Objective To provide reference for improving the performance of public health by establishing performance evaluation framework of public health in rural areas of China.Methods The performance evaluation framework of public health in rural areas is established by literature research,theoretical derivation and Delphi method.The results of expert consultation are tested by W test of Kendall coordination coefficient and chi-square test.Results The performance evaluation framework of public health in rural areas contains four conceptual modules,ten performance goals and twenty-eight performance evaluation indexes.The positive coefficient of experts is 0.889.The average values of authoritative grade of experts are between 0.681～0.715.The Kendall W uniformity coefficients of the necessity,sensitivity and maneuverability of the indexes are respectively 0.167,0.209 and 0.185.The P values are less than 0.01.Conclusion The performance evaluation framework of public health in rural areas has certain application value.It is necessary to pay attention to scientific nature and applicability in developing performance evaluation of public health in rural areas.

Objective To explore the influence on isthmic spondylolisthesis (IS) from lumbar vertebras facet joint orientation (FJO) variation. Methods The lumbar vertebras of 60 patients scanned by 16-slices spiral CT were collected, 30 cases with IS was defined as isthmic group;30 cases with normal lumbar vertebras was defined as control group, the FJO at L3-4, L4-5 and L5-S1 were measured in two groups. The difference between two groups were compared at three levels, the difference between both sides of the facet joint orientation also was compared;the measured data and the data of 60 patients from foreign literature were compared at three levels. Results The FJO in isthmic group were (47.9±6.3)° ,(37.5±7.3)° , (37.9±7.7)° at the right of L3-4, L4-5, L5-S1 levels respectively,the FJO in control group were (53.1 ± 7.3)° , (40.5±6.3)° , (38.5±7.3)° respectively, the FJO in isthmic group were (48.1±6.0)° , (37.9 ± 7.4)° , (37.6 ± 7.6)° at the left of L3-4, L4-5, L5-S1 levels respectively, the FJO in control group were (52.3 ± 7.6)° , (41.6 ± 6.0)° , (38.2 ± 7.2)° respectively. The significant difference was found at L3-4 and L4-5 levels (P < 0.05), the orientation was similar at L5-S1 level (P > 0.05). The difference between the both sides FJO of lumbar vertebras was not found at L3-4,L4-5 and L5-S1 levels (P >0.05). The same as the measured data and the corresponding data from foreign literature(P > 0.05 ). Conclusions It seems possible that the coronal FJO may be the phenotypic representation of the familial etiology of IS. It is helpful for the measurement of lumbar vertebras FJO to find IS early,it is important to reduce and release the IS.

Objective To investgate the application of overall hemostasis potential (OHP) experiment in the high-risk population of prethrombotic state (PTS). Methods The change of absorbance in fibrin formation and degradation was measured with a spectrophotometer at 340 nm when the plasma clotting was triggered by the low concentration of TF in the presence of urokinase. The OHP,overall coagulation potential (OCP) and the overall fibrinolysis potential (OFP) were obtained from the coagulation-fibrinolysis curve based on the computer analysis. To evaluate this OHP method,52 cancer patients,31 coronary artery disease patients,27 mid/late-stage pregnancy women and 100 healthy controls were detected. In addition,the plasma fibrinogen was detected and its correlation with OHP was studied. Results The level of OCP and OHP in PTS high-risk population was significantly higher in cancer,coronary heart disease patients and the mid/late-stage pregnancy women than in the healthy controls (P0.05). Conclusion The OHP assay may indicate the hemostatic balance; therefore,it can be used for evaluation of PTS.

Objective To evaluate the clinical application of the fistulography of multi-slice spiral CT(MSCT)in the diagnosis of anal fistula.Methods A total of 28 patients who were verified operatively of fistula in ano underwent preoperative fistulography of MSCT.The multi-planar reformation(MPR)and surface shadow display(SSD)images were generated and analyzed retrorespectively.Results There were 8 cases with perianal abscess and 20 cases with anal fistula in 28 patients.Complex fistula was diagnosed in 16 cases,and simple inter-sphincteric fistula was found in 4 cases;the inner orificiums of anal fistulas were revealed accurately with MPR images in 18 cases.Conclusion The fistulography of MSCT is valuable for preoperative assessment of anal fistula,in particular for investigation of the inner orificiums of anal fistulas with MPR.

