Fairness, which is of special importance to health economy policies, has the following three major implications: fairness of the state of health, fairness of the delivery of health services and fairness of health fundraising. Traditional methods for measuring fairness include those of range, Lorentz curve, Jeany coefficient, difference index, and, for measuring unfairness, those of slope index, relative index and comprehensive curve. Recently WHO put forward 3 new fairness indexes and measurement methods, viz. measuring the fairness of residents health via the distribution index of child survival rate and disability adjusted life expectancy; measuring the fairness of the delivery of health services via reactivity; and measuring the fairness of health fundraising via the fairness and reasonableness index for the contributions of funds.

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Objective To analyze the present situation of technical efficiency in TCM hospitals throughout the country, discuss the influencing factors causing inefficiency and propose corresponding suggestions. Methods The technical efficiency in 60 TCM hospitals in the country was analyzed using the stochastic frontier cost model for panel data and the influencing factors causing inefficiency were discussed using the multiple stepwise regression method. Results The average technical inefficiency was 22.59% and inefficiency showed an upward trend as the areas shifted from the eastern through the middle to the western regions. Five factors, including the utility rate of beds and the proportion of health technicians among the entire hospital staff, were statistically significant so far as the effect on the increase of the overall cost was concerned. Conclusion The stochastic frontier cost model for panel data is the best method for evaluating the technical efficiency in TCM hospitals. On the basis of the above analysis, suggestions for strengthening scientific management, improving the utility rate of resources and reducing unnecessary waste are put forward.

Efficiency, one of the key principles of economic assessment in the health service sector, has three implications: technical efficiency, cost efficiency and allocation efficiency. The paper gives an account of the various interpretations of some relevant concepts and different assessment methods. The following methods are frequently used to measure technical efficiency: ratio analysis, CPD, comprehensive index, DEA, etc. Economic efficiency is measured by production function while CEA, CUA and CBA are used to assess cost result. The major indexes for assessing allocation efficiency include the proportion between medical and preventive services, the proportion between basic and non basic medical services and the flow direction of total health expenses.

Fundraising policies on the part of both the supply and the requisitioning parties are currently the major health fundraising policies adopted by various countries in the world. Yet these policies, to a greater or lesser extent, failed to incorporate fairness, thus producing the following effects: apparent unfairness of health, hindrance to the accessibility and availability of health services as a result of unfair distribution of health resources, and additional unfairness brought about by rising medical expenses. In order to perfect health fundraising policies and enhance social fairness, it is imperative for us to attach importance to the delivery of basic medical services and preventive health care; health fundraising policies ought to favor more those weak groups of people, such as the poor and those with low incomes; and various forms of payment in advance should be actively promoted.

Objective To investigate the the molecular mechanism of telmisartan for myocardial remodeling in rats with renovascular hypertention. Methods The renovascular hypertensive myocardial hypertrophy model of rats were established by narrowing the left renal artery.The total of 45 mature male SD rats were divided into sham-operated group(n= 15),model control (n = 15 ) and telmisartan group ( n = 15 ) randomly. The rats in telmisartan group were treated with telmisartan (10 mg?kg-1?d-1 ) while those in the sham-operated and model control were reated with the same amounts of distilled water by intragastrical administration . At 8th week of administration, the myocardial structure and function were detected by ultrasonography.The blood pressure was measured by arterial catheterization and calculating the left ventricular mass index (LVMI) .The level of serum calcium and nerve phosphatase ( CaN) and the expression of β-myosin heavy chain ( β-MHC) mRNA were detected. Results The thickness of left ventricular,ejection fraction[(69.23± 1.09)% vs(73.77± 3.00)%], fractional shortening [(30.21±2.02)% vs(35.29±0.90)%],LVMI[(2.83±0.14) mg?g-1 vs(2.32±0.11) mg?g-1 ] were decreased,and the differences were statistically significant (P<0.05).The level of serum calcium and nerve phosphatase (CaN) and the expression of β-myosin heavy chain (β-MHC) mRNA were decreased in telmisartan treated rats,and the differences were statistically significant (P< 0.05) when compared with the model control group. Conclusion Telmisartan can improve the myocardial hypertrophy of renovascular hypertensive rats,and it may downregulate the expression of β-MHC by inactivating of the start signal CaN and its downstream signal pathway.

