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 investigate the distribution of pathogenic bacteria,drug sensitivity,and the relationship between drug sensitivity and Escherichia coli(E.coli) induced enzymes in childhood diarrhea in the last 2 years in Chongqing area,so as to provide important evidence for pediatric clinical therapy.Methods Thirty-one E.coli induced enzymes,extended spectrum ?-laetamases(ESBLs),cephalosporinase(AmpC)detected in different phenotype methods,and drug sensitivity was measured in paper strip method,and the specimens were collected from children′s hospital affiliated to chongqing university of medical sciences from Jan.2005 to Dec.2006 were determined.Among the total,there were 18 enteropathogeic E.coli(EPEC) strains,8 enterotoxigenic E.coli(ETEC) strains and 5 enteroinvasive E.coli(EIEC) strains.In addition,drug resistance tests by paper strip included chloramphenicol(CHL),amikacin(AMK),gentamicin(GEN),norfloxacin(NOF),ciproflocacin(CIP),cefazolin(CEZ),cefoperazone(CPZ),ceftriaxone(CRO),ceftazidime(CAZ),cefotacime(CTX),cefepime(FEP),imipenem(IPM).SPSS 12.0 software was used to analyze the data.Results Three point two percent of the 31 E.coli were drug resistant to IPM,and 35.5%,38.7% to NOF,CIP individually,but more than 60% to AMK,GEN,even more than 67.7% towards cephalosporin(except ceftazidime and cefepime);the gross enzyme-produced rate was 87.1%,rate of single ESBLs,AmpC,and induction of both enzymes simultaneously presented 64.5%,6.5%,16.1% respectively;and there was marked difference in drug resistance when bacteria that produced single AmpC versus bacteria that produced single ESBLs or that produced both ESBLs and AmpC(Pa﹤0.05).Conclusions The relationships among enzyme′s quantity,sort and bacterial resistance are different.These data show E.coli infected by bacterial diarrhea children in Chongqing due to a high rate of induced enzymes,and their drug resistance vary according to the state of induced enzymes.

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.

Objective To analyze the coincidence situation of the results of neonatal ABO blood group reciprocal stereotypy with crossmatching test of allotype blood and to investigating the limitations of cross-matching test in infant blood transfusion and effec-tive measures for ensuring the neonatal safe blood transfusion.Methods The micro-column gel test was adopted to identify the ABO blood group and conduct the crosshatching test of allotype blood in 1 095 cases of neonatal blood samples.Results Among the 1 095 samples,the detected rates of weak A and weak B antigen were 3.99% and 17.93% respectively,and the weak B antigen was predominant.The negative rates of anti-A and anti-B antibody were 53.72% and 60.70% respectively;in the cross-matching test with allotype blood,the main side without appearing agglutination accounted for 52.87% and weak agglutination accounted for 33.27%,and the secondary side appearing weak agglutination accounted for 9.49%.Conclusion The maturity of antibody and an-tigen and the coincidence rates of group typing and reciprocal stereotypy in the newborns are less than those in the adults;so blood transfusion according to the cross-matching test results has certain limitation;high attention should be paid to the accuracy of neo-natal ABO blood type,the individual blood transfusion strategy in the newborn should be determined in order to avoid hemolytic blood transfusion reaction caused by ABO allotype blood transfusion and ensure the blood transfusion safety in newborns.

OBJECTIVE: To compare the content of gastrodine in wild and cultivated Gastrodia elata from different habitats in Guizhou province in order to provide scientific reference for cultivation of G.elata.METHODS: Samples were extracted from G.elata with microwave.RP-HPLC method was used to determine the content of gastrodine in G.elata.RESULTS: The content of gastrodine in wild G.elata was higher than that in cultivated G.elata.The contents of gastrodine in wild G.elata were different from one another while the contents of gastrodine in cultivated G.elata hadn’t obvious differences.CONCLUSION: The quality of wild G.elata is superior to that of cultivated G.elata.The study provide scientific basis for the cultivation of G.elata.

Child ; Child Health Services ; trends ; Delivery of Health Care ; organization & administration ; Education, Medical ; Hospitals, Pediatric ; economics ; organization & administration ; Humans ; Pediatrics ; trends ; Specialization ; Urban Population

ObjectiveTo investigate the effect of rehabilitation time on the motor function and activities of daily living (ADL) of patients with intracerebral hemorrhage.Methods76 patients were randomly divided into the early rehabilitation group (40 cases) and late rehabilitation group (36 cases). The patients of two groups were treated with Bobaths method. The starting times of rehabilitation were 48 h～7 d (early rehabilitation group) and 3～4 weeks (late rehabilitation group) after onset. The therapeutic effect was assessed with Fugl-Meyer Motor Assessment Scale (FMA), modified Barthel index (MBI) and neurological deficit evaluation (ND).ResultsThe scores of the FMA, MBI and ND were not different between two groups before treatment. After one month treatment, the scores of patients in two groups improved significantly, but the early rehabilitation group had a greater improvement compared with the late rehabilitation group. Conclusion Early rehabilitation and late rehabilitation can also facilitate the motor function and ADL of patients with intracerebral hemorrhage recovery, and the therapeutic effect of early rehabilitation is better than late rehabilitation significantly.

