The cultivation of medical and health personnel in the rural areas is currently confronted with severe challenges: very few graduating students go and work in the poverty-stricken or mountainous areas and there is a shortage of rural medical and health personnel. An effective mechanism for solving the problem in a short time has been the establishment of medical and health personnel training centers that recruit students specifically from the mountainous and poverty-stricken areas and assign them back there upon graduation. It has promoted the development of unique curriculums designed specifically for the training of personnel specializing in clinical medicine from rural grassroots. The establishment of long-term mechanisms that ensure the support of the development of the rural medical and health cause by urban medical and health human resources strongly guarantees the development of rural in-service education and non-academic training.

BACKGROUND:It is necessary to dynamicaly monitor the survival, recognition and migration of neural stem cels after implantation.
OBJECTIVE:Toin vitro label fetal rat neural stem cels using MRI technology so as to provide applied evidence of neural stem cels in nervous system repair.
METHODS:Fetal rat neural stem cels were isolated, cultured and labeled folowed by identification and cel viability detection. A rat model of cerebral ischemia-reperfusion injury was established. Fetal neural stem cels labeled by superparamagnetic iron oxide particlesin vitro were transplanted into the left brain of model rats, and unlabeled fetal rat neural stem cels transplanted into the right brain. Prussian blue staining was used to observe the colonization and migration of implanted neural stem cels. MRI tracing was employed to monitor the signal changes of neural stem cels dynamicaly afterin vivo transplantation.
RESULTS AND CONCLUSION:Over 95% fetal rat neural stem cels were labeled successfuly by superparamagnetic iron oxide particles, and under electron microscope, there were iron particles in labeled neural stem cels, which were concentrated in the lysosome and endosome. MRI results showed that the labeled neural stem cels had a changing trend of low signals. No difference was found in the cel viability between labeled and unlabeled cels, but T2WI and T2*WI signals were reduced in labeled neural stem cels. These findings confirm that superparamagnetic iron oxide-labeled fetal rat neural stem cels can highly express, and MRI tracing can be used forin vivo monitoring of neural stem cels.

After the indexes of article count, fraction count, weighted fraction count, and domestic and interna-tional collaboration ratio were calculated using the 2014 nature index of life science issued by British Nature Pub-lishing Group as the data source, the 2014 scientific research outputs in life science of some domestic colleges and universities were analyzed with certain suggestions put forward for reducing the gap in scientific research strength between China and USA.

[Objective]To report the results of treatment of enchondroma of the hand with curettage and porous bioceramic bone grafting. [Methods]Fifteen patients with digital enchondroma were reviewed.The average follow-up period was 30 months.The final function and radiographic appearance of the surgically treated digits were analyzed.[Results]At final evaluation the bony incorporation was uneventful in all patients.The mean functional Muskuloskeletal Tumor Society Score was 29.Radiographs showed apparent partial absorption of bioceramic bone in only two patients.All digits achieved full range of motion after surgery.No complication was found.[Conclusion]Porous bioceramic bone is safe and effective as a bone-filling substance after curettage of enchondroma of the hand.

The theory of multiple streams,a vehicle of public policy analysis in the West,was used to analyze the policy development at Beijing′s suburban village clinics.This approach can clarify the issue steams,policy streams,and political streams,as well as the links between them,as a reference for standardized and quickened development such clinics.

