Improving the basic medical and health service system is an important measure to deepen health care reform.Jilin province has explored its unique way of comprehensive reform of the primary organizations in the province by means of reforming grassroots medical operation mechanism and mode of service,and perfecting the compensation mechanism,achieving remarkable results.This article,based on the overall situation of Jilin province,main contradictions and countermeasures research,made detailed analysis of healthcare reform and bottlenecks encountered in the reform.The author pointed out the direction of Jilin province primary medical and health institutions reform,and put forward feasible policy adjustments and suggestions for such a reform.

Objective:To evaluate the value of color Doppler ultrasound combined with ultrasonic elastography for curative effect of neoadjuvant chemotherapy (NAC) for breast cancer.Methods: 100 patients with breast cancer who has received NAC were divided intoobservation group (50 cases, underwent examination of color Doppler ultrasound scanner combined with ultrasonic elastography) and control group (50 cases, only underwent examination of color Doppler ultrasound scanner) according to the different examination methods. The accuracy, sensitivity and specificity of differential diagnosis methods for curative effect of NAC between the two groups were compared as above data.Results: The accuracy, sensitivity and specificity of differential diagnosis for curative effect of NAC in observation group were 88.00％, 90.00％ and 86.00％, respectively. While them of control group were 78.00％, 80.00％ and 76.00％, respectively. And the differences of these indicators between the two groups were statistically significant (x2=2.01,x2=3.24,x2=3.45, P<0.05).Conclusions: Color Doppler ultrasound combined with ultrasound elastography can diagnose the curative effect of NAC for patients with breast cancer from two aspects which includes tissue hardness and blood supply, and it can achieve more diagnostic accuracy compared with only using simple color Doppler ultrasound.

Objective To investigate the optimal beam tube potential for amorphous silicon/cesium iodide flat panel digital chest radiography(indirect DR). Methods(1)60 healthy adults were undergone digital posteroanterior(PA) chest radiography at 80,100,150 kV respectively.The images quality of these three were compared by 5 independent observers.Several normal anatomy parts of the chest and the overall impression of the images were evaluated;(2)PA chest exposures of the anthropomorphic chest phantom to produce a constant ESDs(entrance skin doses) and exit dose were made using tube potential at 80,100,120,150 kV.The simulated chest nodules were scored. Results The quality of the adult chest radiography and the manifestation of the simulated chest nodules were superior at the lower tube voltages.The contrast of the images were best at 80 kV,while the appearance of the images look like that of the low potential radiography. Conclusion The optimal tube potential for chest DR is considered to be 80~100 kVp,while the high KV technique is no longer suitable for digital equipment.

Juvenile hemochromatosis is an autosomal recessive disease characterized by progressive tissue iron overload which leads to irreversible organ damage and even death.This disease is mainly caused by mutations in two genes:hemojuvelin gene and hepcidin gene.Different mutations have different phenotype.The two genes may act as modifying genes in HFE hemochromatosis.Hepcidin secreted by liver plays a central role in the regulation of iron homeostasis.HJV can act as a bone morphogenetic protein(BMP)co-receptor which is required for HJV to regulate hepcidin expression and iron homeostasis.Recent researches suggest that the bone morphogenetic protein(BMP)signaling pathway mediated by HJV is a significant mechanism for HJV to regulate hepcidin expression and iron homeostasis.HJV mutant impaires BMP signaling which results in hepcidin expression decrease and abnormal iron metabolism.

Objective To establish a SYBR Green based real-time fluorescence quantitative PCR method for detecting human Annexin Ⅱ mRNA expression,and to detect the level of Annexin Ⅱ mRNA in human breast cancer cells MCF-7 and MDA-MB-231.Methods The specific primers were designed according to the conserved sequence of human Annexin Ⅱ gene.Total RNAs were extracted from human breast cancer cells(MCF-7,MDA-MB-231),then RNAs were transcribed reversely into cDNAs.The plasmid standards were constructed.The relative expression levels of human Annexin Ⅱ mRNA in human breast cancer cells were detected by this method.Results The square(r2 )of correlation coefficient of the standard curve in this method was 0.997,the melting curve analysis showed the single peak.The the intra-batch and inter-batch variable coefficients in the pGM-T Annexin Ⅱplasmid standard substance were 6.2%,7.8% and 9.1%,12.3% respectively.The further study indicated that AnnexinⅡ mRNA in MDA-MB-231 was higher than that in MCF-7(P<0.01).Conclusion The established SYBR Green real time fluorescence quan-titative PCR method for detecting human AnnexinⅡ is of good specificity and repeatability and can be used for quantitatively detec-ting AnnexinⅡ mRNA in breast cancer cells.

Objective To study the value of color Doppler ultrasound in diagnosis of deep vein thrombosis (DVT) of lower extremity and pulmonary embolism (PE) in spinal cord injury (SCI). Methods 60 PE patients (PE group) and 35 SCI patients without PE (control group) received color Doppler ultrasound examination for DVT of lower extremity. Results PE group included 36 SCI patients (PE-SCI group) and 24 no-SCI patients (PE-no-SCI group). There were 15 cases with lower extremity thrombosis in PE-SCI group, and 9 cases in PE-no-SCI group (P>0.05), while there were 5 cases in the control group. There was significantly different in lower extremity thrombosis between PE group and the control group (P<0.01). In PE group, the detection rate was not significantly different between acute PE (detected 11 cases out of 37 cases) and chronic PE (detected 10 cases out of 23 cases) (P>0.05). 31 cases were rechecked as lower extremity venous valve regurgitation and calf muscle vein dilation (51.7%) in PE group while 8 cases in the control group (22.9%) (P<0.01). Conclusion There is not significantly different in the detection rate of DVT of lower extremity in PE patients with and without spinal cord injury, which are higher than in the patients without PE. Color Doppler ultrasound is necessary to check DVT in acute and chronic PE patients.

