Justice in health and health care is a very important problem.After pointing out the reasons why the problem becomes a hot topic and the content of justice in health and health care,the thesis expounds that justice in health and health care is more than medical issues, it must be considered within the context of social justice;justice and efficiency in health and health care is in accordance;the key point is the allocation of medical resource;the start point and end point is justice in health state;the vitals is policy;the kernel is paying more attention to the vulnerable group.

Physical beauty does not only equal to the shape of body fit for the formal principles of aesthetics, but also the embodiment of culture, and its essence lies in body which embodies wisdom. So plastic surgery does not equal to shape body according to the formal principles of aesthetics, it has to be directed by somaesthetics. Prudence in dealing with the cultural and time-varying differences of physical beauty embodies and even creates the culture of physical beauty.

Objective:Use a new F-PCR method to develop a hepatitis C virus(HCV) diagnostic kit, test the kit through clinical trial and compare it with immunological method. Methods: Fluorescence PCR(F-PCR) is a method which combines PCR and fluorescence probe hybridization together to measure DNA/RNA. Because in-tube monitoring of fluorescence signal can be done to stand for the quantitity of PCR product. Electrophoresis and UV detection are eliminated, so after-PCR cross-contamination which causes false positive can be avoided. Results:A clinical diagnostic kit for HCV with this method is developed. 512 clinical serum samples were tested with this kit, using HCV FLISA kit from Abbott Co.and HCV Fluorescence RT-PCR kit from Biotronics Co. (B-PCR) as control. The results shows :positive rate is 30.5%,sensitivity 97.3 % and specificity 98.1% . Conclusion: F-PCR is obviously superior to ELBA, and higher than B-PCR in sensitivity. The specificity of those three kits have no statistic difference. F-PCR can be used to monitor RNA of HCV in serum, and could be useful for clinical diagnose and therapy effects monitoring.

Objective:To compare the concordance between subjective experience and clinician-rated in different treatment phrase of elderly patients with depressive disorder,and to explore the relevant factors.Methods:Sixty-nine consecutive elderly patiems with depressive disorder diagnosed with International Classification of Diseases-10 criteria were included.The Visual Scale for Depression(VSD) were used to evaluate subjective experience of depression,while the Hamilton Depression Scale (HAMD),Hamilton Anxiety Scale (HAMA),Minimum Mental State Examination (MMSE) were used by clinician to evaluate depression symptom,anxiety symptom and cognition at baseline,2-,4-and 52-week of the treatment respectively.Results:Compared with baseline,VSD scores were increased at 2 weeks and 4 weeks [(2.7 ± 1.6),(5.3 ± 2.0) vs.(7.0 ± 1.8),P ＜ 0.001],HAMD scores were decreased at 2 weeks and 4 weeks [(36 ± 11),(17 ±9) vs.(9 ±8),P ＜0.001],HAMA scores were decreased at 2 weeks and 4 weeks [(27 ± 10),(14 ±8) vs.(7 ±6),P ＜0.001].No significant differences were found between 4 weeks and 52 weeks.There was no correlation between VSD and HAMD scores at baseline and 2 weeks.There were significant correlations among scores of VSD and HAMD(r =-0.31,-0.74,Ps ＜ 0.05),HAMA (r =-0.36,-0.76,Ps ＜ 0.05) at 4 weeks and 52 weeks.Using logistic regression analysis,the concordance between VSD and HAMD related with the factors of HAMD,higher scores of anxiety/somatization factor were associated with lower concordance (OR =0.87),and higher scores of weight factor (OR =1.86),diurnal variation factor (OR =2.00),hopelessness factor (OR =1.13) were associated with higher concordance.Conclusion:Compared with acute depression phase,concordance between subjective experience and clinician-rated for depression may be higher at depression remission phase in elderly patients with depression,which suggests that characteristics of depression symptom may have a certain impact on the self-awareness for depression experience.

