Objective: To analyze the cluster effect of urban health care expenditure and the impact of carbon emissions. Methods:Calculating spatial correlation Moran index and building spatial panel econometric model. Results: There are significant spillover effects of health care expenditure from 2007 and 2010; per capita carbon emissions, per capita income and age structure significantly affect health care expenditure. Conclusions:It is needed to pay more attention to environmental protection.

The epidemiological effects of native and mutated YMDD motif in the HBV genome under the selective pressure of lamivudine were investigated. YMDD wild and mutation motif in HBV genome were detected by flow through reverse dot blots (FT-RDB) with KaiPuTM DNA HybriMax Rapid Hybridization Machine based on the principle of "Flow-through hybridization" and by the traditional Reverse Dot Blot assay. Sera from 1021 suspected lamivudine-resistant chronic HBV carders after more than 8 months of lamivudine therapy and the corresponding archived sera were collected and assayed. We found 35.94% were single type infections with 8.03% YMDD, 7.93% YIDD and 19.98% YVDD. It was also found that 64.06% were mixed infections including 1.96% YMDD and YIDD, 51.62% YMDD and YVDD, 1.96% YIDD and YVDD, 8.52% YMDD, YIDD and YVDD. The levels of infections containing YVDD motif reached 82.08%. The pretreatment infectious status were: YMDD single infection was 36.93%; YIDD single infection was 6.07%; YVDD single infection was 17.04%; YMDD and YIDD mixed infection was 0.97%; YMDD and YVDD mixed infection was33.99%; YIDD and YVDD mixed infection was 0.98%; YMDD, YIDD and YVDD mixed infection was 4.02%. Infections containing YVDD motif were only 56.03%. The 34.32% mutation rate of YMDD motif to YVDD was significantly higher than the 10.97% of YMDD to YIDD (U=10.98, P<0.05), as estimated by Mann-Whitney U-test for non-parametric data. HBV containing YVDD motif might have an evolutionary ascendancy and become the dominant type under the selective pressure of lamivudine.

Objective Through detect the expression of DLC1 and RhoA protein in breast cancer tissues ,investigate the effect of DLC1 and RhoA in lymphatic metastasis of breast cancer .Methods Totally 25 breast cancer specimens that had occurred lymph node metastasis and 30 breast cancer specimens that had not occurred lymph node metastasis were collected ,the expression of DLC1 and RhoA were tested by immunochemistry ,and the experimental data were analyzed by statistical methods .Results The positive rate of DLC1 in the breast cancer specimens that had occurred lymph node metastasis was 44 .00% ,that had not occurred lymph node metastasis was 73 .33% (χ2 =4 .889 ,P=0 .027) ,and the positive rates of RhoA in the two specimens were 92 .00%and 50 .00% (χ2 =11 .264 ,P=0 .001) .Spearman rank correlation analysis showed the expression of DLC 1 and RhoA had a nega‐tive correlation in breast cancer tissues (r= -0 .454 ,P=0 .000) .Conclusion The breast cancer lymphatic metastasis and is closely related to the low expression of DLC1 and the high expression of RhoA .

Objective To investigate the changes of coagulatory functions in patients with fragmental femoral fractures before operation.Methods Twenty adults patients undergoing fragmental femoral fractures, ASA class Ⅰ , hospitalized on the injury day, were selected as test group (group Ⅰ) . Fifteen healthy adults were selected as control (group Ⅱ). The fasting venous blood samples were taken on the morning of 2nd and 6th day after femoral fracture for measurement of the parameters of thromboelastography (TEG) [including R-time, K-time, alpha angle, maximum amplitude (MA) and elastic shear modulus (G)], D-dimer concentration (D-Di), platelet count (PLC) and platelet aggregation rate (PAgR) .Results The values of TEG parameters, D-Di, PLC and PAgR were in normal ranges in group Ⅱ. Compared with those in group Ⅱ, in group Ⅰ the K time was shortened and alpha angle, MA, G, D-Di increased significantly on the 2nd day after femoral fracture(P

Objective To explore ways for the supervision of department directors. Methods Job responsibility agreements with department directors were signed and a series of assessment standards were established. Results The methods adopted were standardized, individualized and easy to use. Conclusion Job responsibility agreements with department directors and a standard assessment system are currently effective measures for the supervision of department directors.

