Xuening Granule is a traditional Chinese patent medicine based on San Huang Xie Xin Tang. The effective Component of each herbal medicine were extracted individually and then mixed together to form granules. This process avoids the chemical reactions among the drugs in order to enhance the the effects. The major contents are determined and differentiated to control its quality

An analysis of the fundamental concepts for public hospital reform further defined public hospitals and other hospitals,business and non-business in nature,public benefits and welfare,as well as public benefits and profit-oriented hospitals.These distinctions can help reformers of public hospitals clarify their concepts,make clear the purpose and direction of the public hospitals reform,so as to speed up the reform with theory support.

This paper studied the development stages in terms of the public nature of public hospitals in China and analyzed the causes for their weakened public benefits.It proposed the principle of government guidance,achieving government purchasing of healthcare services as the roadmap,as well as building and improving the service purchasing system,performance appraisal system,and payment review system along with supervision system.These measures are designed to make public hospitals in their public benefit nature with scientific system design,powerful institutional guarantee,and efficient execution strategies.

Objective:To analyze the mechanism on integration of health care services at the county and town-ship level from the perspective of stakeholder theory. Methods: The stakeholder interest demand was determined by word frequency analysis of interview data from stakeholders in the three regions of Qianjiang, Huangpi, and Zhen-jiang;the degree of attention and gains and losses of stakeholders towards various demands was investigated from the three regions through interest demand questionnaires;the impact of demand benefits on behavioral responses has been evaluated through comprehensive evaluation theory and game theory. Results:Regional integration policies reflect the interest demands of stakeholders in varying degrees; the higher were the scores of demand benefits in interest de-mands questionnaires, the stronger was the willingness of stakeholders to coordinate integration policies. Conclusion:The policies of integration of health care services in rural China should consider all stakeholder interest demands;the better the interest demands of the stakeholders are satisfied, the stronger their motivation for integration reform will be, which may affect the implementation effects of local integration reforms to some extent.

Objective To optimize the extraction process of volatile oil and inclusion preparation of hydroxypropyl-β-cyclodextrin from compoundJinling Sini Siwu Shixiaosan Granules.Methods The orthogonal approach of L9 (34) was applied to investigate the volume of volatile oil extraction by 3 factors to obtain the optimum extraction conditions. With inclusion rate of volatile oil and yield of inclusion compound as comprehensive evaluation indexes, the optimum preparation conditions were discussed. The characterization of this prepared inclusion was analyzed by TLC.Results The optimum extraction conditions were as follows:the crude medicine with medicinal powder was shattered into 20 meshes;8 times the amount of water was added and was extracted for 8 h. The best inclusion conditions were as follows:the proportion of volatile oil to HP-β-CD was 1∶6, with inclusion temperature of 30℃, grinding time of 2 h. Analysis results of TLC showed that stable inclusion compound was formed from volatile oil and HP-β-CD.Conclusion The optimized extraction process and inclusion preparation are with stable quality and high feasibility.

The aim of this study is to investigate the effect of fluoxetine (FLX) on the expressions of BDNF and Bcl-2 in the hippocampus, the amygdala and the prefrontal cortex of conditioned fear (CF) model mice. Forty eight mice were randomly divided into three groups, normal control group, CF stress group and FLX-pretreated CF group. The FLX-pretreated CF group was given FLX (10 mg x kg(-1) x d(-1)) for 7 days before CF stress. After CF stress model was established, all mice were given behavioral experiments to test whether FLX impaired or improved the auditory and contextual fear conditioning. Then mice were sacrificed. The expressions of BDNF and Bcl-2 were detected by Western blotting. The results showed that the freezing time of FLX-pretreated CF group was significantly lower than that of CF group; FLX pretreatment up-regulated the expression of Bcl-2 in the hippocampus at 1 d after CF stress (P < 0.001), but no significant differences was observed at 7 d; BDNF significantly increased in the hippocampus at 7 d (P < 0.001), but no differences at 1 d; the expressions of BDNF and Bcl-2 in the amygdala and the prefrontal cortex were of no obvious differences between CF group and FLX-pretreated CF group at 1 d or 7 d after CF stress. Parallel to these changes, pretreatment with FLX could affect histopathologic changes induced by CF stress. Furthermore, the results indicated that FLX pretreatment could protect against CF stress-induced neurological damage via the activation of BDNF and Bcl-2 in hippocampus.
Amygdala ; metabolism ; Animals ; Behavior, Animal ; Brain-Derived Neurotrophic Factor ; metabolism ; Fear ; drug effects ; Fluoxetine ; pharmacology ; Hippocampus ; metabolism ; Male ; Memory ; drug effects ; Mice ; Mice, Inbred ICR ; Prefrontal Cortex ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Random Allocation ; Stress, Psychological ; metabolism

OBJECTIVE: To analyze the characteristics of medical malpractice from different grades of hospitals and to explore forensic investigation strategies in assessing medical dispute. METHODS: A total of 206 cases of medical dispute from 2009 to 2010 investigated by the Department of Forensic Medicine in Nanjing Medical University were selected and analyzed according to fault incidence, fault-prone part, and degree of causality in the treatment. RESULTS: Among the 206 cases analyzed, tertiary hospitals, secondary hospitals and primary hospitals showed medium, high and low error rate, respectively. A majority of medical malpractice cases were distributed in the departments of surgery, medicine and gynecology. CONCLUSION The frequency and severity of medical malpractice in primary hospitals were high, which were gradually reduced in tertiary and secondary hospitals.
Dissent and Disputes ; Expert Testimony ; Forensic Medicine ; Gynecology/statistics & numerical data* ; Hospital Departments/statistics & numerical data* ; Humans ; Incidence ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Retrospective Studies ; Time Factors

