Objective To measure the changes of total factor productivity (TFP)of Zhejiang medical facilities for decision makers to promote their service efficiency.Methods Collecting the panel data of 2005-2010(four input indexes and five output indexes)from medical facilities in Zhejiang province and measuring with Malmquist index of DEA programs of DEAP2.1.Results The average annual TFP growth rate in the period is 2.0％.A further decomposition found that the average annual growth rate of technology progress is 1.8 ％,while that of technical efficiency and pure technical efficiency is only 0.2％respectively.In the meantime,no scale efficiency growth was found.Conclusion The average annual growth of total factor productivity of Zhejiang medical institutions is substantially low in the period,with technology recession found as well.To maximize productivity of the medical sector,the allocation and internal management should be strengthened to stimulate technical efficiency and scale efficiency while encouraging technology innovation.

Adult ; Female ; Humans ; Middle Aged ; Thyroid Diseases ; microbiology ; Tuberculosis, Endocrine

AIM: To study the effect of garlicin on protecting nonalcoholic fat liver in rats induced by high fat diet and explore the pathogenesis involved. METHODS: According to the dosage of garlicin and diet, fifty SD rats were randomly divided into five equal groups: normal control group, model control group and garlicin (10, 20, 30 mg/kg) groups. Apart from the rats in normal control group, the rats were all fed with high fat and high cholesterol diet. After 12 weeks, the levels of serum endotoxin (ETX), total cholesterols (TC), triglyceride (TG), superoxide dismutase (SOD), malondialdehyde (MDA), transaminase and free fatty acids (FFA) were detected. The levels of MDA, SOD, glutathione hormone (GSH) in hepatic tissue were also detected. Then the features of live pathology were observed. RESULTS: The levels of ETX, TC and TG in garlicin groups were significantly lower than those in model control group (P

Objective To assess and compare the advantages and disadvantages of five fields of three dimensional conformal radiation therapy(3DCRT),three fields of 3DCRT and the simulator-guided radiation therapy for patients with esophageal carcinoma.Methods Twenty patients with esophageal carcinoma were treated by three dimensional conformal radiation therapy,at the same TPS,three Dimensional conformal radiation therapy target and normal tissue of three radiotherapies were simulated.The treatment planning was five days per week with 1.8～2.0 Gy per fraction。 5 fractions per week,5OGy per 5～6 weeks. Results Compared with simulator-guided radiation therapy,3DCRT planning has better dose distribution and protection of normal tissue. Conclusion Esophageal cancer conformal radiotherapy can reduce the radiation injury of the normal tissue and complications,and improve treatment of conformal radiotherapy and the target dose distribution.

A 51-year-old man presented with a 4-month history of upper abdominal distending pain and 1-month history of cutaneous nodules and plaques on the neck, trunk and bilateral thighs. The patient underwent many gastrointestinal tract examinations in several local hospitals, and symptomatic treatment did not work. The biopsy of nodules on the abdomen revealed medium- to large-sized atypical lymphoid cells within numerous small vessels in lower dermis and subcutaneous fat tissue. Additionally, the atypical cells were present exclusively within vascular lumina. Immunohistochemical labeling showed the reactivity of neoplastic cells to CD2, CD99, CD3ε, CD43, CD56, Epstein-Barr virus-encoded small nuclear RNAs (EBER), and cytotoxic proteins such as T-cell intracellular antigen-1 (TIA-1) and perforin, but not to CD4, CD8, CD20, CD79a,CD30, cytokeratin (CK), S100, or CD68. The endothelial cells lining the involved vessels exhibited the reactivity to CD31 and CD34. Based on the above findings, the patient was diagnosed with intravascular NK/T-cell lymphoma firstly manifesting as gastrointestinal tract symptom and complicated by skin lesions. Following combined chemotherapy with cyclophosphamide, daunorubicin, vincristine, prednisone and etoposide, the patient experienced a quick and satisfactory recovery and the follow-up still continued.

OBJECTIVETo observe the efficacy of Modified Xiaoyao Decoction (MXD) combining clomipramine in treatment of depression.

METHODSOne hundred and five depression patients were randomly assigned to two groups. The treated group (53 patients), all were differentiated as Gan-qi stagnation syndrome type and treated with MXD combining clomipramine 25-50 mg/d. The control group (52 patients) treated with clomipramine 75-225 mg/d alone. The treatment lasted for 8 weeks in both groups. Scores of depression was assessed with Hamilton Depression Scale (HAMD) before treatment and at the 2nd, 4th, 8th week of the treatment, efficacy and adverse reactions were evaluated with Global Impression of Change (CGI) and Treatment Emergent Symptom Scale (TESS) respectively.

