Objective: To explore the impacts of demographic structure, environmental quality on household health care expenditures. Methods: Based on 2000-2010 inter-provincial panel data, the method of dynamic panel SYS GMM is used. Results:(1) The rise of elederly dependency ratio promotes residents’ health care expenditures; (2) the decline in juvenile dependency ratio is also the acceleration factor of health care expenditures; (3) the seriousness of environmental quality pollution expands the health care demand. Conclusion: To improve the health status residents, it is needed to implement the medical insurance system for the eldly, construct the health care insurance system for the children, besides, environment protection should be people oriented.

This paper presents a method for trace level analysis of microcystins in water using solid-phase extraction and high performance liquid chromatography.The optimized condition enabled the determination of common microcystins at levels as low as 0.02～0.05μg/L,and the liner range is from 0.1μg/L to 50 μg/L. The method has been applied to the analysis of field sample from Dianchi lake.

Objective To study the efficacy and safety of methylcarboprost suppository in preventing postpartum hemorrhage of cesarean section.Methods Two hundred and nine puerperants with cesarean section were randomly divided into two groups: test group(n=103),1mg methylcarboprost suppository was given sublingually after peritoneotomy,and control group(n=106),20IU oxytocin intravenous drip immediately after neonate delivery. 20IU oxytocin were injected into uterine muscularis in the both groups after neonate delivery.The amount of bleeding in perioperation and 24 hours after delivery were measured.Results The blood loss volumes in perioperation and 24hour after delivery in test group were 191 2ml and 317 2ml respectively, and in control group were 216 6ml and 350 5ml respectively,and there was significant difference in the blood loss volume between the two groups(P

BACKGROUND: The presence of various microorganisms in dental unit waterlines has been revealed by numerous reports previously. However, impact of different dental procedures on microbial contamination in dental unit waterlines (DUWLs) remains unclearly.OBJECTIVE: To assess the level of microbial contamination in water effluent from the high-speed handpiece line of dental chair units (DCUs) among different specialty departments in a provincial stomatological hospital. Thus, to propose individual infection control measures for different specialty departments according to their properties of microbial contamination.DESIGN, TIME AND SETTING: A cross-sectional investigation was designed and conducted in Guangdong Provincial Stomatological Hospital and Laboratory of Microbiology, School of Public Health and Tropical Medicine, Southern Medical University, between May 2007 and March 2008.MATERIALS: The materials used in this investigation including nutrient agar, blood plates, biochemical testing kit, agglutination testing kit and Gram staining agents. These materials were purchased from Guangdong Huankai Microbial Science and Technology Co., Ltd.METHODS: Water sampling was conducted at 80 DCUs of different specialty departments in Guangdong Provincial Stomatological Hospital. A total of 60 mL, with 6 mL for once sampling of water effluent from the high-speed handpiece line of each DCU were collected aseptically after the finish of the daily clinical work on every second Friday between May and October in 2007. Standard isolation and identification technique of bacteria was adopted.MAIN OUTCOME MEASURES: Concentration of bacteria and prevalence of 3 species of bacteria in water effluent from the high-speed handpiece line of DCUs among different specialty departments were evaluated.RESULTS: Concentration of bacteria in water effluent from the high-speed handpiece line of DCUs averaged 5.67×10~2 cfu/mL, ranged from 5.15×10 to 1.59×10~3 cfu/mL. The microbial concentration of water samples from Department of Periodontics was significantly higher than that from other departments, while the microbial concentration of water samples from Department of Oral Surgery was the lowest (P = 0.000).CONCLUSION: Contamination in water effluent from the high-speed handpiece line of DCUs varied from different specialty departments in the provincial stomatological hospital. It is suggested that DUWLs flushing should be performed routinely, especially for the department without frequent use of the high-speed handpiece in the daily work, and extra infection control measures should be adopted for the department with severe clinical operative contamination.

