Since the China's new healthcare reform has launched , beneficial policies introduced by the central and local governments has promoted the rapid development of private hospitals .This paper taking Sichuan Province as an ex-ample analyzes the development of private hospitals from four points of view:hospital amount, scale, location and services package, using 2002—2014 hospital-level data, which provides decision support for formulating and improving relative pol-icies.As per the analysis of the data at hand , it has been confirmed that private sector has developed quickly during the 13 years, with the number of hospitals increasing by 19.2%annually.Private hospitals were mainly of small-scale.Although the proportion of services provided by privates sector has grown yearly , it was merely 14.5%in 2014.The hospital location that the private sector selected concentrated mainly in developed regions , but the proportion of private hospital in the un-derdeveloped region has risen steadily .In terms of types of service provided , there were certain differences between private and public sector.Compared to the public sector, the private sector provided a higher proportion of specialized medical services, concentrating on otolaryngology , cosmetic plastic surgery , cardiovascular services , etc.

BACKGROUND:Tripterygium wilfordi and its certain monomers have exact clinical effects on rheumatoid arthritis. However, there are few studies about a systematic discussion on pharmacodynamic material basis and molecular mechanism of Tripterygium wilfordi. OBJECTIVE:To explore the pharmacodynamic material basis and molecular mechanism ofTripterygium wilfordi in treating rheumatoid arthritis. METHODS: Based on the platform of Discovery Studio 4.0, the molecular set of Tripterygium wilfordiwas built and compared with the rheumatoid arthritis drug set from Therapeutic Target Database in chemical space. After that, network pharmacology was used to explore the interactions ofTripterygium wilfordi and therapeutic targets related to rheumatoid arthritis. RESULTS AND CONCLUSION:The molecular sets ofTripterygium wilfordi and drugs for treating rheumatoid arthritis had similar chemical space. The pharmacodynamic material basis ofTripterygium wilfordi had 46 compounds, such as celacinnine, epigalocatechin, euonine, triptolide. They could mediate inflammation, regulate immune response, inhibit cartilage and bone destruction, improve blood stasis-type rheumatoid arthritis by acting on 10 targets, such as tumor necrosis factor-α, JAK-1, matrix metaloproteinase-1, matrix metaloproteinase-3, matrix metaloproteinase-9. Computer simulation could intuitively trace out the multi-ingredient, multi-target and multi-pathway effects of Tripterygium wilfordi.

Objective To investigate the correlation between the CD40 gene( - 1 C/T)single nucleotide polymorphism(SNP) and acute coronary syndromes(ACS), and the expression of CD40 on platelets. Method A total of 562 patients with ACS canfirmed by coronary angiography were divided into 3 groups according to the clinical characteristics, namely ACS patients( n = 210), stable angina(SA) patients( n = 189) and control group( n = 163).ACS was defined as ischemic chest pain at rest resulting in admission to hospital and > 50% stenosis in a major coronary artery with or without a rise in troponin Ⅰ. SA was defined as stable effort-related angina without change in angina pattern in 3 months. Patients with infection, tumor, or liver or kidney disease were excluded The gene polymorphism was measured by the polymerase chain reaction and restriction fragment length polymorphism(PCR-RFIP) and identiffed by sequencing. The expression of CD40 on platelets was detected by flow cytometry. The frequency, distribution of genotypes was compared using cross-tabulation and standard X~2 test. Result The CC genotype(31% ) and C allele of frequency(57.9%)of CD40 gene in ACS patients were significantly higher than those in SA(15.9%, 43.1% ) and control groups( 16.1%, 42.6% ). No significant difference of the genotypes or allele frequencies was found between SA and control group(X~2 = 0.053, P = 0.974;X~2 = 0.017, P = 0.897). 1he expression of CD40 on platelets in patients with C alleles carries was significandy higher than that of T allele carries in each group( P <0.0001). Conclusions CD40- 1C/T polymorphism was associated with ACS in Chinese Han nationallity.

