BACKGROUND: Clinical studies have discovered heart rate variability (HRV) is closely correlated with autonomic nervous system, sub-health and sudden death. Medical studies have summarized some chaotic medical science and homeostasis relevance theory. But so far the combination could still not systematically explain the clinical manifestation or summarize the diagnostic standards for sub-health and effective index to prevent sudden death. OBJECTIVE: To elucidate the correlation among autonomic nervous system, sub-health and sudden death by using chaotic medicine and homeostasis, so as to provide theoretical basis for evaluating sub-healthy state using HRV and preventing sudden death HRV. RETRIEVAL STRATEGY: A computer-based online search of Pubmed was undertaken to identify the articles published in English between January 1995 and June 2007 with the keywords of "chaotic medicine, heart rate variability (HRV), Sudden death, Sub-health, homeostasis". Meanwhile, the Weblog and CNKI database were searched for relevant articles dated from January 1995 and June 2007 with the same keywords in Chinese. Fifty-six papers were searched. After the first trial, only articles ①closely correlated with chaotic medical science, sudden death and sub-health, and ②published recently or in authority magazine in same field were selected. Repetitive studies were excluded. LITERATURE EVALUATION: The review articles, basic and clinical experiments about chaotic medical science, HRV, sudden death, sub-health, and homeostasis as well as articles published in related weblogs were selected. DATA SYNTHESIS: ①In any individual composed of multi-cells and multi-system, there are at least three-level chaotic system: overall chaotic system, cardiovascular chaotic system maintaining the blood pressure and cell chaotic system. Healthy state is that the three chaotic systems are in normal condition. Disease and sub-healthy state is the sub-stable state of chaotic system caused by the overstress of central nervous system, overexcitation of autonomic nerves and HRV decrease when there is some cell or cardiovascular system malfunction, and the information is feedback to central nervous system. ②Based on the theory about chaotic medicine and homeostasis, there are four states in individual chaotic motion: health, disease, sub-health, and homeostasis border before sudden death. The health is the homeostasis of body; disease and sub-health are the sub-homeostasis and may develop from healthy state because various factors; they may transform each other and both of them may lead to sudden death for unsteady. ③The extreme tension of central nervous system and over-excitation of autonomic nerves result in the destabilizing overall chaotic motion. Stimulation induces system destabilizing and sudden death because the patient cannot maintain arterial blood pressure. CONCLUSION: Long-term healthy state is unpredictable, but we can forecast 1-2 days situations by short-term HRV testing for 512 times in the early morning of every day, and judge the healthy state after sleep, and the change tendency of healthy state. Accordingly, we could predict person is in healthy state, sub-healthy state or unsteady border state that could cause sudden death.

Objective To investigate the influence of left ventricular-arterial coupling(VAC) on clinical prognosis of elderly patients with septic shock.Methods A total of 56 elderly septic shoek patients were enrolled in this study,all of whom were admitted to Department of Intensive Care Unit in Zhejiang Hospital from August 2014 to October 2015.The patients were divided into two groups according to the status of left ventricular-arterial coupling when septic shock was diagnosed,which were left ventricular-arterial uncoupling group(UC group) and left ventricular-arterial coupling group(C group).Various parameters were recorded,including blood lactate level,central venous oxygen saturation(ScvO2),serum level of N-terminal pro-brain natriuretic peptide(NT-proBNP) and cardiac troponin Ⅰ (cTN Ⅰ),dose of vasoactive drugs,the total fluid volume and urine volume per hour within 24 hours.The 28-day survival rate was a key index of prognosis.Multivariate logistic regression was taken to analyze risk factors related to death within 28 day.Results Compared with C group,UC group had lower values of left ventricular ejection fraction[(42.43 ±4.76)％ vs (53.17±3.01)％;P＜0.01] and cardiac index[(2.36±0.68) L· min-1 · m 2vs (2.93±0.45)L · min-1 · m-2;P ＜0.01].Yet serum levels of NT-proBNP[lg NT-proBNP 3.93 ±0.53 vs 3.40 ±0.63;P =0.004] and cTN Ⅰ [lg cTN Ⅰ-0.16 ± 0.68 vs-1.03 ± 0.69;P ＜ 0.001] in UC group were higher than those in C group.Moreover,the total fluid volume within 24 hours [(3 806.3 ± 831.4) ml vs (3 142.0±770.0) ml;P =0.016],blood lactate level[(5.61 ±2.68) mmol/L vs (3.93 ± 1.59)mmol/L;P =0.043] and dose of norepinephrine[(0.630 ±0.300) μg · kg-1 · min-1 vs (0.292 ±0.234)μg · kg-1 · min-1;P =0.001] in UC group were greater than those in C group,while ScvO2 [(60.75 ±2.91)％ vs (64.42 ±2.19)％;P＜0.001] and urine volume per hour[(0.518 ±0.358) ml vs (0.926 ±0.678) ml;P =0.007] were less than those in C group.Compared with C group,UC group had a lower 28-day survival rate [43.2％ (19/44) vs 9/12;P =0.049].Ea/Ees ratio was negatively correlated with LVEF,ScvO2 (r =-0.686,P ＜ 0.001;r =-0.411,P =0.002),positively correlated with NT-proBNP,cTN Ⅰ (r =0.294,P =0.028;r =0.363,P =0.006),yet no obvious correlation was noticed with blood lactate level (r =0.170,P =0.21).Multiple logistic regression analysis showed that VAC(OR =11.187,95％ CI 2.489-50.285;P =0.002),lactate level (OR =1.727,95 ％ CI 1.164-2.563;P =0.007) and lg cTN Ⅰ (OR =0.247,95 ％ CI 0.079-0.779;P =0.017) were independent risk factors affecting 28-day mortality.Conclutions In elderly patients with septic shock,left ventricular-arterial uncoupling indicates a lower 28-day survival rate,worse cardiac function and tissue perfusion.Ea/Ees ratio might sever as a predictive indicator of 28-day mortality.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.

Objective It analyzes the equity of pharmacists'allocation in China's healthcare organizations from 2012 to 2021,in order to provide reference for improving the service accessibility of pharmacists.Methods Based on the degree of agglomeration,analyzing the current situation and changing trend of pharmacists'allocation in healthcare organizations among different areas and provinces.Results The current allocation of pharmacists in China's healthcare organizations has not met the requirements.The situation in the eastern economically developed areas is better than that in other areas of the country either by geography or by population.While the western areas are large and sparsely populated,so the accessibility of pharmacist service is poor based on geographical allocation,but the equity is good based on population allocation.In the central area,the accessibility of pharmacist service is better when the allocation is based on geographical,but the equity is worse when the allocation is based on population.Conclusion China should further enrich the team of pharmacists in healthcare organizations to promote the coordinated development of different provinces.Furthermore,it also helps to promote the equity of pharmacists'allocation in China's healthcare organizations.