Since its founding,the Management Center of Shenzhen Public Hospitals,on the basis of summarizing and inheriting reform outcomes in the past,has been working on to streamline the relationship between the government,public hospitals and the society in line with the general reform requirements of the stateupholding public welfare nature,motivating and ensuring sustainability.The center carries out a general reform covering the hospital management system,operating mechanism,supervision mode,and service mode.This way the center has built a set of contemporary hospital management system fitting Shenzhen' s conditions,encouraging hospital operations to better embody the interests of the government,medical workers and the society,and to better cover quality,equity and efficiency,thus effectively improving the management performance and services of the hospitals in question.

BACKGROUND: Pancreatic stem cells can be differentiated into endocrine functioning cells under a suitable cultivation condition, suggesting that pancreatic stem cells can be used as a new source of islet in treating diabetes mellitus.OBJECTIVE: To discuss the expression of stem cell in different purities of pancreatic islets.DESING: A controlled observation based on cells.SETTING: Third People's Hospital of Mianyang City.MATERIALS: The experiment was conducted in the Center Laboratory (Key Laboratory of Chongqing City), the First Affiliated Hospital of Chongqing Medical University from March 2005 to March 2006. Thirty healthy male SD rats, of clean grade, aged 50 days were used in this study. During the experiment, the disposal of animals corresponded to Animal Ethical Standard. Cytokeratin (CK)-19 and β-actin were designed by Shanghai Invitrogen Biological Co., Ltd.Brdu reagent, mouse anti-rat Brdu monoclonal antibody, rabbit anti-mouse (RAM) CK-19 polyclonal antibody and Brdu immunohistochemical kit were from Boster Co., Ltd. (Wuhan); HistostainTM -DS double immunohistochemical staining kit was purchased from Beijing Zhongshan Company.METHODS: Rats were intraperitoneally injected with Brdu for labeling, and subjected to perfusion with Ⅴ-type collagenase via pancreatic ducts, with pancreas being excised, ripped, beaten up, digested and centrifuged to obtain pancreatic islet sediments. After being precipitated, the sediments were divided into 3 groups. Group A: The isolated sediments of islets were not purified; Group B: The sediments were added slowly with 25% Ficoll-400 and Hanks solution for purification; Group C: The sediments were slowly added with 25% Ficoll-400, 11% Ficoll-400 for purification in order.MAIN OUTCOME MEASURES: Expressions of Brdu and CK-19-positive cells in the islet samples were detected by immunohistochemical method, and mRNA expression of CK-19 in the different purities of islets was detected by reverse transcription-polymerase chain reaction.RESULTS: ① The purity of islets in the group A was the lowest. The purity of islets obtained by different purification techniques showed significances among the three groups (F =89.42, P ＜ 0.05). ②Positive expressions of Brdu and CK-19 in the group A were significantly higher than those in the group B and group C (F =18.64, 22.12, 38.61. P ＜0.01). ③Expression of CK-19 mRNA in the group A was significantly higher than that in other groups, with group C showing the lowest.CONCLUSION: Expressions of Brdu and CK-19-positive cells exist in different purities of islets, suggesting the existence of more stem cells in the low purify of islets.

In order to reform the medical talent evaluation system, establish evaluation systems of physician competency, and implement physician resources management systems according to work position, and the compensa-tion system which reflects the value of medical services, The basic principles and standards of different physician tiers and grades are created in Shenzhen based on literature review, expert consultation and the methods from the American Centers for Medicare and Medicaid Services ( CMS) . Some results have achieved, including medical competency as-sessment of a certain number of physicians in the pilot project ( the coincidence rate of special hospitals is higher than general hospitals, respectively 78. 9% and 44. 8% ), comprehensive personnel systems reforms in public hospi-tals, and the trial selection of medical talents. The paper also provides some implications:The cognition of all sectors of society and physician themselves should be improved, Transitional policies for position recruitment and performance pay needs further improvement. Meanwhile, the grade evaluation system of non-physicians must also be given greater attention.

Aim To study the anti-inflammatory activity of the Channa argus bile.Methods The bile was isolated and purified by extraction and silica gel column chromatography.Then the compounds were identified by hydrogen and carbon spectra.The spleen lymphocytes proliferation assay and Lipopolysaccharide(LPS) induced mouse macrophage RAW264.7 releasing Nitrogen Monoxide(NO) experiment were used to evaluate the anti-inflammatory activity.Results Compound(C1) of sodium taurocholate and compound(C2) of sodium taurochenodeoxycholate were isolated by activity tracing.The cell relative viabilities of the two compounds on Concanavalin A(Con A) induced spleen lymphocytes proliferation assay were 65.9%±11.7% and 60.5%±9.4%, which were significantly different from the result of model group (P<0.01), respectively.The NO production of LPS-induced RAW264.7 release of NO was (16.4±1.9) μmol·L-1 and (15.5±1.7) μmol·L-1, which were significantly different from the result of model group(P<0.01).Conclusion Sodium taurocholate and sodium taurochenodeoxycholate from Channa argus perform the anti-inflammatory activities but have no cytotoxic effect on spleen lymphocytes and macrophage.

