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 Effects of methylprednisolone on observation of intramedullary spinal cord tumor treatment.Methods Through the 9 cases of intramedullary spinal cord tumors in patients after adjuvant therapy of methylprednisolone clinical observation and analysis.Results 9 cases of ostoperative patients after treatment with methylprednisolone,his condition to resume soon,but the response to 5 cases of side effects,as symptomatic treatment can be back to normal.Conclusions Application of adjuvant therapy of methylprednisolone after spinal marrow tumor effects although good,it should be noted that the occurrence of side effects,and do:the right of dispensing,close observation and timely manner.

Objective:To analyze essential health care equity in cities and counties of Hainan in order to provide the basis for its development. Methods:Based on health statistics of Hainan, China and OECD countries, indicators of essential health care equity in cities and counties were analyzed. Results:Equity in distribution of resources, the hospi-tal geographical distance is large difference, physician-to-nurse ratio is 1:1. 2, and the Gini coefficient is more than 0. 3. Equity in financing, health care spending per capita is less than the national level. Cities and counties with high government budgets for health are located in regional centers. The hospitalization costs compensation with new rural co-operative medical scheme is about 50%. Equity in service supply, bed occupancy rate below 90% and drugs accounted for 30% ~40% in most cities and counties. Regional differences in maternal and child health management are small, but below the national level. Conclusions:The situation of essential health care resources is related to the political and economic climate. Financing mechanisms for essential health care are imperfect;and a low supply of basic medical and public health services reduced the quality of essential health care. Suggestions:Rational distribution of essential health care resources should be promoted;essential health care financing should be increased;and the capability of essential health care supply should be improved.

Objective To study the safety and efficacy of selective head cooling (SHC) with mild systemic hypotherrnia in neonates with HIE. Methods Fifty-four term infants with severe neonatal HIE were randomly assigned to the head cooling group (n=27) and control group (n=27). Forty-one infants in 96 h after admission were eligible for the study(SHC group n=21, control group n=20). In SHC group, the naso-pharyngeal temperature was maintained at (34.0±0.2) ℃ and rectal temperature maintained at 34～35 ℃ for 72 h, then rewarmed spontaneously. In control group, normal rectal temperature was maintained. During the period of the study, the infants of two groups were monitored on nasopharyngeal temperature, heart rate, respiratory rate,transcutaneous arterial oxygen saturation and blood pressure. Primary adverse effects inclu-ding severe arrhythmia, venous thrombosis or hemorrhage and severe hypotension were observed. The efficacy indicators including rate of death and severe disability, exercise and cognition development index were as-sessed. Results Severe arrhythmia, hypotension and renal failure were not found in both groups. Follow-up was conducted until postnatal 18 months and was not available in 6 babies (3 in SHC group and 3 in control group respectively). Death and severe disability occurred in 4 of 18 infants (22.2%)in SHC group and in 9 of 17 infants(52.9% ) in the control group respectively (P<0.05). Conclusion SHC for 72 h with mild systemic hypothermia in neonates with HIE is safe and effective. The therapy could reduce the risk of disabili-ty and handicap significantly.

2 weeks ) were screened by BAEP. Results Hearing-ability of 11 children(11/23,47.8%) was abnormal,one month later hearing-ability of 2 children was abnormal, and there months later hearing-ability of only 1 child was abnormal. Conclusion Hyperbilirubinemia may cause hearing-ability damage in neonates and BAEP is one of effective audiometric means.

OBJECTIVE:To observe the clinical effects of Stronger Neo-Minophagen C(SNMC)in the treatment of liver function damage caused by anti-tumor medicine.METHODS:60cases of liver injury caused by anti-tumor medicine were randomly divided into the treatment group(32cases)and the control group(28cases).SNMC injection was given in the treatment group as a supplement to the primary therapy in the control group.RESULTS:The treatment group with SNMC showed significantly greater improvement than the control group in the liver functions(ALT,AST,T.BIL)(P

