Adult ; Female ; Humans ; Intestinal Neoplasms ; Male ; Middle Aged ; Sarcoma, Myeloid

Objective To analyze allocation of health resources and utilization of health services,and evaluate the equity of health resources allocation and health services utilization.Methods Concentration curve and concentration index(CI)were used to evaluate the equity of health resources allocation in terms of health professionals,hospital beds,medical institutions,outpatient visits and hospitalizations in China.Results The CI for health professionals,hospital beds,and medical institutions is 0.038,-0.012,and-0.116 respectively.That for outpatient visits and hospitalizations is 0.111 and -0.023 respectively.Conclusion Health resources allocation in hospital beds and health professionals is fair,while the equity of medical institutions and outpatient service utilization needs to be improved.

Objective To evaluate the efficiency of health resources allocation of 31 provinces,autonomous regions and cities in China in 2011,identify the causes for low allocation efficiency and provide suggestions accordingly.Methods By ways of literature research and data envelopment analysis.Results The average efficiency value of these provinces and cities was 0.973.The health resources allocation of 18 provinces and cities were found efficient in general,and that of the other provinces and cities were found non-efficient.They respectively account for 58.1 ％and 41.9％.Conclusion To improve the efficiency of health resources allocation of the 13 provinces and cities,their policymakers should increase government funding support,attract private capital into medical institutions,optimize health investment scale,improve medical management and foster medical and health personnel development.

OBJECTIVE To search a method for identifying Clostridium perfringens and genotyping their toxin for gene diagnosis by multiplex PCR.METHODS The mutiplex PCR was developed with three sets of primers(designed) based on the sequences of three C.perfringens toxin genes(CP?,CP? and CPE) published in GenBank to identify C.perfringens and genotype their three toxin genes.RESULTS Three expected(sequences) were (obtained) successfully by multiplex PCR and identified by electrophoresis.CONCLUSIONS The(specific) sequences of C.perfringens could be amplified and their three genes of toxins could be identified by this multiplex PCR(system).Such method should be helpful for developing gene diagnosis well.

Objective To compare the efficacy of total pelvic floor reconstruction with mesh patch and vaginal hysterectomy with anterior and posterior vaginal wall repair for presby-pelvic floor dysfunction patients.Methods We randomly chose 92 pelvic floor dysfunction inpatients of our hospital from September 2007 to February 2009 and divided them into 2 groups:total pelvic floor reconstruction group(n=70) underwent total pelvic floor reconstruction with mesh patch[12 patients of this group complicated with stress incontinence,4 patients received tension free vaginal tape-obturator(TVT-O) simultaneously];control group(n=22) received vaginal hysterectomy with anterior and posterior vaginal wall repair(3 patients of this group complicated with stress incontinence).A follow-up for 3 to 18 months after the surgery were taken in all the patients.Results In total pelvic floor reconstruction group,no recidivate case was found and the FOP scores and cure rate were 0 and 100% respectively.In control group,there were 7 recidivate cases,all of who were primary vagina anterior wall bulge patients.The cure rate of control group was 68%;For the patients complicated with stress incontinence,they were all cured by TVT-0 or by ascending the front patch in total pelvic floor reconstruction group,but 1 case was as before operation and 2 cases were even worse in control group.Conclusion Total pelvic floor reconstruction with vicarious materials had a definite efficacy for presby-pelvic floor dysfunction.

Objective: To study the psychological status and influencing factors in patients with nephritic syndrome(NS) before and after percutaneous renal biopsy(PRB).Methods: 235 cases of NS were examined by Symptom Check List-90(SCL-90) and STAI 24 hours before and 6 hours after PRB.Results: Before PRB,factorial anxiety and phobic anxiety were higher than norm,while after the procedure,only somatization score was still higher than norm;In men,there was a higher score than that of women after PRB,all indices were seen decreased significantly;Higher scores were seen in under-60 years old than over-60 years old.Conclusions: Before and after PRB,many factors were involved in and responsible for patients' psychological symptoms.

AIM: To investigate the early changes of retinal function in diabetic patients detected by multifocal electroretinogram (mfERG).METHODS: The first-order kernel responses of mfERG were recorded from eyes of 33 normal control subjects,63 diabetic patients without retinopathy and 43 diabetic patients with background retinopathy. The response densities and implicit times of N1 and P1 were compared among the control, diabetic patients without retinopathy and diabetic patients with retinopathy.RESULTS: The response densities of N1 and P1 in central 3 rings were reduced significantly in diabetic eyes with and without retinopathy. And the implicit times of N1 and P1 were delayed significantly only in diabetic eyes with retinopathy.CONCLUSION: mfERG can detect the early changes of retinal function quantitatively in diabetic patients. Analysis of response densities and implicit times of N1 and P1 can reflect the progress of local retinal dysfunction in diabetes.

