By equality in the healthcare retorm we mean equal access to healthcare protection.Future reiorm should establish a fair value concept and make great efforts to solve the serious lack of fairness in the current healthcare system.Efficiency in the healthcare refers to not only higher revenue income of medical institutes but also to utmostly meet the citizens" needs for medical service.For the sake of the most cost - effective distribution of the insufficient budgets and medical resources,medical services have to be diversified for an improved efficiency. In the framework of the healthcare reform,relations between equality and efficiency is the unity of opposites,and top priority shall be given to equality while maintain efficiency.

Child ; Child, Preschool ; Clinical Laboratory Techniques ; DNA, Fungal ; genetics ; Evidence-Based Medicine ; Fungi ; genetics ; isolation & purification ; Humans ; Infant ; Mycological Typing Techniques ; Mycoses ; diagnosis ; microbiology ; Polymerase Chain Reaction ; Serologic Tests ; Specimen Handling

Objective To report carpal tunnel release using Universal Subcutaneous Endoscope System from anatomical and clinical point of view for the purpose of avoiding operative complication and improving clinical efficacy. Methods Operation approach and adjacent structures were observed and measured on 18 fresh upper limb specimens and 26 formaldehyde solution fixed upper limb specimens. Nineteen patients with 21 carpal tunnel syndrome (CTS) were treated with this method under local anaesthesia without tourniquet. The incision is made in the wrist just 2-3 cm superior to palmar crease of the wrist at the medial border of the palmaris longus. The operation plane is just under the deeper layer of deep fascia. The instrument points to the third web. The median nerve and its branches, flexor retinaculum and superficial palmar arch were carefully observed. Results The results were satisfactory in all patients. Conclusion Single wrist portal arthroscopic procedure is a safe, simple and efficient approach if the anatomic structures of the wrist are perfectly clear to the opeator.

Objective: To investigate the curative effects of Shuanghongtong Decoction (Flos carthami, Radix Ginseng Rubra and Radix Ophiopogonis) diabetic neuropathy peripheral (DPN) and its mechanism.Methods:28 DPN patients were treated with Shuanghongtong Decoction for 3 weeks. The symptom and the peroneal nerve conduction velocity (SNCV) were observed before and after the experiments respectively. The diabetic rats reduced by STZ were treated with the same decoction for 4 weeks, at the end of the experiments the nerve conduction velocity (NCV) and the activity of aldose reductase (AR) were measured.Results: Some symptoms such as acra pain, numbness, asthenia and the peroneal SNCV were significantly improved after treatment with decoction. The animal experiments showed that the NCV were significantly increased and the activity of AR significantly decreased in diabetic rats as compared with the normal rats.Conclusion: Shuanghongtong Decoction could improve the symptom and increase the NCV of DPN. It's mechanism may be through inhibiting the activity of AR then improving the diabetic metabolism disorder.

Acute Disease ; Adult ; Humans ; Male ; Occupational Diseases ; diagnosis ; therapy ; Phosphines ; poisoning ; Poisoning ; diagnosis ; therapy

Objective To assess the reliability and validity of the Tree-Drawing Test in medical college students.Methods The study randomly selected 312 aged 19 to 23-year-old medical students to take part in TreeDrawing Test.In addition,a total of 275 college students were selected to receive re-test,30 days late and Pearson correlation coefficient of two tests were calculated.The three raters were invited to assess 30 trees painting score,analyzing the Kendall coefficient of concordance between the scores to verify raters' reliability; parts of students also participated in the 16PF test,SAS,SDS test,analyzing the correlation coefficient between the various test results,in order to assess the effectiveness of the Tree-Drawing Test.Results The re-test reliability in different time was 0.570-0.733 and 0.341-0.713 (P＜0.05),the raters' reliability was 0.491 ～ 0.626(P＜0.05),there are some correlations between Tree-Drawing Test and 16PF,SAS,SDS.Conclusion The Tree-Drawing Test has good reliability and validity; it can be applied to the detection of college students' psychological assessment and psychological problems.

