The forepassed socialized medicine system for urban workers has many ethical faults. The institutional reform on the social medical insurance for urban workers will readjust the relationships between government, hospitals, employers and patients. It means much to ethics, and impulses the basic health service towards self-determination, duty and justice. But it has some problems about the responsibility of government,the sanction of hospitals and the burden of patients. At last,the paper offers some suggestions for improvement.

The curative effect of chemotherapy in malignant tumors has been unsatisfactory because of drug resistance and the toxicity of chemotherapeutic drugs. Extensive studies on the metabolism of tumor cells have been undertaken to determine a novel se-lective antitumor drug. An increasing number of studies have demonstrated the close relation between the malignant behavior of tumor tissues and their specialized energy metabolism. Hyper-lipogenesis is one of the metabolic characteristics of the rapid proliferation of tu-mor cells. Stearoyl-coenzyme A desaturase 1 (SCD1) is a critical enzyme in fatty acid synthesis because it catalyzes the conversion of saturated fatty acids into monounsaturated fatty acids. This enzyme is closely related to obesity, fatty liver disease, insulin resistance, and a series of metabolic syndromes. It is also involved in the occurrence and progression of cancer. Determining the function of SCD1 in malignant tumors would provide a new therapeutic target in chemotherapy.

Objective To investigate the comparability of test seven tumor marks results of two electrochemiluminescence immu-noassay analyzer between Roche Cobas E411 and Cobas E601 .Methods According to United States Clinical and Laboratory Stand-ards Institute (CLSI) EP9-A2 document ,E411 was acted as comparison method (X) and E601 was as the experimental method (Y ) .Alpha fetoprotein (AFP ) ,carcinoembryonic antigen (CEA ) ,carbohydrate antigen125 (CA125 ) ,carbohydrate antigen199 (CA199) ,carbohydrate antigen153(CA153) ,total prostate specific antigen(TPSA) and free prostate specific antigen(FPSA) levels of patient samples were tested and the results were analyzed .Results The correlation between the two systems was good and the bias was acceptable in the medical decision level .Conclusion Two systems have good concordance in detecting the seven tumor markers ,w hich can meet the clinical need .

There is still a certain recurrence rate after extensive lymphadenectomy even to patients with node-negative gastric cancer.It promotes the researchers to use a more sensitive and effective way to track tumor cells which are missed,especially lymph node micrometastases.With the development of detection tech-nology,the diagnostic rate of micrometastasis is significantly increased.There are so many controversies about the impact of lymph node micrometastases that no consensus on the clinical treatment can be reached.In recent years,with the rise of endoscopic therapy,how to balance the relationship between the quality of life and the safety makes the research of micrometastases more urgent.

Objective To investigate the diagnostic value and the clinical significance of six tumour markers of pleural effusion and serum in patients with lung cancer by detecting tumour marker and pleural effusion cytological examination. Methods Carcinoembryanic antigen (CEA), cancer antigen 19-9 (CA19-9),squamous cell carcinoma antigen (SCC), neuron specific enolase(NSE), cytokeratin 19 fragments(CYFRA21-l)and progastrin releasing peptide (ProCRP) levels in pleural effusion and serum sample from 50 cases of lung cancer and 30 cases of benign lung disease were detected by chemical and enzyme-linked immunosorbent assay.At the same time, the specimen of patients from pleural effusion was examinated by cytological method.According to the data above, the rational clinical diagnosis value were established by ROC curves. Results Six tumour markers in pleural effusion of lung cancer were higher than those of benign lung diseases, CEA,CA19-9, CYFRA21-1 and ProGRP were the highest group (P<0.05). The ratio of CEA, serum CYFRA21-1and CEA levels in pleural fluid and serum (P/S) in the group was the largest area under the ROC curve.Conclusion Pleural fluid CEA, the ratio of CYFRA21-1 and CEA levels in pleural fluid and serum (P/S) is helpful to differentiating benign and malignant pleural effusion diseases.The diagnostic value of pleural fluid CEA is important.

