Centering on the reform practice in Sanming featuring a synergistic reform in public health services,medical insurance and medicine production-circulation (Tripartite-sector reform below),this paper focused on the top-level design of the management system in such a reform and its synergistic operation mechanism.The authors probed into the main reasons for its grounding-breaking success and challenges,to pave way for their discussions on the reproducibility and sustainability of the reform.

Success of Sanming's heahhcare reform relies heavily on the government's dominant role.Based on this inspiration,the paper discussed the responsibilities expected of the government in health protection of the people as required by national strategy,public interests and market demands,and presented the corresponding responsibilities of the government in the protection,leadership,scrutiny and management for the sake of public health.In addition the paper recommended on policies to make up for the absence and dislocation of governmental responsibilities,including all-out efforts for legislations in health protection,greater government subsidy for health protection,development of a comprehensive supervision system,and establishment of entities accountable for people's health in general.

Objective:To establish the HPLC fingerprint of Centellae herba and determine the content of asiaticoside, madecassic acid and asiaticoside B simultaneously; To compare the quality differences of Centellae herba collected in different months. Methods:The chromatographic condition was a Shimadzu InertSustain C18 column (4.6 mm×250 mm, 5 μm) with a mobile phase consisting of acetonitrile and 2 mmol/L beta cyclodextrin in gradient elution at the flow rate of 0.8 ml/min. The detection wavelength was 204 nm, and the column temperature was 30 ℃. The different Centellae herba materials of collected in 2-12 months from Chenzhou were studied by the similarity evaluation combined with cluster analysis, principal component analysis and the three contents determination. Results:The HPLC fingerprint of Centellae herba was established and 9 common peaks were designated. The eleven samples were different, which can be aggregated into 4 categories and the quality of Centellae herba collected in July was the best. Conclusion:The established fingerprint and multi-components quantitative method are stable and reliable, which can provide a reference for the quality control and the utilization of Centellae herba resource.

Objective To investigate the effects of 11-ethoxyviburtinal of Valeriana jatamansi Jones on the expression of enterochromaffin cells ( EC) and mast cells ( MC) in rats with irritable bowel syndrome ( IBS) . Methods The IBS rat model was induced by chronic unpredictable stress with isolation. Male SD rats were randomly divided into six groups:control group,model group, pinaverium group at the dose of 25 mg/kg,and high-, mid-and low-dose of 11-ethoxyviburtinal group at dose of 1. 2, 0. 6, and 0. 3 mg/kg respectively. The number of 5-HT positive immunoreactive colonic EC was detected by the method of immunohistochemistry and that of colonic MC was measured with toluidine blue staining. Results Compared with control group, the number of 5-HT positive immunoreactive colonic EC and MC increased significantly in model group ( P <0 . 05 ) . The high dose of 11-ethoxyviburtinal could significantly de-crease the number of colonic EC and MC ( P<0 . 05 ) . Conclusion The 11-ethoxyviburtinal of Valeri-ana jatamansi Jones could significantly reduce the number of 5-HT positive immunoreactive 5-HT positive immunoreactive EC and MC in colon tissue of rats with IBS.

Cloning of flanking sequences of double-copy gene is a challenge in molecular biology. We developed a method to solve this problem by combining an optimized inverse PCR (iPCR) with TAIL-PCR. First, Southern blotting analysis was used to determine a proper restriction enzyme that could obtain proper-length restriction fragments that contained the target gene. Then optimized iPCR was performed to amplify the restriction fragments that contained the separated copies of the gene. Based on the obtained sequences, TAIL-PCR was performed to amplify further flanking regions of the gene. With this method, we obtained all of the EcoR I restriction fragments (2.2-5.1 kb) and Hind III restriction fragments (8.5-11.7 kb) of mitochondrial atpA gene in cytoplasmic male sterile (CMS) line and maintainer line of Upland cotton. The results showed that this method was an efficient approach to clone flanking sequences of double-copy gene.
Chromosome Walking ; Cloning, Molecular ; Gene Expression Regulation, Plant ; Genes, Mitochondrial ; Genes, Plant ; genetics ; Gossypium ; genetics ; Plant Proteins ; genetics ; metabolism ; Polymerase Chain Reaction ; methods ; Terminal Repeat Sequences

As a recognized and effective decision-making assessment tool, health technology assessment can provide scientific support for scientific decision-making such as medical devices deployment and management. This study highlighted the necessity of medical device health technology assessment by studying the development history of health technology assessment at home and abroad. On this basis, the authors pointed out the necessity of medical device health technology assessment from the perspective of laws and decrees of the country, deepening of the healthcare reform, medical insurance directory, as well as enhancement of medical quality and patient safety. Also analyzed are such problems as development of health technology assessors, system construction, and policy transformation capability.