Objective To investigate the safety and efficacy of structured triglycerides in parenteral nutrition in elderly patients with acute biliary tract infection.Methods 62 elderly patients with acute biliary tract infection under conservative therapy were randomly divided into structured triglycerides (ST) group and medium-chain triglycerides plus long-chain triglycerides (MCT/LCT) group.Patients underwent parenteral nutrition for 5 days.Levels of hepatic enzymes,blood triglycerides,nitrogen balance,fasting blood insulin and glucose were compared between the two groups after 5 days of parenteral nutrition.Results There were no significant differences in levels of hepatic enzymes,blood triglycerides and fasting blood glucose between ST group and MCT/LCT group.Plasma total bilirubin (T-Bill) levels were increased in the two groups,and T-Bill level dropped faster in the ST group than in the MCT/LCT group after 7 days of parenteral nutrition(P＜ 0.05).The difference in total cholesterol level dropping was significant between ST group and MCT/ LCT group (P＜0.05).The cumulative nitrogen balance for 5 days had significant difference between ST and MCT/LCT groups [(4.7-±-2.2) g vs.(2.8±0.7) g,P＜0.05].STG group versus MCT/LCT group had less fluctuation of fasting blood insulin level after 1,4 and 7 days of parenteral nutrition.Conclusions In the acute phase of biliary tract infection in elderly patients,ST-based parenteral nutrition can provide energy and help maintain nitrogen balance,with a little fluctuation of fasting blood insulin level.Short-term nutritional support may have better tolerance in the liver and has little effect on the change of hepatic enzymes.

Objective:To quantify the tryptase and T cell immunoglobulin mucin domain-3(TIM-3)double positive mast cells in hu-man chronic periodontitis tissue using double immunofluorescence staining.Methods:25 healthy controls,28 chronic mild periodontitis and 30 chronic advanced periodontitis patients were included.The gingival specimens were stained with HE for histology,and with double immunofluorescence staining for the identification of tryptase and TIM-3 double positive mast cells in gingival tissue.Results:In chronic periodontitis tissue the degree of gingival inflammation was significantly increased,the densities(cells/mm2 )of tryptase and TIM-3 double positive mast cells were significantly increased(P<0.05),in addition,that in chronic advanced periodontitis group was significantly higher than in the chronic mild periodontitis group(P<0.05).Conclusion:Tryptase and TIM-3 double positive mast cells has the similar tendency as the severity of periodontitis inflammation in human periodontitis tissue.Tryptase and TIM-3 double positive mast cells may play an important role in human chronic periodontitis.

Objective To understand the incidence and clinical characteristics of scabies-associated glomerulonephritis and to investigate its pathogenesis.Methods The patients with scabies from Qijiang District People's Hospital.were collected from the outpatient department and divided into the simple scabies group (A) and glomerulonephritis group (B) according to whether complicating glomerulonephritis.The general clinical indicators and serum C-reactive protein(CRP),complement components C3 and C4,immunoglobulin,TNF-α,IL-6,IL-1β and IL-18 in the early stage of the disease were determined and compared between the two groups.The differences of above indicators were collected and compared between before and after clinical cure in the patients with scabies-associated glomerulonephritis.Results Among 376 cases of scabies,16 cases developed glomerulonephritis.The clinical manifestations included glomerular hematuria and/or mild-moderate proteinuria.The kidney injury manifestations in 12 cases were completely disappeared at 2-6 months after scabies cure.The levels of serum CRP,IgG,TNF-α,IL-6,and IL-18 in the group B were significantly increased and the serum C3 level was significantly decreased compared with the group A,the differences were statistically significant(P＜0.05).The levels of serum IgG,hs-CRP,TNF-α,IL-6 and IL-18 after cure in 12 cases of clinically cured scabies-associated glomerulonephritis were significantly decreased and the serum C3 level was significantly increased,and the difference was statistically significant compared with the early onset stage(P＜0.05).Conclusion The majority of prognosis in scabies-associated glomerulonephritis is good.Its occurrence is closely correlated with immune and inflammatory reactions induced by sarcoptes mites irffection.