In the health service field,health resources and health service supple capacity were related with the resource and capacity in economics.Health resources,health service supple capacity and their relationships were important factors for the cooperation and benign interaction of hierarchical medical institutions.However,inversion of health resources and health dislocation of service supply capacity exacerbated the agglomeration degree of patients in the tertiary medical institutions under the impact of residents' freely searching for medical service concept.Vicious interaction and mutual competition among hierarchical medical institutions had become an important obstacle for the implementation of hierarchical medical services.Therefore,its mechanism needed to be clarified while the corresponding policy recommendations should be proposed.

Objective: To observe the therapeutic efficacy of tuina plus cupping on chronic fatigue syndrome (CFS). Methods: A total of 100 CFS patients meeting the inclusion criteria were randomly divided into a treatment group and a control group according to the random number table in the sequence of visit, with 50 patients in each group. The treatment group was treated with tuina plus cupping therapy, 3 times a week. The control group was given oral tablets of wild American ginseng lozenges. After 3 months of treatment, the score of fatigue questionnaire scale (FS-14) was observed and the efficacy was evaluated. Results: The total effective rate was 92.0％ in the treatment group, versus 76.0％ in the control group and the difference between the two groups was statistically significant (P<0.05). After treatment, the FS-14 scores of the two groups decreased, and the intra-group differences were statistically significant (both P<0.05). The change of FS-14 score after treatment in the treatment group was more significant than that in the control group (P<0.05). Conclusion: Tuina plus cupping is effective for CFS, and can improve fatigue symptoms significantly.

Objective To study the expressions of casein kinase 2α(Ck2α),β-catenin, survivin in ovarian cancer tissue and analyze the relationships between them, and to explore the clinical application value. Methods Immunohistochemistry staining was used to detect the expressions of Ck2α,β-catenin and survivin in 8 cases of simple ovarian cysts tissue,8 cases of ovarian benign tumor tissue and 29 cases of ovarian cancer tissue;the correlations of the expressions of Ck2α,β-catenin,survivin in ovarian cancer tissue and their associations with the clinicopathologic characteristics were analyzed.Results The expression levels of Ck2α,β-catenin and survivin in ovarian cancer tissue were significantly higher than those in simple ovarian cysts tissue and ovarian benign tumor tissue(P<0.05);the Ck2αexpression level in ovarian cancer tissue was positively corelated with the expression levels ofβ-catenin and survivin(r=0.438,r=0.479,P<0.05);the expression levels of Ck2α,β-catenin and survivin in low-medium differentiation group were significantly higher than those in high differentiation group (P<0.05);the expression levels of Ck2α,β-catenin and survivin in stagesⅡandⅢ group were significantly higher than those in stage Ⅰ group(P<0.05).Conclusion The protein expression levels of Ck2α,β-catenin and survivin are increased in ovarian cancer tissue, and three are positive corelations between them;Ck2α,β-catenin and survivin may play an important role in the occurrence and development of ovarian cancer;the combined detection of them has important clinical value.

A bacterial strain Eml isolated from contaminated soil of Shengli oil field was identified as Rhodococcus ruber according to its phenotype, physiological and chemical properties, and its 16S rRNA gene sequence. This strain could degrade various polycyclic aromatic hydrocarbons as well as alkanes in petroleum, and produce bioemulsifier. The results indicated that strain Eml could produce bioemulsifier efficiently when n-hexadecane was used as sole carbon source. The optimal conditions for the synthesis of bioemulsifier were as followed: 10g/L of n-hexadecane, 1g/L of yeast extract, media initial pH 7, and cultivation was carried out at 30℃ on a rotary shaker at 200 rpm. Under these conditions the surface tension of culture decreased to the lowest value, around 30 mN/m, after 1 day, and the emulsifying capacity was 100% . The concentration of bioemulsifier reached to the highest value, around 68 times of CMC , after 5 days' cultivation. The results also showed that the bioemulsifier produced by this strain should be lipid.

