This paper made an analysis of China's health system,regarding the present development and questions in the medical security system,the health service system,the health financing system and health management system.Based on the studies,the author proposed overall planning and accelerated reform in an effort to distinguish the role boundaries of the government and the market,streamline the health management system and enhance service functions.Furthermore,the author recommended to build a sustainable health financing system,build and better the urban-rural health security system,and promote health service system reform centering on public hospital reform,achieving the Pareto improved efficiency.

Objective: To anal yze the reasons for the increasing Chinese residents’ self-medication, and provide references for reasonable positioning and development of self-medication. Methods:Using the National Health Service Survey data (1993, 1998, 2003, and 2008), and use multivariate logistic regression analysis to study the influencing factors of self-medication. Results: Chinese residents’ self-medication have differences in the both time and space dimensions. The influencing factors of medical decision include the demographic characteristics of the diseased residents, medical insurance system, the available of specialized medical services space, family economic conditions, healthy living behaviors, daily health situation, two-week morbidity cognition and two-week morbidity outcomes etc. Conclusion: The alternative function of self-medication determines its reasonable development space. The increasing rate of Chinese residents’ self-medication has many influencing factors.

In recent years, Chinese residents’self-medication has a rapid upward trend. From the perspective of behavioral economics, it analyzes the reasons for the increasing proportion of Chinese residents’self-medication which has been tested by four data of National Health Service Survey, and provides objective understanding reference for the self-medication.

In recent years, there is a rapid upward trend of Chinese residents’self-medication. It analyzes the formation mechanism of self-medication from three directions: inheritance mechanism, power mechanism and strengthening mechanism. It explains the cause of rapid rise of self-medication, and provides useful lessons for objective understanding of self-medication.

Objective To investigate the effect of synchronous chemotherapy combined with spleen polypeptide on immune function in patients with esophageal cancer and cardiac cancer after operation. Methods Sixty postoperative patients of esophageal and esophagogastric junction carcinoma were collected in the Fourth Hospital of Hebei Medical Universitythe from March 2013 to January 2014,and were randomly divided into two groups,including 30 cases were treated with simple chemotherapy as control group,and the other 30 cases were treated with chemotherapy combined with lineal polypeptides as experimental group. Results There were no significant differences in terms of CD3,CD4 and CD4/CD8 between the two groups before operation( P>0. 05) . After two cycles of chemotherapy,the CD3,CD4,CD4/CD8 of experimental group were all significantly higher than the control group((76. 08±8. 04)% vs. (38. 58±6. 40)%,(42. 91±7. 73)% vs. (42. 91±7. 73)%,1. 31 ±0. 21 vs. 1. 16±0. 22),and the differences were significant(P=0. 037,0. 022,0. 008). The survival quality of the experimental group was better than that of the control group ( P=0. 038 ) . The proportion of patients with WBC in the normal range of the experimental group was significantly higher than that in the control group (80. 0% vs. 53. 3%,P=0. 028). The adverse reactions of the digestive system in the experimental group were lower than those in the control group, the difference was statistically significant between the two groups ( acid reflux and heartburn:26. 7% vs. 63. 3%,P=0. 004;nausea and vomiting:33. 3% vs. 73. 3%,P=0. 002;loss of appetite:46. 7% vs. 80. 0%,P=0. 007) . Conclusion The treatment of the patients with esophageal cancer and cardiac cancer after chemotherapy with spleen peptides can improve immunity,and improve the quality of life of patients after chemotherapy and chemotherapy.

Objective To identify risk factors, incidence and trends of nosocomial infections in the neonate ward. Methods Total 6395 hospitalized neonates were sub-grouped by state of maturity, attending to neonate intensive care unit (NICU), length of stay, underlying diseases, use of antibacterial agents and mechanical ventilation. Clinical data were retrospectively analyzed in each subgroup. Results Among 6395 hospitalized neonates, 168 (2.63%) had nosocomial infections, and the incidence rates were of statistical difference among groups (P<0.01), Lower respiratory tract was the most frequent infection site accounting for 80.9% of all infections. 61.3% eases were caused by gram negative bacteria, in which 72.06% were enterobacteriaceae. Conclusions To prevent nosecomial infection among neonates the following measures should taken: improve care for NICU and premature babies, reduce length of stay, avoid invasive procedures, isolate infected neonates and use antibacterial agents rationally.

