Total Expenditure on Health (TEH) is an important instrument for evaluating policies of medical reform. To analyze the results and characteristics of TEH under the new medical reform, and prospect the changing trends of TEH during the 12th Five-Year Plan in Jiangsu, reflect the health related policies tend of increasing the government input on health, reduce the household’s out-of-pocket proportion in recent years. Suggestions were proposed for the future changing trends of health economic policies which require attention.

Pathology is an important bridge subject in medicine.It has many knowledge and abstract content.Micro class is a new form of expression,it has Situation reality,topic prominent,diversified resources,Flexible form,interactive strong,dynamically generated,easy to spread and easy to use advantages,etc.The micro course is applied in pathology teaching,refer to the teaching syllabus for the design and production of micro courses,comb through the knowledge points,heavy and difficult explanation and systematic summary to carry out classroom teaching.Practice shows,micro class can stimulate students' interest in learning,improve learning efficiency,and then achieve the purpose of improving pathological scores.

BACKGROUND: The occurrence of the late complications of diabetes is correlated with genetic factors. It has been reported that angiotensin I converting enzyme(AGE) gene is considered as the risk factor of the occurrence of the diabetic cardiovascular complications.OBJECTIVE: To investigate the correlation between the polymorphism of ACE gene and the cardiovascular complications of type 2 diabetes.DESIGN: A case-controlled study based on type 2 diabetic patients.SETTING: A laboratory of general biology,faculty of biology in a medical college.PARTICIPANTS: The study was conducted in the Molecular Biological Laboratory of North China Coal Medical College between February 2001 and June 2002. Type 2 diabetic patients selected from outpatient and inpatient departments of the affiliated hospital of our college were divided into two groups based on the complication of myocardial infarction. Myocardial infarction group(infarction group, n = 68) included 29 males and 39 females aged of(65±3) years old; non-myocardial infarction group(non-infarction group, n = 190) included 161 males and 29 females aged of(60±1) years old. Inclusion criteria: All patients were in accordance with WHO diagnostic criteria for type 2 diabetes set in 1985,and myocardial infarction was diagnosed by MRI; Exclusion criteria: Patients who had incomplete data or who were uncooperative.METHODS: Genome DNA was extracted by routine phenol/chloroform method. Amplified products were analyzed by 20 mL/L of agarose gel electrophoresis. The results were observed after ethidium bromide staining. The frequency of alleles and genotype was compared between two groups.MAIN OUTCOME MEASURES: The comparison of the distribution of ACE alleles and genotype in both groups of patients.RESULTS: DD homozygote frequency of type 2 diabetic patients complicated with myocardial infarction (64.7%) significantly increased to 41.2%(χ2 = 0. 833,P<0. 05) compared with 33.2% of patients without myocardial infarction (55.0%),while D allele frequency also significantly increased in patients with myocardial infarction as well (χ2 = 3. 849 1,P<0.05).CONCLUSION: D allele and DD genotype are risk factors of the occurrence of myocardial infarction in type 2 diabetes,and surveillance of these indicators provides theoretical references for the secondary rehabilitative prevention and the improvement of long term quality of life in diabetic patients complicated with myocardial infarction.

ObjectiveThe purpose of this study was to investigate the effect of health education on the recovery of insight in schizophrenic patients. MethodThe insight of patients in health education and control groups was assessed by SAUMD and BPRS bdfore and 4, 8, 12 weeksafter trentment. ResultThe recovery of insight of health education group was significantly different from control group after treatment. Theinsight scores was significantly related to major symptom, cultural level and disease course. ConclusionThe health education for schizoprenicpatients was important in recovering insight and illness and promoting patients go back to society early.

With advances in surgical techniques,laparoseopic surgical instruments and constant equipment innovation,minimally invasive surgery has become the main stream of this century.Wide range of applications of endoscopy and laparoscopy as the representative of the revolutionary changes in diagnosis and treatment of digestive diseases since the second half of last century is the main symbol.Patients obtained benefits from the minimally invasive technique to reduce the trauma and pain,shorten the course of treatment,and gain rapid recovery.Singleincision laparoscopic surgery (SILS) is proposed in recent years.It differs from conventional multiports laparoscopic surgery,with only a small 2-3 cm incision at the body's natural scar-umbilicus as the approach to assist laparoscope and surgical instruments into the abdomen cavity.In this paper,the surgical experiences of SILS based on 800 cases and understanding of the SILS at home and abroad were presented to talk about the application of SILS technique in digestive surgery.

Abnormality of sphincter of Oddi is divided into the anatomical and functional ones. Anatomical abnormality includes stenosis and insufficiency, and the dyskinesia of sphincter of Oddi is composed of hypermotility and hypomotility. Many biliopancreatic diseases are associated with the abnormality of sphincter of Oddi, which include congenital pancreaticobiliary maljunction, gallstones, primary choledocholithiasis and hepatolithiasis, post-cholecystectomy syndrome, and pancreatitis. The proper acknowledgement of abnormality of sphincter of Oddi is of importance to improve the diagnosis and therapy of corresponding biliopancreatic diseases.

Objectives:To study the clinical features of multiple organ dysfunction syndrome(MODS) complicated with hypoalbuminemia. Methods:80 cases of MODS whose APACHE Ⅱ was from 17 to 18 were selected and devided into two groups according to existance of peritoneal infection or not. Results:The occurrence rate of hypoalbuminemia was 73.8% in the 80 cases. The rate was 97.0% in the group complicated with peritoneal infection,with the lowest level occurring on the second day and being (24? 3.5 )g/L, and 57.4% in the group without peritoneal infection,with the lowest level occurring on the seventh day and being (35?2.9)g/L.There were very marked differences between the two groups( P

Objective To investigate the influence of CD146-siRNA on epithelial-mesenchymal transition in human ovarian cancer cell line A2780.Methods The influence of loss of CD146 on the mRNA and protein expressions of E-cadherin,vimentin,and fibronectin was evaluated by real-time polymerase chain reaction (RT-PCR) and Western blotting.Results Compared to non-transfected (control group) and those transfected with RNAi-NC (RNAi negative control group),the mRNA and protein expressions of Ecadherin were significantly increased in A2780 cell lines transfected with RNAi-CD146.The loss of CD146 expression down-regulated the mRNA and protein expression of vimentin and fibronectin(P ＜ 0.05).Conclusions CD146-siRNA can suppress epithelial-mesenchymal transition in human ovarian cancer cell line A2780.

This article introduces the explorations in improving minimally invasive therapies and techniques for intra-and extrahepatic bile duct stones in this center,including laparoscopic choledocholithotomy without the placement of T tube,laparoscopic partial hepatectomy for the treatment of intrahepatic bile duct stones using an anastomosis stapler for liver partition,and modification of percutaneous transhepatic cholangioscopy.The improved therapies and techniques above have achieved good clinical effects,and a scientific judgment of their clinical effects still depends on a large number of cases and randomized controlled clinical trials.

Objective:To establish the competency model for medical representatives in China. Methods:Firstly, the competen-cy elements for medical representatives were defined through the literature research and logic analysis, the importance of each element was then evaluated by a questionnaire, and the survey results were analyzed by a factor analysis approach. Lastly, the weight of each factor was confirmed by analytic hierarchy process. Results & Conclusion: The competency model, which consists of 5 dimensions ( professional quality, professional ethics, knowledge, personal characteristics and relationship management) , 26 competency elements and the weight of each factor, is established successfully.