Health care policy should follow principles of total efficiency, no-harm, fairness and justice as ethi-cal standards for public policy. Diagnosis Related Groups( DRGs) as a sign of new health care reform ( NHCR) is implemented as a pilot program across the country, with the obvious function of suppressing excessive growth in medi-cal costs and over-treatment. From the dimension of ethical values, the DRGs has avoided unethical individuals, fol-lowed the principle of total efficiency and achieved the equalization of social security. However it has also increased ethical risks and been adverse to the development of medical research. To realize the reasonable development of DRGS, the construction of DRGs must be improved, and security policies must be reasonable and feasible; orderly measures must be established to ensure promotion and implementation;the government’s financial investment must be increased to protect the social welfare of public hospitals;a sound communication mechanism must be implemented, and interaction between medical institutions and insurance institutions must be strengthened.

Objective To evaluate the value of ultrasound elastography in the diagnosis of breast tumor ,and compared with imaging analysis .Methods To collect the image data of 160 patients ,confirmed by pathology ,a total of 182 ,preoperative ultra-sound elasticity imaging and DWI ,ultra sonic elastography diagnosis by five points method ,DWI on the basis of the measured ADC value in the diagnosis of lesions ,respectively compared with pathology .Results Ultrasound elastography diagnosis of 89 malignant tumors ,of which the correct diagnosis of 78 malignant tumors ,7 misdiagnosis ,11 benign misdiagnosed as malignant diagnosis;93 benign tumors ,86 of correct diagnosis ,11 misdiagnosis ,7 malignant misdiagnosed as benign ,sensitivity was 87 .6% ,specificity of 92 .5% ,the Accuracy was 93 .9% ;ultrasound elastography and DWI combined imaging diagnosis of 86 malignant tumors ,81 correct diagnosis of malignant tumors ,4 misdiagnosis ,5 from the benign misdiagnosed as malignant diagnosis ,96 benign tumors ,92 correct diagnosis ,5 misdiagnosis ,the sensitivity was 94 .1% ,specificity of 95 .8% ,the accuracy was 97 .2% .Conclusion Ultrasound elas-tography in breast benign and malignant tumor diagnosis with higher sensitivity and specificity ,accuracy ,joint DWI can significantly improve the sensitivity and specificity of breast benign and malignant tumor diagnosis ,accuracy .

OBJECTIVETo investigate the effect of intensive rosuvastatin therapy on adhesion molecules in patients with peripheral atherosclerosis and explore the possible upstream mechanism.

METHODSTwenty asymptomatic patients with peripheral atherosclerosis were enrolled and given 5-20 mg/day rosuvastatin for 3 months. Before and after the treatment, the lipid profile and plasma vascular cell adhesion molecule-1 (VCAM-1) levels were examined. The expression of intercellular adhesion molecule-1 (ICAM-1) in the mononuclear cells was measured using flow cytometry, and the mRNA and protein expressions of peroxisome proliferator-activated receptor γ (PPARγ) were detected using RT-PCR and Western blotting, respectively.

RESULTSCompared with the baseline levels, ICAM-1 expression decreased and PPARγ protein expression increased in the lymphocytes. Rosuvastatin therapy did not produce obvious effects on plasma VCAM-1 level or ICAM-1 expression in the monocytes in these patients.

CONCLUSIONRosuvastatin produces anti-inflammatory effects by decreasing the expression of ICAM-1 in mononuclear cells, and its upstream mechanism may involve the PPARγ pathway.

Atherosclerosis ; drug therapy ; metabolism ; Cell Adhesion Molecules ; metabolism ; Female ; Fluorobenzenes ; administration & dosage ; therapeutic use ; Humans ; Intercellular Adhesion Molecule-1 ; metabolism ; Male ; Middle Aged ; Monocytes ; drug effects ; metabolism ; PPAR gamma ; metabolism ; Pyrimidines ; administration & dosage ; therapeutic use ; Rosuvastatin Calcium ; Sulfonamides ; administration & dosage ; therapeutic use ; Vascular Cell Adhesion Molecule-1 ; metabolism

Objective To study the impact of anatomical resection (AR) for hepatocellular carcinoma with microvascular invasion on early tumor recurrence.Methods 178 consecutive patients with solitary hepatocellular carcinoma who underwent liver resection at the Affiliated Tumor Hospital of Guangxi Medical University from January 2012 to December 2015 were retrospectively studied.These patients were divided into four groups according the types of resection (anatomical resection AR or non-anatomical resection NAR) and the surgical margins (narrow or wide margin).All the patients were followed up until the tumor recurred or two years after surgery.The recurrence-free survival and the types of recurrence for the 4 different groups were compared.Results The 6 months,1-,2-year disease-free survival rates in the AR (n =55) and NAR groups (n =123) were 87.0％,79.2％,74.5％ and 78.5％,61.3％,45.7 ％,respectively,(P ＜ 0.05).Through pair-wise comparisons of the four groups,there were no significant differences in early recurrence between the narrow surgical margin group and the wide surgical margin group,regardless of the types of surgery.The early recurrence rates of the AR groups were significantly lower than that of the NAR groups,regardless of the widths of the surgical margins.Multivariate analysis showed that AR was a protective factor of early recurrence (HR =0.417,95％ CI 0.229 ～ 0.761).Further analysis of the recurrence patterns of AR and NAR showed that the recurrence types were mainly sohtary for AR (solitary,61.5％;multiple 30.8％) and multiple recurrence for NAR (solitary,32.2％;multiple 61.0％).Conclusion AR improved early recurrence-free survival of patients with microvascular invasion.