There is a long path to go on the course of Chinese medical supply reform program.With the development of medicare system,the use of Internet + to promote Chinese medical supply reform program and to provide usefulsolutions to the present medicare problems in China could be very difficult.

Objective To study the clinical efficacy and plasma concentrations of tacrolimus in renal transplant patients. Methods Kidney transplant patients were randomly divided into experimental group and control group. Control group was treated with cyclosporin A, experimental group was treated with tacrolimus. Clinical efficacy of two groups was compared,and plasma concentrations of tacrolimus the experimental group were tested at different periods. Results Compared with the control group,experimental group D-BILI and the concentration of T-BILI significantly lower,rate of acute rejection and infection significantly reduced,the differences were statistically significant (P <0.05) ;At the same time,in the experimental group,blood concentration of FK506 in patients at different periods after surgery were different. Conclusions . Tacrolimus was expected to develop ithe main immunosuppressant, its blood concentration factors of further research would be beneficial for to provide a reasonable regimen the clinical organ transplant patients.

OBJECTIVE: The purpose of this study was to establish two-dimensional gel electrophoresis (2-DE) profiles of serum of myasthenia gravis patients, and to identify the differential proteomic expressions between normal persons and myasthenia gravis patients with spleen and kidney deficiency syndrome. METHODS: Samples of serum protein were extracted by repeated freeze-thaw method and separated by two-dimensional electrophoresis. Differential proteomic expressions between the myasthenia gravis patients and the normal control persons were identified by two-dimensional polyacrylamide gel electrophoresis, silver staining, image-master 2-DE software analysis, peptide mass fingerprinting based on matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS), BioWorks and NCBI software database searching. RESULTS: The two-dimensional polyacrylamide gel electrophoresis profiles of serum proteins were successfully established by 2-DE. Twenty-one of the significant differential proteins were selected and identified by MALDI-TOF-MS. Eight of them were finally identified. CONCLUSIONS: The 2-DE profiles of serum proteins were established and the differential proteomic expressions were identified by proteome technique in our study. This can be an experimental basis for further research of the pathogenesis and treatment of myasthenia gravis.

In recent years,scientific research of our hospital has achieved remarkable progress with the implementation of discipline-centered ideology,personnel training strategy and adequate incentive policy.The paper briefly introduces the achievements in scientific research and the measures adopted,and analyzed the key factors associated with science research management.

Objective:To assess the efficacy and safety of electroacupuncture (EA) at Houxi (SI 3) in treating acute lumbar sprain. Methods: Randomized controlled trials (RCTs) involving EA at Houxi (SI 3) for acute lumbar sprain were retrieved from PubMed (1966-2014), EMBASE (1980-2014), Cochrane Library (Issue 1, 2014), CQVIP Database (1989-2014), Wanfang Digital Journal (1998-2014), the Chinese Biological Medical Literature Database (CBM, 1978-2014), and China National Knowledge Internet (CNKI, 1979-2014). The collection of data also adopted hand-search of the relevant journals from the Library of Shanghai Jiao Tong University. All of the data were first evaluated and extracted by two reviewers independently with a specially designed form. Then, the available data were analyzed by the Cochrane Collaboration's RevMan 5.2.0 software. Results:A total of 6 trials involving 1 288 patients were eligible. Meta-analysis showed that the total effectiveness rate in the EA group was significantly different when compared with Nimesulide [RR=1.33; 95% CI (1.19 to 1.49)] and Mobic [RR=1.08; 95% CI (1.03 to 1.14)], but similar to that of acupuncture at Yaotongdian (EX-UE 7) [RR=71.09; 95% CI (1.00 to 1.19)] and Diclofenac Sodium [RR=1.08; (95% CI 0.96 to 1.21)]. The recovery rate in the EA group was significantly different when compared with Mobic [RR=1.67; (95% CI 1.45 to 1.92)] and Nimesulid [RR=1.37; (95% CI 1.15 to 1.62)], but similar to that of acupuncture at Yaotongdian [(RR=1.35; 95% CI 0.99 to 1.84)] and Diclofenac Sodium [(RR=1.19; 95% CI 0.88 to 1.61)]. Conclusion:Up to the search date, there are few high quality RCTs to evaluate the clinical efficacy of EA at Houxi (SI 3) for acute lumbar sprain, especially studies in English. Yet EA at Houxi (SI 3) still appeared to be an efficacious method for acute lumbar sprain, despite several inherent defects of the included studies. Further large scale trials are required to define the role of EA at Houxi (SI 3) in the treatment of this disease.

To observe the effects of Guanxinkang (GXK) decoction, a compound traditional Chinese herbal medicine, on expressions of peroxisome proliferator-activated receptor γ (PPARγ), liver X receptor α (LXRα) and ATP-binding cassette transporter A1 (ABCA1) in apolipoprotein E (ApoE)-knockout mice with atherosclerosis.