In order to summarize and perfect the basic skill practicing method in acupuncture teaching and form a characteristic teaching, the research on skill training and technique improving of acupuncture and tuina major was carried out. The undergraduate students in acupuncture and tuina major from College of Acupuncture-Moxibustion and Tuina were randomly divided into an experimental group and a control group. Students from both groups received the basic courses of acupuncture-moxibustion and tuina as requested in the syllabus and the special teaching was added to the experimental group, namely "three practice" (strength practice, coordination practice, targeted practice of acupuncture basic skills) and "three enlightenment" (technique enlightenment, mind and qi enlightenment, efficacy enlightenment). During and after the courses, the teaching effectiveness was evaluated on the basis of needling manipulation. The peacetime score in the experimental group was superior to that in the control group (38.03 +/- 1.14 vs 33.25 +/- 1.31, P < 0.05), the total score in the experimental group was superior to that in the control group (84.03 +/- 6.30 vs 78.05 +/- 6.55, P < 0.05). The special teaching method of "three practice" and "three enlightenment" can improve the effect of skill training teaching method. It highlights the unique feature of central plains by integrating the essence of Shaolin internal qigong and Chen-style Taiji, it can also provide new ideas for the practical teaching of TCM professional courses and the construction of characteristic professionals.
Acupuncture ; education ; manpower ; Acupuncture Therapy ; methods ; Humans ; Students ; Teaching

Objective The aim of this study was to investigate the diagnostic impact of polymerase chain reaction (PCR) assays for fungal pathogens in fluid samples,and to evaluate the feasibility of fast PCR diagnostic method for the invasive fungal infection.Methods The sterility body fluid samples from 60 cases hospitalized immunocompromised patients with clinical underlying diseases and suspect of invasive infections with fungi between January 2008 and December 2011 were processed for microscopy and cultures.Applying fungal ITS4 and ITS86 universal primers to amplify pathogenic fungi genes from the sterility body fluid with method of rapid PCR.The results were compared between the standard and PCR methods.Results Humoral direct clinical specimens by PCR amplification of DNA fragments with the scan results were similar.Positive rate of PCR test with clinical body fluid samples and the traditional fungal cultivation was similar.There was no significant statistical difference [38.3％ (23/60) vs 33.3％ (20/60),P ＞ 0.05].Conclusions PCR test is feasibility with clinical fungal diagnosis from directly humoral specimens.To amplify the clinical sterility body fluid samples with ITS fungal universal primers and PCR method might provide an accurate and rapid approach to detect the pathogenic fungi.Its methods on early diagnosis and prognosis of invasive fungal infections are of guiding significance.

Objective To compare the traumatic indicators of complete video-assisted thoracoscopic surgery (c-VATS) with traditional open surgery (TOS) for lung cancer patients, and further explore the minimal invasiveness of c-VATS. Methods From January 2010 to February 2013, 45 cases with complete video-assisted thoracoscopic surgery (c-VATS gurop) and 42 cases with traditional open surgery (TOS group) were compared in operation time, intraoperative blood loss, duration of chest drainage, the perioperative cytokine and immune cells (CRP,WBC,N,L),pain score and shoulder function score. Results There was no significant difference between groups in sex, age, pathological type, stage,operating time and the perioperative cytokine and immune cells (CRP, WBC, N, L) ( >0.05);Compared with TOS group, c-VATS group intraoperative blood loss was significantly reduced [(167.4±68.5) mL vs (288.6±84.0) mL, =0.000];Drainage time of TOS group was significantly longer than that of c-VATS group [(4.64±2.10) days vs (3.20±1.20) days, =0.000];The postoperative pain measurements in c-VATS group were less than that in TOS group, but the difference between groups was not significant on postoperative 1 day ( =0.542) and significant on postoperative 3 day,7 day,30 day ( = 0.034, 0.000, 0.000) . Patients activities of daily living scores at postoperative 7 day and 30 day in c-VATS group were significantly better than those in TOS group, with statistically significant differences ( =0.000,0.000) . Conclusion Whether the short-term effect or the long-term results,the VATS lung resection is better than the traditional open surgery. c-VATS resection of lung cancer is more invasive.

