Many provinces are carrying on Public Hospital Personnel Filing System Reform while facing a series of barriers cause a slow progress or the results not up to expectations.Supporting policies' adjustment is called to ensure the smooth progress of the reform.

Objective:To explore the lipid-regulating effect and safety of atorvastatin combined fenofibrate therapy in patients with coronary heart disease (CHD)complicated diabetes mellitus (DM).Methods:A total of 100 pa-tients with CHD complicated DM were enrolled.Based on routine treatment,patients were randomly and equally di-vided into statin group (n=50,received 20mg atorvastatin,once/night)and combined treatment group (n=50,re-ceived 20mg atrovastatin once/night,combined fenofibrate 200mg once/d).Serum levels of total cholesterol (TC), triglyceride (TG),low density lipoprotein cholesterol (LDL-C)and high density lipoprotein cholesterol (HDL-C) were measured before,six and 12 weeks after treatment,levels and standard-reaching rates of above blood lipid were observed before and after treatment;adverse reactions and clinical events were recorded.Results:Compared with before treatment after six-week treatment,there were significant reductions in serum levels of TC,TG and LDL-C in both groups,and they further decreased after 12-week treatment (P <0.05~ <0.01),compared with statin group after 12-week treatment,there were significant reductions in levels of TC [(4.35±0.71)mmol/L vs. (4.09±0.56)mmol/L],TG [(2.35±0.62)mmol/L vs.(1.65±0.49)mmol/L]and LDL-C [(2.01 ±0.39) mmol/L vs.(1.85±0.22)mmol/L]in combined treatment group,P <0.05 or <0.01;HDL-C level significantly rose in both groups after treatment,and it′s more significant after 12 weeks,but there was no significant difference between statin group and combined treatment group (P >0.05).After 12-week treatment,standard-reaching rates of LDL-C,TG,HDL-C,all standard-reaching of above three indexes and non HDL-C (70%,68%,80%,58% and 70%)in combined treatment group were significantly higher than those of statin group (50%,46%,48%,10% and 48%)respectively,P <0.05 or <0.01. No severe adverse reactions were observed in two groups during treatment. Conclusion:Atorvastatin combined fenofibrate treatment is more effective than atorvastatin monotherapy in patients with coronary heart disease complicated diabetes mellitus.It can improve blood lipid level more comprehensively, contribute to comprehensive standard-reaching of blood lipids,and possess better safety and tolerance.

〔Abstract〕 The paper introduces the informatization management system in specialist clinic blood-taking room, which compares with the process before informatization from the aspects of error rates of blood samples, patients satisfaction, hospital labor costs and so on to highlight the advantages of informatization management.The progressiveness, existing problems and corresponding countermeasures are discussed, informatization management could improve work efficiency and patients satisfaction.

Objective: To analyze the relationship between meteorological factors and the number of daily heart failure (HF) patients for emergency room (ER) visit at Fengxian district of Shanghai in order to provide the experience for prevention and control of HF morbidity. Methods: Daily number of HF patients treated in ER of our hospital from 2012-01 to 2014-12 with corresponding meteorological, air pollution data at the same period were collected and analyzed by Spearman correlation study and multiple stepwise regression analysis. Results:①The differences of temperature, humidity, air pressure at 24-, 48-hour before and 48-hour after ER visit were positively related to the number of HF patients; the number of HF patients was signiifcantly related to the differences of temperature and air pressure at 48-hour before ER visit,P<0.001.②Multiple stepwise regression analysis showed that the most affecting meteorological factor for ER visit of HF patients was the daily lowest temperature,P<0.05, the second factor was the daily average relative humidity,P<0.05. Conclusion: Radical changes of temperature, relative humidity and air pressure elevated the number of HF patients for ER visit; daily lowest temperature and decreased relative humidity were the important factors for elevating the number of HF patients for ER visit.

