An evaluation scale of medical services quality was developed on the basis of "patients' experience". The questionnaires were developed by, among others, searching relevant literature, collecting well-established assessment scales, measuring patients' experience and satisfaction, brain-storming, literature analysis. Delphi method was adopted for expert consultation. Scale items were screened and revised. The key indexes were converted. Field surveys were conducted for testing the reliability and validity of the scale. Our modified evaluation scale for measuring medical services quality based on "patients' experience" included 6 dimensions (tangibility, reliability, responsiveness, assurance, empathy and continuity), and 50 items. The novel scale based on "patients' experience" may better serve the purpose of assessing medical services quality.

OBJECTIVE:To provide reference for benign sustainable development of traditional Chinese and ethnic medicine enterprises in Guizhou. METHODS:Taking 129 traditional Chinese and ethnic medicine enterprises of 9 city and prefecture in Gui-zhou as survey object,questionnaires survey was conducted in 55 enterprises by stratified sampling according to location. The data statistical analysis was carried out in respects of related policies familiarity,product positioning,independent innovation from 2009 to 2013. Relevant development countermeasures were put forward. RESULTS & CONCLUSIONS:45.1% of enterprises ex-pressed to know and be familiar with relevant policies,51.0% expressed to alert but only understand,and 3.9% said largely un-known. At the past five years,the annual output value and sales revenue of enterprises had risen year by year. Almost 80% produc-tion and technical personnel of enterprises had the junior title or no title;marketing department staff mainly had college and second-ary school degree,accounting for 47.5% and 25.3% respectively;research personnel mainly had bachelor and college degree,ac-counting for 57.0% and 33.7% respectively. At the past five years,independent innovation input took up 2.4% of sales revenue av-eragely. There are problems,such as small and medium enterprises occupying dominate position;enterprises lacking of sufficient understanding on related policies;strategies being adjusted slowly;independent innovation input intensity needing to increase. Countermeasures and suggestions are put forward,such as strengthening the relevant policy advocacy,guiding corporate mergers and acquisitions,closely paying attention to industry development,changing innovation ideas,and attaching importance to research of exclusive production of essential medicine.

Humans ; Occupational Health ; Occupational Health Services

Objective To explore the relationship between the apoptosis of cerebellar granule cell and the changes of caspases-3 and Bcl-2 in rats with methylmercury intoxication.Methods We chronologically observed the pathological changes of cerebellum in rats given methylmercury[4 mg/(kg?d)] at day 11, 15, 18 and 19. The apoptosis of cerebellar granule cell was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end-labeling (TUNEL) method, and the relationship between the apoptosis and the expression of caspases-3 and Bcl-2 was evaluated.Results At day 18, some sparse TUNEL positive granular cells could be observed, mainly in deep lamina adjacent to the white matter. At day 19, the apoptotic cells markedly increased, while the number of granular cells decreased with a well preservation of Purkinje cells demonstrated by calvindine immunostaining. MRF-1 and glial fibrillary acidic protein(GFAP) dyeing demonstrated severe microglia reaction and astrocytosis. From day 11, caspasese-3 mRNA expression up-regulated, increased gradually and reached peak at day 18, then decreased markedly at day 19. In contrast, Bcl-2 mRNA expression down-regulated from day 11, and decreased obviously at day 19. Zic-1 as a marker of granule cell decreased gradually after methylmercury administration and indicated degeneration of granule cells.Conclusion Cerebellar granular cell degeneration induced by methylmercury is related to apoptosis mediated by caspases-3 and Bcl-2 down regulated.

Furbenicillin is a broad-spectrum semisynthetic penicillin with strong antibacterial activity against Gram-negative bacteria. Furbenicillin sodium is determined by volumetric method in current criteria. However, the criteria does not contain an assay of related substances of furbenicillin sodium. In this study, we established a method for detection and analysis of furbenicillin sodium and its related substances by HPLC. The analysis was performed with a C18 column under a gradient elution, the detection wavelength was 225 nm, and the column temperature was 35 degrees C. The reliability and accuracy of established method was validated in this study. Pure samples of furbenicillin sodium and its related substances were prepared. The structures, biological activities, and chromatographic retention behaviors of furbenicillin sodium and its related substances were identified using NMR, CLSI agar dilution method, and HPLC. All results in the current study provide ample evidence that this method is able to determine the reasonable limits in the quality-control protocol for furbenicillin sodium.
Anti-Bacterial Agents ; chemistry ; Chromatography, High Pressure Liquid ; Magnetic Resonance Spectroscopy ; Penicillins ; Quality Control ; Reproducibility of Results

Humans ; Nephritis ; etiology ; therapy ; Prognosis ; Purpura, Schoenlein-Henoch ; complications ; therapy ; Sjogren's Syndrome ; etiology ; therapy

Objective To explore the detection rate and major risk factors of nodular thyroid diseases among adults.Methods A total of 35 495 adults who carried out health checkup during January 1st,2009 and December 31th,2010 in our center were assessed for the occurance of nodular thyroid diseases and the size and number of thyroid nodules by age and gender.Chi-square test,rank sum test and Chi-square trend test were used for data analysis.Results The total detection rate of nodular thyroid diseases was 33.87％ (female vs male:41.76％ vs 29.68％).The prevalence of single thyroid nodule was decreased with age,as opposed to multi-thyroid nodules.Single thyroid nodule was more commonly seen in males,which was reversed in multi-thyroid nodules.Small,middle and large thyroid nodules were found in 77.49％,18.19％ and 4.32％ males or 72.57％,21.59％ and 5.84％ females,respectively.Moreover,thyroid cancer was detected in 0.4‰ of those with nodular thyroid diseases.Conclusions The detection rate of nodular thyroid diseases among adult health checkup receivers was higher,which calls on the needs of intensive monitor and effective prevention of the condition.

