The Cooperative medical system,like the insurance,has the adverse selection,this article points out the concept of adverse selection,and raises some efficient way to control the adverse selection.

Objective:To explore the levels of serum leptin,adiponectin and resistin in simple obesity and also to investigate their roles in this disease. Methods:The serum adiponectin,resistin,leptin,anthropometric and biochemical measurements of fasting blood glucose,fasting insulin were detected in 31 simple obesity subjects and 30 normal subjects. Results:① The adiponectin level in obesity group was significantly lower than that in normal group,but levels of leptin and resistin were higher(P

[Objective ] To evaluate the curative effect of urinary retention caused by hyperplasia of prostate gland after treatment of electric acupuncture to Ciliao and Zhongliao acupoints combined with ultrashort wave therapy.[Methods] 35 patients were treated by electric acupuncture to Ciliao and Zhongliao acupoints cooperating with ultrashort wave therapy.Residual urine volumn(RUV),frequency of urinary retention,the therapeutic effect and follow-up were recorded and statistically analyzed.[Results] 29 patients were able to urinate after the therapy,except for 6 patients who were still in urinary retention condition.Effective rate were up to 82.8%.[Conclusion] It proved that the less the frequency was,the better the clinical effect would be.However,no matter how frequent the retention was,our combination therapy still worked,and both effects of the near future and long-term were proved to be fine.Special therapeutic action from Shu acupoint,electric acupuncture's electric current effect,and physical therapy of ultrashort wave contributed to the outcome.

quamous metaplasia occurred, the expression of occludin and ZO-1 in cells were similar to those in control group, which might play a role in the defense function of neovaginal mucosa.

Objective To probe into the inequality found in primary public health service available to the migrant population and permanent residents. Methods With on-site interviews, 581 migrant workers and 581 permanent residents in a county in Zhejiang province were surveyed, to learn the inequalities between the two in the expenditure, access and outcomes of the public health service accessible to each. Results only 7. 8% of the migrant population ever had access to medical aid, a ratio far below that of the permanent residents; 40. 9% of the migrant population may turn down medical service beyond their affordability, a ratio far higher; for the migrant population, their ratio of gynecological checkup is 58. 7%, lower than that of the permanent residents (67. 7%). Conclusion Resources and financial allocation to institutions of public health should be enhanced, and social medical and insurance system should be developed and improved, in an effort to encourage the equality of primary public health services accessible to various sectors of the population.

ObjectiveTo explore the effect and mechanism of LQC on the immune function of B lymphocytes and NK lymphocytes in mouse with impaired immune function. Methods Mice with impaired immune function led by Cyclophosphamide (Cy)were used as experimental animmals, and divided into five groups randomly, twelve mice in every group, which is NS control group, Cy control group, Cy+ LQC minor and major dose group, and Cy + LQC decoction group. NS control group was given NS 0.2 ml/d subcutaneously 10 d, and the rest groups were given Cy 0.8 ml/d subcutaneously (20 mg/kg · d-1) 10d, to establish a mouse model of immune dysfunction. Since the 11th day each group was given NS, Cy, LQC minor dose, major dose and fructus ligustri lucidi decoctoin. Mice of each group were killed after 7 days. The percentage of B lymphocytes (CD3 - CD19 + ) and NK lymphocytes (CD3 - CD 16 + CD56 + ) in the peripheral blood of the experimental mice were detected by flow cytometer. ResultsIn comparison with LQC major dose group [ (20.44± 1.78)and(19.12± 1.70) ], fructus ligustri lucidi group[ (19.90± 1.42) and (20.17± 1.66) ], CD3-CD19+and CD3-CD16+CD56+ cells of LQC minor dose group[ (11.54±0.98) and (12.46±0.08)]were decreased significantly (P＜0.01), which were increased significantly compared with Cy group[ (4.53± 1.70) and (5.03 ±1.22) ] (P＜ 0.01), but they had no significant difference with NS [ ( 11.84 ± 0.99) and ( 12.90± 0.28) ] (P ＞ 0.05).In comparison with Cy group and NS group, CD3-CD19+ and CD3-CD16+CD56+ cells of LQC major dose group were increased significantly (P＜0.01), which had no significant difference with fructus lignstri lucidi group (P＞0.05). Conclusion The immune functions of the mice with impaired immune function were improved by LQC, it also could increase the quantity ofCD3-CD19+ cell and CD3-CD16+CD56+ cell. The dose of LQC was positively correlated with the modulation effect of LQC on the immune function.

