The division of specialists and general practitioners is the important of the establishment of a GP system. According to the theory of labor division, the study analyzes the evolution mechanism on the division of spe-cialists and general practitioners and discusses the main factors influencing the division in China. It is found that transaction costs of general practices are not much lower than that of specialist medical care, which encourages outpa-tients to visit specialists in hospitals. Additionally, transaction costs of referral are much higher than profits. There-fore, while there is no division of specialists and general practitioners, it has been difficult to address competition between them and the quality and the efficiency of general practice care in community health centers. Moreover, the income gap does not attract medical students to work in general practices, which has worsened the quality and effi-ciency of general practices. Finally, the transaction costs of general practices have continually increased. This vicious cycle has hindered the division of specialists and general practitioners in China.

Treatment of CIN2～3 includes cervical ablation,cervical local excision and hysterectomy,while cervical local excision is the standard procedure for CIN2～3.The recurrence rate was 0.7%～21% after surgery treatment of CIN2～3;The high risk factors of recurring are positive margin,serious lesion and age over 40.The follow-up items for postoperation involve cytology,colposcopy,ECC and HPV testing;If there were 2 LSIL or 1 HSIL for cytology,the patients should be given colposcopy examination and ECC.Retreatment must be clinically individual one.It is the same significance for follow-up and treatment of CIN2～3.

OBJECTIVE:To develop a new way for the extration and determination of naringin in Davallia mariesii. METH-ODS:Naringin in D. mariesii was extracted by ASE350 accelerated solvent extraction system;HPLC was performed for the con-tent determination of naringin in D. mariesii,the column was Kinetex XB-C18 with mobile phase of methanol-5%acetic acid(25∶75, V/V)at a flow rate of 0.8 ml/min,detection wavelength was 283 nm,column temperature was 40℃,and injection volume was 10 μl. RESULTS:The linear range of naringin was 0.073 0-0.730 0 μg(r=0.999 9);the limit of quantitation was 0.73 μg,the limit of detection was 0.022 μ g;RSDs of precision, stability and reproducibility tests were lower than 2% ;recovery was 98.92%-100.85%(RSD=0.72%,n=6). CONCLUSIONS:The method is simple,accurate and specific,and can be used for the content determination of naringin in D. Mariesii.

Our understanding of the immunological mechanisms of rejection has greatly improved over the past 10 years. The allografts have maintained long survival without immunosuppressive treatment in the several organ-transplant recipients combined with hematopoietic stem cell transplantation. The authors attributed the successful outcome to the cotransplantation of donor stem cells. The review will analyze firstly conditions of the recipients, and then review the theoretical basis and history regarding donor-specific tolerance of allograft, and it will also clarify that there is no direct link between the donor-specific transplantation tolerance and hematopoietic stem cell transplantation.

Objective To study the effect improvation of lung function and prognosis of singulair and seretide for moderate to severe AECOPD . Methods 78 patients associated with moderate to severe AECOPD from January 2014 to June 2016 in our hospital were researched.They were divided randomly into observation and control groups according to the order of admission, 39 cases in each group.In the control group, they were treated by conventional anti-infective, expectorant, oxygen, suction seretide.In the observation group, using singulair on the basis of the control group.Clinical data, clinical efficacy, clinical symptoms begin to improve time, hospitalization time, blood gas analysis (PaO2, PaCO2) after five days and pulmonary function after treatment forced expiratory volume in one second ( FEV1 ) , call gas peak velocity ( PEF) , forced expiratory volume in one second than the forced vital capacity (FEV1/FVC), maximum mid-expiratory flow rate (MMEF) were compared with each other.Results Their clinical data of patients and other general information and basic condition had no significant difference between each other.The effective rate of observation group and control group were 97.44%and 87.18%, clinical effecicy of observation group was better than the control group, the difference was statistically significant (u=2.2805, P<0.05).Postoperative hospital stay, time of symptoms began to improve of the observation group were shorter than the control group, the difference was statistically significant (P<0.05), PaO2 of 5-day post-treatment of observation group was higher, and PaCO2 was lower, the difference was statistically significant (P<0.05).Lung function of two groups of patients had no significant difference before treatment, after treatment, pulmonary function in the observation group (including FEV1, PEF, FEV1/FVC, MMEF) was better than the control group, the difference was statistically significant (P<0.05).Conclusion Seretide combined with singulair to treat severe AECOPD has a good effect, it can significantly improve the therapeutic effect and improve the patient's lung function.

