The paper introduced the building of the distance medical education platform of the hospital,and explored the quality assurance system for such education,along with an outcome appraisal.The author proposed that the hospital should provide theory lectures,surgical demonstrations and case analysis by means of this platform to primary hospitals,which will be significant for normalizing primary hospitals' medical service,enhancing their academic and management levels,and healthcare homogenization.

OBJECTIVE:To analyze the market tendency and the overall marketing situation in clinical application of antipodagrics in hospitals of China.METHODS:The analysis was performed with the help of the parameters obtained from domestic authoritative medical economy information network.RESULTS&CONCLUSIONS:The competition for the pro?duction and the marketing of benzbromarone is fierce,yet its antipodagric effect and market prospect are generally considered to be good,manufactories of colchicine and allopurinol remain unchanged and the competition for these products is mild.An?tipodagrics market is expected to be further expanded.

A simple, precise, and rapid high-performance liquid chromatographic method was developed and validated for the simultaneous determination of vitexin-2-O-glucoside, vitexin-2-O-rhamnoside, rutin, vitexin, and hyperoside. The HPLC separation was performed using a Shim-pack VP-ODS C18 column (250 mm × 4.6 mm i.d. , 5 μm) with the isocratic mobile phase consisting of tetrahydrofuran/acetonitrile/0.05％ phosphoric acid solution (20:3:77, v/v/v), and the flow rate was set at 1.0 mL/min. UV detection was carried out at a wavelength of 360 nm and the whole analysis took 25 min. The method was linear in the range of 4.12-206.00 μg/mL for vitexin-2-O-glucoside, 4.05-202.50 μg/mL for vitexin-2-O-rhamnoside, 1.64-82.00 μg/mL for rutin, 1.74-87.00 μg/mL for vitexin, and 1.41-70.60 μg/mL for hyperoside with the correlation coefficient for each analyte more than 0.998.The limit of detection (LOD) and limit of qnantitation (LOQ) were 0.6 and 2 ng for vitexin-2-O-glucoside, 0.6 and 2 ng for vitexin-2-O-rhamnoside, 0.3 and 1 ng for rutin, 1 and 3 ng for vitexin, and 0.5 and 2 ng for hyperoside, respectively. Lntra- and inter-day precision and accuracy (RSD) were less than 3％. The developed HPLC method was successfully applied to the analysis of five flavonoids in hawthorn leaves, hawthorn fruits, and the preparations containing hawthorn leaves or fruits.

Objective: To analyze the status and general trend of urban residents’ health equity and health performance. Methods:Adopting standardization of concentration index, the extended concentration index and health performance index. Results: Chronic disease and self-assessed health of urban residents in China gradually improved from 2007 to 2011, while disability of those people did not improve significantly. Health inequity exists among urban residents with different incomes. Chronic disease and disability are inclined to the poor while self-assessed health is inclined to the rich, but the unfair degree has decreased gradually by year; the self-assessed health and the health performance of chronic disease has been improved from the comprehensive health level and equity, the disability sustains serious condition. Conclusion: China’s new health care reform does not significantly improve the domestic urban residents’ health equity and health performance, the objective set of the health care reform in China should pay more attention to health equity.

Objective To select and analyze the drug types for treatment of patients with diabetes in the older adults.Methods The clinical data including age,gender,disease duration,drugs (types and frequency) for 320 elderly cases with diabetes were retrospectivly analyzed Results With aging,duration of diabetes had been extended(P＜0.05),but no difference between the sex ratio.The frequency of insulin (32.2％) and metformin (29.7％)were the highest in the selective therapy for senile diabetes patients.But other types of drugs such as alpha glycosidase inhibitor (19.4 ％),sulfonylureas for promoting secrete (10.9 ％) and thiazolidinedione (7.8 ％) also occupied certain proportion.Conclusions The metformin has been widely applied for senile diabetes patients,and it is usually need to be in combination with other drugs and be paied more attention to monitoring in the whole process.

