Objective Discuss the function and disadvantage of mark-up on medicine which affects the economical operation of Chinese medicine hospital. Methods Analysis the advantages and disadvantages, the influence on the characteristic of Chinese medicine produced by mark-up on medicine, through the 2012Chinese medicine statistic abstract and policies. Results Mark-up on medicine occupies an important position in the economical operation of hospital, especially the Chinese medicine hospital. Conclusion Compensate policies are necessary for the cancellation of the mark-up on medicine.

Objective To observe the change of cerebral oxygen metablism and the level of blood lactate in early stage of sepsis in rats.Method Sixty-four SD rats were randomly(random number)divided into septic group and control group.The sepsis model of rat was made by lipopolysaccharide (LPS,10 mg/kg)injected intra-abdominally,and rats of control group were treated with the same amount of physiological saline instead.And each group was further divided into 4 sub-groups of4 h,6 h,12 h and 24 h after treatment.At each interval,blood samples were obtained via jugular vein for detecting blood oxygen saturation (Sjv02)and blood lactate(LA).The blood oxygen saturation(Sa02)of ventral aorta was also measured.Arteriovenous oxygen content difference (AVD02) and oxygen extraction fraction (OEF) were studied.These four variables were analyzed and compared between two groups.Results The AVD02 and OEF in sepsis group were higher than those in control groups of 3 h,6 h and 12 h (P<0.05) ,but lower than those in control group of24 hours (P<0.05).The Sjv02 in sepsis group was lower than that in control groups of 3 h,6 h and 12 h (P<0.05),but increased to that in control group of 24 h (P>0.05).LA in sepsis group was higher than that in control group in each interval (P<0.05).Conclusions In early stage of sepsis,cerebral perfusion,cerebral oxygen supply and cerebral oxygen extraction increase.The global oxygen metabolic variables(Sjv02,AVD02 and OEF)and the level of LA can be used to objectively and accurately evaluate the cerebral oxygen metabolic dysfunction in early stage of sepsis.

The service of Traditional Chinese medical institutions consists Outpatient Care and Inpatient Care. The author summarizes the service situation of Traditional Chinese medical institutions in the last six years, by contrasting and analyzing the following quotas: the total number of treatment in the emergency door, the number of discharged patients, hospital admissions per 100 outpatient emergency treatment, rate of utilization of hospital beds, the average days of staying in hospital and doctors work efficiency, and then give some reasonable suggestions.

ObjectiveTo study the present human resources of TCM hospitals in China, for decision making of TCM hospitals HR strategy in the future. Methods Collection of statistics released by the Ministry of Health and the State Administration of Traditional Chinese Medicine from 2005 to 2009, for analysis of the general structure and trends of hospital staff at large, headcount and makeup of medical personnel, and the structure and trends of TCM professionals in TCM hospitals. Results In 2009, there were 2,728 TCM hospitals, employing 518, 5000 staff, including 427, 900 medical personnel, accounting for 82.52％ of the total; TCM practitioners account for 45. 61％ of clinicians in TCM hospitals;a shortage of nursesisfoundin TCM hospitals as comparedto general hospitals. ConclusionIt is imperative to revise the staff quota standard of TCM hospitals, and to increase the number of TCM practitioners and nursing staff in TCM hospitals.

