Objective:To study the status quo of National Essential Medicine System ( NEMS) in village clinics of a province in western China. Methods:Individual in-depth interview was carried out with village doctors and their managers of a province in western China, to understand the subsidies of zero-markup rate, compensations for general medical fees, and status quo of NEMS assessment mechanism and its impacts on prescribing behavior of village doc-tors. Results:In the surveyed area, the intervention of NEMS has not achieved the desired objectives: the prescri-bing behavior of village doctors has not changed significantly;general medical fee system has failed to achieve reason-able compensations;and the assessment mechanism done by village doctor managers has been a mere formality. Con-clusions and Suggestions:To ensure the feasibility, effectiveness and sustainability of the intervention, the area poli-cymakers should take into full consideration the special nature of village doctors.

Objective: To explore the effect of resveratrol (Res) on angiogenesis of human umbilical vein endothelial cells (HUVEC) with the possible mechanisms in vitro.
Methods: The HUVECs were cultured in 6 groups.①Control group, HUVEC were cultured with high glucose in DMEM,②Res group, the cell were cultured with Res at different concentrations,③Res with PI3K blocker LY294002 (Res+Blocker 1) group, ④Blocker 1 group, HUVEC were cultured with LY294002 alone, ⑤Res with eNOS blocker L-NAME (Res +Blocker 2) group and ⑥Blocker 2 group. The effect of Res on HUVEC proliferation was detected by CCK-8 kit, the protein expressions of p-Akt, p-eNOS were examined by Westin blot analysis, nitric oxide (NO) level was measured by nitrate reduction method and the endothelial cell migration was assayed by transwell chamber method.
Results: ① Compared with Control group, HUVEC proliferation increased in Res (1, 5μmol/L ) group, P<0.01, the proliferation in Res (5μmol/L) group was higher than those in Res (0.2, 10, 20μmol/L) group, P<0.01, while Res (20 μmol/L) group could inhibit the proliferation P<0.01. ②Compared with Control group, Res (5μmol/L) group had the higher protein expressions of p-Akt, p-eNOS, P<0.05-0.01, higher NO level, P<0.05.③Compared with Res group, Res+Blocker 1 group had lower expressions of p-Akt, p-eNOS, P<0.01, lower NO, P<0.05; the expressions of p-Akt, p-eNOS and NO level were similar between Res+Blocker 1 group and Blocker 1 group, all P>0.05.④Compared with Control group, the cell migration and tubing formation were higher in Res (5μmol/L) group, P<0.01;compared with Res group, the cell migration and tubing formation were lower in Res+Block2 group, P<0.01.
Conclusion: Res could up-regulate NO level via activating PI3-K/Akt/eNOS signaling and therefore, improving the proliferation, migration and tubing formation of HUVEC in vitro.

Objective To analyze the clinical features of adult patients with acute intestinal obstruction secondary to Meckel's diverticulum and the experience in management of the disease.Methods The clinical data and pathological features of 9 patients with acute intestinal obstruction secondary to Meckel' s diverticulum were retrospectively analyzed. Results All patients were diagnosed with acute intestinal obstruction secondary to Meckel's diverticulum via abdominal cavity exploration and underwent surgical treatment. Before surgical treatment, 1 out of 9 patients was correctly diagnosed as acute intestinal obstruction secondary to Meckel's diverticulum, and the other 8patients were diagnosed as acute intestinal obstruction. Diverticulum was resected in 5 cases and the rest 4 cases received partial excision of small intestine including the diverticulum. Pathological examination showed that all patients had inflammatory changes in diverticulum. Some patients were complicated with mucosal erosion, small ulcers, bleeding or perforation. Forty-four percent (4/9) of diverticula contained ectopic tissue. All patients were cured. Conclusion Meckel's diverticulum is a rare cause of acute intestinal obstruction and preoperative diagnosis is difficult. Diverticulum,howere,is likelihood to develop strangulation or contains ectopic tissue, so that the surgical treatment should be performed early.

Objective To investigate the degradation characteristics of the large-scale brain functional networks during aging by functional magnetic resonance imaging measurement and explore its intrinsic mechanism.Methods 40 healthy subjects including 20 elderly persons [mean aged(72.4 ±4.6)years] and 18 young persons [mean aged(23.9± 1.8) years] were enrolled in this study.All subjects underwent functional MRI scanning at blood oxygenation level-dependent contrast resting state.Four canonical resting-state networks,including the default mode network (DMN),dorsal attention network (DAN),executive control network (ECN),salience network,and visual network,were extracted by the seed zone and double regression methods.The functional connectivities in these canonical networks were compared between the young and elderly persons.Results Compared with young persons,the elderly showed the distinct and disruptive alterations in the large-scale aging-related resting brain networks.The impairment of ECN was the most serious,followed by the impairment of DAN.The salience networks and DMN showed relatively limited functional connectivity disruption.The networks associated to higher-order brain functions were impaired,while the visual network,which served as a network related to low-order brain functions,had no significant change.Conclusions The aged brain in healthy subjects is characterized by organized change in networks,and the selective impairments of large-scale brain networks were more significant in the networks associated to higher-order brain functions as compared with the networks related to low-order brain functions.

