The paper analyzes the orientation of health management function of government under the perspective of new public service theory, tries to reveal the unimplementation, dislocation, offside and absence of government function at four aspects including health service system, health organization operating mechanism, health management system and health service supervision system, and puts forward six approaches for transformation of government function of health management.

Objective To investigate the appropriate timing of B-lynch suture in the treatment of atonic postpartum hemorrhage during cesarean section.Methods A total of 90 patients with atonic postpartum hemorrhage during cesarean section from January 2012 to December 2014 in our hospital were included in the study.They were divided into two groups, early suture group (applying B-lynch suture when the amount of postpartum hemorrhage reaching 500 ml, n=66 cases) and late suture group (applying B-lynch suture when the amount of postpartum hemorrhage reaching 1000 ml, n=24 cases).The hemostatic effect, amount of bleeding, blood transfusion rate, incidence of DIC, duration of hospitalization, and the puerperal morbidity were compared between the two groups.Results All the 90 patients were successfully treated and were discharged after comprehensive treatment.The amount of postpartum hemorrhage of the early suture group was (656±118) ml, which was significantly less than that of the late suture group [(1550±432) ml, t=-10.003, P=0.001].The rate of blood transfusion of the early suture group was 3.0% (2/66), which was significantly lower than that of the late suture group [(50.0%, 12/24), x2=26.092, P=0.000].There was no case of DIC in the early suture group, and the incidence of DIC in the late suture group was 16.7% (4/24), with the difference statistically significant (Fisher''s exact test, P=0.004).The puerperal morbidity in the early suture group was 3.0% (2/66) and that of the late suture group was 25.0% (6/24), with statistically significant difference (x2=7.952, P=0.005).There was no statistically significant difference in the hospitalization stay between the two groups (P>0.05).Conclusions B-Lynch suture is an effective method in the treatment of atonic postpartum hemorrhage during cesarean section, and early use of it can get better curative effect, such as less bleeding amount and lower rates of blood transfusion, DIC and complications like puerperal morbidity.In case the bleeding volume reaches 500 ml and the general conservative hemostatic methods are ineffective, B-Lynch suture is recommended immediately.

Hepatitis B virus(HBV) infection is a severe health problem in the world.However,there is still not a satisfactory therapeutic strategy for the HBV infection.To search for new anti-HBV agents with higher efficacy and less side-effects,the inhibitory activities of traditional Chinese medicine Rheum palmatum L.ethanol extract(RPE) against HBV replication were investigated in this study.Quantitative real-time polymerase chain reaction(PCR) was employed to analyze the inhibitory activity of RPE against HBV-DNA replication in a stable HBV-producing cell line HepAD38; the expression levels of HBV surface antigen(HBsAg) and e antigen(HBeAg) were also determined by enzyme linked immunosorbent assay(ELISA) after RPE treatment.RPE could dose-dependently inhibit the production of HBV-DNA and HBsAg.The concentration of 50% inhibition(IC50) was calculated at 209.63,252.53 μg/mL,respectively.However,its inhibitory activity against HBeAg expression was slight even at high concentrations.RPE had a weak cytotoxic effect on HepAD38 cells(CC50 = 1 640 μg/mL) and the selectivity index(SI) was calculated at 7.82.Compared with two anthraquinone derivatives emodin and rhein,RPE showed higher ability of anti-HBV and weaker cytotoxicity.So Rheum palmatum L.might possess other functional agents which could effectively inhibit HBV-DNA replication and HBsAg expression.Further purification of the active agents,identification and modification of their structures to improve the efficacy and decrease the cytotoxicity are required.

Objective To analyze the clinical features and causes of benign paroxysmal positional vertigo(BPPV).Methods The clinical data of 521 patients with BPPV were collected.The percentage of patients with BPPV in all the outpatients with dizziness and vertigo,the clinical characteristics of BPPV,and the prevalence of comorbidity with migraine were analyzed.Results BPPV accounted for 35.7% of patients with vertigo and 12.1% of patients with dizziness.Among the 521 patients with BPPV,158(30.3%)were male and 363(69.7%)were female,with an average age of(57.5?12.8)years old(20 to 93 years old).Right semicircular canals were involved in 323 cases(62.0%),and left semicircular canals in 187 cases(35.9%).The latency period of nystagmus of vertical canals was(3.22?2.37)s,and time of persistence was(8.31?7.98)s.The latency period of nystagmus of horizontal canals was(2.33?1.50)s,and the time of persistence was(14.77?11.40)s.There were significant differences in the latency period of nystagmus and time of persistence between the vertical and horizontal canals(P=0.001 and P=0.000).Fifteen patients(2.9%)had a history of head trauma and 39(7.5%)were complicated with migraine.Conclusion BPPV is prevalent in patients with dizziness and vertigo,and misdiagnosis and missed diagnosis should be avoided.

