The study focused on tertiary public hospitals in Hangzhou,investigating the comments of both hospitals workers and foreigners in the city with questionnaires and literature search.The foilowing four problems were identified in the study in the foreigner medical services in Hangzhou:Communication barriers between doctors and foreign patients,insufficient communication of medical service information,poor service environment and service attitude,and payment mechanism for medical insurance and charges.On such basis,the authors recommended policy changes for the government to improve foreigner-oriented medical services,including building the regulations up to intemational customs for medical services,reforms in the payment system,medical insurance management,as well as planning and promotions of foreigner-related service institutions,and management strategies for key elements within the hospital

OBJECTIVE:To study the effects of Total sasponins of Pannax Notoginseng(PSN)on oxidative stress during atherosclerogenesis(AS)in rabbits accelerated by persistent inflammation.METHODS:A total of 24 Japanese big-eared rabbits were divided into control group,high lipid group,persistent inflammatory group,and PSN group to be treated accordingly.Serum levels of C reactive protein(CRP),nitric oxide(NO)and malondialdehyde(MDA)as well as the activity of superoxide dismutase(SOD)were given a dynamic monitoring;and aortic atherosclerotic plaque areas were measured.RESULTS:In the persistent inflammatory group,serum levels of CRP and MDA were increased significantly,but SOD activity and level of NO were decreased significantly,aortic atherosclerotic plaque area was increased obviously,and CRP level was positively correlated with both MDA content and plaque area,showing significant difference as compared with the high-lipid group(P

Applying the effective teaching theory to the small-class teaching of pharmacology can improve the flexibility of small-class teaching mode under the guidance of the concept of effective teaching and high efficiency. The course chapters were randomly selected for traditional teaching mode or small-class teaching mode based on effective teaching theory in the same class. Practice has proved that the small-class teaching based on AO-AMFM can enhance student analysis and make careful smart objective and teaching frame work before class, and can also reach prompt activation, multi-learning, effective feedback and multi-summary, which can significantly improve students' learning enthusiasm and learning efficiency.

According to the working principle of vertical ultrasonic vial washing machine, receiving respective force of small water droplets on the inside wall of vials and the minimum air velocity of blowing off water droplets can be obtained based on the analysis of water-droplet-related parameters. The inside wall model of 7 mL vial created by GAMBIT was divided into fine grids. Then the Realizable k-epsilon Two Equation Turbulence Model was adopted and the flow field of vial by FLUENT software was simulated when air was flushing inside the wall. In that case, the optimal position, inner diameter and the corresponding minimum air velocity of needle can be acquired to meet the needs of vial washing machine applied to 7 mL vial.
Equipment Design ; Models, Theoretical ; Needles ; Software

Objective To explore application of pulse indicator continuous cardiac output(PICCO)in the treatment of septic shock during continuous renal replacement therapy (CRRT).Methods 34 patients with septic shock who underwent CRRT were randomly divided into the control group and the experimental group.Heart rate(HR),mean arterial pressure(MAP)and central venous pressure (CVP) were monitored in the control group.The experimental group were monitored by PICCO technology in addition to conventional monitoring,the hemodynamics parameters were collected such as end-diastolic volume index (GEDI),extravascular lung water index(EVLWI),and systemic vascular resistance index(SVRI),etc.Dehydration volume and supplementary volume were controlled by means of two group's hemodynamics parameters.The change of Acute Physiology And Chronic Health Evaluation-Ⅱ (APACHE Ⅱ),lactate (Lac),saturation of central venous oxygen(SevO2) and oxygenation index (PaO2/FiO2) were observed.Results After treatment of 72h,the decrease of APACHE Ⅱ and lactate in the experimental group was higher than those in the control group,the increase of ScvO2 in the experimental group was higher than those in the control group,the increase of PaO2/FiO2 in the experimental group was evidently higher than those in the control group.Conclusions During PICCO monitoring technique to guide CRRT therapy in patients with septic shock,the volume status of patients can be accurately controlled,organizational cycle can be improved,oxygenation of lung can be obviously improved,which contributes to treatment of septic shock.

The study is to investigate the effect of angiotensin II (Ang II) and its receptor blockers on migration and endothelin-1 (ET-1) expression of rat vascular adventitial fibroblast subpopulations. Vascular adventitial fibroblasts were individually expanded by using cloning rings, and the effects of Ang II on the migration of adventitial fibroblast subpopulations were evaluated by Transwell. Fluorescence quantitative-PCR detected the expression of preproET-1 mRNA induced by Ang II, and its receptor antagonists losartan and PD-123319. The concentration of ET-1 was determined by ELISA. It showed that spindle shaped and epithelioid shaped cells were isolated by using cloning rings, named as spindle cells and round cells. RT-PCR showed that fibroblast subpopulations did not have leukocytes, endothelial cells and smooth muscle cells, namely pure cell lines. Compared with respective control cells, two subpopulations had transferring ability. Ang II significantly improved round cells migration in a concentration-dependent manner, and had no obvious influence on spindle cells migration. Ang II (1 x 10(-8) - 1 x 10(-6) mol x L(-1)) significantly increased the expression of preproET-1 mRNA in round cells (P < 0.01), and had no significant effect on the expression of preproET-1 mRNA in spindle cells. Losartan blocked the expression of preproET-1 mRNA induced by Ang II in round cells, and had no significant effect on the expression of preproET-1 mRNA in spindle cells. The effects of Ang II and ET-1 receptor inhibitors on the release of ET-1 were similar to the expression of preproET-1 mRNA. The results indicate that there are two cell subpopulations: round cells and spindle cells in rat vascular adventitial fibroblasts. Ang II significantly improved cells migration, and increased the expression of ET-1 in round cell subpopulation. It suggested that there may be different migratory mechanisms in two cell subpopulations, and the two subpopulations may play a different role in vascular remodeling and reparative process.

