Objective: To study the influencing factors of the rural medical service demand. Methods: The gravity model of medical service demand was derived based on Individual utility function and profit objective function of medical institutions, and the data regression examine model of some county-level and district-level hospital were used. Results: According to the research, the main factors influenced the quantity of medical services come from medical supplies. With the increase of resident disposable income, the elasticity of demand for medical services decreased, while visiting distance of elasticity of demand for medical services increased. Conclusion: To increase the accessibility of medical service, it needs to set meeting the resident’s personal demand as the center, to promote the development of private hospitals. The scale of large hospitals should be limited so as to lead large-scale hospitals to separate low value-added medical services and to promote effective implementation of the treatment classification system.

Objective: To study the antitumor effect of Lycium barbarum polysaccharide (LBP X) and its immunity regulating effect on S 180 bearing mice. Methods: S 180 bearing mice were used as animal model. The effect of LBP X on tumor weight and immune function was observed. Results: LBP X could inhibit the growth of S 180 effectively and increase thymus index, the macrophage phagocytic function, anti SRBC antibody secreted by the spleen cells, lymphocyte proliferation and CTL activity and decrease LPO markedly in S 180 bearing mice. Conclusion: The mechanism of tumor inhibition by LBP X was due to enhance the immune function.

For decades, coping has undergone intensive investigation through different theoretical lens. In this paper, three theoretical standings in coping research were proposed:namely,the process theory, the trait theory and the situation theory. Relevant research and measurements were introduced. In the end, different perspectives were reevaluated and implication for further research was discussed.

Objective: To explore the effect of perfectionism on depression using anxiety as a controllng variable,and to find possible personality moderators.Methods: 407 undergraduate students from 8 universities in Beijing and Xi'an completed a battery of questionnaires,including Frost Multidimensional Perfectionism Scale(FMPS),Beck Depression Inventory(BDI),Personality Adjective Checklist(PACL) and Self-rated Anxiety Scale(SAS).Results: Hierarchical Regression Analysis confirmed the effects of two negative perfectionism dimensions hesitating over actions and concerning over mistakes,on depression after controlling anxiety.The effect of organization on depression was moderated by the personality trait of cooperation.Conclusion: Dimensions of perfectionism have diverse effects on depression.Psychological intervention should be carried out according to individual characteristics.

Objective: To explore the effects of Lycium barbarum polysaccharide (LBP-X) on IL-2 and TNF-? gene expressions in human peripheral blood mononuclear cells. Methods: RT-PCR (reverse transcription-polymerase chain reaction) was used to detect the gene expressions of IL-2 and TNF-?. Results: LBP-X at 5-40 mg/L upregulated the levels of IL-2 and TNF-? mRNA in human peripheral blood mononuclear cells after optimal time culture. Conclusion: The immunoenhancing effect of Lycium barbarum polysaccharide may be associated with its stimulation of IL-2 and TNF-? gene expressions.

Amyotrophic lateral sclerosis (ALS) is a rare neurodegenerative disease characterized by progressive loss of upper and lower motor neuron. Insomnia is one of the widespread but underappreciated non-motor symptoms in ALS patients, which may not only seriously affect patients′ quality of life, but also reflect the lesions of central nervous system in ALS. This review summarizes the insomnia symptoms reported in current ALS studies, and summarizes the somatic factors and central nervous system changes associated with insomnia in ALS patients, so as to provide ideas for the development of effective intervention measures and future research.

Objective: To examine the reliability and validity of MBI-SS and discuss the academic characteristics that affect burnout. Methods: 353 undergraduate students were administrated MBI-SS and Academic Characteristic Survey. Results: Confirmatory factor analyses showed that the expected three-factor structure of the adapted versions of the MBI- Students Survey (including Exhaustion, Cynicism, and Reduced Efficacy) fitted to the data. Exploratory factor analyses showed that the Academic Characteristic Survey includes six dimensions. The result of Regression showed that 44.4% variance of student burnout can be explained by Academic Characteristics. Conclusion: Student burnout includes three dimensions: Exhaustion, Cynicism and Reduced efficacy. Academic self-efficacy,academic stress,relationship with teachers and relationship with fellow students are significant predictors for student burnout.

