The paper describes the short and medium term (within 2 to 5 years) priorities that any region in China right now faces in working out and implementing its regional health planning, viz. the coordinated development strategy of medicine and health, medical security and social economy. The authors hold that to achieve the coordinated growth of the health cause and society, it is imperative to overcome in the short run logically related obstacles in four aspects: ineffective solution to the apparent problems followed with interest by both the social and health sectors and lack of effective operating conditions accompanying medical insurance reform, both resulting in the lack of a driving force in the reform within hospitals; difficulty in achieving breakthroughts in the development of the health cause; and the probability of a regional health planning becoming a mere formality because of the above factors. In addition, the fact that reform of medical and health institutions in their setup and ownership of property rights lags behind macroscopic social economic reform obscures the explanation of and solution to the above problems. Based on the research results, the paper sets forth the priorities in short and medium term planning.

Objective:To study the current status and needs of Community Care for disabled elderly in Beijing and put forward the suggestions for improving the elderly Community Care system. Methods:Descriptive statistical a-nalysis, Chi-square test and Multivariate logistic analysis were adopted to analyze the situation of Community Care for Disabled elderly using data from the community survey of elderly population in Beijing. Results:The status of health is not optimistic for Disabled elderly, there are high demands for the community health services and welfare facilities for elderly and the needs for services provided by part-time home care, day care and volunteers are high, but those services and facilities provided by communities were found to be inadequate. Conclusion:China has a large popula-tion base of Disabled elderly and its number grows fast, but community care supply is in shortage and cannot meet the needs of those people. It is therefore urgent to improve community health services and community care system.

Objective To construct the assessment index system for general nursing goals management based on the performance structure theory. Methods Expert interviews and Delphi expert enquiry were used to complete the construction of index system, and SPSS17.0 was used to do data statistics and reliability analysis. Results The assessment index system for general nursing goals management was constructed which contained 6 level-Ⅰindicators such as nursing quality, nursing safety, nursing service, teaching and training, the contribution of department and the communication skills and 22 level- Ⅱ indicators. The department monthly examination scores calculation method and feedback mechanism were also established. The expert positive coefficients were 97.6%and 98.8%respectively, the authority coefficients were 0.85 and 0.86, the importance and feasibility mean scores of every index were 3.86-4.98 and 3.98-4.88, and coefficients of variation were 0.03-0.27 and 0.05-0.25 in 2 rounds of enquiry. The importance of level-Ⅰor level-Ⅱ indicators and operability coordination coefficients were 0.10-0.36, the significance test showed P<0.05. Conclusions The design of each dimension of the index system gives full consideration to 3 dimensions of performance: task-adaptive-relationship. Representative of key indicators is strong. The Delphi method used in building is scientific and the results are reliable. The maneuverability of calculate Method is strong, easy to quantify. The feedback mechanism has a strong incentive by combining the assessment results closely with the individual interests. The establishment of the index system can provide scientific and objective basis for the full implementation of the general nursing goals management.

