Social capital has become an important service provider of medical and health undertakings in China.Its active participation in health management industry services promotes the overall development of China's health industry.The paper discusses the four important roles of social capital in health management industry,and puts forward four development strategies,including the transformation to the high-end health management services,and undertaking basic health management services and public and private health management of the joint venture and the development of specialized health management service.

As an important basic industry group of health industry,health management provided beneficial development environment for health management industry,which had important significance on improving the development of the whole health industry.It analyzed the development trend of domestic and foreign health management industry and the current problems of the health management industry development in China.The development strategies of health management industry in China were discussed from guarantee mechanism,system construction,new mood development,improving the elements,health and culture training,payment mechanism innovation and exploring the characteristics.

OBJECTIVETo investigate clinical curative effects of gluteal muscle contracture release combined with insertion of gluteus maximus tendo-chilles lengthening with Z-shaped in treating severe gluteal muscles contracture.

METHODSFrom 2006 May to 2011 May, 20 patients (35 sides) with severe gluteal muscle contracture were collected, including 12 males and 8 females, aged from 8 to 34 years old with an average of 13 years old; the courses of disease ranged from 3 to 21 years. All patients manifested abnormal gait at different degree, knees close together cannot squat,positive syndrome of Ober, positive test of alice leg. Gluteus contracture fascia release were performed firstly in operation, then insertion of tendo-chilles lengthening with Z-shaped were carried out. Preoperative and postoperative gait, and knee flexion hip extensor squat test, cross leg test, adduction and internal rotary activity of hip joint, stretch strength and motor ability after hip abduction were observed and compared.

RESULTSTwenty patients were followed up for 1 to 5 years. Gluteus maximus were released thoroughly, and snapping hip was disappeared, Ober syndrome were negative. There was significant differences in knee flexion hip extensor squat test, adduction and internal rotary activity of hip joint,stretch before and after operation (P<0.01). Gluteus muscle strength was protected,stretch strength and motor ability of hip joint were recovered well. Among them,31 cases got excellent results and 4 good.

CONCLUSIONFor severe gluteal muscles contracture,insertion of gluteus maximus tendo-chilles lengthening with Z-shaped performed after gluteus contracture fascia release could release gluteal muscle contracture to the greatest extent and obtain postoperative curative effect without resection of normal hip muscle fibers and destroy joint capsule.

Adolescent ; Adult ; Buttocks ; surgery ; Child ; Contracture ; surgery ; Female ; Hip ; surgery ; Humans ; Male ; Muscle, Skeletal ; surgery ; Thigh ; surgery ; Young Adult

Objective To analyze the treatment-delay situation of tuberculosis(TB) patients and its influencing factors in ethnic minority areas to provide reference basis for formulating the effective prevention and control measures.Methods The medical records data in 1166 cases of pulmonary TB in Jinping county during 2010-2014 were collected from national TB information management system,their treatment-delay related situation was analyzed and its influencing factors were also analyzed by adopting the Logistic regression model.Results Among 1 166 cases of pulmonary TB reported by Jinping County during 2010-2014,568 cases were treatment-delay,the treatment-delay rate was 48.71％ (568/1 066),the treatment-delay time ≥30 d accounted for 67.25 (382/568),which ≥183 d(half a year) accounted for 6.51％ (37/568),which ≥365 d accounted for 2.64％ (15/568),and the maximal treatment-delay time reached 7 years(2 549 d);the multivariate Logistic regression analysis results showed that compared with non-peasants,sputum smear negative,non-critical patients,peasants(OR=1.867,95％ CI:1.300-2.700),sputum positive(OR=1.631,95 ％ CI:1.200-2.100),critical patients(OR =0.684,95 ％ CI:0.500-0.900) were the risk factors for the treatment-delay in the pulmonary TB patients in ethnic minority areas.Conclusion The treatment-delay of pulmonary TB patients in ethnic minority areas has no relation with the nationality difference,patient's peasant occupation,sputum smear positive and whether severe case are the influencing factors of treatment-delay in pulmonary TB patients.

Objective To explore the value of serum HBsAg quantification in prediction of interferon treatment of HBeAg-positive chronic hepatitis B (CHB). Methods 75 patients with HBeAg-positive CHB received peginterferon alfa-2a (PegIFNα-2a) at a dose of 180 μg weekly for 48 weeks with 24 weeks of a pose-treatment follow-up. Serum HBsAg quantification and level of HBV DNA were measured during the treatment and the pose-treatment follow-up. Results In the post-treatment follow-up , the patients were divided into sustained response (SR) group, relapse group, and non-response group. Serum level of HBV DNA did not differ significantly between SR group and relapse group , but was lower than that in non-response group. However , there was no significant difference in HBsAg quantification between relapse group and non-response group , but the level of quantification was higher in both group than in SR group. Serum HBsAg declined more than 1 log10 IU/mL at week 12 , with sensitivity , specificity , and positive and negative predictive value of 86%, 94%, 95%and 94%. The accuracy of the cut-off with a 1 log10 IU/mL decrease in HBsAg level at week 12 of PegIFNα-2a therapy to predict SVR was assessed using receiver operating characteristic curve , and the area under the curve was 0.952. Conclusion The change in serum HBV DNA level could not predict SR effectively, but serum HBsAg quantification is an ideal parameter for predicting the efficacy of interferon therapy.

