Objective To analyze the value of carbon nanoparticles in the cleaning of thyroid cancer lymph node.Methods 80 patients with thyroid cancer from March 2012 to March 2013 were included in this study.Based on the sequence of enrollment,they were randomly divided into two groups:the therapy group (n=40)were received Nano carbon lymphatic tracer before basic operative treatment and the control group (n=40)were directly received the same basic operative treatment.The liver function parameters in two groups were observed and compared statistically. Results The operating time,operative blood loss and postoperative drainage volume had no statistically significant difference between two groups.The incidence of postoperative hypocalcemia in experimental group was lower than that in blank control group(P<0.05 ).The parathyroid hormone level in experimental group on the first postoperative day was higher than that in blank control group(P<0.05 ).The number of resected lymph nodes in experimental group was more than that in blank control group(P<0.01).Conclusion Nano carbon lymphatic tracer technique can increase the cleaning number of lymph node of thyroid cancer patients in central region,and realize the accurating tumor stage.

Recent researches have revealed that iron-overload could lead to osteoporosis and bone morphogenetic protein 6(BMP-6)could enhance the expression of hepcidin. Therefore, it is believed that BMP-6 might play a key role in the treatment of such kind of osteoporosis. This paper focuses on the newest papers regarding the relationship between BMP-6 and iron-overload osteoporosis in order to lay a foundation for further research on the osteoporosis induced by iron overloading.

The paper uses computer multimedia technology to collect and switch audio and video signals, constructs the remote High Definition ( HD) surgery demonstration system which supports live broadcast, recorded broadcast, rebroadcast and video-on-demand depending on the network communication routing technology.It introduces functions, design scheme and composition of the system and points out that the system can realize HD video transmission and video talkback between the surgery scene and the classroom.Thus, tech-nical level of clinical surgery teaching can be enhanced.

Objective To analyze rural doctors′ social mentality with the theory of relative deprivation.Methods 642 rural doctors from 225 villages of 1 5 counties in Shandong were selected for a questionnaire survey.The factor analysis method was used to reduce the scale dimension and simplify the scale.Analysis of rural doctors′vertical and horizontal relative deprivation was made based on different reference groups.Results Rural doctors tend to identify themselves with rural teachers and doctors in township hospitals,and 60.0% identify themselves as the low income group.39.9% of them found a higher income,while 33.5% of them found a higher social status.76.3% of them found their social contributions are higher.91.4% of them hold that villagers benefit from the new healthcare reform policies,while 65.9% of them hold themselves as benefiting from such policies.This indicates a low sense of achievement.Conclusions Compared with the reference groups,rural doctors feel an obvious sense of relative deprivation comparing both horizontally and vertically.They hold themselves as underpaid and have little sense of achievement for the policies.In this consideration,the government should increase subsidies to lift pay for rural doctors,and to identify their legitimacy,in order to stabilize these medical workers.

Objective To explore the effects and mechanisms of hepatitis B virus-X protein (HBx) on invasion and migration of hepatocellular carcinoma (HCC) cells.Methods The retrospective cohort study was conducted.The clinicopathological data of 30 patients with liver tumor (20 with HCC and 10 with benign tumor of liver) who were admitted to the Affiliated Hospital of Xuzhou Medical College between July 2014 and July 2015 were collected.HCC tissues of 20 patients with HCC (with history of HBV infection) were collected by surgical resection and peritumoral normal tissues (outside of tumor capsule) of 10 patients with benign tumor of liver (without history of HBV infection) were collected.The expressions of epidermal growth factor receptor 3 (ErbB3)in HCC tissues and peritumoral normal tissues were detected by immunohistochemistry (IHC).The relative expressions of ErbB3 and HBx in HCC tissues and peritumoral normal tissues were detected by Western blot,and relative expressions of ErbB3 in HepG2 of which green fluorescent protein (GFP) and GFP-HBx were respectively transfected were detected.The relative expressions of ErbB3 mRNA in HepG2 transfected by GFP and GFP-HBx were detected by real-time polymerase chain reaction (RT-PCR).The migration and invasion of HepG2 were respectively detected by Transwell assay with and without matrix.The measurement data with normal distribution were represented as $± s.The comparisons between groups were evaluated with the independent-sample t test.Correlation analysis was done by the Pearson test.Results (1) The expressions of ErbB3 were detected by IHC:relative value of mean optical density (MOD) of ErbB3 in HCC tissues of 20 patients with HCC and peritumoral normal tissues of 10 patients with benign tumor of liver were 2.54± 1.33 and O.99±0.29,respectively,with a statistically significant difference (t =6.542,P ＜ 0.05).(2) The relative expressions of ErbB3 and HBx were detected by Western blot:relative expressions of ErbB3 and HBx were respectively 0.79±0.13,1.10±0.28 in HCC tissues of 10 patients with HCC and 1.07±0.17,0 in peritumoral normal tissues of 10 patients with benign tumor of liver,with statistically significant differences (t =3.229,19.486,P＜0.05).The results of Pearson test showed that there was a positive correlation of expression between ErbB3 and HBx in HCC tissues (r=O.637,P＜ 0.05).(3) The relative expressions and transcriptional levels of ErbB3 were detected by Western blot and RT-PCR:relative expressions of ErbB3 in HepG2 of which GFP and GFP-HBx were respectively transfected were O.75±0.11 and 1.10±0.10,respectively,with a statistically significant difference (t=4.291,P＜0.05).The relative expressions of ErbB3 mRNA in HepG2 of which GFP and GFP-HBx were respectively transfected were O.38±0.03 and O.94±0.07,respectively,with a statistically significant difference (t=11.703,P＜O.05).(4) The effects of ErbB3 on migration and invasion of HepG2:numbers of transmenbrane cell in HepG2 of which His and His-ErbB3 were respectively transfected by Transwell assay with matrix were respectively 271± 18 and 463± 31,respectively,with a statistically significant difference (t =8.202,P＜0.05).Numbers of transmenbrane cell in HepG2 of which His and His-ErbB3 were respectively transfected by Transwell assay without matrix were respectively 315±38 and 549±34,respectively,with a statistically significant difference (t =8.310,P＜0.05).Conclusion HBx protein can promote the invasion and migration of hepatocellular carcinoma cells through up-regulating expressions of ErbB3 protein.

