Improving the basic medical and health service system is an important measure to deepen health care reform.Jilin province has explored its unique way of comprehensive reform of the primary organizations in the province by means of reforming grassroots medical operation mechanism and mode of service,and perfecting the compensation mechanism,achieving remarkable results.This article,based on the overall situation of Jilin province,main contradictions and countermeasures research,made detailed analysis of healthcare reform and bottlenecks encountered in the reform.The author pointed out the direction of Jilin province primary medical and health institutions reform,and put forward feasible policy adjustments and suggestions for such a reform.

Objective:To evaluate the value of color Doppler ultrasound combined with ultrasonic elastography for curative effect of neoadjuvant chemotherapy (NAC) for breast cancer.Methods: 100 patients with breast cancer who has received NAC were divided intoobservation group (50 cases, underwent examination of color Doppler ultrasound scanner combined with ultrasonic elastography) and control group (50 cases, only underwent examination of color Doppler ultrasound scanner) according to the different examination methods. The accuracy, sensitivity and specificity of differential diagnosis methods for curative effect of NAC between the two groups were compared as above data.Results: The accuracy, sensitivity and specificity of differential diagnosis for curative effect of NAC in observation group were 88.00％, 90.00％ and 86.00％, respectively. While them of control group were 78.00％, 80.00％ and 76.00％, respectively. And the differences of these indicators between the two groups were statistically significant (x2=2.01,x2=3.24,x2=3.45, P<0.05).Conclusions: Color Doppler ultrasound combined with ultrasound elastography can diagnose the curative effect of NAC for patients with breast cancer from two aspects which includes tissue hardness and blood supply, and it can achieve more diagnostic accuracy compared with only using simple color Doppler ultrasound.

Objective To investigate the optimal beam tube potential for amorphous silicon/cesium iodide flat panel digital chest radiography(indirect DR). Methods(1)60 healthy adults were undergone digital posteroanterior(PA) chest radiography at 80,100,150 kV respectively.The images quality of these three were compared by 5 independent observers.Several normal anatomy parts of the chest and the overall impression of the images were evaluated;(2)PA chest exposures of the anthropomorphic chest phantom to produce a constant ESDs(entrance skin doses) and exit dose were made using tube potential at 80,100,120,150 kV.The simulated chest nodules were scored. Results The quality of the adult chest radiography and the manifestation of the simulated chest nodules were superior at the lower tube voltages.The contrast of the images were best at 80 kV,while the appearance of the images look like that of the low potential radiography. Conclusion The optimal tube potential for chest DR is considered to be 80~100 kVp,while the high KV technique is no longer suitable for digital equipment.

Juvenile hemochromatosis is an autosomal recessive disease characterized by progressive tissue iron overload which leads to irreversible organ damage and even death.This disease is mainly caused by mutations in two genes:hemojuvelin gene and hepcidin gene.Different mutations have different phenotype.The two genes may act as modifying genes in HFE hemochromatosis.Hepcidin secreted by liver plays a central role in the regulation of iron homeostasis.HJV can act as a bone morphogenetic protein(BMP)co-receptor which is required for HJV to regulate hepcidin expression and iron homeostasis.Recent researches suggest that the bone morphogenetic protein(BMP)signaling pathway mediated by HJV is a significant mechanism for HJV to regulate hepcidin expression and iron homeostasis.HJV mutant impaires BMP signaling which results in hepcidin expression decrease and abnormal iron metabolism.

Objective To establish a SYBR Green based real-time fluorescence quantitative PCR method for detecting human Annexin Ⅱ mRNA expression,and to detect the level of Annexin Ⅱ mRNA in human breast cancer cells MCF-7 and MDA-MB-231.Methods The specific primers were designed according to the conserved sequence of human Annexin Ⅱ gene.Total RNAs were extracted from human breast cancer cells(MCF-7,MDA-MB-231),then RNAs were transcribed reversely into cDNAs.The plasmid standards were constructed.The relative expression levels of human Annexin Ⅱ mRNA in human breast cancer cells were detected by this method.Results The square(r2 )of correlation coefficient of the standard curve in this method was 0.997,the melting curve analysis showed the single peak.The the intra-batch and inter-batch variable coefficients in the pGM-T Annexin Ⅱplasmid standard substance were 6.2%,7.8% and 9.1%,12.3% respectively.The further study indicated that AnnexinⅡ mRNA in MDA-MB-231 was higher than that in MCF-7(P<0.01).Conclusion The established SYBR Green real time fluorescence quan-titative PCR method for detecting human AnnexinⅡ is of good specificity and repeatability and can be used for quantitatively detec-ting AnnexinⅡ mRNA in breast cancer cells.

Objective To study the value of color Doppler ultrasound in diagnosis of deep vein thrombosis (DVT) of lower extremity and pulmonary embolism (PE) in spinal cord injury (SCI). Methods 60 PE patients (PE group) and 35 SCI patients without PE (control group) received color Doppler ultrasound examination for DVT of lower extremity. Results PE group included 36 SCI patients (PE-SCI group) and 24 no-SCI patients (PE-no-SCI group). There were 15 cases with lower extremity thrombosis in PE-SCI group, and 9 cases in PE-no-SCI group (P>0.05), while there were 5 cases in the control group. There was significantly different in lower extremity thrombosis between PE group and the control group (P<0.01). In PE group, the detection rate was not significantly different between acute PE (detected 11 cases out of 37 cases) and chronic PE (detected 10 cases out of 23 cases) (P>0.05). 31 cases were rechecked as lower extremity venous valve regurgitation and calf muscle vein dilation (51.7%) in PE group while 8 cases in the control group (22.9%) (P<0.01). Conclusion There is not significantly different in the detection rate of DVT of lower extremity in PE patients with and without spinal cord injury, which are higher than in the patients without PE. Color Doppler ultrasound is necessary to check DVT in acute and chronic PE patients.