Objective To retrospectively investigate the endoscopic characteristics and pathological features of colorectal polyps in over-aged patients (≥80 years). Methods The 1617 colonoscopies performed between January 2006 and December 2010 were enrolled in our retrospective analysis. The detection rate, size, location, form and pathological feature of polyps in 150 over-aged patients were investigated, and they were compared with those in 832 young patients (＜60 years) and 635 old patients (60-79 years) with colorectal polyps. Results The detection rate of polyps was 62.0% in over-aged group, and was significantly higher than in young group and old group (30.2% and 48.7%, respectively, χ2=56.58 and 8.64,both P＜0.001). The malignant transformation rate of ascending colon polyp was 5.4% in over-aged group, and was significantly higher than in young group (1.2%, χ2=4.90, P＜0.05), but there was no significant difference between over-aged group and old group (3.9%, χ2=0.36, P＞0.05). There were no statistical differences in canceration rate, polyp diameter, morphology and adenomatous polyp rate among the three groups. The malignant transformation rate was significantly increased in adenomatous polyps with diameter over 2 cm, but didn't reach statistical significance. Conclusions The polyp detection rate is noticeably higher in the over-aged than in the old and the middle-aged, and the malignant transformation probability is also increased. The colonoscopy indications in the high risk age groups should appropriately be broadened, they should receive regular intervals follow-up, and undergo polypectomy in time if necessary.

Objective To observe the efficacy and side effects of Jianpi Qutan Decoction combined with Quetiapine in the treatment negative symptoms of schizophrenia.Methods 60 inpatients with schizophrenia were randomly divided into two groups,with one group treated with Jianpi Qutan Decoction combined Quetiapine and the other group treated with Quetiapine.Effects and side effects were assessed with the Positive and Negative Syndrome Scale (PANSS) and Treatment Emergent Symptoms Scale (TESS) respectively 1,4 and 8 weeks before and after the treatment.Results There was no significant difference in the overall efficacy between the two groups,but the improvement of the negative symptoms and illness provocation was significantly better in the treatment group than that in the control group respectively (P＜0.05).Moreover,the adverse reaction was milder in the treatment group.Conclusion It is suggested Jianpi Qutan Decoction in combination with typical antipsychotics is effective and safe in treating negative symptoms in schizophrenia patients.

Changes of corneal properties induced by laser in situ keratomileusis (LASIK) results in low inaccurate intraocular pressure (IOP) readings by Goldmann applanation tonometry (GAT). Before and after LASIK, the applied value of IOP, measured by dynamic contour tonometry (DCT) in comparison to GAT, was evaluated. Before and 1, 4 weeks after LASIK, the IOP in 30 cases (60 eyes) was measured by GAT and DCT respectively. The obtained results were statistically processed by SPSS11.5 statistical software. The results showed that central corneal thickness (CCT) could affect GAT measurements but not DCT measurements. The comparison of IOP one and 4 weeks after LASIK revealed that the readings from GAT was separately decreased by 5.00 +/- 1.12 and 5.45 +/- 1.13 mmHg as compared with those before LASIK, while those from DCT had no significant difference. It was concluded that LASIK-induced changes of CCT could influence the accuracy of GAT measurements, but had no influence on those from DCT. DCT was more beneficial to the measurements of IOP in normal eyes and those subject to LASIK surgery.

We detected the seroprevalence of Toxoplasma gondii (T.gondii) in the wild birds in northeast China.The wild bird's blood was collected from the cutaneous ulnar vein and the serum was isolated and used for detection of anti T.gondii antibody by modified agglutination test (MAT).Results showed that totally 179 birds' serum samples were collected.Twenty serum samples (11.17％) were positive with T.gondii antibody,which belonged to 9 orders,17 families and 31 species.The seroprevalence against T.gondii was about 5.26％ (1/19) in Columbiformes,9.09％ (9/99) in Passeriformes,14.29％ (3/21) in Falconiformes,15.00％ (5/22) in Piciformes,16.67％ (1/6) in Coraciiformes,and 25.00％ (1/4) in Anseriformes.Based on their feeding behavior,the seroprevalence was 12.00％ (3/25) in carnivorous wild birds,10.60％ (15/141) in omnivorous wild birds,and 15.38％ (2/13) in the wild birds feeding on aquatic animals or plants.These wild birds also can be sorted as migratory and sedentary (non-migratory) according to their migration habits,and the serum positivity was 11.67％ (14/120),and 10.71％ (6/59) respectively.The seroprevalence against Toxoplasma gondii in wild birds in northeast China is about 11.17％,which indicates a common infection of Toxoplasma gondii in wild birds.

