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.

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.

Objective To analyze the clinical application of detecting anti Mullerian hormone (AMH) in the patients with polycystic ovary syndrome (PCOS).Methods A total of 480 cases with PCOS and 500 cases of healthy females were selected in the study.The levels of AMH in the patients with PCOS were compared between the two groups.Results The levels of AMH,luteinizing hormone (LH),testosterone (T) in patients with PCOS were significantly higher than those in the healthy control group (P＜0.05).Differences of the levels of estradiol (E2) and follicle-stimulating hormone (FSH) in patients with PCOS and thosein healthy control group had no statistical significance(P＞0.05).As the age increased,the level of AM H obviously declined.Conclusion The level of AMH in patients with PCOS is obviously higher than that in the healthy ones,it declines with the age increasing.

Objective To develop a sandplay analysis evaluation matrix for children with tic disor?ders. Methods 113 children were chosen as the study subjects . Based on the grounded theory,the open coding,correlated coding and core coding were carried out on coding elements for sandplay process to gain the third?level,second?level and first?level evaluation codes. The reliability and validity of the codes were tested.Results The sandplay analysis evaluation matrix for children with tic disorders was established inclu?ding 48 third?level,17 second?level and 3 first?level evaluation codes. The codes were proved to be reliable and valid through the comparison and conditional coding with query. Conclusion The sandplay analysis e?valuation matrix for children with tic disorders,which is established based on the grounded theory,is reliable and operable. It can be used as a tool to assess the psychological or behavioral problems of children with tic disorders dynamically.

Background and purpose:Both very important therapeutic targets of NSCLC,vascular endothelial growth factor (VEGF) and epidermal growth factor receptors (EGFR),are over expressed in non-small cell lung cancer (NSCLC).The aim of this study was to discuss the expression of VEGF and EGFR in NSCLC as well as its clinical significance.Methods:The expression of VEGF and EGFR was detected in 186 NSCLC samples using the immunohistochemical method.The expression of VEGF and VEGR in NSCLC patients with various pathological characteristics was observed and the correlation between them was analyzed.Results:The expression of VEGF in NSCLC was correlated with lymph node metastasis (P

Objectives:To compare the susceptibility of serum lipoproteins to oxidation and the effects of high-density lipoprotein on oxidative stress in patients with lipid turbulence.　Methods:VLDL, LDL and HDL were isolated using sequential ultracentrifugation from serum of patients with chronic renal failure (CRF) (n=45), myocardial infarction survivor (MIS) (n=33) , cerebral infarction(CI)(n=33) ,type 2 diabetes mellitus(DM)(n=53) and normal individuals (n=44). The degree of lipid peroxidation was estimated using the thiobarbituric acid-reactive substances (TBARS) value and the susceptibilities of lipoproteins to oxidation were assessed by measuring the increased absorbance value at 234 nm due to the conjugated dinene formation. Lipid levels and lipoprotein fractions were measured using standard methods.　Results: VLDL obtained from the patient groups showed significant increase in TBARS values, especially from the patients with MIS (compared with control group, P<0.001). In addition, LDL from MIS and DM groups and HDL from CI and DM groups also showed markedly increase in TBARS content. Significant decrease in lag time was observed in both VLDL and LDL fractions from the four patient groups. However, no change was found in the lag time in HDL fraction from the patient group compared with control group. In addition, HDL from the four patients exhibited significantly decreased inhibitory effects on in vitro oxidation of LDL, with the most significant decrease in HDL from CRF and MIS groups.　 Conclusions:The oxidative modification of lipoproteins in vivo in patients with serum lipid turbulence might be involved in the development of atherosclerosis in these patients.