Objective: To understand the economic operation status of primary health services institutions from 2007 to 2012 in Hunan. Methods: Collecting relevant data from health statistics yearbook and health financial annual report. Descriptive statistics was used to analyze the data. Results: ⑴The quantity of medical services increased steadily within a narrow range , per capita daily burden of doctors were remarkably increased, bed utilization ratio got a significant growth but still lower than hospital level; ⑵the total revenue rose by year, the growth rate of drug revenue had a descending trend, financial aid revenue was growing strongly with 84% growth rate in 2010 and 72%in 2011; ⑶the total expenses rose by year, the drug expenses was almost steady, while the medical expenses had a remarkable rise, as a result, the proportion of drug expenses was descending from 35.4% in 2007 to 27.02% in 2012; ⑷the balance rate stayed at lower level, and negative balance had been existed since 2011 and the medical revenue and expenditure’ loss was most serious. Conclusion: Since the implement of new medical reform, especially the implement of essential medicine institutions, the balance of financial revenue and expenditure of primary health services institutions have been serious. Self compensation ability are poor, the institutions were facing development difficulty, it needed supports from comprehensive reform measures.

Objective To systematically evaluate the efficacy of traditional Chinese medicine/herbal decoction combined with ursodeoxy-cholic acid (UDCA)in the treatment of primary biliary cirrhosis (PBC),and to provide a reference for clinical medication.Methods Lit-erature published before July 31,2014 was searched in databases as follows:Cochrane Library,PubMed,China National Knowledge Infra-structure (CNKI),Chinese Scientific Journals Full-text Database (VIP),Chinese Biomedical Literature Database (CBM),and Wanfang Data.The randomized controlled trials (RCTs)comparing the efficacy of traditional Chinese medicine/herbal decoction combined with UD-CA versus UDCA alone in PBC patients were included in the analysis.The methodological quality of included trials was assessed and the data were extracted,followed by meta-analysis using RevMan 5.0 software.Results A total of 12 RCTs were included,involving 681 patients with 346 in the test group and 335 in the control group.The results of meta-analysis showed that,after 6 months of treatment,the overall response rate,improvement rate,and biochemical indices of liver function (ALT,ALP,GGT,and TBil)and hepatic fibrosis in the test group were significantly improved compared with those in the control group (all P<0.05).There were no significant differences between the two groups in the immunological indices such as IgA,IgG,anti-mitochondrial antibody (AMA),and AMA M2 subtype (all P>0.05 ). Conclusion Traditional Chinese medicine/herbal decoction combined with UDCA markedly improves the indices of hepatocellular necrosis and cholestasis,degree of hepatic fibrosis,and clinical symptoms in PBC patients after 6 months of treatment,but leads to no significant im-provement in immunological indices.Due to the limited number of included RCTs and patients through systematic evaluation,and the pres-ence of selection bias and publication bias,more double-blind randomized controlled trials with large sample size,multicenter involvement, and high quality are required to provide convincing evidence.

Objective To explore the effective countermeasures for the Scientific research funds auditing in medical schools.Methods Political-Economic-Social Technological (PEST) method was used to analyze the macro environment changes for research funding audit,including policy,economics,social,technology..We described the situation in the research funds auditing,based on the model of Strengths-Weaknesses Opportunities-Threats (SWOT).Results Some counter-measures in the research funds auditing are recommeded for solution.Conclusions The PEST-SWOT model could provide effective countermeasures for the research funds auditing in medical schools.

Two hundred and forty patients with primary hypertension in Weifang Community were randomly sampled as contract group and another 240 hypertensive patients were sampled as control group.Patients in contract group signed service contract with general practitioners (GPs),who provided individualized service for hypertension management.Patients in control group receive conventional outpatient service for hypertension management.The clinical data of patients before and one year after contracted services were documented and compared with those in control group.The results showed that in contract group the average systolic pressure decreased from 134.60 mm Hg (1 mm Hg =0.133 kPa) to 130.62 mm Hg (P =0.000),reaching-the-target-BP rate increased from 56.3％ to 85.5％ (P =0.000),serum total cholesterol and triglyceride decreased significantly one year after receiving contracted services (P =0.000) ; while these indicators were not significantly changed in control group (all P ＞ 0.05).The results indicate that the contracted services of GPs can improve the effectiveness of hypertension management in community.

Objective:To investigate the clinicopathologic features and diagnostic methods of intraductal papillary(IP)lesions of the breast.Methods:The clinical data of 1 679 patients who had been pathologically diagnosed as having IP were analyzed retrospectively.Results:Nipple discharge is the most common clinical symptom of IP. According to the postoperative pathological results, IP patients were divided into solitary IP group and multiple IP group . Nipple discharge was more common in solitary IP group ( P<0.05). Bloody discharge and duct nipple discharge and discharge in unilateral breast were the most common clinical symptom of IP, though the difference was not significant ( P>0.05). The accuracy of diagnosing IP by fiberoptic ductoscopy(FDS) was 88.66% which was significantly higher than that of breast ultrasound and mammography. Solitary IP patients with nipple discharge undergoing FDS before surgery and lesions were more often detected located in general or level Ⅰ-Ⅱ duct system ( P<0.05). Postoperative follow-up did not show malignant transformation in solitary IP group, while there were 4 cases in the multiple IP group of malignant transformation and higher recurrence rate of IP ( P<0.05). Conclusions:Bloody discharge, single duct nipple discharge and unilateral breast involving 1esion and 1esions located in the general or level Ⅰ-Ⅱ duct system are common clinical features of IP. FDS has advantages in the diagnosis of IP with nipple discharge. For fear of recurrence , and malignant transformation in multiple IP, active postoperative follow-up should be carried out.

