The core problem of current rural health services is a governance problem, that is, how the basic rural health resources can be used more effectively. Based on the study of history and reality, this paper suggests that in the existing “government-market” framework, the village is the third perspective worthy of consideration. Inside the village community, the trust, network and cooperation between people which were based on the traditional rural acquaintances society capital and the institutional resources in the organizations at the primary level will be able to in-crease the degree of organization, thereby reducing the transaction costs between the government or the market and rural residents. The village power will be able to better take advantage of government and market mechanisms, and thus solve the problem of rural health resource utilization more effectively.

AIM: To study the protective effect of glutamine (Gln) against endotoxemia by observing the effect of glutamine on heat shock proteins (HSPs) and tumor necrosis factor-? (TNF-?) in endotoxemic rats. METHODS: The rats were randomly divided into 3 groups, lipopolysaccharide group (LPS), glutamine-treated group (Gln) and control group (C). The blood was drawn from lateral tail vein for analysis of cytokine levels at 0, 2, 4 and 6 h post-lipopolysaccharide (LPS) challenge. TNF-? was measured by radioimmunity assay. Multiple tissues were harvested from the rats, and HSP70 was detected by immunohistochemistry. At the same time, lung, liver, and ileum tissue section were stained with hematoxylin and eosin. RESULTS: Gln treatment resulted in marked attenuation of TNF-? expression at 2 h post-LPS injection (P

Humans ; Suicide ; Forensic Pathology

Objective To investigate the clinical characteristics and currently treatment status of intractable ulcerative colitis (IUC). Methods A retrospective analysis was conducted on the data of inflammatory bowel disease patients, who were hospitalized in Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, from January 1999 to December 2009. According to the reaction to glucosteroids (GCS) treatment, they were divided into GCS effective group and intractable group. The general data, lesion, clinical symptoms and laboratory findings of these two groups were compared.Further treatments and the results of intractable group were analyzed. Results Totally 234 UC patients were enrolled, of which 37.6％ (88/234) patients received GCS treatment, intractable group and effective group took up 23.9％ (21/88) and 76.1％ (67/88) respectively. There was no significant difference of lesion between two groups (P＞0.05). Compared with effective group, the proportion of intractable group was higher in moderately severe bellyache[38. 1 ％ (8/21) vs 13. 4％ (9/67), P＝0.012, OR＝3.97, 95％CI:1.29～12.23], anemia[61.9％(13/21) vs 32.8％(22/67), P＝0.018,OR＝3.32, 95％CI:1.20～9.20], thrombocytosis[57.1％(12/21) vs 29.9％(20/67), P＝0.023,OR＝3.13, 95％ CI: 1.14 ～8.61]and hypoalbuminemia[38.1 ％ (8/21) vs 11.9％ (8/67), P＝0.007, OR＝4.54, 95％CI: 1.44～ 14.32]. Some patients of intractable group could be remission through extending period of GCS treatment, adding the immunomodulators or biological agents and intestinal segment excision. Conclusion UC patients with moderately severe bellyache, anemia,thrombocytosis, hypoalbuminemia at the onset of disease, which may indicate relatively poor response to GCS treatment. Immunomodulators, biological agents and surgery are the further treatment for IUC patients.

Objective To explore and analyze the related factors for cirrhosis patients with hospital infection.Methods Clinical data of 750 patients with cirrhosis in our hospital were retrospectively analyzed.Related factors for hospital infection including gender,age,length of hospital stay,Child-Pugh classification,accompanying invasive procedures,associating the underlying disease,using antibacterial drugs and the sites of hospital infection and pathogen distribution were analyzed.Results The infection rate was 20.7％ (155/750).The infections were mainly spontaneous bacterial peritonitis [54.8％ (85/155)],followed by respiratory,digestive,urinary tract and skin.Pathogenic bacteria were mainly Gram-negative bacteria [56.1％ (101/1)],followed by Gram-positive bacteria and fungi.Patients aged over 70 years,with hospital stay over 4 weeks,with higher Child-Pugh classification,associated with invasive procedures,combined with underlying diseases,and treated with antimicrobial drugs were much easier to get hospital infection (x2=12.2,16.3,49.46,55.2,20.95,26.24,all P＜0.05).Conclusions Patients aged over 70 years with long hospital stay and more severe liver damage,accompanied by invasive procedures,combined with basic diseases and treated with antimicrobial agents are the related factors for hospital infection in patients with cirrhosis.

BACKGROUND: Chitosan/poly (3-hydroxybutyrate) (PHB) copolymer has been paid close attention for special biological source of Chitosan and PHB. However, there has been no proper method for them to polymerize effectively.OBJECTIVE: To prepare chitosan/PHB graft copolymer in a homogeneous medium, using a gentle initiator.DESIGN, TIME and SETTING: This study, a single-sample experiment, was performed at the Research Center of Chemistry, Xi'an University of Architecture and Technology, Xi'an, Shaanxi Province, China from August 2007 to October 2007.MATERIALS: Chitosan: DD=100%, Mη=123000, Kyoto, Japan. PHB was purchased from Aldrich chemicals and the molecular weight was 10000.METHODS: Chitosan was grafted with poly (3-hydroxybutyrate) (PHB) in acetic acid/dimethyl sulfoxide system, and benzoyl peroxide (BPO) was used as initiator. The reaction temperature was 85℃ and the reaction continued for 5 hours with nitrogen protection. Grafting reaction and the chemical structure of the copolymer were confirmed by infrared analysis, NMR and elemental analysis. The crystal form and thermal stability of copolymer were characterized with wide-angel X-ray diffraction (WAXD) and thermogravimetric/differential thermal analysis balance, respectively.MAIN OUTCOME MEASURES: The chemical structure of copolymer, crystal form as well as thermal stability.RESULTS: Grafting reaction was confirmed by infrared analysis, NMR and elemental analysis. Wide angle X-ray diffraction and thermogravimetric analysis indicated that graft copolymer was different from chitosan and PHB in crystalline morphology, and had a good thermal stability.CONCLUSION: Using BPO as initiator, chitosan/PHB grafting copolymer is prepared and it has a steady property.

