Objective To provide reference for focusing and improving policy efficiency in China by establishing the conceptual model and index system of effectiveness of Township and Village Health Services Integration Policy(TVI).Methods The conceptual model and index system of TVI effectiveness were established by literature review and Delphi method.Comprehensive Index Method and Weighted TOPSIS Method were used in index consistency check.Results The conceptual model and index system of TVI effectiveness contain four conceptual modules,8 policy goals and 27 evaluation indexes.The positive coefficient of experts is 0.95 and authoritative grades of experts are more than 0.90.Conclusion Based on SPO Model,the conceptual model and index system of TVI effectiveness in China have been established,which consists three aspects:construction of organization system,health services and satisfaction.

ObjectiveTo investigate and analyze the current primary quality management situation in TCM clinical studies.Methods One sub-center unit from 39 projects of “Prevention and Treatment of Difficult and Complicated Disease of TCM” plan of the“11th Five-year National Key Technology R&D Program” was chosen. Executive condition of the primary quality control of each unit was under field investigation, and quality control quantitative evaluation indexes were used to conduct quantitative evaluation.Results Results were shown as the forms of statistical description and radar map. The average and median scores of primary quality management were 5.05 and 5.2, respectively. The best and preferable proportions of 39 units were 25.64% and 28.21%. Other 46.15% of these units performed poor. The problem mainly manifested on insufficient frequency and bad normalization of primary quality management, such as comprehensiveness and integrity of inspection contents, cases, problem recordings and problems timely feedback.ConclusionAlthough the primary quality management is widely conducted in TCM clinical studies, there are still some problems to be settled and improved.

Objective: This research is conducted to analyze the background, the main practices and the results of the synergistic service of health institutions in Changzhou city, as well as to provide references for promoting the construction of integrated medical and health service system.Methods: This paper uses qualitative interviews and questionnaires to collect information and analyzes the data based on synergetic management theory.Results:Changzhou city has tentatively achieved the synergy of its health institutions by introducing relevant policies, setting up healthcare unions at the municipal level, integrating internal resources among healthcare unions, establishing health information platform and feedback mechanism, etc.Conclusion: The regional synergistic service of health institutions can be effectively promoted by introducing policies at the municipal level, promoting the mutual sharing and communication on information, and integrating internal resources among healthcare unions.But, as there still exist problems such as the distribution of benefits is not perfect, the degree of synergy is not close, etc., thus, the government is suggested to expand the implementation scope of the close-type medical service synergy and further improve the distribution policy of benefits.

Biomedical Research ; Clustered Regularly Interspaced Short Palindromic Repeats ; Humans

Objective To compare the advantages and disadvantages of smear immunohistochemistry and biopsy of bone marrow in the detection of non-Hodgkin lymphoma (NHL) infiltration. Methods 60 newly diagnosed patients with NHL were collected. Smear immunohistochemistry and biopsy of bone marrow were applied to detect bone marrow involvement in those patients. The relations between the results of two detection methods and the relevant clinical characteristics, such as age, blood routine examination, lactic dehydrogenase, extensive infiltration, B symptom, performance status, clinical stage and so on were analyzed. Results Positive rate of bone marrow involvement in bone marrow smear immunohistochemistry group was higher than that in bone marrow biopsy group [10.0 % (6/60) vs. 3.3 % (2/60), P=0.008]. When detection on B cell infiltration, positive rates were 6.6 % (4/60) and 3.3 % (2/60) in smear immunohisto chemistry group and biopsy group, respectively (P=0.007), and when detection on T cell infiltration, the positive rates were 3.3%(2/60) and 0 (0/60), respectively. Furthermore, two detection method was not correlated with related clinical characteristics, such as bone marrow biopsy, immunohistochemistry, gender, age, Karnofsky score, B symptom, extranodal involvement, lactic dehydrogenase, thrombocyte, Hb, neutrophils, lymphocyte and staging (all P>0.05). Conclusions The positive rate of bone marrow smear immunohistochemistry is superior to bone marrow biopsy in the detection of bone marrow involvement of NHL. As for the immunophenotyping of NHL, sensitive rate of bone marrow smear immunohistochemistry is also better than that of bone marrow biopsy.

