An analysis on the human resources, equipments and budgets of the township hospitals in Wenzhou City discovered the following setbacks: Changeable management system, poor positioning of their functionality, difficulty to play their roles, insufficient funding, inadequate infrastructure, slow development, lack of medical technicians, low level of medical services, and lack of development momentum. Based on these findings, the author proposed the following to upgrade their functionality and promote their development: Clearly positioning their functionality, improving the financial assurance mechanism, deepening system reforms in these hospitals, and further clarifying job divisions.

Objective To study the best collected time of fructus ponciri trifoliatae determine the naringin in it by RP-HPLC method. Methods The hypersil ODS C18 (250 mm?4.6 mm, 25 ?m) column was used. The mobile phase consisted of acetonitrile-0.1% phosphoric acid (21∶79), the detection wavelength was 283 nm. The flow rate was 1.0 mL/min. Result The calibration curve of naringin was in good linearity over 0.164 4～0.832 0 ?g, and the regression equation was Y =156 681X -84 834 (r =0.999 9). The average recovery was 98.49%, and RSD=2.68%. Conclusions The method is simple, quick, sensitive, accurate, reproducible and can be used to control the quality. Fructus ponciri trifoliatae should be collected in the beginning and middle of June.

OBJECTIVE:To establish UPLC fingerprint of Gehua formula granules. METHODS:UPLC method were adopted. The determination was performed on Zorbax Eclipse XDB-C18 column with mobile phase consisted of acetonitrile-water at the flow rate of 0.5 mL/min. The detection wavelength was set at 264 nm,column temperature was 25 ℃,and the sample size was 1 μL. Using tectorigenin as reference substance,UPLC chromatograms of 10 batches of Gehua formula granules were determined. The common peak identification and similarity evaluation were conducted by TCM Chromatogram Fingerprint Similarity Evaluation Sys-tem(2004 A edition). RESULTS:14 common peaks were identified in UPLC chromatograms of 10 batches of Gehua formula gran-ules and similarities were all higher than 0.90. UPLC chromatograms of 10 batches of samples were in good agreement with control fingerprint. CONCLUSIONS:Established UPLC fingerprint can provide reference for identification and quality evaluation of Gehua formula granules.

Objective: To explore the effects of ramipril, trimetazidine and the combination of ramipril and trimetazidine on renal cell apoptosis index (AI) and cytochrome C (Cyt-C) expression in experimental rats with chronic heart failure (CHF).
Methods: CHF model was established by partially banding of abdominal aorta superior to renal artery in experimental rats. A total of 50 male Wistar rats were randomly divided into 5 groups: Sham operation group, Model group, Ramipril group, Trimetazidine group and Combination (ramipril and trimetazidine) group.n=10 in each group. Renal tubular cell AI was examined by TUNEL method, mRNA and protein expressions of Cyt-C were detected by RT-PCR and Western Blot analysis in each group respectively.
Results: Compared with Sham operation group, Model group had increased AI of renal tubular cells, increased mRNA and protein expressions of Cyt-C,P<0.01. Compared with Model group, Ramipril group, Trimetazidine group and Combination group showed decreased AI of renal tubular cells (20.02 ± 1.14) %, (20.10 ± 1.2) % and (14.27 ± 1.40) % vs ( 40.82 ± 1.31) %; reduced Cyt-C mRNA expression (0.54 ± 0.06), ( 0.56 ± 0.05) and (0.44 ± 0.04) vs (0.89 ± 0.03); reduced Cyt-C protein expression (1.50 ± 0.11), (1.58 ± 0.12) and (0.75 ± 0.06) vs (2.53 ± 0.10); the most reduction was obtain by Combination group, allP<0.01.
Conclusion: Ramipril and trimetazidine can inhibit renal cell apoptosis and effectively improve the renal function in CHF rats. Combined medication is better than either of them alone.

Objective To study the effect of the PDCA management on safety management of venous transfusion by indwelling needles?.Method The measures included standardizing nurses manipulation,improving the management system related to venous transfusion,and regulating details management process for tube fixing and dressing and tube maintenance.Results The rates of unstandardized maintenance and obstruction of tubes after the enforcement of details management were significantly lower than those before its enforcement(P<0?05).Conclusions PDCA management is effective for standardizing nursing implementation and ensuring the safety of venous transfusion by indwelling needle?

Purpose To investigate the value of dual-source CT with dual-energy virtual non-contrast imaging in the diagnosis of cervical lymph node disease. Materials and Methods The dual-energy scan data of 126 lymph nodes from 50 patients confirmed pathologically were reviewed. The difference of average CT value, signal to noise ratio, contrast to noise ratio, image subjective assessment and lesion detectability between virtual non-contrast imaging and conventional non-contrast scan were analyzed. The radiation dose of virtual non-contrast imaging and real non-contrast imaging of cervical lymph node were also compared. Results ①The consistency of virtual plain scan combined with dual-energy contrast imaging in the diagnosis of six typical pathological types were all satisfactory (Kappa>0.7, P<0.01), and the detection rate of non-specific lymphadenitis, lymphomas and lymph node metastasis of thyroid carcinoma was higher among the six types (93.1%, 86.7% and 100.0%, respectively, Kappa=0.983, 0.893; P<0.01), and had the highest detection rate of lymph node metastasis of thyroid carcinoma (100.0%, Kappa=1.000, P<0.01). ②There was no significant difference among the average CT, signal to noise ratio and contrast to noise ratio of conventional scan and virtual non-contrast imaging during arterial phase and venous phase (H=3.125, 4.374, 4.037;P>0.05).③ Compared with conventional enhanced scan, dual-energy phases reduced radiation dose by about 19%. Conclusion Dual-energy virtual non-contrast imaging combined with contrast imaging can provide clear images in the diagnosis of enlarged cervical lymph nodes and reduce radiation dose of subjects, thus can be expected to replace real scan.