Objective To explore the application of PBL teaching method and brainstorming method in the training of medical students' medical record writing ability,in order to strengthen the cultivation of medical students' medical record writing ability.Methods 122 medical undergraduate interns of Grade 2010 majoring in clinical medicine in our hospital were taken as the research object,of which 60 were in the experimental group,62 were in the control group.PBL teaching combined with brainstorming method was used in the experimental group,while the control group used the traditional teaching method of teaching.After the end of the training course,data were analyzed using SPSS 19.0 software,count data and measurement data were analyzed using chi square test and t test to carry out the significant test between the two groups of data,the training effect was compared between the two groups.Results The results of questionnaire in the experimental group were significantly higher than those in the control group,and the difference was statistically significant,The experimental group theory test scores were higher than the control group[(84.28 ± 6.65) vs.(74.52 ± 6.75)],and the difference was statistically significant;The experimental group outstanding achievement ratio was higher than the control group,and the difference was statistically significant;The proportion of operation and non operative medical records in the experimental group were higher than that in the control group (P=0.005,P=0.004).Conclusion Combined application of PBL teaching method and brainstorming method plays a positive role in superposition and complementation.It gives full play to and mobilizes the students' enthusiasm and initiative,and the training effect is obviously superior to the traditional teaching method,therefore it is worth popularization and application in the training of students' medical record writing ability.

Objective To study the prescription and preparation technology of breviscapine microemulsion for parenteral injection,and to evaluate its quality.Methods The prescription was selected and optimized through single-factor test and the pseudo-ternary phase diagram method.The preparation technology was investigated,and the particle diameter,drug content,encapsulation efficiency and haemolyticus were evaluated.Results The prescription composition of breviscapine microemulsion was soybean oil:phospholipid:HS15:PEG400:water=1:0.1:0.55:0.55:6.64 (m/m),with the drug content of 4.01 mg·mL-1,the acquired breviscapine microemulsion exhibited light yellow,uniform and transparent,with average particle diameter of 92.1 nm and encapsulation efficiency of 96.8%.The compatibility test showed no drug precipitation and the preparation was no hemolytic crisis.Conclusion The preparation of breviscapine microemulsion injection is correspond to the main index of parenteral injection.

Aim To observe the mRNA expressions of cell cycle regulators at different time points during the hypertrophic process of H9 c2 rat cardiomyoctes in-duced by angiotensin Ⅱ stimulation.Methods H9c2 myocytes were stimulated with 1.0 μmol · L-1 angio-tensin Ⅱ (Ang Ⅱ)for scheduled time.Cells were stained by Rhodamine labeled phalloidin and the cell area was measured by ImageJ software.mRNA expres-sion levels of cyclin B,D,E,cyclin dependent kinase (CDK)1,2,4,6,and CDK inhibitor p21 were de-termined by real-time PCR at different time points (0, 5,10,30 min,and 1,2,3,6,12,24,48 h).Re-sults H9 c2 cell size increased soon after stimulation of Ang Ⅱ;mRNA expressions of cyclin E,CDK4 and CDK2 all reached the peak at 5 min after stimulation of Ang Ⅱ;mRNA expression of cyclin D was increased dramatically at 10 min,followed by a decrease trend. However,the mRNA expression of cyclin B and CDK6 both showed two peaks,a p2 1 mRNA level was up to the peak at 30 min,and the expression was lowest at 3h.Although its expression increased gradually after 3h,p21 mRNA remained low level.Conclusion mRNA expression levels of the cell cycle regulators fluctuate and jointly facilitate the hypertrophic process of cardiomyocytes.

AIM: To investigate the expression of extracellular matrix metalloproteinase inducer(EMMPRIN) and endothelin converting enzymes(ECE) in non-small-cell lung carcinoma(NSCLC),and their relationship with lymphoid metastasis and prognosis.METHODS: Expression of EMMPRIN and ECE in 77 cases of patients with NSCLC was detected immunohistochemically.The relationship of the expression of EMMPRIN and ECE with tumor size,histological type,differentiation,lymphoid metastasis,clinical stage,and prognosis were analyzed.RESULTS: The expressive rate of EMMPRIN and ECE was 66% and 45%, respectively.The expression of EMMPRIN and ECE was associated positively with lymphoid metastasis(both P0.05).The expression of EMMPRIN was associated with the expression of HGF in NSCLC(P