The government purchasing of community health service was an important way to change the mode of health service supply,which was also an important way to improve the primary health service supply system.On the basis of government purchasing of community health service development in China,it analyzed the current situation and insufficient coverage of Shenzhen municipal government purchasing community health services,proposed the improvement strategies for improving government guarantee and management capacity,standardizing government purchasing process and enhancing the management of relationship among the main bodies so as to solve the problems of insufficient government guarantee level,nonstandard purchasing process and insufficient cooperative management concept.

Preterm birth is the core issue of neonatology and perinatology researches,and the incidence of preterm birth increasing overall in recent years.With the development of modem health care,preterm birth survival rate has been increasing to some extent,while the prognosis is poor because of serious complications.Epidemiological studies of preterm birth is essential for improving the diagnosis and treatment of premature infants,and this summary introduces the clinical epidemiology of preterm birth through the definition,incidence,related factors,major complication and so on.

There exists different view in the goal of investigative study.Based on the self-fulfilling cycles of self-regulated learning,the author of the article puts forward that developing the ability of self-regulated learning by doing investigative study according to each phase characteristic of self-regulated learning is one of the important goals of investigative study.

OBJECTIVE:To observe the clinical efficacy and safety of amlodipine besylate combined with lisinopril and hydro-chlorothiazide,atorvastatin in the treatment of severe primary hypertension complicating with carotid atherosclerosis. METHODS:90 patients with severe primary hypertension complicating with carotid atherosclerosis were divided into control group (45 cases) and observation group(45 cases)according to random lottery form. Both groups were given Atorvastatin calcium tablet 20 mg/time orally,qd;control group was additionally given Amlodipine besylate tablet 5 mg/time orally,qd;observation group was additional-ly given Lisinopril and hydrochlorothiazide tablet 10 mg/time orally,qd,on the basis of control group. Both groups were treated for 8 weeks. Clinical efficacies of 2 groups were compared as well as blood pressure level,IMT,PV of carotid atherosclerosis, hs-CRP,TNF-α before and after treatment. The occurrence of ADR was recorded. RESULTS:Total response rate of observation group was significantly higher than that of control group,with statistical significance (P<0.05). Before treatment,there were no significant differences in SBP,DBP,IMT,PV,hs-CRP and TNF-α level(P>0.05). After treatment,the levels of SBP,DBP, IMT,PV,hs-CRP and TNF-α level in 2 groups were significantly lower than before;the observation group was significantly lower than the control group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR be-tween 2 groups (P>0.05). CONCLUSIONS:Amlodipine besylate combined with lisinopril and hydrochlorothiazide,atorvastatin in the treatment of primary hypertension complicating with carotid atherosclerosis can effectively control the blood pressure level, delay the progression process of carotid atherosclerosis,reduce the inflammatory reaction degree,but dose not increase the occur-rence of ADR with good safety.

The study of quality control of Chinese medicine has always been the hot and the difficulty spot of the development of traditional Chinese medicine (TCM), which is also one of the key problems restricting the modernization and internationalization of Chinese medicine. Multivariate statistical analysis is an analytical method which is suitable for the analysis of characteristics of TCM. It has been used widely in the study of quality control of TCM. Multivariate Statistical analysis was used for multivariate indicators and variables that appeared in the study of quality control and had certain correlation between each other, to find out the hidden law or the relationship between the data can be found,.which could apply to serve the decision-making and realize the effective quality evaluation of TCM. In this paper, the application of multivariate statistical analysis in the quality control of Chinese medicine was summarized, which could provided the basis for its further study.
Medicine, Chinese Traditional ; standards ; Multivariate Analysis ; Quality Control

Objective To observe the inhibitory action of Qigefang on cell proliferation,movement,secreting MMP-2 and MMP-9 of MGC gastric cancer cell line.Methods MGC cell line of gastric cancer was cultured and divided into five groups randomly:low-,middle-,high-dose group of Qigefang,5-FU group,control group.Qigefang was added in Qigefang group to make final concentration of 35,70,140 mg/mL,5-FU in chemothapy group to 50 ?g/mL,and PBS in control group.Tumor cell proliferation was detected by MTT,moving ablity of tumor cell by agar drop,and MMP-2,MMP-9 activity by gelatinase zymography.Results Qigefang had obviously depressant effect on proliferation of MGC cell.It became more obviously with raising drug density.Moving ability of all dose Qigefang groups and 5-FU group were more feeble than control group.The difference was significant(P

