Reform of the property right system in medical institutions is an important part of Chinas health reform. It is closely related to the reform of the health investment system, the operating mechanism of medical institutions, regional health planning, the structural readjustment of health services, and the health management system. For this reason, the paper offers an account of the motive, objective, major forms, place and functions of the reform of the property right system in medical institutions as well as some other issues worthy of attention.

Objective To compare distribution and antimicrobial resistance of methicillin-sensitive Staphylococcus aureus(MSSA)and methicillin-resistant Staphylococcusaureus(MRSA)in hospitalized children,and provide refer-ence for empirical use of antimicrobial agents.Methods Isolation and clinical data of Staphylococcus aureus (S. aureus)from hospitalized children in a hospital during 2011-2015 were analyzed retrospectively,distribution and antimicrobial resistance between MSSA and MRSA were compared.Results A total of 919 strains of S.aureus were isolated,632(68.77% )of which were MSSA,287(31.23%)were MRSA.65.03% of MSSA infection and 64.11% of MRSA infection were in children aged 29 day-1 year old.80.38% of MSSA and 79.09% of MRSA were isolated from sputum specimen.MSSA and MRSA were mainly distributed in department of pediatric respiratory medicine(50.73%,45.89% respectively)and department of pediatric neurology(22.98%,26.84% respectively). Resistance rates of MSSA to antimicrobial agents were<20.00% except penicillin and erythromycin;resistance rates of MRSA to penicillin,oxacillin,erythromycin,and clindamycin were all>40.00%;resistance rates of MR-SA to tetracycline,erythromycin,clindamycin,levofloxacin,ciprofloxacin,moxifloxacin,nitrofurantoin,and ri-fampin were all higher than MSSA.Conclusion MSSA is main S.aureus isolated from hospitalized children,in-fants under 1 year of age are the main population,the main distribution departments of MSSA and MRSA from re-spiratory tract specimen are similar,antimicrobial resistance of MRSA is generally higher than that of MSSA.

A series of new coumarin-based benzotriazole derivatives were successfully synthesized via a multi-step sequence of cyclization, etherification and N-alkylation, and were confirmed by 1H NMR, IR, MS spectra as well as elemental analyses. All these synthesized coumarin compounds were evaluated for in vitro antimicrobial activities against four Gram-positive bacteria, four Gram-negative bacteria and three fungi by two fold serial dilution technique. The bioactive assay showed that all these prepared coumarin benzotriazoles could inhibit the growth of the tested bacterial and fungal strains. Title compounds 11a-11e and 13a-13c were more active than chloromycin on Proteus vulgaris ATCC 6896. Coumarin benzotriazoles 11a and 11b displayed comparable antibacterial efficacy against Staphylococcus aureus ATCC 25923 and Micrococcus luteus ATCC 4698 in comparison with reference drug chloromycin. Compared to fluconazole, compounds 11a-11d displayed stronger inhibition on Aspergillus fumigatus ATCC 96918. Moreover, coumarin-based benzotriazoles in combination with antibacterial chloromycin or antifungal fluconazole, showed notable antimicrobial efficacy with less dosage and broader antimicrobial spectrum. More importantly, fluconazole-insensitive A. fumigatus and methicillin-resistant Staphylococcus aureus N 315 (MRSA) were sensitive to these combined drugs.

