Based on the process and challenges of Universal Health Coverage(UHC) in global,the Association of Southeast Asian Nations(ASEAN) and domestic contexts were exanined.The process of realizing UHC in the international world as a whole and separately as different health system patterns was illustrated as well as the initiatives taken by the United Nation and regional agencies.The overall process,patterns of health systems,channels of health finance and design of institutions under the framework of ASEAN 10+3 UHC Network were reviewed.Opportunities and challenges for UHC in China were discussed.

Objective:To establish two-dimensional electrophoresis profiles with high resolution and reproducibility from immortalized human endocervical cell(H8) and cervical cancer cell(CaSKi),and to identify the differential expressions of cytoplasmic proteins.Methods:H8 cells and CaSKi cells were incubated,the cytoplasmic proteins of H8 cells and CaSKi cells were extracted and seperated by means of immobilized pH gradient-based two-dimensional gel electrophoresis(2-DE).The differential expression proteins were analyzed by using ImageMaster 2D analysis software.Results:We obtained well-resolved,reproducible 2-DE patterns,and 8 notable differential protein spots were defined in 2-DE gels.Conclusion:Cytoplasmic proteins of cervical precancerous lesion and cervical cancer are separated by means of immobilized pH gradient-based two-dimensional gel electrophoresis(2-DE).The expression maps of proteomics in cytoplasmic proteins of H8 and CaSKi are established.There are significant differences in proteome between cytoplasmic proteins of H8 cells and CaSKi cells.These data may be valuable for differential proteomics research of cervical precancerous lesion and cervical cancer.

It started with the legitimacy of commercial insurance agencies undertaking claiming services for basic medical insurances.Experiences and warnings from the international world in this area were examined and causes behind it were scrutinized,under a context of the contracting-out of public services.The domestic picture was also drew and arguments were given.A three-step strategy was suggested for China's contracting-out of claiming services for basic medical insurances.

Objective To investigate the patients' radiation dose received in digital radiography (DR) and provide basic data for developing diagnostic reference levels.Methods The patient' s ESD was estimated using the TLDs and DAP was measured by the dose-area product meter.The E values were then calculated by the DAP using Monte Carlo data and RefDose software.Measurements were made for twelve types of examination:skull PA,skull LAT,chest PA,chest LAT,abdomen AP,pelvis AP,cervix spine PA,cervix spine LAT,thoracic spine PA,thoracic spine LAT,lumber spine PA and lumber spine LAT.Results Both kV and mAs varied in the same type of examination for ESD,DAP and E(F =33.47,24.68,43.19,P ＜ 0.05).The dose each time for lumber spine LAT was the highest,reached 4.62 mGy in ESD and 2.26 Gy·cm2 in DAP,respectively.The E of abdomen AP averaged as 0.59 mSv,higher than that of lumber spine LAT.Even for the same type of examination,the dose from each equipment was different.Conclusions DR has the potential to reduce the patients' radiation doses.The guidance levels suitable for Chinese population should be established as soon as possible.

Objectives: To investigate the current state of pension security for rural doctors in 12 provinces those have not introduced related policies. Methods:Two counties were chosen in each province. Data was analyzed in terms of coverage, types and intention of pension security for rural doctors in these areas. Results:The study found that the proportion of rural doctors with pension security was 81. 4% in these areas. 57. 1% of rural doctors with pen-sion security had urban and rural pension insurance. Differences exist among these areas. The safeguard level is too low, and the willingness of rural doctors to attend to pension security is not strong enough. Results:The mechanism of pension security for rural doctors must be improved. These areas should implement classified guidance and syn-chronize various models to solve the problem of pension security for rural doctors.

Anastomotic leakage (AL) has always been a persistent issue for colorectal surgeons. It is still difficult to reduce the incidence of AL despite the advances in technology and equipment. With the development of evidence-based medicine, increasing high-risk factors for AL have been identified. How to efficiently and systematically combine and quantify these isolated risk factors to provide a scientific early warning of AL in clinical practices and help surgeons in choosing the optimal prophylactic strategies, is of great significance for reducing the incidence of AL. There are generally two types of AL prediction models in colorectal surgery, including prognostic models (for preoperative and intraoperative AL prediction) and diagnostic models (for early warning and improving the early diagnosis rate of AL). Prophylactic strategies for AL include stabilizing the underlying diseases, improving anemia and hypoalbuminemia, choosing an appropriate operative time window, and emphasizing and improving anastomotic techniques (including choosing an appropriate size of stapler). However, a prophylactic ostomy is still the most common method for surgeons. However, how to reduce the morbidity of complications following prophylactic ostomy and how to avoid the conversion of the prophylactic stoma to permanent stoma need further study.
Humans ; Anastomotic Leak/etiology* ; Colorectal Surgery/adverse effects* ; Digestive System Surgical Procedures/adverse effects* ; Anastomosis, Surgical/methods* ; Risk Factors

