Chronic Disease ; Constipation ; diagnosis ; drug therapy ; Evidence-Based Medicine ; Humans ; Integrative Medicine

Objective:To analyze the causes and countermeasures for the inefficiency of implementing the contract community health service policy.Methods:Based on the authority and regulation of organization,it innovatively used the French organization theory,build an analysis framework of organizational actors adapting to the general organization.On the above basis combined with the characteristics of contract health service,it constructed a new organizational structure of contract health service and analyzed the low efficiency of policy implementation from the three relations among the actors,the power and the rule.Results and Conclusion:It needed to focus on authority and rule to rationally division the authorities of actors,optimize the organizational structure,adjust the benefit relationship of actors;play the regulation role,implement the incentive and constraint mechanism to improve the execution efficiency of contract health service policy.

Traditionally it has been widely accepted that our genes together with adult lifestyle factors determine our risk of developing noncommunicable diseases such as type 2 diabetes mellitus ,cardiovascular disease and obesity in lat-er life.Currently, there is substantial evidence that the early life environment plays a key role in determining our suscepti -ble to such diseases in later life .As an increased focus on the understanding of central insulin resistance , central nerve sys-tem plays an extremely important role in regulating the peripheral glucose homeostasis .Substantial studies have indicated that it may be regulated by epigenetic mechanisms .Epigenetics can be defined as the study of heritable changes in gene ex-pression that do not involve alterations in the DNA sequence .Epigenetic processes play a central role in regulating tissue specific gene expression and hence alterations in these processes can induce long -term changes in gene expression and me-tabolism which persist throughout the lifecourse .This review will focus on the epigenetic machanisms of central neuroregula-tion between early life environment and glucose metabolism in adulthood .

Objective: To study the relation among cognitive dysfunction, depression, and location of brain lesion in patients with their first stroke Method: Sixty-two patients with their first episode of single loci stroke demonstrated by CT scan were tested with WAIS-RC, HAMD and SSS Results: Final Intelligence Quotient (FIQ), Verbal Intelligence Quotient (VIQ) and Verbal score of WAIS-RC in patients with anterior lesions were significantly lower than those in patients with posterior lesions (P0 05) Multiple step-regression showed that depression, age and education had influence on IQ of patients Conclusion: Patients with anterior stroke has more cognitive dysfunction

Objective To study the clinical features,surgical treatments and the prognosis of the103patients with the metastatic tu mors in the spine.Methods From Jan.1996to Dec.2001,103cases were treated by operation in our department,there were62males and41females,aging from33to79years old(average,59years).The lesions were located at cervical spines in34cases,thoracic spines in39,lumbar spines in25and sacrum in5.The patients underwent anterior,posterior,combined or staged antero-posterior operations based on the location of lesions in the spine.Most of the patients were adopted vertebral recon-struction and internal fixation depending on the conditions.Preoperative clinical evaluation included of gen-eral condi tions,X-ray films,CT scan,MRI and ECT in order to decide the endurance of the patient to the sur gi cal treatment.The operation was only considered when the patient could have the ex pected survival time more than6months.Operative indications,surgical methods and prognosis were analyzed and summa -rized.Re sults The postopera tive follow-up ranged from6months to5years.No death related to the op-eration.Eighty-five of 103cases had partial or even complete relief of local pain and radiculopathy,54cases were im proved in neu rological status caused by spinal cord compression.The postoperative survival rates at6months,one year,two years,three years and four years intervals were97.1%,90.3%,44.7%,29.1%and8.7%respectively,9patients survived more than4years.Conclusion Local pain was the predomi nant symptom in metastatic tu mor of spine,and some of them suffered from spinal cord and nerve compromise.The surgical treatments for the spinal metastatic diseases were indicated depending spinal instability,progressive neurological deteriora tion,in tractable pain,or the need for histological diagnosis.The most im por tant factor being consid-ered was the patient's condition when operative treatment was decided.The anterior,posterior,combined or staged antero-poste rior operations were influenced by location of lesions in the spine,en durance of the patient,life ex pectan cy and so on.Surgical interven tion could stabilize and reconstruct the spine,relieve pain,maintain or improve the neurological status of the patients,thus improve the life qualities in limited life expectancy pa-tients.[

Antidepressive Agents ; therapeutic use ; Depression ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Electroacupuncture ; Humans ; Integrative Medicine ; Phytotherapy

