Objective:In recent years, the medical systems has continuously explored the construction of Regional Medical Association, and promoted the classification diagnosis and treatment mode, as the reform of the medical system in our country. Through the regional information sharing, the Medical Association can realize the interconnection and information resource sharing among various medical institutions at all levels, which is for optimizing the allocation of medical resources, improving the level of medical services and alleviating the difficult and expensive medical treatment has an important significance.Methods: This paper adopted the method of literature research. Through the arrangement of the Chinese Medical Association of exploration and the progress of abroad regional medical care grade development, the paper focused on the analysis of problems in preparation and the continued operational of the Medical Association projects, such as guiding patient stratification clinics, the utilization of data in medical research, protection of the quality of medical care, integration of data and other critical medical problems. Results: The paper also presented the following recommendations to build and operate high-quality of the Medical Association, rational allocation of functions at all levels of medical institutions to guide patient stratification clinics, establish disease specialist data centers, and establish quality evaluation system to protect the quality of medical care, develop information standards and integrate medical data.Conclusion:Establishing Regional Medical Association is significantly important to optimize the distribution of medical resources, improve the levels of basic medical services and relieve the problems in the treatment.

Based on the Drugdataexpy and the prescription modern application database, this study explored the formulation regularity of ancient and modern prescriptions for the treatment of sinusitis. The Chinese medicinal prescriptions for the treatment of sinusitis with various syndromes were retrieved from the above databases and the corresponding formulation regularity was investigated by frequency analysis, association rule analysis, and factor analysis. Eighty-seven Chinese medicinal prescriptions were included, involving five syndrome types of sinusitis and 160 Chinese medicine, which were mainly effective in releasing exterior, clearing heat, and tonifying deficiency, and acted on the lung meridian due to cold and warm nature and pungent and bitter flavor or on the spleen meridian due to warm nature and pungent flavor. Seventeen core Chinese medicine were screened out by topological data analysis, including Angelicae Dahuricae Radix, Magnoliae Flos, Glycyrrhizae Radix et Rhizoma, Xanthii Fructus, and Scutellariae Radix. Chinese medicine such as Magnoliae Flos, Angelicae Dahuricae Radix, and Xanthii Fructus were commonly used in the treatment of sinusitis of wind-heat in the lung meridian, while the combination of Glycyrrhizae Radix et Rhizoma, Magnoliae Flos, Angelicae Dahuricae Radix, Chuanxiong Rhizoma, etc. was the key compatibility in treating sinusitis of dampness-heat in the spleen and stomach. Six common factors were extracted from the factor analysis of the above two syndrome types. The findings indicate that the exterior-releasing, heat-clearing, and deficiency-tonifying Chinese medicine with cold and warm nature and pungent flavor are preferential options for the clinical treatment of sinusitis. Treatment should be based on syndrome differentiation and key therapeutic principles should be followed.
Data Mining ; Medicine, Chinese Traditional ; Meridians ; Rhizome ; Sinusitis/drug therapy*

BACKGROUND:Bone marrow stromal stem cells(BMSCs)do not allow for single differentiation of chondrocytes due to their multi-directional differentiation,bone morphogenetic protein secreted from osteoblasts affect the non-differentiated precursor cells and promote their osteoblast differentiations,while those differentiated cells are bound to form tissues.OBJECTIVE:To in vitro induce canine BMSCs differentiate into chondrocytes,and to investigate the method and conditions of chondrocyte differentiation in vitro.DESIGN,TIME AND SETTING:Single sample observation was performed in the Laboratory of Tissue Engineering,Sun Yat-sen University between March 2005 and January 2006.MATERIALS:One male dog,aged 4 months,was involved to harvest BMSCs from the rib.METHODS:Rib BMSCs extracted from bone marrow of 2.0-3.0 mL were cultured in vitro. When cells reached a confluence at 8-11 days,trypsinization was conducted and then halted with L-DMEM synthesis culture solution containing 10% fetal bovine serum. Cellular suspension was collected and centrifuged,cells were rssuspended and incubated at a ratio of 1:3. The third generation of cells were cultured and amplified,10 μg/L basic fibroblast growth factor 2 mL was added to replenish culture medium twice,then 1 mg/L transforming growth factor β1 of 2 mL was applied to induce BMSCs differentiation into chondrocytes.MAIN OUTCOME MEASURES:Toluidine blue and alcian blue stains were applied to determine cartilage matdx secretion,immunohistochemistTy was used for the detection of cartilage specific Ⅱ collagen expression.RESULTS:After BMSCs were primarily cultured and subcultured in vitro,they were shown to grow well at the fourth generation,those induced by basic fibroblast growth factor and transforming growth factor β1 were positive for toluidine blue and aician blue staining;immunohistochemistry showed a positive outcome for type Ⅱ collagen,indicating the induced BMSCs exhibited chondrocyte's characteristics.CONCLUSION:Utilizing basic fibroblast growth factor and transforming growth factor β1,the induced canine BMSCs could differentiate into chondrocytes,which is considered as an ideal seed cells for cartilage tissue engineering.

