The counterpart support by urban hospitals to rural hospitals is an important measure of the healthcare reform and health poverty alleviation, especially useful for reform of county-level public hospitals.A study of the policy development and an analysis on the development status quo of 16 county-level public hospitals following their acceptance of such support in Hunan and Hubei province, confirmed the practical significance of such counterpart support.The authors also found defects in personnel training, technology innovation and policy fine-tuning, in need of improvements.

ObjectiveTo determine the current students' social anxiety status and maternal factors in school students( grade 5-7) in Harbin,and provided scientific guidance relevant to students'social anxiety.Methods 1526 mother-child pairs collected by random cluster sampling,children completed the social anxiety scale for children (SASC),security scale,coping strategies questionnaire( consist of ambivalence and avoidance subscale),acceptance scale and psychological control scale,and mothers completed the center for epidemiologic studies depression inventory (CES-D),self-rating anxiety scale (SAS).ResultsThe total positive detection rate of social anxiety was 13.6％,there was no significantly difference between boys and girls (P ＞ 0.05) ; the positive detection rate of Grade 6 was higher than Grade 5 and Grade 7.There were positive correlation between social anxiety and mother's psychological control,mother's depression,mother's anxiety ( r =0.228,0.143,0.122) ; negative correlation with mother's acceptance( r =-0.214).Linear regression indicated that only three variables (mother's psychological control,mother's acceptance,mother's depression) were at the P ＜ 0.05 level.The regression coefficients for the three variables were 1.557,- 1.092 and 0.040,respectively.ConclusionMaternal highly psychological control,lowly acceptance and maternal anxiety depression all play a role in promoting the occurrence of students' social anxiety.

Objective To explore the construction and application of cloud-based healthcare information system (CHIS).Methods The process of CHIS employment and implementation for primary-level medical and healthcare institutions was elaborated by the example of a city after the analysis and comparison of mode difference between traditional and cloud construction.Results CHIS integrated regional medical resources and realized integrated application of medical and public healthcare resources,mobile integration of regional operation and continuous innovation in construction mode,and facilitated uniformed management,high-efficiency running and maintenance as well as business development.Conclusion CHIS contributes to enhancing medical inforrnatization in primary institutions,promoting continuous medical innovation and innovating medical informatization mode.

ObjectiveTo analyze the internet-based cognitive behavior therapy (ICBT) intervent medical university students' social anxiety,and provide experiences and theoretical basis for future social anxiety interventions.Methods45 medical students of social anxiety were voluntarily divided into the one-to-one intervention group,one-to-five intervention group and control group.The control group did not intervene,one-to-one intervention group and one-to-five intervention group were interfered single person or team by cognitive behavioral therapy,respectively.The level and symptom of social anxiety of the 3 groups were assessed before and after the intervention by social phobia inventory(SPIN) and Social anxiety symptoms interview inventory.ResultsAfter the intervention,the scores of SPIN and the 3 subscales within it (fear,avoidance and physiological) of one-to-one ICBT group and one-to-five ICBT group were lower than those of the control group (SPIN scores:one-to-one ICBT group 15.60 ±7.87,one-to-five ICBT group 14.87 ± 8.83,control group 20.20 ± 11.46).Variance analysis showed that,in addition to physiological subscale(F =0.641,P ＞ 0.05 ),the scores of SPIN,fear and avoidance subscales had significant differences among the3 groups (F=3.764,P=0.018; F=3.606,P=0.021 ; F=5.444,P=0.005).In the analysis of participants'social anxiety symptoms,after treatment,in one-to-one ICBT group,there was 1 participant changed into subthreshold social anxiety and 1 participant into normal in the 2 threshold social anxiety participants.All the 3 subthreshold social anxiety participants changed into normal.In one-to-five ICBT group,there was 1 threshold social anxiety participant lapsed to subthreshold social anxiety,1 subthreshold social anxiety participants still remained in subthreshold social anxiety,2 symptomatic social anxiety participants changed into normal.But there were no significant changes in control group.ConclusionsAll the two methods of intervention have a certain effect.The effect of one-to-one intervention therapy is most significant.