Coronary Artery Disease ; pathology ; Humans ; Medicine, Chinese Traditional

Objective To evaluate the validity of assessing synovitis and tenosynovitis by using musculoskeletal ultrasound scoring systems after standardized training in Chinese doctors.Methods All participants received a 30 minutes' training for the ultrasound scoring systems of synovitis and tenosynovitis.Ten static images were applied to evaluate the changes before and after training,respectively.Each parameter was assessed by a four scale semi-quantitative system recommended by outcomes measures in rheumatoid arthritis clinical trials (OMERACT).Paired t-test was used to assess the differences before and after training.Results Thirteen rheumatologists and two ultrasonographers completed the entire procedure.Significant differences were found before and after training when assessing the severity of gray-scale of synovitis (0.61± 0.30 vs 0.45±0.23;t=2.230,P＜0.05) and power Doppler of synovitis (0.57±0.26 vs 0.31±0.18;t=2.928,P＜0.05) and tenosynotis (0.56±0.15 vs 0.31±0.16;t=5.286,P＜0.05),while no significant difference was found when assessing the gray scale of tenosynovitis (t=-1.679,P＞0.05).Conclusion Standardized training is helpful to improve the validity of ultrasound scoring systems of synovitis and tenosynovitis in Chinese rheumatologists and ultrasonographers.The validity of assessing gray-scale of tenosynovits needs improvement.

Objective To compare the efficiencies of imatinib and dasatinib in patients with chronic myeloid leukemia-chronic phase (CML-CP).Methods The databases were retrieved,including Cochrane Library,OVID,Embase,PubMed,China National Knowledge Infrastructure (CNKI),WanFang database and VIP database,besides,references of articles were further to search.The quality of randomized controlled trials (RCTs) was assessed by the Cochrane collaboration' s risk tool.Meta-analysis was performed by RevMan 5.1 software.Results A total of 5 articles involved 2 031 patients with CML-CP were included.Meta-analysis showed that the rate of complete cytogenetic response (CCyR) at the 12th month in dasatinib group was higher than that in imatinib group [83.6 ％ (478/572) vs 70.6 ％ (406/575),OR =2.11,95 ％ CI 1.59-2.80,P＜ 0.05],and the rate of major molecular response (MMR) at the 12th month in dasatinib group was higher than that in imatinib group [49.3 ％ (296/600) vs 30.6 ％ (185/605),OR =2.22,95 ％ CI 1.75-2.82,P ＜ 0.05].Conclusion Dasatinib can improve CCyR and MMR rate at the 12th month in CML-CP patients.

Objective To summarize the clinical features of different racial patients with celiac disease (CD) and analyze the disease prevalence,diagnosis and treatment in Chinese population.Methods All the patients were diagnosed as CD and enrolled in Beijing United Family Hospital between January 2005 and July 2015.Clinical data including nationality,age,symptoms,endoscopic and pathological findings,outcome were collected and compared in patients from different countries.Results A total of 87 patients were enrolled including 63 Caucasians,18 Asian patients and 6 Middle East patients.The peak age of disease onset was 40-60 years old.Patients with typical symptoms such as chronic diarrhea and weight loss only accounted for 20.7％ (18/87) and 9.2％ (8/87) respectively.Some patients presented with nonspecific symptoms such as abdominal pain and bloating [32.2％ (28/87)],even constipation [5.7％ (5/87)].13.8％ (12/87) patients were previously diagnosed as irritable bowel syndrome.The incidence of abdominal pain,bloating,diarrhea and constipation between Asians and Caucasians had no statistical significance (P ＞ 0.05);but the proportions of weight loss,growth retardation,iron deficiency anemia and dermatitis herpetiformis in Asian group were significantly higher than that in Caucasian group (P ＜ 0.05).IgA type of anti-gliadin antibody (AGA),endomysium antibody (EMA) and tissue transglutaminase antibody (tTGA) were dominant autoimmune antibodies in patients with CD,which accounted for 58.6％ (51/87),44.8％ (39/87) and 36.8％ (32/87) respectively.The endoscopy showed that the lesion of CD was mainly located in small intestine,with reducing severity from the proximal to the distal small intestine.The lesions of duodenal bulb and descending duodenum appeared more significant in Asian group.Accordingly pathological intestinal atrophy and the degree of intraepithelial lymphocytosis were more severe in Asian patients.All 87 cases took the gluten-free diet (GFD).Eighty-one cases received serological follow up and 8 with endoscopic intestinal biopsy.The celiac disease antibodies in 47 patients turned negative from 6-9 months after GFD treatment,while 34 patients turned negative from 12-18 months after GFD.All patients reported disease remission to some extent.After 1 year GFD treatment,the pathology of endoscopic intestinal biopsy in 8 patients showed significant improvement of villous atrophy and lymphocyte infiltration.Conclusions CD patients with typical clinical manifestations are not the majority.Serological celiac disease antibodies (AGA,EMA and tTGA) have a high diagnostic value.GFD treatment is effective on majority of celiac patients.Clinical manifestations,endoscopy,intestinal pathology,and response to GFD in Chinese patients are not the same as Caucasians.Clinicians need to pay attention to the differential diagnosis.