Objective To investigate the correlation between the characteristics of intracranial lesions and the level of cognitive function in patients with an initial diagnosis of brain metastases.Methods A retrospective analysis was performed in 51 patients with an initial diagnosis of brain metastases who were admitted to The Second Hospital Affiliated to Suzhou University from January 2015 to April 2016.CT and (or) MRI were used to determine the characteristics of intracranial lesions and the Montreal Cognitive Assessment was used to evaluate the cognitive function of patients.Comparison between groups was made by Mann-Whitney U test.The correlation between ranked data was analyzed by Spearman rank correlation test.Results Of the 51 patients with an initial diagnosis of brain metastases,47(92%) had cognitive impairment,including mild cognitive impairment in 31(61%) and dementia in 16(31%).There was no significant difference in level of cognitive function between the patients with involvement of the left hemisphere alone and those with involvement of the right hemisphere alone (P=0.425).The patients with involvement of both hemispheres had a significantly lower level of cognitive function than those with involvement of the left hemisphere alone (P=0.042).The patients with involvement of three or more brain lobes had a significantly lower level of cognitive function than those with involvement of one or two brain lobes (P=0.015,0.024).The intracranial lesion volume and edema volume had no significant effect on the overall cognitive function of patients (P=0.077,0.178).The patients with>3 intracranial lesions had a significantly lower level of cognitive function than those with 1-3 intracranial lesions (P=0.010).Conclusions More than 90% of patients with an initial diagnosis of brain metastases have cognitive impairment.Cognitive impairment is mainly associated with lesion site,involvement of brain lobes,and number of lesions,but not with lesion volume and edema volume.

AIM To study the chemical constituents from Polygonum hydropiper L..METHODS The petroleum ether,ethyl acetate and n-butanol fractions of 95％ ethanol extract from P.hydropiper were isolated and purified by silica,Sephadex LH-20 and recrystallization,then the structures of obtained compounds were identified by spectral data.RESULTS Thirteen compounds were isolated and identified as β-sitosterol (1),aniba dimer A (2),succinic acid (3),quercetin (4),gallic acid (5),daucosterol (6),quercetin-3-O-β-D-glucoside (7),kaempferol-3-O-β-D-glucoside (8),quercetin-3-O-β-galactoside (9),kaempferol-3-O-β-galactoside (10),stigmast-4-ene-3β,6a-diol (11),fumaric acid (12),ellagic acid (13).CONCLUSION Compounds 11 and 12 are isolated from genus Polygonum for the first time,compounds 2,8,10 and 13 are first obtained from this plant.

Objective : To understand the current situation and influencing factors of occupational burnout among vaccination personnels in Haining. Methods : The vaccination staffs of all vaccination clinics in Haining were investigated by the general questionnaire and Maslach Burnout Inventory. Logistic regression model was used to analyze the influencing factors for job burnout of vaccination personnels. Results : A total of 160 questionnaires were distributed and 158 valid questionnaires were collected. The effective rate of questionnaires was 98.75%. A total of 91 vaccination staffs suffered from occupational burnout,accounting for 57.59%. Among them,the median（inter-quartile range）of the scores of emotional exhaustion,depersonalization and personal achievement were 13.00（14.00）,4.00（6.00）and 26.50（17.00）,respectively,which were all lower than the normalized scores（22.19,7.12 and 36.53,P<0.05）. The results of logistic regression analysis showed that having confidence in vaccination was a protective factor for emotional failure（OR=0.175,95%CI：0.058-0.523）and low sense of achievement（OR=0.272,95%CI：0.079-0.937）in vaccination personnels;having experience in adverse event following immunization（AEFI）was a risk factor for depersonalization（OR=3.125,95%CI：1.472-6.633）and occupational burnout（OR= 2.391,95%CI：1.189-4.807）in vaccination personnels. Conclusion A certain proportion of vaccination staffs in Haining suffered from occupational burnout. The experience of AEFI was a risk factor for their occupational burnout.

Exosomes are nano-vesicles released by many kinds of cells. Exosomes play a significant role in cell-to-cell communication and substance transportation through direct effect of signaling molecules on the cell membrane surface, intracellular regulation of cellular content during membrane fusion, or regulation of release of various bioactive molecules. Several studies have reported that culture supernatant of stem cells has some related exosomes to take part in wound repair. The secretion of exosomes is depended on the source and the physiological and pathological condition of deriving cells. How to stimulate the stem cells to produce exosomes maximally and their clinical application are worthy to explore. In this review, we summarize the biological function and application of exosomes derived from stem cells in wound repair.