ObjectiveTo analyze the literature characteristics on essential hypertension treated by external therapy of traditional Chinese medicine, summarize the current research situation and trend in the field, and to provide a reference for relative researches.MethodsThe papers relevant to treatingessential hypertension with external therapy of TCM included inSinoMedwere statistically analyzed from the aspects of publishing year, journals distribution,author’s unit and districtdistribution,research funds and literature content with bibliometrics method.ResultsThe total number of the literature for analyzing was 226, the number of papers increased gradually.Authors of the papers were mainly from TCM universities or colleges.Papersdistributedmainly in the more economically developed regions,which issued the largest amountinGuangdongprovince.Papers supported by research funds accounted for 16.81% in all the literature. Most literaturewasclinical research and the most commonly used for external therapywasacupuncture.ConclusionThe research and clinical work of essential hypertension treatment with external therapy of traditional Chinese medicinewerepaid more close attention in recent years, but therewerestill some problems that need to be solvedto form a viable, effective treatment system.

Objective To evaluated the effect of the regional cooperative rescue model implemented on the length of time from first medical contact (FMC) to balloon dilation (B),economic expense and prognosis in patients with acute coronary syndrome (ACS).Methods Patients with ACS (including ST-segment elevation and non-ST-segment elevation) selected from other hospitals within 24 hours after onset were treated with emergency percutaneous coronary intervention.Patients were divided into two groups, regional cooperative rescue group and control group without the regional cooperative rescue model approved.The lengths of FMC-to-B time and Door-to-B time (from arrival at emergency department or OPD to balloon dilation),time required for patients referred to our hospital,cardiac function,averaged hospital costs,average hospital stay,percentage of medication used and a major adverse cardiac event (MACE) were analyzed.Results Mean FMC-to-B time,Door-to-B time,referral time and time consumed to obtain informed consent were significantly shorter [(106±33) min,(31 ±8) min,(62 ±18,8 ±3) min] vs.[(231 ±35) min,(109 ±26) min,(98 ±31) min,(28 ±11) min,respectively] by implementing the regional cooperative rescue compared with control group,and LVEF was increased,and LVED was deceased inregional cooperative rescue group.The mean costs [(44 123.0 ±3 427.0) yuan vs.(51 587.0 ±5 621.0)] yuan,days of hospital stay [(8.7 ±4.1) vs.(13.2 ±6.4)] and percentage of medication used were significantly decreased in the regional cooperative rescue group.The incidence of MACE inregional cooperative rescue group was 6.2％,whereas the incidence in control group was 16.8％.Conclusions The regional cooperative rescue model can improve the prognosis and decrease the FMC-to-B time,the rate of MACE and financial burden in patients with ACS.

Objective To understand the current situation of adversity quotient (AQ) of senior nursing students,then to provide reference for nursing educators to conduct AQ education and improve the comprehensive quality of nursing students.Methods 474 senior nursing students in Fuzhou were investigated with the Lusi Scale.Results AQ of senior nursing students was (67.84±5.62),the five dimensions were between 50 and 89.Gender,education qualifications,grades and academic performance had a significant impact on AQ of nursing students,among which gender and grade had certain prediction effect for nursing students' AQ.Conclusions AQ level needs of senior nursing students need to be further improved; Nursing educators should take targeted interventions and personalized measures to enhance the ability of anti-frustration,lay the foundation for better adaptation of clinical care.

Objective To analyze the relationship among the general self-efficacy,self-esteem and professional identification of nursing baccalaureate students and to provide some suggestions for educational practice. Methods A total of 403 nursing baccalaureate students in traditional Chinese medicine colleges were recruited. They were investigated with general self-efficacy scale (GSES), Rosenberg self-esteem scale(SES)and questionnaire for baccalaureate nursing students (QBNS). The relationship among general self-efficacy,self-esteem and professional identification was analyzed by multiple stepwise regression analysis. Results The mean score of general self-efficacy was 23.81± 5.27. There were significant differences in the score of general self-efficacy among different grades and enrollment methods (P<0.01). The nursing students,general self-efficacy was positively correlated with self-esteem,professional identification,professional emotion and professional skills(r=0.11-0.50, P<0.05). Conclusions Nursing educator should pay attention to the cultivation of self-esteem and professional identity in the training of nursing student in order to improve the self-efficacy of nursing students.

