A new stage for healthy China： new characteristics and urgency of public health / 上海预防医学

Building a strong public health system has become an urgent task in the new era. Based on more than eight years of systematic research， we believe that five aspects need to be prioritized for a strong system. First， we should change the perspective on public health， using the word “gonggong jiankang” to replace “gonggong weisheng” and the word “gonggong jiankang tixi” to replace “gonggong weisheng tixi”， to lead the public health system development. Second， we should develop a suitable public health system and continuously improve the health capacity for governance. Third， we should make it clear that the goal of building a strong system is not far-fetched， and we need to consolidate the existing institutional advantages of China’s public health system： when encountering major problems， we can maintain a unified goal and mobilize the whole society to cooperate effectively to accomplish the goal. However， we need to make up for shortcomings one by one， especially to solve the key problem of lacking a strong coordination mechanism in daily work. Fourth， we should pursue excellence and consolidate the“suitable” mechanism proven in the process of coping with the COVID-19， so that efficient mechanisms to deal with major issues can be used in routine work， and efforts should be made to consolidate the advantages of prevention and control of infectious diseases and emergency response，so as to achieve the balanced development of regions categories and units.Finally， it is necessary to strengthen the coordination of government and research institutions， in the aspects of technological innovation， talent team building and accurate consulting services， and work together to pursue a suitable and strong system to realize the modernization of the health system and capacity for governance.

HucMSC-Ex alleviates inflammatory bowel disease via the lnc78583-mediated miR3202/HOXB13 pathway / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

As a group of nonspecific inflammatory diseases affecting the intestine, inflammatory bowel disease (IBD) exhibits the characteristics of chronic recurring inflammation, and was proven to be increasing in incidence (Kaplan, 2015). IBD induced by genetic background, environmental changes, immune functions, microbial composition, and toxin exposures (Sasson et al., 2021) primarily includes ulcerative colitis (UC) and Crohn's disease (CD) with complicated clinical symptoms featured by abdominal pain, diarrhea, and even blood in stools (Fan et al., 2021; Huang et al., 2021). UC is mainly limited to the rectum and the colon, while CD usually impacts the terminal ileum and colon in a discontinuous manner (Ordás et al., 2012; Panés and Rimola, 2017). In recent years, many studies have suggested the lack of effective measures in the diagnosis and treatment of IBD, prompting an urgent need for new strategies to understand the mechanisms of and offer promising therapies for IBD.

Study on health management service specification and support systems for chronic patients / 中华医院管理杂志

This article introduces the health management service specification for a chronic patient population. The concept of this specification comes from the whole process of people-centered and integrated health management of the chronic patient population. It is also based on the World Health Organization′s integrated chronic patient population management model. The completion of the specification has gone through several rounds of expert discussion in related fields in China. The contents include seven key links: suspect selection, clinical diagnosis, health assessment, intervention plan development, intervention plan implementation, follow-up, and health reassessment. It also includes establishing a professional team and developing a support system and mechanism of financing, compensation, and incentives. The specification aims at integrating regional health resources through standardizing service technology and scientific management concepts. It would help to improve the efficiency and quality of health management of chronic patient population in China, thereby reducing the economic burden of chronic diseases for patients and their families, and achieving the goal of improving residents′ health.

Construction of health management model based on primary health care / 中华医院管理杂志

Health promotion is to intervene all health influencing factors, health management is the specific measure to implement health promotion strategy, and primary health care is the basis and way to achieve the goal of Universal Health Coverage. Based on the analysis of the relationship among health promotion, health management and primary health care, the authors put forward a health management model based on primary health care, which is based on the primary health care system, effectively integrates all relevant health services and resources, implements a full human-centered process and comprehensive life-cycle health management, conducts effective intervention on health influencing factors, improves residents′ health conditions, and builds a long-term mechanism for poverty prevention in China. Primary health care-based health management model asks for a systematic health management service system and an effective collaborative support mechanism. Primary health care-based health management services emphasize the application of basic principles of primary health care, and focus on the integration of prevention and medical treatment, group and individualization, service provision and self-management. The key is to clarify and standardize the tasks, paths, standards, and quality control of health management services. Meanwhile, centering on the connotation of health management services, the county-level medical and health institutions, health personnel, health information, health financing, and operating mechanisms should be coordinated and integrated to ensure the effectiveness and sustainability of health management services.

