With reference to the research report of American Medical Association on the healthcare system,the paper analyzed the existing medical service,and probed into the causes of poor quality of care The author staged the six countermeasures highlighting patient-focus,safe,effective,timely,efficient and fair medical service models,in the hope of improving quality of care and ensuring patient safety.

[Objective] To sum up teacher He Lingzhi’s clinical experience and academic ideas on diagnosing and treating IgA nephrosis. [Method] From casa morbi, mechanism and clinical treatment based on differentiation of signs, it expounds teacher He Lingzhi ’s clinical experience and academic points, exampled with a case. [Result] The disease has main mechanism of Qi deficiency, teacher He Lingzhi divides the IgA nephrosis into types of Qi deficiency of lung and spleen, spleen and kidney, both deficiency of lung and kidney, Yang deficiency of spleen and kidney, Yin deficiency of liver and kidney, both deficiency of Qi and Yin, Yin and Yang, thus forms the treating rules of tonifying Qi to reinforce spleen, tonifying lung to nourish kidney, tonifying liver and kidney, Qi and Yin, Yin and Yang. The case here was relieved the nephrosis symptoms with the treatment. [Conclusion] Teacher He Lingzhi has rich clinical experience in treating IgA nephrosis with differentiation of signs, with definite cure effect.

Nicotinic acid could increase high density lipoprotein and reduce serum total cholesterol, low density lipoprotein cholesterol and triglycerides in human bodies, thus is frequently applied in treating low high-density lipoprotein cholesterol and hypertriglyceridemia in clinic. However, according to the findings, nicotinic acid could also cause adverse effects, such as skin flush, beside its curative effects. In this study, bioisosterism, fragment-based search and Lipinski's Rule of Five were used to preliminarily screen out potential TCM ingredients that may have similar pharmacological effects with nicotinic acid from Traditional Chinese medicine database (TCMD). Afterwards, homology modeling and flexible docking were used to further screen out potential nicotinic acid receptor agonists. As a result, eleven candidate compounds were derived from eight commonly used traditional Chinese medicines. Specifically, all of the candidate compounds' interaction with nicotinic acid receptor was similar to nicotinic acid, and their docking scores were all higher than that of nicotinic acid, but their druggability remained to be further studied. Some of the eight source traditional Chinese medicines were used to lower lipid according to literature studies, implying that they may show effect through above means. In summary, this study provides basis and reference for extracting new nicotinic acid receptor agonists from traditional Chinese medicines and improving the medication status of hyperlipidemia.
Drug Evaluation, Preclinical ; Drugs, Chinese Herbal ; chemistry ; Humans ; Models, Molecular ; Molecular Structure ; Nicotinic Acids ; chemistry ; Nicotinic Agonists ; chemistry ; Protein Binding ; Receptors, G-Protein-Coupled ; agonists ; chemistry ; Receptors, Nicotinic ; chemistry

Objectives To analyze the deployment of medical equipment and its impacts on medical services of hospitals.Methods Existing data collection,a survey of public hospitals and a chart review of acute myocardial infarction(AMI)inpatients were used to collect related data.Gini coefficients,Chi-square and multivariate model were used to analyze deployment of medical equipment and its impacts on medical services.Results The number of CTs and that of CTs per million population in Pudong new area were higher than those of MRIs and DSAs,and the distribution of CTs among districts in Shanghai was relatively equal(Gini coefficient was 0.20).But lack of DSAs in some public general hospitals had affected the AMI inpatient care.Conclusions Public hospitals and governments in China should keep at a balance the demand of medical services,deployment level of medical equipment,and financial affordability for the society,governments and hospitals.