Objective To investigate the effects of N-acetylcysteine (NAC) on the expression of transforming growth factor-β1 (TGF-β1) in renal cortex of diabetic nephropathy rats.Methods A rat model of DN was established.The rats were randomly divided into control group,DN group and NAC group.After 8 weeks treatment,urinary albumin excretion rate (UAER) was determined.The expression of TGF-β1 in renal cortex was detected by immunohistochemistry and RT-PCR analysis.Pathomorphological changes of renal cortex were observed.Results (1)The levels of UA ER were significantly higher in DN group and NAC group [(1268.3±297.5) μg/24 h and (315.9-±86.8) μg/24 h] than in control group [(31.2±8.9) μg/24 h,q-29.85,16.76,both P＜0.01].The groups of DN and NAC versus group of control showed the increased levels of activity of TGF-β1 in renal cortex [immune-histochemistry index of glomerular mesangial area:7.35±1.17 and 3.87 ± 0.71 vs.1.95±0.34,q= 10.75,5.82,both P＜0.01];immune-histochemistry index of renal tubulointerstitium [21.21± 3.78 and 10.67±1.86 vs.3.62±0.79,q=15.20,11.36,both P＜0.01];the expression of mRNA in renal cortex[0.72±0.06 and 0.45±0.05 vs.0.23±0.04,q=9.13,7.45,both P＜0.01].The pathomorphological changes were significant in DN group and NAC group.(2)The NAC group versus DN group showed a decreased levels of UAER (q=8.17,P＜0.01),activity of TGF-β1 in renal cortex [immune-histochemistry index of glomerular mesangial area:q= 4.97,P＜0.01]immune-histochemistry index of renal tubulointerstitium (q = 6.86,P ＜ 0.01 );the expression of mRNA in renal cortex (q= 3.69,P＜0.05) and showed improvement of pathomorphology in renal cortex.(3) There was a significantly positive correlation between expression quantity of TGF-β1 mRNA in renal cortex and UAER level in NAC group(r= 0.749,P＜0.05).Conclusions The protective effects of NAC on the kidney of DN rats may be partly related with inhibition on the expression of TGF-β1.

Objective To study the feasibility, safety and clinical application value of LRH, comparing with abdominal radical hysterectomy (ARH) . Methods A total of 80 patients' clinical data were collected to analyze the development of LRH in Yunnan Tumor Hospital while compared with another 40 patients between June 2012 to June 2013 of ARH for some associative indexes. Results The patients were divided into group A and B equally.Compared with Grope A, the time of operation decreased 26.9%, 37.2% has been augment for lymph gland sweeping, the amount of bleeding and intraoperative complication reduced 37.3% and 7.5% in Grope D, respectively, with distinctive difference ( >0.05) .Hospitalization expenses had a small degree reduced but no distinctive difference.The learning curve of LRH was 40 approximately.Comparison between LRH and ARH in the same period showed that LRH was more splendid than ARH in several index.1 case relapsed in 2-48 months follow-up in ARH while no relapse in the other group. Conclusion LRH is safe and feasible and has good prospects in clinical application and deserves clinical generalization because of its advantages such as less trauma,less pains, quick recovery,less scars and aesthetical appearance.

Objective To explore the relationship between ERG4 gene overexpression and azole resistance in clinical Candida albicans strains. Methods The National Committee for Clinical Laboratory Standards (NCCLS)M27-A2 broth microdilution method was conducted to evaluate antifungal susceptibility of 34 clinical Candida albicans isolates in vitro. Total RNA was extracted from these Candida albicans strains and transcribed into cDNA. Real-time fluorescence-based quantitative PCR was performed to determine the mRNA expression of ERG4 gene. Statistical analysis was carried out by a two-sample t-test. Results The expression level of ERG4 mRNA was significantly higher in fluconazole-resistant than in -sensitive Candida albicans strains (4.20 ± 2.56 vs. 1.72 ± 1.33, t = 3.99, P < 0.05), higher in itraconazole-resistant than in -sensitive Candida albicans strains (3.60 ± 2.47 vs. 1.66 ± 1.61, t = 3.71, P < 0.05), and higher in voriconazole-resistant than in -sensitive Candida albicans strains (3.99 ± 2.72 vs. 2.07 ± 1.58, t = 2.91, P <0.05). Further more, increased ERG4 mRNA expression was also observed in isolates cross-resistant to all the three azole antifungal agents compared with those susceptible to all of them (4.49 ± 2.73 vs. 1.69 ± 1.82, t = 3.81, P < 0.05). Conclusions The overexpression of ERG4 gene may be associated with cross resistance to fluconazole, itraconazole and voriconazole in clinical Candida albicans strains, but its exact role is expected to be investigated through downregulation of the ERG4 gene.