Objective To compare the single-shot fields irradiated by three focusing modes of γ-knife and explore the approaches for improving the quality of stereotactic radiosurgery.Methods GAFCHROMIC(R) EBT3 mode flushing-free film was used to measure the single-shot fields irradiated by multi-source static focusing modes,multi-source single-axis rotating focusing mode and single-source double-axis rotating focusing mode of γ-knife.Also the uniformity and penumbra of the single-shot fields were compared.Results The 2D dose distribution of the single-shot fields irradiated by three focusing modes of γ-knife was different.In the axis (x,y,z),the rang of penumbra axial length ratios of multisource static focusing modes,multi-source single-axis rotating focusing mode and single-source double-axis rotating focusing mode were 0.13-0.48,0.17-0.33 and 0.28-0.54,in the diagonal direction of the wings plane (NSD,PSD),were 0.31-0.39,0.38-0.43 and 0.54-0.72,respectively;the penumbra axial length ratio of single-source double-axis rotating focusing mode was bigger than in multi-source static focusing modes and multi-source single-axis rotating focusing mode.On the no-wings plane,the area ratios of 80％ dose curve enveloped and 50％ dose curve enveloped(A80％/A50％)were 0.40,0.47 and 0.19,on the wings plane,were 0.61,0.53 and 0.35,respectively.The field uniformity of multi-source static focusing modes and multi-source single-axis rotating focusing mode were superior to single-source doubleaxis rotating focusing mode.Conclusions Considering dose distribution of the single-shot fields,the multi-source static focusing modes devices and the multi-source single-axis rotating focusing mode devices should be preferred,when important tissues and organs are adjacent to the target areas.Compared with single-source double-axis rotating focusing mode,both multi-source static focusing modes and multi-source single-axis rotating focusing mode could make more target areas to be surrounded by high dose region.

Recent studies have shown that TCM treatment for bone metabolic diseases, such as steroid-induced avascular necrosis of the femoral head, has definite efficacy and has received extensive attention. However, due to lack of molecular biological basis of pharmacodynamics mechanism, it has not yet reached the standard of scientific treatment. The discovery of OPG/RANK/RANKL system has become a new breakthrough point in the prevention and treatment of bone metabolic diseases. The pathogenesis of deficiency of spleen and kidney - blood stasis - caused by phlegm arthralgia caused by blood stasis is closely related to the system. The effect of the final control of the system from the deficiency theory can be expressed through the axial micro-information. This article discussed the TCM syndrome differentiation of steroid-induced osteonecrosis of the femoral head and the relation of regulation of bone metabolism combined with the OPG/RANK/RANKL system, and provided the basis for prevention and treatment of this disease.

Objective: To investigate the effect of platycodin D on necroptosis of prostate cancer PC-3 cells, and to explored its mechanism related to forkhead transcription factor O3a (FOXO3a). Methods: PC-3 cells were treated with caspase inhibitor Z-VAD-FMK or caspase-3-specific inhibitor AC-DEVD-CHO, and then were exposed to different concentrations of platycodin D for 72 h. The survival rate of PC-3 cells was detected by MTT method. The cell morphology and membrane integrity of PC-3 cells treated with platycodin D were detected by typan blue staining and lactic dehydrogenase (LDH) release test, respectively. The expression levels of key necroptosis factors including mixed lineage kinase domain-like (MLKL), phospho-MLKL (p-MLKL) and its tetramer, as well as FOXO3a and its downstream molecules including factor-associated suicide ligand (FasL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) proteins in PC-3 cells treated with different concentrations of platycodin D were detected by Western blotting. The expression level of FOXO3a protein in the nucleus of PC-3 cells was detected by immunofluorescence. After PC-3 cells were transfected with FOXO3a-siRNA or the negative control (NC)-siRNA by liposome, and the expression levels of FOXO3a, FasL and TRAIL proteins were detected by Western blotting. The cell viability and cell membrane integrity of PC-3 cells after FOXO3a gene silencing and treatment with platycodin D were detected by MTT method, typan blue staining and LDH release test, respectively. Results: The survival rate of PC-3 cells treated with platycodin D was decreased in a concentration-dependent manner. There was no significant difference in the survival rate of PC-3 cells treated with DMSO, Z-VAD-FMK and AC-DEVD-CHO combined with the same concentration of platycodin D (all P > 0.05). After the treatment with platycodin D, the trypan blue staining rate and LDH release rate of PC-3 cells were significantly increased (both P < 0.05). The expression levels of MLKL, p-MLKL and its tetramer in PC-3 cells treated with platycodin D were up-regulated (all P < 0.05), and the effect on p-MLKL tetramer was the most significant. Platycodin D also promoted the transposition of FOXO3a into the nucleus, and up-regulated the expressions of FOXO3a and its downstream molecules FasL and TRAIL (all P < 0.05). After transfection with FOXO3a-siRNA, the expression level of FOXO3a protein in PC-3 cells was down-regulated (P < 0.05). Compared with NC-siRNA + platycodin D group, the survival rate of PC-3 cells in FOXO3a-siRNA + platycodin D group was increased (P < 0.05), and the positive rate of typan blue staining and LDH release rate were decreased (both P < 0.05). Conclusion: Platycodin D can induce caspase-independent necroptosis of prostate cancer PC-3 cells, which is involved in FOXO3a pathway and promoting the phosphorylation of MLKL.

Objective To observe the expression of P21 and CDK6 in cervical squamous cell carcinoma,and to investigate the relationship between their expression and cervical squamous cell carcinoma.Methods The expression of CDK6 and P21 in 100 cases of cervical squamous cell carcinoma,20 cases of cervical CIN lesions and 20 cases of normal cervical tissues were detected by immunohistochemical ABC method,and the relationship between them and tumor differentiation,invasion depth,lymph node metastasis and clinical stage were analyzed.Results The expression rates of P21 and CDK6 in cervical squamous cell carcinoma tissues were significantly higher than those in CIN lesions and normal cervical tissues;The low expression of P21 was associated with the depth of tumor invasion,lymph node metastasis and clinical stage (P＜0.05),and was not associated with the degree of tumor differentiation (P＞0.05);The high expression of CDK6 was associated with tumor differentiation,invasion depth,lymph node metastasis and clinical stage (P＜0.05).Conclusion The abnormal expression of P21 and CDK6 may play an important role in the occurrence and development of cervical squamous cell carcinoma,and the two may have a certain significance in the prognosis of cervical squamous cell carcinoma.