Objective:To analyze the efficiency and influencing factors of Chinese medical and health resources. Methods:Based on the panel data of 31 mainland provinces from 2003 to 2011 in China, use the two-stage Malmquist-Tobit model to analyze. Results:The efficiency of Chinese medical and health resources shows an increasing trend, which is dual driven by improvement of technical efficiency and technological progress. The efficiency varies among different areas, and the descending order of efficiency value is east, west and center. The level of economic development, population density, the proportion of profitable hospitals, the levels of urbanization and education can promote Chinese medical and health efficiency with different extent. Conclusion:To improve the efficiency of Chinese medical and health resources, it needs to promote economic development level, allocating health resources reasonably, and advancing urbanization and education levels orderly.

Objective To observe the clinical effect of psychological intervention combined with alendronate and low molecular heparin calcium on the treatment of senile osteoporotic fracture. Methods From February 2014 to March 2017, clinical data of 82 elderly patients with osteoporotic fracture in the first people's hospital in Jiande were retrospectively analyzed. All the patients were randomly divided into the control group and the experimental group with 41 cases in each group. The control group patients were given alendronate sodium and low molecular heparin calcium; At this basis, the experimental group were received psychological nursing intervention. The effect in the two groups was compared. Results After treatment, bone mineral density (BMD) index and pain scores in the two groups were significantly improved. BMD and pain scores in the experimental group were significantly better than those in the control group (P<0.05). The total effective rate was 95.12% (39/41) and the complication rate was 17.07% (7/41) in the experimental group, while in the control group were respectively 70.73% (29/41), 36.59% (15/41), the differences were statistically significant (P<0.05). Conclusion Psychological intervention combined with alendronate sodium and low molecular heparin on the treatment of senile osteoporotic fracture has significant effect, can effectively improve the clinical symptoms of patients, reduce the incidence of complications, with clinical application value.

Objective To demonstrate simultaneously on transcription and translate levels the tyrosine-hydroxylase(and somatostatin)gene expression and peptide storage in same intrinsic cardiac ganglionic neuron of bufo bufo gargarizans. Methods Using immunohistochemical method,in situ hybrodization method and in situ hybrodization/immunohistochemical double labeling method on freeze-sections of sinus venanum cavanum of bufo bufo gargarizans atrial posterior wall (30*!?m)to observe THmRNA and /or TH-IR and SSmRNA and /or SS-IR dyeing neurons of intrinsic cardiac ganglia. Results There are kinds of positive neurons:1.TH-IR positive neurons;2.THmRNA positive neurons;3.TH mRNA/TH-IR double positive neurons and 1.SS-IR positive neurons;2.SSmRNA positive neurons;3.SSmRNA/SS-IR double positive neurons.Conclusion 1.TH mRNA and TH appearing in same intrinsic cardiac ganglionic neuron demonstrate that a part of intrinsic cardiac ganglionic neurons are possibly adrenergic sympathetic neurons;2.SSmRNA positive neurons and SSmRNA/SS-IR double positive neurons indicat that SS could be a neurotransmitter of intrincic cardiac ganglinic neurons.It provides neuroanatomy evidence of regulating cardiac function(excitatory conduct、cardiac muscle secrete and contract)by intrinsic cardiac SS-nergic neuron.

Objective To explore the feasibility and safety of right ventricular septal pacing with active fixation electrodes.Methods This was a randomized and control clinical trial.Patients implanted with pacemaker were randomly divided into two groups.One group underwent the right ventrieular high septal pacing with the active fixation electrodes(RVS group),and the other group underwent the right ventricular apical pacing with the passive fixation electrodes(control group).The parameter was recorded in two groups in and after operation and compared accordingly.Results (1)There were no significant differences in the procedure time between two groups[averaged(59.6±3.2)and(60.2±3.7)minutes respectively].But the time of exposing X-ray was significant longer in RVS group.(2)There was no significant difference in acute implanting measurement,except perioperative and postoperative threshold 1 month in RVS group was higher than that in control group(P＜0.05 or＜0.01).After 3 months,there was no significant difference.(3)Impedance decreased significantly in 1 month and 3 months in RVS group[P＜0.01 or＜0.05).(4)There was no difference in R-wave sensing between two groups.(5)After 100%pacing,the mean QRS duration Was shorter in RVS group,but the difference was not significant.(6)Operations in two groups came off smoothly and there were no complications.Conclusion It is feasible and secure to pace from RVS with active fixation electrodes.

