Objective To identify appropriate subjects for public hospitals social evaluation which fit and match the public hospital social evaluation index system.Methods The methods of literature review,expert consulting and comprehensive evaluation were used.SWOT analysis,appropriateness ranking and classification were made to such six evaluation subj ects as civil servants,medical workers, professional organizations,patients and their family,the public at large and mass media representatives. Results For the support dimension,the top three appropriate evaluation subj ects are professional social organizations,the public at large and medical workers in turn.For the process dimension,the top three subj ects are social professional organizations,civil servants and the public at large.For the result dimension,the top three are professional organizations,the public at large and civil servants.Conclusions Diversified evaluation subj ects independently represented and guided by non-government third-party professional organizations seem a better solution for China′s present specifics.Such a mechanism is authorized by the government,involving patients and their family,the public and social observers,and mass media representatives,supported and coordinated by government departments and public hospitals.

BACKGROUND: Nuclear factor-kappa B (NF-κB) plays a key role in regulating expressions of cytokines and adhesion factors during transcription and in central adjustment during corneal graft rejection reaction.OBJECTIVE: To study the dynamic expressions of NF-κB, intercellular adhesion molecular 1 (ICAM-1) and vascular endothelial growth factor (VEGF) in corneal graft and to investigate the interventional effect of cyclosporin A (CsA). DESIGN, TIME AND SETTING: A randomized controlled animal study was performed in the Department of Ophthalmology, Zhujiang Hospital, the First Military Medical University of Chinese PLA between January and July 2005.MATERIALS: 40 SD rats and 50 Wistar rats were included and randomly divided into three groups, syngenic transplantation (10 Wistar rats used as donor and another 20 Wistar rats used as acceptor), allogeneic transplantation (10 Wistar rats used as donor, and 20 SD rats used as acceptor), and allogeneic transplantation+CsA treatment (10 Wistar rats used as donor, and 20 SD rats used as acceptor).METHODS: Comeal transplantation models were established. Gentamicin (2 000 U) was subconjunctivally injected into the experimental eyes of all ecceptors every other day for three times in total; chloroptic (2.5 g/L) was then used two droplets every time, twice a day, and 18 successive days in total; additionally, tropicamide (5 g/L) was also used two droplets every time, once a day, and 7 successive days in total. One day after corneal transplantation, CsA eye droplet (10 g/L) was used in the allogeneic transplantation+CsA treatment group two droplets every time, three times a day, and 18 successive days in total.MAIN OUTCOME MEASURES: Scores of corneal graft rejection reaction index were measured at day 3, 7, 12, and 18 after corneal transplantation; pathological changes of corneal graft were observed at the same time points to detect expressions of NF-κB, ICAM-1, and VEGF.RESULTS: Rejection reaction was not observed in the syngenic transplantation group at 18 days; however, indexes of rejection reaction in the allogeneic transplantation group were higher than those in the syngenic transplantation group at four time points (P<0.05), but indexes in the allogeneic transplantation+CsA treatment group were lower than those in the allogeneic transplantation group (P<0.05). Immunohistochemical examination indicated that NF-κB, ICAM-1, and VEGF were located at corneal epithelial lamina and substantia propria layer and in newborn vascular endothelial cells. At each time point, expressions of NF-κB, ICAM-1, and VEGF in the allogeneic transplantation group were higher than those in the syngenic transplantation group (P<0.05) but lower than those in the allogeneic transplantation+CsA treatment group (P<0.05).CONCLUSION: CsA can weaken nuclear translocation and activity of NF-κB to inhibit expressions of cytokines, adhesion molecules, and other relative factors so as to inhibit ccurrence and development of corneal graft rejection reaction.

