Objective: Analyze the impact of NCMS(new cooperative medical scheme) on rural medical institutions,and give suggestions for the sustainable development of medical institutions and the NCMS.Methods: Collect and analyze the efficiency and the account materials of the county-level healthcare departments and the town-level health centers of Zhen'an County in 2003 and 2006.Results: The implementation of NCMS produced an effect on the increase of the outpatient medical service;the service quality of the county-level medical institutions and the town-level health centers needs to be enhanced in spite of the increase of in-patient medical service;the medical institutions' income increased,and the medical service fees increased rapidly;the expenditure per person and time rose sharply.Conclusions: Management mechanism of NCMS should be further developed,construction and supervision of the county-level medical sectors and the town-level health centers,especially supervision of the quality of medical sectors be enhanced;the payment system be changed to control the growth rate of medical expenses.

OBJECTIVE: To explore the effects of Yiweining Recipe (YWNR), a compound Chinese herbal medicine, on expressions of metalloproteinase-2 (MMP-2) and cyclooxygenase-2 (COX-2) mRNAs in rats with endometriosis (EM). METHODS: Operational self-transplantation was applied in establishing the rat models. Detection of MMP-2 and COX-2 mRNAs was conducted with hybridization in situ. RESULTS: There were significant differences in the expressions of MMP-2 and COX-2 mRNAs between the untreated group and the high-dose YWNR-treated group. YWNR could reduce the expressions of MMP-2 and COX-2 mRNAs. CONCLUSION: YWNR can treat EM through reducing the positive expressions of MMP-2 and COX-2 mRNAs.

Objective: To objectively evaluate the short-term and long-term efficacies of arthrolysis under brachial plexus anesthesia in treating adhesive capsulitis of the shoulder (ACS). Methods: One hundred patients diagnosed with ACS were divided into two groups using the random number method. The two groups both received same active rehabilitation exercises. Besides, 55 cases in the treatment group were given one session of arthrolysis under brachial plexus anesthesia, and 45 cases in the control group were given tuina treatment. Changes in the visual analog scale (VAS) score, Melle score and pressure pain index were observed 1 month and 3 months after treatment. The therapeutic efficacies were also compared. Results: The total effective rate was 96.4％ at the 1-month follow-up and 96.4％ at the 3-month follow-up in the treatment group. The total effective rate was 33.3％ at the 1-month follow-up and 28.9％ at the 3-month follow-up in the control group. There were significant differences between the two groups comparing the total effective rate at the two time points (both P<0.05). The scores of VAS, Melle and pressure pain were significantly different at the 1-month and 3-month follow-ups from those before treatment in the treatment group (all P<0.05); the three scores did not show significant differences at the 1-month and 3-month follow-ups compared with those before treatment in the control group (all P>0.05). Conclusion: Based on the active rehabilitation exercises, one session of arthrolysis under brachial plexus anesthesia can release the adhesion and restore the range of motion and function of shoulder joint in ACS patients. It is superior to rehabilitation exercises plus tuina treatment comparing both short-term and long-term efficacies.

Objective To detect 14 genes including fibrillin-1(FBN1) and so on mutations in 17 patients with Marfan syndrome(MFS) and family members of 2 patients and to investigate the correlation between FBN1 gene mutation and MFS.Methods Genomic DNAs were extracted from whole blood sample of 17 patients and 43 family members.After DNA samples were amplified by polymerase chain raction(PCR), we used capture panels to get target genes which would be sequenced by Illumina HiSeq2500 Analyzers(Illumina, SanDiego, USA).The target genes included ACTA2、CBS、FBN1、FBN2、MYH11、COL3A1、SMAD3、TGFBR1、TGFBR2、MYLK、MSTN、COLA2、TGFB2 and SLC2A10.The results of sequencing would be compared with multiple databases, including NCBI dbSNP, HapMap, 1000 human genome dataset and database of 100 Chinese healthy adults, to find gene mutation.Finally, these mutations would be validated using conventional Sanger sequencing methods.Results A total of 10 FBN1 mutations and 1 actin alpha2(ACTA2) mutation in 17 patients were identified, of which 8 FBN1 mutations and 1 ACTA2 mutation were novel.One FBN1 mutation was underwent family investigation and we found in this family, all patients had this mutation and others did not have it.Conclusion Missense mutation of c.7280G>A in the 59th exon of FBN1 gene is new pathogenic mutation for MFS.The other 8 novel mutations may be the pathogenic factors of MFS.