Aim To explore the neuroprotective effects and possib le mechanism of bellidifolin on focal cerebral ischemia in rats.Methods Focal ce rebral ischemia was induced by permanent occlusion of the proximal portion of ri ght middle cerebral artery occlusion (MCAO). A neurological examination was perf ormed on each rat 4 hours,24 hours after ischemia by the method of Berderson .T he infarcted size was measured by 2,3,5-triphenrytetrazolium chloride(TTC) st aining technique at 24 hours post-ischemia.Effect of bellidifolin on intercellu lar adhesion molecule-1 (ICAM-1) and B lymphocyte myeloma (Bcl-2) immunoreact ive positive cells in peri-infarct region following ischemia and the histological neuronal changes were observed by means of immunohistochemical staining and H E staining.Result Bellidifolin significantly reduced infarc- ted size and improved the neurological deficit in rats .Bellidifolin produced effects of reduction in expression of ICAM-1 and upregulation of antia poptotic protein Bcl-2 on focal cerebral ischemia.Conclusion B ellidifolin has neuroprotective effects on focal cerebral ischemia in rats by or al administration.Mechanism of neuroprotective effects is related to downregulat ion of ICAM-1 and upregulation of antiapoptotic protein Bcl-2 on focal cerebr al ischemia.

Objective To study the change of Insulin-like growth factor 1(IGF-1)and Epidermal growth factor(EGF)level in blood of newborns with asphyxiated.Investigation the effect of stomach-intestine hormone to newborns asphyxiated.Methods plasma IGF-1,EGF level of 48 neonatal asphyxia and 36 normal newborns(1d,3d,7d)were tested by radioimmunoassay.Result In comparision with normal neonatal,IGF-1,EGF level of neonatal asphyxia reduced significantly(P

Objective To observe the diagnostic value of telomerase,VEGF,CD44_ V6 ,MMP_2,MMP_9and their combined examination in distinguishing malignant pleural effusion from benign one.Methods Sixty patients with pleural effusions were observed,thirty of them sufferring from malignant pleural effusion and thirty of them sufferring from benign one.The expression of telomerase,CD44_ V6 ,VEGF,MMP_2,MMP_9were tested in the pleural effusion by RT-PCR and ELISA technique.The sensitivity and the specificity of each examination method were calculated,in order to find out appropriate combination.Results As single-item detection,the diagnosetic value of VEGF was the best,the cutoff of VEGF was 181.1pg/ml,the sensitivity of VEGF examination was 90.0%,and the specificity was 86.7%.The sensitivity and the specificity of combined examination VEGF+CD44_ V6 and VEGF+MMP_2 were the best,the sensitivity of VEGF+CD44_ V6 was 83.3%,and the specificity was 90.0%.The sensitivity of VEGF+MMP_2 was 80.0% and the specificity was 93.3%.Conclusion The level of telomerase,VEGF,CD44_ V6 ,MMP_2,MMP_9in malignant pleural effusion is clearly higher than that in benign pleural one,the difference having significant statistic meaning.VEGF has higher sensitivity and specificity .Of combined examination,VEGF+CD44_ V6 and VEGF+MMP_2 have higher sensitivity and specificity.

