This paper reviews the long-term care policy in Japan and discusses successes and challenges in order to provide policy guidelines for China. All Japanese adults aged 65 or over are covered by the long-term care in-surance ( LTCI) program and are eligible for both in-home and institutional-care services following a thorough, sys-tematic care certification process. The program is financed by a mix of general tax revenues from the three levels of gov-ernment , income-tested premiums, and standardized co-payments. A key success of the policy is its universal and compre-hensive coverage. Notwithstanding this success, increasing costs remain a challenge as Japan’s population ages and the number of LTCI users increases. Learning from the experience of Japan, China should establish a long-term care system, which covers all the aged population, mainly focuses on in-home care, and qualifies social funding to invest.

Objective To investigate the preventive effect of post abortion care(PAC) on unsafe sexual behaviors and deficiency in the knowledge of unmarried females,especially the youth in order to prevent repeated.unintended pregnancies as well as to promote the unmarried female's reproductive health.Methods During the period from Jan.2012 to Jun.2013,171 unmarried young women (＜ 24 years old) were enrolled in the study who were underwent free willed induced abortion due to unwanted pregnancy in Maternal and Child Health-Care Hospital of Huangpu District of Shanghai.Their reproductive health related knowledge,attitude and behavior were investigated by questionnaires.Based on the information above,they were provided with a series of post abortion services and improvement of reproductive health cognition and prevention effect of repeat pregnancy were evaluated after the intervention.Results After the nosocomial PAC intervention,the research objects are improved in the contraceptive knowledge and contraceptive behavior largely than before.The awareness rate on the female fertile time was increased from 53.8％ (92/171) to 80.6％ (137/170).The common contraceptive awareness rate increased from 49.1％ (84/171) to 91.8％ (156/170).The difference was statistically significant (x2 =27.30,x2 =75.69,P ＜ 0.05).After 1 year follow-up,the PAC intervention make in contraceptive behavior change.The contraception rate increased from 8.2％ (14/171) to 65.3％ (111/170).The contraceptive failure rate was reduced from 35.7％ (61/171) to 4.7％ (8/170) (x2 =165.24,36.12,P ＜ 0.05).There was not complications occurrence.Conclusion PAC can improve the contraception rate and reduce the unmarried female youth repeated abortion rate effectively.

The method of ratio coefficient of amino acid, based on the theory of amino acid balance, is a new one designed to evaluate nutritional value of food protein. The calculation and the meaning of Ratio Coefficient (RC) and Score of RC (SRC) are described. RC can be used to judge limit amino acid and to calculate the amount that shall be added to a fortified food. SRC can be used to evaluate nutritional quality of protein. A high correlation was obtained between SRC and Biological Value (BV), P

Objective: To investigate the effects of Zhu Yun Pill(ZYP) in the treatment of infertility due to luteal phase defect(LPD).Methods: 163 infertility patients due to LPD were randomly divided into three groups in terms of ZYP group,progesterone group and combination group(ZYP and progesterone).Then the therapeutic efficacy was judged by the pregnancy rate(PR),endometrial biopsy,the level of serum hormone and basal body temperature before and after the treatment.Result: 40 women were pregnant in ZYP group(cure rate,33.33%),8 in the progesterone group(cure rate,26.67%) and 9 in the combination group(cure rate, 69.23%).The symptomatic amelioration and total effective rate of ZYP group were obviously higher than single exogenous progesterone group(P

