Firstly,this article introduces the background and detailed content about the New health care reform of the United States.Then it describes the basic principles of these reforms and the problems to be solved,putting forward author's own speculative viewpoints to these health care reforms.Finally,it list the reference to New health care reform of our country.

Objective To investigate the effects of electroacupunctures at Baihui,Fengfu,and Shenshu on the cognitive function and learning memory of mice exposure with ionizing radiation.Methods C57BL/6J (30-day old) mice were randomly divided into l0 groups consisting of the control group,X-ray exposure groups (4,8 and 16 Gy),electroacupuncture-nonacupiont (E-nonA) groups (4,8 and 16 Gy) and electroacupuncture-acupiont (EA) groups (4,8 Gy and 16 Gy),with 10 mice assigned to each group.The mice were irradiated (IR) on the left cerebral hemisphere with doses of 4,8 and 16 Gy.Some mice were electroacupunctured for 3 courses of treatment.Using weight as a measurable parameter,the open-field test and Morris water maze test were used to evaluate the curative effects.Results Compared with the control group,the weights of mice in the exposure groups (8 and 16 Gy) significantly decreased (t =2.917,9.650,3.043,2.882,P ＜ 0.05) at 7 and 14 d,while the weights of the E-nonA (8 and 16 Gy) and EA groups (8 and 16 Gy) were not significantly altered.Compared to the model groups (8 and 16 Gy),the weights of EA groups (8 and 16 Gy) significantly increased (t =6.602,5.409,19.660,2.975,P ＜ 0.05).In the open-field test,the crossing times and the rearing time of exposure model groups (8 and 16 Gy) significantly decreased compared to the control group (t =2.183,2.119,2.369,2.231,P ＜ 0.05).Compared with model groups (8 and 16 Gy) and E-nonA groups (8 and 16 Gy),the crossing times and rearing time of the EA groups were significantly increased (compared with model:t =8.914,2.727,4.325,4.178,P ＜ 0.05;compared with E-nonA:t =4.030,3.014,2.150,4.771,P ＜0.05).In the Morris water maze,compared with the control,the latent period of model group (4 Gy) was significantly increased and the crossing times significantly decreased (t =4.544,3.422,P ＜ 0.05);compared to model and E-nonA groups (4 Gy),the latent period of EA group significantly increased (compared with model:t =2.877,P ＜ 0.05;compared with E-nonA:t =3.001,P ＜ 0.05).At day 2 and 3,the latent period of model groups (8 and 16 Gy) significantly increased (t =2.544,3.706,3.796,7.934,P ＜ 0.05) and the crossing times (t =2.120,2.393,P ＜ 0.05) significantly decreased,resident time in target area of model group (8 Gy) was significantly decreased (t =2.543,P ＜ 0.05) compared to the control group.Compared with model and E-nonA groups (8 and 16 Gy),the latent period of EA gourps significantly decreased (compared with model:t =5.404,7.869,4.104,15.590,P ＜ 0.05;compared with E-nonA:t =2.938,7.955,6.566,10.350,P ＜ 0.05) while the through times and resident time in target area significantly increased in the EA group (8 Gy) (compared with model:t =2.673,2.613,P ＜ 0.05;compared with E-nonA:t =3.345,2.179,P ＜ 0.05).Conclusions Irradiation with a dose higher than 8 Gy could induce mice brain injury.Electroacupuncture can alleviate the radiation damage of cognitive function as well as learning and memory functions in mice.

Objectives:To investigate the impact of doctor-attacking on medical students’ occupation atti-tude. Methods: We conducted a sample survey towards different major of Wenzhou Medical University by using self - made questionnaire. Reults: The occupation attitude of interviewee is not so bad, the confidence about the occupation is really deep down and the occupational sense of mission worries a lot of people. Doctor-attacking cases damage the honorable sense of occupation, even threatens basic personal security. The spread passive emotion by Network media , as well as the varied choices of occupations, expand the influence of hospital violence. Conclusions: The fre-quent occurrences of doctor-attacking cases weaken the occupational attitude of medical students and became the obstruc-tion to be a doctor,countermeasures should be taken from multiaspect of society,media,schools and teachers through a va-riety of ways.