1. Microsurgical relationships of the arteries at the base of the brain and the trigeminal nerve were studied bilaterally on 30 brains. Twenty seven trigeminal nerves made contact with the arteries 33 times which represents 55 percent of the cases. Six of 27 trigeminal nerves had double contact.2. Of 33 arteries in contact with 27 nerves, seventeen involved the superior cerebellar arteries (SCA) (28.33?5.82%), seven the anterior inferior cerebellar arteries (AICA) (11.67?4.15%) and nine the middle inferior cerebellar arteries (MICA) (15.0?4.61%).3. The outer diameter of the superior cerebellar artery is the largest averaging 1.41?0.20 mm; the anterior inferior cerebellar artery comes next averaging 1.06?0.36 mm and the middle inferior cerebellar artery the smallest, averaging 0.62?0.14 mm.4. 27 trigeminal arteries arising from the upper or middle segement of the basal artery were found on the ventral surface of the trigeminal nerves in 17 brains, and 16 trigeminal branches arising from the AICA. MICA. and PICA were also found at the roots of 16 trigeminal nerves. Anastomoses were noted between the trigeminal arteries and the trigeminal branches in four cases of 16 trigeminal nerves.5. The association between the neurovascular contact and the trigeminal neuralgia are discussed. It is suggested that the neurovascular contact either from dorsal or ventral aspects may be the anatomical cause of the trigeminal neuralgia.6. The neurovascular contact of the trigeminal nerve with the SCA was usually on the dorsal or dorsalmedial aspect of the nerve, but the point of contact with AICA or MICA was mainly on the ventral aspect of the nerve. Besides, there are trigeminal arteries and trigeminal branches at the ventral surface of the nerve. All these topographic observations provide microsurgical information for neurosugeons.

Objective To evaluate the diagnosis and treatment procedures for malignant pheochromocytoma. Methods 12 cases of malignant pheochromocytoma surgically treated were reviewed.This series comprised of 4 male and 8 female patients.All the tumors were confirmed on surgery and pathological studies. Results All the cases were operated.One died of hypotension after surgery.11 cases have been followed up for 2.5～13.0 years.4 died of recurrence and complication of hypertension.3 died of extensive metastases more then one year after operation.One died of pulmonary infection 4 years after operation and the others have been surviving. Conclusions Imaging procedures are important for the diagnosis of malignant pheochromocytoma.Recurrent tumors greater than 5 cm in diameter and uneven density in the tumor denote malignancy.Prompt radical extirpation of the tumor is the only means to achieve a long survival.

Objective To compare the diagnostic value of soluble intercellular adhesion molecule 1 (sICAM-1) with c-reactive protein (CRP) in serum of women with premature rupture of membranes (PROM) for detecting chorioamnionitis. Methods 55 pregnant women with term PROM including 18 pregnant women with preterm premature rupture of membranes (PPROM) and 20 normal pregnant women at term were enrolled. Maternal serum sICAM-1, CRP were measured by Sandwish enzyme-linked immunoabsorbent assay (ELISA). Chorioamnionitis was histologically confirmed after delivery. Results (1)Maternal serum levels of sICAM-1 and CRP were statistically significantly higher in women with PROM than that without it;(2)Maternal serum levels of sICAM-1 and CRP were statistically significantly higher in women with chorioamnionitis than those without it;(3)In the complicated chorioamnionitis group and in the uncomplicated with chorioamnionitis group, serum levels of sICAM-1 in PPROM women were similar with those in TPROM women, whereas serum levels of CRP in PPROM women were statistically significantly higher than those in TPROM women;(4)The sensitivity, specificity, postive predictive value, negtive predictive value, Kappa index and area under receiver operating characteristic (ROC) curve of maternal serum sICAM-1(cutoff 104.7 ?g/L) and CRP(cutoff 10.3 mg/L) for diagnosing chorioamnionitis were 100%, 91.2%, 87.5%, 100%, 0.20, 0.995 and 81.0%, 73.5%, 65.4%, 86.2%, 0.13, 0.811, respectively; (5) Maternal serum levels of sICAM-1 compared with one another among mild histologic chorioamnionitis group, severe histologic chorioamnionitis group and clinical chorioamnionitis group, the difference are statistically significantly (P