Objective: As the breakthrough for public hospital reform in China, County public hospital comprehensive reform has become the main part of the reform, the reasonable use of New Rural Cooperative Medical System(NCMS) would strongly push the process of new medical reform. Methods: The method of mathematical modeling was applied in policy imitate of hospital operation historical data, to estimate the increasing of decreasing status of NCMS hospital compensation expenditure after the implementation of county-level public hospital comprehensive reform measurement in 10 county-level public hospital. Results: Through analyzing the operation data of applying county-level public hospital comprehensive reform measurement in 10 county-level public hospital from 2010 to 2012, there was 66.67% annual time, the NCMS compensation expenditure for public hospitals increased to 23.075 6 million yuan, which increased by 1.691 7 yuan averagely. Conclusion: After the implementation of comprehensive reform policies, the influencing factors of NCMS funds on the decreasing degree of county-level public hospital expenditure were mainly the proportion of pre drug addition ratio and basic drug sales in the total drug sales.

Objective To evaluate the medical students' medical professionalism.Methods Totally 1200 medical college students from first grade to fourth were randomly selected to do the self-designed questionnaire of medical occupation spirit using the method of cluster sampling.Principal component analysis was applied to do data processing and analysis.Results ①Two principle components were extracted,the first principal component included the attitude on the personal contact with patient,attitude on the in-depth clinical practice aiming at improving the ability of doctor-patient communication,attitude on playing multiple roles in contacting patient and the understanding of the physician-patient relationship.The second principal component included the working attitude toward history collection,the sense of pride when be praised “proficiency” and the attitude towards difficult operations.② The scores of medical occupation spirit for medical students of first grade to four grade were:-4.4226,-0.0343,-5.1397,0.6827.The score was the highest in grade three medical students followed by grade two and grade one.Conclusion Unstable development trend was observed in medical occupation spirit among medical students and due attention should be paid.Strengthening the medical studenl occupation spirit education and training should focus on two aspects:the subjective aspect,namely active communication and exchange with patients who have subjective dynamic consciousness; the objective aspect,namely the attitude towards the grasp of professional skills.

[Objective]To search for a good way for complex total hip arthroplasty(THA) and hip reconstruction.[Method]From February 1995 to June 2007,THA was done 95 hips in 86 patients with good preoperative preparation,full evaluatibn and complete simulation the details occurring at operation.[Result]Eighty one patients were followed up from 6 months to 10 years(average 3.5 years).All patients were measured by Harris score.The preoperative Harris score in the patients ranged from 35 to 50(average 42.1).The postperative score ranged from 70 to 90(average 82.3).Leg length discrepancy ranged from 1 to 12 cm preoperative.(average 4 cm),but from 0 to 5 cm postperative(average 1.5 cm).Two with serious leg length discrepancy,one is 6 cm,the other is 12 cm,after the operation,one is 2 cm,the other is 5 cm.Two had poor incision healing,upper femur split occurred in 3,one with hip prothesis dislocate,nerve injury happened in 2 and two had venous embolism.[Conclusion]Anatomic structure in complex total hip arthroplasty changes so much that it is hard to rebuild and replace a normal hip anatomic structure.Excellent clinical outcome can be achieved with full preparation and evaluation before operation and careful management at opertation.