As traditional Chinese medicine components have become a hotspot in the field of traditional Chinese medicine study, they have followed a development trend of diversity and false identification. In studies on a new modem product, we shall encourage the diversified development mode, but avoid the false concept identification of traditional Chinese medicine components. In this paper, by analyzing the current development of traditional Chinese medicine components and problems, we discussed the standardization of traditional Chinese medicine components, with the aim of reducing and avoiding the situations to study non-traditional Chinese medicine components as traditional Chinese medicine components.
Drugs, Chinese Herbal ; chemistry ; Medicine, Chinese Traditional ; methods ; standards ; Reference Standards

Objective To systematically review the efficiency of 18 F-FDG PET in glioma grading by using Meta-analysis. Methods Retrieval in PubMed and China National Knowledge Infrastructure (CNKI)was performed. Relevant papers concerning with glioma diagnoses with 18 F- FDG PET were selected. Paper quality was evaluated according to the standard of diagnostic test recommended by Cochrane Workshop. The data of glioma malignancy degree defined as semi-quantitatively and qualitatively were extracted from the papers. Meta-analysis was conducted with the Meta-Disc software to calculate pooled weighted sensitivity and specificity with 95% confidence interval (CI). Summary receiver operating characteristic (SROC) curve was performed and the areas under the curve (AUC) were calculated. Results Seven hundred and fifty-three patients from 17 papers ( 16 in English, 1 in Chinese) were included. Two hundred and seventy-two patients from 11 papers were using semi-quantitative (tumor to cortex ratio, T/C; tumor to white matter ratio,T/W) method and 481 patients from 9 papers were using qualitative method (visual observation, some of the papers had 2 or more methods). After heterogeneity test was done, different effect models were selected. The pooled weighted sensitivity, specificity and diagnostic odds ratio (DOR) with 95% CI for T/C group was 0. 952 (95% CI: 0. 903 -0. 980), 0. 409 (95% CI: 0. 318-0. 504) and 11. 746 (95% CI:5. 368-25. 702) respectively. The pooled weighted sensitivity, specificity and DOR with 95% CI for T/W group was 0. 857 (95% CI: 0. 768-0. 922), 0. 538 (95% CI: 0. 431 -0. 642) and 22. 066 (95% CI:7. 077-68. 800) respectively. The pooled weighted sensitivity, specificity and diagnostic odds ratio (DOR)with 95% CI for qualitative method was 0.810 (95%CI: 0.757-0.855), 0.870 (95%CI: 0. 819-0.911 ) and 15.282 (95% CI: 3. 716-62. 851 ) respectively. The AUC for T/C group, T/W group and qualitative method was 0.8604, 0. 8373 and 0. 8724 respectively. Conclusions Grading glioma by 18 F-FDG PET with semi-quantitative method may provide high diagnostic sensitivity. If qualitative method is used, the diagnostic specificity may be higher.

Objective To discuss Buyang-huanwu decoction preventing the formation of lower limb deep vein thrombosis (DVT) after major orthopedic surgery.Methods 60 patients were randomly divided into a treatment group and a control group.The treatment group was treated with oral liquid of Buyang-huanwu,twice a day; while the control group was treated with 5000IU of low molecular heparin through subcutaneous injection,once daily.Prothrombin time (PT),activated partial thromboplatin time (APTT),fibrinogen (FIB),D-dimer,lower limb deep vein color B ultrasonic and the wound flow changes after 48 hours were observed at 1st,7th,and 14th day after medication.Results ①)Comparison on the incidence of DVT:The incidence of DVT in the treatment group was higher than the control group at 7th day after medication,this incidence turn to equal in the two groups at the 14th day after medication,while at the end of therapy,the incidence of DVT in the treatment group was lower than the control group with significant difference (P＜0.05).②Comparison on D-dimer changes:D-dimer at the 1st and 14th day were (0.782 ± 0.472) mg/1 and (0.320 ± 0.102) mg/1 in the treatment group and (0.720±0.421)mg/1 and (0.417 ± 0.217) mg/l in the control group.Comparing with the same group before treatment [the treatment group was(0.548±0.245)mg/1; the control group was (0.560±0.195) mg/l],D-dimer was increased at the 1 st day with obvious difference (P＜ 0.05),but reduced at the 14th day,without statistical difference (P＞0.05).Conclusion Buyang-huanwu decoction did not show good effects as low molecular heparin at the beginning of the treatment,but the its whole therapeutic effects and safety was better in treating lower limb deep vein thrombosis after major orthopedic surgery.

Acupuncture Therapy ; Adult ; Amenorrhea ; chemically induced ; drug therapy ; Antipsychotic Agents ; adverse effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Phytotherapy