Objective:To investigate the protective effect of fasudil on the striated muscle in rats with acute organophosphorus pesticides poisoning(AOPP).Methods:The AOPP model was established by peritoneal injection of dichlorvos (DDVP).Rats were randomly divided into control group(n=8),poisoned group(n=8)and pretreated group(n=8).All rats in the 3 groups were supported with breathing machine connected with the tube from incision of trachea.The control group was peritoneally in-jected 0.9% sodium chloride solution (0.4 mL).The poisoned group and the pretreated group were peritoneally injected DDVP (30 mg/kg).The pretreated group was peritoneally injected fasudil(10 mg/kg)30 min before anesthesia.Serum level of cardiac troponin T(cTnT)was measured by using autonomic biochemical analyzer,and creatine kinase isoenzyme MM(CK-MM)and lactate dehydrogenase isoenzyme M(LDH-M)were measured by enzyme-linked immunosorbent assay(ELISA)2 h later.The expression levels of Rho-associated coiled-coil containing protein kinase I (ROCKI)mRNA of left ventricular myocardium and left gastrocnemius muscle were analyzed by reverse transcriptase polymerase chain reaction(RT-PCR).Results:Compared with the poisoning group,the striated muscle poisoning symptoms were less serious in the pretreated group.Compared with the con-trol group,the level of cTnT in the poisoning group and the pretreated group significantly increased(P <0.05).Compared with the poisoning group,the level of cTnT in the pretreated group significantly decreased(P <0.05).The levels of CK-MM and LDH-M were not obviously different among 3 groups.Compared with the control group,the expression level of ROCKI mRNA of left ventricular myocardium and left gastrocnemius muscle in the poisoning group significantly increased(P <0.05).Com-pared with the poisoning group,the expression level of ROCKI mRNA of left ventricular myocardium and left gastrocnemius muscle in the pretreated group was significantly inhibited(P <0.05).Conclusions:Fasudil can relieve symptoms of AOPP in rats.Fasudil has protective effect on the striated muscle in rats.

Objective: To analyze the clinical characteristics of X-linked inhibitor of apoptosis (XIAP) deficient patients with clinical manifestation of Crohn's disease. Methods: Clinical manifestations, laboratory investigations, genetic testing and therapeutic interventions of one case of XIAP deficiency who was admitted to Department of Gastroenterology in Children's Hospital, Zhejiang University School of Medicine in May 2016 were summarized. PubMed and Chinese database for articles published from January 2016 to June 2017 were searched using the key words of'Crohn's disease’and'XIAP’, and the relevant literature was reviewed. Results: The case we reported was a 6-year-1-month-old boy with recurrent bloody stool for 2 months, and abdominal pain with fever for 2 weeks. The patient had a past history of hemophagocytic lymphohistiocytosis (HLH) and epilepsy in the past one year. Complete blood cell count showed mild anemia (Hb108 g/L). The patient had an elevated high-sensitivity C reactive protein (86 mg/L) and erythrocyte sedimentation rate (46 mm/1h) . White blood cells, pus cells and red blood cells were found on routine stool examination. Biochemical panel showed hypoalbuminemia (25.2 g/L) , elevated transaminase (alanine aminotransferase 175 U/L, aspartate transaminase 229 U/L) , hypertriglyceridemia (4.41 mmol/L) , and hyperferritinemia (>1 650.0 μg/L) . Magnetic resonance enterography revealed the intestinal wall thickening and increased enhancement in parts of illeum and colon. Capsule endoscopy revealed multiple ulcers in jejunum. Colonoscopy showed multiple ulcers in colon and the pathological examination revealed chronic inflammation in mucosa of terminal ileum and colon, which was combined with partial necrosis and ulceration. Some phagocytes were seen in bone marrow smears. The patient was given multiple diagnoses, including hemophagocytic lymphohistiocytosis, Crohn's disease, sepsis, epilepsy, severe malnutrition, and hypoproteinemia. The pediatric Crohn's disease activity index (PCDAI) was 37.5. Genetic testing identified a hemizygotic mutation of c.910G>T chrX:123022501 p.G304X in XIAP. The parents had no such mutation. The patient showed response to infliximab with oral intake of mercaptopurine and corticosteroids, and had remission with PCDAI of 0. There were 9 relevant articles (Chinese 0 English 9), which showed 33.3% XIAP deficient patients manifested with inflammatory bowel disease(IBD), who might have other manifestations such as hemophagocytic lymphohistiocytosis or splenomegaly simultaneously or sequentially. Those patients showed poor response to monotherapy. Conclusion XIAP deficient patients have various clinical manifestations. Genetic testing is important to those male pediatric IBD patients who have the complicated symptoms or little response to standard therapy.

