OBJECTIVE:To provide policy recommendations for improvement of the pooled medicines procurement policy through legal analysis. METHODS:The pooled medicines procurement policies in China were reviewed and compared with related laws and regulations to analyze the problems and put forward recommendations. RESULTS:For the pooled medicines procurement policy,there were several conflicts between it and the Bidding Law,Government Procurement Law,Anti-monopoly Law and An-ti-unfair Competition Law. In terms of the pooled medicines procurement institution,there were conflicts between it and Bidding Law,Government Procurement Law. In terms of the price-volume linkage and the main body of tendering,there were conflicts be-tween it and the Bidding Law. In terms of the organization and participants,there were conflicts between it and the Anti-monopoly Law and Anti-unfair Competition Law. CONCLUSIONS:The pooled medicines procurement system should rationalize the main body of tendering,insist on volume secured procurement and price-volume linkage,establish reasonable incentive mechanism through supporting heath system reform policies,eatablish and perfect modern government principles in the field of medicines regulation. The pooled drug procurement policy should be moderately adjusted to follow the above laws in order to raise the procurement efficiency.

Objective To construct the recombinant plasmid pCMV-Myc-PIASX? and express the fusion protein in mammalian cells.Methods PIASx? fragment was digested from the original vector pGADT7 with SalⅠand NotⅠ,and then was inserted into the targeted pCMV-Myc vector by the recombinant DNA technique.After identification,the recombinant plasmid was transfected into CHO cells.The expression of recombinant Myc-PIASx? fusion protein was detected by Western blotting.Results By the restriction enzyme digestion,fragment purification,ligation and transformation,the recombinant plasmid was obtained.The right recombinant plasmid pCMV-Myc-PIAS3 was identified with enzyme digestion and sequencing.By EcoRⅠ digestion analysis,pCMV-Myc-PIASx? showed a 5641 bp band.By XbaⅠdigestion analysis,pCMV-Myc-PIASx? showed two expected band of 3291 bp and 2349 bp.A specific protein expression band at 68 000(PIASx? fusion protein) was showed in Western blotting,which matched recombinant plasmid.Conclusion The recombinant plasmid of pCMV-Myc-PIASx? is sucssesefully constructed,which provids a good tool for further function study on PIAS family.

Objective To construct the eukaryotic expression recombinant PIAS3 plasmid fused with Myc protein and express the fusion protein Myc-PIAS3.Methods The full length PIAS3 fragment of 1 851bp was amplified by PCR and ligated into pMD18-T vector. The full length PIAS3 fragment was subcloned into eukaryotic pCMV-Myc vector between SalⅠ and NotⅠ sites.The recombinant pCMV-Myc-PIAS3 plasmid was trandfected into PC3 cells.The eukaryotic expression Myc-PIAS3 protein was checked by Western blotting with Myc antibody.Results The recombinant plasmid showed right sequence by the full length sequencing.The recombinant plasmid of pCMV-Myc-PIAS3 was identified by enzyme digestion.As expected,by EcoRⅠ digestion,it showed two bands of 4 357bp and 1 318 bp. By XbaⅠdigestion,it showed two bands of 3 291 bp and 2 384 bp.The sequencing result showed a N-terminal Myc of 13 amino acids followed with PIAS3 gene sequence in right reading frame.The pCMV-Myc-PIAS3 plasmid was transfected into prostate cancer PC3 cells.A specific protein expression band at relative molecular mass 68 000 was obtained by using Myc-antibody with Western blotting method.Conclusion The recombinant plasmid of pCMV-Myc-PIAS3 is sucssesefully constructed,and Myc-PIAS3 fusion protein is sucssesefully expressed.