Objective To determine the dose of ropivacaine leading to convulsion and the convulsant action of midazolam. Methods Twenty healthy adult rabbits weighing 2.5-3.5kg were randomly divided into two groups with ten animals in each group: ropivacaine group(R) and midazolam-ropivacaine group(MR). Middle artery of ear was cannulated for MAP, HR monitoring and blood sampling for blood gas analysis and determination of plasma lactate and ropivacaine concentrations. Edge vein of ear was cannulated for administration of drugs. In both groups animals received intravenous infusion of 0.75% ropivacaine at a rate of 0.5m1/min until convulsion occurred. In MR group midazolam 0.8 mg/kg was given intravenously before ropivacaine.Results The dose of ropivacaine leading to convulsion was 4.86mg/kg for R group and 12.26mg/kg for MR group. Plasma ropivacaine concentration was 11 .52pg/ml in group Rand 16.77pg/ml in MR group. Convulsion lasted for 7.25 mm(R group) and 8.59mm(MR group) . Plasma lactate concentration increased significantly during convulsion in R group but remained unchanged in MR group. Blood pH decreased significantly during convulsion in R group but there was little change in PaCO2 and PaO2. Blood pH, PaO2 and PaCO2 did not change significantly during convulsion in MR group. There was no significant change in MAP and HR during convulsion in R group. In MR group MAP and HR decreased by 31 % and 35% respectively during convulsion and returned to baseline value gradually after ropivacaine infusion was stopped. All animals survived the experiment in both groups. Conclusions Ropivacaine is less cardiovascular toxic. Pretreatment with 0 . 8mg/kg midazolam greatly increases the dose of ropivacaine leading to convulsion. Midazolam can effectively prevent and treat CNS toxicity of ropivacaine.

It remains controversial whether tumor necrosis factor (TNF)-α antagonism is effective for asthma. This meta-analysis was performed to evaluate efficacy of TNF-α antagonism in treatment of patients with asthma. MEDLINE, EMBASE, LILACS, and CINAHL databases were searched for English-language studies published through January 3, 2010. Randomized-controlled trials comparing TNF-α antagonism with control therapy were selected. For each report, data were extracted in relation to the outcomes analyzed: asthma exacerbation, asthma quality of life questionnaire scores, and forced expiratory volume in 1 second. Four assessable trials were identified including 641 patients with asthma. TNF-α antagonism therapy was superior to control therapy in preventing exacerbations in asthmatics [pooled odds ratio 0.52 (95% confidence interval 0.29-0.88), P=0.02]; however, there was a nonsignificant reduction in asthma quality of life questionnaire scores [0.23 (0 to 0.47), P=0.05], forced expiratory volume in 1 second [0.03, (-0.14 to 0.10), P=0.74] when analyzed using standardized mean differences. TNF-α antagonism was superior to control chemotherapy in terms of asthma exacerbation, but not asthma quality of life questionnaire scores or forced expiratory volume in 1 second.

Objective To investigate the relationship between familial hemiplegic migraine (FHM ) with the mutation of CACNA1A gene .Methods Total genomic DNA of a family affected members and 1 000 normal controls was extracted for conduc‐ting the CACNA1A gene sequencing research and the bioinformatics analysis .Results The novel mutation site c .1168A>G of ex‐on located in CACNA1A gene led to Asn to be replaced with Asp (N390D) .Conclusion The mutation(N390D) of CACNA1A gene is a newly found novel pathogenic mutation lead to familial hemiplegic migraine .

