Around the world, the supply of health services faces challenges, especially in developing nations that suffer from inadequate infrastructure and aging equipment, frequent shortages of medicine and supplies, and low capacity and efficiency of primary health care. At present, more and more governments adopt public-private partner-ships to achieve public policy goals. Among those, Brazil, South Africa, and India have made greater achievements in changing the roles of local government, increasing the supply of primary health care and health care quality, pro-moting health care equality, meeting the needs of multi-level medical services, and promoting health capabilities by using public-private partnerships. This paper provides an overview of public-private partnership practices in the three countries, discusses their reform experiences, and concludes with implications which may be helpful for promoting and scaling up PPP in primary health care in China.

Objective To evaluate the efficacy of i-scan endoscopy in detecting small colorectal precancerous lesions.Methods A total of 127 patients were randomized into 2 groups to underwent conventional colonoscopy and i-scan endoscopy respectively.The findings were compared with pathologic examinations.Results A total of 84 lesions were detected by conventional endoscopy in 64 patients,while 147 lesions were found in 63 patients with high resolution detection only,which was increased to 259 with i-scan,including 102 flat lesions.With respect to histology,adenomatous lesions could be predicted with a high sensitivity (80％) and a high specificity ( 100％ ) by i-scan endoscopy.Conclusion More small colorectal lesions can be detected by i-scan endoscopy,which can distinguish neoplasm from non-neoplasm colorectal lesions.

ObjectiveTo evaluate digital chrome endoscopy (I-Scan) and confocal laser endomicroscopy (CLE) for diagnosis of Barrett esophagus (BE).MethodsFrom July 2010 to July 2011,a total of 878 outpatients who had upper gastrointestinal symptoms underwent routine endoscopy and I-Scan examination,screened patients with suspected Barrett's epithelial were further referred to CLE and endoscopy.The detection rate and image features of BE between routine endoscopy and I-Scan,and the diagnosis of BE between pathology and CLE,were compared respectively.ResultsSuspected BE was diagnosed in 46 patients (5.2％) by routine endoscopy,and in52 (5.9％) by I-Scan,and there was no significant difference in detection rate between 2 methods (x2 =0.533,P ＞ 0.05 ).The detection rate of paliform blood vessels between SCJ and GEJ was higher using I-Scan (35/52,67.3％ ) than routine endoscope (21/46,45.7％,P ＜0.05).A total of 19 suspected BE underwent CLE and biopsy,and BE was diagnosed by CLE with a sensitivity of 93％ and a specificity of 100％.ConclusionI-Scan is capable of identifying paliform blood vessels between SCJ and GEJ,and can improve the detection rate of suspected BE.CLE is able to provide in-vivo histological diagnosis of BE with a high sensitivity and specificity.

The medical and health organization management information system at grass-root level and platform at county level for data exchange in Sichuan Province were designed and constructed according to the health information exchange service network in Sichuan Province and standard medical CDA file, in order to implement data exchange on the medical and health organization management information system at grass-root level and platform at county level, to insure the basic medical and health service for the public, and to improve their health level.

Objective Discuss propofol in aged patient do not have painful gastroscope inspection in calm ease pain effect and safety.Methods Inspect gastroseope divide into observation group(propofol group) with compare group(conventional gastroscope group).Observe each group of record to receive the gastroscope operating time.nar- cotic thing role time and reaction in skill,before inspecting in rear BP,HR,SpO_2 and skill rear questionnaire investi- gation.Results The case owned is inspected all consummately,observe group to have negative role less,patient is more easy to accept.Conclusion It is rapid to have effect in propofol inspects without painful gastroscope,recovery time short,negative role lose,is comfortable and safe.

Objective To provide the evidence for health management decision-making and rational use of drugs grass root clinics by studying their drug prescription rules.Methods The prescribed drugs in clinics of 5 township health centers from September 2012 to September 2014 were retrieved from The Management Information System of Sichuan Grass Root Medical Institutions.Their big data were analyzed using R language.Results The commonly pre-scribed drugs in clinics were vitamin B6, vitamin C and cefixime tablets, which were usually used in combination. Conclusion Health administrative organizations can strengthen their supervision and management of prescribed drugs and promote their rational use in grass root clinics using unified management information system of grass root medical institutions in combination with information technology .

