Objective:To analyze the mechanism on integration of health care services at the county and town-ship level from the perspective of stakeholder theory. Methods: The stakeholder interest demand was determined by word frequency analysis of interview data from stakeholders in the three regions of Qianjiang, Huangpi, and Zhen-jiang;the degree of attention and gains and losses of stakeholders towards various demands was investigated from the three regions through interest demand questionnaires;the impact of demand benefits on behavioral responses has been evaluated through comprehensive evaluation theory and game theory. Results:Regional integration policies reflect the interest demands of stakeholders in varying degrees; the higher were the scores of demand benefits in interest de-mands questionnaires, the stronger was the willingness of stakeholders to coordinate integration policies. Conclusion:The policies of integration of health care services in rural China should consider all stakeholder interest demands;the better the interest demands of the stakeholders are satisfied, the stronger their motivation for integration reform will be, which may affect the implementation effects of local integration reforms to some extent.

Adult ; Aged ; Cartilage Diseases ; diagnosis ; therapy ; Humans ; Laryngeal Cartilages ; Laryngeal Diseases ; diagnosis ; therapy ; Male ; Middle Aged

Objective To evaluate the effect of hydrogen-rich saline on the expression of phosphor-p38 mitogen-activated protein kinase (p-p38MAPK) during cerebral ischemia-reperfusion (I/R) in rats.Methods Seventy-two adult male Sprague-Dawley rats,weighing 220-250 g,were randomly divided into 3 groups (n =20 each) using a random number table:sham operation group (group S),I/R group and hydrogen-rich saline group (group I/RH).Cerebral ischemia was induced in chloral hydrate-anesthetized rats by 2 h middle cerebral artery occlusion in I/R and I/RH groups.The artery was only exposed but not occluded in group S.At 3 days before operation and immediately after onset of reperfusion,hydrogen-rich saline (0.6 mmol/L) 10 ml/kg was intraperitoneally injected in group I/RH,while the equal volume of normal saline was given in S and I/R groups.Neurological deficits were blindly assessed and scored at the end of 24 h reperfusion.The animals were then sacrificed,and brains were removed for microscopic examination and for determination of the cerebral infarct size (by TTC),brain water content,cell apoptosis (by TUNEL),and expression of p38MAPk and phosphor-p38MAPK (p-p38MAPK) (by immunohistochemistry and Western blot).Apoptosis index was calculated.Results Compared with group S,neurological deficit score,apoptosis index,brain water content and cerebral infarct size were significantly increased,and the expression of p38MAPK and p-p38MAPK was up-regulated in I/R and I/RH groups.Compared with group I/R,neurological deficit score,apoptosis index,brain water content and cerebral infarct size were significantly decreased,and the expression of p38MAPK and p-p38MAPK was down-regulated in group I/RH.The pathological changes of cerebral tissues were significantly attenuated in group I/RH as compared with group I/R.Conclusion Hydrogen-rich saline can reduce cell apoptosis through inhibiting p-p38MAPK expression,thus attenuating cerebral I/R injury in rats.

Objective To explore the expression of PRR11(Proline-rich protein 11) in human osteosarcoma and investigate the effect of PRR11 on the proliferation of human osteosarcoma cells.Methods Immunohistochemical staining was applied to detect the PRR11 expression in 75 cases of osteosarcoma and corresponding normal tissues.Western blotting was used to examine PRR11 protein expression levels in osteosarcoma cell lines.We used siRNA to knock down the expression of PRR11 and tested the effects of PRR11 down-regulation on the proliferation in SaOS2 cells.Results PRR11 was overexpressed in osteosarcoma specimens compared to their paired normal tissues,the over expression rate of PRR11 in osteosarcoma and corresponding paracancerous tissues were 76％(57/75) and 9.33％(7/75) with statistical difference(P<0.05).The high expression of PRR11 was correlated with tumor pathological grade and lymphatic metastasis(P<0.05).PRR11 was expressed in 4 osteosarcoma cell lines which were SaOS2,143B,U2OS and MG63 respectively,the expression was highest in SaOS2 cells.Silencing PRR11 inhibited cell growth as compared with control cells(P<0.05).Conclusion PRR11 is overexpression in human osteosarcoma and promotes its progression by enhancing proliferation.The increased expression of PRR11 in osteosarcoma is a new target for treatment and early diagnosis of human osteosarcoma patients.

Objective To evaluate the effect of hydrogen on the activation of caspase-3 in brain tissues during cerebral ischemia-reperfusion (I/R) in rats.Methods Thirty-six healthy adult male Sprague-Dawley rats,weighing 220-250 g,were divided into 3 groups (n=12 each) using a random number table:sham operation (group S),I/R group and hydrogen group (group H).Cerebral ischemia was induced by occlusion of the middle cerebral artery followed by reperfusion in I/R and H groups.In group H,hydrogen-rich saline 5 ml/kg (0.6 mmol/L) was injected intraperitoneally at 3 days before establishment of the model and immediately after the onset of reperfusion.At 24 h of reperfusion,the rats were sacrificed,and hippocampal tissues were obtained for determination of neuroapoptosis (by TUNEL),apoptotic neuron count and expression of activated caspase-3 (by Western blot).The brain tissues in the ischemic area were obtained and stained with haematoxylin and eosin for examination of the pathological changes.Results Compared with group S,the expression of activated caspase-3 was significantly up-regulated,and the apoptotic neuron count was increased in I/R and H groups (P<0.05).Compared with group I/R,the expression of activated caspase-3 was significantly down-regulated,the apoptotic neuron count was decreased (P<0.05),and the pathological changes of brain tissues were significantly reduced in group H.Conclusion The mechanism by which hydrogen inhibits neuroapoptosis during cerebral I/R is probably related to inhibited activation of caspase-3 in brain tissues of rats.

