Objective To evaluate the medical efficiency of sample hospitals in Sanming city before and after Sanming health care reform.Methods One tertiary hospital,two general county hospitals and two TCM county hospitals in Sanming were sampled for the study.Two dimensions(the intensity index of medical work and work efficiency index)were selected.In addition,six indexes were identified,namely the number of discharged patients,number of outpatients and emergency diagnostics,doctor′s daily workload per capita for inpatients,bed turnover times,bed utilization rate and average days of stay.Descriptive trend analysis and comprehensive index method were applied in turn to evaluate the longitudinal changes in medical efficiency at the sample hospitals before and after the medical reform.Results The five sample hospitals in Sanming were found with less days of stay in average,and three were found with year-by-year rise of medical efficiency index,with one of them rising from 1.57 to 2.42.Conclusions Sanming′s health care reform has effectively improved internal operational efficiency at the sample hospitals,and has well addressed the relationship of medical service efficiency and scale expansion.On the other hand,the relationship between work intensity and medical efficiency needs to be further balanced,resource allocation to be further optimized,and more priority to be put in the development of TCM hospitals.

Child, Preschool ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Sturge-Weber Syndrome ; diagnosis ; Tomography, X-Ray Computed

Objective In order to investigate the relationship among reflux esophagitis,Barrett's e- sophagus and esophageal adenocarcinomas,the expressions of Cdx2 and MUC2 gene were studied.Methods Using immunohistochemistry,the expressions of the Cdx2 and MUC2 were detected in the esophageal mu- cosa of 30 patients with reflux esophagitis,18 patients with Barrett's esophagus and 25 patients with esopha- geal adenocareinoma.Results The positive rate and staining intensity of Cdx2 and MUC2 expressions in re- flux esophagitis,Barrett's esophagus and esophageal adenocarcinoma were significantly higher than those in normal esophageal mucosa(P

The clinical manifestations, laboratory tests and treatment of 5 cases of simple virilizing with 211-hydroxylase deficiency were analyzed. The average age was 17 at the first hospital visit. The manifestation included abnormal external genitalia at birth, no secondary sexual characteristics developed during adolescence and no menstrual cycles, and their near-adult height (NAH) was affected. The chromosome karyotype of the patients was 46 XX. The CT scans showed bilateral adrenal hyperplasia. The testosterone levels were (665 ± 334 ) μg/L, which were reduced to (81 ± 25 ) μg/L after dexamethasone suppression. The levels of adrenocorticotropic hormone were 123 (57 - 563) ng/L and ＜ 5 ng/L respectively before and after dexamethasone suppression test. Early diagnosis and early treatment is particularly important for improvement of the disease outcomes.

Aim: A new derivative LC-MS method was developed for the simultaneous determination of zofenopril and its active metabolite zofenoprilat to investigate the pharmacokinetic characteristics of zofenopril and zofenopri-lat in healthy Chinese volunteers after single and multiple oral doses of zofenopril calcium tablets. Methods: Ten Chinese healthy volunteers were given three single oral doses of 15,30, and 60 mg, respectively, and consecutively the multiple doses of 30 mg. The concentration and pharmacokinetic parameters of both the parent drug and the active metabolite were simultaneously determined by derivative LC-MS method using p-bromophenacyl bromide (p-BPB) as the derivative reagent. Results: After the single oral administrations of 15, 30, and 60 mg of zofeno-pril calcium, there was no significant difference in the t_(1/2) of both zofenopril and zofenoprilat among the three do-ses. The values of AUC_(0-24h) and c_(max) for both zofenopril and zofenoprilat showed the good linearities to the dosage over the dose range from 15 mg to 60 mg. There were no significant differences in AUC_(0-24h) and c_(max) for both com-pounds between female and male volunteers. After multiple oral administration( 30 mg once daily for 6 days ), the average steady state plasma concentration( c_(av)) for zofenopril was (5. 07 ±1. 06) ng/mL with the degree of fluctu-ation (DF) of 14. 26 ± 2. 94. The c_(av) for zofenoprilat was (6. 28 ± 1. 87) ng/mL with the DF of 11. 61 ±4. 68. The accumulation index values for zofenopril and zofenoprilat were 0. 94 ± 0. 31 and 0. 83±0. 13, respec-tively. Conclusion: Both zofenopril and zofenoprilat were demonstrated of linear kinetics after single administra-tion and showed no accumulation after multiple administration of the test zofenopril calcium tablets. There was significant difference in the pharmacokinetic characteristics for zofenopril calcium between healthy Chinese and European volunteers.

AIM: To investigate the protective effect of Ginkgo biloba extract (GBE) on diabetic testis and explore its possible mechanism. METHODS: Testicular structure of streptozotocin-induced diabetic rats was observed under light microscopy (LM) and transmission electron microscopy (TEM). Content of malondialdehyde (MDA), NO_2~-/NO_3~- and activity of superoxide dismutase (SOD), nitric oxide synthase (NOS) were determined in testicular homogenate. RESULTS: In diabetic rats, it was manifestated as deformation of seminiferous tubule, atrophy and shedding of germinal epithelium under LM, while expansion of smooth endoplasmic reticulum, formation of fatty vacuoles and decrease of lysosome obviously in the cytoplasm of sertoli cell under TEM, the injury of testicular tissue was improved by GBE. Compared with diabetic rats, activity of SOD increased while activity of tNOS and iNOS, content of MDA and NO_2~-/NO_3~- decreased in GBE-treated rats. CONCLUSION: GBE could effectively prevent the development of diabetic testis and the effect may be partly achieved by resisting lipid peroxidation,restraining the activity of testicular tissue iNOS and reducing the pathological alterations of NO. [