Objective To explore the mastery of relevant knowledge and skills for autism rehabilitation teachers in Beijing private rehabilitation agencies. Methods 51 autism rehabilitation teachers were selected from 10 Beijing private rehabilitation agencies and tested with self-prepared questionnaire. Results Rehabilitation teachers believed that professional knowledge, rehabilitation skills and special education basics ranked the former three positions as for knowledge importance; teachers' basic skills, professional knowledge and special education basics ranked the former three positions as for knowledge mastery. There were difference in academic background and business life. 95% teachers believed that the training form was knowledge plus case plus guidance. The best training time was weekends or summer and winter vacations. The curriculum expected mainly focused on behavior modification, class management, and training system that generally used for children with autism. Conclusion Autism rehabilitation teachers in Beijing private rehabilitation agencies urgently need training in the aspects of expertise, rehabilitation skills and so on.

A method of LC-QTOF/MS combining with chemical synthesis has been used to determine the structures of three novel bile acids from bear bile powder. Reference substances of tauroursodeoxycholic acid and taurochenodeoxycholic acid were oxidized by pyridinium chlorochromate. The products were analyzed by LC-QTOF/MS. Total 4 products including 3 isomers were predicted and identified according to the PCC oxidation theory and LC-QTOF/MS results. Bear bile powder samples were dissolved by methanol and analyzed by LC-QTOF/MS. Three unknown peaks were found and identified as 2-[[(3beta, 5beta)-3-hydroxy-7, 24-dioxocholan-24-yl]amino]-ethanesulfonic acid, 2-[[(5beta)-3, 7, 24-trioxocholan-24-yl]amino]-ethanesulfonic acid and 2-[[(5beta, 7beta)-7-hydroxy-3, 24-dioxocholan-24-yl]amino]-ethanesulfonic acid, separately, by matching their results with that of oxidation products above.
Animals ; Bile ; chemistry ; Bile Acids and Salts ; analysis ; chemistry ; Chromatography, Liquid ; methods ; Isomerism ; Molecular Structure ; Oxidation-Reduction ; Powders ; chemistry ; Spectrometry, Mass, Electrospray Ionization ; methods ; Taurochenodeoxycholic Acid ; chemistry ; Ursidae

OBJECTIVETo investigate the characteristics of microbial degradation of aniline by a stable bacterial consortium.

METHODSThe bacterial consortium was isolated from activated sludge treating chemical wastewater using aniline as the sole source of carbon and nitrogen by enrichment and isolation technique. The biomass was measured as optical density (OD) at 510 nm using a spectrophotometer. Aniline concentrations were determined by spectrophotometer. The intermediates of aniline degradation were identified by GC/MS method.

RESULTSThe bacterial consortium could grow at a range of aniline concentrations between 50 and 500 mg/L. The optimal pH and temperature for aniline degradation were determined to be 7.0 and 30, respectively. The presence of NH4NO3 as an additional nitrogen source (100-500 mg/L) had no adverse effect on bacterial growth and aniline degradation. The presence of heavy metal ions, such as Co2+, Zn2+, Ni2+, Mn2+ and Cu2+ had an inhibitory effect on aniline degradation.

CONCLUSIONSThe isolated bacterial consortium can degrade aniline up to 500 mg/L effectively and tolerate some heavy metal ions that commonly exist in chemical wastewater. It has a potential to be applied in the practical treatment of aniline-containing wastewater.

Aniline Compounds ; metabolism ; Bacteria ; Biomass ; Bioreactors ; Carcinogens ; metabolism ; Chemical Industry ; Hydrogen-Ion Concentration ; Metals, Heavy ; analysis ; Waste Disposal, Fluid ; methods ; Water Pollutants ; metabolism

Child, Preschool ; Chondromatosis, Synovial ; diagnosis ; diagnostic imaging ; surgery ; Diagnostic Errors ; Female ; Humans ; Tibial Fractures ; diagnosis ; Tomography, X-Ray Computed