In appropriate prescribing is a global problem. It is especially salient in China, where drug sales constitute a major portion of health care providers' incomes, price distortions are rampant, and oversight is lax. However, few data exist on the prevalence of inappropriate prescribing in China. This study, the first of its kind in China, examined 230,800 prescriptions written between 2007 and 2009 by 784 community health institutions in 28 cities across China. The data show substantial overprescribing, including twice as many prescriptions for antibiotics as recommended by the World Health Organization and rates of injection that are three times higher than in similar countries. These findings point to the need to integrate rational prescribing into China's ongoing health care reform. M arket-oriented reforms in the past three decades have brought unprecedented economic prosperity to China. At the same time, they dismantled the structure of China's equitable, albeit rudimentary, health care system. Today, with the Chinese Ministry of Health setting very low prices for physician consultation, hospitalization, and services, drug "markups" have become the major source of revenue for health care providers.Unlike the United States and many other countries, China does not have a widespread retail pharmacy system. Patients typically fill their prescriptions at the same hospital or clinic that they visit for care. These health care providers don't receive a dispensing fee but rather earn the difference between wholesale and retail price. Because these drug-related revenues are a major source of financial support for health care providers, one of the detrimental consequences is inappropriate or irrational prescribing. 1The irrational prescribing is further exacerbated by runaway manufacturer prices and lax oversight. This environment poses a serious risk for patients' health and sources of health care. 2Recognizing the ever-worsening problems in basic health care coverage, disease-induced poverty, disparities, and the resulting social instability, the Chinese government has launched a multitude of reforms. Central to the reforms has been the reconstruction of affordable and convenient community health service networks that provide basic disease prevention, medical treatment, rehabilitation, health education, and family planning services within designated urban communities. These networks are composed of health centers, each providing about 50 beds and serving 30,000 to 50,000 residents, and satellite health stations, each serving about 3,000 residents. 4 Most of these institutions are owned or subsidized by municipal governments; the rest are owned by private practitioners, trade organizations, and other nonprofit entities.5 By the end of 2008, 98 percent of the cities in all of China's thirty-one provinces had developed community health service networks. 6 In 2010 China's minister of health, Zhu Chen, Reform In China

This genome-wide search for susceptibility genes to type 2 diabetes/impaired glucose homeostasis (IGH) was performed on a relatively homogenous Chinese sample with a total number of 257 pedigrees and 385 affected sibpairs. Two regions showed significant linkage to type 2 diabetes/IGH in the Chinese. T ype 2 diabetes is a complex disease that develops in individuals with genetic susceptibility to impaired insulin secretion, as well as to impaired insulin sensitivity, in the presence of appropriate environmental factors, particularly those leading to obesity (1). Marked increases in the prevalence of type 2 diabetes occur in those societies or countries that have experienced tremendous economic development from a starting point of an impoverished economic base (2). Along with the economic development in China, nationwide surveys have revealed an increase in the prevalence of diabetes in the adult population from 0.9 to 2.4% over the years 1980 -1994 (3). In Shanghai, China, the prevalence of diabetes was only 1.0% in 1978 but had reached 9.8% by the turn of the last century, i.e., there has been a 10-fold increase within the last two decades in the Shanghai population alone (4,5).Genetic heterogeneity of type 2 diabetes has been suggested among ethnic groups (6). This may be one of the reasons for the different locations of susceptibility loci reported to be linked to type 2 diabetes among ethnic groups in genome-wide scans (7-22). In the large geographic area of China, 56 ethnic groups are officially recognized, the Han being the largest. The Chinese of Han ethnicity reside throughout China, mostly in the eastern and central regions. Studies of the origin of the East Asian population revealed that, even within the Han ethnic group, considerable genetic heterogeneity might exist according to geographical location (23)(24)(25). Because appropriate definition of a more homogenous sample set is one of the issues for a genome-wide screen for type 2 diabetes susceptibility genes, geographical genetic heterogeneity should be considered when conducting such a study on the Chinese population. Thus, the genome-wide screen reported in this study was performed with Chinese pedigrees recruited from a limited geographic area in China. RESEARCH DESIGN AND METHODSPedigrees for this study were selected from a sampling scheme for the collection of multiplex diabetic families aimed at the genetic studies of type 2 Additional information for this article can be found in an online appendix at http://diabetes.diabetesjournals.org. ASP, affected sibpair; IA-2, protein tyrosine phosphatase-like protein; IGH, impaired glucose homeostasis; LOD, logarithm of odds; MLS, maximum likelihood score; MODY, maturity-onset diabetes of the young; NPL, nonparametric linkage.

Purpose. To determine the efficacy and safety of preoperative intravitreal conbercept (IVC) injection before vitrectomy for proliferative diabetic retinopathy (PDR). Methods. 107 eyes of 88 patients that underwent pars plana vitrectomy (PPV) for active PDR were enrolled. All patients were assigned randomly to either preoperative IVC group or control group. Follow-up examinations were performed for three months after surgery. The primary bioactivity measures were severity of intraoperative bleeding, incidence of early and late recurrent VH, vitreous clear-up time, and best-corrected visual acuity (BCVA) levels. The secondary safety measures included intraocular pressure, endophthalmitis, rubeosis, tractional retinal detachment, and systemic adverse events. Results. The incidence and severity of intraoperative bleeding were significantly lower in IVC group than in the control group. The average vitreous clear-up time of early recurrent VH was significantly shorter in IVC group compared with that in control group. There was no significant difference in vitreous clear-up time of late recurrent VH between the two groups. Patients that received pretreatment of conbercept had much better BCVA at 3 days, 1 week, and 1 month after surgery than control group. Moreover, both patients with improved BCVA were greater in IVC group than in control group at each follow-up. Conclusions. Conbercept pretreatment could be an effective adjunct to vitrectomy in accelerating postoperative vitreous clear-up and acquiring stable visual acuity restoration for PDR.

Peripheral nerve damage does not fully explain the pathogenesis of trigeminal neuralgia (TN). Central nervous system changes can follow trigeminal nerve dysfunction. We hypothesized that brain white matter and functional connectivity changes in TN patients were involved in pain perception, modulation, the cognitive-affective system, and motor function; moreover, changes in functional reorganization were correlated with white matter alterations. Twenty left TN patients and twenty-two healthy controls were studied. Diffusion kurtosis imaging was analyzed to extract diffusion and kurtosis parameters, and functional connectivity density (FCD) mapping was used to explore the functional reorganization in the brain. In the patient group, we found lower axial kurtosis and higher axial diffusivity in tracts participated in sensory, cognitive-affective, and modulatory aspects of pain, such as the corticospinal tract, superior longitudinal fasciculus, anterior thalamic radiation, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, cingulated gyrus, forceps major and uncinate fasciculus. Patients exhibited complex FCD reorganization of hippocampus, striatum, thalamus, precentral gyrus, precuneus, prefrontal cortex and inferior parietal lobule in multiple modulatory networks that played crucial roles in pain perception, modulation, cognitive-affective system, and motor function. Further, the correlated structural-functional changes may be responsible for the persistence of long-term recurrent pain and sensory-related dysfunction in TN.