OBJECTIVE:To provide reference for the construction of suitable evaluation index system for the implementation of National Essential Medicine System in community health service center.METHODS:The frame of evaluation index system was designed by theoretical analysis,literature study and expert interviews methods.Delphi method was used to establish evaluation index system for National Essential Medicine System in Shanghai community health service center.Analytic hierarchy process was adopted to determine the weights of indicators at all levels.RESULTS:The positive coefficients of the two rounds consultations were 88.24％ (15/17) and 86.67％ (13/15).The authority coefficient of structural index,processing index and result index in the first round consultation were 0.68,0.68 and 0.69,respectively,which showed that the authority degree was higher.The coefficient of concordance in the second round consultation was higher than the first round (the indexes of structure,process and result in two rounds consultation were 0.286,0.306,0.193 and 0.345,0.358,0.337,respectively),which indicated the expert opinions were highly consistent.Established evaluation index system consisted of 3 fiust-level indexes,13 second-level indexes and 27 third-level indexes.CONCLUSIONS:The selected experts were representative,the consultation results were reliable,established evaluation index system was rational and the setting of weights was scientific.Also this study was a methodological exploration.

Objective To study the clinical characteristics of intrauterine re-adhesions treated by transcervical resection of adhesion (TCRA). Methods Between January 2012 and January 2015, 12 patients with intrauterine re-adhesions after TCRA in other hospitals had fertility requirements , including 10 cases of severe intrauterine adhesions and 2 cases of moderate intrauterine adhesions .In our hospital , the 12 patients underwent laparoscopic exploration and TCRA .After operation the patients were treated with artificial cycle therapy for 3 months and then underwent hysteroscopic examination . Results In the operation, the remaining of 50%endometrium was found in 1 case, the remaining of 30%endometrium was found in 1 case, and the remaining of 20%endometrium in 9 cases.Only petechial and patchy residual endometrial islands were found in 1 case.Uterine dysplasia was found in 3 cases.Re-examinations of hysteroscopy 3 months after surgery showed 4 cases of uterine cavity normal recovery , 6 cases of moderate intrauterine adhesions, and 2 cases of mild intrauterine adhesions .Follow-up for 18-42 months (mean, 28.5 months) in the 12 cases showed 2 cases of term pregnancy and 1 case of spontaneous abortion .The other 9 patients had no pregnancy , 3 of which withdrew the treatment and 6 of which underwent further treatment . Conclusions Patients with intrauterine re-adhesions usually have seriously damaged endometrium and poor recovery .We suggest that TCRA should be completed by experienced professionals to reduce the residual endometrial destruction , so as to improve the treatment outcomes of intrauterine adhesions .

To provide suggestions for perfecting essential drug centralized bidding and purchasing system. Methods:Using literature method to analyze comparatively essential drug bidding purchasing implement plans of 30 provinces in China. Results:Bidding mode in most provinces was double envelope system. Most evaluation methods did not distinguish the quality level, while there were great differences among provincial evaluation standard and scores of economic, technical and business bidding. Conclusion: To explore scientific and reasonable evaluation standard, it needs to establish an authoritative evaluation system for reference, choose the objective index as far as possible and properly increase the amount of bidding manufacturer.

Objectives To search for the relationship between HP and lesions of gastric mucosa of children.Methods Four hundred and fifty-eight bioptic specimens-from eastrie mueosa in children were strained with hematoxylin-eosin(HE)and Warthin-Starry for light microscopic study.Results HP was detected in 152 specimens. HP deteetable rate-in specimens with normal mucosa was 1. 1%, in compari-on with 42.3% in those with chronic superficial gastritis and 14. 3% in those with chronic atrophic gastrins .Specimens with chronic active gastritls, mostry manitesting local active lesions,had HP detectable rate of as high as 80.2%、69. 7% of the specimene with HP were found to have obvious lymph follicles reaction within lamina propria in their gastric mucosa.Conclusions There is a close relationship between HP infection and Pediatric chronic gastritis(especially chronic active gastritis). Histopathologically, HP-associated gastritis is characterized by chronic and local active inflamations, and tbe formation of lymph follicles within lamina propria.

