This essay probes into the reality,causes and solutions to the moral conflicts in the healthcare reform in current China,aiming to provide reference from an ethical perspective for correctly understanding and solving the problems in current healthcare reform.

Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Pruritus Vulvae ; therapy

Objective: To optimize the extraction process of Yunpitongbian decoction.Methods: With the extraction yield and the contents of hesperidin and atractylenolide Ⅲ as the comprehensive evaluation indices, and based on the results of single factor tests, Box-Behnken response surface methodology was used to optimize the extraction process with the extraction duration, extraction times and liquid-solid ratio as the independent variables.Results: The optimum processing conditions were as follows: extracted three times with 15-fold amount of solvent and extraction time of 66 min.The measured value of comprehensive score was 1.198 40, which was close to the predicted value of 1.204 78.Conclusion: The optimized extraction process of Yunpitongbian decoction is simple and feasible with good predictability.

Objective To explore the difference of the impact with different hydrosalpinx pretreatment methods in vitro fertiliza-tion-embryo transfer ﹝ IVF-ET ﹞.Methods 160 patients with routine IVF-ET’s hydrosalpinx were random divided into two groups :the first 80 patients undergoing routine bolt blocking the fallopian tubes for the study group;the other 80 patients with rou-tine salpingectomy as control group patients,after treatment,compare the difference on ovarian function between the two groups.Re-sults In the study group,although these difference,the average number of oocytes,fertilization rate,clinical pregnancy rate and other indicators,were not statistically significant (P>0.05),they were higher than the control group;early abortion rate was no significant difference either (P>0.05),but the tubal pregnancy rate was lower than the control group,and the difference was statis-tically significant (P<0.05).Conclusion Tubal bolt blocking technique is an effective method for hydrosalpinx pretreatment,and partly superior than gynecological surgery for keeping ovarian function and IVF-ET treatment targets.So,it has a broad application prospects in vitro fertilization-embryo transfer.

Objective:To establish a method to detect food allergen based on Latex-enhanced immune turbidimetry ( PETIA) and apply to clinic.Methods: The PETIA method was used for evaluating the detection system including standard curve , detection-limit,stability, intra-assay and inter-assay precision and cross-reactivity,clinical normal serum specimens and clinical allergic diseases serum specimens were measured to evaluated the perspective of the clinical application .Results: The standard curve :Y=837.1 x2-125.2x+10.036, linear range: 0.0-400 U/ml, the correlation coefficient of the standard curve was 0.996, the intrabatch and interbatch precision was<10%.The normal reference range was≤33.5 U/ml,the AUC of ROC curve was 0.957,the sensitivity was 89.61%,The specificity was 65.22%, the accuracy was 84.00%, and the positive predicted value was 89.61%, the negative predicted value was 65.22%.the test results have strong correlation with ELISA ( r=0.890 2 ) .Conclusion: The PETIA method for detecting food allergen achieved corresponding clinical application standards and may be used for the diagnosis of food allergies .

Objective:To study the biocompatibility of porous Ti processed by laser solid forming(LSF)with osteoblasts.Methods:SD rat osteoblasts were seeded on porous Ti surface processed by LSF.Adhesion,proliferation and ALP activity of the osteoblasts were measured at different time,and all samples were observed under SEM.Dense sand-blasted Ti sheets were used as the controls.All data were statistically analyzed.Results:Adhered cells on porous Ti were more than those on nonporous Ti sheets after 2 and 3 hours of culture(P <0.05).At 4 and 7 days,cell proliferation and ALP activity were significantly higher on porous Ti than those on the controls(P <0.05).Conclusion:Porous Ti processed by LSF possesses good biocompatibility with osteoblasts.