Objective To explore the feasibility of establishing the model of chronic blliary(pancreatitis) by incompletely ligaturing common bile duct.Methods Fifty Wistar rats were randomly(divided) into three groups: control group,experimental control group and model group.The rats in model group were exposed the root of common bile duct to enter duodenum using the dissolubility bowel line to ligating a needle with common bile duct,then drew out the needle,closing the abdominal cavity.The rats in experiment control group were opened the abdominal cavity and dissociated common bile duct,then closing the abdominal cavity.Results Compared with control group,the serum bilirubin and(amylase) of blood in model group were increased in 3 days and 14 days respectively and fibrotic(proliferation) of pancreatic tissues were found in 30 days.In model group,23% of rats developed(pancreatic) pseudocyst.Conclusions Incompletely ligating the common bile duct of Wistar rats could(induce) chronic pancreatitis and pancreatic fibrosis in 30 days.Strictures of common biliary duct may play a key role in chronic biliary pancreatitis.

Objective To observe the effect of aminoguanidine by intraperitoneal injection on apoptosis of chondrocyte with osteoarthritis.Methods Totally 32 rabbits were divided into 3 groups at random.Both the experiment and the model groups were fixed by plaster cast in the right hind straighten limb,while the control group received no treatment.The experiment groups were injected with aminoguanidine in abdominal cavity,100mg/(kg?d),and the control groups were injected the same voluminal normal saline in abdominal cavity.At the 4th week,we killed 4 rabbits from the normal group,and 6 from the control group and the experiment group,respectively.At the 8th week,we put the rest to death.We drew the materials from each sample for pathological observation on the whole and under the light microscope by HE and immunohistochemical staining,and counted apoptosis cells by TUNEL for statistical analysis.Results Compared with the control group,the experiment group was more similar to the normal group in general observation and optical microscope observation by HE staining.Both iNOS positive expression cell by immunohistochemical staining and apoptosis cell calculation by TUNEL of the experiment group were fewer than those of the control group(P

BackgroundDiabetic retinopathy (DR) is a progressive vision-threatening complication of diabetes mellitus,but its pathogenic mechanism is still unclear. Recent studies showed that it may be associated with the inflammation response of retinal capillary. Cytokines can cause induction of proinflammatory and adhesion molecules and thereby increase monocyte endothelial cell adhesion, which is now accepted as the early key event in the development of DR. ObjectiveThe present study was to determine the relationship between the stages of DR and the levels of serum vascular endothelial growth factor (VEGF) , interleukin-2 ( IL-2 ), tumor necrosis factor-alpha (TNF-α) in diabetic patients. Methods This was a pilot case-controlled study. Ninety patients with type 2 diabetes mellitus were included in this clinical trial and 30 healthy individuals were enrolled as controls. The patients were grouped into the non-diabetic retinopathy(NDR) group,background DR group and proliferative DR(PDR) group according to the results from ophthalmoscopic examination and fundus fluorescein angiography(FFA) ,with 30 patients for each group. The levels of serum VEGF,IL-2,TNF-α were assayed by ELISA and compared among the 4 groups.Written informed consent was obtained from each subject before received any related medical examination to this study. ResultsThe mean serum VEGF levels were(217.35±27. 87)ng/L,(298.31±49.26)ng/L,and(341.23±40. 18)ng/L, respectively, and mean serum IL-2 levels were( 12. 12± 1. 57 )ng/L, (16.43 ±2. 26 )ng/L, and (21.36±0. 86) ng/L,respectively and mean serum TNF-α levels were( 11.63±0. 94) ng/L, ( 17. 52±0. 65) ng/L,and(22. 01±0. 87 ) ng/L respectively in the patients with NDR ,background DR and PDR, showing significant differences from healthy controls with( 193.46±37. 39 ) ng/L for serum VEGF, ( 8. 99 ±0. 57 ) ng/L for serum IL-2 and ( 7.31 ±0. 52 ) ng/L for serum TNF-α ( F =126. 38, P＜0. 0 1 ;F =120. 37, P＜0. 01 ;F =99. 84, P＜0. 01 ). The levels of serum VEGF, IL-2, and TNF-α in the patients with the NDR,background DR and PDR were increased significantly. The level of serum VEGF showed the positively significant correlation with serum IL-2 level and TNF-α level ( r =0. 749, P ＜ 0.01 ; r =0. 631,P＜0. 01 ). The serum levels of VEGF, IL-2 and TNF-α showed a significantly positive correlation with the prolongation and severity of DR(r=0. 791 ,P＜0. 01 ;r=0. 665 ,P＜0. 01 ;r=0. 632,P＜0. 01 ). ConclusionsVEGF, IL-2 and TNF-α play active roles in the generation and development of diabetic retinopathy, and the level of serum VEGF is closely associated with the levels of serum IL-2 and TNF-α. during the development of DR.

This paper introduces the construction of standard magnet hospital.Combined with the standard, summarizes the current situation of the working environment of postpartum nurses working in China,in order to provide reference for carrying out scientific environmental support,human resource allocation,reducing the job burnout and turnover rate.