ObjectiveTo observe the 2-8 years' follow-up results of percutaneous laser disc decompression(PLDD) on cervical spondylotic radiculopathy,and to identify factors affecting the outcome of PLDD.MethodsEighty-seven patients with cervical spondylotic radiculopathy were treated consecutively by PLDD in our hospital from December 2002 to June 2009,who were followed up for 2-8 years.There were 32males and 26 females,with the mean age of 51.8 years (range,26-74).The results were evaluated according to the Japanese Orthopedic Association's score of cervical spondylotic radiculopathy(JOA 20 score) and numeric rating scales (NRS) after surgery.Two years after the operation,the excellent and good rate of JOA score of patients with different genders,ages and duration of each subgroup will be compared.ResultsThe excellent and good rate were 37.9％,51.7％,65.5％,81.0％,82.8％,80.9％,72.4％ and 72.7％ at 1,3,6months and 1,2,4,6,8 years after operation respectively.Significant difference was found between the time points of 6 months to eight years after operation and that of one month after operation.The NRS score of the pain symptoms at the final follow-up was significantly reduced(P＜0.05).The excellent and good rate of patients whose course of disease (93.3％) was less than 18 months was significantly higher than that of those whose course of disease was over than 18 months(71.4％) two years after operation (P＜0.05).Conclusion The intermediate-term curative effect of PLDD for the treatment of cervical spondylotic radiculopathy is reliable and stable,and the postoperative curative effect may be influenced by patients' duration of disease.

Talents constitute core resource in the development of healthcare sector. Based on the situation of the talent team in the Affiliated Hospital of Qingdao University, the authors systematically constructed the hierarchical and classified system for talent cultivation, centering on three key areas of talent cultivation, evaluation and assessment. The authors analyzed the achievements since the implementation in 2016, namely the innovation of talent evaluation, the construction of discipline echelon, and the communication and inter-departmental cooperation. At the same time, the authors further put forward targeted suggestions to promote the development of talent teams in terms of transforming the human resource management model, increasing policy support and funding, implementing refined management, and improving talent evaluation indicators by the levels and types.

Objective To establish a five-color flow cytometric immunophenotyping protocol and valuate its clinical application in leukemia and lymphoma. Methods Samples from 73 cases of acute leukemia and 30 cases of lymphoma were analyzed using a comprehensive antibody panel with five-color combination. The antibody combination CD7/CD33/CD19/CD13/CD45 and MPO/cCD79a/cCD3/CD117/CD45,composed of different lineage distinctive and lineage sensitive markers of B, T and myeloid cells, were applied to determine the lineage originality of leukemia and lymphoma celia. The markers used in the second step analysis were based on the findings of the first step. Results Five-color compensation can be performed automatically and easily with the advanced digital compensation program. The results showed that the expression ratio of CD19 in B-ALL was 100% (27/27), cCD79, pesitivity was 92.6% (25/27) and CD7,cCD3 was expressed in all T-ALL cases (8/8). The B-ALL could be staged depending on the expression level of CD34 ,CD10 ,cμ,sIgM and the T-ALL could be dearly staged dependent on the expression level of CD2,CD1a,,CD4,CD4,CD8. The expression ratio of cMPO, CD117 was 89. 5% (34/38) and 81.6% (31/38) in AML respectively, however CD7 was also expressed in 26.3% (10/38) of AML cases. Combined with morphology, immanophenotypes could be used for diagnosing AML with subtyping. The CD19/SSC gating can be used for immunophenotyping of B cell lymphoma with differential diagnosis. The number of robes required was significantly reduced with our panel from 12 tubes of 3-color to 6 tubes of 5-color. Implementation of the five-color protocol had resulted in 20% reduction in reagent costs. Conclusions The application of fivecolor staining protocol significantly improve the sensitivity and accuracy of measurement of immunophenotypes of acute leukemia and lymphoma. It reduces the cost and can be widely applied in the clinical laboratory diagnosis.