Objective To investigate the pathological features,diagnosis and treatment of primary malignant melanoma in esophagus (PMME).Methods The clinical data of 3 patients with PMME who were admitted to the Beijing Friendship Hospital from January 2008 to June 2009 were retrospectively analyzed.All the patients received esophageal barium radiography,electronic fiberesophagoscopy,esophageal endoscopic ultrasonography,computed tomography,and underwent surgery.Adjuvant therapy and immunotherapy were applied postoperatively.Results The results of barium radiography showed irregular filling defect presentation in the distal esophagus.The results of endoscopy showed a purple black tumor with a length of 3-8 cm in the esophagus.The results of endoscopic ultrasonography showed that the tumor was derived from the mucosal layer with low echo density.The results of computed tomography showed thickness of the lower segment of the esophagus.All the 3 patients received left thoracic approach esophagectomy and esophagogastrostomy.Histopathology and immunohistochemistry confirmed malignant melanoma.The expressions of Mart-1,HMB-45 and S-100 antigen were positive.The survival time of 2 patients was longer than 3 years,and 1 patient died of metastasis 6 months after operation.Conclusions PMME is a kind of rare and malignant tumor with dismal prognosis.Surgical management is the first choice,adjuvant chemotherapy and immunotherapy are hopeful to increase the survival time of the patients.

Objective To investigate the technique and clinical results of total hip arthroplasty in treating post-traumatic hip fusion ankylosis secondary to operation in acetabular combined with femoral head fracture.Methods From October 2009 to January 2015,7 patients (7 hips) with post-traumatic hip fusion ankylosis underwent total hip arthroplasty.There were 6 males and 1 female with an average age of 38 years (range,25-51 years).There were 4 hips on the left side,3 hips on the right side.Open reduction and internal fixation were performed on all patients.One patient had a postoperative deep infection and 6 patients underwent implant removal.The hip bony fusion ankylosis was developed secondary to post-traumatic arthritis after the surgery of ipsilateral acetabular combined with femoral head facture.The interval between internal fixation and total hip arthroplasty was 37.6 months on average (range,21-67 months).The hip bony fusion ankylosis was relieved by wedge shape osteotomy at femoral neck level.The cemenfless prostheses were implanted in suitable places based on the accuracy position of acetabular center.One infection case was treated via surgical debridement,removal of all the screws,and antibiotic-loaded cement spacer implantation in the first stage.The cementless prostheses were implanted in the second stage.Results The average operation time and blood loss was 108 min (90-150 min) and 320 ml (280-450 ml) respectively.The internal fixation devices were explanted completely,including plate and screw in 5 cases,only screw in 1 case,intramedullary nail and screw in 1 case.The mean fallow-up period was 32.5 months (range,15-48 months).The average Harris hip score improved from 48.8±6.5 points preoperatively to 92.6±5.1 points post-operatively (t=22.82,P=0.001).Osseointegration was developed in all of the acetabular and femoral components at 3 months post-operatively.Radiograph analysis showed satisfied position of acetabular cup and no evidence of implant migration or center of rotation change.Stem subsidence (＜1.0 mm) occurred in 2 cases and heterotopic ossification in 2 cases (Brooker type Ⅰ and type Ⅱ in 1 case,respectively) at one year postoperatively.No complication occurred,such as damages of vessels and nerve,dislocation,component loosening or infection.Conclusion The wedge shape osteotomy of femoral neck is a safe and reliable method in treating hip fusion ankylosis.Total hip arthroplasty can be achieved by reconstruction of acetabular center,suitable components implanted in anatomical position and ideal reconstruction of soft tissue around hip.

BACKGROUND:The influence of Tol-like receptor 2 (TLR2), Tol-like receptor 4 (TLR4), Tol-like receptor 6 (TLR6) signal transduction pathway and active Treg in children with Henoch-Schonlein purpura has been unknown.
OBJECTIVE:To investigate the expression of TLR2, TLR4 and TLR6 in peripheral blood mononuclear cells and Treg immune response in patients with Henoch-Schonlein purpura, and to explore the role of TLR2, TLR4, TLR6 and Treg activation in the pathogenesis of Henoch-Schonlein purpura.
METHODForty-two hospitalized children with Henoch-Schonlein purpura were enrol ed in this study. Another 15 healthy children were selected as controls. TLR2, TLR4 and TLR6 at protein level in peripheral blood mononuclear cells were detected by flow cytometey;reverse-transcription PCR and real-time PCR were used to evaluate the level of MyD88;the levels of transforming growth factor-βand interleukin-10 were measured by enzyme-linked immunosorbent assay. t-test or t’-test was used to compare the levels of these genes and proteins. Pearson’s correlation test was done for correlation analysis.
RESULTS AND CONCLUSION:Compared with the control group, the protein levels of TLR2, TLR4, TLR6 and the relative expression level of MyD88 mRNA were significantly up-regulated (P<0.01). The serum levels of transforming growth factor-βand interleukin-10 were higher in the Henoch-Schonlein purpura children than the healthy children (P<0.05). There was a significant correlation between the protein levels of TLR2, TLR4, TLR6 and mRNA level of MyD88 (P<0.01), but no relationship was found between TLRs and interleukin-10, transforming growth factor-β(P>0.05). The excessive activation of TLR2, TLR4, TLR6 may be involved in the process of Henoch-Schonlein purpura via MyD88-dependent pathway, and the compensatory activation of Treg may participate in protective immunity.