Objective To establish a rapid detection approach by visual interpretation directly for OprD2 resistance gene of Pseudomonas aeruginosa based on the Loop-mediated isothermal amplification (LAMP),and provide a quick and effective method for clinical monitoring of Pseudomonas aeruginosa strains.Methods Totally 47 strains of Pseudomonas aeruginosa collected from December 2011 to June 2012 in Southwest Hospital of microorganisms were prospectively studied.Four LAMP primers (two inner,two outer) were designed according to the six zones of the OprD2 gene of Pseudomonas aeruginosa.A positive reaction is indicated by the color change after adding an intercalating dye (hydroxy naphthol blue) to the reaction solution.This method was used to detect and analyze the distribution of OprD2 resistance gene in 47 strains of Pseudomonas aeruginosa and its coirelation with antibiotic resistance.Results The LAMP assays showed 100％ specificity for the OprD2 gene,and the sensitivity (with the lowest detection limits of 17.414 μg/L) was 10-fold higher than that of conventional PCR assays.The OprD2 gene was negative in 23 strains by both conventional PCR and LAMP.In OprD2 negative strains,the resistance rate of cefotaxime,levofloxacin,aztreonam,piperacillin,imipenem and meropenem was 100％ (23/23),57％ (13/23),48％ (11/23),48％ (11/23),48％ (11/23) and 43％ (10/23).Compared with the OprD2 positive strains,statistical analysis showed that the resistance rate of imipenem,levofloxacin and meropenem in OprD2 negative strains increased significantly (chisquare value is 9.155,4.846,4.037,P value was 0.002,0.028,0.045,and so there was significant difference).Conclusions The established LAMP approach in this study enables rapid,sensitive and specific detection of OprD2 gene in Pseudomonas aeruginosa by visual interpretation.Deficiency of OprD2 gene confers Pseudomonas aeruginosa a basal level of resistance to carbapenems especially to imipenem.The identification of OprD2 gene distribution in Pseudomonas aeruginosa is helpful to the selection of antimicrobial agents in the infection treatment.

Objective:To evaluate the expression of CXCR4 and the migration rate of bone marrow stromal CD34+cells in differ-ent risk groups with myelodysplastic syndromes (MDS) using correlation analysis. Methods: Forty MDS patients were divided into low-and high-risk groups based on the International Prognosis Scoring System (IPSS). The former was composed of 20 patients with IPSS<1.5, whereas the latter was composed of 20 patients with IPSS≥1.5. Bone marrow (BM) samples of these patients and 10 nor-mal controls were collected. CD34+cells were separated and purified. The expression of CXCR4 was determined by flow cytometry. The migration rate of CD34+cells on the chemotactic effect of SDF-1αand on the effect of bone marrow stromal cells were measured. Results:The expression rate of CXCR4 was higher in the high-risk MDS group than in the low-risk and control groups (P<0.000 1). No significant differences existed between the low-risk and the control groups (P>0.05). The migration rate of CD34+cells on the ef-fects of SDF-1αand marrow stromal cells were significantly increased in the high-risk MDS group compared with those in the low-risk and control groups (P<0.000 1). Migration rate of CD34+cells on the effect of marrow stromal cells was positively correlated with CX-CR4 expression (P=0.000 1). Conclusion:The CXCR4 expression and migration rates of CD34+cells on the effect of marrow stromal cells are significantly higher in the high-risk MDS group than in the low-risk group. Migration rate has a positive correlation with the CXCR4 expression, which further indicates that MDS is a heterogeneous group of hematopoietic stem cell malignancies. The expres-sion and function of SDF-1 and its receptor CXCR4 differ within each group with various risks. SDF-1 and CXCR4 may be involved in MDS pathogenesis.

Objective To determine the diagnostic value of shoulder MR arthrography in revealing the injuries of anterior glenoid labrum,and to compare MR arthrography with arm in neutral position with MR arthrography with arm in abduction and external rotation(ABER)position.Methods MR arthrography of the shoulder,including additional oblique axial sequences with the patient in the ABER position,was performed in 44 patients.The injuries of anterior glenoid labrum of these patients were retrospectively evaluated.The result was compared with that of arthroscopy.Results For displaying the abnormalities of anterior glenoid labrum,the sensitivity,specificity,and accuracy of axial MR images with arm in neutral position were 79.3%(23/29),100%(15/15),and 86.4%(38/44),respectively.While the results of ABER position oblique axial images were 93.1%(27/29),100%(15/15),and 95.5%(42/44), respectively.The difference of sensitivity between axial and ABER-position scans was statistically significant (P