Objective: To analyze the efficiency and differences of China Community Health Service, to analyze the shares of eastern-middle-western regional differences and the difference within each region in the total efficiency difference. Methods: The super efficiency DEA model and decomposition of Gini coefficient by Subgroups are used to analyze the provincial data in China from 2008 to 2011. Results: The eastern-central-western regional difference is the major cause of the efficiency differences in China Community Health Service. In the meantime, the shares of the difference within each region in the total efficiency difference are also non-negligible. Conclusion: To narrow the efficiency differences among eastern, central and western areas; improve the inter-regional flow of community health service resources; improve the support and supervision on the backward regions; make regional policies to coordinate the internal resources of community health services and strengthen the assessment mechanism using efficiency as the indicator.

Transcatheter closure as an alternative to medical surgery has become a preferred therapeutic method to atrial septal defect (ASD).However,thrombopoiesis after occluder implantation has been reported comprehensively and causes a series of serious complications such as cerebral embolism、myocardial infarction,pulmonary embolism and so on.Reasons of device thrombopoiesis are closely associated with atrial fibrillation,persistent atrial septal aneurysm,occluder type,activated coagulation system and occluder endothelialization process.This paper summarizes correlation factors of occluder thrombopoiesis and current related prevention proposal after transcatheter closure of ASD,and provides theoretical and experimental foundation for prevenition of device thrombopoiesis after occluder implantation of ASD.

Nco-adjuvant endocrine therapy has provided opened new alternatives for locally advanced breast cancer, especially for patient groups such as the elderly, those who are not suited for chemotherapy, and those whose response may not be optimal. The latest generation of endocrine therapy for breast cancer,aromatase inhibitors, has proved superior to tamoxifen in terms of toxicity and efficacy in the adjuvant setting.Compared with neo-adjuvant chemotherapy, the appropriate patients to receive nco-adjuvant endocrine therapy can achieve similar short-term benefit. However, because of fewer long-term follow up results, the overall prognosis is not clear.

New technologies and ideas are constantly emerging recently. With the arrival of the era of minimally invasive surgery, most of the colorectal cancer surgeries can be conducted through minimally invasive techniques. In this study, we discuss the status, characteristics, controversy, and consensus of minimally invasive techniques in colorectal cancer surgery.

Objective: To investigate the role of SDF-1/CXCR4 in metastasis of renal cell carcinoma and to observe the intracellular location of different CXCR4 segments in renal carcinoma cells. Methods: The potential nuclear localization sequences of different CXCR4 were discovered by nuclear localization software and experiments. Full length and truncated forms of CXCR4 were fused with green fluorescent protein pEGFP-N1 and their influence on subcellular localization was examined by confocal microscopy after transfecting them into renal carcinoma cell line A498. Results: Analysis with PSORT II Prediction revealed that the nuclear localization sequence region of CXCR4 was located between amino acids 146 and 149(RPRK). Expression products of the recombinant plasmids with SDF-1 stimulation, including EGFP-CXCR4 (1-510 bp), EGFP-CXCR4(1-765 bp) and wild-type EGFP-CXCR4, were mainly located in the cell nuclei. However,expression product of EGFP-CXCR4(1-267 bp) with SDF-1 stimulation was mainly located in the renal cell cytoplasm. Expression product of wild-type EGFP-CXCR4 full length plasmid without SDF-1 stimulation was mainly located in the cell cytoplasm; these results accorded with the results of bioinformatics analysis. Conclusion: Nuclear localization sequence of CXCR4 is located in the amino acids 90 to 170, which provides a theoretical basis for further clarifying the nuclear localization sequences of CXCR4 in renal cell carcinoma cells and for finding new potential target for inhibiting the metastasis of renal cell carcinoma.

Sepsis is a systemic inflammatory disease caused by infection that affects the lungs and can develop into acute lung injury or acute respiratory distress syndrome.Acute lung injury caused by sepsis is one of the common critical diseases in intensive care unit, which is often manifested as intractable hypoxemia, diffuse double pneumonia infiltration, pulmonary edema, etc.Its pathogenesis is complex, and there is no specific treatment method at present.MicroRNAs are non-coding gene regulators involved in the regulation of various physiological and pathological processes of the body, including sepsis acute lung injury.This paper briefly summarized the pathophysiological mechanism of acute lung injury in sepsis, summarized the regulatory mechanism of miRNAs on alveolar macrophages, epithelial cells and endothelial cells during the pathogenesis of ALI, and finally comprehensively expounded the current situation and future direction of miRNAs in the treatment of acute lung injury in sepsis.