Objective Taking the total amino-acid, total flavones, chlorogenic acid, and volatile oil in Chrysanthemum morifolium as index to investigate the internal quality which relates to collection periods and processing methvods in order to compare the quality of species from oringinal habitats. Methods The contents of colorogenic acid in C. morifolium was analyzed by HPLC; the content of total flavones and amino-acid in C. morifolium were measured by spectrophotometery; and the volatile oil obtained by steam distilation extraction was weighted. Results The every indexes of viviparious chrysanthemum except chlorogenic acid was the best among various flowering periods so the viviparious chrysanthemum can be used as the first-class tea. The common tea produced by half-booming and full-booming flowers with higher yield and appropriate index. The machine processing is fast and suitable for the production to a large-scale. Conclusion The quality of C. morifolium planted in Ruicheng, Shanxi Province is equal to that in Tongxiang, Zhejiang Province, which depends on the collecting periods and processing methods, so does the volatile oil rather than the evironment of the habitat.

OBJECTIVE:To investigate the situation of ADR reporting entities in Henan province and Hebei province to pro-vide reference for the improvement of ADR monitoring. METHODS:Literatures were consulted to investigate the ADR monitoring at home and abroad. With the subject of ADR reporting entities(pharmaceutical manufacturers,drug distributors and medical insti-tutions)in Henan and Hebei province,questionnaires and descriptive statistical analysis were conducted to analyze the results. RE-SULTS:186 valid questionnaires were received. There were respectively 58 and 62 ADR reporting entities with ADR monitoring de-partment in Henan and Hebei province,all of them had personnel who were responsible for ADR;ADR monitoring mostly belonged to quality control department in pharmaceutical manufacturers and drug distributors,and pharmacy department in medical institu-tions;most were equipped with computer,printer,phone and other basic office equipments;most were not clearly for major duty;there were respectively 24 and 2 entities with special budget for ADR monitoring;95.7% and 96.8% had communication with the local ADR monitoring centers,however,the information feedback was not ideal;86.7%and 98.9%had training for the stuff;stan-dard operation procedure was relatively good in Hebei province;96.7% and 98.9% would report ADR immediately after finding ADR,92.3% and 97.8% would record and backup the reported ADR;the form mainly by network report;the average degree of satisfaction evaluation in Henan province was higher than Hebei. CONCLUSIONS:According to the results,it is suggested to pro-mote the implementation of ADR monitoring by optimizing the work conditions,ensuring work fund and strengthening work feed-back.

OBJECTIVE:To understand the present situation of ADR reporting entities in Shaanxi and Sichuan province,and provide evidence for the improvement of ADR monitoring. METHODS:Getting the overview of ADR monitoring at home and abroad by reading a lot of literature,the ADR monitoring entities(drug manufacturers,drug distributors and medical institutions) in Shaanxi and Sichuan province were selected as subject for cluster sampling,questionnaires were sent out and descriptive statis-tics analysis was adopted to processing and analyze the results. RESULTS:Totally 198 questionnaires were received,100 for Shaanxi province and 98 for Sichuan province. In Shaanxi and Sichuan province,there are 61 and 63 investigated subjects had es-tablished ADR monitoring departments,98.0% and 100% had had personnel for the ADR work;ADR monitoring work mostly be-longed to the quality control department in drug manufacturers and drug distributors,and belonged to pharmacy department in medi-cal institutions;most of them were equipped with computer,printer and other basic office equipment;however,the major duty of most was not clearly;13 and 23 subjects had special budget for ADR monitoring;87 and 89 subjects had communication with lo-cal ADR monitoring center,however,the information feedback was not very ideal;training the workers accounted for 80.0% and 83.0%,respectively;in terms of system construction,the standard operation procedure was relatively good,and the other related was not ideal;reporting quickly when finding ADR was 89.0% and 96.9%,88.0% and 96.9% of which had backup records for ADR reporting,it was mainly network report;Shaanxi province was better than Sichuan province about the satisfaction evaluation of ADR work. CONCLUSIONS:According to the results,it is suggested to adjust the structure of workers,buy related software re-source,improve the responsibilities and strengthen the financial support to promote the implementation of ADR monitoring.

Objective To assess the difference in detection of simulated chest nodules in different lung fields with dual-energy digital subtraction chest radiography by receive operating characteristic curve (ROC) analysis.Methods Dual-energy digital subtraction chest radiography was performed on 20 volunteers with simulated chest nodules. ROC analysis was made in the evaluation results on regular DR images and soft tissue images in different lung fields respectively.Results Az was greater on the soft tissue images than on the regular DR images in the superior lung fields and outer zone of middle lung fields. There were significant differences in the superior lung fields and outer zone of middle lung fields.Conclusion Dual-energy digital subtraction chest radiography is superior to regular DR image on detecting more chest nodule lesions, especially in the superior lung fields and outer zone of middle lung fields. So the two techniques should be united to diagnose.