Diacylglycerol o-acyltransferase 1（DGAT1）is the key enzyme in fat metabolism.When DGAT1 gene who encodes this enzyme is mutated，it can affect the intracellular fat metabolism in organism with various clinical manifestations.DGAT1 gene deficiency is one of the causes of congenital diarrhea and enteropathies.The onset age in patients with DGAT1 deficiency is early.The main clinical manifestations of such patients include protein-losing enteropathy，malnutrition and other nutritional disorders.There is no specific drug for such disease so far.Early identification of DGAT1 deficiency and nutritional therapy in early infancy can treat this disease effectively and improve the prognosis.

ObjectiveTo investigate the cognition of e-cigarette compositions and hazards and its influencing factors among secondary school personnel （junior， senior and vocational high school） in Shanghai， so as to provide ideas for improving the cognition level of e-cigarettes among the school personnel and tobacco control efforts on campus in the future. MethodsA multi-stage stratified cluster random sampling method was used to conduct an anonymous online questionnaire survey among 1 767 secondary school personnel in Shanghai. ResultsThe proportion of school staff who had used e-cigarettes was 3.79%. The participants who were not sure whether the e-cigarette smoke was “mainly water vapor （incorrect）” and whether the e-cigarette smoke “contained nicotine （correct）” and “contained formaldehyde （correct）” accounted for 62.71%， 54.44% and 61.91%， respectively. Among them， 68.48%， 55.46% and 50.37%， respectively， agreed that e-cigarettes would be “addictive”， “harmful” and “that second-hand smoke was harmful”. Binary logistic regression analysis showed the following risk factors for the low level of school personnel’s awareness of e-cigarette compositions： age ≥40 years （OR=1.65， 95%CI： 1.32‒2.06）， working in junior high school （OR=1.37， 95%CI： 1.09‒1.73）， educational attainment level as junior college or below （OR=1.67， 95%CI： 1.02‒2.74）， and not having participated in tobacco control education activities （OR=1.37， 95%CI： 1.08‒1.73）. Meanwhile， working in junior （OR=1.43， 95%CI： 1.12‒1.83） or senior （OR=1.44， 95%CI： 1.08‒1.92） high school， educational attainment level as junior college or below（OR=2.10， 95%CI： 1.24‒3.56）， having used e-cigarettes （OR=2.98， 95%CI： 1.63‒5.42）， not having participated in tobacco control education activities （OR=1.49， 95%CI： 1.16‒1.92） and low level of awareness of e-cigarette compositions （OR=4.24， 95%CI： 3.44‒5.23） were risk factors for the low level of school personnel’s awareness of e-cigarette hazards. ConclusionsThe level of e-cigarette awareness among school personnel in Shanghai is low， especially those who are older， had low educational attainment level and had used e-cigarettes. In the future， tobacco control education for school personnel should be strengthened to improve their cognition and ability of tobacco control on campus.

Iron is an essential element for living organisms that plays critical roles in the process of bacterial growth and metabolism. However, it remains to be elucidated whether piuB encoding iron-uptake factor is involved in iron uptake and pathogenicity of Xanthomonas axonopodis pv. glycines (Xag). To investigate the function of piuB, we firstly generated a piuB deletion mutant (ΔpiuB) by homologous recombination. Compared with the wild-type, the piuB mutant exhibited significantly reduced growth and virulence in host soybean. The mutant displayed markedly increased siderophore secretory volume, and its sensitivity to Fe³⁺, Cu²⁺, Zn²⁺ and Mn²⁺ was significantly enhanced. Additionally, the H₂O₂ resistance, exopolysaccharide yield, biofilm formation, and cell mobility of ΔpiuB were significantly diminished compared to that of the wild-type. The addition of exogenous Fe³⁺ cannot effectively restore the above characteristics of ΔpiuB. However, expressing piuB in trans rescued the properties lost by ΔpiuB to the levels in the wild-type. Taken together, our results demonstrated that PiuB is a potential factor for Xag to assimilate Fe³⁺, and is necessary for Xag to be pathogenic in host soybean.
Iron ; Glycine max ; Virulence ; Xanthomonas axonopodis/genetics* ; Hydrogen Peroxide