Objective To investigate the frequency distribution of proprotein convertase subtilisin/kexin 9 (PCSK9) gene I474V polymorphisms and their relationship with patients with ischemic stroke (IS)of Uygur and Han ethnic groups in Xinjiang Uygur Autonomous Region.Methods The I474V polymorphism was identified by polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) in 407 patients with IS(including 219 Hans and 188 Uygurs)and 425 health controls (including 255 Hans and 170 Uygurs),and some specimens were sequenced.Results (1) Between IS group and control group,the genotypes Ⅱ and Ⅳ had no statistically significant differences in the levels of triglycerides (TG),high-density lipoprotein cholesterol (HDL-C) ; Total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C) levels had statistically significant differences; LDL-C levels had also statistically significant differences.Between IS and control groups,TC,LDL,HDL-C levels of genotype Ⅱ showed statistically significant difference.In the IS group,TC,LDL-C levels of Ⅳ genotype were significantly higher than the control group,the difference being statistically significant.(2) There was statistically significant difference in the genotype distribution between IS and control groups (9.5％ (77/814) vs 4.5％ (38/850),x2 =16.09,P =0.000).And the distribution of allele frequency was statistically different (18.9％ (77/407) vs 8.9％ (38/425),x2 =17.38,P =0.000).(3) The differences of I474V loci Ⅳ genotype frequency distribution in Xinjiang Uygurs and Hans were statistically significant (27.7％ (52/188) vs 11.4％ (25/219),x2 =17.40,P =0.000; 12.9％ (22/170) vs 6.3％ (16/255),x2 =5.57,P =0.018) ; So did the Ⅴ allele frenquency distribution (13.8％ (52/376) vs 5.7％ (25/438),x2 =15.58,P =0.000; 6.5％ (22/340) vs 3.1％ (16/510),x2 =10.44,P =0.001).(4) There was statistically significant difference in the genotype distribution and allele frenquency distribution between IS group and control group in the Xinjiang Uygurs (27.7％ (52/188) vs 12.9％ (22/170),x2 =11.79,P =0.001 ; 13.8％ (52/376) vs 6.5％ (22/340),x2 =10.44,P =0.001) ; But there was no statistically significant difference in the Hans.Conclusions Ⅱ and Ⅳ genotypes are dominant in the I474V polymorphism loci of PCSK9 gene.The genotype of PCSK9 gene I474V polymorphism is correlated with increasing serum levels of TC and LDL-C.I474V polymorphism is associated with cerebral IS course in Xinjiang region.There is statistically significant difference in the genotype I474V distribution between Uygur and Han groups.I474V polymorphism has a relationship with the occurrence of IS in Xinjiang Uygurs.Ⅳ may be a susceptible genotype and Ⅴ may be a genetic susceptible allele of the Xinjiang Uygurs.

Objective To examine the effects of IL-10 on cardiac fibroblasts ( CFBs) proliferation and phenotype transformation to myofibroblasts (MyoFbs) induced by transforming growth factor-β1 (TGF-β1);and to investigate the regulating pathways .Methods Cardiac fibroblasts were isolated from cardiac ventricles of neonatal SD rats . The passage 2~4 were used and divided into the following groups for treatment:1) control group, 2) IL-10 reac-tion group, 3) TGF-β1 reaction group, and 4) IL-10 plus TGF-β1 reaction group (TGF-β1 treatment followed with IL-10 pretreatment ) .Cells proliferation was assessed by MTT assay and immunocytochemistry staining for prolifera-ting cell nuclear antigen (PCNA);the phenotype transformation into MyoFbs was assessed by immunocytochemistry of α-smooth muscle actin (α-SMA);extracellular signal related kinase ( ERK1/2) and P38 kinase pathways were assessed by western-blot.Results TGF-β1 (10 μg/L) treatment boosted the proliferation and the expression ofα-SMA significantly (P<0.01), while IL-10 (10, 50 or 100 μg/L) plus TGF-β1 co-treatment induced lower cell proliferation and expression of α-SMA than treating with TGF-β1 alone ( P<0.05 ) , with the inhibitory effect of IL-10 being concentration dependent .TGF-β1 could significantly stimulate the ERK 1/2 and P38 kinase phospho-rylation ( P<0.01 ) , however IL-10 (100 μg/L) plus TGF-β1 co-treatment failed to down-regulated the phospho-rylation of ERK1/2 and P38 kinase compared with TGF-β1 alone ( ERK1/2:P<0.05;P38:P<0.01 ) .Conclu-sions IL-10 can attenuate TGF-β1-induced CFBs proliferation and phenotype transformation to MyoFbs .The in-hibitory effects may explained by a mechanism of inhibiting the activation of ERK 1/2 and P38 kinase .