Objective To observe the effects of Sishen Pills on gene and protein expressions of toll-like receptor 2 (TLR-2) and toll-like receptor 4 (TLR-4) of colonic tissue in spleen-kidney yang deficiency rats with ulcerative colitis (UC); To discuss its mechanism of action for spleen-kidney yang deficiency UC. Methods Lavage of senna +intraperitoneal injection of hydrocortisone injection + enema of 2,4,6-trinitrobenzene sulfonic acid/ethanol were used to establish the model of UC of spleen-kidney yang deficiency type. 90 Wister rats were randomly divided into blank group, model group, Salazosulfadimidine group and the Sishen Pills high-, medium- and low-group. Each medication group was intervened by relevant medicine. RT-qPCR was used to detect the expressions of TLR-2 and TLR-4, and Western blot was used to detect the protein expressions of TLR-2 and TLR-4. SOD and MDA in serum were detected. Results Compared with the blank group, SOD activity decreased and MDA content increased in the model group (P<0.01); gene and protein expressions of TLR-2 and TLR-4 increased significantly (P<0.05). Compared with model group, SOD increased and MDA content decreased in all the medication groups (P<0.05, P<0.01); gene and protein expressions of TLR-2 and TLR-4 decreased (P<0.05, P<0.01). Conclusion Sishen Pills can achieve the treatment of UC by improving the metabolism of oxygen radicals in colonic tissue and regulating the immune system of the intestinal epithelium.

OBJECTIVE:To compare the curative effect of domestic cefoperazone/sulbactam and imported one for lower respiratory infection. METHODS:The curative effects of domestice vs. imported cefoperazone/sulbactam in 201 vs. 198 patients with lower respiratory infection in recent two years in our hospital were analyzed retrospectively. RESULTS:The effective rate was 61.6% for imported product and 51.7% for domestic product. Significant difference was noted between 2 groups statistically(P

Adolescent ; Cardiac Catheterization ; nursing ; Child ; Child, Preschool ; Female ; Heart Defects, Congenital ; nursing ; surgery ; Humans ; Infant ; Infant, Newborn ; Intraoperative Care ; Male ; Postoperative Care ; Preoperative Care

Acetabulum fracture, the inner fracture of the joint, has be en divided into 10 kinds. Because acetabulum is an irregular body, no single ope ration approach can solve all kinds of acetabular fracture. Appropriate selectio n of the operative approach according to the type of fracture is very important. Kocher-Langenbeck approach, extended-iliofemoral approach and ilioinguinal ap proach are often used in clinic now. Because of its complicated procedures and m any complications resulting from the approach, the application of extended-ilio femoral approach is decreasing. Because of its predominant advantage and improve ment of the operation techniques, the use of ilioinguinal approach is obviously increasing in proportion. Since the united approach can reveal clearly so that i t facilitates reduction and internal fixation, it is recommended by the surgeons at home and abroad.

0,but,prognostication capability was very weak,Q2Y=-0.607

OBJECTIVE:To study the pharmacokinetics of balofloxacin tablets in Chinese healthy volunteers.METHODS:A single dose of 100 or 200 mg balofloxacin tablets were given to 12 healthy volunteers in a randomized crossover design.Concentrations of balofloxacin in plasma and urine were determined by HPLC with data processed by DAS(drug and statistics)software.RESULTS:After administration of balofloxacin 100 mg and 200 mg,the Cmax were(0.970?0.245)?g?mL-1 and(1.849?0.466)?g?mL-1;the tmax were(1.25?1.10)h and(1.24?0.81)h;the t1/2 were(7.14?1.01)h and(7.11?0.72)h;the AUC0～36 were(7.309?1.368)?g?h?mL-1 and(15.214?1.727)?g?h?mL-1;AUC0～∞ were(7.531?1.386)?g?h?mL-1 and(15.695?1.762)?g?h?mL-1;the accumulative eliminating rates within 36 h in urine were(64.47?11.56)% and(63.24?11.93)%,respectively.CONCLUSION:The pharmacokinetics of balofloxacin in healthy volunteer after oral administration was characterized by high peak concentration and long half life.The method is sensitive,accurate,reliable and specific,and can satisfy the requirements for pharmaceutical study.