Objective Taking the total amino-acid, total flavones, chlorogenic acid, and volatile oil in Chrysanthemum morifolium as index to investigate the internal quality which relates to collection periods and processing methvods in order to compare the quality of species from oringinal habitats. Methods The contents of colorogenic acid in C. morifolium was analyzed by HPLC; the content of total flavones and amino-acid in C. morifolium were measured by spectrophotometery; and the volatile oil obtained by steam distilation extraction was weighted. Results The every indexes of viviparious chrysanthemum except chlorogenic acid was the best among various flowering periods so the viviparious chrysanthemum can be used as the first-class tea. The common tea produced by half-booming and full-booming flowers with higher yield and appropriate index. The machine processing is fast and suitable for the production to a large-scale. Conclusion The quality of C. morifolium planted in Ruicheng, Shanxi Province is equal to that in Tongxiang, Zhejiang Province, which depends on the collecting periods and processing methods, so does the volatile oil rather than the evironment of the habitat.

Objective To realize antimicrobial resistance and carrying status of OXA carbapenemase among imi-penem-resistant Acinetobacter baumannii (IRAB)isolated from patients of Hohhot,so as to provide guidance for the prevention and control of healthcare-associated infection(HAI)caused by multidrug-resistant Acinetobacter bauman-nii .Methods 49 IRAB isolates from 3 tertiary first-class hospitals in Hohhot between January and December 2012 were collected,antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion method,four geno-types(blaOXA-51-like ,blaOXA-23-like ,blaOXA-24-like ,blaOXA-58-like )of OXA carbapenemase were detected by polymerase chain reaction (PCR).Results All 49 isolated IRAB strains were found to be highly resistant to antimicrobial agents (81 .63%-100.00%)except to minocycline (8.16%);blaOXA-51-like was identified in 49 strains (100.00%),42 (85.71 %)of which also carried blaOXA-23-like gene ,blaOXA-23-lik and blaOXA-51-like were both found in three hospital, blaOXA-24-like and blaOXA-58-like weren’t found.Conclusion IRAB strains present multidrug resistance,resistant to mi-nocycline is the lowest;blaOXA-23-like is the main drug-resistance mechanism of IRAB in Hohhot.

Objective To observe the expression of cysteine rich-protein 61 (Cyr61) on renal tubular cells,to explore its effects against hypoxic induced kidney injury and the underlying mechanisms.Methods A stably Cyr61 expressed tubular cell line Cyr61-HK2 was established based on HK2 cells and recombinant Cyr61-lentivirus.BrdU incorporation assay was used for cell proliferation.The apoptosis of cells was analyzed by flow cytometry with Annexin V and propidiumiodide staining.Western bloting was used to detect the protein expression of BAD,Akt and ERK.Results (1) Cyr61-HK2 cells displayed more proliferation ability than HK2 cells.(2) Under hypoxia condition,the apoptosis of both HK2 and Cyr61-HK2 cells increased,but the apoptosis of Cyr61-HK2 cells was lesser than HK2 cells.(3) The expression of Cyr61 led to the phosphorylation of BAD,Akt and ERK on 0 h,0.5 h,1 h (all P ＜ 0.05).Conclusion The expression of Cyr61 can promote cell proliferation and dampen cell apoptosis induced by hypoxia,which may be involved in the Akt/ERK signal pathway.

Objective To evaluate and testify the diagnostic efficacy of the ADC value of the diffusion-weighted imaging (DWI) in prostatic peripheral zone cancer. Methods There were 40 patients with prostatic diseases proved by ultrasound guided systemic biopsy. DWI scans were performed with 1.5T MR scanner using TOSORPA coil and b value of 800 s/mm2. The peripheral zones of prostate were divided in six areas and were attributed to noncancerous and cancerous areas according to the results of biopsy. The minimal ADC values of each peripheral zone were recorded and analyzed. Results There were 240 areas, in which 89 areas were cancerous and the others were noncancerous. The mean ADC value of cancerous areas was (0.98±0.30)×10-3 mm2/s, while the noncancerous areas was (1.59±0.29)×10-3 mm2/s. The diagnostic sensitivity, specificity and accuracy were 80.58%, 92.42% and 86.73% respectively with cutoff point ≤1.24×10-3 mm2/s, whereas 66.56%, 96.95% and 86.26% respectively with cutoff point ≤1.04×10-3 mm2/s. The diagnostic sensitivity was 98.63%, the specificity was 37.07%, the accuracy was 58.82% with cutoff point <1.69×10-3 mm2/s. Conclusion The ADC value ≤1.24×10-3 mm2/s should be regarded as the diagnostic standard of prostate cancer. When ADC value is between (1.04-1.24)×10-3 mm2/s, some cancer might be missed.