[ ABSTRACT] AIM: To determine the aberrant methylation status in the gene promoter regions of CDH13, RASSF1A, DLEC1, SEPT9 and RUNX3 by detecting the plasma specimens and the value of their combined detection for di-agnosis of lung cancers.METHODS:Nest methylation specific PCR ( nMSP) was used to detect the promoter methylation status of the 5 genes in the plasma from 106 normal controls, lung cancer tissues, lung benign tissues and the plasma from 106 patients with lung cancers.Multiple displacement amplification ( MDA) was used to amplify modified genomic DNA to solve the problem of insufficient of plasma DNA template.RESULTS: The positive rates of promoter methylation of CDH13, RASSF1A, DLEC1, SEPT9 and RUNX3 in the lung cancer tissues were 51.9%, 44.3%, 54.7%, 36.8%, 24.5%, respectively, and those in the plasma were 46.2%, 41.5%, 50.9%, 31.1%, 19.8%, respectively.The re-sults of the Kappa consistency check showed that the lung cancer tissues and the plasma had obviously coherence in the methylation status of the 5 gene promoter regions.Combination of DLEC1, CDH13, RASSF1A, and SEPT9 had a higher di-agnostic efficiency than the others, as their ACC value was 0.8208 and youden index was 0.6415 ( with the sensitivity of 81.13% and the specificity of 83.02%) .CONCLUSION:Combination detection of promoter methylation of lung cancer-related genes in the plasma is expected to apply to the early diagnosis of lung cancer.

Objective To determine,in our experience,the prevalence and presence of risk factors for metabolic syndrome (MS) in heart transplant recipients.Methods We studied 135 patients who underwent heart transplantation in our hospital from September 2000 to December 2011,According to the diagnostic criteria of MS,they were divided into two groups.All variables that could be related to the development of MS during the follow-up period were analyzed.The prevalence and presence of risk factors for MS in our experience were determined.Student t-test,Wilcoxon rank sum test and x2 test were used for univariate statistical analysis and logistic regression for multivariate analysis.Results (1) Of the 135 patients,63 developed MS (46.67％) during a mean follow-up period of 47.3 months.The multivariate analysis identified the follows as predictive factors for the development of MS:age (OR=1.09,95％ CI 1.01-1.22,P＜0.05),body mass index (BMI) (OR=1.65,95％ CI 1.16-1.87,P＜0.05),history of DM (OR =3.27,95％ CI 1.12-34.21,P＜0.05).Conclusion In our population,the prevalence of MS after heart transplant is 46.67％ during a mean follow-up period of 47.3 months.Age,pre-operative overweight especially BMI,and history of DM were significant and independent risk factors for the development of MS during the follow-up period.For these patients,dose of immunosuppressant and diet control are important.

Objective To explore the association between single nucleotide polymorphisms (SNPs) in WNK1 gene and ischemic stroke in Uygur population. Methods Ten tagging single nucleotide polymorphisms (tSNPs) of the WNK1 gene in 295 ischemic stroke patients and 318 control subjects were genotyped,and the association between these tSNPs and ischemic stroke were conducted.The 10 tSNPs were rs3858703, rs11611246, rs7305065, rs1990021, rs34408667, rs12309274, rs1012729, rs956868,rs12828016 and rs953361. They were determined by the Multiplex SNaPshot platform. All data were analyzed using t-test,x2-test and Logistic regression. Linkage disequilibrium and Haplotype were analyzed by Haploview software.Results There were no significant differences between cases (25.6％) and controls(30.0％ ) of the 10 tSNPs in WNK1 gene.When the samples were further stratified according to gender,rs11611246 T allele was found to be associated with a reduced risk of ischemic stroke,with a per-allele OR of 0.448(95％ CI 0.269-0.746,P =0.002) in female cases than in female controls. The significance remained after adjustment for the covariates of age,and for the covariates of age,BMI,cigarette smoking,alcohol drinking,hypertension,diabetes and hyperlipidemia.In addition,no association between the other 9 tSNPs and ischemic stroke were found in Uygur subjects.Conclusion The study reports a new genetic variant,rs11611246,located in the fourth intron of the WNK1 gene,decreasing the risk of ischemic stroke in Uygur population.The T allele might be the protecting factor of ischemic stroke in female Uygur.