AIM: To study the protective effects of the extract of Ginkgo biloba (EGB) on brain tissues in experimental diabetic rats and explore its possible mechanisms. METHODS: Thirty male Sprague-Dauley rats were divided into three groups: normal control group, diabetic group and EGB-treated group. Strepozotocin were injected intraperitoneally on the later two groups to induce diabetes, EGB-treated group was injected intraperitoneally with EGB, and the others were treated with normal saline at the same volume. After five weeks, the content of endothelin (ET), malondial dehyde (MDA), NO2~-/NO 3~-, and the activity of superoxide dismutase (SOD), nitric oxide synthase (NOS) were determined in brain homogenate, and the level of blood glucose, insulin and ET were measured respectively. In addition, the morphologic changes of the brain tissue were studied by light microscopy and electron microscopy, respectively. RESULTS: In diabetic group, there were degeneration of neuron, brain edema, softened focus and demyelination in the white matter of brain by light microcopy. There were expansion of mitochondria of neuron and gliocyte, the shortened of crista, demyelination of neurofiber and injury of blood-brain-barrier by the electron microscopy. After treated with EGB, the pathological changes decreased in brain under light microcopy and electron microcopy. Compared with diabetic rats, the activity of SOD and the level of serum insulin increased, while the level of blood ET, the activity of NOS, the content of ET, MDA, NO2~-/NO3~- decreased in EGB-treated rats (P

A 22-year-old patient was admitted to the hospital with a solitary,gradually growing and painless mass in the left shoulder for 2 years.Physical examination revealed no abnormality except for the skin lesion.Skin examination showed an elevated lesion measuring about 3.5 cm× 2.0 cm × 1.5 cm with smooth surface and normal color,which was located in the subcutaeous tissue,indurated and movable.Resection of the tumor was performed under local anesthesia.On visual observation during operation,the tumor was sited in the subcutaneous fat tissue,nodular-like and surrounded locally by fibrous pseudocapsules with a grey incisal surface and mild texture.Microscopicalty,the tumor was extremely similar to breast fibroadenoma with multiple lobuli,and each of the lobuli was composed of tubiform structures,basal cell-like epithelial cell trabs and fibromyxoid stroma abundant in fibroblast-like spindle cells.No hair bulb or primitive dermal papillae were observed in the lobuli,which were separated by compact collagen fibers infiltrated by a few scattered inflammatory cells.Fibromyxoid strotma was surrounded by basal cell-like epithelial cell strabs in most lobuli,and some tubiform structures were filled with a little thin lightly eosinophilic material in a concentric arrangement.Immunohistochemistry showed that intralobular epithelial cells were strongly positive for cytokeratin 5/6,but negative for CAM5.2 or carcinoembryonic antigen (CEA).In addition,the lightly eosinophilic material in lumens was negative for periodic acid-Schiff (PAS) staining.These results suggested that the tubiform structures were immature follicles,but not sweat ducts.The patient was diagnosed with nodular fibrofolliculoma (NFF) based on the clinical manifestations,morphological features,immunohistochemical and PAS staining results.No relapse was observed in more than 3 months of postoperative follow-up.As a benign trichogenic adnexal neoplasm with unique clinicopathological manifestations,NFF may be a new entity of cutaneous adnexal neoplasm.

AIM: To investigate the effects of extract of Ginkgo biloba (EGb) on diaphragm from diabetic rats. METHODS: Sprague-Dauley rats were divided into three groups: normal control, diabetic group and EGb treatment group. The morphologic changes of diaphragm tissues were studied by light and electron microscopy, the activities of succinate dehydrogenase (SDH), superoxide dismutase (SOD), nitric oxide synthase (NOS) and contents of malondialdehyde (MDA), nitric oxide (NO_2~-/NO_3~-) in the diaphragm mitochondria were assayed by spectophotometer, respectively. RESULTS: The activities of SOD, SDH decreased in diabetic diaphragm mitochondria, but the activitiy of NOS, the contents of NO_2~-/NO_3~-, MDA increased compared with control group. The activities of SOD, SDH were increased as well as NOS were decreased and the contents of NO_2~-/NO_3~-, MDA decreased in EGb treatment group compared with the diabetic group. CONCLUSION: EGb may protects the diaphragm mitochondria of diabetic rats by enhancing the function of respiratory chain, anti-oxidation and decreasing NO level. [

In order to study the therapeutic time window of dimethylaminoethyl ginkgolide B mesylate(XQ-1H) in the permanent focal ischemia of rat,we used the rat model of the permanent middle cerebral artery occlusion (pMCAO).Doses of 15.6,7.8 and 3.9 mg/kg of XQ-1 H were intravenously administered at 0.5,1,2,3 h after MCAO,respectively.Neurological scores,infarct sizes,water contents and pathological changes in each interval were determined at 72 h after MCAO.It was observed that XQ-1 H administered at 0.5 and 1 h after MCAO significantly reduced the cerebral infarct size and edema,and produced significant reductions in the neurological deficits.The protective effect of XQ-1H on the neuron cells was proved by pathological observations.In addition,the contents of MDA,lactate,and the activities of SOD were measured.Reduction in the contents of MDA and lactate and enhancement in the activities of SOD were attributed to the pretreatment of XQ-1H at 0.5 and 1 h.Our results showed that the therapeutic time window of XQ-1H extended for up to 1 h after MCAO.