The strong administrative system of Chinese public hospitals seriously affects the hospital reputa-tion evaluation .This paper is to discusses the practical significance of the construction of third -party reputation eval-uation system for public hospitals and put forward the tentative idea based on the present reputation management of do -mestic and overseas hospitals .

Objective To investigate the mortality and cause of death in inpatients with cerebral infarction. Methods The clinical data of 515 patients with cerebral infarction as the underlying cause of death from January 2005 to December 2009 were analyzed retrospectively. The hospital mortality, direct cause of death,and constituent ratio of the cause of death were calculated. The clinical features,such as classification of the Trial of Org 10 172 in acute stroke treatment( TOAST),age and duration of hospital-ization were analyzed. Results ( 1 )The hospital mortalities in patients with cerebral infarction from 2005 to 2009 were 2. 0%(91/4 659),2. 1%(110/5 264),1. 9%(95/5 035),1. 2%(100/8 656),and 1. 0%(119/11 640),respectively. The overall mortality rate was 1. 5%(515/35 254),basically had a declining trend year by year(χ2 =42. 39;P<0. 01).(2)The mortalities of the inpatients with cerebral infarction in the young( <45 years),middle-aged(45 to 59 years),elderly(60 to 74 years),and aged ( >74 years)groups were 1. 1%( 22/2 009 ),1. 0%( 112/11 158 ),1. 5%( 221/14 311 ),and 2. 1%(160/7 776),respectively. They increased with increasing age(P<0. 01).(3)The TOAST classification in 515 died patients were as follows:57. 3%(n=295)for large-artery atherosclerosis,19. 4%(n=100) for cardioembolism,14. 4%(n=74)for cryptogenic stroke,7. 0%(n=36)for small-artery occlusion and 1. 9%(n=10)for other reasons. The five leading direct cause of death were cerebral hernia 49. 3%(n=254),primary central respiratory and circulatory failure 25.0%(n=129),pneumonia 8. 9%(n =46), cerebral-cardiac syndrome 5. 8%( n =30 ),and multiple organ failure 5. 6%( n =29 ).( 4 ) The mean age of death was 67 ± 12 years old. The patients who died of cerebral hernia and primary central respiratory and circulatory failure were younger than those who died of pneumonia(65 ± 13,68 ± 11,and 75 ± 10,respectively;all P<0. 01). The median length of hospital stay was 3 days. The length of hospital stay in patients who died of hernia,primary central respiratory and circulatory failure,and cerebral-cardiac syndrome were significantly shorter than those who died of pneumonia and multiple organ failure( the median length of hospital stay was 3. 0,3. 0,3. 0,12. 5,and 9. 0 days,respectively;all P <0. 05). Conclusions The mortality of hospitalized patients with cerebral infarction have a declining trend year by year. Brain disease itself is the most important reason of early death for patients with cerebral infarction, indicating that it is the important point of prevention and treatment in clinical work.

OBJECTIVETo observe and evaluate the clinical effect of acupuncture at "Siguan" combined with the Gallbladder Meridian acupoints on migraine.

METHODSWith randomized controlled trial design, 87 patients were randomly divided into an observation group (42 cases) and a control group (45 cases). The observation group was treated with acupuncture at "Siguan" including Hegu (LI 4) and Taichong (LR 3), combined with the Gallbladder Meridian acupoints including Fengchi (GB 20), Shuaigu (GB 8), Qiuxu (GB 40) and Zulinqi (GB 41), while the control group was treated with acupuncture at the Gallbladder Meridian acupoints, including Fengchi (GB 20), Shuaigu (GB 8), Qiuxu (GB 40), Zulinqi (GB 41), Yanglingquan (GB 34) and Hanyan (GB 4). The treatment was given every other day in two groups, 3 times per week for totally 6 weeks. The migraine intensity, migraine frequency and lasting time of each migraine were observed before and after treatment, and 3-month follow-up was performed after treatment. The clinical efficacy in two groups was evaluated.

RESULTSCompared with those before treatment, the migraine intensity, frequency and lasting time were all reduced significantly after treatment in the two groups (all P<0.01), which were more obvious in the observation group (all P<0.05). At the end of the treatment, the total effective rate was 95.2% (40/42) in the observation group and 80.0% (36/45) in the control group, which had statistical difference (P<0.05). After 3-month follow-up, the total effective rate was 88.1% (37/42) in the observation group and 75.6% (34/45) in the control group, which had no statistical difference (P>0.05).

