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简介：AbstractBackground:The End Tuberculosis (TB) Strategy of the World Health Organization highlights the need for patient-centered care and social protection measures that alleviate the financial hardships faced by many TB patients. In China, TB treatments are paid for by earmarked government funds, social health insurance, medical assistance for the poor, and out-of-pocket payments from patients. As part of Phase III of the China-Gates TB project, this paper introduces multi-source financing of TB treatment in the three provinces of China and analyzes the challenges of moving towards universal coverage and its implications of multi-sectoral engagement for TB care.Main text:The new financing policies for TB treatment in the three provinces include increased reimbursement for TB outpatient care, linkage of TB treatment with local poverty alleviation programs, and use of local government funds to cover some costs to reduce out-of-pocket expenses. However, there are several challenges in reducing the financial burdens faced by TB patients. First, medical costs must be contained by reducing the profit-maximizing behaviors of hospitals. Second, treatment for TB and multi-drug resistant TB (MDR-TB) is only available at county hospitals and city or provincial hospitals, respectively, and these hospitals have low reimbursement rates and high co-payments. Third, many patients with TB and MDR-TB are at the edge of poverty, and therefore ineligible for medical assistance, which targets extremely poor individuals. In addition, the local governments of less developed provinces often face fiscal difficulties, making it challenging to use of local government funds to provide financial support for TB patients. We suggest that stakeholders at multiple sectors should engage in transparent and responsive communications, coordinate policy developments, and integrate resources to improve the integration of social protection schemes.Conclusions:The Chinese government is examining the establishment of multi-source financing for TB treatment by mobilization of funds from the government and social protection schemes. These efforts require strengthening the cooperation of multiple sectors and improving the accountability of different government agencies. All key stakeholders must take concrete actions in the near future to assure significant progress toward the goal of alleviating the financial burden faced by TB and MDR-TB patients.

简介：AbstractBackground:The global prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing. The pathogenesis of NAFLD is multifaceted, and the underlying mechanisms are elusive. We conducted data mining analysis to gain a better insight into the disease and to identify the hub genes associated with the progression of NAFLD.Methods:The dataset GSE49541, containing the profile of 40 samples representing mild stages of NAFLD and 32 samples representing advanced stages of NAFLD, was acquired from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified using the R programming language. The Database for Annotation, Visualization and Integrated Discovery (DAVID) online tool and Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database were used to perform the enrichment analysis and construct protein-protein interaction (PPI) networks, respectively. Subsequently, transcription factor networks and key modules were identified. The hub genes were validated in a mice model of high fat diet (HFD)-induced NAFLD and in cultured HepG2 cells by real-time quantitative PCR.Results:Based on the GSE49541 dataset, 57 DEGs were selected and enriched in chemokine activity and cellular component, including the extracellular region. Twelve transcription factors associated with DEGs were indicated from PPI analysis. Upregulated expression of five hub genes (SOX9, CCL20, CXCL1, CD24, and CHST4), which were identified from the dataset, was also observed in the livers of HFD-induced NAFLD mice and in HepG2 cells exposed to palmitic acid or advanced glycation end products.Conclusion:The hub genes SOX9, CCL20, CXCL1, CD24, and CHST4 are involved in the aggravation of NAFLD. Our results offer new insights into the underlying mechanism of NAFLD progression.

简介：AbstractObjective:This survey was designed to understand the misconceptions about labor epidurals.Methods:This voluntary and anonymous online survey on wenjuan.com was conducted from September 1st, 2015 to January 1st, 2016 via mainly WeChat groups dedicated to perinatal healthcare providers in China. The questionnaire included items inquiring the knowledge and opinions about labor epidural analgesia related to maternal complications, baby safety, and effect on laboring. Incomplete surveys were excluded from the data analysis. The data was presented as percentages and a Chi-square test or Fisher’s exact test, as appreciate, was used to quantitatively compare the results.Results:A total of 1412 respondents completed surveys with 42.9% (606/1412) of them being anesthesiologists, 35.1% (495/1412) being obstetricians, 11.8% (167/1412) being midwives, 3.7% (52/1412) being labor and delivery nurses, and 6.5% (92/1412) being hospital administrators and unspecified. The study revealed a lack of knowledge in labor pain control. Although 82.4% (1164/1412) of respondents were familiar with labor epidural analgesia, 8.9% (126/1412) did not know how it works, and 1.1% (15/1412) never heard it in a multiple-choice question. The three main groups (anesthesiologists, obstetricians, and midwives/labor and delivery nurses) were chosen for comparisons. Opinions among these three groups concerning five questions in the three main concerns were evaluated using a statistical significance of P<0.05.Conclusion:The results in our survey indicated an urgent need of continuing medical education to multidisciplinary specialties to improve evidence-based medical practices as these misconceptions have existed for over 10 years in the medical professionals. Lack of public awareness fueled by misconceptions related to labor epidural analgesia may be associated with a lack of professional knowledge. Correct knowledge in professionals needs to be disseminated to the public in order to dispel possible misconceptions and rumors about labor epidural analgesia. This would not only enhance patient understanding of their care but also improve maternal, fetal, and neonatal outcomes.

