The implementation of hierarchical diagnosis and treatment policies will have a significant impact on the entire health care system .From the view the implementation of the policies of provinces now , tertiary hospital has been defined as a whole , and did not consider differences between grade b class 3 hospital and grade a class 3 hospital.Based on the overview of the policies , this article analyzed the external environment of the grade b class 3 hospital facing from strengths , weaknesses , opportunities and threats by using SWOT Analysis .Then propose counter-measures and suggestions of enhancing its ability and competitiveness to respond to the policies .

AIM: To investigate the protective effect of crude Paecilomyces tenuipes polysaccharides(cPtPs) and Paecilomyces tenuipes polysaccharides(PtPs) in a rat model of acute hepatic necrosis induced by carbon tetrachloride(CCl4).METHODS: Wistar rats were divided into four groups(control group,CCl4 group,cPtPs+CCl4 group and PtPs +CCl4 group),the four groups were given intragastrically with normal saline,cPtPs and PtPs for 15 d,respectively.In the last two days,these groups except control group were injected peritoneally with CCl4.Serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),direct bilirubin(DBIL) and indirect bilirubin(IBIL) were detected by automatic biochemistry analyzer.Pathological changes of hepatic tissue were assessed by hematoxylin-eosine(HE) staining.The levels of superoxide dismutase(SOD) and malondialdehyde(MDA) in liver homogenate were analyzed using xanthinoxidase and thio-barbituric acid,respectively.The concentration of Ca2+ in hepatocyte mitochondria was determined by colorimetric method.The expression of ?-smooth muscle actin(?-SMA) was examined in hepatic tissue by immunohistochemical method.RESULTS: Compared with control group,serum levels of ALT,AST,TBIL,DBIL and IBIL in CCl4 group increased significantly,denaturation and necrosis implicated to the whole hepatic lobules.Compared with CCl4 group,serum levels of ALT,AST,TBIL,DBIL and IBIL in PtPs +CCl4 group decreased significantly,denaturation and necrosis located in the third region of hepatic lobules,the level of SOD increased and MDA decreased(P

AIM: To study the immune regulation of paecilomyces cicadidae total polysaccharides. METHODS: After subcutaneous injection with 200 mg/L paecilomyces cicadidae total polysaccharides in the back of the rats for 17 days, the white blood cell (WBC) counts, and the levels of lipid peroxide (LPO) and reduced glutathione (GSH) in the spleen and thymus of rats were detected. The alveolar macrophages (AM?) cultured with 10% fetal bovine serum-RPMI-1640 for 2 h in vitro , then the activity of lactate dehydrogenase (LDH) and acid phosphatase (ACP) were detected by automatic biochemistry analyzer, and the ability devouring neutral red in the AM? were examined. RESULTS: Compared with control group, the WBC, the levels of GSH in the spleen and thymus, and the activities of LDH and ACP were significantly increased and the ability of devouring neutral red was also strengthened( P

AIM: To investigate the effect of puerarin on diabetic myocardial damage and to explore its possible mechanisms in rats. METHODS: The male Sprague-Dawley rats were randomly divided into normal control group, diabetic group, high dose puerarin (160 mg/kg), middle dose puerarin (120 mg/kg), low dose puerarin (80 mg/kg) treatment groups and aminoguanidine (100 mg/kg) treatment group. Corresponding drugs were intraperitoneally injected once a day. The animals in normal control group and diabetic group were given equal propylene glycol. 12 weeks later, the rats were sacrificed and their cardiac muscles were collected. Myocardial structure was observed under transmission electron microscope (TEM). The blood glucose concentration and the activities of superoxide dismutase (SOD), Ca~(2+)-ATPase, Na~+-K~+-ATPase and the content of malondialdehyde (MDA) in myocardial homogenate were measured biochemically. In addition, the mRNA expressions of peroxisome proliferator activated receptor γ (PPAR-γ), glucose transporter-4 (GLUT-4) and aldose reductase (AR) in myocardial tissues were determined by reverse transcription polymerase chain reaction (RT-PCR). RESULTS: It is observed that the myofibrils were diminished, broken or fused, some lipid droplets deposited in the cytoplasm of cardiocytes and part of cristae of mitochondria were broken or disappeared under TEM in diabetic group. The activities of SOD, Ca~(2+)-ATPase, Na~+-K~+-ATPase as well as the mRNA expressions of PPAR-γ and GLUT-4 decreased significantly (all P<0.01). The blood glucose concentration and the MDA level and the AR mRNA expression increased obviously (all P<0.01) in diabetic group as compared to those in normal control group. How-ever, in puerarin treatment groups, the above changes were reversed, a significant differences of those were found as compared to those in diabetic group (P<0.05 or P<0.01, respectively). The pathological change of cardiac muscles was relieved. It showed that myofibrils were well-arranged and only few lipid droplets deposited in the cytoplasm of cardiocytes and most mitochondria had clear and regular cristae under TEM in puerarin treatment groups. CONCLUSION: Puerarin exerts preventive and remedial effects on the diabetic myocardium, which may be related to up-regulating the mRNA expressions of PPAR-γ and GLUT-4, promoting glucose uptake and relieving oxidative stress damage.

