Objective To analyze the inter-provincial utilization efficiency of health resources and master the differences between these regions so as to rationalize the allocation of such resources.Methods This paper called into play the data envelopment analysis to survey the efficiency of interprovincial health resourcas utilization,and the Malmquist productivity index method for further breakdown of the total factor productivity.Results Years 2003 to 2008 averaged an yearly growth of 6.8% for the total factor productivity of health resources in 31 provinces;the rate of technological progress was positive,while the annual rate averaged 5.2%;a slight growth of technical efficiency at the growth rate of 1.5%.Conclusion Years 2003 to 2008 saw an increase of varying extent in the total factor productivity,yet an insufficient utilization of health technology in the provinces in general.Compared to the efficiency of the central provinces,low efficiency was found in both the eastern and western regions in China.The westem regions made a faster progress in technology utilization,thus narrowing the gap of health resources among the provinces.

The diagnosis and treatment of multiple myeloma (MM) have make remarkable progress, which were reviewed in the 57th American Society of Hematology (ASH) annual meeting. In this annual meeting, the effects of advanced proteasome inhibitor (PI), antibody, checkpoint blockade, immunomodulatory agent (IMiD), histone deacetylase (HDACI) and chimeric antigen receptor T-cell (CAR-T), and new diagnostic technologies were reported. The real point is to apply the best available diagnosis and therapy at this meeting. At present, regardless of advances, all of randomized clinical trials push to combined agents, and combined with hematopoietic stem cell transplantation, efficacy will be improved in further. So some professors also refered to 2015 year as 'the advance year of MM'.

BACKGROUND: Mature brain contains neural stem cells. It is very important that how to directionally induce the differentiation of neural stem cells into a specific neuron, substitute for damaged neurons, in effective treatment of nervous system disease.OBJECTIVE: To study the role of vascular endothelial growth factor in the proliferation and differentiation of neural stem cells in vivo.Neurobiology, Xiangya School of Medicine, Central South University from June 2007 to June 2008.MATERIALS: A total of 24 healthy male Sprague Dawley rats were randomly assigned to model control, an'dbody treatment and sham operation groups.METHODS: Rat models of hippocampal fimbria and fomix transsection were established in the model control and antibody treatment groups. Rats in the sham operation only received digging skull operation. Immediately following model induction, rats in the antibody treatment group were subjected to 4 μL anti-vascular endothelial growth factor antibody. The needle was inserted at anterior fontanelle+0.6 mm, lateral side+0.6 mm and ventral side-5.5 mm at the affected side. Rats in the model control and sham operation groups were subjected to an equal volume of saline.MAIN OUTCOME MEASURES: The expression of vascular endothelial growth factor, Nestin and proliferating cell nuclear antigen was observed using immunohistochemical method. Proliferating cell nuclear antigen index was calculated.RESULTS: Compared with the sham operation group, the expression of vascular endothelial growth factor and Nastin was significantly increased at the septal area following hippocampal fimbria and fornix transsection in the model control group (P < 0.01). Compared with the model control group, Nestin expression was significantly decreased in the antibody treatment group (P< 0.01). The proliferating cell nuclear antigen diffusely expressed in neuronal cytoplasm in the sham operation group, with the presence of non-specific staining, and the proliferation index was nearly 0. A little proliferating cell nuclear antigen was found in the model control group, with a proliferating index of 1%. Following antibody treatment, the proliferating index was decreased to 0.CONCLUSION: Following septal area damage, the increased expression of vascular endothelial growth factor induces the occurrence of neural stem cells. High expression of vascular endothelial growth factor may be the promoting factor of occurrence and differentiation of neural stem cells, and the basis of self-repair following bran damage.