OBJECTIVE:To explore the role of clinical pharmacists in the treatment of pan-drug resistant Acinetobacter bau-mannii infection. METHODS:Clinical pharmacists participated in the treatment for a severe pneumonia case of pan-drug resistant A. baumannii infection. Clinical pharmacists supplied overall pharmaceutical care and suggestions with respects to initial medication scheme evaluation,pathogen judgment,therapy drug selection,ADR disposal,etc.,including anti-infective treatment of moxifloxa-cin 0.4 g,ivgtt,qd+meropenem 0.5 g,ivgtt,q8 h+linezolid 0.6 g,ivgtt,q12 h;anti-pan-drug resistant A. baumannii infection of cefoperazone sodium and sulbactam sodium 3.0 g,ivgtt,q8 h+tigecycline 50 mg,ivgtt,q12 h;liver protection of ademetionine 1, 4-Butanedisulfonate 1.0 g,ivgtt,qd+reduced glutathione 1.8 g,ivgtt,qd. RESULTS:After 25 d treatment,the patient hadn’t been fe-vered,and hemogram and hepatic function index decreased to normal value. CONCLUSIONS:Clinical pharmacist should be en-gage in anti-infective treatment and pharmaceutical care,and provide physicians reasonable medication suggestion so as to promote care rate in the clinic.

Objective: To explore the mechanism of herb-partitioned moxibustion for ulcerative colitis (UC) through observing the colonic mucosal histopathological changes and the expression of nuclear factor kappaB (NF-kB) and peroxisome proliferators-activated receptorγ (PPARγ) mRNA of UC rats. ＜br> Methods: Male SD rats were randomly divided into a normal group and a model group. UC model was established by general immunological plus local irritation method. After model identification, rats in the model group were randomly divided into a model group, a herb-partitioned moxibustion (HPM) group and a Western medicine (Salicylazosulfapyridine, SASP) group. Rats in the HPM group received treatment at bilateral Tianshu (ST 25) and Dachangshu (BL 25), two cones for each point, once a day for 7 d. SASP group rats were gavaged with SASP. The pathological scores were evaluated according to hematoxylin-eosin (HE) staining of colonic tissues. We used light microscopy to observe degree of colonic mucosal damage and the quantitative polymerase chain reaction (QPCR) to detect the expression of NF-κBp65 and PPARγ in colorectal mucosa. ＜br> Results: Compared with the normal group, histopathological scores were significantly higher in the model group (P＜0.05); compared with the model group, the scores were decreased significantly in the HPM group and the SASP group. Compared with the normal group, NF-κBp65 mRNA expression was increased with statistical significance in the model group (P＜0.05); compared with the model group, NF-κBp65 mRNA expressions were decreased significantly in the HPM group and the SASP group. Compared with the normal group, PPARγ mRNA expression was increased significantly in the model group (P＜0.05); compared with the model group, PPARγ mRNA expressions were decreased significantly in the HPM group and the SASP group. ＜br> Conclusion: HPM could improve the mucosa damage of UC rats, which is possibly through down-regulating NF-κBp65 to achieve anti-inflammatory effect. Whether decreasing the PPARγ mRNA is possibly involved in preventing precancerosis will need further study.

Objective: To investigate the improving effects of different moxibustion therapies on colonic injury in rats with ulcerative colitis (UC), and on the expression of Bcl-2 and Bax mRNA.Methods: Rats model of UC was made with immune methods and local stimulation. The models were treated with different moxibustion therapies 14 times, and then the expression of Bcl-2 and Bax mRNA were tested in the colonic tissue with fluorescent quantitative PCR. Results: (1)General scores of colon and histologic scores of injury were improved in all treatment groups except the model group (P＜0.05, P＜0.01); (2) The expression of Bcl-2 mRNA in the model rats of UC was higher than that in the normal rats (P＜0.01), whereas Bax lower (P＜0.01); (3) After treatments, the expression of Bcl-2 mRNA was lower in the herb cake-partitioned moxibustion, ginger-partitioned moxibustion, and garlic-partitioned moxibustion groups than that in the model group (P＜0.05, P＜0.01), and Bax mRNA in the herb cake-partitioned and ginger-partitioned groups was higher (P＜0.05). Conclusion: Herb cake-partitioned moxibustion, ginger-partitioned moxibustion, garlic-partitioned moxibustion, and mild moxibustion could improve the pathological injury in UC rats. Herb cake-partitioned moxibustion, ginger-partitioned moxibustion, and garlic-partitioned moxibustion could inhibit the expression of Bcl-2 mRNA and Bax mRNA in the colonic tissue of UC rats to regulate the ratio of Bcl-2/Bax mRNA.

