This essay probes into the reality,causes and solutions to the moral conflicts in the healthcare reform in current China,aiming to provide reference from an ethical perspective for correctly understanding and solving the problems in current healthcare reform.

Objective To evaluate food intolerance sensitivity among 2962 health check-up receivers from the First Hospital of China Medical University.Methods Serum samples of 2962 adults were collected from January 2008 to June 2010.Serum allergen-specific IgG antibodies of 14 kinds of food were detected by ELISA.The data were analyzed by using One-way analysis of variance.Results In this study,the rate of food intolerance was 0.4%(mushrooms) to 38.0%(eggs).Higher rates of food intolerance were found in egg,crab,shrimp,milk,and cod fish(Eggs 32.5%,crabs 26.0%,shrimps 19.8%,milk 13.8%,and cod fish 12.0% respectively).However,wheat,pork,and mushroom showed relatively lower rates of food intolerance(Wheat 0.8%,pork 0.4%,and mushrooms1.4% respectively).Positive reaction to food intolerance was even stronger in women(9.4% versus 8.2%).Conclusion It is discovered by study that in general population,the diversity of intolerance among different food is associated with 4 factors: gender; age; feature of food; individual diversity.It is recommended that the status of intolerance to food in the general population be investigated by health management.

Using the angiography and the corrosion methods we studied the arterial distribution of the papillary muscles of the left ventricle in llo dog hearts, according to the peculiarities of vasculature, disscused the influence of obstruction of coronary artery upon the papillary muscle.The anterior and posterior papillary muscles in dog all are tethered type. The average length and width of anterior papillary muscle are 1.96 cm. and 1.10cm, respectively, while those in the posterior papillary muscle are 2.04 cm. and 1.20 cm. respectively.The origins of arterial blood supply of anterior papillary muscle may be classiffied into 4 types, type Ⅰ, in which the arterial branehes are from the anterior descending artery, is in leading position(71%); type Ⅱ, in which branches are both from the anterior descending and left circumflex arteries, is in the next place(18%). Origins of arterial branches of posterior papillary muscle are classed under 2 types: type Ⅰ, in which all arterial branches are from the left circumflex artery, is the most, 91%, among them 65% from the posterior branch of the left ventricle.The peculiarities of arterial distribution in papillary muscles are as follows: 1. All artery branch entering the papillary muscle are of Class B. 2. All are segmental distribution in papillary muscles. Each muscle recieyes 2-9 branches, mostly 5 or 6 branches. 3. Each half of one papillary muscle recieves several branches symmetrically. 4. The arrangement of hrauches may be classiffied into several types; mixed type is the most, then comes the transverse type. 5. The branches anastomose each other to form the subendocardial plexus, which is most evident in the middle and upper third of the papillary muscle.

Objective:To develop the Counseling Skills Rating Scale for Psychological Aids Hotline (CSRSPAH),an instrument to objectively assess the quality of process of counseling or intervention provided by hotline operators,and to test its validities and reliabilities.Methods:A draft of the scale,which consisted of 50 items under 5 dimensions,was designed in line with previous researches and the practice.In pilot study,supervisors at Beijing psychological aids hotline,assessed tape recorded sessions and gave feedbacks on the draft of the scale.The scale had been revised based on the pilot study.Twenty-eight items were deleted,and several items were rephrased.Finally,a scale which consisted of 22 items within 3 dimensions,i.e.counseling process,attitude,and communication skill,was developed.The scoring standards of the scale were also developed.To evaluate the IntraClass Coefficients (ICC) of the CSRSPAH,each of the tape records of 37 callings from 2005 to 2007 were assessed by 7 supervisors independently,using the scale.And the tape records of other 318 callings from 2013 to 2014 were also assessed by supervisors,using the CSRSPAH.The results of the 318 assessed callings were used to test the construct validities with the Confirmative Factor Analysis.The Cronbach a coefficients of the total score and three dimensions,the discriminant indices of every items,and correlations of each items and each dimensions were calculated,based on the 318 assessed callings.Results:One of the items (referral) was deleted due to excessive amount of missing data.Results of cortfirmative factor analysis of the remained 21-item scale revealed that the 3-factor construct structure of the scale was robust.The fitting indices of the confirm factor analysis were,x2/df=675.21/186,CFI =0.92,NNFI =0.91,RMSEA =0.10,SRMR =0.08.The Cronbach α coefficients of the total score,scores of counseling process,attitude,and communication skill,were 0.89,0.68,0.81 and 0.77,respectively.The ICCs of the inter-rater reliabilities of the total score and 3 dimensions of the scale were 0.67,0.59,0.59,and 0.67,respectively.The discriminant indices of all the 21 items ranged from 0.09 to 0.32.The correlation coefficients of scores of each items and scores of 3 dimensions and total scores were greater than 0.30,and reached statistical significance.Conclusion:The validities and reliabilities of the Counseling Skills Rating Scale for Psychological Aids Hotline are acceptable.The scale could be used in assessing the quality of hotline counseling or intervention,and related studies in the future.