Objective:To investigate the polymorphism of HLA-DQA1 genes in Jing nationality of Central Vietnam.Methods:Applied PCR-SSP tecnique to determine the polymorphism of the HLA-DQA1 alleles of 105 healthy children and youth,unrelated individuals in Central of Vietnam.Results:10 HLA-DQA1 alleles were detected of which DQA1*0104 were the most common allele with frequency of 21.3% and lowest frequency is DQA1*0601.Conclusion:The results indicate that HLA-DQA1 alleles polymorphism of Jing nationality in Central Vietnam is different from the other Chinese. [

Objective To investigate the significance of serum neuron specific enolase (NSE) in the severity and prognosis assessments of diffuse axonal injury (DAI).Methods The levels of serum NSE were measured by radioimmunoassay (RIA) at 12 hours and 1st,2nd,3rd,7th and 14th days after injury in 79patients with DAI.The relationship of serum NSE level with the severity and the prognosis of DAI were analyzed in the patients with DAI.Another 15 patients with only limb fracture and without hemorrhagic shock treated in the hospital during the same period served as the control group.Results The serum NSE levels of the mild injury group were (10.47 ± 2.75) ng/L,(13.41 ± 3.45) ng/L,(16.41 ±4.14) ng/L,(15.57 ±4.28) ng/L,(7.95 ±2.79) ng/L,and (6.39 ± 1.55)ng/L at 12 hours and 1st,2nd,3rd,7th and 14th days after injury.The serum NSE levels of the moderate injury group were (14.98 ± 3.78) ng/L,(19.88 ± 4.78)ng/L,(22.41 ±5.50) ng/L,(20.11 ±6.60) ng/L,(14.59 ±6.64) ng/L,and (8.31 ±3.83) ng/L respectively at 12 hours and 1st,2nd,3rd,7th and 14th days after injury.While the serum NSE levels of the severe injury group were (27.22 ± 4.54) ng/L,(36.43 ± 10.38) ng/L,(41.32 ± 12.44) ng/L,(43.98 ±9.51) ng/L,(42.22 ± 13.05) ng/L,and (37.59 ± 12.96) ng/L at 12 hours and 1st,2nd,3rd,7th and 14th days after injury respectively.The NSE levels in each time point were significantly higher in the severe injury group than in the mild and moderate injury groups (F within =28.11,P ＜ 0.001 ; F between =57.34,P ＜0.001 ;F interaction =8.21,P ＜ 0.001 ;P ＜ 0.01).Compared with the control group ((6.26 ± 1.35) ng/L),the serum NSE levels of the DAI group were significantly different at 12 hours after injury ((18.16 ± 3.76)ng/L,t =2.938,P ＜ 0.01).At three months after injury,patients were divided into the decreased group (n =9),poor prognoses group (in vegetative state or severely disabled,n =29) and good prognoses group (moderately disabled or completely recovered,n =41) according to the GOS score.The serum NSE levels of the decreased group were (32.07 ± 5.73) ng/L,(43.12 ± 15.04) ng/L,(48.26 ± 14.89) ng/L,(50.47 ±11.05) ng/L,(52.90 ±3.82) ng/L,and (56.17 ± 14.62) ng/L respectively at 12 hours and 1st,2nd,3rd,7th and 14th days after injury.The serum NSE levels of the poor prognoses group were (21.90 ± 4.95) ng/L,(24.13 ± 9.94) ng/L,(26.43 ± 6.99) ng/L,(21.62 ± 9.77) ng/L,(15.80 ± 7.15) ng/L,and (10.16 ± 2.33) ng/L respectively at 12 hours and 1st,2nd,3rd,7th and 14th days after injury.The serum NSE levels of the good prognoses group were (13.61 ±4.56) ng/L,(13.75 ±5.10) ng/L,(14.77 ±5.41) ng/L,(13.47 ±4.49) ng/L,(8.92 ± 5.61) ng/L,and (6.60 ± 2.30) ng/L at 12 hours and 1 st,2nd,3rd,7th and 14th days after injury respectively.At each time point,the serum NSE levels were significantly different in the decreased group than in the good prognoses and the poor prognoses groups (F within =18.70,P ＜ 0.001 ; F between =62.97,P ＜0.001 ;F interaction =11.83,P ＜0.001).Conclusion The serum NSE levels can be regard as an index for judging the injury severity and prognosis of DAI,and can be used to guide the option and adjustment of therapeutic approaches for patients with DAI.

For the purpose of resolving such current problems as low inclusion ratio and high exit ratio in the single-disease clinical pathway management,the paper proposed an idea of clinical pathways grouping management,in line with DRG management and based on traditional clinical pathway management practice and China' s conditions.Proposed in the paper are such measures for government service procurement,as quality control mechanism,price negotiation mechanism,performance-based payment mechanism,and supervision mechanism.These measures are designed to provide incentives for medical institutions and medical workers,control irrational rise of medical expense,optimize expense makeup,and improve both quality of care and patient satisfaction.Thanks to the China Rural Health Development Project in place in Henan province where DRG-based clinical pathway grouping management and government service procurement are in trials,the following outcomes are achieved.Namely,significant expansion of diseases coverage and population coverage,efficient control of per-patient/per-visit expenses,and a steady rise of surgery and treatment expenses which embody value of service of medical workers.Other benefits include 50％ to less than 30％drop of drugs proportion,gradual optimization of medical expenses makeup,obvious improvement of quality of care.These measures have made hospitals,insurance providers and patients satisfactory.