Objective To explore the effect of surface electromyographic biofeedback (SEMG-BFT) combined with electrical stimulation on the swallowing function of stroke survivors with dysphagia,and to evaluate the electromyographic activity of the submental muscles in swallowing various foods so as to provide a basis for future rehabilitation of such patients.Methods Sixty patients were randomly divided into a treatment group and a control group,each of 28.Both groups were given low-frequency electrical stimulation and conventional swallowing training.The treatment group was additionally provided with SEMG-BFT.Before the treatment as well as after 2 and 4 weeks of treatment,the swallowing function of both groups was evaluated using the Kubota drinking water test (KDWT) and a Gugging swallowing screen (GUSS).Surface electromyographs of the submental muscles were recorded during empty swallowing,swallowing 10 ml of dilute liquid and swallowing 10 ml of paste.Results After two and four weeks of treatment,the average KDWT and GUSS scores of both groups had improved significantly,but that of the treatment group was significantly higher than that of the control group at each time point.After 2 and 4 weeks of treatment,significant differences were found in swallowing duration and the average amplitude of the sEMGs compared with before the treatment in both groups.The difference between the groups was significant at each time point.Conclusions SEMG-BFT combined with electrical stimulation can significantly improve swallowing function.Paste food can be used safely in the early evaluation and treatment of swallowing dysfunction.

Background As a main suppressing neurotransmitter in visual system,gamma-aminobutyric acid (GABA) participates in the transmission and regulation of visual information.GABA and dopamine (DA) coexist in the visual cortex,and their mutual effects should be clarified.Objective This study was to investigate the effect of DA on GABA-activated current in vitro in cultured visual cortical neurons of rats.Methods Neutrons from visual cortex of clean neonatal rats were isolated and cultured by explant culture method.The neutrons cultured for 11 -to 14- days were collected for the record of whole cell currents of GABA-A (IGABA) channels in vitro using patch clamp technique.The DA solution (100mmol/L),SKF38393 (10mmol/L) solution and quinpirole solution(10mmol/L) were prepared with double distilled water and then the extracellular fluid was added to different concentrations.The IGABA changing rate under the action of SKF38393+SCH23390,SKF38393+Quinpirole for different time was recorded respectively and compared with that of action of DA,SKF38393,SCH23390,Quinpirole.The IGABA activated by extracellular fluid along served as control.Results The IGABA was significantly attenuated after activated by ≥10μmol/L of DA or SKF38393 separately in comparison to that of extracellular fluid action (P＜0.05).In various time of action,there were obviously differences in IGABA between DA or SKF38393 action and extracellular fluid (P＜0.05,P＜0.01).No evident change in IGABA changing rate was found after only SCH23390 action in comparison with extracellular cells (P＜0.05).However,after combination of SCH23390 and SKF38393,IGABA changing rate reduced by 19.49%.No significant differences were found in the changing rates of IGABA among different concentrations of quinpirole action groups compared with extracellular fluid group (P＞0.05);while when quinpirole was combined with SKF38393,the IGABA was elevated in comparison with only SKF38393 action group (P＜0.05).Conclusion Dopamine participates in the transfer and regulation of visual information through suppressing GABA-activated currents from neutrons of visual cortex at time-dependent manner in vitro.

Objective By studying the different blood volume blood donors machine adopt platelet product aggregation,platelet content,the machine adopt circulating volume,etc,analysis of different blood volume machine adopt donors on appropriate conditions.Methods The base material of randomly selected 307 blood donors,through blood related index in the study of circulating volume,blood volume,gender,platelets,Hct,Pct count before collection,machine adopt of platelet aggregation and the relationship between the acquisition time;different blood volume,blood platelet count grouping machine adopt the different of platelet aggregation rate,different amount of platelets collect blood volume group,the comparison of blood circulation.The use of statistical software SPSS 17.0,data analysis,analysis including multiple regression analysis,chi-square test,t test,etc.Results 1)The lower count of platelets,Hct,Pct count before collection,the longer the acquisition time,and gender and Pct has nothing to do with the acquisition time the longer the acquisition time,the higher the machine adopt the possibility of platelet aggregation.2)Low blood volume and low platelet count group,machine mining platelet aggregation rate is higher.3)Machine adopt donors of blood volume is higher,the machine adopt the platelet collection amount,the more and the less blood circulation.Conclusion According to the different blood volume blood donors check-up indicators,further carries on the reasonable analysis,optimized machine mining scheme,especially to reasonable arrangement of low blood volume blood donors,so as to improve the quality of platelet collection.