Grounded theory was used to summarize and analyze influencing factors and their mechanism on availability of essential medicine.Four factors which influenced the availability of essential medicine were singled out:defective top design in the essential medicine system,interactions among its policies,deviations in the policy implementation by government agencies,and deficiency of supporting policies for the system.The availability of essential medicine in rural areas was influenced by a variety of factors.The ideas and methods of the grounded theory prove helpful for this study.In the future studies,both qualitative and quantitative study should be made to perfect this model formed by the grounded theory,to identify roadblocks and underlying causes in order to provide evidence for improving availability of essential medicine in rural areas.

Objective To comprehensively evaluate prevention and health care services of community health centers in Shandong province since the ongoing health reform and provide policy basis for development of community health services.Methods To study with rank sum ratio method and important quadrant models.Results Seventy-eight percent of community health centers were appraised as“average”.Overall satisfaction of residents for preventive and health services was 2.66 points.Preventive and health services of community health centers are expected to improve.Conclusion Overall prevention and health services of CHS centers were found less than satisfactory.Prevention and health services of CHS centers in regions a and B were poor,which deserves attention of the government health authorities.The government is expected to take actions to promote development of CHS centers for prevention and health care service.

Objective To study the different types of medication guidance for community doctors in the context of essential medicine system,and analyze its influencing factors.Methods SPSS 1 9.0 was called into play for statistical analysis of data gathered,and the medication guidance behavior of the doctors were graded on the two dimensions of personal willingness and practical action.With important quadrant method,the medication guidance behavior of such doctors was classified,while the multiple linear regression was used to study the influencing factors.Results Most of the community doctors of the fourteen counties fall into the area of “high willingness and less action”,with only a few falling into the area of the “high willingness and more action”. Major influencing factors of their willingness on medication guide were found to include impacts on job autonomy,attention to essential medicine system, and the forms to improve income.Major factors of the doctors'actions on medication guide include awareness of essential medicines,awareness of essential medicines catalog,and training outcomes. Conclusion The community doctors have high personal willingness for medication guidance related to essential medicines,but only a number of them carried it in their work.Therefore,it is necessary to take actions to strengthen awareness of the doctors for medication guidance and encourage them to carry it out.

To study performance problems found in China's essential medicine system.The SmithModel of system implementation was called into play in a systematic collation and analysis for the ideal policies,system implementation agencies,target groups and policy environment in its performance,along with relationships among the four factors.The system is found with a number of loopholes as the system itself is highly idealized,its system objectives set inappropriately,problems found with the four factors,and tension and conflicts among these factors.Given these problems found in its performance,it is inappropriate to make drastic changes to avoid instability of the system at its early stage.Government departments in question are advised to comprehensively analyze the four factors and their relationships then taking effective measures to deal with them and the tension,conflict among them.This can ensure effectively implementation of the essential medicine system.

Objective To evaluate the township hospitals'medical service efficiency in Shandong province,and to provide references for the development in township hospitals under the background of the essential medicine system.Methods The method of data envelopment analysis(DEA)was used to analyze the township hospitals' medical service efficiency in Shandong province before and since the implementation of the essential medicine system.Results For the township hospitals in Shandong province in general,their relative efficiency ratio of the medical service efficiency dropped from 66.67% to 53.33% since the implementation of the essential medicine system.In terms of the input and output,the non-DEA effective township hospitals are found with insufficient output as measured by the output indicator,while some input indicators input were found as excessive.Conclusion The low scale efficiency has become the main factor for the low service efficiency of such hospitals since the implementation of the essential medicine system in Shandong province.In order to improve the medical service efficiency,it is important to continue to improve the essential medicine system,increase the medical staff's incentives, improve the fiscal compensation policy,and keep the policy continuity.