Human enterovirus 71 (EV71) is one of the major etiological agents for the hand, foot, and month disease (HFMD) and is causing frequent, widespread occurrence in the mainland of China. The single positive-stranded RNA genome of EV71 is translated into a single polyprotein which is autocleavaged into structural and nonstructural proteins. The functions of many nonstructural proteins characterized in the life cycle of virus are potential targets for blocking viral replication. This article reviews the studies of the structures and functions of nonstructural proteins of EV71 and the anti-enterovirus 71 drugs targeting on these nonstructural proteins.

ObjectiveTo explore the relationship among 14 kinds of intolerant food by using association rules to provide evidence for more reasonable diet intake.Methods A total of 2962 adults who received medical examination at the First Affiliated Hospital of China Medical University during January 2008 and June 2010 were enrolled in this investigation.ELISA was used to detect allergen-specific IgG antibody of 14 kinds of food.An association rules model was established by SPSS Clementinel2.0.In order to find positive intolerance association rules,food frequency was recorded with SPSS 16.0.Results Five most commonly seen food intolerance were eggs,crabs,shrimp,milk,and cod (positive rates were 32.5％,26.0％,19.8％,13.8％ and 12.0％,respectively).Positive association rules were found in crab and shrimp,or milk and eggs.Single order association was found in female,while multi-order association was identified in male.Conclusions Our data show a strong positive association among animal foods.Female may be affected by milk,eggs and seafood,while male may be affected by a variety of foods.

Objective:To understand the characteristics of the callers with the diagnosis of mental disorders called Beijing Psychological Crisis Hotline for help,in order to provide specific psychological intervention services for them in future.Methods:From December 2002 to December 2008,24217 different callers'data collected from a computer-based operating system of the Beijing Psychological Crisis Hotline were analyzed.According to their self-reported of having the diagnoses of mental disorder or not,the callers were divided into the ones with diagnosis (n=6516)and the ones without diagnosis (n =17701).The callers'demographic characteristics,their main counseling problems and the suicide-related factors in the two groups were compared.Results:The top five main counseling problems in the group with diagnosis were mental problems,the mental illness related knowledge,the problems of family relationships,working problems and interpersonal problems.Mental problem ranked first in both groups.Compared to the group without diagnosis,the diagnosed ones were more likely to be found in such group of people as women,aged between 20 -29 and 30 -44,having 10 or more years of education and the unem-ployed.The results of the assessments of 11 suicide-related risk factors showed that callers with diagnoses had higher prevalence of most suicide-related factors than those in the other group(P <0.001 or 0.05),which included suicidal intention and behavior while calling,history of attempted suicide,severe depressive symptoms,severe physi-cal illness,history of being abused,afraid of being attacked,suicidal history of relatives or associates,severe of hopeless.Conclusion:The hotline counselors should be aware of the necessity of assessing the severity of depres-sion and other suicide-related factors for the callers with mental disorder diagnoses before providing any psychologi-cal intervention.Moreover,except for providing interventions on the callers'psychiatric problems,the hotline coun-selors should also identify and help to deal with the stress events in their lives.

Objectives:To explore the prevalence and correlates of attempted suicide among Beijing psycho-logical aids hotline callers,in order to provide knowledge of hotline-based suicide prevention.Methods:From De-cember 2002 to December 2008,all the effective callers who consulted themselves'psychological problem,by Bei-jing psychological aids hotline were interviewed by professional hotline operators during the consulting calling.Data of whether callers attempted suicidal behavior in 2 weeks prior to the calling,gender and other 5 demographic char-acteristics of callers were collected via hotline interview.A questionnaire including depression screening scale,com-mon psychiatric symptoms such as delusion,hallucination,etc.,a history of substance abuse or dependence,a histo-ry of suicidal behavior,having had acute or chronic life events,and severity of hopeless was used during hotline in-terview.Logistic regression model was used.Results:In 22 415 interviewed callers,362 (1.6%)callers (233 fe-males)reported that they attempted suicidal behavior in 2 weeks prior to the calling.After adjusted for demographic characteristics,prior suicidal behavior 2 weeks before calling (OR=4.43,95%CI:3.37-5.83),hopelessness (OR=2.01,95%CI:1.52-2.67),substance abuse (OR=1.97,95%CI:1.48 -2.62),acute negative life events (OR=1.94,95%CI:1.49-2.52),and severe depressive symptoms (OR=1.45,95%CI:1.08-1.95)were associatedwith attempted suicide among hotline callers.Conclusion:The rates of attempted suicide among hotline callers are probably high.Suicide prevention in hotline would shed light on improving coping skills for life events and sub-stance abuse problems for hotline callers.