Objective To investigate the function of serum and bile leptin in the formation of gallstones.Methods Patients were divided into two groups:gallbladder cholesterol gallstone group (group A,n =58) and non-gallstone group (group B,n =33).With a body mass index of 24 kg/m2 for the standard,the group A was also divided into the group A1 (body mass index ≥24 kg/m2,n =30) and group A2 (body mass index ＜ 24 kg/m2,n =28).Group B was divided into group B1 (body mass index≥24 kg/m2,n =18) and group B2 (body mass index ＜24 kg/m2,n =15).Fasting blood samples from all study participants were assayed for total bile acid,total cholesterol,triglyceride,low density lipoprotein,high density lipoprotein,apolipoprotein AI,apolipoprotein B,lipoprotein (a).Serum leptin and bile leptin were measured using an enzyme-linked immunosorbent assay.Results A total of 58 patients with gallbladder cholesterol gallstone and 33 controls were included in the study.The serum level of leptin,total cholesterol,low density lipoprotein,apolipoprotein B and triglyceride were significantly increased,high density lipoprotein and apolipoprotein AI significantly decreased in patients with gallbladder cholesterol gallstone compared with controls(P ＜0.05).While bile leptin,total Bile acid,lipoprotein(a) were no significant difference between group A and group B (P ＞ 0.05).Serum leptin in patients with gallbladder cholesterol gallstone were significantly positively correlated with Body Mass Index(r =0.65,P =0.01),Especially when Body Mass Index ≥ 24 kg/m2 (r =0.73,P ＜ 0.01).Conclusions Changes in levels of serum leptin may affect levels of blood lipid,some lipoprotein and bile leptin,then promote the formation of cholesterol stones.

A three-phase depletion/repletion/depletion feeding study was designed to investigate the changes of Se levels and glutathione peroxidase (GSH-Px) activities in tissues and blood in rats fed for 6 weeks low-Se diet (6 ppb Se) from a Keshan disease area during the supplementations of Se as Ziyang high-Se wheat (1.175 ppm Se) or sodium selenite (dietary Se 219 and 223 ppb respectively) and after the supplements were discontinued, and to evaluate the relative bioavailability of Se in the wheat. The resalts showed that the average bioavailability of Se in high-Se wheat derived from the values at wk 2, 4 and 6 of supplement was close to that in selenite when plasma, erythrocyte, kidney, liver and cardiac Se contents were used as the response criteria, the relative bioavailabilities being 98%, 104%,100%,96% and 101% (sodium selenite = 100%) respectively. The bioavailability was lower for Se in high-Se wheat (70% or 90%) than for selenite when estimated by erythro-cyte or cardiac GSH-Px activities. However, the bioavailabilities of high-Se wheat Se in various tissues were not all the same at different stages of supplement. In addition, the effect of Se in high-Se wheat in maintaining either Se levels in heart, liver and erythrocyte or GSH-Px activity in heart was superior to that of selenite 3 weeks after the Se supplements were withdrawn.

Objective To explore the relationship between parental authority,parental psychological control, parental attachment and medical students' social anxiety, and to provide theoretical guidance for medical students' mental health.Methods 2105 medical students were assessed with the social phobia inventory (SPIN), Parental authority questionnaire (PAQ), Parental psychological control questionnaire, Inventory of parent attachment (IPA).Results The mean SPIN score of social anxiety was 17.75 ± 10.47.Girls scored higher than boys,but there were no statistically significant differences between them( 17.97±10.44 vs 17.29 ± 10.52, t =1.305, P=0.192).Rural medical students scored higher than urban students,and the difference had statistical significance (19.47 ± 10.60 vs 15.85 ± 10.01, t = 7.478, P ＜ 0.01 ).Stepwise regression revealed that, for urban students' anxiety, father communication and mother authoritative/flexible were protective factors, father unconscionable emotional response, mother alienation, father unconscionable viewpoint and mother communication were risk factors; and for rural students' anxiety father communication was protective factor, mother alienation and mother authoritarian were risk factors.Conclusion Factors such as parental authority, parental psychological control and parental attachment will affect medical students' social anxiety.But the factors are not same between urban and rural.So these factors are considered when carrying out health education for parents.