Objective To explore the effects of different courses of electro-acupuncture at Baihui,Fengfu,and Shenshu of both sides on the behavior of mice exposed to radiation.Methods Fifty C57BL/6Jmice 30 days old were randomly and equally divided into control group,model group (exposure to radiation of 8 Gy),electro-acupuncture group 1 (1 week of treatment),electro-acupuncture group 2 (2 weeks of treatment),and electro-acupuncture group 3 (3 weeks of treatment).The mouse model of radiation-induced brain injury was established by exposure to radiation of 8 Gy and treated with electro-acupuncture.The open field test and Morris water maze test were used to evaluate the cognitive function and spatial learning and memory,respectively.Group t-test difference.Results In the open field test,the model group had significantly fewer vertical or horizontal movements than the control group (P=0.032,0.029,0.028),while the electro-acupuncture groups 2 and 3 had significantly more vertical or horizontal movements than the model group (P=0.001,0.017,0.000).In the Morris water maze test,compared with the control group,the model group had significantly longer latency,a significantly lower frequency of entry into the goal box,and significantly shortened residence time,indicating substantially worse performance of spatial learning and memory (P=0.023,0.001,0.001).Compared with the model group,the electro-acupuncture groups 2 and 3 had significantly shortened latency,a significantly higher frequency of entry into the goal box,and significantly longer residence time (P=0.046,0.017,0.049,0.007,0.031,0.009).Conclusions Different courses of electro-acupuncture treatment at Baihui,Fengfu,and Shenshu of both sides can substantially improve the cognitive function and spatial learning and memory in mice exposed to radiation.Particularly,2 and 3 weeks of electro-acupuncture treatment give the best outcomes.

Aim To investigate the influence of Ramu-lus mori polysaccharides ( RMP) on blood glucose and anti-oxidative effect in streptozotocin ( STZ )-induced diabetic mice .Methods Diabetic mice were induced by intraperitoneal injection with 120 mg? kg -1 STZ and were randomly divided into the following 5 groups with 20 animals per group: model group , valsartan group ( 20 mg? kg -1 ) , low-, medium-, high-dose (0.3,0.6,1.2 g? kg -1 ) of RMP groups.Other 20 normal mice were treated as normal control group .The mice were administered orally for 90 d.On 45 d of ad-ministration , the 24 h urine was collected through met-abolic cages for urine protein detection .Pathological changes of kidney tissues were observed through HE staining .The serum levels of urea nitrogen ( BUN) and creatinine ( Cr ) were detected by automatic biochemical analyzer; and the manganese superoxide dismutase (Mn-SOD), catalase(CAT), malonaldehyde(MDA) and mitochondrial respiratory chain complex Ⅰ,Ⅲac-tivity of kidney tissues were also determined .ELISA method was used to detect ROS content in renal cortex . The SIRT1 , FOXO1 and NF-κB protein expressions were analyzed by Western blot .Results Compared with model group, the FBG, microalbuminuria, BUN and Cr were decreased by RMP medication ( P <0.05).The activities of Mn-SOD, CAT and mitochon-drial respiratory chain complex Ⅰ,Ⅲ in RMP groups were enhanced , while MDA and ROS levels were re-duced. Moreover, the expressions of SIRT1 and FOXO1 were up-regulated by RMP , the expression of NF-κB was down-regulated ( P<0.05) .Conclusion RMP exerts renal protective effect through up-regula-ting the expressions of SIRT1 and FOXO1 in renal cor-tex , which may relate to the improvement of anti-oxida-tive capability .

