Public hospital reform pilots have been initiated recently and it is necessary to clarify some key issues. To this end, thispaper touches upon six fundamental issues, discussing the generality and value for the existence of public hospitals, differences between reforms of public hospital and those of state-owned enterprise, the public financing for and regulation on public hospitals, relationship with the private sector, as well as service and function positioning of public hospitals.

Animals ; Brain-Derived Neurotrophic Factor ; metabolism ; Hypothalamus ; metabolism ; Male ; Physical Conditioning, Animal ; physiology ; Rats ; Rats, Sprague-Dawley

Objective To explore the interaction between serum melatonin and the status of disease and probe the effect factor of serum melatonin change in asthmatic children.Methods Serum melatonin was measured in asthmatic children with 15 cases of mild persistent asthma,15 cases of moderate persistent asthma,15 cases of severe persistent asthma,15 cases of stable asthma and 15 cases of normal subjects by enzyme-linked immunosorbent assay(ELISA).Results The levels of serum melatonin in the 5 groups of mild persistent asthma,moderate presistent asthma,Severe Persistent asthma,Stable asthma,control subject were(22.76?5.16)ng/L,(16.79?3.35)ng/L,(11.54?1.45)ng/L,(22.06?3.36)ng/L,(28.72?4.32)ng/L,respectively.There were significant differences between any of them(Pa

OBJECTIVETo explore the feasibility of replacement of ordinary syringes by auto-disposal syringes (AD) in China.

METHODSSampling survey was conducted in Hebei province to collect data on the direct medical spending of hepatitis B and their Disability Adjusted Life Year (DALY) losses. The financial burden on hepatitis B was calculated based on the result of field survey as well as through data-base of the Second National Health Services Survey of MOH in 1998. The cost-benefit analysis was employed, in which the saving of the financial burden on hepatitis B patients attributing to unsafe injections was taken as the benefit of intervention and the increased expenditures of AD syringes as the costs.

RESULTSThe total financial disease burden of Hepatitis B in China in 2001 was between RMB 16.19 and 20.17 billion Yuan and the financial disease burden per patient was between RMB 1755.38 and 1409.64 Yuan. Study on the cost-benefit analysis in the replacement intervention program showed high financial feasibility. The Benefit-Cost Ratio (BCR) of the measure was between 32.46 and 97.39, which was bigger in rural areas than that in cities. The direct BCR was less than one when the price gap between ordinary syringe and AD exceeded RMB 0.24 Yuan.

CONCLUSIONThe intervention of safe injection practice through universal usage of AD to replace ordinary syringe seemed to be applicable due to its high potential economic benefits.

China ; epidemiology ; Cost-Benefit Analysis ; Cross Infection ; economics ; etiology ; prevention & control ; Cross-Sectional Studies ; Disposable Equipment ; economics ; statistics & numerical data ; Equipment Reuse ; statistics & numerical data ; Female ; Hepatitis B ; economics ; transmission ; Humans ; Injections ; adverse effects ; economics ; instrumentation ; Male ; Risk Factors ; Sampling Studies ; Surveys and Questionnaires ; Syringes ; economics