Objective To Compare characteristics between the psychological aids hotline callers who had single attempted suicide and those callers who had repeated attempted suicide. Methods The analysis was conducted on the da?tabase of Beijing psychological aids hotline from Dec., 2002 to Dec., 2008. All the effective callers were consulted by pro?fessional hotline operators. During the calling, the callers were interviewed on their attempted suicides, depression and 11 correlates associated with caller's suicidal behaviors. Results Among 4519 callers who had attempted suicide, 2441 (54%) of them had attempted suicide once, and the other 2078 (46.0%) callers had repeated suicide attempts. After ad?justed for gender, age, and the other 4 demographic variables, history of being abused (OR=1.35, 95%CI: 1.08~1.67), afraid of being attack (OR=1.35, 95%CI: 1.01~1.59), relatives or associates with prior suicidal behavior history (OR=1.17, 95%CI: 1.001~1.36), hopelessness (OR=1.20, 95%CI: 1.02~1.40), and psychological treatment history (OR=0.73, 95%CI:0.62~0.86) were associated with repeated suicide among hotline callers. Conclusions To improve the effective?ness of hotline based suicide prevention, assessment of risk of repeated attempted suicide among the callers with a histo?ry of prior attempted suicide should focus on the history of being abused, afraid of being attack, hopelessness, relatives or associates with prior suicide history, and psychological treatment history.

OBJECTIVE: More than 70% of hepatic alveolar echinococcosis (HAE) are inoperable. Thus, long-term, or even life-long, pharmacological treatment with benzimidazoles is necessary. For effective treatment, it is of great importance to employ imaging techniques to detect and monitor the non-resectable parasitic viability. Therefore, this study aimed to evaluate diffusion-weighted imaging (DWI) in assessing the viability of HAE in comparison to 18-fluoro-deoxyglucose (18F-FDG) positron emission tomography, combined with computed tomography (PET/CT). MATERIALS AND METHODS: Positron emission tomography, computed tomography and DWI (b-values: 0, 800 s/mm2) were retrospectively analysed in eight patients with clinically-verified HAE to, generate the apparent diffusion coefficient (ADC) map. The activity of HAE lesions in both techniques were determined independently by two radiologists according to the following standard: (+), marked focally or perilesionally increased FDG uptake/high signal intensity; (−), a hepatic defect without FDG uptake/no high signal intensity. Every lesion's maximum standardized uptake value (SUV(max)) on the PET/CT images and mean ADC values on the parametric ADC maps were measured respectively. Results of PET/CT and DWI were compared on a per-lesion-basis. Pearson's correlation coefficient was assessed for statistical analysis. RESULTS: A total of 14 HAE lesions were detected. Eight lesions (diameter 3–15 cm) showed perilesional hyper-signal intensity on DWI. This was visualised on PET/CT as increased FDG uptake. They mainly existed in the lesion's border with normal liver parenchyma. Five lesions (diameter < 2 cm) were detected as nodular hyperintensity on DWI and a ‘hot spot’ on PET/CT in the same distribution. One patient, who had received oral drug therapy for three years showed significantly decreased perilesional hyperintensity on the DWI and a hepatic defect without any FDG uptake on PET/CT. Pearson's correlation coefficient indicated a significant inverse correlation of the ADC and the SUV(max) (r = −0.67, p < 0.001). CONCLUSION: Diffusion-weighted imaging is capable of offering information on visually detecting the HAE lesions' viability and may be useful for routine application in the initial diagnosis of HAE.
Benzimidazoles ; Diagnosis ; Diffusion ; Drug Therapy ; Echinococcosis ; Echinococcosis, Hepatic ; Electrons ; Humans ; Liver ; Magnetic Resonance Imaging ; Parasites ; Positron-Emission Tomography and Computed Tomography ; Positron-Emission Tomography ; Retrospective Studies