Objective To observe the association of vesicular glutamate transporter of typeⅠ (VGluT1 ) like immunoreactive(LI) ,the differentiation-associated Na+ dependent inorganic phosphate cotransporter(DNPI) LI and glutami cacid decarboxy lase(GAD) LI terminals with GABAA receptor ?3 subunit(GABAAR ?3) LI neurons in mesencephalic trige minal nucleus of the rat.Methods Triple immun of luorescencehis to chemical staining technique and confo call aser scanning micros copy were used.Results Alargenumber of neuronal cell bodies showed GABAA R?3 LI immunoreactivity atallrostrocaudal level softhe Vme ,and most of GABAAR ?3 LI cells were large (2 5 5 0 ?m)pseudouni polarneurons.The dense VGluT1 LI,DNPL LI and GAD LIterminal sdistri buted widelyin Vme ,some VGlu T1 DNPI LI and GAD LIterminals surrounded the somata of the GABAAR ?3 LI Vmeneurons ,and made close contacts with them .Conclusion Proprioceptive sensory signals from the or of acialregionmight be modulated at the level of the primary afferent cell bodies in the Vme both by glutamatergic and GABAergic axonal terminals from other brain areas,and the effect of GABAergic terminals might be mediated by post synaptical GABAA receptors .

ObjectiveTo investigate the clinical efficacy of points injection of mouse nerve growth factor in treating sciatic nerve injury.MethodAcupuncture point injection of injectable mouse nerve growth factorwas performed in 60 patients with sciatic nerve injury. Points Huantiao(GB30)and Zusanli(ST36)were selected. Treatment was given once daily, for a total of 30 times. Sensory and motor functions were assessed (MS and SS) and electromyography (EMG) was performed before and after treatment to compare motor nerve conduction velocities (MCV) and sensory nerve conduction velocities (SCV) in the injured nerves and EMG changes in the musclescontrolled by the injured nerves.ResultAfter treatment, nerve function was restored to more than S3M3, with an efficacy rate of 81.7%, in 49 patients. Neuro-electrophysiological study showed that regenerative potentials occurred, accounting for 71.7%,in43patients. Denervated potentials were fewer after treatment than before; there was a significant difference (P<0.05). The mean MCV value increased after treatment compared with before; there was a significant difference (P<0.05). ConclusionAcupuncture point injection of mouse nerve growth factor can markedly improve sensory and motor functions in the regions controlled by the injured sciatic nerve. It provides an effective way to promote the repair of sciatic nerves and the reconstruction of limb function after the nerves are injured.

Summarized in the paper are the practices and experiences of hospitals across China,in their optimization of medical resources under the Healthcare Improvement Initiative to meet medical needs.Namely rationally allocating medical resources to strengthen emergency rescue,introducing new technologies to improve procedures and efficiency,introducing day surgery and day-care units,and innovating resource sharing among others.The author also recommended on further optimization of medical resources.

Objective To know the pollution status and the cytotoxicity of PM2.5 in Hangzhou,Zhejiang.Methods PM2.5 was collected in the center of Hangzhou city in spring and summer in 2005,the weighting method was used for PM 2.5 collection.WI-38 cell line was used as the target and the cells were treated with PM2.5 at different doses.The cytotoxicity of PM2.5 was tested by cloning efficiency.Results According to the Air Quality Standard for PM2.5 of U.S.EPA(issued in 1997),it was showed that the rates exceeding standard of PM2.5 concentration in spring and summer were 96.7% and 90.0%,respectively,but the rates were 33.3% and 20.0% compared with the standard newly issued in 2006.WI-38 cell survival rate was 100%,99.6%,96.2%,85.0%,73.8%,54.6% and 100%,97.0%,96.9%,88.0%,83.0%,64.7% respectively when treated with PM2.5 in spring and in summer of 0,25,50,100,200,500 ?g/ml.There was a significant difference except 25 ?g/ml and 50 ?g/ml in summer.Conclusion There is an obvious PM2.5 pollution in Hangzhou,which is heavier in spring than in summer,the cytotoxicity of PM2.5 in the polluted air may be higher.

Objective:To compare the changing trends and differences of bed numbers,doctor numbers and medical service utilization in the US.and China so as to provide polity implication for the health care reform in China from the supply side.Methods:The data of beds,doctors,hospitalization and outpatient service utilization from the website of OECD and CDC of the United States as well as Chinese Statistical Yearbook of Health and Family Planning were used to describe the trends.Results:The beds per 1000 people in China had exceeded that of the US,while the doctors per 1 000 people in China was less than the US.Both the two countries had yearly increasing trend of outpatient visits.However,the hospitalization was decreasing in the US,while the growth rate of hospitalization was even higher than the outpatient visits in China.Conclusion:The decrease of bed amount and the increase of outpatient amount were the main changing trend of medical resources and service utilization in the US.The imbalanced structure of medical resource supply in China resulted the overuse of hospitalization services.In the supply side reform of medical reform in China,it suggested to promote the cooperation of medical insurance,drug and health care,adjusted the reform thought from resource amount into the promotion of service quality,changed the health management system from disease centered into health centered.

Objective To investigate the changes of cholesterol efflux,the scavenger receptor class B type Ⅰ(SR-BI) protein expression in THP-1 maerophage derived foam cells treated with Lippolysaecharide (LPS), and to discover the role of NF-κB pathway in this process.Methods The foam cells were treated with LPS along or treated with N-p-Tosyl-L-phenylalanine chloromethyl ketone(TPCK) for 24 h.The protein levels of SR-BI and intranuclear NF-κB p65 were measured by Western blotting.Cellular lipid accumulation was determined by high performance liquid ehromatograpby analysis.Cholesterol efflux was determined by FJ-2107P type liquid scintillator.Results The expression of SR-BI was decreased after treated with LPS,while the intranuclear NF-κB p65 protein level was increased by LPS.The results also showed that cellular lipid accumulation was increased ,while the cellular cholesterol efflux was decreased in THP-1 maerophage derived foam cells after exposed to LPS for 24 h and these changes can be reversed partly by pretreatment with TPCK.Conclusion LPS could down-regulate the expression of SR-BI, promote the accumulation of lipid and decrease cellular cholesterol efflux in THP-1 maerophage derived foam cells ,which should be related to the TLR4/NF-κB dependent pathway.

