This paper deals with the process of the reform and development of the social medical insurance scheme in urban China and the reasons for reform. At the same time, the paper presents the model of financing new urban employees' medical insurance in China.

Fundus autofluorescence (FAF) relies primarily on the presence of accumulated lipofuscin in the retinal pigment epithelium (PRE) cells. It has emerged as a valuable tool to detect and evaluate the viability and structural changes of the RPE in live. As a non-invasive, repeatable, simple and efficient means of detection. FAF imaging can provide information of RPE structure and function to assistant the diagnosis of many retinal diseases with other conventional fundus imaging technologies. With quantitative analysis and complementary analysis with other fundus imaging technologies, the FAF features of different retinal diseases will be further understood. This knowledge will not only extend the reasonable and unique clinical applications of FAF, but also will contribute to the understanding the pathogenesis and improving the treatment of many retinal diseases.

Objective To evaluate the quantity,category and the distribution of health resources of Traditional Chinese Medicine(TCM)in order to advise on optimizing TCM service system.Methods Based on the concept of agglomeration degree,this paper compared and analyzed the agglomeration of TCM resources in terms of medical institutions,their beds and medical workers.Results Currently the agglomeration degree of TCM health resources is found to be low,as TCM medical institutions tend to be small,with most of them being TCM clinics.Conclusions To rationalize the distribution of TCM medical resources,we must increase financial input and provide supportive policies,actively encourage healthy development of TCM medical institutions,strength TCM medical service system development in areas of poor TCM resources.

Objective To study the effects of different dosages of valproic acid (VPA) in the disease onset, the level of motor dysfunction and survival time to the amyotrophic lateral sclerosis (ALS) model mice. Methods The ALS model mice (hSOD1-G93A gene positive) was screened and genotyped. Then,the model mice were random divided into treated groups( n = 18) and control group( n =6). The treated groups were i.p. injected with different dosage of VPA, but the control group was given isodose of saline. The assessment of the motor dysfunction stared from 12 weeks after birth and continued till death, the onset time and the survival time were recorded and compared. Results High dosage of VPA can prolong the onset time (9. 8 ± 1.4) days( P <0. 05), survival time ( 15.5 ±0. 9) days( P <0. 05), but it was not statistically significant to improve the motor dysfunction for the model mice. Compared with the control group,low and middle dosage of VPA were not statistically significant to prolong the onset time, the survival time for the model mice, and the level of motor dysfunction. Conclusions High dosage of VPA can delay the onset time of the ALS model mice and prolong the survival time, and which has neuroprotective effects against the neuronal degeneration in the hSOD1-G93A-gene-positive model mice.

Objective:To observe the curative effects of puerarin injection(葛根素注射液) on variant angina pectoris(VAP) and its influences on endothelial functions.Methods:Fortyeight cases with VAP were randomly divided into treated and control group.The treated group was treated with puerarin injection 300500 mg infused intravenously once a day，meanwhile the control group treated with conventional therapy.The therapeutic course was 1014 days for both groups.Before and after using drugs the changes in endothelin(ET) and nitric oxide (NO) were observed in two groups.Results:In both groups after therapy the clinically symptomatic convalescences and changes in electrocardiography (ECG) compared with before therapy had significant differences,but in comparison between two groups the differences had not statistical significant.Otherwise regarding to the ET and NO the differences were significant between treated group and control group.Conclusions:Puerarin injection not only possesses obviously curative effects on symptomatic convalescence and ECG changes but also is able to improve the endothelial functions.

Objective To analyze the inter-provincial utilization efficiency of health resources and master the differences between these regions so as to rationalize the allocation of such resources.Methods This paper called into play the data envelopment analysis to survey the efficiency of interprovincial health resourcas utilization,and the Malmquist productivity index method for further breakdown of the total factor productivity.Results Years 2003 to 2008 averaged an yearly growth of 6.8% for the total factor productivity of health resources in 31 provinces;the rate of technological progress was positive,while the annual rate averaged 5.2%;a slight growth of technical efficiency at the growth rate of 1.5%.Conclusion Years 2003 to 2008 saw an increase of varying extent in the total factor productivity,yet an insufficient utilization of health technology in the provinces in general.Compared to the efficiency of the central provinces,low efficiency was found in both the eastern and western regions in China.The westem regions made a faster progress in technology utilization,thus narrowing the gap of health resources among the provinces.

Dysfunction of microRNA (miRNA) is associated with occurrence and development of tumor.MiRNA are very stable in blood serum,significantly tumor-related and tissue-specific.The detection of serum miRNA is convenient,little-invasive and fast,and then serum miRNA can be used as a new biomarker for tumor diagnosis.

Objective To analyse the economies of scale in public hospitals in Zhejiang Province. Methods One hundred and twenty-five public hospitals in Zhejiang Province with qualification no less than class two level two were selected as sample hospitals. Douglas production function was employed to analyse the relationship between investment and output in sample hospitals between 2004 to 2006, with two types of production models established by medical service and incomes in hospitals as dependent variables. Results From 2004 to 2006, the medical service and incomes of sample hospitals were in line with economies of scale. The production increase rate was higher than investment increase rate. The medical service, incomes, total assets and number of staff in class three hospitals were higher than those in class two hospitals (P =0.000). Conclusion Economies of scale is the ultimate incentive to continuous outstretch for hospitals. Hospitals should rationally control the scale so as to avoid problems in medical service caused by overstretch.

Objective To study the operative method for severe duodenal trauma.Methods The clinical data of 38 cases of severe duodenal trauma complicated with pancreatic injury who underwent different operations between 1992—2006 year were reviewed.Results In 8 cases duodenal diverticulization was performed,of which 5 cases were cured,2 cases developed intestinal fistula,and one died.Of 9 cases who underwent panceaticoduodenectomy(PD),3 were cured but 6 had pancreatic leakage,and 3 of them died.Of 16 cases who had primary repair of ruptured duodenum with simple suture or patch suture,13 cases cured,2 cases developed intestinal fistula and one patient died.Five patients underwent duodenal repair and excision of head of pancreas plus pancreaticojejunostomy(PD with preserved duodenum),4 cases recovered and 1 had pancreatic leakage,but 3 with wrap-type pancreaticojejunostomy had no complications.Conclusions The repair of ruptured duodenum with simple suture plus duodenostomy and jejunostomy is preferential option for majority of cases of duodenal trauma.This procedure plus removal of head of pancreas and pancreaticojejunostomy(PD with preserved duodenum) can be used for severe pancreatic injury with excellent result,but duodenal diverticulization or panceaticoduodennectomy must not be undertaken lightly.

Objective To determine the quantitative indices of conservative treatment for perforation of peptic ulcer. Methods The clinical data of 321 patients admitted from 1990 to1999 were analyzed retrospectively. Score was obtained according to patients' age, extension of abdominal pain, time of perforation, fever,abdominal paracentisis,free air of abdominal cavity, etc.Results Conservative treatment was given to 85 patients who scored ≤ 2, of whom 81 (95.2%) recovered.In 22 patients who scored 3, 16 (72.7%) recovered.In 8 patients who scored 4, 2 (25.0%) recovered.Conclusions If the perforating ulcer patients scored less than 2, conservative treatment should be given.For those who scored 3, conservative treatment can be given for the first 24h,and then whether to continue conservative treatment or change to operation should be considered according to patients' condition.For patients scored ≥ 4 , an operation should be performed as soon as possible.