Objective:To compare the immediate therapeutic effect and safety between esmolol and lanatoside in con-trolling ventricular rate for patients with rapid atrial fibrillation.Methods:A total of 72 patients with rapid atrial fi-brillation (ventricular rate ≥120 beats/min)were randomly and equally divided into esmolol group and lanatoside group.Esmolol group received first dosage of 0.5 mg/kg intravenously for 1 min,then were observed for 5 min,if ventricular rate still >100 beats/min or decreased <20%,the 0.5 mg/kg esmolol was appended,meanwhile main-tained by 0.05mg·kg-1 ·min-1 via micro pump at first,maintenance dose can increase to a maximum 0.3mg· kg-1 ·min-1;lanatoside group received first dosage of 0.4mg or 0.2mg slow intravenous injection,if ventricular rate still >100 beats/min or decreased<20%,the another 0.2mg was appended.The onset time and adverse reac-tions were recorded after administration.Results:Compared with lanatoside group,there was significant reduction in mean onset time [(39.2±8.7)min vs.(5.6±3.1)min]in esmolol group,P<0.01;compared with before adminis-tration,there was significant decrease in ventricular rate in two groups after administration,P<0.05 or<0.01. On 2h af-ter administration,compared with lanatoside group,there was significant increase in decreasing range of ventricular rate (29% vs.39%)in esmolol group,P<0.05. The total effective rate and adverse reaction rate was no significant difference (P>0.05)between two groups.Conclusion:Intravenous using esmolol is efficient and safe,and it can be regarded as pre-ferred therapy to control ventricular rate in patients with rapid atrial fibrillation.

Objective: To investigate the effects of Pantoprazole on the expression of TFF1 in stress-induced gastric mucosal lesions in rats, and the mechanism thereof. Methods: Fifty-six rats were randomly divided into seven groups, normal group, model groups (3 groups) and model therapy groups (3 groups). The rat model of water immersion- restraint stress (WRS) was established in model groups, model group1(the immediately after establishing models), model group 2 (4 h after establishing models) and model group 3(8 h after establishing models). The model therapy groups were divided into model therapy group 1 (immediately after establishing models), model therapy group 2 (4 h after establishing models), and model therapy group 3 (8 h after establishing models). The ulcer index (UI) and histological changes were observed after WRS in rats. The expression of TFF1 was detected by immunohistochemistry. Results: After WRS, the gastric mucosa was widely damaged in rats. UI were increased and the expression of TFF1 was decreased in model groups. After intervention with Pantoprazole, UI was lower in model therapy group than those in model groups (model group 1 vs model therapy group 1,69.13±1.97 vs 23.38±1.30, P ＜ 0.01; model group 2 vs model therapy group 2, 57.50±8.81 vs 10.38±3.02, P ＜ 0.01; model group 3 vs model therapy group 3, 43.50±6.76 vs 5.88±1.25, P ＜ 0.01). The staining scores of TFF1 were increased (model group 1 vs model therapy group 1, 0.55±0.11 vs 0.92±O.15, P＜ 0.01; model group 2 vs model therapy group 2, 0.76±0.24 vs 1.36±0.21, P＜ 0.01; model group 3 vs model therapy group 3, 1.12±0.16 vs 1.65±0.11, P ＜ 0.01). Conclusion: TFF1 may participate in the protection of gastric mucosa and promote ulcer recovery. Pantoprazole may participate in the defense of gastric mucosa through mediating the up-regulation of TFFI expression.

Antithrombin III (AT III) is the most important anti-clotting substance. Recombinant human antithrombin III (rhAT III) expressed in transgenic goat milk attracts more and more attention. Develop an effective purification route for rhAT III is vital to its industrial production. An efficient purification method was developed for the rapid purification of rhAT III by isoelectric precipitation and heparin affinity chromatography. First, casein was effectively removed by isoelectric precipitation. rhAT III was further purified by heparin affinity chromatography. In the process of heparin affinity chromatography, the effects of pH and temperature on the stability of rhAT III were studied, and the effects of operating conditions, elution gradient, flow rate and sample loaded, on the purification efficiency were also studied. Under the optimized conditions, the protein recovery of rhAT III was about 90% with purity over 99%, while its activity recovery was about 50%. Such a purification process is very simple and effective, and it would provide a valuable reference for the further scaling-up of industrial production.
Animals ; Animals, Genetically Modified ; Antithrombin III ; biosynthesis ; Chromatography, Affinity ; Female ; Goats ; Heparin ; Humans ; Mammary Glands, Animal ; metabolism ; Milk ; chemistry ; Recombinant Proteins ; biosynthesis

