This paper made systematic description of the three objectives of sustainable development designed for the policy based on the sustainability theory for the health sector.The essential drug system for secondary hospitals comprises the list coverage and allocation percentage of essential drugs,requirements for bidding and purchasing as well as pricing practice; management and conditions of these hospitals,including leadership determination and competency,doctors prescription behavior,and supportive reforms at these hospitals; external policies and social environment,including government financial subsidy,medical service prices adjustment,medical insurance,and the awareness and attitude of the people on essential drugs.

Within the KABP model as a framework,the authors studied these behaviors at the following three levels,namely knowledge and learning,beliefs and attitude,and behavior.Such aspects as the education background and training,drug expertise,drug infonmation sources,personal experience and habits,attitudes,needs of physicians and patients',socio-demographic characteristics were discussed among others to probe into how physicians' personal behavior affects their prescription behavior.Recommendations raised include education and training,provision of correct drug information,greater publicity,better compensation mechanism of public hospitals,strengthened supervision,establishment of the system of prescription audit,etc.

Substance P (SP) and calcitonin gene-related peptide (CGRP) are the neuropeptides released from the sensory nerve endings.Neuropeptides play a role in bone and the relevant organs.It exerts functions in regulation of the bone metabolism,fracture healing and pain by a certain way.The biological properties and distributions of SP and CGRP are closely related to the pathogenesis and development of bone metabolism,fracture healing and pain.

Objective To analyze the clinical features of patients with cholelithiasis treated in our hospital in the recent 10 years to explore the changing tendency of the spectrum of cholelithiasis in the Jiaodong region. Methods The clinical data of 2899 patients receiving operation for cholelithiasis in this hospital between January 1998 and January 2008 were retrospectively analyzed. The clinical parameters of sex, age and the lesion sites were reviewed. Compared with the clinical data of cholelithiasis patients in 1991, the data of the 2899 patients were statistically analyzed by SPSS 12.0 package.Results Significant differences existed in sex, e peak morbidity, and lesion sites. The ratio of male patients and female patients with cholelithiasis in differents site had obvious diversity. The constituent ratio of the female was manifestly higher than that of the male. The peak morbidity age range of cholecystolithiasis was 40 to 69. The peak age of gallbladder stones combined with common bile duct stones was 70 to 79, which was the same as that of common bile duct stones. The peak age of intrahepatic bile duct stones was 40 to 59. The constituent ratio of cholecystolithiasis was obviously higher than cholelithiasis in other sites. The incidence of cholecystolithiasis increased with age. Conclusion In the recent 10 years, female's ratio of gallbladder stones and intrahepatic stones was higher than male's.The morbidity of cholelithiasis significantly increased in aged patients. The spectrum of cholelithiasis has changed significantly.

Object Through performing the service satisfaction survey,to learn their interest claim and discover the service defects ,so as to provide advice and countermeasures.Method Using field survey methods and statistics analysis to study.Result The satisfaction of relatives of pediatric patients at the level of "relatively good" and "good" is about 60% both in medical treatment environment and equipment ,over 70% in medical treatment effect,doctor capacity,nursing capacity and overall assessment,but only 5.1% in medical expenses.Conclusion Relatives of pediatric patients have high satisfaction in treatment capability of medical staff,medical treatment effect as well as overall assessment ,normal satisfaction in medical environment and equipment,but lowest satisfaction in medical expenses,and the satisfaction in tertiary hospital is not high.Relatives in some districts demand much in some aspects,such as improving hospital environment,attaching importance to ward hygiene ,improving service attitude,and providing single ward ect.

Objective To study the quality of outpatient prescriptions for patients of different age groups at both township and village level,for the purpose of evaluating the outcomes and problems of the ongoing healthcare reform at primary levels.Methods 100 outpatient prescriptions of April 2015 were mechanically sampled randomly from two township hospitals and 8 village clinics in counties A and B in Hubei province.These prescriptions were analyzed for the drug count per prescription,percentage of intravenous prescriptions,that of antibiotics,that of hormones and average cost per prescription.Results At the township hospitals,the drug count per prescription(2.02)of county A was less than that of county B(3.26),while the percentage of intravenous prescriptions(30.30%),that of antibiotics(47.98%)and hormones(6.57%)of county A were significantly less than those of county B(50.65%,69.08% and 15.13% respectively).At village clinic level,the percentage of intravenous prescriptions(31.05%)of county A was higher than that of county B(20.34%),the average prescription costs(￥29.28)of county A was less than county B(￥31.45);while in terms of children′s prescriptions,average drug count of county A(2.50)was higher than county B(2.09),and its proportion of antibiotics(65.91%)was higher than county B(45.56%).Conclusions General primary care reform is faced with challenges of poor control of intravenous injection and use of antibiotics,particularly at village clinics and pediatric drug use in terms of prescription quality control.Both township and village levels should strengthen the supervision over the drug suppliers,guide the demand side to rationally use drugs and focus on the reasonableness of the medication of village clinics and children.