Objective To build the relationship model of childhood aubuse, personality, insecurity and dissociative trait in medical students. Methods Through stratified sampling,262 medical students were investiga?ted by the Personal Report of Childhood Abuse( PRCA) ,Dissociative Trait Scale( DTS) ,Self?Rating Feeling of In?security Scale( SRFIS) ,Revised NEO Five?Factor Inventory( NEO?FFI?R) . A path analysis was applied by AMOS (Analysis of Moment Structures) version 7.0. Results ①Childhood abuse was positively related to insecurity, dissociative trait and neuroticism( r=0.248~0.361, P<0.01) ,but was passively related to extraversion,agreeable?ness and conscientiousness( r=-0.168~-0.250, P<0.01). Insecurity was positively related to dissociative trait and neuroticism( r=0.479~0.522, P<0.01) ,but was passively related to extraversion,agreeableness and conscien?tiousness( r=-0.234~-0.324, P<0.01). Dissociative trait was positively related to neuroticism( r=0.597, P<0.01) ,but was passively related to openness, extraversion, agreeableness and conscientiousness ( r=-0. 133~-0.453, P<0.05). ②The path analysis showed that childhood abuse was directly related to insecurity(B=0.339, P<0.01)and personality(B=-0.226, P<0.01)of medical students. Personality was directly related to insecurity and dissociative( B=-0.609~-0.363, P<0.01) . Insecurity was directly related to dissociative trait( B=0.448, P<0.01) . Personality and insecurity mediated entirely the relationship between childhood abuse and dissociative trait of medical students. The model fit indexes were χ2/ df =1.151<3.000, P=O.080>0.05,RMSEA=0.024<0.050, GFI=0.935,AGFI=0.909,NFI=0.923,RFI=0.902,IFI=0.989,TLI=0.986 and CFI=0.989. Conclusion Per?sonality and insecurity as mediated variable mediate the relationship between childhood abuse and dissociative trait of medical students. Childhood abuse has no direct effect on dissociative trait of medical students.

BACKGROUNDTo explore the clinicopathological changes of non-small cell lung cancer tissues after neoadjuvant chemotherapy with MVP (MMC+VDS+DDP) regimen and its concordance with clinical evaluation, and to study the clinical value of neoadjuvant chemotherapy.

METHODSA total of 84 patients with NSCLC were randomized into combinated therapy group (42 cases) and surgical group (42 cases). The combinated therapy group were given MVP regimen for 2 cycles before operation and 2-4 cycles after operation, however, the surgical group only received surgical treatment. The efficacy of preoperative chemotherapy were determined by pathologic examination under light microscope and electron microscope and clinical evaluation.

RESULTSCombinated therapy group showed various degrees of degeneration and necrosis of tumor cells, which was not found in surgical group. The overall response rate of neoadjuvant chemotherapy was 59.5% (25/42) by both pathological and clinical evaluation. The coincidence ratio of the two evaluation methods was 71.4% (Kappa value=0.407,P < 0.01). Between the two groups, there was a significant difference in total survival rate (P=0.047). And further analysis showed that survival rate was remarkably different in patients with stage III between the two groups (P=0.037), but not in those with stage I and II (P > 0.05).

CONCLUSIONSDegeneration and necrosis with fibrosis are the main pathological phenotypes of the primary lesion after induction chemotherapy, which can be showed by clinical evaluation to chemotherapy efficacy. The preoperative and postoperative adjuvant chemotherapy may be benefical to patients with stage-III NSCLC.

The magnamosis device for stage-one repair of the rectovaginal tistula consists of two arc magnets. Drawing the interrupting thread along the fistula margin via the vaginal side, and pulling the string to arrange the magnets at the fistula base along the long axis of the vagina, we made the magnamosis device automatically clipped to seal the fistula. After removing the threads we kept the device for 2-4 weeks till the natural detachment of it when the compressed tissue in between healed after vascular necrosis. This device utilizing the unique ability of magnamosis to fulfill anastomosis under inflammatory infected state reduces the current high relapse rate and colostomy drawbacks of the conventional rectovaginal neoplasty.
Female ; Gynecologic Surgical Procedures ; instrumentation ; methods ; Humans ; Magnetics ; Magnets ; Pressure ; Rectovaginal Fistula ; surgery ; Wound Healing

BACKGROUNDTo investigate the role of nm23 gene mutation in human non small cell lung cancer (NSCLC).

METHODSThe mutation of nm23 gene was detected in 53 primary NSCLC tissues and 5 cases of other pulmonary benign or malignant disease tissues by PCR SSCP.

RESULTSNo mutation of nm23 gene was found in all 58 specimens.

CONCLUSIONSThe mutation of the nm23 gene may not effectively forebode the aggressiveness and metastatic potential of NSCLC.