Objective:To investigate the impact of social determinants of health on the inequality of child health and health care utilization.Methods:Information of 1 118 children aged 0 to 16 is extracted from the Chinese Family Panel Studies(CFPS)year 2008 cross sectional survey data for the analysis.Age standardized concentration curves and concentration indices are employed to assess the inequalities for incidence of low birth weight,self reported good health,adequate timing of breast feeding,health insurance coverage and incidence of catastrophic health expenditures for these children.Concentration indices are decomposed to four levels of social determinants of health(community,family,mother and individual level)to understand their contributions to health inequality respectively.Results:There are health inequalities existing in the investigated children,among which social factors at mother and family level have the largest contribution.Conclusion:To respond to the call by the WHO to achieve health equity through action on the social determinants of health in a generation,the inequalities of health and health care utilization amongst Chinese children should be put on the policy agenda,and social policies should intervene from multiple social dimensions,especially from family and mother levels.

Gastrectomy ; methods ; Humans ; Laparoscopy ; Stomach Neoplasms ; surgery

Objective: To explore behavior problems and family environment of children with video games dependence Method:34 video games dependent children and 34 normal children were assessed with EPQ for children and Achenbach Children's Behavior Checklist Parents of both groups were asked to fill up Family Environment Scale-Chinese Version Result:The P and L scores of EPQ were higher in the study group than in control Social status, school status, withdraw, anxiety/depression, social problems, delinquent problems extroversive behavior problems and the total score of CBCL were also higher in the study group Children with video games dependence had families with lower intimacy, lower expressioness, lower active-reaction orientation and organization Their families had more conflicts than families of normal children Conclusion: Video games dependent children have more behavior problems and poorer family environment

Objective To investigate the transactivating effect of hepatitis C virus(HCV)core protein on inducible nitric oxide synthase(iNOS)gene promoter and the molecular biological mecha- nisms of HCV pathogenesis.Methods Polymerase chain reaction(PCR)technique was employed to amplify the sequence of iNOS promoter by using HepG2 genomic DNA as template,and the product was cloned into pGEM-T vector.The iNOSp gene was cut from T-iNOSp by KpnⅠand XhoⅠ,and then was cloned into pCAT3-Basic,the constructed vector was named as pCAT3-iNOSp,pCAT3-iN- OSp was transfected into the LO_2 cell line.LO_2 cell was also cotransfected with pcDNA3.1(-)-core and pCAT3-iNOSp by FuGENE 6 transfection reagents.The LO_2 cells transfected with pCAT3-Basic was used as negative control.The activity of CAT in LO_2 cells was detected by an ELISA kit after 48 hours,which reflected the transactivating function of HCV core protein to iNOS gene promoter.Re- sults The expressive vector pcDNA3.1(-)-core and report vector pCAT3-iNOSp had been construc- ted and confirmed by restriction enzyme digestion and sequencing.The expression of CAT in LO_2 cells transfected with pCAT3-iNOSp and peDNA3,1(-)-core was 11 times as higher as that of pCAT3-bas- ic,and 6 times as higher as that of pCAT3-iNOSp.Conclusion It is suggested that HCV core protein can transactivate iNOS gene promoter.

Objective:China was categorized as one of the 68 countdown countries to achieve the United Nations Millennium Development Goals (MDG) 5. This paper aimed to analyze the situation of maternal survival, and coverage of proven cost effective interventions in China, where specific attention was paid to disparities. Methods: National maternal and child mortality surveillance data were used to estimate maternal mortality ratio (MMR). Coverage for proven interventions was analyzed based on National Health Services Survey, where experts' consultations were made for complementation. Results: There had been a significant reduction of MMR in China, however great disparities existed, with rural Ⅱ to Ⅳ areas experiencing 2 to 5 times higher maternal mortality risks than urban areas and accounting for over 70% maternal mortality burdens. Postpartum hemorrhage, pregnancy associated hypertension, embolism and sepsis were the leading causes, and over 75% of the maternal mortality was caused by preventable or curable causes. Maternal health services utilization decreased in accordance with region' s development level. Socioeconomic factors like financial difficulties were the main obstacles hindering access of care.Even those who made deliveries in hospitals faced different probabilities in receiving qualified care according to their socioeconomic standings. Conclusion: China is on track to achieve MDG 5, however great disparities exist. It is necessary to specifically target rural types Ⅱ to Ⅳ areas. Major causes of maternal mortality which can be prevented or averted through the provision of essential obstetrical care. Yet as compared with maternity health needs, insufficient coverage of maternal and child health (MCH) care services and poor service quality are the leading predisposing factors contributing to maternal mortality in China.