To develop an analytic method for qualitative and quantitative analysis of dodecatetraenamides A, B in 42 samples of two official species of Asari Radix et Rhizoma( ARR) (37 samples of Asarum heterotropoides var. mandshuricum with different collection time and 5 samples of Asarum sieboldiivar. seoulense). The HPLC-IT-TOF-MS/MS methods for the qualitative and UPLC-PDA methods for the quantitative analysis were established. Dodecatetraenamides A, B were identified by comparing the retention time, UV absorption spectrum and quasi-molecular ion peak [ M + H]+ with the reference compound using HPLC-IT-TOF-MS/MS. The content of dodecatetraenamides A and B in ARR were determined by UPLC-PDA. The separation was successfully carried out on a ACQUITY UPLC BEH C18 (2.1 mm x 100 mm, 1.7 µm) column eluted with mobile phases of water (A) and acetonitrile (B) in gradient program (0-3 min, 35% B; 3-5 min, 35%-36% B; 5-6 min, 36%-43% B; 6 min-11 min 43% B; 11-12 min, 43%-100% B). The column temperature was 45 °C, and the detection wavelength was set at 254 nm. The flow rate was 0.6 mL · min(-1). On one level mass spectrometry scanning, the results showed that the quasi-molecular ion [M + H] + of both dodecatetraenamides A and B were m/z 248.20. The quantitative method with UPLC-PDA has made the baseline separation of the constituents, which were reported as mixtures in the most literatures. The average recovery of dodecatetraenamides A and B were 97.90% and 99.86%, the relative standard deviation were 0.4% and 1.1%, respectively. The contents of dodecatetraenamides A, B in all ARR samples was in the range of 0.11-3.89 and 0.24-6.65 mg · g(-1). Their contents reduced with the extension of storage time. Compared with the samples of 2013, the average content of the two constituents in the samples collected in year 2002-2003 reduced 34% and 36%, respectively (P < 0.05). Compared the A. sieboldii var. seoulense and A. heterotropoides var. mandshuricum with the same collective time and production area, the average contents of the two constituents in latter were up to (1.59 ± 0.75) mg · g(-1) and (2.90 ± 1.17) mg · g(-1), respectively, significantly higher than that in A. sieboldii var. seoulense (dodecatetraenamide A were (0.78 ± 0.52) mg · g(-1), dodecatetraenamide B were (1.69 ± 0.83) mg · g(-1)) (P < 0.05). The content of the dodecatetraenamide A in overground part was in the range of 0.11-0.33 mg · g(-1), dodecatetraenamide B was 0. 24-0.60 mg · g(-1), which were much lower than that of the underground part of ARR (dodecatetraenamide A was in the range of 0.73-3.89 mg · g(-1), dodecatetraenamide B was 2.11-6.24 mg · g(-1)). The method was certified to be simple, accurate and reliable and could be used for qualitative and quantitative analysis of dodecatetraenamide A and B in different species of ARR, also can be used for the comprehensive quality control of traditional Chinese medicine, Asari Radix et Rhizoma.
Amides ; chemistry ; Asarum ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Mass Spectrometry ; Molecular Structure ; Rhizome ; chemistry

OBJECTIVETo investigate the potential of Gomphidius viscidus, a kind of ectomycorrhizal fungi, for phytoremediation of anthracene in soil.

METHODSAbsorptioe changes of micro-habitat were studied in detail.

CONCLUSIONEctomycorrhizal plants have a strong potential for remediation of polycyclic aromatic hydrocarn characteristics of both active and inactivated mycelia.

RESULTSA high calculated adsorption capacity of 1,886.79 mg/g and 1,515.15 mg/g at 25 °C, pH 6.0 for active and inactivated mycelia respectively, was obtained based on Langmuir model. The ANT biosorption was more ideally characterized by the Langmuir model than by the Freundlich model. The biosorption of anthracene to biomass was extremely fast and could be modeled with pseudo-second order adsorption kinetics. Moreover, ectomycorrhizal mycelia demonstrated a strong ability to adjust the physiological process to get adapted to the change of micro-habitat.

Adsorption ; Anthracenes ; analysis ; Basidiomycota ; growth & development ; Biodegradation, Environmental ; China ; Chromatography, High Pressure Liquid ; Hydrogen-Ion Concentration ; Mycelium ; growth & development ; Mycorrhizae ; growth & development ; Soil Pollutants ; analysis ; Temperature

Background The pathological change of the anterior uveitis is the disruption of blood-aqueous barrier.Slit lamp examination appears to be limited for the evaluation of inflammatory response,and fluorescine angiography is an objective approach.However,there are few relative studies up to now in China.Objective Aim of this study was to observe the characteristics and assess the clinical applications of iris fluorescein angiography (IFA)in Chinese uveitis with brown iris.Methods Forty eyes of 40 normal subjects and 21 eyes of 13 patients with the anterior uveitis were collected in this study.IFA,slit-lamp examination and iris photograph were performed on the subjects.All individuals were informed consented at the initiation of this study.Results In normal eyes,fluorescence in iris vessels was blocked by the melanin pigment,but peripupillary weak fluorescent leakage was seen in the normal eyes with the age of ＞60 years old.The multiple patterns of fluorescence leakage were found in the patients suffered from uveitis of various etiologies although the negative slit-lamp finding,including the leakage of fluorescein around the pupillary margin and radial iris vessels in the eyes with mild diseases,transmitted fluorescence of regular iris vessels in the eyes with diffuse and local iris atrophy,and vascular tufts of the pupillary margin with coiled interwind tight clusters of thin vessels at the early phase in the eyes with dilated capillaries,microvascular anomalies and new vessel formation.The hyperfluorescence remained throughout the IFA duration.Conclusions IFA findings in uveitis vary depending on the topography,type and severity of inflammation.IFA has a good clinical applying value because of its objective assessment ability of the degree of the blood-aqueous barrier breakdown and iris neovascularization breakdown.It can exhibit the unvisible lesion under the slit-lamp and monitor the efficacy of medical theraphy in patients with active or quiescent uveitis.

