Objective To divide the medical services currently offered by various medical institutions into priority,extended and non-essential items.Methods The items were divided according to their actual usage at these hospitals,and such services were screened based on hospital positioning and clinical pathway of diseases.Results The selected priority services at the primary,secondary and tertiary hospitals were 255, 378 and 820 respectively.Their proportions in total medical services of these hospitals were 92.9%,95.9% and 97.4% respectively,and the proportion of their costs in total medical service costs were 57.9%,76.8% and 84.5% respectively.Conclusions The selected priority items had covered most of the services and costs,which deserve promotions at all the hospitals as it embodied the principle of benefiting the majority of the population.

Objective To determine the main contents and key points of the essential medical services by means of priority setting of diseases with high incidence and serious damage based on the demand of residential medical services.Methods The priority setting method is applied in this study,and the incidence,prevalence,hospitalization rates and the ratio of different types of inpatient are used as indicators to reflect medical demand and utilization.The integrated balance method is also used,and the priority diseases list is made based on the analysis from the view of disease onset,considering the service delivery,social equity and the health financing.Results Based on the data analysis made,this paper proposed that the priority diseases cover 29,66 and 103 types for primary hospitals,secondary hospitals and tertiary hospitals respectively.The main diseases so determined include hypertension,diabetes, maternal and child health,severe mental illness,infectious diseases,emergency treatment,etc.Conclusions The method and result of setting priority disease and main disease can be the basis of setting for main diseases in essential medical services.

Boundaries definition plays a key role in defining the scope of essential medical coverage of the country and the governmental role positioning in medical service offerings.It is also a precondition of furthering the ongoing healthcare reform.This paper analyzed the data of health service demand,supply and financing using the priority setting and the integrated balance methods.It suggested that the definition of the essential medical services should embody Chinese characteristics and be consistent with the Party′s governing philosophy and social core values.It also should be fully considered that the administration system,the governing philosophy,the medical insurance system and the government duty in the healthcare system of China.This paper proposed a multiple-criteria defining of the essential medical services,which should focus on main healthcare issues in China,and be adapted to the current healthcare reform process.Three dimensions need to be considered in the defining,which are the demand,supply and financing of the healthcare services,along with the impact of the housing,equipment,personnel, technology,supplies,drugs and other medical service elements.This paper presented the overall framework of essential medical services in four levels,which is composed of the basic package,the core package,the priority package and the expansion package.

Antigens, CD20 ; metabolism ; Epstein-Barr Virus Infections ; virology ; Female ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Lymphoma, Large B-Cell, Diffuse ; pathology ; virology ; Middle Aged ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; virology

In order to reaction the quality present situation, problems on the current quality of animal sources of drugs are summed up by using test data analysis, literature search and marketing research. This paper can also help the improvement of the quality management, the revision of the relevant department policy system and the improvement of standards.
Animals ; China ; Medicine, Chinese Traditional ; standards ; Pharmaceutical Preparations ; analysis ; standards ; Quality Control

OBJECTIVETo systematically review the effectiveness of bone substitute augmentation combined with internal fixation versus internal fixation alone in treating proximal femoral fractures in the elderly.

METHODSSubject term and keywords were searched from Pubmed, Cochrane databases and CNKI from database foundation to August 2015. Randomized controlled studies and qusi-randomized controlled studies on bone substitutes augmentation combined with internal fixation versus internal fixation alone for the treatment of proximal femoral fractures in the elderly were chosen. Postoperative re-displacement, re-operation rate, complications (infection and bone ununion), functional outcome, quality of life scores and muscle strength were seen as outcome indicators. Enumeration data were statistical analyzed by risk difference and 95% confidence interval. Measurement data were analyzed by standardized mean difference and 95% confidence interval. If the same measurement data were evaluated by different standards in different studies, standardized mean differences and 95% confidence interval were used. The methods of statistical analysis were used by Cochrane databases.

RESULTSEleven RCTs (677 patients) were included. Meta-analysis results indicated that bone substitutes augmentation combined with internal fixation occurred fewer re-displacement [SMD = -0.75, 95% CI (-1.03, -0.47)] and obtained better function [SMD = 0.40, 95% CI (0.20, 0.59)]. While there were no significant differences in reoperation rate [RD = 0.02, 95% CI (-0.05, -0.09)], pain at 1 week after operation [MD = -1.79, 95% CI (-13.55, -9.96)], pain ranged from 6 to 8 weeks [MD = -7.24, 95% CI (-20.07, -5.59)], postoperative pain at 12 weeks [MD = -0.32, 95% CI (-4.9, -3.55)], muscle strength [MD = 1.25, 95% CI (-6.98, -9.48)], bone ununion [RD = 0.02, 95% CI (-0.01, -0.05)] and postoperative complications [MD = 0.01, 95% CI (-0.03, -0.04)].

CONCLUSIONCompared with single internal fixation, bone substitutes augmentation combined with internal fixation for the treatment of proximal femoral fractures in the elderly less occur re-displacement and could obtain better functional recovery.