Objective To identify the correlative and risk factors of non-oxygenation factors associated with postoperative prolonged mechanical ventilation (PMV) of aortic dissection(AD).Methods AD patients undergoing surgery during January 2010 and January 2015 were enrolled.Prolonged mechanical ventilation was defined that duration of ventilation more than 48 h.Results There were 240 patients,average age was (50 ± 12)years.The correlative factors with postoperative PMV were:pre-opervative white blood cell (WBC) (r =0.241,P =0.003),emergency operation (r =0.263,P =0.004),Debakey type (r =-0.379,P =0.000),duration of operation (r =0.329,P =0.000),postoperative diastolic pressure (r =-0.205,P =0.007),heart rate (r =0.246,P =0.001),postoperative hemoglobin (r =-0.213,P =0.005),calcium(r =-0.262,P =0.001),glucose (r =0.274,P =0.000),lactate(r =0.272,P =0.000) and pericardial effusion (r =0.239,P =0.032).Logistic analysis indicated that:the duration of operation,WBC and postoperative blood calcium were:2.063,1.285,0.016,respectivly(all P ＜ 0.05).Conclusions The correlative factors were:preoperative WBC,emergency operation,Debakey Type,duration of operation,heart rate,postoperative diastolic pressure,hemoglobin,calcium,glucose,lactate,and pericardial effusion.Duration of operation,WBC and postoperative blood calcium were risk factors predicting PMV.

OBJECTIVETo explore the effect and mechanism of cinnabaris and realgar in promoting awake effect of endotoxin- induced brain injury rat applied with Angong Niuhuang Wan.

METHODNormal rats implanted cortical electrode in advance were divided into 6 groups: control, model, the Angong Niuhuang Wan (AGNH, 0.4, 0.2 g · kg(-1)), the Angong Niuhuang Wan without cinnabaris and realgar (QZX-AGNH, 0.32, 0.16 g · kg(-1)). Rats in the control and model groups were given distilled water. After three days of intragastric administration, the brain injury model was injected with endotoxin through tail vein. Then trace electro-corticogram (EcoG) 1-6 h after LPS injection, and compare the power and relative power of beta (β) and delta-waves (δ) at 6 h of these groups. The content of acetylcholine (Ach) and the affinity of M-receptor (M-R) in cortex and brainstem were detected by alkaline hydroxylamine colorimetric method and radioactive ligand binding assay, respectively.

RESULTAGNH (0.4, 0.2 g · kg(-1)) could increase the power and relative power of β and AGNH (0.4 g · kg(-1)) showed better action on brain electrical activation. QZX-AGNH showed weak effect on it. AGNH (0.4 g · kg(-1)) could increase the affinity of M-R in cortex and the content of Ach in brainstem. The action of QZX-AGNH was not obvious.

CONCLUSIONIn endotoxin-induced brain injury rats, AGNH can raise the cholinergic system function of cortex, and strengthen the uplink of cortex activation of brainstem cholinergic system, improve the level of cortical activity and enhance the activation of EcoG to promote the body's awakening. QZX-AGNH show weak effect. Cinnabaris and realgar play an important role in promoting awake effect in endotoxin-induced brain injury applied with Angong Niuhuang Wan. The mechanism may be related to cortical and brainstem cholinergic system function.

Animals ; Brain Injuries ; chemically induced ; drug therapy ; physiopathology ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; Endotoxins ; adverse effects ; Humans ; Male ; Rats ; Rats, Sprague-Dawley

Objective To investigate the academic level and influence of the Chinese Journal of Digestive Surgery from the point of articles published and the authors.Methods The articles and authors of Chinese Journal of Digestive Surgery from 2002 to 2012 were retrieved from the Wanfang database and the China National Knowledge Internet database.The full texts were browsed and saved,and then the data were input to Excel for bibliometric analysis.Results There were 1917 articles were published in the Chinese Journal of Digestive Surgery during the past 11 years,and the average number of articles per issue was 29.05.The rate of articles with funded projects was 30.62％,and the citation rate was 58.52％.Authors were from 32 provinces,municipalites and Hong Kong.The numbers of articles contributed by authors from Chongqing,Beijing and Shanghai ranked top 3,which were 446(23.27％),240(12.52％) and 203(10.59％),and followed by authors from Sichuan,Jiangshu and Guandong.The number of articles from affiliated hospitals of Medical Schools was 1382 (72.09％).The cooperation rate was 4.37,and the coauthor rate was 90.03％.Conclusions Chinese Journal of Digestive Surgery is an academic journal with high quality and strong influence.The distribution of authors of the Chinese Journal of Digestive Surgery is wide,and the cooperative rate of authors is high,while the distribution of authors is disproportionate.

