Sixty five stroke patients undergoing rehabilitation training in our hospital from May 2010 to May 2013 were randomly divided into study group (n =32) and control group (n =33).Patients in study group received intramuscular injection of botulinum toxin A (BTX-A) in the affected limbs before rehabilitation training started.The F wave amplitude and F/M value,muscle tension and TUG test and 10 m free walking test results of patients in two groups were observed before and 4 weeks after treatment.Compared to the results before treatment,the amplitude of F wave and F/M value after 2 and 4 weeks of treatment in study group decreased significantly (P ＜ 0.05).Compared to control group,the indexes at each time point after treatment in study group were significantly different (P ＜ 0.05).The muscle tension score in study group after 4 weeks of treatment decreased significantly (P ＜ 0.05),and also lower than that in control group (P ＜ 0.05).Before treatment there were no significant differences in TUG test and 10 m free walk test between two groups (P ＞0.05) ; while TUG test and 10 m free walk test in study group were better than those in control group after 4 weeks of treatment (P ＜ 0.05).The TUG test and 10 m free walk test had little improvement in control group after treatment (P ＞ 0.05).The results indicate that botulinum toxin A injection can reduce amplitude of F wave in the corresponding segment of spinal cord motor neurons and improve the walking ability of stroke patients.

Objective To divide the medical services currently offered by various medical institutions into priority,extended and non-essential items.Methods The items were divided according to their actual usage at these hospitals,and such services were screened based on hospital positioning and clinical pathway of diseases.Results The selected priority services at the primary,secondary and tertiary hospitals were 255, 378 and 820 respectively.Their proportions in total medical services of these hospitals were 92.9%,95.9% and 97.4% respectively,and the proportion of their costs in total medical service costs were 57.9%,76.8% and 84.5% respectively.Conclusions The selected priority items had covered most of the services and costs,which deserve promotions at all the hospitals as it embodied the principle of benefiting the majority of the population.

Objective To determine the main contents and key points of the essential medical services by means of priority setting of diseases with high incidence and serious damage based on the demand of residential medical services.Methods The priority setting method is applied in this study,and the incidence,prevalence,hospitalization rates and the ratio of different types of inpatient are used as indicators to reflect medical demand and utilization.The integrated balance method is also used,and the priority diseases list is made based on the analysis from the view of disease onset,considering the service delivery,social equity and the health financing.Results Based on the data analysis made,this paper proposed that the priority diseases cover 29,66 and 103 types for primary hospitals,secondary hospitals and tertiary hospitals respectively.The main diseases so determined include hypertension,diabetes, maternal and child health,severe mental illness,infectious diseases,emergency treatment,etc.Conclusions The method and result of setting priority disease and main disease can be the basis of setting for main diseases in essential medical services.

Boundaries definition plays a key role in defining the scope of essential medical coverage of the country and the governmental role positioning in medical service offerings.It is also a precondition of furthering the ongoing healthcare reform.This paper analyzed the data of health service demand,supply and financing using the priority setting and the integrated balance methods.It suggested that the definition of the essential medical services should embody Chinese characteristics and be consistent with the Party′s governing philosophy and social core values.It also should be fully considered that the administration system,the governing philosophy,the medical insurance system and the government duty in the healthcare system of China.This paper proposed a multiple-criteria defining of the essential medical services,which should focus on main healthcare issues in China,and be adapted to the current healthcare reform process.Three dimensions need to be considered in the defining,which are the demand,supply and financing of the healthcare services,along with the impact of the housing,equipment,personnel, technology,supplies,drugs and other medical service elements.This paper presented the overall framework of essential medical services in four levels,which is composed of the basic package,the core package,the priority package and the expansion package.

The somatostatin analogue pasireotide is a new type of protein which is the first therapeutic agent targeted to the pituitary.Pasireotide can prevent adrenocorticotropic hormone release and inhibit the growth of tumor cells after coupling with somatostatin receptor of the target cell membranes.Pasireotide has a high binding affinity for most of somatostatin receptor (SSTR) subtypes and in particular for SSTR5.Pasireotide can paly an important role in the new round of new targets for individualized diagnosis and treatment of tumors through the studies of translational medicine.