Practice and implications of the medical insurance payment system reform: Exploration based on Health XI Project / 中国卫生政策研究

Medical insurance payment reform is an important part of healthcare reform in China. Based on the practice and research of China Rural Health Project ( hereinafter referred asHealth XI Project) financed by World Bank (WB) and UK Department for International Development (DFID) implemented in 40 counties of 8 Chinese provinces between 2009 and 2014 , this thesis analyses the principle and feasible policy route of medical payment re-form for the country, by ways of reviewing the policy evolution, and summarizing the process of project pilot from sin-gle mode of payment-a simple mixed payment-to the comprehensive payment system reform and analyzing the advanta-ges and disadvantages of medical insurance payment methods.

Increasing insurance protection efforts and improving the fairness of health care services: A-nalysis on the convergence mechanism between New Rural Cooperative Medical Scheme and Healthcare Financial Assistance Program / 中国卫生政策研究

The goal of China's health care insurance system is to improve the fairness and accessibility of health care services for low-income people. In the past 10 years of practice, the insurance has made remarkable a-chievements and gained popularity among broad masses of people. With the support of World Bank and UK Depart-ment for International Development, China Rural Health Development Project ( hereinafter referred as Health XI Project) have used the advantages of unique funding, management and human resources to launched a series of pro-ject activities, with the main goal of achieving effective convergence between the New Rural Cooperative Medical Scheme (NRCMS) and Healthcare Financial Assistance Program (HCFAP) in order to explore the assistance system of catastrophic diseases. Some areas have achieved seamless convergence between NRCMS and HCFAP to explore the assis-tance program for catastrophic diseases in the context of confirming and optimizing the management of services covered by the project, especially conducting a series of exploration and practice activities in the aspects of increasing new funding channels to establish theCatastrophic Disease Assistance Fund, strengthening the related supporting regulations, etc. The results show that the utilization of services covered by HCFAP in the project has significantly improved, the protection level of health insurance has greatly improved, and the people satisfaction has significantly increased.

Applications of the performance evaluation index system for rural public health service system in China's rural health reform / 中国卫生政策研究

Objective: To evaluate the project performance of public health service system in rural areas during the implementation of China Rural Health Project ( hereinafter referred to asHealth XI Project) . Methods: In this paper, all 40 counties covered by the Health XI Project are selected as case study. This paper uses the performance evaluation index system for rural public health system developed for the project and continuously collect input and out-put indexes between 2008 and 2013 in order to conduct a comprehensive analysis and evaluation. Results: During the implementation of the Health XI Project, the inputs and outputs of the rural public health service system had gradual-ly increased in all the countries covered by the project. The score for inputs and outputs increased from 22. 73 and 39. 05 in 2008 to 32. 62 and 57. 60 in 2013, with a growth rate of 43. 15% and 47. 50%, respectively. The input scores significantly grew faster than output scores in some provinces. The input-output ratio increased from 1. 72 to 1. 77, with slight fluctuations between different years. Conclusion: The application of the performance evaluation index system for public health service system in monitoring project implementation process can help to timely discover the weak links associated with the implementation of rural public health service system, and thus take effective measures to promote the improvement of the system. . When increasing investment in public health, how to efficiently use re-sources and improve the service effectiveness is still an urgent problem.

A road to new healthy countryside:Policy design and initial effects of China's healthy rural re-construction / 中国卫生政策研究

Healthy rural reconstruction is a widely explored intervention implemented by China Rural Health Devel-opment Project with the support of the World Bank and UK Department for International Development. By using initial pro-ject baseline data survey, mid-term evaluation and supervision, terminal evaluation of acquired qualitative and quantitative data,this paper analyzes the intervention policy design and initial effects of China's healthy rural reconstruction. With transforming the living environment in rural areas as the starting point, the project has relatively achieved good results, by using different policy measures such as improving the environment, creating a social environment conducive to villagers' health, expanding and providing high-quality health services, foster healthy behaviors and lifestyles, etc. The main results include the expansion of the project to cover 745 administrative villages, the environment of healthy villa-ges is much better than other neighboring villages, villagers' health knowledge has been greatly increased, lifestyle be-haviors of villagers have improved, the attitudes and participation rate of residents in cultural and sports activities have improved, etc. This paper suggests implementing the healthy rural reconstruction nationwide. It is very important to in-tegrate the concept of healthy village throughout the connotation of all kinds of new rural reconstruction, so the concept of health is deeply rooted in rural areas and imperceptibly change people's living behaviors and habits.

