Coordinated care delivery is faced with various challenges to carry out in China,which are major decisions to make for decision makers,including how to push forward,how to deliver resources, services and patients to primary institutions,and how to ease the difficulties and affordability of seeing doctors.Based on analysis of roadblocks in coordinated care delivery in China,the authors provided near-term and long-term policy recommendations on the system,including how to build a scientific and reasonable healthcare delivery system,coordinated care delivery by stages,building incentives and constraint mechanisms,and enhancing public awareness and patient-doctor education.

Concept of coordinated care delivery is clearly defined,before a comparative analysis is made between such a concept and the integrated care delivery concept which is popular overseas and similar.On such basis,a theory framework is established for building and implementing such care delivery in line with the integrated theory of care delivery systems.Coordinated care delivery system now in place in China aims at rationally delivering medical resources,services and patients to primary institutions,by means of efficiently distributing resources and service systems and integrating care delivery flows,thus offering patients with cost effective and appropriate services and optimizing the care delivery system.

Analyzed in the paper is the present development of medical rehabilitation service system in Beijing,Changsha,and Urumqi,in an effort to identify key measures,and discover problems found with the policy environment and system building.Based on such findings,the authors proposed such measures as developing policies and regulations, optimizing resource allocation, strengthening training of rehabilitation personnel and greater publicity.

Authors described the patterns,core measures and mechanisms of coordinated care delivery in the localities and analyzed initial outcomes of this practice.It is found that such practice has optimized distribution of regional healthcare resources,implemented first visit to primary institutions, and the care delivery to separate emergency from outpatient service.In addition,the paper analyzed problems found in localities in terms of policy,public hospitals and primary institutions,and proposed elements required for coordinated care delivery system to succeed,such as enhanced policy support, enhanced multi-departmental coordination,and public hospital reform to explore feasible approaches.

This paper summarized practices and experiences of other countries in coordinated care delivery system building,and described the care delivery systems used in various healthcare fundraising patterns.It is found that most countries have defined duties and service coverage of healthcare institutions at all the levels and measures to ensure rational patient flow.In the end,the paper concluded found experiences of these countries and inspirations for China.

Objective To evaluae possible association between interleukin-1 beta (IL-1?) gene exon 5 polymorphism and childhood asthma.Methods The study was conducted in two different groups: asthmatic children(n=55) and healthy children(n=35). The IL-1? gene exon 5 polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP). Results Frequencies of CC,CT and TT genotypes were 92.7%,7.3%,0, and frequencies of C,T allele were 96.4%,3.6% in asthmatic group. However, frequencies of CC,CA and AA genotypes were 85.7%,14.3%,0, and frequencies of C,T allele were 92.9% ,7.1% in healthy group. There were no significant difference in distribution of genotypes and allele frequencies between two groups.Conclusion IL-1? gene exon 5 polymorphism may not be associated with childhood asthma.

In order to evaluate the ability of human standing balance scientifically, we in this study proposed a new evaluation method based on the chaos nonlinear analysis theory. In this method, a sinusoidal acceleration stimulus in forward/backward direction was forced under the subjects' feet, which was supplied by a motion platform. In addition, three acceleration sensors, which were fixed to the shoulder, hip and knee of each subject, were applied to capture the balance adjustment dynamic data. Through reconstructing the system phase space, we calculated the largest Lyapunov exponent (LLE) of the dynamic data of subjects' different segments, then used the sum of the squares of the difference between each LLE (SSDLLE) as the balance capabilities evaluation index. Finally, 20 subjects' indexes were calculated, and compared with evaluation results of existing methods. The results showed that the SSDLLE were more in line with the subjects' performance during the experiment, and it could measure the body's balance ability to some extent. Moreover, the results also illustrated that balance level was determined by the coordinate ability of various joints, and there might be more balance control strategy in the process of maintaining balance.
Acceleration ; Biomechanical Phenomena ; Humans ; Models, Biological ; Motion ; Nonlinear Dynamics ; Postural Balance ; physiology

Objective To provide references for building the medical rehabilitation system in China by learning the progress and compliance of rehabilitation departments construction at tertiary hospitals. Methods Comparative and quantitative methods were used for dynamic analysis qualitative interview to learn the index compliance of the hospitals in question in 201 1-2012.Results Compared with 201 1, average days of stay of the rehabilitation departments declined in general,yet with insufficient therapists;introduction of early rehabilitation intervention was but 57.1%,and the functional assessment rate of rehabilitation service was less than satisfactory.Conclusion Lack of manpower,varying levels of medical rehabilitation services,and neglect for functional assessment were found to be the main problems in construction of medical rehabilitation departments for the time being.

OBJECTIVETo establish the determination method of 2,3,5,4'-tetrahydroxystilbene-2-O-beta-D-glucoside in Yangan Oral Liquid.

METHOD2,3,5,4'-tetrahydroxystilbene-2-O-beta-D-glucoside was determined by HPLC on C18 column, in acetonitrile-water (14:86) solution as a mobile phase, detection wavelength as 320 nm.

RESULTThis method showed a good linear relationship. The average recovery was 99.05% and RSD was 1.31%.

CONCLUSIONThe method was simple with styong specificity and good repriducibility and can be used for quality control for Yangan Oral Liquid.

Chromatography, High Pressure Liquid ; methods ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; isolation & purification ; Glucosides ; analysis ; Plants, Medicinal ; chemistry ; Polygonum ; chemistry ; Quality Control ; Stilbenes ; analysis

Objective To explore the effect of complement activation on bone marrow mesenchymal stem cells (BMSCs)and evaluate the effect after transfection of complement regulatory proteins.Methods Bone marrow aspirate was harvested from 10 cases of patients suffered from fractures.Mesenchymal stem ceils were isolated,indentified cultured and then experimented in vitro.The complement cytotoxicity on the mesenchymal stem cells in autologous serum was measured by Europium cytotoxicity assay.The samples were divided into BMSCs group,BMSCs+ autologous human serum (AHS) group and BMSCs+ inactivated autologous human serum (iAHS) group.The complement membrane attack complex (MAC) deposited on the membranes was detected by flow cytometry.Finally,the cytotoxicity on BMSCs was measured after transfected with membrane complement regulatory proteins (mCRPs).All samples were divided into BMSCs with mCRPs untransfected group and BMSCs with mCRPs transfected group.Results More than 95％ of cells derived from bone marrow were identified to be mesenchymal stem cells through detection of cell surface markers by flow cytometry.The cytotoxicity of untreated cells was 0.41％± 1.48％.BMSCs harvested from the 10 patients all had cytotoxicity after incubated with autologous serum,and the cytotoxicity was 32.59％±2.73％,while cytotoxicity after incubated with complement inactivated autologous serum was 2.59％±3.08％,which was similar to control group.Complement attack complex (MAC) could be detected on the BMSCs incubated with autologous serum,which implied the complement activation.After transfection of mCRPs,the cytotoxicity of autologous serum on transfected cells was decreased.The cytotoxicity of untransfected cells (41.70％±4.47％) had significant difference compared to the cells transfected with CD55 (21.87％±2.19％),the cells transfected with CD59 (18.67％± 1.42％),and the cells transfected with CD46+CD55+CD59 (28.43％±2.14％).CD55,CD59 and CD46+CD55 +CD59 transfected groups could impair effectively the cytotoxicity from complement.However,the cytotoxicity impairment was less effective in CD46 transfected cells (39.30％±3.96％),which had no significant difference compared to untransfected cells.Conclusion Membrane complement regulatory proteins could effectively protect bone marrow mesenchymal stem cells from attacks by complement.