BACKGROUND:Corneal neovascularization not only seriously affects vision, it is also a high-risk factor for the rejection after allogeneic ceratoplasty, thus it is always a hot issue and in ophthalmology to investigate the pathogenesis of corneal neovascularization and the inhibitors for blocking its formation.OBJECTIVE: To induce model of corneal neovascularization in rats using nylon suture, and investigate the mechanism of nuclear factor-кB (NF-кB) in the occurrence and development of corneal neovascularization using dexamethasone as the glucocorticoid inhibitor for corneal neovascularization.DESIGN: A randomized controlled trial.SETTING: Department of Ophthalmology, Zhujiang Hospital of Southern Medical University.MATERIALS: The experiments were carried out in the Zhujiang Hospital of Southern Medical University from January to April 2005. Fifty-five healthy male Wistar rats of clean degree were used. Rabbit-anti-rat NF-кB P65 monoclonal antibody, rabbit-anti-rat vascular endothelial growth factor (VEGF) and intercellular adhesion molecule-1 (ICAM-1)monoclonal antibodies, and 3,3-diaminobenzidine (DAB) kit were purchased from Wuhan Boster Biological Technology Co., Ltd.METHODS: ① Interventions: The rats were randomly divided in the saline control group (n =25), dexamethasone group(n =25) and normal comea group (n =5). Corneal neovascularization using nylon suture was induced in rats in the saline control group and dexamethasone group, and then saline and dexamethasone was dropped to the right eye of the rats respectively, 2 drops for each time, 3 times a day for 18 days. Not any treatment was given to the rats in the normal cornea group. ② Evaluations: The score of corneal neovascularization was evaluated in the saline control group and dexamethasone group at 1, 3, 7, 12 and 18 days postoperatively. Corneal sections were prepared to observe the histological changes of cornea under light microscope; The expressions of NF-кB, VEGF and ICAM-1 were detected with immunohistochemical staining.MAIN OUTCOME MEASURES: ① Score of corneal neovascularization; ② Histological changes of cornea; ③ Expressions of NF-кB, VEGF and ICAM-1 in cornea.RESULTS: ① Score of corneal neovascularization: The corneal neovascularization was obviously inhibited, and scores of corneal neovascularization at different time points were all significantly lower than those in the saline control group (P ＜0.05-0.01). ② Histological changes of cornea: In the dexamethasone group, corneal neuvascularization and the infiltration of inflammatory cells after suture were obviously alleviated as compared with those in the control group, and the corneal structures in each layer were relatively complete. ③ Expressions of NF-кB, VEGF and ICAM-1 in cornea: In the dexamethasone group, the expressions of NF-кB, VEGF and ICAM-1 at each time points were all lower than those in the saline control group (P ＜ 0.05). The intensity of the expression of NF-кB was positively correlated with the score of corneal neovascularization and the expressions of ICAM-1 and VEGF (r =0.961, 0.922, 0.958, P ＜ 0.01).CONCLUSION: NF-кB is involved in the formation of corneal neovascularization possibly through upregulating the expressions of its downstream genes (VEGF, ICAM-1). Dexamethasone can inhibit the expressions of many factors related to corneal neovascularization regulated by NF-кB, including cytokines and adhesion molecules, through reducing the activity of NF-кB, and then suppresses the occurrence and development of corneal neovascularization.

Cardiopulmonary resuscitation is the most comonly used method facing cardiac arrest.The 2010 CPR guidelines emphasized high quality chest compressions and recommended continuous compression for 2 minutes after defibrillation to minimize interruptions in compressions.However,starting chest compressions immediately after a defibrillation shock may be harmful,if the heart is providing spontaneous beats and being subjected to external compressions at the same time.So it is very important to recognize ROSC during CPR,the methods of which include touching the pulse,amplitude spectral area,partial pressure end-tidal carbon dioxide,coronary perfusion pressure,central venous oxygen saturation,chest compression fraction,regional cerebral oxygen saturation,photoplethysmography,conjunctival oxygen tension,transthoracic-impedance plethysmography and echocardiography.This paper gives a review of the ROSC prognosis and recognition methods during CPR.

Social evaluation governance strategy was introduced to study the social management path for public hospitals.On the basis of definition of social governance and social evaluation theory, clarification of the concepts and relationship logic of public hospital′s social evaluation,and analysis of the context analysis of their social evaluation policy,the paper discussed the establishment of social evaluation and governance theory logic framework of public hospitals.In terms of such realization paths as the purposes,indexes,entities,and methods of the evaluation,as well as result release and application of the evaluation,recommendations were made.

Objective:To analyse the degree of equality of New Rural Cooperative Medical Scheme (NRCMS) in different economic regions. We provide a reference for equal development of the NRCMS and the reform of the political system and mechanism under the provincial-controlled county fiscal system. Methods:A typical province was chosen with provincial-controlled county fiscal system was fully implemented several years. We collected data on coverage, financing and compensation for the NRCMS from 2005 to 2011. We used the variable coefficient, uniformity coefficient, Theil Index for comprehensive evaluation. Results:Per capita financing has not reached the bottom line. From 2005 to 2011, inter-re-gional and intra-regional variation coefficient, Theil index of service coverage, financing level and hospital actual compen-sation has declined year by year. The degree of inequality in economically developed regions was greater than in less eco-nomically developed regions and economic medium region. Conclusion:The degree of equalization of the NRCMS in the province continuously improved. Innovation of provincial-controlled county fiscal system and mechanism provides a favora-ble environment and forming conditions for equalizing the development of the NRCMS. The paper suggested exploring and building fiscal classification step transfer payment institution and dynamic prediction model of the NRCMS, further optimi-zing financing mechanism, promoting the provincial management system of the NRCMS as soon as possible in order to pro-mote the equalization development.

