In order to set up sustainable fundraising mechanisms for community health services, it is necessary to calculate the sum of compensation needed for basic public health services and formulate compensation policies on the basis of defining items of basic public health services and in accordance with the economic levels of various regions. At the same time, it is necessary to enforce government purchases after working out strict assessment criteria so as to ensure that funds for community health services are genuinely devoted to basic public health services.

The diagnosis of polypoid lesions of the gallbladder plays a key role in the selection of treatment methods.However we still lack of effective means to exclude the malignant transformation currently.It is believed that lesions,whose diameter more than 10 mm,tend to be malignant.In addition,multiple imagings and related risk factors can also bring us some valuable tips.This article summarizes the current research progress related to the differential diagnosis of the disease,hoping to provide help for the clinicians in the timing of operation for such disease.

Objective To investigate the adaptation of metabolism of arthrodial cartilage for limb lengthening. Methods Thirty New Zealand rabbits were randomized into two groups, limb lengthening group (group A) and delay observation group (group B). Every group was subdivided into three sub-groups according to distraction degree: 10%, 20% and 40%. Upper-tibia metaphysis lengthening was adopted at 1 mm/d rate of distraction and iconography changes of knee joint were observed with X-ray, the morphologic changes of chondrocyte and cartilago articularis on tibial flat were observed with light and electric microscope. The changes of cartilage surface were observed with scanning microscope. Results 1) There was no obvious iconography change of knee at every time phase in each group. 2) Pale of cartilage on tibial flat were just noted in group A40 and B40. 3) The arrangement of chondrocyte was disorder in A40, some degenerating and generating chondrocytes were found in the same group. The number of chondrocytes increased, and the volume was expanded in group B20 or B40, the degenerating chondrocytes were not found in the same group. 4) Low-grade expansion of endoplasmic reticulum and swelling of chondrosome were found in part of chondrocyte in group B40 contrasting with the other groups. The numbers of endoplasmic reticulum and matrix alveolus increased in chondrocyte. The same changes were observed in group A. 5)The cartilage surface lost its smoothness during distraction, and this kind of changes were more severe when distraction increased. Conclusion The articular cartilage showed certain adaption to stimulation of distraction during low degree distractions. To greater distraction degrees some abnormality in metabolism of arthrodial cartilage may occure.

In order to investingate the stability of the half-ring sulcated external fixator,it was used to fix the bone after artificial fracture of the tibia shaft and tibia lengthening with proximal metaphyseal osteotomy were performed on 20 and 22 goats respectively.After operation,the animals were allowed to roam about freely,walking or jumping.In the fracture group,radigraphy of the tibia shaft,strength determination of the limb,and histological study of the fractured site were performed at the end of the 6th week.And in the lengthening group,x-ray examination and histological study were done after the 10th week.All the findings indicate that the external fixator designed in our department is well qualified to meet the requirement for the fixation of fractrued bones and the lengthened bones as well.

Aim: To study the effect of pulsed electromagnetic fields(PEMF) stimulation on the repair of rats grafted sciatic nerve. Methods: One hundred Wistar rats were classified randomly into two groups, a control group (group A, n = 50) and a PEMF group(group B, n = 50). The biological effect of the grafted nerve, the relative lumbar spinal cord and one of the ending organs - triceps muscle was studied at the same time. Results: The neuron's vitality in lumber spinal cord had been stimulated in the PEMF- treated rats. The Wallerian degeneration of the nerve distal to the grafted was accelerated after PEMF stimulation. The increased regeneration of the nerve was found throughout 16 weeks recovery period in PEMF group. Application of PEMF had decreased the atrophy of the triceps muscle caused by denervation and promoted its functional recovery. Conclusion: PEMF stimula- tion may enhance the regeneration of the injured peripheral nerve.