Objective To explore the vitamin D nutritional status of urban residents in Jinan,in order to provide the basis for the prevention and treatment of chronic diseases associated with vitamin D insufficiency.Methods 1478 cases aged 30-90 years,including 602 men (59.8± 13.0) years on average and 876 women (57.4±12.9) years on average were selected by a stratified random sampling from 3 community medical care institutions in Jinan.Subjects were divided into six groups according to the 10-year interval.Serum 25-hydroxyvitamin D [25(OH) D] level was measured by enzyme-linked immunosorbent assay (ELISA).Serum [25(OH) D] level ≥ 75 nmol/L was defined as vitamin D sufficient,(50.0 ～ 74.9) nmol/L as vitamin D critical value,25.0 ～ 49.9 nmol/L as vitamin D insufficiency,＜ 25 nmol/L as vitamin D deficiency.All data processing and statistical analysis were finished by SPSS 13.0.Results The average level of [25 (OH) D] was 58.60 nmol/L in males [95％ CI:56.7-60.5 nmol/L] and 54.17 nmol/L in females [95％ CI:52.8-55.8 nmol/L],which were less than 75 nmol/L.The average level of [[25(OH) D] was 49.1nmol/L in females aged 70-79 years (95％CI:45.7～52.5 nmol/L),41.7 nmol/L in females aged 80-90 years (95％CI:38.2 ～46.7 nmol/L),which were less than 50 nmol/L.The percentage of cases with vitamin D deficiency,insufficiency,critical value,and sufficiency was 5.6％,33.4％,36.5％,24.4％ in males,and 6.5％,42.9％,32.6％,18.1％ in female respectively.The incidence of vitamin D deficiency and insufficiency was increased with ageing (male:x2 =33.68 P＜0.01,female:x2 =55.7,P＜0.001).The percentage of vitamin D deficiency and insufficiency was more in females than in males (60-69 years old:x2=9.387,P＜0.05,80-90 years old:x2=8.896,P＜0.05).The [25 (OH) D] level was lowest in winter (48.8 nmol/L,95％CI:46.8～50.9 nmol/L) and highest in autumn (60.2 nmol/L,95％ CI:58.0～62.3 nmol/L).The incidence of vitamin D deficiency and insufficiency was highest in winter (x2 =18.364,P＜0.05).Conclusions Vitamin D deficiency and insufficiency are widely prevalent in urban residents,which is more severe in the elderly and females.Serum [25(OH) D] level is related to season,and the vitamin D deficiency and insufficiency are severe in winter.

Objective To observe the characteristic features of musculoskeletal ultrasound (MSUS) in gouty arthritis (GA) and to assess its value in GA diagnosis.Methods Patients with GA and non-GA who underwent MSUS examination in Chinese PLA General Hospital were enrolled in this study. The synovitis,tenosynovitis,soft tissue swelling,bone erosion,bursitis and ossification were measured by greyscale ultrasound,and the synovial vascularity was measured by power Doppler ultrasound to evaluate the degree of inflammation.Results The ultrasound images of GA were intended to have specific features like tophus,hyperechoic deposition on the surface of the articular hyaline cartilage ( double contour sign ),hyperechoic deposition in the synovium appearing as bright stippled foci,and bright strap in tendons with a significant difference when compared with non-GA group (P ＜ 0.05).The percentage of tenosynovitis and bone erosion in non-GA group was higher than that in the GA group with a significant difference (P ＜0.05 ). Tophus,double contour sign,bright stippled foci or bright stippled foci in tendons together suggested gout with a specificity of 92.4％ and a sensitivity of 60.3％,the AUC of ROC was 0.764 ( P ＜0.05).Conclusion Tophus,double contour sign,bright foci and bright strap detected by MSUS are of diagnostic value on GA and MSUS may be a promising tool in diagnosing GA.

60 Gy.The 5-year local control rates are 92%,71% and 87% respectively(P=0.9194),and 5-year overall survival rate are 68%,62% and 53% respectively(P=0.4194).There is no significant difference of overall survival and local control rate between these three dose groups.Five patients with dose of more than 50Gy died of late toxicities.Conclusions:Adjuvant radiotherapy for Stage Ⅱ and Ⅲ patients with rectal cancer dose not show dose response.There is no improvement of local control and survival due to the escalation of dose.The dose of conventional radiotherapy is better at less than 50Gy.Overdosage may lead to severe toxicities.

Objective To compare the effect of TNF-α preconditioning and ischemic preconditioning on hepatic ischemia-reperfusion injury ( IRI) and investigate the underlying mechanisms of TNF-αpreconditioning. Methods Fourty healthy male Wistar rats were random-ly divided into four groups which were Sham-operated group ( SO) ,ischemia-reperfusion group ( IR group:produced by total inflow occlusion for 30 min) ,ischemic preconditioning group ( IPC group:induce with 10 min hepatic ischemic and open 10 min before IR) and TNF-αpre-conditioning group ( TPC group:intraperitoneal injection with 1 μg/kg TNF-a 30 min prior to IR) . The sample of blood and hepatic tissue of all groups were taken after experiment. The protein levels of NF-κBp65 and Bcl-2 in the hepatic tissue were detected by immunohistochemis-try. Results There was significant difference (P<0. 05) between IR group and IPC group,TPC group on the level of ALT,AST and the expression of NF-κBp65 and Bcl-2,apoptosis index in hepatic tissue. There was no significance difference (P>0. 05) between IPC group and TPC group. Conclusion TNF-α preconditioning decreased the intensity of hepatic IRI,just as ischemic preconditioning,by induces an de-crease in the NF-κBp65 expression and an increase in the Bcl-2 expression.

Adenoma, Pleomorphic ; metabolism ; pathology ; surgery ; Aged ; Carcinoma ; metabolism ; pathology ; surgery ; Cell Transformation, Neoplastic ; Humans ; Lung Neoplasms ; metabolism ; pathology ; surgery ; Male ; Mucin-1 ; metabolism ; S100 Proteins ; metabolism ; Vimentin ; metabolism