The drug and medical consumables management center in Wuhu features the operational mechanism separating the decision-making power of drug purchasing,the executive power and the supervision power.This practice terminates the interest chain previously found between medicine suppliers with hospitals,pharmacies and doctors,creating the Wuhu Model of drug and medical service separation at public hospitals.The drug zero-profit policy reshapes the drug supply system and the existing compensation mechanism of public hospitals,further defining the Wuhu Model.This model is paving the way for the same reform to be carried out nationwide.

The separation of drug and medical service is key to alleviating the social problem of high medical expenses,and the top thing to do is to cut off the profit link found in the drugs purchase and sales interests chain.Pharmacies of the hospital are found to play a crucial role in this chain,as they not only take part in the decision-making of drug purchase but also directly purchase and dispense drugs.Wuhu has established the Medicine and Medical Consumables Management Center,which directly regulates the pharmacies and detach them from this chain,weakening their rent-seeking power.Practices of this reform found the pharmacies no longer playing a dominant role in drug purchase/dispensation on one hand,and yet less incentives of the pharmacies due to management by the Center on the other,resulting in poorer pharmaceutical management of the hospital as a result.In this consideration,pharmacies have experienced a detachment and return process from their hospital in the reform of drug and medical service separation in Wuhu.Experiences prove the correct way out is to guide the pharmacies to upgrade from logistics in drug supply to innovated services,thus better serving hospital management.

Objective To investigate the clinical features of pregnancy complicated severe hepatitis and summarize experience in diagnosis and treatment so as to decrease maternal mortality.Methods Forty-two cases of pregnant women with severe hepatitis in the hospital were retrospectively analyzed.According to the outcome,all subjects were divided into death group(27 cased) and survival group(15 cases).Clinical data including viral markers,clinical manifestations,blood biochemistry,clinical treatment and pregnancy outcomes were recorded.Results (1) Pathogen examination showed that the major infection was hepatitis B virus (HBV),accounting for 64.29％ (27/42).(2) The first symptoms was gastrointestinal symptoms,accounting for 73.81％ (31/42).(3) The level of serum albumin,cholesterin (CH) and cholinesterase (CHE) in survival group were (29.91 ± 6.78) g/L,(2.80 ± 1.02) μmol/L and (5 399.4 ± 1 096.5) U/L respectively,significantly higher than that in death group((25.14 ± 7.36) g/L,(1.73 ± 0.77) μmol/L,(3423.6 ± 1102.7) U/L respectively).The serum creatinine(SCr) and prothrombin time (PT) levels in survival group were (83.06 ± 47.23) μ mol/L,(18.98 ± 6.72) s,lower than that in death group ((231.54 ± 58.90) μmol/L,(44.16 ± 5.38) s).The differences were statistically significant (t =2.07,3.84,5.57,8.37,13.29 ; P ＜ 0.05 or P ＜ 0.001).(4) The mortality rate of patients who chose pregnancy termination was 31.58％ (6/19),lower than the overall average mortality rate 64.29％ (27/42) and the difference was statistically significant (x2 =5.636,P =0.018).Conclusion HBV infection is the main reason for pregnant women with severe hepatitis.Gastrointestinal symptoms is the main symptom.Serum albumin,SCr,PT,serum CH and CHE can be regarded as prognostic indicators of the disease.Active comprehensive treatment and timely pregnancy termination can reduce maternal mortality.

Objective To explore the clinical effect of adenovirus dipivoxil combined with Anluohuaxian pill in the treatment of chronic hepatitis B cirrhosis .Methods 98 patients with chronic hepatitis B liver cirrhosis were randomly divided into the two groups .49 cases in the control group were treated with adenovirus dipivoxil ,and 49 ca-ses in the observation group were given adenovirus dipivoxil combined with Anluohuaxian pill .The clinical effect of two groups was observed .Results The total effective rate of the observation group was 92.9%,which was significant-ly higher than 69.4% of the control group (χ2 =9.37,P<0.05).Before treatment,the alanine aminotransferase (ALT),hyaluronic acid (HA) and albumin/globulin (A/G) between the observation group and the control group had no significant differences (t=0.213 1,1.212 2,0.403 2,all P>0.05).After treatment,the ALT,HA and A/G of the two groups were significantly improved compared with those before treatment ,the improvement of the observation group was better than control group ,the difference was statistically significant ( t=11.302 1,9.012 1,7.312 4,all P<0.05).Conclusion In clinical practice,adenovirus dipivoxil combined with Anluohuaxian pill in the treatment of patients with chronic hepatitis B cirrhosis has good therapeutic effect ,it can improve the clinical symptoms and pa-tients'liver function ,so as to improve the liver detoxification function and the clinical treatment effect ,which worthy of clinical application and promotion .

Female ; Hemangioma ; therapy ; Humans ; Infant, Newborn ; Syndrome ; Thrombocytopenia ; therapy

The cause of dilated cardiomyopthy (DCM) has not been elucidated yet .The poor prognosis and lack of specific and effective treatment became a serious health problem .Therefore to establish animal models of DCM to study the pathogenesis and treatment is necessary and urgent .At present the molding method of DCM mainly includes drug induction, immunological induction and molecular biology , etc.This article reviews the mature and commonly used establishing methods and mechanism of DCM models .

Acute Disease ; Aged, 80 and over ; Fibrin Fibrinogen Degradation Products ; analysis ; Humans ; Male ; Pulmonary Embolism

Female ; Fetal Diseases ; etiology ; Hemangioma ; complications ; Humans ; Infant, Newborn ; Splenic Rupture ; etiology ; Thrombocytopenia ; complications

The Cooperative medical system,like the insurance,has the adverse selection,this article points out the concept of adverse selection,and raises some efficient way to control the adverse selection.

β-Glucan is a kind of highly conservative composition on fungal cell wall.As a recognition receptor of β-glucan,dendriticcell-associatedC-typelectin-1 (dectin-1)widely distributeinsingle-nuclea macrophages system,dendritic cells ( DC )and neutrophil cells.Through the identification of fungal cell wall composition and cells signal transduction,dectin-1 induces the production of cytokine and chemokine and then starts a nonspecific and specific immunity response.Dectin-1 plays a key role in antifungal immune response.Here,the molecular structure,tissue cells,signal transmission and the immune inflammation role of dectin-1 in corneal infection were reviewed.