Objective To explore pre-hospital delay factor of coronary reperfusion therapy for ST-elevation acute myocardial infarction (STEAMI) patients presenting with non-chest pains. Methods A retrospective observation was conducted. The clinical data of STEAMI patients underwent emergency percutaneous coronary intervention (PCI) admitted to Luoyang Central Hospital Affiliated to Zhengzhou University from August 2013 to August 2015 were analyzed. The patients were divided into chest pain group and non-chest pain group according to the presence of chest pain or not. Clinical characteristics were compared between the two groups, and incidence of major adverse cardiac events (MACE), door-to-balloon time, door-to-electrocardiograms (ECG) time and ECG-to-balloon time were evaluated. Influencing factors of pre-hospital delay was analyzed by logistic multiple stepwise regression. Results A total of 259 patients with STEAMI were enrolled, including 154 patients with chest pain and 105 presented with non-chest pains. Compared with chest pain group, the patients in the non-chest pain group were older (years: 68.12±8.93 vs. 62.34±7.12, P < 0.05), less female (26.67% vs. 42.20%, P< 0.05), and had a higher past history of angina, stroke and heart failure (27.61% vs. 13.63%, 31.42% vs. 18.83%, 26.67% vs. 11.68%, respectively, all P < 0.05), and higher percentage of Killip ≥ Ⅲ patients (15.24% vs. 6.49%, P < 0.05), the lower ambulance use (26.67% vs. 44.81%, P < 0.01), longer hospitalization time (days: 12.50±2.89 vs. 9.50±2.67, P < 0.05), higher incidence of MACE (19.05% vs. 9.09%, P < 0.05), longer door-to-balloon time and door-to-ECG time (minutes: 159.01±51.21 vs. 115.31±36.74, 53.06±18.17 vs. 30.35±9.93, both P < 0.01). It was shown by logistic multivariate regression analysis that no-chest pain [odds ratio (OR) = 5.14, 95% confidence interval (95%CI) = 2.34-10.81, P < 0.001], age ≥ 65 years old (OR = 1.43, 95%CI = 0.93-2.99, P = 0.022), diabetes (OR = 1.57, 95%CI = 0.66-2.15, P = 0.015) and no-ambulance transport (OR = 1.55, 95%CI = 0.73-2.75, P < 0.001) were risks factors of coronary reperfusion delay ≥ 2 hours. Conclusions STEAMI patients presenting without chest pain showed higher incidences of MACE, longer time of ECG obtained and initial PCI time delay. Clinicians should try to reduce the delay time of the patients in order to improve patient survival rates.

Objective: To explore the effect of low-level laser irradiation (LLLI) preconditioning on milieu of infarcted myocardium in experimental rats.
Methods: The myocardial infarction (MI) model was established by left anterior descending (LAD) artery ligation in female rats. 3 weeks later, the qualified MI rats were randomly divided for 3 groups: ① LLLI preconditioning group, the rats received thoracotomy for LLLI by a 635nm, 5mW diode laser with the energy density of 0.96 J/cm2 for 150 seconds, n=26. ② Control group, the rats received thoracotomy for daylight irradiation, n=27. ③ Sham operation group, the rats received thoracotomy without LAD ligation, n=24. The Expressions of myocardial vascular endothelial growth factor (VEGF), glucose-regulated protein 78 (GRP78), superoxide dismutase (SOD) and malondialdehyde (MDA) were evaluate by real time-PCR, Western blot analysis and other relevant laboratory test at 1 hour, 1 day and 1 week after treatment. The myocardial cell apoptosis was examined by TUNEL staining, and left ventricular function was detected by echocardiography.
Results: LLLI preconditioning obviously increased the myocardial VEGF, GRP78 expression and SOD activity, decreased MDA production; while it could not really improve the myocardial cell apoptosis at peri-infarcted area and left ventricular function in experimental rats.
Conclusion: LLLI preconditioning may improve the milieu of infarcted myocardium via decreasing the oxidative stress in experimental rats.

