Coordinated care delivery is faced with various challenges to carry out in China,which are major decisions to make for decision makers,including how to push forward,how to deliver resources, services and patients to primary institutions,and how to ease the difficulties and affordability of seeing doctors.Based on analysis of roadblocks in coordinated care delivery in China,the authors provided near-term and long-term policy recommendations on the system,including how to build a scientific and reasonable healthcare delivery system,coordinated care delivery by stages,building incentives and constraint mechanisms,and enhancing public awareness and patient-doctor education.

Concept of coordinated care delivery is clearly defined,before a comparative analysis is made between such a concept and the integrated care delivery concept which is popular overseas and similar.On such basis,a theory framework is established for building and implementing such care delivery in line with the integrated theory of care delivery systems.Coordinated care delivery system now in place in China aims at rationally delivering medical resources,services and patients to primary institutions,by means of efficiently distributing resources and service systems and integrating care delivery flows,thus offering patients with cost effective and appropriate services and optimizing the care delivery system.

This article summarizes and analysis the rules of acupoint selection in the treatment of dysmenorrhea.Method:Computer retrieval and manual search were combined to look for domestic literature on dysmenorrhea treated by acupuncture and moxibustion in year 2003 to 2011.There were altogether 20 qualified articles,concerning 28 acupoints.The above results showed that in the treatment of dysmenorrhea,the commonly used points are distributed in Ren,spleen meridian of foot-Taiyin,foot Yangming meridian and foot Taiyang meridian.Specific acupoints was the main type for selecting points.

Humans ; Neurodegenerative Diseases ; prevention & control ; Quercetin ; therapeutic use

Objective: To explore the effect of resveratrol on the chemosensitivity of cervical cancer cells and its regulatory mechanism. Methods: Hela/DDP cells were divided into four groups: Hela/DDP group, resveratrol group, CDDP group, and resveratrol+CDDP group. Cell viability and proliferation were detected by CCK-8. Cell cycle and apoptosis were tested by flow cytometry. The expressions of p21, CDK2, cyclinD1, caspase-9, caspase-3, Bcl 2 and Bax were measured by Western blot. Results: The sensitivity of Hela/DDP cells to cisplatin was lower than that of Hela cells (P<0.01). Resveratrol significantly enhanced Hela/DDP cells' sensitivity to cisplatin (P<0.01). The inhibition of CDDP on the proliferation of Hela/DDP cells was increased by resveratrol (P<0.01). The G1 phase arrest of CDDP on Hela/DDP cells was enhanced by resveratrol (P<0.01). The expression of p21 was higher in resveratrol group and CDDP group than in Hela/DDP group, and the expressions of CDK2 and CyclinD1 were lower than in Hela/DDP group (P<0.01). Compared with CDDP group, the expression of p21 in resveratrol+CDDP group was elevated with the decrease in CDK2 and cyclinD1 expressions (P<0.01). The induction of CDDP on the apoptosis of Hela/DDP cells was elevated by resveratrol (P<0.01). The expressions of caspase-3, caspase-9 and Bax were higher in resveratrol group and CDDP group than in Hela/DDP group, and the expression of Bcl-2 was lower than in Hela/DDP group (P<0.01). Compared with CDDP group, apoptosis in resveratrol+CDDP group was increased with the reduced expression of Bcl-2 (P<0.01). Conclusion: Resveratrol enhances the chemosensitivity of cervical cancer cells by inducing cell cycle arrest and apoptosis.