BACKGROUND: Transplantation of neural stem cells into inner ear brings hope for treatment of sensorineural deafness, while guinea pig is the preferred animal in developing animal models of aminoglycosides poisoning-induced deafness. Successful animal models have been established after study for several scores of years. How to isolate neural stem cells and label them from hippocampi of guinea pigs is one of the problems to be solved in transplantation of stem cells into inner ear.OBJECTIVE: To isolate and culture neural stem cells from hippocampi of newborn guinea pigs so as to lay basis for transplantation of neural stem cell in the treatment of sensorineural deafness.DESIGN: Single sample observation SETTING: Staff Room of Microbiology and Immunology, Zhengzhou University MATERIALS: This experiment was carried out at the Staff Room of Microbiology and Immunology, Zhengzhou University from March to June 2005. Newbornguinea pigs born within 24 hours of either gender, weighing 50 to 80 g, provided by Experimental Animal Center of Zhengzhou University were used in this experiment.METHODS: Neural stem cells from the hippocampal tissue of newborn guinea pigs were isolated and cultured by serum-free medium containing basic fibroblast growth factor (bFGF) and epidermal growth factor (EGF).Expression of nidogen was detected with immunocytochemical staining.Neural stem cells were labeled by DAPI.MAIN OUTCOME MEASURES: ① In vitro growth of neural stem cells; ② neural stem cells nidogen expression was identified by immunofluorescent staining; ③ labeled stem cells by fluorescence and detected the labeling rate.RESULTS: ①Clone-like cluster of neural stem cells were obtained from hippocampal tissue ② Neural stem cells could express nidogen. ③Labeling rate of DAPI was 93.4% and no attenuation of fluorescence brightness as observed after 8 generations in culture.CONCLUSION: The cells obtained from hippocampal tissues of newborn guinea pigs can be used as donor cells in the treatment of neurosensory deafness by transplanting neural stem cells, for their obvious proliferation ability and high-labeled efficiency with fluorescent dye.

Child ; Humans ; Practice Guidelines as Topic ; Syncope ; diagnosis

Adult ; Cross-Sectional Studies ; Humans ; Male ; Muscle, Skeletal ; injuries ; Musculoskeletal Diseases ; epidemiology ; Occupational Diseases ; epidemiology ; Welding

Objective To establish and clinically evaluate a method to adjust tube current(mA)individually for obtaining images with consistent noise and optimized radiation dose in 64-slice spiral helical CT coronary angiography.Methods (1)80 patients,as a control group,were underwent CT coronary angiography(CTCA)using 64-muhislice spiral helical CT with fixed mA(650 mA).Two radiologists first assessed image quality of the fixed mA group by scoring from 1 to 5.A minimal dose requirement for meeting clinical diagnosis with the desired noise level(standard deviation SD0)were decided.By analyzing the images of the control group,we also established correlation between the image noises of timing bolus(TB)scans and cardiac(CA)scans and set up a formula to predict the required mA value for obtaining the desired cardiac image noise for individual patient.(2)Subsequently,another group of 80 patients(study group)wero scanned with individually adjusted mA using the established formula and the practicability of this method was then evaluated.The independent sample t test was used to compare the values of the two groups.Results (1)The noise of TB and CTCA scans was linearly correlated with r2=0.994. (2)A cardiac image noise level of 28 HU was found to be adequate for clinical diagnostic purpose based on the image quality analysis.(3)The average noise for the acquired cardiac images was found to be 28.97 HU for the study group with individually adapted mA using the established formula.The standard deviation of the image noisein study group was 1.93,which was much smaller than 5.14 in the fixed mA group,but the average image scores for the study group(4.27±0.68)and fixed group mA(4.03 4-0.93)were not statistically different.(4)In the study group,63 out of 80 patients required tube currents below the standard 650 mA,yielding an average CTDIvol of58.32 mGy,which was about 32.1%dose reduction than that of fixed mA(85.94 mGy).The lowest CTDIvol was 19.27 mGy with 160 mA which was 22.4%of the average CTDIvol in control group.Conclusion Adjusting mA individually based on timing bolus scan noise analysis is an accurate and practical method to obtain consistent image quality for different cardiac pailents and to minimize the radiation dose for individuals compared to the fixed mA.

GDP-mannose-3', 5' -epimerase (GME), which converts GDP-mannose into GDP-L-galactose, is essential for the biosynthesis of L-ascorbic acid in higher plants. The molecular characterization of two GME genes from rice has been reported. Firstly,both cDNAs were isolated from the rice mature leaves using RT-PCR technique. By comparing their sequences with homologues from other plants, it was found that GME genes were highly conserved among plant species, though phylogenetic study showed that all known GMEs could be divided into two distinct groups corresponding to monocots and dicots. Secondly, the genomic organization of rice OsGME genes was investigated, and a similarity of splice patterns was revealed. Finally, the expression patterns of the two cDNAs have been studied in various tissues and under different stress conditions by semiquantitative RT-PCR assay. The results showed that the OsGME1 transcript was up-regulated in response to cold stress, and gibberellin might regulate L-ascorbic acid levels by affecting transcription of both OsGME genes.