Objective To study the inhibition of Cephalanoplos(Bunge) kitam extract on human liver cancer cells.Method The inhibition of Cephalanoplos(Bunge) kitam extract on human liver cancer cells was measured with MTT colorimetic method,The human liver cancer cell apoptosis was studied by transmission electron microscope and TUNEL staining.Results The inhibition was enhanced with concentration increase of Cephalanoplos(Bunge) kitam extract and time of culture.With Cephalanoplos(Bunge) kitam extract 10,20,40,80 mg/L for 24,48,72,96h,the cell apoptosis was significant by T test.Conclusion Cephalanoplos(Bunge) kitam extract can inhibit the growth of BEL-7402 cancer cells.

OBJECTIVE:To observe the therapeutic efficacy of active immunization combined with dydrogesterone in the treatment of recurrent abortion,and its effects on serum levels of leptin(LP)and adiponectin(ADPN). METHODS:Totally 103 patients with recurrent abortion from department of gyhecology,Jinan Third People's Hospital during Nov. 2015 to Nov. 2016 were selected as trial group,and then divided into trial group one(n＝51)and trial group two(n＝52)according to admission order. Other 100 normal pregnant women were taken as control group. Trial group one was given active immunization combined with dydrogesterone,including that lymphocytes from the patients'spouse were injected subcutaneously into the patient,every half a month,3 times of active immunization as a course of treatment,and was given Dydrogesterone tablet 10 mg after pregnancy,bid, until 3 months after the pregnancy. Trial group two was given Dydrogesterone tablet 10 mg,bid,until 3 months after the pregnancy. The serum levels of β-HCG,LP and ADPN were compared between trial group and control group at admission,the serum levels of β-HCG,LP,ADPN and pregnancy outcome(recurrent abortion,full-term pregnancy and successful delivery rate) was compared between 2 trial groups after treatment. RESULTS:At admission,the serum levels of β-HCG,LP and ADPN in trial group were significantly lower than control group. After treatment,the levels of β-HCG,LP and ADPN,successful delivery rate and full-term pregnancy rate in trial group one were significantly higher than trial group two, recurrent abortion rate was significantly lower than trial group two,with statistical significance(P＜0.05). No adverse reactions were observed in the study. CONCLUSIONS:The use of active immunization combined with dydrogesterone can significantly improve the serum levels of LP and ADPN as well as pregnancy outcome,with good safety.

Objective:To identify the key convergence points in the medical-nursing combined care among literature, and establish a mechanism for medical-nursing combined care integration from the perspective of the synergy theory, for the purpose of promoting the integrated development of such care in China.Methods:Relevant literature on the medical-nursing combined care were retrieved from the CNKI database from September 2013 to September 2021. The search formula used was TI= "the medical-nursing care integration" AND SU=(convergence+ transformation+ coordination+ mechanism), while supplementary searches were made using " pkulaw.com database" and Baidu Scholar database. The method of literature content analysis was used to screen key points of the medical-nursing combined care, and the convergence mechanism was built based on the perspective of the synergy theory.Results:A total of 42 literatures were included in this study, 8 key convergence points of medica-nursing combined care integration were identified. Namely the 4 key horizontal convergence points of medical care, aging care, rehabilitation and nursing, the 3 key vertical convergence points of home care, institution care and community care, and the one key convergence point of institutional medical care. Based on the synergy theory and the 8 key convergence points, the " 431" convergence mechanism of medical-nursing combined care was constructed. This mechanism refered to the horizontal linkage of healthcare, nursing, rehabilitation and aging care, the vertical redirection among home care, institution care and community care modes, and the development mode focusing on institutional aging care.Conclusions:At present, the poor convergence between aging care and nursing care in China is a key roadblock hindering the integrated development of aging and nursing care. Medical-nursing combined care should be conducive to the " 431" convergence development, achieving horizontal linkage, vertical redirection, and resource sharing, for the purpose of high-quality development of China′s aging care system.