Objective To analyze and discuss the effect of heat preservation on the recovery time of BIS and the concentration of propofol in the recovery period of the elderly patients with general anesthesia in order to provide guidance for clinical treatment.Methods 78 elderly patients with general anesthesia were selected as the subjects, and the patients were divided into the control group and the study group with 39 cases in each group.The patients were divided into the control group and the study group.Control group, only to be liquid input and covered by drapes, research group take liquid input and peritoneal flushing fluid heating and heating blanket coverage of insulation measures, were recorded and compared between the two groups from anesthesia began to operation to complete the different time points of esophageal temperature and MAP, and to observe the recovery time of patients and effect compartment concentration differences.Results Two groups at T0, T1 esophageal temperature no significant difference, study group T2-T6 esophageal temperatures were significantly higher than those of the control group (P<0.05), maps of the other two groups at different time points had no significant difference;when two groups of patients with propofol withdrawal BIS values had no significant difference, and in the time of discontinuation BIS is more than or equal to 80 recovery time and effect compartment concentration have significant difference (P<0.05).Conclusion The surgical treatment of elderly patients with general anesthesia can help maintain the body temperature, shorten the recovery time of BIS and reduce the concentration of propofol in the recovery period.

Objective:To investigate the effects of dexmedetomidine on short-term prognosis in elderly patients with gastric cancer after laparoscopic radical gastrectomy.Methods:A total of 60 elderly patients with gastric cancer admitted to Shanxi Provincial Cancer Hospital from June 2018 to September 2019 were selected as the research objects. The patients were randomly divided into the observation group and the control group according to random number method, 30 cases in each group. All patients underwent laparoscopic radical gastrectomy. The patients in the control group received routine intravenous anesthesia, and the patients in the observation group were assisted with intravenous infusion of dexmedetomidine on the basis of anesthesia in the control group. The general situation during and after surgery, hemodynamics and postoperative delirium of patients in the two groups were observed and compared.Results:The anal exhaust time and hospitalization time in the observation group was shorter than that in the control group [(72±10) h vs. (79±13) h, t = 8.384, P = 0.031; (11.0±1.7) d vs. (12.9±1.9) d, t = 7.404, P = 0.022]. While the time of abdominal drainage was (8.4±2.8) d and (8.6±1.6) d, respectively in the observation group and the control group, and the difference was not statistically significant ( t = 0.958, P = 1.092); the volume of abdominal drainage was (534±50) ml and (545± 55) ml, respectively, and the difference was not statistically significant ( t = 0.847, P = 1.202). Compared with the preoperative baseline, the mean arterial pressure (MAP) in the two groups was stable during the operation. At extubation, the MAP in the control group [(104±5) mmHg, 1 mmHg = 0.133 kPa] was higher than that in the observation group [(92±7) mmHg] ( t = 7.383, P < 0.01); in the control group, the MAP at extubation was also higher compared with the preoperative MAP [(92±9) mmHg] ( P < 0.05). The heart rate in the observation group was lower than that before surgery and the same period in the control group.The incidence rate of delirium and suspicious delirium was 3% (1/30) and 7% (2/30) in the observation group, 10% (3/30) and 13% (4/30) in the control group within 7 d after surgery, and there were statistically significant differences in delirium and suspicious delirium between the two groups ( χ2 = 9.394, 7.485, all P < 0.05). Conclusion:Dexmedetomidine can reduce the incidence of delirium in elderly patients with gastric cancer after laparoscopic radical gastrectomy, and make the hemodynamics more stable and recovery faster.

With the frequent occurrence of natural disasters, incidence rate of PTSD and sleep-disorder is rising. So, how to treat them effectively has become a hot spot. This article analyzed the literature about improvement of PTSD and sleep-disorder based on the perspective of soothing and regulating liver, and primarily discussed the effectiveness and feasibility of treating PTSD from liver, with a purpose to lay work foundation for improving common diagnosis and treatment system of PTSD and sleep-disorder.

Objective To investigate the effect of gemcitabine on the cell cycle and apoptosis of the human pancreatic cancer cell line MiaPaCa-2 with Beclinl gene silencing.Methods siRNA targeting at Beclinl gene was constructed,then it was inserted into an expression vector and transfected into MiaPaCa-2 cells.The Beclinl mRNA and protein expression were detected by RT-PCR and Western blot.Gemcitabine was used to treat MiaPaCa-2 with Beclinl gene silencing,then the cell cycle and apoptosis were detected by flow cytometry.Results The MiaPaCa-2 cells with Beclinl gene silencing were successfully constructed,and the expression of Beclin1 mRNA was decreased from 1.0 in control group to 0.295,and number of cells in S and G2 phase was decreased,but number of cells in G1 phase was increased,and there was no change in apoptosis.After gemcitabine treatment,number of cells in S phase was further decreased,but number of cells in G1,G2 phase was increased,and apoptosis was inhibited.Conclusions Beclinl gene silencing can change the cell cycle of pancreatic cancer cells MiaPaCa-2,and influence the effects of gemcitabine on cell cycle and apoptosis.