OBJECTIVE:To provide reference for improving propaganda level and effect of rational drug use. METHODS:Questionnaire survey was designed to investigate the recognition,attitude and demand of consumers in retail pharmacies,students in parts of pharmaceutical universities and their parents and patients in parts of hospitals in more than 10 provinces(autonomous re-gions and municipalities)for propaganda of rational drug use,and the results were statistically significant. RESULTS:The question-naires ranged from 100 to 2 000 in each province (autonomous region and municipality),and totally 11 700 questionnaires were sent out,11 490 were received with recovery of 98.2%;10 980 were effectively received with effective recovery of 95.6%. 78.4%respondents heard of the concept of rational drug use,proportion of young and middle-aged people in 18-44 years old was signifi-cantly higher than other age group,the proportion was significantly increased by the improvement of education,and the proportion of people closer to the city was higher(P<0.001);the respondents who can fully understand the content of the propaganda account-ed for 22.7%,while higher education held higher proportion on“fully understand”,and people closer to the city held higher pro-portion on“fully understand”and“partially understand”(P<0.001);only 9.5% respondents could fully trust propaganda activity, proportion of choosing“partially trust”was generally increased by the improvement of education(P<0.001);and 69.1% respon-dents hoped to obtain relevant knowledge,people who had more purchase frequencies showed stronger willing(P<0.001);the top 3 preferences of respondents for propaganda forms were“face to face guidance from physicians and pharmacists”,“reading drug in-structions”and“reading professional books”. CONCLUSIONS:With insufficient recognition on rational use of drugs,coverage of propaganda about rational drug use needs further expand,public understanding of propaganda contents about rational drug use is fairly limited and people’s trust level towards propaganda is not high,but the public has strong desires to obtain the knowledge about rational drug use. Therefore,various means should be adopted to improve the effects on propaganda of rational drug use.

Animals ; Apoptosis ; Female ; Male ; Nasal Mucosa ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Rhinitis, Allergic, Perennial ; metabolism ; pathology

Animals ; Estrogens ; metabolism ; Gene Expression Regulation ; Humans ; Osteoarthritis ; complications ; genetics ; metabolism ; Pain ; etiology ; Pain Measurement ; Temporomandibular Joint ; pathology ; Temporomandibular Joint Disorders ; complications ; genetics ; metabolism ; Wnt Signaling Pathway

Aged ; Chondrosarcoma ; Humans ; Laryngeal Neoplasms ; Male ; Middle Aged

Objective To study the relationship between tyrosine phosphorylation(TP)and protein expression of insulin receptor substrate-1(IRS-1)and insulin resistance in patients with gestational diabetes mellitus(GDM).Methods IRS-1 expression and TP in skeleton muscle tissue were determined by Western blot and immunoprecipitation in women with GDM(GDM group,n=22),normal pregnant women(normal pregnancy group,n=22)and normal nonpregnant women(normal nonpregnant group,n=13).Fasting plasma glucose(FPG)and fasting insulin(FINS)were measured by oxidase assay and immunoradioassay. Results(1)The levels of FPG,FINS,and insulin resistance index were calculated according to homeostasis model assessment [ HOMA-IR;(5.6?0.8)mmol/L,(15.4?5.1)mU/L,and 1.2?0.5 ] in GDM group were significantly higher than those in normal pregnancy group [(4.4+0.5)mmol/L,(10.6 ?3.1)mU/L,and 0.8?0.3;P

Objective To explore the value of dexamethasone(DEX) for neuronal cell injury and death by observing the effect of DEX on excitatory amino acid(EAA) and monoamine neurotransmitter in cerebral tissue of neonatal rat with hypoxia-ischemia.Methods Hypoxic-ischemic neonatal rat models were established,the levels of EAA and monoamine neurotransmitter in cerebral tissue were analyzed by using capillary electrophoresis and fluorospectrophotometry method.The rats were divided into 4 groups: small dose DEX group pre-treated with DEX(0.5 mg/kg) prior to hypoxia-ischemia,large dose DEX group pre-treated with DEX(10 mg/kg) prior to hypoxia-ischemia,HIE group and shamful operation group.Results The levels of EAA and monoamine neurotransmitter contents in HIE group were significantly higher than those in shamful operation group(P0.05).EAA contents of large dose DEX group greatly decreased compared with HIE group (P