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

OBJECTIVETo compare postoperative blood loss under different negative pressures of drainage after total hip arthroplasty for the treatment of femoral neck fractures.

METHODSFrom January 1st to December 30th 2013, 74 patients with femoral neck fractures treated with total hip arthroplasty were randomly divided into two groups: high negative pressure drainage group and low negative pressure drainage group. In high negative pressure drainage group, there were 34 cases including 10 males and 24 females, with a mean age of (75.94 ± 9.02) years old, and the patients were treated with 60 kPa negative pressure of drainage. In the low negative pressure drainage group, there were 40 cases including 13 males and 27 females, with an average age of (74.93 ± 8.90) years old, and the patients were treated with 30 kPa negative pressure of drainage. The amount of total drainage, total blood loss, and hemoglobin change were compared between these two groups.

RESULTSAll the patients got primary healing without infections. In high negative pressure drainage group,the change of hemoglobin was (41.74 ± 15.69) g/L, total blood loss was (1,217.73 ± 459.50) ml and the drainage volume was (312.94 ± 103.44) ml; while in low negative pressure drainage group,the results were (34.90 ± 12.90) g/L, (904.01 ± 381.58) ml and (129.25 ± 44.25) ml separately. All the results in high negative pressure drainage group were higher than those in the other group. Three days after operation, the change of hemoglobin was (46.00 ± 13.29) g/L and total blood loss was (1,304.72 ± 421.75) ml; while in low negative pressure drainage group, the changes of hemoglobin was (43.87 ± 11.39) g/L and total blood loss was (1,196.78 ± 344.20) ml; there were no statistically significant differences between two groups.

CONCLUSIONWhen placing drainage devices after total hip arthroplasty for the treatment of femoral neck fractures, the level of negative pressure should be chosen according to preoperative level of hemoglobin and HCT in patients. For old patients with femoral neck fracture, low negative pressure is more suitable.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Case-Control Studies ; Female ; Femoral Neck Fractures ; surgery ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; Postoperative Hemorrhage ; prevention & control

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.

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.

Objective To evaluate the value of fMRI guided brain surgery for the lesions in or around Broca's area.Methods Forty-three patients with lesions in or adjacent to the Broca's area were studied.fMRI imaging was obtained by BOLD technique with the tasks of reciting.Fiber tract imaging of white matter was obtained by DTI technique.All functional imaging and anatomic imaging were transferred to neuronavigation system.The technique of direct cortical stimulation was used to validate the language cortex in fMRI.The lesions were resected in microscope.Results Broca's area activation was detected in 38 cases..The distance between the fMRI peak and direct cortical stimulation was rated as overlapping (<1 cm diatance) in 25 cases and neighbouring (<2 cm diatance) in 11 cases.Total lesion resection was achieved in 17 cases, subtotal resection in 14 cases, and partial resection in 12 cases.Postoperative neurological functions were improved in 8 cases, unchanged in 31 cases, and temporary worsen in 4 cases.Conclusions The identification of the Broca's area by reciting task in fMRI is sensitive and precise.The fMRI is helpful to decrease the side effect injury in the brain surgery for the lesions in or around the Broca's area.