Objective To study the ameliorative effect on postinfarction heart failure of Ad_5-HGF (adenovirus-mediated human hepatocyte growth factor) in swine models. Methods Totally 12 young swine were randomly divided into 2 groups which were: Ad_5-HGF group (treatment group) and null- Ad_5 group (control group). At four weeks and seven weeks after left anterior descending coronary artery ligation in swine hearts, coronary angiography and Gate cardiac perfusion imaging were performed to evaluate the degree of collateral artery growth (Rentorp), cardiac perfusion, and heart function. The expression of HGF was examined by ELISA. Immunohistochemistry was performed to illustrate the angiogenesis of SMA~+ vessels. Results (1) In comparison with the null- Ad_5 group, high expression of human HGF was observed in the myocardium of the Ad_5-HGF group. (2) The improvement in LVEF was more obvious in the Ad_5-HGF group than the control group in 7 weeks. Cardiac perfusion was significantly improved in the Ad_5-HGF group. (3) In the Ad_5-HGF group, growth of collateral blood vessels and also the number of SMA~+ vessels per mm~2 were significantly greater. Conclusion (1) High expression of human HGF is observed in the myocardium through intracoronary transfection. (2) HGF can improve collateral artery formation and ameliorate heart function. (3) HGF can increase the number of vessels that are coated with SMC.

Objective This study investigated into the relationship between single nucleotide polymorphisms(SNPs)of thrombospondin-1 gene(TSP-1)and acute coronary syndrome(ACS).Methods From Nov.2003 to Sep.2005,fragment of exon thirteen in TSP-1 gene from 323 cases of ACS and 273 subjects without coronary heart disease were analysed by polymerase chain reaction and restriction fragment length polymorphism,and sequence analysis was done for confirmation in the First Affiliated Hospital of Nanjing Medical University.Results Of the 596 subjects participating in the study,only 6 of the heterozygotes and none of the homozygotes were detected for the 700S allele.The prevalence of the 8831G in the healthy controls was less frequent than those of the west populations(0.4%vs 11%,P

The new approaches were designed to have anti-inflammatory analgetics act concentratively on the surrounding of pathological nerve roots or to inject collagenase directly to the protruding lumbar intervertebral disc for more simple and effective treatment of the low back pain. Method: The approaches to epidural lateral recess via incisura margo lateralis of lamina arcus vertebrae or margo medialis of joint processus artieularis were supposed and applied in clinic after study of anatomy and analysis of lumbar vertebra X-ray and CT photographes. The safety and feasibility of the approaches were evaluated according to the test of block region, measurement of therapeutic effect and monitoring of CT during the whole procedures in some cases. Result: A total of 170 cases via the incisura margo lateralis of lamina areus vertebrae were tested, 168 cases turned out to be successful and 2 cases failing. Another 15 cases via margo medialis of joint proeessus articularis, all punctures were successful. Conclusion: The approaches can lead to epidural lateral recess precisely to obtain a better treatment. When the technique is applied to discolysis, no X-ray machine will be needed and therefore no injury of X-ray occurs to both doctors and patients.

Objective The research was to achieve Shanghai resident satisfaction of primary health service after new health reform.Methods During self-compiled questionnaire survey,the research adapted stratified random sampling to select 9 community health centers in Shanghai urban,rural and suburb areas.Results Shanghai resident satisfaction rate of new health reform was 85.2％.Satisfaction rate of basic medical security system was 85.0％.Satisfaction rate of basic medical service was 96.5％.Satisfaction rate of basic public health service was 95.1％.Age,region,job,education and income were main factors to satisfaction of primary health service.Conclusion From an overall point of view,Shanghai resident satisfaction of primary health service after new health reform was high.However,the level of basic medical security and convenience of reimbursement were not high.Medical expenses of primary health care institution had not been effectively controlled.Basic medicine could not fully meet the medication needs of primary health care institutions.

