Objective To study the clinical efficay of the therapy adefovir dipivoxil combined with reduced glutathione in the treatment of decompensated hepatitis B cirrhosis .Methods 76 cases of decompensated hepatitis B cirrhosis were divided into the treatment group and the control group ,38 cases in each group .Both groups take symptomatic and supportive treatment ,the obser-vation group plus adefovir dipivoxil combined with glutathione therapy .After 3 months treatment ,we observed liver function ,hepa-titis B virus DNA quantification and assessed the clinical efficacy .Results After treatment ,the treatment group liver function im-proved was significantly better than the control group (P<0 .05) ,the total effective rate was higher than the control group (P<0 .05) ,the rate of hepatitis B virus DNA turn to negative was significantly higher than the control group (P<0 .01) .Conclusion Adefovir dipivoxil combined with reduced glutathione therapy for decompensated hepatitis B cirrhosis can effectively improve liver function ,suppress hepatitis B virus DNA undetectable ,reduce the incidence of the complication ,and worthy of promote in our clini-cal practice .

Objective To explore the clinical value of procalcitonin (PCT ) and blood culture in the united diagnosis of early blood stream infection .Methods The blood specimens of 625 patients were collected ,the serum level of PCT was detected by EL‐FA ,and the blood culture was accessed at the same time .23 cases of blood culture positive samples were received continuous detec‐tion of PCT ,and the results were analyzed .Results Positive rate of PCT was 41 .01% (0 .05 -2 .58 μg/L)in patients with blood culture negative results (negative group) ,and that in patients with blood culture positive results (positive group) was 80 .77%(0 .05-200 .00 μg/L) .The positive rate of PCT in positive group was significantly higher than negative group (χ2 =65 .12 ,P<0 .01) .Positive rates of PCT in patients with infection of Candida tropicalis ,kinds of bacteria ,Gram‐negative bacilli and Gram‐posi‐tive cocci were 100 .00% ,100 .00% ,92 .11% and 56 .81% ,respectively .Continuous detection of PCT in 23 patients with blood cul‐ture positive results showed that patients with gradually decreased PCT level suggested a good prognosis ,and patients whose PCT levels were higher than 10 μg/L and were maintained at high levels had poor prognosis .Conclusion Simultaneously blood culture and PCT detection was important to the early diagnosis and treatment of blood stream infection .

Objective To explore methods to measure the management level of Chinese hospitals in natural conditions of Chinese hospitals, for improvement of their operation efficiency. Methods The methodology of World Management Survey( WMS) was introduced, and the questionnaire was localized using expert consultation method. Double-blind telephone interviews were conducted to investigate the management level of Chinese hospitals in the four dimensions of standardized operation, performance monitoring, target setting and talent management. Results The management level of hospitals in China varied greatly from places. Among them, the hospital management scoring was found to range from 2. 50 to 2. 75 in most cases, averaging 2. 55. These hospitals scored relatively poor at the four specific management practices of hospital layout(2.48), performance communication(2.27), talents retention, and clarity and comparability of objectives(2. 45). Management level of a hospital was correlated to such factors as its history, ownership form, human capital and hospital size. Conclusions This study uses WMS methodology to quantify Chinese hospital management. The overall management level of Chinese hospitals is expected to improve with much gaps to cover. At this stage, it is imperative to solve the unbalanced and inadequate development of hospital management levels, among regions, hospital grades and forms of ownership.

After more than 100 years of development， spray drying technology has become more mature and widely used， and it is of great importance in the field of traditional Chinese medicine （TCM）. TCM powders prepared by spray drying is the raw material of dispensing granules， and the powder properties have an important influence on subsequent molding process and product quality. As a new form of TCM， dispensing granules have been included in the management category of TCM decoction pieces， indicating a broader application market， and a consensus has also been reached on the importance of TCM powder research. Based on this， the author summarized the application progress of spray drying in the study of TCM powders， including the factors affecting spray drying process， such as liquid properties， process parameters and equipment factors， as well as the application of computational fluid dynamics （CFD） and thermodynamic model in spray drying process simulation. Moreover， some commonly used pharmaceutical excipients for the modification of TCM powders were also introduced such as maltodextrin， microcrystalline cellulose and povidone. In addition， spray drying technology can also be used as a preparation technology for new drug delivery systems such as microcapsules and solid dispersions. Through the summary of this paper， the author suggests that the future research direction of spray drying of TCM can be carried out from the aspects of application rule of the coprocessing auxiliary materials based on the "unification of medicines and excipients"， the "structure-property" relationship of spray-dried powders and the application of computer simulation and design， so as to further enrich the application of spray drying in the field of TCM powders.