Objective:To analyze the patterns of intercellular communication in facioscapulohumeral muscular dystrophy (FSHD) by single-cell nuclear transcriptome sequencing.Methods:Bilateral asymmetrical lesions mouth orbicular muscle of two patients with FSHD and mouth orbicular muscle of two healthy patients were selected. Six samples were obtained, and were divided into control group, mild group and severe group. The normal orbicularis muscle sample was collected from 2 healthy individuals (the control group). The muscle samples in the mild group were from two patients with relatively normal muscle sides, and the samples in the severe group were from two patients with more severe muscle damage sides. Single-cell nuclear transcriptome sequencing was performed on all cells of the three groups. Reduced dimension clustering and cell definition were performed to identify differentially expressed genes and enrichment pathways. Intercellular communication patterns among major cell types and key signaling pathways were explored by cellular communication analysis.Results:Differential gene expression analysis of FSHD bilateral muscle samples identified 46 functionally differentially expressed genes associated with the disease in different cell types, related to apoptosis, oxidative stress, immune inflammation, and muscle function. Intercellular communication was generally increased in the severe group. Fibro-adipogenic progenitors (FAPs) and macrophages are important signaling sources in the abnormal muscle microenvironment of FSHD and are closely associated with disease progression. There are six unique signaling pathways in the mild group, including bone morphogenetic proteins (BMP), transforming growth factor-β (TGF-β), CXC motif chemokine ligand (CXCL), adhesion G protein-coupled receptor E5 (ADGRE5), interleukin-16 (IL-16), and wingless-type MMTV integration site family (WNT) signaling pathways. These signaling pathways are mainly involved in the interaction between macrophages, FAPs, and adipocytes and may be involved in the regulation of fat deposition and fibrosis changes in the diseased muscle.Conclusions:Single-cell nuclear transcriptome sequencing provides a relatively comprehensive pattern of intercellular communication between key cell types in FSHD, providing an appropriate reference for understanding the intercellular regulatory mechanisms of the FSHD muscle microenvironment.

Critical care medicine is the last line of defense for people′s lives and health, and it is necessary to attach great importance to the development of critical care medicine and the construction of treatment capabilities. This study analyzed the development effect of critical care medicine and critical care capacity in China, analyzed the shortcomings of the current shortage of talent and treatment capacity reserves in the field of critical care medicine, combed the experience of foreign countries in attaching importance to the reserve of critical care resources, the mechanism of combining peacetime and wartime, and the construction of critical care database. Targeted suggestions were proposed to strengthen development planning, optimize investment mechanism, improve talent cultivation and growth, and build critical care database, so as to provide reference for promoting the development of critical care medicine and improving the ability of critical care in China.

Improving the construction of new mechanisms for the operation of public hospitals is an important task in promoting the comprehensive reform of public hospitals and the construction of modern hospital management systems.It analyzes the background of constructing new operational mechanisms based on policy evolution,histori-cal evolution,and practical needs,and analyzes the problems of imbalanced management resource allocation struc-ture,one-sided pursuit of economic benefits,low input-output efficiency,and low personnel enthusiasm in hospital operation.It proposes to grasp the key path and main measures to improve the construction of new operating mecha-nisms for public hospitals while respecting industry characteristics,adhering to government leadership,and improving market regulation.

Objective To investigate the effect of baldrinal on irritable bowel syndrome (IBS) induced by chronic-acute stress and its influences on the protein expressions of 5-hydroxyindoleacetic acid (5-HIAA) and relevant receptors of 5-hydroxytryptamine (5-HT) in rats.Methods SD rats were randomly divided into control group,model group,high-dose baldrinal group (0.6 mg/kg),mid-dose baldrinal group (0.3 mg/kg),low-dose baldrinal group (0.15 mg/kg) and pinaverium group (25 mg/kg).The rat model of IBS was established by using chronic-acute stress combined with independent feeding for observing the influence of baldrinal on the scores of abdominal withdraw reflection (AWR).The content of colonic 5-HIAA was detected by using high performance liquid chromatography (HPLC),and influences of baldrinal on protein expressions of colonic 5-HT1 A,5-HT3A and 5-HTR4 were detected by using Western blotting.Results Thc scores of AWR content of colonic 5-HIAA were decreased in high-dose baldrinal group,middose baldrinal group and low-dose baldrinal group compared with model group (P ＜ 0.05).The protein expressions of colonic 5-HT1A,5-HT3A and 5-HTR4 were regulated in high-dose baldrinal group,middose baldrinal group and low-dose baldrinal group.Conclusion Baldrinal has significant inhibitory effect on gastrointestinal hyperfunction in rat model of IBS and reduce viscera sensitivity,which indicates that baldrinal can relieve IBS symptoms.The effective mechanism may be related to the regulation effect of baldrinal on 5-HIAA contents and protein expressions of relevant receptors of 5-HT.