Objective:To find out the key demand and connection point of health quality education for students of different stages by analysis of their health quality characteristics and the main contribution path, and then explore strategies to improve health quality. Methods:The stratified random cluster sampling method was carried out to select the sample population in Hangzhou. The variance analysis, curve fitting and multivariate linear regression analysis were used to analyze health quality characteristics and the main contribution path. Results:The health quality of pri-mary school students was best;the difference in quality between college students and junior high school students was not statistically significant ( P>0. 05 );and high school students had the worst health quality. The high school stage is the weakest link of health quality education. The order of the health education path and the means for improving the health quality of college, high school, and primary school students differ. With the improvement of students’ lev-el, the students that require physical quality promotion gradually decreases; the moral quality demand remains sta-ble;and the psychological quality and social adaptation ability present the tendency of a gradual increase. Conclu-sion:Student health quality shows a tendency to decreases with the rise of learning phase. The education departments should foster health consciousness and habits for students, form a healthy lifestyle behavior and ways of thinking for high school students, shape healthy personalities to improve health literacy and social adaptation abilities for college student, which is the key strategy for promoting the health quality of all-round development of the students and a-chieve the primary education goal of “health education”.

AIM: To investigate whether grafting neural stem cells (NSCs) improves the impaired cognitive deficits and spatial recognition after ischemic-hypoxic brain damage (HIBD) in neonatal rats. METHODS: Non-immunosuppressed 7-day-old SD rats were used as research subject and randomly divided into 3 groups: (1) sham group (n=10); (2) HIBD group (n=11); (3) transplant group (n=13). (2) and (3) were anesthetized and subjected to a hypoxic/ischemic injury obtained by combination of left carotid ligation and exposure to 8% oxygen for 2 h. At 3 days post injury, hypoxic-ischemic brain damaged animals were re-anesthetized and randomized to receive stereotactic injection of NSCs prelabeling with BrdU or control media into the hippocampus in the ipsilateral hemisphere. Cognitive (i.e., learning) deficits were assessed at 2 to 4 weeks after transplantation. At the end of the behavioral tests, the animals were killed and evaluated for NSC survival and histopathological analysis. RESULTS: Transplant group showed significantly improved cognitive function in selected tests as compared with HIBD group during the 4-week observation period. They took less time than HIBD group in finding the 3 arms baited with water and had a decreased number of working and reference memory errors in radial maze acquisition tests. Histological analysis showed that transplanted NSCs attenuated CA1 cell loss after HIBD, and NSCs survived for as long as 4 weeks after transplantation and were detected in the hippocampus. CONCLUSION: These data suggest that transplanted NSCs attenuate brain damage and cognitive dysfunction after hypoxic-ischemic brain damage. This approach warrants continued investigation in light of potential therapeutic uses.

AIM: To discuss the mechanism of hyperbaric oxygen(HBO) therapy by assessing the changes of neural stem cells(NSCs),after hypoxic-ischemic brain damage(HIBD) in neonatal rats.METHODS: Seven-day-old SD rat pups were randomly divided into 4 groups: control group(CON,n=16),HIBD group(n=16),hyperbaric air group(HBA,n=16),and HBO group(n=16).The HIBD model was produced by permanent occlusion of left common carotid artery and was exposed to a mixture of 8% oxygen and 92% nitrogen for 2 h(at 37 ℃).HBA and HBO treatment was administered by placing pups in a chamber(2 ATA for 1 h) 1 h after hypoxia exposure and performed once daily for 7 days.BrdU immunohistochemistry was used to assess how the insult had affected NSCs in the SVZ of the lateral ventricle and DG of the hippocampus.The NSCs from the ipsilateral SVZs were isolated at 3 weeks recovery from hypoxia-ischemia(HI).The number of spheres was then counted as an index of the number of NSCs residing within the SVZ.RESULTS: At 3 week survival,the SVZ of HIBD group was smaller and markedly less cellular than control group.BrdU-positive cells were dramatically decreased in the SVZ and DG of the affected hemisphere(P

Objective To analyze and summarize the clinical features of delayed occurrence of senile asthma,to add the knowledge and understanding of the disease. Methods To retrospectively analyze clinical data of the cases of senile asthma treated in our hospital,all the cases were divided into groups of early onset senile asthma and delayed occurrence senile asthma,according to the age of first onset.Then related indexes were analyzed,to summarize the clinical features of group of delayed occurrence of senile asthma. Results There were 28 cases of delayed occurrence of senile asthma,accounting for 34.6% of total cases.Compared to early onset group,there was no significant difference (all P＞0.05) between two groups for the following items such as age,allergic history and positive rate of family's history,disease causes,clinical symptoms,basic diseases and complications,proportion of severe cases,rate of misdiagnosis and mistreatment,proportion of standardized treatment and un-standardized treatment,prognosis of diseases and mortality.Both groups had low rate of knowledge and application on PEF monitoring equipment and ACT score.The period of misdiagnosis and mistreatment for delayed occurrence group was shorter than the early onset group (P＜0.05＝; the seasonal nature and day and night pattern was significant in delayed occurrence group (P＜0.05＝. Conclusion Late onset elderly asthma had the features such as shorter course of the disease,relatively obvious onset rule during day and night,and obvious symptoms during night,which are different from that of early onset group.