OBJECTIVE:To observe clinical efficacy and safety of salvianolate in the treatment of acute exacerbation of chron-ic obstructive pulmonary disease(AECOPD). METHODS:80 AECOPD patients were selected and randomly divided into observa-tion group and control group,with 40 cases in each group. Both groups received mechanical ventilation. Control group was given routine treatment of theophyllinum,bronchodilators and glucocorticoid;treatment group was additionally given Salvianolate injec-tion 200 mg,qd,ivgtt,on the basis of control group. Clinical efficacy was observed in 2 groups,blood hemorheology indexes were also observed before and after treatment. The mechanical ventilation time,ICU residence time and ADR were recorded in 2 groups. RESULTS:Clinical total effective rate of observation group was 95.00%,which was significantly higher than 70.00% of control group,with statistical significance(P<0.05). Before treatment and 2 d after treatment,blood rheology indexes of treatment group were improved significantly(all P>0.05),and whole blood reduction viscosity of control group was improved significantly(P<0.05). Mechanical ventilation time and ICU residence time of treatment group was significantly shorter than that of control group (P<0.05). No ADR was found in 2 groups. CONCLUSIONS:Salvianolate can significantly improve the blood coagulation status of AECOPD patients receiving invasive mechanical ventilation,and has the advantages of good clinical efficacy and low cost of medical treatment.

Objective To explore the regularity of incidence of agonal respiration (AR) and agonal respiration frequency rate (ARFR) during untreated cardiac arrest (CA) after ventricular fibrillation (VF) in a swine model.Methods Ten healthy male domestic pigs weighing (25.0± 3.0) kg were employed in this experiment.VF was induced by intraventricular shock with alternating current without treatment for 8 minutes.The incidence of AR and ARFR per minute were recorded for 8 minutes.Statistical analysis was performed using SPSS 19.0 system software.Results AR occurred in all animals after VF induced CA within 8 minutes.There was 1 animal showed AR at the first minute with ARFR (0.2±0.1) times/min,4 animals showed AR at the second minute with ARFR (1.2 ± 1.0) times/min,7 animals showed AR at the third minute with ARFR (2.7 ± 1.4) times/min,all animals showed AR at the fourth to fifth minute with ARFR (3.7 ± 1.6) times/min and (3.2 ± 1.9) times/min,7 animals showed AR at the sixth minute with ARFR (1.3 ± 1.0) times/min,no animal showed AR at the seventh minute,and 1 animal showed AR at the eighth minute with ARFR (0.2±0.1) times/min.The first and the last AR were observed at (2.02±0.84) minutes and (5.21 ± 1.12) minutes respectively.Occurrence of AR reached its peak at the fourth to fifth minute,and it was absent at the seventh minute.ARFR after CA showed a crescendo-decrescendo pattern,which increased from (0.2±0.1) times/min to (3.7±1.6) times/min followed by a fall to (0.2±0.1) times/min.Conclusions AR is one of the symbolic signs after CA.AR occurred in all animals during untreated VF,and it reaches its peak at the fomrth to fifth minute,with a crescendo-decrescendo pattern of ARFR.Effective identification and treatment in victim with AR timely can help to improve the success rate of cardiopulmonary resuscitation and survival rate.

Objective? To investigate and analyze the domestic and oversea studies on heart failure symptom clusters through a bibliometric analysis, and provide evidence basis for future clinical nursing research. Methods? The CNKI the Wanfang Science and Technology Journal Full-text Database, the China Biomedical Literature Database (CBM), the PubMed, and the Web of Science database were searched for the articles both in Chinese and English about heart failure symptom clusters published from database establishment dates to August 31st, 2018 and analyzed on their published years, distribution of journals, and research content. Results? A total of 21 articles complied with the standard were retrieved with the first published article dated back to 2009. Among them, there were 13 cross-sectional studies, 4 longitudinal studies, 3 reviews, and 1 tool development. Although different studies had differences in research design, sample characteristics, assessment tools, and analytical methods, the main findings were basically the same: somatic symptom cluster and emotional symptom cluster were common symptom clusters in patients with heart failure; somatic symptom cluster mainly included shortness of breath, dyspnea, fatigue, declined physical strength, dyscoimesis; emotional symptom cluster mainly included anxiety, depression, cognitive disorder; there was still controversy about the classification of edema. Conclusions? At present, the research on heart failure symptom clusters in China and abroad is still at the initial exploration stage, and the research results are still unstable. In the future, we can further develop long-term dynamic observation of heart failure symptom clusters and explore corresponding symptom management strategies.