Objective　To analyze the influence of multiple variable factors on the occurance rate of pneumothorax associated with transthoracic needle aspiration biopsy of the lung. Methods　Fluoroscopically guided lung biopsies were performed in 46 patients. Variable factors were analyzed including lesion size, location, number of puncture, presence of emphysema and patients position after needle biopsy of the lung. Results　Pneumothorax occurred at 9 (19.6%) of 46 patients and that occurred at 4 (44.4%) of 9 emphysematous patients. Among them 2 necessitated chest drainage tube placement. The pneumothorax occurance rate was 30% (3/10) for lesions of diameter 3cm or less in size. In the dependent group, pneumothorax occurred in 4 of 20 patients (20%). In the nondependent group, pneumothorax occurred in 5 of 26 patients (19.2%). Conclusion　The correlation showed that increasing frequency of pneumothorax with decreasing size of lesions. An increased rate of pneumothorax was correlated with presence of emphysema. Patients with emphysema are more likely to have a symptomatic pneumothorax. No significant differences were found in the incidence of pneumothorax between patients placed with the puncture site dependent after biopsy and those placed with the puncture site nondependent.

Objective:To Compare the operational status of the New Rural Cooperative Medical Scheme( NCMS) in 14 Counties of 6 provinces. Methods:Two provinces were selected from eastern, central and western areas respec-tively and then two counties were chosen randomly from each province, but each of Jiangsu and Guangxi Provinces pro-vided 3 to reach the sample number of 14 counties. Excel 2007 was used for descriptive and comparative analysis of fund and in-patient service for NCMS. Results:The average funding standard was about 300 and 350 Yuan for 2012 and 2013. Hospitals outside county were frequently used and the ratio was over 40% in county I. Except Jiangsu and An-hui, the rate of enrollees who get compensation for inpatient service was over 10% and the actual compensation rate more than 50%, Fujian being an exception. Average hospitalization costs per time were different among counties and significantly rose in 2013. The ratio of out of pocket inpatient service expenses to the net rural household income was diverse among counties and it declines in some of them in 2013. The rate of fund for hospitals outside county was high and that of G counties was more than50%. The fund surplus rate was negative in that same year and was accumulatively ranging between 1 and 2%. Conclusions:The NCMS financing level was low and the personal financing responsibility was lighter;the enrollees didn’t contribute enough. In-patient service utilization structure was not rational in different level hospitals. The actual compensation rate for inpatient service didn’t increase a lot and the medical expenses burden didn’t alleviate apparently. The funds supervision was weak and it probably leaded to a high risk fund deficit.

Objective:To analyze the status quo and problems of the health human resources of township health center.Methods:296 township health centers in 18 counties of 6 provinces were selected with typical sampling and workers in the centers as target population.Relative administrative officials and directors of township health centers were interviewed.Descriptive analysis and thematic analysis were conducted with quantitative data and qualitative da-ta.Results:The volume and distribution of human resources in township health centers are not balanced and the allo-cation standard of the middle area is low.The null establishment and the employees out of establishment coexist.The allocation of health human resources inside township health centers is not reasonable and the ratio of health profes-sionals is lower than national standard.The rate of senior professionals is low.That health workers are out of stock is a potential problem in some counties.Medical education is not matched with the demand of township health centers.The recruitment policy is inappropriate and the remuneration of health professionals is low.It is difficult for the worker in township health centers to get professional promotion.Recommendations:The structure of workers in township health centers and the recruitment policy should be adjusted.The path of professional promotion should be clear in order to ex-pand the space of career development of workers in township health centers.Improving the remuneration of workers in township health centers should be considered to increase the attractiveness of the post in township health centers.