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 measure the changes of total factor productivity (TFP)of Zhejiang medical facilities for decision makers to promote their service efficiency.Methods Collecting the panel data of 2005-2010(four input indexes and five output indexes)from medical facilities in Zhejiang province and measuring with Malmquist index of DEA programs of DEAP2.1.Results The average annual TFP growth rate in the period is 2.0％.A further decomposition found that the average annual growth rate of technology progress is 1.8 ％,while that of technical efficiency and pure technical efficiency is only 0.2％respectively.In the meantime,no scale efficiency growth was found.Conclusion The average annual growth of total factor productivity of Zhejiang medical institutions is substantially low in the period,with technology recession found as well.To maximize productivity of the medical sector,the allocation and internal management should be strengthened to stimulate technical efficiency and scale efficiency while encouraging technology innovation.

Objective To treat scalp lacerations by using the hair apposition technique (HAT) and to compare the HAT with standard suturing in a controlled prospective trial. Method Fifty patients with scalp lacerations were treated either by HAT or by standard suturing. Two groups were evaluated in consumed times for operation, pain sores, and complications. Results There were 30 HAT patients and 20 patients treated with suturing. The took shorter operation time consumed[(3.33 vs. (6.05 t = 4.85.P < 0.01], and HAT produced significantly lower pain score [(1.73vs. (3.20t = 4.01,P < 0.01]. There was a trend that more and more patients were willing to have HAT performed. Conclusions The advantages of HAT include a shorter time consumed for operation, less pain, satisfactory wound healing, and high acceptance by patients. HAT is acceptable for treating scalp lacerations in emergency room.

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.

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.

AIM: To observe the effect of Chang'ankang Capsule (Radix Astragali, Rhizoma loptidis, Flos Lonicerae, etc.) on rat's colitis induced by trinitrobenzene sulfonic acid (TNBS) and investigate its mechanism. METHODS: The rat's colitis was induced by TNBS and ethanol, one week later the rats were given the medicine for 14 days. The 21st day the mucosal damage index (CMDI) and histopathology (HP) of the colon were observed. Meanwhile the level of myeloperoxidase (MPO), nitric oxide (NO), superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), maiondiadehyde (MDA), catalase (CAT) were detected. RESULTS: CMDI and HP, biochemistry in model rats showed that the models were successful. Chang'ankang groups significantly alleviated CMDI, HP, and improved the high level of MPO, NO and MDA, promoted the content of SOD, GSH-PX, CAT. CONCLUSION: Treatment with Chang'ankang shows beneficial effects on rat's ulcerative colitis by alleviating damage of free radical and NO and leukocyte.

Objective:To investigate Cinnamic aldehyde effects on expression of E-cadherin and MMP-9 and proliferation of lung adenocarcinoma A549 cells,and explore the possible mechanism of Sonic Hedgehog (SHH) signaling transduction.Methods:After co-cultured with Cinnamic aldehyde at the concentration of 0,10,20 and 40 μg/ml for 24 h,48 h and 72 h respectively,A549 cells were tested for their proliferation by MTT assay;E-cadherin and MMP-9 level in the supernatant by ELISA;expression of E-cadherin and MMP-9 mRNA by realtime-PCR with SYBR GreenⅠ;and protein expression by Western blot.Results: ①Cinnamic adehyde with concentration at 10 μg/ml would inhibited proliferation of A 549 cells after 24 hours′treatment;with concentration at 10, 20 and 40μg/ml can affect the proliferation significantly ( P<0.05 );with concentration of 40μg/ml cinnamic adehyde for 72 h,the re-markably inhibition of proliferation in A 549 cells was observed , the highest inhibitory rate was ( 93.782 ±5.036 )%.②Cinnamic aldehyde also increased migration rate of A 549 cells.③Expression of components on Hedgehog signaling pathway in A 549 was higher than that in human HBE cells.Cinnamic aldehyde could increase further upregulate of components expression in Hedgehog signaling pathway of A549 cells.④Secretion level of E-cadherin,mRNA and protein were decreased in A549 cells co-cultured with Cinnamic al-dehyde,while secretion level of MMP-9,mRNA and protein level in A549 cells co-cultured with cinnamic aldehyde were increased.Pre-treatment with 2 nmol/ml cyclopamine,an increasing of secretion level of E-cadherin ,mRNA and protein level in A549 cells was observed,decreasing of secretion level of E-cadhein,mRNA and protein level was also observed in A 549 cells.Conclusion:Cinnamic aldehyde inhibits the proliferation in a time-and dose-dependent manner and effected expression of E-cadherin and MMP-9 through sonic hedgehog signaling pathway in lung adenocarcinoma A 549 cells.

Objective: To conifrm the omentopexy decreasing the susceptibility of ventricular arrhythmia in experimental rats with chronic myocardial infarction (MI) by nerve remodeling.
Methods: The MI model of SD rats was established by left coronary artery ligation. 3 weeks later, the qualiifed animals were randomized into 3 groups for the 2nd operation. ① Sham operation group, the rats received the 2nd operation without ligation, ② Isolated MI group, the rats received the 2nd operation without omentopexy, ③ Omentopexy group, the rats received the 2nd operation with omentopexy. n=20 in each group. 4 weeks after the 2nd operation, the electrophysiological characteristics were assessed by relevant techniques, the new and sympathetic nerves in MI border zone were examined by immunohistochemistry, the protein expressions of connexin43 and nerve growth factor (NGF) were measured by western blot analysis and the cardiac endothelin-1 (ET-1) level was evaluated by ELISA.
Results: Compared with Isolated MI group, Omentopexy group showed decreased susceptibility of arrhythmia (3.5 ± 1.2) vs (0.9 ± 0.2), improved electrical transduction (1.5 ± 0.2) mV vs (3.4 ± 0.3) mV and decreased capture threshold (5.5 ± 0.3) mV vs (2.2 ± 0.2) mV, all P<0.05. Compared with Isolated MI group, immunihistochemisty indicated that Omentopexy group had decreased new and sympathetic nerves in MI border zone, as for GAP43:(1388.4 ± 244.9)μm2/mm2 vs (768.6 ± 144.1)μm2/mm2, for TH:(1552.4 ± 270.3)μm2/mm2 vs (1018.5 ± 124.7)μm2/mm2, all P<0.05. Western blot analysis showed that Omentopexy group had the lower NGF expression and higher connexin43 expression;ELISA demonstrated that Omentopexy group had the lower ET-1 expression, P<0.05.
Conclusion: Omentopexy may decrease the susceptibility of ventricular arrhythmia after MI in experimental rats, which might be related to the cardiac nerve remodeling.

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 .