Coordinated care delivery is faced with various challenges to carry out in China,which are major decisions to make for decision makers,including how to push forward,how to deliver resources, services and patients to primary institutions,and how to ease the difficulties and affordability of seeing doctors.Based on analysis of roadblocks in coordinated care delivery in China,the authors provided near-term and long-term policy recommendations on the system,including how to build a scientific and reasonable healthcare delivery system,coordinated care delivery by stages,building incentives and constraint mechanisms,and enhancing public awareness and patient-doctor education.

Concept of coordinated care delivery is clearly defined,before a comparative analysis is made between such a concept and the integrated care delivery concept which is popular overseas and similar.On such basis,a theory framework is established for building and implementing such care delivery in line with the integrated theory of care delivery systems.Coordinated care delivery system now in place in China aims at rationally delivering medical resources,services and patients to primary institutions,by means of efficiently distributing resources and service systems and integrating care delivery flows,thus offering patients with cost effective and appropriate services and optimizing the care delivery system.

Atrial Fibrillation ; pathology ; Humans ; Peptidyl-Dipeptidase A

Analyzed in the paper is the present development of medical rehabilitation service system in Beijing,Changsha,and Urumqi,in an effort to identify key measures,and discover problems found with the policy environment and system building.Based on such findings,the authors proposed such measures as developing policies and regulations, optimizing resource allocation, strengthening training of rehabilitation personnel and greater publicity.

Objective To explore the level of serum transforming growth factor-β1 (TGF-β1) in patients with prehypertension and impaired fasting blood glucose.Methods A total of 180 healthy subjects with matched age and sex was divided into 3 groups:group A (blood pressure ＜ 120/80 mmHg and fasting blood glucose ＜6.1 mmoVL),group B (prehypertension and fasting blood glucose ＜6.1 mmol/L),group C (prehypertension and 6.1 mmol/L≤ fasting blood glucose ≤7.0 mmol/L).There were 60 subjects in every group.Serum TGF-β1 was measured by Enzyme-Linked Immunosobent Assay (ELISA),fasting blood glucose,triglyceride,total cholesterol,low-density lipoprotein cholesterol ( LDL-C),high-density lipoprotein cholesterol ( HDL-C),Uric Acid ( UA),body mass index (BMI) were determined.Results The level of serum TGF-β1 in group B and C was higher in that in group A( t =2.071,and 2.147,P ＜0.05 ).The level of serum TGF-β1 was higher in group C than group B,but no significant difference was observed ( P ＞0.05).The pearson correlation analysis showed there was a significant correlation between TGF-β1 and systolic blood pressure ( r =0.279,P =0.047).Conclusions The level of serum TGF-β1 was higher in patients with prehypertention which may mediate the target organ damage caused by the prehypertention.

Objective To explore whether an individual' s intention to gamble varied across different types of gambling. Methods A total of 373 Macau students completed a questionnaire survey on intention to gamble dealing with thirteen types of gambling,and exploratory factor analyses were conducted. Results The analyses showed two factors that had eigenvalues greater than one and explained a total of 59. 455 percent of the variance,with the largest factor explaining 32.59 percent. Participants' intentions to gamble were relatively lower in gambles of low counterparty with mean scores varying from ( 1.62 ± 1.13 ) to ( 2.20 ± 1.35 ), while the intentions were higher in gambles of high counterparty with mean scores varying from ( 2.34 ± 1. 39 ) to ( 3.02 ± 1.55 ). Conclusion Respondents' degree of intention to gamble was highly domain-specific, varying with the type of gambling.An individual' s intention to gamble is not consistent across all content domains, which implied that a potential gambler is not necessarily intended to gamble in all types of gambling.

Aged ; Aged, 80 and over ; Candidiasis ; complications ; microbiology ; Coal Mining ; Esophagitis ; complications ; microbiology ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; microbiology

Objective To investigate clinical effect of surgical treatment of complex scapular fracture with improved minimally invasive Judet approach and annularity internal fixation.Methods In this retrospective study,17 patients with complex scapular fracture accepted open reduction and internal fixation with improved minimally invasive Judet approach complying with the three points-two lines annularity internal fixation principle.After postoperative rehabilitation training,the curative effect was evaluated by the neer shoulder joint function score evaluation.Results All the 17 patients were followed up for 14 months on average (12-25 months).According to neer score evaluation,the percent of patients with excellent and good results was 88.2％ (excellent:12 cases;good:3 cases;middle:2cases;unsatisfactory:no case).Conclusions Improved minimally invasive Judet approach hase simple operation,adequate exposure and less injury.Annularity internal fixation complying with the three points-two lines principle is a safe and effective method for the treatment of complex scapular fracture.

Objective:This study aimed to identify the morphology of mast cells by using a modified toluidine blue staining scheme,so as to provide a powerful reference for the experimental basis research of mast cells.Methods:Bone marrow-derived mast cells were induced in vitro.After 4 weeks,the cells were collected,fixed,and stained.Mast cells were fixed at different temperature during different time.The optimum condition was determined by comparing the effects of toluidine blue staining.Results:Bone marrow cells were induced to differentiate into mast cells by SCF and IL-3 in vitro.When mast cells were stained with modified toluidine blue staining,the staining effect was better.Mast cells were round or oval and the cell membrane was complete and the cytoplasm was filled with a large number of purple particles.Conclusion:In this study,we successfully applied a modified toluidine blue staining method to mast cells cultured in vitro.The results showed that the condition at 37 ℃ full fixation with staining could reduce the degeneration of mast cells.This method was easy to operate with good stability.It was suitable for the morphological observation of mast cells cultured in vitro.

Objective To observe the curative effect and safety of interventional therapy of uterine fibroids using Embosphere and Pingyangmycin lipiodol emulsion.Methods The clinical data of 120 cases with uterine fibroids treated in our hospital were reviewed,and the patients were according to the different treatments given,divided into two groups (each with 60 cases).Patients in control group were treated with interventional therapy of Pingyangmycin lipiodol emulsion,while patients in the study group were given interventional therapy of Embosphere.The clinical efficacy and safety in the two groups were compared.Results The total efficiency in the study group was 93.33%,which was significantly higher than that in the control group (75.00%),and the difference was statistically significant (P<0.05).The comprehensive indexes after the treatment were improved in both groups compared with those before the treatment,and the improvement in the study group was significantly better than the control group (P<0.05,P<0.01).Besides,the total incidence of adverse effects in the study group was 11.67%,which was significantly lower than that in the control group (26.67%)(P<0.05). Conclusion The interventional therapy using Embosphere has better effect on uterine fibroid compared with the therapy using Pingyangmycin lipiodol emulsion,which is worthwhile to be brought into clinical application.