Objective To explore proper methods of and environment for people oriented management so as to meet the various new challenges confronting hospitals. Methods The means of retrospection plus the Delphi method and sociological investigations were adopted. Results An exploration was made into the theories and principles to be followed, the means to be adopted and the human environment to be created in implementing people oriented management. Conclusion Hospitals implementing people oriented management and thus achieving maximized benefits in human resources management will be able to enhance their market shares and maintain sustainable development.

Objective To observe the therapeutic effect of Gegen Decoction plus Sini Powder for polycystic ovarian syndrome(PCOS) women with acne and to explore its possible therapeutic mechanism.Methods Seventy cases of PCOS women with acne aged 18-45 years were randomized into treatment group and control group,35 cases in each group.The treatment group was given Gegen Decoction plus Sini Powder orally and the control group was given Diane-35 orally.The treatment lasted for 12 weeks.After treatment,the skin lesions and symptom scores were observed.The body mass index (BMI),serum dihydrotestosterone (DHT),interleukin-6 (IL-6) and interleukin-8 (IL-8) were detected before and after treatment.Results (1) The markedly effective rate of the treatment group was 80.00％ and that of the control group was 57.14％,the difference being significant between the two groups(P ＜ 0.05).(2) After treatment,the total scores of the symptoms and the scores of each symptom such as sweating,sleeping and physical strength in both groups were decreased(P ＜ 0.01),and the decrease in the treatment group was superior to that in the control group(P ＜ 0.05).(3) The BMI and serum levels of DHT,IL-6 and IL-8 in both groups were significantly decreased after treatment (P ＜ 0.01),and the decrease in the treatment group was superior to that in the control group(P ＜ 0.05).Conclusion Gegen Decoction plus Sini Powder is effective for the treatment of PCOS women with acne,and the mechanism is probably related with the decrease of BMI and serum DHT,IL-6 and IL-8 levels.

Objective To evaluate the relationship between pressure derived fractional collateral flow (Q C/Q N) and left ventricular remodeling after acute myocardial infarction(AMI) Methods The Q C/Q N was measured in 21 patients with first AMI treated with percutaneous transluminal coronary angioplasty (PTCA), being determined by simultaneous measurement of mean aorta pressure (P a), distal coronary pressure (P w) during the balloon occlusion 21 patients were divided into two groups according to the value of Q C/Q N (group A, Q C/Q N≥0 25, group B, Q C/Q N0 05) At one month follow up, the difference in EF ( P 0 05) Both ESVI and EDVI were considerably increased in two groups Conclusion Angiographic Rentrop′s classification has its limitation in assessing the collateral circulation Q C/Q N is a major determinant of left ventricular remodeling and prognosis in patients with AMI

0.05). In HiLo group, the levels of MDA and SOD did not changed signific antly(P

Juvenile hemochromatosis is an autosomal recessive disease characterized by progressive tissue iron overload which leads to irreversible organ damage and even death.This disease is mainly caused by mutations in two genes:hemojuvelin gene and hepcidin gene.Different mutations have different phenotype.The two genes may act as modifying genes in HFE hemochromatosis.Hepcidin secreted by liver plays a central role in the regulation of iron homeostasis.HJV can act as a bone morphogenetic protein(BMP)co-receptor which is required for HJV to regulate hepcidin expression and iron homeostasis.Recent researches suggest that the bone morphogenetic protein(BMP)signaling pathway mediated by HJV is a significant mechanism for HJV to regulate hepcidin expression and iron homeostasis.HJV mutant impaires BMP signaling which results in hepcidin expression decrease and abnormal iron metabolism.