Objective :To compare the clinical efficay between dynamic hip screw (DHS)and proximal femoral nail(Intertan) fixation after closed reduction for the treatment of elderly patients with Evans type Ⅰ intertrochanteric fracture .Methods :Among 70 elderly patients with intertrochanteric fracture (Evans Ⅰ ) undergoing surgical treatment ,30 cases (DHS Group) were treated by closed reduction and DHS internal fixation and the other 40 cases (Intertan Group) were treated by closed reduction and Intertan fixation .Results :All the patients were followed up for 6-24 (12 .0 ± 3 .0) months .All the fractures were healed and no complication such as failure of internal fixation or femoral head necrosis occurred . There was statistically significant difference between operation time the DHS group and the Intertan group with 40-90 (63 .6 ± 8 .4) min and 40-90 (55 .6 ± 9 .8) min in DHS Group and Intertan Group ,respectively .And the intraoperative blood loss were 100-200 (145 .4 ± 22 .5) mL and 100-200 (92 .4 ± 25 .5) mL in DHS Group and Intertan Group ,respectively .Furthermore ,the duration of stay were 6-16 (11 .2 ± 2 .8) days and 6-9 (7 .9 ± 1 .1) days in DHS Group and Intertan Group ,respectively .There were significant difference regarding operation time ,intraoperative blood loss ,and duration of stay between the two groups(P< 0 .05) .Wound healing were achieved by postoperative liquefaction wound care in 4 cases of DHS group .There was no significant difference regarding fracture healing time between the 2 .5-4 .0 (3 .4 ± 0 .8) months in DHS Group and the 2 .5-4 .0 (3 .2 ± 0 .7) months in Intertan Group(P> 0 .05) .There were statistically significant differences between the two groups regarding Harris function scores after operation ,which were 67-84 (73 .5 ± 5 .1) points in DHS Group and 70-86 (77 .9 ± 3 .7) points in Intertan Group , and function scores which were 23-40 (30 .8 ± 3 .2) points in DHS Group and 25-44 (34 .4 ± 2 .9) points in Intertan Group (P<0 .05) .There was no significant difference between two groups regarding pain scores ,which were 20-44 (34 .9 ± 4 .8) points in DHS Group and 20-44 (35 .8 ± 5 .0) points in Intertan Group ,and activity range scores ,which were 2-4 (3 .0 ± 0 .8) points in DHS Group and 2-4 (3 .0 ± 1 .0) points in Intertan Group (P> 0 .05) .Conclusions :The Intertan and DHS internal fixation are effective methods for the treatment of elderly patients with intertrochanteric fractures .Intertan showed less trauma ,shorter duration of stay ,and better recovery of hip function .

The massive water and steam are consumed in the production of cellulose ethanol, which correspondingly results in the significant increase of energy cost, waster water discharge and production cost as well. In this study, the process strategy under extremely low water usage and high solids loading of corn stover was investigated experimentally and computationally. The novel pretreatment technology with zero waste water discharge was developed; in which a unique biodetoxification method using a kerosene fungus strain Amorphotheca resinae ZN1 to degrade the lignocellulose derived inhibitors was applied. With high solids loading of pretreated corn stover, high ethanol titer was achieved in the simultaneous saccharification and fermentation process, and the scale-up principles were studied. Furthermore, the flowsheet simulation of the whole process was carried out with the Aspen plus based physical database, and the integrated process developed was tested in the biorefinery mini-plant. Finally, the core technologies were applied in the cellulose ethanol demonstration plant, which paved a way for the establishment of an energy saving and environment friendly technology of lignocellulose biotransformation with industry application potential.
Bioelectric Energy Sources ; economics ; Biofuels ; analysis ; Biotransformation ; Ethanol ; analysis ; metabolism ; Fungi ; metabolism ; Industrial Microbiology ; methods ; Lignin ; metabolism ; Steam ; Water ; analysis

In order to understand the potential target and related mechanism of action of Termina-lia Chebula treatment,network pharmacology and molecular docking methods were used in this experiment,and the challenge test of Salmonella from yak was performed.The active ingredients and potential targets of Terminalia Chebula were screened through HERB cluster identification database,TCMSP database and SwissTargetPrediction web page tool,and"gastroenteritis"was searched through OMIM and GeneCards database.Cytoscape and STRING databases were used to construct the Terminalia Chebula PPI network to screen out key targets,the intersection targets between Terminalia Chebula and enteritis were obtained through Venny platform,and gene ontol-ogy(GO)and Kyoto encyclopedia database of genes and genomics(KEGG)were enriched through DAVID database.The core target of screening was verified by molecular docking.After that,the gastrointestinal inflammation model of mice was established,the pathological changes of gastroin-testinal tract were observed,and the effect of Terminalia Chebula on the target protein was veri-fied by Western blot test.The results showed that:after analyzing and sorting out 8 main active in-gredients of Terminalia Chebula,118 targets of Terminalia Chebula were screened,11 161 targets of gastroenteritis and 100 targets of intersection were obtained;the core targets of PTGS2,CASP3,SLC3A2,Bax,Bcl-2 and TP53 of Terminalia Chebula and enteritis were obtained through PPI network.GO and KEGG enrichment analysis collected 337 items and 138 items,respectively,mainly related to chemokine pathway,PI3K-Akt signaling pathway,apoptosis related pathway,i-ron ion transport related pathway,NF-κB signaling pathway,etc.The results of molecular docking showed that chebulidic acid,the first active component of chebulidic acid,can bind to Bax,Bcl-2,PTGS2 and SLC3A2 through hydrogen bonding,hydrophobic action,π-π packing force and other intermolecular forces.The pathological tissue sections showed that Terminalia Chebula could sig-nificantly recover gastrointestinal tissue injury.Western blot test results showed that Terminalia Chebula can regulate the process of apoptosis and iron death through Bax/Bcl-2 and PTGS2/SLC3A2 pathways to achieve the effect of treating intestinal inflammatory damage.The results showed that Terminalia Chebula can regulate the occurrence and development of enteritis by regu-lating apoptosis and iron death through Bax/Bcl-2 and PTGS2/SLC3A2 pathways.Terminalia Chebula has the characteristics of multi-target and multi-pathway in the treatment of enteritis.