Objective To detect whether trichostatin(TSA) can induce HL-60 differentiation in vitro. Methods MTT method was used to test the effect of TSA on HL-60 cell growth. Cell cycle was tested by flow cytometry. CD11b expression was tested for detecting cell differentiation, RT-PCR was used to detect the mRNA expression of c-myc in the cells treated by TSA. Results Down-regulation of cell proliferation was observed and cells significantly accumulated at the G0 and G1 phase in HL-60 cells treated with TSA( P <0. 01). Dif-ferentiation rate was 15. 24% after being treated by TSA for 48 h. mRNA of c-myc was down regulated in time-dependent manner. Conclusion TSA can inhibit proliferation and induce differentiation in HL-60 cells.

Objective To clone VEGF gene and construct its eukaryotic expression vector for the evaluation of the possability of VEGF gene therapy in orthopedic disease. Methods Human vascular endothelial growth factor(hVEGF) cDNA was amplified by nested PCR method from the HL60 cells and cloned to expression vector pcDNA 3. The cDNA was identified by enzyme digestion and DNA sequencing. Rabbit osteoblasts were transfered with pCD-hVEGF165 plasmid by lipofectin mediated gene transfer method. The transient expression of VEGF were detected by Streptavidin-Biotin-enzyme Complex(SABC). Results The cloned cDNA was confirmed to be VEGF165 cDNA. It was observed that the expression of human VEGF gene was detected distinctly 72 h after transfering. Conclusion We successfully cloned hVEGF 165 gene and construced its eukaryotic expression vector, which provided the further foundation of VEGF gene therapy for ostenecrosis,bone defeat and fracture.

Objective To observe the clinical efficacy of acupoint application plus modifiedZhi Sou powder in treating post-cold cough.Method A total of 120 patients with post-cold cough were randomized into group A, group B, and group C, 40 cases in each group. Group A was intervened by acupoint application plus modifiedZhi Sou powder, group B by oral administration ofZhi Sou powder, and group C by oral administration of compound Dextromethorphan syrup. The three groups were intervened once a day, 7 days as a treatment course. The clinical efficacies were compared after 2 treatment courses, and the adverse reactions during the study were observed.Result The total effective rate was 87.5% in group A, 67.5% in group B and 60.0% in group C. The total effective rate in group A was significantly different from that in group B and group C (P<0.05). The adverse reaction rate was 7.5% in group A, 5.0% in group B and 72.5% in group C. The adverse reaction rates in group A and B were significantly different from the rate in group C (P<0.01).Conclusion Acupoint application plusZhi Sou powder is an effective approach in treating post-cold cough, and it’s more effective than ordinary drug and produces less adverse reactions.

[Objective]To evaluate surgical outcomes of hemivertebra resection only via posterior approaches followed by short-segment transpedicular instrumentation for correction of the congenital scoliosos. [Method]A group of patients with a single hemivertebra between the ages 5-16 years who underwent operative treatment were evaluated.Hemivertebra resection through posterior approach and short-segment transpedicular instrumentation were used for correction of the scoliosis and kyphosis deformities.Radiographic evaluation were conducted before and after operation and at follow-up visits.Cobb's angles of the segmental curve,total main curve,cranial and caudal compensatory curves and kyphosis were measured on the posteroanterior and lateral radiographs.[Result]The cases in this study showed satisfied results.The mean Cobb's angle of segment curve was 41.5? before surgery and 15.1? after surgery with a 63.6% correction,and 14.7? at the lastest follow-up assessment with a 64.6% correction;total main curves improved from 46.9?to 18.4?,with a 60.8% correction;17.5?at last follow-up,with a 62.7% correction;the correction ratio for kyphosis was from 15.4?kyphosis to normal physical profile;cranial and caudal compensartory curves were obviously improved.[Conclusion]Hemivertebra resection and short-segment transpedicular instrumentation could be performed only through posterior approach,which had exerted satisfactory correction on congenital scoliosis.If the operation is performed before the maturity of the bone,it will effectively prevent the formation of secondly spinal deformities.

Objective To identify the charactor of wide QRS complex tachycardia( WCT)throuGh transesophaGeal atrial pacinG( TEAP ). Methods TEAP and intracadiac electrophysioloGical examination infoamation of l2 cases WCT were collected and analyzed from January to February in 20l2 of Wuhan Asia Heart Hospital. Results Comparison of TEAP and intracadiac electrophysioloGical examination showed that l0 in l2 patients were match. Conclusion TEAP is a rapid and convenient method to diaGnose most WCT.