To observe the effects of Guanxinkang (GXK) decoction, a compound traditional Chinese herbal medicine, on serum lipids and apolipoprotein A I (ApoA I), apolipoprotein B (ApoB), apolipoprotein E (ApoE), C-reactive protein (CRP), serum amyloid A protein (SAA) and fibrinogen (Fbg) concentrations of ApoE-knockout mice with atherosclerosis, and to explore the mechanism of GXK decoction in anti-atherosclerosis.

OBJECTIVE: To study the modulation of Jianjining Recipe (JJNR), a traditional Chinese compound herbal medicine for invigorating spleen and kidney on differential protein expression in spleen of rats with experimental autoimmune myasthenia gravis (EAMG). METHODS: EAMG rats were randomly divided into four groups: untreated group, JJNR-treated group, Qiangji Jianli capsule (QJJLC, a traditional Chinese compound herbal medicine)-treated group and prednisolone acetate (PA)-treated group. After therapeutic intervention with the above drugs for four consecutive weeks, the level of differential protein expression was analyzed by two-dimensional electrophoresis and matrix assisted laser desorption/ionization time-of-flight mass spectrometry. RESULTS: Twelve differential proteins were identified by comparing EAMG rats and normal rats. The levels of allograft inflammatory factor-1, peroxiredoxin I and actin-related protein 2/3 complex subunit 5 were significantly regulated by JJNR (P<0.01). These proteins were closely associated with immune response and cell movement. CONCLUSION: The results suggest that there are differential protein expressions between EAMG rats and normal rats. Furthermore, as a Chinese medicine prescription with effect of invigorating spleen and kidney, JJNR can effectively regulate the levels of some EAMG-related protein expression.

OBJECTIVE:To provide data and reference for pharmacist legislation. METHODS:Questionnaire survey was de-signed investigate and analyze the staffing situation,education level,professional composition,age composition,professional titles composition,continuing education and wage of pharmacists who worked in medical and health institutions from 16 states (cities) in Yunnan province,and suggestions were put forward for relevant legislation. RESULTS:Totally 10 questionnaires were received from provincial medical and health institutions,and 16 from state (city) Health and Family Planning Commission,with effective recovery of 100%;data covered 1 561 medical and health institutions,involving 7 409 pharmacists. The numbers of pharmacy per-sonnel/hospital beds in tertiary hospitals,secondary hospitals and class-1 hospitals were 1∶15.49,1∶17.50,1∶20.68,numbers of pharmacy personnel/health professional and technical personnel in hospital accounted for 5.62%,6.18%,5.30%,respectively;most pharmacists in tertiary hospitals were mainly undergraduate degree(35.21%),doctor degree accounted for 0.15%,the high-est ratio of education was junior college degree in secondary hospitals(41.60%)and class-1 hospitals(57.51%);most pharmacists graduated in pharmacy in tertiary hospitals(94.14%),70.22% in secondary hospitals and only 10.50% in class-1 hospitals;phar-macy personnel mainly held the pharmacist professional titles in tertiary,secondary and class-1 hospitals (33.83%,37.89% and 63.55%),senior professional titles accounted for 5.88%,2.71% and 0.21%,respectively;only a few have learning experience and almost less than 6 months (9.17%,5.84% and 21.32%),and 80 pharmacists were certificated as clinical pharmacists in the whole province;generally,all wage was concentrated in 2 000-2 999 per month (27.72%,41.80% and 55.90%,respectively). CONCLUSIONS:Shortage of hospital pharmacists and lack of senior personnel are the main problems in Yunnan province,and wage is not high,especially in primary hospital,this situation is more obvious. The current situation of pharmacists in the hospital should be more taken into consideration during the legislative process in aspects of clearing and guaranteeing access qualifications, responsibilities,status,rights and interests,and pharmaceutical technology and service charges should be established.

Objective To investigate the main risk factors influencing the pre-hospital delay of patients with acute ischemic stroke (AIS) for preventing methods.Methods A retrieval was done across the epidemiologic studies on pre-hospital delay of AIS patients during 2004 to 2015 using the key words of ischemic stroke,prehospital delay,treatment delay.According to the inclusion and exclusion criteria,the literature was collected and the literature quality was assessed.The data were extracted for meta-analysis by RevMan software.Results Sixteen epidemiologic studies were included.Totally,there were 2,966 cases of prehospital delay and 2,468 cases of non-delay.The pooled OR values and 95％ CI by multivariate analysis were as follows:the degree of awareness of stroke was 0.5 (0.3,0.82),emergency medical service (EMS) was 0.49 (0.29,0.85),National Institute of Health Stroke scale (NHISS) score 0.58 (0.36,0.95),outpatient visit as first visit 4.28 (1.44,12.74),distance 0.76 (0.61,0.95),medical history of ischemic stroke 0.37 (0.18,0.79) (with significant differences in OR value,P＜0.05).Conclusions The protective factors for pre-hospital delay of acute ischemic stroke patients include:strengthened awareness of stroke,effective EMS,high NHISS score,short distance,medical history of ischemic stroke.The main risk factor is that their outpatient visit is their first visit for medical treatment.Therefore,we need to enhance the health education to the patients and their families about awareness of stroke,improve the use of EMS and build complete and efficient green path for the stroke patient.