Objective To study the anti-depressive mechanisms of acupuncture by investigating the effects of acupuncture on depressive behaviors and amino-neurotransmitter in hippocampus in rats treated with chronic mild unpredicted stresses.Methods Thirty adult SD rats were randomly divided into a normal group,a depressive model group and an acupuncture group,with 10 rats in each group.Separated feeding,long-term unpredictable and middle stimulation stress were used for development of depression rat model.At the same time,the third group was treated by acupuncture.Autonomic behavior was measured with Open Field test and concentration of amino-neurotransmitter in hippocampus was measured by high performance liquid chromatography coupled with fluorescence detection.Results Compared with the normal group,autonomic activity of the rats and the concentration of GABA were significantly reduced in the model group,while the concentration of Glu was significantly increased(P0.05).Conclusion Acupuncture could reverse the depressive behaviors of rats caused by middle stimulation stress,and its anti-depressive mechanisms is related to the function of regulating the concentration of amino-neurotransmitter in hippocampus.

Objective: To observe the clinical efficacy and safety of the combination therapy of sitagliptin and irbesartan in the treatment of early diabetic nephropathy.Methods: Totally 49 cases of initial diagnosed diabetic nephropathy were randomly divided into the observation group (25 cases) and the control group (24 cases).On the basis of diabetic diet, health education and regular hypoglycemic drugs, the control group was treated with irbesartan tablets, 150 mg, po , qd, and on the basis of the control group, the observation group was treated with sitagliptin tablets 100mg, po , qd.All the patients were treated for 3 months.The fasting blood glucose (FBG), postprandial blood glucose (PBG), glycosylated hemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), urinary microalbumin (mAlb) and body massindex(BMI) were compared between the groups before and after the treatment.Results: After the treatment, FBG, PBG, HbA1c, SBP, DBP and mAlb in the observation group were significantly lower than those before the treatment (P＜0.05).Hypoglycemia occntrredin in one patient in the observation group.There were no significant changes in FBG, PBG and HbA1c in the control group (P＞0.05), and SBP, DBP and mAlb decreased significantly (P＜0.05).After the treatment, the decrease of FBG, PBG, HbA1c and mAlb in the observation group was more significant than that in the control group, and the difference was statistically significant (P＜0.05).The decrease of blood pressure between the groups was not statistically significant (P＞0.05).Hypoglycemia occnrredin in one patient in the observation group.There was no significant difference in BMI between the groups and before and after the treatment (P＞0.05).There was no significant difference in the incidence of hypoglycemia between the groups after the treatment (P＞0.05).Conclusion: The combination of sitagliptin and irbesartan in the treatment of early diabetic nephropathy can effectively decrease blood glucose, reduce mAlb excretion and delay the progression of nephropathy.