Objective To evaluate the value of PET-CT in patients with breast cancer and to determine if the PET-CT can provide additional information to predict early response to neoadjuvant chemotherapy (NAC).Methods NAC was given to 20 patients with breast cancer confirmed by biopsy puncture from September 2009 to March 2012.The PET-CT was carried out for all patients before NAC.TEC program with three weeks for one cycle was selected.After 6 days of the first cycle,the PET-CT was performed again.The changes of standard uptake value before and after the first cycle were compared.At the same time hand palpation was selected to detect the changes in tumor size before and after the first cycle of NAC.The changes of the standard uptake value and in tumor size need to refer to the pathology Miller & Payne classification methods to evaluate the efficacy of the NAC.Results The SUV were (7.51±1.76) Bq/ml and (4.98±1.61) Bq/ml before and after chemotherapy (t =7.916,P ＜ 0.05) the maximum tumor diameters were (9.62±4.38) cm and (8.89±4.08) cm before and after NAC (t =2.154,P＞ 0.05).SUV had highly correlated with pathological MP classification (r =0.725,P =0.000); while for the tumor size there was no significant change (r =0.026,P =0.824).Conclusion PET-CT can predict the efficacy earlier and is more accurate than clinical efficacy standard for the NAC.

Thirty four patients with decompensated cirrhosis received umbilical blood stem cell transplantation via hepatic artery from December 2008 to August 2009. The symptoms and biochemical testing results were observed before and after stem cell transplantation. One month after the transplantation,appetite was improved in 32 patients ( 94% ), physical capacity improved in 29 patients ( 85% ) and the abdominal distention relieved in 28 patients (82%). Abdominal B-ultrasonography showed that ascites decreased in 15 cases(60% ), and disappeared in 9 cases(36% ). Six month later the mean serum albumin levels were increased from ( 30. 9 ± 0. 6) g/L to ( 35.5 ± 2. 5 ) g/L( P ＞ 0. 05 );alanine aminotransferase levels decreased from (57 ±7) U/L to (46 ± 10) U/L(P ＞0. 05);total bilirubin decreased from (47 ±5 )μmol/L to (25 ±4) μmol/L(P =0. 017);prothrombin time decreased from ( 17.9 ±0. 7) s to ( 16. 4 ±1.3) s (P ＞ 0. 05 ). Hemophagocytic syndrome developed in one case but no severe adverse reactions occurred. The results indicate that umbilical blood stem cell transplantation may improve liver function in various degrees with safety for patients with liver cirrhosis.

Objective:To study the effects of LPS and TNF-? on the expression of SSeCKS and morphology as well as cytoskeleton of endothelial cell, so as to explore the role of SSeCKS in cell morphology changes.Methods:The cultured Bovine pulmonary artery endothelial cells(BPAEC) was induced by LPS, TNF-? and the expression of SSeCKS was detected by in situ hybridization,Western blot and immunohistology. Immunofluorescent staining method with confocal laser-scanning fluorescence microscope was used to observe the effects of LPS and TNF-? on the morphology of endothelial cells and the organisation of SSeCKS as well as cytoskeleton.Results:Firstly, we found that TNF-? could induce the expression of SSeCKS in a concentration and time dependent manner , meanwhile LPS had no effects on SSeCKS expression. Secondly, it was observed that LPS and TNF-? induced reorganization of F-actin and SSeCKS in endothelial cell. Thirdly,PKC inhibitor Ro-31-8220 reversed the effect of LPS,TNF-? on F-actin and SSeCKS in endothelial cells.Conclusion:The results demonstrate that TNF-? could induce endothelial cell to express SSeCKS; PKC plays a role in the reorganization of SSeCKS and F-actin in endothelial cells induced by LPS and TNF-?; the results suggest that the mechanism for reorganization of cytoskeleton induced by LPS, TNF-? be partially related to the SSeCKS of ECs.

Objective To investigate the change and effect of SSeCKS(src suppressed c kinase substrates)in the activation of hepatic stellate cells(HSCs).Methods HSCs were isolated from normal rats,the change of SSeCKS mRNA expression on HSCs culture in vitro was determined using real.time PCR.protein level was determined by Western blot and immunofluorescence methods.A rat model of liver fibrosis was established.The expression and location of SSeCKS and α-SMA(α-smooth muscle actin)in liver tissues were detected by immunofluorescence methods.Results SSeCKS mRNA expression WaS loW in freshly isolated HSCs cell and the expression increased in activated HSCs in vitro.In liver fibrosis tissue,the number of SSeCKS-positive cells was increased and these cells were distributed along the sinusoids which also contained α-SMA positive cells.Conclusion The expression of SSeCKS was increased in activated HSCs in vitro.Therefore.SSeCKS may be involved in the liver inflammation and fibrosis.