Objective To observe the clinical efficacy ofXing Nao Kai Qiao (brain-awakening and orifice-opening) needling plus thunder-fire moxibustion in treating vertebrobasilar ischemia.Method Fifty-five patients with vertebrobasilar ischemia were randomized into a treatment group of 26 cases and a control group of 29 cases. The treatment group was intervened byXing Nao Kai Qiao needling plus thunder-fire moxibustion, while the control group was by oral administration ofYangxue Qingnao granules. The blood flow of vertebrobasilar arteries were observed by using ultrasonic Doppler blood-flow detector before and after intervention, and the clinical efficacies were compared between the two groups.Result The recovery and markedly-effective rate and total effective rate were respectively 61.5% and 96.2% in the treatment group, versus 34.5% and 89.7% in the control group, and the differences were statistically significant (P<0.01,P<0.05). The VS and VD of vertebral arteries and VS of basilar arteries were significantly changed after intervention in the treatment group (P<0.05). The VS of basilar arteries was significantly changed after intervention in the control group (P<0.05). After treatment, The VS of vertebral and basilar arteries in the treatment group was significantly different from that in the control group (P<0.05).ConclusionXing Nao Kai Qiao needling plus thunder-fire moxibustion is an effective approach in treating vertebrobasilar ischemia.

Objective To better understand the clinical features and the diagnosis of monoclonal gammopathy of undetermined significance (MGUS) associated with systemic lupus erythematosus (SLE).Methods A case of MGUS with SLE were described including clinical manifestations and pathologic data.Literatures were also reviewed.Results The patient was admitted because of proteinuria.Laboratory findings showed monoclonal gammopathy.However,both bone marrow exam and iconography showed no signs of multiple myeloma.Lupus nephritis Ⅳ + Ⅴ was proved by kidney biopsy.Prednisone and tacrolimus were used with significant clinical improvement.Conclusion MGUS associated with SLE is not rare.MGUS criteria based on 2003 international MM working group should be used to differentiate MGUS from MM.Monoclonal protein level,plasma cell in bone marrow and free light chain are risk factors for MM progression.Treatment is based on lupus disease activity and organ damage severity.

Objective To investigate the effect of liraglutide combined with glargine insulin in treating the patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods Sixty-one cases of newly diagnosed T2DM in the endocrinology department of Affiliated Chaozhou Central Hospital of Southern Medical University,from August 2014 to December 2015 were selected and divided into two groups according to the random number table.The observation group (29 cases) was treated with liraglutide combined with glargine insulin and the control group (32 cases) was given the intensive insulin therapy.The curative effects before and after treatment were analyzed and compared between the two groups.Results The fast plasma glucose(FPG),postprandial 2 h blood glucose(PPG),glycosylated hemoglobin(HbA1c),fasting C peptide(FCP),postprandial 2 h C peptide(PCP),insulin resistance index(HOMA-IR),blood lipid indicators and body mass index after 12-week treatment were decreased in the treatment and follow up periods,while pancreatic β cell function index (HOMA-β) and HDL-C were increased,indicating that the two kinds of treatment method all were effective.The effect onset in the observation group was faster,the above indexes after 4-week treatment were significantly improved compared with before treatment.The above indexes after 4-,12-week treatment in the observation group were significantly superior to those in the control group,the difference was statistically significant(P<0.05).Conclusion Liraglutide combined with glargine insulin has better effect in the aspects of reducing blood glucose,regulating blood lipid,decreasing the body mass and islet function recovery than the intensive insulin treatment and is worthy of clinical promotion and application.

OBJECTIVE:To establish a method for contents determination of luteoloside,quercetin and hyperoside in Lonicera japonica. METHODS:HPCE was performed silica capillary column with detection wavelength of 360 nm and separation voltage of 20 kV,electrokinetic sampling,sampling voltage of 15 kV,sampling time of 5 s,operation temperature of 25 ℃.The buffer was consisted of 60 mmol/L sodium tetraborate-50 mmol/L natrium carbonicum-50 mmol/L hydroxypropyl-β-cyclodextrin(pH 9.2). RE-SULTS:The linear ranges of luteoloside,quercetin and hyperoside were 0.06-0.56mg/mL (r=0.9881),0.08-0.56 mg/mL (r=0.9892),0.06-0.49 mg/mL(r=0.9796),respectively. RSDs of precision,stability and reproducibility tests were all lower than 2.0%. The recoveries were 96.12%-99.77%(RSD=1.29%,n=6),95.90%-98.35%(RSD=0.89%,n=6),94.07%-97.45%(RSD=1.33%,n=6),respectively. CONCLUSIONS:The method is simple,accurate,stable and reproducible,and can be used for simultaneous determination of luteoloside,quercetin and hyperoside in L. japonica.