OBJECTIVE: To discuss the goal and the measures that should be taken in the reform of Chinese medical and health system. METHODS: The changes of Chinese medical and health system were briefly reviewed and the current problems in which were analyzed, then the goals and the corresponding measures in the future medical and health system reform were put forward. RESULTS & CONCLUSION: The reform of Chinese medical and health system should in line with medical insurance reform and drug circulation system reform. The central financial expenditure system should be reformed by carrying out the principle of “common benefits” and eliminating differential treatment between city and countryside or among areas so as to implement equalization in medical and health service. The concerned departments should improve resource management system and optimize medical resources allocation. The government should strengthen the monitoring on medical and health service industry to facilitate its healthy development.

Objective: To evaluate the methylation status at CpG site -55 in the interferon-gamma (IFN-γ) gene promoter and its effect on IFN-γ expression in chronic hepatitis B. Method: The authors recruited 30 patients with HBeAg-positive chronic hepatitis B (CHB), 30 HBeAg-negative CHB patients, and 30 healthy blood donors. Pyrosequencing was used to determine the methylation status at CpG site -55 in the IFN-γ gene promoter following bisulfite treatment of DNA in peripheral blood, mononuclear cells (PBMCs). The expression of IFN-γ was analyzed by real-time RT-PCR and ELISA. HBV DNA in PBMCs was detected by nested PCR. Results: The methylation level at CpG site -55 in the IFN-γ gene promoter was significantly increased, resulting in subsequent down-regulation of the expression of this cytokine in CHB. The methylation level at CpG site -55 was significantly higher in HBeAg-positive patients than in HBeAg-negative ones (P < 0.01) and was also significantly higher in PBMCs from HBV DNA-positive patients than from HBV DNA-negative ones (P < 0.01); the methylation level at CpG site -55 was positively correlated with the amount of HBV DNA in serum (P < 0.01). Conclusion: IFN-γ gene expression appears to be regulated by methylation of the IFN-γ gene promoter in CHB; the methylation level at CpG site -55 is associated with HBV infection.

Objective: To evaluate the methylation status at CpG site -55 in the interferon-gamma (IFN-γ) gene promoter and its effect on IFN-γ expression in chronic hepatitis B. Method: The authors recruited 30 patients with HBeAg-positive chronic hepatitis B (CHB), 30 HBeAg-negative CHB patients, and 30 healthy blood donors. Pyrosequencing was used to determine the methylation status at CpG site -55 in the IFN-γ gene promoter following bisulfite treatment of DNA in peripheral blood, mononuclear cells (PBMCs). The expression of IFN-γ was analyzed by real-time RT-PCR and ELISA. HBV DNA in PBMCs was detected by nested PCR. Results: The methylation level at CpG site -55 in the IFN-γ gene promoter was significantly increased, resulting in subsequent down-regulation of the expression of this cytokine in CHB. The methylation level at CpG site -55 was significantly higher in HBeAg-positive patients than in HBeAg-negative ones (P < 0.01) and was also significantly higher in PBMCs from HBV DNA-positive patients than from HBV DNA-negative ones (P < 0.01); the methylation level at CpG site -55 was positively correlated with the amount of HBV DNA in serum (P < 0.01). Conclusion: IFN-γ gene expression appears to be regulated by methylation of the IFN-γ gene promoter in CHB; the methylation level at CpG site -55 is associated with HBV infection.

Objective To investigate manifestations of chronic obstructive parotitis (COP) under sialoendoscope and to evaluate curative effects of duct dilatation and drug perfusion for COP. Methods Twelve patients with COP were examined by sialoendoscopy. Treatment was performed by duct dilatation and gentamycin perfusion one week later. Results There were 11 cases of sialodochitis (complicated by sialostenosis in 7 cases, including 4 cases of polyps and 2 cases of mucus embolism, and simple sialodochitis in 4 cases) and 1 case of simple sialostenosis. Follow-up for 4 weeks showed that results were excellent in 4 cases, good in 7 cases, and poor in 1 case. Conclusions Sialoendoscopic exploration with dilatation procedure and drug perfusion offers certain short-term curative effects in the management of COP.

Objective To investigate the efficacy of recombinant human erythropoietin(rHuEPO) in treating the anemia in obstrics. Methods 40 antepartum anemia patients and 36 postpartum anemia patients were treated with rHuEPO 8000IU intravenously. Another 40 antepartum and 36 postpartum anemia patients were selected as control. Oral supplementation of iron and folic acid were used both in study and control group. Results The hemoglobin level was increased significantly in the study group than control group both in the prenatal and postpartum anemia patients. ( P0.05 )。 Conclusion rHuEPO therapy for obstetric anemia is effective and safe.

Objective To evaluate the effect of ZISHENYUTAIWAN in the treatment of threatened abortion. Methods From March to September 2000, ZISHENYUTAIWAN was used to treat 221 cases of early threatened abortion and 10 cases of late threatened abortion in 8 hospitals in Beijing. Results Effective rate of early threatened abortion is 91.89%. Conclusions ZISHENYUTAIWAN is effective and with less side effect for early threatened abortion.

