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.

An analysis of the fundamental concepts for public hospital reform further defined public hospitals and other hospitals,business and non-business in nature,public benefits and welfare,as well as public benefits and profit-oriented hospitals.These distinctions can help reformers of public hospitals clarify their concepts,make clear the purpose and direction of the public hospitals reform,so as to speed up the reform with theory support.

This paper studied the development stages in terms of the public nature of public hospitals in China and analyzed the causes for their weakened public benefits.It proposed the principle of government guidance,achieving government purchasing of healthcare services as the roadmap,as well as building and improving the service purchasing system,performance appraisal system,and payment review system along with supervision system.These measures are designed to make public hospitals in their public benefit nature with scientific system design,powerful institutional guarantee,and efficient execution strategies.

Nucleotide-binding oligomerization domain protein 2 (NOD2) involves in host immune responses to pathogens and regulates natural immunity and specific immunity by identifying the peptidoglycan of bacterial cell walls and cleavage product muramyl dipeptide.As a newly discovered intracellular pattern recognition receptor,NOD2 plays important roles in the development of primary hepatocellular carcinoma by gene mutate,inducing liver inflammatory reaction and activating relevant signaling pathways.

Objective To investigate galectin3 on proliferation and migration of esophageal cancer Eca109 cells.Methods A lentiviral vector for over-expression of RNA targeting galectin3 was designed to transfect Eca109 cancer cells following plasmid-mediated transfection manual (Eca109/Gal3 cells).Inverted fluorescence microscope was used to observe the expression of EGFP.The proliferation of Eca109 cells was measured by cell counting Kit-8 assay.Eca109 cells apoptosis was determined by Annexin-V/7-AAD doublestaining.The migration capacity of Eca109 cells was determined in transwell assays.Western blot analysis was used to measure the expression of galectin3 protein.Results Galectin-3 expression was detected in Eca109 cells,with the Galectin3 expression in Eca109/Gal3 cells much more than non-transfected cells (t =14.33,P ＜ 0.05 ; t =10.28,P =0.037).Compared with non-transfected Eca109 cells,proliferation increased significantly in Eca109/Gal3 cells (t =-17.277,P ＜ 0.05 ; t =-13.4,P ＜ 0.05).Galectin3 evidently decreased in Eca109 cell apoptosis (t =3.053,P ＜ 0.05 ; t =5.446,P ＜ 0.05).Transwell migration assay showed that a greater number of Eca109/Gal3 cells crossed the artificial basement membrane compared with non-transfected Eca109 cells and negative control Eca109 cells (t =3.465,P ＜ 0.05; t =3.252,P ＜ 0.05).Conclusion Galectin3 expression is detected in transfected esophageal cancer Eca109 cells,whose overexpression can result in enhanced proliferation,migration,invasion as well as reduced apoptosis.These data indicate that in-depth research of galectin-3 may prove to be a potential molecular target for the treatment of esophageal cancer.

The management methods of medical equipment are discussed in the following 7 aspects: archives management,use management,maintenance,metrology management,new knowledge learning,enhancement of staff's skill and personnel cultivation.

There are 250 species of Zanthoxylum (Rutaceae) in the world. This genus distributed in tropical and subtropical regions. Alkaloids are the major and representative ingredients in these plants including quinolines, isoquinolines, and amide alkaloids, with such biological activities as anti-tumor, anti-inflammatory, analgesic, anti-virus, anti-platelet aggregation, anti-bacteria and anti- oxidant. These species have been used for a long time to treat toothache, urinary and venereal diseases, lumbago and rheumatism. This review summarizes the chemical constituents and pharmacological activities from the Z. sppplants, in an effort to the systematic research and application of the alkaloids of this genus.
Alkaloids ; chemistry ; pharmacology ; Animals ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Molecular Structure ; Zanthoxylum ; chemistry

Objective To analyze the impact of performance-based contract management mode purchased by government on the equity and efficiency of public health services in rural areas.Methods Randomized controlled method,agency investigation and questionnaire survey on public health services recipients were used.Results The utilization of residents health records management services,child health management services,health care management of patients with hypertension and type 2 diabetes in pilot counties was higher quality absolutely fair.Gini＜0.2,CI≈0.The overall effectiveness,technical validity and effectiveness of scale of the townships in pilot counties were better than that in non-pilot county.Conclusion This management mode helps to improve the equity of public health services and service efficiency.

Objective To investigate the feasibility of using problem-based learning in nursing clinical teaching in the obstetrics and gynecology department.Methods Sixty-six nursing students were randomly divided into PBL group and lecture-based learning(LBL)group .At the end of their internship,the two groups were compared in terms of examination performance,learning attitude and aptitude,and their feedback on the two learning modes.Results The students in the PBL group were significantly better than those in the control group in terms of examination performance,learning attitude and aptitude,and their feedback on the learning mode(P<0.001).Conclusions PBL may be effective in the improvement of their attitude to learning and aptitude,the comprehensive ability.It can provide an environment to promote internal learning motivation for students.

OBJECTIVETo investigate the morphological features of the perforator from the first plantar metatarsal artery, so as to provide anatomic basis for the reconstruction of soft-tissue defects of the forefoot.

METHODSThe first metatarsophalangeal joint was chosen as the landmark on 30 human cadaveric feet prefused with red latex. The following contents were observed under surgical magnifier: (1)The origin, courses,branches,distribution of the perforator of the first plantar metatarsal artery; (2)The anastomoses among the perforator of the first plantar metatarsal artery and other arteries on the medial aspect of the foot. Simulated operation was performed on one fresh specimen.

RESULTSThe perforator of the first plantar metatarsal artery passed through the space between the tendon, the abductor hallucis and the first metatarsal bone, and its entry point into the deep fascia was located (2. 3 ± 0.7 ) cm proximal to the first metatarsophalangeal joint. The perforator anastomosed with either the medial tarsal artery, the medial anterior malleolus artery or the branch of the medial plantar artery on the superior margin of the abductor hallucis, forming a longitudinal arterial chain,through which small branches were given off to the skin of the medial aspect of the foot. The perforator was( 1. 1 ± 0.2) mm in diameter and(3.2 ± 0.2) cm in length.

CONCLUSIONThe flap based on the perforator of the first plantar metatarsal artery can be harvested as an axial flap to repair the defects of soft tissue on the forefoot.

Anatomic Landmarks ; anatomy & histology ; Arteries ; anatomy & histology ; Cadaver ; Foot ; Foot Injuries ; surgery ; Humans ; Metatarsal Bones ; blood supply ; Metatarsophalangeal Joint ; anatomy & histology ; Muscle, Skeletal ; anatomy & histology ; Perforator Flap ; blood supply ; Reconstructive Surgical Procedures