Aim To establish the standards for evaluation of microcirculation in a rat hind limb ischemia model.Methods Rats were subjected to unilateral femoral artery ligation.After 4 weeks,the regional blood flow in skeletal muscles was measured by fluorescent microsphere assay.Formation of collateral vessels was determined by microangiography.Capillary density was examined by immunostaining for CD34.Results In ischemic limbs,regional blood flow decreased significantly,some collateral vessels formed with typical "corkscrew" appearance,and histological analysis showed lower capillary density.Conclusion Quantitative assessment of microcirculation in a hind limb ischemia model is established.

OBJECTIVE：To investigate the effects of pharmaceutical management intervention on the use of TCM injection in primary medical institutions. METHODS ：Twenty grass-roots health centers in Yichun city ，Jiangxi province were randomly selected. Relying on Department of Pharmacy and Health Services of the Municipal Health Committee and the Quality Control Center for Pharmacy Affairs of the City ，Yichun People ’s Hospital took the lead in establishing the prescription evaluation criteria for TCM injection ，training pharmaceutical service skills ，conducting special reviews on prescriptions/medical orders ，improving control measures ，obtaining relevant data of drug use in primary health centers by issuing questionnaires on the use of TCM injection and randomly selecting prescriptions/medical orders for comments. The relevant data without drug administration （before intervention）from Jan. to Jun. 2018 were taken as the non-intervention group ，and the relevant data with drug administration （after intervention）from Jan. to Jun. 2019 were taken as the intervention group. The use of TCM medicine injection ，DDDs，DDC and sequencing ratio were compared before and after intervention. At the same time ，the prescriptions/medical orders of TCM injections before（1 222 copies）and after （1005 copies）intervention were randomly selected for comment and the reasonable situations of the prescriptions/medical orders were compared before and after the intervention. RESULTS ：After intervention ，total amount ， consumption sum and DDDs of top 10 TCM injections in the list of amount were significantly decreased. The reasonable rate of prescriptions and medical orders was 48.04％ before intervention ， but increased to 70.65％ after intervention. Besides ， unreasonable situations before and after intervention all manifested as inappropriate indications. After the intervention ，the unreasonable rates of Xuesaitong powder for injection （lyophilized），Xueshuantong injection ，Xingnaojing injection （two specifications），Shengmai injection ，Xueshuantong for injection （lyophilized）and Qingkailing injection were significantly lower than before intevention （P＜0.05）. CONCLUSIONS ：Pharmaceutical administration intervention can reduce the total amount and the consumption sun of TCM injection in primary medical institutions ，and promote rational drug use in the clinic.

Objective: To discuss the effect of high-density fat-binding SVF-GEL in female facial lipofilling. Methods: This is a retrospective study including 32 female patients, received facial fat transplantation during June 2017 to June 2018 in Yichun College. Each patient underwent high-density fat-binding SVF-GEL transplantation for facial surgery. Patients′satisfaction with the surgery and the rate of secondary surgery was evaluated. Fat was harvested from the inner thigh, centrifuged at 1200 g for 3 min, and the liquid was removed. The upper 2/3 part is prepared for SVF-GEL, for further used in delicate lipofilling in eyelid, tear groove and nasolabial groove. The lower 1/3 high density fat was used for volume restoration, such as forehead, temporal area and cheek. Results: All patients had significant improvements in facial contours with mild swelling and short recovery time. The satisfaction rate was 68.8%(22/32), and the second operation rate was 15.6%(5/32). Conclusions High-density fat-binding SVF-GEL transplantation can achieve good results in correcting facial volume loss.

