With reference to the research report of American Medical Association on the healthcare system,the paper analyzed the existing medical service,and probed into the causes of poor quality of care The author staged the six countermeasures highlighting patient-focus,safe,effective,timely,efficient and fair medical service models,in the hope of improving quality of care and ensuring patient safety.

[Objective] To sum up teacher He Lingzhi’s clinical experience and academic ideas on diagnosing and treating IgA nephrosis. [Method] From casa morbi, mechanism and clinical treatment based on differentiation of signs, it expounds teacher He Lingzhi ’s clinical experience and academic points, exampled with a case. [Result] The disease has main mechanism of Qi deficiency, teacher He Lingzhi divides the IgA nephrosis into types of Qi deficiency of lung and spleen, spleen and kidney, both deficiency of lung and kidney, Yang deficiency of spleen and kidney, Yin deficiency of liver and kidney, both deficiency of Qi and Yin, Yin and Yang, thus forms the treating rules of tonifying Qi to reinforce spleen, tonifying lung to nourish kidney, tonifying liver and kidney, Qi and Yin, Yin and Yang. The case here was relieved the nephrosis symptoms with the treatment. [Conclusion] Teacher He Lingzhi has rich clinical experience in treating IgA nephrosis with differentiation of signs, with definite cure effect.

The distribution fate and solubilization behavior of indomethacin through the intestinal tract were investigated with in vitro lipolysis model, by comparing the Capmul MCM and Labrafil M 1944 CS type I lipid formulations. The results showed that the more favorable solubilization was in the aqueous digestion phase from each lipid formulations for indomethacin. The lipolysis rate and extent were decided with chemical constitution of the lipid excipients, which meant that less indomethacin was transferred from the long chain polar oil lipid solution into the aqueous digestion phase. Increasing the concentration of indomethacin in the lipid formualitons from a solution to a suspension led to a linear increase in the concentration of indomethacin attained in the aqueous digestion phase from lipid formulations. This study also implied that adverse effects of the lipolysis rate and extent on drug absorption were could be taken into consideration when screening lipid formulations. Lipid suspensions likely had better enhancement of drug absorption. Last, this study demonstrated that a potential basis for optimizing and assessing type I lipid formulations and also researching in vivo-in vitro correlations of lipid formulations were provided by an in vitro lipolysis model.

OBJECTIVE:To study the pharmacokinetics of balofloxacin tablets in Chinese healthy volunteers.METHODS:A single dose of 100 or 200 mg balofloxacin tablets were given to 12 healthy volunteers in a randomized crossover design.Concentrations of balofloxacin in plasma and urine were determined by HPLC with data processed by DAS(drug and statistics)software.RESULTS:After administration of balofloxacin 100 mg and 200 mg,the Cmax were(0.970?0.245)?g?mL-1 and(1.849?0.466)?g?mL-1;the tmax were(1.25?1.10)h and(1.24?0.81)h;the t1/2 were(7.14?1.01)h and(7.11?0.72)h;the AUC0～36 were(7.309?1.368)?g?h?mL-1 and(15.214?1.727)?g?h?mL-1;AUC0～∞ were(7.531?1.386)?g?h?mL-1 and(15.695?1.762)?g?h?mL-1;the accumulative eliminating rates within 36 h in urine were(64.47?11.56)% and(63.24?11.93)%,respectively.CONCLUSION:The pharmacokinetics of balofloxacin in healthy volunteer after oral administration was characterized by high peak concentration and long half life.The method is sensitive,accurate,reliable and specific,and can satisfy the requirements for pharmaceutical study.

OBJECTIVE:To compare the curative effect of domestic cefoperazone/sulbactam and imported one for lower respiratory infection. METHODS:The curative effects of domestice vs. imported cefoperazone/sulbactam in 201 vs. 198 patients with lower respiratory infection in recent two years in our hospital were analyzed retrospectively. RESULTS:The effective rate was 61.6% for imported product and 51.7% for domestic product. Significant difference was noted between 2 groups statistically(P

Objectives To analyze the deployment of medical equipment and its impacts on medical services of hospitals.Methods Existing data collection,a survey of public hospitals and a chart review of acute myocardial infarction(AMI)inpatients were used to collect related data.Gini coefficients,Chi-square and multivariate model were used to analyze deployment of medical equipment and its impacts on medical services.Results The number of CTs and that of CTs per million population in Pudong new area were higher than those of MRIs and DSAs,and the distribution of CTs among districts in Shanghai was relatively equal(Gini coefficient was 0.20).But lack of DSAs in some public general hospitals had affected the AMI inpatient care.Conclusions Public hospitals and governments in China should keep at a balance the demand of medical services,deployment level of medical equipment,and financial affordability for the society,governments and hospitals.