RESULTSAfter treatment the scores in both groups were significantly different from those before treatment (P < 0.01), but no significant difference was found between the two groups (P > 0.05). Main adverse reactions were dry mouth, constipation in the treated group, much less than those in the control group, which were mainly dry mouth, constipation, dizziness, insomnia, blurred vision and prolonged Q-T interval (P < 0.01).

CONCLUSIONMXD combining clomipramine has the efficacy on depression similar to clomipramine, but has less adverse reactions.

Adolescent ; Adult ; Antidepressive Agents, Tricyclic ; therapeutic use ; Clomipramine ; therapeutic use ; Depression ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Treatment Outcome ; Young Adult

Objectiv e:To investigate the effect of different culture conditions on the differentiation of Treg and Th17 to lay a foundation for exploring the methods to reverse the immune tolerance induced by tumor microenvironment.Methods:The IL-6 gene was cloned and stablely transferred into the tumor cell line expressing TGF-β.The conditioned mediums ( CM) were prepared by collecting the culture supernatants of tumor cell lines with or without IL-6 expression and used in the in vitro culture of peripheral blood mononuclear cells ( PBMC ) .The changes of Treg and Th17 in PBMC treated with different CM were detected with flow cytometry ( FCM) .Results:The expression of TGF-βin BEL-7402 was higher than that in HepG2.Thus the BEL-7402 was selected for preparation of cell line stablely transfected with IL -6 gene.ELISA detection confirmed the effective expression of IL -6 by the identified cell lines.It was showed that the Treg increased in PBMC treated with culture supernatants of tumor cells .However,the presence of IL-6 reversed the increase of Treg and promoted the differentiation of Th 17.Conclusion: The culture supernatants of tumor cells increases the proportion of Treg.However,the presence of IL-6 in this CM can reverse the increase of Treg and raise the proportion of Th 17.

Objective To explore the related factors of anxiety and gloomy mentality people aged 60-80 years and investigate the effectiue methods to intervention.Methods A follow-up study was proportional and carried out in Xicheng district of Beijing.Multi-phase,stratified,unequal cluster sampling was adopted to investigate old people in 2011 with WHO-QOL,Memorial University of Newfoundl and Scale of Happiness,Social Support Rating Scale,Self-Rating Anxiety Scale and Self-rating Depression Scale.2342 old people were randomly divided into control group and trial group.The trial group received health education,community social support,lightening the psychological stress in face to face,psychology guiding and group discussion.The control group received general observation only.Results Among 2342 old people,126 (5.3％) obtained anxiety and 201(8.6％) had gloomy mentality.The anxiety in the elderly was significantly related to age,marriment,culture,job,family type,family relationship,housing,income,medical insurance,retirement type,reading,keeping pets,character,training,feeling adjusting,life quality,subjective well-being,social support,depression (all P ＜ 0.05).The depression in the elderly was significantly related to gender,marriment,culture,job,family type,family relationship,housing,income,medical insurance,retirement type,reading,watching plays,character,feeling adjusting,drinking,training,life quality,subjective well-being,social support,anxiety (all P＜0.05).Scores of two groups had no significant difference before intervention.The change in scores of anxiety and depression in the trial group was obviously lower than in control group (P＜0.05).Conclusions The anxiety and gloomy mentality are common in old people aged 60-80 years in Xicheng District,which independently associated with related factors such as life quality,subjective well-being,social support and so on.After 6 months of treatment,the scores of anxiety and depression in the trial group is obviously lower than in control group.

Animals ; Liver ; pathology ; Liver Cirrhosis ; pathology ; Male ; Rats ; Rats, Wistar ; Reproducibility of Results ; Staining and Labeling ; methods

OBJECTIVETo find out an effective therapy for obesity induced by antipsychotic agents.

METHODSOne hundred and one cases of obesity who were being treated with antipsychotic agents were randomly divided into an observation group and a control group. The observation group were treated with electroacupuncture at Quchi (LI 11), Zusanli (ST 36), Fenglong (ST 40), Shangjuxu (ST 37) and Xiajuxu (ST 39), once a day for 8 weeks; and no treatment was given to the control group. The Brief Psychiatric Rating Scale (BPRS) was used for assessment of therapeutic effect and the Treatment Emergent Symptom Scale (TESS) for adverse effects.

RESULTSThe clinically effective rate of the observation group (54.9%) was superior to the control group (10.0%) with a significant difference between the two groups (P<0.05). The BPRS score-reducing rate was 24.92% and 28.62% in the both groups respectively, and with no adverse effects.

CONCLUSIONElectroacupuncture has a good therapeutic effect on obesity induced by antipsychotic agents, and it improves the patient's compliance with no adverse effect.

Acupuncture Points ; Antipsychotic Agents ; Electroacupuncture ; Humans ; Obesity