Inhalation chemotherapy and immunotherapy is a developed technique for respiratory neoplasm recently. It is easy manipulated with high local response and little side effects. The drugs include 5 FU,DDP, taxol, camptothecin,interleukin 2 and GM CSF, etc. Inhalation chemotherapy and immunotherapy have been successfully applied for the therapy of primary lung cancer as well as the lung metastases other tumor.

Objective To evaluate the role of extracelluar signal-regulated kinase (ERK)-cyclic AMP response element binding protein (CREB) signaling pathway in the spinal cord in naloxone-induced withdrawal response in morphine-dependent rats.Methods Fifty male adult SD rats,aged 2 months,weighing 200-250 g,in which intrathecal catheters were successfully implanted without complications,were randomly divided into 5 groups (n =10 each):group control (group C); group morphine dependence (group MD); group morphine withdrawal (group MW); group U0126 (ERK signaling pathway blocker); group dimethyl sulfoxide (DMSO,solvent for U0126).Morphine dependence was induced by increasing doses of subcutaneous morphine for 6 days.The initial dose of morphine was 10 mg/kg twice a day and was increased by 10 mg/kg twice every other day until 50 mg/kg on 6th day in groups MD,MW,U0126 and DMSO.Morphine withdrawal response was induced by intraperitoneal naloxone 4 mg/kg at 4 h after last morphine administration in groups MW,U0126 and DMSO.U0126 150μg (in DMSO 10 μl) and DMSO 10 μl were administered intrathecally at 30 min before naloxone administration in groups U0126 and DMSO respectively.Morphine withdrawal response (0=no withdrawal response,3 =severe response)and touch evoked agitation (0 =no agitation,2 =severe agitation) were observed and scored during 1 h after naloxone administration.The animals were then sacrificed and the spinal cord was removed for determination of the expression of phosphorylated ERK (p-ERK) and phosphorylated CREB (p-CREB) by immuno-histochemistry and Western blot.Results Morphine withdrawal significantly up-regulated the p-ERK and p-CREB expression in group MW compared with group C ( P ＜ 0.05).Withdrawal response score and touch evoked agitation score were significantly increased in groups MW,U0126 and DMSO as compared with group MD ( P ＜ 0.05).U0126 pretreatment significantly attenuated naloxone-induced increase in withdrawal response score and touch evoked agitation score and down-regulated p-ERK and p-CREB expression in group U0126 as compared with group MW ( P ＜ 0.05).Conclusion ERK-CREB signaling pathway in the spinal cord is involved in morphine withdrawal response in morphine-dependent rats.

ObjectiveTo study the effects of dl-3n-butylphthalide on study and memory abilities and hippocampus expression of MMP-9 in rat model of radiation injuries of brain.MethodsWistar rats were divided into radiation group radiated by linear accelerator and control group.Morris water test were taken to study the learning and memory ability of rats in each group before irradiation and 120 d after irradiation.ResultsMorris water maze test results showed that:in the academic test,compared with model group,high-dose butylphthalide group and low dose butylphthalide group had significantly shorter escape latency( (79.61 ± 7.17 )s,(43.64 ± 4.72)s,(42.15 ±4.19 ) s) and decreased number of errors ( 36.43 ± 6.59,14.58 ± 4.22,13.66 ± 3.91 ) (P ＜ 0.01 ).In the memory test,compared with model group,high-dose butylphthalide group and low dose butylphthalide group had significantly longer the former platform quadrant time respectively (30.09 ± 3.68 ) s,( 31.25 ± 3.17 ) s vs ( 17.57 ±4.29) s and faster swimming speed respectively (P ＜ 0.01 ).ConclusionButylphthalide can significantly reduce hippocampal neurons expression of MMP-9,which indicates that butylphthalide has curative effect on radiation brain injuries by regulating the expression of MMD-9.

Long-term failure in choice of materials for artificial esophagus (AE) and in treating incidence of postoperative com-plications of esophageal cancer has resulted in lack of ideal AE regeneration. As one of the innate elements forming the human body, carbon possesses high tissue affinity. Artificial esophagus as the induced stent of esophageal regeneration is the best choice for replac-ing esophageal defects and for reintroducing oral feeding after cancer radical resection.