Humans ; Stress, Physiological ; Takotsubo Cardiomyopathy ; diagnosis ; therapy

Objective To investigate the pathogen distribution and drug sensitivity in childhood bacillary dysentery,and to guide clinically the selection of reasonable antibiotics.Methods Bacterial drug susceptibility test was performed by standard Kirby-Bauer method.The results were interpreted according to NCCLS 2002.Results Of the 98 cases,there were two types of positive bacterial species:sh.flexneri(n = 77)and sh.sonnei(n = 21).Both sh.flexneri and sh.sonnei were sensitive to cefoperazone,eeftazidime,ceftriaxone,cefoperazone/sulbactam and fura- zolidone,and insensitive to ampicillin and co-trimoxazole.Conclusion sh.flexneri was the major pathogen of child- hood bacillary dysentery.The third generation cephalosporins were the first choice for shigella infections.

Analyzed in the paper is the present development of medical rehabilitation service system in Beijing,Changsha,and Urumqi,in an effort to identify key measures,and discover problems found with the policy environment and system building.Based on such findings,the authors proposed such measures as developing policies and regulations, optimizing resource allocation, strengthening training of rehabilitation personnel and greater publicity.

BACKGROUND:There are numerous studies about mechanical changes of recast cobalt-chromium ceramic al oys. However, little is reported on the mechanical properties of cobalt-chromium ceramic al oys containing once-used al oys after recasts.
OBJECTIVE:To study the effects of different proportion of once-used al oys to recasting cobalt-chromium al oys on their mechanical properties, including tensile strength, yield strength, elongation and hardness.
METHODS:Cobalt-chromium al oys cast samples were prepared and recast for three times (40%once-used al oys were added per time). The tensile strength, 0.2%yield strength, percentage of elongation, flexural strength and Vickers hardness of each specimen were measured. In addition, microscopic metal ographic observation was done.
RESULTS AND CONCLUSION:Being recast for three times, cobalt-chromiun al oys showed no significant differences on their tensile strength, 0.2%yield strength, percentage of elongation, flexural strength and Vickers hardness. GenerationⅠal oy samples had uniform size, smal diameter and smal carbide size distributing along the grain boundary, mainly exhibiting spherical and irregular wormlike forms. Generations Ⅱ and Ⅲ samples were uniform in shape, but crystal grains were coarsened a little. Carbide from Generation IV samples began to be coarsened, irregular wormlike carbides were increased in amount, and a few of non-metal ic inclusions could be found in grains. Cobalt-chromium al oys can be recast after addition of 40%once-used al oys for three times at least in air environment, without decrease of the mechanical properties.

OBJECTIVE:To systematically evaluate the efficacy and safety of cetuximab in the adjuvant chemotherapy treat-ment of advanced non-small cell lung cancer(NSCLC),and to provide evidence-based reference for clinical treatment. METH-ODS:Retrieved from Cochrane Library,PubMed,CJFD and Wanfang database,randomized controlled trials (RCT) about cetux-imab adjuvant chemotherapy (test group) versus single chemotherapy (control group) in the treatment of advanced NSCLC were collected,and Meta-analysis was performed by using Rev Man 5.2 statistical software after extracting data and evaluating quality. RESULTS:A total of 8 RCT were included,involving 2 367 patients. Results of Meta-analysis showed survival rate in 1 year [OR=1.33,95%CI(1.08,1.64),P=0.006],partial remission rate [OR=1.48,95%CI(1.23,1.78),P<0.001],total effective rate [OR=1.34,95%CI(1.19,1.51),P<0.001],incidence of leucopenia [OR=1.50,95%CI(1.23,1.83),P<0.001],incidence of rash [OR=53.26,95%CI(13.09,216.65),P<0.001] and incidence of infusion reactions [OR=3.72,95%CI(1.86,7.42),P<0.001] in test group were significantly higher than those of control group,there were significant differences in 2 groups. However,there were no significant differences in the complete remission rate [OR=1.57,95%CI(0.91,2.70),P=0.11] and incidences of other ADR(P>0.05). CONCLUSIONS:Cetuximab has good efficacy in the adjuvant chemotherapy treatment of advanced NSCLC,however,the incidence of ADR should be prevented in clinic. Duo to the methodology limit of included studies,large-scale and high quality RCT are required for further validation of the conclusions.