BACKGROUND:Excessive apoptosis and decreased infiltration of cytotrophoblasts are essential causes for hypertension in pregnancy. Human placenta-derived mesenchymal stem cels contribute to damage repair, which has been shown in many studies, and moreover, human placenta-derived mesenchymal stem cels have a certain endocrine function and can act on the other tissues in an autocrine or paracrine manner. Therefore, we attempt to explore whether the human placenta-derived mesenchymal stem cel can repair damaged cytotrophoblasts, and then to gestational hypertension.
METHODS/DESIGN:This is a randomized controled cytological experiment. Human placenta-derived mesenchymal stem cel culture medium is colected and filtrated as human placenta-derived mesenchymal stem cel conditioned medium. Human cytotrophoblasts, JEG-3 cels, are cultured and randomized into three groups:15% normal pregnant serum is added in control group; 15% serum from severe pre-eclampsia patients is added in gestational hypertension model group; and in condition medium group, 15% serum from severe pre-eclampsia patients is added for 24 hours of culture, and then human placenta-derived mesenchymal stem cel conditioned medium containing 15% serum from severe pre-eclampsia patients is used instead. Flow cytometry is used to detect cel apoptosis rate.
DISCUSSION: This study wil help to find the feasibility of cel transplantation for gestational hypertension by exploring the effect of human placenta-derived mesenchymal stem cels on cytotrophoblasts function in gestational hypertension.
ETHICAL APPROVAL: The protocol is approved by the Ethics Committee of Shenyang Central Hospital of Shenyang Medical University. Informed consent is obtained from normal and pre-eclampsia women in pregnancy.

Objective:To observe the clinical effect of electroacupuncture (EA) at four sacral points on overactive bladder syndrome.Methods:A total of 120 female patients with overactive bladder syndrome were allocated to a treatment group of 80 cases and a control group of 40 cases on a voluntary basis.The patients in the treatment group received EA at four sacral points,and the treatment was given three times a week for 6 consecutive weeks,while the patients in the control group received oral administration of M-receptor antagonist tolterodine tartrate,which was given 4 mg each time,once a day for 6 consecutive weeks.Then the symptom scores were compared between the two groups before and after treatment.Results:At the end of treatment,the symptom scores showed statistical significant differences in comparing with those before treatment in both groups (both P＜0.01);the symptom score in the treatment group was lower than that in the control group,showing a statistically significant difference (P＜0.05).Conclusion:EA at four sacral points is an effective method for overactive bladder syndrome.

Objective:To explore the clinical effect of multidisciplinary cooperation model in the prevention of acquired dysphagia in ICU.Methods:A multidisciplinary team was set up to collect 118 patients in Neurosurgery ICU of our hospital as the research object. The patients were divided into the experimental group and the control group, 59 cases in each group. The control group implemented the routine nursing measures of ICU, and the experimental group implemented the multidisciplinary cooperative nursing mode. The incidence of ICU acquired swallowing disorders (ICU-ASD) and complications of the two groups were compared.Results:There was no significant difference between the two groups in the incidence of swallowing dysfunction 24 hours after tracheal extubation ( P>0.05). The incidence of swallowing dysfunction 48 hours and 72 hours after tracheal extubation in the control group was 11.86% (7/59) and 16.95% (10/59) respectively, while the test group was 1.69% (1/59) and 3.39% (2/59) respectively. The difference was statistically significant ( χ 2values were 4.827 to 7.230, P< 0.05 or 0.01); the incidence of aspiration, aspiration pneumonia and malnutrition in the control group were 11.86% (7/59), 10.17% (6/59) and 8.47% (5/59), respectively, while the test group were 1.69% (1/59), 0 and 0, respectively, with statistically significant difference ( χ 2value was 4.827, P< 0.05). Conclusion:Multidisciplinary cooperation model can effectively prevent the incidence of ICU-ASD, and ultimately reduce the incidence of complications.