Objective:To establish the quality standard for two effective components in extractum glycyrrhizae capsules. Methods:Radix glycyrrhizae was identified by a TLC method. The contents of liquiritin and ammonium glycyrrhizinate in extractum glycyrrhizae capsules were determined by HPLC. An Inertsil C18 (150 mm × 4. 6 mm, 5μm) column was used. The mobile phase consisted of ace-tonitrile (A)-0. 2％ phosphoric acid (B) (0-8 min: 20％A-20％A;8-34 min: 20％A-50％A;34-35 min: 50％A-100％A;35-40 min:100％A-20％A) at a flow rate of 1. 0 ml·min-1 . The detection wavelength was at 237 nm under 25℃. Results: The spots in TLC were clear. Liquiritin showed a good linear relationship within the range of 0. 0020-0. 1000 mg·ml-1(r=0. 9995). The aver-age recovery was 100. 29％, and the RSD was 2. 94％(n=6). Ammonium glycyrrhizinate showed a good linear relationship within the range of 0. 0020-0. 1000 mg·ml-1(r=0. 9998). The average recovery was 101. 46％, and the RSD was 2. 33％(n=6). Conclu-sion:The method is simple,reliable and reproducible, which can be used for the quality control of the preparation.

Objective To investigate the effect of low sound pressure level infrasound on che-mokine-mediated inflammatory response in spinal cord in rats with neuropathic pain.Methods Seven-ty-two healthy male SD rats were randomly divided into sham operation group (group Sham),neuro-pathic pain group (group NP)and low sound pressure level infrasound intervention group (group LNP),24 in each.The sciatic nerve injury models were established.3 d after the model constructed, the rats in group LNP started to receive low sound pressure level infrasound therapy,4 h per day, continued for 21 d.1 d before surgery (T0 )and 3 d after surgery (T1 ),all rats were detected me-chanical paw withdrawal threshold (MWT).Respectively,after treated for 7 d (T2 ),14 d (T3 )and 21 d (T4 ),eight rats were randomly selected from each group and their MWT was measured.The ex-pressions of MCP-1 mRNA,CCR2 mRNA,TNF-αmRNA,IL-1βmRNA,and IL-6 mRNA in spinal cord in rats were detected using quantitative PCR,the expressions of MCP-1 protein and CCR2 protein in spinal cord in rats were detected by using Western blot.Results MWT in groups NP and LNP at T1-T4 was lower than that of group Sham,and that in group LNP at T3-T4 were higher than that of group NP,respectively (P <0.05).Compared with group Sham,the relative expression levels of MCP-1 mRNA,CCR2 mRNA,TNF-αmRNA,IL-1βmRNA,and IL-6 mRNA in spinal cord tis-sues in groups NP and LNP at T2-T4 were increased (P <0.05);compared with group NP,the rela-tive expression levels of MCP-1 mRNA,CCR2 mRNA,TNF-αmRNA,IL-1βmRNA,and IL-6 mR-NA in spinal cord were decreased in group LNP at T3-T4 (P <0.05 ).Western blot analysis showedthat the relative expression levels of MCP-1 protein and CCR2 proteinin spinal cord in groups NP and LNP at T2-T4 were higher than that of group Sham,while relative expression levels of MCP-1 protein and CCR2 proteinin spinal cord in group LNP at T3-T4 were lower than that of group NP. Conclusion The low sound pressure level infrasound could effectively reduce neuropathic pain in rats, possibly via inhibiting chemokine-mediated cascade inflammatory reaction.

Objective To investigate the effects of clearing liver and purging the heart decoction( CLPHD) combined with methimazole on hormone levels in hyperthyroid rats. Methods Rats were administered with levothyroxine (600 μg·kg-1 ) for 3 weeks to establish the hyperthyroid model,and the serum contents of T3,FT3,T4,FT4,TSH and TRAb in hyperthyroid rats treated with CLPHD combined with methimazole were detected. Results Methimazole, CLPHD, and the combination therapy significantly reduced food intake,water intake and body temperature of the hyperthyroid rats. All treatments reduced levels of FT3, T4 and FT4 in hyperthyroid rats. Compared with the CLPHD mono-therapy, the combination therapy significantly lowered serum T4 in hyperthyroid rats,but not the TRAb level. Conclusion CLPHD combined with methimazole can obviously improve the function of thyroid gland in hyperthyroid rats.