Objective: To explore the effect of omentopexy combining autologous atrial tissue patch cardiomyoplasty for treating the chronic myocardial infarction (MI) in experimental rats.
Methods:The MI model of SD rats was established by left coronary artery ligation. 3 weeks later, the qualiifed animals were randomized into 4 groups for the 2nd operation. ① Control group, the rats only received re-thoracotomy, ② Atrial appendage group, the autologous atrial tissue patch was harvested from left atrial appendage of rats and transplanted to infarcted zone, ③ Omentum group, the omentum of rats was transplanted to infarcted zone through diaphragm and ④ Combination group, the left atrial appendage tissue and omentum were transplanted to infarcted zone together. 4 weeks after the 2nd operation, the cardiac function was evaluated by echocardiography, the size and scar thickness of the infarction were examined by Masson staining, the survival of transplanted atrial tissue and angiogenesis were measured by immunohistochemistry, the protein expressions of VEGF, MMPs and TIMP-3 were examined by Western blot analysis, and the activities of MMPs were
identiifed by gelatin zymography.
Results:4 week after the 2nd operation, transplanted left atrial appendage tissue only survived in Combination group. The areas of infarction were similar among different groups, P>0.05. Compared with Control group, Combination group had the increased scar thickness (329 ± 33)μm vs (391±31)μm, improved LVEF (47.5 ± 4.5)%vs (57.9 ± 5.8)%, improved LVFS (20.7 ± 2.0)%vs (25.2 ± 3.6)%, all P<0.05. Compared with Control group, both Omentum group and Combination group demonstrated higher density of angiogenesis at infracted area (33/0.2) mm2 vs (49/0.2) mm2 and (33/0.2) mm2 vs (48/0.2) mm2, all P<0.01. Combination group had decreased protein expressions of MMPs, while the expressions of TIMP-3 were similar among different groups, the activities of MMP-2 and MMP-9 were decreased by 68%, P=0.002 and 64%, P=0.016 respectively.
Conclusion:Omentopexy could improve the angiogenesis and support the survival of transplanted autologous atrial tissue patch, therefore improve the cardiac function in experimental rats with chronic MI.

Objective To describe the CSP genotypic profile in clinical isolates of Aspergillus fumigates from different regions of China,and to investigate if there is a difference in antifungal susceptibility among A.fumigates of different CSP genotypes and from different regions.Methods Totally,112 A.fumigates strains clinically isolated from Fujian,Shanghai,Hebei and Beijing were included in this study,and identified according to macro-and micro-morphological characters,growth temperature and β-tubulin sequence.Classic A.fumigatus strains were typed according to CSP gene sequence.The minimal inhibitory concentrations (MICs) of voriconazole,itraconazole and amphotericin B to A.fumigates were determined in accordance with the National Committee for Clinical Laboratory Standards (NCCLS) M38-A protocol.Results All the strains were identified as classic A.fumigates,and fall into 11 CSP genotypes.The most common genotypes were t04A (n =32),t03 (n =17) and t01 (n =24) in all the strains,tl0,t04A and t01 in Fujian,t04A and t01 in Shanghai,t01,t03 and t04A in Hebei,t02,t04A,t01and t03 in Beijing.One A.fumigatus strain was identified as a new CSP type t25 in Fujian,which showed no obvious difference in morphology,growth rate or appropriate growth temperature from the other CSP genotypes of A.fumigatus strains.No statistical difference was found in the susceptibility to amphotericin B,itraconazole or fluconazole among different genotypes of A.fumigates,whereas the MICs of itraconazole were significantly lower in A.fumigates isolates from Fujian than in those from the other three regions.Conclusions The CSP genotypic profile of A.fumigates varies in clinical isolates from different regions.No significant difference is observed in the susceptibility to amphotericin B,itraconazole or fluconazole among different CSP genotypes of A.fumigates,but the susceptibility to itraconazole is somewhat different between A.fumigates strains from different regions.