In principle,the administrative body can use the administrative contract within its competence,as long as the purpose is to achieve administrative purpose or public services.In the medical and health sector,by the contract,it clears that the government is the investor to providing public medical and health goods,and it determines the administrative privileges and the administrative responsibility to provide services of the health administrative body in the medical and health sector;meanwhile,it makes administrative enforcement more acceptable through absorbing administrative counterpart to participate in administrative activities and reflecting its interests in the contract by consultation;moreover,it regularizes the collaboration between the administrative body to make the respective responsibilities of the administrative body more clearly.

Objective To compare the clinical effect and adverse reactions of different concentrations of dezocine epidural anesthesia for cesarean section.Methods According to digital table,120 cases of elective cesarean section were randomly divided into 4 groups with 30 cases in each group, the group D1 was given with dezocine 2.5mg,the group D2 with dezocine 5mg,the group D3 with dezocine 10mg,the group M with morphine 2mg.All the drugs used in postoperative epidural analgesia after cesarean section.To observe resting pain and conduct the VAS scoring at postoperative 4,8,12,24h and record various adveme reactions.Results The VAS scores at postoperative 4,8,12h in the group D1 were lower than those in the D2,D3,M with statistical difference(all P<0.05).The VAS scores at postoperative 4,24h had no statistical difference among D2,D3,M groups(all P>0.05).The VAS scores at postoperative 8h in the group D3 were lower than those in the D2,D3,M with statistical difference(all P<0.05). There were no statistical differences among 4 groups at postoperative 24h(all P>0.05).The incidence rates of nause-a and vomiting the group M were higher than that in the group D1,D2 and D3,showing statistical difference among them(P<0.05).Conclusion Appropriate concentrations of dezocine used in postoperative epidural analgesia after cesarean section has definite effect and less adverse reactions.

Fifty-two patients exactly diagnosed as rheumatoid arthritis in the active stage in clinic were treated by acupuncture plus western medicine. Thirty days made up a course of treatment. There were significant differences in clinical symptoms, signs, and immunological indexes between pretreatment and posttreatment (P<0.05, P<0.01). The treatment of rheumatoid arthritis in the active stage by acupuncture plus western medicine could effectively regulate humoral immunity and enhance the clinical therapeutic effect.

Objective To investigate the role of nitric oxide synthase (NOS) in neurotoxic mechanisms of beta amyloid (A?) and the pathogenesis of Alzheimer′s disease (AD). Methods 35 adult rats were divided into 3 groups: normal control,saline injection,and A? 1 40 injection groups A? 1 40 was initially solubilized in saline (10?g/?l) and incubated for at least 1 week before use 1?l incubated A? 1 40 or saline were injected into dorsal blade of dentate gyrus in right hippocampus of rats Immunohistochemical assay of neuronal NOS (nNOS) and inducible NOS (iNOS) was performed at the 2 nd,10 th,and 30 th day after A? 1 40 or saline injection. Results The nNOS like immunoreactivity (nNOSLIR) neurons were found in different brain regions such as cortex,striatum and hippocampus of normal rats,and the number of neurons in dentate gyrus was 8 96?0 31 The number and configuration of nNOSLIR neurons were found without changes after saline injection (8 97?0 29) At 2,10,and 30 d after A? 1 40 injection,the number of nNOS neurons at the site around injection was significantly reduced (3 13?0 27,2 89?0 19 and 2 91?0 25 respectively),but there were no notable differences at these three experimental time points iNOS like immunoreactivity (iNOSLIR) cells were not found in any brain region of normal or saline injected rats After A? 1 40 injection,a large percentage of glia (mainly were astrocytes) had an activated morphological change and showed a strong iNOSLIR around the injection site The responded areas with these cells were 0 905?0 082,0 962?0 161 and 0 935?0 125 mm 2 respectively at 2,10 and 30 day after A? 1 40 injection,but there appeared no significant differences among them. Conclusions The results demonstrate that intrahippocampal injection of A? 1 40 may result in a significant loss of nNOS neurons and induce a considerable expression of iNOS in astrocytes,indicating that NOS may play an important role in neurotoxic mechanisms of A? and the pathogenesis of AD

