Lots of problems has exposed in medical system,especially in unreasonable utilization of health resources.This article,from the viewpoint of utilization of health resource,analyzes current problems and countermeasures of the reasonable utilization of health resources.

ObjectiveTo identify the main problems and provide information for making plans on medical resources allocation by analyzing the dynamic trends of medical resources allocation and service efficiency in Guangzhou after reform and opening-up. MethodsDescriptive analysis, Ascend and Descend Trends Test and ratio analysis were used to compare medical resource allocation and utilization efficiency at different development phases. ResultsCurrently health resources per capita in Guangzhou are close to those in developed countries or areas, but relative shortage derived from demand-driven increase still exists. There is a central tendency toward big comprehensive hospitals, the quality of medical resources is rather low, and efficiency of medical services tends to descend. ConclusionIt showed that when the government making plans on medical resources allocation, strict entry regulation should be reinforced, the standard of medical resource quality should be improved, appropriate space should be left for further development. Medical resources should be directed to reallocate to communities and rural areas in a right way, medical service efficiency and accessibility should be improved.

Objective To investigate the clinicopathologic and immunohistochemicalcharacteristics of primary squamous cell carcinoma of the breast(PSCCB). Methods Sixteen patients with primary squamous cell carcinoma of the breast were retrospectively reviewed. Twelve cases with a follow-up information were evaluated for ER, PR, C-erbB-2, HCK, Ki-67 expression. Results PSCCB is a very rare neoplasm,constituting 0.8 % of all breast carcinoma over 28 years(1981-2008) in our hospital. The patients age varied from 25 to 72, median age is 49 years old. All patients received operative treatment. Seven patients had metastatic disease in axillary lymph nodes. Three patients died from metastases and tumour recurrence.Tumors were usually ER-negative, but most cases showed high molecular cytokeratin (HCK) expression.Conclusion In terms of the clinical feature, there were no differences between the PSCCB and the other breast cancer. PSCCB could be confirmed by pathology. The prognosis is in controversial. Standard therapy should be studied and recommended in future.

Objective:To establish a GC fingerprint analysis method for identification of volatile oil in ultramicro-powder of Houttuynia cordata from different habitats, then to control the quality sensitively.Methods: GC was used to analyze the volatile constituents of ultramicro-powder of Houttuynia cordata from 12 different habitats;SPDTM-1CapillaryColumn(30m?0.32mm?0.25?m),temperature programming and FID detector were applied.Results: The mutual mode of GC fingerprints was set up and the similar degrees to the volatile oil from of different habitats were compared.Conclusion:The GC fingerprints of volatile oil in ultramicro-powder can be used to identify the Houttuynia cordata from different habitats and evaluate its quality.

The traditional experimental teaching of pathology has defect in training the students' operating ability and mobilizing the initiative of students to observe.Pathology Department of North Sichuan Medical College has developed pathology specimens-making competition for undergraduate students.The students observed,chose and made specimens by themselves after sufficient review of the relevant pathology knowledge.The competition has mobilized the enthusiasm of students effectively and developed their operating ability.This form of teaching should become beneficial supplement to the experimental teaching of pathology.

Objective:To identify the allergens which can react with Chinese allergic patients in shrimp and crab ,and analysis their reaction-rates.This results would provide foundation for further research on allergen-detection and desensitization therapy.Methods:Allergen components in Metapenaeus ensis ,Macrobrachium rosenbergii and Charybdis feriata by using 46 portions of shrimp(crab) allergic patients’ serum IgE in Western blot.Results:The reactions between shrimps and allergic patients ’ serum IgE were stronger than that between crab and serum.32-38 kD Tropomysin (TM),40 kD Arginine kinase (AK),60-80 kD Hemocyanin (Hc) and 21 kD arcoplasmic calcium-binding protein(SCP) were the major allergens in shrimps.TM,AK and Hc were common major allergens among shrimps and crab and TM shared the highest reaction-rate.Compare to the results of some from American researchers , AK,Hc and SCP have higher reaction-rate when react with Chinese patients serum ,and we also found a new allergen in shrimp.Con-clusion:For Chinese patients , shrimps have higher reaction-rate than crabs and the allergens among shrimps and crabs which are roughly same.There are some differences in allergens among different human races.A new allergen with 48 kD was found in this re-search.