Objective To investigate the expression of nerve tissue protein S-100(S-100)and gap junctional protein connexin 43(Cx43) in rat adenohypophyseal folliculo stellate cells(FSCs) under the influence of ovariectomized osteoporosis(OVX-OP) and estrogen replacement therapy(ERT). Methods Sixty 10 month old female rats were randomly divided into sham operation control group(Sham), ovariectomy group (OVX) and ovariectomy+ERT group (OVX+ERT). L4-6 bone mineral density(BMD) of the animals in Sham group and OVX group were measured by dual energy X-ray absorptiometry(DEXA) at the end of 6 weeks after operation. From 7th week, rats in OVX+ERT group were treated with nilestriol(1 mg?kg -1?week-1) for 6 weeks. Rat L4-6 BMD in OVX+ERT group were measured at the end of 12 weeks after operation. Expression of S-100 and Cx43 in FSCs was detected using immunofluorescent histochemistry and laser scanning confocal microscopy(LSCM). Results L4-6 BMD was significantly lower in OVX group (0.193?0.006) g/cm2 than in Sham group(0.211?0.013) g/cm2 and in OVX+ERT group (0.204?0.010) g/cm2 (P

Hilar cholangiocarcinoma is a type of malignant tumor of the extrahepatic ductal system.Due to hepatic artery and portal vein involvement within the liver hilum,the resection rate is low and the prognosis is poor.However,with several advances in imaging technology achieved during the last decades,the accuracy of diagnosing and assessing the resectability of hilar cholangiocarcinoma has been greatly improved.In fact,some new classification and staging systems have been proposed to evaluate the tumor.This review will discuss the recent advances in the classification,staging,and preoperative resectability assessment for hilar cholangiocarcinoma.

Acute respiratory distress syndrome (ARDS) is a serious state threaten human health with a high mortality about 30%-40%. At present, there is no effective treatment for ARDS. Microvesicles derived from mesenchymal stem cells (MSC-MVs) have a heterogeneous subcellular structure secreted by MSCs. It plays an important role in the repair of tissue and organ damage.Recent studies have shown that MSC-MVs, played an important role in repairing lung injury, may replace MSC for cell therapy. Therefore MSC-MVs may bring new hope for ARDS treatment.

Objectives:To investigate the relationship between coronoid process hyperplasia(CPH)and temporomandibular joint ankylosis(TMJA) and to analyze its pathologic mechanism and clinical meaning.Methods:28 patients with TMJA from 1984 to 2004 were retrospectively studied.The length of coronoid process and the mouth-opening degree were measured on their depicting map of panoramic radiographs.106 subjects with normal TMJ were enrolled as the controls.The relationship between CPH and case history of TMJA was statistically analysed.Results:Coronoid process in TMJA subjects was longer than that in the controls(P

Objective To investigate the surgical method and clinical efficacy of hilar cholangio carcinoma in Bismuth type Ⅳ.Methods The retrospective descriptive study was adopted.The clinical data of 1 patient with hilar cholangiocarcinoma in Bismuth type Ⅳ who was admitted to the Renji Hospital affiliated to Shanghai Jiaotong University in October 2014 were collected.The patient had complaint about right upper abdominal pain for half month.Enhanced CT scan showed soft-tissue mass at hepatic hilum.After accurate assessment,the patient underwent radical resection of hilar cholangiocarcinoma + right hemihepatectomy + perihilar resection + right caudate hepatectomy + Roux-en-Y hepaticojejunostomy.The operation time,volume of intraoperative blood loss,results of pathological examination,postoperative complications,time of drainage tube removal,discharge time and follow-up were observed.The follow-up was performed to detect the life quality and tumor recurrence by outpatient examination and telephone interview up to July 2015.Results The patient received successful radical resection of hilar cholangiocarcinoma + right hemihepatectomy + perihilar resection + right caudate hepatectomy + Roux-en-Y hepaticojejunostomy.Operation time and volume of intraoperative blood loss were 480 minutes and 300 mL,respectively.The result of pathological examination showed that the size of hilar bile duct was 4 cm× 3 cm × 2 cm and poor-differentiated adenocarcinoma infiltrated through bile duct into liver tissues and right branch of portal vein.Two lymph nodes in the 8th group,1 in the 12a group and 3 in the 12p group were positive by detection,showing the metastasis of cancer cells.The resection margins of liver and bile ducts were negative,achieving a R0 resection.The patient had a removal of negative pressure drainage tube at postoperative day 7 and discharged from hospital at postoperative day 12,with a good recovery and without the complications of biliary fistula,abdominal infection and hepatic failure.During the 9-month follow-up,there was a good life quality and no tumor recurrence.Conclusion The radical resection rate of Bismuth type Ⅳ tumor can be increased by accurate preoperative evaluation,rational surgical approach,individualized surgical planning and precise intraoperative procedures.