AIM: To investigative the inhibitory effects of Paecilomyces cicadae polysaccharide (PcPS) against HBV in vitro, and the effects on the Toll like receptor 4 (TLR4) mRNA expression in HepG2.2.15 cell strain. METHODS: HepG2.2.15 cell strain was co-cultured in vitro with PcPS in different concentrations, and lamivudine (LMV) was applied as positive control. MTT assay was employed to detect the cytotoxicities of PcPS in vitro, when the HepG2.2.15 cells was used as target cells. The effects of PcPS on the secretion of HBsAg and HBeAg were assayed by ELISA method. Fluorescence quantitative-PCR (FQ-PCR) was used to detect the inhibitory effects of PcPS on the content of HBV-DNA and TLR4 mRNA in HepG2.2.15 cells. RESULTS: The inhibitory effects of PcPS on the HBsAg and HBeAg were observed and the maximum inhibitory ratio up to 44.8% and 31.0%, respectively. The same inhibitory effects of PcPS on the HBV-DNA replication and TLR4 mRNA expression in HepG2.2.15 cells were also found. CONCLUSION: A certain concentration of PcPS significantly inhibits HBV replication in vitro.

Objective To provide the nurse care evidence of nutritional intervention in patients with lung cancer during radiotherapy and chemotherapy by analyzing the nutritional status of these patients.Methods 55 patients with lung cancer who received chemotherapy and radiotherapy were selected.The nutritional status of these patients were evaluated by laboratory examination data at the time of hospitalized,ongoing and the end of radiotherapy. Results The hemoglobin(Hb),albumin(ALB),body mass and body mass index(BMI)were (130.50 ±17.80)g/L, (41.02 ±5.68)g/L,(61.29 ±8.75)kg,(22.36 ±2.78)kg/m2 respectively at admission;(115.90 ±19.00)g/L, (37.94 ±5.55)g/L,(59.95 ±9.05 )kg,(21.86 ±2.86)kg/m2 respectively during the course of radiotherapy;(110.40 ±19.40)g/L,(36.91 ±5.30)g/L,(58.91 ±9.30)kg,(21.48 ±2.99)kg/m2 respectively at the end of radiotherapy.At different stages of radiotherapy,the nutritional index gradually decreased,the Hb was lower in the middle of the radiotherapy than on admission,the difference was significant(t =8.611,P <0.05).The Hb in the late stage of radiotherapy was lower than the middle,the difference was significant(t =2.492,P <0.05).Although the ALB in the latter stage of radiotherapy was lower than the middle,but the difference was not statistically significant (t =1.464,P >0.05),and the difference was significant compared with on admission(t =4.815,P <0.05).The weight of the patients in the middle period of radiotherapy was less than the time of admission,but the difference was not statistically significant(t =0.781,P >0.05).The weight of patients in the late stage of radiotherapy was lower than the medium term,but the difference was not statistically significant as well(t =0.601,P >0.05),and there was no significant difference compared with on admission(t =1.382,P >0.05).The BMI of the patients with radiotherapy was lower than that at the time of admission,the difference was not statistically significant(t =0.091,P >0.05).The BMI of patients with radiotherapy was lower than that in the medium term,whereas the difference was not statistically significant(t =0.690,P >0.05),and the difference was not statistically significant compared with on admission(t =1.599,P >0.05).The Hb (F =16.643,P =0.000)and ALB(F =7.736,P =0.001)decreased significantly in particular.Conclusion The risk of malnutrition in patients with lung cancer is exist during radiotherapy and chemo-therapy,and it is obvious in the middle -late stage,the changes of physical and biochemical indexes have been appeared,and among them,Hb and ALB are the most obvious,so should be monitored and managed cause these data varied significantly.

