant differences between the two groups in the postoperative state anxiety (all P﹤0.01)and the postoperative self-care compliance score was higher than the control group.Conclusion Structured preoperative instruction reduces preoperative anxiety and improve compliance in elderly patients with senile cataract.

Objective To explore the clinical value of renal biopsy in the diagnosis of atypical lupus nephri-tis(LN). Methods The clinical and renal pathological data of 28 cases with atypical LN were analyzed retrospective-ly. Results All 28 patients could not fulfill the ACR diagnostic criterion,misdiagnosed as primary nephritic syndrome 21 eases,chronic glomerulone-phritis syndrome 4 cases ,asymptomatic hematuria 2 cases and asymptomatic proteinuria 2 cases,all renal biopsy showed changes consistent to lupus nephritis,pathological types:3 cases were class Ⅱ,4 cases were class Ⅲ,21 cases were class Ⅳ ,7 cases were class Ⅴ,2 cases was class Ⅳ+ Ⅴlupus nephritis,the clinical manifestations of nephritic syndrome were mostly pathological type Ⅳ and Ⅴ, the chronic glomerulonephritis syndrome showed diversification of pathological type, asymptomatic hematuria and/or proteinuria were mostly pathological type Ⅱ and Ⅲ. Conclusion clinical manifestations of atypical LN is no specific and easy to be misdiagnosed. Renal bi-opsy has great value in the diagnosis of atypical LN.

Objective To explore the regularity of hematopoietic materials during the clonal evolution of aplastic anemia(AA), paroxysmal nocturnal hemoglobinuria (PNH) , myelodysplastic syndrome (MDS) and acute leukemia(AL). Methods Patients diagnosed as AA, PNH, MDS and AL were recruited as cases and health volunteers were recruited as controls. Serum folic acid, vitamin B12 and ferritin levels were measured by radioimmunoassay and competitive enzyme immunoassay,before and after-treatment. Results Before treatment,the level of serum folic acid in PNH group were significantly lower than that in the control group(P<0. 05). Vitamin B12 and ferritin levels of MDS patients were higher than the control group (P < 0. 05); Serum Folic acid level in AL patients was significantly lower than the control group (P < 0. 05). In contrast, vitamin B12 and ferritin levels were higher than the control group(P <0. 05). Compared to pre-treatments AA patients, vitamin B12 and ferritin levels of MDS patients were significantly higher(P <0. 01) ;Serum folic acid level in AL patients was significantly lower(P < 0.05). However,vitamin B12 and ferritin levels were higher. Compared to pre-treatments MDS patients, serum folic acid level in AL patients was significantly lower(P < 0. 05) , whereas vitamin B12 and ferritin levels were higher(P < 0. 05). The comparison of hematopoietic materials between pre-and post-treatments among the groups showed that there was no significant difference for AA patients between pre- and post-treatments in the levels of serum folic acid and vitamin Bl2 (P > 0. 05), whereas ferritin was significantly higher after treatment caused by transfusion in AA patients(P<0. 05) ;ln PNH patients,serum folic acid was significantly higher after treatment(P<0. 05) ,and there was no significant difference in the levels of vitamin B12 and ferritin between pre-and post-treatments (P >0. 05). In MDS patients, there was no significant difference in the level of ferum folic acid between pre-and post-treatments (P > 0. 05) , whereas vitamin B12 and ferritin levels were significantly lower after treatment (P < 0. 05); In AL patients,serum folic acid was significantly higher after treatment(P <0. 05) .whereas the levels of vitamin B12 and ferritin were significantly lower after treatment (P <0. 05). Conclusions There are significant difference in serum folic acid,vitamin B12 and ferritin among the patitents of AA,PNH,MDS and AL and would be helpful in discovering the interrelationship among the four diseases pertinent to the clonal evolution,prognosis,treatment and prognosis.