Therapeutic effect of splenic autologous transplantation on rat liver cancer induced by DEN / 局解手术学杂志

Objective To investigate the therapeutic effect of autologous transplantation of spleen on rat liver cancer induced by DEN. Methods Forty rats were randomly divided into A and B group on average. Total spleens of 40 rats were resected, which preserved in liquid nitrogen. All splenectomy rats were feeded with DEN to induce hepatocellular carcinoma. After 12 weeks ,all rats which had were successfully induced liver cancer were transplanted by autologous spleen in group A. Group B were sham operation as control. Results Survival period was significantly higher in group A than that in group B. But transplanted splenic tissue had not recovered to normal morphological structure until these rats died. Conclusion Autologous transplantation of spleen has therapeutic effect for liver cancer induced by DEN.

Reflection on application of health project evaluation / 中国卫生政策研究

Project supervision and management with a focus on project performance is an important measure to achieve project objectives and meet the need for scientific management of public health projects. Currently, many models widely used internationally are faced with limitations when used domestically. Research in the paper is based on the three basic problems that exist in the process of domestic health project evaluations, combines the practices of the National Health and Family Planning ( NHFPC) Center for Project Supervision and Management, and proposes the logical framework of the compound evaluation model according to the theoretical assumptions behind health project evaluations. Complex health project evaluations should bear a proper understanding of the basic concept of evaluative features with a focus on project results and effects and importance attached to an analysis of factors that impact project implementation.

Effects of early intelligent feedback rehabilitation training system of lower extremities on walking ability in stroke patients with hemiplegia / 中国脑血管病杂志

Objective To observe the effects of early intelligent feedback rehabilitation training system of lower extremities on walking ability in stroke patients with hemiplegia. Methods Forty post-stroke hemiplegic patients (onset 0. 05). Four weeks after treatment, the FMA-L scores were improved in both the intelligent and conventional rehabilitation groups compared to before treatment (P<0. 01);the differences were 20. 0 ± 6. 2 and 5. 1 ± 1. 6 respectively before and after treatment. The degree of improvement of the intelligent rehabilitation group was better than that of the conventional rehabilitation group (P<0. 01). Holden walking function classification showed that only the intelligent rehabilitation group was improved as compared to before treatment (P<0. 01). Four weeks after treatment ,the strength and tone of the tibialis anterior muscle and gastrocnemius muscle of both groups were increased compared to before treatment (P <0. 01 ). The differences of the strength and tone of the tibialis anterior muscle were 20 +7 and 12 +4μV respectively in the rehabilitation groups before and after treatment,and those were 12+4 and 9+3μV in the conventional rehabilitation group;the differences of the strength and tone of the gastrocnemius muscle of the intelligent rehabilitation group were 25+8 and 19+6μV respectively before and after treatment,and those of the conventional rehabilitation group were 10+3 and 11+2μV respectively. There was significant difference between the intelligent rehabilitation group and the conventional rehabilitation group (P <0. 01 ). Conclusion The treatment of early intelligent feedback rehabilitation training system of the lower extremities may significantly improve the walking ability of the lower extremities in stroke patients with hemiplegia.

Maternal cell contamination of prenatal samples and the potential effects on prenatal diagnosis results / 中华妇产科杂志

Objective To assess the frequency and significance of maternal cell contamination (MCC)in the invasive prenatal diagnosis,and to analysis the MCC effect on prenatal diagnosis results.Methods Totally 519 amniotic fluid samples from second trimester pregnancy,57 chorionic villus samples from first trimester pregnancy,and 576 blood samples from corresponded pregnant women were collected and genotyped by Promega PowerPlex 16 system.MCC was determined according to the genotyping results.Karyotypic and molecular diagnosis results were contrasted between MCC and non-MCC specimen of the same fetal.Results MCC presented in 3.1％(16/519)uncultured amniotic fluid,1.3％(7/519)cultured amniotic fluid and 5％(3/57)villi specimens.In the study of fetal karyotype,MCC had no significant effect on normal female fetus;but for male fetus and abnormal female fetus,there were risk of erroneous results of mosaics.As to molecular diagnosis,MCC resulted in more complex effects for the different diagnostic methods.And 10％ MCC had led to misdiagnosis.Conclusions For the prenatal cytogenetic tests,MCC should be excluded when there were mosaicism karyotype results or suspicious MCC of chorionic villi samples.The effects of MCC had more seriously impact on prenatal molecular testing,which suggesting the recommend regular identity test for MCC should bc carried out.