Objective To investigate the physicochemical properties,structural characters and antitumor activity of a polysaccharide PTPS-1 from Paecilomyces tenuipes.Methods PTPS-1 was obtained by DEAE-cellulose and Sephadex G-100 chromatography column.The methods of HPLC,GC,IR,and NMR were used to investigate the molecular weight,monosaccharide composition,and structural characters of PTPS-1.The CCK-8 kit was used to determine the proliferation of PTPS-1 on murine splenocyte and the supernatant of the murine macrophage with PTPS-1-stimulated on Sp2/0 cells.Results PTPS-1,whose molecular weight was 1.84?104 and purity was 98.977%,contained mannose(Man) and galactogen(Gal) as monosaccharide constitute in molar ratio of 1.3∶1.It consisted of a backbone of ?-(1→6),?-(1→2),and ?-(1→3) linkage,whose branches were made by Gal-(1→3) linkage.PTPS-1 significantly stimulated the murine splenocyte proliferation and the supernatant of macrophage inhibited the growth of Sp2/0 cells in vitro.Conclusion PTPS-1 is a polysaccharide from P.tenuipes with immunomodulatory and antitumor activity.

Objective:To modify Ganodermalucidum polysaccharides(GLP) with sulfate and observe the protective effect of Ganodermalucidum polysaccharide sulfate (GLPS) on the cerebral ischemia reperfusion injury in the rats,and to investigate its mechanism.Methods:GLP was modified by sulfation to obtain GLPS.A total of 100 SD rats were randomly divided into sham operation group, model group, GLP group (40 mg·kg-1·d-1), GLPS group (40 mg·kg-1·d-1) and nimodipine group (1 mg·kg-1·d-1).The cerebral ischemia reperfusion models were established by middle cerebral artery occlusion method in the rats.The neurologic deficit score and the content of water in brain tissue of the rats with cerebral ischemia reperfusion injury were detected and the activities of superoxide dismutase(SOD) and the levels of malondialdehyde (MDA) were detected.The levels of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB),tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1) and interleukin-6 (IL-6) in the brain tissue homogenate were detected by ELISA.Western blotting method was used to detect the protein expression levels of HSP70 and p-Akt in the brain tissue of the rats.Results:Compared with model group, the neurological function scores of the rats in GLP group and GLPS group were decreased(P<0.01),the water contents in brain tissue were decreased(P<0.05), the SOD activities were increased and the MDA levels were decreased(P<0.05), and the levels of NF-κB, TNF-α, IL-1 and IL-6 were decreased(P<0.05);the effect in GLPS group was significantly better than that in GLP group(P<0.05).The results of Western blotting method showed that the p-Akt protein expression levels in the brain tissue of the rats in GLP and GLPS groups were increased compared with model group (P<0.05);compared with model group, the HSP-70 protein expression level in the brain tissue of the rats in GLPS group was increased(P<0.01),but the effect in GLP group was not obvious.Conclusion:Sulfation can significantly improve the protective effect of GLP on the cerebral ischemia reperfusion injury in the rats and its mechanism may be related to regulating the HSP70/PI3K/Akt signaling pathway and inhibiting the inflammatory reaction damage to the nerve cells of reperfusion.

Combined with the development of modem hospital pharmacy,in light of the present condition of the continuing education for the hospital pharmacists,based on the continuing education mode and method of the affiliated provincial hospital of Anhui medical university pharmacists,from the establishment of continuing education's goal and mode,the construction of hierarchical continuing education system,and education content integration aspects,this paper expounds the role and influence of the pharmacist professional skill contest.Through pharmacist professional skill contest,pharmacist can test and evaluate the hospital pharmacist professional ability,gradually improve pharmaceutical service level and quality of pharmacists.By introducing the pharmacist professional skill contest,pharmacist can not only timely adjust the continuing education's plan and ways,better coordinate with the development of hospital pharmacists,but also provide important technical support and talent reserves for the pharmacist professional skill contest.

AIM: To explore the activative effect of water extract from cultured mycelium of Paecilomyces cicadae (P. cicadae) on peritoneal macrophages (PM?) and alveolar macrophages (AM?) of rats.METHODS: The rats were randomly divided into four groups: normal control group(Ⅰ), cyclophosphamide (Cy) group (Ⅱ), P. cicadae group(Ⅲ), Cy+ P.cicadae group(Ⅳ).The rats were bred in the same circumstance and were administered with corresponding drugs by subcutaneous injection for 26 days. PM? and AM? of rats were irrigated by normal saline and collected by centrifuge and incubated in a humidified incubator for 2 h at 37 ℃. The activities of acid phosphatase (ACP) and lactate dehydrogenase (LDH) in the PM? and AM? were determined by biochemical methods, and the capability of PM? and AM? in phagocytosis of neutral red were measured by colorimetric method too. RESULTS: After administering P. cicadae to rats, the activities of ACP and LDH in PM? and AM? of normal rats were elevated significantly,and the reduction of the activities of ACP and LDH in PM? and AM? of rats due to Cy was notably antagonized, and the capability of PM? and AM? phagocytizing the neutral red were strengthened significantly.CONCLUSION: P. cicadae can activate the PM? and AM? of rats.