The division of specialists and general practitioners is the important of the establishment of a GP system. According to the theory of labor division, the study analyzes the evolution mechanism on the division of spe-cialists and general practitioners and discusses the main factors influencing the division in China. It is found that transaction costs of general practices are not much lower than that of specialist medical care, which encourages outpa-tients to visit specialists in hospitals. Additionally, transaction costs of referral are much higher than profits. There-fore, while there is no division of specialists and general practitioners, it has been difficult to address competition between them and the quality and the efficiency of general practice care in community health centers. Moreover, the income gap does not attract medical students to work in general practices, which has worsened the quality and effi-ciency of general practices. Finally, the transaction costs of general practices have continually increased. This vicious cycle has hindered the division of specialists and general practitioners in China.

Objective To evaluate the effects of mechanical stretch preconditioning on pathological stretch-induced damage to type Ⅱ alveolar epithelial cells.Methods A549 cells cultured in vitro were randomly divided into 6 groups (n =5 each)using a random number table:control group (Ⅰ group),pathological stretch group (Ⅱ group) and different time mechanical stretch preconditioning + pathological stretch group (group Ⅲ-Ⅵ).A549 cells were exposed to 20％ cyclic stretch at 0.3 Hz for 6 h in Ⅱ group.In Ⅲ-Ⅵ groups,A549 cells were exposed to 5％ cyclic stretch at 0.3 Hz for 15,30,60 and 120 min,respectively,and then exposed to 20％ cyclic stretch at 0.3 Hz for 6 h.After the end of pathological stretch,the apoptosis in cells was detected using flow cytometry and was calculated.F-actin expression was determined using flow cytometry.Results Compared with group Ⅰ,the apoptosis rate was significantly increased,and the expression of F-actin was up-regulated in Ⅱ group.Compared with group Ⅱ,the apoptosis rate was significantly increased in groups Ⅳ-Ⅵ,and the expression of F-actin was up-regulated in groups Ⅴ and Ⅵ.Conclusion Preconditioning with mechanical stretch (30-120 min) can mitigate pathological stretch-induced damage to type Ⅱ alveolar epithelial cells.

In this experiment, the murine melanoma cell B16-F10 oncolysates transfected by recombinant vaccinia viruses encoding human IL-2(IL-2VBO) were used as vaccine. When the tumor-bearing mice were treated by following injection of IL-2VBO into tumor site, the tumor growth was inhibited and the survival time prolonged. The PBL from IL-2VBO treated mice showed higher cytotoxicity to the wild type B16-F10 but not to YAC-1 cells than that from control groups. The results showed the active specific immunity was induced by the IL-2VBO. On accout of its stronger immuogenicity and some advantages in preparing and storing, the IL-2VBO might be used as a kind of effective vaccine in the cancer active specific immunotherapy.

International experiences can provide evidences for general practitioners ( GPs) system building in China. The paper reviews the development of GP systems from several typical countries of different insurance sys-tems, including national health care systems, commercial medical insurance systems, and social medical insurance systems, etc. The factors that influence GPs systems are analyzed. It is found that the control force of health security system on health system, the control force of specialists on health system, the incentive mechanism of general prac-tice, and the development of general medicine influence the establishment of GPs systems. Finally, this paper pro-vide several policy implications:First, in order to meet the needs of public health, a GPs system with Chinese char-acteristics should be established;Second, the core values of general medicine should be promoted to provide public support for the establishment of a GPs system;Third, a sound incentive mechanism should be established for the de-velopment of a GPs system to improve the status of general practitioners;Fourth, the division of general practitioners and specialists should be promoted to improve the development of general medicine.

Angiogenesis after cerebral ischemia iS increasingly receiving attention.The expression of angiogenesis growth factor increases after cerebral ischemia.It promotes endothelial proliferation and neovascularization,and thus improves blood supply in ischemic regions and decreases the volume of infarction.The combination of exogenous angiogenesis growth factor.stem cell transplantation and therapeutic angiogenesis to promote angiogenesis was mainly achieved by promoting the expression of angiogenesis growth factor."Ihe further study of the mechanism of angiogenesis after ischernia will provide theoretical basis for the treatment of ischemic stroke.