PURPOSE: To report the 5-year follow-up results of a randomized controlled trial comparing bipolar transurethral resection of the prostate (TURP) with standard monopolar TURP for the treatment of benign prostatic obstruction (BPO). MATERIALS AND METHODS: A total of 220 patients were randomized to bipolar plasmakinetic TURP (PK-TURP) or monopolar TURP (M-TURP). Catheterization time was the primary endpoint of this study. Secondary outcomes included operation time, hospital stay, as well as decline in postoperative serum sodium and hemoglobin levels. All patients were assessed preoperatively and followed-up at 1, 6, 12, 24, 36, 48, and 60 months postoperatively. Parameters assessed included quality of life, transrectal ultrasound, serum prostate-specific antigen level, postvoid residual urine volume, maximum urinary flow rates (Qmax), and International Prostate Symptom Score. Patient baseline characteristics, perioperative data including complications, and postoperative outcomes were compared. Complication occurrence was graded according to the modified Clavien classification system. RESULTS: PK-TURP was significantly superior to M-TURP in terms of operation time, intraoperative irrigation volume, resected tissue weight, decreases in hemoglobin and sodium, postoperative irrigation volume and time, catheterization time, and hospital stay. At 5 years postoperatively, efficacy was comparable between arms. No differences were detected in safety outcomes except that the clot retention rate was significantly greater after M-TURP. CONCLUSION: Our results indicate that PK-TURP is equally as effective in the treatment of BPO, but has a more favorable safety profile in comparison to M-TURP. The clinical efficacy of PK-TURP is long-lasting and comparable with M-TURP.
Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostate/*surgery ; Transurethral Resection of Prostate/adverse effects/*methods ; Treatment Outcome

Objective: To understand the influence of post-abortion care (PAC) on the reproductive health of unmarried female college students,and to provide scientific basis for reproductive health education. Methods: A total of 486 unmarried female college students who received artificial abortion voluntarily due to unwanted pregnancy and had complete follow-up data were investigated by questionnaires before and six months after the operation from July 2017 to June 2018 in the Tongde hospital of Zhejiang Province. Results: There were 248 patients with abortion history, including 15 patients with abortion frequency ≥3 times.72 cases of high-risk abortion, the high-risk factors were re-abortion within half a year and the number of abortion ≥3 times; After PAC intervention, the awareness rate on menstruation and ovulation knowledge, scientific contraceptive knowledge, prevention of sexually transmitted diseases knowledge(types of diseases,raltes of transmission and preventive measures), and the harm of abortion knowledge(short-term and longterm complications), was higher than before(χ2=21.42, 69.65, 71.09, 52.80, 63.25, 187.59, 356.02, P<0.05). Before intervention, only 53.7% (261/486) of female college students used medium and low efficiency contraceptive measures, only 0.4% (2/486) were high-efficiency contraceptive measures. After intervention, all of them used contraceptive measures, The rate of effective contraceptive measures in the immediate and six months after operation was 85.4% (415/486) and 68.3% (332/486) respectively, which was significantly higher than before(χ2=786.10, P<0.05). Conclusion PAC service for female college students can improve awareness rate of sexual and reproductive health, enhance effective contraceptive measures, reduce the risk of repeated abortion.

Objective: To explore the effect of plan-do-check-act (PDCA) cycle on contraceptive methods after induced abortion in female college students. Methods: A total of 456 unmarried female college students who underwent artificial abortion in Tongde Hospital of Zhejiang Province from January 2018 to May 2019 were selected. These students were randomly divided into control group (n=228) and intervention group(n=228). Students from the control group accepted Post Abortion Care (PAC) service, while the intervention group accepted the management of PDCA cycle on basis of PAC services. Results: In the intervention group, the rate of highly effective contraception immediately after abortion and six months after abortion were 91.23% and 71.17% respectively, while in the control group were 82.89% and 60.00%, the intervention group was higher than the control group(χ2=7.03, 5.98, P<0.05). The rate of unsafe contraceptive in the intervention group six months after abortion was 3.60%, while in the control group was 20.00%, the intervention group was lower than the control group(χ2=28.35, P<0.05). Conclusion The PDCA cycle can effectively improve the utilization rate of high efficiency contraceptive methods after induced abortion in college students, reduce the rate of unsafe contraceptive six months after abortion, and it is helpful to reduce the incidence of short-term unplanned pregnancy after abortion.