32 cases of children small cerebral abscess di-agnosed with CT scaning are reported. The maxi-mum diameter of the enhancement area was 2. 2cm. 29 cases did not give a history of infection. In30 cases, Epileptic seizures were usually the Initialand main symptoms, but local neurological signswere usually absent. All of the cases were treatedby antibiotic therapy. The duration of the therapyin most childhood patients was 2～3 months exceptthree who were over 3 months.

Objective To study the correlation between the drug-resistance variation and the genotypes of hepatitis B virus (HBV)detected by the PCR-reverse dot blot and the relation between the HBV variation loci with the liver function indexes and HBV DNA viral loading.Methods The serum samples from 462 patients with chronic hepatitis B treated by oral nucleoside drugs were screened.The PCR-reverse dot blot was adopted to detect the drug-resistance gene mutation loci and genotypes.The correla-tion between the HBV drug-resistance mutant with the genotypes,liver function indexes and HBV DNA viral loads was performed. Results Among 462 patients taking nucleoside drugs for treating chronic hepatitis B,45 drug-resistance mutants were detected with the mutation rate of 9.74%;in which,16 cases (35.5%)were 180M and 204I/V mutant,6 cases(13.3%)were 204V,13 ca-ses(28.9%)were 204I mutant,3 cases (6.7%)were 180V mutant and 3 cases(6.7%)were 236T mutant.The HBV genotyping showed 105 cases of genotype B,337 cases of genotype C,0 case of genotype D and 2 cases of other genotypes.Conclusion (1)The HBVgenotypes in Maoming area may be different from the genotypes in other southern regions and is dominated by HBV-C geno-type.(2)The PCR-reverse dot blot method is a detection method for fastly and accurately finding the drug-resistance loci after nu-cleosides therapy.(3)The clinical analysis demonstrates that the drug-resistance mutation loci has no correlation with the liver func-tion index ALT(P >0.05),but there was certain correlation between the drug-resistance mutation loci in hepatitis B and HBV DNA viral load(P <0.05).

Objective To investigate the effect of γ-glutamylcysteine synthetase (γ-GCS),in the kidney fibrosis of MRL/lpr lupus mice.Methods The expression of connective tissue growth factor(CTGF)and γ-GCS in the kidney tissue of MRL/lpr lupus mice and control mice were detected by reverse transcriptase PCR (RT-PCR)and immunohistochemistry.The relationship between CTGF and γ-GCS was analyzed.Results The transcription and expression of CTGF in the kidney tissue of MRL/lpr lupus mice was significantly higher as compared with that of the control mice(CTGF mRNA:1.052±0.004 vs 0.402±0.009,P<0.01;CTGF protein:3.364±0.460 vs 1.206±0.271,P<0.01);whereas the expression of γ-GCS mRNA was decreased in MRL/lpr lupus mice(0.952±0.011 vs 1.145±0.066,P<0.01).Pearson's regression analysis showed that there was a negative correlation between CTGF and γ-GCS(r=-0.902,P<0.01).Conclusion The decreased expression of γ-GCS in the kidney of MRL/lpr lupus mice may compromise the ability of antioxidative stress,and there is a negative correlation between γ-GCS and CTGF.This suggests that the perturbation of γ-GCS may contribute to the progress of kidney fibrosis.

Objective To observe the changes of number and proportion of CD4+CD25+FOXP3+ cells in peripheral blood of active rheumatoid arthritis patients (RA),and explore the function of recombinant human TNFR Ⅱ-Fc on the CD4+CD25-FOXP3+ Treg cells.Methods ① Forty severe RA patients were selected,who were divided into the combined treatment group (TNFR Ⅱ-Fc+MTX) and MTX only group according to the principle of randomized,double-blind,parallel and placebo-controlled study.All patients were treated for 12 weeks.Flow cytometry was used to analyze and compare the expression ratio of CD4+CD25+FOXP3 +Treg cells of RA patients' peripheral blood.Forty healthy controls were selected for parallel comparison.② VAS,DAS28,HAQ average of the two groups at different periods were compared.Matched t test was used to examine the quantity data between the groups.Results ① The proportion of CD4+CD25+FOXP3+ cells in the peripheral blood of active rheumatoid arthritis patients was significantly lower than healthy group [ (5.4±1.4)％ vs ( 7.5±1.5 )％,P＜0.01 ].The proportion of CD4+CD25+ FOXP3+ Treg cells in combined treatment group was significantly higher [(7.0+1.2)％ vs (5.2±1.6)％,P＜0.01 ] after TNFR Ⅱ-Fc and MTX combination therapy for 12 weeks.The increase rate of CD4+CD25+FOXP3+Treg cells in combined treatment group was evidently more remarkable than MTX only group [ (7.0 ± 1.2)％ vs (5.6 ±0.7 )％,P＜0.01].② After 12 weeks treatment,the arerage scores of VAS,DAS28 and HAQ of the combined treatment group were better than MTX only group,and the difference was statistically significant (P＜0.01).Conclusion This study has shown that the healing effect of TNFR Ⅱ -Fc combined with MTX is better than MTX only.TNFR Ⅱ -Fc can restore and improve the proportion of CD4+CD25+FOXP3+ Treg cells in active RA patients,which is likely to be an important mechanism for the treatment of RA patients.