Objective:To observe the efficacy of using electroacupuncture(EA)plus stuck-needle lifting method to treat intractable facial paralysis based on the myofascial theory. Methods:Ninety patients with intractable facial paralysis were divided into a control group and an observation group using the random number table method,with 45 cases in each group.The control group was given conventional EA treatment,and the observation group received EA plus the stuck-needle lifting method based on the myofascial theory for 4 consecutive weeks,6 sessions each week.The electromyographic results,modified Portmann scale(MPS)score,facial nerve function index(FNFI),and total effective rate were compared. Results:There were no significant differences in the MPS and FNFI scores between the two groups before treatment(P>0.05).After treatment,the total effective rate and FNFI and MPS scores were notably higher in the observation group than in the control group(P<0.05).There were no significant differences in the electromyographic readings between the two groups before the intervention(P>0.05).After the intervention,the observation group had a shorter blink reflex R1 latency and a higher facial nerve compound muscle action potential compared with the control group,and the between-group differences were statistically significant(P<0.05). Conclusion:EA plus stuck-needle lifting method based on the myofascial theory can enhance treatment efficacy for intractable facial paralysis.

AIM:Toobservetheeffectsofmicroparticlesderivedfrombonemarrowmesenchymalstemcells ( MSC-MPs) on angiogenesis and cardiac function in a rat myocardial infarction model .METHODS:MSCs were obtained from Sprague-Dawley rats.MSCs were treated under serum-free condition in hypoxia for 72 h, and the microparticles were isolated from the supernatants .The phenotypic profile of MSC-MPs was determined by bead-based flow cytometry and the morphology was observed under a transmission electron microscope .The rat myocardial infarction model was established . The cardiac function was evaluated by echocardiography after the intramyocardial injection of MSC -MPs.The myocardial in-farct size was observed by Masson staining .The blood vessel density in the peri-infarcted area was measured using immuno-histochemical staining for von Willebrand factor and α-smooth muscle actin.The expression of vascular endothelial growth factor ( VEGF) was analyzed by real-time PCR.RESULTS: Apoptotic MSCs released a large quantity of microparticles which were phenotypically similar to the parent MSCs and 100~1 000 nm in diameter.The cardiac functions of myocardial infarction rat model were improved at 7 d and 28 d after intramyocardial injection of MSC-MPs compared with control group . The myocardial infarct size was reduced and angiogenesis was promoted significantly in the infarcted heart injected with MSC-MPs 28 d after treatment .MSC-MPs treatment also increased the expression level of VEGF within 7 d.CONCLU-SION:MSC-MPs protect cardiac tissue from ischemic injury and improve cardiac function by promoting angiogenesis after myocardial infarction .

Objective To investigate the difference of quality of life in patients with different symptom dimensions of obsessive-compulsive disorder(OCD).Methods Collected 54 cases of outpatient and the first inpatient with OCD to be the research group and 54 normal persons were the control group.The quality of life was assessed with SF-36,and compared the scores.An analysis was performed on the major categories of the YBOCS-SC to derive symptom dimension scores.Results Compared to the control group,patients with OCD showed significant impairment in seven domains of quality of life,especially in the mental health(t=12.474,P＜0.01),the roleemotional(t=9.407,P＜0.01),the social functioning(t=8.862,P＜0.01) and the vitality(t=8.057,P＜0.01).The patients with distinct symptom dimensions of ①symmetry/order,contribution rate 21.60％ ; ②contaminate/clean,contribution rate 16.37％; ③ aggression/religion,contribution rate 12.34％; ④ sex/check,contribution rate 10.90％.They showed different severity of the impairments in four domains of quality of life,the role-physical(F=5.199,P=0.004),the bodily pain (F=3.169,P=0.034),the role-emotional (F=9.350,P=0.000),the mental health(F=4.854,P=0.005).The differences mainly found between the ①②③group and the ④group by LSD multiple testing.Conclusion The mental health is severely damaged with OCD patients.There is stability with the structure of the symptom dimensions of OCD.And it maybe showed the heterogeneity of the symptoms for the significant difference of impairments of quality of life in patients with OCD.