Objective:To observe influence of exercise rehabilitation combined diet guidance on cardiac function and quality of life (QOL) in patients after heart valve replacement .Methods:A total of 120 patients after heart valve replacement were selected and randomly divided into control group (n=60 ,received routine health education ) and experiment group (n=60 ,received diet guidance and exercise rehabilitation based on routine health education ) .After discharge ,patients re‐ceived outpatient follow‐up for six months ,body weight ,cardiac function and QOL on six months after surgery were fol‐lowed up and observed in two groups ,and the results were statistically compared .Results:Compared with control group six months after discharge ,there were significant rise in left ventricular ejection fraction [ (51.75 ± 9.30)% vs .(57.73 ± 6.13)% ] andoxygenmetabolicequivalent [(7.05±1.85)METsvs.(11.34±2.18)METs],andeachitemscoreofQOL and total score of QOL [ (4.98 ± 0.40) scores vs .(6.49 ± 0.53) scores] ,P<0.05 or <0.01;and significant reduction in body weight [(67.75 ± 10.67) kg vs .(61.25 ± 10.34) kg] in experiment group ,P<0.01. Conclusion:Exercise rehabili‐tation combined diet guidance can avoid rapid increase in body weight after surgery ,promote recovery of cardiac function and improve quality of life after surgery in patients with heart valvular diseases .

OBJECTIVE: To establish RP-HPLC method for the fast determination of floxuridinein in serum and homogenate of some of the organs of mice. METHODS: The determination was performed on C18 chromatographic column with its mobile phase consisted of phosphate buffer(pH= 7.4) - methanol(95∶5) and with its detection wavelength at 268nm. RESULTS: Linear detection concentration ranges of floxuridinein were all at 15～240?g/ml. The minimum detection concentration was 3?g/mL(S/N≥3). The average extraction recovery was above 95%. The average recovery ranged from 91%to 112%. Both the intra-day and inter-day precisions were less than 10%. CONCLUSION: The method is simple, rapid, reliable and economical, and it can be used for the determination of serum floxuridinein concentration and the study of its body distribution in animals.

OBJECTIVE:To optimize the preparation techniques for floxuridinyl diacetate solid lipid nanoparticles(FUDRA-SLN).METHODS:The FUDRA-SLN was prepared by film-ultrasound dispersion method with soybean phos?pholipids as carrier,and the preparation techniques were optimized by means of an orthogonal test design with entrapment ef?ficiency and appearance as indexes of investigation.RESULTS:The FUDRA-SLN prepared in the optimized techniques was even and regular in appearances,with particle diameter at(215?83)nm,entrapment efficiency at98.27%and drug loading dosage at8.20%.CONCLUSIONS:FUDRA-SLN prepared by the optimized film-ultrasound dispersion method has a high entrapment efficiency and high drug loading dosage,and this method is suitable for the laboratory preparation.

Objective To explore the imaging features of liver tumors with real-time tissue elastography.Methods Eighty-five liver lesions in 67 cases were scanned with conventional ultrasonography and elastography using HI-Vision900 system and then assessed with grade scores.Results on ultrasound were compared with those on pathology.Results Majority of lesions with grade a-b on elastography were identified as benign on pathology, while most of masses with grade c-e on elastography were confirmed as malignant on pathology.The sensitivity, specificity and accuracy were 93.5%, 87.0% and 91.8% for elastography to detect malignant lesions,74.2% ,73.4% and 74.1% for conventional ultrasound.The Kappa value of two doctors on elastography in group Ⅰ (the depth of the lesion ≤10cm) was significantly higher than group Ⅱ (the depth of the lesion ＞10cm).Conclusions Real-time tissue elastography of liver tumors provides a new convenient,non-invasive diagnostic methods,contribute to identify the benign and malignant live tumors.

Objective To observe the therapeutic effect of catgut-embedding (CE) therapy based on respiration-induced reinforcing and reducing and electro-acupuncture (EA) therapy in treating simple obesity with spleen deficiency and dampness retention. Methods Sixty simlpe obesity patients with spleen deficiency and dampness retention were randomized into CE group and EA group, 30 cases in each group. The acupoints selected for the two groups were the same, and the points were Zhongwan, Shuifen, Qihai, Guanyuan, Tianshu, Liangmen, Daheng, Fujie, Quchi, Xuehai, Yinlingquan, Fenglong, and Ashi. CE group was given CE therapy with the needling for CE therapy referred to the respiration-induced reinforcing and reducing method, and EA group was given EA therapy for 2 continuous treatment courses, 4 weeks constituting one course. Body mass and body mass index (BMI) of the two groups before and after treatment were observed, and the clinical efficacy was also evaluated after treatment. Results (1) After treatment for 2 courses, body mass and BMI of the two groups were obviously decreased(P<0.05 compared with those before treatment), but the differences between the two groups were insignificant (P > 0.05). (2) The total effective rate of CE group was 90.0% and that of EA group was 86.7%, and the difference between the two groups was insignificant (P > 0.05). Conclusion The therapeutic effect of CE therapy based on respiration-induced reinforcing and reducing in treating simple obesity with spleen deficiency and dampness retention is similar to that of EA therapy, and the patients can choose anyone of them for loosing body weight according to the preference.