Objective To assess the equity of health resources configuration in Zhejiang,and provide references for regional health planning.Methods The Lorenz curve,Gini coefficient and Theil index were used to calculate and analyze.Results The Gini coefficient in 2009-2011 calculated by population density was between 0.330～0.343,which meant comparatively rational.The main reason of inequity configuration for hospital beds and nurses was inter-regional difference.Conclusion The Theil index could remedy the disadvantage that Gini coefficient could not reflex the total inequity was brought up by inter-regional or intra-regional difference.The health resource configuration should based on population health need and health service demand.

The mainstay of nonpharmacological therapy of chronic heart failure patients is low sodium diet. This paper introduced the modified and unmodified influencing factors of patient compliance to low-sodium diet in chronic heart failure patients in order to provide new clues for the development of patient compliance.

Objective To evaluate the research input-output efficiency of 15 medical universities,and provide references for improving synthetic research efficiency.Methods Selected research input-output key indicators,and used CCR model and SE-DEA model to statistic and analyze.Results The average value of comprehensive efficiency of 15 medical universities was 0.811,pure technical efficiency value was 0.978,scale efficiency value was 0.827.There were 5 DEA efficient universities,7 pure technical efficient universities among 10 Non-DEA efficient universities.Conclusion The total research efficiency of medical universities in our country remained to improve,and should emphasize adjusting scientific research scale.

Scientificly forecasting the health resources is the premise and foundation for making health resource planning.This paper summarized the application scope and characteristics of commonly used statistical models for health resources forecasting,introduced many S type curve prediction models commonly used in natural and social economic fields,hackled and concluded the weight calculation methods of combination forecasting models,and on this basis put forward that multivariable time series model or combination forecasting model based on single time series model and multi-linear regression equation of the predictive value should be set up for forecasting health resources,so as to provide methodological references for related forecasting research.

Objective To compare the effects of different extracts of Rheum palmatum on weight and tissue structure of hypothalamusand and pituitary of adult female rats,and screen the main reproductive toxicity extract.Methods The water,chloroform,ethyl acetate,and n-butanol extracts and water-soluble substance of R.palmatum were prepared by polarity gradient extraction method.Female adult rats were randomly divided into blank control group,rhubarb water extract group,and different extracts groups.The dosage of all the groups was equivalent to 4.00 g/kg crude rhubarb.Rats were administered with extracts by gavage for 60 d.Body mass growth rate of rats were calculated before and after administration.The pathological changes of hypothalamic arcuate nucleus neurons and pituitary gonadal cell were observed with light microscope.Results Compared with the blank control group,the body mass growth rate of rhubarb water extract group was decreased (P ＜ 0.05),while those in the different extracts groups were increased (P ＜ 0.01);The hypothalamic arcuate nucleus neurons of rhubarb water extract group showed chromatin marginalization,nissl substance dissolving,fuzzy boundary of nuclear membrane,as well as hell cells,and the total number of adenohypophysis cells reduced and the cells arranged in irregular.However,there were no apparent pathologic changes in different extracts groups.Conclusion Rhubarb water extract administration by long-term dose can reduce weight growth rate and result in pathologic changes of hypothalamic arcuate nucleus and adenohypophysis,while the different extracts can increase weight growth rate significantly and have little effects on the organizational structure ofhypothalamic arcuate nucleus and adenohypophysis.

Objective To investigate the capability of empathy for pain in migraineurs without aura.Methods Thirty migraineurs without aura and thirty matched healthy controls were recruited.Picturecued Empathy for pain paradigm was used to compare the capability of empathy in the migraine group with that in the control group.Results Compared with the control group,the migraine group had diminished ability to discriminate painful from nonpainful pictures,and the discrimination accuracy was significantly reduced ((2.55±0.61) vs (2.88±0.38);t=-2.505,P=0.01).In the task laterality,there was no difference in discrimination accuracy between two groups(P＞0.05).The rating scores of patients were evidently smaller than those of control group ((3.01±0.52) vs (3.37±0.47);t=-2.827,P=0.006).Pearson correlation analysis showed that the age of migraineurs was negatively correlated with the discrimination accuracy(r=-0.393,P =0.031),and there was no correlation between migraineurs' educational years,disease course,severity,Mini-mental State Examination,Hamilton Anxiety Scale,Hamilton Depression Scale,Verbal Fluency Test,Stroop Test and the idex of empathy for pain (all P＞0.05).Conclusion Migraineurs without aura have deficiency in the capability of empathy for pain.