Objective To observe the changes of haemodynamics and cerebral state index during double-lumen endobronchial intubation with glidescope ranger video laryngoscope (GSVL) and macintosh direct laryngoscope (MDLS). Methods Forty-eight ASA Ⅰ or Ⅱ patients aged 35 ～ 67 yrs were enrolled in this study, who were scheduled for elective pulmonary cancer or cancer of esophagus radical correction tients were random divided into 2 groups( n =24 each), GSVL group and MDLS group. After anesthesia was induced, all patients were given a score of Cormack grading under MDLS and GSVL, and then endobronchial intubation was performed. Noninvasive BP and HR were recorded before and after induction of anesthesia, during endobronchial intubation and after endobronchial intubation was completed for 1,2, 3, 4,5 min. The CSI was continuously monitored and recorded before and after induction of anesthesia, and after endobronchial intubation for 1 ～ 2 min and 3 ～ 5 min. Results Compared with MDLS group, the rate of Cormack grade 1 was significant higher in GSVL group (91% vs 58% ) ( P ＜0. 01 ). BP of two groups at T1 and T5 ～ T7 were significantly decreased compared to T0 values ( P ＜0. 01 ). Endobronchial intubation (T2 ～T4) caused significant increase in BP and HR compared to post-induction values(T1 ) ( P ＜0. 01).The highest values of HR after intubation exceeded even their baseline values before induction of anesthesia.The haemodynamic responses to endobronchial intubation in GSVL group at T2 ～ T4 were significantly different from those in MDLS group( P ＜0. 05). CSI of two groups at T1 was significantly decreased compared to To values( P ＜0. 01 ), CSI of two groups at T2 induced significant increase compared to T1 values, and the increase of CSI in MDLS group was stronger than that in GSVL group( P ＜0.01). Condusion The haemodynamic responses produced by orotracheal intubation using GSVL had more obvious advantages than MDLS, but GSVL seemed to provide a clear view of glottis and a little change CSI effect.

Objective To evaluate pit pattern analysis for detection of early colorectal carcinoma and precancerous lesions. Methods A total of 162 lesions in 144 patients were examined with magnifying colonoscopy after staining, and their pit patter was analyzed with morphology and pathologic diagnosis. Results With confirmation of pathology, there were 34 non-neoplastic lesions and 128 neoplastic ones, in which 12 were carcinomas. The pit patterns in most non-neoplastic lesions (76. 5%, 26/34) were type Ⅰ or Ⅱ , and those in most neoplastic lesions (96. 1% , 123/128) was type Ⅲ, Ⅳ or Ⅴ. Pit patterns of cancerous lesions were mainly type Ⅴ (75.0%, 9/12), and those of 3 cases of advanced cancers were all type Ⅴ N. Conclusion Pit pattern classification is a very important tool to differentiate between neoplastic, nonneoplastic lesions and early cancer, which helps to decide later therapeutic intervention.

OBJECTIVE To evaluate the drug resistance of Candida isolated from patients' specimen in clinic.METHODS The minimal inhibitory concentration(MIC) test to 243 Candida strains was performed using ATB-Fungus drug susceptibity plate provided by Bio-Merieux.RESULTS The most popular species of Candida in clinic was Candida albicans(64.6%),C.glabrata(14.4%),C.tropicalis(11.1%),C.parapsilosis(5.8%)and C.krusei(4.1%).There was a certain resistance to the 4 kinds of common antifungals including flucytosine,amphotericin B,fluconazole and itraconazole.The resistance status of C.krusei was the most serious,Its resistance rate to 4 kinds of antifungals was 20.0%,50.0%,30.0% and 40.0%,respectively.The drug resistance rate of 5 species of Candida to itraconazole was higher than that to fluconazole.CONCLUSIONS The commonly encountered Candida produce particular resistance to common antifungals,and it is very necessary to detect and control them.

OBJECTIVE To explore the distribution of 16S rRNA methylase and aminoglycoside modifying enzymes in continuous isolates of Pseudomonas aeruginosa(PAE).METHODS The antibiotics susceptibility was tested by K-B method,the 16S rRNA methylase(rmtB) and aminoglycoside modifying enzymes were detected by polymerase chain reaction(PCR),the positive genes were amplified and sequenced by PCR fluorescence spectrophotometry.RESULTS Among 20 strains of PAE,the 16S rRNA methylase and 5 kinds of aminoglycoside modifying enzymes had been detected.The 5 kinds of aminoglycoside modifying enzymes were aac(3)-Ⅱ,aac(6′)-Ⅰb,aac(6′)-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰ,respectively.And more,the rmtB in the first and third strains was sequenced,and translated into amino acid,and the translated amino acid sequence was compared with GenBank,suggesting there be different amino acid sequence.This was confirmed as two new subtypes.CONCLUSIONS Resistant to antibiotics PAE in our hospital is mainly related to 16S rRNA methylase and 5 aminoglycoside modifying enzymes,and 2 new subtypes of 16S rRNA methylase are discovered.