AIM:To investigate the effects of resveratrol ( Res) on the proliferation of ARPE-19 cells and to ex-plore the possible mechanisms.METHODS:After ARPE-19 cells were treated with Res at concentrations of 0, 50, 100, 150, 200 and 300 μmol/L for 24 h, 48 h and 72 h, the effects of Res on the proliferation of the cells were tested by CCK-8 assay.The ARPE-19 cells were treated with Res at concentrations of 0, 100, 150 and 200 μmol/L for 48 h.The effects of Res on the cell cycle and apoptosis were detected by flow cytometry with Annexin V-FITC/PI staining.The protein expression of proliferating cell nuclear antigen (PCNA) was detected by immunofluorescent assay.The mRNA expression of PCNA, P21 and P27 was determined by real-time PCR.RESULTS:The results of CCK-8 assay showed that Res inhibited the prolifera-tion of ARPE-19 cells in a time-and dose-dependent manner.The treatment with Res for 48 h resulted in an arrest of cell cycle at S phase without increasing cell apoptosis.Res inhibited the protein expression of PCNA in ARPE-19 cells.The re-sults of real-time PCR showed that Res increased the mRNA expression of P21 and P27, and decreased the mRNA expres-sion of PCNA.CONCLUSION: Res inhibits the proliferation of ARPE-19 cells and induces the cell cycle arrest at S phase.The mechanism may be related to up-regulation of P21 and P27, and down-regulation of PCNA.

BACKGROUND:Spinal canal decompression is needed in posterior pedicle screw fixation surgery for thoracolumbar burst fractures combine with spinal cord injury. The structure of posterior spine is often damaged. The posterolateral bone fusion in al fixed segment is stil the main surgery. In order to further reduce fusion segment and maintain motor unit, it is necessary to perform selective segmental bone graft fusion during fixation and decompression.
OBJECTIVE: To discuss the advantages of selective posterolateral vertebral fusion for thoracolumbar fracture with spinal injury through comparing with posterolateral vertebral fusion.
METHODS: Data of 83 thoracolumbar burst fracture cases, who received posterior lumbar decompression and short segment fixation with pedicle screws and bone graft through injured vertebra from January 2006 to July 2013, were analyzed retrospectively. According to fusion segments, above patients were divided into selective posterolateral vertebral fusion group (n=42) and the whole posterolateral vertebral fusion group (n=41). Perioperative index, internal fixation, vertebral height loss rate, Cobb angle, spinal nerve recovery and Oswestry Disability Index were compared between the two groups.
RESULTS AND CONCLUSION:(1) Al cases were folowed up for 25-32 months. (2) There was no statistical significance in operation time, intraoperative blood loss and ambulation time between the two groups (P > 0.05). Postoperative drainage volume was less in the selective posterolateral vertebral fusion group than in the whole posterolateral vertebral fusion group (P < 0.05). Before removal of fixator, there was no loosened fixator or breakage of screw or stick. (3) There were improvements in the rate of vertebral front height loss and Cobb angle in both groups at various time points after operation (P < 0.05). There was no statistical significance in the rate of vertebral front height loss and Cobb angle in both groups (P > 0.05). (4) There was no significant difference in fusion rate at 6 months after treatment between the two groups (P > 0.05). Fusion was achieved in both groups before removal of the fixator. (5) Spinal nerve recovery was found after treatment in both groups. No significant difference in Oswestry Disability Index was detected in final folow-up (P > 0.05). (6) Results verified that compared with the whole posterolateral vertebral fusion, selective posterolateral vertebral fusion can obtain a good vertebral height and prevent Cobb angle loss again, reduce the internal fixation loosening and breakage. After removal of the fixator, selective posterolateral vertebral fusion can reduce spinal motion unit lost, and decrease the adjacent vertebral degeneration.