Aged ; Aged, 80 and over ; Bone Substitutes ; administration & dosage ; Female ; Femoral Fractures ; surgery ; therapy ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Randomized Controlled Trials as Topic ; Treatment Outcome

Objective To investigate the changes and clinical significance of serum lactate dehydrogenase (LDH),creatine kinase (CK),glutamate pyruvate transaminase (AST),and cerebrospinal fluid lactate dehydrogenase (CSF LDH) in adult patients with acute central nervous system infection.Methods The levels of myocardial enzymes (AST,LDH,and CK) in serum of 96 adult patients with acute intracranial infection in 7days and 39 healthy people were measured by Beckman automatic biochemical analyzer and enzyme rate assay,and CSF LDH level in 96 patients were measured simultaneously.Results (1) The serum myocardial enzymes (LDH,CK,and AST) of intracranial infection group (47 cases with viral encephalitis,30 cases with tuberculous meningitis,and 19 cases with purulent encephalitis) were significantly higher than those of normal control group (P ＜0.01).(2)The myocardial enzymes (LDH,and AST ) of patients with cerebral functional disorder were significantly higher than those of patients with normal cerebral function (P ＜0.05).(3)The levels of serum AST,LDH,and CK in the virus encephalitis group,serum AST and LDH in the purulent encephalitis group,and serum LDH in the tuberculous meningitis group were significantly higher than those in the control group (P ＜ 0.01).The CSF LDH level in the viral meningitis group was prominently lower than that in the tuberculous encephalitis group and purulent encephalitis group,respectively (P ＜0.01).(4) No correlations were found between CSF LDH and serum myocardial enzymes (P ＞0.05).Conclusions (1)There is significant change in the levels of serum LDH,CK,AST,and CSF LDH of adult patients with acute intracranial infection,especially in infected patients with cerebral functional disorder,and the change of LDH is the most obvious.(2)The levels of serum myocardial enzymes and CSF LDH are helpful to the differential diagnosis of intracranial infection in early stage,and judging the severity of the illness.

Background Oxidative stress plays an important role in the pathogenesis of diabetic complications.Peroxiredoxin 6(Prx6) is a doubly-functional protein.and its ability to eliminate phospholipid hydroperoxides is essential. Objective The aim of this study was to investigate the dynamic expression of Prx6 in the retina of streptozotocin(STZ)-induced diabetes and explore its correlation with the progression of diabetic retinopathy. Methods Diabetes was induced by an intraperitoneal injection of streptozotocin(STZ)in 48 clean Wistar rats.The rats were sacrificed at 1,2,and 4 months after the injection of STZ,and expressions of Prx6 protein and Prx6 mRNA in the retina was determined by immunohistochemistry and reverse transcription polymerase chain reaction.Another 12 matched normal Wistar rats were used as the control group. Results The resuh of immunohistochemistry showed that Prx6 protein was expressed in the cytoplasm of the outer nuclear layer(ONL)and inner nuclear layer(INL)in normal rats,and low expression of Prx6 protein was observed in the ganglion cell layer (GCL).In the first month,Prx6 protein was strongly expressed in the INL and the ONL of diabetic rats.However.two and three months after STZ administration,the expression of Prx6 protein was absent in the retina,showing a considerable difference among different course groups(F=22 967.63,P＜0.05).Furthermore,the expression trend of Prx6 mRNA in the retina was similar to that of the Prx6 protein with a significant difference among different course groups(F=942.84,P＜0.05). Conclusion It is conceivable that normal maintenance of Prx6 expression may be important to the prevention of diabetic retinopathy.We hypothesize that oxidative impairments in the retina that develop over time may partly contribute towards the development of retinal dysfunction,which eventually leads to retinal degeneration during the progressive phase of STZ-induced diabetes in adult rats.

Objective To investigate the impact of aging and vascular endothelial function on arterial stiff- ness in patients with isolated systolic hypertension.Methods Patients with isolated systolic hypertension (ISH,n=75)age-matched healthy subjects(n=30)and young healthy subjects(n=50)were submitted to deter- mination of aortic pulse wave velocity(baPWV)and vascular endothelial function evaluated by flow-mediated dila- tion(FMD).Results baPWV was progresively decreased(ISH:2459.2?436.8 vs elderly healthy:2097.2? 315.7 vs young healthy:1619.7?214.2 cm/s,P

Objective To investigate the effect of simulated microgravity on the proliferation and differentiation of the human megakaryocyte cells in vitro. Methods The fourth generation rotating cell culture system (RCCS-4) was used to generate the simulated microgravity environment. The cell viability was assessed by trypan blue staining method. The proliferation of cells was assessed by cell counting method and CCK8 method. The CD41+/CD61+ cells rate and the cells cycle were detected by flow cytometry. The expression levels of thrombopoietin receptor (c-mpl) and transcription factors were detected with RT-PCR. Results After 24, 48, 72 h, culture under simulated microgravity resulted in a significant decrease in the cell number , proliferative activity, cells in the G2/M phase and levels of c-mpl mRNA expression in comparison with that under the normal gravity (P < 0.05). After 48 h and 72 h culture, CD41+/CD61+ cells ratio decreased and RUNX-1 mRNA expression was down-regulated in cells of the group SMG compared with that of the group NG (P < 0.05). Conclusion Microgravity can inhibit the proliferation and differentiation of human megakaryocyte cells in vitro. The mechanism may be that TPO/c-mpl pathway was inhibited by down regulating the expression of c-mpl which transcriptional inhibition lead to.