CONCLUSIONThe "Siguan" combined with the Gallbladder Meridian acupoints could significantly relieve the migraine intensity, frequency and lasting time, and its improvement of symptoms and short-term efficacy are superior to those of the Gallbladder Meridian acupoints alone.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Female ; Gallbladder ; physiopathology ; Humans ; Male ; Meridians ; Middle Aged ; Migraine Disorders ; physiopathology ; therapy ; Young Adult

Objective To investigate the chemical constituents of Polygala fallax.Methods The chemical constituents were isolated and purified via silica gel and Sephadex LH-20 column chromatography as well as recrystallization.Their structures were determined on the basis of spectral analysis and physicochemical properties.Results Six compounds were isolated and identified as 3-O?-D-glucopyranosyl senegenic acid(Ⅰ),tenuifolin(Ⅱ),presenegenin(Ⅲ),1,7-dimethoxy-2,3-methylenedioxy xanthone(Ⅳ),sinapinic acid(Ⅴ),ferulic acid(Ⅵ).Conclusion Compounds Ⅲ—Ⅵ are isolated from P.fallax for the first time.Compound Ⅰ is a new triterpenoid saponin,named fallaxsaponin A.

OBJECTIVE: To establish an HPLC method to determine the dissolutions of felodipine and metoprolol tartrate in compound felodipine controlled release tablets. METHODS: An HPLC method was established with Agilent Eclipse C18 column (4.6 mm×250 mm, 5 μm).A mixture of 0.3% SDS (pH adjusted to 2.5 with phosphoric acid)-acetonitrile-methanol V:V:V(40:50:10) was used as the mobile phase. The column temperature was 25°C. The flow rate was 1 mL·min-1 and the detection wavelength was set at 233 nm. RESULTS: The relative retention time of felodipine and metoprolol tartrate was 6.20 and 8.45 min respectively. The linear ranges of these two drugs were 1-24 μg·mL-1 (r=0.9999) and 10-240 μg·mL-1 (r=0.9999). The average recoveries of felodipine and metoprolol tartrate were 99.99% and 99.91% respectively. The RSDs of this method were all less than 2%. CONCLUSION: The established method is sensitive, accurate and reliable for determination of the dissolutions of felodipine and metoprolol tartrate in compound felodipine controlled release tablets.

Objective To explore the role of a new apoptosis related gene TFAR 19 in the pathogenesis of systemic lupus erythematosus (SLE) and the relationship between TFAR 19 and SLE.Methods ELISA was used to test if there is relation between TFAR 19 and SLE.Results It was found that in active SLE patients there was higher titer of TFAR 19 antibody than that in stability patients and normal controls.No significant difference was seen between stability patients and normal controls.Conclusion It is first put forward that TFAR 19 may be related with SLE pathogenesis and disease activity.

Objective To investigate the expressions of receptor for advanced glycation endproducts (RAGE) and nuclear factor κB(NF-κB) in brain hippocampus of rat with chronic fluorosis,and to reveal the mechanism of brain damage resulted from chronic fluorosis.Methods Sixty clean grade SD rats were randomly divided to three groups(20 rats in each group,10 female and 10 male) fed with different contents of fluoride,control group with normal tap-water(＜ 0.5 mg/L fluoride),small dosage of fluoride exposure group(10 mg/L fluoride in tap-water) and large dosage of fluoride exposure group(50 mg/L fluoride) for six months.Then the rats were killed by femoral artery bleeding and hippocampus was removed.Protein and mRNA levels of RAGE and NF-κB in the hippocampus were determined by Western blotting and quantitative real time PCR,respectively.Results As compared to the control groups[(100.00 ± 2.60)％,(100.00 ± 7.80)％],the expressions of RAGE and NF-κB at protein level in the hippocampus were significantly increased in the small dosage of fluoride exposure groups [(205.00 ± 15.30)％,(156.00 ± 12.20)％] and the large dosage of fluoride exposure groups[(232.00 ± 10.90)％,(162.00 ± 9.80)％,all P ＜ 0.05]; for the mRNA level of RAGE and NF-κB,the expressions were higher in the small dosage of fluoride exposure groups(1.27 ± 0.09,0.83 ± 0.15) and the large dosage of fluoride exposure groups (2.60 ± 0.19,1.27 ± 0.19) than those of the control groups(0.66 ± 0.18,0.32 ± 0.08,all P＜ 0.05).Conclusions The increased expressions of RAGE and NF-κB in the hippocampus of rat brain are caused by chronic fluorosis,and these changes may be associated with the mechanism of nerve injury.