BACKGROUND:Daily flushing of dental unit waterlines (DUWLs) is believed to be the least expensive and simplest method for reducing the level of microbial contamination in DUWLs.Authorities' guidelines suggest that high-speed handpieces should be run to discharge water for 30 seconds after use on each patient.However,the guideline is inaccurate for clinicians according to the time-dependent flushing since the maximum flow rate of flushing water varied from dental chair units (DCUs).OBJECTIVE:To assess the level of microbial contamination in water effluent from the air-water syringe and the high-speed handpiece line of DCUs and prevalence of three species of bacteria detected in DUWLs at each flushing volume.Thus,practical water flushing measures could be proposed according to the effect of volume-dependent dental unit waterline flushing on the microbial contamination in DUWLs.DESIGN,TIME AND SETTING:A cross-sectional investigation was designed and conducted in Guangdong Provincial Stomatological Hospital and Laboratory of Microbiology,School of Public Health and Tropical Medicine,Southern Medical University between May 2007 and March 2008.MATERIALS:The materials used in this investigation including nutrient agar,blood plates,biochemical testing kit,agglutination testing kit and Gram staining agents.These materials were supported by Guangdong Huankai Microbiological Science and Technology Ltd.METHODS:Water sampling was conducted at 80 DCUs in a stomatologicel hospital.A total of 6 mL,2 mL for once sampling,of continuous water flushing from the air-water syringe and the high-speed handpiece line of each DCU respectively were collected aseptically after the finish of the daily clinical work on every second Friday,between May 2007 and October 2007.Standard isolation and identification technique of bacteria was adopted.MAIN OUTCOME MEASURES:Concentration of bacteria and prevalence of three species of bacteria in water effluent from the air-water syringe and the high-speed handpiece line of DCUs at each flushing volume were evaluated.RESULTS:The median concentration of bacteria in water effluent from either the air-water syringe or the high-speed handpiece line of DCUs was 5.67×10~2 cfu/mL,and there were no statistical differences among microbial concentrations of first three 2-mL flushing water samples (P>0.05).Prevalence of Staphylococcus spp.from the third 2-mL flushing water sample demonstrated an obviously higher level than that of Staphylococcus spp.from the first two 2-mL (P < 0.05),while prevalence of Streptococcus spp.and Actinomycete spp.kept at a relative stable level (P > 0.05) at each flushing volume.CONCLUSION:Volume-dependent water flushing procedure stays a more practical measure for reducing microbial contamination in DUWLs rather than time-dependent flushing,but the volume of flushing water needs to be further evaluated.

In the perspective of medical ethics,doctor-patient relationship is a particular kind of social relations that contains a combination of factors such as biological,psychological and social basis,including certain moral standards and ethical norms formed.Ethical property is a fundamental property of the doctor-patient relationship.In current medical practice,doctor-patient relationship unprecedented tensions,conflicts between doctors and patients,the frequent occurrence of medical trouble,has become the social factors of disharmony and highly attention.In order to make the medical humanity regression and construct a new doctor-patient relationship reflecting equality and cooperation,with medical ethics as the angle of view,the author the author has discussed and demonstrated how to improve doctor-patient ethics accomplishment,rebuild the doctor-patient relationship of trust,reshape the respect for life and personality of medical humanism spirit,safeguard the equality of the subject position of both doctors and patients,and how to provide humane medical services etc.in order to indicate the direction for the deepening of China's reform of the medical system and provides theoretical support.

Objective To investigate clinical value of procalcitonin (PCT ) in guiding treatment of infection in elderly patients with heart failure .Methods A total of 120 cases of elderly patients with heart failure and infection were divided into control group (50 cases) ,receiving conventional anti-infection treatment ,and observation group(70 cases) ,receiving adjusted anti-infection treat-ment based on serum PCT levels .Treatment efficiency ,cost of treatment ,hospitalization duration and other indicators were com -pared between the two groups .Results Effective rate of observation group was 78 .57% ,which was not significantly different with the 78 .00% of control group ( P > 0 .05) .Cost of treatment ,hospitalization duration ,application time of antibiotics ,antibacterial drug costs ,superinfection and mortality were significantly different between the two groups (P< 0 .05) .After treatment ,levels of e-rythrocyte sedimentation rate ,C-reaction protein ,white blood cells and neutrophil in the two groups were significantly improved (P< 0 .05) .After treatment ,C-reaction protein level of observation group was lower than control group (P < 0 .05) .Conclusion PCT based anti-infection treatment could help shorten the treatment time ,reducing treatment costs and improving outcomes ,and might be worthy of clinical application .

Objective To investigate the effect of local delivery of paclitaxel on bile duct scar formation and biliary stricture in guinea pig.Methods Models of end-to-end anastomosis of the common bile duct were established in 42 guinea pigs.The animals were randomly divided into paclitaxel and control groups.In the paclitaxel group,the drug solution(1000 ?mol/L,0.05 ml) was smeared onto the anastomotic wound before closing the abdomen.The animals were killed in 3 days,2 weeks,and 1 month after the operation(7 in each group at each time point).The sepcimens of the common bile duct were obtained for histological examination.Transmission electron microscopy was employed to observe the ultrastructure of paclitaxel-induced apoptotic cells.Results Histological examination showed inflammatory reaction and hyperplasia of the bile duct wall.The bile duct wall of the paclitaxel group was significantly thiner than that of the control group in 3 days and 1 month after the operation [3 days:(574.41?24.53)?m vs(802.98?24.42) ?m,t=-6.604,P=0.000;1 month:(1383.36?36.64) ?m vs(1518.56?34.89)?m,t=-2.672,P=0.020].Paclitaxel-induced cell apoptosis and injured cell organs were found by transmission electron microscopy.Conclusion Single local delivery of paclitaxel can inhibit biliary stricture in one month.

There are many problems existing in humanities and social science courses in education and teaching of medical colleges and universities.Changing concepts of education,adjusting the curriculum,improving teaching methods and improving the quality of teachers are effective measures in medical colleges to strengthen the humanities and social science courses.We have made a preliminary exploration on teaching practice for humanistic education and professional education.

85.0%),but they were lack of knowledge of special knowledge,41.1% of them knew AIDS diagnostic criteria,18.4% of them knew "window phase";the differences of nurse mastery of AIDS occupational prevention knowledge before and after the intervention were significant(P