AIM: To establish an HPCE method for determining the fingerprint of Compound Danshen Dropping Pill.(Radix et Rhizoma salviae miltiorrhizae,Radix et Rhizoma notoginseng,Borneolum Syntheticum) METHODS: A standard fingerprint was set up under following conditions: capillary,50 ?m (id)?50.0(eff.41.5) cm,uncoated;detector,UV 203 nm;injection,50 mbar(10 s);running voltage,20 kV;buffer,50 mmol/L sodium tetraborate and 50 mmol/L boric acid(pH 9.0,containing 30 mmol/L SDS) and acetonitrile(4∶1,v/v). RESULTS: Based on the fingerprints of 10 batches Compound Danshen Dripping Pills,an average electropherogram was used as the standard fingerprint,among which there were 14 characteristic peaks. CONCLUSION: The fingerprint analysis can be used for assessing the quality consistency of Compound Danshen Dropping Pill from batch to batch.

Objective To investigate the musculoskeletal ultrasound (MSUS) findings in Chinese knee osteoarthritis (OA) patients.Methods All the MSUS data were from the outpatients with knee OA who visited Department of Rheumatology and Clinical Immunology,Peking University First Hospital from February 2013 to August 2014.MSUS findings included number and position of osteophyte,synovitis,thickness of cartilage,and so on.Comparisons between groups were made using t test,Chi-square tests.Results Six hundreds and seventy-four patients were included.Almost all the patients (96.1％) had osteophytes,most patients had both knees osteophytes.The most common osteophyte location was femoral (85.2％),followed by tibia and the upper edge of patella.The number of osteophytes differed from none to ten,and the distribution of bilateral knee osteophytes was symmetrical in most patients.There was no significant difference in the number of osteophytes between male and female,and patients over 60 years old had more osteophytes than the patients aged 60 or below.In all bursae lesions,the suprapatellar bursa were the most commonly affected [effusion,279 (41.4％),synovial hyperplasia,189(28.0％),synovitis 24 (3.6％)].There was no significant difference in the cartilage thickness between bilateral knees.But the cartilage thickness of female patients was significantly thinner than that of men [left:(2.0±0.5) mm vs (2.5:1:0.8) mm,t=3.859,P＜0.05;right:(2.0:1:0.5) mm vs (2.5±0.8) mam,t=4.109,P＜0.05],and the patients over 60 years old had thinner cartilage than patients younger than 60 years old [left:(2.0±0.6) mm vs (2.2±0.6) mm,t=2.108,P＜0.05;right:(2.0±0.6) mm vs (2.2±0.6) mm,t=2.507,P＜ 0.05].None patient had Calcium pyrophosphate dehydrate (CPPD) deposition in the cartilage.Conclusion In the ultrasonographic findings of knee OA in China,osteophyte could be found in 96％ patients,the most common location of osteophyte is the femur area.The distribution of bilateral knee osteophytes is symmetrical in most patients.Patients over 60 years old have more osteophytes.Nearly haff patients have joint effusion,one third patients have synovial hyperplasia or synovitis.Bilateral knee cartilage degeneration is symmetrical.Women and patients over 60 years old have thinner cartilage.

To observe the effects of paeoniflorin and total flavones extracted from Qixue Bingzhi Recipe on proliferation of vascular smooth muscle cells (VSMCs) cultured in endothelial cell conditioned medium (EC-CM) induced by oxidized low-density lipoprotein (ox-LDL) and the expressions of platelet-derived growth factor and its receptor genes.