OBJECTIVE:To observe the effects of Gegenqinlian colon positioning tablet(GGQLJC)on colon tissue PPAR-γ, NF-κB p65 protein expressions of model rabbits with damp-heat type ulcerative colitis(UC). METHODS:56 rabbits were random-ly divided into normal group(normal saline),model group(normal saline),sulfasalazine tablet(SASP)group(positive control, 0.300 g/kg),Gegenqinlian tablet (GGQL) group (0.225 g/kg) and GGQLJC high-dose,medium-dose,low-dose groups (1.036, 0.518,0.259 g/kg),8 in each group. Except for normal group,rabbits in other groups were cultured for damp-heat-type UC mod-el,intragastrically administrated in the second day of last administration,once a day,for 14 d. Disease activity index(DAI),co-lonic mucosal damage index (CMDI),histological damage (TDI) were scored;colon,spleen and thymus indexes were deter-mined;PPAR-γ,NF-κB p65 protein expressions in colon tissue were detected. RESULTS:Compared with normal group,DAI, CMDI,TDI scores and spleen index,colon index,NF-κB p65 protein level in colon tissue in model group were significantly in-creased(P<0.01);thymus index,PPAR-γprotein level in colon tissue were significantly reduced(P<0.01). Compared with mod-el group,above-mentioned indexes in each administration group were significantly improved (P<0.05 or P<0.01). Compared with GGQL group,DAI and TDI scores,spleen index,colon index,NF-κB p65 protein level in colon tissue in SASP group, GGQLJC high-dose,medium-dose groups were significantly decreased (P<0.05);PPAR-γ protein level in colon tissue in SASP group,GGQLJC high-dose,medium-dose groups were significantly increased (P<0.05 or P<0.01). CONCLUSIONS:GGQLJC has certain improvement effects on model rabbits with damp-heat type UC,which is superior to GGQL. The mechanism may be re-lated to increasing PPAR-γprotein level and decreasing NF-κB p65 protein level in colon tissue.

Objective To study absorption characteristic of dioscin from Dioscorea nipponica Makino extract in rat intestine.Methods Single-pass intestinal perfusion (SPIP) model was used for rat in situ and HPLC was used to determine the concentrations of dioscin.The effects of different intestinal segments,drug concentration and P-glycoprotein (P-gp) inhibitor on intestinal absorption were investigated.Results Dioscin could be absorbed in the whole intestine,the absorption rate constant (Ka) and the apparent coefficient (Papp) of dioscin decreased following the sequence of ileum > duodenum =jejunum > colon.Absorption parameters of dioscin had no significant difference at different concentrations (40,80,120 mg·L-1).There were significant differences in Ka and Papp values between P-gp inhibitor group and no P-gp inhibitor group(P<0.05).Conclusion The saturate phenomena was not observed under the test range of drug concentration,and the absorption mechanism may be passive diffusion transport.Dioscin in Dioscorea nipponica Makino extract may be the substrate of P-gp.

Objective To investigate the correlation between dynamic changes in esophageal impedance and dilated intercellular space (DIS) of patients with acid-induced non erosive reflux disease (NERD).Methods From September 2013 to July 2014,a total of 35 patients with NERD and 20 healthy controls were selected and underwent 24 h multichannel intraluminal impedance and pH monitoring (MII-pH monitoring),acid perfusion test and gastroendoscopy examination.One piece of mucosa tissue was taken under gastroendoscope from the anterior and posterior walls at 2 cm above the dentate line of the esophagus.Intercellular space (ICS) of the esophageal epithelia cells was measured by software after hematoxylin and eosin staining.t test and variance analysis were performed for statistical analysis.Pearson correlation analysis was used for correlation analysis.Results Impedance baseline of distal esophagus and impedance recovery rate of patients with NERD were lower than those of healthy control group,which were (2 998±701) Ω vs (3 880±1 054) Ω and (30.1±14.0) Ω/min vs (53.0±14.5) Ω/min,and the differences were statistically significant (t=3.65,5.41;both P＜0.01).Compared with healthy control group,ICS of the esophageal epithelial cells was obviously wider (1.03 ± 0.20) μm vs (0.66±0.14) μm,and the difference was statistically significant (t=-6.57,P＜0.01).Impedance baseline of esophagus and impedance recovery rate of patients with positive acid perfusion test were lower than those of patients with negative acid perfusion test,which were (2 755±680) Ωvs (3 411±536) Ω and (25.4±13.0) Ω minvs (33.4±9.8) Ω /min,and the differences were statistically significant (t =2.99,2.03;both P＜0.05).The correlation between impedance recovery rate and ICS was negative (r=-0.70,P＜0.01).Conclusions Recurrent reflux induced injury and delayed mucosal headline may be the factors of impaired mucosal integrity in patients with NERD.The changes esophageal of impedance baseline to a certain extent reflected the degree of esophageal mucosal integrity impairment.

Objective To analyze the influential factors of clinical pregnancy rate of the frozen-thawed embryo transplantation. Methods The data of 3 192 FET patients in the reproductive medicine center of our hospital up to May 2014 were analyzed retrospectively. According to ages, reasons of infertility, types of infertility, duration of infertility, drug regimen, the number and the time of embryo transplantation, we divided these patients into six groups for comparing the clinical pregnancy rate. Results The FET clinical pregnancy rate of the under 35 years group was higher than the 35~39 years group and the over 39 years group (33.96%vs. 27.58%and 19.35%; P<0.05, respectively). The duration of infertility in the clinical pregnancy group was significantly shorter than the non-pregnancy group (P<0.05). The clinical pregnancy rate in the group with three embryos transplanted was higher than the group with only two embryos transplanted (41.01% vs. 28.75%; P < 0.05). Among the group with the age of over 40 years, those with three embryos transplanted had a higher clinical pregnancy rate than those with only one embryo transplanted (25.49% vs. 0.00%; P < 0.05). The clinical pregnancy rate of the frozen blastocyst transplantation group was higher than that of the cleavage-stage transplantation group (40.00%vs. 26.27%;P<0.05). Conclusion Age, infertility duration, the number and the time of frozen embryo transplantation may affect the clinical pregnancy rate among the FET patients. An individualized transplantation program based on age may improve the patient′s clinical pregnancy rate.