AlM: To explore the expression and significance of cysteine- rich 61 ( CCN1/Cyr61 ) in oxygen - induced retinal neovascularization ( RNV) of mice and study the inhibition effect of CCN1 specific siRNA on RNV.
METHODS:Two hundred healthy C57BL/6J mice were chosen and randomly divided into control group, hyperxia group, hyperxia control group and CCN1 treated group, with 50 mice in each group. The hyperxia control group was treated with vector plasmids by intravitreal injection. The CCN1 treated group received CCN1 siRNA recombinant plasmids by intravitreal injection. Adenosine diphosphate-ase ( ADPase) stained retina flat-mounts was performed to assess the retinal vascular profiles, HE staining was applied to count the number of vascular endothelial cell nuclei breaking through the internal limiting membrane, protein and mRNA level expression of CCN1 were measured by immunohistochemistry, Western blot and RT-PCR.
RESULTS: There were large nonperfusion area and a large number of vascular endothelial cell nuclei breaking through the internal limiting membrane ( 25. 25 ± 1. 26;23. 12 ± 1. 16 ) in the hyperxia group and the hyperxia control group. Regions of nonperfusion and vascular endothelial cell nuclei (8. 47±1. 15) were decreased in the CCN1 treated group compared to the hyperxia group and the hyperxia control group. Compared with the control group, there were high protein and mRNA expression of CCN1 in the hyperxia group and the hyperxia control group. The expression of CCN1 protein and mRNA were decreased in the CCN1 treated group compared with the hyperxia group and hyperxia control group (all P<0. 05).
CONCLUSlON: The abnormal expression of CCN1 has close relation with RNV. The development of RNV can be markedly inhibited by RNA interference targeting CCN1, which, we believe, will provide new molecular targets and a rationale for clinical developing new strategy for ROP therapy.

Objective To investigate the effect of cefuroxime axetil on vaginal microecological balance in mice.Methods Twenty specific pathogen free (SPF)female mice were randomly divided into experimental group A and B and control group C and D with 5 mice in each group.Mice in experimental groups A and B were given dissolved cefuroxime axetil by gavage for 5 days,mice in the control groups C and D were given 0.9% saline instead.Vaginal secretions from experiment group A and the control group C were collected on d1 after drug withdrawal,and from experiment group B and control group D were collected on d5 after drug withdrawal.The vaginal pH,Lactobacillus,Enterobacter,Staphylococcus and Streptococcus colony forming units (CFU)were measured,and the ultrastructure of Lactobacillus was observed with scanning electron microscope (SEM).The density and diversity of vaginal flora were determined.t test and Z test were used to analyze data.Results Compared to control group C,vaginal pH was increased in experimental group A on d1 (t =2.675,P <0.05 ),and CFU of Lactobacillus,Enterobacter,Staphylococcus and Streptococcus decreased significantly (t =-2.741 , -1 3.501 , -3.077 and -2.598,all P <0.05 );compared to control group D,vaginal pH in experimental group B was increased on d5 (t =4.797,P <0.05),and CFU of Lactobacillus,Enterobacter,Staphylococcus and Streptococcus decreased significantly (t =-3.737,-6.81 6, -1 6.079 and -3.580,all P <0.05 ).The morphology of Lactobacillus showed wrinkled,broken cell wall and cell debris in experiment groups A and B under the electron microscope.The density and diversity of vaginal florain experimental groups A and B were decreased compared to those in control groups C and D (Z = -2.437 and -2.297,both P <0.05 ).Conclusion Broad-spectrum antibiotics cefuroxime axetil can increase vaginal pH, destroy the cell wall of dominant bacterial Lactobacillus,and reduce vaginal flora diversity and density,resulting in disturbance of vaginal micro-ecologicalbalance.

Catheter Ablation ; methods ; Child ; Epicardial Mapping ; Female ; Heart Aneurysm ; complications ; surgery ; Humans ; Tachycardia, Ventricular ; complications ; surgery

Objective To investigate the changes of IL-6, IL-10 and TNF-αafter cholecystectomy.Methods 46 cases with cholecystolithiasis were selected and divided into 2 groups.23 in control group were treated with open cholecystectomy, experimental group were treated with laparoscopic cholecystectomy.The levels of IL-6, TNF-α, IL-10 and CD4 +/CD8 +T were compared in the two groups pre-and post-treatment.ResuIts Compared with pre-treatment, two groups of patients with IL-10, TNF-α, IL-6 and CD4 +T and CD4 +/CD8 +T increased (P<0.05), compared with control group, experimental group IL-10, TNF-α, IL-6, CD4 +/CD8 +T levels were higher (P<0.05).ConcIusion Laparoscopic cholecystectomy can significantly reduce the IL-6, TNF-αand IL-10 levels, reduce the body′s stress response to surgery, and reduce blood flow, shorten the operation time.

Objective: To evaluate the potential dose influence to organs at risk (OARs) and targets of adaptive radiotherapy (ART) for non-small cell lung cancer (NSCLC). Methods:Twice positional CT images of 12 patients with locally advanced NSCLC were captured during radio-(n=3) or radio-chemotherapy (n=9) for ART simulation. The twice positional scanningplan was fused using MIM software. The variation of irradiation doses for the lung, heart, and spinal cord was evaluated, and the prescription doses for the targets were escalated. Results:Adaptive radiation enabled dose reduction by an average of 3.53%for lung V20 and by 2.55%for V30. The mean dose for the lung decreased by 2.11 Gy. The dose was reduced by an average of 4.17%for heart V30 and by 3.37%for V40. Meanwhile, the maximum dose for the spinal cord was reduced by 3.52 Gy on average. Lung sparing with ART enabled an iso-mean lung dose escalation of the Planning gross tumor target volume dose, which improved by an average of 1.25 Gy. Conclusion:The adap-tation of radiotherapy for continuous tumor shrinkage during the treatment course for NSCLC reduces doses to OARs, enables signifi-cant dose escalation, and has the potential to increase local control.