Objective: To investigate knowledge, attitudes, and practice on exercise and dietary behaviors among the primary and middle school pupils in Shandong province, and to provide a theoretical basis for a targeted education on diet and physical health among the primary and middle school students. Methods: A questionnaire survey was conducted among 6 161 students from 3 cities in Shandong province by random cluster sampling. Results: Self-reported rate of having breakfast every day for primary and middle school students were 85.0% and 75.3% ,respectively(χ2=84.0，P<0.01). 41.2% of primary school students were reported to do physical exercises more than 60 minutes every day and the rate was only 29.6% for middle school students(χ2=270.0，P<0.01). 39.2% of boys were reported to do physical exercises more than 60 minutes every day and the rate was 28.7% for the girls(χ2=90.4，P<0.01). The awareness rates of knowledge about dietary and physical exercise among primary and middle school students were 44.4% and 55.8%, respectively(χ2=702.0，P<0.01). The awareness rates among boys and girls were 50.4% and 51.9% respectively (χ2=12.4，P<0.01). Parents’ occupation, knowledge score and education level of mother were influencing factors of breakfast behavior everyday. The physical exercise was influenced by gender, parents' occupation, knowledge score and education level of mother. Conclusion It is necessary to educate students to take healthy diet and have more physia1 activities. Families, schools and government departments need to take feasible measures to ensure the time and intensity of pupils’ physical exercise through many ways.

Objective: To investigate the feasibility and efficacy of the establishment of regional cooperative acute ST-segment elevation myocardial infarction (STEMI) rescue network among the prefectural-level city hospitals in China. Methods: Based on real-time remote electrocardiogram transmission and "120" emergency systems, we established a regional collaborative STEMI treatment network with our hospital as the network unclears including 8 second-class affiliated hospitals of Jiangsu University in 2013. STEMI treatment time, therapeutic effects and economic indexes were compared before (from January 2010 to December 2012, 180 cases, pre-network) and after (From January 2013 to December 2015, 374 cases, post-network) the establishment of the regional collaborative STEMI treatment network. Results: Post establishment of the rescue network, mean first medical contact (FMC) to balloon (FMC-to-B) time, referral time and obtaining informed consent time were all significantly decreased from (191±41), (94±18), (25±9) minutes to (93±19), (53±18), (7±5) minutes, respectively, in comparison with the pre-network era(all P<0.05). There was a trend of prolonged FMC-to-B time in proportion to aging of STEMI patients(trend P<0.05). Three months post discharge, LVEF was higher (55.3%±10.7% vs. 48.8%±12.1%, P<0.05) and LVEDd was lower ((49.1±10.8)mm vs.(51.8±9.2)mm, P<0.05) in the post-network group compared to pre-network group.In-hospital mortality was also significantly reduced post the establishment of the rescue network (2.14%(8/374) vs. 3.89%(7/180), P<0.05). The results also showed that the total costs (42 017(25 069, 75 148)yuan vs.51 030(28 137, 105 861)yuan), days of hospitalization ((9.1±4.5) days vs. (15.3±4.8)days) and percentage of medicine and consumables were all significantly decreased in the post-network group compared to pre-network group(all P<0.05). Conclusion Establishment of the regional cooperative rescue network is feasible among the prefectural-level city hospitals in China. Establishment of such network can improve the prognosis and decrease the FMC-to-B time, the rate of in-hospital mortality and financial burden of patients with STEMI, and serves as an effective strategy to improve the rescue ability for STEMI patients.

Objective: To investigate the associations between smoking and literacy on health among 4-6 grade primary school students. Methods: A questionnaire survey was conducted to research on health literacy and smoking among 4-6 grade pupils in Shandong province, through a multi-stage stratified cluster random sampling method. Sociodemographic characteristics, health literacy level and smoking rate were collected from respondents. Binary logistic regression analysis was used to evaluate the association of smoking and health literacy. Results: A total of 9 240 questionnaires were distributed, with the rate of valid response as 99.7%. The current smoking rate of the students was 2.6%, on higher in boys (3.1%) than in girls (2.0%). 60.8% of 4-6 grade students were found to have adequate health literacy level. Levels of literacy health in both boy and girl school students appeared 56.7% and 64.9%, respectively. Results indicated that health literacy in smokers (14.4%) was lower than that in non-smokers (62.0%). Results from the binary logistic regression analysis showed that the independent influencing factors would include grade, father’s education level, economic situation of the family, self-assessment on the school record and literacy on health (P<0.01). After controlling the other independent variables, the smoking rate was 8.62 (1/0.116) times in students with low literacy level on health, than those with high literacy level. Conclusions Literacy on health was significantly associated with smoking in the 4-6 grade pupils of Shandong province.