Objective To investigate the dynamic variation of subsets of myeloid derived suppressor cells (MDSC) and their ratio in septic mice, and to discuss their role in the development of sepsis. Methods Male C57BL/6 mice were randomly divided into sepsis model group and sham group according to random number table. Polymicrobial sepsis was induced by using cecal ligation and puncture (CLP), while mice in sham group only underwent laparotomy and laparorrhaphy without CLP. Thirty mice in each group were used to observe living condition, and the 20-day survival rate was compared between the two groups. In addition, subsets of MDSC in peripheral blood, spleen and bone marrow were analyzed with flow cytometry for other 60 mice (12 mice at each time point, as 0, 3, 7, 12 and 20 days). Spleens were harvested at 7 days for weighing, and single cell suspension of spleen tissue was prepared for splenocyte counting. Histopathologic changes in spleen tissue and liver tissue were observed under light microscope after hematoxylin and eosin (HE) stain. Results ① No mice died in sham group within 20 days after the operation. On the other hand, 10 mice in model group died within 20 days, and the difference in survival rate between the two groups was statistically significant (100.0% vs. 66.7%, χ2 = 11.861, P = 0.001). ② The spleens in model group showed obvious enlargement and significantly outweighed as compared with those in sham group (mg: 413.33±41.63 vs. 111.67±17.56, t = 11.564, P = 0.000), and the total count of splenocytes was significantly higher than that in sham group (×109/L: 21.20±2.43 vs. 1.87±0.06, t = 13.578, P = 0.005). ③ Pathological sections with HE staining showed that the liver tissue and spleen tissue remained normal in sham group. In model group, the hepatic tissue showed acute inflammatory reaction, including tissue disruption, capillary congestion, infiltration of neutrophils, marked edema of hepatocytes and focal hepatocellular necrosis. Abnormalities were also found in the spleen tissue: the red pulp and white pulp were disordered, splenic sinus was congested with numerous red cells, the splenic capsule thickened, immature myeloid cells with circular nuclei proliferated in the subcapsular region and perivascular region, splenic cord and splenic sinus were infiltrated with a large number of hematopoietic cells. ④ No significant changes in the monocytic MDSC (M-MDSC) and granulocytic MDSC (G-MDSC), and their ratio were found in peripheral blood, spleen and bone marrow at every time point in sham group. On the other hand, in model group, the ratio of M-MDSC and G-MDSC was continuously increased in peripheral blood, spleen and bone marrow, and M-MDSC only slightly decreased at 20 days. On the other hand, the ratio of M-MDSC/G-MDSC rose at first followed by a decrease. The ratio of M-MDSC/G-MDSC in peripheral blood was higher than 1 from 3 days after the operation, reaching the peak at 12 days (compared with 0 day: 4.16±0.53 vs. 0.79±0.11, P < 0.05), while the ratio of M-MDSC/G-MDSC in spleen and bone marrow after CLP were lower than 1 at all time points, reaching the peak on 7 days after the operation (compared with 0 day: 0.70±0.06 vs. 0.25±0.02 in spleen, 0.39±0.06 vs. 0.11±0.01 in bone marrow, both P < 0.05), and then gradually decreased afterwards. Conclusion Subgroups of MDSCs were continuously aggregated in the peripheral blood, spleen and bone marrow, and their ratio rose first and decreased afterwards along with the development of sepsis, and the changes may reflect the change of immune status at different stages of sepsis.

Objective To probe into the current services and outcomes of township hospitals following their transformation, and their future positioning of functionality. Methods Pinpointing townships A, B and C as samples from a district in Beijing, in which field surveys were made in the township hospitals to learn their services, service provision methods and outcomes. Results Among the current services provided by these three hospitals, those of public health and primary healthcare nature in hospital A account for 50% each; those in hospital B account for 70% and 30% respectively; those in hospital C account for 60% and 40% respectively. Recommendable services provided in these hospitals include universal coverage of medical files, management of infectious diseases, public health emergency management, and immunization. Conclusion Township hospitals as the center of the 3-tier rural health service network, deserve a repositioning of their functionality to fit the health needs of residents at large.

It is shown by the typical investigation on the status of doctor-patient relationship in ten cities of China that the government should shoulder heavy responsibilities in the establishment of harmony doctor-patient relationship.On the basis of this investigation,this article reviews the governmental measure in health management and policy,analyzes the factors of governmental responsibility and presents some proposal of it.

10.3969/j.issn.2095-4344.2013.26.014