Objective: To demonstrate the influence of HMGB34367,a subfamily member of the high-mobility group protein B1(HMGB1),as a transcriptional factor of the ?-SMA gene expression.Methods: We cloned HMGB34367 cDNA from the fibrotic lung tissue of the Balb/C mouse treated with BLM by RT-PCR,sub-cloned it into a eukaryotic expression vector pcDNA 3.0 or pEGF-N2,and constructed a report plasmid,pDsRed-SMA,encoding red fluorescence(RFP) driven by ?-SMA promoter.Following the co-transfection of pDsRed-SMA and HMGB34367-pcDNA3.0/ pEGF-N2-HMGB34367 in the cultured 16HBE cells,we tested the expression of the RFP in the absence and presence of TGF?1 by fluorescence microscopy.After the transfection of HMGB34367-pcDNA3.0,the nucleus extracts from the transfected cells were subjected to electrophoretic mobility shift assay(EMSA) for the detection of the binding activity of HMGB34367 with ?-SMA promoter CarGB motif.RT-PCR was performed for the evaluation of the ?-SMA gene expression in the cells.Results: The over expression of HMGB34367 activated the ?-SMA promoter and enhances the expression of the ?-SMA gene.An increased binding activity of HMGB34367 with CarGB motif was detected by EMSA in the transfected cells.Conclusion:HMGB34367,a member of HMGB1 family,could act as a transcription factor for the transcriptional activation of the ?-SMA gene,which may play an important role in the development of lung fibrosis.

Objective To study the effect of different processing methods on paeoniflorin content and to provide a basis for stabilizing the processing technology of white peony root.Methods RP-HPLC method was used to determine the content of paeoniflorin on Agilent Eclipse XDB-C18(150 mm?4.6 mm,5 ?m),with mobile phase of acetonitrile-0.1% phosphoric acid(14∶86),flow rate of 1.0 mL/min,column temperature of 25 ℃,and detective wavelength of 230 nm.Results The average recovery rate was 99.195%,RSD=0.8%(n=6).The content of paeoniflorin was 0.55%,2.70%,3.40%,3.25%,respectively.Conclusion In the processing of white peony root,heating,water immersion and sulfur smoked have greater effect of paeoniflorin content in white peony root.

Objective To investigate the use of sodium hyaluronate and the preservation of epidural fat in the prevention of epidural scar adhesion after microendoscopic discectomy (MED). Methods A total of 300 patients receiving MED from July 2000 to October 2001 were randomly divided into 2 groups: patients in group A were given sodium hyaluronate with the preservation of epidural fat, while those in group B were on the contrary. Results The mean follow-up duration was 42 months in the group A and 44 months in the group B, respectively. The rate of excellent or good results was 98.6% in the group A (144/146), while 93.8% in the group B (135/144) ( ? 2=4.731, P =0.030). Postoperatively, the pain reappeared in 4 cases in the group A and in 6 cases in the group B, respectively, in which a re-operation was required. Re-operations found the epidural scar adhesion was grade 0 (3 cases) and grade 1 (1 case) in the group A, and grade 2 (2 cases) and grade 3 (4 cases) in the group B ( P =0.005). Conclusions Use of sodium hyaluronate with the preservation of epidural fat can improve the efficacy of MED and effectively prevent epidural scar adhesion.

Objective:To evaluate the value of serum anti citrullinated antibody ( anti CCP-Ab) ,anti keratin antibody ( AKA) and rheumatoid factor ( RF) diagnostic significance of these 3 kinds of index in RA.Methods:256 patients with RA ,92 patients with other autoimmune diseases,50 cases of healthy people were anti CCP-Ab,AKA,RF detection,and the results were analyzed.Results:single target detection ,diagnostic sensitivity of RA from high to low was RF ,anti CCP-Ab,AKA,specific from high to low was AKA ,anti CCP-Ab, RF,anti CCP-Ab and AKA combined detection in clinical diagnostic efficiency.Conclusion: RF,AKA,anti CCP-Ab three index have advantages and disadvantages in diagnosis of RA ,the diagnosis of AKA ,anti CCP-Ab serum of RF negative RA is a powerful complement to,in accordance with the selection of project portfolio appropriate experimental conditions ,the early diagnosis of RA and early treatment ,improve the prognosis had higher value.