Annual salary system reform at public hospitals in Sanming was cited as an example,to touch upon the five components of equity in such a reform,namely external equity,internal equity,individual equity,procedural equity and interactive equality.The significance,roadblocks and essential conditions were then analyzed,to come up with such recommendations as development of a mechanism for remuneration survey and dynamic adjustment,and a system for better posts grading and evaluation,as well as better performance appraisal tools,and a competent performance appraisal system.

Objective To explore the pathogenesis of autism by observation of changes of brain-derived neurotrophic factor(BDNF) positive neurons and the morphology of pyramidal cells in hippocampal CA1 region,and provide theoretical evidence for the therapeutic schedule.Methods Animal model of autism was obtained by Schneider method.Using the immunohistochemistry methods and image analysis,the number of BDNF positive neurons was examined in hippocampal CA1 region of the autism model rats and the normal rats,and the changes of pyramidal cell were observed in hippocampal CA1 region after HE staining.Results The numbers of BDNF positive neurons in the hippocampal CA1 region of the autism model rats were more than those of the normal rats (5.00 ±1.60 vs 3.00 ± 1.04,t =3.63,P =0.0015).The morphology of pyramidal cells showed that the pyramidal cells of the autism model rats in hippocampal CA1 region had apoptosis.Conclusion The occurrence of autism may be related to the changes of BDNF and the morphology of pyramidal cells in hippocampal CA1 region.

In line with guidelines of the health reform and realities in China,we comprehensively analyzed the strengths,weaknesses,opportunities,and threats in improving the hierarchical medical system by means of the SWOT method.Based on such,we proposed some corresponding development countermeasures,for policy and decision references in developing a medical system of reasonable division of responsibilities.

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.

[ ABSTRACT ] AIM: To investigate the expression and clinical significance of bone morphogenetic protein 3 (BMP3) in hilar cholangiocarcinoma tissues.METHODS: Thirty cases of hilar cholangiocarcinoma specimens were col-lected.The expression of BMP3 at mRNA and protein levels in the tumor tissues and paracancerous tissues was detected by real-time PCR and Western blot.The hilar cholangiocarcinoma paraffin-embedded specimens (n=103) were collected. The protein expression of BMP3 was determined by immunohistochemical method, and the relationship of BMP3 protein ex-pression with clinical pathological characteristics was evaluated.RESULTS:In the 30 patients with hilar cholangiocarcino-ma, the expressions of BMP3 protein and mRNA in 22 cases of tumor tissues were significantly decreased compared with the adjacent normal tissues.The results of immunohistochemistry showed that 87 cases were negative and 16 cases were weakly positive in all 103 cases of hilar cholangiocarcinoma.The expression of BMP3 protein was associated with the tumor TNM staging, lymph node metastasis and tumor differentiation (P<0.05).CONCLUSION:BMP3 gene might be inhibited in human hilar cholangiocarcinoma.The down-regulation of BMP3 gene might be associated with the carcinogenesis and devel-opment of hilar cholangiocarcinoma.

The system of first contact in community health institutions, as the core element of hierarchical di-agnosis and treatment system, is of great importance for reforming successfully China’ health service system. The sys-tem of first contact in community health institutions implemented among labor workers in Shenzhen City plays an im-portant role in patients ’ distribution and the interested parties can accept this mandatory system. Campared with Shenzhen City, the level of services is enough to meet patients’ primary health demands in some cities which the com-munity health service develops well, and it should be thought highly of the mandatory in the process of policy imple-mentation in order to ensure the implementation effect.

Objective To establish an HPLC method for simultaneous determination of Quercetin , Luteolin, pigenin in Matricaria Chamomila L.. Methods HPLC analysis was performed on Agilent Zorbox SB-C18 column (4.6 mm×250 mm, 5 μm) with the methanol and phosphoric acid as mobile phase in equal degree model, and the column temperature was set at 25 ℃, and the flow rate was 1.0 ml.min-1 and the detecting wave length was at 350 nm. Results The linear response ranges were from 0.25-4.04 μg of Quercetin (r=1.000, n=6) and from 0.25-3.98 μg of Luteolin (r=1.000, n=6) and 0.25-4.02 μg of Apigenin (r=1.000, n=6);and the recoveries, the precision and the stability RSD of Quercetin, Luteolin and Apigenin meet the requirements. The average recovery rate of quercetin, luteolin and apigenin was 93.64%, 95.85% and 95.40%, respectively. Conclusions All 3 samples in Matricaria Chamomila.L were determined by HPLC. The method is simple, rapid, and reproducible. It can be used as reference for the quality control of Matricaria Chamomila L..