Surgical resection of liver diseases such as liver cancer,traumatic hepatic rupture,it was often faced with ischemia-reperfusion injury of the residual liver,which significantly increased the risk of surgical treatment and impact the postoperative recovery of patients.Autophagy was a way of programmed cell death after hepatic ischemia reperfusion.When researching hepatic ischemia-reperfusion injury simulated by animal experiments,it ofen detected the level change of autophagy marker molecular LC3-Ⅱ representing the activity of cell autophagy.Now the authors write the research progress of LC3-Ⅱ in hepatic ischemia-reperfusion injury.

Objective　To investigate the validity of the Chinese version of the Symptom Check-List-90 (the SCL-90) in Chinese population. Methods　A total of 624 normal person and 268 out patients were examined with the SCL-90. Results　（1）The internal consistency of the original subscales was found to be good and Cronbach's coefficient alpha ranged from 0.78 to 0.90; （2）Discrimination function analysis based on the 9 original subscales showed that the power of the SCL-90 in discriminating the patients and the community was good with a corrective rate of 80.6%; （3）Factor analysis on the items of the questionnaire yielded a very strong un-rotated first factor which could represent other factors; （4）High inter-correlations were found between the 9 original subscales of the SCL-90 with a correlation coefficient ranging from 0.39 to 0.79. Conclusion　(1) The SCL-90 is acceptable as a research setting and psychiatric screening inventory; (2) The SCL-90 does not have potential as an inventory to distinguish different diagnostic groups; (3) The SCL-90 is not a multidimensional inventory.

Objective To discuss the surgical outcome and operative technique of the modified trans-petrosal presigmoid approach in treating cases with facial nerve palsy after petral bone fracture trea- ted with facial nerve canal decompression method.Methods A total of 15 cases with facial nerve pal- sy were treated with traumatic facial nerve canal decompression technique with the trans-petrosal presig- mold approach combined with high-dose hormone therapy,whereas 12 cases were treated with traditional Chinese medicine.The clinical data were analysed and compared retrospectively according to House- Brackmann facial nerve grading scale.Results At acute stage,eight(53.3%)out of 15 cases recov- ered to levelⅠ(P＜0.05),with no significant postoperative complications such as CSF leakage. Conclusions This approach is simple and safe and can expose extensively the facial nerve bone canal and effectively alleviate the edemous facial nerve aided by high-dose hormone therapy.Therefore,it is suitable for surgical treatment of acute facial nerve palsy after petral bone fractures.

OBJECTIVE: To study the percentages of polymorphonuclear leukocytes (PMN), mononuclear cells (MNC) and fibroblastic cells (FBC) in different post-traumatic intervals after skeletal muscle mechanical injury in rats. METHODS: The rat model of skeletal muscle mechanical injury was established. The rats were divided into injured groups (6 h, 12 h, 1 d, 3 d, 7 d, 10 d and 14 d after injury) and control group. The percentages of PMN, MNC and FBC in different post-traumatic intervals after skeletal muscle mechanical injury were assessed with HE staining and image analysis. RESULTS: At post-injury 6-12h, the percentages of PMN and MNC infiltration appeared in injured sites and that of PMN reached peak. At 1 d, the percentage of MNC infiltration appeared and reached peak, while that of PMN decreased. At 3-7 d, the percentage of FBC gradually increased, while that of PMN and MNC decreased. At 10-14d, the percentage of FBC reached peak. CONCLUSION The percentages of PMN, MNC and FBC in injured zones showed time-dependent changes, which might be used as reference index for determination of age of skeletal muscle injury.
Animals ; Fibroblasts ; Muscle, Skeletal/injuries* ; Neutrophils ; Rats ; Time Factors

This study aims to investigate the genetic characteristics of hemagglutinin in wild-type measles viruses in Henan Province, China and to provide a basis for measles control and elimination. Specimens were collected from suspected measles cases in Henan during 2008-2012. Cell culture was performed for virus isolation, and RT-PCR was used to amplify hemagglutinin gene. The PCR products were sequenced and analyzed, including construction of phylogenetic tree and analysis of the distance between the isolated virus and the reference virus; then, the variations in predicted amino acids were analyzed. The results showed that 12 measles viruses were isolated in Henan Province and identified as H1a genotype; the nucleotide and amino acid homologies were 98.0%-100% and 97.2%-99.8%, respectively. One glycosylation site changed in all the 12 sequences because of the amino acid mutation from serine to asparagine at the 240th site, as compared with Edmonston-wt. USA/54/A. Overall, the wild-type measles virus genotype circulating in Henan Province from 2008 to 2012 was H1a, with high homology between strains; there were some variations in amino acid sequences, resulting in glycosylation site deletion.
China ; Hemagglutinins ; genetics ; Humans ; Measles ; virology ; Measles virus ; classification ; genetics ; isolation & purification ; Molecular Sequence Data ; Phylogeny ; Viral Proteins ; genetics