The article summarized relevant theories and successful practical experience about medical resource integration, analyzed the background of regional medical-trust in Shanghai, and discussed three different model of regional medical-trust building, and their own advantages and disadvantages. Furthermore it discussed the main framework of regional medical-trust pilot reform,including administrative and operational model, insurance-payment model and visiting-doctor model. Then, it introduced the reform strategies of regional medical-trust pilot and present progress.

OBJECTIVE:To compare the anti-inflammation,analgesia effects of decoctions extracted from Aconiti lateralis with different leaf shapes(dahua leaf,xiaohua leaf)from different producing areas(Jiangyou,Butuo). METHODS:Animals were randomly divided into blank group(distilled water),positive group,groups of Aconiti lateralis with dahua,xiaohua leaf from Ji-angyou,groups of Aconiti lateralis with dahua,xiaohua leaf from Butuo(with dose of 5 g/kg,calculated by crude drug). The an-ti-inflammation effect of decoctions extracted from Aconiti lateralis with different variety sources and leaf shapes was investigated by xylene-induced ear swelling test (n=12) in mice and egg white-induced toe swelling test (n=10) in rats (positive drug was Dexamethasone acetate tablet,0.005 g/kg). And its analgesic effect was investigated by acetic acid-induced writhing body reaction test(n=12)and hot-plate-induced pain test(n=12)in mice(positive drug was Morphine hydrochloride tablet,0.0025 g/kg). RE-SULTS:The decoctions extracted from Aconiti lateralis with dahua,xiaohua leaf from Butuo and xiaohua leaf from Jiangyou can significantly reduce the ear swelling degree(P<0.01). The decoctions extracted from Aconiti lateralis with dahua leaf from Jiangy-ou and Butuo can significantly decrease the toe swelling degree after 6 h of medication(P<0.05). And decoctions extracted from Aconiti lateralis with xiaohua leaf from Butuo can significantly reduce the number of writhing body in mice with acetic acid-in-duced pain and prolong the pain threshold of mice with hot-plate-induced pain (P<0.05 or P<0.01). CONCLUSIONS:Aconiti lateralis with dahua and xiaohua leaf from Butuo and with xiaohua leaf from Jiangyou show better anti-inflammation effect,and Aconiti lateralis with xiaohua leaf from Butuo shows better analgesic effect.

ObjectiveTo dynamically observe the effects ofJieduan Niwan Formula on mitochondrial apoptotic pathway in acute-on-chronic liver failure (ACLF) rats; To further reveal the possible mechanism ofJieduan Niwan Formula.MethodsSPF Wistar rats were randomly divided into normal group, model group andJieduan Niwan group. 13-week porcine serum injection followed withD-galactosamine and lipopolysaccharide joint acute attack was used to established ACLF model in all rats except for normal group. Rats inJieduan Niwangroup were orally givenJieduan NiwanFormula for 3 days before acute attack. Rats were sacrificed respectively at 4, 8 and 12 h after models were established. The expressions of Bid, Cytochrome C (Cyt C) and hepatocyte ultrastructure were detected by Western blot method, immunohistochemical analysis and transmission electron microscope, respectively.Results Compared with normal group, the levels of Cyt C and Bid in model group increased at 4 h and peaked at 8 h but decreased at 12 h (P<0.05); however, the levels of Cyt C and Bid inJieduan Niwan group were lower than those in model group at 4 and 8 h but higher at 12 h (P<0.05). The ultrastructures were significantly damaged in model rats, which severity was escalated through time; inJieduan Niwan group, the degree of injury decreased at each timing.ConclusionJieduan NiwanFormula can efficiently alleviate the hepatocyte damage in ACLF rats, and the mechanism might be involved in the inhibition of the mitochondrial apoptotic pathway.