Objective To observe endoplagmic reticulum stress in bone tissue of fluomsis rats and further explore the pathogenesis of skeletal fluorosis.Methods 48 Wistar rats were divided into 4 groups according to their body mass.The control and low.calcium group were fed with normal diet(0.79%calcium)and low-calcium diet(0.79%calcium)respectively,and both drank tap water(sodium fluoride concentrations＜1 mg/L).High fluoride and low.calcium plus high-fluoride groups were fed with normal diet(0.79%calcium)and low-calcium diet (0.79%calcium)respectively,and both drank tap water containing sodium fluoride(sodium fluoride concentrations 221 mg/L).During experimental period,rats were measured body mass once a week with a stand diet and water available ad libiturn.The experimental period was 3 months.The biochemical techniques were used to test the indicators of oxidative stress and ALP in seFum of fluorosis rats.The total RNA was extracted from the one side of the femur,and the transcription level of Bip,Xbp1,CHOP and PDI were investigated by reverse transcription polymerase chain reaction(RT-PCR).Results The level of MDA in serum of low-calcium plus high-fluoride group wag higher than that of the control[(14.74±3.11)μmol/L vs(10.15±1.96)μmol/L,P＜0.05];the activity of GPx was ma~edly higher in hish-fluoride group compared with the control[(3.87±0.41)×103 U/L vs(2.85± 0.55)×103 U/L,P＜0.05];the level of uric acid in sel'um was significantly lower both in high-fluoride group and low-calcium plus high-fluoride group compared with the respective control and the low-calcium group[(73.95± 9.52)μmol/L vs(110.43±25.48)μmol/L,(54.32±22.09)μmol/L vs(101.71±17.01)μmol/L,P＜0.05]. The activity of ALP wag obviously higher in low-calcium plus high-fluoride group compared with the control [(24.77±4.57)×103U/L vs (12.91±3.97)×103U/L,P＜0.01)].The mRNA expression of Bip/GAPDH in bone tissue was markedly higher in bone of high-fluoride group and low-calcium plus high-fluoride group compared with the control(1.38±0.24,1.35±0.12 vs 1.14±0.06,P ＜ 0.05). The expression of Xbp1/GAPDH in bone tissue significantly increased in low-calcium plus high-fluoride groups compared with the control and the low-calcium group (1.48±0.20 vs 1.02±0.25,1.07±0.25,P ＜ 0.05 or ＜ 0.01);and CHOP/GAPDH in bone tissue significantly increased in low-calcium plus high-fluoride groups compared with the control(0.84±0.18 vs 0.52±0.07,P ＜ 0.05 ). Conclusions Accelerated osteogenetic action is seen in fluorosis rats,accompanied by oxidative stress and bone endoplasmic reticulum stress,which is likely involved in the pathogenesis of skeletal fluorosis.

Objective To observe the regulating effect of inhaling glucocorticoid on imbalance of IL-4/interferon-?(IFN-?) cytokines in children with first onset wheezing .Methods IL-4 and IFN-? levels were examined in separated serum of 60 children wheezing with first onset wheezing,they were divided into abnormal level of IL-4/IFN-? group (n=38) and normal level of IL-4/IFN-? group(n=22,group C) depending on the level of IL-4/IFN-?,and 38 cases with abnormal level of IL-4/IFN-? were randomly divided into group A and B.Group B and C were given routine treatment without intervening treatment,while group A inhaled beclomethasone dipropionate aerosols for 3 months after routine treatment.Twenty healthy children for routine physical examinations in the same period were selected as healthy control group,who were examined for IL-4 and IFN-? with the same methods.Results Before treatment,the levels of IL-4 and IL-4/IFN-? in group A and B were significantly higher than those in group C and healthy control group(Pa

Objective To learn about electrolytes imbalance and water intoxication in children treated with high-dose cyclophosphamide(HD-CTX)as well as the renal function and the relative clinical symptoms,and study the mechanisms of hyponatremia.Methods Patients' clinical manifestations during and after HD-CTX therapy were summarized.Serum electrolytes and creatinine(Cr)were detected before and 6 or 8 hours after therapy with HD-CTX,antidiuretic hormone(ADH) in some patients were measured.Results Of 108 therapeutic cases 24 accompanied with vomits and 22 with a decreased urine output,in which 4 developed eyelid or ankle edema.Seven cases had neural-sarcous symptoms and 5 cases had abdominal pain or diarrhea.Serum sodium decreased significantly after HD-CTX[(139.12?3.30) mmol/L vs(134.06?8.23) mmol/L] in whom rechecked after 6 h,(141.77?3.59) mmol/L vs(133.26?6.41) mmol/L in those rechecked after 8 h(Pa0.05].Serum Cr increased 8 h after therapy[(29.95?13.61) ?mol/L vs(43.33 ? 17.25) ?mol/L P