A review of the system background for the multi-institution physician practice in China,and an analysis for the specific constraints for physicians of public hospitals to embrace such a practice On this basis, the paper probed into the measures to encourage the physicians for doing so. The measures recommended include advanced design, improvement of the quality of care and safety mechanism,incentives mechanism, mandatory enforcement of medical liability insurance to minimize risk exposure of such a practice, aiming at advancement of this practice.

Aim To assess the protective role of chry-sophanol in rats with diabetes-associated cognitive de-cline (DACD) and explore the potential molecular mechanisms.Methods The learning and memory performance was assessed by Morris water maze test;the activities of AChE,ChAT,iNOS and oxidative stress markers including CAT,SOD and GSH-PX in the hippocampus were detected using respective com-mercial kits.The level of BDNF was also measured with commercial ELISA kit.Results Chrysophanol significantly improved learning and memory functions in the diabetic groups.Additionally,the activities of AChE,BDNF also found to be evidently increased, while decreased activities of ChAT,iNOS,CAT,SOD and GSH-PX were observed in the hippocampus of dia-betic rats.Conclusions Collectively,chrysophanol has a protective role against DACD and this neuropro-tection is associated with increasing BDNF level.Chry-sophanol can also suppress the activities of iNOS, CAT,SOD and GSH-PX in diabetic rats.It is likely to be a novel therapeutic drug for the treatment of diabetic patients with cognitive deficits in clinical practice.

Objective To understand the status of the HR and payroll system at county public hospitals in Guangxi,and to put forward basic path and targeted policy suggestions of the reform.Methods In June 2016,a field survey was made on the HR and payroll status of county-level public hospitals in 14 prefecture level cities in Guangxi,along with descriptive and inferential analysis.Results During 2013 to 2015 period,the total income of the sample hospitals had increased to some extent, mainly due to rise of hospitals'business revenue.The multiple of medical workers''wages, given some rise, remained stable compared to average wages of urban employees,as their monthly after-tax income ranged but 3 001-5 000 yuan in most cases.A large salary gap was found between those within the staffing plan and those beyond, and the latter has higher turnover rate.The performance appraisal system is poorly accepted by medical workers,as only 1.34%of them hold their current pay as ideal.Conclusions The reforms should prioritize the payroll system, better the performance appraisal system, upgrade the staffing plan management and innovate HR recruitment mode.These measures should constitute the reform of the HR and payroll system at county public hospitals.

OBJECTIVE：To establish the method for the con tent determination of related substances in belinstat. METHODS ： HPLC method was adopted and the principal component self-control comparison method with correction factor was used to calculate the contents of related substances. The determination was performed on ODS-AM column with 1.02％ potassium dihydrogen phosphate buffer （pH value adjusted to 3.5 with phosphoric acid ）-acetonitrile（85∶15，V/V）as mobile phase A ，1.02％ potassium dihydrogen phosphate buffer （pH value adjusted to 3.5 with phosphoric acid ）-acetonitrile（30 ∶ 70，V/V）as mobile phase B （gradient elution ），at the flow rate of 1.0 mL/min. The column temperature was set at 30 ℃，and the detection wavelength was 220 nm. The sample size was 10 μL. RESULTS：The linear ranges of belinstat and impurities A ，D，F，G，H were 0.113-1.693， 0.050-1.496，0.117-1.750，0.098-1.471，0.120-1.799，0.100-1.506 μ g/mL（r≥0.999 7）. The correction factors of the last 5 impurities were 1.0，1.0，1.2，1.5，1.0；the detection limits were 0.250，0.590，0.490，0.600，0.500 ng，respectively. The quantification limits were 0.500，1.170，0.980，1.200，1.000 ng，respectively. The recoveries were 90.18％-111.48％（RSD＝ 1.52％-4.78％，n＝9）. RSDs of stability （100 h）and precision tests were no more than 16％，and the durability was good. Impurities A ，D and H were detected in 3 batches of belinlestat ，the contents were 0.030％-0.038％，0.019％-0.022％ and 0.012％-0.013％，respectively. The contents of other maximum monomer impurities were 0.012％-0.013％ and the total impurities were 0.075％-0.084％. Impurities B ，C，F，G were not detected. CONCLUSIONS ：The method for the content determination of related substances in belinstat has been successfully established ，and the method is accurate and specific.

ObjectiveMicrotube associated protein-2 （MAP-2）， alpha-tubulin （α-tubulin）， and synaptophysin （SYP） are important proteins in neuronal signal communication. This paper observed the effects of modified Zhigancao Tang on the expression of serum α-Synuclein （α-Syn） and its oligomers， MAP-2， α-tubulin， and SYP of patients with liver and kidney deficiency of Parkinson's disease （PD）， analyzed their correlation， and evaluated the therapeutic effect of modified Zhigancao Tang in patients with liver and kidney deficiency of PD based on α-Syn transmission pathway mediated by neuronal communication in vivo. MethodsA total of 60 patients with PD who met the inclusion criteria were randomly divided into a treatment group （30 cases） and a control group （30 cases）. Both groups were treated on the basis of PD medicine， and the treatment group was treated with modified Zhigancao Tang. Both groups were treated for 12 weeks. The changes in UPDRS score， TCM syndrome score， and expression of serum α-Syn and its oligomers， MAP-2， α-tubulin， and SYP were observed before and after 12 weeks of treatment in each group. The correlation between the above-mentioned serum biological indexes and the levels of serum α-Syn and its oligomers was analyzed. ResultsAfter treatment， the TCM syndrome score， UPDRS score， UPDRS-Ⅱ score， and UPDRS-Ⅲ score of the treatment group were significantly decreased （P<0.05， P<0.01）. The UPDRS score， UPDRS-Ⅱ score， and UPDRS-Ⅲ scores in the treatment group were significantly decreased compared with those in the control group after treatment （P<0.05）. After treatment， the total effective rate of the control group was 63.3% （19/30）， and that of the treatment group was 86.7% （26/30）. The clinical effect of the observation group was better than the control group （Z=-2.03， P<0.05）. The total effective rate of the observation group was better than that of the control group， and the difference was statistically significant （χ²=5.136， P<0.05）. After treatment， the oligomer level of serum α-Syn and MAP-2 level in the treatment group were significantly decreased （P<0.05， P<0.01）. The levels of serum α-Syn and its oligomers， as well as α-tubulin in the treatment group， were significantly decreased compared with those in the control group after treatment （P<0.05， P<0.01）. Serum α-Syn was correlated with serum MAP-2 and α-Syn oligomer in patients with PD （P<0.05， P<0.01） but not correlated with serum SYP . Serum α-Syn oligomers of patients with PD were correlated with serum MAP-2 and α-tubulin （P<0.05， P<0.01） but not correlated with serum SYP level. Serum SYP of patients with PD was correlated with serum MAP-2 （P<0.05）. ConclusionModified Zhigancao Tang has a therapeutic effect on patients with liver and kidney deficiency of PD by inhibiting the production of α-Syn oligomers and intervening α-Syn microtubule transport pathway in vivo.