Objective To provide the experimental evidence for clinical application of taurine,rat model of intrauterine growth restriction (FGR) was made to investigate influence of prenatal administration of taurine on neurogenesis.Methods Fifteen pregnant rats were divided into control,FGR model and taurine groups,5 rats for each group.Rats in the control group were supplied with unlimited food and drink while the other two groups were fed by 40％ food intake of the control group throughout pregnancy.Since gestational day 12,taurine (100 mg/kg) was added into diet of taurine group every day until term delivery.Brain tissues were obtained immediately after baby rats were born.Expression of proliferating cell nuclear antigen (PCNA),neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP) of brain tissue was measured by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry; meanwhile,numbers of PCNA-immunoreactive cells in subventricular zone,subgranular zone and cerebral cortex were compared with ANOVA test or q test.Results Levels of PCNA mRNA and GFAP mRNA expression in FGR group were significantly higher than those of control group (PCNA mRNA:1.002±0.011 vs 0.894 ± 0.040,P＜0.01; GFAP-mRNA:1.012±0.013 vs 0.913±0.012,P＜0.01).Compared to FGR model group,mRNA expressions of PCNA and GFAP in taurine groups were higher (1.090±0.029,P＜0.01 ; 1.034±0.011,P＞0.05).There was a significant decrease in the expression of NSE mRNA in FGR group compared with control group (0.796±0.036 vs 1.582±0.057,P＜0.01),while the expression in taurine group (0.933±0.027) was significantly higher than that in FGR model group (P ＜ 0.01).PCNA immunoreactive cells were mostly distributed in subventricular zone,followed by subgranular zone and cerebral cortex.Conclusions Prenatal application of taurine could enhance neurogenesis of FGR newborn rats and improve survival of neurons to ameliorate FGR brain damage.

Objective To investigate the changes of serum cytokines in children with mycoplasma pneumoniae pneumonia (MPP).Methods A total of 239 children with MPP hospitalized in our department from Jan 2008 to Dec 2009 served as MPP group,which were redivided into mild MPP group (n =152) and severe MPP group ( n =87 ).Two hundred and sixty-three acute bronchopneumonia children without MPP infection served as non-MPP group.Fifty cases who would undergo hernia and phimosis elective surgery in pediatric surgery department served as control group.All children with pneumonia were detected mycoplasma pneumoniae antibodies and cytokines (TNF-α,IFN-γ,IL-1β,IL-4,IL-6) of serum in the first day of hospitalization and recovery period.Children in control group were detected the level of cytokines only once.Results Serum levels of TNF-α,IL-1β,IL-6 in MPP group and non-MPP group were higher than those in　control group ( P ＜ 0.01 ).No significant differences of IFN-γ and IL-4 levels were found among three groups ( P ＞ 0.05 ).Compared with non-MPP group,the levels of IFN-γ,IL-1β and IFN-γ/IL-4 were higher in MPP group ( P ＜ 0.01 ).The levels of TNF-α,IL- 1β,IL-6,and IFN-γ/IL-4 were significantly decreased in　the recovery period of MPP (P ＜0.001,P ＜ 0.05 ).The levels of TNF-α,IL-1β and IFN-γ/IL-4 in severe　MPP children were higher than those in mild MPP children ( P ＜ 0.01 ).Conclusion The immunologic　function of MPP children is unbalanced.The serum levels of TNF-α,IL-1β,IL-6,and IFN-γ/IL-4 are correlated with severity of MPP,which help to evaluate the state of MPP.

Objective To improve the diagnosis and treatment of acute exacerbation in idiopathic pulmonary fibrosis(IPF)Methods A case with clinical proven acute exacerbation in IPF and treated with corticosteroid was described and the foreign literature was reviewed.Results Most patients with idiopathic pulmonary fibrosis(IPF)show slowly progressive deterioration.However,accelerated deterioration also occurs without any definite factors on infection,heart failure,et al in a few of patients with IPF who have previously shown slowly progressive deterioration,and for part of patients corticosteroid treatment is effective.Conclusion Some acute exacerbation in idiopatic pulmonary fibrosis can be idiopathic.

With the increased survival of the low birth weight,brain injury in the premature infants be-comes a problem of enormous importance. The introduction of the term “encephalopathy of prematurity” is the current recognition that preterm brain injury is a complex of white and gray matter damage. The combination of white matter injury and neuronal/axonal deficits constitutes encephalopathy of prematurity. The preterm infants develop primary destructive brain lesions,secondary degeneration and disturbance of maturation from hypoxia-is-chemia and inflammation,which leads to cerebral palsy,cognitive,behavioral,or language deficits. This article reviews the neuropathology,pathogenesis,therapy and neurodevelopmental disability of encephalopathy of pre-maturity.