Objective To determine whether volume transfer coefficient (Ktrans )can be used to differentiate high-grade glioma (HGG)and metastasis.Methods Thirty-nine patients with brain tumors (12 HGG,27 metastases)underwent dynamic contrast en-hanced MR imaging before surgical resection or stereotactic biopsy.Images were acquired with a three-dimensional (3D)fast gradi-ent echo sequence.Gadolinium-based contrast agent was injected intravenously with dosage of 0.1 mmol/kg bodyweight at a rate of 3.0 mL/s.Ktrans and Ve were calculated from the DCE MRI data.The results of Ktrans and Ve were compared between the 2 types of tumors.Receiver operating characteristic curve analysis was performed for each of the variables in differentiation cerebral metastasis from HGG.Results The Ktrans values in the parenchyma of HGG and metastases were 0.10 (0.11,0.71)min-1 and 0.21 (0.05, 0.77)min-1 ,respectively.The difference was not statistically significant (P>0.05).The Ktrans values in the peritumoral region of the HGG and brain metastasis were 0.04 (0.01,0.10)min-1 and 0.01 (0.00,0.06)min-1 ,respectively.There was a significant difference between the Ktrans values in the peritumoral edema of HGG and cerebral metastases (P<0.05).The optimal cutoff value of Ktrans for differentiating HGG from cerebral metastases was 0.03,with sensitivity of 75% and specificity of 70%.Conclusion Ktrans values in the peritumoral edema may be useful in the differentiating cerebral metastases between HGG.

OBJECTIVE: To investigate the effects of interventional therapy with norcantharidin-alginic acid/poly acid anhydride microspheres (N-MS) infusion via hepatic artery on hepatoma in rats. METHODS: N-MS was prepared by emulsion-chemical crosslink technique. Eighty-nine hepatoma-bearing rats were randomly divided into five groups, which were normal saline group, norcantharidin (NCTD) group, blank microsphere (B-MS) group, NCTD-lipiodol group and N-MS group. Normal saline, NCTD, B-MS, NCTD-lipiodol and N-MS were injected via hepatic artery accordingly. After the interventional therapy, eight rats from each group were observed for survival time, and the rest rats were killed on the 8th day after intervention to measure the tumor volume and necrostic degree. The apoptotic index of liver tumor cells was detected by TUNEL staining, and the expression of ki-67 was assayed by immuno-histochemical streptavidin-biotin peroxidase method. RESULTS: The survival time of the rats in the N-MS group was prolonged as compared with those in the other four groups, and the tumor volume of the rats in the N-MS group was smaller than those in the other four groups. The tumor growth rate and the expression level of ki-67 in the N-MS group were both significantly lower than those in the other four groups. The tumor necrotic degree and the apoptotic index in the N-MS group were significantly higher than those in the other four groups. CONCLUSION: Interventional therapy with N-MS could yield preferable therapeutic effects on hepatomas in rats. This anti-tumor efficacy may be associated with microvessel embolization in liver tumor and the sustained releasing of NCTD. Its inhibiting effect on tumor cell proliferation maybe result from decreasing the expression of Ki-67 and inducing the tumor cell apoptosis.

MicroRNA (miRNA for short) can induce mRNA cleavage or inhibit mRNA translation and regulate gene expression in the post-transcriptional level, which involves cell development, proliferation, differentiation, apoptosis, and a series of important biological processes. Recent studies have found that the abnormal regulation of miRNA's target genes may be involved in tumor resistance. And it is expected to become important tumor resistance-associat-ed molecular markers and therapeutic targets. Mechanism of traditional Chinese medicine (TCM) and its active ingre-dients can affect miRNA to regulate target proteins and target genes mediated tumor multidrug resistance. It can pro-vide new ideas for the mechanism of reversing multidrug resistance by TCM.