Objective To examine the occupational stability,training needs and capacity building requirements of the general practitioners purposely trained to work in rural communities,for improvement of policies regarding their training and issues related. Methods There counties were selected by stratified random sampling, where general practitioners graduated from such training completed an anonymous questionnaire. Focus group interviews were made to officials of the local Health and Family Planning Commission,those of primary healthcare institutions,and general practitioners themselves. Results The of the 190 valid questionnaires recovered, male accounted for 34. 2% and female 65. 8%. These general practitioners were mostly satisfied with their working environment, social status, work stress and job achievement,yet with lower satisfaction with their salary and availability of medical devices. Consideration of resignation was reported by only 5. 3% of them,with more males than females. As high as 63. 2% of them prefer to work in hospitals of county level. 91. 1% of them held it as necessary to participate in standard resident training,and 98. 4% held it as necessary to have on-job training. 94. 7% of them have participated in further education to gain a bachelor degree in medicine. Conclusions These doctors were found with high stability to work in rural communities and low turnover intention. Further studies are required to encourage these general practitioners to serve rural communities in a long term, and to improve the standard resident training mechanism,and their career development.

Objective To analyze the medical service capacity of primary healthcare in Zhejiang province since the ongoing healthcare reform and put forward suggestions. Methods Key indicators of healthcare resources and medical service utilization from 2009 to 2015 reflecting the primary healthcare were identified,for a quantitative analysis in terms of the structure-process-outcome dimensions. Results In terms of structural service capacity,the average headcount growth rate of primary healthcare′s technical personnel was 5. 7% per year; the personnel competence structure kept improving; the hospital beds at primary institutions and their ratio among all were slightly decreased,with better devices and informatization. In terms of procedural service capacity,the proportion of primary institutions with contract-based services amounted to 89. 9%,with the standard contract signing rate up to 18. 8%. In terms of consequential service capacity,the average growth rate of the number of outpatient visits at primary institutions was 6. 3%. The amount and proportion of inpatients were slightly decreased,while the hospital bed utilization ratio was increased slightly. Conclusions It is necessary to further strengthen the training and introduction of primary healthcare professionals. The functional orientation of hospitals at various levels should be clarified, encouraging contract-signing of general practitioners, promote the medical insurance payment reform featuring the capitation payment at primary level,and improve the income distribution and incentive mechanism.

Objective To explore the role of Toll like receptor 2 (TLR2) in the pathogenesis of acne vulgaris. Methods Venous blood was collected from 30 normal human controls and 90 patients with acne vulgaris. The patients were equally divided into three groups, i.e., mild, moderate and severe groups, according to disease severity. Flow cytometry was performed to detect the expression of TLR2 in PBMCs, and double antibody sandwich ELISA to measure the levels of serum interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α). Results A significant increase was observed in the expression of TLR2 in PBMCs, serum level of IL-8and TNF-α in the three groups of patients with acne vulgaris compared with the normal human controls (all P ＜0.01). The expression of TLR2 was positively correlated with the expression of IL-8 (r=0.382, 0.517,0.436,respectively, all P＜0.05) and TNF-α(r=0.641, 0.725, 0.593, respectively, all P＜0.05) in the patients with mild, moderate and severe acne vulgaris, respectively, and with the severity of acne vulgaris (r = 0.406,P＜0.01 ). Conclusion The expression level of TLR2 and related cytokines seems closely correlated with the severity of acne vulgaris.

Objective To evaluate the effectiveness of Chronic Care Model in hypertension management in community health services.Methods Three hundred patients diagnosed with hypertension participated in this study and were divided into intervention and control groups.In the following 9 months,intervention measures based on the Chronic Care Model were delivered to intervention group,while the conventional measures to control group.Data collected before and after the intervention were analyzed uuing descriptive statistics,t-test,x2-test and analysis of covariance by SPSS16.0 for Windows.Results The intervention group had statistically significant positive effectiveness in drinking habit,daily salt intake(decreased 0.78g),diastolic blood pressure (decreased 2mmHg),BMI(decreased 0.4) and SF-36 physical component summary score(decreased 1.7)(P＜0.05).The intervention group had better improvement in BMI and SF-36 physical component summry score than the control group.Conclusion The health outcomes of patients with hypertension could be improved by applying the Chronic Care Model featured diet,exercise habits and other health related factors management.