Objective To investigate the predictive value of 4 183 Da peptide of dermcidin protein in the early diagnosis and differential diagnosis of ischemic heart disease.Methods A prospective controlled study was conducted.Serum samples were drawn from 161 patients with acute coronary syndrome [ACS,including 46 patients with unstable angina (UA),23 with acute non-ST elevation myocardial infarction,and 92 with acute ST segment elevation myocardial infarction],111 subjects for routine physical examination,including 45 patients with hypertension history,42 with coronary heart disease,22 with diabetes,and 54 patients with non-ACS (including pulmonary embolism,aortic dissection aneurysm,arrhythmia,myocarditis,coronary myocardial bridge,pleurisy,pneumothorax,pneumomediastinum,rib fracture,reflux esophagitis,peptic ulcer,and pancreatitis) to serve as controls.4 183 Da peptide of dermcidin protein was assessed with matrix assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS) technology,and myeloperoxidase [MPO,determined by point-of-care testing (POCT) and enzyme linked i mmunosorbent assay (ELISA),respectively],high sensitive C-reactive protein (hs-CRP),heart type fatty acid binding protein (H-FABP),myoglobin (MYO),cardiac troponin Ⅰ (cTnⅠ),and MB isoenzyme of creatine kinase (CK-MB) were quantitated with biochemical analysis.The power of the biomarkers above for early diagnosis and differential diagnosis for ischemic heart disease were judged by comparison of their sensitivity and specificity.Results ① It was showed by one-way ANOVA that 4 183 Da peptide was higher in ACS group than that in control group (relative abundance:22.05 ± 16.97 vs.15.52 ± 14.09,P =0.001),but no difference was found between ACS group and non-ACS group (relative abundance:22.05 ± 16.97 vs.19.99 ± 17.63,P =0.416).② The specificity and sensitivity of the 4 183 Da polypeptide and MPO for predicting ACS and UA were compared with the receiver operating characteristic curve (ROC).It was showed that the 4 183 Da polypeptide had predictive values for ACS and UA,and the areas under the ROC curve (AUC) was 0.625 and 0.651 (both P ＜ 0.01),but MPO was not found to have predictive value (AUC was 0.440 and 0.336,respectively,both P ＞ 0.05).③ It was showed by the values of multi-markers in differential diagnosis of ACS and non-ACS disease that the specificity and sensitivity of 4 183 Da peptide in the differential diagnosis of acute myocardial infarction (AMI) and non-ACS disease were less than those of MYO,cTnⅠ,H-FABP,markers of myocardial damage,which AUCs were 0.569 vs.0.796,0.833,0.838,and equal to MPO (POCT/ELISA) and hs-CRP,AUC of which was 0.569 vs.0.505 (POCT)/0.477 (ELISA) and 0.545.But both the value of 4 183 Da peptide and MYO,cTnⅠ,H-FABP in the differential diagnosis of UA and non-ACS disease was not found,where AUC was 0.456,0.525,0.658,0.568.Conclusion 4 183 Da polypeptide,a fragment of dermcidin protein,may have association with the onset of ischemic heart disease,and may be helpful in the early diagnosis of ACS.

A method was developed for purification of 20S proteasome (20S core particle, CP) by combining differential centrifugations with nondenaturing polyacrylamide gel electrophoresis (native-PAGE), irrespective of species origins of CPs. CP purified from human erythrocytes was subjected to proteomic analysis by two-dimensional gel electrophoresis (2-DE) and matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS), revealing 33 spots of subunit isoforms with different molecular weights and isoelectric points, more than 14 constituent subunits. Furthermore, other four CPs were purified from yeast, mouse liver, two pancreatic cancer cell lines SW1990 and PANC-1 using this method mentioned above, and subjected to proteasome heterogeneity analysis by native/SDS-PAGE (native/sodium dodecyl sulphate polyacrylamide gel electrophoresis), together with CP from erythrocytes. The method described acts as a rapid and effective tool for CP isolations, and the results obtained may be served as a footstone for the investigations of species-dependent proteasome heterogeneity.

Object:The paper aims to analyze Taiwanese experience in pharmaceutical procurement, pharma-ceutical benefits and reimbursement schedule, and make references for the Mainland China. Methods:Through read-ing and analyzing the Taiwanese government policy and the literature published to find out the pharmaceutical pro-curement measures, different medicines’ pricing strategy and its reimbursement mode compared with the Mainland China. Results: Hospitals can purchase medicines based on their own needs, and the purchase price was formed through negotiating with providers and buyers. It has been found that Taiwan only controls the medicines reimburse-ment prices. The international reference pricing is adopted for new medicines, and the originators, bioequivalence/bioavailability generic medicines and general generics reimbursement prices are very high at international reference prices, and need to be weakened in order to fit the requirements. Moreover, the medicine quality is one of the stand-ards considered in case of making decisions on the reimbursement prices. In addition, the reimbursement price is as-sociated with procurement price. When the spread is larger than 30%, the government will adjust the reimbursement to fill the gap. Conclusions: Through the system design and adjustment, the Taiwanese Government have set up a better procurement and reimbursement co-ordination in the pharmaceutical segment, and formed the reasonable prices for the case. The Taiwanese experience can be taken as a reference for the mainland China to refine its procurement reforms and reimbursement policy.