Solidarity is the foundation of European health care and policy. However, it is constantly discussed by the new concept of personal responsibility, liberalism and privatization. In some European countries, out of pocket money was used more because of the limited resources which indeed weakened the solidarity, an element which con-sistently marks the difference among the European Union countries, and the main source of European political com-mitment and accountability associated with health. In the universal health care reform tide, the European government restrains its power in detailed operation on the health care and pharmaceuticals delivery, medical insurance design, and health resource allocation, but this is done through more specific supervision to ensure solidarity in health care system.

Priority setting of health resource allocation depends on effective and comprehensive government-based stewardship, the national research of which lacks comprehensive considerations. The paper articulates the trend of western research from solo economic analysis to a combined comprehension of political economies, systemic con-straints and health financing, to consider the scope, strategy and enforced framework for government rationing within a larger organizational and political context. In the health decision-making practice, the best formula for interdiscipli-nary tools is a test of stewardship capacity. A multi-disciplinary approach from the perspectives of politics, health e-conomies, philosophy, law and evidence-based medicine must be adopted for the priority setting of health resource al-location. Finally, a clear stewardship phased objective is proposed as well as strategies, with emphasis on health de-cisions from “stewardship as structure” to “stewardship as a process” with challenges that lie ahead.

Objective:To evaluate the China’s fairness of health resource distribution in recent years. Methods: Index of priority for health services (IPHS)and index of resources distribution ( IRD) were applied to test the allocation status of health resources with the horizon and vertical comparison analysis. Result: With the development of new health care reform, the public health service gradually improves and the basic health needs are further satisfied. The unfair distribution kept the same among different regions, and the provincial health supply and demand are not matched. Conclusion: Public health resource allocation should keep focus on reducing the divergence from rural-urban dichotomy and narowing inter-provincial gaps.

Healthy China 2030 projected to accelerate the development of health care services, but the healthcare industry in China is still in the early stages of development, and is currently threatened by the lack of the relevant legislation, industry regulations and government supervision.The current plight of supervision on traditional Chinese health care consists of the following factors, lack of legislative guarantee, the overlap between the traditional Chinese medicine(TCM) and traditional Chinese health care services blurred the supervision scope, no unified standards of Chinese health care service industry, low cost of illegal misconduct, regulatory fragmentation without substantive supervision.Based on the domestic and foreign experience, the following recommendations were put forward: Strengthening government supervision of the whole process of the Chinese medicine health care, clearly identifying the monitoring and the main supervision responsibility by legislation, screening the pseudo-information and enhance public Chinese medicine literacy, improving the self-regulation and self-supervision, and a variety of innovated government led supervision methods should be elaborated and put into practice, such as grid monitoring, classification management, establishment of credibility system, joint supervision, and so on.

Objective To discuss the feasibility of endoscopic axillary lymph node dissection by using balloon dilatation.Methods Seven patients with breast cancer from June 2005 to October 2005 were studied.Methylene blue injection around the areola or the tumor in combination with balloon placement in the axilla was performed to create surgical space for further endoscopic axillary lymph node dissection.Results The number of resected lymph nodes was 9~17(mean,12.3).No crushed lymph node was found.Positive lymph nodes were found in 4 patients.The operation time was 95~140 min(mean,114.3 min).The axillary vein and other important anatomic structures were clearly exposed.There was no edema of the upper limbs or other complications in the axillary area.No recurrence was noted during a follow-up survey for 2~6 months(mean,4.6 months).Conclusions Endoscopic axillary lymph node dissection can be performed after the establishment of surgical space by using balloon dilatation.

Vascular cognitive impairment (VCI) is a cognitive impairment caused by cerebrovascular disease and its risk factors,its mechanism is very complex Recent studies have shown that cerebral microbleed (CMB) is correlated with VCI.This article reviews the relationship between CMB and VCI.

Objective To observe the curative effect of acupuncture on insulin receptor substrate 1 ( IRS-1) , IRS-2 and glucose transporter 4 (GLUT4) in skeletal muscle of experimental rats with insulin resistance (IR) . Methods Thirty-two rats were randomly divided into normal group, model group, acupuncture normal group and acupuncture model group. The fasting plasma glucose ( FPG) level was detected with glucose oxidase method, fasting insulin and C-peptide ( C-P) were examined with enzyme linked immunosorbent assay ( ELISA) , insulin sensitivity index ( ISI) was calculated, and IRS-1 mRNA, IRS-2 mRNA and GLUT4 mRNA of skeletal muscle were observed by real-time PCR-based fluorescent assay in each group. Results Compared to the normal group, the FPG, FINS, C-P levels were increased dramatically (P<0.01), ISI, IRS-1 mRNA, IRS-2 mRNA and GLUT4 mRNA of the model group declined remarkably ( P<0.01). Compared to the model group, the FPG, FINS, C-P levels declined evidently ( P<0.05 or P<0.01) , and ISI, IRS-1 mRNA, IRS-2 mRNA and GLUT4 mRNA of the acupuncture model group were increased dramatically ( P<0.01). Conclusion The curative mechanism of acupuncture for insulin resistance is probably related to the increase of IRS-1 mRNA, IRS-2 mRNA and GLUT4 mRNA expression in skeletal muscle which contributes to the improvement of PI3K signal pathway.

AIM: To observe the effects of Yangxue qingnao-containing serum on rat vascular smooth muscle cell (VSMC) proliferation induced by lysophosphatidic acid (LPA). METHODS: The [ 3H]-TdR incorporation and mitogen-activated protein kinasc (MAPK) activity were measured in cultured VSMC. End product of lipid peroxidation-MDA levels were also detected. RESULTS: 1?10 -9 ,1?10 -8 and 1?10 -7 mol/L LPA enhanced the cultured VSMC [ 3H]-TdR incorporation, increased MAPK activity and MDA content in a concentration-dependent manner. 5%, 10% and 15% Yangxue qingnao-containing serum concentration-dependently inhibited the increase in VSMC [ 3H]-TdR incorporation, MAPK activity and MDA content induced by LPA. CONCLUSIONS: LPA has a stimulating effect on VSMC proliferation. The LPA-induced intracellular signal transduction may be related to MAPK activity. Yangxue qingnao can efficiently inhibit LPA -induced VSMC proliferation,MAPK activity and lipid peroxidation. [

OBJECTIVE:To study the stability of omeprazole in micro-pump by continuous administration.METHODS:RP-HPLC were used to determine the concentrations of omeprazole at different times in micro-pump after administrcotion24h by simulating the dose mode in clinical.RESULTS:Omeprazole for injection was stable in6h after administration.CON?CLUSIONS:The time of taking omeprazole via micro-pump should be controled in6h.

L-Carnitine plays an essential role in the transfer of long chain fatty acids from the cytoplasm of a cell into the mitochondrion,where they undergo ?-oxidation.Carnitine deficiency is characterized by plasma and tissue carnitine concentrations below those required for the normal functions of the organism,including cardiomyopathy,myopathy,hypoketonemia,hypoglycemia,hyperammonemia.Studies show that supplement of carnitine could improve the clinical symptoms of some diseases.