Objective:To identify enolase,47 kD allergen,from Litopenaeus vannamei by Mass spectrometry. Methods: The proteins were extracted from Litopenaeus vannamei tissue with acetone precipitation method. The protein components were analyzed by SDS-PAGE and Western blot. By using Matrix-Assisted Laser Desorption/Ionization time of flight mass spectrometry ( MALDI-TOF/TOF-MS) ,the 47 kD allergen from Litopenaeus vannamei was identified as enolase. Results:By SDS-PAGE,we proved that the native protein components from Litopenaeus vannamei were completely. According to the Western blot result more than 14 components could react with the positive serum. MALDI-TOF/TOF analysis results showed that the suspected proteins were enolase. A sensitization frequency was 55%. Conclusion:Enolase was identified as a new allergen of Litopenaeus vannamei.

Objective To discuss the expressions and clinicopathologic significances of insulin-like growth factor Ⅱ mRNA binding protein 3 (IMP3)in squamous intraepithelial lesion (SIL)and cervical squa-mous cell carcinoma (CSCC)before and after the therapy of radiation and chemotherapy.Methods The expressions of IMP3 in 80 cases of CSCC,90 cases of SIL (60 cases of HSIL,30 cases of LSIL)and 30 cases of cervicitis were detected by immunobistochemistry.The relations between IMP3 and clinicopathological cha-racteristics of CSCC were analyzed.Results The expression rates of IMP3 in CSCC,HSIL,LSIL and cervici-tis were 86.3%(69 /80),78.3%(47 /60),33.3%(10 /30)and 0(0 /30),and the difference among the four groups was statistically signicant (χ2 =87.01,P <0.01).The positive expression rate of IMP3 declined by radiation or chemotherapy (60.0% vs.85.0%,χ2 =5.79,P =0.013).The expression of IMP3 was related with lymph node metastasis (χ2 =3.97,P =0.046),differentiated degree (χ2 =5.95,P =0.018),clinical stage (χ2 =5.82,P =0.016)and invasion depth (χ2 =5.73,P =0.017).There was nothing to do with age (χ2 =0.11,P =0.745).Conclusion IMP3 expresses excessively in CSCC,and is associated with pathologi-cal grade and invasion progress.Radio-chemotherapy can reduce the expression of IMP3.

OBJECTIVE:To explore the assessment indicators of the accessibility of essential medicines to comprehensively evaluate the accessibility of essential medicinesand its coverage of medicine supply security and service quality and the improve-ment of the implementation of the new Healthcare reform. METHODS:Retrieved from Chinese and English Literature and the World Health Organization(WHO),theoretical analysis was conducted for the covering the core elements of essential medicines to explore construction ideas and content of essential medicines evaluation index system with international suitability,index appropri-ateness and operability. RESULTS&CONCLUSIONS:A series of medicine policy evaluation guide established by WHO is current-ly the main basis of the accessibility of essential medicines evaluation around the world,however,there are certain limitations for these indicators.According to the concept put forward by WHO and the related organizations,the core elements of the accessibility of essential medicines include:availability,affordability,supply system,sustainable financing,medicine quality and appropriate use.

Objective To make a clinical summary of the variation of cystic duct so as to collect 20 years of operative experience and to provide evidence for preventing injury of bile duct in laparoscopic cholecystectomy. Methods A retrospective analysis were made for 20 000 patients experienced laparoscopic cholecystectomy in the second affiliated hospital of Chongqing medical university and Chonggang General Hospital from April,1993 to December,2011. Results There were 3 265 cases of cystic duct variation which occupied 16. 33% of the 20 000 patients. And there were 3 200 cases of variation in the junction of cystic duct, 51 cases of short cystic duct;and 14 cases of gall-bladder surrounded by the liver. Most of the variation were found in the junction of cystic duct, including 371 cases (11. 36%) of cystic duct accompanied the common hepatic duct and then made a lower confluence;995 cases (30. 47%) of cystic duct traversed above the com-mon hepatic duct and then made a confluence, 643 cases (19. 69%) of cystic duct traversed below the common hepatic duct and then made a confluence;963 cases (29. 49%) of gallbladder neck attached to the common bile duct;and 228 cases (6. 98%) of higher confluence of cystic duct and common bile duct. Conclusion The rate of cystic duct variation accounted for a high rate, and most of the patients were found with a variation in the junction of cystic duct. Being familiar with the categories of cystic duct, discriminating the anatomic structure carefully, using choledochoscopic examination when necessary, and masterting reasonable time to make a transfer to laparocholecystotomy were reliable methods for coping with the injury of bile duct caused by variation of cystic duct.