简介：摘要：空调产品结构复杂多样，影响产品核心质量的因素繁多，如何快速准确完整的识别关键因子，并进行精准管控，是产品工艺设计的核心。本文通过应用公差仿真软件进行尺寸链分析，对产品核心质量需求进行深入剖析，引用仿真软件的敏感度，贡献度分析，进而识别出影响产品核心质量的关键因子，并建立关键因素管理体系，为工艺设计与管理提供理论支撑，可以广泛应用到具备结构装配关联性的机械设计与工艺制造等相关领域。提升了产品工艺设计水平，并为产品结构设计优化与生产过程质量控制等指引方向。

简介：【摘要】工伤保险是社会保险的一个险种，属于强制性参保范畴。在工伤认定过程中，必须要先确定是否是劳动关系，这也是最容易出现争议的地方。怎样确定劳动关系或劳务关系，本研究进行了分析和论述。

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简介：摘要：作为一名教育工作者，良好的师生关系是教育产生效能的关键，它决定了教育的成败。本文通过笔者与学生相处的亲身经历，总结出建立良好师生关系的一些经验。并提供了一些与学生建立良好人际关系的方法，在提供教育之前，为自己扫清障碍，让学生接纳你，进而接受你的教育。

简介：摘要：现在社会对一个人健康标准的评判不在只局限于身体健康，社会适应能力和心理状态也成为了衡量一个人健康与否的标准。身体和心理从来不是独立开的，身体是心理的皮囊，心理的状态反过来再身体上呈现，二者互相纠缠、互相影响才构成了一个多元化的人的形象。本文重点内容就是讨论新时期人际关系和心理健康之间的关系。

简介：摘 要 心理咨询工作，需要通过咨询师和当事人建立咨询关系。咨询师的个人特质对咨询关系的建立有决定性的影响，对咨询关系的进一步加深也有重要的影响，走向都有着重要影响。咨询师可以结合个人特质构建属于自己风格特点的咨询方式。

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简介：摘要：教学方法是教师和学生为完成教学任务所采用的工作手段。它是解决教师怎么教

简介：摘要：septin基因家族是一类具有GTPase活性的基因家族，在胞质分裂、细胞极性和扩散屏障建立中都发挥着重要的作用。Septin的基因改变与一些疾病、特别是肿瘤的发生有关，包括神经胶质母细胞瘤、白血病、乳腺癌、卵巢癌等。

简介：摘要：服装表演是当今社会重要的文化现象，音乐将服装，表演，模特紧紧的联系在一起，使观众透过服饰看到内在的文化蕴含。音乐带来的听觉效果大于视觉效果。本文旨在探求音乐在服装表演中的重要性和作用，音乐与服装表演相辅相成，密不可分的关系，以及不同的音乐带来的不同的情感氛围，探求音乐与服装表演的艺术契合。

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简介：摘要: 教师在传道授业解惑过程中，需要处理大量的人际关系,其中一个重要的关系就是师生关系。教师和学生之间客观存在一些问题和冲突，需要我们恰当地加以处理。

简介：摘 要：建筑是人类赖以生存必不可少的，建筑与环境的融合，与自然环境的和谐，与社会环境的交融，成了当今时代人类的需求。伴随着社会的不断进步，物质经济的不断发展，生态环境问题已成为人类要解决的头等问题，平衡建筑与环境的关系成为人类的共同目标。如何做到让建筑影响环境，让建筑融入环境，创建绿色发展建筑体系是关系到社会和谐及可持续发展的大事。