The unbalanced economic development, the lifestyle changes of the residents, the aging before getting rich and the burden of non-communicable chronic diseases in China have brought great pressure on China′s health system. However, the prevention and control mechanism of chronic diseases in China is far from mature, which restricts the development of the prevention and control of chronic diseases in China. Singapore′s new concept on chronic disease management and the the 3-level theoretical framework are good experience in the world and deserve to be learned by China. This article introduced the Healthy Living Master Plan in health promotion practice in Singapore, and made suggestions on construction of health management system to cope with the disease burden in China.

OBJECTIVETo define the optimal development time of micro-computed tomography (micro-CT) venography in cervical cancer patients and establish 3D CT-based digital pelvic model of the patients.

METHODSThirty patients with cervical cancer stratified by FIGO surgical staging underwent micro-CT scanning of the arterial phase and the venous phase with a delay time of 70, 90 and 120 s. The images were interpreted independently by two experienced radiologists to define the optimal development time in venous phase and establish the imaging diagnosis. Based on the pelvic CT scan data, we segmented the images using the abdominal medical image-3D visualization system followed by 3D image reconstruction to establish the 3D digital pelvic model using FreeForm Modeling System to modify the reconstructed images.

RESULTSThe optimal images were obtained by scanning with a 90-sec delay time. Micro-CT was not sensitive to IB1 phase or earlier phases (1/5), but efficient in advanced stages (≥IB2 phase). In our cases, 25 were diagnosed by micro-CT with a diagnostic accuracy of 64%. Based on these CT data, the pelvic 3D model covering the main organs, vessels, cervical neoplasm, and supplying vessels of the tumor in the pelvic cavity were successfully reconstructed to allow spatial observations of the uterus and the neighboring organs.

CONCLUSIONThe 3D digital pelvic model reconstructed provides a means for staging cervical cancer and facilitates further surgical simulation studies.

Female ; Humans ; Imaging, Three-Dimensional ; methods ; Middle Aged ; Models, Anatomic ; Neoplasm Staging ; Tomography, X-Ray Computed ; methods ; Uterine Cervical Neoplasms ; diagnostic imaging

Under the background of globalization, public health issues are becoming more and more complicated. In the international arena, global health has gradually replaced international health and "global public health" as one of the dominant terms in the field of public health. However, until now, there is no unified understanding and definition for the concept of global health domestically and internationally. In this article, various foreign experts 'views and domestic experts' opinions about the concept of global health are collected and solicited, in order to generalize appropriate Chinese definition of global health of China.
China ; Global Health ; Humans ; Public Health ; Vocabulary

Objective:To summarize the progress and achievement of outpatient experience improvement in tertiary public hospitals from 2016 to 2021, so as to provide basis for further improving outpatient experience and raising outpatient satisfaction.Methods:Based on 5 round third-party evaluations of the China Healthcare Improvement Initiative from 2016 to 2021, descriptive trend analysis was conducted on the outpatient process and outpatient satisfaction, and stratified analysis was conducted on patient satisfaction in different regions and different types of institutions.Results:One hundred and thirty-six core sample hospitals were included in the 5 round evaluation, and 30 153 valid questionnaires were collected in the fifth evaluation in 2021.From 2016 to 2021, the overall satisfaction of outpatients in the 5 round evaluations was 91.4%, 87.3%, 90.1%, 91.1% and 95.4%, respectively. The satisfaction of outpatients to the medical services continued to improve. Outpatient treatment process has been continuously optimized, appointment registration has become the most commonly used way of outpatient registration. The satisfaction of outpatients to the process and environment of treatment in the western region was significantly improved.Conclusions:From 2016 to 2021, the overall satisfaction of outpatients has been consistently improved. Informatization helps to optimize the treatment process, but it is recommended that hospitals should provide special support for elderly outpatients.