OBJECTIVE:To explore the feasibility of using international index of rational drug use for the intervention and evaluation of rational use of antimicrobial agents during perioperative period in patients undergoing thyreoidectiomy.METHODS:The patients in the common surgical department were divided into intervention group and non-intervention group.An intervention control study was performed before intervention(from Mar.to Aug.in 2007)vs.after intervention(from Mar.to Aug.in 2008)on the synchronously discharged thyreoidectomy patients with the international index of rational drug use as references.RESULTS:After prophylactic use of antibiotics in the intervention group,the average antimicrobial application time was decreased from 6.83 days to 2.50 days,the average hospital stay of patients was decreased from 8.24 days to 7.15 days,the average hospitalization fee decreased from 1 895.99 yuan to 1 375.26 yuan,the cost of antibacterials decreased from 852.11 yuan to 538.53 yuan,and the proportion of the cost of antibacterials in the total hospitalization cost reduced slightly.However,all the indexes in the non-intervention group showed little change.CONCLUSION:It is effective and feasible to adopt the international index of rational drug use in the intervention and evaluation of rational use of antimicrobial agents during perioperative period.

OBJECTIVE:To systematically review the efficacy and safety of Moxifloxacin(MFX)in the treatment of acute ex-acerbation of chronic bronchitis (AECB),and provide evidence-based reference for Tational use of MFX. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,Medline,CBM,CJFD,VIP and Wanfang Database,the relevant conference proceed-ings and grey literature were also hand-searched,randomized controlled trials(RCT)about MFX(test group)versus other antibiot-ics (control group) in the treatment of AECB were collected. Meta-analysis was performed by using Rev Man 5.2 software with ITT analysis and PP analysis after literature selection,data extraction and quality evaluation. RESULTS:Totally 14 RCTs were in-cluded,involving 6 058 patients. Results of PP analysis showed,the clinical effective rate in test group was similar to that of con-trol group [RR=1.02,95%CI(1.00,1.04),P=0.06],while bacteria clearance rate was significantly higher than control group [RR=1.07,95%CI(1.04,1.11),P<0.001]. Results of ITT analysis showed,the clinical effective rate in test group was significantly high-er than control group [RR=1.03,95%CI(1.00,1.06),P=0.03],while there was no significant difference in the bacteria clearance rate [RR=1.02,95%CI(0.92,1.12),P=0.73] and the incidence of adverse reactions [RR=0.97,95%CI(0.87,1.08),P=0.52] be-tween 2 groups. CONCLUSIONS:The efficacy of MFX is not inferior to other antibiotics in the treatment of AECB,safety is simi-lar to other antibiotics.

Objective:To purify and characterize the major antigenic components of sand swimming crab,and provide theoretical evidences for the research of standardization of allergenic vaccine.Methods:The crude extract of Linnaeus was prepared using classical method, and electrophoresis of SDS-PAGE was used to separate the proteins of each group. The allergen proteins of 26 crab were identified using Western blot. To distinguish between the primary allergen proteins and secondary allergen proteins, FPLC(Gel Chromatography and ion exchange chromatography) was used to filtrate and identify the allergen protein.Results:SDS-PAGE analysis revealed that sand swimming crab proteins were composed of at lease 9 discrete protein bands, which molecular weight ranging from 13 000 to 90 000. Major bands were of 20 900, 24 200, 27 100, 29 200, 33 700, 38 900, 48 700, 74 700, 89 100 respectively. Western blot assay indicated that the crude extract reacted with sera obtained from 26 crab allergenic subjects and contained 5 allergen bands altogether, and the bands of 74 400 and 48 700 were the major allergenic components. The positive rates of the two major allergen proteins were both 100%, indicating the allergenic components maintained the immunocompetence after yielding from chromatography.Conclusion:The 74 400 and 48 700 bands are the major allergens of sand swimming crab. The major allergen proteins can be purified by chromatography.

In China's new healthcare reform, the pilot local governments explore the practice of establishing a new model of hierarchical diagnosis and treatment system.Zhejiang Province has adopted a special policy of effectively allocating hospital resources and human resources, and efficiently improving primary healthcare institution capability and patient satisfaction(hereinafter referred to as double allocation, double improvement), focusing on the implementation of the 'Healthcare Talents Project', in order to fill a vacancy of human resources in primary healthcare institutions.This paper uses system dynamics modeling and the WISN method of WHO to estimate the gap in physician supply in primary healthcare institutions.After building the system dynamics model of 'Healthcare Talents Project', this paper simulates the influence of the policy on the vacancy of doctors in primary healthcare institutions and analyzes the sensitivity of regulatory factors.The simulation results show that, there are a big gap in physician supply of about 14,000 to build the hierarchical diagnosis and treatment system.The project can gradually increase the number of primary doctors, and the policy may fill the vacancy by 2021.However, if the efficiency of the hospital doctors who give assistance to primary institutions is increased by 10%, the targeted training and recruitment 100% achieve the policy plans and objectives, the project goal may be achieved by 2020.Therefore, this project can effectively adjust the human resources structure quickly and reasonably, and it can be used as reference for the reform of hierarchical diagnosis and treatment system.