Objective To understand the changes of the coverage of medical insurance and the utilization of medical services from 2000 to 2009.Methods The data on medical insurance and utilization of medical services were obtained from China Nutrition Panel Survey conducted by University of North Carolina,Chapel Hill.The trend of medical insurance and use of preventative medical services were examined.And a Logistic regression model was used to estimate the relationship between some social economic status and the enrollment of medical insurance and use of medical services.Results The coverage of medical insurance expanded dramatically from 20％ in 2000 to 89％ in 2009.The rural population experienced higher expansion.The gap between rural and urban populations in terms of insurance coverage was closed.The use of preventive services remained low in both rural and urban populations,with 3.72％ and 4.62％ respectively.Conclusions Both coverage of medical insurance and use of prevention medical services imoroved from 2000 to 2009,which has provided solid foundation for further reforms.

Objective To investigate the protective effect of 3-hydroxybutyrate derivate( methyl-3-hydroxybutyrate and ethyl-3-hydroxybutyrate)on the apoptosis of PC12 induced by FBS deficiency. Methods Methyl-3-hydroxybutyrate and ethyl-3-hydroxybutyrate were prepared by chemical degradation. PC12 cells were divided into different groups:medium with FBS as negative control,medium without FBS as positive control,medium with different concentrations of methyl-3-hydroxybutyrate or ethyl-3-hydroxybutyrate without FBS as sample groups. The shape and viability of cells in each group were analyzed by optical microscope and MTT. Results Compared with the negative control,cells in the positive control group demonstrated a large number of apoptosis,smaller and thinner morphology,and lower activity. However,the activity of cells was improved in the sample groups.Low concentration(0. 01 and 0. 001 mg·mL-1)of methyl-3-hydroxybutyrate and ethyl-3-hydroxybutyrate showed a protective effect on cell apoptosis,and 1 mg · mL-1 had the best protection effect. Conclusion High purity methyl-3-hydroxybutyrate and ethyl-3-hydroxybutyrate can be produced by chemical method,and both chemicals present good effect on protecting the PC12 from apoptosis.

Objective To evaluate effectiveness of prevention and treatment for patients with chronic obstructive pulmonary disease (COPD) for one year at community health-care service (CHS)centers. Methods A quasi-experiment design was used to evaluate effectiveness of community management for patients with COPD who visited and registered at Xiaokunshan and Xinbang CHS centers in Songjiang district of Shanghai in 2008, with COPD patients from Xiaokunshan community CHS center as management group and those from Xinbang as control. Measures for community management included training for local general practitioners in essential knowledge of COPD prevention and treatment, allocation of necessary drugs for COPD treatment, and health education for COPD patients and their family members. No special measures were taken for control group except routine treatment. Results A total of 132 patients were diagnosed as COPD according to their pulmonary function on 2008, 61 at Xiaokunshan and 71 at Xinbang CHS canters.One hundred and two patients, 47 at Xiaokunshan and 55 at Xinbang, finished one-year follow-up. Five patients from Xiaokunshan who were smokers at their first visits and three of them quitted smoking after oneyear management. Meanwhile, none of nine smoked patients from Xinbang quitted smoking in the same period. There was no statistically significant difference in symptom scores, pulmonary function, and forced expiratory volume at the first second (FEV1) between patients in the two groups during one-year follow-up.Average score of quality of life in patients at Xiaokunshan dropped to 39. 12 after one-year management from 46. 96 at their first visits, and that in patients at Xinbang increased to 62. 11 from 56. 55 (P＜0.01).Average six-minute walking distance (6-MWD) in patients at Xiaokunshan reduced to 354. 26 meters after one-year management from 361.66 meters at their first visits, meanwhile that in patients at Xinbang reduced to 351.18 meters from 398.07 meters (P =0. 008). Scores of functional dyspnea in patients at Xiaokunshan fell to 0.34 from 0.40 at their first visit, meanwhile that in patients at Xinbang increased to 1.00 from 0.95(P =0.038). During the one-year follow-up, 13 patients at Xiaokunshan and 53 at Xinbang visited emergency departments for treatment, and four at Xiaokunshan were hospitalized and none died, and five at Xinbang were hospitalized due to acute exacerbation of COPD and four of them died. Conclusions The study suggests that strengthening prevention and treatment for COPD patients at community level by general practitioners, patients themselves and their family members can improve their quality of life, reduce emergency visits and hospitalization, alleviate dyspnea symptoms and delay the decline of 6MWD.