Shenzhen implemented the health reform on the separation of drug prescribing and dispensing.This policy abolished the drug price addition system,which interrupted the interest chain between hospitals and pharmaceutical enterprises,and curbed the over-medication and use of expensive drugs.Such a reform has lowered the average cost of diagnose and treatment,the out-of-pocket payment by those covered by social insurance,outpatient infusion and the utilization of antibiotics.To further strengthen these outcomes and maintain the momentum of this policy,Shenzhen will further improve the compensation system for public hospitals,encourage the medical staffs' work enthusiasm and implement the reform measures actively.

This articles introduced the development of the four systems and eight mechanisms in Shenzhen's health reform,and described the implementing measures of the public hospitals reform and major mechanisms reform.It also reviewed the major achievements and challenges met in the health reform and made an outlook of the future steps in the reform.

Objective To evaluate the effectiveness of web-based mental health services.Methods Web-based mental health services were established in our hospital to offer continuing medical education on mental health and psychological assessments.The access of clinicians to psychiatric knowledge and consultation from psychiatry department was evaluated.Results A total of 803 medical staff took the continuing medical education,and 643 passed the examination.Five hundred and twenty-eight online psychological assessments were completed.The qualification rate of psychiatric examination was 83.3％ vs.31.7％ in educated and non-educated clinicians (x2=32.77,P＜0.01).The common consultation from psychiatry department of the educated group involved anxiety,depression/mania and delirium,of which anxiety and medically unexplained symptoms were comparatively higher while delirium was lower than the non-educated group (x2 values were 4.80,4.59 and 5.16,respectively; all P＜0.05).More use of online psychological assessments was found in the educated group (33.8％ vs.7.6％) before asking for a consultation from psychiatry department (x2=30.04,P＜0.01).Conclusions Online mental health continuing education and psychological assessment could improve psychiatric knowledge and recognition of anxiety and depression in clinicians.

The gradient bioceramics coating was prepared on the surface of Ti-6Al-4V alloy by using wide-band laser cladding. And the effect of technological parameters of wide-band laser cladding on microstructure and sinterability of gradient bioceramics composite coating was studied. The experimental results indicated that in the circumstances of size of laser doze D and scanning velocity V being fixed, with the increasement of power P, the density of microstructure in bioceramics coating gradually degraded; with the increasement of power P, the pore rate of bioceramics gradually became high. While P = 2.3 KW, the bioceramics coating with dense structure and lower pore rate (5.11%) was obtained; while P = 2.9 KW, the bioceramics coating with disappointing density was formed and its pore rate was up to 21.32%. The microhardness of bioceramics coating demonstrated that while P = 2.3 KW, the largest value of microhardness of bioceramics coating was 1100 HV. Under the condition of our research work, the optimum technological parameters for preparing gradient bioceramics coating by wide-band laser cladding are: P = 2.3 KW, V = 145 mm/min, D = 16 mm x 2 mm.
Ceramics ; chemistry ; Coated Materials, Biocompatible ; chemistry ; Lasers ; Materials Testing ; Surface Properties ; Titanium ; chemistry ; X-Ray Diffraction

Objective To investigate the operative methods and clinical significance of the treatment for large acoustic ncuroma with microsurgery by retrosigmoid approach.Methods 15 cases of large acoustic neuroma treated with microsurgery by retrosigmoid approach were systematic analyzed,including the operative approach,microsurgical technique,disposal after operation,prevention and cure of complications.Results Tumors were totally removed in 12 cases and were subtotally removed in 3 cases.Facial nerve was kept ana- tomic intact in 13 cases(86.7%) and acoustic nerve was kept anatomic intact in 6 cases(40.0%).The short period complications happened in 3 cases and no patient died in this series.Conclusion Treatment for large acoustic neuroma with microsurgery by retrosigmoid approach is a safe method,which give small hurt brain tissue and benefit to increase the total removal rate and protect effectively the function of facial nerve and acoustic nerve.

AIMTo study the chemical constituents of the roots of Chloranthus henryi.

METHODSThe constituents of Chloranthus henryi were separated with various chromatographic techniques. structures were elucidated by physico-chemical properties and spectral data.

RESULTSEight compounds were isolated from Chloranthus henryi. They were identified as curcolonol (I), zedoarofuran (II), shizukanolide E (III) , skimmin (IV), calucanthoside (V), chloracoumarin (VI), beta-sitosterol (VII), daucosterin (VIII).

CONCLUSIONChloracoumarin (VI) is a new compound and characterized as 6,8-dimethoxy-7-O-[beta-D-apiofunanosyl(l --> 3 )-D-glucopyranosyl]-2H-benzopyran-2-one. Compounds I, II were isolated from Chloranthus henryi for the first time.

Coumarins ; chemistry ; isolation & purification ; Glucosides ; chemistry ; isolation & purification ; Heterocyclic Compounds, 3-Ring ; chemistry ; isolation & purification ; Magnoliopsida ; chemistry ; Molecular Conformation ; Molecular Structure ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Sitosterols ; chemistry ; isolation & purification