Objective To use the AU2700 biochemical analyzer to evaluate the performance of the reagent kit for determining se-rum glycated albumin(GA)by the enzymatic method.Methods On the basis of the relevant documents of CLSI-EP,the perform-ance evaluation of the Lucica GA-L reagent kit for detecting GA was performed on the precision,accuracy,linearity range and refer-ence range;the correlation between the results detected by the two kinds of reagent kit (enzymatic method)was analyzed.Results The reagent had high precision(CV<3%);the dilution had good linearity;the average recovery rate of GA was 97.7%,the average recovery rate of albumin(ALB)was 96.43%;the detection results by the two kinds of reagent kit had good correlation (r2 =0.976, P <0.01).Conclusion The Lucica GA-L reagent kit shows the good analytical performance on the AU2700 biochemical analyzer, which is consistent to the manufacturers statement and can be better used in clinic.

OBJECTIVE: To analyze and summarize clinical characteristic, treatment scheme and survival rate of primary melanom in nasal cavity and sinus. METHOD: We retrospectively analyzed the 9 patients with primary melanom in nasal cavity and sinus who in data proceed were treated and reviewed the related literature. RESULT: Among the 9 patients, the clinical main symptoms are rhinostegnosis of lateral nasal and intermittent nasal bleeding. Pathologic examination is mainly characterized by tumor cells abnormity and cytoplasm containing pigment or without pigment, and main diagnosis basis is some or all of the positive for HMB45, S-100, melan-A. The survival rate are 88.9% (8/9) of 1-year, 66.7% (6/9) of 3-year and 33.3% (3/9) of 5-year. CONCLUSION The incidence of primary melanom in nasal cavity and sinusis is not frequent in clinic and confirmed by immunohistochemical. The extensive radical excision of focus and combine adjuvant radiotherapy postoperative may improve the survival rate of patients.
Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Melanoma ; diagnosis ; surgery ; Middle Aged ; Nasal Cavity ; Nose Neoplasms ; diagnosis ; surgery ; Paranasal Sinus Neoplasms ; diagnosis ; surgery ; Retrospective Studies

Objective To investigate and contrastive analyse the respective value of tympanograms and high resolution CT scan of temporal bone in the diagnosis of secretory otitis media .Methods The clinical data of 150 hos-pitalized patients with secretory otitis media in Department of ENTHNS ,Tongji Hospital ,Wuhan from 2009 to 2012 were retrospectively analyzed .Based on the surgical finding of tympanic cavity fluid ,the diagnostic accordance rate of tympanograms and temporal bone CT for middle ear effusion were calculated respectively ,and their diagnos-tic value were evaluated .Results The diagnostic accordance rate of tympanogram B for the middle ear effusion in secretory otitis media was 94 .5% (138/146 ears) ,the rate of abnormal tympanograms was 91 .6% (206/225 ears) , while temporal bone CT with a rate of 99 .2% (117/118 ears) .The difference between the latter two data was statis-tically significant(P<0 .01) .Conclusion The temporal bone CT scan ,with a higher diagnostic value for middle ear effusion in secretory otitis media ,could be used as a supplement to the acoustic immittance measurement ,especially to non-B tympanograms for the diagnosis of secretory otitis midia .

Purpose　To introduce a method to isolate cDNA clones using bacteriophage P1-derived artificial chromosome (PAC) or bacterial artificial chromosome (BAC) as probe for hybridization and try to find some novel genes related to hepatocellular carcinoma.　Methods　PAC 579 (D17S926 locus) and BAC 1529 (D17S1529 locus) in the deletion region of chromosome 17p13.3 in human hepatocellular carcinoma were chosen to screening the human liver cDNA library as probe for hybridization. The isolated positive cDNA clones were partially sequenced, then analyzed by computer comparison and Southern blot.　Results　After three cycles of screening, 78 and 8 candidate positive cDNA clones were isolated using PAC 579 and BAC 1529 probes respectively. Further analysis indicated 18 cDNA clones isolated by PAC 579 probe and 5 cDNA isolated by BAC 1529 probe were potential novel genes related to hepatocellular carcinoma.　Conclusions　The isolation of cDNA clones using PAC and BAC probes is effective and practical.