In February 2008 the Xiamen Municipal Government reorganized the health service in Xiamen City to create a"Xiamen Model"for community health service.The community health service centers were divided into two parts:the public health service was directly undertaken by the loal government,and the medical service was affiliated to one of the tertiary hospitals.Both were financed by govemment budget,but operated separately.A recent survey showed that the "Xiamen model" promoted the vertical integration of Xiamen medical resources.increased the service efficiency,reduced the medical and drug cost,and improved the satisfaction of local residents.Nevertheless,there were still some problems;the tertiary hospital should change its service pattern and enhance general practice in the community,the finance compensating mechanism need to be improved.

Resistant starch is starch that escapes from digestion in small intestine and ferments in large intestine. Recent studies have demonstrated that resistant starch can decrease blood glucose, cholesterol, and triglyceride, enhance the sensitivity of insulin, and reduce body weight Therefore, it is useful for the prevention and treatment of diabetes. This article reviewed the effects of resistant starch on blood glucose, blood lipid and insulin resistance of diabetes.

The prevalence of diabetes is reaching epidemic proportions worldwide.Elevated glucose levels and associated increases in blood pressure and dyslipidemia lead to long-term complications including cardiovascular disease,diabetic retinopathy,kidney disease,and nervous system damage.These complications are largely responsible for the great increase in morbidity and mortality seen in diabetes.Unfortunately,once established,diabetes is very diffi cult to treat,and it is currently exerting tremendous pressure on healthcare systems worldwide.For these reasons,diabetes prevention has become a key target for clinicians,patients and policymakers,and a number of potential strategies are under study.The purpose of this article is fi rst to discuss the defi ciency of current preventing strategies,and the potential role and the advantages of Traditional Chinese Medicine(TCM) to prevent diabetes.Following that,based on observational studies as well as on prospective trials,and with respect to the prevention and treatment of diabetes,the authors,therefore,suggest that the best way to approach prevention is through lifestyle modification guided by TCM theory.And those interventions should include not only herbs,but acupuncture,massage,food therapy and mind-body exercise,and they must examine cost-effectiveness as well.Future studies should also be designed with using such interventions and should be of suff icient duration to differentiate between genuine diabetes prevention as opposed to simple delay or masking of the disease.

Archen,a kind of Anthraquinone,is one of active ingredients of Chinese herb Rhubarb.The researches showed that archen has ideal therapeutic effects on diseases of circulatory system,digestive system，nervous system and tumor. The paper reviewed related researches on pharmacology of archen from year 2004 to 2008 and made a summary of the researching development of it.

Objective To observe The liver lipogenic gene expression of animal model of phlegm and dampness syndrome. Methods According to the theory "Obese people have much more phlegm and dampness", the animal model of phlegm and dampness was built by high fat feeding. After 10 weeks' high fat feeding, we examined liver HE slice, the level of lipids in the normal and model group rats .The liver lipogenic gene expression including LXRα, SREBP-1c, and FAS were detected by fluorescence real time quantative PCR. Results Compared with that of the normal group rat, there was increasing lipids both in serum and liver in the model rats. There was typical appearance of fatty accumulation in the liver cells examined by liver HE staining. The expression of SREBP-Ic and FAS was much higher in phlegm and dampness group than that in the normal group, although there was no difference in the expression of LXRα. Conclusion The fatty accumulation of liver cell in phlegm and dampness group has a close relation to the enhancement of the liver lipoganic gene expression.

Objective To investigate the relationship between microalbuminuria (MAU) and insulin resistance syndrome. Methods A total of 240 patients(130 of them with hypertension) were stratified by oral glucose tolerance status 〔normal glucose tolerance(NGT), impaired glucose tolerance(IGT), and type 2 diabetes mellitus(DM)〕. Morning urine albumin concentration and anthropometric indices, serum lipid, fasting plasma true insulin concentrations were also measured. Results The prevalence of MAU ( defined as morning urine albumin concentration between 20 and 40 mg/L) was increased as the glucose tolerance worsed (8.8%in NGT, 13.7% in IGT, 28.6% in DM, ? 2 =9.313, P

Objective:To analyze the infectious ODDS risks of anticancer plant alkaloids and other anticancer drugs in GI cancer patients with chemotherapy regiments.Method:2384 profiles of cancer patients agreeable with studying condition were collected.All the profiles were evaluated with different variants,and then these variants were analyzed with the logistic liner.Result:The line values of ages,days in hospital,insurances,alkylating agents,platinum antitumor com- pounds and other antitumor drugs were 0.010,0.147,-0.361,-0.930,-0.390,and-1.306.Conclusion:The infection OR of the ages and days in hospital increased OR factors and the medical insurances decreased OR factors.Antitumor antibiot- ics,antimetabolites,plant alkaloids had their higher infectious risks than platinum antiturnor compounds,alkylating agents and other antitumor drugs did in GI cancer patients with chemotherapy regiments.

Knowledge-attitude-practice model is widely used in the self-management of type-2 diabetes.Through proper education,patients can gain diabetic knowledge as well as positive attitude on glucose control.By regulating diet,exercise,self glucose monitoring and medication compliance,diabetic patients are able to control blood glucose more effectively,and have less complications and higher quality of life.Researches on the application and effectiveness of various diabetic knowledge,attitude and self-management behavior scales are reviewed in this article.

Objective To investigate the prediction value of ultrasound endometrial pattern at the day of hCG administration on clinical outcome in patients undergoing in vitro fertilization-embryo transfer (IVF-ET).Methods 679 cycles of IVF-ET conducted between January 2011 and December 2012 in Beijing Obstetrics and Gynecology Hospital were reviewed retrospectively.All cycles were divided into three groups based on the endometrial pattern measured on the hCG day:group A (n =411) with triple line endometrium,group B (n =228) with no obvious triple line endometrium,group C (n =40) with homogeneous hyperechoic endometrium.Clinical outcomes such as implantation rate,pregnancy rate and miscarriage rate were analyzed.Results Among three groups,the implantation rates were 27.05％,20.33％,19.57％,respectively (x2 =9.04,P =0.01); the pregnancy rates were 34.31％,25.00％,12.50％,respectively (x2 =12.20,P =0.00).The implantation rate and pregnancy rate in group A were higher than the other two groups (P ＜0.05).The miscarriage rates were 16.31％,19.30％,40.00％,respectively(P ＞ 0.05),there were no significant difference among them.Conclusions The ultrasound endometrium pattern on the day of hCG administration has predictive value on clinical outcome in patients undergoing in vitro fertilization-embryo transfer.

OBJECTIVE: To evaluate the quality of reports published in recent 10 years in China about quantitative analysis of syndrome differentiation for diabetes mellitus (DM) in order to explore the methodological problems in these reports and find possible solutions. METHODS: The main medical literature databases in China were searched. Thirty-one articles were included and evaluated by the principles of clinical epidemiology. RESULTS: There were many mistakes and deficiencies in these articles, such as clinical trial designs, diagnosis criteria for DM, standards of syndrome differentiation of DM, case inclusive and exclusive criteria, sample size and estimation, data comparability and statistical methods. CONCLUSION: It is necessary and important to improve the quality of reports concerning quantitative analysis of syndrome differentiation of DM in light of the principles of clinical epidemiology.