OJECTIVE To investigate the preventive effect of Fengliao extract on ulcerative colitis of mice. METHODS Using the intestinal propulsion rate experiment and senna induced diarrhea model , the intestinal propulsion rate, diarrhea rate and index of diarrhea were observed. Mice were randomly divided into normal group,model group,mesalazine hydrochloride group and Fengliao extract 11.7, 23.4 and 46.8 g · kg-1 group. The mouse colitis model was induced by 4% dextran sulfate sodium. The mice were administraed once daily for 7 d while the disease activity index(DAI)score was calculated and the activity of tumor necrosis factor α(TNF-α),interleukin-1β(IL-1β), myeloperoxidase(MPO) and content of malondialdehyde(MDA) and nitric monoxide (NO) in colon tissue were determined. RESULTS Fengliao extract 46.8 g · kg-1 inhibited the intestinal propulsion rate(P<0.05),reduced the frequency of diarrhea and the diarrhea index(P<0.05). Results of colitis showed that the body mass of mice in the model group was significantly decreased but the DAI score increased compared with normal group(P<0.05). The activity of MPO and the contents of IL-1β,TNF-α,MDA and NO in colon mucosa were increased(P<0.01). Compared with the model group,Fengliao extract 46.8 g·kg-1 decreased the DAI score(P<0.05)while Fengliao extract 46.8 and 23.4 g · kg-1 reduced MPO activity in colonic mucosa and content of IL-1β,TNF-α,MDA and NO in colonic homogenate(P<0.05). CONCLUSION Fengliao extract can significantly improve the DSS induced colitis in mice,which is probably associated with its antispasmodic and anti-diarrheal effect as well as the reduced release of inflammatory mediators and antioxidants.

Objective To verify the reliability of TLD-based quality audit for radiotherapy dosimetry of medical electron accelerator in non-reference condition by monitoring the dose variations from electron beams with different field sizes and 45° wedge and the dose variations from photon beams with different field sizes and source-skin distance.Methods Both TLDs and finger ionization chambers were placed at a depth of 10 cm in water to measure the absorbed dose from photon beams,and also placed at the depth of maximum dose from electron beams under non-reference condition.TLDs were then mailed to National Institute for Radiological Protection,China CDC for further measurement.Results Among the 70 measuring points for photon beams,58 points showed the results with a relative error less than ± 7.0％ (IAEA's acceptable deviation:± 7.0％) between TLDs and finger ionization chambers measurements,and the percentage of qualified point numbers was 82.8％.After corrected by P,value,62 points were qualified and the percentage was up to 88.6％.All of the measuring points for electron beams,with the total number of 24,presented a relative error within ± 5.0％ (IAEA's acceptable deviation:± 5.0％) between TLDs and finger ioization cylindrical chambers measurements.Conclusions TLD-based quality audit is convenient for determining radiotherapy dosimetric parameters of electron beams in non-reference condition and can improve the accuracy of the measuring parameters in connection with finger chambers.For electron beams of 5 MeV ＜ E0 ＜ 10 MeV,the absorbed dose parameters measured by finger ionization chambers,combined with TLD audit,can help obtain the precise and reliable results.

OBJECTIVE:To systematically review the effects of long-term oral low-dose of azithromycin on pulmonary func-tion and clinical signs of patients with stable COPD. METHODS:Retrieved from PubMed,Medline,CJFD,VIP and Wanfang da-tabase,randomized controlled trials(RCTs)about long-term oral low-doses of azithromycin for stable COPD were collected. After quality evaluation according to modified Jadad scale,Meta-analysis was conducted by Rev Man 5.2 statistical software. RESULTS:A total of 13 RCTs were included,involving 1207 patients. Meta-analysis showed that,long-term oral low-doses of azithromycin could significantly improve FEV1[SMD=0.78,95%CI(0.62,0.93),P<0.001],FEV1%[SMD=0.81,95%CI(0.61,1.00),P<0.001],FEV1/FVC [SMD=3.91,95%CI(2.58,5.24),P<0.001] and 6MWD[SMD=23.74,95%CI(21.20,26.18),P<0.001] in sta-ble COPD patients,meanwhile significantly reduce dyspnea score [SMD=-1.15,95%CI(-1.60,-0.71),P<0.001],quality of life score [SMD=-1.82,95%CI(-2.74,-0.90),P<0.001] and 24 h sputum volume[SMD=-18.68,95%CI(-24.79,-12.56), P<0.001],with statistical significance. CONCLUSIONS:Long-term oral low-doses of azithromycin can improve pulmonary func-tion,dyspnea,activity tolerance and quality of life in acute exacerbation of COPD patients.