Background:Helicobacter pylori(Hp)is an important pathogen for peptic ulcer and gastric cancer,and is reportedly associated with a variety of extragastrointestinal diseases. However,there is no body fluid detection technique for Hp infection in clinical practice. Aims:To identify Hp infection-associated differentially expressed proteins in urine with relative molecular mass more than 10 kDa and provide potential biomarkers for diagnosis of Hp infection through body fluid detection. Methods:Midstream urine was collected from volunteers in the morning,and 13 C-urea breath test was performed to determine Hp infection. Each of 15 Hp-negative and 15 Hp-positive urine samples were mixed respectively for protein extraction. Spectra data were acquired by high performance liquid chromatogram-mass spectrometry,and label-free technology was used for relative quantitative analysis. The other 26 urine samples(15 Hp-negative and 11 Hp-positive) were used for validation by full scan. IPA software was employed for bioinformatics analysis. Results:A total of 475 urinary proteins were detected by label-free quantitative analysis and 42 differentially expressed proteins were identified. Finally,11 significantly up-regulated differentially expressed proteins were confirmed by external scanning validation. Bioinformatics analysis revealed the molecular functions,biological pathways,and related diseases of these differentially expressed proteins. Conclusions:These 11 differentially expressed proteins more than 10 kDa identified in urine might be potential biomarkers for diagnosis of Hp infection and provide molecular evidence for the correlation of Hp infection with extragastrointestinal diseases.

Objective To observe the change rules of expressions of IL-1β, IL-4, IFN-γ and TGF-β1 in serum and colon tissue in rats with ulcerative colitis of spleen-kidney yang deficiency type; To explore the action in the progress of ulcerative colitis of spleen-kidney yang deficiency type.MethodsComposite method was used to establish rat models with ulcerative colitis of spleen-kidney yang deficiency type. 75 Wistar rats were randomly divided into blank group, model 3 d group, model 7 d group and model 21 d group. ELISA was used to test the levels of IL-1β, IL-4, IFN-γ and TGF-β1 in serum and colon tissue.Results Compared with the blank group, contents of IL-1β and IFN-γ in model group increased significantly (P<0.05,P<0.01), and the contents of IL-4 and TGF-β1 content decreased (P<0.05,P<0.01),especially in the model 7 d group (P<0.01).ConclusionThe pro-inflammatory factor IL-1β, IFN-γ and anti-inflammatory factor IL-4 and TGF-β1 play an important role in rats with ulcerative colitis of spleen-kidney yang deficiency type.

A new dynamic in vitro intestinal absorption model for screening and evaluating lipid formulations was established by means of the characteristics of the intestinal digestion and absorption of the lipid formulations. This model was composed of two systems, including intestinal digestion and the intestinal tissue culture, which drew the evaluation method of intestinal absorption into the in vitro lipolysis model. The influence of several important model parameters such as Ca2+, D-glucose, K+ on the two systems of this model has been investigated. The results showed that increasing of Ca2+ concentration could be significantly conductive to intestinal digestion. The increasing of D-glucose concentration could stepped significantly down the decay of the intestinal activity. K+ was able to maintain intestinal activity, but the influence of different concentration levels on the decay of the intestinal activity was of no significant difference. Thus the model parameters were set up as follows: Ca2+ for 10 mmol x L(-1), D-glucose for 15 mmol x L(-1) and K+ for 5.5 mmol x L(-1). Type I lipid formulation was evaluated with this model, and there was a significant correlation between the absorption curve in vitro and absorption curve in vivo of rats (r = 0.995 6, P < 0.01). These results demonstrated that this model can be an attractive and great potential method for the screening, evaluating and predicting of the lipid formulations.

This paper report the development of a new dosage form - self-microemulsifying mouth dissolving films, which can improve the oral bioavailability of water insoluble drugs and have good compliance. A three factor, three-level Box-Behnken design was used for optimizing formulation, investigated the effect of amounts of microcrystalline cellulose, low-substituted hydroxypropyl cellulose and hypromellose on the weight, disintegration time, cumulative release of indomethacin after 2 min, microemulsified particle size and stretchability. Optimized self-microemulsifying mouth dissolving films could fast disintegrate in (17.09 +/- 0.72) s; obtain microemulsified particle size at (28.81 +/- 3.26) nm; and release in vitro at 2 min to (66.18 +/- 1.94)%. Self-microemulsifying mouth dissolving films with broad application prospects have good compliance, strong tensile and can be released rapidly in the mouth through fast self-microemulsifying.