Objective To evaluate whether recombinant human erythropoietin (rh-EPO) could increase the angiogenic responses in preterm rat models with periventricular white matter damage (PWMD).Methods Three-day postnatal rats were divided into 3 groups randomly:the sham group,the hypoxic-ischemic (HI) group and the recombinant human erythropoietin(rh-EPO)treatment group.Rat pups underwent permanent ligation of the right common carotid artery followed by 60 mL/L O2 for 4 h or sham operation and normoxic exposure.Immediately after the HI,rats received a single intraperitoneal injection of rh-EPO (5 U/g)or saline.Angiogenesis-related cells (CD34 + cells),microvessel density (MVD)and arteriovenous related genes (ephrinB2 and EphB4)were examined at 48 h and 96 h after operation.Results At 48 h after operation,the proteins of CD34 in HI rats increased compared with the sham rats (HI group vs Sham group:0.54 ± 0.05 vs 0.42 ± 0.05,P ＜ 0.05).However,the MVD,the mRNA of ephrinB2 and EphB4 did not change (P ＞ 0.05).The proteins of CD34,the mRNA of ephrinB2 and EphB4 increased after rh-EPO treatment compared with HI rats.However,the MVD did not increase.As the proteins of CD34 increased further at 96 h after operation (HI group vs Sham group:0.85 ± 0.06 vs 0.62 ± 0.06,P ＜ 0.05),the MVD (3.14 ± 1.21 vs 1.50 ± 1.04),ephrinB2 (7.51 ± 1.89 vs 1.28 ± 0.24) and EphB4 (4.58 ± 0.82 vs 1.21 ± 0.22) also increased (all P ＜ 0.05).And the proteins of CD34 increased after administration of rh-EPO(EPO group vs HI group:0.98 ± 0.07 vs 0.85 ± 0.06,P ＜0.05) and MVD(EPO group vs HI group:4.71 ± 1.38 vs 3.14 ± 1.21,P ＜0.05) were increased after administration of rh-EPO.However,the ephrinB2 and EphB4 did not increased after administration of rh-EPO at 96h time point.Conclusion Endogenous regenerative response is triggered in the damaged tissues and rh-EPO increases the angiogenesis in model rats with PWMD.

Objective To investigate the serum levels of biochemical indexes such as calcium,phosphorus,iron,zinc,and alkaline phosphatase of children in Kaschin-Beck disease areas and control areas in Qinghai Province.Methods According to the results of Kaschin-Beck disease monitoring in Qinghai Province,Tangnaihai Township of Xinghai County and Gandu Town of Hualong County were chosen as Kaschin-Beck disease areas and Qushian Township of Xinghai Country was chosen as a control.Children aged 7 to 15 in boarding schools in these areas were chosen as the study subjects in June 2014.Serum alkaline phosphatase level was determined by enzyme colorimetry and the serum iron,zinc,calcium and phosphorus levels were determined by colorimetry.Calcium to phosphate ratio was calculated at the same time.Results Fifty-nine qualified serum samples of children were sampled in Kaschin-Beck disease areas and 45 in control area.Serum alkaline phosphatase levels in Kaschin-Beck disease areas and control area were (311.34 ± 85.31) and (264.09 ± 73.44)U/L,respectively,and the difference was statistically significant (t =-2.97,P ＜ 0.05).Children's serum phosphorus levels in Kaschin-Beck disease areas and control area were (1.62 ± 0.17) and (1.43 ± 0.13)mmol/L,respectively,and the difference was statistically significant (t =-6.29,P ＜ 0.05).Calcium to phosphorus ratio were 1.62 ± 0.17 and 1.82 ± 0.21,respectively,and the difference was statistically significant (t =5.53,P ＜ 0.05).Compared with the control area,the level of children's serum zinc was (19.96 ± 1.70) and (20.59 ± 2.45)μmol/L;the level of serum calcium was (2.59 ± 0.11) and (2.57 ± 0.11)mmol/L;and the level of serum iron was (15.06 ± 7.02) and (17.01 ± 6.70)μmol/L.The differences between these three biochemical indicators were not statistically significant between Kaschin-Beck disease areas and control area (t =1.39,-0.64,1.44,all P ＞ 0.05).Conclusion In Kaschin-Beck disease areas in Qinghai Province,the level of children's serum alkaline phosphatase and phosphorus have increased markedly and the calcium to phosphate ratio has decreased obviously.