Child ; Coronary Aneurysm ; diagnostic imaging ; physiopathology ; Coronary Thrombosis ; diagnostic imaging ; physiopathology ; Coronary Vessels ; diagnostic imaging ; physiopathology ; Female ; Humans ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnosis ; diagnostic imaging ; physiopathology ; Ultrasonography, Doppler

Objective To investigate the therapeutical effect and mechanism of tiotropium bromide in patients with stable phase midrange and severe chronic obstructive pulmonary disease (COPD). Methods Seventy-eight patients with stable phase midrange and severe COPD were selected, and they were divided into observation group (40 cases) and control group (38 cases) according to treatment method. All patients were given conventional treatment. The patients in observation group were given tiotropium bromide, and the patients in control group were given terbutaline according to the needs for 12 weeks. The changes of dyspnea, 6 min walking distance, pulmonary function, leukotrienes C4 (LTC4), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-ɑ) before and after treatment, and drug adverse reaction were observed. Results The dyspnea score after treatment in observation group was significantly lower than that in control group:(2.9±0.5) scores vs. (3.5±0.7) scores, 6 min walking distance in observation group was significantly longer than that in control group: (427.67±70.36) m vs. (365.41±61.42) m, forced expired volume in 1 second (FEV1) and FEV1/forced vital capacity in observation group were significantly higher than those in control group:(1.76±0.89) L vs. (1.29±0.53) L and (67.43±9.52)%vs. (56.32±8.51)%, LTC4, IL-8 and TNF-αlevels in observation group were significantly lower than those in control group: (397.41± 198.57)μg/L vs. (1 181.95±207.54)μg/L, (434.81±176.05) ng/L vs. (823.37±165.43) ng/L and (0.15±0.02) ng/L vs. (0.25 ±0.02) ng/L, there were significant differences ( P<0.01). Pearson correlation analysis result showed that serum LTC4 level was negatively related to FEV 1 (r=-0.578, P=0.024);and the serum IL-8 level was negatively related to FEV1 (r=-0.542, P=0.019). There was no obvious drug adverse reaction in the two groups. Conclusions Tiotropium bromide can significantly improve the clinical manifestations in patients with COPD. Tiotropium bromide may take effects by blocking various inflammatory factors release in the stable phase of COPD.

0.05),but the ratio of fPSA/tPSA in PC group was very lower than that in BPH group(P20.0 ?g/L,the sensitivity and the specificity was 91.6%(22/24) and 87.5%(21/24).Conclusion It can improve the differential diagnosis between PC and BPH to use the ratio of fPSA/tPSA combining with the serum tPSA.It is important for the observation of the differential diagnosis and the therapeutic effects of PC and the preparation of the high risk persons and etc.

OBJECTIVE:To establish a method for the simultaneous determination of chloramphenicol and dexamethasone sodium phosphate in ear drops by HPLC METHODS:Chloramphenicol and dexamethasone sodium phosphate were separated with a mobile phase of methanol-phosphate buffer solution(0 34% KH2PO4 solution)(60∶40,v/v,1 0ml/min)on Kromasil C8 column and detected at 240nm RESULTS:Good linearity appeared in the concentration of chloramphenicol 100～500?g/ml,r=0 9 999,the recovery was 98 5%～100 8%,RSD≤1 5%;and good linearity showed in the concentration of dexamethasone sodium phosphate 16～80?g/ml,r=0 9 990,the recovery was 98 8%～100 6%,RSD≤2 0% CONCLUSION:This method can simultaneously detect both ingredients in the ear drops

The skeletal muscle relaxing effects of gentamicin (Gen) and amikacin (Amk) were investigated and compared with tubocu-rarine (Tub) in rat phrenic nerve-muscle preparation, conscious chicken and mouse. The potency of the neuro-muscular blocking action of Gen was two times that of Amk. The blocking effect of Gen was observed as an 'all or none' phenomenon with a bigger S value compared with Tub. The drug concentrations were decreased by pumping drug free perfusate into or-gan baths to simulate an elimination rate constant fixed at 0. 1/min. To plot effects against declined concentrations there was a clockwise hysteresis loop with Tub, but a counter-clockwise hystereksis loop presented by Gen. The mode of the skeletal muscle relaxing effect of Gen and Amk was classified as non-depolarization like Tub.