Objective To investigate the relationship between acute biliary pancreatitis and pancreaticobiliary maljunction and the role of magnetic resonance cholangiopancreatography(MRCP) in evaluation of pancreatico biliary maljunction.Methods To compare the liver function indicators of different groups of acute biliary pancreatitis patients(153 cases) associated with pancreatico biliary maljunction and without pancreatico biliary maljunction before and after the conservative treatment.Results The 32 acute biliary pancreatitis patients with pancreatico biliary maljunction detected by MRCP were compared with the 121 cases without pancreatico biliary maljunction.The ALT,AST,GGT after conservative treatment in both group of pancreatico biliary maljunction and Npancreatico biliary maljunction were significantly decreased (P ＜ 0.05).ALT,AST and GGT of pancreatico biliary maljunction group were higher than that of Npancreatico biliary maljunction group with statistical significance (P ＜ 0.05).Conclusions MRCP as a noninvasive cholangiopancreatography study of pancreatico biliary maljunction is a safe and reliable examination method,pancreatico biliary maljunction is one of the important causes of acute biliary pancreatitis.

Objective To analyze the differences in microRNA (miRNA) expression between A549 and A549/DDP cells and explore the association between miRNA expression and drug resistance in non-small cell lung cancer (NSCLC).Methods The drug resistance of A549/DDP cells was evaluated using CCK-8 assay and flow cytometry.Microarray technique and RT-PCR were used to analyze the differential expression of the miRNA between A549 and A549/DDP cells.Enforced or inhibited target miRNA expression in cisplatin resistant cell was used to investigate whether miRNA involve in modulating the sensitivity of NSCLC cells to chemotherapeutic agent,exploiting the emerging knowledge of miRNA for the development of new human therapeutic applications for overcoming anticancer drug resistance and trying to discover biomarkers that were better able to predict the cancer chemotherapy sensitivity.Results The drug resistance index of A549/DDP cells relative to the parental A549 cells was 18.Microarray analysis of A549 and A549/DDP cells identified 51 differentially expressed genes (≥4-fold),including 24 up-regulated and 27 down-regulated genes in A549/DDP cells.RT-PCR identified 9 miRNA that were differentially expressed between A549 and A549/DDP cells.Of these differentially expressed miRNA,miR-376c,miR-31,miR-29a,miR-221 showed significantly increased expression,and miR-196a,miR-20a,miR-20b,miR-17,miR-451 showed significantlylowered expression in A549/DDP cells as indicated by the results of microarray analysis and RT-PCR.DDP sensitivity was increased 11.7 ％ in A549/DDP cells transfected with miR-17,but the chemosensitivity was decreased when miR-451 was over-expressed or miR-29a was inhibited by selective inhibitor,the reduction was 15.5 ％,12.9 ％,respectively,whereas chemosensitivity did not change when miR-376c,miR-31,miR-221 were inhibited or miR-196a,miR-20b,miR-20a were over-expressed.Conclusion A549/DDP cells show a different miRNA expression profile from its parental A549 cells,suggesting the involvement of miRNA in tumor cell drug resistance.miR-17 has the potential to be an efficient agent for preventing and reversing DDP-resistance in NSCLC.These results provide a strong rationale for the development of miRNA-based therapeutic strategies aiming to overcome cancer cell resistance.

Objective To investigate the value of fractional contrast medium bolus injection in improving the quality of CT portography.MethodsA total of 42 patients were randomly divided into two groups which were all given iohexol (350mgI/mL) as the contrast medium.20 patients in the group A were injected with conventional method (dosage of 100ml, rate of 4mL/s).The group B (22 patients) were treated with fractional contrast medium bolus injection, the first phase with 60mL contrast medium (rate of 4mL/s) and the second phase (10s delayed) with 40mL contrast medium (rate of 4m/s).The tube was washed by 20mL saline with the same rate of injection at both phases.The CT values and the image quality of the branches of the portal vein were evaluated according to the original and postprocessed images.Independent samples test was used to compare the CT values of the portal vein, splenic vein, superior mesenteric vein, hepatic parenchyma and portal vein-liver parenchyma.The subjective evaluation scores of the image quality were compared by wilcoxon.ResultsThe CT values of the portal vein, splenic vein and portal vein-liver parenchyma in the group B were significantly higher than that in the group A (t=3.317,3.523,P<0.01).There was no significant difference in CT values of hepatic parenchyma and superior mesenteric vein between the two groups.Subjective quality score in the group B was superior to that in the group A, and the difference was statistically significant.T The two evaluation physicians agreed well.ConclusionThe technique of fractional contrast medium bolus injection can significantly improve the image quality of CT portograghy.