Tolerance of gastric cancer cells to 5-fluorouracil mediated by integrin αvβ6 through extracellular signal-regulated protein kinase / 中华消化外科杂志

Objective To explore the role of integrin αvβ6 in mediating the tolerance of gastric cancer AGS cells to 5-fluorouracil, and to determine whether direct β6-extracellular signal-regulated protein kinase(ERK) binding is involved. Methods Gastric cancer AGS cells in the logarithmic phase were incubated with either 5-fluorouracil for 24 hours ( control group), with 0.1 g/L of mouse anti-αvβ6 monoclonal antibody 10D5 for 6 hours and then with 5-fluorouracil for24 hours ( 10D5 group), with IgG2a and 5-fluorouracil ( IgG2a group), or with 5-fluorouracil and 20 μnol/L of ERK inhibitor PD98059 for 24 hours ( PD98059 group). Cell proliferation,apoptosis and the expression of Bcl-2 and caspase-3 protein were detected by MTT assay, flow cytometry and western blotting, respectively. All data were analysed by one-way analysis of variance and LSD test. Results The cell inhibition rates of the control group, 10D5 group, IgG2a group and PD98059 group were 28.1% ±2.7%,84.5% ± 1.6%, 31.4% ±5.2%, 86.7% ±5.2%, respectively, with a significant difference ( F = 342. 5, P ＜0.05). The apoptosis rates of the control group, 10D5 group, IgG2a group, and PD98059 group were 6.6% ±1.4%, 30.6% ± 2.4%, 8.1% ± 1.3%, 36.0% ±4.0%, respectively, with a significant difference among the four groups (F = 105.4, P ＜0.05 ). There was a significant difference in the expression of caspase-3 and Bcl-2 among the four groups (F=292.1, 181.6, P＜0.05). Conclusion Integrin αvβ6 can mediate the tolerance of gastric cancer AGS cells to 5-fluorouracil through direct β6-ERK binding.

Clinical analysis of modified pancreatoduodenectomy with preservation of ascending portion of duodenum / 中华消化外科杂志

Objective To investigate the value of modified pancreatoduodenectomy in the treatment of ampullary carcinoma by comparing the efficacy of pancreatoduodenectomy with preservation of ascending portion of duodenum and that of Whipple procedure. Methods The clinical data of 133 patients with ampullary carcinoma who had been admitted to the Qilu Hospital from 1990 to 2006 were retrospectively analyzed. Of the 133 patients, 88 received Whipple procedure (group A) and 45 received pancreatoduedenectomy with preservation of ascending portion of duodenum (group B). The preoperative condition of the patients and short- and long-term efficacy of the 2 procedures were compared by Fisher exact probability, t test, chi-square test, Kaplan-Meier survival curve and Log-rank test, and the differences between the efficacy of the 2 procedures were compared. Results The operation time, time of gastrointestinal function recovery, hospital stay and ratio of patients with blood transfusion were (366±111) minutes, (7.4±1.4) days, (24±9) days and 76% (67/88) in group A, and (325±32)minutes, (4.3±1.4)days, (31±14)days, 42% (19/45) in group B, with significant difference between the 2 groups (t = 2.34, 2.08, 1.98 ; χ2 = 14.99, P < 0.05). The medium survival time of patients in groups A and B were (19.0±1.5)months and (16.9±1.7) months, with no significant difference between the 2 groups (χ2 = 0.46, P > 0.05). There was no significant difference in the occurrence of postoperative complications between the 2 groups (P > 0.05). Conclusions Pancreateduodenectomy with preservation of ascending portion of duodenum can be applied for patients with ampullary carcinoma.

Research of peritoneal micrometastasis in patients with gastric carcinoma / 中国现代普通外科进展

Objective:To investigate the related factors and clinical significance of peritoneal micrometastasis in patients with gastric carcinoma,providing theoretical basis for resection range。Methods:CK19,CK20 immunohistochemistry were performed on 62 patients' tissues taken from anterior lobe of transverse mesocolon,posterior wall of omental bursa,pancreatic capsule and rectovesical pouch or Douglas pouch during the operations,compared with HE staining and peritoneal lavage cytology(PLC).Results:No metastasis was found by HE staining.Peritoneal micrometastasis were found in 27 cases out of 62 by immunohistochemistry,and its positive rate was 43.55%,obviously higher than PLC(14.52%).The peritoneal micrometastasis of gastric carcinoma had relations with diameter of tumor,depth of infiltration,clinical stage,lymph node metastasis(P0.05).Conclusion:Immunohistochemistric measure of CK 19 and CK20 can be effective to detect the micrometastasis of gastric carcinoma,which is helpful to guide clinical staging and useful to provide evidence for accurate selection of operation and postoperative treatment.Routine detection of peritoneal micrometastasis should be taken in patients of advanced gastric carcinoma,especially with a large size of serosa invasion.Multiple spots sampling is helpful to improve the detection rate.Anterior lobe of transverse mesocolon and pancreatic capsule should be peeled,and radical resection of omental bursa should be considered as routine operation in these patients.