Objective To evaluate the clinical effect of the individualized treatment of congential entropion.Methods Totally 150 patients (285 eyes) with congenital entropion were analyzed,the individualized procedures were performed,including the simple incision and suture surgery for simple congenital entropion,removing the redundant skin of lower eyelid for congenital entropion with redundant skin of lower eyelid but without epicanthus,the correction of entropion combined withY-V epicanthoplasty for congenital entropion with epicanthus and the recession of lower eyelid retractor for congenital entropion with lower eyelid retraction.The clinical effect,the percentage of cure and the complication of these cases were evaluated.Results The excellent results were achieved and no relapse or complications occurred in all cases.The total cure rate was 98.6％ (281 of 285 eyes).The cure rate of simple congenital entropion was 92.0％ (23 of 25 eyes).The cure rate of congenital entropion with redundant skin of lower eyelid was 100％ (41 of 41 eyes).The cure rate of congenital halflength entropion accompanied by epicanthus was 99.4 ％ (179/180 eyes).The cure rate of congenital entropion associated with lower eyelid retraction was 97.4％ (38 of 39 eyes).Conclusions Individualized operations not only have well curative effect for various congenital entropions,but recurrence rate and complications have been reduced.

Objective:To discuss clinical effect of Zhuyu Zhixuetang to chronic endometritis （CE） with syndrome of Qi deficiency and blood stasis and to study improvement effect to pregnancy outcome. Method:One hundred and forty-four patients were randomly divided into two groups， patients in control group were 72 cases and in observation group were 72 cases. In control group， 66 patients completed the therapy because of 4 falling off or missing visit and 2 eliminated， and in observation group， 65 patients completed the therapy because of 3 falling off or missing visit and 5 eliminated. In two groups. anti-infection treatment was gicen to patients. Patients in control group got Fuke Qianjin Pian， 6 tablets/time， 3 times/day. Patients in observation group got Zhuyu Zhixuetang， 1 dose/day. The treatment was continued for 3 months and the follow up was recorded for 6 months. Before and after treatment， changes of menstrual volume， period and cycle were recorded. And hysteroscopy and color Doppler ultrasound of vagina were made， and endometrial morphology and endometrial receptivity were evaluated ［endometrial thickness， resistance index （RI）， pulsation index （PI） and blood flow index （FI）］ were evaluated， and pathology of endometrial were tested. And scores of syndrome of Qi deficiency and blood stasis were graded， levels of interleukin-1 β （IL-1 β）， IL-6 and tumor necrosis factor-α （TNF-α） and T-lymphoid subsets （CD3⁺， CD4⁺， CD8⁺） in peripheral blood were measured. Pregnancy and miscarriage were recorded and the safety was evaluated. Result:After treatment， menstrual volume， menstrual period， cycle and complete normal rate of menstruation in observation group were all higher than those in control group （P<0.05）. Endometrial thickness and FI were more than those in control group （P<0.01）， RI and PI were lower than RI and PI in control group （P<0.01）. And compared with control group， levels of IL-1β， IL-6， TNF-α and CD8⁺ were less （P<0.01）. And levels of CD3⁺， CD4⁺ and CD4⁺/ CD8⁺ were higher than the data in control group （P<0.01）. During 6 months follow-up， pregnancy rate in observation group was 46.97% （31/66） was higher than 27.69% （18/65） in control group （χ²=5.197， P<0.05）. Total effective rate of endometrial morphology was 96.97% （64/66） higher than 86.15% （56/65） in control group （χ²=4.981， P<0.05）. Total effective rate endometrial pathology was 95.45% （63/66） higher than 84.62% （55/65） in control group （χ²=4.304， P<0.05）. Total effective rate of comprehensive clinical effect was 93.94% （62/66） higher than 81.54% （55/65） in control group （χ²=4.696， P<0.05）. There was no adverse reactions related to traditional Chinese medicine. Conclusion:Zhuyu Zhixuetang can regulate menstruation， relieve clinical symptoms， improve endometrial morphology under hysteroscopy， regulate systemic and local immune inflammatory response， improve CP， thus improve pregnancy outcome， with better comprehensive effect and safety.