Objective:To study the coronal microleakage of flared root canal teeth restored with computer aided design and computer aided manufacturing (CAD/CAM)fiber post and core.Methods:60 extracted human mandibular premolars with single canal were divided into 3 groups randomly(n =20).The roots of the teeth were restored with CAD/CAM glass fiber post and core(group A), prefabricated glass fiber post(group B)and gold alloy dowel-and-core(group C)respectively.The specimens were immersed in India ink for 4 weeks.Subsequently all teeth were demineralized,dehydrated and rendered transparent.Then coronal microleakage was ob-served with stereomicroscope.Nonparametric data were analyzed.After that,All the specimens was demineralized completely in nitric acid,Then the interface between the post,resin cement and canal wall was observed and recorded.Results:The microleakage was found in all the 3 groups,group A and C showed less microleakage than group B(P <0.05).But no difference was detected between group A and C(P >0.05).Microleakage mostly appeared at the interface between post and resin cement in group A and C,while in group B,it appeared between resin cement and the wall of root canal totally.Conclusion:CAD/CAMfiber post and core demonstrates less coronal microleakage than prefabricated glass fiber post.

Objective:To construct bispecific minibody by using anti HBsAg and anti RBC single chain Fv(ScFv).Methods:A “knob” variant T366W was first obtained by replacement of a small amino acid with a larger one in the human IgG1 CH 3 domain.The knob was designed to insert into a “hole” in another CH 3 domain which was created by replacement of three large residues with three smaller residues:T366S:L368A:Y407V.The “knob into hole” mutation:S354C:T366W/Y349C:T366S:L368A:Y407V.Then a disulfide bond was engineered in combination with previously designed “knob” or “hole” CH 3 was connected to anti HBsAg or anti RBC ScFv genes respectively.Then the two genes were combined together to form a bispecific minibody expression vector.The bispecific minibodies were expressed in E.coli.Results:Three different form of anti HBsAg and anti RBC minibody expression vectors were constructed.They contained wild type CH 3,“knob into hole”CH 3 or “knob into hole” plus disulfide bond CH 3 respectively.The results indicated that these three different types of bacterially expressed minibodies had similar HBsAg and RBC binding activities.The second and third type of minibody could cause agglutination of human RBC when HBsAg was present,which demonstrated bispecific function.Conclusion:Engineered interface of CH 3 can promote formation of heterodimers of different antibodies and faciliates the formation of bispecific antibodies(bispecific minibody) in E.coli expression system.

Objective To investigate the expressions of CD133 and p53 in colorectal cancer and their clin-ical significances. Methods The expressions of CD133 and p53 in 74 colorectal cancer patients were detected by the immunohistochemistry method. The relationships of CD133 and p53 with the clinicopathological parameters and prognosis were analyzed. Results The positive expression rates of CD133 and p53 in colorectal cancer tissues were 33.8%and 55.4%,respectively. The expression levels of CD133 and p53 were not related to age,sex,tumor location and histological type ,and but were significantly related to the histological differentiation ,TNM stage and distant metastasis(P<0.05,respectively). The Spearman correlation analysis showed that there was no correlation between the levels of CD133 and p53. Conclusions The high expressions of CD133 and p53 in colorectal cancer tissues were closely related to the histological differentiation and TNM stage. CD133 and p53 could be used as important biomarkers for the evaluation of malignant biological behavior,and the diagnosis and prognosis of colorectal cancer.

Objective To investigate the incidence, diagnosis and treatment of complications after endoscopic retrograde cholangiopancreatography (ERCP), and to explore the ways of prevention. Methods Clinical data of 930 subjects, in which 510 were older than 60, with cholangiopancreatic diseases who underwent ERCP in the past 2 years were retrospectively analyzed. Results Success rate of ERCP was 96.34% (896/930),and the postoperative complication incidence was 7.85% (73/930). Of all the complications, there were 42 cases of acute pancreatitis, among which 1 was accompanied with biliary tract infection, 4 cases of duodenum perforation, 6 delayed hemorrhage, 2 cardiac dilacerations bleeding, and 19 biliary tract infection (5 combined with infectious shock). All subjects with complications were cured except for 2 deaths. Conclusion ERCP is a safe and effective method for elderly patients. However, due to decreased organ functions and other underlying diseases, complications after ERCP in elderly patients are usually difficult to manage. The key factors in prevention of complications after ERCP includes in obedience to indications, improvement in procedure skills, treatment of accompanied diseases before and after ERCP, and active management of complications.