Objective: To study the expression of hepatocyte growth factor(HGF) in acute pulmonary embolism, and the diagnostic value of HGF thereof. Methods: The acute autoblood pulmonary thromboembolism was used to establish rat pulmonary embolism model. There were blood plasma HGF detection group,organization HGF mRNA detection group and control group respectively. The expressions of plasma HGF and organization HGF were observed during the different periods of acute pulmonary embolism. Results:The expression of HGF was much higher in blood plasma HGF detection group than that of control group at different time points(P ＜ 0.01). The expression of HGF mRNA increased in organization HGF detection group compared with that of control group at 12 h after pulmonary embolism(P ＜ 0.01). Conclusion: The expression of HGF increased in acute pulmonary embolism, which can be used as a diagnosis indicator in acute pulmonary embolism.

OBJECTIVE:To analyze the dyeing status of cinnabar and its pieces,and provide reference for its quality clinical safetey appicaton. METHODS:TLC was used for the qualitative identification of amaranth,carmine,erythrosine,acid red 73, 808 udan and indirubin. HPLC-MS was used to detect the 808 udan :HPLC conditions were as follows,column was Acquity UPLC BEH C18 with mobile phase of cetonitrile-0.1% formic acid(70∶30,V/V)at a flow rate of 0.3 ml/min,the detection wave-length was 520 nm;MS conditions were as follows,ion source was electrospray ionization source,scanning mode was positive ion scanning with full scanning tandem mass spectrometry,nebulizer pressure was 30 psi,drying gas was nitrogen,ion spray voltage was 4 000 V,collision energy was 30 V,and the injection volume was 5 μl. The volumetric method was used for content determi-nation of HgS. RESULTS:TLC spots of amaranth,carmine,erythrosine,acid red 73,808 udan and indirubin were clear and well-separated. 4 batches of 808 udan dyeing were included in the 18 batches of samples,6 batches had non-compliance contents (including 3 batches of 808 udan dyeing). CONCLUSIONS:Dyeing-doped and other quality problems exist in the cinnabaris in markets,which should be noticed.

Objective To investigate the clinical significance of CD14+HLA-G+ monocytes in pe-ripheral blood and the soluble form of HLA-G ( sHLA-G ) in plasma among patients with gastric cancer ( GC) . Methods Blood samples were collected from 135 patients with gastric cancer ( GC group) , 150 pa-tients with chronic gastritis ( CG group) and 80 healthy controls ( HC group) . Flow cytometry analysis and ELISA were used to detect the percentages of CD14+HLA-G+ monocytes in peripheral blood samples, the concentrations of sHLA-G in plasma samples and the levels of alpha fetoprotein (AFP), cacino-embryonic antigen ( CEA) , CA19-9 and CA125 in serum samples. Mann-Whitney U test was performed to analyze the differences between different groups. The feasibility of using CD14+HLA-G+ monocytes, sHLA-G, AFP, CEA, CA19-9 and CA125 as potential biomarkers to differentiate patients with GC from those with CG or healthy subjects was assessed by using receiver operating characteristic ( ROC ) curve analysis. Results The median percentages of CD14+HLA-G+ monocytes in subjects from GC, CG and HC groups were 18. 6% (12. 1%-26. 7%), 7. 3% (4. 2%-11. 0%) and 4. 6% (3. 6%-6. 3%), respectively. The percentages of CD14+HLA-G+monocytes in the peripheral blood of patients with GC were significantly higher than those in patients with CG and healthy subjects (P<0. 001). The concentrations of sHLA-G in plasma samples collected from patients with GC [(100. 6±61. 3) U/ml) were significantly higher than those in pa-tients with CG [(59.5±19. 9) U/ml) and healthy subjects [(45. 8±23. 3) U/ml] (P<0. 001). ROC curve analysis showed that in terms of GC diagnosis, the area under ROC curve ( AUC) , cutoff value, sensi-tivity and specificity for CD14+HLA-G+monocytes and sHLA-G in plasma were 0. 893 and 0. 720, 12% and 85 U/mL, 75. 8% and 50. 5%, 86. 7% and 95. 9% (P<0. 001), respectively, which indicated that CD14+HLA-G+ monocytes and sHLA-G were better than AFP, CEA, CA19-9 and CA125 in differentiating GC from CG and HC. Moreover, the multivariate logistic regression analysis revealed that the CD14+HLA-G+ monocytes, sHLA-G in plasma as well as CA19-9 and CA125 in serum were positively correlated with the risk of GC after excluding the differences caused by age and gender factors. Conclusion The levels of CD14+HLA-G+ monocytes in peripheral blood and sHLA-G in plasma increased dramatically in patients with gastric cancer, which suggested that CD14+HLA-G+monocytes and sHLA-G might be risk factors for GC and could be used as potential biomarkers for the diagnosis of GC.