Objective To learn the business operations of the pilot county-level public hospitals chosen for the 2014 experiment,which were subsidized at different levels in the financial subsidy mechanism reform.Methods County-level public hospitals from 109 counties were sampled as pilots from two provinces of the eastern,central and western regions of China.Descriptive analysis and correlation analysis were made to study their business operations at various subsidy levels.Results Proportional differences in the governmental financial subsidy level make a difference in the revenue and expenditure of county-level public hospitals.The higher the subsidy proportion,the lower the annual average of the total workload of the hospital(P <0.01),the less the inpatient expenditure per hospitalization(P =0.01),and the lower the drug proportion as well(P <0.01 ).Conclusions Financial subsidy plays a key role in the financial balance and business operation of such hospitals.Hence the government is proposed to guarantee its financial subsidy responsibility,to build a long-term financial subsidy mechanism.

Adolescent ; Adult ; Child ; Female ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia ; therapy ; Male ; Middle Aged ; Prognosis ; Young Adult

Objective To evaluate the effects of mechanical stretch preconditioning on endotoxininduced damage to human type Ⅱ alveolar epithelial cells.Methods Human type Ⅱ alveolar epithelial cell line A549 ceils at the logarithmic growth phase were seeded in 96-well plates at a density of 0.5 × 106 cells/ml (2 ml/well).The cells were randomly divided into 3 groups:control group (group C,n =12);lipopolysaccharide (LPS) group (n =36) and 5％ CS + LPS group (n =48).The 5％ CS + LPS group was further divided into 4 subgroups,and A549 cells were exposed to 5％ cyclic stretch for 15,30,60 and 120 min in the 4 subgroups,respectively.LPS with the final concentration of 1 μg/ml was added after the end of mechanical stretch in the 4 subgroups,and A549 cells were incubated for 4 h.The apoptosis in cells was detected using flow cytometry and apoptosis rate was calculated.F-actin expression was determined using immunofluorescence.Results Compared with group C,the early and late apoptosis rates were significantly increased in LPS and 5％CS + LPS groups.Compared with the value at 4 h of LPS incubation in group LPS,the early and late apoptosis rates were significantly decreased,and the reconstruction of F-actin was reduced in 5％CS + LPS group.Conclusion Preconditioning with 5％ cyclic stretch (15-120 min) can mitigate endotoxin-induced damage to human type Ⅱ alveolar epithelial cells.

Objective To investigate the clinical significance and biological role of G-protein coupled receptor 49(GPR49) expression in pancreatic carcinoma.Methods GPR49 expression in tumor and adjacent normal tissues of 77 patients with pancreatic cancer was compared by tissue microarray and immunohistochemistry.And then, the GPR49 expression levels in the tumor tissues of patients with different pathological grades and clinical stages were analyzed.GPR49 positive pancreatic cancer cell line CFPAC-1 was taken as cellular model.CFPAC-1 cells were stimulated with roof plate-specific spondin(RSPO)1, the ligand of GPR49, in vitro.The effect of RSPO1 on CFPAC-1 cells proliferation was evaluated with cell counting.The effect of RSPO1 on the expression of membrane molecular CD44 in CFPAC-1 cells was detected by flow cytometry.CFPAC-1 cells incubated with RSPO1 were subcutaneously implanted into nude mice.And then, the time of tumor formation and tumor size were observed.T test and single factor analysis of variance were performed for statistical analysis.Results GPR49 was widely expressed in all 77 pancreatic cancer tissues.By immunohistochemistry, the score of GPR49 expression in pancreatic cancer tissues was 9.0±2.4, which was higher than that of adjacent normal tissues (5.7±2.4), and the difference was statistically significant (t=8.995, P<0.01).There was no correlation between GPR49 expression and tumor sizes, pathological grades, lymph node metastasis, and clinical stages (all P>0.05).The results of experiments in vitro indicated that RSPO1 could promote CFPAC-1 cells proliferation and up-regulate CD44 expression in CFPAC-1 cells.Experiments in vivo demonstrated that after 30 days the tumor volume of mice implanted with RSPO1-pretreated CFPAC-1 cells was (606.0±188.0) mm3, which was larger than that of PBS-pretreated group ((364.2±83.7) mm3), and the difference was statistically significant (t=2.616, P=0.031).Conclusion GPR49 is widely expressed in pancreatic cancer cells and RSPO1/GPR49 pathway has play a role in promoting the proliferation of pancreatic cancer cells, which might be a potential target for interfering pancreatic cancer.