Objective To explore the effective nursing method of preventing the deep vein thrombosis according to D-Dimer and lower limb vein B ultrasonic examination.Methods The study investigated 120
patients with femoral neck fracture who were operated hip replacement in Wuxi No.2 People′s Hospital during September 2013 to June 2015. The participants were randomly divided into four groups with 30 cases in each group: basic care group, early path functional training group, SCD group, and early path functional training combined with SCD group. D-Dimer and thrombosis detection rate according to the lower limb vein B ultrasonic examination were observed and compared among the four groups.Results D-Dimer of the four groups had little differences before and after 24 hours of the operation ( P>0.05) , but had differences after 7 days and 14 days of the operation (P<0.05). Moreover, the early path functional training combined with SCD group had lower D-Dimer compared to the basic care group ( P<0.05) . Besides, no thrombosis occurred before and after one day of the operation among the four groups, however, the thrombosis detection rates had significant differences after 7 days and 14 days of the operation (P<0.01). After 7 days of operation, the thrombosis detection rate for the early path functional training combined with SCD group was already lower than the others (P<0.01). After 14 days of operation, the basic care group had the highest thrombosis detection rate while the early path functional training combined with SCD group had the lowest thrombosis detection rate ( P<0. 01 ) . Conclusions The method of SCD combined with early path functional training can effectively prevent the deep vein thrombosis after hip arthroplasty surgery.

Objective:To explore the research status, hotspots, and directions in traditional Chinese medicine treatment for postoperative gastrointestinal dysfunction both domestically and internationally.Methods:The bibliometric software CiteSpace 5.7.R5 was used to visually analyze literature published on the China National Knowledge Infrastructure and Web of Science core collection from establishment until 2022, and to draw the knowledge graph of authors, research institutions, and keywords.Results:After screening by two researchers, a total of 1 012 Chinese articles and 111 English articles were included. The analysis of annual publication volume showed that this field was showing an upward trend both domestically and internationally. The co-occurrence analysis of authors displayed that Hu Kaiwen and Jingwen Yang had the highest number of publications. Institutional co-occurrence analysis indicated that there were relatively few mature and influential teams formed domestically and internationally, and research institutions had limited cross-regional cooperation. Keyword clustering analysis revealed that the research hotspots mainly focused on integrated traditional Chinese and Western medicine nursing, clinical research, and traditional Chinese medicine external treatment methods.Conclusions:The research on the treatment of postoperative gastrointestinal dysfunction with traditional Chinese medicine is mainly concentrated in China, but there are few closely cooperating and stable research teams. Research in this field is still in its developmental stage both domestically and internationally, close cooperation between multiple institutions and authors is needed to form influential teams to conduct in-depth research on the mechanisms and principles of this field, making significant contributions to its development.

Objective To investigate the diagnosis and treatment experiences for pancreatic trauma. Methods Clinical data of 25 patients with pancreatic trauma admitted to the First Affiliated Hospital of Sun Yat-sen University from August 2003 to July 2014 were retrospectively analyzed. There were 17 males and 8 females, with age ranging from 7 to 54 years and a median age of 26 years. The informed consents of all patients were obtained and the local ethical committee approval had been received. According to the scale of American Association for the Surgery of Trauma (AAST) for pancreatic trauma, 3 cases were classiifed as gradeⅠ, 9 as gradeⅡ, 7 as gradeⅢ, 5 as gradeⅣand 1 as gradeⅤ. The diagnosis, treatment and prognosis of the patients were observed. Results Two patients were observed with consciousness disorders and the other 23 suffered from acute abdominal pain of varying extent. Elevated serum amylase was observed in 63% (15/24) of the cases. Seven cases were observed with increasing amylase via abdominocentesis before operation. Seventeen cases underwent preoperative ultrasound examination and the rate of conifrmed diagnosis was 41%(7/17). Fourteen cases underwent preoperative CT scan and the rate of conifrmed diagnosis was 71%(10/14). Three grade I cases underwent peripancreatic drainage alone. Among the 9 cases of gradeⅡ, 2 received conservative therapy, 6 underwent peripancreatic drainage and 1 received pancreatic rupture repair. Among the 7 cases of gradeⅢ, 4 underwent proximal pancreatic stump closure+distal pancreaticojejunostomy, 2 underwent distal pancreatectomy with splenectomy and 1 underwent distal pancreatectomy alone. Among the 5 cases of gradeⅣ, 4 underwent proximal pancreatic stump closure+distal pancreaticojejunostomy and 1 underwent proximal pancreatic stump closure+distal pancreaticogastrostomy. One case of gradeⅤunderwent pancreatic necrosectomy+duodenorrhaphy+peripancreatic drainage. Of the 25 patients, 2 death case were observed, 6 developed pancreatic ifstula and 5 developed pancreatic pseudocyst after operation. One patient with pancreatic ifstula was cured after receiving pancreatic duct stent drainage by endoscopic retrograde cholangiopancreatography (ERCP). Two patients with pancreatic pseudocyst were cured after undergoing cyst drainage. The other patients with pancreatic ifstula and pseudocyst were cured after undergoing ultrasound-guided puncture drainage. Conclusions Increasing amylase in the serum and lfuid by abdominocentesis before operation can be regarded as indicators of pancreatic trauma. Preoperative CT scan is of certain signiifcance in the diagnosis and classifying the pancreatic trauma. Surgical operation for pancreatic trauma should be selected according to the types, grades of trauma and related complications.