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.

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

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 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.

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.

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.

Physiology course has become an important teaching part of non-medical professions in medical colleges,but there are no normative teaching textbooks and the corresponding teaching syllabus for these non-medical professions,which causes teaching contents chaos and affects the teaching effect.According to their attributes and characteristics,the research group explores continuously the physiology teaching contents suitable for non-medical professions,pays attention to contents settings which are common-sense,practical,systematic and flexible,in order to promote physiology teaching development in non-medical professions.

ObjectiveTo investigate the anti-tuberculosis treatment response and outcomes in treatment naive patients infected with multidrug-resistant tuberculosis (MDR-TB).MethodsA total of 408 patients who were diagnosed with MDR-TB in Shanghai Pulmonary Hospital from January 2006 to January 2009 were recruited in this study.These patients were divided into two groups based on their previous treatment history:treatment naive group and re treatment group. The treatment response,outcomes andadverse eventswere observed. The outcomes of thesetwo groupswere compared by cohort analysis and x2 test.ResultsThe sputum conversion rates,the lesions absorption rate and the cavity closing or shrinking rate of the treatment naive MDR TB group were significantly higher than those of the re treatment group,while the adverse events rate was not significantly different between two groups (x2 =0.434,P＞0.05).Among 89 treatment naive cases,66 cases (74.16％) were cured,8(8.99％) completed the full treatment course,7(7.87％) were treatment failure,3(3.37％) died,and 5(5.62％) were lost to follow-up.Among the 319 cases of re-treatment MDR TB group,134 (42.01％) were cured,31(9.72％) completed the full treatment course,116 (36.36％) were treatment failure,12(3.76％) died,26(8.15％) were lost to follow-up.The cure rate of the treatment naive MDR-TB group was significantly higher than that of re-treatment group (x2=28.783,P＜0.01).The factors influencing the treatment outcomes included the stage of the disease,the range of lesions and cavity, the patients'generalnutritional status, underlying complications,and the drug-resistant strains. Conclusions The anti-tuberculosis treatment outcomes are better in treatment naive patients with MDR-TB infection compared to the treatment experienced and retreated patients.Therefore,the status of the drug resistance should be closely monitored in order to detect MDR-TB as early as possible.With the early diagnosis,the treatmcnt regimen may be modified timely and as a result the treatment outcomes can be improved.

Objective To investigate the influence of VEGF expression on the apoptosis of pancreas subjected to ischemia/reperfu-sion injury. Methods Thirty male SD rats were randomly divided into three groups (rt = 10). Group A was served as sham-operation group. Groups B were subjected to 30 min of ischemia by clamping of celiac artery and superior mesenterie artery then releasing for 6 hours to produce ischemia/reperfusion injury model. Groups C were treated with VEGF antisense oligodeexynueleotide after isehemia. Rats were sacrificed, the pancreas was obtained to detect the VEGF expression by immunohistochemical method, and apoptosis was determined by TUNEL staining. Results Apoptosis appeared and VEGF expression up regulated in pancreas after Isehemia/reperfusion injury. Comparison between Groups C and Groups B showed a significant down regulation of VEGF expression (P <0. 05) and a notable increase of apoptotic index (P < 0. 05). Conclusion VEGF expression suppresses apeptosis of pancreas during the course of ischemia/reperfusion injury and may play an important role in protection of pancreas against the ischemia/repeffusion injury.