Objective To investigate the clinical efficacy of new-type patent endotracheal tube in difficult endotrachea intubation patients.Methods Seventy-three patients with the abnormal airways were selected as our subjects.Patients were given the traditional endotracheal tube by mouth after anesthesia.The successes patients in terms of endotracheal intubation were as group Ⅰ (n =73).The failed patients were asgroup Ⅱ (n =63),who performed the secondary endotracheal intubation with new type patent endotracheal tube.Analyze the success rate of intubation of the two groups when on use the tube core.Results The first time intubation success rate and intubation success rate was (2.7％ (2/73),13.7％ (10/73) respectively) in Ⅰ group,and 73.02％ (46/63) and 98.41％ (62/63) respectively in the group Ⅱ,and there was the significant difference between two groups (x2 =36.01,31.08 respectively,P ＜ 0.01).Conclusion The new type endotracheal tube was proved with three advamage of good plasticity,without need of auxiliary core intubation with trachealtube and give full play to lead the soft cannula guide tubes leading role.Therefore,the new type patent endotracheal tube has more efficacy over traditional tube.

Objective To analyze the impact of medical insurance reimbursement mechanism on the income of urban community health centers run by various entities. Methods The data of the baseline survey of community health centers in 28 cities made in 2007 were called into play. These data were used to compare the percentage of the annual medical insurance income from outpatient clinics of three types of community health centers in their gross annual income and their annual outpatient clinic income. Results For 929 community health centers with income from medical insurance reimbursement, the average percentage of their annual income from outpatient clinic accounts for 24% of their gross annual income and 26. 09% of their annual outpatient income;In respect of the reimbursement rates of medical insurance at outpatient clinics, the highest come from those run by enterprises, secondly those by the government,and the least those run by social organizations or individuals. Conclusion The mechanism of medical insurance reimbursement has already affected the income of the third type of community health centers. It is recommended to raise the coverage rate of medical insurance of such type of centers and their reimbursement rates of medical insurance. This may further consolidate the policies of medical insurance reimbursement.

Objective:To investigate the efficacy and safety of different doses of tirofiban combined with coronary artery intervention in treatment of Non ST-segment elevation acute coronary syndromes (NST-ASC).Methods:110 cases with NST-ACS from October 2014 to January 2016 in our hospital were chosen and divided into the all dose group and half dose group.The TIMI blood grade before and after treatment,cardiac function before and after treatment for 30 d,major adverse cardiac events and bleeding events,hospitalization expenses and hospitalization days were recorded and compared between two groups.Results:Compared with before treatment,the TIMI 2 grade and 3 grade were obvious decreased,and the left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV) after treatment for 30 d were all obvious decreased,while the left ventricular ejection fraction (LVEF) were significant increased,P＜0.05.And the TIMI blood flow grading,LVEDV,LVESV and LVEF before and after treatment in two groups had no significant difference (P＞0.05),and the major adverse cardiac events and hospitalization days of two groups had no significant difference,P＞0.05.While the bleeding events and hospitalization expense of all dose group was obvious higher than those of half dose group,P＜0.05.Conclusions:The half dose group of tirofiban combined with coronary artery intervention in treatment NST-ACS has obvious efficacy,it can decrease the bleeding events and hospitalization expense.

To achieve the goal of universal healthcare coverage,and the objective of the ongoing healthcare reform to establish an essential healthcare system,the study proposed a financial framework for building the essential medical service package,covering medical services offered by primary medical institutions,treatment of major diseases,and essential medical services offered by secondary and tertiary hospitals.With data over the years of the total medical expense and medical service usage as the basis,and in the principles of affordability and cost-effectiveness,the total financing quota of essential medical services is expected to reach 1 940.846-2 1 62.41 7 billion,accounting for 30.66%-34.1 6% of the total healthcare expenditure.75% of the financing load should be carried by the government and society, focusing on financing medical services offered by primary institutions and lowering out-of-pocket burden of residents.

Single nucleotide polymorphisms (SNPs) are genetic variations that determine the differences between any two unrelated individuals. Various population groups can be distinguished from each other using SNPs. For instance, the HapMap dataset has four population groups with about ten million SNPs. For more insights on human evolution, ethnic variation, and population assignment, we propose to find out which SNPs are significant in determining the population groups and then to classify different populations using these relevant SNPs as input features. In this study, we developed a modified t-test ranking measure and applied it to the HapMap genotype data. Firstly, we rank all SNPs in comparison with other feature importance measures including F-statistics and the informativeness for assignment. Secondly, we select different numbers of the most highly ranked SNPs as the input to a classifier, such as the support vector machine, so as to find the best feature subset corresponding to the best classification accuracy. Experimental results showed that the proposed method is very effective in finding SNPs that are significant in determining the population groups, with reduced computational burden and better classification accuracy.