OBJECTIVE: Researches on total hip replacements are always the hot spots in recent years. The replacements have obtained satisfactory outcomes in clinic. However, the long-term effect is limited because of the material and technical problems. This paper is to summarize the developmental trend and the prospect of clinical application for total hip replacements in 10 years.DATA SOURCES: A computer-based online search of Medline database was undertaken to identify relevant articles published in English from January 1996 to January 2006 by using the keywords of "total hip replacements, surgical robot, tissue engineering, virtual endoscopy". Meanwhile,Chinese relevant articles published from January 1990 to December 2005 were searched in Wanfang database, the keywords were "total hip replacements, material, virtual endoscopy, surgical robot, tissue engineering" in Chinese.STUDY SELECTION: The articles were primarily checked, and the references in each literature were reviewed. Articles about the study on total hip replacements were involved; Meanwhile, the repetitive studies or Meta analysis were excluded.DATA EXTRACTION: Totally 39 relevant articles were collected, and 22 of them accorded with the. Inclusive criteria, 17 old or repetitive ones were excluded. Of the 22 articles, 5 were about the influence of artificial joint material on prosthetic loosening and its carcinogenesis; 2 about the microinvasion of joint replacement induced by computer-aided surgery navigation; 1 about the introduction of surgical robot; 3 about the development of custom-made and specially made artificial joint; 9 about the possibility for the surface replacement of hip; and 2 about the combination of tissue engineering technique and artificial joint.DATA SYNTHESIS: Modern researches on total hip replacements are exploring wearing tolerant prosthesis to reduce the prosthetic loosening caused by osteolysis and bone resorption. The computer-aided design/made technique is used for special design and manufacture according to the need of disease, so as to solve the fracture around prosthesis and meet the need of limb salvage surgery. The computer-aided surgery navigation realizes the microinvasion of joint replacement and the fast recovery after surgery. The successful rate of total hip replacements is improved by developing localized surgical robot in China. By using the virtual endoscopy, we can accurately know the damaged conditions of intraarticular cartilage and sub-cartilage bone, which are also able to be quantifized, so that more suitable and reliable prosthesis can be selected to increase the accuracy. The tissue engineering technique in repairing defect can increase the synostosis of prosthesis, and perfect the technique of joint replacement.CONCLUSION: In the coming 10 years, total hip replacements will develop towards stability, harmlessness, microinvasion, mechanization, individualization and diversification, so that the total hip replacements will be much stander and safer with higher successful rate.

Objective To detect the correlation of serum myoglobin (Mb) and creatine kinase (CK) levels in multiple trauma patients with outcome and renal failure and compare the prognostic value of the two predictors.Methods Forty-one patients with multiple trauma (ISS ≥ 16 points) were analyzed at days 1,3,7,and 14 posttrauma,for serum Mb and CK concentrations.Moreover,simplified acute physiology score Ⅱ (SAPS Ⅱ),injury severity score (ISS),as well as Glasgow coma score (GCS)at day 1 postrauma,final outcome,and presence or absence of renal failure were recorded.Correlation of serum Mb and CK with ISS,GCS,and SAPS Ⅱ was analyzed.Predictive values of Mb and CK for outcome and development of renal failure after multiple trauma were measured and compared at days 1,3,and 7 posttrauma,according to receiver operating characteristic (ROC) curve.Results Serum Mb concentration revealed a positive correlation with SAPS Ⅱ at each time point and with ISS at days 7 and 14,but a negative correlation with GCS at days 3,7,and 14.Similarly,serum CK concentration presented a positive correlation with SAPS Ⅱ at days 3,7,and 14 and with ISS at days 7 and 14,but a negative correlation with GCS at days 7 and 14.To predict outcome of the multiple trauma patients,area under the ROC curve for serum Mb at days 1,3,and 7 was 0.542,0.900,and 0.981 respectively and for serum CK was 0.232,0.771,and 0.968 respectively.To predict development of renal failure,area under the ROC curve for serum Mb at days 1,3,and 7 was 0.864,0.949,and 0.955 respectively and for serum CK was 0.480,0.889,and 0.939 respectively.Conclusions Serum Mb and CK are both predictive of outcome and development of renal failure following multiple trauma.Whereas in co；rast with CK,serum Mb appears to be a more sensitive marker.

Objective Using Doppler ultrasound measured in femoral artery flow velocity variation rate method to predict fluid responsiveness.Methods 80 patients were measured femoral artery flow velocity variation rate (△Vpeak)by mastering the ultrasound skills of the attending physician.Passive leg raising test (PLR)stroke vol-ume variation (△SV)was used to analyze the peak value of the femoral artery flow velocity,rate of femoral artery peak velocity of respiratory changes,and the results were compared with results of PICCO monitoring to predict patients with their response to the treatment capacity,to evaluate clinical feasibility.Results Reactive groups in the PLR test before the experiment and hemodynamic changes:PLR test reaction group in before the test and test process, HR,MAP,CAP index changes were not obvious (P >0.05),but ultrasonic detection and PICCO detection showed SV and CO varied significantly (t =15.24,P =0.00;t =13.64,P =0.00),the two kinds of methods to forecast results was consistent.In the absence of the anti should patients in PLR test before the experiment and hemodynamic chan-ges:PLR test unreacted group in before the test and test process,HR,MAP,CAP,SV and CO index change were not obvious (all P >0.05).Conclusion By ultrasonic method for measuring femoral artery flow speed variation rate can exactly evaluate the capacity status of critically ill patients,and effectively predict fluid responsiveness,the prediction results and PICOO monitoring results are highly consistent.It is a safe and efficient prediction method,which is worthy of promotion in clinical intensive observation.