Objective Aim of the study is to investigate the expression of syndecan-4 and nuclear factor κB(NF-κB) in the kidney of rat with chronic fluorosis,and to reveal the mechanism of kidney damage resulted from the toxicity of excessive amount of fluoride.Methods According to body mass and sex,sixty SD rats were randomly divided to three groups according to body mass and fed with different contents of fluoride:control group with normal tap-water(＜ 0.5 mg/L fluoride),small dosage of fluoride exposure group (adding 10 mg/L fluoride in tap-water) and large dosage of fluoride exposure group (50 mg/L fluoride) for six months.The protein level of syndecan-4 and NF-κB in the kidney was detected by Western blotting and syndecan-4 mRNA level by quantitative real time PCR.Results As compared to the control group[(100.0 + 8.1)％],the expression of syndecan-4 at protein level in the kidney of rat was significantly increased in the small dosage of fluoride exposure group [(198.5 + 5.6)％,P ＜ 0.05] and large dosage of fluoride exposure group [(209.2 + 13.0)％,P ＜ 0.05]; the protein levels of NF-κB in the small dosage of fluoride exposure group[(284.4 + 11.1)％,P ＜ 0.05] and in the large dosage of fluoride exposure group[(343.2 + 2.9)％,P ＜ 0.05] were significantly increased than that of the control group[(100.0 ± 10.7)％].The mRNA levels of syndecan-4 in the kidney in the small dosage of fluoride exposure group and large dosage of fluoride exposure group(0.431 + 0.058 and 0.453 ± 0.065,both P ＜ 0.05,respectively) were significantly increased than that of the control(0.128 + 0.026).Conclusions The increased expression of NF-κB in the kidney is induced by increased expression of syndecan-4,which may be involved in kidney damage of chronic fluorosis.

Objective To study the influence of breast-feeding on the common neonatal comorbidities of very low birth weight (ELBW) infants.Method A retrospective study was conducted in our hospital from July 2014 to September 2015.The ELBW infants with birth weight between 1 000 g and 1 500 g were enrolled into the study.The infants were assigned into three groups according to human milk intake during hospitalization:high-volume breast feeding group (the high-volume group) (human milk equal to or greater than 75％),small-volume breast feeding group (the small-volume group) (human milk less than 75％) and premature formula group (the formula group) (exclusive formula fed during hospitalization).The general status,weight gain,the incidences of gastrointestinal dysfunction,neonatal necrotizing enterocolitis (NEC),late onset sepsis,premature retinopathy (ROP),bronchopulmonary dysplasia (BPD) and periventricular leukomalacia (PVL) during hospitalization were compared between the three groups.Logistic regression analysis was applied.Result A total of 210 cases were included in the study.32 cases in the high-volume group,73 cases in the small-volume group and 105 in the formula group.The incidence of NEC (Bell's stage Ⅱ and Ⅲ) in the high-volume group was significantly lower than the small-volume group and the formula group (6.3％ vs.24.7％,26.7％) (P ＜ 0.05).No statistical differences existed as for the incidences of gastrointestinal dysfunction,sepsis,ROP,BPD,and PVL (P ＞0.05).Logistic regression analysis showed that the odds ratio (OR) of survival without NEC in the highvolume group were 0.183 compared with the formula group and 0.204 compared with the small-volume group;and the 95％ confidence interval were 0.041 ～0.818,0.044 ～ 0.938 respectively.No statistically significant differences existed among the three groups in the growth rate of body weight,the time needed to regain birth weight,the time needed to reach total enteral nutrition and the length of hospital stay (P ＞0.05).Conclusion High-volume breast milk intake can reduce the incidence of NEC (Bell's stage Ⅱ and Ⅲ).Breast-feeding has little adverse effects on common comorbidities of ELBW infants.Enhanced breastfeeding has similar efficacy comparing with formula feeding in the catch-up growth.

Abstract LRR-RLKs plays an important role in multiple signal transduction in plant.One full-length cDNA encoding a LRR-RLKs homologue was isolated from maize through in silico cloning and named as ZmLRRPK1(GenBank accession:EU873320).The predicted ZmLRRPK1 protein has 594 amino acids with an estimated molecular mass of 66kDa and an isoelectric point of 5.42.ZmLRRPK1 has the typical domain of LRR-RLKs.RT-PCR analysis indicated that ZmLRRPK1 expression was induced by ABA,mannitol and salt in coleoptiles of maize and kept high level during 24 hours.